3.1 demographic characteristics of the participants
19522 nurses completed the questionnaires. However, 100 questionnaires were removed from analysis because of following reasons: (1) Responders’ age was logically incorrect; (2) Participants’ working years were more than their age. Therefore, effective respond rate was 99.49%.
As shown in Table 1, female nurses dominated the main responders (95.66%). Participants’ age ranged from 18 to 62 years old. Most (55.11%) of the included nurses were with associate degree, while only 4531 nurses (23.33%) originally graduated from college or university and got bachelor degree. However, 54.91% of the included nurses finally got bachelor degree after receiving continuous education. 10487 nurses were working at a secondary level of hospital and 8619 nurses were at tertiary hospital. In the current study, working years of nurses ranged from 1 to 41 years. Nurses who worked nightshift were more than 55%. Besides, nurses on the schedule of nightshift working were younger, less working age, mainly never married, less educated than those without nightshift. And more than 70% of the respondents worked at the Inpatient General Department. 68.02% of the nurses were married and 28.71% were never married. Only 36.75% of the nurses reported without any child. Nearly 70% of the respondents reported monthly income per family member more than 2000 RMB (¥2000).
Table 1 Demographic data of the participants
|
|
Frequency
|
Percentage
|
Gender
|
|
|
Male
|
842
|
4.34%
|
Female
|
18580
|
95.66%
|
Age
|
|
|
≤25 year
|
4636.0
|
23.87%
|
26~35 year
|
11329.0
|
58.33%
|
36~45 year
|
2535.0
|
13.05%
|
≥46 year
|
922.0
|
4.75%
|
Basic education level
|
|
|
Secondary diploma
|
4187
|
21.56%
|
Associate degree
|
10704
|
55.11%
|
Baccalaureate degree
|
4531
|
23.33%
|
Highest education level
|
|
|
Secondary diploma
|
495
|
2.55%
|
Associate degree
|
8234
|
42.39%
|
Baccalaureate degree
|
10664
|
54.91%
|
Master’s degree/PHD
|
29
|
0.15%
|
Hospital level
|
|
|
Primary or community
|
316
|
1.63%
|
Secondary
|
10487
|
54.00%
|
Tertiary
|
8619
|
44.38%
|
Working years
|
|
|
≤5 year
|
8788
|
45.25%
|
6~15 year
|
8243
|
42.44%
|
16~25 year
|
1523
|
7.84%
|
≥26 year
|
868
|
4.47%
|
Nightshift status
|
|
|
Yes
|
10846
|
55.84%
|
No
|
8576
|
44.16%
|
Working department
|
|
|
Outpatient
|
2277
|
11.72%
|
Emergency
|
1165
|
6.00%
|
Impatient general ward
|
13599
|
70.02%
|
ICU
|
2381
|
12.26%
|
Marital status
|
|
|
Single
|
5577
|
28.71%
|
Married
|
13211
|
68.02%
|
Widowed
|
47
|
0.24%
|
Divorced
|
587
|
3.02%
|
Number of children
|
|
|
0
|
7138
|
36.75%
|
1
|
7701
|
39.65%
|
2
|
4507
|
23.21%
|
3
|
76
|
0.39%
|
Living with parents
|
|
|
Yes
|
9852
|
50.73%
|
No
|
9570
|
49.27%
|
Per capita income
|
|
|
≤550
|
690
|
3.55%
|
551~1200
|
2185
|
11.25%
|
1201~2000
|
3005
|
15.47%
|
2001~3000
|
5025
|
25.87%
|
3001~6000
|
6142
|
31.62%
|
>6000
|
2375
|
12.23%
|
3.2 Distribution of mean scores of subscales and overall HPLP
In the current study, the mean score of self-actualization, health responsibility/physical activity, nutrition, job safety, interpersonal support and overall HPLP were 27.61±5.42 out of a score of 36, 22.71±7.77 out of a score of 44, 10.43±2.97 out of a score of 16, 22.05±3.97 out of a score of 28, 20.19±4.67 out of a score of 28, and 102.99±19.93 out of a score of 144, respectively.
