护士工作压力源、睡眠质量和心理健康的关系

Relationship among job stressors, sleep quality and psychological health of nurses

目的探讨护士工作压力源、心理健康和睡眠质量三者的关系。方法采用修改后的护士工作压力源量表（nurseiobstressorsquestionnaire—revised．NJSQ—R）、匹兹堡睡眠质量指数量表（pittsburghsleepqualityindex，PSQI）和症状自评量表（symptomchecklist90，SCL-90）对广西某三甲综合医院681名女性护士进行问卷调查。利用SPSSl9．0进行数据处理。结果①NJSQ．R总均分[（1．50±0．62）分]和5个工作压力源因子均分[工作环境和性质：（1．60±0．65）分；人际关系：（1．21±0．73）分；病人及家属态度：（1．63±0．74）分；危重病人护理：（1．38±0．71）分；职业发展：（1．97±0．72）分]与SCL-90总均分[（1．64±0．69）分，r=0．32～0．50]和PSQI总分[（8．11±3．52）分，r=0．28—0．35]呈显著正相关（P〈O．01）。SCL-90和PSQI之间呈显著正相关（r=0．46，P〈0．01）。②SCL-90（JB=0．387，P〈0．01）、职业发展（β=0．120，P〈0．05）对PSQI有显著直接影响；工作环境和性质（β=0．235，P〈0．01）、危重病人护理（β=0．151，P〈0．05）通过SCL-90间接影响PSQI。③PSQI对SCL-90有显著的直接影响（β=O．344，P〈0．01）；职业发展（β=0．113，P〈0．05）通过PSQI间接影响SCL-90；工作环境和性质对SCL-90有直接（β=0．172，P〈O．01）和间接（β=0．184，P〈0．01）的影响。结论护士工作压力越大，睡眠质量越差，心理健康水平越低。根据压力来源的不同，护士工作压力可直接或间接的影响护士睡眠质量和心理健康。睡眠质量和心理健康两者可能存在双向相关性。

Objective To explore the relationship among job stressors,sleep quality and psychologi- cal health of nurses. Methods 708 female nurses in a 3-A-grade general hospitals of Guangxi were chosen and asked to fil] out the Nurse Job Stressors Questionnaire-Revised （NJSQ-R） ,Pittsburgh Sleep Quality In- dex（PSQI） and Symptom Checklist 90（ SCL-90）. Results （1） The total mean score of NJSQ-R （ 1.50±0. 62） and the five job stressors,including the job environment and characters（ 1.60±0.65 ） , personal relation- ship（1.21±0.73） ,the attitude of patient and their relatives（1.63±0.74） ,professional skill（ 1.38±0.71 ） and social status and career development（1.97±0.72） were positively related with the total mean score of SCL-90 （1.64±0.69） （ r=0.32-0.50, P〈0.01 ）and the total score of PSQI（8.11±3.52） （ r= 0.28-0.35, P〈0.01）. There was a positive relationship between SCL-90 and PSQI（ r=0.46, P〈0.01 ））.（2） SCL-90（ β= 0.387, P〈 0.01 ）and the job stressor of the social status and career development（ β= 0.120, P〈0.05）were directly sig- nificantly associated with PSQI. The job stressor of job environment and characters（ fl=0.235, P〈0.01） and professional skill （β= 0.117, P〈 0. 05 ） were indirectly associated with PSQT mediated by SCL-90. （3） PSQI was directly significantly associated with SCL-90（β= 0.344, 〈0.01 ）. The job stressor of the social status and career deve]opment was indirectly significantly associated with SCL-90 mediated by PSQI （β= 0.113, P〈 0. 05）. And the job stressor of job environment and characters was directly （β= 0.172, P〈0.01 ）and indirectly （β= 0.184, P〈0.01 ） associated with PSQI mediated by SCL-90. Conclusion The higher the job stress ,the more the mental health problem,and the poor the sleep quality among nurses. Job stressors have direct or indirect influence on psychological health and sleep quality, depending on the nature of job stressors. In addi- tion, the result suggests that a bidirectional relationship exists between sleep quality and psychological health.