Các yếu tố ảnh hưởng đến động lực làm việc của nhân viên tại bệnh viện thống nhất thành phố hồ chí min

TAP CHi CONG THIflfNG CAC YEU TO ANH Hl/CfNG DEN DONG L d c LAM VIEC CUA NHAN VIEN TAI BENH VIEN THONG NHAT THANH PHO HO CHI MINH • DINH KIEM - PHAN TIEU TRAM TOM TAT: Nghidn effu dffdc thffc hidn nham muc dich xac dinh cdc yeu td' dnh hffdng dd'n ddng Iffc Iam viec ciia nhan vien (NV) tai Benh vien Thdng Nhd't (BVTN) Thdnh ph6 H Chi Minh Sd lieu phuc vu d l tai dffdc thu thdp, khao sdt tff 165 nhan vidn dang lam viec tai BVTN Phffdng phdp md hinh ca'u true tuye'n tinh (SEM) dffdc ffng dung nghien cffu nham xdc dinh cdc yeu to' dnh hffdng de'n dpng life lam vide cua nhdn vidn y td' dd'i vdi tS chffc Kd't qua thffe hidn nghidn cffu da cho thd'y cd yd'u td'tae ddng dd'n ddng Iffc lam vide cua NV tai BVTN, dd la: cong viec thu vi, sff cdng nhan, thu nhap va phuc ldi, dao tao va phat trien, mdi trffdng lam viec, mdi quan hd vdi dong nghidp, lanh dao trffc tid'p Trong dd, yd'u td' mdi trffdng lara vide cd tdc ddng manh nha't d^n dpng lffc lam vide cua NV tai BVTN Tiif khoa: Yeu td' anh hffdng, dpng Iffc Iam viec cua nhan vien, Benh vien Thd'ng Nhat Thanh phd' Ho Chl Minh Gidi thieu tong quat Bdnh vien Thd'ng Nha't Id mdtbenh vien trung ffdng loai I trffc thupc Bd Ytd'ddng tai phd Ho Chi Minh Luc mdi ldp, bdnh vidn chi cd quy md 450 giffdng va chu ye'u la kham vd dieu tri ndi va ngoai chung Hien nay, Benh vien dd phdt trien va md rdng quy md 1225 giffdng, gdm: 29 khoa Idm sdng, 10 khoa cdn ldm sdng, II cd quan vdi gan 1300 can bd vidn chffc thffc hien nhiem vu chinh la kham va chffa bdnh cho can bp cao cd'p cua Ddng, Nha nffdc, life Iffdng vii trang, nhdn ddn cac tinh phia Nam va khu vffc lan can Benh vidn eung dffdc Bp Y te' dau tff, quan tam, cd sd vat chd't, nhdn lffc vay chd't lffdng dich vu y te'ngay cdng tdng Tuy vay, va'n de nhdn life dang gap nhieu khd khan ca vi chd't Iffdng vdsd'Iffdng Dd'i vdi cha't Iffdng, va'n de ndi trdi lam han che' de'n hidu qua thffc hidn cong 184 So 12-Thang 7/2019 viec la ddng Iffc Iam viec ciia nhdn vidn Hien tai, mdi trffdng lam vide tai cd sd y td' ndi chung chiu dffng nhieu dp Iffc, tid'p xuc vdi benh nhan co nguy cd cao Iam eho nhan vien y te' dd chan nan cdng viec va lam viec se kem hieu qua, tff cd the gdy nhffng sai sdt chan doan va dieu tri bdnh dan de'n nhffng hau qua dang tide Nghidn cffu sff dung md hinh dinh Iffdng PLS-SEM nhdm tap trung phdn tich khdm phd cdc yd'u to'anh hffdng dd'n tao ddng Iffe lam vide cho nhan vidn tai Bdnh vidn Thd'ng Nha't Thanh phd' Ho Chi Minh Nhffng ke't qua se la cd sd de nhffng nha quan ly tham khdo, de xud't giai phdp nham tang cffdng ddng li;c ldm vide eho bdc sT nham giup dpi ngu nhan vien y te Iam vide ngdy cang hieu qud, gan bd lau dai vdi bdnh vidn vS ndng cao ehat Iffdng cham sdc va bdo ve nhdn dan qUANTRj-qUANLY Phffdng phdp phdn tich ca'u tnic tuyd'n tinh Id cdng cu dinh Iffdng cao cap nghidn cffu kinh td', ky diuat PLS-SEM chi mdi dffdc sff dung ra't bid'n nhffng nam gin ddy va thffdng dffdc gpi la phffdng phap phdn tich thdng tin the' he diff hai (HuUand & Lam, 1996) Theo Hair et al (2014), tff nhffng nam 2000, sd nghien cffu sff dung PLS SEM dffde edng bd tang len theo cd'p sd' nhan Md hinh nghien cu'u 2.1 Khung ly thuyet nghien cdu Nghien cffu ve ddng lffc Iam vide eua nhan vien gdn vdi mdt to chffc da dffdc nghien cffu kha phd bie'nffffdcddy Lidn quan dd'n de tai ddng lffc lam viec ttdn did' gidi thi ed md hinh 10 nhan td' tao dong life Iam viec dffdc phdt trid'n bdi Kenneth S.Kovach (1987), nd dffdc bid'n rdng rai va difdc nhilu nhd nghidn cffu kiem dinh nham kham phd edc nhdn td' tao ddng life lam viec d nhilu Iinh vu'c khac Tren thd' gidi da cd nhieu nghidn cffu di sdu vao nganh Y te' nhff: Cdng trinh ciia tac gia Mischa Willis - Shattuck va cdng sff (2008) tid'n hanh nghidn cffu tai mdt sd' qudc gia dang phat tri^n d chau Phi va chau A (cd ca Viet Nam) ve cac ye'u td' anh hffdng de'n dpng life lam vide cua NVYT Cong trinh nghien cffu cua Persefom Lambrou (2010) "Cdc yd'u td' anh hffdng den dpng Iffc lam vide ciia nhan vidn y td' d bdnh vidn Nicosia tai Cyprus" Ngoai ra, d Viet Nam cung cd nhieu nghien cffu ve vdn de ndy vdi nhffng kd't qud tidu bieu nhff cong trinh nghien cffu eua Hodng Hing Hanh (2011) diffc Men cdng trinh "Nghien cffu cac ye'u to lien quan