基于潜在剖面分析的护士良心压力分型及其影响因素

目的 探索护士良心压力分型及影响因素。方法 采用便利抽样法,于2021年4—10月选取山东省2所三级甲等医院的1 120名护士为研究对象,使用一般资料调查问卷、医院伦理氛围量表、良心压力量表进行调查。采用潜在剖面分析探索护士良心压力分型,采用多分类无序Logistic回归分析各个类别的影响因素。结果 护士良心压力可分为低良心压力型（67.41%）、中等良心压力型（23.84%）和高良心压力型（8.75%）。第一学历较高（OR=1.353,P=0.001）、医院伦理氛围较差（OR=0.954,P<0.001）是中等良心压力型的影响因素。女性（OR=0.382,P=0.042）、上周工作时长较长（OR=0.349,P=0.003）和医院伦理氛围较差（OR=0.938,P<0.001）是高良心压力型的影响因素。结论 护士的良心压力存在异质性。性别、第一学历、上周工作时长、医院伦理氛围是影响护士良心压力潜在类别的重要影响因素。护理管理者应关注不同性别、学历护士的良心压力特征,合理配置人力资源,营造良好的医院伦理氛围,降低护士良心压力水平。

Classification and Influencing Factors of Stress of Conscience in Nurses: A Latent Profile Analysis

Objective To explore the classification and influencing factors of stress of conscience in nurses. Methods Convenience sampling was used to select 1,120 nurses from 2 tertiary grade-A hospitals in Shandong province from April to October 2021. General information questionnaire, Hospital Ethical Climate Survey, and Stress of Conscience Questionnaire were used to conduct the survey. Latent profile analysis was used to explore the classification of stress of conscience, and disordered multinomial logistic regression to analyze the influencing factors of each profile. Results The stress of conscience of nurses could be divided into low stress of conscience group (67.41%), medium stress of conscience group (23.84%) and high stress of conscience group (8.75%). Higher first degree (OR=1.353, P=0.001) and poorer hospital ethical climate (OR=0.954, P<0.001) were predictors of medium stress of conscience group. Female (OR=0.382, P=0.042), longer working hours in the last week (OR=0.349, P=0.003) and poorer hospital ethical climate (OR=0.938, P<0.001) were predictors of high stress of conscience group. Conclusion There is heterogeneity in the stress of conscience among nurses. Sex, first degree, working hours in the last week and hospital ethical climate are important predictors of the latent categories regarding stress of conscience among nursing staff. Nursing managers should pay attention to different nurses’ stress of conscience according to the sex and educational background. Rational allocation of human resources and good hospital ethical climate are beneficial to reducing the level of stress of conscience.