不同职级临床护理人员从事相关护理项目压力情况的调查

目的调查不同年资、学历、职称临床护理人员执行相关护理项目的压力情况。方法采用文献检索和专家会议法，自行设计临床护理人员护理项目压力情况调查表，便利选取3所三级甲等综合性医院450名临床护理人员进行问卷调查。结果调查表的内部一致性Cronbach’s α系数为0．783，因子分析累计贡献率为60．91％；调查对象的学历以大专为主（占57％）、年资以≤5年为主（占63％）、职称以初级为主（占77％）；护士对重大抢救的主观感受压力最大（占20．1％）、压力经常的护理项目为独立当班（占28．1％）、压力一般的为留置胃管（占34．0％）、压力偶尔的为健康教育（占13．7％）、从无压力的为更换液体（占35．8％）；独立当班、留置胃管、重大抢救护理项目的压力在不同职称、年资和学历护士中均有统计学意义（P〈0．01），健康教育在不同年资护士中有统计学意义（P〈0．01），护理会诊在不同职称护士中有统计学意义（P〈0．01）。结论护理管理者应强化5年以内护士临床操作技术的专业化培训，并科学界定不同职级护理人员的护理项目权限，为合理构建临床护理人员能级体系提供科学方法。

Investigation of Stressors Caused by Related Work Items Undertaken by Clinical Nurses in Different Class of Position

Objective To investigate the stressors caused by related work items among clinical nurses with different work seniorities, degrees and titles. Method By means of documents searching and experts meeting, we designed a questionnaire about the stress caused by the work items undertaken by the clinical nurses. Four hundred and fifty clinical nurses in 3 Grade-A integrated hospitals were randomly selected to finish the questionnaire. Result The Cronbach＇s α factor of the questionnaire was 0. 783. The total contribution rate of the gent analysis was 60. 91%. Most of the nurses in the survey sample were with associate degree （accounted for 57%）, with working experience of more than 5 years （accounted for 63%）, and with academic title of primary level （accounted for 77%）. The subjective pressure to the nurses against the severe salvage was the major stressor （accounted for 20. 1%）. The most frequent stressor （28. l%） was the subjective pressure against being on duty on one＇s own; the normally frequent stressor （34.0%） was per-forming indwelling gastric tube; the next stressor （13.7%） was health education; and the least frequent stressor （35.80%） was maintaining the venous transfusion. There were statistical differences among the nursing items such as being on duty on one ~s own, gastric tube, and severe sal- vage in the nurses in different titles and seniorities（ P〈0.01）. There was statistical difference in the item of health education in nurses with different seniorities（ P〈0.01）. There was statistical difference in the item of nursing consultation in nurses with different titles（ P 〈0.01）. Conclusion The nursing managers should enhance the clinical skill specialized training to the nurses whose seniority is less than 5 years, and define the privileges for the nurses in different titles to differen- tiate nursing items scientifically. It could provide a scientific method for establishing the frame-work of ability level system of clinical paramedics properly.