院前急救护士职业应激、不确定性忍受力与职业倦怠的关系

Relationship between occupational stress, uncertain endurance and job burnout of pre-hospital emer-gency nurses

目的 探讨院前急救护士的职业应激、不确定性忍受力与职业倦怠的关系.方法 采用分层整群抽样方法抽取380名院前急救护士为调查对象,采用职业倦怠量表[MBI,包括情绪枯竭（EE）、去人格化倾向（D）和低成就感（PA）]、不确定性忍受力量表（IUS）、护士工作应激源量表[NSS,包括与护士期望值有关的应激（NSS1）、与家庭有关的应激（NSS2）、与人际关系有关的应激（NSS3）、与工作性质有关的应激（NSS4）、与患者有关的应激（NSS5）、与工作负荷有关的应激（NSS6）]测评.结果 工龄小于3年的院前急救护士EE[（33.58±4.34）分,（22.33±4.05）分,（21.50± 4.36）分,P〈0.05]、PA得分[（26.98±4.31）分,（16.14±4.28）分,（16.81±4.36）分,P〈0.05]大于工龄3~10年或10年以上人员;护士EE[（33.82±4.28）分,（22.96±4.39）分,（21.04±4.62）分,P〈0.05]、PA得分[（27.02±4.21）分,（16.04±4.31）分,（16.01±4.30）分,P〈0.05]大于护师或以上人员;月收入小于0.3万人员PA得分大于月收入0.3万或以上人员[（26.75±4.24）,（16.47±4.27）,（17.11±4.34）, P〈0.05];学历本科或以上人员PA得分大于专科或以下人员[（26.33±4.36）,（17.24±4.28）,P〈0.05）].回归分析显示,IUS与NSS1得分相乘交互作用项与EE、D得分相乘交互效应成立（β=0.33、0.33,均P〈0.05）;IUS与NSS5得分相乘交互作用项与EE、D得分相乘交互效应成立（β=0.31、0.30,均 P〈0.05）;IUS与NSS3得分相乘交互作用项与D得分乘交互效应成立（β=0.34,P〈0.05）.结论 院前急救护士的职业倦怠因工龄、职称、受教育程度、工资而异,受职业应激和不确定性忍受力协同影响.

Objective To investigate the correlation between occupational stress,uncertain endur-ance and job burnout of pre-hospital emergency nurses. Methods A total of 380 pre-hospital emergency nurses were recruited by stratified cluster sampling method.The occupational burnout scale（MBI）including emotional exhaustion（EE）,depersonalization（D）and diminished personal accomplishment（PA）,the In-tolerance of Uncertainty Scale（IUS）,the Nursing Stressor Scale（NSS）including stresses associated with nurse expectations（NSS1）,with family（NSS2）,with interpersonal relationship（NSS3）,with nature of work （NSS4）,with patient（NSS5）and with work load（NSS6）were applied for all subjects.Results The pre-hospital emergency nurses who had worked less than 3 years got the higher EE score（33.58 ± 4.34）and higher PA score（26.98±4.31）than those who had worked 3 to 10 year（22.33±4.05,16.14±4.28,P〈0.05） or longer than 10 years（21.50±4.36,16.81±4.36,P〈0.05）.Nurses got higher EE score（33.82±4.28,22.96 ±4.39,21.04±4.62,P〈0.05）,and higher PA scores（27.02±4.21,16.04±4.31,16.01±4.30,P〈0.05）than the nurse practitioner or above levels.People whose monthly income were below 0.3 million got higher PA scores than those whose monthly income were 0.3 million or more（26.75±4.24,16.47±4.27,17.11±4.34,P〈0.05）.People who got degrees of bachelor or above had PA scores which was more than people who got de-grees under bachelor（26.33±4.36,17.24±4.28,P〈0.05）.Regression analysis showed that the multiplication score between IUS and NSS1 had the interaction effect with EE and D scores（β=0.33,0.33,P〈0.05）; the multiplication score between IUS and NSS5 had the interaction effect with EE and D scores（β=0.31,0.30, P〈0.05）and the multiplication score between IUS and NSS3 had the interaction effect with D scores（β=0.34,P〈0.05）.Conclusion The pre-hospital emergency nurses＇job burnout varies according to their length of service,job title,educational level and salary,and is also influenced by the combination of occupational stress and uncertain endurance.