N G H I E N CCfU KHOA HOC
MOT SO YEO TO LIEN QOAN OEN DONG LUC LAM VIEC CUA DIEU DUONG 8ENH VIEN GIAO THONG VAN TAI TRUNG UONG, NAM 2013
ThS. HOANG MANH TOAN' - TS. TRAN QUANG HUY^
1- Benh vien Giao thong v$n tai; 2- Cue QLKCB 80 Y te Ngu^ thSm dmh- PGS. NGO TOAN DINH TdMTAT
Muc t i e u : Tim hieu dpng liic lam viec cua api ngij dieu du'ang tgi Benh vien Giao thong van tai Trung u-ang va cac ygu 16 lien quan.
D o i tirp-ng: Dieu dirang lam sang (146 ngu-o-i).
Phucyng p h a p : Nghien cu-u mo ta cat ngang.
Ket q u a : 100% doi tu-png nghien ciru coi yeu to cong viec la dpng lu-c lam viec (cao nh§t), trong k h i c h i c o 6 1 % y k i g n c h o r l n g y e u t 6 c h e d p c h i n h s a c h v a c h e d p q u a n t r i l a d p n g ILPC lam viec (thap nhat); Ygu t6thi>a nhan thanh tich va phat trien s y nghiep cung chi du-pc 62,3% v a 6 7 , 1 % d6itu'ang nghien ciJu coi la dpng lyc lam viec. Cac yeu t6 khac nhu- mdi quan he vffi lanh dao, voi dong nghigp va dieu kien lam viec co ty le kha cao doi tu'png nghien CLKU coi la dpng lyc lam viec (dao dpng tCr 79,5% - 96,6%); Tuoi va chiFc vy cong tac co lien quan co y nghTa thong ke vol dpng lyc lam viec cOa digu du-ffng; Opng lyc lam viec cao n h i t 6- nhom digu du-ong tre, dieu du-ang trwang va thap nhat a nhom digu du-ong hanh chinh, nhom dieu du-ang tren 50 tuoi.
Ket luan: (i) Mpi di^udu'ong deu coi y e u t 6 c6ng viec la dpng l y c l a m viec (100%); (li)Ygu t 6 c h e ap chinh sach va quan tn chi du'p'c 6 1 % so d i l u du'ang coi la dpng lyc lam viec (thap nhat); (lii) Co m6i lien quan co y nghTa thong kg gii>a dpng lyc lam viec voi nhom tu6i va chi>c vu.
TiF k h o a : Bpng lyc lam viec, Oieu du'ang ABSTRACT:
Objective: To understand the motivation of nursing staff at the Central Transport Hospital and related factors.
S u b j e c t s : Clinical Nurses (146 people).
M e t h o d s : cross-sectional descriptive study.
R e s u l t s : 100% of the study subjects considered work itself as work motivation (the highest), while only 6 1 % indicated factors such as policies and governance regime as work motivation (lowest). The factor of recognition of achievement and career development were considered as work motivation by only 62.3% and 67.1 % of study subject respectively. Other factors such as relationship with leaders, colleagues or working conditions that have a high proportion of study subjects considering as work motivation (ranging from 79.5% - 96.6%); Age and work position had statistically significant relation with work motivation of nurses; work motivation was highest among young nurses, nurse managers and lowest among administrative nurses and nurses aged over 50 years old.
C o n c l u s i o n s : (i) All nurses participated in the study considered job itself as work motivation; (ii) Factors such policies and governance regime are considered as work motivation by only 61 % of nurses considered motivation (lowest); (iii) There was statistically significant relation between working motivation with age groups and work positions.
K e y w o r d s : work motivation, nurses
^ ^ ' D l £ u DUONG 3 I
NGHIEN CCrU KHOA H p c
1.DJlTVi^NDl
Dpng lyc lam viec la s y khat khao va t y nguyen cua ngu'oi lao dpng d l tang cu-ang n6 lyc nh§m hu'ang tai viec dat cac muc tieu cua to chLFc, la kgt qua tong hoa cua nhigu ygu t6 tac dpng den con ngu'oi lao dpng, Cac hpc thuygt v§
dpng lyc lao dong cho th^y co cac each tigp can khac nhau d6i vai viec tao dpng lyc. Tuy nhign, tat ca cac hpc thuyet dgu co mot kgt luan chung:
Tang cu'ong dong lyc d6i vai ngu'oi lao dpng se nang cao thanh tich lao dpng va cac thanh cong Ion hon cua to chirc [5-8].
