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Hastanede Çalışan Hemşirelerin Çalışma Ortamı Algısı: Trakya Örneği

Year 2019, Issue: 3, 614 - 621, 01.12.2019

Abstract

Araştırma Trakya bölgesindeki hastanelerde çalışan hemşirelerin çalışma ortamı algısını belirlemek amacıyla yapıldı. Tanımlayıcı tipteki bu araştırma Trakya bölgesinde bulunan en büyük üç devlet hastanesinde çalışan gönüllü 382 hemşire ile Temmuz-Ağustos 2017 tarihleri arasında yapıldı. Veriler hemşirelerin tanımlayıcı özellikleri için bilgi formu ve Lake 2002 tarafından geliştirilen, Türkçe geçerlilik ve güvenirlik çalışması 2011 yılında Türkmen, Badır, Balcı ve Akkuş-Topçu tarafından yapılan “Hemşirelik İş İndeksi- Hemşirelik Çalışma Ortamını Değerlendirme Ölçeği Hİİ-HÇODÖ ” ile toplandı. Veri analizinde sayı, yüzde, ortalama, standart sapma, tek yönlü varyans analizi, bağımsız gruplarda t testi ve korelasyon analizi kullanıldı. Hemşirelerin yaş ortalaması 33.63±7.98, birimde çalışma yılı ortalaması 4.5±5.16 yıl, kurumda çalışma yılı ortalaması 8.5±7.91 yıl idi. Hemşirelerin çalışma ortamını değerlendirme ölçeği puan ortalaması 72.21±13.769’du. Çalışılan birime göre yapılan incelemede hemşirelerin yönetime katılma ve kaliteli bakım için gerekli hemşirelik kaynakları alt boyutlarında ameliyathane ve yoğun bakım hemşirelerinin puan ortalamasının düşük olduğu, çalışma ortamını en çok hemşirelerin yönetime katılması ve temsil gücü alt boyutunun etkilediği ve ölçekten alınan puan arttıkça birim ve kurum memnuniyetinin de arttığı belirlendi. Araştırma sonuçları ameliyathane ve yoğun bakımda çalışan hemşirelerin çalışma ortamlarını daha kötü olarak değerlendirdiklerini, hemşirelerin yönetime katılmasının çalışanlar açısından önemli olduğunu ve memnuniyeti artırdığını gösterdi

