This study aimed to clarify the factors affecting rapid turnover of novice nurses in a prospective manner. We carried out an investigation in 20 university hospitals whose directors of nursing service departments accepted our request to cooperate with our research program. These hospitals were selected from all of the 102 university hospitals listed in The Hospital Catalog of Japan. The subjects were 1,203 novice hospital nurses who gave their informed consent for participation in our study. The questionnaires, which dealt with burnout, assertiveness, stressful life events, reality shock, ward assignment preference, transfer preference, job satisfaction (workplace, salary, workload, and overtime), social support and coping mechanisms were completed by 923 novice nurses in June 2003. Then, their turnover was investigated in December 2003. Thirty-seven novice nurses (4.0%) quit during this period. Multiple logistic regression analysis showed that the factors affecting rapid turnover were 1) graduation from vocational nursing schools, 2) dissatisfaction with assignment to a ward contrary to their desire, and 3) no peers for support. Assignment of novice nurses to wards they choose as far as possible, avoidance of assigning novice nurses to wards alone, and establishment of a support system for nurses who graduate from vocational nursing schools seem to be important for preventing rapid turnover of novice nurses. (J Occup Health 2006; 48: 49-61)
Aim: This prospective cohort study aimed to clarify the relationship between the level of assertiveness and the incidence of burnout in novice nurses in their first year at university hospitals and to obtain indices of assertion training in order for them to avoid burnout. Methods: The subjects were 1203 novice nurses working at 20 university hospitals in Japan who gave informed consent to participate in this research. The questionnaires were completed by 949 novice nurses in June 2003, and they were divided into two cohorts to observe the incidence of burnout, which was investigated in June 2004. Results: At the baseline, we obtained responses from 1030 novice nurses (85.6%) who had agreed to join the study. Ninety-two (20.5%) of the novice nurses experienced burnout and 43 (7.2%) experienced serious burnout. Both high and low levels of assertiveness score tended to high incidence rates of burnout. Multiple logistic regression analyses showed that the factors affecting burnout were lack of senior nursing staff support and very low and low levels of assertiveness, and those affecting serious burnout were male gender, hospital location in Tokyo, and very low and low levels of assertiveness. Conclusions: Novice nurses tend to burn out easily when their assertiveness scores are too low or too high. The ideal value of the assertiveness score seems to be medium.
The purpose of this study was to examine the correlation of medical incidents and errors among nurses with factors describing their lifestyle, health, and work environment. We analyzed questionnaires completed by 6,445 female hospital nurses engaged in shift work in Japanese hospitals with general wards of more than 200 beds. Logistic regression analysis indicated that the risk for medical incidents/errors was predicted by being under treatment, absence due to sickness in the past 6 months, workplace, break times during night shift, bodily pain, and role (emotional). These results indicate that to prevent the occurrence of medical incidents/errors, it is necessary to regard current/recent illness, bodily pain, and role (emotional) as a nurse's personal problems and break times during the night shift and workplace as administrative problems.
This exercise program can promote physical and psycho-social aspects of the health in the elderly, and may reduce the amount of care that the elderly require.
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