The Study On The Relationship Between Structural Empowerment、Emotional Commitment And Patient Safety Culture Of Medical Staff

Objective:The main purpose of this study is to investigate the status quo of structural empowerment,emotional commitment and patient safety culture perception of medical staff in a third-grade a hospital in Changchun,analyzed relevant influencing factors,and discussed the correlation among the three variables.Through this study,the theoretical premise for the construction of hospital patient safety culture is strengthened,which lays the foundation for the improvement of patient safety culture level and provides the basis for managers to formulate targeted intervention measures.Methods:This study was carried out on the basis of a systematic review of relevant domestic and foreign literatures,such as structural competence,emotional commitment and patient safety culture,and a comprehensive review of relevant theories,research methods and domestic and foreign research status.Using the affective commitment subscale of the organizational commitment scale developed by PSCHO patient safety culture scale,job performance condition scale-II(CWEQ-II)and Meyer et al.(1993)as the research tool,the convenient sampling method was adopted to investigate the doctors and nurses who has worked for more than a year in a third-grade a hospital in changchun city.600 questionnaires were distributed,and 546 questionnaires were collected,with a recovery rate of 91.0%.The questionnaires were screened,and 517 questionnaires were left,with an effective rate of 86.2%.EpiData 3.0 software was used for data entry and database building.SPSS21.0 statistical software was used to analyze and sort out the data.The general data of the respondents were described by descriptive statistics,and the counting data were described by frequency and percentage.Quantitative data are described by means of standard deviation.Mean plus or minus standard deviation was used to describe the status and dimensions of patient safety culture,structural empowerment and emotional commitment.T-test or anova was used to compare the relationship between different general demographic factors,patient safety culture,structural empowerment,emotional empowerment and their dimensions.Multiple linear regression was used to analyze the influencing factors of patient safety culture,structural capacity and emotional capacity.Pearson correlation analysis was used to analyze the correlation among the three variables.AMOS21.0 was used to construct the structural equation model to explore the specific relationship between structural empowerment and emotional commitment to patient safety culture.Results:1.Patient safety culture score of medical staff: the total average score of patient safety culture of 517 medical staff was(3.69±0.35),Among the nine dimensions of patient safety culture,the highest score was(4.19±0.63),followed by learning ability(3.78±0.76)and department safety habit(3.72±0.47).The two lowest dimensions were shame and unsafe behavior perception(3.25±0.71)and(3.30±0.79),respectively.Manager participation and department safety habit are the dominant area,and unsafe perceptual behavior is the area to be improved.At the organizational level,the departmental level,and the individual level,The highest scores were at the organizational level(3.90±0.49),Low scores on the individual level(3.72±0.45).There were statistically significant differences in the total scores of safety culture among medical staff and patients with different ages,genders,educational background,years of working experience,departments,personnel categories,professional titles,employment forms,average daily working hours,average number of night shifts,frequency of patient communication,number of adverse events or errors(P<0.05).Patient communication frequency,weekly night shift frequency,professional title,educational background,age and category are the influencing factors of patient safety culture perception.2.Score of the structural empowerment of medical staff: the total score of the structural empowerment of medical staff in this survey is(21.13±3.56),It’s in the middle level.The scores of the six dimensions from high to low are: formal rights(3.71±0.87),informal rights(3.69±0.75),support(3.61±0.79),opportunities(3.43±0.82),resources(3.45±0.84)and information(3.25±0.97).There were statistically significant differences in the scores of ability awarding in the structural empowerment among different ages,educational background,years of working experience,departments,personnel categories,professional titles,employment forms,average frequency of weekly night shifts and frequency of patient communication(P<0.05).Professional title,category,educational background and department are the influencing factors for the perception of structural empowerment.3.The score of emotional commitment of medical staff: the score of emotional commitment of 517 medical staff in this survey is(4.07±0.80),which is above the average.Different ages,educational background,years of working experience,departments,personnel categories,professional titles,employment forms,patients’ communication frequency and the number of adverse events and errors had an impact on affective commitment score(P<0.05).Professional title,category and educational background are the influencing factors of affective commitment perception.4.Correlation of patient safety culture,structural empowerment,and emotional commitment: the total score of patient safety culture was positively correlated with the total score of structural empowerment and each dimension(P<0.01),and the correlation between formal power and sense of shame was the highest,with a correlation coefficient of 0.772.In addition to the dimension of learning ability,the total score of patient safety culture and the remaining eight dimensions were positively correlated with emotional commitment(P<0.05),and the correlation between emotional commitment and the total score of patient safety culture was the highest.There was a positive correlation between the total score of affective commitment and structural empowerment and its dimensions(P<0.05).5.Structural empowerment give significant path coefficient of patient safety culture(r=0.33,P < 0.01),the structural empowerment is given to emotional commitment to the path coefficient of significant(r=0.60,P < 0.01),the emotional teaching can significant path coefficient of patient safety culture(r=0.23,P < 0.01),the emotional commitment between structural empowerment and patient safety culture has partial intermediary role,intermediary effect value of 0.20.Conclusions:1.Patient safety culture score of medical staff: the total average score of patient safety culture of 517 medical staff was(3.69±0.35),It’s above average.Managers’ participation and department safety habits are the dominant areas,while unsafe perceptual behaviors are the areas to be improved.Patient communication frequency,weekly night shift frequency,professional title,educational background,age and category are the influencing factors of patient safety culture perception.The score of structural empowerment of medical staff is(21.13±3.56).Professional title,category,educational background and department are the influencing factors for the perception of structural empowerment.The score of emotional commitment of medical staff in the hospital was(4.07±0.80),which was above the average.Professional title,category and educational background are the influencing factors of affective commitment perception.2.There are pairwise correlations between the structural empowerment,emotional commitment and patient safety culture of medical staff,and both of them have significant positive effects on patient safety culture.3.Emotional commitment partially mediates the relationship between structural empowerment and patient safety culture perception.