二孩政策下妇幼专科医院护士心理健康水平与社会支持的关系:应对方式的中介效应

Study on the relationship between mental health level and social support of nurses in maternal and child specialist hospital under the universal two-child policy:mediating effects of coping style

目的调查二孩政策下妇幼专科医院护士心理健康水平、应对方式和社会支持的现状及其相互作用。方法采用便利整群抽样法选取佛山市某妇幼专科医院505名护士为研究对象,通过一般资料问卷、症状自评量表(Symptom Checklist-90,SCL-90)、简易应对方式问卷、社会支持评定量表进行横断面调查,使用t检验、Pearson相关和结构方程模型方法进行数据分析。结果505名护士SCL-90总均分为(1.58±0.49)分,其中强迫、人际关系敏感、焦虑、敌对、恐怖、偏执、精神病性7个因子分高于全国常模(均P<0.05)。SCL-90总分与积极应对方式及社会支持均呈负相关(均P<0.01),与消极应对呈正相关(P<0.05)。结构方程模型结果显示,社会支持对SCL-90得分发挥直接影响(β=-0.27,P<0.001),社会支持对积极应对方式发挥直接影响(β=0.44,P<0.001),积极应对方式对SCL-90发挥直接影响(β=-0.17,P<0.001)。Bootstrap法验证了积极应对方式在妇幼专科医院护士社会支持与心理健康间存在不完全中介效应(Z=-4,P<0.001),中介贡献率为22.22%,社会支持与心理健康的直接效应量为77.78%。结论二孩政策下,某妇幼专科医院护士心理健康水平整体较全国护士低,积极应对在社会支持与心理健康间存在部分中介作用,社会支持对心理健康的影响以直接影响为主。

Objective To investigate the status of mental health,coping style and social support in nurses working in maternity and child care hospital under the universal two-child policy,and to explore the relationship between them.Methods In this cross-sectional study,a total of 505 nurses were recruited from a Women and Children hospital in Foshan City Guangdong Province through convenient cluster sampling.Four questionnaires were used in this study:Demographic data questionnaire,Symptom Checklist-90(SCL-90),Simple Coping Style Questionnaire(SCSQ)and Social Support Rating Scale(SSRS),and t-test,Pearson correlation,structural equation modeling methods were applied to analyze the data.Results The average score of SCL-90 for the nurses was(1.58±0.49),among which 7factors(coercion,interpersonal sensitivity,anxiety,hostility,terror,paranoia and psychosis)were higher than the national norm(both P<0.05).The total score of SCL-90 was negatively correlated with positive coping style and social support(both P<0.01);while positively correlated with negative coping(P<0.05).Structural equation model results showed that social support had a direct impact on SCL-90 score(β=-0.27,P<0.001),and social support had a direct impact on positive coping styles(β=0.44,P<0.001),positive coping style has a direct impact on SCL-90(β=-0.17,P<0.001).The Bootstrap method verified that there was an incomplete mediating effect between the social support and mental health of nurses in maternal and child specialist hospital(Z=-4,P<0.001),the mediation contribution rate was 22.22%,and the direct effect of social support and mental health was 77.78%.Conclusions Under the universal two-child policy,the mental health level of nurses in maternity and child-reared hospitals is lower than that of national group.Positive coping styles have some mediating effects between social support and mental health,but the direct impact was the majority.