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护士的压力维度、应对模式与心理病理风险:一种以人为本的方法。

Stress dimensions, patterns of coping, and psychopathological risk among nurses: a person-centred approach.

作者信息

Vallone Federica, Cattaneo Della Volta Maria Francesca, Zurlo Maria Clelia

机构信息

Department of Humanities, University of Naples Federico II, Via Porta di Massa 1, Naples, 80133, Italy.

Dynamic Psychology Laboratory, Department of Political Science, University of Naples Federico II, Via Rodinò 22, Naples, 80138, Italy.

出版信息

BMC Nurs. 2024 Aug 16;23(1):569. doi: 10.1186/s12912-024-02250-y.

Abstract

BACKGROUND

Nurses are increasingly demanded to achieve gold-standards of care with fewer resources. Dealing effectively with stress experienced in their daily-work-life is thus crucial. This study is based on the Demands-Resources-and-Individual-Effects (DRIVE) Nurses Model and applied the person-centred approach with a twofold objective: 1. to identify patterns of coping strategies (Problem-Focused; Seek-Advice; Self-Blame; Wishful-Thinking; Escape/Avoidance) adopted by nurses to deal with perceived stress; 2. to explore potential differences in perceived Demands (Effort), Resources (Rewards, Job-Control, Social-Support), and Psychopathological Symptoms (Anxiety, Phobic-Anxiety, Obsessive-Compulsive, Somatization, Depression, Interpersonal-Sensitivity, Hostility, Psychoticism, Paranoid-Ideation) according to the emerged patterns.

METHOD

This cross-sectional study was reported by using the STROBE Checklist. Overall, 265 nursing professionals completed self-report measures. Non-hierarchical k-means-cluster-analysis was employed to derive patterns of coping. MANOVAs were used to test differences in Demands, Resources, and Psychopathological Symptoms according to the emerged patterns.

RESULTS

Three stable and meaningful patterns of coping were identified and labelled as Active/Solution-Oriented, Dysregulated/Emotion-focused, and Passive/Disengaged. Nurses belonging to Dysregulated/Emotion-focused group emerged to be at higher risk (higher effort/psychopathological suffering; lower resources) - followed by Passive/Disengaged group - in comparison with nurses belonging to Active/Solution-Oriented group.

CONCLUSION

Fostering nurses' awareness of their latent coping patterns and supporting active approaches/emotional regulation strategies for stress management should represent a key goal when defining interventions promoting nurses' health within/beyond the healthcare settings.

摘要

背景

人们越来越要求护士用更少的资源达到护理的黄金标准。因此,有效应对日常工作生活中的压力至关重要。本研究基于需求-资源-个体效应(DRIVE)护士模型,并采用以人为主的方法,有两个目标:1. 识别护士为应对感知到的压力而采用的应对策略模式(问题聚焦;寻求建议;自责;如意算盘;逃避/回避);2. 根据出现的模式,探索在感知需求(努力)、资源(回报、工作控制、社会支持)和心理病理症状(焦虑、恐惧焦虑、强迫观念与行为、躯体化、抑郁、人际敏感、敌意、精神症性、偏执观念)方面的潜在差异。

方法

本横断面研究按照STROBE清单报告。总体而言,265名护理专业人员完成了自我报告测量。采用非分层k均值聚类分析得出应对模式。使用多变量方差分析来检验根据出现的模式在需求、资源和心理病理症状方面的差异。

结果

识别出三种稳定且有意义的应对模式,并分别标记为积极/以解决问题为导向、失调/以情绪为导向和消极/脱离。与属于积极/以解决问题为导向组的护士相比,属于失调/以情绪为导向组的护士出现更高风险(更高的努力/心理病理痛苦;更低的资源),其次是消极/脱离组。

结论

在界定促进护士在医疗环境内外健康的干预措施时,培养护士对其潜在应对模式的认识,并支持积极的方法/情绪调节策略以管理压力,应是一个关键目标。

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