基于ABC-X模型的安宁疗护护士共情疲劳的影响因素研究  

Study on influencing factors of empathy fatigue in hospice nurses based on ABC-X model

作　　者：孙亚莉 赵云[2] 李正静[1] 张柳柳[2] 王梅香[2] 刘腊根[3] 羊波[4] 蒋秀娟 周杉杉 Sun Yali;Zhao Yun;Li Zhengjing;Zhang Liuliu;Wang Meixiang;Liu Lagen;Yang Bo;Jiang Xiujuan;Zhou Shanshan(Department of Interventional Therapy,Jiangsu Cancer Hospital,Nanjing 210009,China;Department of Nursing,Jiangsu Cancer Hospital,Nanjing 210009,China;Department of Thoracic Surgery,Jiangsu Cancer Hospital,Nanjing 210009,China;Department of Urology Surgery,Jiangsu Cancer Hospital,Nanjing 210009,China)

机构地区：[1]江苏省肿瘤医院介入治疗科,南京210009 [2]江苏省肿瘤医院护理部,南京210009 [3]江苏省肿瘤医院胸外科,南京210009 [4]江苏省肿瘤医院泌尿外科,南京210009

出　　处：《中国实用护理杂志》2024年第28期2180-2188,共9页Chinese Journal of Practical Nursing

基　　金：江苏省卫健委课题(M2020001);江苏省老年健康科研项目(LK2021012)。

摘　　要：目的以ABC-X模型(A:压力源;B:资源;C:主观认知;X:结果)为理论框架分析安宁疗护护士共情疲劳的现状和影响因素,为开发综合性的干预策略提供依据。方法经方便抽样法选取2022年4—6月国内从事安宁疗护的325名护士为研究对象,以ABC-X模型为理论框架分析安宁疗护护士共情疲劳的影响因素,经一般情况调查表、共情疲劳量表、简易应对方式量表、心理弹性量表及护理工作环境量表对安宁疗护护士开展横断面调查,采取SPSS 26.0软件开展统计分析。结果325名安宁疗护护士,女316名,男9名,年龄(33.0±7.9)岁,共情疲劳总分为(91.16±9.60)分,共情满意得分为(31.35±6.01)分,职业倦怠得分为(28.43±5.86)分,继发应激创伤得分为(31.38±5.76)分,积极应对方式、消极应对方式、心理弹性、护理工作环境得分分别为(37.46±5.69)、(21.28±6.90)、(89.84±16.46)、(117.13±19.95)分。职称为安宁疗护护士共情满意的负向预测因子(t=-4.22,P<0.05),简易应对方式、心理弹性、护理工作环境为正向预测因子(t=4.52、3.05、9.03,均P<0.05),可解释总变异的56.7%;心理弹性、简易应对方式、护理工作环境为安宁疗护护士职业倦怠的负向预测因子(t=-6.93、-3.54、-2.51,均P<0.05),用工性质为正向预测因子(t=2.36,P<0.05),可解释总变异的49.4%;简易应对方式、心理弹性、护理工作环境均为安宁疗护护士继发性创伤应激的负向预测因子(t=-5.40、-3.25、-5.95,均P<0.05),可解释总变异的48.8%。结论结合ABC-X模型发现,安宁疗护护士共情疲劳受护理工作环境、心理弹性以及应对方式影响,需要护理管理者积极采取措施改善护士的工作环境和应对方式,提升其心理弹性水平,进而减轻其共情疲劳。ObjectiveTo analyze the status and influencing factors of empathy fatigue in hospice nurses based on ABC-X model(A:stressor event;B:resources available to a family;C:family sperceptions of the stressor;X:likelihood of crisis),so as to provide a reliable basis for developing comprehensive intervention strategies.MethodsA total of 325 nurses engaged in hospice care in China from April 2022 to June 2022 were selected by convenient sampling method.The influencing factors of empathy fatigue of hospice care nurses were analyzed by ABC-X model(working environment,resilience and coping style).The hospice care nurses were investigated by self-made general questionnaire,Chinese version of Empathy Fatigue Scale,Simplified Coping Style Questionnaire,Coping Style Resilience Scale and Nursing Work Environment Scale.The statistical analysis was performed by SPSS.26.0 statistical software.ResultsThere were 316 females and 9 males with age of(33.0±7.9)years old.The total score of empathy fatigue in 325 hospice nurses was(91.16±9.60)points,the scores of empathy satisfaction,ocupational burnout and secondary traumatic stress were(31.35±6.01),(28.43±5.86),(31.38±5.76)points respectively.The scores of positive coping style,negative coping style,psychological resilience and nursing working environment were(37.46±5.69),(21.28±6.90),(89.84±16.46),(117.13±19.95)points respectively.The negative predictive factor for empathy satisfaction among nurses with the professional title of palliative care(t=-4.22,P<0.05),and the positive predictive factors for simple coping strategies,psychological resilience,and nursing work environment(t=4.52,3.05,9.03,all P<0.05),could explain 56.7%of the total variation.Psychological resilience,simplified coping strategies,nursing work environment were negative predictive factors for occupational burnout among hospice nurses(t=-6.93,-3.54,-2.51,all P<0.05),while work nature was a positive predictive factor(t=2.36,P<0.05),which could explain 49.4%of the total variation.Simplified coping strategies,psych

关 键 词：护士 ABC-X模型 安宁疗护 共情疲劳 相关性 影响因素 

分 类 号：R192.6[医药卫生—卫生事业管理]