Researchon The Relationship Among Nurses' Practice Environment,work Engagementand Job Burnout Basedon The Job Demands-resources Model

Objective:This study investigated the current situation of nurses' practice environment,work engagement and job burnout in the third-class general hospitals in Jiangxi Province,and analyzed the influence of nurses' general demographic data on their practice environment,work engagement and job burnout.This study absorptiones on comparing the differences among male and female nurses,exploring the relationship between nurses' practice environment,work engagement and job burnout,and exploring the effect of nurses' practice environment and work engagement on job burnout.Reasonable suggestions were put forward to improve nurses' practice environment,promote work engagement and alleviate job burnout,so as to provide reference for hospital managers.Methods:The subjects selected six Class-A general hospitals with a relatively large number of male nurses,and matched female nurses according to department,age,education background,professional title,working years,marital status,etc.the survey time was June to August 2019.A total of 408 nurses,including 209 male nurses and199 female nurses,were investigated by using Revised Nurses' Practice Environment Scale,Utrecht Work Engagement Scale and Maslach Burnout Inventory.SPSS 20.0and Amos 24.0 software were used for statistical analysis.Results:1.The total score of nurses' practice environment was(2936.48±480.35),and the average score of items was(81.57 ± 13.34).The average scores of each dimension from high to low are as follows: quality management,professional improvement,medical and nursing cooperation,leadership and communication,manpower,internal support,clinical nursing professionalism,salary,social status,hospital management participation.The total score of nurses' work engagement was(64.13±23.27),and the average score of items was(3.77±1.37),from high tolow: absorption dimension,dedication dimension,vigour dimension,and nurses' emotional exhaustion,depersonalization and personal accomplishment dimensions.The average scores of items were(2.31±1.20),(1.46±1.33)and(3.80±1.32),respectively.2.There were significant differences in the scores of gender,department,age,number of children,highest educational background,professional title,employment form,annual income,reason of job choice,number of night shift and teaching work in nurses' practice environment(P < 0.05).There were significant differences in the scores of nurses' work engagement in gender,age,employment form,reason of choosing job and number of night shift(P < 0.05).There were significant differences in the scores of job burnout among nurses in terms of working years,reasons for choosing careers,the number of night shifts and the situation of specialized nurses(P < 0.05).Male nurses were lower than female nurses in clinical nursing professionalism,dedication dimension,absorption dimension and total score of work engagement,and the difference was statistically significant(P < 0.05).3.There was a significant positive correlation between nurses' practice environment and work engagement and each dimension(P < 0.01),and a significant negative correlation between nurses' practice environment and each dimension and emotional exhaustion dimension(P < 0.01).There was a significant negative correlation between quality management,nursing cooperation,professional improvement and depersonalization dimension(P < 0.05),and a significant positive correlation between nurse practice environment and each dimension and personal accomplishment dimension(P < 0.01).The total score of nurses' work engagement,vigour dimension and dedication dimension were significantly negatively correlated with the dimension of emotional exhaustion(P < 0.05),while nurses' work engagement and each dimension were positively correlated with the dimension of personal accomplishment(P < 0.01).4.Staffing and career selection are the main influencing factors of emotional exhaustion,with 6.3% explanatory ability;quality management,hospital management participation and night shift are the main influencing factors of depersonalization,with 6.9% explanatory ability;dedication dimension and vigour dimension are themain influencing factors of personal accomplishment,with 40.4% explanatory ability.5.Nurses' practice environment has a direct positive predictive effect on job burnout,and its effect value is 0.517.Nurses' work engagement has a direct negative predictive effect on job burnout,and its effect value is-0.332.Nurses' practice environment has a direct negative predictive effect on job burnout,and its effect value is-0.113.Nurses' work engagement can indirectly negatively predict job burnout through the practice environment.The indirect effect of nurses' work engagement is-0.172,accounting for 60.4% of the total effect.Conclusion:1.The practice environment of 408 nurses in 6 three-class general hospitals in Jiangxi Province is at a high level,the work engagement is in the upper-middle level,and the phenomenon of job burnout is more serious.2.Among the demographic variables,gender,department,age,number of children,highest educational background,professional title,employment form,annual income,reason for choosing a job,number of night shift and teaching work have a certain influence on nurses' practice environment.Gender,age,employment form,job selection reasons and the number of night shifts have a certain impact on nurses' work engagement.The working years,the reasons for choosing a career,the number of night shifts and the situation of specialized nurses have a certain influence on nurses' job burnout.Male nurses are significantly lower than female nurses in clinical nursing professionalism,dedication dimension,absorption dimension and work engagement.3.There was a significant correlation among nurses' practice environment,work engagement and job burnout.4.Career reasons and manpower are the main influencing factors of emotional exhaustion;night shift,quality management and hospital management participation are the main influencing factors of depersonalization;dedication dimension and vigour dimension are the main influencing factors of personal accomplishment.5.Nurses' practice environment has a direct positive predictive effect on work engagement,nurses' practice environment and work engagement have a direct negative predictive effect on job burnout,and nurses' work engagement has a partialmediating effect on job burnout in the practice environment.Nurses' work engagement can indirectly negatively predict job burnout through the practice environment.