三级医院急诊科护士患者安全文化感知在其职业倦怠与安全行为中的中介效应分析

Mediating effect of perceived patient safety culture on job burnout and safety behavior of nurses in Emergency Department of ClassⅢhospitals

目的探讨三级医院急诊科护士患者安全文化感知在职业倦怠及其安全行为中的中介作用。方法本研究为横断面研究。采用目的抽样与方便抽样相结合的方法,于2021年2月26日—3月14日选取9个省/直辖市的39家医院455名急诊科护士为研究对象。采用一般资料问卷、职业倦怠量表、医疗保健机构患者安全文化测评量表、护士安全行为问卷进行调查。共收回有效问卷428份,有效回收率为94.07%。结果428名急诊护士职业倦怠得分为52(38,64)分,患者安全文化得分为150(139,166)分,护士安全行为得分为54(49,58)分。急诊科护士的职业倦怠得分与患者安全文化感知得分(r=-0.661,P<0.01)、护士安全行为得分(r=-0.513,P<0.01)均呈负相关;急诊科护士的患者安全文化感知得分与其安全行为得分呈正相关(r=0.482,P<0.01)。急诊科护士患者安全文化感知在其职业倦怠与安全行为中具有中介效应,占总效应的34.90%。结论三级医院急诊科护士具有中度的职业倦怠,其安全行为及对患者安全文化的感知还有提升空间,在三者关系中,患者安全文化感知在职业倦怠与护士安全行为中具有一定的中介效应。在急诊科护理管理中,可采取系列措施预防或降低急诊科护士职业倦怠水平、加强患者安全文化建设,提升护理行为的安全性。

Objective To explore the mediating effect of perceived patient safety culture on job burnout and safety behavior among nurses in Emergency Departments of ClassⅢhospitals.Methods This study was a cross-sectional study.From February 26 to March 14,2021,455 Emergency Department nurses from 39 hospitals in 9 provinces/municipalities were selected as the participants by a combination of purposeful sampling and convenience sampling.455 Emergency Department nurses was conducted through WeChat using the General Information Questionnaire,Maslach Burnout Inventory(MBI),Hospital Survey on Patient Safety Culture(HSOPSC),and the Nurse Safety Behavior Questionnaire(NSBQ).A total of 428 valid questionnaires were collected,with a valid recovery rate of 94.07%.Results Among 428 Emergency Department nurses,the scores of job burnout,perceived patient safety culture and nurse safety behavior were 52(38,64),150(139,166)and 54(49,58),respectively.The job burnout score of Emergency Department nurses was negatively correlated with the perceived patient safety culture score(r=-0.661,P<0.01)and the safety behavior score(r=-0.513,P<0.01).There was a positive correlation between the perceived patient safety culture score and the safety behavior score of Emergency Department nurses(r=0.482,P<0.01).The perceived patient safety culture of Emergency Department nurses has a mediating effect between their job burnout and safety behavior,accounting for 34.90%of the total effect.Conclusions Nurses in Emergency Department of ClassⅢhospitals have moderate job burnout,and there is room for improvement in their safety behaviors and perceived patient safety culture.In the relationship among the three,perceived patient safety culture has a certain mediating effect between job burnout and safety behavior of nurses.In Emergency Department nursing management,a series of measures can be taken to prevent or reduce the job burnout of nurses,strengthen the construction of patient safety culture and other measures to improve the safety of nursing behavior.