摘要
目的:分析反刍性沉思在护士第二受害者痛苦与职业倦怠间的中介作用,以期为改善护士职业倦怠提供参考.方法:于2023 年12月至 2024 年3月,采用便利抽样法,抽取北京市、安徽省、山西省共 7 家三级甲等医院 535 名经历过不良事件的护士为研究对象,使用一般资料调查表、第二受害者经验及支持量表、事件相关反刍性沉思问卷和Maslach职业倦怠量表进行调查.采用结构方程模型进行数据分析.结果:护士第二受害者痛苦、侵入性反刍性沉思、目的性反刍性沉思及职业倦怠得分为(42.05±8.56)、(14.64±7.70)、(15.67±7.32)、(54.09±16.41)分.反刍性沉思以侵入性反刍性沉思和目的性反刍性沉思为独立中介对职业倦怠产生影响,其中第二受害者痛苦对职业倦怠的总效应值为 0.398(P<0.001),总间接效应值为 0.162(P<0.001),中介效应占总效应值的 40.70%.结论:护士第二受害者职业倦怠水平偏高,有待改善.护理管理者应采取措施减轻护士第二受害者痛苦,引导其将侵入性反刍性沉思转化为目的性反刍性沉思,从而降低职业倦怠水平.
Abstract
Objective:To explore the relationships among second victim distress,ruminative contemplation,and job burnout in nurses,and to examine the mediating role of ruminative contemplation in the relationship between second victim distress and job burnout in nurses.Methods:A total of 535 nurses who had experienced adverse events were recruited by convenience sampling method from 7 tertiary grade A hospitals in Beijing,Anhui,and Shanxi provinces from December 2023 to March 2024.A survey was conducted by the general information questionnaire,the Second Victim Experience and Support Tool,the Event-Related Rumination Inventory and the Maslach Burnout Inventory,and the data was analyzed by structural equation model.Results:The scores for second victim distress,intrusive ruminative contemplation,deliberate ruminative contemplation,and job burnout among nurses were(42.05±8.56),(14.64±7.70),(15.67±7.32),and(54.09±16.41)points,respectively.Ruminative contemplation,with both intrusive and deliberate ruminative contemplation as independent intermediary variables,had an effect on job burnout.Specifically,the total effect of second victim distress on job burnout was 0.398(P<0.001),and the total indirect effect was 0.162(P<0.001),with the mediating effect accounting for 40.70%of the total effect.Conclusion:The level of job burnout among nurses experiencing second victimization is relatively high and requires further improvement.Nursing administrators should take measures to alleviate the distress of nurses as second victims,guide them to transform intrusive rumination into purposeful rumination,and thereby reduce their levels of job burnout.
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