湖北省5家三级甲等综合医院精神科护士知觉压力、职业倦怠与心理健康的现状及相关性

Status and correlation of perceived stress,job burnout and mental health of psychiatric nurses in five grade-A tertiary general hospitals in Hubei Province

目的了解湖北省5家三级甲等综合医院精神科护士知觉压力和职业倦怠与心理健康的现状及相关性。方法选取2019年9—11月在湖北省5家三级甲等综合医院精神科病房的186名护士为研究对象,采用自制的一般情况调查表、知觉压力量表(PSS)、症状自评量表(SCL-90)和MASLACH职业倦怠量表-服务行业版(MBI-HSS)进行调查并分析精神科护士知觉压力、职业倦怠与心理健康的水平。结果186名精神科护士PSS评分为39.48±7.43,MBI-HSS评分为68.11±12.95,情感衰竭、去人格化倾向和个人成就感都以中度为主,分别占51.1%、54.3%和43.0%。SCL-90评分为149.61±41.27,所调查的精神科护士SCL-90量表躯体化、强迫、人际敏感、抑郁、焦虑、敌意、恐怖和偏执评分及总分均高于全国常模(t=9.591、7.601、5.282、4.611、11.215、11.399、6.325、3.925和7.451,均P<0.01)。Pearson相关分析结果显示,PSS量表评分与MBI-HSS量表情感衰竭、去人格化倾向维度评分及总分均呈正相关(r=0.641、0.540、0.608,均P<0.01),与个人成就感维度评分呈负相关(r=-0.440,P<0.01)。PSS量表评分与SCL-90量表的各个维度评分及总分均呈正相关性(r=0.387、0.584、0.521、0.543、0.518、0.519、0.388、0.466、0.361和0.533,均P<0.01),MBI-HSS量表情感衰竭维度评分与SCL-90量表的各个维度及总分均呈正相关(r=0.550、0.688、0.659、0.669、0.640、0.641、0.509、0.579、0.570和0.688,均P<0.01),MBI-HSS量表去人格化倾向维度评分与SCL-90量表的各个维度及总分均呈明显正相关性(r=0.349、0.550、0.560、0.537、0.457、0.535、0.376、0.408、0.503和0.529,均P<0.01),个人成就感评分与SCL-90量表各个维度及总分均呈明显的负相关性(r=-0.381、-0.468、-0.470、-0.467、-0.434、-0.367、-0.420、-0.358、-0.515和-0.486,均P<0.01),职业倦怠总分与SCL-90量表的各个维度及总分均呈正相关(r=0.252、0.358、0.339、0.341、0.316、0.387、0.205、0.308、0.225和0.339,均P<0.05)。结论湖北省5家三级甲等综合医院精神科护士普遍存在知觉压力、职业倦怠与心理健康问题,且三者存在着明显的相关性,降低精神科护士的知觉压力及职业倦怠感有助于提高护士的心理健康水平。

Objective To study the status and correlation of perceived stress,job burnout and mental health of psychiatric nurses in five grade-A tertiary general hospitals in Hubei Province.Methods 186 psychiatric nurses were collected from five grade-A tertiary general hospitals in Hubei Province from September November 2019.The self-designed general situation questionnaire,perceived stress scale(PSS),symptom checklist scale(SCL-90)and Maslach burnout inventory-human service survey(MBI-HSS)were used to investigate and analyze the levels of perceived stress,job burnout and mental health of psychiatric nurses.Results PSS score of 186 psychiatric nurses was 39.48±7.43,MBI-HSS score was 68.11±12.95.The emotional exhaustion,depersonalization tendency and personal achievement were mainly at the medium level,accounting for 51.1%,54.3%and 43%,respectively.SCL-90 score was 149.61±41.27,and the score of somatization,compulsion,interpersonal sensitivity,depression,anxiety,hostility,terror and paranoia of SCL-90 and total SCL-90 score of psychiatric nurses were higher than the national norms(t=9.591,7.601,5.282,4.611,11.215,11.399,6.325,3.925,7.451,all P<0.01).Pearson correlation analysis showed that the score of PSS scale was significantly positively correlated with the scores emotional exhaustion and the depersonalization dimension of MBI-HSS scale and the total score(r=0.641,0.540,0.608,both P<0.01),and was significantly negatively correlated with the score of personal achievement dimension(r=-0.440,P<0.01).The score of PSS scale was significantly positively correlated with the each dimension score and total score of SCL-90 scale(r=0.387,0.584,0.521,0.543,0.518,0.519,0.388,0.466,0.361 and 0.533,all P<0.01).The emotional exhaustion score of MBI-HSS scale was significantly positively correlated with the score of each dimension and total score of SCL-90 scale(r=0.550,0.688,0.659,0.669,0.640,0.641,0.509,0.579,0.570,0.688,all P<0.01).The depersonalization dimension score of MBI-HSS scale was significantly positively correlated with the score of each dimension and total score of SCL-90 scale(r=0.349,0.550,0.560,0.537,0.457,0.535,0.376,0.408,0.503,0.529,all P<0.01),while the total score of personal achievement was significantly negatively correlated with the score of of each dimension and total score of SCL-90 scale(r=-0.381,-0.468,-0.470,-0.467,-0.434,-0.367,-0.420,-0.358,-0.515,-0.486,all P<0.01).The total score of MBI-HSS scale was significantly positively correlated with the score of each dimension and total score of SCL-90 scale(r=0.252,0.358,0.339,0.341,0.316,0.387,0.205,0.308,0.225,0.339,all P<0.05).Conclusion Perceived stress,job burnout and mental health problems are common among psychiatric nurses in five grade-A tertiary general hospitals in Hubei Province,and there is a significant correlation among them.Reducing the perceived pressure and job burnout of psychiatric nurses is helpful to improve their mental health.