临床护士职业倦怠与资质过剩感及心理契约破裂的相关性分析

Analysis of correlation between overqualification,psychological contract breach and job burnout in clinical nurses

目的了解临床护士职业倦怠现状,分析资质过剩感及心理契约破裂与职业倦怠的相关性,以期为管理者制定降低职业倦怠的干预措施提供参考。方法采用便利抽样法,2023年7—8月选取天津市某三级甲等医院291名护士为调查对象,采用一般资料调查表、职业倦怠量表、资质过剩量表和护士心理契约调查问卷进行问卷调查,并对数据进行分析。结果291名临床护士职业倦怠总分为(49.55±10.27)分,资质过剩感总分为(29.95±10.21)分,心理契约破裂总分为(66.40±18.07)分。临床护士职业倦怠与资质过剩感及心理契约破裂均呈正相关(r=0.540、0.691,均P<0.01),职业倦怠中情绪衰竭、玩世不恭与资质过剩感及心理契约破裂各维度均呈正相关(r=0.405~0.583,均P<0.01),成就感低落与资质过剩感及心理契约破裂各维度均呈负相关(r=-0.548~-0.390,均P<0.01)。最高学历、值夜班次数、日均睡眠时间、资质过剩感及心理契约破裂均是临床护士职业倦怠的影响因素(均P<0.05),其中资质过剩感及心理契约破裂是护士职业倦怠的主要影响因素,可解释总变异的42.4%。结论天津市某三级甲等医院291名临床护士职业倦怠处于中等水平,职业倦怠与资质过剩感和心理契约破裂呈正相关。管理者可通过降低临床护士的资质过剩感及心理契约破裂水平,以减弱其职业倦怠感,进而降低护士离职率,维持医疗卫生服务体系的稳定发展。

Objective To understand the current situation of job burnout among clinical nurses,and to analyze the correlation between overqualification and psychological contract breach with job burnout,with a view to providing reference for managers to formulate interventions to reduce job burnout.Methods Convenience sampling method was used to select 291 nurses from a grade-A tertiary hospital in Tianjin from July to August 2023 as survey subjects.General information questionnaire,Maslach burn-out inventory general survey,perceived overqualification scale,and psychological contract questionnaire of nursing staff were used for questionnaire survey,and the data were analyzed.Results The total score of 291 clinical nurses'job burnout,overqualification and psychological contract breach were(49.55±10.27),(29.95±10.21)and(66.40±18.07)points,respectively.The job burnout of clinical nurses was positively correlated with overqualification and psychological contract breach(r=0.540,0.691,both P<0.01),the emotional exhaustion dimension and the cynicism dimension of job burnout were positively correlated with each of the dimensions of overqualification and psychological contract breach(r=0.405-0.583,all P<0.01),and the dimensions of the sense of underachievement were negatively correlated with each of the dimensions of overqualification and psychological contract breach(r=-0.548--0.390,all P<0.01).The highest educational level,number of night shifts,average daily sleep time,overqualification and psychological contract breach were all the influencing factors of job burnout among clinical nurses(all P<0.05),among which the overqualification and the psychological contract breach were the main influencing factors of job burnout among nurses,which could explain 42.4%of the total variance.Conclusion Totally 291 clinical nurses in a grade-A tertiary hospital in Tianjin have moderate levels of occupational bumout,which is positively correlated with overqualification and psychological contract breach.Managers can reduce the level of clinical nurses'overqualification and psychological contract breach in order to weaken their job burnout,and then reduce the rate of nurses'turnover and maintain the stable development of the health care service system.