自我效能感对新冠肺炎疫情期间发热预检分诊护士心理健康的影响  

Effects of self-efficacy on mental health of nurses in fever preexamination and triage department during COVID-19

作　　者：杨程惠 周波[1] 潘舒娅 YANG Chenghui;ZHOU Bo;PAN Shuya(Department of Psychosomatic Medicine,Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,Chengdu 610072,China;University of Electronic Science and Technology of China&Sichuan Provincial People's Hospital,Chengdu 610072,China)

机构地区：[1]四川省医学科学院·四川省人民医院心身医学中心,四川成都610072 [2]电子科技大学附属医院·四川省人民医院,四川成都610072

出　　处：《东南大学学报（医学版）》2020年第4期463-469,共7页Journal of Southeast University(Medical Science Edition)

基　　金：国家重点研发计划(子课题)(2017YFC0113907);中央级公益性科研所基本科研业务费项目(2019PT310020)。

摘　　要：目的:探讨新型冠状病毒肺炎发热预检分诊处护士一般自我效能感、压力知觉、心身反应对其心理健康的影响及作用机制,为制定改善其心理健康的有效方案提供理论依据。方法:采用一般自我效能感量表(GSES)、压力知觉量表(PSS-10)、心身症状量表(PSSS)以及一般心理健康量表(K-10)对45名预检分诊护士进行问卷调查。采用SPSS 23.0统计软件进行描述性分析、相关性分析;采用Hayes编制的SPSS宏程序PROCESS进行链式中介效应检验。结果:共收回41份有效问卷,回收有效率为91.11%。K-10得分为(19.51±7.89)分,63.4%的护士心理健康状况欠佳;PSS-10得分为(14.27±4.85)分;GSES得分为(2.44±0.58)分;PSSS得分为(12.07±9.09)分,41.5%的护士有明显心身症状。GSES得分与K-10得分呈负相关(r=-0.406,P<0.01),PSS-10得分、PSSS得分均与K-10得分呈正相关(分别为r=0.659,P<0.01;r=0.782,P<0.01)。自我效能感影响心理健康的路径有两条,即通过压力知觉的中介作用对心理健康产生影响(β=-0.142,Boot SE=0.103,95%CI-0.425^-0.022)和通过压力知觉、心身症状的链式中介作用对心理健康产生影响(β=-0.130,Boot SE=0.081,95%CI-0.336^-0.023)。结论:自我效能感可能不直接作用于预检分诊护士的心理健康,而是通过压力知觉和心身症状的中介作用影响其心理健康,因此心理干预的重点放在缓解压力知觉水平和减轻心身反应上,也许能更快提升发热预检分诊护士心理健康水平。Objective:To explore the influence of triage nurses'general self-efficacy,perceived stress,psychosomatic reaction on mental health and their mechanism during COVID-19,in order to provide theoretical basis for formulating effective mental health improvement program.Methods:A total of 45 nurses were investigated with general self-efficacy scale(GSES),perceived stress scale(PSS-10),psychosomatic symptom scale(PSSS)and 10-item kessler psychological distress scale(K-10).SPSS 23.0 software was used for descriptive analysis and correlation analysis.PROCESS,a macro program of SPSS compiled by Hayes,was used to test the chain mediating effect.Results:41 valid questionnaires were collected,the effective rate was 91.11%.The score of K-10 was 19.51±7.89,63.4%of nurses had poor mental health;the score of PSS-10 was 14.27±4.85;the score of GSES was 2.44±0.58;the score of PSSS was 12.07±9.09,41.5%of nurses had obvious psychosomatic symptoms.There was a negative correlation between GSES and K-10(r=-0.406,P<0.01),and a positive correlation between PSS-10,PSSS and K-10(r=0.659,P<0.01;r=0.782,P<0.01).There were two ways for self-efficacy to affect mental health:through the mediating effect of perceived stress on mental health(β=-0.142,Boot SE=0.103,95%CI-0.425 to-0.022);through the chain mediating effect of perceived stress and psychosomatic symptoms on mental health(β=-0.130,Boot SE=0.081,95%CI-0.336 to-0.023).Conclusion:Self-efficacy does not directly affect the mental health of the preexamination and triage nurses,but through the mediating effect of perceived stress and psychosomatic symptoms.Therefore,the focus of psychological intervention may be to alleviate the level of perceived stress and psychosomatic response,and may be able to improve the mental health level of the preexamination triage nurses faster.

关 键 词：新冠肺炎 护士 自我效能 压力知觉 心身反应 心理健康 

分 类 号：R749.92[医药卫生—神经病学与精神病学]