Cung giong nhu' mot s6 bgnh vien khac, nguQn nhan lyc y tg tai Benh vien Giao thong van tai Trung u'ong, trong do co dpi ngO digu du^ong dang bj thigu, khong du dap ieng yeu cau ciia cong tac cham soc ngu'oi benh. Nhu'ng cau hoi du'pc dat ra la hign tai dpng lyc lam viec cua dpi ngu dieu du'ang nhu" thg nao? Co nhu'ng ygu t6 nao anh hu'ang den dong lyc lam viec ciia dpi ngu nay? Oe tra lai cau hoi tren, chung toi di tign hanh nghign ciru: "Mpt so ygu t6 lign quan dgn dpng lyc lam vigc cua digu du'ang vien lam sang tai Benh vien Giao thong van tai Trung u'ang, nam 2013". Nghien ciru nhSm muc tigu: Mo ta dpng lu^c lam vigc va xac djnh mpt so yeu to lien quan den dpng lyc lam viec ciia cac oigu du'ang vien l§m sang tai Bgnh vign Giao thong van tai Trung u'ang.
2.PHirdNGPHAPNGHIlNCini
Nghign cifu mo ta cat ngang tren d6i tu'p'ng dieu du'ang vign lam sang cua 13 khoa lam sang Bgnh vien Giao thong van tai Trung u'ang.
Nghign ci>u du'pc tien hanh tai Benh vign Giao thong van tai Trung u'ang tCr thang 2/2013 dgn thang 6/2013.
Phu'ong phap thu thap so lieu: T y dign bp cau hoi CO cau true.
Phan tich va XCK ly s6 ligu: S6 lieu dinh lu-ang du'ffc nhap vao may tinh b§ng ph^n mgm EpiData 3.1 va du'pc xir ly bang ph§n mgm SPSS 16.0.
Phan tich h6i quy Logistic du'oc ap dung de ph§n tich moi lign quan giu-a dpng lyc lam viec cua dieu du'ang vai cac bien xa hpi - nhan khau/
nghe nghiep.
3.KiTQU&NGHIlNCini
3.1. ThOng dn chung v i d6i tnvng nghlftn ciiili Bang 1. Thong tin chung ve do! tu'p'ng nghien
CLPu ( n = 1 4 6 )
Thong tin chung Gipi:
Nam NO' Tuoi.
<30 3 1 - 4 0 4 1 - 5 0
>51 Tinh trang hon nhan'
Doctiian Co gia dinh Ly hon, goa bua Trinh do chuyen mon.
Di§u du'dng trung hoc Dieu duang cao dang Oi4u du'ffng dai hoc Ngu'oi thu nhap chinh trong gia dinh'
Co Kiiong
Thu nhap trung binli/lhang (dong):
< 3.000 000 3.100.000-4.000.000
> 4 000.000 Thpi gian cong tac
< 1 0 nam
> 10 nam Chirc vu
Dieu difpng tnrffng khoa Dieu dirpng hanh chinh Digu duang vien Loai iao dong (bien ch^, hop dong).
Bien che Hpp d6ng Phan ioai cong viec
Hanh chinh Cham sdc
So l i r ^ n g
21 125 71 37 25 13 38 103
5 120
6 20
85 61
20 55 71 90 56 13 11 122
121 25 32 114
T y l j H
14,4 65,6
48,6 25,3 17,1 8,9 26 70,5 3,4 82,2 41 13,7
58,2 41,8
13.7 37,7 48,6
61,6 38.4
8,9 7,5 83,6
82,9 17,1
21,9 78,1
I 4 2Ei»,^Di6UDUONS^
N G H I E N CCru KHOA HOC
So lieu a Bang 1 cho t h i y digu du'ang vign lam sang chii ygu la nu- (85,6%). Chir ygu digu du'ang thuoc nhom tuoi < 30 tuoi (48,6%); digu du'ang thupc nhom tuoi 4 1 - 50 chigm ty lg 1 7 , 1 % va nhom tuoi 3 1 - 40 chiem 25,3%. D6i tu'png dieu du'ang co trinh dp trung hpc chigm ty lg cao (82,2%), lao dpng hop dong chiem 1 7 , 1 % .
