Objective: To explore the influence of triage nurses' general self-efficacy, perceived stress, psychosomatic reaction on mental health and their mechanism during COVID-19, in order to provide theoretical basis for formulating effective mental health improvement program. Methods: A total of 45 nurses were investigated with general self-efficacy scale (GSES), perceived stress scale (PSS-10), psychosomatic symptom scale (PSSS) and 10-item kessler psychological distress scale (K-10). SPSS 23.0 software was used for descriptive analysis and correlation analysis. PROCESS, a macro program of SPSS compiled by Hayes, was used to test the chain mediating effect. Results: 41 valid questionnaires were collected, the effective rate was 91.11%. The score of K-10 was 19.51±7.89, 63.4% of nurses had poor mental health; the score of PSS-10 was 14.27±4.85; the score of GSES was 2.44±0.58; the score of PSSS was 12.07±9.09,41.5% of nurses had obvious psychosomatic symptoms. There was a negative correlation between GSES and K-10 (r=-0.406, P<0.01), and a positive correlation between PSS-10, PSSS and K-10(r=0.659, P<0.01; r=0.782, P<0.01). There were two ways for self-efficacy to affect mental health:through the mediating effect of perceived stress on mental health (β=-0.142, Boot SE=0.103, 95% CI-0.425 to -0.022); through the chain mediating effect of perceived stress and psychosomatic symptoms on mental health (β=-0.130, Boot SE=0.081, 95% CI-0.336 to-0.023). Conclusion: Self-efficacy does not directly affect the mental health of the preexamination and triage nurses,but through the mediating effect of perceived stress and psychosomatic symptoms. Therefore, the focus of psychological intervention may be to alleviate the level of perceived stress and psychosomatic response, and may be able to improve the mental health level of the preexamination triage nurses faster. |
[1] 中国疾病预防控制中心.2019新型冠状病毒疫情进展和风险评估[R/OL].(2020-01-28)[2020-04-26].http://www.chinacdc.cn/yyrdgz/202001/P020200128523354919292.pdf.
[2] 中国疾病预防控制中心.新型冠状病毒肺炎疫情分布[R/OL].(2020-04-26)[2020-02-26].http://2019ncov.chinacdc.cn/2019-nCoV/.
[3] 四川日报.四川:建立三级预检分诊,单流向通道层层把守[R/OL].(2020-02-13)[2020-04-26].http://sc.people.com.cn/n2/2020/0213/c345167-33790371.html.
[4] 聂光辉,吴俊端,唐峥华,等.工作场所欺负与护士心理健康的关系:自我效能感的调节作用[J].中国临床心理学杂志,2014(5):901-903.
[5] 吴钒,范舒敏.榜样对学生自我效能感的影响[J].东南大学学报(哲学社会科学版),2016(S2):165-168.
[6] LUSZCZYNSKA A,SCHOLZ U,SCHWARZER R.The General Self-Efficacy Scale:Multicultural Validation Studies[J].J Psychol,2005,139(5):439-457.
[7] 张澜,王伟,雷璇,等.觉察压力量表在部分中国人群中的应用研究[J].中国卫生统计,2009,26(6):625-627.
[8] 宋霞,付微微,周敏林,等.狼疮性肾炎患者心理弹性与自我效能及应对方式的相关性研究[J].现代医学,2019,47(4):435-438.
[9] 杨凤池,王亚东,李梅,等.SARS防治一线医务人员的心理健康状况的调查分析[J].中国全科医学,2003(7):601.
[10] O'LEARY A.Self-efficacy and health:Behavioral and stress-physiological mediation[J].Cogn Ther Res,1992,16(2):229-245.
[11] 周成超,楚洁,王婷,等.简易心理状况评定量表Kessler10中文版的信度和效度评价[J].中国临床心理学杂志,2008,16(6):627-629.
[12] 王振,王渊,吴志国,等.应激感受量表中文版的信度与效度[J].上海交通大学学报(医学版),2015,35(10):1448-1451.
[13] LI L,PENG T,LIU R,et al.Development of the psychosomatic symptom scale (PSSS) and assessment of its reliability and validity in general hospital patients in China[J].Gen Hosp Psychiat,2020,64:1-8.
