全国男性护士离职意向及其注入因素的全国性描述性研究 A national descriptive study of male nurses' turnover intentions and their injection factors
邓军1*、王鹏2、徐天3、柯力4、雷洋5、舒丁6 Deng Jun1*, Wang Peng2, Xu Tian3, Ke Li4, Lei Yang5, Shu Ding6
摘要 summary
在中国注册男护士数量的增加，特别是专门针对他们的 The increase in the number of registered male nurses in China, especially specifically for them
离职意向仍然有限。虽然已知高离职意愿会加剧护士的劳动力短缺，但导致中国注册男性护士离职意愿的国家水平和独特因素尚不清楚和探索不足。 Intentions to leave remain limited. Although it is known that high turnover intention will exacerbate the labor shortage of nurses, the national level and unique factors that lead to the turnover intention of registered male nurses in China are still unclear and underexplored.
目的探讨我国注册男护士及其普通护士的离职意向- ObjectiveTo explore the resignation intention of registered male nurses and their general nurses in China.
环境因素，重点关注在以往研究中受到有限关注的变量。 Environmental factors, with a focus on variables that have received limited attention in previous studies.
在这项横断面研究中，我们从 1,000 多家医院招募了 13,088 名注册的疟疾患者 In this cross-sectional study, we recruited 13,088 registered malaria patients from more than 1,000 hospitals
在2023年5月和8月之间在中国各地进行调查。数据收集通过在线问卷进行。对数据进行单变量分析和多项逻辑回归分析。 Surveys were conducted across China between May and August 2023. Data collection was conducted through an online questionnaire. Univariate analysis and multinomial logistic regression analysis were performed on the data.
临床试验编号不适用。 Clinical trial number is not applicable.
结果分析显示，我国 71.6%71.6 \% 的注册男护士具有中高流动率 The analysis 71.6%71.6 \% of the results showed that the registered male nurses in China had a medium to high turnover rate
意图没有孩子、较低的职业声望和较低的工作价值的男性男性更有可能发生 Male males with intentions to have no children, lower career prestige, and lower job values are more likely to occur
表现出更高的颠覆意图。其他导致高离职率的重要因素包括：贷款满意度、有限的职业发展机会和来自医院的最低支持。 Exhibits a higher intent to disrupt. Other important factors that contribute to high turnover rates include: loan satisfaction, limited career development opportunities, and minimal support from hospitals.
结论我国注册男护士中度至高死亡率- Conclusions: Moderate to high mortality rate among registered male nurses in China-
超越传统职业问题的驱动因素。本研究强调了针对非目标探索变量的重要性，如工作价值、职业声望和婚姻压力，以制定目标干预措施，以提高工作满意度和减少人员流动率。 Drivers of problems beyond traditional careers. This study highlights the importance of exploring variables for non-goals, such as job worthiness, career prestige, and marital stress, to develop targeted interventions to improve job satisfaction and reduce turnover.
在医疗保健领域，护士不仅在病人护理中，而且在医疗支持和康复过程中也发挥着关键作用[1].技术对比在全球医疗保健系统的动态发展中至关重要，它面临着日益增长的挑战，以及人口老龄化和医疗服务需求增加的挑战 ］尽管对护士护士的需求不断增加，但全球护士的持续短缺仍然很明显 In the field of healthcare, nurses play a key role not only in patient care, but also in the process of medical support and rehabilitation[1].Technology contrast is crucial in the dynamic development of the global healthcare system, which faces growing challenges, as well as the challenges of an aging population and increasing demand for medical services] Despite the increasing demand for nurse nurses, the ongoing shortage of nurses worldwide remains evident
[ 3，高周转率加剧了这一问题，并威胁到患者的安全和护理质量].截至2022年底，中国报告共有 4435 万执业医师和522.4万注册护士，翻新手术护士与护士的比例为 1:1.181: 1.18 As of the end of 2022, China reported a total of 44.35 million licensed physicians and 5.224 million registered nurses, with a ratio of nurses to nurses in 1:1.181: 1.18 renovated surgery
[4].尽管这些数据表明存在大量的劳动力，但护理领域的保留挑战仍然存在，尤其是在男性护士中[5]. [4]. Although these data suggest the presence of a large workforce, retention challenges persist in the nursing field, especially among male nurses[5].
