急診科護(hù)士同情心疲乏的現(xiàn)況調(diào)查及影響因素分析*

□ 廖德珺 LIAO De-jun 張秀霞 ZHANG Xiu-xia 顏雷雷 YAN Lei-lei

Objective To investigate the current situation of nurses' compassion fatigue in emergency department and to analyze the influencing factors. Method The general demographic data questionnaire, Moral Distress Scale-revised (MDS-R), and medical staff compassion fatigue scale were used to investigate 270 nurses from emergency department of 11 tertiary Class-A hospitals in Zhejiang Province. Results The moral distress of emergency department nurses was at a mild level; and compassion fatigue were at a medium level. The Spearman correlation coefficient showed that moral distress was positively correlated with compassion fatigue. Multivariate linear regression analysis showed that the total score of moral distress, the position, the satisfaction with income, the satisfaction with the night shift arrangement, and the self-cognition of whether being qualified for the job were the factors affecting the compassion fatigue in nurses of emergency department (p＜0.001). Conclusion Compassion fatigue existed in nurses in emergency department, and it should be addressed with interventions targeting influencing factors.

同情心疲乏(compassion fatigue，CF)是指，對(duì)遭受疾痛的人提供關(guān)懷照護(hù)后出現(xiàn)的情緒壓力[1]。同情心的經(jīng)常運(yùn)用，會(huì)造成護(hù)士對(duì)待事物的消極反應(yīng)，同時(shí)不利于工作積極性和生活質(zhì)量的提高[2]。道德困境(moral distress)是指，個(gè)體知道應(yīng)該采取的正確行動(dòng)，但由于內(nèi)部或者外部的各種原因無法實(shí)行時(shí)產(chǎn)生的痛苦感受和/或心理失衡[3]。急診科護(hù)士作為醫(yī)院的特殊護(hù)士群體，長期面對(duì)急危重癥患者，容易出現(xiàn)情感過度支出及由于各種原因所致的心理失衡情況。本研究旨在了解急診科護(hù)士同情心疲乏的現(xiàn)狀及同情心疲乏與一般人口學(xué)和道德困境的相關(guān)性，為急診科護(hù)士同情心疲乏的干預(yù)措施提供依據(jù)。

對(duì)象與方法

1.研究對(duì)象。于2018年1月至4月，采用便利抽樣法，選取浙江省11所三級(jí)甲等醫(yī)院的270名急診科護(hù)士為研究對(duì)象。納入標(biāo)準(zhǔn)：注冊(cè)護(hù)士。排除標(biāo)準(zhǔn)：(1)預(yù)計(jì)調(diào)查期間外出進(jìn)修、休假者；(2)實(shí)習(xí)護(hù)士。研究對(duì)象均知情同意參加本次調(diào)查研究。

2.方法。采用問卷調(diào)查法。調(diào)查工具：(1)一般資料調(diào)查問卷。自行設(shè)計(jì)問卷，內(nèi)容包括：性別、年齡、工作年限、職稱、職務(wù)、婚姻狀況、學(xué)歷、對(duì)經(jīng)濟(jì)收入是否滿意、對(duì)急診科夜班安排是否滿意、認(rèn)為自己能否勝任急診科工作、是否曾因工作中遇到的道德困境考慮離開原工作崗位、是否考慮離開現(xiàn)工作崗位。(2)中文版護(hù)士道德困境量表(Moral Distress Scale-revised，MDS-R)：該量表由國內(nèi)學(xué)者孫霞[3]翻譯而成，內(nèi)容包括：個(gè)體責(zé)任、不能維護(hù)患者最大利益、價(jià)值沖突和損害患……