某医院护理人员工作能力与职业紧张相关性分析

[目的]探讨影响护理人员工作能力的职业紧张和职业心理卫生因素,为提高护理人员的工作能力提供科学依据. [方法]采取职业紧张测量问卷和工作能力指数调查表对某医院545名护理人员进行调查,对获得的数据进行相关与逐步回归分析. [结果]与护理人员的工作能力指数呈正相关的因素是职业心理卫生(P＜0.01);与工作能力指数呈负相关的因素是物理环境、缺乏社会支持、缺乏提升机会、缺乏参与机会、工作前景、工作危险、工作冲突、工作负荷(P＜0.01).引入逐步回归方程的3个因素是职业心理卫生、物理环境和缺乏社会支持. [结论]影响护理人员工作能力的职业因素是多方面的,主要是职业心理卫生、缺乏社会支持和物理环境.     

某医院护士职业紧张和职业心理相关回归分析

目的：探讨影响护士心理健康的职业紧张和职业心理因素，为提高护士的心理健康水平提供科学依据。方法：采取职业紧张与职业心理测量问卷和症状自评量表（SCL-90）对某医院545名护士进行调查，对获得的数据进行相关与逐步回归分析。结果：与护士SCL-90呈负相关的因子是心理满足、信心充足、心情平静和工作满意感（P〈0．01）；呈正相关的因子是工作冲突、心理需求、物理环境、工作危险、工作负荷、工作前景、缺乏提升机会、缺乏参与机会、缺乏社会支持（P〈0．05）。引入逐步回归方程的6个因素为心理满足、信心充足、工作危险、心情平静、缺乏社会支持和工作满意感。结论：影响护士心理健康的职业因素是多方面的，主要因素为心理满足、信心充足、工作危险、心情平静、缺乏社会支持和工作满意感。     

重症脑血管病死亡危险因素分析

目的 分析影响重症脑血管病患者死亡的危险因素.方法 回顾性分析226例重症脑血管病患者的临床资料.将死亡危险因素分为三类进行分析：Ⅰ类为不可干预因素,包括性别、年龄以及家族遗传史.Ⅱ类为疾病危险因素,包括高血压、高血脂、糖尿病、心血管疾病（冠心病、心脏瓣膜病、心房颤动）、脑血管病发作史.Ⅲ类为生活方式因素,包括吸烟、饮酒、肥胖、高盐饮食、高蛋白饮食、缺乏运动.采用单因素和多因素Logistic回归方法进行分析.结果 单因素分析结果显示年龄、高血压、糖尿病、心脏瓣膜病、脑血管病发作史、吸烟、饮酒、高盐饮食以及缺乏运动是重症脑血管病患者死亡的重要危险因素（P＜0.01或＜0.05）.多因素Logistic回归分析显示年龄（OR=1.242,P=0.001）、脑血管病发作史（OR=2.325,P=0.000）、缺乏运动（OR=-1.172,P=0.010）与重症脑血管病患者死亡相关.结论 重症脑血管病是与多种因素相关的疾病,有针对性地对重症脑血管病的危险因素进行早期干预,可以有效降低患者的死亡风险,降低病死率.     

远洋船员乙型肝炎病毒感染的影响因素分析

目的 分析舟山海岛地区远洋船员感染HBV的影响因素,为该地区乙型肝炎的防治提供科学依据.方法 本研究选择2011年7月1日至2012年6月30日在舟山医院进行体检且HBsAg指标阳性的453名远洋船员作为感染组.按照1：1选择以年龄±2岁、同工种且乙型肝炎标志物检测全阴者进行匹配,设立453名对照,并进行影响因素分析.结果 单因素分析结果表明,乙型肝炎疫苗接种是感染HBV的保护因素（OR=0.507,x2=11.339,P＜0.05）,而饮用生水和出国劳务是感染HBV的危险因素（OR=1.471、2.215,P＜0.05）.多因素条件Logistic回归分析显示,乙型肝炎疫苗接种史是海岛船员感染乙型肝炎的保护因素（OR=0.523,x2=10.150,95％CI：0.351～0.779）,出国劳务史是海岛远洋船员感染乙型肝炎的危险因素（OR=1.992,x2=5.000,95％CI：1.089～3.646）.结论 出国劳务史是海岛船员感染乙型肝炎的主要危险因素,乙肝疫苗接种史是HBV感染的保护因素,应强化远洋船员乙型肝炎疫苗接种,并加强远洋船员的安全性健康教育.     

