工作压力、心理韧性、领悟社会支持对辅助生殖科护士共情疲劳的影响

doi:10.3969/j.issn.1674-8115.2021.12.004

上海交通大学学报(医学版) ›› 2021, Vol. 41 ›› Issue (12): 1565-1571.doi: 10.3969/j.issn.1674-8115.2021.12.004

• 临床护理专题 • 上一篇

工作压力、心理韧性、领悟社会支持对辅助生殖科护士共情疲劳的影响

胡玉莲¹^,²(), 章雅青¹()

^1.上海交通大学护理学院，上海 200025
^2.上海交通大学医学院附属国际和平妇幼保健院辅助生殖科，上海 200030

收稿日期:2021-08-02 出版日期:2021-12-28 发布日期:2022-01-28
通讯作者: 章雅青 E-mail:pc3110@163.com;zhangyqf@163.com
作者简介:胡玉莲（1981—），女，主管护师，硕士生；电子信箱：pc3110@163.com。
基金资助:
上海市护理高原学科建设项目国际合作科研基金(Hlgy1803gj);上海市护理学会面上项目(2018MS-B05);上海交通大学医学院科技基金项目(Jyhz2018)

Effects of work stress, psychological resilience and perceived social support on compassion fatigue of nurses in assisted reproduction departments

Yu-lian HU¹^,²(), Ya-qing ZHANG¹()

^1.Shanghai Jiao Tong University School of Nursing, Shanghai 200025, China
^2.Assisted Reproduction Department, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China

Received:2021-08-02 Online:2021-12-28 Published:2022-01-28
Contact: Ya-qing ZHANG E-mail:pc3110@163.com;zhangyqf@163.com
Supported by:
Nursing Plateau Discipline Construction Project of Shanghai Education Commission(Hlgy1803gj);General Program of Shanghai Nursing Association(2018MS-B05);Science and Technology Fundation of Shanghai Jiao Tong University School of Medicine(Jyhz2018)

摘要/Abstract

摘要：

目的·了解我国辅助生殖科护士的工作压力、心理韧性、领悟社会支持、共情疲劳现状，在此基础上探讨其量性关系模型。方法·采用方便抽样法，于2020年9月—12月应用一般资料问卷、护士工作压力源量表、心理韧性量表、领悟社会支持量表与共情疲劳量表，对我国东、中、西部17个省市32所三级甲等医院的511名辅助生殖科护士进行问卷调研。通过基础统计学和结构方程模型，构建工作压力、心理韧性、领悟社会支持、共情疲劳间的量性关系模型，分析上述变量之间的关系及其他3个变量对我国辅助生殖科护士共情疲劳的影响。结果·辅助生殖科护士共情疲劳各维度的条目均分分别为共情满意（3.68±0.63）分、职业倦怠（2.39±0.52）分、继发性创伤应激（2.46±0.56）分，均处于中等水平；辅助生殖科护士的工作压力、心理韧性、领悟社会支持和共情疲劳之间具有相关性（均P=0.000）。结构方程模型结果显示：工作压力对共情满意有直接负向作用（β=-0.34，P=0.000），对共情疲劳症状有直接正向作用（β=0.25，P=0.000）；心理韧性对共情满意有直接正向作用（β=0.53，P=0.000），对共情疲劳症状有直接负向作用（β= -0.29，P=0.000）；心理韧性在工作压力和共情疲劳症状之间、工作压力与共情满意之间起到中介作用；领悟社会支持对共情满意和共情疲劳症状作用不显著。结论·我国辅助生殖科护士共情疲劳受多种因素影响，其中心理韧性对于提高共情满意的作用显著。建议从提升护士的心理韧性着手，采取有效措施提高护士的心理韧性，降低护士共情疲劳的发生率，从而提高护理质量。

关键词: 共情疲劳, 工作压力, 心理韧性, 领悟社会支持, 护士, 辅助生殖技术

Abstract:

Objective·To understand the current status of work stress, psychological resilience, perceived social support, and compassion fatigue among assisted reproduction department nurses in China, and explore their quantitative relationship model on this basis.

Methods·Using a convenience sampling method, 511 assisted reproduction department nurses from 32 tertiary hospitals in 17 provinces and cities in the eastern, central and western economic regions of China were surveyed from September to December 2020 with using a general information questionnaire, the Nurses' Work Stressor Scale, the Mental Toughness Scale, the Appreciative Social Support Scale and the Compassion Fatigue Scale. Through basic statistics and structural equation modeling, we constructed a quantitative relationship model among work stress, psychological resilience, perceived social support, and compassion fatigue, and analyzed the relationships among these variables and their effects on compassion fatigue among assisted reproduction department nurses in China.

