正念冥想干预对护士第二受害者的职业认同及其离职倾向的影响

The impact of mindfulness meditation intervention on the occupational identity and turnover intention of the second victim of nurses

目的探讨正念冥想干预对护士第二受害者的职业认同及其离职倾向的影响。方法采用便利抽样法抽取2019年1—6月武汉大学中南医院46名在半年内经历过医疗不良事件的护士第二受害者,然后为她们开展了8周正念冥想干预。在整个干预过程中,采用自身前后对照设计,分别于干预前、干预2 h、干预4周和干预8周后采用第二受害者经验及支持量表(SVSET)和护士职业认同量表评估护士第二受害者的离职倾向、缺勤及其职业认同感水平。结果护士第二受害者在经过正念冥想干预后,离职倾向在干预前、干预2 h、干预4周、干预8周分别为(3.28±0.87)、(3.20±0.83)、(2.85±0.92)、(2.71±0.87)分;职业认同总分分别为(95.83±10.65)、(107.72±10.21)、(117.24±16.08)、(120.26±12.89)分;职业认同中把握感分别为(4.91±0.83)、(5.47±0.81)、(5.83±0.91)、(5.94±0.80)分;一致感分别为(4.61±0.78)、(5.09±0.85)、(5.54±1.12)、(5.76±0.85)分;有意义感分别为(4.38±1.03)、(5.04±0.75)、(5.44±0.86)、(5.59±0.76)分;自我效力感分别为(4.71±0.82)、(5.33±0.63)、(5.83±0.84)、(5.90±0.77)分;自我决定感分别为(4.43±0.97)、(5.06±0.81)、(5.59±0.91)、(5.62±0.87)分;组织影响感分别为(4.17±0.96)、(4.71±0.85)、(4.96±0.99)、(5.30±0.88)分;患者影响感分别为(4.59±0.96)、(5.08±0.84)、(5.70±0.83)、(5.83±0.68)分,差异有统计学意义(F时间值为6.609~48.132,P<0.05或0.01)。结论正念冥想干预可有效降低护士第二受害者的离职倾向并提高她们的职业认同感,为帮助护士第二受害者走出困境提供了一种有效方法。

Objective To explore the influence of mindfulness meditation intervention on the professional identity and turnover tendency of the second victim of nurses.Methods The convenience sampling method was used to select the second victim of 46 nurses who experienced medical adverse events within six months from January to June 2019 in Zhongnan Hospital of Wuhan University,and then an 8 weeks of mindfulness meditation intervention was carried out for them.In the entire intervention process,a self-control study was conducted,the Second Victim Experience and Support Scale(SVSET)and the Nurse Occupational Identity Scale were used to assess nurses'turnover intentions,absence and professional identity before the intervention and at 2 hours,4 weeks,and 8 weeks after the intervention.Results By analyzing the data,the results showed that after the mindfulness meditation intervention,the second victim of the nurse before intervention,2h,4 weeks,and 8 weeks of intervention were 3.28±0.87,3.20±0.83,2.85±0.92,2.71±0.87,the difference was statistically significant(Ftime value was 6.609,P<0.05).Before and after the intervention of the sense of grasp in professional identity were 4.91±0.83,5.47±0.81,5.83±0.91,5.94±0.80,the difference was statistically significant(Ftime value was 20.973,P<0.01).Consensus before and after intervention were 4.61±0.78,5.09±0.85,5.54±1.12,5.76±0.85,the difference was statistically significant(Ftime value was 22.237,P<0.01).The meaningful sense before and after intervention were 4.38±1.03,5.04±0.75,5.44±0.86,5.59±0.76,the difference was statistically significant(Ftime value was 23.656,P<0.01).The self-efficacy before and after intervention were 4.71±0.82,5.33±0.63,5.83±0.84,5.90±0.77,the difference was statistically significant(Ftime value was 28.866,P<0.01).The self-determination before and after intervention were 4.43±0.97,5.06±0.81,5.59±0.91,5.62±0.87,the difference was statistically significant(Ftime value was 25.237,P<0.01).Before and after intervention,the influence of tissue was 4.17±0.96,4.71±0.85,4.96±0.99,5.30±0.88,the difference was statistically significant(Ftime value was 16.487,P<0.01).Before and after intervention,the patients'feelings were 4.59±0.96,5.08±0.84,5.70±0.83,5.83±0.68,the difference was statistically significant(Ftime value was 25.406,P<0.01).Conclusion This article provides an effective method to help nurses'second victims out of their predicament which confirms that mindfulness meditation intervention can effectively reduce turnover tendency of nurses'second victims and improve their professional identity.