dd'n ddng life lam viec cua bac si Bdnh vidn Y hpc C6 truyen Trung ffdng ndm 2011" Cdng trinh cua Nguydn Dffe Trffdng (2015) nghien cffu "Ddng lffc lam vide cua nhan vien y td' khd'i lam sang vidn phdp y tam than trung ffdng vd mpt so yd'u to lidn quan nam 2015" Cdng trinh nghien cffu cua Nguydn Viet Trieu (2015) nghien cffu "Dpng life lam vide vd mdt sd'yd'u to lien quan eua nhan vidn y td', tai Bdnh vidn Da khoa Hoan My Cd Mau nam 2015" Nhin chung, cac nghien cffu nffdc deu difa tren cd sd md hinh 10 nhan td' ciia Kovach, cac tdc gid da so sanh nhffng net tffdng ding va di biet dd'i vdi nghidn cffu dae thu cua minh, tff dd gan loc hoac bd sung cdc nhdn td mang tinh thffc tien va phu hdp hdn Kd' thffa ke't qua nghien cffu ciia cac tdc gia hdn, md hinh nghien cffu dffdc de xud't bao gom yeutd(frmh 1) Hinh 1: M6 hinh nghien cOu Cong w$c thu v| Su cong nh$n Thu nhSp va phuc ldi £)ao tao va phat trien Lanh dao trffc tiep 2.2 Thang cdc khdi niem nghien cdu Thang cac bie'n quan sat (Bdng 1) 2.3 PhiiOngphdp phdn tich vd kich thi^c mdu 2.3.1 Phucmg phdp phdn tich Theo Henseler & Chin (2010), md hinh nghien cffu dffdc danh gid qua bffdc la danh gid md hinh Iffdng vd md hinh ca'u tnic Diu tien, md hinh Iffdng dffdc ddnh gid thdng qua ddnh gid dd tin cdy, gid tri hdi tu vd gia tri phan biet ciia cdc khdi nidm Iffdng md hinh Trffdc tidn tie'n hanh Iffdng mffc dd phu hdp eiia md hinh vdi dff lidu nghidn cffu, sff dung chi sd' SRMR (standardized root mean square residual) de so sdnh Ye'u can ehi sd' SRMR phai dat gid tn nhd hdn 0.08 hoac 0,1 (Hu and Bentier "(1999)) Ngoai ra, Henseler et al (2014) cung eho rang chi sd' SRMR la ehi so' md hinh phu hdp (Goodness of fit) cua md hinh PLS-SEM, cd the dffdc sff dung nd d l tranh hidn tffdng sai lech didng sd rad hinh Vdi dd tin cay (rehability) eiia cdc bien quan sat phai cd he so' tdi ngodi (outer loading) ldn hdn hodc bang 0,5 Uii dat yeu cau vl dd tin cdy va hd sd tin cdy tdng hdp (composite rehability) phai ldn hdn hodc bang 0,7 thi dat dd tm cay md hinh (HuUand, 1999) Vdi dp gia tri hdi tu (convergent validity) dffdc sff dung dl ddnh gid sff dn dinh cua thang Theo Fornell and Larcker (1981), hd so' AVE (average variance extracted) phai ldn hdn hoac bang 0.5 So 12-Thdng 7/2019 185 TAP CHi CONG IHIfdNG Bang Thang cdc bien quan sdt Nhan to Congviec thuvi Sucdng nh^n Thu nhSp va phuc ldi Oac tao va phat trien lam vi§c Moi quan h$ vdi ddng nghi^ Lanh dao trffc tiep Ma hda Bien quan sat CV1 Anh/chi luon chu dpng cdng viec dUOc giao CV2 Anh/ch! ludn nd'luc lam viec nham dat muc tieu chung ciia Benh vien CV3 Anh/chj cd tinh than trach nhiem doi vdi cdng viec ma minh dam nhan CV4 Anh/ ch! cho rang minh cd mot cdng viec on dmh va an toan CNI Lanh dao san sang ddn nhan nhQng sang ki§n cai ti€'n cua anh/ chj CN2 Lanh dao ludn ghi nhan nhOng ket qua ma anh/ch; dgt dupc CN3 Anh/cht thffdng xuyen dong gdp y kien vao cac quySt dmh quan trpng cua benh vien CN4 Phffdng phap binh xet thi dua va khen thudng hien cua benh vien la cdng bang hop ly TNI Anh/chj cam thay minh dupc tra luong tUdng xdng vdi nhQng viec ma anh chj lam TN2 Anh/chj cam thay minh cd dupc nang IUdng dung hgn va dung quy djnh TN3 Anh/chj cam thay hai Idng vdi cO hdi tang IUdng TN4 Che dd phu cap, dac thu cong viec cua anh chj la phu hpp DTI Kinh nghiem lam viec cua anh/chj dUdc nang cao qua qua trinh iam viec DT2 Anh/cht duoc benh vien tgo dieu kien, cd hpi de hoc tap nang cao trinh dp DT3 Benh vien dam bao cdng bSng vide hpc tap, bdi dudng nhan vien DT4 Cdng tac quy hogch can bp dUdc thffc hidn tdt DT5 Vide bd nhidm lanh dao khoa, phdng dam bao cdng bang hpp ly MT1 Thdi gian lam viec phu hpp MT2 Ndi lam viec dam bao su an toan thoai mai MT3 Cdng viec cua anh/chi on dmh, khdng lo mat viec MT4 Anh/chi dupc cung cap day du phuong tien may moc va thiet bi phuc vu cho cdng viec DN1 Dong nghidp cua anh/chj luon san Idng giup dd \Sh DN2 Cac dong nghiep ludn hdtrp Chia se kinh nghiem chuydn mon vdi anh/chi cdng viec DN3 Dong nghidp cua anh/chj la ngudi thdn thien trung thffc DN4 Anh/chi dupc hoc hoi chuyen mdn, kinh nghiem tCf dong nghidp LDI Lanh dao cua anh/chi giai quye't tdt nhUng khd khan vudng mac ddn Vj khoa, phdng LD2 Lanh dao quan tam ddn tam tu, nguyen vong cua nhan vien cap dffdi LD3 Lanh dao cd ddng vien kip thdi anh/chi hoan nhiem vu LD4 Lanh dao hudng