三级医院急诊科医务人员工作场所欺凌、心理韧性与心理健康的相关分析

摘要/Abstract

摘要： 目的了解三级医院急诊科医务人员工作场所欺凌、心理韧性与心理健康现状及其相关性,分析工作场所欺凌、心理韧性对心理健康的影响,为改善医务人员心理健康状况提出建议。方法 2024年1—2月采用方便抽样方法选取绵阳市6所三级医院急诊科医务人员为调查对象,采用工作场所欺凌量表、心理韧性量表与心理健康量表对268名急诊科医护人员进行横断面调查,并对数据进行分析。结果 268名急诊科医务人员工作场所欺凌得分为（57.78±16.30）分,心理韧性得分为（76.25±13.65）分,心理健康得分为（30.94±7.02）分。单因素分析显示,不同性别、婚姻状况、教育背景、岗位类别、急诊科工龄、每周平均加班时间、轮值夜班、健康状况、工作压力、睡眠质量、接受心理减压培训的急诊科医务人员心理健康得分比较,差异均有统计学意义（均P<0.05）。相关分析显示,急诊科医务人员心理健康得分与心理韧性得分呈正相关（r=0.497~0.772,均P<0.05）,与工作场所欺凌性得分呈负相关（r=-0.492~-0.658,均P<0.05）。婚姻状况、每周平均加班时长、健康状况、工作压力、睡眠质量、工作场所欺凌和心理韧性均是急诊科医务人员心理健康的影响因素（均P<0.05）,共解释总变量的56.1%。结论三级医院急诊科医务人员心理健康状况欠佳,工作场所欺凌和心理韧性是其重要影响因素。管理者应重视医务人员工作场所欺凌行为,提高心理韧性,从而改善医务人员心理健康状况。

关键词: 急诊科, 医务人员, 工作场所欺凌, 心理韧性, 心理健康, 影响因素

Abstract: Objective To investigate the current situation and correlation of workplace bullying,psychological resilience and mental health among medical staff in emergency department of tertiary hospitals,analyze the influence of workplace bullying and psychological resilience on mental health,and provide suggestions for improving the mental health status of medical staff. Methods From January to February 2024,a convenience sampling method was used to select medical staff in emergency departments of six tertiary hospitals in Mianyang City as the survey subjects. A cross-sectional survey was conducted on 268 emergency department medical staff using the workplace bullying scale,psychological resilience scale,and mental health scale,and the data were analyzed. Results The workplace bullying score of 268 emergency medical staff was （57.78±16.30）points,the score of psychological resilience was （76.25±13.65）points,and the score of mental health was （30.94±7.02）points. Univariate analysis showed that there were statistically significant differences in mental health scores of emergency medical staff with different genders,marital status,educational background,job category,length of service in the emergency department,average weekly overtime hours,night shifts,health status,work pressure,sleep quality,and those who received psychological decompression training（all P<0.05）. Correlation analysis showed that the mental health score of medical staff in emergency department was positively correlated with the psychological resilience score（r=0.497-0.772,all P<0.05）,and negatively correlated with workplace bullying（r=-0.492--0.658,all P<0.05）. Marital status,average weekly overtime,health status,work pressure,sleep quality,workplace bullying and resilience were the main influencing factors of mental health of medical staff in emergency department（all P<0.05）,which explained 56.1% of the total variables. Conclusion The mental health status of emergency medical staff in tertiary hospitals is poor,and workplace bullying and resilience are important influencing factors. Managers should pay attention to workplace bullying behavior among medical staff and improve their psychological resilience,so as to improve the mental health status of medical staff.

Key words: Emergency department, Medical staff, Workplace bullying, Psychological resilience, Mental health, Influencing factors

中图分类号:

R192

敬星操, 王英. 三级医院急诊科医务人员工作场所欺凌、心理韧性与心理健康的相关分析. [J]职业与健康, 2025, 41(6): 778-784.

JIN Xingcao, WANG Ying. Correlation analysis of workplace bullying,psychological resilience,and mental health among emergency department medical staff in tertiary hospitals. [J]OCCUPATION AND HEALTH, 2025, 41(6): 778-784.

