The Occupational Risks, organizational climate perception and Self-rated health of Chinese Nurses in Tertiary hospital: A large-scale Cross-Sectional Survey

The Occupational Risks, organizational climate perception and Self-rated health of Chinese Nurses in Tertiary hospital: A large-scale Cross-Sectional Survey | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Occupational Risks, organizational climate perception and Self-rated health of Chinese Nurses in Tertiary hospital: A large-scale Cross-Sectional Survey Jinyu He, Jiarui Zhang, Jinman Zhou, Jiarui Fu, Yue Du, Yiwei Wang, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6183161/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Objective This study aimed to investigate occupational risk, organizational climate perception and self-rated health among Chinese nurses working in tertiary hospitals and explore the correlation between occupational risk, organizational climate perception and self-rated health . Design and method This paper described a large cross-sectional study involving 5178 nurses working in tertiary hospitals across 14 provinces in China. The research was conducted through an online cross-sectional survey in which participants completed a questionnaire between July 10th and October 10th, 2018, via an access link or Quick Response QR code. Data were analyzed using descriptive statistics, Pearson’s correlation, and a hierarchical multiple regression analysis. This cross-sectional study adhered to the STROBE reporting guidelines. Results Chinese nurses in tertiary hospitals faced the greatest occupational risks from psychosocial and organizational factors, leading to severe consequences. Nurses' years of service, education, position, hours, and department affected their risk levels. Occupational risk was linked to poorer organizational climate, less self-protection awareness, and worse self-rated health. Nurses at high risk and lacking self-protection awareness faced heightened danger. Conclusions It is imperative to prioritize occupational risks arising from psychosocial and organizational factors. Improving self-protection awareness, especially for high-risk nurses, is also crucial. Efforts are needed to create a supportive work environment, enhance risk education, provide stress workshops, add protective gear, strengthen risk management, improve job security, and offer counseling and emotional support. Clinical trial number not applicable occupational risks organizational climate perception self-rated health Chinese nurses 1. Introduction Nurses, as the largest occupational group in the healthcare field, face occupational hazards daily and are among the most vulnerable groups in hospitals.( 1 , 2 ). Occupational hazards faced by nurses include exposure to blood and body fluids, sharp instrument injuries, radiation, workplace violence, physical and psychological hazards from the working environment, and the quality of care provided( 3 ).Owing to their frequent contact with patients, nurses are also at higher risk of contracting infectious diseases and may have a negative impact on their physical health, job satisfaction, and the quality of care they provide, especially in tertiary health institutions where the workload is more pronounced( 4 – 7 ). Especially during COVID-19, nurses served on the front lines and played a central role in the battle against the pandemic.( 8 ). An extraordinary pressure is imposed on nurses due to the sudden onset of the COVID-19 pandemic, which is accompanied by an increase in workload, physical fatigue, disruption of the work-life balance, lack of personal protective equipment, and nurses' fear of being infected with COVID-19 themselves or their families. They faced complex care and treatment processes, which could cause emotional exhaustion and may have negatively impacted their health.( 9 , 10 ). Internationally, this situation poses a series of challenges to health services with respect to human resource management in nursing. Frequent nurse turnover in hospitals can lead to a reduction in staffing level, which negatively impacts on the quality of care and patient safety( 11 ). Given this, nursing staff, who work tirelessly to improve people's health are often exposed to various health-threatening factors in their work environment, deserve more attention from health policymakers and hospital administrators( 12 ). Earlier studies reported that a healthy environment is particularly important for nurses. Ma’s research, for example, foregrounded the association between both hospital and unit environments with hospital-acquired pressure ulcers( 13 ). In Aiken’s research, it has been proved that the surgical mortality rate in sampled hospitals with better care environments educated nurses was approximately 60% lower compared with those that were poorly staffed with under-par care environments( 14 ). Care environment has also been shown to contribute to better patient outcomes( 15 ). Improvements in the work environment of nurses also help reduce hospital-acquired pressure ulcers and 30-day readmissions in Medicare patients undergoing surgery. In addition, it also provides satisfactory experience for patients( 16 ). Therefore, a healthy nurse work environment is significant not only for patients’ health but also for nurses’ health,work commitment and engagement( 17 – 21 ). However, we do not know whether occupational risks are related to nurses’ satisfaction with their work environment, and if this relationship exists, how this influence is exerted. In China, according to the 2023 National Statistical Bulletin on the development of healthcare, the current situation of the healthcare system in China is complex, and nurses in tertiary hospitals face unique challenges( 22 ). Despite accounting for only 10.05% (3855) of the total 38,355 hospitals in China in 2023, tertiary hospitals received a disproportionately high number of patients, with nearly 61.74% (more than 2.6 billion) of the total hospital visits. This high patient volume indicates that nurses in tertiary hospitals are exposed to a greater variety of diseases, often with greater severity and complexity. Additionally, nurses in tertiary hospitals are more likely to interact with the family members of patients, which can add to the complexity and emotional burden of their work. Unsafe nurse staffing leads to increased nurse turnover rates( 22 ),the pooled prevalence of nurse turnover was 18% in China( 23 ).Moreover, the "patient-centered" medical system championed in China puts additional pressure on nurses to deliver optimal medical care that prioritizes not only physical discomfort but also emotional well-being. Thus, nurses in China are expected to maintain a stable mental and emotional state, which can be particularly challenging for tertiary hospitals. In summary, the situations faced by nurses in tertiary hospitals in China are complex and multifaceted, highlighting the need for further research to better understand and address the challenges they face. Nurses' perception of work and self-rated health are important for nurse administrators and hospital organizations as occupational risks can have a psychological and physical impact on nurses and may affect their organizational climate perception and self-rated health. Previous studies have found that there is a growing awareness of the importance and effectiveness of self-rated health, which can predict mortality across population( 24 ). Therefore, self-rated health is used to represent people’s health condition, and try to analyze the correlations between occupational risks and self-rated health. By describing the current occupational hazards faced by nurses, including both frequency and severity, this study provides valuable information to help administrators better understand and address these risks. Additionally, studying nurses' organizational climate perceptions and self-rated health can shed light on the potential impact of these occupational hazards on their well-being and job satisfaction. This study also aims to explore the correlations between occupational risk, organizational climate perception, and self-rated health, as this can provide further insights into how different factors may be interconnected. Overall, this study can help develop appropriate strategies and interventions to against risks and enhance the organizational climate among nursing staff. 2. Methods 2.1 Study Design In this study, a nationwide cross-sectional online survey study was conducted to identify the prevailing clinical occupational risks faced by nurses working in tertiary hospitals in China. Online questionnaires were completed by nurses throughout the country in a confidential and anonymous way from 10 July to 10 October 2018. This large-scale survey was successfully completed with the support of the Hospital Occupational Health Group of Quality, Health, Safety, and Environmental Protection of the Management Committee of China Research Hospital Association. 2.2 Participants and Data Collection The questionnaires were completed by nurses in tertiary hospitals in 14 provinces (including Chongqing, Guizhou, Heilongjiang, Beijing and Qinghai) in China. The inclusion criteria include: working as a nurse and a regular employee of a tertiary hospital, having more than 1 year of clinical work experience, and providing informed consent for voluntary participation. The online questionnaire platform, 'Lediaocha' was utilized in this study to get online survey and collect the corresponding records. Nurses had convenient access to participate in the survey through the 'Lediaocha' platform by utilizing the provided access link and QR code for the online questionnaire. We usually used a WeChat group to forward the questionnaires. A web link ( https://www.lediaocha.com/survey)o r the Quick Response QR code of our questionnaire survey was sent via mobile phone to participants outside of working hours. Two main measures were taken to control the quality. Firstly, the 'Lediaocha' platform can also recorded the duration of time participants dedicated to answering the questionnaire. We utilized the response time as a criterion to determine whether a questionnaire is valid. Based on our pre-survey test, any questionnaire completed in less than 5 minutes was deemed invalid. Secondly, a dedicated section was included at the end of the questionnaire for quality control. Participants were requested to evaluate their own response process upon completion. If participants selected either of the following responses: "Due to certain reasons, I failed to complete this questionnaire seriously, and recommend excluding it" or "Due to certain reasons, I was interrupted and could only ensure careful completion of a portion of the questionnaire," their data would be excluded from the subsequent analysis. The data management platform showed that a total of 12784 questionnaires were distributed, and 5187 participants completed valid questionnaires. The response rate was 40.57%. 2.3Instruments 2.3.1 Occupational Risks The way of accessing occupational risks was derived from the classification of occupational hazard in nursing according to the International Occupational Hazards Database of the International Labor Organization Occupational Safety and Health Information Centre. It used 28 items to measure occupational hazard among nurses in the previous 12 months. At first, we got the possibility of occupational hazard by self-report, five dimensional (accidental hazard, physical hazard, chemical hazard, biological hazard, and psychosocial and organizational factors) model of occupational risks revised by Li et al( 25 ), with items rated on a 5-point Likert-type scale ranging from 1 to 5 (1 = seldom, 2 = fewer, 3 = sometimes, 4-often, 5 = frequently). The total occupational hazard score is computed to quantify the respondent's overall level of occupational hazard. We also test the severity of the occupational hazard by 5-point Likert-type scale ranging from 1 to 5 (1 = can be ignored 2 = a little injury 3 = general 4 = serious 5 = very serious). Then we got the occupational risks by multiplying the possibility of occupational hazard by the severity of it. The Cronbach's alpha of the five dimensions is 0.803, 0.789, 0.799, 0.824 and 0.881, respectively. 2.3.2 organizational climate perception In this study, we defined organizational climate perception as the combination of work environment satisfaction, self-protection awareness and job satisfaction. Work environment satisfaction was evaluated with a rating scale multiple-choice question (Multiple Choice Questions,MCQ): "What is the level of your satisfaction with the environment where you work? (Mainly refers to the safety, comfort, and harmony of the objective hospital environment in which you work, excluding salary and promotion factors)'. This item was scored on a 5-point Likert-type scale ranging from 1 to 5 (1-very dissatisfied.2- dissatisfied. 3-neutral. 4-satisfied. 5-very satisfied). The item was reverse-scored to facilitate data analysis. Thus, higher scores indicated higher work environment satisfaction. A rating scale MCQ: "how do you evaluate your self-protection awareness in your work" used to measure self-protection awareness. It was also scored on a 5-point Likert-type scale ranging from 1 to 5 (1-very uncareful.2-uncareful. 3-neutral. 4-careful. 5-very careful). Job satisfaction was also evaluated with a rating scale MCQ: 'Overall. how satisfied are you with your current job?' This item was rated on a 5-point Likert-type scale ranging from 1 to 5 (l-very dissatisfied. 2-dissatisfied 3-neutral 4-satisfied. 5-very satisfied). The eligibility and validity of the item have been proven in previous studies. 