In the process of univariate analysis, all demographic data including gender, age, basic education level, highest education level, hospital level, working years, nightshift status, working department, marital status, number of children, living with parents, monthly income per person were analyzed. The outcome of univariate analysis was presented in Table 2. The mean score of all subscales and the overall HPLP differed in participants with different ages, hospital level, working years, nightshift status, working department, marital status and monthly income per person, and such differences were statistically significant (P<0.05).
Table 2 also presented horizontal comparison in mean score of 5 subscales and overall HPLP in different demographic characteristics. Regarding nurses’ age, we found that participants who aged more than 45 got higher mean score of all 5 subscales and the overall HPLP than other age groups in the study. Such a difference was significant through pairwise comparison (P<0.001). In terms of highest education level shown in Table 2, the mean score of all subscales and overall HPLP was higher in participants with postgraduate degree or above than that in nurses with other education background. Moreover, such differences in subscales and overall HPLP except in job safety were significant (P<0.001). Additionally, higher mean score was presented in participants working in Tertiary hospitals and the difference was statistically significant when performing pairwise comparison (P<0.05). Moreover, the result showed significant difference in the mean score of all subscales and the overall HPLP in subjects with different working years (P<0.001). As seen in Table 2, nurses who worked more than 26 years reported higher mean score than other groups (P<0.05). Compared with nurses who were not on nightshift rotation, nurses on nightshift rotation got lower mean score in all subscales and the overall HPLP, and the statistical test indicated that such differences were significant (P<0.001). Surprisingly, it was reported that widowed nurses got the highest mean score for each subscale and the overall HPLP in the current study. According to the Table 2, there was a significant difference between the mean score of each dimension of the scale and the working departments participants working in (P<0.001). Not surprisingly, nurses working in the ICU got the lowest mean score while nurses in the Outpatient got the highest mean score. As for monthly income per person, it was found that the higher income, the higher mean score in the study. Obviously, nurses with monthly income per person>6000 Yuan got the highest mean score for each dimension and the overall HPLP.
Table 2. Distribution of Subscales and overall HPLP
|
|
self-actualization
|
health responsibility / physical activity
|
Nutrition
|
job safety
|
interpersonal support
|
Overall HPLP
|
Gender
|
|
|
|
|
|
|
Male
|
28.00±5.57
|
25.09±8.95
|
10.31±2.98
|
22.41±4.05
|
20.65±4.76
|
106.45±21.50
|
Female
|
27.59±5.41
|
22.60±7.69
|
10.43±2.97
|
22.03±3.97
|
20.17±4.66
|
102.83±19.84
|
t
|
2.117
|
7.941
|
-1.202
|
2.646
|
2.94
|
4.796
|
P
|
0.034
|
<0.001
|
0.23
|
0.008
|
0.003
|
<0.001
|
Age
|
|
|
|
|
|
|
≤25 year
|
27.11±5.41
|
23.16±7.92
|
9.92±2.95
|
22.23±3.98
|
20.64±4.69
|
103.05±20.16
|
26~35 year
|
27.51±5.44
|
22.19±7.77
|
10.23±2.95
|
21.85±4.00
|
19.86±4.69
|
101.64±19.95
|
36~45 year
|
28.38±5.20
|
23.15±7.42
|
11.52±2.74
|
22.35±3.85
|
20.46±4.51
|
105.86±18.94
|
≥46 year
|
29.19±5.18
|
25.61±6.99
|
12.40±2.50
|
22.81±3.84
|
21.26±4.31
|
111.27±18.34
|
F
|
61.446
|
77.314
|
387.735
|
28.877
|
3558.998
|
3561.706
|
P
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
Basic education level
|
|
|
|
|
|
Secondary diploma
|
28.00±5.28
