临床护士重度职业倦怠预测模型的构建

The preliminary construction of a predictive model for severe job burnout in clinical nurses

目的了解临床护士重度职业倦怠发生的危险因素,并构建预测模型。方法通过便利抽样法收集2021年10月至12月湖北、山西、四川等地区594名临床护士作为调查对象,采用一般资料调查表、职业倦怠量表、良心压力问卷、组织支持量表进行调查。将职业倦怠作为二分类资料处理,应用最优子集回归法筛选出预测因素并构建列线图模型,采用曲线下面积评估预测模型区分度,运用校准度曲线评价模型校准度。结果594名护士检出重度职业倦怠181名,占30.47%。经最优子集回归法筛选出5个预测变量为妇产科、儿科(OR=0.399,95%CI[0.193,0.824])、轮值夜班(OR=1.637,95%CI[1.031,2.587])、加班频率3~5次/周(OR=0.383,95%CI[0.151,0.967])、良心压力(OR=0.236,95%CI[0.088,0.634])、组织支持感(OR=5.664,95%CI[2.326,13.796])。构建的预测模型AUC为0.709,校准曲线与理想概率曲线基本平行。结论临床护士重度职业倦怠预测模型预测效果良好,可为评估护士职业倦怠严重程度提供借鉴。

Objective To understand the risk factors of severe job burnout in clinical nurses,and to build a prediction model.Methods A total of 594 clinical nurses from hospitals in Hubei,Shanxi and Sichuan from October to December 2021 were collected by convenient sampling method.General data questionnaire,Maslach Burnout Inventory General Durvey,Stress of Conscience Questionnaire,Perceived Organizational Support were used to investigate.Job burnout was treated as binary data,the optimal subset regression method was used to screen out the predictive factors and built a line graph model.The area under the cure was used to evaluate the differentiation of the predictive model,and the calibration curve was used to evaluate the calibration of the model.Results Totally,181 nurses were detected with severe job burnout,accounting for 30.47%.Five predictive variables were selected by optimal subset regression method,which were obstetrics and gynecology(OR=0.399,95%CI[0.193,0.824]),night shift(OR=1.637,95%CI[1.031,2.587]),overtime work frequency 3~5 times per week(OR=0.383,95%CI[0.151,0.967]),conscience pressure(OR=0.236,95%CI[0.088,0.634]),perceived organizational support(OR=5.664,95%CI[2.326,13.796]).The AUC of the constructed prediction model was 0.709,and the calibration curve was basically parallel to the ideal probability curve.Conclusion The prediction model of severe job burnout of clinical nurses has good prediction effect,which can provide reference for evaluating the severity of job burnout of nurses.