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Ket qua kiem djnh cac gia thuyet nghien ciru cho thdy cac nhan to trong mo hinh diu tac dong duang (cac nhan to deu co he so 13 +) hay eac nhan t l diu tac dong tich cuc din Y dinh cho[r]
(1)PHAN TICH CAC YEU TO ANH HlTOTVG DEN
QUYET DINH CHON LAM NlT HO SINH TAI BENH VIEN PHU SAN THANH PHO CAN THO
Tang Kim Thuong TOM TAT
Muc tieu cua bai bao la xac dinh cac nhan td anh hudng den quylt djnh ebon lam nur ho sinh tai Benh vien Phu san ph6 Cdn Tho Dii lieu dugc thu thap tii viec phong vdn true tilp 191 nu ho sinh dang lam viec tai benh vien Sau danh gia tin cay Cronbach's Alpha va phan tich nhan to kham pha (EFA), cac nhan t l lien quan dugc su dung dl tiln hanh phan tich nhan t l khdng djnh (CFA) va sau cung la phan tich cdu true tuyin tinh (SEM) Kit qua cho thdy quylt dinh cua cac nCr ho sinh chiu anh huong cua 05 nhan to: (1) Nhan thuc kilm soat hanh vi, (2) Chudn chii quan, (3) Thai do, (4) Thu nhap, (5) Van hoa tl chuc Can cu vao kit qua uoc lugng muc dp tac dong cua cac nhan to, dua mot so giai phap nham tri va thu hiit nguon nhan luc nii hp sinh cho benh vien
ABSTRACT
The objective of this paper is to identity the factors influencing the decision to be a midwife at Can Tho Gynecology Obstetric Hospital Data were collected from direct interviews with 191 midwives working in the hospital After evaluating Cronbach's Alpha reliability and Exploratory Factor Analysis (EFA), relevant factors were used to perform Confirmatory Factor Analysis (CFA) and finally Structural Equation Modeling (SEM) The results show that the decision of midwives is influenced by five factors: (1) Behavioral control perceptions, (2) Subjective norm, (3) Attitudes, (4) Income, (5) Organizational culture Based on the results of estimating the level of impact ofthe factors, we recommend some solutions to maintain and attract the midwife human resources for the hospital
Keywords: Midwife, Can Tho Gynecology Obstetric Hospital
1 Tong quan
Ngay nQ- hg sinh la mgt nhQ:ng nguon lyc co ban mang luai y t l va dong mgt vai tro rat quan trgng, gop phdn ddc lyc cong tac cham soc sue khoe cho nguofi dan Tai Viet Nam hien co mgt mang luoi nQ- ho sinh lam viec tir thj din nong thon, ho dam nhiem da.sl cae hoat dong v l cham soc su-c khoe ban ddu eho nguoi dan, dae biet la
(2)KINH TE, TAI CHINH, QUAN TRI KINH DOANH
ti mi, ehinh xac viee tryc tiep cham soc ba me va tre em, moi truang lam viec dgc hai, kha nang rnae eae benh truyen nhiem eao, eae djp le tet deu phai true ca thay vi dugc nghi nhu cac nganh nghi khae
Ngay nay, xa hgi cang phat trien thi nhu eau cham soc sire khoe eua ba me va tre em cang tang, doi hoi dgi ngu nQ- hg sinh nhilu vl s6 lugng va ehdt lugng tay nghi Tuy nhien so nguai theo hgc va lya chgn nghi hg sinh de phat triln nghe nghiep cang it hoac ehi gan bo vai cong viec mgt thai gian ngdn Do do, tae gia da chgn dk tai "Phan tich cae yeu to anh huang din quylt djnh chgn
lam NQ- hg sinh tai Benh vien Phu san ph6 Can Tho" de benh vien hoan thien eac chinh sach doi vai nguon nhan lyc la cae nQ- hg sinh nham giiip benh vien thu hiit dugc ngudn nhan lye CO chdt lugng eao dap ung tot cong tac cham soc sire khoe eiia ba me va tre em tai benh vien
