背景:护士面临不成比例的高自杀意念和非自杀自我伤害(NSSI)的比率。工作场所暴力的作用,孤独,和抑郁症状加剧这些问题的了解很少。本研究旨在探讨这些关系,为改善护士心理健康提供干预措施。
方法:进行了一项横断面研究,该研究涉及通过便利抽样方法选择的1,774名中国护理人员。工作场所暴力,抑郁症状,和孤独感使用中文版的工作场所暴力量表(WVS)进行评估,9项患者健康问卷(PHQ-9),和三项孤独量表,分别。参与者匿名完成自我报告问卷,以确保遵守道德标准。统计分析利用结构方程模型(SEM)来检验变量之间的复杂关系,从而阐明工作场所暴力的影响,孤独,和抑郁症状对护士自杀意念/NSSI结局的影响。
结果:护士165名(7.8%)被报告有不同程度的自杀意念,139名(7.8%)参与者被报告有不同程度的NSSI。工作场所暴力对自杀意念的最终模型显示出良好的模型拟合指数(CMIN/DF=3.482NFI=0.969CFI=0.977TLI=0.955RFI=0.938,RMSEA=0.037SRMR=0.035)。工作场所暴力对孤独感的影响路径(β=0.163,P<0.001),工作场所暴力通过孤独和抑郁症状对自杀意念的间接影响为0.100(95CI=0.085,0.121),孤独感对抑郁症状自杀意念的间接影响为0.128(95CI=0.100,0.158).同样,工作场所暴力对NSSI的最终模型显示出良好的模型拟合指数(CMIN/DF=3.482NFI=0.967CFI=0.976TLI=0.953RFI=0.935,RMSEA=0.037SRMR=0.034),工作场所暴力对NSSI的影响途径(β=0.115,P<0.001),工作场所暴力通过孤独和抑郁症状对NSSI的间接影响为0.075(95CI=0.055,0.096),孤独感通过抑郁症状对NSSI的间接影响为0.102(95CI=0.076,0.130).
结论:我们的研究揭示了工作场所暴力在护士自杀意念和NSSI中的作用,由孤独和抑郁症状介导。针对工作场所暴力的干预措施对护士的福祉至关重要,可能减少孤独和抑郁症状,并降低自杀意念和NSSI的风险。然而,需要进一步的研究来探索额外的介体和途径,采用纵向设计来建立因果关系,并为受工作场所暴力影响的护士制定量身定制的干预措施。
BACKGROUND: Nurses face disproportionately high rates of suicidal ideation and non-suicidal self-injury (NSSI). The role of workplace violence, loneliness, and depressive symptoms in exacerbating these issues is poorly understood. This study aims to explore these relationships to inform interventions for improving nurses\' mental health.
METHODS: A cross-sectional study involving 1,774 Chinese nurse staff selected through convenient sampling methods was conducted. Workplace violence, depressive symptoms, and loneliness were assessed using the Chinese versions of the Workplace Violence Scale (WVS), the 9-item Patient Health Questionnaire (PHQ-9), and a three-item loneliness scale, respectively. Participants completed self-report questionnaires anonymously to ensure adherence to ethical standards. Statistical analysis utilized structural equation modeling (SEM) to examine the intricate relationships among variables, thereby elucidating the impact of workplace violence, loneliness, and depressive symptoms on nurses\' suicidal ideation/NSSI outcomes.
RESULTS: Nurse staff 165 (7.8%) were reported different level of suicidal ideation and 139 (7.8%) participants were reported different level of NSSI. And the final model of workplace violence on suicidal ideation shown a good model fit index (CMIN/DF = 3.482 NFI = 0.969 CFI = 0.977 TLI = 0.955 RFI = 0.938, RMSEA = 0.037 SRMR = 0.035). The pathway of workplace violence to loneliness (β = 0.163, P < 0.001), the indirect effect of workplace violence on suicidal ideation via loneliness and depressive symptoms were 0.100 (95%CI = 0.085, 0.121), the indirect effect of loneliness on suicidal ideation via depressive symptoms were 0.128 (95%CI = 0.100, 0.158). Similarly, the final model of workplace violence on NSSI shown a good model fit index (CMIN/DF = 3.482 NFI = 0.967 CFI = 0.976 TLI = 0.953 RFI = 0.935, RMSEA = 0.037 SRMR = 0.034), the pathways of workplace violence to NSSI (β = 0.115, P < 0.001), the indirect effect of workplace violence on NSSI via loneliness and depressive symptoms were 0.075 (95%CI = 0.055, 0.096), the indirect effect of loneliness on NSSI via depressive symptoms were 0.102 (95%CI = 0.076, 0.130).
CONCLUSIONS: Our study unveils the role of workplace violence in nurses\' suicidal ideation and NSSI, mediated by loneliness and depressive symptoms. Interventions targeting workplace violence are crucial for nurses\' well-being, potentially reducing loneliness and depressive symptoms and lowering the risk of suicidal ideation and NSSI. However, further research is needed to explore additional mediators and pathways, employing longitudinal designs to establish causality and develop tailored interventions for nurses affected by workplace violence.