参考文献

[1] 赵立莉,夏春萍,顾思浩,等.医务人员心理健康状况与关爱路径[J].中国医院院长,2024,20(3):82-84.
[2] 袁媛,陈英,韩海宏,等.医务人员焦虑抑郁现状与工作强度的相关性[J].中国健康心理学杂志,2019,27(7):1059-1063.
[3] 杨柳,郭琼杰,史文宗,等.医务人员焦虑抑郁障碍与工作压力、应对方式及社会支持的关系[J].职业与健康,2020,36(22):3080-3084.
[4] 李佳怡,胡银环,张泽苗,等.医务人员心理求助行为影响因素质性研究的系统评价[J].医学与社会,2023,36(12):92-97.
[5] SIENRA-MONGE J J L,LUNA D,FIGUEROLA-ESCOTO R P,et al.Positive mental health questionnaire(PMHQ) for healthcare workers:A psychometric evaluation[J].Healthcare(Basel),2023,11(23):3041.
[6] 沈昶邑,徐初琛,徐逸,等.上海市医务人员心理健康、心理弹性、社会支持、人际关系现状及相关性[J].职业与健康,2023,39(10):1344-1349.
[7] 姚家慧,瞿惠燕,朱文轶,等.青年医护人员工作压力、应对方式与心理健康影响的研究[J].上海中医药大学学报,2022,36(S1):259-263.
[8] 谢金娜,李金娥,廖思琴,等.工作场所欺凌对综合医院医务人员职业抱负的影响研究[J].职业与健康,2019,35(16):2234-2236,2240.
[9] FATTORI A,NERI L,AGUGLIA E,et al.Estimating the Impact of Workplace Bullying:Humanistic and Economic Burden among Workers with Chronic Medical Conditions[J].Biomed Res Int,2015,2015:708908.
[10] EINARSEN S,HOEL H,NOTELAERS G.Measuring exposure to bullying and harassment at work:validity,factor structure and psychometricproperties of the negative acts questionnaire-revised[J].Work Stress,2009,23(1):24-44.
[11] 荀洪景,刘化侠,田芝丽.负性行为问卷中文版信度、效度初步检验[J].中国护理管理,2012,12(6):21:23-24.
[12] YU X N,ZHANG J X.Factor analysis and psychometric evaluation of the Connor-Davidson resilience scale(CD-RISC) with Chinese people[J].Soc Behav Pers,2007,35(1):19-30.
[13] 张杨,崔利军,栗克清,等.增补后的一般健康问卷在精神疾病流行病学调查中的应用[J].中国心理卫生杂志,2008(3):189-192.
[14] 杜学礼,陈璐,陈芸.上海市三级医院医务人员心理健康状况及其影响因素分析[J].上海预防医学,2021,33(12):1181-1186.
[15] 张玲玲,薛小静,敬星操.心理资本在急诊科医务人员抗逆力与职业认同中的中介作用[J].职业与健康,2022,38(4):479-483.
[16] JONE M,CLARKE S,AMPHLETT S.Reducing the burden on Welsh ambulance services and emergency departments:A mental health 999 clinical support desk initiative[J].Emerg Nurse,2024,35(2):1025-1029.
[17] 陈玥烨,王玲玲,孙瑞琪,等.我国急诊科医护人员职业倦怠现状的meta分析[J].职业与健康,2023,39(8):1121-1125.
[18] 杨海东,张静,强强,等.江苏省精神科护士职业倦怠感与心理健康相关性分析[J].临床心身疾病杂志,2020,26(4):92-94,170.
[19] HAGLUND K,KNORRING L,EEERN L.Psychiatric wards with locked doors--advantages and disadvantages according to nurses and mental health nurse assistants[J].J Clin Nurs,2006,15(4):387-394.
[20] 张玲玲. 绵阳市4所三级甲等医院急诊科护士知觉压力、工作场所心理暴力与工作疏离感的相关分析[J].职业与健康,2024,40(2):224-228.
[21] WEI L,GUO Z,ZHANG X,et al.Mental health and job stress of nurses in surgical system:what should we care[J].BMC Psychiatry.2023,23(1):871.
[22] 徐文胜. 急诊的医疗安全管理与医疗纠纷防范[J].中国卫生产业,2017,14(11):111-112.
[23] 刘青,王英,吕芙蓉.四川省5所三级甲等医院急诊科医务人员心理困扰、功能性躯体症状与睡眠质量的关系研究[J].职业与健康,2023,39(12):1638-1643.
[24] 吴慧莉,陈钢,鲁学良,等.睡眠限制对记忆力及注意力影响[J].中国公共卫生,2009,25(4):503-504.
[25] 肖意苹,张烜,吕苒,等.护士工作场所欺凌与自杀风险的关系研究[J].护理学杂志,2024,39(5):78-82.
[26] 朱凯,钱敏,徐培镕,等.逆境商在护士工作场所欺凌与心理健康间的中介效应分析[J].职业与健康,2023,39(23):3225-3229.
[27] XU H,CAO X,JIN Q X,et al.The impact of the second victim's experience and support on the career success of psychiatric nurses:The mediating effect of psychological resilience[J].J Nurs Manag,2022, 30(6):1559-1569.
[28] 杜晓东. 急诊男性医护人员心理韧性现状调查及对策分析[J].中国药物与临床,2019,19(23):4059-4061.
[29] 林琳,何国平.国外关于护士心理韧性的研究进展[J].解放军护理杂志,2018,35(17):41-44.