dan nhiet tinh cho anh/ chi cong viec 186 So 12-Thang 7/2019 Nguon Hoang Hdng Hanh (2011) Hoang Hdng Hanh (2011) Nguyeh Viet Trilu (2015) Hoang Hdng Hanh (2011) Nghien cdu dmh linh Nghien cdu dinh tinh Nguyeh Vidt Trieu (2015) QUAD TII-QUAN IV Nhan to Ma hoa TM1 SUthoa man cdng vi§c D$ng life lam vl^c Bien quan sat Nguon Anh/chi hai long vdi cdng viec dang lam Nguyeh Viet Trieu (2015) TM2 Anh/chi mong mudn gan bo lau dai vdi benh vidn TMS Anh/chj ludn coi benh vien la mai nha thU hai cua minh TM4 Anh/chj cam thay tu tin gidi thidu ve noi lam viec DL1 Anh/chj iudn cam thay hUng thu lam viec DL2 Anh/chi thay dupc dpng vien cdng viec DL3 Anh/chi thudng lam vide vdi tam trang tdt nhat DL4 Anh/chj ludn noHuc het sUc minh de hoan cdng viec dupc giao DL5 Anh/chi luon tich cue tham gia cac hoat dpng cua benh vien Nghien cUu dmh tinh Ngudn: Ket qud thdo ludn nhom cua tdc gid, 2019 variance extracted) se khdng dinh dffdc dp gia tri hdi tu He sd' tai cua mdi bie'n quan sdt ldn nhan tdldn hdn hodc bang 0,7 va cd y nghia Id bang chffng ve dp tin cay cua cdc thang Dd gia tri phdn biet (discriminant vahdity) dffdc kiem dmh de Iffdng dp gia tri phan bidt giup dam bao sff khac bidt, khdng cd md'i quan he tffdng quan giffa cdc ye'u td' sff dung Iffdng cde nhdn td' (Haff vd edng sff, 2014) bang each binh phffdng tdng phffdng sai trich AVE Ki^m dinh Bootstrapping v^ dd tin cay cua md hinh, cde ky thudt phan tich va danh gid md hinh d trdn, chung ta e^n phai ddnh gid chung ve dp tm cay eua cdc tham so'ffdcIffdng la hd't sffc c^n thid't Trong NCKH, cd nhieu phffdng phap khac de danh gia dd tin edy cua cdc ffdc lffdng md hinh, nhffng dffdc sff dung tffdng dd'i phd bid'n Id phffdng phap kiem dinh Bootstrapping Npi dung chu yd'u diing ky thudt thay the' de chpn lffa sff phii hdp (Schumaker va Lomax (2004)), Bootstrapping diing Id'y mdu lap lai, dd mau ban dau ddng vai trd tong the 2.3.2 Kich thudc mdu phdn tich Kich thffdc mau eho phffdng phdp ffdc Iffdng dffde sff dung md hinh ca'u true tuye'n tinh (PLS-SEM) cd loai Id mdu nhd < 100, mdu trung binh 100 - 200 va mdu ldn > 200 (Haff va cdng sff, 2014), Cd mdu cua nghidn ClJu la 165, nhff vdy cd bdn da ddp ffng dffdc ydu cau cua phffdng phap phan tich Kd't qua nghidn cihi va thao luan 3.1 Ddnh gid sdbg tin cdy cua thang md hinh nghiin cdu 3.1.1 Kiim dinh Cronbach's Alpha Kd't qua kiem dinh dd tin cay bang hd sd' Crdnbach's Alpha cho tha'y cdc thdnh phan cua thang dffde trinh bdy Bang Kd't qua kiem dinh cdc phan cua thang ddu ed Bdng Ket qud kj^m dd Hn cqy cua thang STT Thang Cronhtiach's Alpha SS bien quan sat lai Cong viec thu vj 818 Sucdng nhan 0.784 Thu nhap va phuc loi 0.815 4 Dao tao va phat then 786 5 Moi trudng lam viec 816 Moi quan he v6i dong nghiep 0.847 Lanh dao trdc tiep 0.828 Sd thoa man 0.840 Ddng luc lam viec 0.865 Nguon: Ket qud phan tich tif sd lieu khao sdt, 2019 So 12-Thang 7/2019 187 TAP CHi CQNG THIftfNG Cronbach's Alpha > 0,6 va khdng ed bid'n Iffdng ndo ed tffdng quan be hdn 0,3 Nhff vdy, 38 bid'n quan sdt cdn lai tid'p tuc dffdc dffa vdo phan tich nhan td'khdm phd EFA 3.1.2 Phdn tich nhdn td'EFA Ket qud phdn tich nhdn td'EFA cho cdc bie'n doc lap Phffdng phdp trich nhan td' dffdc sff dung Principal Component Analysis va phep quay Varimax Thang dffdc chd'p nhdn 0.5 < KMO < (Hair & cong sff, 1998); he sd Sig = 0.000 cua kiem dinh Bartiett cho bid't cac bie'n quan sat tffdng quan vdi cd y nghia thd'ng kd; tdng phffdng sai trich cd gia tri > 50% (Gerbing & Anderson, 1988) Kd't qua phan tich trich nhdn to' EFA dffdc trinh bay Bang cho tha'y cd bid'n quan sdt bi loai bie'n tai Idndca nhan to'la bid'n quan sat cua thang "Dao tao vd phdt tridn" (DT4) sau loai I bid'n quan sat ndu tren, ta thffe hidn lai qua trinh phan tich EFA eho ke't qud nhff sau: + Hd sd KMO dat 0.771 eho thd'y phdn tich nhan td' EFA phii hdp vdi dff lieu Thd'ng ke Chi-Square cua kiem djnh Bartiett dat 1833.394 vdi mffc y nghia Sig = 0.000 cho dia'y cdc bien quan sdt c6 tffdng quan vdi xet trdn pham vi tdng thd + Kd't qua phdn tich EFA eho tha'y tdng phffdng sai trich TVE Id 65.548% (>50%), dieu th^ hidn rang nhdn to' dffdc trich cd thd gidi thich dffdc trdn 65.548% sff bid'n thidn cua dif lieu Ddy la ke't qua chd'p nhan dffdc va viec xdy dffng md blnh la phu hpp + He so' tai nhan td' giao ddng tff 0.720 dd'n 0.847 (>0.5), khdng cd bie'n