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医院工作场所暴力和同情行为对中国护士压力、睡眠质量和主观健康状况的影响:一项横断面调查。

Impact of workplace violence and compassionate behaviour in hospitals on stress, sleep quality and subjective health status among Chinese nurses: a cross-sectional survey.

机构信息

Department of Pharmacy, Harbin Medical University Cancer Hospital, Harbin, China.

Department of Health Management, School of Public Health, Harbin Medical University, Harbin, China.

出版信息

BMJ Open. 2018 Oct 3;8(10):e019373. doi: 10.1136/bmjopen-2017-019373.

Abstract

OBJECTIVES

The aim of this study is to describe the current state of workplace violence (WPV) and compassionate behaviour towards nurses and to explain how they affect nurses' stress, sleep quality and subjective health status.

DESIGN

A cross-sectional online survey study.

SETTING

The survey was conducted across eight provinces in China.

PARTICIPANTS

A total of 1024 nurses were recruited to complete an online questionnaire survey from February to May 2016 in China.

RESULTS

Approximately 75.4% participants had experienced some form of violence. Most of the participants experienced WPV such as verbal violence (65.2%), made difficulties (54.5%), tarnished reputation (37.5%), mob behaviour (34.9%), intimidation behaviour (18.8%), physical violence (14.6%) and sexual harassment (5.9%). In this study, 92.4% participants experienced compassionate behaviour from their coworkers (84.9%), supervisors (67.3%), and from their patients (65.3%). The results show that the exposure to WPV behaviour significantly affected the psychological stress (β=0.295, p<0.01), sleep quality (β=-0.198, p<0.01) and subjective health status (β=-0.252, p<0.01) of nurses. The exposure to compassionate behaviour significantly affected the psychological stress (β=-0.229, p<0.01), sleep quality (β=0.326, p<0.01) and subjective health status (β=0.342, p<0.01) of nurses. The results of the mediation analysis showed that psychological stress is a partial mediator in the relationship between violence and sleep quality (β=-0.458, p<0.01) and between violence and subjective health (β=-0.425, p<0.01). Moreover, psychological stress also partially mediated the relationship between compassionate behaviour and sleep quality (β=-0.473, p<0.01), and between compassionate behaviour and subjective health (β=-0.405, p<0.01).

CONCLUSION

In China, most nurses have experienced different forms of WPV from patients and/or their relatives, as well as experiencing various forms of compassionate behaviour from their coworkers, supervisors and/or patients. This study investigates the prevalence of the different types of WPV and compassionate behaviour. Several aspects of harm to nurses from exposure to violence is confirmed. We found that WPV can damage nurses' health outcomes, while compassionate behaviours were beneficial to their health outcomes. A harmonious nursing environment should be provided to minimise threats to nurses' health status.

摘要

目的

本研究旨在描述目前工作场所暴力(WPV)和对护士的同情行为的现状,并解释它们如何影响护士的压力、睡眠质量和主观健康状况。

设计

横断面在线调查研究。

地点

该调查在中国八个省份进行。

参与者

共有 1024 名护士被招募,于 2016 年 2 月至 5 月在中国完成在线问卷调查。

结果

约 75.4%的参与者经历过某种形式的暴力。大多数参与者经历过 WPV,如言语暴力(65.2%)、制造困难(54.5%)、诋毁名誉(37.5%)、群体行为(34.9%)、恐吓行为(18.8%)、身体暴力(14.6%)和性骚扰(5.9%)。在这项研究中,92.4%的参与者从同事(84.9%)、主管(67.3%)和患者(65.3%)那里得到了同情。结果表明,暴露于 WPV 行为显著影响护士的心理压力(β=0.295,p<0.01)、睡眠质量(β=-0.198,p<0.01)和主观健康状况(β=-0.252,p<0.01)。暴露于同情行为显著影响护士的心理压力(β=-0.229,p<0.01)、睡眠质量(β=0.326,p<0.01)和主观健康状况(β=0.342,p<0.01)。中介分析结果表明,心理压力是暴力与睡眠质量(β=-0.458,p<0.01)和暴力与主观健康(β=-0.425,p<0.01)之间关系的部分中介,也是同情行为与睡眠质量(β=-0.473,p<0.01)和同情行为与主观健康(β=-0.405,p<0.01)之间关系的部分中介。

结论

在中国,大多数护士曾经历过来自患者及其家属的不同形式的 WPV,以及来自同事、主管和/或患者的各种形式的同情行为。本研究调查了不同类型 WPV 和同情行为的流行程度。证实了一些暴露于暴力对护士的危害。我们发现 WPV 会损害护士的健康状况,而同情行为则对他们的健康状况有益。应提供和谐的护理环境,以尽量减少对护士健康状况的威胁。

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