介入科医护人员心理焦虑状况及影响因素分析

目的评价介入手术室医护人员的心理焦虑状况,并分析影响因素。方法选取我院介入手术室医护人员120例作为本研究样本研究对象,采用焦虑自评量表（SAS）对样本人员的心理焦虑状况进行评价,然后采用我院自行设计的焦虑原因调查表对样本人员心理焦虑状况的影响因素进行调查,采用单因素χ²检验和多因素logistic回归分析探究造成介入手术室医护人员心理焦虑的独立危险因素。结果 120例样本医护人员当中,焦虑发生率为46.67%（56/120）;医护人员已婚（P=0.000,OR=4.263）、担心电离辐射（P=0.011,OR=3.625）、担心抗肿瘤药物危害（P=0.011,OR=2.869）、缺乏对家人的照顾（P=0.012,OR=6.123）、生活节律不规律（P=0.011,OR=4.012）以及担心消毒因子影响（P=0.000,OR=3.111）是造成介入科医护人员心理焦虑的主要影响因素,已婚、缺乏对家人的照顾以及生活不规律是导致焦虑的保护因素。结论应针对上述因素提出改善措施,减少医护人员的心理焦虑。     

导致剖宫产切口早期感染相关因素的多因素分析

目的探讨导致剖宫产术后切口感染的独立危险因素。方法2001年1月～2009年12月我院剖宫产发生切口感染共46例作为观察组．按1：1随机选择无切口感染剖宫产产妇46例作为对照组,比较两组在产妇及手术方面相关指标上的差异,先进行单因素χ^2、t检验;然后将单因素分析有显著性差异的变量进行多元逐步Logistic回归分析。结果单因素分析结果显示15个因素与切口感染有关（P〈0．05）,以切口感染为应变量,其他统计量作为自变量赋值后进行多因素回归分析,结果显示术后切口感染独立危险因素为：手术操作持续超过2h（x1,OR=3．21）、腹部脂肪厚度≥3cm（x2,OR=2．97）、合并其他基础疾病（x3．OR．=2．67）、第二产程实行剖宫产术者（x4,OR=1．98）,回归方程为：Logistic y=15．22＋4．45x1＋4．23x2＋3．67x3＋2．87x4。结论剖宫产术后切口感染是多因素综合作用的结果,应针对上述因素预防和控制切口感染的发生。     

长治地区5055名新生儿出生体重异常现状及影响因素分析

目的 了解长治地区新生儿出生体重情况及影响因素,为孕期保健提供参考依据.方法 回顾性分析2007年1月至2011年12月本地区分娩的5 055名活产新生儿出生体重及性别、孕周、孕妇年龄、产次、孕妇生活地区（城乡）,通过单因素分析和多因素Logistic回归分析进行统计处理,探讨影响出生体重的影响因素.结果 5055名新生儿平均出生体重为（3 128±675）g,低出生体重儿发生率为14.6％,巨大儿发生率为8.2％.经单因素x2检验,孕妇生活地区、孕周、孕母年龄是低出生体重儿和巨大儿的影响因素（x2值分别为223.807、34.120,2 211.570、68.941,92.199、18.745）,产次与低体重儿发生有关（x2=54.822）,性别与巨大儿发生有关（x2=34.503）,差异均有统计学意义（P＜0.05）.Logistic回归分析进行结果显示,早产（OR=37.147,95％ CI：30.094～45.853）、生活在农村（OR=0.390,95％ CI：0.310～0.492）孕母年龄（OR=0.864,95％CI：0.779～0.959）是低出生体重儿发生的危险因素,而男婴（OR=0.524,95％ CI：0.423～0.650）、生活在城市（OR=0.616,95％CI：0.501～0.758）、过期产（OR=4.175,95％CI：2.918～5.974）及孕母年龄偏大（OR=1.229,95％CI：1.104～1.368）是巨大儿发生的危险因素.结论 本地区新生儿平均出生体重低,巨大儿和低出生体重儿发生率高,城乡差异存在,因地制宜的提供科学的干预措施和孕产期保健服务、普及优生优育知识及适龄孕产,是控制出生体重在合理范围内的有效措施.     

