TAP CHiY Dl/OC LAM SANG 108 Tap 12-567/2017
Danh gia du* dinh va mot so yeu to anh huong din viec lua chon nganh cham soc sue khoe tam th§n cua sinh vien dai hoc diiu duong
Evaluation of the intention and the factors affecting the choice of worldng in mental health nursing industry
Ph?m Thu Hirdug, To Thanh Phmrag Benh vien Tdm than Trung uang 1
Tom \kt
/Wucf/eu;Danh gia eae yeu t d anh hudng den viee lUa chon lam vi^c trong chuyen nganh cham soc sdc khde tam t h i n eua sinh vien dai hpe dieu dufing n l m cudi. Ddi tugng vd phuang phdp: Md t l cat ngang trdn 522 sinh vien nam cudi he cU n h i n dieu dUcfng tai TrUdng Dai hpc Y Ha Ngi va TrUdng Dai hoc Oi^u dudng Nam Djnh trong thdi gian tU 20/5/2016 tdi 20/6/2016. Kit gud: Sinh vien cd diem dU djnh l l m viee trong chuyen n g l n h c h l m sde sUe khde tam than thap < 20 diem ehiem 41,2%; sinh vien cd diem dU djnh trung blnh tU 21 den 40 dl^m chiem 55,2% va sinh vien co diem dU dinh cao > 40 diim chi ehiem 3,6%. Kit ludn: Sinh vien dieu dudng TrUdng Dai hgc Y Ha Ndi v l TrUdng Dai hgc Dieu dUdng N a m D j n h c d d i e m d U ^ n h d m Q c t r u n g b i n h t r o n g viec lua chgn lam viec trong chuyen nganh cham sdc sdc khde t i m than. Yeu to thai do va sU Cing hg eda nhUng ngudi xung quanh eung nhu trudng hgc va noi cU tru gan benhvien la nhUngyeutd c d y nghTa trong viec anh hudng tdi d u dinh lUa chgn lam viee trong chuyen nganh cham sde sdc khde tam than.
Tdkhda: Yeu t d I n h hudng, lUa chgn, cham sde sUe khde t i m than, sinh vien.
Summary
06/ect/Ve;To evaluate the faaors influencing the selection of work in the mental health care field of final year nursing students. Subject and method: A cross-sectional study was conducted on 522 undergraduate nursing students at Hanoi Medical University and Nam Dmh University of Nursing from 20 May to 20 June. Result: 41.2% of the students had low intended workpoints (< 20 points); 55.2% had average points (21 to 40 points), and only 3.6% with high score (> 40 points). Conclusion: The nursing students of Hanoi Medical University and Nam Dinh University of Nursing had moderate points in choosing to work in mental health care. The attitudinal and supportive factors ofthe people, as well as the school and residence near the hospital, were significant factors influencing the intention to work in the mental health field.
Keywords: Influence factors, choices, mental health care, students.
Ngay nhdn bdi. 16/5/2017, ngdy chdp nhgn ddng- 23/6/2017
Nguaiphdn hdi- To Thanh Phuang. Email: [email protected] - Benh vien Tdm thdn Trung uang 1
JOURNALOF 108-CLINICAL MEDICINE A N D PHARMACY
1 . f>at van de
To ehde Y te The gidi (WHO) d l ehi ra rang sUc khde t i m t h i n la mdt thanh p h l n quan trong eua sUc khde t o l n c l u . CIc van de ve benh t i m than duge cho la nguyen n h i n cua nhieu benh nghiem trgng v l tan tat tren toan the gidi. Theo thdng ke, cd k h o i n g 450 trieu ngUdi tren toan the gidi bj anh hudng bdi benh t i m than hay cae rdi loan tam t h i n va ehiem 13% ganh nang bdnh tat toan cau. Tai Viet Nam, theo dieu tra qude gia cua Benh vien T i m than Trung uong nam 2002 cho thay ty le mac 10 benh tam t h i n thUdng gap I114,9% [2].