社会角色理论认为，社会期望往往为男性和女性规定不同的行为和责任关系，注入他们的职业选择和经历 [6]].历史上，护理一直被视为女性主导的职业，在中国 ，护理在文化上与女性气质有联系 Historically, nursing has been seen as a female-dominated profession, and in China, nursing is culturally associated with femininity
[7].因此，男护士往往面临着极其复杂的角色，因为社会规范确实与他们的选择无关。这种不协调可能会导致压力增加和工作满意度降低，从而导致更高的颠覆意图。男性护士也可能遇到因其在劳动力中的少数地位而产生的职业压力，职业压力理论强调的心理压力是基于歧视、有限的同伴支持和有限的职业发展的来源 [7]. As a result, male nurses are often faced with extremely complex roles, as social norms are really irrelevant to their choices. This incongruity can lead to increased stress and lower job satisfaction, leading to higher subversive intent. Male nurses may also experience occupational stress due to their minority position in the workforce, and the theory of occupational stress emphasizes psychological stress as a source of discrimination based on discrimination, limited peer support, and limited career advancement
[8].这些压力源，加上社会上的肥胖，导致了在男性护士中观察到的较高的人员流动率。 [8]. These stressors, combined with obesity in society, lead to the higher turnover rates observed among male nurses.
然而，在过去的几十年里，人们越来越认识到男性对这个职业的重要性。纳入男性护士可以帮助医疗保健队伍多样化，改善团队动态，并解决导致疾病的性别不平衡 However, over the past few decades, there has been a growing recognition of the importance of men to this profession. The inclusion of male nurses can help diversify the health care workforce, improve team dynamics, and address the gender imbalance that leads to disease
〕.特别是，疟 〕. In particular, malaria
疾患者在病人护理中有独特的视角，特别是在高压领域，如精神健康、紧急护理和重症护理环境，这些领域的存在可以提高患者的预后 [ 10]. 更多的男性加入护理行业不仅缓解了全球护理时代，而且也缓解了更具包容性和代表性的医疗环境。 Patients with diseases have unique perspectives in patient care, especially in high-pressure areas such as mental health, urgent care, and critical care settings, and the presence of these areas can improve patient outcomes [10]. More men joining the nursing profession not only eases the global era of nursing, but also a more inclusive and representative healthcare environment.
截至2020年，中国男性护士超过13万，占护士总数的 approximately 2.9%[11],12]2.9 \%[11], 12] 。虽然男性参与护理的比例明显增加，但它 As of 2020, there are more than 130,000 male nurses in China, accounting for approximately 2.9%[11],12]2.9 \%[11], 12] one of the total number of nurses. While there has been a significant increase in the proportion of men involved in caregiving, it
仍然占很小比例，男护士继续面临职业发展的重大障碍［13］.文化的刻板印象和社会偏见往往削弱护理作为男性职业的地位］。尽管中国的男护士在医疗保健中发挥着至关重要的作用，但他们经常被认为不太适合护理角色，限制了她们的职业成长，并导致了更高的人员流动率[15]].历史数据显示，2010年至2015年，中国顶级医院的男性护士流动率明显接近 17.2%17.2 \% ，而女护士为 8.3%[16]]8.3 \%[16]] 。 Still a small percentage, male nurses continue to face significant barriers to career advancement [13]. Although male nurses in China play a vital role in healthcare, they are often considered less suitable for nursing roles, limiting their professional growth and leading to higher turnover rates [15]].Historical data shows that from 2010 to 2015, the turnover rate of male nurses in China's top hospitals was significantly closer 17.2%17.2 \% , while that of female nurses 8.3%[16]]8.3 \%[16]] .
考虑到对医疗保健服务和患者护理方面的更广泛影响，男性患者离职意愿的上升趋势令人担忧 [17] ]. 解决留住男护士的问题是重要的，既要减轻持续的劳动力短缺，也要挑战阻碍男性进入和留在护理行业的社会刻板印象。转变意图，通常是实际工作离职的主要诱因，在不同的地区和设置中有显著差异[18]].例如，之前在韩国和黎巴嫩进行的研究报告显示，离职意图为 22.2%22.2 \% ［19］在护士中为 43%43 \% 各自地在中国，非常不安，精神病护士和武汉护士的离职意图高达 20.2%20.2 \% Considering the broader impact on healthcare delivery and patient care, the upward trend in male patients' willingness to leave jobs is worrying [17] ]. It is important to address the issue of retaining male nurses, both to alleviate the ongoing labor shortage and to challenge the social stereotypes that prevent men from entering and remaining in the nursing profession. For example, previous studies in South Korea and Lebanon have shown that the intention to leave 22.2%22.2 \% [19] among nurses who 43%43 \% are based in China is very uneasy, and the intention to leave in psychiatric nurses and nurses in Wuhan is as high as 20.2%20.2 \%
[21] and 47.3%47.3 \% [ 22各自地然而，这些男性往往关注混合性别人群，并试图探索导致男性决定离开这个职业的独特因素。为了解决这一差距，Chen 等人 [9 ]进行了一项针对男护士的全国性调查。然而，他们的 627 名男护士的总人数，不足以代表中国的13万多名男护士的经验。这提出了关于其基因多样性的问题。 [21] and 47.3%47.3 \% [22] Separately, however, these men tend to focus on mixed-gender populations and try to explore the unique factors that lead men to decide to leave the profession. To address this gap, Chen et al. [9] conducted a nationwide survey of male nurses. However, their total number of 627 male nurses is not representative of the experience of more than 130,000 male nurses in China. This raises questions about its genetic diversity.
