背景:自从COVID-19爆发以来,全世界的研究人员更多地关注护士经历的继发性创伤应激(STS)问题。这种压力对护士的健康和护理质量都有不利的影响,可能会破坏护理团队的稳定性,并阻碍满足日益增长的护理服务需求的能力。COVID-19大流行的影响,以及全球对ICU护理需求的增长,给ICU护士带来了巨大的压力,严重损害他们的身心健康。值得注意的是,ICU护士也面临着高度的道德困扰,和道德韧性可以有效缓解这种困扰,提高护理质量。
目的:本研究旨在检查ICU护士的道德韧性和STS水平,探讨它们之间的关系,找出影响STS的因素。
方法:这项横断面研究涉及来自西安两家三级医院的229名ICU护士,中国,在2023年11月至12月期间参加。数据是通过电子邮件使用匿名电子问卷收集的,包括自行设计的人口统计和工作生活相关特征问卷;Rushton道德弹性量表;和二级创伤压力量表。描述性统计,t检验,采用方差分析和层次回归分析对数据进行分析。
结果:研究结果表明,ICU护士的道德韧性和STS评分处于中等水平。分层回归分析表明,STS与Rushton道德弹性量表的子量表呈负相关,特别是道德逆境应对(β,-0.156;95%CI,-1.241至-0.039)和关系完整性(β,-0.245;95%CI,-1.353至-0.388),这是STS的重要预测因素。此外,良好的睡眠质量(β,-.396;95%CI,-14.948至-7.117)和因工作困难而寻求心理咨询(β,.107;95%CI,0.237-9.624)作为ICU护士STS的重要预测因子,随着模型对STS方差的解释增加到45.5%,△R2=.167,F=16.482(p<.001)。
结论:这项研究发现,ICU护士的道德韧性和STS水平适中,它们是负相关的。这表明提高ICU护士的道德韧性可能有助于降低其STS水平。
结论:研究表明,ICU护士的道德韧性和继发性创伤应激水平处于中等水平,表明需要采取措施增强他们的道德韧性并减少他们的继发性创伤压力,因为他们的存在不仅会影响ICU护士的健康,还会降低护理质量并增加流失率。
BACKGROUND: Since the outbreak of COVID-19, researchers worldwide have focused more on the issue of secondary traumatic stress (STS) experienced by nurses. This stress has an adverse effect on the health of nurses and the quality of nursing care, potentially undermining the stability of the nursing team and hindering the ability to meet the growing demand for nursing services. The impact of the COVID-19 pandemic, and the rise in global demand for ICU nursing, has placed a significant strain on ICU nurses, severely damaging their mental and physical health. Notably, ICU nurses also face high levels of moral distress, and moral resilience can effectively alleviate this distress and improve the quality of care.
OBJECTIVE: This study aimed to examine the levels of moral resilience and STS among ICU nurses, to explore their relationship and identify the factors influencing STS.
METHODS: This cross-sectional study involved 229 ICU nurses from two tertiary hospitals in Xi\'an, China, who participated between November and December 2023. The data were collected through email using anonymous electronic questionnaires, encompassing a self-designed demographic- and work-life-related characteristic questionnaire; the Rushton Moral Resilience Scale; and the Secondary Traumatic Stress Scale. Descriptive statistics, t-tests, analysis of variance and hierarchical regression analysis were performed to analyse the data.
RESULTS: The findings of the study indicated that ICU nurses\' moral resilience and STS scores were at an intermediate level. Hierarchical regression analysis indicated that STS was negatively correlated with the subscales of the Rushton Moral Resilience Scale, specifically moral adversity coping (β, -0.156; 95% CI, -1.241 to -0.039) and relational integrity (β, -0.245; 95% CI, -1.453 to -0.388), which are significant predictors of STS. Additionally, good sleep quality (β, -.396; 95% CI, -14.948 to -7.117) and seeking psychological counselling because of work difficulties (β, .107; 95% CI, 0.237-9.624) emerged as significant predictors of STS among ICU nurses, with the model\'s explanation of the variance in STS increasing to 45.5%, △R2 = .167, F = 16.482 (p < .001).
CONCLUSIONS: This study found that ICU nurses have moderate levels of moral resilience and STS, which are negatively correlated. This suggests that improving the moral resilience of ICU nurses may help reduce their STS levels.
CONCLUSIONS: The study revealed that ICU nurses\' moral resilience and secondary traumatic stress levels were at a moderate level, indicative of the need to take measures to enhance their moral resilience and reduce their secondary traumatic stress, as their presence not only affects the health of ICU nurses but also diminishes the quality of care and increases turnover rates.