Z2. BAng mto lam vt^c cAa diAu diAlng 3.2.1. Yeu to cong viec la dpng tire lam viec Ty le digu du'ang d6ng y vai ygu to cong viec la dpng lyc lam viec chiem ty le tir 87,7% (Cong viec on djnh, an toan) den 100% (Ket qua cong viec; Chju trach nhiem vg cong viec; Ng lyc nh^m dat muc tigu chung) va ty le dieu du'ang dong y chung vai yeu t6 cong viec la dpng lyc la 100%.
3.2.2. Sy thipa nhan thanh tich la dong IIFC lam viec
Ty Ip dieu du'ang dong y vai ygu to s y thira nhan thanh tich la dpng lyc lam viec dao dpng tCf 42,5% (Tham gia vao cac quyet djnh quan trpng) den 97,3% (Ghi nhan cua dong nghiep voi kgt qua cong viec). Ty le dong y chung cho ygu to nay la dpng lyc chi ta 62,3% (Hinh 1).
nghigm qua lam vigc) va ty lg dong y chung cho ygu t6 phat trien su' nghiep la dpng lyc dat 67,1 % (Hinh 2).
Hinh 1. Yeu to thira nhan thanh tich la dgng luc lam vi$c.
3.2.3. Sir phat triin sir nghi$p la dpng lire lam vifc cua dieu dwvng
Ty Ip di^u d u a n g dong y yeu to phat trien s y nghipp la dpng lyc lam viec dao dpng 68,5% (Dao tao nang cao trinh d6) d^n 100% (Nang cao kinh
Onmg 1 67 1% 1 i ; 9 %
tisas. cao kmlingluein qua lain wn: 100°o
1
LapkehaachcongMK tM l 1 93J:°=
^4
ConglaccanboduiigquyUDili I 89^0 |n%
Cong bang ttong hoclep 1 BS^°=
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•Codoiigliic 68 5%
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•HioJlg 40°, 60°»
315"o 1 80°o lOflOo
Str giu nl^^ cfia doiig nglu«|j vol kel qiin cong v]«c Sii giu nhan cua lanh dao im Ler qiia cong
S(t don nliiln cua doiip iigliiep vm sang
SIT donnluni ci'ia lanli djio voi ;ang kien Cap Den danh gia III qua cong \ttc Buth.\el ihi diia, khen tlmong TTiani gia cac qu> e( dinli quanDong a
•Codonghlc iKhoiigc
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97 J % 966%
9i9=i 9i 2°o 90 4%
87%
° 1 " 5 40% 60°'i, odpi^hic
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Hinh 2. Yeu td phat triin su-nghiep la dong li/c lam viec.
3.2.4. Cac yeu to ve SIP thanh dat la dpng luv lam viec
Ty lg digu du'ang d6ng y vai yeu to ve s y thanh dat la dpng lyc lam vigc dao dpng tCr 74,7%
den 96,6% va ty lg dong y chung coi cac yeu to nay la dpng lyc dgt 83,6%.
3.2.5. Yeu to gia dinh la dpng luv lam viec Ty le dieu du'ang dong y vol yeu to ve gia dinh la dong lyc lam viec deu dat ty le tren 90%, thap nhat la 97,3 % (Ty hao) va cao nhgt la 99,3% (Dong vign, khich lg va cam thong, chia se). Ty lg d6ng y chung vai yeu t6 gia dinh la dpng lyc lam viec la 96,6%.
3.2.6. Cac yeu to quan he v&i lanh dao, dong nghiep la dpng lire lam viec
Ty le dieu du'ang dong y vai ygu t6 moi quan he vai lanh dao, d6ng nghiep la dpng lyc lam viec cua dieu du'ang dao dpng ti> 85,6% (Lanh dao l i n g nghe, chia se) dgn 97,9% (Lanh dgo chi dao). Ty le dong y chung vg yeu t6 nay dat 87,7%.