2.3.3 self-rated health Self-rated health in this study include psychological stress and subjective health. Both were measured by one rating scale MCQ. For psychological stress, the question was 'A person falls into a state of tension, uneasiness. nervousness, anxiety, or sleeplessness at night because of certain psychological reasons. Have you ever felt this way in recent years? How would you rate this feeling?' Participants were asked to rate their symptoms on a 5-point scale from 'never' to 'very serious', with higher scores indicating higher stress. For subjective health, the question was “How would you rate your health status”, and it was rated on a 5-point Likert-type scale ranging from 1 to 5 (l = very healthy. 2-healthy 3- general 4-sometimes unhealthy. 5-always unhealthy). 2.4 Data analysis First, we describe occupational hazards and their average severity in different dimensions. Subsequently, descriptive statistical analyses were conducted to explore the nurses’ demographic characteristics. Frequencies, means, and standard deviations (SDs) were used to describe sample characteristics. One-way analysis of variance (ANOVA) was used to examine occupational risks. Pearson's correlation coefficient was used to examine the relationships among the study variables (occupational risk, work environment satisfaction, self-protection awareness, job satisfaction, stress symptoms and subjective health). Hierarchical linear regression analysis was performed to test the effects of the independent variables, especially occupational risk, on organizational climate perception and self-rated health. Demographic variables, including education level, marital status, department, professional title, service years, and working time, were entered into Step 1 of the hierarchical regression analysis model to eliminate their interference on the dependent variables. We also addressed the relative impact of each category of variables on organizational climate perception and self-rated health using this analysis model. In Step 2, both demographic variables and occupational risks were entered into the model to test how much variance occupational risks could explain among the dependent variables. We have provided the data, including F and △R 2 . Standardized regression coefficient (β) and p-value for each step in the regression model. All analyses were conducted using SPSS V22.0. Statistical significance was defined as a two-tailed p value < 0.05. 3. Results 3.1 Occupational hazard dimensions As for the occupational hazard dimensions, we can find that the psychosocial and organizational factors account for the most frequent occupational hazard. Simultaneously, these factors also result in the most severe consequences among the five dimensions. As shown in Table 1 , the mean of occupational risks from psychosocial and organizational factors is 6.81, which is the highest among the five dimensions of hazard. Additionally, the average of all kinds of occupational risks is 4.53. Table 1 Frequency and Severity in different kinds of Occupational Hazards (n = 5178) Hazard Dimension Frequency Severity Risks Mean SD Mean SD Mean SD 1. accidental hazard 1.45 0.49 2.31 1.19 3.47 2.32 2. physical hazard 1.64 0.79 2.29 1.24 4.05 3.41 3. chemical hazard 1.58 0.75 2.28 1.27 3.87 3.23 4. biological hazard 1.68 0.76 2.49 1.26 4.47 3.43 5.psychosocial and organizational factors 2.30 0.96 2.72 1.13 6.81 4.88 3.2 Demographic Characteristics and ANOVA models for the occupational risks The demographic characteristics of the respondents and the ANOVA models for the occupational risks of nurses are shown in Table 2 . Out of the 5178 nurses surveyed, the majority of participants (67.3%) reported having provided medical services for a duration of 1–10 years. More than half of the respondents (63.8%) held a bachelor’s degree, with 66.2% of them being married, and the majority identified as Junior nurses (65.7%). In terms of department distribution, over a quarter of the respondents (27%) were from pediatrics department, followed by internal medicine (24.9%), surgery (12.1%) and obstetrics and gynecology (10.0%). Table 2 Characteristics of the Respondents (n = 5178) Characteristics N % M ± SD F P Service Years 6.703 20 618 11.9 4.53 ± 2.98 Education categories 17.608 <0.00 College degree or below 1860 35.9 4.21 ± 2.82 Bachelor 3301 63.8 4.72 ± 3.06 Postgraduate degree or above 17 0.3 4.72 ± 2.78 Marital status 2.610 0.074 Single 1650 31.9 4.39 ± 3.01 Married 3426 66.2 4.60 ± 2.97 Divorce or loss of spouse 102 2.0 4.47 ± 2.96 Professional position 6.671 <0.00 Junior Nurse 3389 65.4 4.47 ± 3.03 Medium-grade Nurse 1288 24.9 4.79 ± 2.94 Senior Nurse 284 5.5 4.60 ± 2.80 Unrated 217 4.2 3.94 ± 2.65 Working time (hours) 4.109 0.016 ≤ 8 1746 33.7 4.62 ± 2.89 9–14 3414 65.9 5.47 ± 2.92 >14 18 0.3 6.14 ± 5.51 Departments 4.224 <0.00 Internal medicine 1291 24.9 4.46 ± 2.99 Surgery 625 12.1 4.69 ± 3.02 Obstetrics and Gynecology 520 10.0 3.96 ± 2.64 Pediatrics 1433 27.7 4.65 ± 2.92 Infectious Disease 112 2.2 4.82 ± 3.02 Oncology Department 104 2.0 4.54 ± 3.43 Clinical Laboratory 17 0.3 3.83 ± 2.93 Imaging Department 41 0.8 3.71 ± 2.46 Pharmacy Department 12 0.2 3.87 ± 3.36 Operation room 309 6.0 5.12 ± 3.76 Other 714 13.8 4.47 ± 2.82 As shown in Table 2 , it is observed that the group with a length of service between 16 and 20 years tend to exhibit higher occupational risks compared to groups with different lengths of service ( P < 0.001). Nurses holding a bachelor’s degree reported significantly higher occupational risks than those with other educational qualifications ( P < 0.001). In terms of professional position, the highest occupational risks were found among medium-grade nurses ( P < 0.001). The operation room was identified as the department with the highest occupational risks, followed by the department of infectious diseases. Furthermore, there were statistically significant differences in occupational risks among nurses working in different departments ( P < 0.001). Approximately 66.3% of participants reported workingmore than 8 hours per day. However, in this investigation, the differences in occupational risks based on marital status and working hours were not statistically significant ( P > 0.05). 3.3 Information and correlations between study variables The means, SDs and Pearson correlations of continuous study variables are presented in Table 3 . As depicted in the table, all variables exhibited significant correlations with each other. Specifically, in this research, occupational risks demonstrated negative correlations with work environment satisfaction (r=-0.362, P < 0.01), self-protection awareness (r=-0.215, P < 0.01), job satisfaction (r=-0.302, P < 0.01) and subjective health (r=-0.286, P < 0.001). A positive correlation was observed between occupational risks and psychological stress (r = 0.389, P < 0.05). In this analysis, the regression analysis incorporated several control variables, including types of service years, education background, marital status, professional positions, working time and departments. Table 3 Means, standard deviations (SD) and correlations of continuous variables Variables Mean SD 1 2 3 4 5 6 1. Occupational risk 4.53 2.98 1 2. Work environment satisfaction 3.57 0.86 -0.362 ** 1 3. Self-protection awareness 4.27 0.68 -0.215 ** 0.401 ** 1 4. Job satisfaction 3.33 0.81 -0.302 ** 0.518 ** 0.266 ** 1 5. Psychological stress 2.87 1.04 0.389 ** -0.399 ** -0.188 ** -0.405 ** 1 6. Subjective health 3.48 0.84 -0.286 ** 0.510 ** 0.294 ** -0.330 ** -0.346 ** 1 * p < 0.05, ** p < 0.01, Correlation is significant at the 0.01 level (2-tailed). 3.4 Hierarchical Linear Regression Models Two hierarchical regression analyses were conducted to examine the influence of occupational risks on organizational climate perception (Table 4 ) and self-rated health (Table 5 ), while controlling for the effects of the demographic variables. In this study, occupational risks were posed as an independent variable, while organizational climate perception (work environment satisfaction, self-protection awareness and job satisfaction) and self-rated health (psychological stress and subjective health) served as dependent variables, respectively. In step 1, the influence of demographic variables (education level, marital status, departments, professional title, service years, working time) on each dependent variable was explained. In step 2,the joint influence of demographic variables and the explanatory variable on response variable was demonstrated. Table 4 Hierarchical linear regression models for organizational climate perception Variables Work environment satisfaction Self-protection awareness Job satisfaction Step1(β) Step2(β) Step1(β) Step2(β) Step1(β) Step2(β) Control variables Education level -0.055 ** -0.033 -0.087 *** -0.073 *** -0.036 -0.018 Marital status 0.009 0.011 0.077 ** 0.078 *** 0.031 0.032 Departments 0.018 0.025 0.049 * 0.053 ** 0.008 0.014 Professional title 0.048 * -0.046 * 0.052 * 0.051 * 0.062 ** 0.061 ** Service Years -0.137 *** -0.128 *** -0.068 *** -0.062 ** -0.028 -0.020 Working time -0.132 *** -0.104 *** -0.026 -0.009 -0.107 *** -0.083 *** Occupational risk -0.313 *** -0.191 *** -0.216 *** F 15.259 *** 52.733 *** 6.701 *** 18.952 *** 7.129 *** 31.696 *** R 2 0.037 *** 0.133 *** 0.016 *** 0.052 *** 0.017 *** 0.084 *** △R 2 0.096 *** 0.036 *** 0.067 *** * p < 0.05, ** p < 0.01, *** p < 0.001 (two-tailed). Table 5 Hierarchical linear regression models for self-rated health Variables Psychological stress Subjective health Step1(β) Step2(β) Step1(β) Step2(β) Education level 0.016 -0.009 -0.063 *** -0.047 * Marital status 0.003 0.000 -0.021 -0.020 Departments -0.025 -0.033 0.040 * 0.044 * Professional title -0.035 -0.033 0.085 *** 0.083 *** Service Years 0.063 * 0.052 * -0.099 *** -0.092 *** Working time 0.110 *** 0.078 *** -0.159 *** -0.139 *** Occupational risk 0.354 *** -0.230 *** F 6.735 *** 56.070 *** 18.798 *** 36.795 *** R 2 0.016 *** 0.140 *** 0.045 *** 0.094 *** △R 2 0.124 *** 0.052 *** * p < 0.05, ** p < 0.01, *** p < 0.001 (two-tailed). As shown in Table 4 , occupational risks accounted for an additional 9.60% of the variance in predicting work environment satisfaction in step 2. A negative correlation between occupational risks and work environment satisfaction was observed among the respondents (β=-0.313, P < 0.001). The test of △R 2 yielded asignificant result, indicating that occupational risks was a significant predictor of work environment satisfaction. occupational risks exhibited negative associations with self-protection awareness (β=-0.191, P < 0.001) and job satisfaction (β=-0.216, P < 0.001) as well. Taking into account all the above-mentioned factors, these results suggest the presence of negative correlations between occupational risks and organizational climate perception among Chinese nurses. As indicated in Table 5 , occupational risks accounted for an additional 12.4% of the variance in predictingpsychological stress in step 2. The test of △R 2 was significant. Thus, these data are consistent with the notion that occupational risks function as a significant predictor of psychological stress (β = 0.354, P < 0.001). Consistent with the above results, occupational risks were negatively correlated with subjective health (β=-0.230, P < 0.001). Overall, these two findings demonstrated that occupational risks also had a negative correlation with nurses' self-rated health. The higher occupational risks are, the worse self-rated health will be. 4. Discussion In this study, a comprehensive cross-sectional survey was conducted to investigate the occupational risks, organizational climate perception, and self-rated health status among Chinese nurses employed in tertiary-level hospitals. We investigated the interrelationships between these factors within this population. Previous studies have primarily focused on identifying contributing factors and analyzing the association between nurses’ health and burnout, but limited research has explored the potential influence of occupational risks on nurses' perceptions of organizational climate and their own health assessments. Our results indicated that the occupational risk levels among nurses in tertiary hospitals were slightly elevated compared to a large-scale study conducted on Chinese healthcare workers( 26 ), aligning with the results of Niujie’s study( 27 ). This finding reaffirms that the occupational risks are more pronounced in tertiary hospitals. Among the five types of occupational hazards assessed, psychosocial and organizational factors were reported as the most frequent and severe, indicating that they occurred most frequently and had the most serious consequences. Based on the survey questions, the majority concerned health problems stemming from excessive workloads. Thus, heavy workloads and environmental stressors appear to be substantial contributing factors. However, most previous studies on occupational risks among Chinese nurses have disregarded the influence of psychosocial and organizational factors. Notably, Hwang’s research revealed that nurses employed in hierarchical organizational cultures reported higher levels of job satisfaction( 28 ). Additionally, studies have shown that healthcare workers in hospitals with a greater emphasis on employee well-being experienced lower average durations of occupational risks. A review paper summarizing 20 original studies concluded that human resource strategies implemented by organizations effectively enhanced nurses’ job satisfaction( 29 ). Consequently, both hospital administrators and nursing leaders should prioritize the assessment and optimization of organizational culture and the work environment, especially in tertiary hospitals. Our results showed no significant difference in occupational risks among nurses with varying work schedules, which was an unexpected outcome. This is likely