这篇论文试图通过对比大规模的全国调查来弥补这一差距，特别关注中国不同地区和医疗机构的男护士的任何意图。以往关于护士离职意向的研究通常集中在工作满意度、工作环境、职业发展机会上，提出有价值的见解，但往往忽略了重要的因素 [23] ]. 为了解决这个问题，我们探索了一些未被研究的变量 ，这些变量可能具有未来男性的离职意图，比如基于性别的职业压力、工作场所感知的社会支持和歧视经历。通过深入研究这些未被探索的方面，我们的研究不仅揭示了男性护士转变意图的理解，而且强调了她们在更广泛的护理队伍中面临的明显挑战。特劳阿的全面调查涵盖了广泛的人口统计范围 The paper attempts to bridge this gap by contrasting large-scale national surveys, with a particular focus on any intentions of male nurses in different regions and medical institutions in China. Previous studies on nurses' turnover intentions have often focused on job satisfaction, work environment, and career development opportunities, providing valuable insights but often ignoring important factors [23] ]. To address this question, we explored a number of unstudied variables that may have future male turnover intentions, such as gender-based occupational stress, perceived social support in the workplace, and experiences of discrimination. By delving into these unexplored aspects, our research not only sheds light on the understanding of male nurses' transformation intentions, but also highlights the obvious challenges they face in the broader nursing workforce. Traua's comprehensive survey covers a wide range of demographics
本研究旨在深入了解该群体的具体挑战和需求，其目标是告知策略，以加强中国护理人员的稳定性。 This study aims to gain insight into the specific challenges and needs of this group, with the goal of informing strategies to strengthen the stability of caregivers in China.
方法 method
设计 devise
我们开展了一项全面的、全国性的描述性研究，以调查中国各地注册男性护士的离职意愿，并为影响其离职意愿的因素提供见解。在频闪仪陈述后报告了测试结果。 We conducted a comprehensive, nationwide descriptive study to investigate the turnover intention of registered male nurses across China and to provide insights into the factors influencing their turnover intention. The test results were reported after the stroboscope presentation.
参与者 participator
参与者是通过由中国护理协会男护士工作委员会进行的有针对性的推广来招募的。我们采用分层方便抽样 ，其中邀请来自中国 1000 家医院的男性护士参加一项电子调查。将医院分为三级医院、附属医院和初级保健设施，以提高医疗保健服务的代表性。虽然分层被用于包括不同类型的医院，但使用方便抽样可能会限制样本的代表性，因为参与者是基于可用性而不是随机选择的。这可能会引入选举偏见，因为那些更关注专业网络的个人或那些有特殊经验的人可能更有可能对调查做出反应 Participants were recruited through targeted outreach conducted by the Male Nurse Working Committee of the Chinese Nursing Association. We used stratified convenience sampling, in which male nurses from 1,000 hospitals in China were invited to participate in an electronic survey. Divide hospitals into tertiary hospitals, affiliated hospitals, and primary care facilities to improve the representativeness of health care services. While stratification is used to include different types of hospitals, the use of convenience sampling may limit the representativeness of the sample because participants are selected based on availability rather than randomly. This can introduce electoral bias, as individuals who focus more on professional networks or those with special experience may be more likely to respond to surveys
[24].未来的研究应考虑采用样本能力抽样方法，以减少潜在的偏差，以证明中国更广泛的男护士人群。在 2023年5月至8月期间，特苏尔维通过微信平台进行了报道和管理。采用以下标准纳入：（1）拥有有效的护理执照，（2）在医院积极工作，（3）至少有一年的护理工作经验，以及 [24]. Future studies should consider the use of sample capacity sampling methods to reduce potential bias to demonstrate a broader population of male nurses in China. Between May and August 2023, Tessurvay reported and managed through the WeChat platform. The following criteria were used for inclusion: (1) possession of a valid nursing license, (2) active employment in the hospital, (3) at least one year of nursing work experience, and:
（4）提供知情同意书，并自愿参与研究。因休假、继续教育、出差或在研究期间预防参与的任何其他原因而被排除在调查之外的个人。 (4) Provide informed consent and voluntarily participate in the study. Individuals who are excluded from the survey for sabbatical, continuing education, business travel, or any other reason to prevent participation during the study.