3.2.7. Cac yeu to ve chinh sach va che dp quan trj la dpng lire lam viec
Ty le digu du-ong dong y vai yeu t6 ve chinh sach va che dp quan tri la dpng lyc lam viec dao
^^afc'DlEU DUONG 5 I
NGHIEN ClJU KHOA HOC
dong tip t h j p nhat la 51,4% (Luong va phu cap) va den cao nhSt la 97.3% (H6 trg 6m dau, thai san). Ty le dieu du-ong co dpng lire chung v j y§u to nay dat 6 1 % .
3.2.8. Cac yeu to ve dieu kien lam viec la dgng ILK lam viec cua dieu duvmg
Ty le dieu du'o'ng ddng y vai cac y§u t6 di§u kien lam viec la dong lyc lam viec cua d i j u dlf&ng dat thap nhat la 82,2% (Co so vat c h i t , trang t h i i t bi day du) va cao nhat la 87,7% (BiSu kien lam viec) Ty le d6ng y Chung ven ySu td nay dat 79,5% (Hinh 3).
EMeiikieiilaiiinec
Cosovjl dial, trai^tluelbi an loan
Cosoviilchal dang Quel bl diiy dn
• Co dpng liic - Kliong co doiigluc
Hinh 3. Yeu to vS diSu kien lam viec la dgng Igc lam viec.
3.3. Mdt s6 y^u i6 Il6n quan d^n ddng lUto lam vi$c ciia didu duSng
S6 ligu vg kgt qua mo hinh h6i quy Logistic (Bang 2) xac djnh m6i lien quan cua dpng lyc lam viec vai cac yeu to giai, tuoi, trinh dp chuygn mon cao nhat, ngu'oi thu thap chinh trong gia dinh, thu nhap hang thang, tham nign cong tac, chirc vu, logi lao dpng, phan loai cong viec. Phan tich da bien cho thliy yeu t6 tinh trang hon nhan, nhom thu n h | p trung binh hang thang, thai gian cong tac, loai lao dpng la yeu t6 n h i l u do phan tich dan bien yeu t6 tinh trang hon nhan, nhom thu nhap trung binh hang thang, thai gian cong tac, loai lao dpng CO m6i lien quan vai dpng lyc lam viec. Tuy nhign, trong mo hinh hSi quy da bign m6i quan he nay tra thanh khong co y nghTa. Chi co m6i lign quan cd y nghTa th6ng kg giu'a tuoi, chirc vu vai dpng lyc lam vigc (p < 0,05).
B a n g 2. Diem t r u n g b i n h d o n g ILPC lam v i | c cua dieu du>vng t h e o cac yeu to nhan k h a u , nghe nghiep khi dp dMng phan t i c h hoi quy L o g i s t i c
TT
Cac yeu to ve xa hoi va nhan khau/nghe
nghiep Giai Tuoi Tinh trang hon nh&n Trinh 36 chuy§n mon cao nhat Nguoi thu nhap chinh trong gia flinh Thu nhap hang thang Tham men cong tac Chirc vu Loai lao dong Phan loai c5ng viae
H;s6 ho!
quy (B) 2,23 -7.06 -1.27
•3.83 0.66 -2.29 1,07 -7,56 6,51 2,83
Saisd chuan (SE) 4,04 2,48 3.97 2.17 3.28 2.81 5.55 3,58 4,5 4,98
Gia trjp 0,58 0,005 0.749 0,08 0.84 0.42 0.85 0.037 015 0,571
9S%CI
0.88-1,14 0.29-3,46 0,46-2.17 0,76-1,31 0,24-4,12 0,45-2,23 0,24-4,12 0.38-2,66 0,62-1,62 0,42-2,39 Tir kgt qua phan tich hoi quy da bien ta c6 phu'ang trinh:
Diem trung binh dong lyc lam viec = 150,99 - 7,06 X tuoi - 7,56 x chirc vu
Phu'ang trinh nay co nghTa: Khi co cung mOt chii'c vu, ngu tang them 1 tuoi, diem trung binh dpng lyc se giam di 7,06 diem khi cCing mpt chi>c vy nhu' nhau va khi c6 cung mot tu6i neu chipc vy tang Ign 1 bac (tang tif nhan vien len di^u duong hanh chinh, tLr dieu du'ang h^nh chinh Ign dieu du'ang tru'dng), diem trung binh dpng lyc lam viec se giam 7,56 diem.