due to the paucity of available data investigating the relationship between working hours and occupational risks. Existing literature suggests that individuals tend to experience burnout when working excessively long hours, which may potentially increase their exposure to occupational hazards( 30 ). Therefore, further research is warranted to investigate the influence of work hours on occupational risks among this population. The data obtained in this study revealed a negative correlation between occupational risks and both work environment satisfaction and job satisfaction, indicating that a work environment charactered by low occupational risks tends to be more appealing to employees. Furthermore, the results demonstrated that the job satisfaction of healthcare workers decreases following exposure to occupational hazards. According to Shiyu’s study( 26 ), work environment satisfaction serves as a mediator of job dissatisfaction when occupational hazards occur. Investing in the improvement of work environments among nurses has the potential to reduce the incidence of hospital-acquired pressure ulcers( 13 )and other occupational risks. Magnet hospitals are renowned for fostering a healthy work environment, and some studies have indicated that magnet recognition can positively enhance hospital reimbursements( 16 ). Nursing leaders play an irreplaceable role in fostering a positive work environment( 31 ). Therefore, we recommend that hospital administrators dedicate more resources towards cultivating healthy work environments. This can be achieved by developing transformational nurse leaders who exhibit constructive and supportive leadership approaches, and are capable of nurturing a warm organizational culture. Hospital administrators can also reap the benefits of a positive work environment. Few studies have considered self-reported self-protection awareness, which should be recognized as a crucial factor in understanding occupational risks. In our study, we incorporated self-reported self-protection awareness as an indicator, finding an average score of 4.27, falling between “careful” and “very carefully.” Interestingly, we observed a negative correlation between occupational risk and self-reported self-protection awareness; namely, the higher the occupational risk nurses face, the lower their perceived self-protection awareness. This suggests that individuals with low self-protection awareness are more susceptible to occupational risks. There are two possible reasons for this. First, from the nurses’ perspective, they may have become accustomed to their work environment. Even if they are aware of the high occupational risks associated with their surroundings, they might develop the belief that they would be fortunate enough to avoid any negative effects. This mindset can lead to a diminished appreciation for the importance of self-protective measures. Alternatively, the work environment itself may contribute to this phenomenon. Departments with elevated occupational risks may be equipped with an abundance of advanced protective equipment, which may inadvertently foster a false sense of security among the nursing staff( 32 ). This tendency is perilous and highlights the critical need to enhance healthcare providers’ awareness of personal protective measures to mitigate the occurrence of occupational hazards. Managers should pay more attention to this issue, organize regular training courses( 33 ) to improve their compliance with universally adopted precautions( 34 ), and sharing real-world case studies of occupational risks, so as to encourage nurses to safeguard themselves against the occupational risks, especially in high-risk clinical settings. Our study found that higher occupational risk was associated with lower self-reported health among nurses. This may be attributed to the anxiety and psychological stress induced by the elevated occupational risk, which can instill a heightened sense of vulnerability and fear of potential harm. Occupational health is a multifaceted issue that spans individual, social, and national levels. While providing comprehensive counseling services and follow-up checks for every at-risk worker may prove too costly, it is crucial to recognize the substantial impact the workplace environment can have on an individual's well-being and the various occupational risks it may encompass( 35 ). Existing research has demonstrated that exposure to high levels of work-related stress could lead to increased future health risks among nurses( 36 ). Furthermore, some research find that nurturing character strengths and authentic nurse leadership( 37 ), with their positive impact on nurses’ health, may help mitigate occupational risks. In this regard, we believe that additional longitudinal studies would be more effective in exploring the relationships between occupational risks, organizational climate perception and self-rated health. 5. Limitations The limitations of this study are as follows. First, the cross-sectional observational design precluded the ability to determine causal relationships among the variables examined. Future prospective studies are needed for further exploration. Second, our dataset did not comprehensively represent the entire population of nurses in China. Even though the study design considered geographical variation, population density, and socioeconomic status and chose hospitals in different provinces, the included institutions were predominantly situated in relatively affluent regions. Further studies with nationwide representative samples are warranted. The single-answer multiple-choice questions (MCQ) adopted in the questionnaires are another problem. To ensure the quality of our questionnaire, we tried to remain simple and less time-consuming using single-answer multiple-choice questions (MCQ) to measure self-protective awareness and psychological stress. However, this approach makes it challenging to ensure consistency between objective outcomes and self-reported responses, further constraining our analysis based on the findings from other studies. Despite these limitations, this study contributes to the understanding of occupational risks faced by nurses in tertiary hospitals and explores the relationships between occupational risks, organizational climate perception, and self-rated health . 6. Conclusion and Clinical Implications The study findings indicate that psychosocial and organizational factors were the predominant occupational risks faced by Chinese nurses in tertiary hospitals, resulting in the most severe consequences. Significant variations in occupational risk were observed based on nurses' years of service, education level, position, working hours, and department. Furthermore, the analysis revealed negative associations between occupational risk, organizational climate perception, self-protection awareness, and self-rated health. Nurses exposed to high occupational risk and lacking self-protection awareness face elevated levels of danger. Consequently, managers, policymakers, and employers should prioritize addressing occupational hazards stemming from psychosocial and organizational factors. Additionally, emphasis should be placed on enhancing self-protection awareness, particularly among nurses working in high-risk units. Administrators and researchers need to dedicate further efforts towards creating a harmonious environment, strengthening risk education, conducting stress reduction workshop, adding protective equipment, reinforcing risk management, improving the career security system for nursing staff, and offering psychological counseling and emotional support. Strengths and limitations of this stud y ► Strengths of this study include the large sample size, the representativeness of the sample with respect to Chinese nurses in tertiary hospitals in 14 provinces. ► A large-sample survey was conducted to investigate the incidence of five types of occupational risks which include occupational risks from psychosocial and organizational factors among nurses. ► A significant finding that occupational risks are negatively correlated with self-reported self-protection awareness, and the publication of this article will further promote China’s hospital management policy to enhancing self-protection awareness, particularly for nurses working in high-risk units.. ► Single-answer multiple-choice questions (MCQ) adopted in questionnaires makes it hard to ensure the consistency between the objective outcomes and the self-reported answers. ► The cross-sectional nature of this study could not determine whether there was a causal relationship among these variables. Abbreviations MCQ: Multiple Choice Questions SDs: standard deviations ANOVA: analysis of variance Declarations Ethics approval and consent to participate The study was conducted in accordance with the ethical guidelines of the Ethics Committee of the College of Public Health, Harbin Medical University (HMUIRB20180305) and was approved by the Ethics Committee of Harbin Medical University. Additionally, the study adhered to the ethical principles outlined in the Declaration of Helsinki . All participants received both oral and written information regarding the study's objectives, the voluntary nature of their participation, and their right to withdraw at any time without providing a reason. Written informed consent was obtained from all participants prior to their inclusion in the study. Ethical Conduct of Research The study was conducted in compliance with the ethical guidelines of the Ethics Committee of the College of Public Health, Harbin Medical University (HMUIRB20180305), and approved by the Ethics Committee of the Harbin Medical University. Consent for publication Not Applicable. Data availability The data for this study is not publicly available. Nonetheless, the corresponding author can provide it anonymously upon a reasonable request. Acknowledgements We gratefully acknowledge all the study participants, without them, it is not possible to complete these projects. Author contributions This collaboration, Yue Du,Yiwei Wang and Yu Shi are the correspondence authors of this study, responsible for designing, guiding, organizing and planning this study. Jinyu He is responsible for qualitative data analysis and manuscript writing.Jiarui Zhang and Jinman Zhou are responsible for quantitative data collection and data analysis.Jiarui Fu advised and revised several drafts of the manuscript. Funding Information This publication is a result, in part, from research supported by the Research Fund (2022BH010) to Yu Shi given by Vanke school of public health, Tsinghua University, Chinese National Science Foundation (72074065) and China-WHO Biannual Cooperation Project (2020-2021) (GJ2-2021-WHOPO-E2) Conflicts of interest statement The authors declare no competing interests. References Goksu CS, Yucel D. O-141 EXAMINING THE IMPACT OF PSYCHOSOCIAL RISKS ON NURSES' INTENTION TO LEAVE: A STUDY IN A UNIVERSITY HOSPITAL. Occupational Medicine. 2024(Supplement_1):Supplement_1. Freimann T, Merisalu E. Work-related psychosocial risk factors and mental health problems amongst nurses at a university hospital in Estonia: A cross-sectional study. Scand J Public Health. 2015;43(5):447-52. Zhang SE, Liu W, Wang J, Shi Y, Fan L. Impact of workplace violence and compassionate behaviour in hospitals on stress, sleep quality and subjective health status among Chinese nurses: A cross-sectional survey. BMJ Open. 2018;8(10):e019373. Shahrour G, Dardas LA. Acute stress disorder, coping self-efficacy and subsequent psychological distress among nurses amid COVID-19. Journal of Nursing Management. 2020;28(7). . !!! INVALID CITATION !!! . Lasebikan O, Ede O, Lasebikan N, Anyaehie U, Oguzie G, Chukwujindu E. Job satisfaction among health professionals in a federal tertiary hospital in Nigeria. Nigerian journal of clinical practice. 2020;23(3):371-5. Molina-Praena J, Ramirez-Baena L, Gómez-Urquiza JL, Caadas GR, Fuente EIDL, Fuente CDL. Levels of Burnout and Risk Factors in Medical Area Nurses: A Meta-Analytic Study. International Journal of Environmental Research and Public Health. 2018;15(12). Nursing JOC. Who speaks for nursing? COVID-19 highlighting gaps in leadership. Murat M, Kse S, Savaer S. Determination of stress, depression and burnout levels of front‐line nurses during the COVID‐19 pandemic. International Journal of Mental Health Nursing. 2020. Lasalvia A, Bonetto C, Porru S, Carta A, Tardivo S, Bovo C, et al. Psychological impact of COVID-19 pandemic on healthcare workers in a highly burdened area of north-east Italy. Cambridge University Press. 2021. Antwi YA, Bowblis JR. The Impact of Nurse Turnover on Quality of Care and Mortality in Nursing Homes: Evidence from the Great Recession. Upjohn Working Papers & Journal Articles. 2016. Masood K, Ahmad M, Zafar J, Haq MU, Ashfaq A, Zafar H. Assessment of occupational exposure among pakistani medical staff during 2007-2011. Australasian Physical & Engineering Sciences in Medicine. 2012;35(3):297-300. Ma C, Park SH. Hospital Magnet Status, Unit Work Environment, and Pressure Ulcers. Journal of Nursing Scholarship An Official Publication of Sigma Theta Tau International Honor Society of Nursing. 2015;47(6):565–73. Aiken LH, Clarke SP, Sloane DM, Lake ET, Cheney T. Effects of hospital care environment on patient mortality and nurse outcomes. J Nurs Adm. 2008;39(5):223-9. Raso R, Fitzpatrick JJ, Masick K. Clinical Nurses' Perceptions of Authentic Nurse Leadership and Healthy Work Environment. JONA: The Journal of Nursing Administration. 