Exploring the influence of trust relationships on motivation in the health sector: a systematic review.
Exploring the influence of trust relationships on motivation in the health sector: a systematic review.
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DOI：
10.1186/s12960-015-0007-5
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发表时间：
2015-03-31
影响因子：
4.5
通讯作者：
Gilson L
中科院分区：
文献类型：
--
作者：
Okello DR;Gilson L
敬业和积极的卫生工作者在提供高效和有效的卫生服务，改善患者的卫生保健体验方面发挥着重要作用。对人力资源激励的兴趣日益浓厚，导致全球关注绩效薪酬战略，但对培养内在动机的关注却很少。职场信任关系包括个人之间的公平对待和相互尊重。这种关系使卫生保健工作者与其同事、主管、经理和患者之间能够合作，并可能成为内在动机的来源。本文提出了一项定性系统综述的结果，这些研究提供了关于HW动机的证据，以考虑这些研究表明工作场所信任关系对动机的可能影响。在五个电子数据库中检索了2003年至2013年10年间发表的关于各类干部工作积极性的研究成果的文章，并提供了完整的免费英文文本。数据提取涉及考虑信任关系和动机之间的联系，通过确定研究如何直接或间接提及和讨论相关因素。来自低收入和中等收入国家的23篇文章和来自高收入国家的8篇文章达到了预定的质量和纳入标准，并进行了专题综合评价。与同事、主管和经理、雇用组织和患者之间的信任关系直接或间接地影响着HW动机。与信任有关的动机因素包括尊重；认可、赞赏和奖励；监督;团队合作;管理支持;自治;沟通、反馈和开放；人员短缺和资源不足。据作者所知，这是关于卫生部门信任和动机的首次系统综述。有证据表明，职场信任关系促进了医护人员之间的社会互动和合作，影响了医护人员的内在动机，并对医护人员的留任、绩效和护理质量产生了影响。人力资源管理和组织实践对于维持工作场所信任和人力资源激励至关重要。对鼓励工作场所信任关系的动机水平和因素的研究和评估应包括信任和动机如何相互作用并为保留、绩效和护理质量发挥作用。本文的在线版本（doi:10.1186/s12960-015-0007-5）包含补充材料，仅供授权用户使用。
Dedicated and motivated health workers (HWs) play a major role in delivering efficient and effective health services that improve patients’ experience of health care. Growing interest in HW motivation has led to a global focus on pay for performance strategies, but less attention has been paid to nurturing intrinsic motivation. Workplace trust relationships involve fair treatment and respectful interactions between individuals. Such relationships enable cooperation among HWs and their colleagues, supervisors, managers and patients and may act as a source of intrinsic motivation. This paper presents findings from a qualitative systematic review of empirical studies providing evidence on HW motivation, to consider what these studies suggest about the possible influence of workplace trust relationships over motivation. Five electronic databases were searched for articles reporting research findings about HW motivation for various cadres published in the 10-year period 2003 to 2013 and with available full free text in the English language. Data extraction involved consideration of the links between trust relationships and motivation, by identifying how studies directly or indirectly mention and discuss relevant factors. Twenty-three articles from low- and middle-income countries and eight from high-income countries that met predetermined quality and inclusion criteria were appraised and subjected to thematic synthesis. Workplace trust relationships with colleagues, supervisors and managers, employing organisation and patients directly and indirectly influence HW motivation. Motivational factors identified as linked to trust include respect; recognition, appreciation and rewards; supervision; teamwork; management support; autonomy; communication, feedback and openness; and staff shortages and resource inadequacy. To the authors’ knowledge, this is the first systematic review on trust and motivation in the health sector. Evidence indicates that workplace trust relationships encourage social interactions and cooperation among HWs, have impact on the intrinsic motivation of HWs and have consequences for retention, performance and quality of care. Human resource management and organisational practices are critical in sustaining workplace trust and HW motivation. Research and assessment of the levels of motivation and factors that encourage workplace trust relationships should include how trust and motivation interact and operate for retention, performance and quality of care. The online version of this article (doi:10.1186/s12960-015-0007-5) contains supplementary material, which is available to authorized users.