4.BANUIAN
Cac ySu td vi su- thu^ nhan thanh tich la dgng /uc lam viec cua 6i§u dtrong
57,5% so dieu du'ang cho r i n g hp khong du'pc tham gia vao viec ra cac quy^t djnh quan trpng ciia benh vign va co 13% so dieu duang cho rang viec binh xet thi dua. khen thuang hien tai ciia benh vien la chua hap ly va cong bang, chua d y a trgn nang lyc va hieu qua cdng vi?c.
v I n mang tinh binh quan chia deu. Tren thyc te,
I 6 ^ ^ ^ A r D l S u DUONG
NGHIEN c a u KHOA HOC
khen t h u d n g nhan vign n h i m khuygn khich tinh t h i n lam viec cua nhan vien. Viec khen thudng hap ly va cdng b i n g gdp phan tang dpng lyc lam vigc. Nhung tren hgt la s y ghi nhan ciia d6ng nghigp va lanh dao doi vdi cong viec cua digu d u d n g . Tham chi chi mpt khoan tien rat nho nhung cung cd y nghTa to Idn vdi ngudi nhan bdi vi dieu do chirng to r i n g lanh dao bigt tdi nhirng cong viec kho khan cua hp. Ty lg digu d u d n g dong y vdi yeu td cdng bang trong binh xet thi dua khen t h u d n g trong nghien ciru cua chung toi cao hon so vdi nhan vien y te huyen Binh Xuygn (87% so vdi 65,5%) [3],
Cac ySu td v4 si/phat triSn si/nghiep la dong ILPC lam viec cua diiu duung
89% y kien dong y cong tac dg bat can bp hpp ly la mpt hinh thuc khuygn khich quan trpng.
Dao tao va phat trien la cac hoat dpng de duy tri va nang cao chat Iuang nguon nhan lyc ciia co quan, la digu kien quyet djnh de cac to chirc dung vu'ng va t h i n g lai trong moi trudng canh tranh.
Do do, trong cac to chu'c, cong tac dao tgo va phat then can phai thyc hien mpt each cd to chuc va ke hoach [5]. S6 dieu d u d n g ddng y trong nghign c u u cua chung tdi chiem ty le cao han so vdi ty Ip nay trong nghien c u u cua Tran Thj Chau trgn 987 d i l u d u d n g tai Thanh pho Hd Chi Minh va thap han cac nhan vign y te tai huyen Binh Xuyen (68,5% so vdi 60,49% va 78,7%). Tuy ty le dieu d u d n g trong nghign c u u cua chung tor dong y coi cong tac dao tao bgi d u d n g nang cao trinh dp la dpng lyc cao han cac nghign ciru khac [2],[3] nhung ty le ddng y chung coi phat trien s u nghigp la dpng lyc chf chiem 67% ngn benh vien cung nen chu trpng han cong tac dao tao nang cao trinh dp chuyen mdn.
C^c yiu to ve chinh sach va che do quan tri la dong li/c lam vi$c cua dieu dimng
Hien nay che dp dai ngo dang cd nhieu b i t cap da lam anh hudng den vigc dpng vien can bd y te lam v i | c vdi trach nhigm cao va phat huy d u a c het kha nang. V d i chu truang xa hpi hoa
cdng tac y tg, thu nhap cua dieu d u d n g cd ca hpi d u p e cai thien. Tuy vay chi cd 51,4% so digu dudng cho r i n g miPc thu nhap hang thang la hpp ly va cung chi cd 55% so dieu d u d n g cho r i n g miFC thudng trong cac djp lg, Tgt la hap ly. Ket qua nay cung tuang t y vdi kgt qua cua mpt so nghign ciru khac, vi vay digu nay doi hdi lanh dao benh vien, lanh dao nganh va cac ca quan xay dyng chinh sach co s y quan tam hon nu'a [5].