2020;50. McHugh, Matthew, D., Sloane, Douglas, M., et al. Hospitals Known for Nursing Excellence Associated with Better Hospital Experience for Patients. Health Services Research Hsr. 2016. Duchaine CS, Aubé K, Gilbert-Ouimet M, Vézina M, Ndjaboué R, Massamba V, et al. Psychosocial Stressors at Work and the Risk of Sickness Absence Due to a Diagnosed Mental Disorder: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2020;77(8). Jonge JD, Blanc PML, Peeters MCW, Noordam H. Emotional job demands and the role of matching job resources: A cross-sectional survey study among health care workers. International Journal of Nursing Studies. 2008;45(10):1460-9. Kurtessis JN, Eisenberger R, Ford MT, Buffardi LC, Adis CS. Perceived Organizational Support: A Meta-Analytic Evaluation of Organizational Support Theory. Journal of Management. 2015;43(6). Thompson JA, Bunderson JS. VIOLATIONS OF PRINCIPLE: IDEOLOGICAL CURRENCY IN THE PSYCHOLOGICAL CONTRACT. Academy of Management Review. 2003;28(4):571-86. Trner M, Pousette A, Larsman P, Hemlin S. Coping With Paradoxical Demands Through an Organizational Climate of Perceived Organizational Support: An Empirical Study Among Workers in Construction and Mining Industry. SAGE Publications. 2017(1). http://www.nhc.gov.cn/guihuaxxs/s3585u/202408/6c037610b3a54f6c8535c515844fae96.shtml BAE SH. Assessing the impacts of nurse staffing and work schedules on nurse turnover: A systematic review. International Nursing Review. 2024;71(1). Wu F, Lao Y, Feng YL, Liuyan. Worldwide prevalence and associated factors of nursing staff turnover: A systematic review and meta-analysis. nursing open. 2024;11(1). Baumbach L, Frese M, Hrter M, Knig HH, Hajek A. Patients Satisfied with Care Report Better Quality of Life and Self-Rated Health—Cross-Sectional Findings Based on Hospital Quality Data. Healthcare (2227-9032). 2023;11(5). 李红, 宋亦男, 王小芳, 张琼瑶, 徐景日. 护理职业风险评估软件开发和应用. 中国护理管理. 2009(9):3. Shi Y, Xue H, Ma Y, Wang L, Yan G. Prevalence of occupational exposure and its influence on job satisfaction among Chinese healthcare workers: a large-sample, cross-sectional study. BMJ Open. 2020;10(4):e031953. 牛杰. 山西省六所综合性医院护理职业风险调查研究 [硕士]2010. Hwang E. Effects of the organizational culture type, job satisfaction, and job stress on nurses' happiness: A cross-sectional study of the long-term care hospitals of South Korea. Japan Journal of Nursing Science. 2019;16(3). Niskala J, Kanste O, Tomietto M, Miettunen J, Tuomikoski AM, Kyngs H, et al. Interventions to improve nurses' job satisfaction: A systematic review and meta‐analysis. Journal of Advanced Nursing. 2020;76(7). Hsu YY, Bai CH, Yang CM, Huang YC, Lin TT, Lin CH. Long Hours' Effects on Work-Life Balance and Satisfaction. BioMed Research International. 2019;2019:1-8. Specchia ML, Cozzolino MR, Carini E, Pilla AD, Damiani G. Leadership Styles and Nurses' Job Satisfaction. Results of a Systematic Review. International Journal of Environmental Research and Public Health. 2021;18(4):1552. Tan L, Kovoor JG, Williamson P, Tivey DR, Collinson TG, Hewett PJ, et al. Personal Protective Equipment and Evidence-Based Advice for Surgical Departments During COVID-19. Journal of the American College of Surgeons. 2021;233(5):e79-. Doig C. Education of medical students and house staff to prevent hazardous occupational exposure. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne. 2000;162(3):344-5. Nelsing S, Nielsen TLJ, Nielsen BNHO. Incidence and risk factors of occupational blood exposure: A nation-wide survey among Danish doctors. European Journal of Epidemiology. 1997;13(1):1-8. Psychosocial and occupational risk perception among health care workers: a Moroccan multicenter study. Bmc Research Notes. 2015;8(1):408. Bardhan R, Heaton K, Davis M, Chen P, Lungu CT. A Cross Sectional Study Evaluating Psychosocial Job Stress and Health Risk in Emergency Department Nurses. International Journal of Environmental Research and Public Health. 2019;16(18):3243. Zhang SE, Yang LB, Zhao CX, Cao DP. Contribution of Character Strengths to Psychology Stress, Sleep Quality, and Subjective Health Status in a Sample of Chinese Nurses. Frontiers in Psychology. 2021. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6183161","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":444822355,"identity":"7b3ca415-3acd-4c6a-9e1b-55e08cd34558","order_by":0,"name":"Jinyu He","email":"","orcid":"","institution":"Tsinghua University","correspondingAuthor":false,"prefix":"","firstName":"Jinyu","middleName":"","lastName":"He","suffix":""},{"id":444822356,"identity":"393386d1-6c3a-4c3f-a800-10a800e5bf51","order_by":1,"name":"Jiarui Zhang","email":"","orcid":"","institution":"Shenzhen Second People's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Jiarui","middleName":"","lastName":"Zhang","suffix":""},{"id":444822358,"identity":"da646bf1-bba3-4ad1-801f-08a067bfac30","order_by":2,"name":"Jinman Zhou","email":"","orcid":"","institution":"Tianjin Medical University","correspondingAuthor":false,"prefix":"","firstName":"Jinman","middleName":"","lastName":"Zhou","suffix":""},{"id":444822359,"identity":"3cf9c3bb-1317-464a-af16-3771e8d7d275","order_by":3,"name":"Jiarui Fu","email":"","orcid":"","institution":"Tianjin Medical University","correspondingAuthor":false,"prefix":"","firstName":"Jiarui","middleName":"","lastName":"Fu","suffix":""},{"id":444822361,"identity":"3921cd0f-ab5f-45e2-be3f-2b7adabae0b8","order_by":4,"name":"Yue Du","email":"","orcid":"","institution":"Tianjin Medical University","correspondingAuthor":false,"prefix":"","firstName":"Yue","middleName":"","lastName":"Du","suffix":""},{"id":444822363,"identity":"0a72096d-c38a-4c43-8314-4f9c19139790","order_by":5,"name":"Yiwei Wang","email":"","orcid":"","institution":"Guangxi Normal University","correspondingAuthor":false,"prefix":"","firstName":"Yiwei","middleName":"","lastName":"Wang","suffix":""},{"id":444822365,"identity":"caf5b858-2d89-45d4-9457-02269427c50e","order_by":6,"name":"Yu Shi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAuElEQVRIiWNgGAWjYBACAyBiBpH8zMyHH5CmRbKdLc2ABC0gxnkeBQmitJhLJG/+XFBwOHHzYR6g/hqbaIJaLGeklUnPMDicuO0w74EHDMfSchsIOuxGjhkzD1gLX4IBY8NhorQYfwZp2dzMYyBBrBYDaZCWDcxEaznzrAyoJd14xmFgICcQ5ZfjwBDj+WMt299/+PCDDzU2hLUwCCSAyGYIJ4GgchDgPwAi64hSOwpGwSgYBSMUAAAG0kAI0pdBCQAAAABJRU5ErkJggg==","orcid":"","institution":"Tianjin Medical University","correspondingAuthor":true,"prefix":"","firstName":"Yu","middleName":"","lastName":"Shi","suffix":""}],"badges":[],"createdAt":"2025-03-08 09:23:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6183161/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6183161/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":81281964,"identity":"09551371-8aec-46aa-9119-d86ecceaa72e","added_by":"auto","created_at":"2025-04-24 10:21:09","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1257086,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6183161/v1/0a25b7b0-f585-416a-9017-87f4445122d7.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Occupational Risks, organizational climate perception and Self-rated health of Chinese Nurses in Tertiary hospital: A large-scale Cross-Sectional Survey","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eNurses, as the largest occupational group in the healthcare field, face occupational hazards daily and are among the most vulnerable groups in hospitals.(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Occupational hazards faced by nurses include exposure to blood and body fluids, sharp instrument injuries, radiation, workplace violence, physical and psychological hazards from the working environment, and the quality of care provided(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).Owing to their frequent contact with patients, nurses are also at higher risk of contracting infectious diseases and may have a negative impact on their physical health, job satisfaction, and the quality of care they provide, especially in tertiary health institutions where the workload is more pronounced(\u003cspan additionalcitationids=\"CR5 CR6\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eEspecially during COVID-19, nurses served on the front lines and played a central role in the battle against the pandemic.(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). An extraordinary pressure is imposed on nurses due to the sudden onset of the COVID-19 pandemic, which is accompanied by an increase in workload, physical fatigue, disruption of the work-life balance, lack of personal protective equipment, and nurses' fear of being infected with COVID-19 themselves or their families. They faced complex care and treatment processes, which could cause emotional exhaustion and may have negatively impacted their health.(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Internationally, this situation poses a series of challenges to health services with respect to human resource management in nursing. Frequent nurse turnover in hospitals can lead to a reduction in staffing level, which negatively impacts on the quality of care and patient safety(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Given this, nursing staff, who work tirelessly to improve people's health are often exposed to various health-threatening factors in their work environment, deserve more attention from health policymakers and hospital administrators(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eEarlier studies reported that a healthy environment is particularly important for nurses. Ma\u0026rsquo;s research, for example, foregrounded the association between both hospital and unit environments with hospital-acquired pressure ulcers(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). In Aiken\u0026rsquo;s research, it has been proved that the surgical mortality rate in sampled hospitals with better care environments educated nurses was approximately 60% lower compared with those that were poorly staffed with under-par care environments(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Care environment has also been shown to contribute to better patient outcomes(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Improvements in the work environment of nurses also help reduce hospital-acquired pressure ulcers and 30-day readmissions in Medicare patients undergoing surgery. In addition, it also provides satisfactory experience for patients(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Therefore, a healthy nurse work environment is significant not only for patients\u0026rsquo; health but also for nurses\u0026rsquo; health,work commitment and engagement(\u003cspan additionalcitationids=\"CR18 CR19 CR20\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). However, we do not know whether occupational risks are related to nurses\u0026rsquo; satisfaction with their work environment, and if this relationship exists, how this influence is exerted.\u003c/p\u003e \u003cp\u003eIn China, according to the 2023 National Statistical Bulletin on the development of healthcare, the current situation of the healthcare system in China is complex, and nurses in tertiary hospitals face unique challenges(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Despite accounting for only 10.05% (3855) of the total 38,355 hospitals in China in 2023, tertiary hospitals received a disproportionately high number of patients, with nearly 61.74% (more than 2.6\u0026nbsp;billion) of the total hospital visits. This high patient volume indicates that nurses in tertiary hospitals are exposed to a greater variety of diseases, often with greater severity and complexity. Additionally, nurses in tertiary hospitals are more likely to interact with the family members of patients, which can add to the complexity and emotional burden of their work.\u003c/p\u003e \u003cp\u003eUnsafe nurse staffing leads to increased nurse turnover rates(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e),the pooled prevalence of nurse turnover was 18% in China(\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e).Moreover, the \"patient-centered\" medical system championed in China puts additional pressure on nurses to deliver optimal medical care that prioritizes not only physical discomfort but also emotional well-being. Thus, nurses in China are expected to maintain a stable mental and emotional state, which can be particularly challenging for tertiary hospitals. In summary, the situations faced by nurses in tertiary hospitals in China are complex and multifaceted, highlighting the need for further research to better understand and address the challenges they face.\u003c/p\u003e \u003cp\u003eNurses' perception of work and self-rated health are important for nurse administrators and hospital organizations as occupational risks can have a psychological and physical impact on nurses and may affect their organizational climate perception and self-rated health. Previous studies have found that there is a growing awareness of the importance and effectiveness of self-rated health, which can predict mortality across population(\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). Therefore, self-rated health is used to represent people\u0026rsquo;s health condition, and try to analyze the correlations between occupational risks and self-rated health.\u003c/p\u003e \u003cp\u003eBy describing the current occupational hazards faced by nurses, including both frequency and severity, this study provides valuable information to help administrators better understand and address these risks. Additionally, studying nurses' organizational climate perceptions and self-rated health can shed light on the potential impact of these occupational hazards on their well-being and job satisfaction. This study also aims to explore the correlations between occupational risk, organizational climate perception, and self-rated health, as this can provide further insights into how different factors may be interconnected. Overall, this study can help develop appropriate strategies and interventions to against risks and enhance the organizational climate among nursing staff.