2 Co' Sff Iy thuyet va mo hinh
2.1 Ly thuyet hdnh dong hop ly
Thuylt hanh dgng hgp ly (Theory of Reasoned Action TRA) dugc Ajzen va Fishbein xay dung tir nam 1975 va dugc hieu chinh, ma rgng theo thai gian Mo hinh TRA nhu sau (hinh 2.1):
Niem tin vao nai dang ky du tuyin
Do luong niem tin doi voi noi du tuyin
Nhimg nguoi anh huang se nghT rang toi
nen hay khong nen
Do luang niem tin doi voi noi du tuyin
\ , \
/ /
Thai dp
\
N y
/
Chuan chu quan
Xu huong hanh vi — •
Hanh vi thuc sir
2.2 Mo hinh nghien cieu de xudt
can cir vao co so ly thuylt va luge khao eac nghien cu-u di truoc tac gia dl xudt mo hinh nghien ciru g6m 05 nhan t l dgc lap la: Nhan thirc kilm soat hanh vi, Chudn chu quan Thai
Hinh 2.1 Thuylt hanh dong hgp ly (TRA)
Nguon Fishbein vd Ajzen, 1975
(3)Hinh 2.2 Mo hinh nghien cu-u d l xuat 3 PhwoTig phap nghien eii'u
Qua trinh phan tieh dQ- lieu nghien ciru dugc thyc hien qua cac giai doan: - Buoc 1: Danh gia tin cay cua thang
- Buoc 2: Phan tieh nhan to kham pha EFA Buoc 3: Phan tieh nhan t l khdng djnh CFA Buoc 4: Phan tich cdu triic tuyin tinh SEM - Buoc 5: Kilm djnh Boostrap
- Buoc 6: Kilm djnh su khae biet 4 Kit qua kiem dinh mo hinh va cac gia thuyet
4.1 Md td mdu nghien cu-u
Bg du lieu sau dugc lam sach gIm 191 mdu thoa man dilu kien eua phan tich nhan t l kham pha va mo hinh cdu true tuyin tinh (Hair va cgng sy, 2006; Hoyle, 1995; Kline, 1998; Jackson, 2001,2003)
4.2 Ket qud kiem dinh Cronbach's Alpha
Bang 4.1: Bang tong hop kit qua phan tich Cronbach's Alpha
STT Thang
Nhan thirc kilm soat hanh vi
Chuan chu quan Thai
Thu nhap
Cronbach's Alpha
(4)KINH TE, TAI CHINH, QUAN TRI KINH DOANH
Ket qua bang 4.1 eho thay he so Crobach s Alpha ciia cae thang deu Ion hon 0,7 nen thang eua eae nhan to dat dugc
4.3 Ket qud phdn tich EFA
tin cay, phii hgp cho phan tich nhan to kham pha (EFA) (Nunnanlly, Bumstein, 1994)
Bang
CQ4 CQl CQ2 CQ3 TN4 TNI TN3 TN2 HV4 HV2 HV3 HVl TDI TD3 TD2 TD4 HVl HV4 HV2 HV3
4.2: Ket qua ma tran xoay nhan to Nhan to
1 0,904 0,890 0,879 0,853
2
0,953 0,852 0,835 0,801
3
0,893 0,891 0,877 0,808
4
0,862 0,860 0,807 0,781
5
0,828 0,738 0,737 0,736
Ket qua phan tieh nhan to kham pha (EFA) cho thdy gia trj KMO = 0,904 > 0,7 Qua eho thay he so KMO nghien cuu dugc danh gia la rat tot Khang djnh eae bien quan sat eo tuong quan vai tong the, thoa dieu dien nghien cuu Chi so tong binh phuang he so tai nhan to tich luy (Cumulative) la 73,063%
Nguon: Kit qud phdn tich so lieu
> 50% thoa yeu
cdu Chi so giai thieh 73,063% mo hinh nghien eiiu Ket qua ma tran xoay nhan to dugc eho hinh sau (bang 4.2):
4.4 Ket qud phdn tinh nhdn to khdm phd
(5)(ej)-»-[cQ2
(g>-»4cQT
(e3>-»-[cQ4}^ @-»-[cQ3
@ — VH2
(g)-*-[w3
VH4 (e8)-»{vHT
HV2 HV1
TD4
^jV*-pi>J4
TN3
Chi-square/df = 1,322 Rmsea = ,041
P= ,004 TLI = ,979 CFI =,983
TN2
Hinh 4.1 Ket qua phan tich CFA 4.1.1 Do phu hop eiia mo hinh
Kit qua tu- hinh 4.1 eho thay Chi-Square/df = 1,332 < (Carmines & Mc Iver, 1981); Rmsea = 0,041 < 0,08 (Steiger, 1990); CFI = 0,983 > 0,90 (Bentler & Bonett, 1980) ; TLI = 0,979 > 0,90 (Bentler & Bonett, 1980) Mo hinh phu hgp eho phan tieh SEM
4.4.2 Gia tri hoi tu
Ket qua tir hinh 4.1 cho thay eac trgng so deu Ion hon 0,5 tai mue y nghTa P = 0,000 < 0,05 Nen mo hinh dat gia trj hgi tu
