文献分享 | Coming and going: A narrative review exploring the push-pull factors during nurses' careers
来源： International Journal of Nursing Studies
DOI：https://doi.org/10.1016/j.ijnurstu.2024.104908
Abstract
Background:Shortages of nurses are one of the biggest challenges healthcare systems face around the world. Given the wide range of contexts and individuals working in nursing, a ‘one-size-fits-all’ retention strategy is unlikely to be effective. Knowing what matters most to nurses at different career stages would help employers and policy-makers who want to enhance nurse retention to design tailored strategies.
背景：护士短缺是全球医疗保健系统面临的最大挑战之一。鉴于从事护理工作的环境和个人的广泛性，“一刀切 ”的留用策略不太可能有效。了解什么对处于不同职业阶段的护士最重要，将有助于希望提高护士留用率的雇主和政策制定者设计出量身定制的策略。
Objective:To review and synthesise findings from recently published literature on the push-pull factors influencing nurses' decisions at the micro level, to enter and stay (or leave) at key career stages (i.e. pre-career, training, early-, mid- and late-career, and return to practice).
目的：回顾并综合近期发表的文献中有关影响护士在关键职业生涯阶段（即职业生涯前期、培训、职业生涯早期、中期和后期以及重返工作岗位）决定的微观推拉因素的研究结果。
Methods:We undertook a set of structured searches of the literature and a narrative synthesis to explore factors that motivate individuals to enter the nursing profession and the push-pull factors influencing nurse retention at different career stages. Electronic databases CINAHL, Medline, Scopus and Embase were searched in December 2022 (and updated in November 2023) for English language publications. Additional health workforce sources, such as King's Fund and Nuffield Trust, were also searched.
方法：我们对文献进行了一系列结构化检索，并进行了叙述性综述，以探讨促使个人进入护理行业的因素，以及在不同职业阶段影响护士留任的推拉因素。我们在 2022 年 12 月（2023 年 11 月更新）对电子数据库 CINAHL、Medline、Scopus 和 Embase 中的英文出版物进行了检索。此外，还搜索了其他卫生工作者资料来源，如国王基金和纳菲尔德信托基金。
Results:227 articles met the criteria for inclusion in the narrative review. Some push-pull factors were common to nurses across all career stages, including workplace support, flexible schedule patterns, opportunities for career advancement, fair treatment and salaries. In contrast, some challenges and push-pull factors were unique to each career stage. Students experienced difficulty in adjusting and balancing education and life; early-career nurses experienced transition shocks; mid-career nurses were frustrated by the lack of career advancement; late-career nurses desired more recognition; nurses returning to practice were discouraged by their lack of confidence and the cost of return-to-practice courses.
结果：227 篇文章符合纳入叙述性综述的标准。有些推拉因素对所有职业阶段的护士都是共同的，包括工作场所的支持、灵活的时间安排模式、职业晋升机会、公平待遇和薪酬。相比之下，有些挑战和推拉因素则是每个职业阶段所特有的。护理学生在调整和平衡教育与生活方面遇到困难；早期职业生涯的护士经历了转型冲击；中期职业生涯的护士因缺乏职业发展而感到沮丧；晚期职业生涯的护士希望得到更多认可；重返执业岗位的护士因缺乏自信和重返执业岗位课程的费用而感到气馁。
Conclusion:Our findings reinforce the view that factors influencing nurses' choices about whether to enter, continue or leave nursing jobs are multi-factorial and multi-dimensional. Policy and employment practices should be informed by research that has a more nuanced insight into what matters most to whom and at what career stage.
结论：本研究结果强化了这样一种观点，即影响护士选择进入、继续或离开护理工作岗位的因素是多因素和多维度的。政策和就业实践应借鉴研究成果，更细致地了解什么对什么人、在什么职业阶段最重要。
Keywords:Career cycle; Career theory; Micro-level; Motivation; Nursing staff; Push-pull factors;Retention
关键词：职业周期；职业理论；微观层面；激励；护理人员；推拉因素；留任
（译文仅供参考）
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