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Study Design\u003c/h2\u003e \u003cp\u003eIn this study, a nationwide cross-sectional online survey study was conducted to identify the prevailing clinical occupational risks faced by nurses working in tertiary hospitals in China. Online questionnaires were completed by nurses throughout the country in a confidential and anonymous way from 10 July to 10 October 2018. This large-scale survey was successfully completed with the support of the Hospital Occupational Health Group of Quality, Health, Safety, and Environmental Protection of the Management Committee of China Research Hospital Association.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Participants and Data Collection\u003c/h2\u003e \u003cp\u003eThe questionnaires were completed by nurses in tertiary hospitals in 14 provinces (including Chongqing, Guizhou, Heilongjiang, Beijing and Qinghai) in China. The inclusion criteria include: working as a nurse and a regular employee of a tertiary hospital, having more than 1 year of clinical work experience, and providing informed consent for voluntary participation.\u003c/p\u003e \u003cp\u003eThe online questionnaire platform, 'Lediaocha' was utilized in this study to get online survey and collect the corresponding records. Nurses had convenient access to participate in the survey through the 'Lediaocha' platform by utilizing the provided access link and QR code for the online questionnaire. We usually used a WeChat group to forward the questionnaires. A web link (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.lediaocha.com/survey)o\u003c/span\u003e\u003cspan address=\"https://www.lediaocha.com/survey)o\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003er the Quick Response QR code of our questionnaire survey was sent via mobile phone to participants outside of working hours. Two main measures were taken to control the quality. Firstly, the 'Lediaocha' platform can also recorded the duration of time participants dedicated to answering the questionnaire. We utilized the response time as a criterion to determine whether a questionnaire is valid. Based on our pre-survey test, any questionnaire completed in less than 5 minutes was deemed invalid. Secondly, a dedicated section was included at the end of the questionnaire for quality control. Participants were requested to evaluate their own response process upon completion. If participants selected either of the following responses: \"Due to certain reasons, I failed to complete this questionnaire seriously, and recommend excluding it\" or \"Due to certain reasons, I was interrupted and could only ensure careful completion of a portion of the questionnaire,\" their data would be excluded from the subsequent analysis. The data management platform showed that a total of 12784 questionnaires were distributed, and 5187 participants completed valid questionnaires. The response rate was 40.57%.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3Instruments\u003c/h2\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003e2.3.1 Occupational Risks\u003c/h2\u003e \u003cp\u003eThe way of accessing occupational risks was derived from the classification of occupational hazard in nursing according to the International Occupational Hazards Database of the International Labor Organization Occupational Safety and Health Information Centre. It used 28 items to measure occupational hazard among nurses in the previous 12 months. At first, we got the possibility of occupational hazard by self-report, five dimensional (accidental hazard, physical hazard, chemical hazard, biological hazard, and psychosocial and organizational factors) model of occupational risks revised by Li et al(\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e), with items rated on a 5-point Likert-type scale ranging from 1 to 5 (1\u0026thinsp;=\u0026thinsp;seldom, 2\u0026thinsp;=\u0026thinsp;fewer, 3\u0026thinsp;=\u0026thinsp;sometimes, 4-often, 5\u0026thinsp;=\u0026thinsp;frequently). The total occupational hazard score is computed to quantify the respondent's overall level of occupational hazard. We also test the severity of the occupational hazard by 5-point Likert-type scale ranging from 1 to 5 (1\u0026thinsp;=\u0026thinsp;can be ignored 2\u0026thinsp;=\u0026thinsp;a little injury 3\u0026thinsp;=\u0026thinsp;general 4\u0026thinsp;=\u0026thinsp;serious 5\u0026thinsp;=\u0026thinsp;very serious). Then we got the occupational risks by multiplying the possibility of occupational hazard by the severity of it. The Cronbach's alpha of the five dimensions is 0.803, 0.789, 0.799, 0.824 and 0.881, respectively.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003e2.3.2 organizational climate perception\u003c/h2\u003e \u003cp\u003eIn this study, we defined organizational climate perception as the combination of work environment satisfaction, self-protection awareness and job satisfaction. Work environment satisfaction was evaluated with a rating scale multiple-choice question (Multiple Choice Questions,MCQ): \"What is the level of your satisfaction with the environment where you work? (Mainly refers to the safety, comfort, and harmony of the objective hospital environment in which you work, excluding salary and promotion factors)'. This item was scored on a 5-point Likert-type scale ranging from 1 to 5 (1-very dissatisfied.2- dissatisfied. 3-neutral. 4-satisfied. 5-very satisfied). The item was reverse-scored to facilitate data analysis. Thus, higher scores indicated higher work environment satisfaction. A rating scale MCQ: \"how do you evaluate your self-protection awareness in your work\" used to measure self-protection awareness. It was also scored on a 5-point Likert-type scale ranging from 1 to 5 (1-very uncareful.2-uncareful. 3-neutral. 4-careful. 5-very careful). Job satisfaction was also evaluated with a rating scale MCQ: 'Overall. how satisfied are you with your current job?' This item was rated on a 5-point Likert-type scale ranging from 1 to 5 (l-very dissatisfied. 2-dissatisfied 3-neutral 4-satisfied. 5-very satisfied). The eligibility and validity of the item have been proven in previous studies.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003e2.3.3 self-rated health\u003c/h2\u003e \u003cp\u003eSelf-rated health in this study include psychological stress and subjective health. Both were measured by one rating scale MCQ. For psychological stress, the question was 'A person falls into a state of tension, uneasiness. nervousness, anxiety, or sleeplessness at night because of certain psychological reasons. Have you ever felt this way in recent years? How would you rate this feeling?' Participants were asked to rate their symptoms on a 5-point scale from 'never' to 'very serious', with higher scores indicating higher stress. For subjective health, the question was \u0026ldquo;How would you rate your health status\u0026rdquo;, and it was rated on a 5-point Likert-type scale ranging from 1 to 5 (l\u0026thinsp;=\u0026thinsp;very healthy. 2-healthy 3- general 4-sometimes unhealthy. 5-always unhealthy).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Data analysis\u003c/h2\u003e \u003cp\u003eFirst, we describe occupational hazards and their average severity in different dimensions. Subsequently, descriptive statistical analyses were conducted to explore the nurses\u0026rsquo; demographic characteristics. Frequencies, means, and standard deviations (SDs) were used to describe sample characteristics. One-way analysis of variance (ANOVA) was used to examine occupational risks. Pearson's correlation coefficient was used to examine the relationships among the study variables (occupational risk, work environment satisfaction, self-protection awareness, job satisfaction, stress symptoms and subjective health).\u003c/p\u003e \u003cp\u003eHierarchical linear regression analysis was performed to test the effects of the independent variables, especially occupational risk, on organizational climate perception and self-rated health. Demographic variables, including education level, marital status, department, professional title, service years, and working time, were entered into Step 1 of the hierarchical regression analysis model to eliminate their interference on the dependent variables. We also addressed the relative impact of each category of variables on organizational climate perception and self-rated health using this analysis model. In Step 2, both demographic variables and occupational risks were entered into the model to test how much variance occupational risks could explain among the dependent variables. We have provided the data, including F and △R\u003csup\u003e2\u003c/sup\u003e. Standardized regression coefficient (β) and p-value for each step in the regression model. All analyses were conducted using SPSS V22.0. Statistical significance was defined as a two-tailed p value\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Occupational hazard dimensions\u003c/h2\u003e \u003cp\u003eAs for the occupational hazard dimensions, we can find that the psychosocial and organizational factors account for the most frequent occupational hazard. Simultaneously, these factors also result in the most severe consequences among the five dimensions. As shown in Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, the mean of occupational risks from psychosocial and organizational factors is 6.81, which is the highest among the five dimensions of hazard. Additionally, the average of all kinds of occupational risks is 4.53.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFrequency and Severity in different kinds of Occupational Hazards (n\u0026thinsp;=\u0026thinsp;5178)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHazard Dimension\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eSeverity\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003eRisks\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1. accidental hazard\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e3.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e2.32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2. physical hazard\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e4.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3.41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3. chemical hazard\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e3.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3.23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4. biological hazard\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e4.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3.43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5.psychosocial and\u003c/p\u003e \u003cp\u003eorganizational factors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e6.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e4.88\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Demographic Characteristics and ANOVA models for the occupational risks\u003c/h2\u003e \u003cp\u003eThe demographic characteristics of the respondents and the ANOVA models for the occupational risks of nurses are shown in Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Out of the 5178 nurses surveyed, the majority of participants (67.3%) reported having provided medical services for a duration of 1\u0026ndash;10 years. More than half of the respondents (63.8%) held a bachelor\u0026rsquo;s degree, with 66.2% of them being married, and the majority identified as Junior nurses (65.7%). In terms of department distribution, over a quarter of the respondents (27%) were from pediatrics department, followed by internal medicine (24.9%), surgery (12.1%) and obstetrics and gynecology (10.0%).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCharacteristics of the Respondents (n\u0026thinsp;=\u0026thinsp;5178)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eService Years\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6.703\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026ndash;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1952\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.29\u0026thinsp;\u0026plusmn;\u0026thinsp;2.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u0026ndash;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1531\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.71\u0026thinsp;\u0026plusmn;\u0026thinsp;3.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11\u0026ndash;15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e724\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.56\u0026thinsp;\u0026plusmn;\u0026thinsp;2.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e16\u0026ndash;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e353\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e5.01\u0026thinsp;\u0026plusmn;\u0026thinsp;3.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e618\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.53\u0026thinsp;\u0026plusmn;\u0026thinsp;2.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation categories\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e17.608\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCollege degree or below\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1860\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.21\u0026thinsp;\u0026plusmn;\u0026thinsp;2.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBachelor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3301\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e63.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.72\u0026thinsp;\u0026plusmn;\u0026thinsp;3.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePostgraduate degree or above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.72\u0026thinsp;\u0026plusmn;\u0026thinsp;2.