重症监护室护士角色压力现状及其影响因素研究

发布时间：2018-05-19 15:15

本文选题：ICU护士 + 角色压力　；参考：《遵义医学院》2017年硕士论文

【摘要】：目的:分析ICU护士角色压力的现状;研究ICU护士角色压力的影响因素并提出应对措施。方法:本研究采用定量研究与定性研究相结合的实证方法对相关问题进行探究。首先,以分层抽样的方法选取贵州省遵义市两所综合性三级甲等医院的ICU护士作为研究对象。共发放问卷250份,回收有效问卷229份,有效回收率为91.6%。研究工具为一般人口学调查资料和ICU护士角色压力量表。所收集的数据采用SPSS19.0统计软件进行相关统计分析,统计方法包括描述性统计分析、t检验和方差分析。然后,运用目的性抽样方法从已经参与前期调查问卷的250名ICU护士选取访谈对象进行半结构式深入访谈了解其角色压力的影响因素,本研究按照饱和原则共访谈10位ICU护士。对访谈内容进行整理、分析并提炼出相关的主题,再对主题进行归类,升华为ICU护士角色压力的影响因素的主题概念。结果:1、ICU护士的角色压力总分为(73.56±11.49)分,角色压力均分为(3.06±0.48)分。角色压力的三个维度中角色负荷均分最高(3.48±0.63),角色冲突得分其次(3.27±0.63),角色模糊得分最低(2.09±0.52)。2、t检验及方差分析结果显示,ICU护士角色压力在不同婚姻状况、收入水平、科室得分有统计学意义(P值均0.05)。3、半结构式深入访谈结果可提炼影响ICU护士角色压力的因素包括城乡卫生资源分配不均、ICU护理人力资源短缺、ICU患者及家属的特点和附属医院发展需要的社会性因素;医院组织的双重管理及双重权威、医院组织上下级沟通不畅、医院组织内群体期望的分歧的组织因素;ICU医护关系不协调的人际关系因素;ICU护士个人角色扮演能力不足的个人因素。结论:1、ICU护士的角色负荷和角色冲突是其角色压力的主要方面。2、ICU护士的角色压力受社会、医院组织的客观因素的影响。因而政府应在城乡卫生资源的分配上切实履行宏观调控的职责和加强对放弃治疗的指导,医院应完善ICU3、护理人才的管理、完善上下级沟通制度、合理分配管理权限、加强对ICU护士的人文关怀和社会支持。3、ICU护士的角色压力也受人际关系和其个人特性等的主观因素的影响。一方面,ICU医生与护士应共同建立平等、融洽的人际关系,ICU患者及家属也应树立对疾病理性的认知。另一方面,各科室ICU护士自身应加强角色学习,如良好的沟通能力、合理的时间分配能力等角色技能以胜任角色要求,学会利用各种社会支持系统及自我调整进行减压。
[Abstract]:Objective: to analyze the status quo of ICU nurses' role stress, to study the influencing factors of ICU nurses' role stress and to put forward countermeasures. Methods: in this study, quantitative and qualitative studies were used to explore the related problems. Firstly, ICU nurses from two comprehensive Grade 3A hospitals in Zunyi City, Guizhou Province, were selected by stratified sampling. A total of 250 questionnaires were sent out, 229 valid questionnaires were collected, and the effective recovery rate was 91.6%. The research tools were the general demographic survey data and the ICU Nurses role stress scale. The collected data are analyzed by SPSS19.0 software. The statistical methods include descriptive statistical analysis and variance analysis. Then, 250 ICU nurses who had participated in the pre-survey questionnaire were selected to conduct semi-structured in-depth interviews to find out the influencing factors of their role stress. According to the saturation principle, 10 ICU nurses were interviewed in this study. The contents of the interview were sorted out, the relevant themes were analyzed and abstracted, then the themes were classified and sublimated as the theme concept of the influencing factors of ICU nurses' role stress. Results the total score of role stress was 73.56 卤11.49, and the score of role stress was 3.06 卤0.48. Among the three dimensions of role stress, the average score of role load was the highest (3.48 卤0.63), the score of role conflict was 3.27 卤0.63, the score of role ambiguity was the lowest (2.09 卤0.52) and the result of ANOVA showed that the role stress of ICU nurses had different marital status and income level. The scores of departments had significant P values of 0.05 and 3.The results of semi-structured in-depth interviews could refine the factors affecting the role stress of ICU nurses, including the characteristics of patients and their families who were suffering from the shortage of nursing human resources in urban and rural areas and the lack of nursing human resources in ICU. Social factors of the development needs of affiliated hospitals; The dual management and authority of the hospital organization, the communication between the higher and lower levels of the hospital organization is not smooth, The organizational factors of different expectations in hospital organization are the incongruous interpersonal factors in ICU nursing care relationship and the personal factors of lack of individual role-playing ability of ICU nurses. Conclusion the role load and role conflict of ICU nurses are the main aspects of role stress. 2. The role stress of ICU nurses is affected by the objective factors of society and hospital organization. Therefore, the government should fulfill the responsibility of macro-control and strengthen the guidance of giving up treatment in the allocation of urban and rural health resources. The hospital should perfect ICU3, the management of nursing talents, the communication system between superior and subordinate, and the rational distribution of management authority. To strengthen humanistic care and social support for nurses in ICU, the role stress of nurses was also influenced by subjective factors such as interpersonal relationship and personal characteristics. On the one hand, ICU doctors and nurses should work together to establish equality and harmonious interpersonal relationship between ICU patients and their families should also establish a rational understanding of disease. On the other hand, ICU nurses in each department should strengthen their role learning, such as good communication ability, reasonable time allocation ability and other role skills to meet the requirements of the role, and learn to use various social support systems and self-adjustment to decompress.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R47

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