『中文摘要』目的:了解急诊科护士的工作压力、应对方式、心理健康状况及其相互之间的关系。方法:采用护士工作压力源量表、应对方式问卷和症状自评量表对石河子大学医学院四所附属医院的急诊科护士采取整群抽样的方法发放调查问卷。将原始资料数据输入计算机用SPSS11.5软件包进行统计学分析和处理。结果:1、所调查急诊科护士工作压力源在五个因子上的均分是:护理专业及工作方面的问题为2.92±0.44,时间分配及工作量问题为2.99±0.59,工作环境及仪器设备的问题为2.54±0.82,病人护理方面的问题为2.94±0.51,管理及人际关系方面的问题为2.55±0.56,总均分为2.81±0.39。2、急诊科护士最多选择的应对方式是解决问题,其后依次为求助、退避、幻想、合理化、自责。3、急诊科护士SCL-90总分≥160分的有43人,占急诊科护士总人数的35.8。在≥160分的急诊科护士中,总分在160～199分的有27人,占22.5;总分在200～239分的有7人,占5.8;总分≥240分的有9人,占7.5。急诊科护士SCL-90各因子与中国常模比较,在躯体化、强迫症状、抑郁、焦虑、敌对、恐怖、偏执、精神病性因子得分和总分与国内常模比较,差异有显著性意义(P<0.05),急诊科护士SCL-90各因子及总分高于中国常模。4、急诊科护士心理健康状况与护士感受到的压力具有显著相关性,即感受到工作压力大的急诊科护士SCL-90评分高,心理健康状况较差。采用解决问题应对方式与SCL-90各因子(除外躯体化症状)呈负相关;采用自责、幻想、退避等消极应对方式与SCL-90各因子分(除外躯体化症状)及总分呈正相关;采用合理化应对方式,SCL-90评分高。5、用多元线性逐步回归分析,自责应对方式、工作压力总均分、退避应对方式三个因素进入了SCL-90总分的线性回归方程。结论:急诊科护士的工作压力在中等偏上水平,高于临床内外科护士。急诊科护士主要以成熟应对方式为主。急诊科护士SCL-90总分阳性检出率为35.8,其心理健康状况低于常模。感受到工作压力大的急诊科护士心理健康状况较差;采用成熟的应对方式有利于护士的心理健康。急诊科护士工作压力的大小以及采用自责、退避应对方式对急诊科护士的心理健康影响最大,且对急诊科护士的心理健康状况有一定的预测作用
【Abstract】Objective:Thestudyistoinvestigatethecurrentstatusoftheworkingpressure,copingstyleandthementalhealthoftheemergencydepartmentnurses,aswellastounderstandtherelationsbetweentheworkingpressure,copingstyleandmentalhealthoftheemergencydepartmentnurses.Method:ApplyingtheNurseJobStressorsScale,CopingStyleQuestionnaireandtheSCL-90Questionnairetoinvestigatealltheemergencydepartmentnursesthatcomesfromfouraffiliatedhospitalsofsomemedicalcollege.Allthecalculationandstatisticswereperformedwiththecomputerprogram,SPSSversion11.5.Results:1.Thestressorsoftheinvestigatednursesaredividedintofivefactorsandeachmeanmarkofthefiveaspectsareasfollows:2.92±0.44attheaspectofnursingprofessionandwork,2.99±0.59attimedistributionandworkload,2.54±0.82attheworkingenvironmentsandequipments,2.94±0.51atthepatientnursing,and2.55±0.56atthemanagementaswellashumanrelations.Thetotalmeanscoreis2.81±0.39.2.Thecopingstylemostusedbyemergencydepartmentnursesisproblemsolving,othersareseekinghelp,retreat,illusion,rationalizationaswellasself-reproach.3.35.8ofthenursesinemergencydepartmentgotmoremarksthan160attheSCL-90,amongthesenursesmentionedabove,theproportionoftotalscoreoftheSCL-90between160and199is22.5,5.8between200and239,and7.5over240.ComparedwiththehealthadultsofChinesenormontheSCL-90scale,theemergencydepartmentnursesgotmoremarksinsomatization,obsessive-compulsive,interpersonalsensitivity,depression,anxiety,hostility,phobicanxiety,paranoidideation,psychoticism,aswellasthetotalscoreofSCL-90,significantdifferenceisshowed(P<0.05).4.Thementalhealthoftheemergencydepartmentnursesishighlycorrelatedwiththepressurefeltbynurses,whichmeans,thescoreoftheSCL-90scaleoftheemergencydepartmentnurseswhofeltmoreworkingpressureismoreandaccordinglywhosementalhealthisworse.TheCopingStyleofproblemsolvinghadanegativecorrelationwiththevarioussymptomfactorsofSCL-90(exceptofthesomatization).Whilethenegativecopingstyleofself-accusation,illusion,retreatandrationalizationhadapositivecorrelationwiththevarioussymptomfactorsandthetotalscoreofSCL-90.5.Analyzedbymultiplelinearstepwiseregression,theworkingpressureandthecopingstyleofselfaccusationaswellasretreatenteredintotheformula.Conclusion:TheemergencydepartmentNurses’work-relatedstressisabovemoderatelevel,higherthanthatofmedicineandsurgerynurses.Maturecopingstyleismainlyusedbytheemergencynurses.35.8oftheemergencynursesgotscoreover160intheSCL-90,whosementalhealthisnotasgoodastheadultnorm.Thenurseswhofelthighworkingpressurehadbadmentalhealth.Problemsolvingandseekinghelpdogoodtothementalhealthofthenurses,whileself-reproach,illusion,retreataswellasrationalizationdobadtothementalhealthofthenurses.Thefactorswhichinfluencedthementalhealthstatusofemergencydepartmentnursesweremainlytotalmeanscoreofworkingpressure,self-accusationandretreat,whichwerepredictorsofmentalhealthofemergencydepartmentnurses.
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