中国科学院心理健康重点实验室知识库

目的 探讨护士心理灵活性、应对方式与职业倦怠的关系。方法 使用接纳与行动问卷第二版(acceptance and action questionnaire 2nd edition,AAQ-Ⅱ)、简易应对方式量表(simplified coping style questionnaire,SCSQ)和护士职业倦怠量表(nursing burnout scale,NBS)对云南省某地市级三级甲等综合性医院694名护士进行测试,运用结构方程模型和Bootstrap方法分析护士心理灵活性、应对方式与职业倦怠间的关系。结果 (1)AAQ-Ⅱ总分[(21.81±8.23)分]、职业倦怠[(22.71±6.60)分]及其情感耗竭[(8.93±2.87)分]、人格解体[(6.64±2.30)分]、成就感降低维度[(7.14±2.52)分]与应对方式中的消极应对维度[(10.86±4.99)分]呈正相关(r＝0.324～0.510,均P<0.01),与应对方式中的积极应对维度[(26.44±5.86)分]呈负相关(r＝－0.102～－0.143,均P<0.01)；(2)结构方程模型分析显示,积极应对和消极应对在心理灵活性与职业倦怠间具有不完全中介效应(χ2/df＝2.30,GFI＝0.91,AGFI＝0.90,NFI＝0.90,IFI＝0.93,TLI＝0.92,CFI＝0.93,RMSEA＝0.04)；(3)Bootstrap分析显示,积极应对和消极应对的中介效应效果量分别为3.8%、8.9%；应对方式的总中介效应效果量为12.7%。心理灵活性与职业倦怠间的直接效应效果量为87.3%。结论 应对方式在心理灵活性与职业倦怠间有较少的中介作用,心理灵活性对职业倦怠的影响以直接影响为主。

Objective To explore the relationship among psychological flexibility, coping style and job burnout of nurses. Methods A total of 694 nurses from one district level grade A tertiary general hospital in Yunnan were assessed using acceptance and action questionnaire 2nd edition (AAQ-Ⅱ), simplified coping style questionnaire (SCSQ) and nursing burnout scale(NBS). The relationship among psychological flexibility, coping style and job burnout of nurses was analyzed using structural equation model and Bootstrap test. Results (1)Correlation analysis showed that the total scores of AAQ-Ⅱ(21.81±8.23), job burnout(22.71±6.60) and its three dimensions including emotional exhaustion(8.93±2.87), depersonalization(6.64±2.30)as well as reduced personal accomplishment(7.14±2.52) were positively correlated with negative coping dimension of coping style (10.86±4.99)(r=0.324-0.510, all P<0.01), while negatively correlated with positive coping dimension(26.44±5.86)(r=-0.102--0.143, all P<0.01).(2) Structural equation model analysis showed that positive and negative coping dimension had partial mediating effects on the relationship between psychological flexibility and job burnout(χ^2/df=2.30, GFI=0.91, AGFI=0.90, NFI=0.90, IFI=0.93, TLI=0.92, CFI=0.93, RMSEA=0.04).(3) Bootstrap test showed that the mediating effect sizes for positive and negative coping were 3.8% and 8.9% respectively and totally mediating effect size of coping style was 12.7%. Psychological flexibility had much larger effects on job burnout, and the direct effect size was 87.3%. Conclusion Coping style plays a mediating role in the relationship between psychological flexibility and job burnout, but its effect is less important. Psychological flexibility plays a major role and more directly influences on job burnout.

北京科技计划项目(D151100002315003)；云南省卫生科技计划项目(2018NS182)