Dieu dudng chuyen nganh cham sdc sQc khde tam than (CSSKTT) la mdt phan khdng the thieu trong ddi ngu c h l m sdc sUe khde cho ngUdi benh tam than. Hg ddng mdt vai trd quan trgng trong cham sde, dieu tri va b l o ve quyen eon ngudi eua ngudi benh tam than e l trong benh vien va d cdng ddng. Sd lugng dieu dU5ng tam than cCia Viet Nam thap ban rat nhieu so vdi cac nude quanh khu vUc, nganh tam than dang phai ddi mat vdi van de tuyen dung dieu dUdng lam viec vl d l y la chuyen n g l n h duge danh gia la kem hap dan nhat trong c l e chuyen nganh y khoa khae. Ben canh dd, thue hanh dieu dudng tam t h i n d Viet Nam edn nhieu khd khan khi ndi dung ve tam t h i n hgc trong chuang trinh g i l n g day eho dieu dudng cdn so s i i cung nhU thieu sach va tap chi xuat ban djnh kl ve chuyen n g l n h t i m than. Hieu duge nhQng yeu t d ed the I n h hudng den quyet djnh lua ehgn l l m viee trong n g l n h c h l m sde sQe khde tam t h i n eua sinh vien se giup nhQng nha dao tao x l y dung mdt ke hoach g i l n g day phd hgp, tao ddng luc thu hut ddi vdi sinh vien (SV) lUa chgn nganh nay trong tuong lai nhieu han. NhQng thay doi trong d I o tao cung cd the giup cle dieu dUdng tUOng lai cd c l i nhin dung mUe, g i l m ky thj vdi dong nghiep va benh nhan chuyen nganh n l y . Do v l y , ehung tdi tien h l n h nghien cQu su lUa ehgn l l m viec trong chuyen nganh CSSKTT eda sinh vien n h I m mue tieu:
Ddnh gid dg dinh vd mot sd yiu td dnh hudng din viic Iga chgn nganh chdm sdc sdc khde tdm thdn cua sinh viin dgi hgc diiu dudng.
2. Doi tUtfng va phUtfng phap 2.1.Dditi/g'ng
Gdm 522 SV nam eudi he cU nhan dieu du^ng tai TrUdng Dai hgc Y H I Ndi (115 SV) va TrUdng Dai hgc dieu dUdng Nam Djnh (407 SV). Nghien ci3u d u g e t h U c h i e n t Q t h l n g 1 / 2 0 1 6 d e n t h i n g 10/2016.
2.2. Phi/t^gphap
Md t l e l t ngang, ehgn mau thuan tien.
2.3 Cac budc tien hanh
Bude 1: X l y dung b d c l u hdi dUa vao hgc thuyet
"ke hoach hanh v i " eua F Jillian [8].
Nhan thUe/kien thQe cua SV ve chuyen nganh dieu dudng tam than.
D u d i n h lam vide trong chuyen nganh CSSKTT the hien d u djnh cda SV lua chgn lam viec trong chuyen n g l n h dieu dUdng t i m t h i n . Vdi 5 cau hoi trong phan d u djnh dugc tfnh tren thang diem 7 chay tU 0 diem ( r l t khdng ddng y) tdi 6 diem (rat dong 5^), t o n g diem dU djnh chay tU 0 tdi 54, diem eang eao thl cang ed d u djnh lua ehgn lam viec trong chuyen n g l n h t i m t h i n .
Thai do ve viec lUa ehgn l l m viec trong nganh c h l m sdc sUe khde t i m than.
SU ung hd eua nhQng ngudi xung quanh ve quyet dinh lam viec trong nganh t i m than.
NhQng yeu t d thuan Igi v l khd khan khi lam dieu dudng chuyen nganh CSSKTT.
Bude 2: Oieu tra tim hieu niem tin, quan diem eua SV ^ e u dUdng ve viec lua chgn lam viec trong nganh CSSKTT.
2.4. Xit ly so lieu
SPSS version 21 dugc sQ dung de p h l n tich sd lieu.
3. Ket quS
Bdng 1 . Dac dliem chung Giai
Nam NO
So lUomg 40 482
TJU%
7,7 92,3 Nhan xet: Co 40 nam (7,7%) va 482 nfl (92,3%) tham gia ngiiien cijfu.
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TAP CHi Y Dl/gc LAM SANG 108 TSp 12-So 7/2017
Bdng 2. D a n h gia n h a n thurc/kien thuTc cfia sinh vien ve chuyen nganh CSSKTT Tong diem Icien thi^c
s 5 diem
> 5 - 5 l O d l ^ m
> 10 diem
So ti/dng 19 272 231 Trung binh: 9,8 ±2,2.Phamvi3'15
T y l c % 3,6 52,1 44,3
Nhdn xit: Diim trung blnh p h l n kien thUc/nhIn thQc eua SV ve chuyen n g l n h cham sde sQe khde tam t h i n la 9,8 ± 2,2 dao ddng tU 3 - 1 5 diem.
