The Influence of Medical Cooperation on the Work Engagement of Dental Specialist Nurses
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摘要:
目的 调查云南省口腔专科护士医护合作、护士工作投入的现状，探讨医护合作对口腔专科护士工作投入的影响。 方法 采用便利抽样法，于2024年1月至3月，采用一般资料调查问卷表、 医护合作量表、Utrecht工作投入量表对251名云南省口腔专科护士进行了调查。 结果 云南省口腔专科护士医护合作量表调查总分为（85.09±15.14）分，各条目总均分为 （4.052±0.02） 分，患者信息的交流维度总均分为（4.16±0.66） 分，共同参与治疗或护理的决策维度（3.97±0.83）分，护士和医生的关系维度（4.05±0.91）分，分数以患者信息的交流、护士和医生的关系、共同参与治疗或护理的决策维度依次下降。护士工作投入量表调查总分为（50.75±15.69）分，总均分为（3.906±0.123） 分，其中奉献维度均分为（4.04±1.30）分，专注维度均分为（3.89±1.22）分，活力维度均分为（3.83±1.21）分，得分从奉献维度、专注、活力维度均分依次下降。Pearson相关性分析结果显示，医护合作与口腔专科护士的工作投入呈中度正相关（r = 0.574，P < 0.001），量表中各维度与工作投入均呈中度正相关，（r = 0.502-0.574，P < 0.001）。单因素分析显示，性别、职务、收入对口腔专科护士工作投入得分有影响，多元线性回归分析显示，工龄大于5 a的护士医护合作得分显著高于工龄小于5 a的低年资护士（P < 0.05），护士月收入正向影响工作投入得分（P < 0.05），医护对于患者信息的交流显著正向影响工作投入得分（P < 0.05）。 结论 云南省口腔专科护士医护合作处于较高水平，工作投入处于中等水平，口腔专科护士医护合作水平越高，工作投入程度越大。口腔专科护理管理者应考虑能够促进医护合作的各项措施，工作中构建团结和谐的医护合作关系，同时关注影响护士工作投入的因素，并采取相应的措施，促进口腔专科护士工作投入水平，提升口腔医疗护理服务质量。 Abstract:Objective To investigate the current situation of medical cooperation and nurses' work engagement of dental specialty nurses in Yunnan province, and to explore the impact of medical cooperation on the work engagement of dental specialty nurses. Methods a total of 251 dental nurses in Yunnan province were investigated by convenience sampling from January to March 2024 with the general information questionnaire, the medical cooperation scale （NPCS） and the Utrecht work engagement scale （UWES）. Results the total score of the medical cooperation scale for dental specialty nurses in Yunnan province was （85.09 ± 15.14）, the total average score of each item was （4.052 ± 0.02）, the total average score of the communication dimension of patient information was （4.16 ± 0.66）, the decision dimension of joint participation in the treatment or nursing was （3.97 ± 0.83）, and the relationship dimension between nurses and doctors was （4.05 ± 0.91）. The scores decreased in order of the communication of patient information, the relationship between nurses and doctors, and the decision dimension of joint participation in the treatment or nursing. The total score of nurses' work engagement scale was （50.75 ± 15.69）, and the total average score was （3.906 ± 0.123）. The average score of the dedication dimension was （4.04 ± 1.30）, the average score of focus dimension was （3.89 ± 1.22）, and the average score of the vitality dimension was （3.83 ± 1.21）. The score decreased in turn from the dimension of dedication, focus and vitality. Pearson correlation analysis showed that medical cooperation was moderately positively correlated with the work engagement of dental specialty nurses （r = 0.574, P < 0.001）, and all the dimensions of the scale were moderately and positively correlated with the work engagement （r = 0.502-0.574, P < 0.001）. Single factor analysis showed that gender, position and income had an impact on the work engagement score of dental specialty nurses. Multiple linear regression analysis showed that nurses with more