| BACKGROUNDThe shortage of nurses and the instability of the nursing team are serious problems facing medical institutions around the world,and the high turnover rate is an important cause of this problem.In recent years,the annual turnover rate of nursing staff in tertiary hospitals in Guangdong Province and Zhejiang Province is higher than 5%,which is not in line with the level of assessment of the national tertiary hospital.Due to the special nature of their work environment and work nature,the emergency department nurses have higher turnover rate and unstable nursing team than the general departments.Studies have shown that improving the influencing factors in the work environment and creating a healthy working environment are conducive to enhancing the professional values of nurses,attracting caregivers,and stabilizing human resources.OBJECTIVES1.Determine the feasibility of the questionnaire on the factors affecting the health work environment of the emergency nurse from the perspective of conservation model theory-2.To understand the current situation of the nursing work environment in the emergency department of the General Hospital of Guangdong Province,and to analyze the influencing factors of the nursing work environment in the emergency department of the general hospital of Guangdong Province from the perspective of Lewin's conservation model theory.METHODS1.Literature research methodUsing Wanfang,Weipu,China Knowledge Network,PubMed,Web of Science and other databases to retrieve relevant research on the influencing factors of nursing work environment at home and abroad,combined with the definition of working environment related concepts,based on the four principles of conservation model theory,the influencing factors The classification is divided into four different aspects,and a questionnaire is initially formed.2.Delphi methodThree rounds of expert consultations were conducted using the Delphi method.Experts rated the correlations of the influencing factors quantitatively.The classification of the influencing factors can be analyzed from different perspectives of the conservation model theory,and the correlation between the influencing factors and the nursing work environment is determined.Finally,23 experts in the field of nursing from 6 regions were included.The scientificity and feasibility of the questionnaire were evaluated by using the expert positive coefficient,expert authority coefficient,expert opinion Kendall harmony coefficient,expert opinion concentration and questionnaire reliability and validity test.3.Questionnaire methodThe general information questionnaire,the Chinese version of the professional practice work environment scale-38,the emergency department health work environment influencing factors questionnaire and an open question were investigated in the emergency department nurses of 34 general hospitals in Guangdong Province.General data were descriptive statistical analysis such as mean,standard deviation,and composition ratio;the influencing factors of professional practice working environment were analyzed by analysis of variance,nonparametric independent sample Kruskal-Wallis H test,Spearman correlation analysis and stepwise multiple regression analysis.RESULTS1.Based on the theory of conservation model,a questionnaire on the factors affecting the health work environment of emergency department was formed.After three rounds of expert consultation,the emergency nuese health work environment influencing factors questionnaire includes energy conservation,structural integrity,individual integrity and social integrity.There are 50 entries in total.The positive coefficients of the experts in the three-round letter questionnaire were 87.5%,89.3%and 88.9%,respectively;the expert authority coefficients were 81.8%,82.4%and 83.9%respectively.The degree of coordination of expert opinions fluctuated between 0.4 and 0.5,and the concentration of opinions was 4.61 to 4.87.The Cronbach coefficient of the total questionnaire reliability is 0.966,and the structural reliability of the influencing factors in different aspects is 0.880-0.915.The content validity of the total questionnaire is 0.992,and the content validity of different factors is 0.994?1.OOO.The content validity of each item is 0.913?1.000.2.Status of health work environment in emergency department of Guangdong General HospitalA total of 748 questionnaires were collected.A total of 618 questionnaires were collected from online electronic surveys,of which 615 were valid questionnaires;the effective recovery rate was 99.5%;130 paper copies were distributed,123 were recovered,and the recovery rate was 94.6%.The professional practice environment of the emergency department of Guangdong General Hospital was(2.92±0.34),which was higher than the professional practice environment of the emergency department of Shanghai tertiary hospital.The difference was not statistically significant compared with the domestic;the age was 18-24 years old.Young group nurses with 0.5-2 years of age and monthly income of ?2999 yuan have high evaluation of professional practice work environment;nurses are lower than nurses and other nurses;nurses in emergency department of Pearl River Delta have the lowest evaluation of work environment Men's evaluation of leadership and autonomy,and control of practice is higher than that of women;there are 5 factors in the energy conservation angle of the regression equation of the total score of professional practice work environment,3 structural integrity angles,and individual integrity angles.There are 8 and social integrity perspectives,which effectively account for 23.8%,14.3%,29.1%,and 27.5%of the total score variation.CONCLUSION1.Emergency nurse health work environment influencing factors Questionnaire expert consultation and reliability and validity test results are good,the process is rigorous and scientific,and the emergency department work environment can be investigated and analyzed from the perspective of conservation model theory.2.The professional work environment of the emergency department of Guangdong General Hospital is consistent with the domestic research results,and the overall score is higher than that of the emergency department of Shanghai tertiary hospital.In terms of scores in all dimensions,the emergency department nurse self-assessment“teamwork”dimension scored the lowest.There are differences in the evaluation of professional practice working environment among nurse groups with different demographic characteristics.3.The working environment of the emergency department affects the physical and mental health of the nurse.Energy conservation,structural integrity conservation,conservation of individual integrity,and conservation of social integrity in nurses in the emergency department of the General Hospital of Guangdong Province are affected by different factors.Managers need to pay attention to the physical and mental health of nurses and create a healthy working environment.4.The factors affecting the healthy working environment of the emergency department of different grade general hospitals are different.The health work environment of the emergency department of the first-level general hospital has fewer influencing factors,which is a small part of the overall environmental impact factors;the secondary and tertiary hospitals have more influential factors in the emergency health work environment,except for some and the general hospital emergency department.In addition to the same factors affecting the healthy working environment,there are also unique influencing factors.Managers of different levels of hospitals need to take targeted measures to improve. |
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