3.1. DUdinh va cac yeu to inh hu&ng den sUl^ chgn ciia sinh vien dieu duShg nam cuoi lam viic trong chuyen nganh cham soc site khoe tam than
00 10 00 2000 3000 40 00 50 00 6000
Bieu do 1. DU djnh cua sinh vien ^ e u dudng ve viec lua chgn llm viec trong chuyen nganh cham soc sUc khde t i m than Nhdn xet: Bleu d d 1 the hien d u dinh cCia sinh vien lUa chgn lam viec trong chuyen n g l n h dieu dufing tam than. Vdi 5 cau hdi trong phan dU dmh dUOc tinh tren thang diem 7 chay tU 0 diem (rat khdng ddng ^) tdi 6 diem (rat ddng y), t d n g diem d u djnh chay tU 0 tdi 54 vdi diem eang eao thl cang cd d u djnh lUa chon llm viec trong chuyen nganh tam t h i n .
3.2. IVhdhgyeu to anh ht/dmg tdisUl^a chgn lam viec trong chuyen nganh
B i n g 3. Mo h i n h h o i q u i da b i e n (hierarchical m u l t i p l e regression) cda nhufng yeu t o anh hUdng t d i d U d j n h iam viec t r o n g chuyen n g a n h CSSKTT
BUAc 1
Btfoic 2
Cac bien Nai cutru gan benh vien tam than(BVTT) Tri/dng hoc
Trli nghiem ca nhan ve siJc kh6e tam than Tiep can thong tin
Ngi/di g i i n g day l o n g kien thiJc Tiep can thong tin NgucJi giSng day Tong ki^n thijfc Thai do
Sa ung hp cua nhufng ngudi xung quanh NhUng yeu to thuan idi va kho khan khi lam dieu dudng chuyen nganh CSSiCTT
B -,47 3,8"
,59"
,63"
,59 ,22 ,29
•,28 ,15 ,10"
1 4*»*
,001
P
-,02 ,16 ,14 ,13 ,05 ,05 ,06 -,02 ,03 ,09 ,63 ,001
T -,55 2,5 3,4 3,06 ,87 1,2 1,8 -,56 1,1 2,7 16,5 ,01
R'
,086
,494 F
8,03***
137,4***
*p<0,05;***p<0,001
JOURNAL OF 108 - CLINICAL MEDICINE AND PHARMACY VoLl2-N''7/2017
Nhdnxet: BIng 3 the hidn md hlnh hdi qui da bi^n di tim hieu d u d m h va nhQng ydu t d anh hudng d^n su IUa chgn cCia SV lam viec trong nganh CSSKTT.
Bang 4. Danh gia ve viec t i e p can t h o n g t i n
sinh vien t u t i m hieu thong t i n ve benh tam than Thudng xuyen
Thlnh thoting ft khi Khong bao gid
Nguon thong t i n sinh vien tham ithao Bao dai
internet Tap chi khoa hoc Tlvi
Sach giao khoa chinh thong
Sinh vi&n xem cac bo phim co vai dien la ngifofi benh tam thSn Thudng xuyen
Thinh thoang It khi Khong bao gid
Ccim nhan ci^a sinh vi§n v l nhQng vai diSn v l ngi/di bgnh tam than Bao luc
Giet hai Ma quai Hal hudc thai qua Khac
So lUtfng (n = 522) 15 283 207 17
88 392 48 159 292
10 262 227 23
259 161 126 257 33
T y l | %
2,9 54,2 39,7 3,3
16,9 75,1 30,5
1,9 50,2 43,5
49,6 30,8 24,1 49,2 7,2 Theo BIng 4, diem trung binh eua mue tiep can thdng tin 11 6,5 + 2,05 vdi thang didm chay Xii 1 diem (trung binh = 6,5 ± 2,05, pham vl 1 -12.).
Dgcdiem chung: Nghidn cQu ddgc thuc hien tren SV he CQ n h i n Dieu dUdng nam cudi tai Trudng Dal hgc Y Ha Ngi v l TrUdng Dai hoe Dieu dUdng Nam Djnh. 584 SV da dang kiddng y tham gia nhUng ehi ed 522 phieu dat tieu chuan dedUa vao p h l n tieh gdm 40 nam (7,7%) va 482 nQ (92,3%). Sinh vien thudc TrUdng Dai hgc Y Ha Ndi chiem 22% (n = 115) v l phan lUn la SV thudc Trudng Dai hgc Dieu dUdng Nam Djnh chiem 78% (n = 407) (BIng 1).
Nhdn thdc/klen thde cda sinh viin vi chuyin ngdnh CSSKTT: Diem trung binh phan kien thUc/nhln thQc cua SV ve ehuyen n g l n h CSSKTT la
9,8 ± 2,2 dao ddng tU 3 - 1 5 didm. Nhin ehung SV co nhan thUe k h i t d t ve chuyen nganh CSSKTT, 44,3%
SV cd kien thUe/nhln thUe tdt, hon 50% SV ed kien thUe trung binh ve ehuyen nganh CSSKTT (Bang 2).