than 5 years of service scored significantly higher in medical cooperation than those with less than 5 years of service （P < 0.05）, the monthly income of nurses positively affected the work engagement score （P < 0.05）, and the communication of patient information between doctors and nurses had a significant positive impact on the work engagement score （P < 0.05）. Conclusion The medical cooperation of dental specialty nurses in Yunnan province is at a high level, and the work engagement is at a medium level. The higher the level of medical cooperation of dental specialty nurses, the greater the degree of the work engagement. Oral specialty nursing managers should consider various measures that can promote the medical cooperation, build a united and harmonious medical cooperation relationship in their work, pay attention to the factors that affect nurses' work engagement, and take corresponding measures to promote the level of work engagement of oral specialist nurses and improve the quality of oral medical care service. -
Key words:
- Dental specialist nurses /
- Nurse /
- Work engagement /
- Nurse–physician collaboration
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表 1 口腔专科护士医护合作量表、工作投入量表的信度及得分情况（$\bar x \pm s $）
Table 1. Reliability and scores of the dental specialist nurse medical cooperation scale and work engagement scale（$\bar x \pm s $）
项目 条目数 总均分 Cronbach，sα系数 医护合作关系量表 21 85.09±15.14 0.969 患者信息的交流维度 8 4.16±0.66 0.919 护士和医生的关系维度 3 4.05±0.91 0.894 共同参与治疗或护理的决策维度 10 3.97±0.83 0.960 护士工作投入量表 15 50.75±15.69 0.961 奉献维度 4 4.04±1.30 0.924 专注维度 5 3.89±1.22 0.883 活力维度 6 3.83±1.21 0.884 
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表 2 口腔专科护士基本特征与医护合作、工作投入的关系 （$\bar x \pm s $）
Table 2. The relationship between the basic characteristics of dental specialty nurses，medical cooperation，and work engagement （$\bar x \pm s $）
项目 n 构成比（%） 医护合作总均分 t/F P 工作投入总均分 t/F P 性别 1.802 0.073 2.270 0.024* 男 10 3.98 93.50±13.42 61.70±15.35 女 241 96.02 84.74±15.13 50.30±15.56 年龄（岁） 1.916 0.092 0.772 0.571 ≤25 38 15.14 89.76±14.26 52.05±17.14 26～30 113 45.02 84.65±14.42 49.27±15.57 31～35 43 17.13 85.47±16.87 51.70±16.49 36～40 37 14.74 80.24±16.39 50.03±15.94 41～45 17 6.77 88.65±12.84 56.53±9.53 >46 3 1.2 76.67±5.13 53.00±16.37 学历 1.110 0.346 0.818 0.485 中专 4 1.59 95.50±9.68 59.25±13.82 大专 43 17.13 86.84±15.92 51.98±18.59 本科 202 80.48 84.59±15.04 50.43±15.10 研究生及以上 2 0.8 76.50±10.61 40.00±1.41 职务 −1.200 0.231 2.252 0.025* 无 204 81.27 85.64±15.14 49.69±15.70 组长及以上 47 18.73 82.70±15.04 55.36±14.95 工作年限（a） 1.377 0.243 ≤5 101 40.24 86.37±15.07 49.18±16.75 0.528 0.715 6～10 83 33.07 84.30±15.34 51.33±14.82 11～15 33 13.15 87.91±13.59 52.45±16.56 16～20 27 10.75 79.85±16.71 51.70±14.68 21 a以上 7 2.79 82.86±11.85 55.00±9.71 职称 1.795 0.168 1.423 0.243 护士 69 27.49 87.87±14.33 52.68±15.88 护师 122 48.61 84.50±15.31 49.06±15.58 主管护师及以上 60 23.9 83.08±15.48 51.98±15.57 聘用形式 0.062 0.950 合同制 242 96.41 85.10±15.22 50.62±15.80 −0.718 0.473 医编 9 3.59 84.78±13.41 54.44±12.48 月收入（元） 0.046 0.955 4.849 0.009* 5000 以下96 38.25 84.85±16.02 47.93±17.41 5000 ～8000 141 56.17 85.14±14.93 51.67±14.50 8000 及以上14 5.58 86.14±11.35 60.86±8.52 婚育情况 1.176 0.310 0.381 0.684 未育 133 52.99 86.44±14.63 49.94±15.82 已育 115 45.82 83.49±15.70 51.65±15.67 离异 3 1.19 86.33±13.87 52.33±12.58 *P < 0.05。
