临床护士心理授权与同情心疲乏程度的关系  

Relationship between psychological empowerment and the degree of compassion fatigue in clinical nurses

作　　者：沈梦菲 赵晓婷 叶红芳[1] 张新月 hen Mengfei;Zhao Xiaoting;Ye Hongfang;Zhang Xinyue(Department of Hematology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China;School of Medicine,Nanjing University,Nanjing 210093,China)

机构地区：[1]南京大学医学院附属鼓楼医院血液科,210008 [2]南京大学医学院,210093

出　　处：《中国实用护理杂志》2020年第13期1003-1009,共7页Chinese Journal of Practical Nursing

基　　金：国家临床重点专科建设项目(2011872);南京鼓楼医院院级课题(ZSA476-2)。

摘　　要：目的调查临床护士同情心疲乏的发生现况,分析心理授权对同情心疲乏程度的影响。方法通过横断面研究,应用社会人口学调查表、中文版专业生命质量量表和心理授权量表对1005名临床护士进行调查,运用有序多分类Logistic回归分析心理授权与同情心疲乏程度的关系。结果同情心疲乏检出率为93.0%(935/1005),轻度同情心疲乏为53.8%(541/1005),中度为22.7%(228/1005),重度为16.5%(166/1005);同情心疲乏三维度得分:同情满意(34.15±5.53)分,职业倦怠(23.96±5.10)分,二次创伤压力(23.73±5.92)分;同情心疲乏程度与心理授权总分及各维度得分均呈负相关(r值为-0.468^-0.094,P<0.05);有序多分类Logistic回归显示:工作影响[比值比(OR)值为1.095,95%置信区间(CI)0.094~0.236,P<0.01]、自我效能(OR值为0.920,95%CI-0.250^-0.054,P<0.01)及工作意义(OR值为0.820,95%CI-0.431^-0.240,P<0.01)是影响同情心疲乏程度的独立危险因素。结论护士以轻度同情心疲乏程度为主,主要表现为二次创伤压力。工作影响得分越高的护士,越有高程度同情心疲乏的可能,而工作意义及自我效能得分越高的护士,越有低程度同情心疲乏的可能。建议护理管理者针对护士已发生的、不同程度的同情心疲乏开展及时的干预与管理,如提升护士对工作意义、自我效能感知水平,并在注重工作影响感知水平的同时避免增加工作负荷。Objective To explore the incidence and degree of compassion fatigue in clinical nurses,and the effects of psychological empowerment on nurses'compassion fatigue level.Methods A total of 1005 clinical nurses were investigated with the general information,Chinese version of Professional Quality of Life Scale,Psychological Empowerment Scale.And the relationship between different degrees of compassion fatigue and psychological empowerment were analyzed by ordinal regression analysis.Results The incidence of sympathetic fatigue was 93.0%,(935/1005),mild was 53.8%(541/1005),medium was 22.7%(228/1005),severe was 16.5%(166/1005).The score of Chinese version of Professional Quality of Life Scale three dimensions:compassion satisfaction,burnout,and secondary traumatic stress of clinical nurses were 34.15±5.53,23.96±5.10,23.73±5.92.The degree of compassion fatigue was negatively correlated with psychological empowerment score and score of each dimension(r values were 0.094-0.468,all P<0.05).The ordinal regression analysis indicated that job impact(odds ratio(OR)value was 1.095,95%credible interval(CI)0.094-0.236,P<0.01),self-efficacy(OR value was 0.920,95%CI 0.250-0.054,P<0.01)and job meaning(OR value was 0.820,95%CI 0.431-0.240,P<0.01)were the independent risk factor of compassion fatigue level.Conclusions The nurses mainly showed mild compassion fatigue,and main manifestation is secondary traumatic stress.The nurses who had more higher job impact scores were more likely to report higher levels of empathy fatigue,while nurses who had higher job meaning and self-efficacy scores were more likely to have low levels of empathy fatigue.Therefore,it is suggested that nursing managers should carry out timely intervention and management in accordance with the different level of compassion fatigue:improve nurses'perception of work meaning and self-efficacy,and avoid increasing workload while paying attention to the influence of work on perception level.

关 键 词：护士 同情心疲乏 心理授权 LOGISTIC回归分析 

分 类 号：R47[医药卫生—护理学]