江苏省助产士任务负荷、压力认知与心理脱离的关系研究

doi:10.3761/j.issn.0254-1769.2023.17.013

摘要/Abstract

摘要：

目的调查江苏省助产士心理脱离现状，并分析其影响因素，旨在为护理管理者采取相应干预措施以提高助产士心理脱离水平提供理论依据。方法采用便利抽样法，于2022年8月—9月应用一般资料调查表、心理脱离量表、助产士创伤压力量表、杰弗逊共情能力量表、任务负荷指数量表对江苏省13个城市、42所医院的614名助产士进行调查。结果共回收有效问卷590份。助产士心理脱离量表总分为（9.24±3.45）分。多元线性回归分析结果显示，婚姻状况、睡眠质量、下班后使用电子设备处理工作事务频率、创伤压力、共情能力及任务负荷是助产士心理脱离的影响因素（P<0.05）。结论助产士心理脱离水平较低，受多种因素影响，管理者应重视助产士心理脱离情况，综合影响因素制订针对性的干预措施以提高助产士心理脱离水平和工作恢复体验，促进其工作投入度和护理质量。

关键词: 助产士, 心理脱离, 创伤压力, 共情能力, 任务负荷, 影响因素分析, 护理管理研究

Abstract:

Objective To investigate the current situation of psychological detachment（PD） of midwives in Jiangsu，and to analyze its influencing factors，with the aim of providing a theoretical basis for managers to take appropriate interventions to improve the level of PD of midwives. Methods Using a convenience sampling method，614 midwives from 13 cities and 42 hospitals of different levels in Jiangsu from August 2022 to September 2022 were investigated by this cross-sectional survey. A self-developed questionnaire，Psychological Detachment Scale，the Traumatic Stress Scale for Midwives，the Jefferson Empathy Scale and National Aeronautics and Space Administration-Task Load Index were adopted to collect data. Results A total of 590 valid questionnaires were collected. The mean total score of the Psychological Detachment Scale was（9.24±3.45）. The marital status，quality of sleep，frequency of after-work use of electronic devices for work，traumatic stress，empathy，and task load were the influencing factors of PD（P<0.05）. Conclusion The low level of PD of midwives is influenced by a variety of factors. Managers，therefore，need to attach importance to the PD of midwives and formulate targeted interventions to improve the level of PD and work recovery experience with a view to promote their work engagement and quality of care.

Key words: Midwives, Psychological Detachment, Traumatic Stress, Empathy, Task Load, Root Cause Analysis, Nursing Management Research

姜微微, 蒲丛珊, 朱珠, 周春秀, 李六兰, 顾晓霞, 蒋盘华, 王建芳, 李霖, 张佳华, 单春剑. 江苏省助产士任务负荷、压力认知与心理脱离的关系研究[J]. 中华护理杂志, 2023, 58(17): 2142-2148.

JIANG Weiwei, PU Congshan, ZHU Zhu, ZHOU Chunxiu, LI Liulan, GU Xiaoxia, JIANG Panhua, WANG Jianfang, LI Lin, ZHANG Jiahua, SHAN Chunjian. The relationship between task load, stress cognition and psychological disengagement among midwives in Jiangsu[J]. Chinese Journal of Nursing, 2023, 58(17): 2142-2148.

图/表 4

表1 调查对象的一般资料及心理脱离的单因素分析（n=590）

Table 1 General data of respondents and univariate analysis of psychological detachment（n=590）

表2 助产士共情能力、任务负荷、创伤压力情况与心理脱离的相关性分析（r值）

Table 2 Pearson correlation analysis between empathy, task load, traumatic stress situation and psychological detachment of midwives（r values）

表3 自变量赋值方式

Table 3 Variables assignment table

表4 助产士心理脱离的多元线性回归分析（n=590）

Table 4 Multiple linear regression analysis of midwives’ psychological detachment（n=590）

