The Impact of Organizational Support on Practice Outcomes in Nurse Practitioners in Taiwan

Li-Hui HO ； Shu-Chen CHANG ； Kevin KAU ； Shu-Ying SHIU ； Sheng-Shiung HUANG ； Ya-Jung WANG ； Shiow-Luan TSAY

《The Journal of Nursing Research》 29卷3期 (2021/06) Pp. 1-9

https://doi.org/10.1097/jnr.0000000000000425

摘要

Background: Nurse practitioners (NPs) in Taiwan have practiced mainly in acute care hospitals since 2006. Although organizational support and level of support have been associated with the successful integration of NP roles and effective practice outcomes, organizational support in the context of NPs in inpatient settings is an area that has been rarely explored in the literature. Purpose: The purpose of this study was to investigate the relationship between organizational support and the practice outcomes of job satisfaction, care effectiveness, and intention to leave in NPs. Methods: A national survey of 512 NPs was conducted that included a demographic characteristics datasheet, the Nurse Practitioner Primary Care Organizational Climate Questionnaire, the Misener Nurse Practitioner Job Satisfaction Scale, and the Nurse Practitioner Care Effectiveness Scale. Multiple regression analysis was applied to explore the specific factors associated with job satisfaction. The statistical significance level was set at .05 with a two-tailed test. All statistical analyses were conducted using SPSS Statistics Version 22.0 software. Results: More than half of the participants were found to be dissatisfied with their hospital managers (54.8%) and with each dimension of organizational support. Overall, 82.1 %of the participants were satisfied with their current practice. A multiple regression analysis showed that the participants who perceived higher levels of organizational support in the workplace (β = .53, p ＜ .001), expressed satisfaction with working with their managers (β=.25, p＜ .001), or perceived better care outcomes (β = .10, p ＜ .001) reported higher job satisfaction. In addition, the participants who expressed intention to leave within 1 year (β = -.09, p ＜ .001) and those with higher patient loads (β=-.09, p＜.001) reported lower job satisfaction. Organizational support was found to explain 50% of the variance in job satisfaction. Conclusions/Implications for Practice: The results of this study highlight organizational support as the most important factor affecting job satisfaction in NPs. Therefore, administrators work to promote organizational support and improve the work environment to enhance the job satisfaction, increase the clinical practice retention, and improve the care outcomes of NPs.

關鍵字

organizational support ； job satisfaction ； care outcomes ； intent to leave ； nurse practitioners

參考文獻

Hu, C.-Y., Chen, M.-H., & Lin, S.-Y. (2014). Psychometric testing of the Chinese version of the nurse practitioner@@$$s job satisfaction scale. Journal of Nursing and Healthcare Research, 10(3), 240-250. https://doi.org/10.6225/JNHR.10.3.240 (Original work published in Chinese)

Aiken, L. H., Sermeus, W., Van den Heede, K., Sloane, D. M., Busse, R., McKee, M., Bruyneel, L., Rafferty, A. M., Griffiths, P.,Moreno-Casbas,M. T., Tishelman, C., Scott, A., Brzostek, T., Kinnunen, J., Schwendimann, R., Heinen, M., Zikos, D., Sjetne, I. S., Smith, H. L., & Kutney-Lee, A. (2012). Patient safety, satisfaction, and quality of hospital care: Cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ, 344, Article e1717. https://doi.org/10.1136/bmj.e1717

Aiken, L. H., Sloane, D.M., Clarke, S., Poghosyan, L., Cho, E., You, L., Finlayson, M., Kanai-Pak, M., & Aungsuroch, Y. (2011). Importance of work environments on hospital outcomes in nine countries. International Journal for Quality in Health Care, 23(4), 357-364. https://doi.org/10.1093/intqhc/mzr022

Albashayreh, A., Al Sabei, S. D., Al-Rawajfah, O. M., & Al-Awaisi, H. (2019). Healthy work environments are critical for nurse job satisfaction: Implications for Oman. International Nursing Review, 66(3), 389-395. https://doi.org/10.1111/inr.12529

Applebaum, D., Fowler, S., Fiedler, N., Osinubi, O., & Robson, M. (2010). The impact of environmental factors on nursing stress, job satisfaction, and turnover intention. The Journal of Nursing Administration, 40(7-8), 323-328. https://doi.org/10.1097/NNA.0b013e3181e9393b