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.610\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.074\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1650\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.39\u0026thinsp;\u0026plusmn;\u0026thinsp;3.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3426\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.60\u0026thinsp;\u0026plusmn;\u0026thinsp;2.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorce or loss of spouse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.47\u0026thinsp;\u0026plusmn;\u0026thinsp;2.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eProfessional position\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6.671\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJunior Nurse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3389\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e65.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.47\u0026thinsp;\u0026plusmn;\u0026thinsp;3.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedium-grade Nurse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1288\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.79\u0026thinsp;\u0026plusmn;\u0026thinsp;2.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSenior Nurse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e284\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.60\u0026thinsp;\u0026plusmn;\u0026thinsp;2.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnrated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e217\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e3.94\u0026thinsp;\u0026plusmn;\u0026thinsp;2.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWorking time (hours)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1746\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.62\u0026thinsp;\u0026plusmn;\u0026thinsp;2.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9\u0026ndash;14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3414\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e65.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e5.47\u0026thinsp;\u0026plusmn;\u0026thinsp;2.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e6.14\u0026thinsp;\u0026plusmn;\u0026thinsp;5.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDepartments\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.224\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInternal medicine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1291\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.46\u0026thinsp;\u0026plusmn;\u0026thinsp;2.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSurgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e625\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.69\u0026thinsp;\u0026plusmn;\u0026thinsp;3.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eObstetrics and Gynecology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e520\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e3.96\u0026thinsp;\u0026plusmn;\u0026thinsp;2.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePediatrics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1433\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.65\u0026thinsp;\u0026plusmn;\u0026thinsp;2.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfectious Disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.82\u0026thinsp;\u0026plusmn;\u0026thinsp;3.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOncology Department\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.54\u0026thinsp;\u0026plusmn;\u0026thinsp;3.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinical Laboratory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e3.83\u0026thinsp;\u0026plusmn;\u0026thinsp;2.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImaging Department\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e3.71\u0026thinsp;\u0026plusmn;\u0026thinsp;2.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePharmacy Department\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e3.87\u0026thinsp;\u0026plusmn;\u0026thinsp;3.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOperation room\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e309\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e5.12\u0026thinsp;\u0026plusmn;\u0026thinsp;3.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e714\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.47\u0026thinsp;\u0026plusmn;\u0026thinsp;2.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, it is observed that the group with a length of service between 16 and 20 years tend to exhibit higher occupational risks compared to groups with different lengths of service (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Nurses holding a bachelor\u0026rsquo;s degree reported significantly higher occupational risks than those with other educational qualifications (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). In terms of professional position, the highest occupational risks were found among medium-grade nurses (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The operation room was identified as the department with the highest occupational risks, followed by the department of infectious diseases. Furthermore, there were statistically significant differences in occupational risks among nurses working in different departments (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Approximately 66.3% of participants reported workingmore than 8 hours per day. However, in this investigation, the differences in occupational risks based on marital status and working hours were not statistically significant (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Information and correlations between study variables\u003c/h2\u003e \u003cp\u003eThe means, SDs and Pearson correlations of continuous study variables are presented in Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. As depicted in the table, all variables exhibited significant correlations with each other. Specifically, in this research, occupational risks demonstrated negative correlations with work environment satisfaction (r=-0.362, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01), self-protection awareness (r=-0.215, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01), job satisfaction (r=-0.302, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01) and subjective health (r=-0.286, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). A positive correlation was observed between occupational risks and psychological stress (r\u0026thinsp;=\u0026thinsp;0.389, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). In this analysis, the regression analysis incorporated several control variables, including types of service years, education background, marital status, professional positions, working time and departments.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMeans, standard deviations (SD) and correlations of continuous variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1. Occupational risk\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2. Work environment satisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.362\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3. Self-protection awareness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.215\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.401\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4. Job satisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.302\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.518\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.266\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5. Psychological stress\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.389\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.399\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.188\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.405\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6. Subjective health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.286\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.510\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.294\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.330\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.346\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003e\u003csup\u003e*\u003c/sup\u003e \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05,\u003c/p\u003e \u003cp\u003e\u003csup\u003e**\u003c/sup\u003e \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01, Correlation is significant at the 0.01 level (2-tailed).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Hierarchical Linear Regression Models\u003c/h2\u003e \u003cp\u003eTwo hierarchical regression analyses were conducted to examine the influence of occupational risks on organizational climate perception (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e) and self-rated health (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e), while controlling for the effects of the demographic variables. In this study, occupational risks were posed as an independent variable, while organizational climate perception (work environment satisfaction, self-protection awareness and job satisfaction) and self-rated health (psychological stress and subjective health) served as dependent variables, respectively. In step 1, the influence of demographic variables (education level, marital status, departments, professional title, service years, working time) on each dependent variable was explained. In step 2,the joint influence of demographic variables and the explanatory variable on response variable was demonstrated.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eHierarchical linear regression models for organizational climate perception\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eWork environment satisfaction\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eSelf-protection awareness\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eJob satisfaction\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStep1(β)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStep2(β)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStep1(β)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eStep2(β)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eStep1(β)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eStep2(β)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eControl variables\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.055\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.033\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.087\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.073\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.036\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.018\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.077\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.078\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.031\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.032\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDepartments\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.049\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.053\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.014\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProfessional title\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.048\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.046\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.052\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.051\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.062\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.061\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eService Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.137\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.128\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.068\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.062\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.028\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.020\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorking time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.132\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.104\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.107\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.083\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupational risk\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.313\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.191\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.216\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15.259\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52.733\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.701\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18.952\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.129\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e31.696\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.037\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.133\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.016\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.052\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.017\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.084\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003e△R\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.096\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.036\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.067\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003csup\u003e*\u003c/sup\u003e \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05,\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003csup\u003e**\u003c/sup\u003e \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01,\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003csup\u003e***\u003c/sup\u003e \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001 (two-tailed).