References

  • Aiken L.H., Sermeus W., Van den Heede K., Sloane DM., Busse R., McKee M., Bruyneel L., Rafferty AM., Griffiths P., MorenoCasbas MT., Tishelman C., Scott A., Brzostek T., Kinnunen J., Schwendimann R., Heinen M., Zikos D., Sjetne IS., Smith HL., Kutney-Lee A. (2012) Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. British Medical Journal, 344(e1717): 1-14. Retrieved from https://www.ncbi. nlm.nih.gov/pmc/articles/PMC3308724/
  • Aiken, L. H., Cimiotti, J. P., Sloane, D. M., Smith, H. L., Flynn, L., & Neff, D. F. Effects of nurse staffing and nurse education on patient deaths in hospitals with different nurse work environments. Medical Care, 2011, 49(12), 1047-53. Retrieved from https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC3217062/pdf/ nihms325665.pdf
  • Aiken L. H., Clarke S. P., Sloane D. M. (2002) Hospital staffing, organization and quality of care: Cross-national findings. International Journal for Quality in Health Care, 14, 5-13. Retrieved from https://doi.org/10.1093/intqhc/14.1.5
  • Aiken, L., Havens, D., & Sloane, D. (2009) The magnet nursing services recognition program. A comparison of two groups of magnet hospitals. American Journal of Nursing, 100: 26–35. Retrieved from https://doi.org/10.1097/NNA.0b013e3181aeb469.
  • Al‐Hamdan Z, Manojlovich M., & Tanima B. (2017) Jordanian Nursing Work Environments, Intent to Stay, and Job Satisfaction. Journal of Nursing Scholarship, 49(1):103-110. Retrieved from https://doi.org/10.1111/jnu.12265.
  • American Nurses Association (2016). Healthy work environment 2016. Retrieved from http://www.nursingworld.org/ American Nurses Credentialing Center. (2005). Magnet recognition program: Application manual. Silver Spring, MD: American Nurses Credentialing Center.
  • Bitek D. E., & Akyol A. (2017) Yoğun bakım hemşirelerinin çalışma ortamına ilişkin algıları ile iş doyumları arasındaki ilişkinin incelenmesi. Yoğun Bakım Hemşireliği Dergisi, 21(1), 1-6.
  • Boev, C. (2012) The relationship between nurses’ perception of work environment and nurse-sensitive patient outcomes in adult critical care. Journal of Nursing Scholarship, 44(4), 368-75. Retrieved from https://doi.org/10.1111/j.1547- 5069.2012.01466.x.
  • Croll, Z. T., Coburn, A. F., & Pearson, K. B. (2012). Promoting a culture of safety: Use of the hospital survey on patient safety culture in critical access hospitals. (Briefing Paper No. 30). Portland, ME: Flex Monitoring Team. Retrieved from https://digitalcommons.usm.maine.edu/cgi/viewcontent. cgi?article=1015&context=rural_hospitals
  • Dirik, H. M., & İntepeler-Seren, S. (2017) The work environment and empowerment as predictors of patient safety culture in Turkey. Journal of Nursing Management, 25(4), 256-265. Retrieved from https://doi.org/10.1111/jonm.12458.
  • Fackler, C. A., Chambers, A. N., & Bourbonniere M. (2015) Hospital nurses’ lived experience of power. Journal of Nursing Scholarship, 47(3), 267-274. Retrieved from https://doi. org/10.1111/jnu.12127.
  • Ho, W. H., Chang, C. S., Shih, Y. L., & Liang, R. D. (2009) Effects of job rotation and role stress among nurses on job satisfaction and organizational commitment. BMC Health Services Research, 9(1), 8. Retrieved from https://doi.org/10.1186/1472-6963-9- 8
  • Janakiraman, R., Parish, J. T., & Berry, L. L. (2011) The effect of the work and physical environment on hospital nurses’ perceptions and attitudes: Service quality and commitment. Quality Management Journal, 18(4), 36-49. Retrieved from https://doi.org/10.1080/10686967.2011.11918334
  • Jones, T. L., Hamilton, P., & Murry, N. (2015) Unfinished nursing care, missed care, and implicitly rationed care: State of the science review. International Journal of Nursing Studies, 52(6), 1121-1137. Retrieved from https://doi.org/10.1016/j. ijnurstu.2015.02.012
  • Kramer, M., Brewer B. B., & Maguire P. (2013) Impact of healthy work environments on new graduate nurses’ environmental reality shock. Western Journal of Nursing Research, 35(3), 348-383. Retrieved from https://doi.org/10.1177/0193945911403939
  • Kramer, M., Schmalenberg C., Maguire P. (2010) Nine structures and leadership practices essential for a magnetic (healthy) work environment. Nursing Administration Quarterly, 34(1), 4-17. doi: 10.1097/NAQ.0b013e3181c95ef4.
  • Kutney-Lee, A., McHugh M. D., Sloane D. M., Cimiotti J. P., Flynn L., Neff D. F., & Aiken L. H. (2009) Nursing: a key to patient satisfaction. Health Affairs, 28(4), 669-677. Retrieved from https://doi.org/10.1377/hlthaff.28.4.w669
  • Lang, G. M., Patrician P., & Steele N. (2012) Comparison of nurse burnout across Army hospital practice environments. Journal of Nursing Scholarship, 44(3), 274-283. Retrieved from https:// doi.org/ 10.1111/j.1547-5069.2012.01462.x
  • Lake, E. T. (2002) Development of the practice environment scale of the Nursing Work Index. Research inNursing&Health, 25(3), 176-188. Retrieved from https://doi.org/10.1002/nur.10032
  • Liu, K., You, L. M., Chen, S. X., Hao, Y. T., Zhu, X. W., Zhang, L. F., & Aiken, L. H. (2012) The relationship between hospital work environment and nurse outcomes in Guangdong, China: a nurse questionnaire survey. Journal of Clinical Nursing, 21(9-10), 1476–1485. Retrieved from http://doi.org/10.1111 /j.1365-2702.2011.03991.
  • Margall, M. A., & Duquette, A. (2000) Working environment at a university hospital: perception of nurses. Enfermería Intensiva, 11(4), 161-169.
  • Mollaoğlu, M., Fertelli T. K., & Tuncay F. Ö. (2010) Hastanede çalışan hemşirelerin çalışma ortamlarına ilişkin algılarının değerlendirilmesi. Fırat Sağlık Hizmetleri Dergisi, 5(15), 17-30.
  • Nayback-Beebe, A. M., Forsythe, T., Funari, T., Mayfield, M., Thoms, W. Jr, Smith, K. K., Bradstreet, H., & Scott, P. (2013). Using evidence-based leadership initiatives to create a healthy nursing work environment. Dimensions of Critical Care Nursing, 32(4), 166-173. Retrieved from https://doi. org/10.1097/DCC.0b013e3182998121.
  • Numminen, O., Ruoppa, E., Leino-Kilpi, H., Isoaho, H., Hupli, M. & Meretoja, R. (2016) Practice enviroment and its association with professional competence and work-related factors: perception of newly graduated nurses. Journal of Nursing Management, 24(1), E1-E11. Retrieved from https://doi. org/10.1111/jonm.12280
  • Paquet, M., Courcy, F., Lavoie-Tremblay, M., Gagnon, S., & Maillet, S. (2013) Psychosocial work environment and prediction of quality of care indicators in one Canadian health center. Worldviews on Evidence Based Nursing, 10(2), 82-94. Retrieved from https://doi.org/ 10.1111/j.1741-6787.2012.00250.x.
  • Purdy, N., Spence-Laschinger, H. K., Finegan, J., Kerr, M., & Olivera, F. (2010) Effects of work environments on nurse and patient outcomes. Journal of Nursing Management, 18(8), 901- 913. Retrieved from https://doi.org/10.1111/j.1365-2834. 2010.01172.x.
  • Shireyn, M. R. (2009). Stress and coping in nurse managers: A qualitative description (Doctoral dissertation). Retrieved from https://scholarworks.iupui.edu/bitstream /handle/1805/1866 /MRShirey%20Dissertation%20PDF%20E%20090106%20 Rev%20ii.pdf;sequence=1
  • Tan, M., Polat, H., & Şahin, Z. A. (2012). Hemşirelerin çalışma ortamlarına ilişkin algılarının değerlendirilmesi. Sağlıkta Performans ve Kalite Dergisi, 4, 67-78.
  • Türkmen, E., Badır, A., Balcı, S., & Akkuş-Topçu, S. (2011). Hemşirelik iş indeksi- hemşirelik çalışma ortamını değerlendirme ölçeğinin Türkçeye uyarlanması: Güvenilirlik ve geçerlilik çalışması. Hemşirelikte Araştırma ve Geliştirme Dergisi, 2, 5-20.
  • Vaughan, L., & Slinger, T. (2013). Building a healthy work environment: a nursing resource team perspective. Nursing leadership (Toronto, Ont.), (26), 70-77.
  • Wang, Y., Dong, W., Mauk, K., Li, P., Wan, J., Yang, G., Fang, L., Huan, W., Chen, C. & Hao, M. (2015). Nurses’ practice environment and their job satisfaction: a study on nurses caring for older adults in Shanghai. PLoS One, 10(9), e0138035. doi: 10.1371/ journal.pone.0138035
  • Yeşiltaş, A., & Gül, İ. (2016). Hemşirelerin çalışmak için tercih ettikleri birimler ve tercih nedenleri. Mehmet Akif Ersoy Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 4(2), 74-87.

