关键词: 道德困境, 结构授权, 心理授权, 中介效应, 感染科护士

Abstract: Objective To explore the status of moral distress,structural empowerment and psychological empowerment of nurses in infection department,ecplore the mediating effect of psychological empowerment between structural empowerment and moral distress. Methods Totally 295 nurses in the infection department from 13 secondary and above hospitals in Shaanxi Province were selected by convenient sampling method from September to Octomber 2021. They were investigated by the moral distress scale,working condition efficacy scale and psychological empowerment scale,and the data were analyzed. Results The total scores[M（P₂₅,P₇₅）] of moral distress,structural empowerment and psychological empowerment in nurses of the infection department were 59.00（36.00,86.00）,59.00（50.00,76.00） and 35.00（28.00,44.00）points,respectively. Nurses' moral distress was negatively correlated with structural authorization and psychological authorization（r=-0.557,-0.619,both P<0.01）,and psychological authorization was positively correlated with structural authorization（r=0.556,P<0.01）. The multiple linear hierarchical regression analysis showed that psychological empowerment played a partial mediating role between structural empowerment and moral distress（P<0.01）,in which the mediating role explained 47.3% of the variance. The structural equation model verified the mediating effect of psychological empowerment,and the mediating effect was 41.16%. Conclusion On the basis of improving the level of nurses' structural authorization,hospital managers should pay attention to psychological authorization,especially in the aspects of work autonomy and work influence,so as to stimulate the personal internal motivation of nurses in infection department,so as to reduce the level of moral distress.

Key words: Moral distress, Structure empowerment, Psychological empowerment, Mediating effect, Nurses in infection department