|
22.80±7.35
|
10.81±2.96
|
22.07±3.87
|
20.16±4.54
|
103.84±19.17
|
Associate degree
|
27.35±5.39
|
22.60±7.85
|
10.19±2.95
|
21.96±4.00
|
20.12±4.70
|
102.22±20.06
|
Baccalaureate degree
|
27.87±5.56
|
22.90±7.95
|
10.62±2.99
|
22.23±4.00
|
20.39±4.71
|
104.01±20.24
|
F
|
28.817
|
2.756
|
77.963
|
7.28
|
5.124
|
17.614
|
P
|
<0.001
|
0.064
|
<0.001
|
0.001
|
0.006
|
<0.001
|
Highest education level
|
|
|
|
|
|
Secondary diploma
|
27.38±5.43
|
23.10±7.10
|
10.71±2.92
|
21.87±4.09
|
20.34±4.58
|
103.40±19.32
|
Associate degree
|
27.44±5.41
|
23.07±7.93
|
10.26±3.01
|
22.08±4.01
|
20.38±4.69
|
103.23±20.29
|
Baccalaureate degree
|
27.74±5.42
|
22.41±7.65
|
10.54±2.94
|
22.03±3.94
|
20.04±4.65
|
102.76±19.67
|
Master’s degree/PHD
|
29.62±5.49
|
25.48±8.82
|
12.52±3.00
|
23.41±4.39
|
21.79±4.74
|
112.83±21.44
|
F
|
6.355
|
12.31
|
19.947
|
1.715
|
9.712
|
2.961
|
P
|
<0.001
|
<0.001
|
<0.001
|
0.162
|
<0.001
|
0.035
|
Hospital level
|
|
|
|
|
|
Primary or community
|
26.64±5.68
|
22.25±7.77
|
10.25±3.05
|
21.63±4.11
|
19.84±4.87
|
100.60±20.67
|
Secondary
|
27.19±5.37
|
22.22±7.51
|
10.21±2.90
|
21.73±3.97
|
19.83±4.61
|
101.18±19.42
|
Tertiary
|
28.15±5.41
|
23.32±8.03
|
10.69±3.03
|
22.46±3.94
|
20.65±4.69
|
105.28±20.28
|
F
|
80.004
|
47.695
|
63.286
|
83.569
|
74.579
|
102.561
|
P
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
Working years
|
|
|
|
|
|
≤5 year
|
27.24±5.42
|
22.90±7.90
|
9.93±2.94
|
22.03±4.05
|
20.31±4.71
|
102.41±20.18
|
6~15 year
|
27.64±5.42
|
22.05±7.67
|
10.50±2.93
|
21.87±3.94
|
19.87±4.66
|
101.95±19.75
|
16~25 year
|
28.62±5.24
|
23.56±7.43
|
11.74592.71
|
22.60±3.77
|
20.71±4.52
|
107.23±18.80
|
≥26 year
|
29.22±5.13
|
25.57±6.98
|
12.44±2.44
|
22.82±3.79
|
21.19±4.29
|
111.25±18.18
|
F
|
60.651
|
77.093
|
399.449
|
27.437
|
37.654
|
95.36
|
P
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
Nightshift status
|
|
|
|
|
|
Yes
|
27.15±5.45
|
22.41±7.87
|
9.78±2.91
|
21.86±4.01
|
19.78±4.70
|
100.97±20.11
|
No
|
28.19±5.31
|
23.10±7.62
|
11.24±2.85
|
22.30±3.92
|
20.71±4.58
|
105.54±19.40
|
t
|
-13.386
|
-6.196
|
-35.138
|
-7.719
|
-13.873
|
-16.037
|
P
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
Working department
|
|
|
|
|
|
Outpatient
|
27.98±5.33
|
23.42±7.39
|
11.39±2.90
|
22.40±3.89
|
21.02±4.54
|
106.20±19.22
|
Emergency
|
27.33±5.37
|
22.86±7.80
|
10.15±2.91
|
21.99±3.90
|
19.90±4.50
|
102.23±19.60
|
Impatient general ward
|
27.61±5.45
|
22.65±7.79
|
10.38±2.96
|
22.01±4.01
|
20.18±4.70
|
102.82±20.06
|
ICU
|
27.38±5,30
|
22.33±7.90
|
9.87±2.91
|
22.00±3.85
|
19.64±4.57
|
101.22±19.71
|
F
|
6.015
|
69.188
|
117.691
|
6.83
|
38.431
|
26.975
|
P
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
Marital status
|
|
|
|
|
|
Single
|
27.13±5.44
|
23.15±7.88
|
9.88±2.92
|
22.27±3.94
|
20.57±4.65
|
102.99±20.08
|
Married
|
27.78±5.38
|
22.50±7.71
|
10.65±2.96
|
21.94±3.99
|
20.01±4.67
|
102.88±19.85
|
Widowed
|
28.89±5.13
|
26.47±7.92
|
11.43±2.83
|
23.21±3.11
|
21.91±3.80
|
111.89±18.16
|
Divorced
|
28.09±5.59
|
23.06±7.69
|
10.60±3.10
|
22.463.96
|
20.51±4.67
|
104.74±20.28
|
F
|
21.565
|
13.167
|
92.192
|
12.479
|
22.057
|
4.772
|
P
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
Number of children
|
|
|
|
|
|
0
|
27.20±5.44
|
23.07±7.90
|
9.93±2.93
|
22.19±3.97
|
20.55±4.65
|
102.94±20.11
|
1
|
27.81±5.43
|
22.65±7.68
|
10.69±2.98
|
22.06±3.95
|
20.09±4.64
|
103.29±19.82
|
2
|
27.90±5.32
|
22.26±7.66
|
10.76±2.92
|
21.83±4.02
|
19.80±4.71
|
102.54±19.78
|
3
|
28.79±5.19
|
22.13±8.68
|
10.83±3.05
|
21.55±4.11
|
19.82±5.01
|
103.11±22.11
|
F
|
22.913
|
10.438
|
106.93
|
8.016
|
26.651
|
1.38
|
P
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
0.247
|
Living with parents
|
|
|
|
|
|
Yes
|
27.62±5.43
|
22.58±7.81
|
10.46±2.97
