天津市三级甲等医院护士情绪劳动、心理弹性及认知重评在职业倦怠中的相关性研究

摘要/Abstract

摘要： 目的了解天津市三级甲等医院护士职业倦怠现状及影响因素,探讨其与情绪劳动、心理弹性及认知重评四者之间的相关性。方法 2024年2—7月采用便利抽样法选取天津市5所三级甲等医院440名护士作为调查对象,使用一般资料调查表、情绪劳动量表（emotional labor scale,ELS）、心理弹性量表（Connor Davidson resiliences scale,CD-RISC）、情绪调节问卷（emotion regulation questionnaire,ERQ）及中国职业倦怠量表（Chinese Maslach burnout inventory,CMBI）进行问卷调查。结果天津市三级甲等医院护士职业倦怠总分为（60.41±9.14）分,情绪劳动总分为（50.36±14.56）分,心理弹性总分为（60.18±15.93）分,认知重评总分为（29.15±6.43）分。相关分析结果显示,护士的职业倦怠总分与表层扮演呈正相关（r=0.148,P<0.01）,与情绪表达（r=-0.162,P<0.01）、深层扮演（r=-0.530,P<0.01）、心理弹性（r=-0.635,P<0.01）、认知重评（r=-0.479,P<0.01）均呈负相关。多因素分析结果显示,不同年龄、职务、每月夜班次数、职业规划、情绪劳动、心理弹性及认知重评进入回归方程（均P<0.05）。结论天津市三级甲等医院护士职业倦怠处于中等偏上水平,年龄、职务、每月夜班次数、职业规划、情绪劳动、心理弹性及认知重评为其独立危险因素。提示医院管理者应为护士提供心理辅导和情感宣泄的途径,减轻护士情绪劳动负荷,同时引导护士运用认知重评策略改变对压力事件看法,提高其心理弹性,有效缓解护士职业倦怠感,进而提高护理质量。

关键词: 护士, 职业倦怠, 情绪劳动, 心理弹性, 认知重评

Abstract: Objective To understand the current situation and influencing factors of occupational burnout among nurses in grade-A tertiary hospital of Tianjin,explore its correlation with emotional labor,psychological resilience,and cognitive reappraisal. Methods From February to July 2024,a convenience sampling method was used to select 440 nurses from five grade-A tertiary hospitals in Tianjin as survey subjects. The general information survey,emotional labor scale(ELS),Connor Davidson resilience scale(CD-RISC),emotion regulation questionnaire(ERQ) and Chinese Maslach burnout inventory(CMBI) were used for the questionnaire survey. Results The total score of occupational burnout among nurses in grade-A tertiary hospital of Tianjin was(60.41±9.14)points,the total score of emotional labor was (50.36±14.56)points,the total score of psychological resilience was (60.18±15.93)points,and the total score of cognitive reappraisal was (29.15±6.43)points. The correlation analysis results showed that the total score of occupational burnout in nurses was positively correlated with surface role-playing(r=0.148,P<0.01),and negatively correlated with emotional expression(r=-0.162,P<0.01),deep role-playing(r=-0.530,P<0.01),psychological resilience(r= -0.635,P<0.01),and cognitive reappraisal(r=-0.479,P<0.01). The results of multivariate analysis showed that different age,position,monthly night shifts,career planning,emotional labor,psychological resilience,and cognitive reappraisal entered the regression equation(all P<0.05). Conclusion The occupational burnout of nurses in grade-A tertiary hospital of Tianjin is at a moderate to high level,with age,position,monthly night shift frequency,career planning,emotional labor,psychological resilience,and cognitive reappraisal as independent risk factors. It is indicated that the hospital managers should provide psychological counseling and emotional release channels for nurses to reduce their emotional workload,and guide nurses to use cognitive reappraisal strategies to change their views on stressful events,improve their psychological resilience,effectively alleviate nurses' sense of professional burnout and thereby improve nursing quality.

Key words: Nurse, Occupational burnout, Emotional labor, Psychological resilience, Cognitive reappraisal

中图分类号:

R181.3⁺1

吴敏, 张亚军, 张春梅. 天津市三级甲等医院护士情绪劳动、心理弹性及认知重评在职业倦怠中的相关性研究. [J]职业与健康, 2025, 41(21): 2912-2917.

WU Min, ZHANG Yajun, ZHANG Chunmei. Correlation study of emotional labor,psychological resilience and cognitive reappraisal on occupational burnout among nurses in grade-A tertiary hospital of Tianjin. [J]OCCUPATION AND HEALTH, 2025, 41(21): 2912-2917.