河南省艾滋病患者服药依从性及影响因素调查

目的 探讨艾滋病患者抗病毒治疗服药依从性及影响因素。方法 采用分层随机抽样的方法,对河南省5个艾滋病防治示范县/市的796名抗病毒治疗患者进行调查,并对相关影响因素进行Logistic回归分析。结果 调查结果显示,有704（88.4%）人服药依从性好;单因素分析显示,不同收入水平（χ2 = 7.674,P = 0.022）、确诊年限（χ2 = 5.203,P = 0.023）、社会支持程度（t = 2.870,P = 0.004;t = 2.500,P = 0.013;t = 2.337,P = 0.020）等对患者服药依从性的影响具有统计学意义;Logistic回归分析显示,影响患者服药依从性的主要因素是:确诊年限（P = 0.006,OR = 0.401）、收入水平（P = 0.003,OR = 0.364）、客观支持（P＜0.001,OR = 1.180）、主观支持（P = 0.002,OR = 1.075）、支持的利用度（P = 0.005,OR = 1.163）。结论 河南省艾滋病患者服药依从性仍需进一步提高,在今后的抗病毒治疗中,应进一步提高患者的社会支持水平以提高其服药依从性。     

上消化道癌危险因素病例对照研究

目的：探讨饮食及其他生活习惯与上消化道癌发生的关系。方法：采用1：1配对病例对照研究，对1248对病例及对照进行饮食、生活行为等问卷调查。资料处理采用条件Logistic回归进行单因素和多因素分析。结果：影响上消化道癌发生有关的危险因素有饮白酒量（OR=1．393 P=0．0020）、食辛辣食物（OR=1．141 P=0．0020）、食小米、薯类（OR=1．180 P=0．0080，OR=1．256 P≤0．001）为危险因素；而食奶类（OR=0．755 P=0．0329）、蒜苔（OR=0．419 P≤0．001）、香蕉（OR=0．525 P=0．0303）、多食肉类、夏天灶火移出室外（OR=0．478 P=0．0670）、已婚（OR=0．392 P=0．0192）为保护性因素。结论：上消化道癌与饮食因素有关，营养素的缺乏是该病的主要危险因素。     

突发新型冠状病毒肺炎期间护理人员焦虑现状与社会支持相关性研究

目的 探讨突发新型冠状病毒肺炎期间护理人员的焦虑现状与社会支持相关性。方法 采用便利抽样法选取辽宁省某新型冠状病毒肺炎医疗救治定点医院护理人员1 344名作为研究对象。采用焦虑自评量表（SAS）以及社会支持评定量表（SRSS）进行调查,人口学特征资料及焦虑得分运用t检验、单因素方差分析,焦虑与社会支持的关系采用Pearson相关性分析,并通过建立两步回归模型分析影响焦虑状态的主要因素。结果 突发新型冠状病毒肺炎期间护理人员焦虑得分标准分（37.75±9.33）分高于国内常模（29.78±0.46）分;不同学历、职称、年限及是否在一线工作方面差异具有统计学意义（P＜0.05）;焦虑与社会支持呈负相关（r = - 0.379,P＜0.01）,与客观支持呈负相关（r = - 0.221 ,P＜0.05）,与主观支持、对社会支持利用度呈负相关（r = - 0.367,r = - 0.155,P＜0.01）;回归分析结果显示自变量作用影响由大到小依次为社会支持总分（β = - 0.268,P＜0.001）、主观支持（β = - 0.138,P＜0.05）、是否在一线工作（β = - 0.100,P＜0.001）、学历（β = 0.073,P＜0.05）,其中社会支持总分为护理人员焦虑影响作用最大。结论 突发新型冠状病毒肺炎期间,更需要重视护理人员的心理状态,在社会支持方面实施相应的干预措施,降低其焦虑水平,使其积极投入工作。     

某地社康医院医护人员的职业紧张与工作能力的关系

目的通过探讨影响医务人员工作能力的职业紧张因素,为提高医务人员的工作能力提供科学依据。方法用职业紧张测量问卷和工作能力指数调查表对深圳市龙岗区社康医院276名医务人员进行调查,对获得的数据进行相关分析和逐步回归分析。结果医护人员的工作能力优、良、中、差的分布比例分别为43.5%、41.3%、14.5%、0.7%。与医务人员的工作能力指数呈负相关的因素是物理环境、缺乏社会支持、缺乏提升机会、缺乏参与机会、工作前景、工作危险、工作冲突、工作负荷(P<0.01)。引入逐步回归方程的4个因素是工作负荷、缺乏社会支持、工作危险和缺乏参与机会。结论多种职业紧张因素可降低社康医院医护人员的工作能力,该区各医疗机构应尽量降低医护人员的职业紧张程度。     

