【作者】 李静；

【导师】 曹枫林；

【作者基本信息】 山东大学 ， 护理学， 2021， 硕士

【摘要】 目的:本研究关注山东省精神科护士的职业倦怠状况,使用潜在剖面分析(Latent Profile Analysis,LPA)识别精神科护士中不同的职业倦怠类型,并进一步探究不同类型的风险因素的累积效应。方法:本研究采用分层整群抽样的方法,于2019年对山东省四家精神病医院进行调查。首先将山东省17个地市级按照经济发展水平分为4层:发达、较发达、一般、欠发达,在每层内将所有城市进行编号,随机抽取一家精神病专科医院,然后根据纳入排除标准对该院的临床护士进行招募。使用研究者自己设计的一般资料情况问卷(包括人口学特征如年龄、受教育程度等和工作相关特征如工作年限、职称等)、马氏职业倦怠量表(Maslach Burnout Inventory-Human Service Survey,MBI-HSS)、归因方式量表、情绪调节量表(Emotion Regulation Questionnaire,ERQ)、心理弹性量表简化版、工作相关生活质量量表第 2 版(Work-related Quality of Life Scale-2,WRQoL-2)、工作要求-工作控制量表(Job Demands and Decision Latitude)和付出-获得不平衡量表(Effort-Reward Imbalance Questionnaire,ERI)。共发放问卷 800 份,回收 781 份,排除主要变量(职业倦怠)缺失的25例,共有756例精神科护士被纳入本研究。数据分析所用到的软件包括SPSS25.0和Mplus7.0。采用LPA、描述性分析、单因素分析和多分类Logistic回归分析等统计学方法。结果:1.一般资料情况如下:本研究中精神科护士平均年龄(35.04±8.45)岁;其中,77.8%为女性;78.7%为已婚护士;78.4%为本科及以上学历。2.潜在剖面分析结果显示,精神科护士职业倦怠可分为4类,分别命名为“低倦怠型”(43.7%)、“中倦怠型”(33.1%)、“高倦怠型”(15.1%)和“成就感不足型”(8.2%)。3.不同潜在职业倦怠类型精神科护士的人口学和工作相关特征比较:本研究中单因素比较结果显示,不同潜在职业倦怠类型精神科护士在性别、年龄、职称和工作年限上的差异有统计学意义(P<0.05)。以职业倦怠类型作为因变量(参照组:“低倦怠型”),将以上变量均纳入多分类Logistic回归模型中,结果显示职业倦怠类型与性别和职称的关系存在统计学意义。4.不同潜在职业倦怠类型精神科护士的累积风险指数的高低排序为:“高倦怠型”(6.78±1.50)>“中倦怠型”(5.92±1.44)>“成就感不足型”(5.06±1.61)>“低倦怠型”(4.42±1.81),(P均<0.05)。5.在控制了一般资料变量后,以“低倦怠型”为参照,随着累积风险指数的增加,精神科护士进入“中倦怠型”、“高倦怠型”和“成就感不足型”各组的风险均是增加的,且进入“高倦怠型”组的风险是最高的,其次是“中倦怠型”、“成就感不足型”,OR值分别为 2.73(2.27,3.29)、1.84(1.61,2.09)和 1.28(1.06,1.54)。结论:1.精神科护士的职业倦怠分类特征较为明显,可分为4个潜在类别,分别命名为“低倦怠型”、“中倦怠型”、“高倦怠型”和“成就感不足型”。2.从个人因素和工作环境因素两个方面来评估精神科护士职业倦怠的累积风险,不同职业倦怠类型组别的累积风险指数存在差异。3.风险因素对精神科护士不同潜在职业倦怠类型的影响存在累积效应。更多还原

【Abstract】 ObjectiveThe aim of this study was to investigate job burnout among psychiatric nurses in Shandong Province,to identify different types of job burnout among psychiatric nurses using Latent Profile Analysis(LPA),and to further explore the cumulative effects of risk factors among the different types.MethodsThis study investigated four psychiatric hospitals in Shandong Province and selected nurses from them by a stratified cluster sampling method.Firstly,according to the level of economic development,the 17 prefectures and cities in Shandong Province are divided into four layers:developed,relatively developed,general and underdeveloped.All cities are numbered in each layer,and the numbers are selected randomly.Then,the survey objects are recruited according to the extracted results.Using general information questionnaires designed by the researchers themselves(including demographic characteristics such as age,education level,etc.,and job-related characteristics such as years of service,title,etc.),Maslach burnout inventory-human service survey(MBI-HSS),attribution style scale,Emotion Regulation Questionnaire,ERQ),simplified version of resilience scale,work-related quality of life scale-2(WRQoL-2),Job Demands and Decision Latitude and effort-reward imbalance questionnaire(ERI).A total of 800 questionnaires were sent out and 781 were recovered.25 individuals with missing major variables(job burnout)were excluded.A total of 756 psychiatric nurses were included in this study.Data analysis were performed by SPSS25.0 and Mplus 7.0.Statistical methods including LPA,descriptive analysis,univariate analysis and multinomial Logistic regression analysis were used.Results1.General profile of psychiatric nurses:(35.04±8.45)years;of these,77.8%were female;78.7 were married nurses;and 78.4%of participants had a bachelor’s degree or higher in education.2.The results of the latent profile showed that psychiatric nurses’job burnout could be divided into four categories,named "low job burnout"(43.7%),"moderate job burnout"(33.1%),"high job burnout "(15.1%)and "insufficient accomplishment job burnout"(8.2%).3.Comparison of demographic and work-related characteristics of psychiatric nurses with different latent job burnout types:The results of the one-way comparison in this study showed that the differences between psychiatric nurses with different latent job burnout types were statistically significant in terms of age,gender,years of work experience and job title(p<0.05).Using burnout category as the dependent variable and "low burnout" as the baseline reference category,the above variables were simultaneously included in a multinomial logistic regression model that showed a statistically significant relationship between different potential burnout types and gender and job title4.The cumulative risk indices of the different latent job burnout types of psychiatric nurses were ranked as follows:"high job burnout"(6.78±1.50)>"moderate job burnout"(5.92±1.44)>"insufficient accomplishment job burnout"(5.06±1.61)>"low job burnout"(4.42±1.81),(ps<0.05).5.After controlling for the general information variables,psychiatric nurses moved into the "moderate job burnout","high job burnout" and "insufficient accomplishment job burnout" as the cumulative risk index increased,using "low job burnout" as a reference.The risk of entering the "high job burnout" was the highest,followed by the "moderate job burnout","insufficient accomplishment job burnout"and "high job burnout"groups[OR:2.73(2.27,3.29),1.84(1.61,2.09)and 1.28(1.06,1.54)respectively].Conclusions1.Job burnout of psychiatric nurses has obvious classification characteristics.They are named "low job burnout","moderate job burnout","high job burnout" and"insufficient accomplishment job burnout"2.The cumulative risk of psychiatric nurses was assessed in terms of both personal and work environment factors,and there were differences in the cumulative risk indices of the different job burnout types.3.There was a cumulative effect of risk factors on psychiatric nurses’different job burnout types.更多还原