Working Environment Perceptions of Nurses Working in Hospital: The Case of Thrace

Year 2019, Issue: 3, 614 - 621, 01.12.2019

Abstract

The study was conducted to determine the perception of the working environment of nurses working in hospitals in Thrace region. This descriptive study was conducted on 382 volunteer nurses working in the three largest state hospitals in Trakya region from July- August 2017. Data for the characteristic features of nurses were collected by the information form and developed by Lake 2002 and the Turkish validity and reliability study conducted by Türkmen, Badır, Balcı & Akkuş-Topçu 2011 with the “Practice Environment Scale- Nursing Work Index PES-NWI ”. Number, percentage, mean and standard deviation, one-way analysis of variance ANOVA , independent t-test and correlation were used for data analysis. The mean age of the nurses was 33.63±7.98, the average of the years of unit experience was 4.5±5.16 and the average of the institutional working year was 8.5±7.91. The mean score of the nurses’ PES-NWI was 72.21±13.769. Examined according to the working unit; it was determined that the average score of operating room and intensive care nurses was low in the Nurse Participation in Hospital Affairs, Nursing Foundations for Quality of Care sub-dimensions, Nurse Participation was the most affecting the working environment and the satisfaction of the unit and the institution increased as the score from the scale increased. The results of the research showed that the nurses working in an operating room and intensive care unit considered the working environment worse and that the nurses’ participation in the management and increased the satisfaction was necessary for the employees