儿科医护人员职业应激状况调查

目的 探讨引起儿科医护人员职业应激的应激源及其缓解因素.方法 选择某市5所市级医院儿科医护人员258名为研究对象,以药房、收费处等科室工作人员169名为对照,采用一般工作紧张问卷对其进行调查,自评法完成问卷.结果 医护人员工作负荷、工作危险、药物使用、每日紧张感、正性情绪、忍耐性行为、物理环境及情绪平衡得分高于对照组,工作冲突、环境控制、技术利用程度及心理卫生、对事责任得分低于对照组,差异均有统计学意义(P<0.05).儿科护士工作前景、工作心理控制源、自尊感、工作满意感、负荷变化、抑郁症状得分高于医生,非工作活动、工作危险、每日紧张感得分低于医生,差异均有统计学意义(P<0.05).多因素分析发现,儿科医护人员应激反应的影响因素为工作单调性、工作需求、非工作活动、工作控制、工作危险、工作前景、社会支持、工作心理控制源及自尊感.结论 儿科医护人员应激程度较高,医生应激程度高于护士;儿科医护人员的主要应激源为工作单调、工作需求高、非工作活动多、工作控制程度低、工作危险性大及工作前景不确定.主要的应对策略为良好的社会支持、外控性格及较强自尊感.     

职业紧张因素对警察肝脏功能的影响

目的探讨职业紧张因素对肝脏功能的影响。方法对某市公安局的163名干警进行职业紧张和肝功影响因素调查,同时检测肝功、血脂和神经胺类神经递质,分析职业紧张对警察肝脏功能的影响及其机制。结果肝功能指标水平在临界值以上者具有竞争性行为和外控性心理,工作负荷重,角色冲突多,对人的责任重,工作单调、躯体抱怨和负性情绪增多,舒张压增高,血脂和单胺类神经递质水平增加。多因素分析表明,工作控制、工作责任、工作危险、工作自主性、工作角色、提升与参与机会、工作心理控制源、应付策略、竞争性行为和社会支持均影响肝脏功能。结论职业紧张对警察的肝脏功能有一定的影响。     

飞机场地勤人员职业紧张及其对心理健康的影响

目的 探讨飞机场地勤人员职业紧张因素及其对心理健康的影响。方法 采用职业紧张问卷，对某市飞机场地勤大队的全体人员进行职业紧张因素和紧张反应调查，对紧张反应进行逐步回归分析。结果 分析表明，角色模糊、角色冲突、定量负荷、负荷变化、工作控制、睡眠时间为主要职业紧张因素；自尊感、工作心理控制源、社会支持是主要缓解因素，地勤人员的心理健康与多种职业紧张因素和缓解因素有关。结论 地勤人员工作中存在着职业紧张因素，这些因素和自尊感以及社会支持等缓解因素对心理健康影响显著。     

Occupational stress in nurses in psychiatric institutions in Taiwan

Nurses are known to be exposed to occupational stress. However, occupational stress is not well documented for nurses in psychiatric institutions in Taiwan. A cross-sectional study was conducted to explore the work-related stress and risk factors of nurses in psychiatric institutions in Taiwan. A structured questionnaire was distributed to nurses at five state-owned psychiatric hospitals in Taiwan in 2001. Demographic information, working environment, and personal health status were inquired. Occupational stress was assessed based on the Chinese version of Job Content Questionnaire (JCQ). General health status and mental health were evaluated by the International Quality of Life Assessment Short Form-36 (IQOLA SF-36). A total of 573 questionnaires were disseminated to nurses and 518 (90.4%) were satisfactorily completed by nurses, including 408 female full-time nurses who had been in their current work for more than 6 months. In the past one month, 17.2% of nurses reported being under significant stress often or always. Assault episodes were reported by 45.1% of nurses in the past 6 months. Among the nurses, 16.9%, 25.2%, 50.0%, and 7.8% belong to the "High strain", "Low strain", "Active", and "Passive" groups, respectively. Perceived occupational stress was associated with young age, widowed/divorced/separated marital status, high psychological demand, low workplace support, and threat of assault at work. Lower general health score was associated with low job control, high psychological demand, and perceived occupational stress. A lower mental health score was associated with low job control, high psychological demand, low workplace support, and perceived occupational stress. We concluded that nurses in psychiatric institutions are under significant stress related to work factors.     

