目的 探究负性情绪在ICU护士心理负荷与报警疲劳间的中介效应。方法 2023年1—3月,采用便利抽样法,选取四川省10家不同等级医院（三级甲等医院和三级乙等医院各3所、二级甲等医院和二级乙等医院各2所）的6个ICU（急诊ICU、综合ICU、儿科ICU、神经ICU、骨科ICU、感染ICU）206名护士作为调查对象。采用一般资料问卷、抑郁-焦虑-压力量表简体中文版、NASA任务负荷指数量表、临床报警疲劳调查问卷对其进行调查,采用SPSS23.0分析ICU护士心理负荷、负性情绪和报警疲劳的相关性,采用AMOS28.0分析ICU护士心理负荷对报警疲劳的中介效应。结果 本研究ICU护士负性情绪总分为17.00（10.00,24.00）分,心理负荷总分为（87.50±13.55）分,报警疲劳总分为（24.18±5.66）分。ICU护士心理负荷总分与报警疲劳总分呈正相关（rs=0.615,P<0.01）,与负性情绪总分呈正相关（rs=0.463,P<0.01）;报警疲劳总分与负性情绪总分呈正相关（rs=0.619,P<0.01）。负性情绪在ICU护士心理负荷与报警疲劳间发挥部分中介效应,中介效应值为0.232,占总效应的32.49%。结论 ICU护士的负性情绪总体呈偏低水平,报警疲劳、心理负荷总体处于中等偏高水平。ICU护士的心理负荷不仅能直接影响报警疲劳,还可以通过负性情绪间接影响报警疲劳。建议护理管理者采取积极措施以降低ICU护士心理负荷和负性情绪,进而缓解报警疲劳。
Abstract
Objective To explore the mediating effect of negative emotions on psychological load and alarm fatigue in ICU nurses. Methods Convenience sampling was used to select 206 nurses from 6 specialized ICUs (Emergency Intensive Care Unit, Intensive Care Unit, Pediatric Intensive Care Unit, Neuro Intensive Care Unit, Orthopedic Intensive Care Unit and Infection Intensive Care Unit) were selected from 10 hospitals of different grades in Sichuan Province (3 tertiary grade-A hospitals, 3 tertiary grade-B hospitals, 2 secondary grade-A hospitals and 2 secondary grade-B hospitals) from January to March 2023. The general information questionnaire, Depression-anxiety-stress Scale (Simplified Chinese version), NASA Task Load Index Scale and Clinical Alarm Fatigue Questionnaire were used to conduct the survey among the nurses.SPSS 23.0 was used to analyze the correlation between psychological load, negative emotions and alarm fatigue of ICU nurses, and AMOS 28.0 to analyze the mediating effect of psychological load on alarm fatigue in ICU nurses. Results The total score of negative emotions, psychological load and alarm fatigue was 17.00 (10.00, 24.00), 87.50±13.55 and 24.18±5.66 respectively. The total score of psychological load was positively correlated with that of alarm fatigue (rs=0.615, P<0.01), and that of negative emotion (rs=0.463, P<0.01). The total score of alarm fatigue was positively correlated with that of negative emotion (rs=0.619, P<0.01). Negative emotion played a partial mediating effect between pshchological load and alarm fatigue in ICU nurses, and the mediating effect value was 0.232, accounting for 32.49% of the total effect. Conclusion The negative emotions of ICU nurses are generally at a low level, and alarm fatigue and psychological load are generally at a medium high level. The psychological load of ICU nurses can not only directly affect alarm fatigue, but indirectly affect alarm fatigue through negative emotions. It is suggested that nursing managers should take active measures to reduce the psychological load and negative emotions of ICU nurses, so as to relieve alarm fatigue.
关键词
负性情绪 /
心理负荷 /
报警疲劳 /
中介效应
Key words
negative emotion /
psychological load /
alarm fatigue /
mediating effect
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参考文献
[1] 喻文菡,陶红兵,林小军,等.医护人员工作负荷与医疗质量和安全的相关性[J].中国卫生质量管理,2017,24(1):23-26.DOI:10.13912/j.cnki.chqm.2017.24.1.07.
[2] 胡光云,叶增杰,王海焦,等.临床护士韧性、情绪困扰、压力负担水平的调查[J].广东医学,2017,38(3):454-458.DOI:10.13820/j.cnki.gdyx.20170301.010.
[3] Ryu H, Jung J, Moon J.Health promotion program for office workers with SEM based on the WHO’s healthy workplace framework[J].Health Promot Int,2020,35(6):1369-1382.DOI:10.1093/heapro/daaa007.
