临床护理人员心理负荷现状及与工作投入、疲劳的关系研究

Study on the status of mental workload and its relationship with work engagement and fatigue among clinical nurses

目的调查临床护理人员心理负荷现状及与工作投入、疲劳的关系,探讨三者间的影响路径。方法采用便利抽样法,应用一般资料问卷、NASA任务负荷量表、Utrecht工作投入量表和疲劳量表-14,于2020年2—3月对上海中医药大学附属市中医医院等6所三级医院的临床护理人员进行横断面调查。结果共回收有效问卷776份,临床护理人员心理负荷总分为76.50(69.00,84.00)分。不同年龄、婚育情况、文化程度、职称和工作年限的临床护理人员心理负荷不同(Z=-2.61,H值为10.22~22.41,均P<0.01)。临床护理人员的心理负荷与工作投入、疲劳呈正相关(r=0.27、0.23,均P<0.01),工作投入和疲劳呈负相关(r=-0.23,P<0.01)。中介效应分析显示,心理负荷对疲劳、工作投入具有正向预测作用(β=0.39、0.35,P<0.01);工作投入在心理负荷与疲劳之间存在遮掩效应,与直接效应的比例绝对值为|-0.17/0.39|。结论临床护理人员存在较高水平的心理负荷,通过工作投入的调节作用能够在一定程度上促进高心理负荷的临床护理人员改善疲劳状态。

Objective To explore the current status of mental workload and its relationship with work engagement and fatigue,as well as the impact path among the three.Methods Clinical nurses from six tertiary hospitals including Shanghai Traditional Chinese Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,etc.were selected to conduct a cross-sectional survey using convenience sampling method from February to March 2020.They were investigated by general information questionnaire,NASA Task Load Index(NASA-TLX),Utrecht Work Engagement Scale(UWES),and Fatigue Scale-14(FS-14).Results The total mental workload score of 776 clinical nurses was 76.50(69.00,84.00).Single factor analysis showed that clinical nurses of different ages,marriage and childbirth status,education level,professional title and working years had different mental workload(Z=-2.61,H values were 10.22-22.41,all P<0.01).Bivariate analysis revealed that the mental workload of clinical nurses was positively correlated with work engagement(r=0.27,P<0.01)and fatigue(r=0.23,P<0.01),and work engagement and fatigue were negatively correlated(r=-0.23,P<0.01).Mediation effect analysis demonstrated that mental workload had a positive predictive effect on fatigue(β=0.39,P<0.01)and work engagement(β=0.35,P<0.01);the suppressing effect of work engagement between mental workload and fatigue,the absolute value of the ratio of the suppressing effect to the direct effect was|-0.17/0.39|.Conclusions The mental workload of clinical nurses is at relatively high level.Hospital administrators can partially improve the fatigue state of clinical nurses with high mental load through the adjustment effect of work engagement.