样本量 Sample size
根据肯德尔山姆综合估计标准，为了评估工具的心理测量特性，样本量应至少是项目数量的 7 倍，至少 100个标准标准占 20 个变量[25]]. 然而，为了获得更准确和稳定的结果，我们招募了更大的样本量。最终，有13338名注册男护士 According to Kendall's Sam Synthesis Estimation Criteria, in order to assess the psychometric properties of the instrument, the sample size should be at least 7 times the number of items, with at least 100 standard criteria accounting for 20 variables[25]]. However, to obtain more accurate and stable results, we recruited larger sample sizes. Eventually, there were 13,338 registered male nurses
来自中国各地的 1000 多家医院参与了这项调查，尽管使用了方便抽样，但仍提供了可靠的分析数据。 More than 1,000 hospitals from across China participated in the survey, which provided reliable analytical data despite the use of convenient sampling.
数据收集 Data Collection
全国调查由中国护理协会协助开展，与当地护理协会协调，通过电子邮件或电话联系医院，邀请医院参与参与。根据其类型（三级、二级、初级保健）选择医院，以确保具有代表性的分布。研究助理通过专业的在线平台与微信小组共享调查链接，微信小组包括所有从参与医院招募的注册男护士。有人强调，每个IP地址只能填写一次。参与者被保证，他们的忓悔性将被维持，他们可以自由地在任何时候退出研究。此外 ，所有参与者都保持匿名，参与也完全是自愿的。如果被调查者花的时间或更少或多于完成调查，则问卷被排除。最后，总共返回了13088个有效的问题。 The national survey was carried out with the assistance of the Chinese Nursing Association, which coordinated with local nursing associations and contacted hospitals by email or phone to invite them to participate. Hospitals are selected according to their type (tertiary, secondary, primary care) to ensure a representative distribution. The research assistant shares the survey link through a professional online platform with a WeChat group that includes all registered male nurses recruited from participating hospitals. It was emphasized that each IP address can only be filled in once. Participants are assured that their remorse will be maintained and that they are free to withdraw from the study at any time. In addition, all participants remain anonymous and participation is completely voluntary. If the respondent spends more or less time than completing the survey, the questionnaire is excluded. In the end, a total of 13,088 valid questions were returned.
仪器 instrument
该研究小组为本研究开发了三个独立的部分，旨在评估男性护士的人口统计信息、工作态度和离职意愿。在全国调查之前，调查机构通过2023年3月进行的试点研究进行了严格的预测试。该试点涉及来自北京和上海两家三级医院的 100 名注册男护士。试点的目的是评估问题的清晰度、相关性和可靠性，以及使用在线平台的整体用户体验。收到的反馈被用来引用几个问题的措辞，并确保文化和语境的适宜性。此外，表面评估-它是通过与护理专家协商而建立的，护理专家审查了该工具，以确认它充分涵盖了预期的领域。根据试点资料，该仪器被认为适合用于全国调查。详细调查问卷的英文版本列在补充问卷中。 The research team developed three separate parts for this study to assess demographics, work attitudes, and turnover intentions among male nurses. The national survey was preceded by rigorous pre-testing by the investigating agency through a pilot study conducted in March 2023. The pilot involved 100 registered male nurses from two tertiary hospitals in Beijing and Shanghai. The purpose of the pilot is to assess the clarity, relevance, and reliability of the issues, as well as the overall user experience of using the online platform. The feedback received was used to quote the wording of several questions and to ensure cultural and contextual appropriateness. In addition, the superficial assessment – it was established in consultation with a nursing professional who reviewed the tool to confirm that it adequately covered the intended areas. Based on the pilot data, the instrument was considered suitable for use in national surveys. The English version of the detailed questionnaire is listed in the supplementary questionnaire.
人口统计信息收集表单 Demographic information collection forms
它是自己设计的关于年龄、教育程度、水平、玛丽塔状况、儿童人数、地理分配、医院、医院就业、医院类型、医院水平、工作单位、就业类型、工作年限、当前职位和职称的工具。 It is a self-designed tool on age, education, level, Marita's condition, number of children, geographical distribution, hospitals, hospital employment, hospital type, hospital level, place of work, type of employment, years of service, current position and job title.
邓军、王鹏和徐田对这项工作的贡献相同。 Deng Jun, Wang Peng, and Xu Tian contributed equally to this work.