Xie Wanqing, Liu Manli, Okoli Chizimuzo T C, Zeng Li, Huang Shuqi, Ye Xin, Liu Fan, Wang Jialin
State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
University of Kentucky College of Nursing, 517 College of Nursing Building, Lexington, KY 40536, USA.
Int J Nurs Stud. 2023 Dec;148:104613. doi: 10.1016/j.ijnurstu.2023.104613. Epub 2023 Sep 30.
Compassion fatigue is a syndrome resulting from long-term work-related traumatic event stress exposure of medical staff. The emergency department is considered to be a high-risk, high-intensity and high-stress work environment, with a high prevalence of trauma and violence. Nurses in the emergency department are more prone to compassion fatigue than nurses in other departments. Compassion fatigue not only affects the physical and mental health, and job satisfaction of emergency department nurses, but also causes serious consequences for patients, such as poor patient outcome, medical errors, and increased patient mortality during hospitalization.
Our study aims to develop and evaluate a predictive model for compassion fatigue among emergency department nurses.
A cross-sectional study.
The emergency department nurses (N = 1014) were recruited from 21 tertiary hospitals (from Chengdu, Chongqing, Guiyang, Guangzhou and Shanghai) in central, southwestern, southern, and eastern China from July 25, 2022 to October 30, 2022.
Univariate and multiple logistic regression analyses were used to determine the potential predictive factors associated with compassion fatigue in emergency department nurses. A nomogram was built based on the predictive factors and internally evaluated using a bootstrap resampling method (1000 bootstrap resamples). The performance of the predictive model was evaluated by measuring the Hosmer-Lemeshow goodness of fit test and calibration curve.
The prevalence of compassion fatigue among emergency department nurses was 75.9 %. The multiple logistic regression analysis revealed that the independent predictive factors for compassion fatigue among emergency department nurses were working position, job satisfaction, diet habit, sleep hours per day, occupational stress, physical harassment and the level of workplace violence, all of which were identified to create the nomogram. The Hosmer-Lemeshow goodness of fit test indicated that the predictive model was well calibrated (χ = 11.520, P = 0.174). The bootstrap-corrected concordance index of nomogram was 0.821 (95 % CI: 0.791-0.851). The calibration curve of the nomogram showed good consistency between the predicted and actual probabilities.
A predictive model of compassion fatigue among emergency department nurses has been developed, based on the general demographic, work-related and lifestyle characteristics, occupational stress, and workplace violence, with satisfactory predictive ability. This model can identify emergency department nurses who are at high risk of compassion fatigue. Our study provides an empirical basis for early detection, early diagnosis and early intervention of emergency department nurses at high risk of compassion fatigue.
同情疲劳是医护人员长期暴露于与工作相关的创伤性事件压力下所导致的一种综合征。急诊科被认为是一个高风险、高强度和高压力的工作环境，创伤和暴力发生率很高。急诊科护士比其他科室的护士更容易出现同情疲劳。同情疲劳不仅会影响急诊科护士的身心健康和工作满意度，还会给患者带来严重后果，如患者预后不良、医疗差错以及住院期间患者死亡率增加。
本研究旨在建立并评估一个急诊科护士同情疲劳的预测模型。
一项横断面研究。
2022年7月25日至2022年10月30日，从中国中部、西南部、南部和东部的21家三级医院（来自成都、重庆、贵阳、广州和上海）招募了急诊科护士（N = 1014）。
采用单因素和多因素逻辑回归分析来确定与急诊科护士同情疲劳相关的潜在预测因素。基于这些预测因素构建了列线图，并使用自抽样重采样方法（1000次自抽样重采样）进行内部评估。通过测量Hosmer-Lemeshow拟合优度检验和校准曲线来评估预测模型的性能。
急诊科护士同情疲劳的患病率为75.9%。多因素逻辑回归分析显示，急诊科护士同情疲劳的独立预测因素为工作岗位、工作满意度、饮食习惯、每日睡眠时间、职业压力、身体骚扰和工作场所暴力程度，所有这些因素都被用于创建列线图。Hosmer-Lemeshow拟合优度检验表明预测模型校准良好（χ = 11.520，P = 0.174）。列线图的自抽样校正一致性指数为0.821（95%CI：0.791 - 0.851）。列线图的校准曲线显示预测概率与实际概率之间具有良好的一致性。
基于一般人口统计学、与工作相关的特征、生活方式、职业压力和工作场所暴力，建立了一个急诊科护士同情疲劳的预测模型，具有令人满意的预测能力。该模型可以识别出同情疲劳高风险的急诊科护士。本研究为同情疲劳高风险急诊科护士的早期发现、早期诊断和早期干预提供了实证依据。