nao cd he sd^tai cao ddng thdi tren hai nhan to' Nhff vay, cac thang dat gia tri hdi tu + Diem dffng trich cdc nhdn to' tai nhdn t^ thff vdi Eigenvalue la 1.422 > I cho thd'y ke't quit phdn tich nhan td la phii hdp + Cde bid'n quan sat cd he so' tai deu dat yeu cau Ket qud phdn tich nhdn to EFA cho cdc bien trung gian Phffdng phap trich nhdn td' duac sff dung la: Principal Axis Factoring vdi phep xoay Promax Ke't qua hd sd KMO = 0.779 > 0,5 Thd'ng ke ChiSquare ciaa kiem dinh Bartiett dat 262,089 vdi mffc Bdng Ket qud EFA thang cdc nhan to dnh tiUdng den dpng lUc lam vr§c STT Nhintd Bien DN2 0.847 DN4 0.845 DNS 0.814 DN1 0.795 LD4 0.801 LDI 0.798 LD2 0.755 LD3 0.739 CV2 0.826 10 CV4 0.786 11 CV1 0.764 0.768 TSn nhfiin to Moi quan he vdi ddng nghidp Lanh dao trgc tISp Cdng viec thu Vj 12 CV3 13 TN3 0.789 14 TN1 0.772 15 TN2 0.757 16 TN4 0.760 188 Sd 12-Thdng 7/2019 ThunhSpv^ phuc 101 QUAN IRj-QUAN l y Nhan to STT Bien 17 MT2 0.809 18 MT1 0.768 19 MT3 0.753 20 MT4 0.731 21 CN2 0.796 22 CNI 0.787 23 CN4 0.742 24 CN3 0.720 2S DTI 0.787 26 DT5 0.767 27 DT3 0.763 28 T§n nhin t5 Ivldi trudng lam viec Sucdng nhan Dao tao va phat tnen 743 DT2 29 Eigenvalue 5.425 2.896 2.764 2.158 2.031 1657 1.422 30 Phddng sal dude gicil thich (%) 19.376 10.343 9.873 7.707 7.255 5.917 5.077 31 PhUdng sai dddc giai thich lich luy (%) 19.276 29.719 39.692 47.300 54 554 60.471 65 548 Nguon: Ket qud phdn tich tH: sd'lieu khdo sdl 2019 y nghia Sig = 0.000 He so Eigenvalues dat 2,704 Tong phifdng sai trich cua thang "Si/ thoa man cdng viec" = 67.605% > 50% Ket qua phan tich nhan to' EFA cho cac bien phu thuoc Phddng phap trich nhan td' diTdc su" dung la: Principal Component Analysis va phep quay Varimax He so KMO = 0.835 > 0.5 Thong ke Chi-Square cua kiem dinh Bartiett dat 366.114 vdi mu'c y nghia Sig = 0.000 He so Eigenvalues dat 3,251 long phrfdng sai trich cua thang "Suthoa man cong viec" = 65.018% > 50% (Bang 4) Nhan to' thu" nhat co bie'n quan sat la CVl, CV2, CV3, CV4 diJdc lap hdp tiir bien cua nhan to "Cdng viec thii vi" dUdc vie't tat la CONGVIEC Nhan to' thiJ hai cd Men quan sat CN 1, CN2, CN3, CN4 dddc tap hdp iij bie'n ciia nhan to' "Sir cong nhan" vie't tat CONGNHAN Nhan to' thu- ba cd bie'n quan sat TNI, TN2, TN3, TN4 difdc tap hdp til bie'n ciia nhan to' "Thu nhap va phuc ldi" vie't tat THUNHAP Nhan to'thu-tir cd bie'n quan sat DT 1, DT2, DT3, DT5 dKdc lap hop lif bie'n cua nhan to "Dao lao va phat trien" vie't tat DAOTAO Nhan to thiJ nam cd bie'n quan sat MTl, MT2, MT3, MT4 Bdng Ket q u a phdn tich nhon to EFA cho c o c bie'n phu thuoc H$ so tai nhan to Bien qiian sat Anh/chi thudng lam viec vdi tam trang tdt nhat Anh/chi thay dUdc ddng vien cong viec Anh/chi ludn cam thay hdng thu lam viec Anh/chi ludn tich cdc tham gia cac hoat ddng cua benh vien Anh/chi ludn nd'luc het sdc minh de hoan cdng viec ducc giao 0.789 Ngudn • Kel qua phdn tich dd lieu ciia tdc gid 2019 So 12-Thdng 7/2019 189 IAP CHi CONG IHIflNC ddOc tap hdp tir bie'n cua nhan to' "Mdi tnfdng Iam vide" vid't tat MOITRUONG Nhan td diiJ sau cd bie'nquansatDN!,DN2,DN3,DN4 difdc tap hdp tiif bid'n cua nhan td' "Md'i quan he vdi dong nghiep" vid't tat DONGNGHIEP Nhan td' thii bay cd bien quan sat LDI, LD2, LD3, LD4 du'dc tap hdp til bien cua nhan to' "Lanh dao tru'c tie'p" vie't tatLANHDAO Cac gia thuye't ciia md hinh hieu chinh dddc dat nhu-sau (Hinh 2); Hinh 2: Md hinh nghien cOu hieu chinh (outer loading) Trong dd, he sd' tin cay tdng help phai Idn hdn 0.7 va he sd' outer loading phai Idn hdn 0.4 (Hair et al., 2014) thi cd y nghla ve gia tri tin cay Ngoai ra, theo Fornell and Larcker (1981) thi tong phifdng sai trich Idn hdn mdc 0.5 se khang dinh dUdc tin cay va gia tri hoi tu eua thang Ke't qua tinh toan ve dp tin cay tong hdp, he sd'tai nhSn td'va phu'dng sai trich cua cac thang phan cho thay cae thang cua khai niem deu dat ydu cau ve dd tin cay va gia tri hdi tu (Bang 5) Bang Ket qua tin cdy va gia trj hpi tu cua thang + Hi: Cdng vide thu vi tac ddng tieh cifc ddn sU thda man ve cdng vide cua nhan vien + H2: Sir cdng nhan tac ddng tich cifc de'n sif thda man ve cdng vide cua NV + H3: Thu nhap va phuc ldi tac dgng tich cilc dd'n su' thda man ve cdng vide eua NV + H4: Dao tao va phat trien tae ddng tieh cife de'n sif thda man ve cdng vide cua NV + H5: Mdi tru'dng lam vide tac ddng tich cifc de'n sif