目的 采用社会认知理论构建肿瘤科护士精神气候影响因素的理论模型,并应用结构方程模型分析各因素对精神气候的直接和间接作用路径。方法 采用多阶段分层整群随机抽样法,于2024年4—5月调查广西壮族自治区12所三级甲等综合医院的291名肿瘤科护士,使用中文版精神气候简式量表、精神型领导量表、组织支持量表、团队合作量表及个人-组织契合度量表收集数据,采用结构方程模型分析影响因素及作用路径。结果 肿瘤科护士精神气候得分为（64.84±13.04）分,精神气候与精神型领导（r=0.423）、组织支持（r=0.338）、团队合作（r=0.295）和个人组织契合度（r=0.267）均呈正相关（均P<0.01）。结构方程模型分析显示,精神型领导对精神气候具有最强的直接影响（β=0.367,P<0.01）,并通过组织支持、团队合作、个人-组织契合度产生间接作用（β=0.092,P<0.01）。组织支持对精神气候的直接效应为0.198（P<0.01）,并通过团队合作和个人-组织契合度进一步发挥间接效应（β=0.074,P<0.05）。团队合作、个人组织契合度对精神气候的直接效应分别为0.135、0.151（P<0.01）。结论 肿瘤科护士精神气候受多种因素协同影响,其中精神型领导和组织支持起重要作用。建议医院管理层应加强精神型领导能力的培养,重点提升领导者在关爱、包容和激励方面的实践技能;定期评估护士需求,为其提供个性化的支持;优化工作环境,营造良好的团队合作氛围。
Abstract
Objective To construct a theoretical model based on social cognitive theory to examine the factors influencing spiritual climate among nurses in oncology department, and to analyze direct and indirect pathways of these factors by structural equation modeling. Methods A multistage stratified cluster random sampling was used to survey 291 nurses in oncology department from 12 tertiary grade-A general hospitals in Guangxi Zhuang Autonomous Region from April to May 2024. Data were collected using the Chinese version of the Spiritual Climate Scale, Spiritual Leadership Scale, Organizational Support Scale, Teamwork Scale, and Person-Organization Fit Scale. Structural equation modeling was used to analyze the influencing factors and the pathways. Results The scores of spiritual climate among nurses in oncology department was 64.84 ± 13.04, and it was positively correlated with spiritual leadership (r=0.423), organizational support (r=0.338), team collaboration (r=0.295), and personal-organizational fit (r=0.267) (all P<0.01). Structural equation modeling demonstrated that spiritual leadership had the strongest direct effect on spiritual climate (β=0.367, P<0.01) and had an indirect effect through organizational support, team collaboration, and personal-organizational fit (β=0.092, P<0.01). Organizational support exerted a significant direct effect on psychological climate (β=0.198, P<0.01), with additional indirect effects mediated through team collaboration and person-organization fit (β=0.074, P<0.05). Team collaboration and person-organization fit demonstrated significant direct effects on psychological climate (β=0.135 and 0.151, respectively, P<0.01). Conclusion The spiritual climate of oncology nurses is influenced by many factors, among which spiritual leadership and organizational support play an important role. It is recommended that hospital administrators should strengthen the cultivation of spiritual leadership, focusing on improvement of the practical skills in care, inclusiveness, and motivation; regular assessment of nurses’ needs to provide personalized support and optimization of working environment to create a good teamwork atmosphere.
关键词
肿瘤科护士 /
精神气候 /
结构方程 /
路径分析
Key words
oncology nurses /
spiritual climate /
structural equations /
pathways analysis
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