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表 3 医护合作与护士工作投入相关性分析
Table 3. Correlation analysis between medical cooperation and nurse work engagement
项目 r P 医护合作量表 0.574 <0.001* 患者信息的交流维度 0.574 <0.001* 共同参与治疗或护理的决策维度维度 0.519 <0.001* 护士和医生的关系维度 0.502 <0.001* *P < 0.05。
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表 4 多元线性回归分析自变量赋值方式
Table 4. Method of assigning independent variables in multiple linear regression analysis
变量 赋值方式 性别 1=男，2=女 年龄 1=25岁及以下，2=26～30，3=31～35，4=36～40，5=41～45，6=46岁以上 学历 中专=1，大专=2，本科=3，研究生及以上=4 职称 护士=1，护师=2，主管护师及以上=3 职务 1=无，2=组长及以上 工作年限 1=5 a及以下，2=6～10，3=11～15，4=16～20，5=21年以上 聘用形式 1=合同制，2=医编 月收入 1= 5000 以下，2=5000 ～8000 ，3=8000 及以上婚育状况 1=未育，2=已育，3=离异 医护合作量表得分 原值代入 工作投入量表得分 原值代入
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表 5 口腔专科护士医护合作影响因素的多元线性回归分析
Table 5. Multiple linear regression analysis of influencing factors of medical cooperation among dental specialist nurses
变量 β S.E β' t P 年龄 ≤25（参照） − − − − − 26～30岁 7.312 11.361 0.225 0.644 0.524 31～35岁 13.175 10.826 0.386 1.217 0.233 36～40岁 13.466 7.116 0.340 1.892 0.068 学历 中专（参照） − − − − − 大专 −32.046 18.002 −0.664 −1.780 0.085 本科 −28.674 15.800 −0.643 −1.815 0.079
工作年限≤5 a（参照） − − − − − 6～10 a 21.538 9.687 0.719 2.223 0.033* 11～15 a 32.699 13.687 0.782 2.389 0.023* 16～20 a 21.877 15.583 0.672 1.404 0.170 21 a以上 38.472 21.636 0.373 1.778 0.085 职称 护士（参照） − − − − − 护师 −12.199 9.724 −0.398 −1.255 0.219 主管护师及以上 −19.872 11.996 −0.666 −1.657 0.107 月收入 5000 以下（参照）− − − − − 5000 ～8000 元4.714 6.903 0.152 0.683 0.500 8000 及以上12.725 8.133 0.336 1.565 0.128 婚育情况 未育（参照） − − − − − 已育 −9.769 5.997 −0.300 −1.629 0.113 *P < 0.05。
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表 6 口腔专科护士工作投入影响因素的多元线性回归分析
Table 6. Multiple linear regression analysis of factors influencing the work engagement of dental specialist nurses
变量 β S.E β' t P 年龄 ≤25岁（参照） − − − − − 26～30 −0.808 2.331 −0.026 −0.347 0.729 31～35 0.600 2.971 0.014 0.202 0.840 36～40 2.859 3.991 0.046 0.716 0.474 41～45 −0.328 10.334 −0.002 −0.032 0.975 学历 中专（参照） − − − − − 大专 −2.825 7.090 −0.068 −0.399 0.691 本科 −3.647 6.903 −0.092 −0.528 0.598 研究生以上 −6.887 11.705 −0.039 −0.588 0.557
工作年限≤5 a（参照） − − − − − 6～10 2.501 2.411 .075 1.037 0.301 11～15 −0.213 3.711 −0.005 −.057 0.954 16～20 3.380 4.574 0.067 0.739 0.461 21 a以上 4.571 7.833 0.048 0.584 0.560 职称 护士（参照） − − − − − 护师 −4.123 2.196 −0.132 −1.877 0.062 主管护师及以上 −4.935 3.512 −0.134 −1.405 0.161 月收入 5000 以下（参照）− − − − − 5000 ～8000 3.85 1.880 0.122 2.046 0.042* 8000 及以上11.28 4.211 0.165 2.678 0.008* 婚育情况 未育（参照） − − − − − 已育 1.019 2.211 .032 0.461 0.645 离异 −1.490 8.004 −.010 −0.186 0.853 共同参与治疗或护理的决策 1.987 1.911 .105 1.040 0.299 护士和医生的关系 2.126 1.485 .123 1.432 0.154 患者信息的交流 9.105 2.233 .383 4.077 <0.001* *P<0.05。
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