Clara Simães, PhD, is Adjunct Professor, University of Minho, School of Nursing, Braga, and Postdoctoral Researcher, Portuguese Catholic University, Institute of Health Sciences, School of Nursing, Porto, Portugal. António R. Gomes, PhD, is Assistant Professor, University of Minho School of Psychology, Braga, Portugal. Patrício Costa, PhD, is Assistant Professor, University of Minho, School of Medicine and Researcher, Life and Health Sciences Research Institute, ICVS/3B's-PT Government Associate Laboratory, Braga, and Assistant Professor, University of Porto, Faculty of Psychology and Educational Sciences, Porto, Portugal.
Nurs Res. 2019 May/Jun;68(3):E1-E11. doi: 10.1097/NNR.0000000000000352.
Cognitive appraisal constitutes an important mechanism in the process of human adaptation to work environment and occupational stress. In this domain, nursing professionals are one of the occupational groups most affected by job stress, suffering high levels of psychological distress.
The aims of this study were to analyze the moderator effect of shift work and the type of job contract on the relationship between work cognitive appraisal and nurses' psychological distress and to explore the interaction effect of the two moderator variables on that relationship.
A sample comprised of 2,310 Portuguese registered nurses completed a sociodemographic and professional questionnaire: the Primary and Secondary Cognitive Appraisal Scale and the General Health Questionnaire-12. Data were analyzed through structural equation modeling and multigroup analyses considering the following groups: (a) "shift" versus "nonshift work"; (b) "precarious job contract" versus "nonprecarious job contract"; and (c) "shift and precarious" versus "shift and nonprecarious" versus "nonshift and precarious" versus "nonshift and nonprecarious."
Data confirmed the invariance for the measurement model, but the structural model presented a significantly worse adjustment for all grouping variables, showing the moderator effect of shift work and job contract and of their interaction. Difference tests in structural path coefficients revealed that shift work moderated the relationship between challenge perception and psychological distress-which was stronger for shift work nurses-and that a higher threat perception was related to greater psychological distress, especially in nurses with a precarious job contract. Among the four categories of interaction between job contract and shift work, cognitive appraisal became central in predicting nurses' mental health, explaining more variance in the group that did shift work and had a nonprecarious job contract.
The study results highlight the need to develop occupational health intervention programs to promote nurses' mental health, focusing on reducing work perception as a threat and on making nurses' jobs more challenging and controllable.
认知评价是人类适应工作环境和职业压力的过程中的一个重要机制。在这个领域，护理专业人员是受工作压力影响最大的职业群体之一，他们承受着较高水平的心理困扰。
本研究旨在分析轮班工作和工作合同类型对工作认知评价与护士心理困扰之间关系的调节作用，并探讨这两个调节变量对该关系的交互作用。
一个由 2310 名葡萄牙注册护士组成的样本完成了一份社会人口学和专业问卷：主要和次要认知评价量表和一般健康问卷-12。通过结构方程建模和多组分析来分析数据，考虑了以下组：（a）“轮班”与“非轮班工作”；（b）“不稳定工作合同”与“非不稳定工作合同”；和（c）“轮班和不稳定”与“轮班和非不稳定”与“非轮班和不稳定”与“非轮班和非不稳定”。
数据证实了测量模型的不变性，但结构模型对所有分组变量的调整效果都较差，显示出轮班工作和工作合同的调节作用及其相互作用。结构路径系数的差异检验表明，轮班工作调节了挑战感知与心理困扰之间的关系-对于轮班工作的护士来说，这种关系更强-而更高的威胁感知与更大的心理困扰相关，尤其是在工作合同不稳定的护士中。在工作合同和轮班工作之间的四种交互作用类别中，认知评价成为预测护士心理健康的核心因素，在轮班工作且工作合同非不稳定的组中解释了更多的方差。
研究结果强调需要制定职业健康干预计划，以促进护士的心理健康，重点是减少工作感知的威胁，并使护士的工作更具挑战性和可控性。