Cac yeu td vi diiu kien lam viec la dong luc lam viec cua diiu duung
Trong nghien ciru nay, ty le dieu d u d n g cho r i n g dieu kien lam viec ciia benh vien dam bao ygu c i u chigm 87,7%; ca s d vat c h i t , trang thigt bj an toan chigm 84,9%; ca s d vat c h i t , trang thiet bj day dii chiem 82,2%. Mac du ty le nay cao han so vdi k i t qua nghien cuu ciia T r i n Quy nam 2005 [4] va Lg Thanh Nhuan nam 2008 [3] nhung vi Benh vien Giao thong vgn tai Trung u o n g la benh vien Hang I ngn v i n can phai d u a c d i u t u xay dyng v a c d them kinh phi d e t r u d e m i t tu sira nhung khu nha da xuong cap nghiem trpng va sau do la hien dai hda benh vien.
5.KiTUlANUAKHUYiNNGH!
Nghien c u u "Mpt s6 yeu td lign quan d i n ddng lyc lam viec ciia dieu dudng vign lam sang tai Bgnh vien Giao thdng van tai Trung u a n g , nam 2013" cho thay: Mpi d i l u d u d n g deu coi yeu t6 cdng viec la dpng luc lam viec (100%); Y l u t l che dp chinh sach va che dp quan tn chl d u a c 6 1 % s6 dieu d u d n g coi la dpng lyc lam vigc ( t h i p n h i t ) ; Cac y l u to khac d u a c coi la dpng luc lam viec chigm ty le kha cao (dao dpng tir 79,5% d i n 96,6%); Cd mdi lign quan co y nghTa t h i n g kg giiJa ddng luc lam viec vdi nhdm tuoi va chuc vu Tuoi cang cao ddng luc lam vigc cang giam.
Dpng lyc lam viec cua dieu d u d n g cao nhat d nhdm dieu d u d n g trudng va t h I p n h i t d nhom dieu d u d n g hanh chinh.
T u ket qua nghien ciru, chiing toi d l nghj Lanh dgo benh vien; (i) D d xuat vdi Cue Y t l Bd Giao
J^aiU-DlCU DUONG 7 I
NGHIEN c a u KHOA HOC
thong v§n tai quan tam han v l chinh sach va kg hoach dao tao can bp; (ii) Xay dyng quy c h l chi tigu npi bp hop ly; (iii) Xay dyng, thyc hign quy dinh, quy c h l lam viec ro rang; (iv) Ap dung cong cu quan ly nhan luc phii hap. Chung toi cung de nghj c i n co nhung nghien ciru s§u han de xac djnh mipc dp tac dpng cua cac y l u t6 d i n dpng lu'c lam viec.
TAI LIEU THAM KHAO
1 8 6 Y te (2011), Bao cao tong quan chung nganh Y t l nam 2011-Chuang V, Tinh hinh nhan lyc y te.
2. Tran Thj Chau & cpng s y (2005), "Khao sat su hai long cua dieu duang vg n g h i nghigp tai 14 ca sd y t l d TP. H 6 Chi Minh", Ky y l u d l tai nghign cuu khoa hpc d i l u dudng toan quoc l i n thir ll, Nha x u l t ban GTVT Ha Npi, tr. 43-49.
3. Le Thanh Nhuan (2008), Thuc trang nguon nhan lyc va s y hai Idng ddi vdi cong viec cua nhan vign y t l c a s d huyen Binh Xuygn, tinh VTnh Phiic - nam 2008, Luan van Thac sT y t l c6ng cdng, Trudng Dai hpc Y te cdng cpng. Ha N6i.
4. T r i n Quy & cong s y (2005), "Sy hai long n g h i nghiep ciia d i l u d u d n g benh vign va
5. Tru'd'ng D^l hoc Kinh t l quoc dan (2007), Giao trinh Quan tri nhan lyc, Nha x u l t ban Dgi hpc Kinh t l quoc dan.
6. Patrick M Mblndyo, Duane Blaauw, Lucy Gilson & Mike English (2009),"Developing a tool to measure health vt/orker motivation in district hospital in Kenya", Human Resources for Health 2009, 7;40.
7 Rachel N Manongi, Tanya C Marchant
& lb Christian Bygbjerg (2006), "Improving motivation among primary health care workers in Tanzania: a health vt/orker prexpective", Human Resources for Health 2006, 4:6.
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Cac nO dieu du&ng Benh vien Da khoa An Phuijc.
I 8 i E » . * D i e u DUONG
