Latent Profile Analysis and Influencing Factors of Clinical Nurses' Psychological Resilience in Oncology Hospitals
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摘要:
目的 调查肿瘤医院临床护士心理韧性现状,识别护士心理韧性的潜在剖面,探究其亚组特征及其影响因素。 方法 采用便利抽样法,选取西南地区肿瘤医院812名临床护士,使用一般资料调查表、心理韧性量表进行调查,使用Mplus8.3进行潜在剖面分析,对肿瘤医院临床护士心理韧性特征进行分类,SPSS 26.0进行χ2检验和无序多分类Logistic回归分析,各因素对不同剖面的影响。 结果 肿瘤医院临床护士心理韧性共识别出3个潜在剖面,分别命名为心理韧性“低韧性组”、“一般韧性组”、“高韧性组”,占比为16.2%、54.6%、19.2%,无序多分类Logistic回归分析结果显示,民族、婚姻状况、科室、职称、工作年限、年收入、性格特征是其潜在剖面的影响因素(P < 0.01)。 结论 肿瘤医院临床护士心理韧性处于中等水平,存在明显的异质性特征,受到诸多因素的影响,护理管理者开展相关培训时应识别其类别特征及影响因素,进行培训方案的调整,针对性干预,加强各级护士心理韧性建设,维护护士身心健康,提高工作效率。 Abstract:Objective To investigate the current status of psychological resilience of clinical nurses in a cancer hospital, identify the potential profile categories of psychological resilience of nurses, and explore its subgroup characteristics and influencing factors, so as to provide a basis for the construction of targeted and scientific psychological resilience intervention strategies. Methods Convenience sampling method was used to select 812 clinical nurses from oncology hospitals in Southwest China, using a general information questionnaire, mental toughness scale, potential profile analysis using Mplus 8.3 to categorise the characteristics of clinical nurses' mental toughness in oncology hospitals, and χ2 test and unordered multiclassified logistic regression using SPSS 26.0 to analyse the effects of each factor on different categories. Results Three potential profiles of mental toughness of clinical nurses in oncology hospitals were identified, which were named as mental toughness “low toughness group”, “general toughness group” and “high toughness group”, accounting for 16.2%, 54.6% and 19.2%, respectively.The results of unordered multiclassified logistic regression analysis showed that ethnicity, marital status, department, title, years of experience, annual income, and personality traits were the influencing factors (P < 0.01). Conclusions Clinical nurses' mental toughness in oncology hospitals is at an intermediate level, and there are obvious heterogeneous characteristics affected by many factors. Nursing managers should identify their categories and influencing factors when carrying out relevant training, make adjustments to the training programme, and make targeted interventions to strengthen the construction of nurses' mental toughness at all levels, to safeguard nurses' physical and mental health, and to improve their work efficiency. -
Key words:
- Cancer hospital /
- Nurses /
- Psychological resilience /
- Latent profile analysis
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表 1 护士心理韧性的潜在剖面模型拟合指标比较
Table 1. Comparison of latent class model fit indicators of nurses' resilience
模型 AIC BIC aBIC Entropy LMR BLRT 类别概率 M1 54158.008 54392.983 54234.203 − − − − M2 48411.585 48768.747 48527.402 0.947 0.446/0.554 M3 46374.910 46854.259 46530.349 0.944 <0.001 <0.001 0.262/0.546/0.192 M4 45015.405 45616.941 45210.465 0.948 0.001 <0.001 0.063/0.356/0.158/0.423 M5 44636.362 45360.085 44871.044 0.918 0.637 <0.001 0.063/0.356/0.149/0.282/0.150 表 2 护士心理韧性的3个潜在剖面归属概率矩阵
Table 2. Attribution probability matrix of three potential categories of nurses' resilience
潜在剖面类别 C1 C2 C3 C1 0.981 0.019 0.000 C2 0.017 0.974 0.009 C3 0.000 0.027 0.974 表 3 不同潜在剖面的护士人群分布特征[n(%)](1)
