背景:护士的职业压力成本不断增加,冲突,医疗服务中的暴力引起了国际关注。然而,研究/干预措施应考虑到病房内的感知压力和冲突以及潜在资源可以跨越医疗环境,影响护士的私人生活,反之亦然,可能造成恶性循环加剧压力,冲突/暴力或,相反,心理/关系福祉的良性循环。基于需求-资源-个体效应(DRIVE)护士模型,并响应深入这一复杂动态的需要,这项研究旨在探索潜在的恶性循环,其特征是护理中与人际冲突相关的感知压力源之间的相互作用(主要/中介效应)的负面影响(与医师冲突,同行,Supervisors,患者/家属),工作-家庭角色间冲突(工作-家庭/家庭-工作-冲突),与工作相关的压力(努力-回报-失衡)对护士心理/关系健康(焦虑,抑郁症,躯体化,人际关系敏感,敌意)。工作资源的潜在调节作用(工作控制,社会支持,还探索了工作满意度)打破恶性循环/促进良性循环。
方法:使用STROBE检查表报告这项横断面多中心研究。总的来说,265名护士完成了自我报告问卷。主要/中介/调节假设通过使用相关分析和Hayes-PROCESS工具进行测试。
结果:数据证实了假设的有害恶性循环(主要/中介效应),在个人层面损害护士的心理健康状况(焦虑,抑郁症,躯体化),而且在关系层面(敌意和人际敏感性)。所有工作资源的调节作用得到了充分支持。
结论:研究结果可用于实施干预措施/实践,以有效防止恶性循环的维持/恶化,并促进医疗机构及其他地区的心理/关系健康。
BACKGROUND: The increasing costs of nurses\' occupational-stress, conflicts, and violence within healthcare services have raised international interest. Yet, research/interventions should consider that perceived stress and conflicts- but also potential resources- within the wards can crossover the healthcare settings, impacting nurses\' private lives and viceversa, potentially creating vicious circles exacerbating stress, conflicts/violence or, conversely, virtuous circles of psychological/relational wellbeing. Based on the Demands-Resources-and-Individual-Effects (DRIVE) Nurses Model, and responding to the need to go in-depth into this complex dynamic, this study aims to explore potential vicious circles featured by the negative effects of the interplay (main/mediating effects) between perceived stressors in nursing linked to interpersonal conflicts (Conflicts-with-Physicians, Peers, Supervisors, Patients/their families), work-family inter-role conflicts (Work-Family/Family-Work-Conflicts), and work-related stress (Effort-Reward-Imbalance) on nurses\' psychological/relational health (Anxiety, Depression, Somatization, Interpersonal-Sensitivity,
Hostility). The potential moderating role of work-resources (Job-Control, Social-Support, Job-Satisfaction) in breaking vicious circles/promoting virtuous circles was also explored.
METHODS: The STROBE Checklist was used to report this cross-sectional multi-centre study. Overall, 265 nurses completed self-report questionnaires. Main/mediating/moderating hypotheses were tested by using Correlational-Analyses and Hayes-PROCESS-tool.
RESULTS: Data confirmed the hypothesized detrimental vicious circles (main/mediating effects), impairing nurses\' psychological health conditions at individual level (Anxiety, Depression, Somatization), but also at relational level (
Hostility and Interpersonal-Sensitivity). The moderating role of all work resources was fully supported.
CONCLUSIONS: Findings could be used to implement interventions/practices to effectively prevent the maintenance/exacerbation of vicious circles and promote psychological/relational wellbeing in healthcare settings and beyond.