|
22.02±4.00
|
20.18±4.69
|
102.86±19.97
|
No
|
27.59±5.41
|
22.84±7.71
|
10.39±2.97
|
22.08±3.95
|
20.21±4.64
|
103.12±19.89
|
t
|
0.357
|
-2.32
|
1.463
|
-0.939
|
-0.495
|
-0.892
|
P
|
0.721
|
0.02
|
0.143
|
0.348
|
0.621
|
0.372
|
Monthly income per person
|
|
|
|
|
≤550
|
26.93±5.98
|
22.63±8.34
|
9.78±3.12
|
21.29±4.33
|
19.60±4.91
|
100.23±21.76
|
551~1200
|
27.00±5.45
|
22.65±7.80
|
9.90±2.93
|
21.57±4.03
|
19.69±4.72
|
100.81±20.16
|
1201~2000
|
27.37±5.28
|
22.43±7.60
|
10.09±2.85
|
21.84±3.92
|
19.83±4.64
|
101.57±19.57
|
2001~3000
|
27.40±5.38
|
22.60±7.83
|
10.26±2.98
|
21.96±3.97
|
20.04±4.66
|
102.26±19.96
|
3001~6000
|
27.78±5.38
|
22.61±7.62
|
10.62±2.94
|
22.16±3.95
|
20.34±4.60
|
103.50±19.66
|
>6000
|
28.61±5.39
|
23.64±7.94
|
11.35±2.94
|
22.91±3.98
|
21.24±4.60
|
107.82±19.43
|
F
|
29.921
|
7.782
|
83.489
|
37.849
|
37.731
|
42.01
|
P
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
3.3 Results of Category Regression
In the process, all significant factors in the univariate analysis were included into the category regression in order to determine the correlation of the demographic data and the HPLP. The results were presented in Table 3. It was observed that gender, highest education level, hospital level, working years, nightshift status, number of children and monthly income per person were included into the predicting equation of average score of self-actualization, and the equation was significant (Adjust R2=0.023, P<0.001). And in those above factors, hospital level, nightshift status, monthly income per person, working years were the four most important factor which might impact on the mean score of self-actualization with the importance rate, namely, 27.5%, 25.6%, 18% and 13.4%. As for responsibility/physical activity, the predicting equation was also significant (Adjust R2=0.025, P<0.001), in which all factors significant in the univariate analysis but living with parents were included. And age was the most important factors with the importance rate 31.2% that might impact the mean score of health responsibility/physical activity. In regard to Nutrition, all included factors significant in the univariate analysis were significant in the predicting equation for the mean score of nutrition (Adjust R2=0.093, P<0.001), and nightshift status was found to be the most important factor with the important weight of 42.1%. Regarding the mean score of job safety, factors including gender, hospital level, working years, nightshift status, working department, marital status, number of children and monthly income per person were included into the predicting equation, and such an equation was tested statistically significant (Adjust R2=0.024, P<0.001). In such an equation, obviously, monthly income per person and hospital level were found as the two most important predicting factor for mean score of job safety. When exploring the predicting model for the mean score of interpersonal support, all included factors but working department were significant (Adjust R2=0.042, P<0.001). As shown in Table 3, it is evident that nightshift status (Importance weight: 24%) and monthly income per person (Importance weight: 20.5%) were the two most important predictive factors for interpersonal support. With regard to the total score of HPLP, gender, age, basic education level, highest education level, hospital level, working years, nightshift status, working department, marital status and monthly income per person were predictive variables in the significant equation (Adjust R2=0.039, P<0.001), and the results indicated that nightshift status (25.6%), hospital level (22.2%), working years (21.8%) and monthly income per person (17.9%) were the four most important predictive factors.