do, thang dat tinh don huong (Steenkamp, Van Trijp 1991)
4.4.4 Gia tri phan biet
Ket qua phan tich ve moi tuong quan giua eae phan hinh 4.1 cho thay moi tuong quan ciia cac phan mo hinh diu < 0,90 tai mire y nghTa P = 0,000 < 0,05 Do do, thang mo hinh dat gia trj phan biet
(6)KINH TE, TAI CHINH, QUAN TRI KINH DOANH
( e l ) — ^ C Q ( e ) — ^ C Q (e3)-H>»j CQ4 (e4)-*»>|CQ3
( e ) - ^ - f v H ( © ) - * - { V H
Chi-square/df = 1,680 R m s e a = ,060
P = ,000 T L I = ,940 CFI =,947
^T^-^-prpT ^ ^ - * - { T D ^ T ^ - » - f T D ^ ^ - * - [ T D
€ ^ ^
Hinh 4.2: Mo hinh cau triic tuyen tinh SEM 4.5.1 Do phil hop ciia mo hinh 4.5.3 Tinh don huong Ket qua tir hinh 4.2 eho thay Chi-Square/df
= 1,680 < (Carmines & Mc Iver, I98I); Rmsea = 0,060 < 0,08 (Steiger, 1990); CFI = 0,947 > 0,90 (Bentler & Bonett, 1980) ; TLI = 0,940 > 0,90 (Bentler & Bonett, 1980) Mo hinh phil hgp vai dir lieu thyc te
4.5.2 Gia tri hoi tu
Kit qua tir hinh 4.2 cho thay cac trgng so diu lan han 0,5 tai mire y nghTa P = 0,000 < 0,05 Nen mo hinh dat gia trj hgi tu
Kit qua tir hinh 4.2 (mo hinh SEM da chuan hoa), chiing ta thay rang khong co tuong quan giira cac sai so ciia cac bien quan sat Do do, thang dat tinh don huong (Steenkamp, Van Trijp 1991)
4.5.4 Gia tri phan biet
(7)4.6 Kit qud kiim dinh Bootstrap
Bang 4.3 - Ket qua kilm dinh Bootstrap
Parameter YD<—CQ YD<—VH YD<—HV YD<™TD YD<™TN QD<—YD SE 0,1 0,1 0,1 0,1 0,1 0,1 SE-SE 0,0 0,0 0,0 0,0 0,0 0,0 Mean 0,1 0,2 0,2 0,2 0,4 0,6 Bias 0,0 0,0 0,0 0,0 0,0 0,0 SE-Bias 0,0 0,0 0,0 0,0 0,0 0,0 C.R(Bias/SE-Bias) -1,8 0,0 -0,7 1,0 1,8 -1,7
| C R | 1,8 0,0 0,7 1,0 1,8 1,7
Ngudn: Ket qud phdn tich sd li$u
Kat qua tren cho thay rang | CR | < nen c6 the ket luan rang lech la rat nh6, khong co y nghTa thong ke is tin cay 95% Do do, chiing ta kit luan rdng cac uac lugng mo hinh dat tin cay, sir dung dugc
4.7 Kit qud kiim dinh gid thuyit nghien cim
Kit qua kilm dinh dugc mo ta hinh sau (hinh 4.3):
Nhan thirc kiem soat hanh vi Chuan chii quan
Thai
Thu nhap
Van hoa to chirc
djnh chon lam
Nil ho sinh
B= +0,60 Quyet djnh chon
lam viec Hinh 4.3 Ket qua kiem dinh gia thuyet nghien cuu
(8)KINH TE, TAI CHINH, QUAN TRI KINH DOANH
5 Ket luan va ham y quan tri
5.1 Kit ludn
Ket qua phan tieh ehi 05 nhan to tae dgng den y djnh lam nir hg sinh tai benh vien Phu san Can Tho lam ea sd cho viec quyet djnh tra nQ- hg sinh lam viec chinh thiic tai benh vien Phuang trinh eae nhan to tac dgng den y djnh va quylt dinh lam viec tai benh vien Phu san Can Tho ciia nir hg sinh nhu sau:
YD = 0,261*HV + 0,101*CQ + 0,240*TD + 0,3I6*TN + 0,I93*VH QD = 0,60*YD
5.2 Hdm y qudn tri
can cu vao kit qua phan tich cac nhan to mo hinh nghien cuu Tac gia dk xudt mgt s6 ham y qu^n trj theo thir tu nhu sau:
5.2.1 Dli vdi nhan to Thu nhap
Kit qud phan tich da dua phuang trinh nhan to
Thu nhap = 0,920*TN4 + 0,877*TN3 + 0,875*TN1 + 0,822*TN2
Bien
TN4
TN3
TNI
TN2
H^slp
0,920
0,877
0,875
0,822
H^m ^ quSn tri
Benh vien cdn xdy dung c^c chinh sach khen thucmg tuang xiing dli vai su dong gop ciia cac na ho sinh cho benh vien
Benh vien co thu nhap tang them giiip cac nu- ho sinh lam viec tai benh vien CO eupc song In djnh
Tra luong tuang xung vai nang luc lam viec ciia nu- hp sinh Muc luong phai dam bao dugc cuoc song cho cac nir hp sinh
