Amil Kusain Tan Jr PhD, RN, MHC, MEDSURG-BC, Elizabeth Capezuti PhD, RN, FAAN, William Ellery Samuels PhD, Ramona Backhaus PhD, Laura M. Wagner PhD, RN, GNP, FAAN
{"title":"长期护理护士的留职意愿、道德困扰和护士执业环境：横断面问卷调查研究。","authors":"Amil Kusain Tan Jr PhD, RN, MHC, MEDSURG-BC, Elizabeth Capezuti PhD, RN, FAAN, William Ellery Samuels PhD, Ramona Backhaus PhD, Laura M. Wagner PhD, RN, GNP, FAAN","doi":"10.1111/jnu.12953","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Many long-term care facilities in the United States face significant problems with nurse retention and turnover. These challenges are attributed, at least in part, to moral distress and a negative nurse practice environment.</p>\n </section>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>The purpose of the study was divided into two parts: first, to investigate the relationships among nurse practice environment, moral distress, and intent to stay; second, to explore the potential mediating effect of the nurse practice environment on the intent to stay among those with high levels of moral distress.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>This study was a descriptive, cross-sectional survey using targeted sampling.</p>\n </section>\n \n <section>\n \n <h3> Participants</h3>\n \n <p>A total of 215 participants completed the surveys. Participants were nationally representative of long-term care nurses by age, years of experience, employment status, and type of health setting.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This study was an online national survey of long-term care nurses' perceptions of their intent to stay, moral distress level (Moral Distress Questionnaire), and nurse practice environment (Direct Care Staff Survey). Structural equation modeling analysis explored intent to stay, moral distress, and the nurse practice environment among long-term care nurses.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The mean moral distress score was low, while the mean nurse practice environment and intent to stay scores were high. Moral distress had a significant, moderately negative association with the nurse practice environment (<i>β</i> = −0.41), while the nurse practice environment had a significant, moderately positive association with intent to stay (<i>β</i> = 0.46). The moral distress had a significant, moderately negative association with intent to stay (<i>β</i> = −0.20). The computed structural equation modeling suggested a partially mediated model (indirect effect = −0.19, <i>p</i> = 0.001).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Since the nurse practice environment partially mediates the relationship between moral distress and intent to stay, interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession.</p>\n </section>\n \n <section>\n \n <h3> Clinical Relevance</h3>\n \n <div>\n \n <ul>\n \n \n <li>Our study demonstrated that the nurse practice environment mediates moral distress and intent to stay.</li>\n \n \n <li>Interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession.</li>\n </ul>\n </div>\n </section>\n </div>","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"56 3","pages":"430-441"},"PeriodicalIF":2.4000,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Intent to stay, moral distress, and nurse practice environment among long-term care nurses: A cross-sectional questionnaire survey study\",\"authors\":\"Amil Kusain Tan Jr PhD, RN, MHC, MEDSURG-BC, Elizabeth Capezuti PhD, RN, FAAN, William Ellery Samuels PhD, Ramona Backhaus PhD, Laura M. Wagner PhD, RN, GNP, FAAN\",\"doi\":\"10.1111/jnu.12953\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Many long-term care facilities in the United States face significant problems with nurse retention and turnover. These challenges are attributed, at least in part, to moral distress and a negative nurse practice environment.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>The purpose of the study was divided into two parts: first, to investigate the relationships among nurse practice environment, moral distress, and intent to stay; second, to explore the potential mediating effect of the nurse practice environment on the intent to stay among those with high levels of moral distress.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Design</h3>\\n \\n <p>This study was a descriptive, cross-sectional survey using targeted sampling.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Participants</h3>\\n \\n <p>A total of 215 participants completed the surveys. Participants were nationally representative of long-term care nurses by age, years of experience, employment status, and type of health setting.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This study was an online national survey of long-term care nurses' perceptions of their intent to stay, moral distress level (Moral Distress Questionnaire), and nurse practice environment (Direct Care Staff Survey). Structural equation modeling analysis explored intent to stay, moral distress, and the nurse practice environment among long-term care nurses.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The mean moral distress score was low, while the mean nurse practice environment and intent to stay scores were high. Moral distress had a significant, moderately negative association with the nurse practice environment (<i>β</i> = −0.41), while the nurse practice environment had a significant, moderately positive association with intent to stay (<i>β</i> = 0.46). The moral distress had a significant, moderately negative association with intent to stay (<i>β</i> = −0.20). The computed structural equation modeling suggested a partially mediated model (indirect effect = −0.19, <i>p</i> = 0.001).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Since the nurse practice environment partially mediates the relationship between moral distress and intent to stay, interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Clinical Relevance</h3>\\n \\n <div>\\n \\n <ul>\\n \\n \\n <li>Our study demonstrated that the nurse practice environment mediates moral distress and intent to stay.</li>\\n \\n \\n <li>Interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession.</li>\\n </ul>\\n </div>\\n </section>\\n </div>\",\"PeriodicalId\":51091,\"journal\":{\"name\":\"Journal of Nursing Scholarship\",\"volume\":\"56 3\",\"pages\":\"430-441\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-01-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Nursing Scholarship\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jnu.12953\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nursing Scholarship","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jnu.12953","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
Intent to stay, moral distress, and nurse practice environment among long-term care nurses: A cross-sectional questionnaire survey study
Background
Many long-term care facilities in the United States face significant problems with nurse retention and turnover. These challenges are attributed, at least in part, to moral distress and a negative nurse practice environment.
Objective
The purpose of the study was divided into two parts: first, to investigate the relationships among nurse practice environment, moral distress, and intent to stay; second, to explore the potential mediating effect of the nurse practice environment on the intent to stay among those with high levels of moral distress.
Design
This study was a descriptive, cross-sectional survey using targeted sampling.
Participants
A total of 215 participants completed the surveys. Participants were nationally representative of long-term care nurses by age, years of experience, employment status, and type of health setting.
Methods
This study was an online national survey of long-term care nurses' perceptions of their intent to stay, moral distress level (Moral Distress Questionnaire), and nurse practice environment (Direct Care Staff Survey). Structural equation modeling analysis explored intent to stay, moral distress, and the nurse practice environment among long-term care nurses.
Results
The mean moral distress score was low, while the mean nurse practice environment and intent to stay scores were high. Moral distress had a significant, moderately negative association with the nurse practice environment (β = −0.41), while the nurse practice environment had a significant, moderately positive association with intent to stay (β = 0.46). The moral distress had a significant, moderately negative association with intent to stay (β = −0.20). The computed structural equation modeling suggested a partially mediated model (indirect effect = −0.19, p = 0.001).
Conclusion
Since the nurse practice environment partially mediates the relationship between moral distress and intent to stay, interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession.
Clinical Relevance
Our study demonstrated that the nurse practice environment mediates moral distress and intent to stay.
Interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession.
期刊介绍：
This widely read and respected journal features peer-reviewed, thought-provoking articles representing research by some of the world’s leading nurse researchers.
Reaching health professionals, faculty and students in 103 countries, the Journal of Nursing Scholarship is focused on health of people throughout the world. It is the official journal of Sigma Theta Tau International and it reflects the society’s dedication to providing the tools necessary to improve nursing care around the world.
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