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新冠疫情期间中国二级和三级医院临床护士职业压力与抑郁的患病率及潜在危险因素

Prevalence and Risk Factors Underlying Occupational Stress and Depression Among Clinical Nurses in Secondary and Tertiary Hospitals of China During COVID-19 Setting.

作者信息

Liu Xiao-Kun, Huang Dan-Ling, Meng Li-Ping, Cheng Wei, Li Yi-Yi, Qin Lu-Lu, Yang Ao, Zeng Fan, Zou Qin, Li Qi-Fu

机构信息

Clinical Psychology Department, The First Affiliated Hospital of Hainan Medical University, Haikou City, Hainan Province, People's Republic of China.

Neurology Department, Graduate School of Tianjin Medical University, Tianjin City, People's Republic of China.

出版信息

Risk Manag Healthc Policy. 2023 Aug 1;16:1377-1389. doi: 10.2147/RMHP.S415349. eCollection 2023.

Abstract

AIM

This study was designed to develop an effective measurement tool for occupational stress among medical staff and to identify the underlying risk factors among clinical nurses in China under depression during and after COVID-19.

METHODS

In the first stage, an occupational stress scale was developed for medical staff based on qualitative and quantitative methods. The dimensions of the scale were based on childhood stress and seven other parameters of working stress. In the second stage, a provincial survey was conducted among clinical nurses in Hainan. The structure of Medical Staff Occupational Stress Scale was tested in secondary and tertiary hospitals. The socio-demographic information, occupational stress (measured using the developed scale), and current depression symptoms (assessed with the nine-item Patient Health Questionnaire) were evaluated. The risk factors for occupational stress-induced depression were tested using multivariate logistic regression.

RESULTS

The Medical Staff Occupational Stress Scale consisted of 42 items under eight dimensions with strong reliability and validity. Almost 80% of the clinical nurses reported obvious symptoms of depression. Based on multivariate logistical regression analysis, the significant risk factors for depression in nurses at secondary hospitals and tertiary hospitals were childhood stress, teaching stress, relationship with patient stress, and administration stress.

CONCLUSION

The Medical Staff Occupational Stress Scale utilized in nursing population is based on strong psychometric features. Childhood stress contributes to occupational stress in nurses. The selection of nurses for clinical work may require evaluation of past history for childhood stress to prevent occupational depression. Teaching stress, relationship with patient stress and administration stress play significant roles in the prevention of depression among clinical nurses.

摘要

目的

本研究旨在开发一种有效的医护人员职业压力测量工具,并识别中国新冠肺炎疫情期间及之后处于抑郁状态的临床护士潜在的风险因素。

方法

第一阶段,基于定性和定量方法为医护人员开发职业压力量表。该量表的维度基于童年压力和其他七个工作压力参数。第二阶段,对海南的临床护士进行省级调查。在二级和三级医院测试医护人员职业压力量表的结构。评估社会人口学信息、职业压力(使用所开发的量表测量)和当前抑郁症状(用九项患者健康问卷评估)。使用多因素逻辑回归测试职业压力诱发抑郁的风险因素。

结果

医护人员职业压力量表由八个维度下的42个项目组成,具有很强的信度和效度。近80%的临床护士报告有明显的抑郁症状。基于多因素逻辑回归分析,二级医院和三级医院护士抑郁的显著风险因素是童年压力、教学压力、与患者关系压力和管理压力。

结论

护理人群中使用的医护人员职业压力量表具有很强的心理测量学特征。童年压力导致护士职业压力。临床工作护士的选拔可能需要评估童年压力史以预防职业性抑郁。教学压力、与患者关系压力和管理压力在预防临床护士抑郁方面发挥着重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/393d/10404045/d17d75bd1a1f/RMHP-16-1377-g0001.jpg

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