临床护士心理弹性与问题解决能力、应对方式的关系研究

Study on the relationship among resilience,problem solving and coping styles of clinical nurses

目的探讨临床护士问题解决能力、应对方式及心理弹性的关系,为提升护士心理弹性提供参考依据。方法采用一般资料调查表、心理弹性量表、中文版问题解决量表及简易应对方式问卷对上海市各级医院1073名临床护士进行问卷调查。结果临床护士心理弹性总分(58.18±12.49)分处于中等水平;积极应对方式及问题解决中的负性问题定向、问题解决能力、回避风格、冲动/疏忽风格等维度是心理弹性的主要影响因素,其中积极应对为心理弹性保护因素的主要预测因子(β=0.372,P<0.001),负性问题定向为心理弹性危险因素的主要预测因子(β=-0.324,P<0.001);在交互效应分析路径中积极应对和问题解决能力均正向影响心理弹性(总效应值为0.509、0.243),负性问题定向、回避风格、冲动/疏忽风格均负向影响心理弹性(总效应值为-0.388、-0.175、-0.079);问题解决能力在心理弹性和积极应对间起到部分中介效应,中介效应占总效应的14.8%。结论护理管理者应关注临床护士的心理弹性水平,采取措施开展相关培训和教育,预防护士心理危机,促进护士的心理弹性提升。

Objective To evaluate the relationship of problem-solving,coping styles and clinical nurses'resilience.Methods A total of 1073 clinical nurses were investigated with general information questionnaire,the Connor-Davidson Resilience Scale,Chinese Version of the Social Problem-Solving Inventory,Simplified Coping Style Questionnaire.Results The scores of resilience of clinical nurses were(58.18±12.49),which was at a moderate level.Positive coping style,the negative problem orientation,avoidance style,impulse/neglect style were the mainly influencing factors of resilience.Positive coping became a major predictor of protective factors for resilience(β=0.372,P<0.001),and the negative problem orientation became the main predictor of risk factors for resilience(β=-0.324,P<0.001).Analysis of interaction effect showed that positive coping and problem-solving abilities had positive effects on resilience(total effect value:0.509,0.243),the negative problem orientation,avoidance style and impulsive/careless style had negative effects on resilience(total effect value:-0.388,-0.175,-0.079).Problem-solving ability played a partial mediating role between resilience and positive coping 14.8%.Conclusion Nursing administrators should pay attention to resilience of clinical nurses and take measures to carry out relevant training and education,enhance the resilience level of nurses to prevent psychological crisis.