综合医院新任护士长心理健康现状及其影响因素分析-现代医学

综合医院新任护士长心理健康现状及其影响因素分析

单位：南京鼓楼医院妇科, 江苏南京 210008

分类号：R395

出版年·卷·期（页码）：2024·52·第十一期（1748-1757）

摘要：

目的: 探究综合医院新任护士长心理健康现状，分析有关影响因素，为改善其心理健康状况提供科学参考。方法: 选取2022年11月至2023年3月南京市6所二级及以上综合性医院新任护士长135名为研究对象，应用一般资料调查问卷、12项一般健康问卷(GHQ-12)、付出-回报失衡问卷(ERI)、情绪调节问卷(ERQ)、中国大五人格问卷简版(CBF-PI-B)、神经质人格分量表进行调查。统计新任护士长心理健康异常率(GHQ-12≥4分判定为阳性)，多因素Logistic回归分析探讨新任护士长心理健康的独立影响因素，建立回归预测模型，评估回归预测模型拟合优度及预测效力。结果: 135名新任护士长心理健康异常率为42.22%(57/135)。多因素Logistic回归分析显示，每周工作时间、职业紧张程度、ERQ量表的表达抑制评分、CBF-PI-B神经质人格分量表评分为新任护士长心理健康的独立危险因素，参与体育锻炼频率、ERQ量表的认知重评评分为独立保护因素(P<0.05)。基于独立影响因素建立回归预测模型，Logit(P)＝-13.269＋0.905×每周工作时间(＞48 h＝2，41-48 h＝1，≤40 h＝0)-1.509×参与体育锻炼频率(至少1周1次＝2，2-4周1次＝1，＞4周1次＝0)＋1.468×职业紧张程度(高＝1，低＝0)-0.413×ERQ量表认知重评评分(分)＋0.216×ERQ量表表达抑制评分(分)＋0.248×CBF-PI-B神经质人格分量表评分(分)。Hosmer-Lemeshow检验显示，模型构建有效。ROC曲线显示，回归预测模型预测AUC为0.982，预测灵敏度为94.74%，特异度为93.59%，准确度为94.07%，阳性预测值为91.53%，阴性预测值为96.05%。结论: 每周工作时间、参与体育锻炼频率、职业紧张、情绪调节方式及神经质人格为综合医院新任护士长心理健康的独立影响因素，依据上述因素构建的回归模型预测价值良好，可通过合理安排工作量，增加体育锻炼频率，合理情绪调节策略及健全绩效分配制度等途径促进护士长心理健康。

Objective: To explore the mental health status of new head nurses in general hospitals, analyze the influencing factors, and provide scientific reference for improving their mental health status. Methods： A total of 135 new head nurses from 6 secondary and above general hospitals in Nanjing from November 2022 to March 2023 were selected as the research objects. The general information questionnaire, 12 general health questionnaires(GHQ-12), effort-reward imbalance questionnaire(ERI), emotion regulation questionnaire(ERQ) and Chinese Big Five Personality Questionnaire-Brief Version(CBF-PI-B) were used for investigation. The abnormal rate of mental health of new head nurses(GHQ-12≥4 points was judged as positive) was counted. Multivariate Logistic regression analysis was used to explore the independent influencing factors of mental health abnormalities of new head nurses, a regression prediction model was established and its goodness of fit was evaluated. Results： The abnormal rate of mental health of 135 new head nurses was 42.22%(57/135). Multivariate Logistic regression analysis showed that weekly working time, occupational stress, expression inhibition score of ERQ scale and score of CBF-PI-B neuroticism personality subscale were independent risk factors for mental health abnormalities of new head nurses, while frequency of physical exercise and cognitive reappraisal score of ERQ scale were independent protective factors(P<0.05). A regression prediction model is established based on independent influencing factors. Logit(P)=-13.269+0.905×weekly working time(>48 h=2,41-48 h=1, ≤40 h=0)-1.509×frequency of physical exercise(at least once a week=2,2-4 weeks once=1, >4 weeks once=0)+1.468×occupational stress(high=1, low=0) -0.413×ERQ scale cognitive reassessment score(points)+0.216×ERQ scale expression inhibition score(points)+0.248×CBF-PI-B neuroticism personality subscale score(points). The Hosmer-Lemeshow test showed that the model construction was effective. ROC curve showed that the regression prediction model predicted AUC 0.982, the prediction sensitivity was 94.74%, the specificity was 93.59%, the accuracy was 94.07%, the positive predictive value was 91.53%, and the negative predictive value was 96.05%. Conclusion： Weekly working hours, frequency of participation in physical exercise, occupational stress, emotion regulation and neuroticism are independent influencing factors of mental health abnormalities of new head nurses in general hospitals. The regression model constructed based on the above factors has good predictive value. It can promote the mental health of head nurses by reasonably arranging workload, increasing the frequency of physical exercise, reasonable regulating emotion and improving the performance rewarding system.

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