References

  • Aiken L.H., Sermeus W., Van den Heede K., Sloane DM., Busse R., McKee M., Bruyneel L., Rafferty AM., Griffiths P., MorenoCasbas MT., Tishelman C., Scott A., Brzostek T., Kinnunen J., Schwendimann R., Heinen M., Zikos D., Sjetne IS., Smith HL., Kutney-Lee A. (2012) Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. British Medical Journal, 344(e1717): 1-14. Retrieved from https://www.ncbi. nlm.nih.gov/pmc/articles/PMC3308724/
  • Aiken, L. H., Cimiotti, J. P., Sloane, D. M., Smith, H. L., Flynn, L., & Neff, D. F. Effects of nurse staffing and nurse education on patient deaths in hospitals with different nurse work environments. Medical Care, 2011, 49(12), 1047-53. Retrieved from https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC3217062/pdf/ nihms325665.pdf
  • Aiken L. H., Clarke S. P., Sloane D. M. (2002) Hospital staffing, organization and quality of care: Cross-national findings. International Journal for Quality in Health Care, 14, 5-13. Retrieved from https://doi.org/10.1093/intqhc/14.1.5
  • Aiken, L., Havens, D., & Sloane, D. (2009) The magnet nursing services recognition program. A comparison of two groups of magnet hospitals. American Journal of Nursing, 100: 26–35. Retrieved from https://doi.org/10.1097/NNA.0b013e3181aeb469.
  • Al‐Hamdan Z, Manojlovich M., & Tanima B. (2017) Jordanian Nursing Work Environments, Intent to Stay, and Job Satisfaction. Journal of Nursing Scholarship, 49(1):103-110. Retrieved from https://doi.org/10.1111/jnu.12265.
  • American Nurses Association (2016). Healthy work environment 2016. Retrieved from http://www.nursingworld.org/ American Nurses Credentialing Center. (2005). Magnet recognition program: Application manual. Silver Spring, MD: American Nurses Credentialing Center.
  • Bitek D. E., & Akyol A. (2017) Yoğun bakım hemşirelerinin çalışma ortamına ilişkin algıları ile iş doyumları arasındaki ilişkinin incelenmesi. Yoğun Bakım Hemşireliği Dergisi, 21(1), 1-6.
  • Boev, C. (2012) The relationship between nurses’ perception of work environment and nurse-sensitive patient outcomes in adult critical care. Journal of Nursing Scholarship, 44(4), 368-75. Retrieved from https://doi.org/10.1111/j.1547- 5069.2012.01466.x.
  • Croll, Z. T., Coburn, A. F., & Pearson, K. B. (2012). Promoting a culture of safety: Use of the hospital survey on patient safety culture in critical access hospitals. (Briefing Paper No. 30). Portland, ME: Flex Monitoring Team. Retrieved from https://digitalcommons.usm.maine.edu/cgi/viewcontent. cgi?article=1015&context=rural_hospitals
  • Dirik, H. M., & İntepeler-Seren, S. (2017) The work environment and empowerment as predictors of patient safety culture in Turkey. Journal of Nursing Management, 25(4), 256-265. Retrieved from https://doi.org/10.1111/jonm.12458.
  • Fackler, C. A., Chambers, A. N., & Bourbonniere M. (2015) Hospital nurses’ lived experience of power. Journal of Nursing Scholarship, 47(3), 267-274. Retrieved from https://doi. org/10.1111/jnu.12127.
  • Ho, W. H., Chang, C. S., Shih, Y. L., & Liang, R. D. (2009) Effects of job rotation and role stress among nurses on job satisfaction and organizational commitment. BMC Health Services Research, 9(1), 8. Retrieved from https://doi.org/10.1186/1472-6963-9- 8
  • Janakiraman, R., Parish, J. T., & Berry, L. L. (2011) The effect of the work and physical environment on hospital nurses’ perceptions and attitudes: Service quality and commitment. Quality Management Journal, 18(4), 36-49. Retrieved from https://doi.org/10.1080/10686967.2011.11918334
  • Jones, T. L., Hamilton, P., & Murry, N. (2015) Unfinished nursing care, missed care, and implicitly rationed care: State of the science review. International Journal of Nursing Studies, 52(6), 1121-1137. Retrieved from https://doi.org/10.1016/j. ijnurstu.2015.02.012
  • Kramer, M., Brewer B. B., & Maguire P. (2013) Impact of healthy work environments on new graduate nurses’ environmental reality shock. Western Journal of Nursing Research, 35(3), 348-383. Retrieved from https://doi.org/10.1177/0193945911403939