thda man ve cdng viec ciia NV + H6: Md'i quan he vdi dong nghidp tac ddng tich ciTc de'n sif thoa man ve edng viec cua NV + H7: Md'i quan he vdi lanh dao tac ddng tich cdc dd'n sif thda man ve cdng vide eua NV + H8: Sif thda man edng viec tac ddng tich eifc dd'n su" thda man ve cdng vide ciia NV 3.3 Phdn tich mo hinh cd'u trdc tuyen tinh (SEM) 3.3.1 Kiim dinh mo hinh ludng (measurement model) De danh gia tin cay cua thang do, nghidn cu'u siJ dung he so' tin cay tong hdp CR, tdng phifdng sai trich AVE va hd sd' tai nhan td' ddn le 190 So 12-Thdng 7/2019 D$ tin c$y long phUdng sai trich tong hpp (AVE) (CR) Nhinto Cronbach's Alpha CONGNHAN 0.764 0.864 0.679 CONGVIEC 0.818 0.879 0.645 DAOTAO 0.731 0.842 0.641 DONGLUC 0.865 0.903 0.650 DONGNGHIEP 0.847 896 0.682 tANHDAO 0.828 0.885 0.659 MOITRUONG 0.816 879 0.644 Nguon KS'i qud phdn tich dd Ueu cua ldc gid, 2019 Gia tri phan bidt (discriminant validity) difdc kiem dinh dd' lu'dng gia tri phan biet giiip dam bao sif khac biet, khdng cd md'i quan he tu'dng quan giifa cac ye'u td' sii dung lifdng cac nhSn td' (Hair va cdng stf, 2014) bang each binh phifdng tdng phu'dng sai trich AVE Cd the tha'y diTdc tat ca cac gia tri HTMT cd gia tri 0.986 > 0.85 Tac gia tid'n hanh loai bd sd' bie'n TM2, TM4, DLl (cd can nhSc ndi dung) Nhuf vay, cac nhan td deu dat yeu cau ve gia tri phan bidt (Bang 6) Thdm vao dd, de xac dinh ty Id HTMT, ndn kie'm dinh xem eae gia tri HTMT cd khac cd j nghia thd'ng ke hay khdng Yeu c^u phai difdc trai qua danh gia khoang tin cay bang phifdng phap Boostrap Cot 2.5% va 97.5% chi ngifdng gidi han va eao ciia 95% khoang tin cay, 3.3.2 Kiem djnh mo hinh cd'u true (structual model) Kiem dinh ve gid dinh vi pham da cong tuyen (Multicollinearty) Vide irdc liTdng hd so' dirdng dSn difa tren h6i QUANTRI-QUANLY Hinh 3: He so' nhdn td tai ngodi bdng Smart PLS J "" 0781—•! DTZ ^^ r Vpa345-»{^ '^X / 0.301 DLl Dl? DL3 { \ DL4 I '^'•^ Ngudn • Ket qud phdn tich dit lieu cua tdc gid 2019 Bang Kef qua CONG NHAN CONG VIEC DAO TAO kiem djnh gid trj phdn biet DONG LUC DONG NGHIEP LANH DAO MOI TRUONG THOA MAN THU NHAP CONGNHAN CONGVIEC 0.197 DAOTAO 0.100 DONGLUC 0.667 391 207 DONGNGHIEP 0.071 0.058 0.078 LANHDAO 0.302 0.378 216 0.501 0.133 MOITRUONG 0.385 0.257 0.203 0.705 0.059 0.312 THOAMAN 0.548 0.438 285 0.894 0.288 0.580 582 THUNHAP 0.273 0.289 0.125 507 094 452 0.489 0.100 294 0.644 Nguon: Ket qud phdn tich dff lieu ciia ldc gid, 2019 quy ciia ti^ng bie'n phu thudc va bid'n dif doan (Hair va edng sif, 2014) Ne'u sd' cac bid'n ddc ISp, nd'u cd xay hien ttfdng da cdng tuye'n thi cac hd sd'difdngdSn khdng dam bao Kd't qua ciia VIF chl rang stf hen ke't gitfa cac nhan td dif doan khdng vi pham gia dmh ve da cdng tuyen vi tS't ca cac he sd' deu nam khoang chap nhSn (VIF = 1.014 - 1.359 THOAMAN vdi he so Nguon: Ke't qud phdn tich dQ liSu c^a tdc gid tac ddng (p = 0.233) (3) THUNHAP ^ THOAMAN vdi hd sd' tac dong (p = 0.229) Ben canh gia trj R^, Q- la mot danh gia bd sung cho md hinh phii hdp (Geisser 1974; Stone, 1974) (4) DONGNGHIEP ^ THOAMAN vdi he so Gia tri Q2 ldn hdn dd'i vdi mot bid'n tiem an ndi tac ddng (p = 0.226) sinh ke't qua cu the chi stf hen quan dtf bao cua (5) DAOTAO ^- THOAMAN vdi he so t^c md hinh dtfdng dan dd'i vdi khai niem phu thudc ddng (p = 0.196) cu the (Chin, 2010) De cd dtfdc gia tri Q', (6) LANHDAO -> THOAMAN vdi hd sd' tic phtfdng phap Blindfolding dtfdc su" dung PLS ddng (p = 0.193) d^ Itfdng Kd't qua eho thEl'y, stf lidn quan dtf bao (7) CONGVIEC -> THOAMAN vdi he so tic Q^ eua nghien etfu do'i vdi ta't ca cac ca'u true ddng (p = O.I70) Idn hdn (0.443 va 0.340), chi rSng tS't ca eac Nhtf vay, ca gia thuye^t deu dtfdc chap nhan bid'n phu thude md hinh deu co mtfc lien d tin cay 95% Dieu cho tha'y cdc gia quan tidn doan (Bang 7) thuyd't dtfa deu tac ddng dd'n stf Ihda man cdng viec cua nhan vien Trong nghien ctfu cDng Tac ddng eua eac yd'u td' dtf doan dtfdc kie'm nhin nhan md'i quan he gitfa Stf thda man cdng dinh bang tac dong cua (P) (Hair va edng stf, (bie'n trung gian) viec dd'i vdi dpng life lam vide 2013) Ket qua cho tha'y, tS't ca cac ye'u to' deu cd cd md'i ttfdng quan manh va cd quan he cung mtfc anh htfdng ttfdng dd'i dao ddng ttf 0.059 chieu nhtf sau: 1.196 (Bang 8) THOAMAN ->• DONGLUC Bang Ket qud gia trj P vd mtjlc d d dnti hi/dng vdi he sd tac ddng (p = 0.738) Gia