参考文献 27

[1]	胡蕾, 姜梅, 徐鑫芬, 等. 中国助产士人力资源现状调查研究[J]. 中华护理杂志, 2020, 55(2):192-197. DOI
	Hu L, Jiang M, Xu XF, et al. Investigation on the current situation of midwives human resources in China[J]. Chin J Nurs, 2020, 55(2):192-197. DOI
[2]	Doherty J, O’Brien D. A participatory action research study exploring midwives’ understandings of the concept of burnout in Ireland[J]. Women Birth, 2022, 35(2):e163-e171. DOI URL
[3]	Sheehy A, Baird K. A qualitative study of early career Australian midwives’ encounters with perinatal grief,loss and trauma[J]. Women Birth, 2022, 35(6):e539-e548. DOI URL
[4]	Geurts SAE, Sonnentag S. Recovery as an explanatory mechanism in the relation between acute stress reactions and chronic health impairment[J]. Scand J Work Environ Health, 2006, 32(6):482-492. DOI URL
[5]	Wang HL, Xu GY, Liang CQ, et al. Coping with job stress for hospital nurses during the COVID-19 crisis:the joint roles of micro-breaks and psychological detachment[J]. J Nurs Manag, 2022, 30(7):2116-2125. DOI URL
[6]	Yang FZ, Ding JL, Ma RQ, et al. Recovery experience:a concept for maintaining quality of life and its mediating effect among female nurses in China[J]. Psychol Res Behav Manag, 2020, 13:831-841. DOI URL
[7]	钱铭怡, 武国城, 朱荣春, 等. 艾森克人格问卷简式量表中国版(EPQ-RSC)的修订[J]. 心理学报, 2000, 32(3):317-323.
	Qian MY, Wu GC, Zhu RC, et al. Development of the revised Eysenck Personality Questionnaire Short Scale for Chinese (EPQ-RSC)[J]. J Chin Psychol Acta Psychol Sin, 2000, 32(3):317-323.
[8]	Steptoe A, Peacey V, Wardle J. Sleep duration and health in young adults[J]. Arch Intern Med, 2006, 166(16):1689-1692. DOI PMID
[9]	Sonnentag S, Fritz C. The Recovery Experience Questionnaire:development and validation of a measure for assessing recu-peration and unwinding from work[J]. J Occup Health Psychol, 2007, 12(3):204-221. DOI URL
[10]	芦德智, 李吉明, 时广颖, 等. 公立医院护士心理脱离测量及对离职倾向的影响[J]. 中国医院管理, 2018, 38(7):65-66,69.
	Lu DZ, Li JM, Shi GY, et al. Measurement of psychological detachment and its influence on the turnover intention of nursing staffs in the public hospital[J]. Chin Hosp Manag, 2018, 38(7):65-66,69.
[11]	Kubota A, Horiuchi S. Traumatic stress experienced by Japanese midwives and its relation to burnout and work engagement[J]. Jpn J Nurs Sci, 2022, 20(1):e12505. DOI URL
[12]	Hojat M, Gonnella JS, Nasca TJ, et al. Physician empathy:definition,components,measurement,and relationship to gender and specialty[J]. Am J Psychiatry, 2002, 159(9):1563-1569. DOI URL
[13]	安秀琴, 杨辉, 徐建萍, 等. 杰弗逊共情量表的编译及评价[J]. 护理研究, 2008, 22(22):2063-2064,2066.
	An XQ, Yang H, Xu JP, et al. Compilation and evaluation of Jefferson Empathy Scale[J]. Chin Nurs Res, 2008, 22(22):2063-2064,2066.
[14]	Hart SG, Staveland LE. Development of NASA-TLX(task load index):results of empirical and theoretical research[M]//Ad-vances in Psychology. Amsterdam:Elsevier, 1988:139-183.
[15]	梁丽玲, 赵丽, 邓娟, 等. NASA-TLX量表的汉化及信效度检验[J]. 护理研究, 2019, 33(5):734-737.
	Liang LL, Zhao L, Deng J, et al. Chinesization,reliability and validity test of National Aeronautics and Space Administra-tion Task Load Index[J]. Chin Nurs Res, 2019, 33(5):734-737.
[16]	Hajiesmaello M, Hajian S, Riazi H, et al. Secondary traumatic stress in Iranian midwives:stimuli factors,outcomes and risk management[J]. BMC Psychiatry, 2022, 22(1):56. DOI PMID
[17]	Liu CP, Yue CY, Liu L, et al. Mediating role of perceived social support in the relationship between perceived stress and job burnout among midwives in the post-COVID-19 era[J]. Nurs Open, 2023, 10(2):479-487. DOI URL
[18]	Yang Y, Yan R, Meng Y. Can’t disconnect even after-hours:how work connectivity behavior after-hours affects employees’ thriving at work and family[J]. Front Psychol, 2022, 13:865776. DOI URL
[19]	Zhou HM, Song XP, Fang LT, et al. How empowering leadership influences medical workers’ work-family conflict in the post-pandemic era:a moderated mediation model of leadership “black box”[J]. Front Psychol, 2022, 13:870753. DOI URL
[20]	Hetland J, Bakker AB, Espevik R, et al. Daily work pressure and task performance:the moderating role of recovery and sleep[J]. Front Psychol, 2022, 13:857318. DOI URL
[21]	Gustavsson K, Jernajczyk W, Wichniak A. Insomnia partially mediates the relationship of occupational stress with mental health among shift working nurses and midwives in Polish hospitals[J]. Nat Sci Sleep, 2022, 14:1989-1999. DOI PMID
[22]	张欣, 董婧琦, 徐舒慧, 等. 轮班制对ICU女护士昼夜活动节律与疲倦的影响[J]. 中华护理杂志, 2021, 56(3):409-414. DOI
	Zhang X, Dong JQ, Xu SH, et al. Associations between circadian activity rhythms and perceived fatigue before and after shift work among female nurses in intensive care units[J]. Chin J Nurs, 2021, 56(3):409-414. DOI
[23]	王金艳, 吴丽萍, 邢丽莉, 等. 297名助产士共情能力调查分析[J]. 护理学报, 2020, 27(14):5-8.
	Wang JY, Wu LP, Xing LL, et al. Empathy of midwives:a 297-case study[J]. J Nurs China, 2020, 27(14):5-8.
[24]	代玲, 曾铁英, 张可, 等. 助产士参与创伤性分娩体验质性研究的Meta整合[J]. 中华护理杂志, 2021, 56(11):1728-1735. DOI
	Dai L, Zeng TY, Zhang K, et al. The experience of midwives’ participating in traumatic birth:a meta-synthesis of qualitative research[J]. Chin J Nurs, 2021, 56(11):1728-1735.
[25]	Mäntymäki M, Najmul Islam AKM, Turel O, et al. Coping with pandemics using social network sites:a psychological detach-ment perspective to COVID-19 stressors[J]. Technol Forecast Soc Change, 2022, 179:121660. DOI URL
[26]	Sonnentag S, Fritz C. Recovery from job stress:the stressor-detachment model as an integrative framework[J]. J Organiz Behav, 2015, 36(S1):S72-S103. DOI URL
[27]	Li YX, Lu H, Zhao Y, et al. Core competencies of the midwifery workforce in China:a scoping review[J]. J Nurs Manag, 2022, 30(2):535-558. DOI URL