The psychosocial work environment and alcohol dependence: a prospective study

Aims: To examine whether a stressful psychosocial work environment predicts alcohol dependence.

Methods: Alcohol dependence of participants in the Whitehall II occupational cohort of London based civil servants (1985–88) was measured in 1991–93 using the CAGE questionnaire. The psychosocial work environment was measured by self report questions on the job demand-support-control model and on the model of effort-reward imbalance. Potential mediators including physical illness and poor mental health (GHQ) were measured at follow up in 1989.

Results: Effort-reward imbalance at work was associated with alcohol dependence in men after adjustment for employment grade and other baseline factors related to alcohol dependence. Although effort-reward imbalance predicted future longstanding illness, poor mental health and negative aspects of close relationships, the association between effort-reward imbalance and alcohol dependence in men was only partially mediated through these health and social support measures. In women, low decision latitude was related to alcohol dependence to some extent, but alcohol dependence among women was more prevalent in higher occupational grades. Men with high job demands or with low work social supports had a slightly reduced risk of alcohol dependence. No association was found between objectively assessed demands, job control, and alcohol dependence in either men or women.

Conclusion: A stressful psychosocial work environment in terms of effort-reward imbalance was found to be a risk factor for alcohol dependence in men. In view of the public health importance of alcohol dependence in working populations these findings call for more emphasis on psychosocial factors in occupational health research and prevention.

     

Gender differences in the effects from working conditions on mental health: a 4-year follow-up

OBJECTIVES: The overall aim was to examine how working conditions in 1993 influenced the occurrence of poor mental health in 1997 among women and men from the general population. Also, the relative importance of other living conditions in relation to poor mental health in 1997 was examined. METHODS: A sample from the general Swedish population (originally examined in 1969) was followed up in 1993 and 1997. Data from these follow-ups were analysed, and both bivariate and multivariate analyses of associations between occupational and non-occupational conditions in 1993 and poor mental health in 1997 -- defined as sub-clinical depression, reduced psychological well-being and high alcohol consumption -- were performed. RESULTS: Several occupational risk indicators were identified for poor mental health among women, especially sub-clinical depression and high alcohol consumption. Occupational factors such as shift work, job strain, no education at the employer's expense, low occupational pride, low stimulation at work and poor social support were related to poor mental health among women. For poor mental health among men, mainly sub-clinical depression, shift work and low occupational pride were identified as risk indicators. Non-occupational factors related to poor mental health among women were poor quality of social contacts, demanding life events, physical inactivity, high perceived physical load outside work and inadequate coping strategies. Among men, smoking and inadequate coping strategies were related to poor mental health. CONCLUSIONS: The difference between women and men, regarding the numbers of identified occupational and non-occupational risk indicators, may partly be explained by the gender-segregated labour market, and partly by other explanations. In our study, we have not succeeded in collecting the relevant information about occupational conditions that is important for men's mental health.     

The relationship between work-related psychosocial factors and burnout among Iranian nurses: Job Demand-Control-Support model

Background:Nursing work environment consists of a number of work-related psychosocial risk factors such as excessive workloads, lack of social support, emotional demands, job insecurity and confronting with challenging situations all of which may induce burnout. The aim of the current study was to investigate the relationship between work-related psychosocial factors and burnout among Iranian nurses.Methods:A cross-sectional study was carried out among 522 nurses. The data related to work-related psychosocial factors and burnout was gathered using Job Content Questionnaire (JCQ) and Maslach Burnout Inventory (MBI), respectively. Pearson’s correlation coefficients were used to examine the relationship between work-related psychosocial factors and burnout.Results:Mean scores of the dimensions of burnout for emotional exhaustion, depersonalization, and reduced personal accomplishment were 13.6 (SD=8.6), 18.42 (SD=7.1), and 28.45 (SD= 9.15), respectively. Psychological and physical job demands were positively correlated with different dimensions of burnout while social support and job control showed negative correlation with them.Conclusion:Appropriate interventions on reducing job demands both psychologically and physically and increasing social support and job control are suggested in prevention of burnout among the studied nurses.Key words: Burnout, psychosocial factors, nurses, job demands, job control, social support