Liu HongZhe, Xiao Yi, Qu Hong
Department of Neurosurgery, General Hospital of the Northern Theater Command, Shenhe District,No.83,Wenhua Road, 110016, Shenyang, People's Republic of China.
BMC Psychol. 2025 Aug 20;13(1):951. doi: 10.1186/s40359-025-03291-x.
Nurses, as the largest professional group in the healthcare industry, often face different psychological problems, among which depressive symptoms is the most common. This study used the latent class analysis (LCA) to classify nurses' depressive symptoms, analyzing the differences in their second victim experience and support, psychological empowerment, and psychological detachment, providing reference for promoting nurses' mental health.
This study was a cross-sectional study, using cluster sampling to select nurses from tertiary hospitals in Liaoning Province from January to May 2024. Self-report questionnaires through Wenjuanxing were distributed, and 1719 nurses effectively completed the survey. The questionnaires included the Patient Health Questionnaire Depression Scale-9 item, the Chinese version of the Second Victim Experience and Support Tool, the Psychological Empowerment Scale, and the Recovery Experience Questionnaire. Mplus 8.3 software was used to conduct LCA, and SPSS 26.0 software was used for chi-square tests and analysis of variance.
Depressive symptoms was classified into three types: "Non depressive group" (40.5%), "Potential depressive symptoms group" (47.6%), and "Severe depressive symptoms group" (11.9%). Nurses with higher levels of physiological distress and career difficulties were more likely to develop potential depressive symptoms (OR = 1.120, 95%CI = 1.057-1.185; OR = 1.070, 95%CI = 1.034-1.107) or severe depressive symptoms (OR = 1.312, 95%CI = 1.187-1.451; OR = 1.171, 95%CI = 1.102-1.244). Nurses with higher levels of management support were less likely to develop severe depressive symptoms (OR = 0.930, 95%CI = 0.898-0.964). Nurses with higher levels of psychological empowerment were less likely to develop potential depressive symptoms (OR = 0.976, 95%CI = 0.963-0.989) or severe depressive symptoms (OR = 0.960, 95%CI = 0.941-0.979).
The cross-sectional design cannot determine the causal relationship between the support system and the relief of depressive symptoms. This study still revealed significant individual differences in depressive symptoms among nurses and the current status of experiences and support for secondary victims. Nursing managers need to reduce the risk of depression symptoms by multidimensional regulation of nurses' psychological emotions.
护士作为医疗行业中最大的专业群体，经常面临不同的心理问题，其中抑郁症状最为常见。本研究采用潜在类别分析（LCA）对护士的抑郁症状进行分类，分析其二次受害者经历与支持、心理授权和心理超脱的差异，为促进护士心理健康提供参考。
本研究为横断面研究，于2024年1月至5月采用整群抽样法从辽宁省三级医院选取护士。通过问卷星发放自填式问卷，1719名护士有效完成调查。问卷包括患者健康问卷抑郁量表-9项、中文版二次受害者经历与支持工具、心理授权量表和恢复经历问卷。使用Mplus 8.3软件进行LCA，使用SPSS 26.0软件进行卡方检验和方差分析。
抑郁症状分为三类：“非抑郁组”（40.5%）、“潜在抑郁症状组”（47.6%）和“重度抑郁症状组”（11.9%）。生理困扰和职业困难程度较高的护士更有可能出现潜在抑郁症状（OR = 1.120，95%CI = 1.057 - 1.185；OR = 1.070，95%CI = 1.034 - 1.107）或重度抑郁症状（OR = 1.312，95%CI = 1.187 - 1.451；OR = 1.171，95%CI = 1.102 - 1.244）。管理支持水平较高的护士出现重度抑郁症状的可能性较小（OR = 0.930，95%CI = 0.898 - 0.964）。心理授权水平较高的护士出现潜在抑郁症状（OR = 0.976，95%CI = 0.963 - 0.989）或重度抑郁症状（OR = 0.960，95%CI = 0.941 - 0.979）的可能性较小。
横断面设计无法确定支持系统与抑郁症状缓解之间的因果关系。本研究仍揭示了护士抑郁症状存在显著个体差异以及二次受害者的经历和支持现状。护理管理者需要通过多维度调节护士的心理情绪来降低抑郁症状风险。
