Study On Influencing Factors And Mechanism Of Nurse Engagement In Long-term Care Facilities

Objective:This study based on a mixed research perspective,this study investigates the level of long-term care nurse engagement and its influencing factors,and builds a long-term care institution nurse engagement model,aiming to provide a reference for managers to improve their management strategies,so as to improve long-term care nurse engagement.,stabilizing the development of the long-term care team to meet the rapidly growing long-term care needs.Methods:This research adopts the exploratory sequential design of the mixed research method,including two different stages.In stage of qualitative research: In-depth interviews were conducted with 31 long-term care nurses and a 3-week participatory observation was conducted on the daily work of nurses in the above three long-term care institutions.The interview transcribed data were analysed and summarized using the Colaizzi phenomenological seven-step analysis method.Then constructing a model of nursesvengagement in long-term care institutions.Quantitative research:Cross-sectional data were collected from a sample of 494 nurses from five long-term care facilities who completed measures of work engagement,organizational climate,job resources and emotional intelligence.Use SPSS24.0 and PROCESS3.3 for statistical analysis.Result:1.The themes of factors influencing nurse engagement in long-term care facilities are: Theme 1: Personal factors,including Poor emotional control,lack of professional ability,need good physical fitness,Theme 2: Work resources,including Insufficient subjective initiative,low social support,timely feedback on work and unclear career development,Theme 3 : Work requirements,including high workload,work-family imbalance,role conflict,theme 4: Nursing organizational climate,including limited working conditions,poor teamwork,poor nursing working environment,management mode is not good,lack of learning and scientific research ability.Monthly income affects the engagement level of nurses in long-term care institutions to a certain extent.The higher the monthly income,the higher the engagement level.2.The total score of engagement is 42.98 ± 11.36,of which the dedication dimension has the highest score and the focus dimension has the lowest score.The monthly income level of nurses in long-term care institutions had a statistically significant difference in their engagement(P<0.05),but there was no statistically significant difference in their gender,age,education,working years,and employment nature(P>0.05).The total score of emotional intelligence was 63.47 ± 10.20,of which the score of self emotional assessment dimension was the highest and the score of emotional application ability dimension was the lowest;The total score of work resources was 111.24 ± 22.26,with the highest score in job autonomy dimension and the lowest score in development opportunity dimension;The total score of nurses’ perception of nursing organization atmosphere in long-term care facilities was 110.15 ±20.57,with the highest score in management support dimension and the lowest score in evidence-based care support dimension.3.There was a positive correlation between the work resources,nursing organizational climate,emotional intelligence,and engagement(P<0.01).And organizational climate was significantly positively correlated with emotional intelligence and engagement(P<0.01).Emotional intelligence was significantly positively correlated with engagement(P<0.01).4.Nursing organization climate positively predicted nurse engagement in long-term care facilities(β= 0.64,P< 0.001).Job resources mediate the relationship between organizational climate and nurse engagement in long-term care facilities(β=0.19,p < 0.001),with the mediating effect accounting for 20% of the total effect.5.Emotional intelligence moderated the mediating role between organizational climate and nurse engagement in long-term care facilities(β= 0.07,P<0.01),specifically regulating the latter half of the mediation model.And only in long-term care nurses with high emotional intelligence,the indirect effect of nursing organizational climate on engagement through job resources is significant.Conclusion:1.Nurse engagement in long-term care faclities is affected by personal emotions,personal abilities and health status,work load,social support at work,role balance,working conditions,nursing working environment,nursing management mode,learning and scientific research and other organizational aspects.2.The level of work engagement,emotional intelligence and perception of nursing organization climate of nurses in long-term care facilities are at a medium level,which needs to be further improved.The available of work resources was limited and need to be further improved too.3.This study constructed a nurse engagement model in long-term care institutions,which is a moderated mediation model.Among them,Nursing organizational climate can directly affect the engagement of nurses in long-term care faclities,and can indirectly affect the level of nurse engagement through mediating effect of job resources.At the same time,emotional intelligence can moderate the mediation of work resources in the relationship between nursing organizational climate and engagement effect,mainly in that only among nurses in long-term care facilities with high emotional intelligence,nursing organizational climate can significantly predict engagement levels through the mediating effect of job resources.