三甲医院ICU护士社会阻抑与离职意愿间的相关性:反刍思维的中介作用

目的 调查三甲医院ICU护士的社会阻抑、反刍思维和离职意愿现状,并探讨三者之间的相关性,以期能为临床护士管理工作提供一定的参考与借鉴。 方法 使用方便抽样,于2017年2-7月间选取陕西省4所三甲医院中符合纳入排除标准的528例ICU护士作为研究对象。使用社会阻抑量表、Nolen-Hoeksema反刍思维量表和离职意愿量表进行调查。使用Pearson相关系数进行相关性分析,并使用Amos 17.0软件进行结构方程模型图的拟合检验。 结果 研究对象社会阻抑总分为(43.63±6.22)分,其中上级阻抑维度为(22.37±5.14)分,同事阻抑维度为(21.26±4.83)分;反刍思维得分为(44.83±9.32)分;离职意愿得分为(17.14±5.10)分,其中14.4%研究对象离职意愿很高,49.4%离职意愿较高。社会阻抑、反刍思维和离职意愿三者之间的两两相关分析差异均有统计学意义(均P<0.01)。反刍思维在社会阻抑和离职意愿之间起部分中介作用,且中介效应的大小为0.27,占总效应的52.9%。 结论 ICU管理者应正视社会阻抑现象的存在,倡导真诚合作的同事关系,积极营造良好的科室人文环境,重视ICU护士的压力缓解和心理疏导工作,以降低其离职意愿,提高临床护理服务质量。 

Social undermining and turnover intention in ICU nurses of tertiary hospital: the mediating effect of rumination

Objective To investigate social undermining, rumination and turnover intention in ICU nurses of tertiary hospital, and explore their relationship in order to provide reference for the management of clinical nurses. Methods Qualified 528 ICU nurses were recruited from 4 tertiary hospitals in Shaanxi Province by convenience sampling between February and July 2017. Social Undermining Scale, Chinese version of Nolen-Hoeksema Ruminative Responses Scale and Turnover Intention Scale were used to collect data. Pearson correlation coefficient was used to analyze the correlation and Amos 17.0 software was used to test the fitting of structural equation model diagram. Results The scores of social undermining was (43.63±6.22), with (22.37±5.14) in supervisor subscale, and (21.26±4.83) in coworker subscale. The scores of rumination and turnover intention were (44.83±9.32) and (17.14±5.10) respectively, among which 14.4% participants had very high turnover intention, and 49.4% had high turnover intention. The pairwise correlation analysis of social undermining, rumination and turnover intention had statistical significance (P<0.01). Rumination exerted a partial mediating effect between social undermining and turnover intention, with the mediating effect of 0.27, which accounted for 52.9% for the total effect. Conclusion ICU managers should recognize the existence of social undermining, advocate sincere cooperative colleague relationship, create a good environment, pay attention to the stress relief and psychological counseling work of ICU nurses, so as to reduce their turnover intention and improve the quality of clinical nursing services.