护士职业紧张与抑郁情绪的关系:组织支持感和心理资本的作用路径

Relationship between occupational stress and depression among nurses:the path of perceived organizational support and psychological capital

背景由于工作的特殊性,护士易产生抑郁情绪。抑郁情绪不仅危害护士的身心健康,还会在一定程度上影响护理质量。职业紧张是护士出现抑郁情绪的影响因素之一,然而探索二者内在作用路径的研究有限。目的探究组织支持感和心理资本在护士职业紧张与抑郁情绪之间的作用路径,为改善护士因职业紧张而产生的抑郁情绪提供参考。方法于2019年3月—8月,采用分层随机抽样法选取山东省某三级甲等医院的720名护士为研究对象。采用付出-回报失衡问卷(ERI)、组织支持感量表(POS)、心理资本量表(PCQ)以及流调中心用抑郁量表(CES-D)进行评定。采用Pearson相关分析考查各量表评分之间的相关性。采用SPSS 26.0宏程序Process 3.3插件中的模型6,通过Bootstrap法进行中介效应分析。结果共658名(91.39%)护士完成有效问卷调查。ERI评分与CES-D评分呈正相关(r=0.499,P<0.01),与POS评分和PCQ评分均呈负相关(r=-0.318、-0.275,P均<0.01);POS评分与PCQ评分呈正相关(r=0.455,P<0.01),与CES-D评分呈负相关(r=-0.401,P<0.01);PCQ评分与CES-D评分呈负相关(r=-0.567,P<0.01);职业紧张对抑郁情绪影响的总效应为0.466(95%CI:0.399~0.534);组织支持感(间接效应值为0.027,95%CI:0.006~0.057)和心理资本(间接效应值为0.059,95%CI:0.013~0.120)均为职业紧张与抑郁情绪之间的作用路径,且组织支持感和心理资本是职业紧张和抑郁情绪之间的链式作用路径(间接效应值为0.051,95%CI:0.031~0.082),链式路径效应占比为10.94%。结论职业紧张是护士产生抑郁情绪的影响因素,职业紧张既可以直接影响抑郁情绪,也可以通过组织支持感和心理资本的独立作用路径或链式作用路径影响抑郁情绪。

Background Due to the prominent particularity of medical work,nurses are prone to developing depression,which not only poses a considerable threat to the physical and mental health of nurses,but also affects the quality of nursing to some extent.Occupational stress is a known contributor to depression in nurses,whereas relatively little research has been done to investigate the underlying mediation path.Objective To explore the mediation effect of perceived organizational support and psychological capital on the relationship between occupational stress and depression among nurses,and to provide theoretical references for the prevention and treatment of occupational stress-induced depression in nurses.Methods From March to August 2019,a stratified random sampling method was utilized to select a sample size of 720 nurses in each department of a grade A tertiary hospital in Shandong Province.All subjects were assessed using Effort-Reward Imbalance Questionnaire(ERI),Perceived Organization Support Questionnaire(POS),Psychological Capital Questionnaire(PCQ)and Center for Epidemiologic Studies Depression Scale(CES-D).Pearson correlation was adopted to examine the correlation among above scales,and multilevel mediation analyses were conducted with model 6 in Process macro(version 3.3)for SPSS 26.0 using Bootstrap re-sampling method.Results A total of 658 nurses(91.39%)completed the effective questionnaire survey.ERI score was positively correlated with CES-D score(r=0.499,P<0.01),and negatively correlated with POS and PCQ scores(r=-0.318,-0.275,P<0.01).POS score was positively correlated with PCQ score(r=0.455,P<0.01),and negatively correlated with CES-D score(r=-0.401,P<0.01).PCQ score was negatively correlated with CES-D score(r=-0.567,P<0.01).The total effect value of occupational stress on depression was 0.466(95%CI:0.399~0.534).Perceived organizational support(indirect effect value of 0.027,95%CI:0.006~0.057)and psychological capital(indirect effect value of 0.059,95%CI:0.013~0.120),separately from each other,mediated the relationship between occupational stress and depression,and a chained mediation effect of perceived organizational support and psychological capital was also demonstrated(indirect effect value of 0.051,95%CI:0.031~0.082),accounting for 10.94%of the total effect.Conclusion Occupational stress is a influencing factor of nurses'depression,which can affect the occurrence of depression both directly and indirectly through either separate or chained mediation of perceived organizational support and psychological capital.