【作者】 赵秀丽；

【导师】 朱秋群；

【作者基本信息】 河北医科大学 ， 护理学， 2010， 硕士

【摘要】 目的:本研究旨在通过对实习护生压力源和应对方式的调查与分析,了解护生的主要压力源和应对方式,分析性格、志愿选择方式、学习情况不同的护生压力源和应对方式的差异,为护理教育者改进教学方法,提高护理教育质量提供理论依据。方法:本研究采用整群抽样的方法,对石家庄市三所三级甲等医院的实习护生进行问卷调查。以一般情况调查表、实习护生压力源调查表、应付方式调查表为研究工具。收集到的资料经整理后,用Excel建立数据库,并用SPSS13.0软件进行统计描述和统计分析。结果:1本次调查共发出问卷232份,回收问卷232份,回收率100%,其中有效问卷220份,有效率94.83%。2护生压力平均水平为(1.15±0.45)分,处于中等水平。位于前10位的压力源依序是处理病人紧急情况的能力、接触传染性疾病、自己所具备的知识水平、学校教学与临床需求之间的差距、出现差错的可能性、病人及家属对您的评价、带教教师对您的评价、将所学知识应用于病人的能力、实习中操作技能的要求、带教教师对您的态度。3不同群体护生,压力源和压力水平分析结果:①总的来看,内向护生压力水平高于外向护生(T=2.73,P<0.05),就各因素来说,内向护生在监督与评价、知识和技能的需求、病人情况方面压力水平高于外向护生(P<0.05),在工作性质与内容、病房环境与设备、教学安排方面二者无明显差异。②总的来看,调剂生压力水平高于自愿选择护理的学生(F=3.55,P<0.05)。就各因素来说,调剂生在工作性质与内容方面,压力水平高于自愿选择的护生(F=7.40,P<0.05),在知识与技能的需求、监督与评价、病人的情况、病房环境与设备和教学安排五方面无明显差异。③总的来看,学习稍差的护生压力水平高于学习优秀的护生(F=5.83,P<0.05)。学习稍差的护生在工作性质与内容、病房环境与设备、教学安排、病人的情况四方面,压力水平高于学习优秀的护生(P<0.05)。而在知识技能的需求和监督评价方面,二者无明显差异。4总的来看护生压力应对方式以“解决问题”和“求助”为主,其次依序为“退避”、“幻想”、“合理化”、“自责”。可见,护生的应对方式以积极成熟的方式为主。5不同群体护生,压力应对方式分析结果:①外向护生比内向护生更多的采用解决问题和求助的应对方式(P<0.05)。在幻想、退避、自责、合理化四种应对方式上,两种性格护生无明显差别。②学习优秀和中等的护生比学习稍差的护生更多的采取解决问题和求助的应对方式(P<0.05),而学习稍差的比学习优秀和中等的更多的采取自责的应对方式(F=6.90,P<0.05)。③自愿选择护理的护生比受别人影响选择护理的护生更多的采用解决问题和求助的应对方式(P<0.05),调剂生与自愿选择护理的学生、调剂生与受别人影响选择护理的学生在应对方式上无明显差异。结论:临床实习是护生适应临床环境与人际关系的关键时期,也是最需要带教老师关心和帮助的时期。在这一时期,护生面临着多种压力源,大多数护生能采取积极成熟的应对方式。不同群体的护生感受到的压力大小和采取的应对方式不尽相同,护理教育者应根据不同特点的护生,采取巩固专业思想、激发学习兴趣、给予心理支持等多种方法,积极帮助护生减轻在实习期间遇到的各种压力,指导和培养护生对压力采取积极的应对方式,以帮助护生顺利度过临床实习时期,提高护理教学质量。更多还原

【Abstract】 Objective: The purpose of this study was to know nursing students’major stressors and coping style through the investigation and analysis of the nursing students during clinical practice. We analyzed the difference in stressors and coping style of different nursing students in character, voluntary choice and learning situation, in order to provide a theoretical basis for nursing educator improving teaching methods and doing good clinical teaching.Methods: This research adopted a method of cluster sampling. A questionnaire of 220 nursing students who practiced in three hospitals of Shijiazhuang was made. The questionnaires included demographic questionnaire, nursing students’stressors scale, coping style questionnaire. Collected data was entered into database by Excel. SPSS13.0 software was applied to analyze the difference in different students which adopted descriptive analysis, t-test, chi-squared test.Results:1 232 subjects completed a questionnaire. The response rate was 100%. 220 valid questionnaires were used in final analysis, validity rate was 94.83%.2 Overall, the stress level of nursing students was at the middle level, the score was 1.15±0.45. The top ten stressors included the ability to deal with patient emergencies, contacting with contagious diseases, the level of knowledge of oneself, the gap between clinical requirement and school teaching, the possibility of making errors, the evaluations of patients and their family, the evaluations of clinical teacher, the ability of making use of knowledge, the requirement of manipulative skill, teachers’attitude toward nursing students.3 The analytic result of different groups about stressor and pressure level:①The pressure level of students with introversive personality was higher than that of students with extroversive personality(T=2.73, P<0.05). As to the attitude and evaluation, the requirement of knowledge and skill, patients’status, the students of introversive personality had more pressure than the students of extroversive personality(P<0.05). As to the content and character of nursing, the circumstance and equipment of patients’room, teaching arrangement, there was no significant difference among different groups.②The adjusted students had more pressure than the students who voluntarily choosed nurse (F=3.55, P<0.05). As to the content and character of nursing, the pressure level of adjusted students was higher than that of the students who voluntarily choosed nurse (F=7.40, P<0.05). There was no significant difference among different groups in supervision and evaluation, the requirement of knowledge and skill, patients’status, the circumstance and equipment of patients’room, teaching arrangement.③The students who had bad performance had more pressure than the excellent students(F=5.83, P<0.05). As to the nursing content and character, the circumstance and equipment of patients’room, teaching arrangement, patients’status, the students who performed badly had more pressure than the students who performed excellently(P<0.05). However, as to the requirement of the knowledge and skill, the supervision and evaluation, there was no significant difference in different groups.4 The main coping styles of nursing students were solving problem and asking for help. Then, coping styles were retread factor, fantasy factor, rationalization factor, self-abuse factor. Therefore, most students could adopt positive coping style.5 The analytic result of coping style about different groups:①The students of extroversive personality were easier to adopt solving problem and asking for help than the students of introversive personality(P<0.05). There was no significant difference in other coping styles.②The students who performed excellently and moderately were easier to adopt solving problem and asking for help than the students who performed badly(P<0.05); Though, the students who performed badly were easier to adopt self-abuse than the students who performed excellently and moderately(F=6.90, P<0.05).③The students who voluntarily choosed nurse were easier to adopt solving problem and asking for help than the students who choosed nurse affected by others(P<0.05). Adjusted students had no significant difference from the students who voluntarily choosed nurse and the students who choosed nurse affected by others.Conclusion:Clinical practice was crucial period for nursing students to adapt to clinical circumstance and interpersonal relationship. They required clinical teachers’concern and help. Meanwhile, nursing students faced with many kinds of stressors. Most students could adopt positive coping style. The pressure level was different for different groups of nursing students. They adopted different ways coping with it. Clinical teaching should adopt multiple teaching methods according to every student’s character such as consolidating professional thought, stimulating students’interest, supporting them in psychology. It was beneficial for students to relieve their pressure, to encourage them to adopt positive coping styles. Consequently, the students could pass the period of clinical practice successfully and we could improve the quality of nursing education.更多还原