疲劳感和工作疏离感在轮值夜班护士昼夜节律改变与职业倦怠间的中介作用  

The mediation effect of fatigue and work alienation on the relationship between circadian rhythm changes and job burnout in night shift nurses

作　　者：韩悦 石婷婷 HAN Yue;SHI Ting-ting(Unit 960 Hospital of the Chinese People's Liberation Army Joint Logistics Support Unit Jinan,Shandong 250001,China;不详)

机构地区：[1]中国人民解放军联勤保障部队第九六〇医院护理部,山东济南250031 [2]中国人民解放军联勤保障部队第九六〇医院肿瘤科,山东济南250031

出　　处：《工业卫生与职业病》2023年第1期53-57,共5页Industrial Health and Occupational Diseases

摘　　要：目的探讨轮值夜班护士昼夜节律改变对职业倦怠的影响以及疲劳感与工作疏离感在其中的中介作用。方法采用便利抽样法,于2019年10月选取济南市某三级甲等医院278名轮值夜班护士进行问卷调查,问卷包括一般资料调查表、昼夜节律类型量表、疲劳量表、护士工作疏离感量表及职业倦怠量表。结果职业倦怠量表测评评分为(56.55±11.01)分,昼夜节律类型量表中的灵活性/刚性分量表测评评分为(13.80±4.95)分,困倦/活力分量表测评评分为(21.31±6.82)分,疲劳量表测评评分为(9.22±3.46)分,工作疏离感量表测评评分为(48.61±9.15)分。Pearson相关性分析结果显示,疲劳、工作疏离感及职业倦怠量表测评评分与昼夜节律类型量表中的灵活性/刚性分量表测评评分均呈明显负相关(r=-0.198,-0.563,-0.521,P<0.01),与昼夜节律类型量表中的困倦/活力分量表测评评分呈明显正相关(r=-0.275,0.571,0.544,P<0.01)。链式中介效应分析结果表明,昼夜节律改变能通过疲劳感和工作疏离感的中介作用对职业倦怠产生影响,且该中介作用包含了三条路径:疲劳感和工作疏离感的单独中介作用以及疲劳感-工作疏离感的链式中介作用。结论昼夜节律改变可以直接增强护士的职业倦怠,也可以通过疲劳感和工作疏离感间接增强护士的职业倦怠,降低疲劳感和工作疏离感有利于缓解轮值夜班护士的职业倦怠。ObjectiveTo explore the effects of night shift nurses’circadian rhythm changes on job burnout,and the mediating role of fatigue and work alienation.MethodsConvenience sampling was used to select 278 night shift nurses from a tertiary A hospital in Jinan in October 2019 to conduct a questionnaire survey.The questionnaires included general information,circadian rhythm type scale,fatigue scale,and nurses’sense of work alienation scale and job burnout scale.ResultsThe score of job burnout scale was(56.55±11.01),the score of flexibility/rigidity subscale in the circadian rhythm type scale was(13.80±4.95),and the score of sleepiness/vitality subscale was(21.31±6.82),the score of fatigue scale score was(9.22±3.46),and the score of work alienation scale was(48.61±9.15);correlation analysis showed that fatigue,work alienation and job burnout were significantly negatively correlated with circadian rhythm flexibility/rigidity(r=-0.198,-0.563,-0.521,P<0.01),and were significantly positive with circadian rhythm sleepiness/vitality score Correlation(r=0.275,0.571,0.544,P<0.01).The analysis of the chain mediation effect showed that circadian rhythm changes affected job burnout through the mediation effect of fatigue and work alienation,and the mediation effect included three paths:the individual mediation effect of fatigue and work alienation,and chain mediation effect of fatigue and work alienation.The circadian rhythm changes can increase the risk of the job burnout of nurses both directly and indirectly through the fatigue and work alienation.Reducing the fatigue and job alienation is beneficial to alleviate the job burnout of night shift nurses.

关 键 词：轮值夜班护士 昼夜节律改变 职业倦怠 疲劳感 工作疏离感 链式中介 

分 类 号：R47[医药卫生—护理学]