[14] SCHWARZER R,ARISTI B.Optimistic self-beliefs:assessment of general perceived self-efficacy in thirteen cultures[J].Word Psychology,1997,3(1-2):177-190.
[15] 王才康,胡中锋,刘勇.一般自我效能感量表的信度和效度研究[J].应用心理学,2001,7(1):37-40.
[16] 周浩,龙立荣.共同方法偏差的统计检验与控制方法[J].心理科学进展,2004,12(6):942.
[17] 余菊芬,马智群.乐山市临床护士一般自我效能感与职业倦怠的调查研究[J].重庆医学,2014(8):957-959.
[18] 聂光辉,吴俊端,唐峥华,等.工作场所欺负与护士心理健康的关系:自我效能感的调节作用[J].中国临床心理学杂志,2014(5):901-903.
[19] 于欣,刘建成,柳学华,等.SARS一线医护人员SCL-90调查分析[J].中国心理卫生杂志,2003,17(8):524-525.
[20] 郑文贵,徐凌忠,周成超,等.凯斯勒心理疾患量表在意外伤害与心理健康关系研究中的应用[J].中国心理卫生杂志,2009,23(3):175-178.
[21] 徐凌忠,王建新,孙辉,等.Kessler 10在我国的首次应用研究及其重要意义[J].卫生软科学,2005,19(6):410-412,421.
[22] 李娉,雷松蕙.护士主观幸福感与一般自我效能感及应对方式的关系[J].广东医学,2014,35(19):3091-3093.
[23] ZHEN W,JUE C,BOYD J E,et al.Psychometric Properties of the Chinese Version of the Perceived Stress Scale in Policewomen[J].PLoS One,2011,6(12):e28610.
[24] 黄津芳,罗夫,孙仁峰,等.小汤山医院医疗队员疗养期间心理健康调查[J].解放军护理杂志,2004(7):30-31.
[25] 陈戈婷,麦顺和,李月心,等.脑卒中病人家庭照顾者压力知觉、应对方式与心理健康相关性研究[J].循证护理,2018,4(12):1092-1095.
[26] 阚博,丁瑛.科技工作者应对方式在压力知觉水平与心理健康状态间的中介效应[J].中华行为医学与脑科学杂志,2014,23(6):546-549.
[27] 陈劲频,胡景,张涛,等.基于SCL-90心理量表对北京市城市社区居民有消化道症状人群的心理健康状况调查研究[J].胃肠病学,2019(8):489-492.
[28] 周王月,刘婉露,丁兆敏,等.临床护士心理健康状况与自我效能的相关性研究[J].微量元素与健康研究,2017(6):69-70.
[29] 高申春.论自我效能感的主体作用机制[J].外国教育研究,1998(6):1-5.
[30] 张文晋,郭菲,陈祉妍.压力、乐观和社会支持与心理健康的关系[J].中国临床心理学杂志,2011,19(2):225-227.
[31] 李俊娇,王维丹.医学生与非医学生压力、应付方式与社会支持[J].中国健康心理学杂志,2013,21(4):606-608.
[32] 于振剑,岳玲梅,王聪哲,等.煤炭企业高管压力知觉、应对方式与心理健康的关系[J].中国健康心理学杂志,2017,25(8):1165-1168.
[33] 张明月,熊波.潜艇艇员心理应激的多因素研究[J].中华航海医学与高气压医学杂志,2009,16(4):239-241.
[34] 吴迪.放射工作人员压力知觉及其与健康关系研究[D].郑州:郑州大学,2008.
[35] 张蕾,王淞,龚启勇.压力知觉与抑郁:大脑左侧额上回与额中回的中介作用[C]//第二十届全国心理学学术会议——心理学与国民心理健康.2017.
[36] 张蕾,谷建岭,陈紫琪,等.压力知觉的神经机制:来自磁共振成像研究的证据[C]//第二十二届全国心理学学术会议摘要集.2019.
[37] 宫媛,刘荣,贺纳斯,等.女性新兵躯体症状对心理健康的影响[J].华南国防医学杂志,2013(3):169-170. |