Dddinh vd cdc yiu to dnh hddng din sdlda chon cua sinh viin diiu dudng ndm cudi Idm viic trotig chuyen ngdnh CSSKTT: Khi d i n h gia sd lieu dUdi goe do ty le SV c6 d u djnh thap, trung blnh va cao, chung tdi nhan thay da sd SV ed dU djnh thap hoac trung binh khi lUa ehgn nganh CSSKTT, chi cd mots6 lugng nhd SV thUe sU cd quyet t i m lam viee trong ITnh VUC nay. Sinh vien cd dd djnh d mUe do trung blnh khi lua chgn lam viee trong n g l n h dieu di/cmg
TAP CHl Y Dl/OC LAM SANG 108 Tap 12-So 7/2017
CSSKTT, vdi t r u n g binh = 22,76; pham vi = 9.854.
Sinh vien cd diem d u d j n h eao nhat = 52 diem va SV cd ^ e m d u dinh thap n h l t = 1 diem. Cu the nhU sau:
Sinh vien cd diem d u djnh thap (^ 20 diem) va t r u n g binh tQ (> 20 - £ 40 diem) ehiem da sd vdi e l e t y le tuong Ung la 41,2% va 55,2% va SV ed diem dU djnh eao (> 40 diem) ehi chlem 3,6% (n = 19) (Bi^u d d 1).
Ket qua nghidn cUu cua ehung tdi tUOng ddi phu hap vdi B Happen (2012), t^' le SV sau khi t d t nghiep lua ehgn ehuyen nganh CSSKTT la t h I p n h l t so vdi cac ehuyen nghanh khIe [4]. BIng 3 the hidn md hinh hdi qui da bien d e t i m hieu dU djnh cua SVdieu dudng lam viec trong chuydn nganh CSSKTT. Md hinh nay duge x l y dung qua 2 bUde. NhUng bien duae the hien I I yeu t d I n h hudng tdi d u djnh eua SV bao gdm nai eu tru gan BVTT, trUdng hgc, trai nghiem e l n h i n ve sQc khde tam than, tiep can thdng tin, ngudi giang day, t d n g kien thde da dugc dUa v I o trong bUde 1 eua md hlnh. Tuy nhien md hinh n l y chi giai thich ddgc 8,6% [F(6,515 = 8,035, p<0,001]vesu bien thien eua bien dUdjnh.
Sinh vien cu tru gan vdi Benh vidn T i m than (BVTO cd y nghTa trong viec d u d o l n d u d j n h cOaSV lua chgn lam dieu dUcfng CSSKTT (p<0,1}. Vdi diem trung binh d U ^ n h cua nhdm sdng gan BVTT 11 22,8
± 10,6 cao han nhdm sdng xa BVTT vdi diem trung b i n h d u d j n h la 19,7 + 9,3.
Sinh vien cd trai nghiem ca n h i n , ed tidp xue vdi ngudi nha, hg hang, ban be, ngUdi quen hole ban t h i n bj mac benh/rdi loan t i m than, ed t h l i do ti'ch eUe han va ed d u djnh l l m viee trong chuyen n g l n h CSSKTT eao hon ele sinh vien khdng cd t r l i nghiem tiep xue trudc dd (p<0,01). Dieu nay the hien d diem trung binh d u djnh eua SV ed t r l i nghiem eao han ban SV khdng cd trai nghidm trUdc dd. Theo Vincent, thanh vien gia dinh, ban be hay g i n n h i cd ngudi bj mac benh tam than khien SV ed dgng luc hcfn trong viee lUa ehgn lam viec trong ehuydn n g l n h CSSKTT [3],
MUc dd tiep can thdng tin di Xd tim hidu ve benh tam than cung cd y nghia trong viee tim hieu du djnh lam viec trong ehuyen n g l n h CSSKTT eua SV (p<0,05). NhQng SV thUdng xuyen t U t i m hieu thdng tin ve benh t i m than tren nhieu ngudn tham khIo,
xem cac phim ve ngudi benh tam than thl ed d u djnh lam viec eao hon nhQng SV khIe (trung blnh = 6,5; pham vi = 2,05). Viee nay chQng t d r i n g sU quan t i m va t i m hieu ve bdnh tam than qua nhieu ngudn thdng tin giup SV hieu hon v l ed xu hudng ehgn l l m viee trong ehuyen n g l n h CSSKTT nhieu hon. Didu nay phu hgp vdi nghien cQu eua Jansen (2015), su quan t i m tdi mdt van de nao do se I n h hUdng tdi quyet djnh eua sinh vien trong lua ehgn lam dieu dudng tam t h i n [6] (BIng 4).
