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Кубанский научный медицинский вестник

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Организационная приверженность среднего медицинского персонала: определение понятия и специфика измерений (обзор зарубежных публикаций)

https://doi.org/10.25207/1608-6228-2025-32-5-96-120

Аннотация

Введение. Вопросам организационной приверженности среднего медицинского персонала в российской исследовательской литературе уделяется пока крайне мало внимания. В то же время в зарубежной научной традиции, берущей свое начало с 1960-х гг., приверженность рассматривается как своеобразная «квинтэссенция», комплексно отражающая в себе отношение работников государственного здравоохранения не только к своей организации, но и к своей профессии, работодателю, труду в целом. В этом смысле приверженность выходит за рамки измерений удовлетворенности/неудовлетворенности трудом, лояльности/нелояльности организации, вовлеченности/невовлеченности в ее работу и т. д.

Цель исследования: на основе анализа зарубежных публикаций систематизировать и критически осмыслить основные подходы к пониманию организационной приверженности среднего медицинского персонала, выявить основные этапы развития данной темы в историографии, основные компоненты и механизмы формирования приверженности в медицинских организациях.

Методы. Проблемно-хронологический, сравнительный и критический анализ литературных источников (n = 3808), размещенных в англоязычной текстовой базе данных медицинских и био логических публикаций «PubMed» и выделенных на основании тематического запроса «organizational commitment of nurses» («организационная приверженность медицинских сестер»).

Результаты. Выделены 4 хронологических этапа изучения вопросов организационной приверженности в зарубежной литературе, отличающиеся как по своему содержанию, так и по направленности научных публикаций. На первом этапе (рубеж 1960/1970-х — 1980-е гг.) публикации, как правило, носили описательный характер и касались в основном характеристики обязательств работников по отношению к своим организациям, приверженности этическим моделям поведения и ценностям профессии. В то же время появились первые исследования, призывавшие к разработке «систем объективных оценок программ охраны труда» работников здравоохранения, которые учитывали бы различные аспекты «трудовой жизни», «ролевую неопределенность» и «ролевые конфликты», влияющие на желание работать в медицинской организации. На втором этапе (1990-е гг.) внимание исследователей привлекли вопросы изучения вовлеченности и удовлетворенности трудом как факторов, определяющих организационную приверженность персонала. В публикациях, посвященных анализу «личного жизненного опыта», внедрения психологических контрактов и моделей «совместного управления», создания «самостоятельных рабочих групп медсестер» и «совместных команд», отмечалась необходимость вовлечения среднего медперсонала в управление организациями. На третьем этапе (рубеж 1990/2000-х — начало 2020-х гг.) появилось множество публикаций, посвященных измерению приверженности среднего медперсонала на основе применения модели Дж. Мейера и Н. Аллен. Большое значение приобрел анализ «особости» медсестринского труда в ключе формирования «культуры учреждений», учета ожиданий сотрудников и создания атмосферы воспринимаемой поддержки. В поле зрения оказались вопросы эмоциональных составляющих труда, совмещенные с комплексным изучением проблем эмоционального истощения, стрессов и стрессоров, профессионального выгорания, деперсонализации и пр. При этом наблюдался процесс расширения географии исследований, совмещенный с попытками понять специфику организационной приверженности за пределами «западного опыта». На четвертом этапе (с начала 2020-х гг.) внимание исследователей привлекли вопросы безопасности персонала на рабочих местах, коллективного эмоционального и профессионального выгорания и сохранения «качества здоровья» среднего медперсонала. Новыми темами стали вопросы влияния цифровизации и мультикультурности на поддержание организационной приверженности и стабильности медсестринских коллективов.

Заключение. В дискуссиях по вопросам содержания организационной приверженности и проблемам его качественного измерения рано ставить точку, так как реальная жизнь ставит все новые и новые проблемы, требующие адекватного изучения и детального научного анализа. Результаты обзора позволяют не только совершенствовать существующие подходы к оценке организационной приверженности, но и разрабатывать комплексные программы организационного развития, ориентированные на удержание, мотивацию и профессиональное развитие среднего медицинского персонала в российских медицинских учреждениях.

Об авторах

К. В. Кузьмин
Государственное бюджетное профессиональное учреждение «Свердловский областной медицинский колледж»
Россия

Кузьмин Константин Викторовичg/10.1016/s1060-135x(97 — кандидат исторических наук, доцент; руководитель Координационного научно-методического центра по социальной работе в системе здравоохранения Свердловской области

ул. Репина, д. 2а, г. Екатеринбург, 620014



Л. Е. Петрова
Муниципальное образовательное учреждение высшего образования «Екатеринбургская академия современного искусства (институт)»
Россия

Петрова Лариса Евгеньевна — кандидат социологических наук, доцент, профессор кафедры социокультурного развития территории

ул. Культуры, д. 3, г. Екатеринбург, 620012



В. С. Харченко
Федеральное государственное автономное образовательное учреждение высшего образования «Уральский федеральный университет имени Первого президента России Б.Н. Ельцина»
Россия

Харченко Вера Сергеевна — кандидат социологических наук, зав. кафедрой медиакоммуникаций

ул. Мира, д. 19, г. Екатеринбург, 620062



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Рецензия

Для цитирования:


Кузьмин К.В., Петрова Л.Е., Харченко В.С. Организационная приверженность среднего медицинского персонала: определение понятия и специфика измерений (обзор зарубежных публикаций). Кубанский научный медицинский вестник. 2025;32(5):96-120. https://doi.org/10.25207/1608-6228-2025-32-5-96-120

For citation:


Kuzmin K.V., Petrova L.E., Kharchenko V.S. Organizational commitment of nursing staff: Definition of the concept and specifics of measurement (review of foreign publications). Kuban Scientific Medical Bulletin. 2025;32(5):96-120. (In Russ.) https://doi.org/10.25207/1608-6228-2025-32-5-96-120

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