上海市急诊科护士抗逆力的潜在类别及影响因素研究

Potential categories and influencing factors of resilience among emergency department nurses in Shanghai

目的探讨上海市急诊科护士抗逆力的潜在类别,分析抗逆力潜在类别的影响因素,为护理管理者制定个性化的抗逆力干预方案提供依据。方法2021年6—10月,以方便抽样法选取上海市2所三级医院和2所二级医院349名急诊科护士,采用《医护人员抗逆力量表》《工作重塑量表》《员工工作激情量表》《领导选择感知量表》对研究对象进行问卷调查,使用潜在剖面分析模型识别抗逆力的潜在类别,并用多分类logistic回归模型分析潜在类别的影响因素。结果回收有效问卷343份,有效回收率98.28%。343名护士抗逆力得分为(71.33±11.41)分,其中决策应对维度(24.84±3.91)分,人际联结维度(16.93±2.57)分,理性思维维度(15.70±2.93)分,柔性自适维度(15.87±3.02)分。急诊科护士抗逆力可分为3个潜在类别,即低抗逆力组(51名,占14.9%)、中等抗逆力组(103名,占30.0%)和高抗逆力组(189名,占55.1%)。logistic回归分析结果显示:工作重塑得分每增加1分,低抗逆力组护士转变为中等抗逆力(波动型)组护士的可能性增加到1.109倍(P<0.001)。工作重塑、工作激情得分每增加1分,低抗逆力组护士转变为高抗逆力组护士的可能性分别增加到1.194、1.094倍(均P<0.01)。结论急诊科护士抗逆力的3个潜在类别呈现出人群特征差异。护理管理者应因人而异,采取阶段性的干预措施,如提升护士的工作激情和工作重塑等方式,增加急诊科护士的抗逆力水平。

Objective To explore the potential categories of resilience in emergency nurses and to analyze the influencing factors in these categories in Shanghai,providing a basis for nursing managers to formulate personalized intervention programs.Methods From June to July 2021,349 nurses in the emergency department from two top tertiary general hospitals and two secondary hospitals in Shanghai were selected by convenience sampling and surveyed using the questionnaires of the Resilience Scale of Medical Staff,the Job Crafting Scale,the Employee Work Passion Scale,and the Perceived Leader Selection Scale.The potential profile analysis model was used to identify the potential categories of stress resistance,and the multi-classification logistic regression model was used to explore the influencing factors of the potential categories.Results A total of 343 valid questionnaires were collected,with a response rate of 98.28%.The mean of the total resilience score of the 343 participants was(71.33±11.41),including decisional coping(24.84±3.91),interpersonal connections(16.93±2.57),rational thinking(15.70±2.93),and flexible adjustment(15.87±3.02).Three latent classes of resilience were identified:the low resilience group(51,14.9%),the moderate resilience group(103,30.0%),and the high resilience group(189,55.1%).Logistic regression analysis showed that for each point increase in work remodeling score,the odds of low resilience nurses transitioning to the moderate resilience group increased to 1.109 times(P<0.001).For each point increase in work remodeling and work passion scores,the odds of low resilience nurses transitioning to the high resilience groups increased to 1.194 and 1.094 times,respectively(both P<0.01).Conclusions Three latent classes of resilience were identified among emergency department nurses with distinct group characteristics.Nursing managers should adopt individualized and phased intervention measures,such as enhancing nurses’work passion and work remodeling,to improve the resilience level of emergency department nurses.