Ket q u i nghien cUu eho t h I y , de lUa chgn nganh nghe, SV eol trgng y kien eua cha me nhat (91%), y kien cua thay cd giao (82,2%) va ban be (82,6%) [1]. Oieu n l y phu hgp vdi nghien cUu eua Happen B (2013) [5], khi sinh vien mudn quan t i m den chuyen n g l n h CSSKTT, hg da nhan ddgc sd khdng dng hd tU phia nhQng dieu dudng chuyen nganh khac, gia dinh va ban be vdi ly do k h i tieu cUc ve ehuyen nganh tam than va dieu dUdng CSSKTT
"khdng thUe su la dieu dUcfng" vi hg khdng duge thuc hidn nhieu kT nang dieu dUdng nhU cle ehuyen n g l n h didu dudng khIe [6]. Theo mdt sd nghien cQu, dieu dudng cac ehuyen nganh khIe lat thieu kT nang va kien thUc khi eham sde eho benh n h i n tam than dang dugc dieu tri d ehuyen khoa hg. Han the, hg cung thudng the hien viec e so, ki thj tham ehi la khdng than thien vdi nhQng benh n h i n do [7].
5. Ket luan
Cd 522 sinh vien nam cudi he cd nhan didu dudng Trudng Dai hgc Y Ha Ndi va Trudng Dal hgc Dieu dudng Nam Djnh, trong do cd 40 nam (7,7%) va 482 nQ (92,3%) tham gia nghien cUu, chung thdi nhan thay:
5.7. Dt/dinh cUa sinh vien trong viec Id^ chpn lam viec trong nganh cham soc sdc khde tdm than
d mUc trung binh - 22,76, pham vi = 9,854, sinh vidn ed diem dU djnh thap (< 20 diem) ehiem 41,2%;
sinh vien ed diem dU djnh trung binh tQ (21 den 40 diem) ehiem 55,2% (n = 288), va sinh vien ed diem dU dinh eao (> 40 didm) chi ehiem 3,6% (n = 19).
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JOURNAL OF 108 - CUNICAL MEDICINE AND PHARMACY VOI.12-N7/2017
5.2. Cac yeu to anh hddng den sd Ida chgn cua sinh vien
Cang ed su ung hd eua nhQng ngUdi xung quanh (r = 0,68, p<0,01), eang ed t h l i do tfch cue (r = 0,28, p<0,01), thl sinh vidn c l n g cd dgng lue lUa ehgn cham sde sUe khde tam than.
Sinh vien d gan benh vien t i m than ed xu hudng chgn nganh nay nhl^u hon.
G i l n g vien g i l n g mdn Didu dUdng sQe khde tam t h i n bao gdm e l dieu dudng va b l e sT se giup sinh vien ed ddng luc nhieu hon trong viec lUa chgn nganh nay.
Sinh vien cd kien thQc t d t hon, ed t r l i nghiem nhieu han (cd ngUdi nha hole ban than bj benh} ve sQc khde tam than se cd xu hUdng ehgn nganh n l y nhieu hon.
Tai lieu t h a m khao
1 BCii Thj Thanh Ha (2009) Tdc dgng cua cha me trong v\ic hudng nghiip cho hoc sinh phd thdng hiin nay.
Nghien cQu gia dinh va gidi 1, tr. 57-66.
2. Phdng ehi dao tuy^n BVTTTWl (2012) Nghiin cull dich te cdc rdi logn tdm thdn tgi cong dang d Viit Nam.
3. Vincent 10 (2015) Factors inHuencing the career choice and retention of community mental health
workers in Ghana. Human Resources for Health 13(56): 11.
Happen B, Gaskin J (2012) The attitudes of undergraduate nursing students towards mental health nursing: A systematic review. Journal of Clinical Nursing 22:148-158.
Happen B (2013) Keeping the flame alight.
Understanding and enhancing interest in mental health nursing as a career. Archives of Psychiatric Nursing 27:161-166.
Jansen M (2015) Psychiatric nursing: An unpopular choice. Journal of Psychiatric and Mental Health Nursing 22:142-148.
Linden M (2011) Attitudes of gualified vs. student mental health nurses towards an individual diagnosed with schizophrenia. Journal of advanced nursing 68(6): 1359-1368.
Jillian F (2004) Constructing guestionnaires based on the theory of planned behaviour A manual for health services researchers. Centre for Health Services Research University of Newcastle 21 Claremont Place Newcastle upon Tyne NE2 4AA United Kingdom.