Table 3. Outcome of Category Regression β(Importance)
|
|
self-actualization
|
health responsibility and physical activity
|
Nutrition
|
job safety
|
interpersonal support
|
Overall HPLP
|
Gender
|
0.025(1.6%) *
|
-0.066(16.7%) *
|
------------------
|
0.015(1.1%) *
|
0.021(1.0%) *
|
0.043(3.9%) *
|
Age
|
0.018(6.7%)
|
0.092(31.2%) *
|
0.076(17.5%) *
|
-0.036(3.6%)
|
-0.047(5.9%) *
|
-0.031(0.1%) *
|
Basic education level
|
0.013(1.4%)
|
------------------
|
0.049(-0.007%) *
|
0.015(0.6%)
|
0.040(1.8%) *
|
0.041(1.6%) *
|
Highest education level
|
0.013(0.7) *
|
-0.037(6.0%) *
|
-0.024(-1.1%) *
|
------------------
|
-0.059(4.9%) *
|
-0.046(1.3%) *
|
Hospital level
|
0.073(27.5%) *
|
0.068(18.8%) *
|
0.052(4.5%) *
|
0.079(28.4%) *
|
0.082(16.5%) *
|
0.089(22.2%) *
|
Working years
|
0.037(13.4) *
|
-0.043(3.6%) *
|
0.079(18.1%) *
|
0.042(9.8%) *
|
0.031(4.0%) *
|
0.080(21.8%) *
|
Nightshift status
|
0.064(25.6%) *
|
0.042(7.3%) *
|
0.162(42.1%) *
|
0.051(11%) *
|
0.105(24.0%) *
|
0.092(25.6%) *
|
Working department
|
0.015(0.5%) *
|
-0.023(2.8%) *
|
-0.056(7.5%) *
|
0.014(1.7%)*
|
-0.048(8.1%)
|
-0.033(4.6%) *
|
Marital status
|
0.009(1.9%)
|
-0.024(4.1%) *
|
0.017(0.7%) *
|
0.053(8.7%) *
|
0.027(3.4%) *
|
0.035(1.0%) *
|
Number of children
|
0.020(2.7%) *
|
-0.035(4.8%) *
|
0.019(1.3%) *
|
-0.016(2.2%) *
|
-0.069(10.0%) *
|
------------------
|
Living with parents
|
------------------
|
0.013(-0.008%)
|
------------------
|
------------------
|
------------------
|
------------------
|
Monthly income per person
|
0.05(18%) *
|
0.033(5.8%) *
|
0.067(10.1%) *
|
0.087(32.9%) *
|
0.091(20.5%) *
|
0.072(17.9%) *
|
R
|
0.155
|
0.16
|
0.306
|
0.16
|
0.208
|
0.203
|
R2
|
0.024
|
0.026
|
0.094
|
0.026
|
0.043
|
0.041
|
Adjust R2
|
0.023
|
0.025
|
0.093
|
0.024
|
0.042
|
0.04
|
P
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
<0.001
|
备注:*:P<0.05
|
|
|
|
|
|
|