参考文献

[1] JUN J,OJEMENI M M,KALAMANI R,et al.Relationship between nurse burnout,patient and organizational outcomes:Systematic review[J].Int J Nurs Stud,2021,119:103933.
[2] 许利刚,王晓晖,乔记兵,等.临床护士组织支持感与工作投入度的关系:情绪劳动与职业倦怠的链式中介作用[J].心理月刊,2024,19(18):14-17.
[3] 姚颖,魏万宏,张艳慧.护士情绪劳动的研究进展及启示[J].护理管理杂志,2021,21(5):349-354.
[4] 王德锋,伍文沛.积极心理学视角下的心理弹性研究[J].心理月刊,2019,14(8):42.
[5] 谭剑,孔雪二,侯璇璇.工作满意度在护士心理弹性与职业倦怠间的中介效应[J].护理学报,2023,30(8):69-73.
[6] GOLDIN P R,MANBER-BALL T,WERNER K,et al.Neural mechanisms of cognitive reappraisal of negative self-beliefs in social anxiety disorder[J].Biol Psychiatry,2009,66(12):1091-1099.
[7] 刘菲. 护士与医生职业倦怠发生状况的比较及相关因素研究[D].济南:山东大学,2017.
[8] 李峥,刘宇.护理学研究方法[M].北京:人民卫生出版社,2018:17-19.
[9] 张娣,顾永梅,于圣萍,等.南通市405名临床护士职业倦怠、反馈寻求行为与离职倾向的关系研究[J].职业卫生与应急救援,2023,41(3):265-270.
[10] 李永鑫. 三种职业人群工作倦怠的比较研究:基于整合的视角[D].上海:华东师范大学,2005.
[11] GRANDEY A A.When the show must must go on:Surface and deep acting as determinants of emotional exhaustion and peer-rated service delivery[J].A Management J,2003,46(12):86-96.
[12] 骆宏,孙庆龄,顾利慧.护士情绪工作能力对职业倦怠的影响研究[J].中华护理杂志,2008,43(11):969-971.
[13] CONNOR K M,DAVIDSON J R.Development of a new resilience scale:The connor-davidson resilience scale(CD-RISC)[J].Depress Anxiety, 2003,18(2):76-82.
[14] 于肖楠,张建新.自我韧性量表与Connor-Davidson韧性量表的应用比较[J].心理科学,2007,30(5):1169-1171.
[15] GROSS J J,JOHN O P.Individual differences in two emotion regulation processes:Implicationsfor affect,relationships,and well-being[J].J Per Soc Psychol,2003,85(2):348-362.
[16] 王力,柳恒超,李中权,等.情绪调节问卷中文版的信效度研究[J].中国健康心理学杂志,2007,15(6):503-505.
[17] 魏涛,邢晓丽,徐步,等.临床护士应对方式与职业倦怠的关系及心理复原力的中介作用[J].职业与健康,2025,41(7):865-869.
[18] 陈田林,孙世健,周群,等.心理弹性在护士情绪劳动与情绪倦怠间的调节效应[J].军事护理,2024,41(5):47-50.
[19] 凡颖,周玉梅,高淑平.心理弹性在临床护士情绪劳动与职业成功感间的中介效应[J].现代临床护理,2024,23(6):8-15.
[20] 谭明焰. 护士情绪调节策略和认知闭合需要与负性情绪的关系研究[D].武汉:武汉轻工大学,2021.
[22] MENG L.Study on the resilience of hospital nurses and related factors[J].J Soc Ethnol,2023,5(1):91-96.
[23] 赵素,姚瑶,王婷.情绪劳动和职业倦怠在血液透析室护士个人-工作契合度与心理健康间的多重中介作用[J].职业与健康,2024, 40(17):2331-2336.
[24] 赵志寒,黄亚兰.后疫情时代传染科护士职业倦怠特点及其与压力、应对方式、心理弹性的相关性研究[J].心理月刊,2024,19(9):15-19.
[25] 陈文峰,韩莉,李宁,等.情绪调节自我效能感护士长绩效感知对科室护士职业倦怠感的影响[J].中国医药科学,2021,11(23):165-169.
[26] 周松,于翠香,查丽玲,等.情绪劳动在ICU护士职业价值观与工作倦怠间的中介作用[J].中华现代护理杂志,2020,26(8):1048-1053.
[27] 王秀秀,吕静,于雪微,等.社区护士对老年人态度、情绪劳动与职业倦怠的相关性分析[J].职业与健康,2021,37(7):931-935.
[28] 郑萍萍,陈少华.广州市三级甲等医院骨科护士情绪劳动策略在睡眠质量与职业倦怠间的中介作用[J].职业与健康,2024,40(14):1883-1888.
[29] 杨瑞,李建民,王宇龙,等.心理弹性在临床护士心理健康和职业倦怠间的中介作用[J].职业与健康,2023,39(9):1182-1186,1191.
[30] 谭剑,孔雪二,侯璇璇.工作满意度在护士心理弹性与职业倦怠间的中介效应[J].护理学报,2023,30(8):69-73.
[31] GOLDIN P R,MANBER-BALL T,WERNER K,et al.Neural mechanisms of cognitive reappraisal of negative self-beliefs in social anxiety disorder[J].Biol Psychiatry,2009,66(12):1091-1099.
[32] 许雪峰,王俊锋.基于认知重评的心理干预对急诊科护士专业生活品质及自我调节疲乏水平的影响[J].河南医学研究,2024,33(14):2596-2599.
[33] 徐颖,徐姝娟,刘梦琪,等.芜湖市某三级甲等医院护士工作压力与职业倦怠的相关性分析[J].职业与健康,2024,40(7):869-873.
[34] 文史宏,肖蕾,揭青玉,等.海南省5家综合医院血液透析室护士工作场所压力、反馈和职业倦怠的相关分析[J].职业与健康,2024, 40(11):1463-1467,1476.
[35] 郑艳玲,余芳,陈艳黎,等.我国全科医生职业倦怠状况及影响因素研究[J].中国全科医学,2019,22(7):764-769.
[36] 胡莹莹,杨一鸣,王文静.中小学教师情绪劳动与职业倦怠的纵向联系:情绪弹性和师生关系的链式中介作用[J].心理发展与教育,2025(3):357-367.
[37] 冯焱森,沈军,任柳.认知重评团体辅导对失能老人护理员焦虑抑郁的影响[J].护理学杂志,2018,33(1):79-82,93.