Objective: To identify the latent category characteristics of self-directed learning competence and innovation behavior of nurses in grade A tertiary hospitals, analyze the influencing factors of different characteristics, and put foward to the corresponding improvement countermeasures. Methods: From October to November 2022, 1 042 nurses from 3 grade A tertiary hospitals were investigated with the general information questionnaire, self-directed learning competence for nurses, and nurse innovation behavior scale. Results: There were three potential profiles of self -directed learning competence and innovation behavior of nursing staff in grade A tertiary hospitals including C1 "insufficient self-directed learning competence-low innovation behavior"(30.33%), C2"general self-directed learning competence-medium innovation behavior"(49.81%), C3 "high self-directed learning competence-proactive innovation behavior"(19.86%). Multiple Logistic regression analysis showed that the importance of nursing research on career development, scientific research atmosphere of the department, career orientation, and frequency of reading professional journals at daily time were influencing factors for different types of self-directed learning competence and innovation behavior among nursing staff ( P<0.05). Conclusion: There was heterogeneity in the self-directed learning competence and innovation behavior of nursing staff in grade A tertiary hospitals. Three expected types of self-directed learning competence and innovation behavior were identified. In particular, attention should be paid to the importance of nursing research on career development, scientific research atmosphere of the department, career orientation, and frequency of reading professional journals at daily time, so as to develop targeted nursing measures for nursing staff with different types of self-directed learning competence and innovation behavior, so as to improve their self-directed learning competence and innovation behavior.

Objective: To explore the relationship and internal mechanism of self-efficacy, readiness for hospital discharge and Internet medical treatment willingness. Methods: A total of 307 patients were selected from a third-class hospital in Tianjin on the day before discharge. Self-efficacy level, readiness for hospital discharge and willingness to adopt“Internet + nursing service” of the patients were investigated by general information questionnaire, readiness for hospital discharge scale, general self-efficacy scale and willingness to adopt “Internet + nursing service” questionnaire. Data were statistically analyzed using SPSS 21.0 and AMOS 21.0. Results: There was a positive correlation between patients’ discharge readiness, self-efficacy and willingness to adopt “Internet + nursing service”( P<0.001). Discharge readiness could not only directly affect patients’ willingness to adopt “Internet + nursing services”, but also indirectly affect the willingness to adopt“Internet + nursing services” through self-efficacy. Conclusion: Self-efficacy plays an intermediary role between middle-aged and elderly patients’ readiness for hospital discharge and willingness to“Internet + nursing service”. Managers should pay full attention to improve the self-efficacy level of such people and enhance their willingness to seek medical treatment on the Internet.

 Objective:To understand the job satisfaction of junior nursing staff and construct its structural model. Methods: A total of 296 junior nursing staff with a working life of less than or equal to 3 years were selected. General information questionnaire, nurse occupation identification scale, nurse occupational values scale, nurse job engagement scale and job satisfaction scale were used to conduct surveys, and then constructed the structural equation model of job satisfaction. Results: The total score of job satisfaction of the 296 nursing staff was 21.54±4.57, and the scores of each dimension were ranking from high to low: satisfaction with colleagues, satisfaction with the work itself, satisfaction with the leader, overall satisfaction, satisfaction with promotion, satisfaction with salary. The results showed that in terms of the overall effect, professional identity had the strongest effect on job satisfaction and the path coefficient was 0.741. In terms of direct effect, professional values had the strongest effect on job satisfaction and the path coefficient was 0.376. Conclusion: The job satisfaction of junior nursing staff was at a relatively high level, and professional identity had the strongest overall effect on job satisfaction. It is recommended to formulate a standardized training system, pay attention to the vocational education of junior nurses, guide them to establish correct professional values, enhance their professional identity and professional investment, then improve job satisfaction.

Objective: To explore the influence of nurses’ authorization ability and job satisfaction on turnover intention in grade A hospitals, and to clarify the mechanism among them. Methods: From October 16, 2018 to October 29, 2018, a cross-sectional questionnaire was conducted among 508 registered nurses in a grade A hospital in Tianjin by questionnaire stars. Results: Psychological empowerment and job satisfaction were negatively correlated with turnover intention( P<0.05), but there was no significant correlation between structural authorization and turnover intention( P>0.05). At the same time, the structural equation model was constructed, which nurses’ psychological empowerment and structural authorization were taken as independent variables, job satisfaction as intermediary variables, and turnover intention as dependent variables. The results showed that the fitting indexes were CMIN/DF=2.182 < 3, GFI = 0.929 > 0.90, AGFI= 0.905 > 0.90, RMSEA = 0.048 < 0.05.The total effects of structural authorization and psychological empowerment on turnover intention were 0.293 and-0.344 respectively, and the total effect of job satisfaction on turnover intention was-0.320. Conclusion: The turnover intention of nurses in grade A hospitals is still on the high level, the psychological empowerment is the main negative predictor, and structural authorization has the strongest indirect effect on nurses’ turnover intention.