Results·The mean item scores of the dimensions of compassion fatigue among nurses in our assisted reproduction departments were compassion satisfaction (3.68±0.63), job burnout (2.39±0.52), and secondary traumatic stress (2.46±0.56), all of which were at moderate levels; there was a correlation between work stress, psychological resilience, perceived social support, and compassion fatigue among nurses in assisted reproduction departments (all P=0.000).The results of structural equation modeling showed that job stress had a direct negative effect on compassion satisfaction (β=-0.34, P=0.000), a direct positive effect on compassion fatigue symptoms (β=0.25, P=0.000); psychological resilience had a direct positive effect on compassion satisfaction (β=0.53, P=0.000), and a direct negative effect on compassion fatigue symptoms (β=-0.29, P=0.000); psychological resilience mediated the effect between job stress and compassion fatigue symptoms and between job stress and compassion satisfaction, and appreciating the role of social support in compassion fatigue symptoms and compassion satisfaction was not significant.

Conclusion·Compassion fatigue of nurses in our assisted reproduction departments is affected by a variety of factors, among which the role of psychological resilience is significant in improving compassion satisfaction. It is recommended to start from enhancing the psychological resilience of nurses, take effective measures to improve the psychological resilience of nurses, reduce the incidence of compassion fatigue of nurses, and thus improve the quality of care.

Key words: compassion fatigue, work stress, psychological resilience, perceived social support, nurse, assisted reproductive technology

中图分类号:

胡玉莲, 章雅青. 工作压力、心理韧性、领悟社会支持对辅助生殖科护士共情疲劳的影响[J]. 上海交通大学学报(医学版), 2021, 41(12): 1565-1571.

Yu-lian HU, Ya-qing ZHANG. Effects of work stress, psychological resilience and perceived social support on compassion fatigue of nurses in assisted reproduction departments[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(12): 1565-1571.

图/表 6

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Item	n （%）
Gender
Male	4 （0.8）
Female	507 （99.2）
Educational degree
Diploma and below	82 （16.0）
Bachelor degree and above	429 （84.0）
Post
Nurse staff	431 （84.3）
Teaching nurse	45 （8.8）
Head nurse and above	35 （6.9）
Job title
Nurse	87 （17.0）
Primary nurse	235 （46.0）
Intermediate nurse and above	189 （37.0）
Marital status
Married	384 （75.1）
Single	127 （24.9）
Employment type
Permanent	156 （30.5）
Contract	355 （69.5）
Child status
With	360 （70.5）
Without	151 （29.5）
Monthly night shift
0 time	325 （63.6）
1‒5 times	145 （28.4）
>5 times	41 （8.0）
Monthly income
<5 000 yuan	52 （10.2）
5 000‒6 999 yuan	107 （20.9）
7 000‒8 999 yuan	168 （32.9）
≥9 000 yuan	184 （36.0）

Item	n （%）
Gender
Male	4 （0.8）
Female	507 （99.2）
Educational degree
Diploma and below	82 （16.0）
Bachelor degree and above	429 （84.0）
Post
Nurse staff	431 （84.3）
Teaching nurse	45 （8.8）
Head nurse and above	35 （6.9）
Job title
Nurse	87 （17.0）
Primary nurse	235 （46.0）
Intermediate nurse and above	189 （37.0）
Marital status
Married	384 （75.1）
Single	127 （24.9）
Employment type
Permanent	156 （30.5）
Contract	355 （69.5）
Child status
With	360 （70.5）
Without	151 （29.5）
Monthly night shift
0 time	325 （63.6）
1‒5 times	145 （28.4）
>5 times	41 （8.0）
Monthly income
<5 000 yuan	52 （10.2）
5 000‒6 999 yuan	107 （20.9）
7 000‒8 999 yuan	168 （32.9）
≥9 000 yuan	184 （36.0）

Item	Score	Item score range	Average score of item
Compassion fatigue
Compassion satisfaction	36.78±6.29	1‒5	3.68±0.63
Job burnout	23.87±5.16	1‒5	2.39±0.52
Secondary traumatic stress	24.58±5.60	1‒5	2.46±0.56
Perceived social support	63.05±11.36	1‒7	5.25±0.95
Family support	21.41±4.44	1‒7	5.35±1.11
Friends' support	21.41±4.08	1‒7	5.35±1.02
Other support	20.24±4.17	1‒7	5.06±1.04
Psychological resilience	64.09±14.97	0‒4	2.56±0.60
Optimism	10.25±2.71	0‒4	2.56±0.68
Tenacity	32.20±8.21	0‒4	2.48±0.63
Self-improvement	21.64±4.90	0‒4	2.70±0.61
Work stress	102.34±15.70	1‒4	2.92±0.45
Problems in nursing profession and work	19.38±3.66	1‒4	2.77±0.52
Problems in time allocation and workload	14.26±2.71	1‒4	2.85±0.54
Problems in working environment and instrumentation	7.32±1.74	1‒4	2.44±0.58
Problems in patient care	26.98±4.43	1‒4	2.45±0.40
Problems in management and interpersonal relationship	21.21±4.60	1‒4	2.36±0.51

