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护士在 COVID-19 大流行期间的压力源和心理困扰:应对和适应力的中介作用。

Nurses´ stressors and psychological distress during the COVID-19 pandemic: The mediating role of coping and resilience.

机构信息

IDOCAL, University of Valencia, Valencia, Spain.

Pablo Olavide University, Sevilla, Spain.

出版信息

J Adv Nurs. 2021 Mar;77(3):1335-1344. doi: 10.1111/jan.14695. Epub 2021 Jan 4.


DOI:10.1111/jan.14695
PMID:33210768
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7753515/
Abstract

AIMS: This study analyses the cross-sectional effect of sources of stress during the peak of COVID-19 pandemic on nurses´ psychological distress, focusing on the mediating role of coping strategies, both problem focused and emotion focused and resilience. DESIGN: Cross-sectional and quantitative analyses. METHODS: Structural equation modelling was performed using survey data obtained during the period between 1 April-25 May 2020 in a sample of 421 nurses from 39 Spanish provinces. RESULTS: Results confirmed that: (a) All the stressors have a significant, direct, and negative relationship with nurses´ psychological distress; (b) Emotion-focused strategies is negatively related to nurses´ psychological distress directly and indirectly through resilience; and (c) Problem-focused strategies is positively related to nurses´ psychological distress and negatively and indirectly through emotion-focused strategies. CONCLUSION: This study identifies an important mediation sequence of stressors on psychological distress through the simultaneous concurrent effect of Problem-focused and Emotion-focused strategies and resilience. It shows that enacting the two coping mechanisms and resilience resources is important to achieve an adaptive effect on nurses´ mental health. IMPACT: Nurses with insufficient preparation and those with high levels of fear of contagion do not enact proper coping strategies. Thus, these nurses need special consideration due to their risk of higher vulnerability.

摘要

目的:本研究分析了 COVID-19 大流行高峰期各种压力源对护士心理困扰的横断面影响,重点关注应对策略(包括问题聚焦策略和情绪聚焦策略)和韧性的中介作用。

设计:横断面和定量分析。

方法:使用 2020 年 4 月 1 日至 5 月 25 日期间在西班牙 39 个省的 421 名护士样本中获得的调查数据进行结构方程模型分析。

结果:结果证实:(a)所有压力源与护士的心理困扰都有显著的、直接的、负相关关系;(b)情绪聚焦策略与护士的心理困扰直接相关,通过韧性间接相关;(c)问题聚焦策略与护士的心理困扰直接相关,通过情绪聚焦策略间接负相关。

结论:本研究通过问题聚焦和情绪聚焦策略以及韧性的同时并发效应,确定了压力源对心理困扰的重要中介序列。它表明,实施两种应对机制和弹性资源对于实现护士心理健康的适应性非常重要。

影响:准备不足的护士和对感染恐惧程度高的护士不会采取适当的应对策略。因此,这些护士需要特别关注,因为他们有更高的脆弱性风险。

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本文引用的文献

[1]
COVID-19 anxiety among front-line nurses: Predictive role of organisational support, personal resilience and social support.

J Nurs Manag. 2020-8-21

[2]
Focus on Mental Health During the Coronavirus (COVID-19) Pandemic: Applying Learnings from the Past Outbreaks.

Cureus. 2020-3-25

[3]
Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: A cross-sectional study.

Brain Behav Immun. 2020-3-30

[4]
Progression of Mental Health Services during the COVID-19 Outbreak in China.

Int J Biol Sci. 2020-3-15

[5]
Reflections on Nursing Ingenuity During the COVID-19 Pandemic.

J Neurosci Nurs. 2020-10

[6]
Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019.

JAMA Netw Open. 2020-3-2

[7]
Nursing and the novel coronavirus: Risks and responsibilities in a global outbreak.

J Adv Nurs. 2020-7

[8]
COVID-19: Emerging compassion, courage and resilience in the face of misinformation and adversity.

J Clin Nurs. 2020-5

[9]
Mental health care for medical staff in China during the COVID-19 outbreak.

Lancet Psychiatry. 2020-4

[10]
Global challenges in health and health care for nurses and midwives everywhere.

Int Nurs Rev. 2020-3

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