Study On The Self-rated Health Status And Its Influencing Factors Of Nurses In 3A Military Hospitals

ObjectivesTo investigate the self-rated health status of nurses in 3A military hospitals;to explore and investigate the psychosocial factors that affect the self-rated health of nurses in 3A military hospitals;and to bring forward the corresponding management strategies to provide reference for the improvement of the heath status of nurses in 3A military hospitals.Research Subjects and Research MethodsThis research uses random cluster sampling method to conduct a field survey from July to September in 2007.The survey is carried out with 1508 nurses in eight 3A hospitals in Beijing,Shanghai,Guangzhou,and Chongqing as its research subjects.There are 1413 valid questionnaires received,accounting for 93.70%.All the research subjects are female.The experimental group constitutes 727 nurses in 3A military hospitals,while the control group is composed of 686 nurses in 3A local hospitals.The following scales are adopted in the questionnaires of this research: Self-rated Health Measurement Scale(SRHMS),Nursing Job Stressor Inventory (NJSI),The Maslach Burnout Inventory(MBI),Simplified Coping Style Questionnaire(SCSQ),etc.In this research,the database is established by using Foxpro 6.0,and the data is processed by applying SPSS13.0 software.The statistical methods used include Descriptive Analysis,t Test,Homogeneity Test of Variances,Variance Analysis, Factor Analysis,Analysis of Correlation,Multiple Stepwise Regression Analysis etc.Results1.The Analysis of the self-rated health status of nurses in 3A military hospitals1) The standard mean of each dimension and subscale of nurses in 3A military hospitals and their total mean are above average,ranging from 6.14 to 9.54.The standard mean of each dimension and subscale of nurses in 3A military hospitals and their total mean are higher than those of nurses in 3A local hospitals.Moreover,there is an evident difference in the comparison of the subscale of psychological health and its positive effect,the subscale of social health and its SSRS,and the total score of self-rated health.2).With further comparison among the 48 entries of the SRHMS of nurses in military hospitals and local hospitals,we find that nurses in 3A military hospitals are better than those in 3A local hospitals in their physical fitness in the aspect of physical health,their sense of confidence,security and happiness in the aspect of psychological health,and their relation with families and friends in the aspect of social health,while their degree of some symptoms like anxiety and compulsion is lower than that of nurses in 3A local hospitals.The evident statistical difference is found through comparison.3) After gathering statistics of the entries of the SRHMS with the mean score lower than 6 points,we find two entries of the subscale of physical health reflecting the status of gastrointestinal symptoms and burnout of the nurses,two entries of the subscale of psychological health reflecting the depression and compulsion of the nurses,and one entry of the subscale of social health reflecting their seeking for help and support from their friends in social activities and in difficulty.2.Analysis on one-factor that affects the self-rated health of nurses in 3A military hospitals The scores of the subscales and the overall scores of the self-rated health of nurses in 3A military hospitals show no difference in aspects of different educational attainments and professional titles,but they show significant statistical difference (P＜0.01) in the aspects of frequently taking physical exercises and having breakfast. There is significant statistical difference in the aspect of different marital statuses (P＜0.05),where the scores of the psychological health and self-rated health of married nurses are higher than those of unmarried nurses in 3A military hospitals.3.The relationship between the job stressors and the self-rated health of nurses in 3A military hospitalsThe difference of scores of the five entries,like little opportunity for further study and training,where the scores of nurses in 3A military hospitals are higher than those of nurses in 3A local hospitals,is of no statistical significance.The scores of the rest of the entries,where the scores of nurses in 3A military hospitals are lower than those of nurses in 3A local hospitals,indicate that job stressors of nurses in 3A military hospitals are fewer than those in 3A local hospitals.Notable statistical significance is found especially in the difference of all the entries in the factors of workload and time distribution,working environment and resources,and patient care.The ten entries with the highest scores of job stressors of nurses in 3A military hospitals and those of nurses in 3A local hospitals are basically the same,the sequence of which is low pay and welfare benefits,regular shifts,little chance of promotion,little opportunity for further study and training,low social status of nursing profession,worries about miswork,too much workload,too few nurses on duty,too much non-nursing work,and no appreciation from patients and their families.The five factor scores of job stressors of nurses in 3A military hospitals in sequence from the highest to the lowest are as follows:nursing and the job,workload and time distribution,patient care,working environment and resources,and management and interpersonal relation.The live factor scores of the job stressors of nurses in 3A military hospitals are significantly negatively correlated with the scores of the subscales and the overall scores of the self-rated health,with the highest degree of correlation with psychological health where the correlation coefficient reaches as high as 0.355.4.The relationship between the burnout and the self-rated health of nurses in 3A military hospitalsThe scores of the entries of the burnout of nurses in 3A military hospitals are mostly lower than those of nurses in 3A local hospitals,and the difference between the two is of evident statistical significance.In the scores of the burnout of nurses in 3A military hospitals,depersonalization and decreased personal accomplishment have high level of exhaustion,accounting for 90.1%and 94.9%respectively.The scores of the subscales and the overall scores of the self-rated health