Zhong Luying, Wang Ling, Zhang Hao, Diao Dongmei, Chen Xiaoli, Zou Liqun
Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Chengdu, China.
Disaster Medical Center, Sichuan University, Chengdu, China.
J Nurs Manag. 2025 Jun 5;2025:1412700. doi: 10.1155/jonm/1412700. eCollection 2025.
Emergency department nurses face severe occupational stress. Effort-reward imbalance (ERI) has been shown to be a significant psychosocial stressor closely linked to adverse health consequences. The primary objective of this study was to construct and rigorously evaluate a predictive model for ERI in emergency department nurses. The model is intended to precisely identify high-risk populations and provide a crucial reference in the formulation of targeted intervention strategies. A descriptive cross-sectional survey design was employed. The study sample comprised 1540 registered nurses from 30 tertiary hospitals in China. The demographic characteristics of the respondents, their responses to the Chinese version of the ERI questionnaire, and their responses to the Chinese Nursing Work Environment (C-NWE) scale were collected via an anonymous online questionnaire. We used multiple logistic regression to develop our predictive model. Subsequently, a nomogram was plotted to simplify the model, and its performance was comprehensively evaluated using the area under the curve (AUC) and bootstrap resampling. The prevalence of ERI among emergency department nurses was determined to be 26.2%. Overcommitment and weekly work hours (≥ 59 h) were identified as independent predictors of ERI. The AUC of the model reached 0.891, demonstrating robust discriminatory power. We constructed a precise predictive model that accurately quantifies the contributions of overcommitment and weekly work hours (≥ 59 h) to the risk of ERI among emergency department nurses. These findings have significant implications for the early identification and effective prevention of ERI in high-stress nursing environments. Healthcare administrators can use our model to identify nurses at high risk of ERI. By taking steps to address overcommitment and manage work hours, they can mitigate the negative impact of ERI, thereby improving the health of emergency department nurses and enhancing the quality of care.
急诊科护士面临着严重的职业压力。努力-回报失衡（ERI）已被证明是一种与不良健康后果密切相关的重要社会心理压力源。本研究的主要目的是构建并严格评估急诊科护士ERI的预测模型。该模型旨在精确识别高危人群，并为制定针对性干预策略提供关键参考。采用了描述性横断面调查设计。研究样本包括来自中国30家三级医院的1540名注册护士。通过匿名在线问卷收集了受访者的人口统计学特征、他们对中文版ERI问卷的回答以及对中国护理工作环境（C-NWE）量表的回答。我们使用多元逻辑回归来建立预测模型。随后，绘制了列线图以简化模型，并使用曲线下面积（AUC）和自助重采样对其性能进行了全面评估。急诊科护士中ERI的患病率为26.2%。过度投入和每周工作时长（≥59小时）被确定为ERI的独立预测因素。该模型的AUC达到0.891，显示出强大的区分能力。我们构建了一个精确的预测模型，该模型准确量化了过度投入和每周工作时长（≥59小时）对急诊科护士ERI风险的影响。这些发现对于在高压力护理环境中早期识别和有效预防ERI具有重要意义。医疗管理人员可以使用我们的模型来识别ERI高危护士。通过采取措施解决过度投入问题并管理工作时长，他们可以减轻ERI的负面影响，从而改善急诊科护士的健康状况并提高护理质量。