Item	Score	Item score range	Average score of item
Compassion fatigue
Compassion satisfaction	36.78±6.29	1‒5	3.68±0.63
Job burnout	23.87±5.16	1‒5	2.39±0.52
Secondary traumatic stress	24.58±5.60	1‒5	2.46±0.56
Perceived social support	63.05±11.36	1‒7	5.25±0.95
Family support	21.41±4.44	1‒7	5.35±1.11
Friends' support	21.41±4.08	1‒7	5.35±1.02
Other support	20.24±4.17	1‒7	5.06±1.04
Psychological resilience	64.09±14.97	0‒4	2.56±0.60
Optimism	10.25±2.71	0‒4	2.56±0.68
Tenacity	32.20±8.21	0‒4	2.48±0.63
Self-improvement	21.64±4.90	0‒4	2.70±0.61
Work stress	102.34±15.70	1‒4	2.92±0.45
Problems in nursing profession and work	19.38±3.66	1‒4	2.77±0.52
Problems in time allocation and workload	14.26±2.71	1‒4	2.85±0.54
Problems in working environment and instrumentation	7.32±1.74	1‒4	2.44±0.58
Problems in patient care	26.98±4.43	1‒4	2.45±0.40
Problems in management and interpersonal relationship	21.21±4.60	1‒4	2.36±0.51

Item	Compassion satisfaction	Job burnout	Secondary traumatic stress	Work stress	Perceived social support	Psychological resilience
Compassion satisfaction	1
Job burnout	-0.738^①	1
Secondary traumatic stress	-0.123^①	0.544^①	1
Work stress	-0.432^①	0.507^①	0.289^①	1
Perceived social support	0.490^①	-0.464^①	-0.161^①	-0.262^①	1
Psychological resilience	0.577^①	-0.518^①	-0.150^①	-0.209^①	0.626^①	1

工作压力、心理韧性、领悟社会支持对辅助生殖科护士共情疲劳的影响

Effects of work stress, psychological resilience and perceived social support on compassion fatigue of nurses in assisted reproduction departments

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参考文献 25

相关文章 15

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Metrics

Item	Absolute adaptation index			Value-added adaptation index					Parsimony adaptation index
Item	RMSEA	GFI	AGFI	NFI	RFI	IFI	TLI	CFI	PGFI	PNFI	PCFI
Adaptation standard	<0.08	>0.90	>0.90	>0.90	>0.90	>0.90	>0.90	>0.90	>0.50	>0.50	>0.50
Data efficacy result	0.077	0.928	0.902	0.940	0.922	0.954	0.940	0.954	0.619	0.723	0.734

Path relation	Unstandardized estimate	SE	CR	P value
Psychological resilience←work stress	-0.347	0.079	-4.422	0.000
Perceived social support←work stress	-0.344	0.100	-3.431	0.000
Perceived social support←psychological resilience	1.042	0.070	14.835	0.000
Compassion fatigue←psychological resilience	-0.101	0.026	-3.951	0.000
Compassion fatigue←work stress	0.134	0.035	3.809	0.000
Problems in management and interpersonal relationship←work stress	1.000			0.000
Problems in patient care←work stress	0.736	0.054	13.571	0.000
Problems in working environment and instrumentation←work stress	1.088	0.078	13.909	0.000
Problems in time allocation and workload←work stress	1.148	0.074	15.472	0.000
Problems in nursing profession and work←work stress	1.125	0.072	15.682	0.000
Family support←perceived social support	1.000
Friends support←perceived social support	1.015	0.046	22.192	0.000
Other support←perceived social support	0.942	0.047	20.174	0.000
Tenacity←psychological resilience	1.000
Self-improvement←psychological resilience	1.019	0.028	36.892	0.000
Optimism←psychological resilience	0.979	0.036	26.944	0.000
Secondary traumatic stress←compassion fatigue	1.000			0.000
Job burnout←compassion fatigue	3.986	0.883	4.513	0.000
Compassion satisfaction←psychological resilience	0.581	0.040	14.688	0.000
Compassion satisfaction←work stress	-0.595	0.069	-8.591	0.000

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