\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eHierarchical linear regression models for self-rated health\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003ePsychological stress\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eSubjective health\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStep1(β)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStep2(β)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStep1(β)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eStep2(β)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.063\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.047\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.020\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDepartments\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.033\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.040\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.044\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProfessional title\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.035\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.033\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.085\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.083\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eService Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.063\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.052\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.099\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.092\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorking time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.110\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.078\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.159\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.139\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupational risk\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.354\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.230\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.735\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56.070\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.798\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36.795\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.016\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.140\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.045\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.094\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003e△R\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.124\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.052\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003e*\u003c/sup\u003e \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05,\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003e**\u003c/sup\u003e\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01,\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003e***\u003c/sup\u003e\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001 (two-tailed).\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, occupational risks accounted for an additional 9.60% of the variance in predicting work environment satisfaction in step 2. A negative correlation between occupational risks and work environment satisfaction was observed among the respondents (β=-0.313, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The test of \u003cem\u003e△R\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e yielded asignificant result, indicating that occupational risks was a significant predictor of work environment satisfaction. occupational risks exhibited negative associations with self-protection awareness (β=-0.191, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and job satisfaction (β=-0.216, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) as well. Taking into account all the above-mentioned factors, these results suggest the presence of negative correlations between occupational risks and organizational climate perception among Chinese nurses.\u003c/p\u003e \u003cp\u003eAs indicated in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e, occupational risks accounted for an additional 12.4% of the variance in predictingpsychological stress in step 2. The test of \u003cem\u003e△R\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e was significant. Thus, these data are consistent with the notion that occupational risks function as a significant predictor of psychological stress (β\u0026thinsp;=\u0026thinsp;0.354, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Consistent with the above results, occupational risks were negatively correlated with subjective health (β=-0.230, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Overall, these two findings demonstrated that occupational risks also had a negative correlation with nurses' self-rated health. The higher occupational risks are, the worse self-rated health will be.\u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eIn this study, a comprehensive cross-sectional survey was conducted to investigate the occupational risks, organizational climate perception, and self-rated health status among Chinese nurses employed in tertiary-level hospitals. We investigated the interrelationships between these factors within this population. Previous studies have primarily focused on identifying contributing factors and analyzing the association between nurses\u0026rsquo; health and burnout, but limited research has explored the potential influence of occupational risks on nurses' perceptions of organizational climate and their own health assessments.\u003c/p\u003e \u003cp\u003eOur results indicated that the occupational risk levels among nurses in tertiary hospitals were slightly elevated compared to a large-scale study conducted on Chinese healthcare workers(\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e), aligning with the results of Niujie\u0026rsquo;s study(\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). This finding reaffirms that the occupational risks are more pronounced in tertiary hospitals. Among the five types of occupational hazards assessed, psychosocial and organizational factors were reported as the most frequent and severe, indicating that they occurred most frequently and had the most serious consequences. Based on the survey questions, the majority concerned health problems stemming from excessive workloads. Thus, heavy workloads and environmental stressors appear to be substantial contributing factors. However, most previous studies on occupational risks among Chinese nurses have disregarded the influence of psychosocial and organizational factors. Notably, Hwang\u0026rsquo;s research revealed that nurses employed in hierarchical organizational cultures reported higher levels of job satisfaction(\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). Additionally, studies have shown that healthcare workers in hospitals with a greater emphasis on employee well-being experienced lower average durations of occupational risks. A review paper summarizing 20 original studies concluded that human resource strategies implemented by organizations effectively enhanced nurses\u0026rsquo; job satisfaction(\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). Consequently, both hospital administrators and nursing leaders should prioritize the assessment and optimization of organizational culture and the work environment, especially in tertiary hospitals.\u003c/p\u003e \u003cp\u003eOur results showed no significant difference in occupational risks among nurses with varying work schedules, which was an unexpected outcome. This is likely due to the paucity of available data investigating the relationship between working hours and occupational risks. Existing literature suggests that individuals tend to experience burnout when working excessively long hours, which may potentially increase their exposure to occupational hazards(\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). Therefore, further research is warranted to investigate the influence of work hours on occupational risks among this population.\u003c/p\u003e \u003cp\u003eThe data obtained in this study revealed a negative correlation between occupational risks and both work environment satisfaction and job satisfaction, indicating that a work environment charactered by low occupational risks tends to be more appealing to employees. Furthermore, the results demonstrated that the job satisfaction of healthcare workers decreases following exposure to occupational hazards. According to Shiyu\u0026rsquo;s study(\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e), work environment satisfaction serves as a mediator of job dissatisfaction when occupational hazards occur. Investing in the improvement of work environments among nurses has the potential to reduce the incidence of hospital-acquired pressure ulcers(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)and other occupational risks. Magnet hospitals are renowned for fostering a healthy work environment, and some studies have indicated that magnet recognition can positively enhance hospital reimbursements(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Nursing leaders play an irreplaceable role in fostering a positive work environment(\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). Therefore, we recommend that hospital administrators dedicate more resources towards cultivating healthy work environments. This can be achieved by developing transformational nurse leaders who exhibit constructive and supportive leadership approaches, and are capable of nurturing a warm organizational culture. Hospital administrators can also reap the benefits of a positive work environment.\u003c/p\u003e \u003cp\u003eFew studies have considered self-reported self-protection awareness, which should be recognized as a crucial factor in understanding occupational risks. In our study, we incorporated self-reported self-protection awareness as an indicator, finding an average score of 4.27, falling between \u0026ldquo;careful\u0026rdquo; and \u0026ldquo;very carefully.\u0026rdquo; Interestingly, we observed a negative correlation between occupational risk and self-reported self-protection awareness; namely, the higher the occupational risk nurses face, the lower their perceived self-protection awareness. This suggests that individuals with low self-protection awareness are more susceptible to occupational risks. There are two possible reasons for this. First, from the nurses\u0026rsquo; perspective, they may have become accustomed to their work environment. Even if they are aware of the high occupational risks associated with their surroundings, they might develop the belief that they would be fortunate enough to avoid any negative effects. This mindset can lead to a diminished appreciation for the importance of self-protective measures. Alternatively, the work environment itself may contribute to this phenomenon. Departments with elevated occupational risks may be equipped with an abundance of advanced protective equipment, which may inadvertently foster a false sense of security among the nursing staff(\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). This tendency is perilous and highlights the critical need to enhance healthcare providers\u0026rsquo; awareness of personal protective measures to mitigate the occurrence of occupational hazards. Managers should pay more attention to this issue, organize regular training courses(\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e) to improve their compliance with universally adopted precautions(\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e), and sharing real-world case studies of occupational risks, so as to encourage nurses to safeguard themselves against the occupational risks, especially in high-risk clinical settings.\u003c/p\u003e \u003cp\u003eOur study found that higher occupational risk was associated with lower self-reported health among nurses. This may be attributed to the anxiety and psychological stress induced by the elevated occupational risk, which can instill a heightened sense of vulnerability and fear of potential harm. Occupational health is a multifaceted issue that spans individual, social, and national levels. While providing comprehensive counseling services and follow-up checks for every at-risk worker may prove too costly, it is crucial to recognize the substantial impact the workplace environment can have on an individual's well-being and the various occupational risks it may encompass(\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). Existing research has demonstrated that exposure to high levels of work-related stress could lead to increased future health risks among nurses(\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). Furthermore, some research find that nurturing character strengths and authentic nurse leadership(\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e), with their positive impact on nurses\u0026rsquo; health, may help mitigate occupational risks. In this regard, we believe that additional longitudinal studies would be more effective in exploring the relationships between occupational risks, organizational climate perception and self-rated health.