[4] 孙振球,徐勇勇.医学统计学[M].北京:人民卫生出版社, 2014:525.
[5] Min CO, Hwasoon K, Whee LY,et al.Clinical alarms in intensive care units: perceived obstacles of alarm management and alarm fatigue in nurses[J]. Healthc Inform Res,2016,22(1):46-53.DOI:10.4258/hir.2016.22.1.46.
[6] 王婧,王建宁,周松,等. ICU护士医疗设备报警疲劳程度及其影响因素的研究[J].中华护理杂志,2017,52(2):211-215.DOI:10.3761/j.issn.0254-1769.2017.02.019.
[7] Hart S G, Staveland L E.Development of NASA-TLX (Task Load Index): results of empirical and theoretical research[J].Advances In Psychology, 1988, 52(6):139-183.DOI:10.1016/S0166-4115(08)62386-9.
[8] 梁丽玲. 基于LPA的护士工作心理负荷现状及其与心理资本、应对方式的关系研究[D].上海:中国人民解放军海军军医大学,2019.
[9] 龚栩,谢熹瑶,徐蕊,等.抑郁-焦虑-压力量表简体中文版(DASS-21)在中国大学生中的测试报告[J].中国临床心理学杂志, 2010, 18(4):443-446.DOI:10.16128/j.cnki.1005-3611.2010.04.020.
[10] 汤丹丹,温忠麟.共同方法偏差检验:问题与建议[J].心理科学,2020,43(1):215-223.DOI:10.16719/j.cnki.1671-6981.20200130.
[11] 王阳,温忠麟,李伟,等.新世纪20年国内结构方程模型方法研究与模型发展[J].心理科学进展,2022,30(8):1715-1733.DOI:10.3724/SP.J.1042.2022.01715.
[12] Gazarian PK.Nurses’ response to frequency and types of electrocardiography alarms in a non-critical care seting: a descriptive study[J]. Int J Nurs Stud2014,51(2):190-197.DOI:10.1016/j.ijnurstu.2013.05.014.
[13] 严文浩. 正念认知疗法对ICU护士自我效能感及负性情绪的影响[J].心理月刊,2020,15(18):49-50.DOI:10.19738/j.cnki.psy.2020.18.018.
[14] 梁婕,田凌云,杨秋红,等.应对方式在重症医学科护士社会支持和职业倦怠间的中介作用[J].中国护理管理,2022,22(1):106-110.DOI:10.3969/j.issn.1672-1756.2022.01.022.
[15] 闫妍. 基于人-机任务的ICU护士工作心理负荷及影响因素研究[D].上海: 中国人民解放军海军军医大学,2021.
[16] Wheelock A,Suliman A,Wharton R,et al.The impact of operating room distractions on stress, workload, and teamwork[J]. Ann Surg,2015,261(6):1079-1084.DOI:10.1097/SLA.0000000000001051.
[17] Marjanovic NS, Teiten C, Pallamin N,et al.Evaluation of emotional excitation during standardized endotracheal intubation in simulated conditions[J].Ann Intensive Care,2018,8(1):117.DOI:10.1186/s13613-018-0460-0.
[18] 沈秋娣,邬聪燕,陈培佩.综合干预策略对儿科护士同情心负荷的影响效果分析[J].中国药物与临床, 2019,19(4):673-675.DOI:10.11655/zgywylc2019.04.067.
[19] Tscholl D, Handschin L, R?ssler J,et al. It’s not you, it’s the design-common problems with patient monitoring reported by anesthesiologists: a mixed qualitative and quantitative study[J]. BMC Anesthesiol, 2019,19(1):87.DOI:10.1186/s12871-019-0757-z.
[20] Yue L, Plummer V, Cross W.The effectiveness of nurse education and training for clinical alarm response and management: a systematic review[J].J Clin Nurs,2017,26(17-18):2511-2526.DOI:10.1111/jocn.13605.
[21] Hannibal GB.Monitor alarms and alarm fatigue[J].AACN Adv Crit Care,2011,22(4):418-420.DOI:10.1097/NCI.0b013e318232ed55.
[22] Storm J, Chen HC.The relationships among alarm fatigue, compassion fatigue, burnout and compassion satisfaction in critical care and step-down nurses[J]. J Clin Nurs.2021,30(3-4):443-453.DOI:10.1111/jocn.15555.
[23] 孙爱玲,付晓丽,余霞. 湖北省5所综合医院肿瘤科护士压力负荷调查[J].护理学报,2015,22(14):73-75.DOI:10.16460/j.issn1008-9969.2015.14.073.
基金
四川医院管理和发展研究中心青年项目（SCYG2023-37）
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