压力知觉在护士第二受害者人格特质与负性体验间的中介效应

Mediating roles of stress perception between personality traits and negative experience in nurses as second victim

目的探讨护士第二受害者的人格特质对其在患者安全事件中负性体验的影响,以及压力知觉在负性体验影响机制中的中介作用。方法采用便利抽样法,于2023年3月至4月选择太原市3所三级甲等综合医院近3个月内经历过患者安全事件的560名护士作为研究对象,采用一般资料问卷、中国大五人格问卷、第二受害者经历与支持量表、中文版压力知觉量表进行调查,采用Pearson相关性分析护士第二受害者人格特质的神经质维度(以下简称神经质人格)、负性体验与压力知觉间的相关性,依照Bootstrap方法,使用PROCESS插件分析压力知觉在护士第二受害者神经质人格与负性体验间的中介作用。结果回收有效问卷560份,有效回收率100.00%。护士第二受害者人格特质得分从高到低依次为严谨性、宜人性、开放性、神经质、外向性,负性体验得分(40.25±10.64),处于较高水平,压力知觉得分为(30.25±5.98)分,处于较高水平。护士第二受害者神经质人格与负性体验呈正相关(r=0.528,P<0.01),并与压力知觉呈正相关(r=0.594,P<0.01);负性体验与压力知觉呈正相关(r=0.339,P<0.01);护士第二受害者神经质人格对负性体验存在直接效应(β=0.519,95%CI:0.318~0.720),紧张感(压力知觉维度之一)在护士第二受害者神经质人格和负性体验间起部分中介作用,中介效应(β=0.148,95%CI:0.006~0.300),中介作用占比为22.70%。结论护士第二受害者高神经质人格不仅可以直接影响其负性体验,还可以通过紧张感(压力知觉的维度之一)影响其负性体验。护理管理者及护士第二受害者可通过改变高神经质人格及缓解紧张感的角度,减轻其在患者安全事件中的负性体验。

Objective To investigate the impact of influence of personality traits of nurses as second victim and negative experience of nurses in adverse event and explore the intermediary roles of stress perception in influencing mechanism of negative experience.Methods Between March and April 2023,a convenience sampling method was employed to select 560 nurses from 3 general hospitals in Taiyuan City to conduct the study.The selected nurse all had experienced adverse events within last 3 months.The survey employed a general information questionnaire,Chinese big five personality questionnaire,second victim experience and support scale and Chinese version of stress perception scale.Pearson's correlation analysis was conducted to explore the correlation between the personality traits of nurses as second victim(specifically neuroticism),negative experiences and stress perception.The mediating role of stress perception between the neuroticism of nurses as second victim and negative experiences of nurses was analysed using PROCESS plug-in with the Bootstrap method.Results All of 560 distributed questionnaires were recovered,with a 100.00%of response rate.Personality traits of nurses as second victim were ranked in descending order with rigor,agreeableness,openness,neuroticism and extroversion.Both negative experiences and stress perception had higher scores(40.25±10.64 and 30.25±5.98,respectively).Neurotic personality in nurses as second victim was positively correlated with negative experience(r=0.528,P<0.01)and stress perception(r=0.594,P<0.01).Negative experiences showed a positive correlation with stress perception(r=0.339,P<0.01).Neurotic personality of nurses as second victim had a significant direct impact on negative experiences[β=0.519,95%CI:0.318-0.720].As one of the stress perception dimensions,tension played a partial mediating role between neurotic personality in nurses as second victim and negative experience[β=0.148,95%CI:0.006-0.300],and a mediating effect percentage of 22.70%.Conclusions The neurotic personality of nurses as second victim can directly affect the negative experiences,either independently or in conjunction with tension.Nursing managers and nurses as second victims can reduce the negative experiences in adverse events by addressing higher neurotic personality and alleviating tension.