Table 3. Distribution characteristics of different latent categories of nurses[n(%)](1)
项目 分类 低韧性组
(n=213)一般韧性组
(n=443)高韧性组
(n=156)χ2 P 性别 女 200(93.9) 412(93.0) 144(92.3) 0.370 0.831 男 13(6.1) 31(7.0%) 12(7.7) 年龄 ≤29 112(52.6) 186(42.0) 67(42.9) 11.734 0.068 30~39 78(36.6) 170(38.4) 58(37.2) 40~49 20(9.4) 68(15.3) 25(16.0) ≥50 3(1.4) 19(4.3) 6(3.8) 民族 汉族 148(69.5) 349(78.8) 111(71.2) 8.033 0.018* 少数民族 65(30.5) 94(21.2) 45(28.8) 否为独生子女 是 51(23.9) 93(21.0) 43(27.6) 2.946 0.229 否 162(76.1) 350(79.0) 113(72.4) 婚姻状况 未婚 94(44.1) 156(35.2) 50(32.1) 12.743 0.013* 已婚 117(54.9) 274(61.9) 97(62.2) 离异或丧偶 2(0.9) 13(2.9) 9(3.0) 生育状况 已生育 102(47.9) 238(53.7) 84(53.8) 2.170 0.338 未生育 111(52.1) 205(46.3) 72(46.2) 居住地 农村 129(60.6) 229(51.7) 79(50.6) 5.338 0.069 城镇 84(39.4) 214(48.3) 77(49.4) 学历 大专 44(20.7) 106(23.9) 32(20.5) 1.509 0.825 本科 166(77.9) 331(74.7) 121(77.6) 硕士及以上 3(1.4) 6(1.4) 3(1.9) 科室 肿瘤内科 101(47.4) 184(41.5) 56(35.9) 12.936 0.044* 肿瘤外科 64(30.0) 113(25.5) 46(29.5) 放疗科 5(2.3) 16(3.6) 10(6.4) 其他 43(20.2) 130(29.3) 44(28.2) 职称 护士 59(27.7) 107(24.2) 33(21.2) 15.025 0.020* 护师 88(41.3) 143(32.3) 56(35.9) 主管护师 65(21.2) 175(35.9) 60(38.5) 副主任护师及以上 1(0.5) 18(4.1) 7(4.5) 职务 护士长 12(5.6) 30(6.8) 12(7.7) 0.638 0.727 无 201(94.4) 413(93.2) 144(92.3) 表 3 不同潜在剖面的护士人群分布特征[n(%)](2)
Table 3. Distribution characteristics of different latent categories of nurses[n(%)](2)
名称 选项 低韧性组
(n=213)一般韧性组
(n=443)高韧性组
(n=156)χ2 P 有无夜班 有 156(73.2) 300(67.7) 107(68.6) 2.111 0.348 无 57(26.8) 143(32.3) 49(31.4) 工作年限(a) ≤5 83(39.0) 150(33.9) 46(29.5) 22.019 0.001* 6~10 66(31.0) 104(23.5) 29(18.6) 11~15 35(16.4) 80(18.1) 38(24.4) >15 29(13.6) 109(34.6) 43(27.6) 月收入(元) <5000 72(33.8) 108(24.4) 43(27.6) 10.992 0.089 5000~7999 86(40.4) 189(42.7) 68(43.6) 8000~10000 51(23.9) 119(26.9) 38(24.4) >10000 4(1.9) 27(6.1) 7(4.5) 聘用方式 编内 29(13.6) 87(19.6) 27(17.3) 3.609 0.165 编外 184(86.4) 356(80.4) 129(82.7) 性格特征 外向型 47(22.1) 117(26.4) 72(46.2) 42.226 <0.001* 内向型 78(36.6) 117(26.4) 19(12.2) 中间型 88(41.3) 209(47.2) 65(41.7) 宗教信仰 有 1(0.5) 16(3.6) 8(5.1) 7.477 0.024* 无 212(99.5) 427(96.4) 148(94.9) *P < 0.05。 表 4 护士心理韧性不同潜在剖面的无序多分类Logistic回归
Table 4. Multivariate analysis of different latent categories of psychological resilience among clinical nurses in cancer hospitals
项目 一般韧性组 高韧性组 b OR 95%CI P b OR 95%CI P 下限 上限 下限 上限 民族 0.569 1.767 1.176 2.656 0.006* −0.013 0.987 0.592 1.647 0.960 婚姻状况 未婚 −1.547 0.213 0.039 1.173 0.076 −2.481 0.084 0.013 0.545 0.009* 科室 肿瘤内科 −0.713 0.490 0.308 0.782 0.003* −0.629 0.533 0.294 0.969 0.039* 肿瘤外科 −0.617 0.539 0.327 0.889 0.015* −0.259 0.772 0.413 1.442 0.417 职称 护士 −2.387 0.092 0.009 0.911 0.041* −3.056 0.047 0.004 0.583 0.017* 护师 −2.399 0.091 0.010 0.835 0.034* −2.819 0.060 0.005 0.661 0.022* 主管护师 −1.910 0.148 0.017 1.265 0.081 −2.393 0.091 0.009 0.911 0.041 工作年限(年) 6-10 −0.201 0.818 0.363 1.841 0.627 −1.238 0.290 0.108 0.775 0.014* 年收入(万元) <5 −1.846 0.158 0.047 0.535 0.003* −0.738 0.478 0.108 2.112 0.330 5-10 −1.279 0.278 0.088 0.878 0.029* −0.506 0.603 0.151 2.412 0.475 11-15 −1.202 0.301 0.096 0.946 0.040* −0.754 0.471 0.118 1.876 0.285 性格特征 外向型 0.008 1.008 0.649 1.564 0.973 0.740 2.095 1.255 3.499 0.005* 内向型 −0.560 0.571 0.380 0.858 0.007* −1.249 0.287 0.154 0.534 <0.001* 注:*P < 0.05。以心理韧性“低韧性组”为参照;民族以少数民族为参照,宗教信仰以有为参照,婚姻状况以离异或丧偶为参照,科室以其他为参照,职称以副主任护师及以上为参照,工作年限以>15为参照,年收入以>20为参照,性格特征以中间型为参照。 -
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