道德困境在临床护士工作场所暴力和共情疲劳间的中介效应分析

Analysis of the mediating effect of moral dilemma between workplace violence and empathy fatigue of clinical nurses

目的探讨道德困境在临床护士工作场所暴力与共情疲劳间的中介效应。方法采用工作场所暴力量表、护士道德困境量表、中文版共情疲劳简短量表对大连市某三级甲等医院的临床护士进行问卷调查。结果近一年内1196名临床护士工作场所暴力发生率为39.4%。临床护士道德困境得分为27.00(10.00,59.75)分。临床护士共情疲劳总分为45.00(27.00,73.75)分。工作场所暴力对共情疲劳具有正向作用(β=0.518,P<0.001),道德困境对共情疲劳具有正向作用(β=0.354,P<0.001),道德困境在工作场所暴力与共情疲劳之间起部分中介作用(间接效应值为0.099),中介效应占总效应的19.11%。结论工作场所暴力可直接影响共情疲劳,也可通过道德困境间接影响共情疲劳。管理者应正向引导护士减轻道德困境,最终改善其共情疲劳状况。

Objective To explore the mediating effect of moral distress between workplace violence and empathy fatigue in clinical nurses.Methods A questionnaire survey of 1196 clinical nurses was conducted by using the Workplace Violence Scale,the Chinese version of Nurse Moral Dilemma Scale and the Chinese version of the Empathy Fatigue Brief Scale.Results The incidence of workplace violence in last year was 39.4%.The score of moral distress was 27.00(10.00,59.75).The total score of empathy fatigue among clinical nurses was 45.00(27.00,73.75).Workplace violence had a positive effect on empathy fatigue(β=0.518,P<0.001),moral distress had a positive effect on empathy fatigue(β=0.354,P<0.001).Meanwhile,moral distress played a partial mediating role between workplace violence and empathy fatigue(indirect effect value 0.099),accounting for 19.11%of the total effect.Conclusion Workplace violence and moral distress can directly and indirectly affect empathy fatigue,so managers need to take effective methods to reduce the frequency of workplace violence,guide nurses to reduce moral distress positively,and improve empathy fatigue ultimately.