目的：了解我国三级公立医院护理人员收入水平及收入满意现状，分析护理人员收入满意的影响因素，从不同社会人口学特征和个人工作相关特征层面探讨护理人员收入水平、收入满意的问题及成因，有针对性地为医院管理者提出改善护理人员收入满意的建议，为新时代薪酬制度改革提供有价值的参考。

方法：基于第五次“全国改善医疗服务第三方评估”医护人员调查数据，获得护理人员收入水平及收入满意度问卷调查结果，共25197份。定性资料的描述采用频数和构成比，定量资料的描述采用中位数和四分位数（P25,P75），收入满意度采用“认同/满意”人数占总人数之比来表示；差异性分析采用Kruskal-Wallis H检验和卡方检验；相关性分析采用Spearman相关检验；多因素分析采用二元Logistic回归模型。

结果：（1）我国三级公立医院护理人员自报实际税后年收入为10.00(6.00,15.00)万元，期望能达到15.00(10.00,20.00)万元，其期望值是实际的1.5倍；收入满意度为43.6%（95%CI：43.0%~44.2%）。

（2）差异性分析结果显示，除护理人员自报实际和期望税后年收入水平在性别之间的差异不具有统计学意义、收入满意度在性别之间的差异具有统计学意义之外，护理人员自报实际和期望税后年收入水平以及收入满意度在年龄、婚姻状况、子女数量、最高学历、地区、医院类型、所在科室、职称、从业年限、聘用形式、担任行政职务、承担教学任务、承担科研任务、每月夜班次数各特征下均具有统计学意义（P<0.001）；特别是，在每月夜班次数分组中护理人员收入满意水平由高到低为1-4次＞0次＞5-8次＞9次及以上，每月夜班次数为1-4次的护理人员收入满意水平最高。

（3）多因素Logistic回归分析显示：性别、年龄、婚姻状况、最高学历是护理人员收入满意的社会人口学影响因素（P<0.05）；调整社会人口学特征后，地区、医院类型、所在科室、聘用形式、担任行政职务、承担教学任务、承担科研任务、每月夜班次数是收入满意的工作相关影响因素（P<0.05）。

（4）对区域省份间收入水平、期望与实际收入差异、收入负担日常消费能力及收入满意程度进行对比发现，工作于中部地区的护理人员收入及收入满意总体状态较好；重庆市收入及收入满意情况最理想；东北三省收入及收入满意总体状态严峻，尤其黑龙江最不乐观。

结论：我国三级公立医院护理人员自报实际税后年收入10.00万元，未达到期望水平；收入满意度43.6%，护理人员对目前收入水平并不满意。目前对收入不满意的护理人员集中于低学历水平、夜班较多、无正式编制的“年轻”护理人员群体，这也是临床照护的主力军，应被重点关注和保障。各区域省份护理人员收入及收入满意情况存在一定差异和特点，可能与当地经济与医疗发展水平、医疗资源分布、医疗投入产出情况有关。建议应重视护理群体，整体提高护理人员起薪水平，满足日常消费需求；探索多渠道多途径提高护理人员收入；合理安排护理人员每月夜班次数；未来仍需进一步分区域深入分析护理人员收入不满原因及其特点。

Objective：To understand the income level and income satisfaction status of nurse in tertiary public hospitals in China, analyze the influencing factors of nurse income satisfaction, and discuss the problems and causes of nurse income level and income satisfaction from the perspectives of different sociodemographic characteristics and personal work-related characteristics. The purpose is to put forward suggestions for hospital managers to improve the income satisfaction of nurse, and provide a valuable reference for the reform of the salary system in the new era.

Methods：Based on the data of the fifth assessments of China Healthcare Improvement Evaluation Survey (CHIES) for medical staff survey, a total of 25,197 questionnaires on the income level and income satisfaction of nurse were obtained. Qualitative data were described by frequency and composition ratio, quantitative data were described by median and quartile (P25,P75), and income satisfaction was expressed by the ratio of "approval/satisfied" to the total number of people; difference analysis Kruskal-Wallis H test and chi-square test were used; Spearman correlation test was used for correlation analysis; binary logistic regression model was used for multivariate analysis.

Results：(1) The actual after-tax annual income of nurse in tertiary public hospitals in China is 10.00 (6.00, 15.00) yuan, and the expectation is 15.00 (10.00, 20.00) yuan, and the expected value is 1.5 times the actual value; the income satisfaction rate is 43.6% (95%CI: 43.0%~44.2%)

(2) The results of the difference analysis showed that, except that the difference in the actual and expected annual income after tax reported by the nurse was not statistically significant between the genders, and the difference in income satisfaction between the genders was statistically significant, the nurse self-reported Report the actual and expected after-tax annual income level and income satisfaction in terms of age, marital status, number of children, highest education, region, hospital type, department, professional title, years of experience, employment form, holding administrative positions, undertaking teaching tasks, undertaking Scientific research tasks and monthly night shift times were statistically significant (P<0.001); especially, in the monthly night shift frequency grouping, the nurse's income satisfaction level from high to low was 1-4 times > 0 times > 5 - 8 times > 9 times and above, and the nurse with 1-4 times of night shifts per month have the highest income satisfaction level.

(3) Multivariate Logistic regression analysis showed that gender, age, marital status, and highest education were sociodemographic influencing factors of nurse's income satisfaction (P<0.05); after adjusting sociodemographic characteristics, region, hospital type, department, employment form , holding administrative positions, undertaking teaching tasks, undertaking scientific research tasks, and the number of night shifts per month were job-related influencing factors of income satisfaction (P<0.05).

(4) Comparing the income level, expected and actual income difference between regions and provinces, daily consumption ability of income burden and income satisfaction, it is found that the income and income satisfaction of nurse working in the central region are generally better; Chongqing has the highest income and income satisfaction. Ideal; the overall state of income and income satisfaction in the three northeastern provinces is grim, especially Heilongjiang is the least optimistic.

Conclusion：The actual after-tax annual income of nurse in my country's tertiary public hospitals was 100,000 yuan, which did not meet the expected level; the income satisfaction was 43.6%, and the nurse were not satisfied with the current income level. Nurse who are dissatisfied with their income are concentrated in the "young" nurse group with low educational level, more night shifts, and no formal establishment. This is also the main force of clinical care, and should be focused on and guaranteed. There are certain differences and characteristics in different regions and provinces, which may be related to the local economic and medical development level, the distribution of medical resources, and the medical input and output. It is suggested that attention should be paid to the nursing group, and the overall starting salary level of nurse should be increased to meet the daily consumption needs; explore multiple channels and ways to increase the income of nurse; reasonably arrange the number of night shifts per month for nurse; in the future, it is still necessary to further analyze the income dissatisfaction of nurse in different regions. reasons and their characteristics.