5.2.2 Doi vai nhan to Nhan thuc kiem soat hanh vi Ket qua phan tieh da dua phuang trinh nhan to
Nhan thirc kilm soat hanh vi = 0,838*HVI + 0,78I*HV3 + 0,7I5*HV4 + 0,703*HV2
Bien
HVl
HV3
HV4
HV2
He sip
0,838
0,781
0,715
0,703
Ham y quan tri
Dac trung ciia benh vien Phu san Can Tha phii hgp vai nganh dao tao cua cac nu- hp sinh
Cac niJ hp sinh luon tu tin se chpn dugc cong viec phii hgp voi ban than lam viec tai benh vien Phu san Can Tha
Cac nij- hp sinh diu co du kiln thurc, ky nang va nhan dinh de quyet dinh nen hay khong lam viec tai benh vien
(9)5.2.3 D6i vai nhan to Thai
Kit qua phan tich da dua phuong trinh nhan to
Thai = 0,874*TD3 + 0,833*TD1 + 0,824*TD4 + 0,8I0*TD2 Bien
TD3 TDI TD4 TD2
H e s l p 0,874 0,833 0,824 0,810
Ham y quan tri
Dugc lam viec tai benh vien la nguyen vpng cua cac nir hp sinh Moi truong lam viec tai benh vien phii hgp vai cac nir hp sinh
Lam viec tai benh vien se giiip cac nii hp sinh co co hpi phat trien nghe nghiep cua minh
Cac niJ hp sinh nhan thdy cac kiln thiic, ky nang ciia toi phii hgp vdi yeu cau cua benh vien
5.2.4 Doi vai nhan t6 Van hoa to chirc
Kit qua phan tich da dua phuong trinh nhan to
van hoa to chirc = 0,898*VHI + 0,890*VH3 + 0,882*VH4 + 0,869*VH2 Bien
VHl VH3 VH4 VH2
H e s l p 0,898 0,890 0,882 0,869
Ham y quan tri Dugc doi xu cong bang, khong phan biet
Quyen lgi cua cac nir hp sinh dugc dam bao day dii Moi trucmg lam viec thoai mai, dugc phat bilu y kiln
Nhirng chinh sach, npi quy cua benh vien dupe quy djnh ro rang 5.2.5 Doi voi nhan to Chuan chii quan
Ket qua phan tieh da dua phuang trinh nhan t l
Chudn chu quan = 0,902*CQ3+ 0,901*CQ4 + 0,883*CQ1 + 0,872*CQ2 Bien
CQ3
CQ4
He sop 0,902 0,901
Ham y quan tri
Thong tin tuyen dung ciia benh vien tren cac phuang tien truyin thong anh huong den quyet dinh cua nir hp sinh
(10)KINH TE, TAI CHINH, QUAN TRI KINH DOANH
TAI LIEU THAM KHAO
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2 Gorsuch (1983) Factor Analysis, 2nded, Hillsdale NJ: Laurence Erlbaum
3 Hair, Black, Babin, Anderson, Tatham (2006) Multivariate Data Analysis, Prentical-Hall International, Inc
4 Kahn, William A (1990) Psychological Conditions of Personal Engagement and Disengagement at Work, Academy of Management Joumal, 33, 4; ProQuest pg 692 5 Trdn Thj Nggc Duyen- Cao Hao Thi (2009) Cdc nhdn to dnh hu&ng den quyet dinh ldm
viic tgi doanh nghiep Nhd nu&c Truang Dai hgc Bach Khoa, DHQG-HCM
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lam viic cua ngu&i lao dong: Nghiin cuu tru&ng hap tgi cdc doanh nghiep thuang mgi dien tu tgi thdnh phd Ho Chi Minh, Luan van thac sT, khoa quan trj kinh doanh, Truong
Dai hgc kinh tl TP H6 Chi Minh
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cong viic cua ieng viin qud trinh tuyin dung Luan van Thac sy Dai hgc Kinh tl TP
H6 Chi Minh
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9 Nguyin Dinh Thg, 2011 Phuang phap nghien curu khoa hgc kinh doanh, Nha xudt ban Dai hgc Lao dgng Xa hgi
10 Vo Thj Thu Trang (2013), Cdcyiu to tdc dong diny dinh dutuyin cua iengvien qud
trinh tuyin dung - Dgi hoc kinh ti TP.HCM, Luan van thac sT, khoa quan trj kinh doanh,
Truang Dai hgc kinh tl TP Ho Chi Minh