are significantly positively correlated with the scores of depersonalization of nurses in 3A military hospitals,and significantly negatively correlated with the scores of emotional exhaustion and the decreased personal accomplishment.5.The relationship between the coping styles and the self-rated health of nurses in 3A military hospitalsFrom the statistical results of the number and percentage of nurses in 3A military hospitals that choose each coping style,we may conclude that the five most commonly used coping styles in sequence are as followings:"to communicate to pour out worries and troubles(42.5%)","to try to look on the bright side of things (40.7%)","to seek for suggestions from relatives,friends,or colleagues(38.6%)","to comfort oneself(35.5%)",and "to find out several solutions to the problem(32.2%)", among which there are four positive coping styles.The least commonly adopted coping styles are "to depend on others to solve the problem(3.3%)","to get rid of worries by smoking,drinking,dosing and eating (4.1%)","to believe that the current situation will change with time,and that the only thing to do is to wait(6.6%)","to cherish the illusion that some wonders would change the current situation(7.7%)",and "to try to put the trouble out of their heads (8.8%)",among which there are five negative coping styles.The scores of the three subscales and the overall scores of the self-rated health are positively correlated with the scores of positive coping styles of nurses under different management patterns(P＜0.01),and negatively correlated with the scores of negative coping styles(P＜0.01).6.Multiple factor analysis of the factors influencing the self-rated health of nurses in 3A military hospitalsMultiple stepwise regression analysis is conducted in the research.The dependent variables are the scores of the subscales and the overall scores of the self-rated health of nurses in 3A military hospitals,while the independent variables are scores of life event,factor scores of positive coping and negative coping,three factor scores of the Maslach Burnout Inventory(MBI),and the five factor scores of job stressors.When a=0.05,positive coping factors and negative coping factors are found in all four regression equations,but the three factors of the Maslach Burnout Inventory(MBI) and the five factors of job stressors are found in different regression equations.7.Pathway analysis of the correlation among the factors influencing the self-rated healthThe study is based on the hypothesis that job stress,burnout,and coping styles of nurses in 3A military hospitals will have impact on their self-rated health,and these factors may have influence on each other as well.Two remarkable pathways are found through the analysis.The most remarkable one is as follows:total stressors factors of depersonalization→positive coping→self-rated health,and the other is: total stressors→factors of decreased personal accomplishment→self-rated health.Conclusion1.The overall level of the self-rated health status of nurses in 3A military hospitals is above average,higher than that of nurses in 3A local hospitals,and a significant difference is found especially in the total scores of the psychological health and the self-rated health.In the self-rated health status of nurses in 3A military hospitals,gastrointestinal symptoms and burnout are found to be more prominent;in their self-rated psychological health status,depression and compulsion are found to be more striking;and their self-rated social health is characterized by seeking help and support from friends when in difficulty.2.The self-rated health status of those nurses in 3A military hospitals who frequently take physical exercises and have breakfast is in good condition;and the overall level of the self-rated psychological health status and the self-rated health status of married nurses in 3A military hospitals is better.3.There are fewer job stressors and less burnout of nurses in 3A military hospitals than those in 3A local hospitals.The principal job stressors are reflected in aspects associated with nursing and the job,such as low pay and welthre benefits, regular shifts,little chance of promotion,and workload and time distribution.4.There are more positive styles and fewer negative ones in the frustration coping styles of nurses in 3A military hospitals,with "to communicate to pour out worries and troubles" and "to try to look on the bright side of things" being the most commonly adopted coping styles.5.There is outstanding impact of job stressors,burnout and coping styles of nurses in 3A military hospitals on their self-rated physical,psychological,and social health,with their most notable influence on the self-rated psychological health.6.Irritable stressors play a somewhat direct role in the self-rated health of nurses in 3A military hospitals,but they may play an indirect role with greater impact through the mediating effects of cognitive evaluation and coping styles.7.For administrators,the means to improve health status of nurses in 3A military hospitals include raising the pay and welfare benefits of nurses,hiring more staff, adjusting shift system,providing more chance of promotion,and adjusting workload and time distribution.Characteristics and Innovation1.This is a systematic and thorough investigation on the self-rated health status of nurses in 3A military hospitals to explore the impact of job stressors,burnout,and coping styles on their health.With a large sample size,the results of the research are highly representative. 2.The research quantificationally reflects the overall level of the self-rated health status of nurses in 3A military hospitals,and their physical,psychological,and social health.It explores and sums up the factors that influence their self-rated health, and the influencing style of each factor on the self-rated health and their interaction.3.The research pertinently comes up management strategies for improving the self-rated health status of nurses in 3A military hospitals.Limitations and Implications1.As a cross-section survey,the limited results of the research need further experimental verification.2.As the sample is just limited to nurses in 3A hospitals,the results of the research cannot be popularized and applied to nurses in hospitals at other levels,which need further expansion.