目的 识别本科护生心理压力类型,并比较不同心理压力类型护生在人口学、应对方式和专业认同的特征差异。方法 于2020年3—4月采用一般资料调查问卷、大学生心理压力源问卷、大学生应对方式问卷和护理本科生专业认同调查问卷对2 999名河北省本科护生进行问卷调查。结果 本科护生心理压力类型可分为“就业压力突出型”（n=570）、“普遍低压力型”（n=1 163）、“普遍中压力型”（n=610）和“普遍高压力型”（n=656）。多元Logistic回归分析结果显示：不同心理压力类型的本科护生在年级、是否担任学生职务、父母亲朋是否从事护理工作、应对方式和专业认同的分布上差异具有统计学意义（P<0.05）;而在性别、报考护理专业原因的分布上差异无统计学意义（P>0.05）。与“普遍低压力型”相比,“普遍高压力型”（OR=0.579,P<0.001）和“就业压力突出型”（OR=0.496,P<0.001）与专业认同得分呈负向关联。结论 本科护生心理压力存在异质性,识别出4个心理压力类型。尤其关注“普遍高压力型”和“就业压力突出型”护生,为各心理压力类型的护生制定针对性的心理疏导策略,引导其正确应对,以提高护生的专业认同感,从而稳定护理队伍。
Objective To identify the types of psychological stress among nursing undergraduates, and compare the differences in demographic characteristics, coping styles and professional identity of students with different types of psychological stress. Methods From March to April 2020, 2,999 nursing undergraduates in Hebei province were surveyed by using general information questionnaire, College Student Psychological Stressors Questionnaire, College Student Coping Style Questionnaire, and Nursing Undergraduate Professional Identity Questionnaire. Results The types of psychological stress of nursing undergraduates were classified into four types as “great employmentstress”(n=570), “generally lowstress ”(n=1163), “generally mediumstress” (n=610) and “generally highstress” (n=656). Multinomial logistic regression analysis showed that there were statistical differences in terms of grade, student leaders or not, whether their parents and friends were engaged in nursing work, coping styles, and professional identity (P<0.05). There was no statistically significant difference in the distribution of sex and reasons for applying for nursing specialty (P>0.05). Compared with the type of “generally lowstress”, “generally highstress” (OR=0.579, P<0.001) and “great employmentstress” (OR=0.496, P<0.001) were negatively correlated with professional identification score. Conclusion There is heterogeneity in psychological stress among nursing undergraduates, and 4 types of psychological stress are identified. Particular attention should be paid to the students with “generally highstress” and “great employmentstress”.Psychological counseling strategies are needed for nursing students with various types of psychological pressure, so as to guide them to cope with the stress correctly, and improve the professional identity of nursing students thus to stabilize the nursing team.
[1] 郝春红,张晓丽,崔保华.护生心理健康状况影响因素调查研究[J].卫生职业教育,2018,36(1):115-117.
[2] 张苏梅,王大军,何瑛,等.消极应对方式在本科护生压力与手机依赖间的中介效应[J].护理学报,2019,26(10):44-48. DOI:10.16460/j.issn1008-9969.2019.10.044.
[3] Zhao Y, Zhou Q, Li J, et al.Influence of Psychological Stress and Coping Styles in the Professional Identity of Undergraduate Nursing Students after the Outbreak of COVID-19: A Cross-sectional Study in China[J]. Nurs Open, 2021,8(6):3527-3537. DOI: 10.1002/nop2.902.
[4] 张秋梅,梅瑞华,徐芳芳,等.医学生压力源及压力强度现状调查研究[J].中国高等医学教育,2017(9):42-43. DOI:10.3969/j.issn.1002-1701.2017.09.020.
[5] 张瑜,崔保华,郝春红,等.某省属高校护理学专业学生压力源差异性分析[J].中华现代护理杂志,2016,22(23):3287-3292. DOI:10.3760/cma.j.issn.1674-2907.2016.23.009.
[6] 王孟成. 潜变量建模与Mplus应用进阶篇[M].重庆:重庆大学出版社.2018.
[7] 尹奎,彭坚,张君. 潜在剖面分析在组织行为领域中的应用[J].心理科学进展,2020,28(7):1056-1070.DOI:10.3724/SP.J.1042.2020.01056.
[8] 崔丽娜. 大学生心理危机及干预机制研究[D]. 重庆:西南大学,2009. DOI:10.7666/d.y1459974.
[9] 胡忠华. 四川省护理本科生专业认同调查分析[D]. 成都:四川大学,2007. DOI:10.7666/d.y1193848.
[10] 刘壮,张悦,刘荣勋,等. 医学生感知压力的潜在剖面分析[J]. 中国卫生统计,2020,37(6):859-861. DOI:10.3969/j.issn.1002-3674.2020.06.015.
[11] Liao PC, Chen SK, Lin SSJ.Latent Profiles of Stress and Their Relationships with Depression and Problematic Internet Use among College Freshmen[J]. Scand J Psychol,2018,59(6):621-630.DOI:10.1111/sjop.12489.
[12] 张铭,刘欢,冯亚玲,等.某护理学院毕业生就业压力现状及影响因素分析[J].沈阳医学院学报,2019,21(3):247-251.DOI:10.16753/j.cnki.1008-2344.2019.03.015.
[13] 吴曼,孙雪芹.本科护生压力与心理健康的关系:心理弹性的中介作用[J].中国健康心理学杂志,2019, 27(2):304-308.DOI:10.13342/j.cnki.cjhp.2019.02.037.
[14] 张群,杨玲,刘俊,等.医务人员职业压力、应对方式与主观幸福感的相关性[J].中国健康心理学杂志, 2019,27(11):1627-1631.DOI:10.13342/j.cnki.cjhp.2019.11.007.
[15] Ferrari S, Rey S, Høglund E, et al.Physiological Responses During Acute Stress Recovery Depend on Stress Coping Style in European Sea Bass,Dicentrarchus Labrax[J]. Physiol Behav,2020, 216:112801.DOI:10.1016/j.physbeh.2020.112801.
[16] 张笑英. 本科及专科护理毕业生应激性事件及应对方式的调查研究[J]. 全科护理,2020,18(26):3547-3550. DOI:10.12104/j.issn.1674-4748.2020.26.039.
[17] 钟雯琴,贾捷,沈舒玲,等. 北京市三级甲等综合医院实习护生专业认同现状的调查分析[J].循证护理,2020,6(12):1387-1393. DOI:10.12102/j.issn.2095-8668.2020.12.023.
[18] 吕思雨,周圣宜,刘恩泽,等.突发公共卫生事件后医学生领悟社会支持与专业认同之间的关系—心理弹性的中介作用[J].大众标准化,2021(16):67-69. DOI:10.3969/j.issn.1007-1350.2021.16.024.
[19] Helbig S, Backhaus J.“Sex Differences in a Real Academic Stressor, Cognitive Appraisal and the Cortisol Response”[J]. Physiol Behav,2017,179:67-74.DOI:10.1016/j.physbeh.2017.05.027.
[20] Moksnes UK, Eilertsen MB, Lazarewicz M.The Association Between Stress, Self-esteem and Depressive Symptoms Inadolescents[J]. Scand J Psychol, 2016, 57(1):22-29.DOI: 10.1111/sjop.12269.