tri P Mtic d$ atih hudng Ngoai ra, cac ddng nhan to'tac Moi quan h$ giQa cac bien dpng ehinh de'n stf thda man dtfdc Trung binh 0.116 CONGNHAN ^ THOAMAN ghi nhan theo thtf ttf quan trpng la 0.059 Nho CONGVIEC -> THOAMAN MOITRUONG ^- THOAMAN, THUNHAP ^ THOAMAN, 0.082 Nho DAOTAO -* THOAMAN CONGNHAN -» THOAMAN, 0.122 Trung blnh DONGNGHIEP ^ THOAMAN DONGNGHIEP -> THOAMAN la hoan toan phu hdp vdi thtfe te' 0.070 Nho LANHDAO -^ THOAMAN cdng vide gan vdi ddng Itfe Iam 0.110 Trung blnh MOITRUONG -> THOAMAN viec hien tai Bdnh vien Thd'ng 1.196 Ldn THOAMAN ^ DONGLUC Nha't Qua ke't qua kiem dinh mo blnh ly thuyd't ta dtfdc mo hinh 091 Nho THUNHAP -> THOAMAN dieu chinh nhtf sau: Ngudn: Ket qud phdn tich du lieu cua tdc gid, 2019 Ttf ke't qua nghidn ctfu da cho tha'y ea ye'u td' deu anh htfdng de'n stf thda man cdng vide cua nhan vien, nhieu Ke't qua cdu true tuyen tinh nha't la: (1) Mdi trtfdng lam vide, (2) Stf cdng nhan, Be kiem tra xem hd so'dtfdng dan cd khae biet (3) Thu nhap va phiic ldi, (4) Md'i quan he vdi dong dang ke' so vdi 0, gia tri t dtfdc tinh toan thdng qua nghidp, (5) Dao tao va phat trie'n, (6) Lanh dao bootstrapping Trong nghien ctfu nay, ky thuat tru'c tid'p, (7) Cdng viec thu vi va ca yd'u to' bootstrapping phi tham so' dtfdc kid'm dinh cho 165 192 So 12-Thang 7/2019 QUANTRI-QUANLV Bang Ket qud Bootstrapping imd hinh cd'u true Moi quan h$ Trpng so gSc Trong s5 tnjng blnh Sai so ChuIn 2.5% 97.5% CONGNHAN-* THOAMAN 0.234 0.233 -0.001 0.115 339 CONGVIEC -> THOAMAN 0.167 0.170 0.003 0.068 0.258 DAOTAO ^THOAMAN 0.192 0.194 0.002 0.076 0.307 DONGNGHIEP -» THOAMAN 0.226 0.227 0.002 0.131 0.316 LANHDAO -^ THOAMAN 0.196 0.195 -0.000 0.076 0.317 MOITRUONG -> THOAMAN 0.248 0.247 -0.001 0.129 -0.385 THOAMAN -> DONGLUC 0.738 0.740 002 0.621 0.819 THUNHAP-> THOAMAN 0.225 0.227 0.001 0.107 0.343 Nguon: Ket qud phdn tich du lieu cua tdc gid, 2019 Bang 10 K§'t qua tdc dpng tnJc tiep cue cac md'i quan he (ky thuqt Bootstrap) Moi quan h$ giOa cac bien H$ so tac dOng Sais£i(SE) Gia tri t Mdc y nghTa CONGNHAN ^THOAMAN 0.233 0.056 4.171 0.000 CONGVIEC ^THOAMAN 0.170 0.049 410 001 DAOTAO-* THOAMAN 0.196 0.059 3.224 0.001 DONGNGHIEP-* THOAMAN 0.226 0.047 4.770 0.000 LANHDAO ^THOAMAN 0.193 0.062 3.158 002 MOITRUONG -> THOAMAN 0.247 0.063 3.908 0.000 THOAMAN -> DONGLUC 0.738 0.048 15.486 0.000 THUNHAP-* THOAMAN 0.229 0.060 755 000 Nguon • KS't qud phdn tich dff lieu cua ldc gid, 2019 Bdng 11 Ket qud tac dong gidn tiep cua cdc yeu to den dong ILTC Idm viec H$s5tacd$ng Sai so (SE) Gia In t Mlic y nghTa HI CONGNHAN - * DONGLUC 0.172 0.044 942 0.000 H2 CONGVIEC -^ DONGLUC 0.125 0.035 483 0.001 H3 DAOTAO - * DONGLUC 0.144 0.043 3.325 0.001 H4 DONGNGHIEP - * DONGLUC 0.167 0.038 4.427 0.000 H5 LANHDAO - * DONGLUC 0.143 0.048 3.030 0.002 MOITRUONG - * DONGLUC 0.183 0.051 3.602 0.000 THUNHAP - * DONGLUC 0.168 0.042 3.989 0.000 THOAMAN - * DONGLUC 0.738 0.048 15.486 0.000 GiithuySi H6 H7 H8 Moi quan h$ Nguon: Ket qud phdn tich dff lieu cua tdc gid 2019 So 12-Thang 7/2019 193 TAP CHi CONG IHtfdNG deu anh htfdng dd'n ddng ltfc lam viec cua nhan vien gid'ng nhtf y kid'n ban dau cua chuyen gia va md hinh nghidn ctfu Kd't qua nghien ctfu eung cho tha'y mtfc quan trpng vdi ttfng ye'u tdanh htfdng dd'n stf thda man cdng viec cua nhan vidn la khdc Ke't qua nghien etfu eho tha'y nhan to': (1) Mdi trtfdng lam vide la yd'u to'tac ddng manh nhat de'n stf thda man cdng vide cua nhan vien vdi he sd' (P = 0.247) Dieu cung phii hdp vdi thtfe td', benh vidn la mdi trtfdng lam vide tid'p xiic vdi eac nguon benh, nhidm khuan cho ndn nha lanh dao da tao mdi trtfdng lam vide than thidn, doan ke't, cung cS'p cac trang thie't bi, may mdc phuc vu cho cong tac kham chffa bdnh, tao mdi trtfdng lam vide thoai mai nham thuc day nhan vien gSn ke't vdi td chtfc Vi the' nhan vidn cang lam vide mdi trtfdng lam vide td't thi cang kich thich ddng life lam vide cua ho Stf cdng nhan la ye'u td' cd tac ddng manh thtf hai dd'n stf thda man cdng vide eua NVYT vdi hd so' (p = 0.233) Thtfc te', nha quan tri tai benh vien ludn quan tam va ghi nhan nhffng tich cua nhan vidn dat dtfdc, tao stf gan bd giffa nhan vidn vdi td chtfc Nd'u nhan vien dtfcfc khen ngdi va dtfdc danh gia cao, ddng life lam viec cang cao Yd'u to tac ddng manh thtf ba dd'n stf thda man cdng vide cua nhan vien dd la thu nhap va phuc ldi vdi he