  • Kramer, M., Schmalenberg C., Maguire P. (2010) Nine structures and leadership practices essential for a magnetic (healthy) work environment. Nursing Administration Quarterly, 34(1), 4-17. doi: 10.1097/NAQ.0b013e3181c95ef4.
  • Kutney-Lee, A., McHugh M. D., Sloane D. M., Cimiotti J. P., Flynn L., Neff D. F., & Aiken L. H. (2009) Nursing: a key to patient satisfaction. Health Affairs, 28(4), 669-677. Retrieved from https://doi.org/10.1377/hlthaff.28.4.w669
  • Lang, G. M., Patrician P., & Steele N. (2012) Comparison of nurse burnout across Army hospital practice environments. Journal of Nursing Scholarship, 44(3), 274-283. Retrieved from https:// doi.org/ 10.1111/j.1547-5069.2012.01462.x
  • Lake, E. T. (2002) Development of the practice environment scale of the Nursing Work Index. Research inNursing&Health, 25(3), 176-188. Retrieved from https://doi.org/10.1002/nur.10032
  • Liu, K., You, L. M., Chen, S. X., Hao, Y. T., Zhu, X. W., Zhang, L. F., & Aiken, L. H. (2012) The relationship between hospital work environment and nurse outcomes in Guangdong, China: a nurse questionnaire survey. Journal of Clinical Nursing, 21(9-10), 1476–1485. Retrieved from http://doi.org/10.1111 /j.1365-2702.2011.03991.
  • Margall, M. A., & Duquette, A. (2000) Working environment at a university hospital: perception of nurses. Enfermería Intensiva, 11(4), 161-169.
  • Mollaoğlu, M., Fertelli T. K., & Tuncay F. Ö. (2010) Hastanede çalışan hemşirelerin çalışma ortamlarına ilişkin algılarının değerlendirilmesi. Fırat Sağlık Hizmetleri Dergisi, 5(15), 17-30.
  • Nayback-Beebe, A. M., Forsythe, T., Funari, T., Mayfield, M., Thoms, W. Jr, Smith, K. K., Bradstreet, H., & Scott, P. (2013). Using evidence-based leadership initiatives to create a healthy nursing work environment. Dimensions of Critical Care Nursing, 32(4), 166-173. Retrieved from https://doi. org/10.1097/DCC.0b013e3182998121.
  • Numminen, O., Ruoppa, E., Leino-Kilpi, H., Isoaho, H., Hupli, M. & Meretoja, R. (2016) Practice enviroment and its association with professional competence and work-related factors: perception of newly graduated nurses. Journal of Nursing Management, 24(1), E1-E11. Retrieved from https://doi. org/10.1111/jonm.12280
  • Paquet, M., Courcy, F., Lavoie-Tremblay, M., Gagnon, S., & Maillet, S. (2013) Psychosocial work environment and prediction of quality of care indicators in one Canadian health center. Worldviews on Evidence Based Nursing, 10(2), 82-94. Retrieved from https://doi.org/ 10.1111/j.1741-6787.2012.00250.x.
  • Purdy, N., Spence-Laschinger, H. K., Finegan, J., Kerr, M., & Olivera, F. (2010) Effects of work environments on nurse and patient outcomes. Journal of Nursing Management, 18(8), 901- 913. Retrieved from https://doi.org/10.1111/j.1365-2834. 2010.01172.x.
  • Shireyn, M. R. (2009). Stress and coping in nurse managers: A qualitative description (Doctoral dissertation). Retrieved from https://scholarworks.iupui.edu/bitstream /handle/1805/1866 /MRShirey%20Dissertation%20PDF%20E%20090106%20 Rev%20ii.pdf;sequence=1
  • Tan, M., Polat, H., & Şahin, Z. A. (2012). Hemşirelerin çalışma ortamlarına ilişkin algılarının değerlendirilmesi. Sağlıkta Performans ve Kalite Dergisi, 4, 67-78.
  • Türkmen, E., Badır, A., Balcı, S., & Akkuş-Topçu, S. (2011). Hemşirelik iş indeksi- hemşirelik çalışma ortamını değerlendirme ölçeğinin Türkçeye uyarlanması: Güvenilirlik ve geçerlilik çalışması. Hemşirelikte Araştırma ve Geliştirme Dergisi, 2, 5-20.
  • Vaughan, L., & Slinger, T. (2013). Building a healthy work environment: a nursing resource team perspective. Nursing leadership (Toronto, Ont.), (26), 70-77.
  • Wang, Y., Dong, W., Mauk, K., Li, P., Wan, J., Yang, G., Fang, L., Huan, W., Chen, C. & Hao, M. (2015). Nurses’ practice environment and their job satisfaction: a study on nurses caring for older adults in Shanghai. PLoS One, 10(9), e0138035. doi: 10.1371/ journal.pone.0138035
  • Yeşiltaş, A., & Gül, İ. (2016). Hemşirelerin çalışmak için tercih ettikleri birimler ve tercih nedenleri. Mehmet Akif Ersoy Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 4(2), 74-87.
There are 32 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Manar Aslan This is me

