基于中介效应的门急诊、发热预检分诊护士心理弹性因果关系路径模型构建研究  

Study on the construction of psychological elastic causality path model of outpatient and emergency,fever pre-examination and triage nurses based on mediation effect

作　　者：付丽明[1] 傅慧敏 陈玉蓓[1] 李婷[1] 严文燕 邓水珠[1] 林小珍[1] 李金云[3] 张丽[4] 王红梅 邱小雪[1] Fu Liming;Fu Huimin;Chen Yubei;Li Ting;Yan Wenyan;Deng Shuizhu;Lin Xiaozhen;Zhang Li;Wang Hongmei;Qiu Xiaoxue(Sanming first hospital affiliated to Fujian Medical University,Sanming,Fujian,365000,China;Fujian provincial maternal and child care service centre,Fuzhou,Fujian,350000,China;Affiliated hospital of Weifang medical college,Weifang,Shandong,350000,China;General hospital of Tianjin University,Tianjin,300070,China;The fifth people's hospital of Longgang district,Shenzhen,Guangdong,518000,China)

机构地区：[1]福建医科大学附属三明市第一医院,福建三明365000 [2]福建省妇幼保健院,福建福州350000 [3]山东潍坊医学院附属医院,山东潍坊261000 [4]天津医科大学总医院,天津300070 [5]深圳市龙岗区第五人民医院,广东深圳518000

出　　处：《齐齐哈尔医学院学报》2021年第23期2099-2105,共7页Journal of Qiqihar Medical University

基　　金：三明市第二批新冠肺炎防控技术研究引导性项目(2020-S-21);中国生命关怀协会生命质量照护研究基金(HL20210105)。

摘　　要：目的门急诊、发热预检分诊护理人员心理弹性及影响因素的路径分析。方法选择所属单位分别为三级甲等、三级乙等、二级甲等、二级乙等医院及社区卫生服务中心304名匿名自愿配合调查的护理人员作为研究对象。采用多中心多部门合作,以一般资料问卷、心理弹性量表(CD-RISC)、中国护士工作压力源量表、职业倦怠量表(MBI-HSS)、护理人员心理症状评定问卷展开调查。用相关量表测查护理人员的心理健康水平,通过路径分析构建具有“中介效应的心理弹性因果关系模型”,具体、科学分析其主要及次要的相关影响因素。结果心理弹性总分为(67.93±15.35)分,与工作压力源、职业倦怠、心理症状存在负相关;分层回归分析显示:职业倦怠解释心理弹性20.6%的变异量;Amos模型分析验证:情绪衰竭、个人成就感、去人格化、躯体化、抑郁对心理弹性有直接影响,情绪衰竭、去人格化、躯体化对心理弹性产生间接影响。结论情绪衰竭、个人成就感、躯体化、抑郁对心理弹性具有负向预测作用,去人格化对心理弹性具有正向预测作用。“中介效应的心理弹性因果关系模型”可具体、科学分析其主要及次要影响因素,为采取正面疏导及必要的心理援助指明了方向。Objective To explore the path analysis of psychological elasticity and influencing factors of nurses in outpatient and emergency department,fever pre-examination and triage department.Methods 304 anonymous nurses from hospitals of grade III A and B,grade II A and B,and community healthcare centre those volunteer to cooperate with the investigation were enrolled as study objects.The multi-center and multi-department cooperation was adopted,general data questionnaire,psychological elasticity scales(CD-RISC),work stressors of Chinese nurses,maslach burnout inventory-human services survey(MBI-HSS),and caregiver psychological symptom assessment questionnaire were used to carried out the investigation.Results The total score of psychological elasticity was(67.93±15.35),which was negatively correlated with job stressors,job burnout and psychological symptoms.Hierarchical regression analysis showed that job burnout explained 20.6%of the variation of psychological elasticity.Amos model analysis verified that emotional exhaustion,personal achievement,depersonalization,somatization and depression have a direct impact on psychological elasticity,and emotional exhaustion,depersonalization and somatization have an indirect impact on psychological elasticity.Conclusions Emotional exhaustion,personal achievement,somatization and depression have a negative predictive effect on psychological elasticity,and depersonalization has a positive predictive effect on psychological elasticity."Psychological elastic causality model of mediating effect"could specifically and scientifically analyze its main and secondary influencing factors;it has pointed out the direction for taking positive counseling and necessary psychological assistance.

关 键 词：门急诊发热预检分诊护理人员 心理弹性 影响路径 心理弹性因果关系模型 

分 类 号：R471[医药卫生—护理学]