so' (p = 0.229) Vi thu nhap va phuc ldi la mdt khia canh quan trong vide khuyd'n khich stf thda man cdng vide, nang eao ddng Itfc lam vide ciia nhan vidn, theo nang sua't lam viec khac se nhan dtfdc cac mtfc thtfdng khac Tid'p theo, yd'u td' tae ddng manh thtf ttf dd'n stf thda man cdng vide cua nhan vidn la md'i quan he vdi dong nghiep vdi he sd' (p = 0.226) Dieu cho tha'y nhSn vidn bdnh vien lam vide vdi tinh than doan kd't, than thien, hd trd edng viec, giiip cho dong nghiep lam vide thoai mai hdn, dat dtfde hidu qua eao hdn Nhan vien lam cdng tac chuydn mdn ludn chia se kinh nghidm nhtf hoi chan benh an dtfa htfdng dieu tn td't cho benh nhan, trao ddi viec siJ dung thudc phu hdp eho ngtfdi benh, cung nhtf nhffng sang kie'n mdi nham dtfa htfdng dieu tri bdnh nhSn mot each td't nhat Dao tao va phat trie'n la ye'u td' tac ddng thtf nam dd'n stf thda man cdng viec cua nhan vien vdi he sd(p = 0.196) Thtfe te'NVYT dang Iam viec bdnh vien chtfa dtfde nang cao trinh 194 So 12-Thang 7/2019 chuydn mdn phii hdp vdi tffng vi tri vide Iam, cdn kiem nhidm nhieu chtfc nang bae si chinh quy cdn thid'u d cac khoa Nhan vidn cd tnnh va nang ltfc chtfa dtfde sap xe'p phu hdp vdi chuyen mdn nhtf trinh dd dtfdc si dai hoc ma phan cdng lam d khoa xet nghiem, can lam sang hoac lam cdng tac chtfdng trinh cdn thid'u nhSn stf Lanh dao trtfc tid'p la yd'u to' tac dong thtf sdu dd'n stf thda man cdng vide cua nhan vidn vdi he so (p = 0.193) Thtfc te' cho tha'y, lanh dao ludn ghi nhan stf ddng gdp cua nhan vidn, khuye'n khich nhan vidn nang cao trinh chuydn mdn Khi nhan vidn gap kho khan chuyen mon, lanh dao ludn chia se kinh nghiem, htfdng dan tan tinh tao dong ltfc Iam viec cho nhan vidn hoan tdt nhiem vu Cdng vide thu vi la yd'u to' cd tac ddng manh it nhat dd'n stf thda man cdng viec cua nhan vien vdi he sd(P = 0.170) Dieu cung phu hdp vdi thifc te', la bdnh vidn da khoa ndn vi tri cua mdi NVYT mdi bd phan la khac Thong tin phan h^i cdng viec gitfa cac khoa Iudn dtfdc cap nhat hang ngay, hang gid de nhSn vidn ndm bat thdng tin v^ bdnh nhSn nham thuan tidn cho vide sap xd'p, luan chuyen bdnh nhan giffa cac khoa phu hdp Nd'u cdng viec dtfdc luan chuyen phu hdp se giup cho nhan vidn lam vide thu vi hdn, tff dd tao dong life eho nhan vien Iam vide hidu qua hdn Dac biet, bie'n trung gian Stf thda man edng viec ed tae ddng rS't manh dd'n ddng ltfc lam vide cua nhan vidn vdi he so' (p = 0.738) Ngoai ra, nghien ctfu cung xem xet tac dong gian tie'p cua de'n sif thda man cdng viec nhan vidn, qua dd yd'u to': (1) Mdi trtfdng lam vide, (2) Stf cdng nhan, (3) Thu nhap va phuc ldi, (4) Md'i quan he vdi dong nghidp, (5) Dao tao va phat trien, (6) Lanh dao trtfc tidp, (7) Cdng viec thu vi, cd tac ddng gian dd'p de'n dong ltfc lam vide eua nhSn vidn tai bdnh vidn Ttf nhtfng phan tich trdn tac gia cd the kd't luan md hinh ly thuyd't phit hdp vdi dff lieu nghidn ciJu cd gia thuye't dtfdc chap nhan Va md hinh ly thuye't dtfde dieu chinh (nhtf ke't luan dtfdi day) Kd't luSn Ke't qua nghien ctfu da danh gia mtfc dd anh htfdng eua ttfng nhan to' cu thd' tac ddng de'n ddng ltfc Iam vide cua nhan vidn mdt td chiJc Trong dd, Mdi trtfdng Iam vide c6 tae ddng manh nha't vdi gia tn trung binh 0.247, tid'p dd'n yd'u td Stf cdng nhan vdi gia tri trung binh 0.233, ye'u td Thu nhap va phuc ldi vdi gia tri trung binh 0.229, QUANTRI-QUANLY ke tiep yeu toMdi quan he vdi dong nghidp cd gia tri trung binh la 0.226, ye'u hdn la yd'u td Dao tao va phat trien vdi gia tri trung binh la 0.196, ye'u td Lanh dao trtfc tid'p cd gia tri trung binh la 0.193 va yd'u td'anh htfdng it nha't la Cdng vide thu vi vdi tri so trung binh la 0.170 Ngoai ra, gan vdi cac ye'u td tac dpng trung gian, nghidn ctfu eung xem xet tac ddng gian tie'p cua stf thoa man cdng viec, qua dd ca ye'u td cd tac dong gian tid'p den ddng Itfc lam vide thdng qua stf thda man cdng vide • TAI LIEU THAM KHAO: Anderson, J.C t& Gerbing, D W, 1998 Structural Equation Modeling in Practice: A Review and Recommended Two-Step Approach Psychologycal Bulletin, 103(3)-411-423 Fornell, C, Larcker, D.F., 1981 Evaluating structural equation models with unobservable variables and measurement error Journal of Marketing Research 18 (1), 39-50 Hair, J F., Hull, G T M Ringle, C M., and Sarstedt, M 2014 A Primer on Partial Least Squares Structural Equation Modeling (PLS-SEM) Thousand Oaks, CA: Sage Hair vd cdng sff (2016), PLS-SEM ca bdn, bdn dich tieng viet cua Nguyin Quang Anh, Nguyen Nggc Duy Phuong vd cdng sU, Viin Qudn tri Kinh doanh Song Hdnh (Luu hdnh ngi bg) Henseler, J., and Chin, W W 2010 A Comparison of Approaches for the Analysis of Interaction Effects Between Latent Variables Using Partial Least Squares Path Modeling Structural Equation Modeling 17(1): 82-109 Hodng Trong, Chu Nguyin Mgng Nggc, 2008 Phdn tich dff lieu nghien ciiu vdi SPSS Thdnh phd Ho Chi Minh • Nhd xudt bdn Hong Dffc Hodng Hdng Hgnh, 2011 Nghien cffu cdcy^u to lien quan di'n dgng life ldm viec cda bdc sT Benh vien truyin trung UOng, Ludn vdn Thac ^r Trudng Dai hoc YteCdng cdng Yhpcco HuUand, John (1999) "Use of Partial Least Squares (PLS) in Strategic Managemenl Research: A Review of Four Recent Studies," Strategic Management Journal, 20:195-224 Kenneth S.Kovach (1987) What motivates employees? Workers and supervisors give difeerent answers Business Horizons, 30(5), 58-65 10 Nguyin Dinh Tho, Nguyin Tht Mai Trang, 2011 Nghiin cffu khoa hgc Marketing lfng dung mo hinh cdu true tuyin tinhSEM ThdnhphoHo ChiMinh: Nhd xud't bdn Dai hgc Qudc gia ThdnhphoHo ChiMinh 11 Mischa Willis - Shattuck vd cdng sU (2008) Motivation and retention of health workers in developing countries: A systematic review BMC health services research, p 247 ISSN 1472-6963 DOI: https://doi.org/10.1186/14726963-8-247 12 Nguyin Ddc Trudng Pham Vdn Tdc & Bid Thi Thu Hd, 2015 Ddng luc ldm viec cua nhdn vien y te kho'i ldm sang Vien Phdp y Tdm thdn Trung UOng Tgp chi YteCdng cong, sd'41 (2016) 13 Nguyin Le Hodng Thuy Td'Quyen (2016) Tong quan ve ly thuyet vd khung ludng vdn xa hdi Tgp chi Khoa hgc Dgi hocMd Thanh phdHd ChiMinh, sdl (46) - nam 2016 14 Nguyin Thi Hodi Thu, Nguyin Viet Trieu vd Bin Thj My Anh, 2015 Ddng lffc ldm viec vd mot sdye'u tdliin quan cua nhdn vien y tetgi Benh vien Da khoa Hodn My, Minh Hdi Cd Mau Tgp chi Yhoc du phdng, tdp 27 sd 13 (2017) trang 146 15 Persefoni Lambrou (2010) Motivation and job satisfaction among medical and nursing staff in a Cyprus public generalhospital 10.1186/1478-4491-8-26 16 Raykov, T, & Widaman, K F (1995) Issues in applied structural equation modeling research Structural Bquaiion Modeling: A Multidiscipllnary Journal,2(4), 289-318 So 12-Thang 7/2019 195 TAP CHi CQNC THlAfNG Ngay nhSn bai: 20/6/2019 Ngay phan bidn danh gia va siJ!a cht?a: 30/6/2019 Ngay cha'p nh§n dang bai: 10/7/2019 Thong tin tdc gid: l.TS DINH KIEM Nguyen Trifdng khoa Quan ly Ngudn nhSn life, Trtfcfng Dai h^c Lao dpng Xa hdi (CSH) TP Hd Chi Minh 2.PHANTIEUTRAM NhSn vidn Quan tri B$nh vi^n Thd'ng Nhat, TP Hd ChiMinh FACTORS AFFECTING THE WORK MOTIVATION OF THONG NHAT HOSPITAL'S EMPLOYEES • Ph.D DINH KIEM Former Dean, Faculty of Human Resources Management, University of Labour and Social Affairs - Ho Chi Minh City Campus • PHAN TIEU TRAM Administration Officer, Thong Nhat Hospital ABSTRACT: This study is to identify factors affecting the work motivation of Thong Nhat Hospital's employees by analyzing data collected from 165 employees working at the hospital The structural equation modeling (SEM) was used in this study to determine the factors affecting the work motivation of medical staff at Thong Nhat Hospital The result shows that there are factors affecting the work motivation of employees working at Thong Nhat Hospital, including interesting work, recognition, income and welfare, training and development, working environment, relationship with colleagues and direct managers Among these factors, the working environment factor is the most influential factor Keywords: Influencmg factors, work motivation of employees, Thong Nhat Hospital 196 So 12-Thdng 7/2019 ... chung ciia Benh vien CV3 Anh/chj cd tinh than trach nhiem doi vdi cdng viec ma minh dam nhan CV4 Anh/ ch! cho rang minh cd mot cdng viec on dmh va an toan CNI Lanh dao san sang ddn nhan nhQng sang... cua benh vien la cdng bang hop ly TNI Anh/chj cam thay minh dupc tra luong tUdng xdng vdi nhQng viec ma anh chj lam TN2 Anh/chj cam thay minh cd dupc nang IUdng dung hgn va dung quy djnh TN3 Anh/chj... khoa hgc Marketing lfng dung mo hinh cdu true tuyin tinhSEM ThdnhphoHo ChiMinh: Nhd xud't bdn Dai hgc Qudc gia ThdnhphoHo ChiMinh 11 Mischa Willis - Shattuck vd cdng sU (2008) Motivation and retention