Selver Gökdemir This is me

Publication Date December 1, 2019
Published in Issue Year 2019 Issue: 3

Cite

APA Aslan, M., & Gökdemir, S. (2019). Hastanede Çalışan Hemşirelerin Çalışma Ortamı Algısı: Trakya Örneği. Yükseköğretim Ve Bilim Dergisi(3), 614-621.
AMA Aslan M, Gökdemir S. Hastanede Çalışan Hemşirelerin Çalışma Ortamı Algısı: Trakya Örneği. J Higher Edu Sci. December 2019;(3):614-621.
Chicago Aslan, Manar, and Selver Gökdemir. “Hastanede Çalışan Hemşirelerin Çalışma Ortamı Algısı: Trakya Örneği”. Yükseköğretim Ve Bilim Dergisi, no. 3 (December 2019): 614-21.
EndNote Aslan M, Gökdemir S (December 1, 2019) Hastanede Çalışan Hemşirelerin Çalışma Ortamı Algısı: Trakya Örneği. Yükseköğretim ve Bilim Dergisi 3 614–621.
IEEE M. Aslan and S. Gökdemir, “Hastanede Çalışan Hemşirelerin Çalışma Ortamı Algısı: Trakya Örneği”, J Higher Edu Sci, no. 3, pp. 614–621, December 2019.
ISNAD Aslan, Manar - Gökdemir, Selver. “Hastanede Çalışan Hemşirelerin Çalışma Ortamı Algısı: Trakya Örneği”. Yükseköğretim ve Bilim Dergisi 3 (December 2019), 614-621.
JAMA Aslan M, Gökdemir S. Hastanede Çalışan Hemşirelerin Çalışma Ortamı Algısı: Trakya Örneği. J Higher Edu Sci. 2019;:614–621.
MLA Aslan, Manar and Selver Gökdemir. “Hastanede Çalışan Hemşirelerin Çalışma Ortamı Algısı: Trakya Örneği”. Yükseköğretim Ve Bilim Dergisi, no. 3, 2019, pp. 614-21.
Vancouver Aslan M, Gökdemir S. Hastanede Çalışan Hemşirelerin Çalışma Ortamı Algısı: Trakya Örneği. J Higher Edu Sci. 2019(3):614-21.