关键词: 安宁疗护, 职业悲伤, 死亡态度, 反刍性沉思, 中介效应分析, 护理管理研究

Abstract:

Objective To investigate the current status of rumination and professional grief among hospice nurses，and to explore the mediating effect of death attitude between the two. Methods A total of 323 nurses in hospitals with hospice services and hospice wards in Hangzhou City were surveyed from April to July 2024 by convenience sampling method. They were investigated with general information questionnaire，Event Related Rumination Inventory，Death Attitude Profile-Revised，and Grief State Scale for Nurses by convenience sampling method. The structural equation model was used to analyze the mediating effect of death attitude between rumination and professional grief among hospice nurses. Results A total of 331 questionnaires were collected，among which 8 invalid questionnaires were deleted，and 323 valid questionnaires were retrieved，with the valid questionnaire recovery rate of 97.58%. The score of intrusive rumination dimension for hospice nurses was 13.34（7.00，20.00），and the score of deliberate rumination dimension was 16.92（11.00，24.00）. The negative attitude towards death scored 38.35（29.00，48.00），while the positive attitude towards death scored 62.88（49.00，78.00）. The total score of Grief State Scale for Nurses was 47.05（40.00，53.00）. Hospice nurses’ intrusive rumination was positively correlated with negative attitudes toward death，professional grief，and negatively correlated with positive attitudes toward death（all P<0.05）；deliberate rumination was negatively correlated with negative attitudes toward death，professional grief，and positively correlated with positive attitudes toward death（all P<0.05）. Negative death attitudes and positive death attitudes partially mediated between intrusive rumination and professional grief，with mediation effects of 0.053 and 0.037，accounting for 12.70% and 9.25% of the total effect. Negative death attitudes and positive death attitudes similarly partially mediated between deliberate rumination and professional grief，with mediation effects of -0.033 and -0.080，accounting for 10.03% and 21.33% of the total effect. Conclusion Death attitudes are a mediating variable between hospice nurses’ rumination and professional grief. Nursing managers can take effective measures to improve hospice nurses’ ruminative contemplation ability and positively guide positive attitudes toward death，thereby reducing their professional grief levels.

Key words: Hospice Care, Professional Grief, Death Attitudes, Rumination, Mediation Analysis, Nursing Administration Research