急诊科护士遭遇医疗暴力与职业紧张及职业倦怠感的相关性

Correlations between medical violence and occupational stress,job burnout among nurses in emergency department

目的调查急诊科护士遭遇医疗暴力情况,分析遭受医疗暴力与职业紧张、职业倦怠感的相关性。方法于2019年6—12月随机抽取宜宾市4家综合医院急诊科护士124人,采用医务场所暴力测定量表调查遭受医疗暴力情况,攻击及暴力管理态度量表(MAVAS)评估护士对医疗暴力行为原因及其管理的认识和态度,职业紧张量表(OSI-R)评估护士职业紧张情况,护士职业倦怠量表(NBS)评估护士职业倦怠感,分析遭遇医疗暴力与职业紧张及职业倦怠感的相关性。结果医务场所暴力测定量表评分为6.7±3.8,其中遭受医疗暴力零频度3人(2.4%),低频度49人(39.5%),中频度51人(41.2%),高频度21人(16.9%);MAVAS评分为91.0±11.7。不同性别、年龄和医院级别急诊科护士医疗场所暴力测定量表评分和MAVAS评分比较差异均无统计学意义(均P>0.05)。护士职业紧张量表中,职业任务问卷(ORQ)、个体紧张反应问卷(PSQ)和个体应变能力问卷(PRQ)得分分别为182.8±31.2、140.6±26.8和125.0±23.4,NBS总分为169.4±19.2,除NBS的压力源维度得分在不同年龄段比较差异有统计学意义外,QSI-R和NBS的总分和各维度评分比较差异均无统计学意义(均P>0.05)。医疗场所暴力评分与PRQ呈负相关,与ORQ、PSQ、NBS及其各维度均呈正相关(均P<0.05)。结论宜宾市4家综合医院急诊科护士遭遇医疗场所暴力发生率高,其遭遇医疗暴力情况与职业紧张和职业倦怠感有相关性,应加强专项培训防范医疗暴力行为。

Objective To survey the status of nurses in emergency department experienced medical violence,explore the correlations between medical violence and occupational stress,job burnout.Methods From June to December 2019,124 emergency nurses were selected randomly from four general hospitals in Yibin City.The medical violence measurement scale was use to investigate the status of medicalviolence,the management of aggression and violence attitude scale(MAVAS)was use to assess nurses'understanding and attitude to the causes and management of medical violence,the occupational stress inventory revised edition(OSI-R)was use to evaluate the occupational stress of nurses,and the nurse burnout scale(NBS)was use to evaluate the job burnout of nurses.The correlations between medical violence and occupational stress,job burnout were analyzed.Results The score of medical violence scale was 6.7±3.8.There were 3(2.4%)nurses with zero frequency of medical violence,49(39.5%)with low frequency,51(41.2%)with middle frequency and 21(16.9%)with frequency.The score of MAVAS was 91.0±11.7.There were no statistically significant differences in medical violence scale score and MAVAS score among emergency nurses in different gender,age and hospital grade(all P>0.05).In nurses'occupational stress scales,the score of occupational role questionnaire(ORQ),personal strain questionnaire(PSQ)and personal resources questionnaire(PRQ)was 182.8±31.2,140.6±26.8 and 125.0±23.4,respectively.The total score of NBS was 169.4±19.2.Except that the difference in the score of pressure source dimension of NBS was statistically significant among age groups,there were no statistically significant differences in total scores and dimension scores of QSI-R and NBS(all P>0.05).The score of medical violence was negatively correlated with PRQ,and positively correlated with ORQ,PSQ,NBS and their dimensions(all P<0.05).Conclusion The incidence of medical violence among emergency nurses of four general hospitals in Yibin City is high,which is related to occupational stress and burnout.Special training should be strengthened to prevent medical violence.