精神科护士心理困扰及其影响因素分析

Research on psychological distress of psychiatric nurses and its influencing factors

目的了解精神科护士心理困扰现状及其相关因素，为采取干预策略提供理论依据。方法按地域划分选取山东省6家三级甲等精神专科医院812名护士，采用心理困扰量表、组织支持感量表、简易应对方式量表和情绪调节策略问卷进行问卷调查。结果精神科护士心理困扰检出率为70．3％，均分为（21．29±8．11）分；不同年龄（F=6．886，P=0．001）、工作年限（F=4．403，P=0．004）、职称（F=6．597，P=0．000）和经历护患冲突次数（F=7．228，P=0．000）对精神科护士心理困扰的影响差异有统计学意义；心理困扰与认知重评（r=-0．093）、积极应对（r=-0．163）、组织支持（r=-0．379）呈显著负相关（P〈0．01），与消极应对（r=0．258）、表达抑制（r=0．160）呈显著正相关（P〈0．01）。回归分析结果显示，积极应对、组织支持、表达抑制、消极应对和护患冲突是精神科护士心理困扰的影响因素（R2=0．224，F=46．611，P=0．000）。结论精神科护理管理者应重视护士情绪管理能力和冲突处理能力的培养，使护士以积极的思维认知和应对方式处理工作中的负性事件，营造支持性的工作环境，从而提高心理健康水平。

Objective To investigate the present status and influencing factors of psychological distress among psychiatric nurses, and provide theoretical basis for intervention measures. Methods Totally, 812 psychiatric nurses in six psychiatric hospitals of Shandong province were selected to complete the Kessler Psychological Distress Scale （K10）, Perceived Organizational Support（POS）, Simplified Coping Style Questionnaire（SCSQ） and Emotion regulation questionnaire（ERQ）. Results The mean scores of psychological distress among psychiatric nurse was （21.29±8.11） points, 70.3% of psychiatric nurses had psychological distress. There were significant differences in psychological distress among psychiatric nurses with different age （F=6.886, P=0.001）, working years （F=4.403, P=0.004）, professional title （F= 6.597, P=0.000） and experience of nurse-patient conflict （F=7.228, P=0.000）.Psychological distress was negatively related to cognitive reappraisal（r =- 0.093）, positive coping style （r =- 0.163） and perceived organizational support（r =- 0.379）, while psychological distress was positively related to expressive suppression（r =0.160） and negative coping style（r =0.258）（all P 〈 0.01）. Regression analysis revealed that the factors impacting psychological distress were positive coping style, perceived organizational support, expressive suppression, negative coping style and nurse-patient conflict （R2=0.224, F=46.611, P=0.000）. Conclusions Psychiatric nursing managers should pay attention to the cultivation of emotional management ability of nurses and the ability to deal with conflict, encouraging them apply positive thinking cognition and positive coping style to deal with negative events in the work, creating a supportive work environment in order to improve the level of mental health.