\u003c/p\u003e"},{"header":"5. Limitations","content":"\u003cp\u003eThe limitations of this study are as follows. First, the cross-sectional observational design precluded the ability to determine causal relationships among the variables examined. Future prospective studies are needed for further exploration. Second, our dataset did not comprehensively represent the entire population of nurses in China. Even though the study design considered geographical variation, population density, and socioeconomic status and chose hospitals in different provinces, the included institutions were predominantly situated in relatively affluent regions. Further studies with nationwide representative samples are warranted. The single-answer multiple-choice questions (MCQ) adopted in the questionnaires are another problem. To ensure the quality of our questionnaire, we tried to remain simple and less time-consuming using single-answer multiple-choice questions (MCQ) to measure self-protective awareness and psychological stress. However, this approach makes it challenging to ensure consistency between objective outcomes and self-reported responses, further constraining our analysis based on the findings from other studies. Despite these limitations, this study contributes to the understanding of occupational risks faced by nurses in tertiary hospitals and explores the relationships between occupational risks, organizational climate perception, and self-rated health .\u003c/p\u003e"},{"header":"6. Conclusion and Clinical Implications","content":"\u003cp\u003eThe study findings indicate that psychosocial and organizational factors were the predominant occupational risks faced by Chinese nurses in tertiary hospitals, resulting in the most severe consequences. Significant variations in occupational risk were observed based on nurses' years of service, education level, position, working hours, and department. Furthermore, the analysis revealed negative associations between occupational risk, organizational climate perception, self-protection awareness, and self-rated health. Nurses exposed to high occupational risk and lacking self-protection awareness face elevated levels of danger. Consequently, managers, policymakers, and employers should prioritize addressing occupational hazards stemming from psychosocial and organizational factors. Additionally, emphasis should be placed on enhancing self-protection awareness, particularly among nurses working in high-risk units. Administrators and researchers need to dedicate further efforts towards creating a harmonious environment, strengthening risk education, conducting stress reduction workshop, adding protective equipment, reinforcing risk management, improving the career security system for nursing staff, and offering psychological counseling and emotional support.\u003c/p\u003e \u003cp\u003e \u003cb\u003eStrengths and limitations of this stud\u003c/b\u003ey\u003c/p\u003e \u003cp\u003e► Strengths of this study include the large sample size, the representativeness of the sample with respect to Chinese nurses in tertiary hospitals in 14 provinces.\u003c/p\u003e \u003cp\u003e► A large-sample survey was conducted to investigate the incidence of five types of occupational risks which include occupational risks from psychosocial and organizational factors among nurses.\u003c/p\u003e \u003cp\u003e► A significant finding that occupational risks are negatively correlated with self-reported self-protection awareness, and the publication of this article will further promote China\u0026rsquo;s hospital management policy to enhancing self-protection awareness, particularly for nurses working in high-risk units..\u003c/p\u003e \u003cp\u003e► Single-answer multiple-choice questions (MCQ) adopted in questionnaires makes it hard to ensure the consistency between the objective outcomes and the self-reported answers.\u003c/p\u003e \u003cp\u003e► The cross-sectional nature of this study could not determine whether there was a causal relationship among these variables.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eMCQ: Multiple Choice Questions\u003c/p\u003e\n\u003cp\u003eSDs: standard deviations\u003c/p\u003e\n\u003cp\u003eANOVA: analysis of variance\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted in accordance with the ethical guidelines of the Ethics Committee of the College of Public Health, Harbin Medical University (HMUIRB20180305) and was approved by the Ethics Committee of Harbin Medical University. Additionally, the study adhered to the ethical principles outlined in the Declaration of Helsinki . All participants received both oral and written information regarding the study's objectives, the voluntary nature of their participation, and their right to withdraw at any time without providing a reason. Written informed consent was obtained from all participants prior to their inclusion in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Conduct of Research\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted in compliance with the ethical guidelines of the Ethics Committee of the College of Public Health, Harbin Medical University (HMUIRB20180305), and approved by the Ethics Committee of the Harbin Medical University.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data for this study is not publicly available. Nonetheless, the corresponding author can provide it anonymously upon a reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe gratefully acknowledge all the study participants, without them, it is not possible to complete these projects.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis collaboration,\u0026nbsp;Yue Du,Yiwei Wang\u0026nbsp;and Yu Shi are the correspondence authors of this study, responsible for designing, guiding, organizing and planning this study. Jinyu He is responsible for qualitative data analysis and manuscript writing.Jiarui Zhang\u0026nbsp;and\u0026nbsp;Jinman Zhou\u0026nbsp;are responsible for quantitative data collection and data analysis.Jiarui Fu advised and revised several drafts of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis publication is a result, in part, from research supported by the Research Fund (2022BH010) to Yu Shi given by Vanke school of public health, Tsinghua University, Chinese National Science Foundation (72074065) and China-WHO Biannual Cooperation Project (2020-2021) (GJ2-2021-WHOPO-E2)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of interest statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eGoksu CS, Yucel D. 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SAGE Publications. 2017(1).\u003c/li\u003e\n\u003cli\u003ehttp://www.nhc.gov.cn/guihuaxxs/s3585u/202408/6c037610b3a54f6c8535c515844fae96.shtml\u003c/li\u003e\n\u003cli\u003eBAE SH. Assessing the impacts of nurse staffing and work schedules on nurse turnover: A systematic review. International Nursing Review. 2024;71(1).\u003c/li\u003e\n\u003cli\u003eWu F, Lao Y, Feng YL, Liuyan. Worldwide prevalence and associated factors of nursing staff turnover: A systematic review and meta-analysis. nursing open. 2024;11(1).\u003c/li\u003e\n\u003cli\u003eBaumbach L, Frese M, Hrter M, Knig HH, Hajek A. Patients Satisfied with Care Report Better Quality of Life and Self-Rated Health\u0026mdash;Cross-Sectional Findings Based on Hospital Quality Data. Healthcare (2227-9032). 2023;11(5).\u003c/li\u003e\n\u003cli\u003e李红, 宋亦男, 王小芳, 张琼瑶, 徐景日. 护理职业风险评估软件开发和应用. 中国护理管理. 2009(9):3.\u003c/li\u003e\n\u003cli\u003eShi Y, Xue H, Ma Y, Wang L, Yan G. Prevalence of occupational exposure and its influence on job satisfaction among Chinese healthcare workers: a large-sample, cross-sectional study. BMJ Open. 2020;10(4):e031953.\u003c/li\u003e\n\u003cli\u003e牛杰. 山西省六所综合性医院护理职业风险调查研究 [硕士]2010.\u003c/li\u003e\n\u003cli\u003eHwang E. Effects of the organizational culture type, job satisfaction, and job stress on nurses\u0026apos; happiness: A cross-sectional study of the long-term care hospitals of South Korea. Japan Journal of Nursing Science. 2019;16(3).\u003c/li\u003e\n\u003cli\u003eNiskala J, Kanste O, Tomietto M, Miettunen J, Tuomikoski AM, Kyngs H, et al. Interventions to improve nurses\u0026apos; job satisfaction: A systematic review and meta‐analysis. Journal of Advanced Nursing. 2020;76(7).\u003c/li\u003e\n\u003cli\u003eHsu YY, Bai CH, Yang CM, Huang YC, Lin TT, Lin CH. Long Hours\u0026apos; Effects on Work-Life Balance and Satisfaction. BioMed Research International. 2019;2019:1-8.\u003c/li\u003e\n\u003cli\u003eSpecchia ML, Cozzolino MR, Carini E, Pilla AD, Damiani G. Leadership Styles and Nurses\u0026apos; Job Satisfaction. Results of a Systematic Review. International Journal of Environmental Research and Public Health. 2021;18(4):1552.\u003c/li\u003e\n\u003cli\u003eTan L, Kovoor JG, Williamson P, Tivey DR, Collinson TG, Hewett PJ, et al. Personal Protective Equipment and Evidence-Based Advice for Surgical Departments During COVID-19. Journal of the American College of Surgeons. 2021;233(5):e79-.\u003c/li\u003e\n\u003cli\u003eDoig C. Education of medical students and house staff to prevent hazardous occupational exposure. CMAJ : Canadian Medical Association journal = journal de l\u0026apos;Association medicale canadienne. 2000;162(3):344-5.\u003c/li\u003e\n\u003cli\u003eNelsing S, Nielsen TLJ, Nielsen BNHO. Incidence and risk factors of occupational blood exposure: A nation-wide survey among Danish doctors. European Journal of Epidemiology. 1997;13(1):1-8.\u003c/li\u003e\n\u003cli\u003ePsychosocial and occupational risk perception among health care workers: a Moroccan multicenter study. Bmc Research Notes. 2015;8(1):408.\u003c/li\u003e\n\u003cli\u003eBardhan R, Heaton K, Davis M, Chen P, Lungu CT. A Cross Sectional Study Evaluating Psychosocial Job Stress and Health Risk in Emergency Department Nurses. International Journal of Environmental Research and Public Health. 2019;16(18):3243.\u003c/li\u003e\n\u003cli\u003eZhang SE, Yang LB, Zhao CX, Cao DP. Contribution of Character Strengths to Psychology Stress, Sleep Quality, and Subjective Health Status in a Sample of Chinese Nurses. Frontiers in Psychology. 2021.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"occupational risks, organizational climate perception, self-rated health, Chinese nurses","lastPublishedDoi":"10.21203/rs.3.rs-6183161/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6183161/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study aimed to investigate occupational risk, organizational climate perception and self-rated health among Chinese nurses working in tertiary hospitals and explore the correlation between occupational risk, organizational climate perception and self-rated health .\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDesign and method\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis paper described a large cross-sectional study involving 5178 nurses working in tertiary hospitals across 14 provinces in China. The research was conducted through an online cross-sectional survey in which participants completed a questionnaire between July 10th and October 10th, 2018, via an access link or Quick Response QR code. Data were analyzed using descriptive statistics, Pearson’s correlation, and a hierarchical multiple regression analysis. This cross-sectional study adhered to the STROBE reporting guidelines.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eChinese nurses in tertiary hospitals faced the greatest occupational risks from psychosocial and organizational factors, leading to severe consequences. Nurses' years of service, education, position, hours, and department affected their risk levels. Occupational risk was linked to poorer organizational climate, less self-protection awareness, and worse self-rated health. Nurses at high risk and lacking self-protection awareness faced heightened danger.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIt is imperative to prioritize occupational risks arising from psychosocial and organizational factors. Improving self-protection awareness, especially for high-risk nurses, is also crucial. Efforts are needed to create a supportive work environment, enhance risk education, provide stress workshops, add protective gear, strengthen risk management, improve job security, and offer counseling and emotional support.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003enot applicable\u003c/p\u003e","manuscriptTitle":"The Occupational Risks, organizational climate perception and Self-rated health of Chinese Nurses in Tertiary hospital: A large-scale Cross-Sectional Survey","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-24 10:05:04","doi":"10.21203/rs.3.rs-6183161/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-23T04:17:11+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"20681613792793250807809465447235423567","date":"2026-05-17T09:38:28+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-19T23:16:04+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"137441693999216740762532008679357460264","date":"2025-04-03T12:14:21+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-03T08:53:08+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-04-03T08:43:55+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-03-25T06:18:50+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-03-24T14:56:01+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2025-03-24T14:54:55+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d5f748d3-4907-4166-924a-f2b03dad227d","owner":[],"postedDate":"April 24th, 2025","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-23T04:17:11+00:00","index":75,"fulltext":""},{"type":"reviewerAgreed","content":"20681613792793250807809465447235423567","date":"2026-05-17T09:38:28+00:00","index":73,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-04-24T10:05:04+00:00","versionOfRecord":[],"versionCreatedAt":"2025-04-24 10:05:04","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6183161","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6183161","identity":"rs-6183161","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}