| Objective: To investigate the status quo of professional career of PICC specialist nurses,and to analyze the direction and path of different stressors’ effects on professional self-efficacy and career status of PICC specialist nurses.To understand how PICC specialist nurses cope with and transform stressors,especially the specific clinical situation in the impact of two types of stressors on the career status and career development of PICC specialist nurses.Clarifying these problems can not only reveal the mechanism of two-dimensional stressors’ perception of employees’ behavior in theory,but also help PICC specialist nurses and managers to understand the impact of stressors on their career more clearly in practice,which can provide reference for the management of stressors and the development of their personal career.Research methods: This study attempts to explore from both qualitative and quantitative perspectives.Firstly,it reviews and summarizes the development of theoretical concepts such as challenging-hindrance stressors and occupational self-efficacy,puts forward research hypotheses,and investigates 291 PICC specialist nurses in Shanghai by means of purposeful sampling.It explores empirically the two-dimensional structure of stress to perceive career status.The effect of occupational self-efficacy on occupational self-efficacy was investigated.A self-designed interview outline was used to collect data by using semi-structured in-depth interviews among 12 specialist nurses.A qualitative study was conducted on stress coping of PICC specialist nurses.On the basis of interviews,strategies and suggestions were put forward to improve stress management of PICC specialist nurses and promote their career development.The results are as follows:(1)157 PICC nurses(53.95%)participated in catheterization,of which 117(74.52%)were catheterized under ultrasound.243 people(83.51%)participated in PICC maintenance work,with an average maintenance life of 6.13 + 3.44 years.248 people(85.22%)have participated in academic exchanges at home and abroad,and 92 people(31.6%)have participated in or presided over scientific research projects within five years.(2)The total score of career status was(83.65± 12.17)and the score rate was 72.73%.Among them,the dimension of retention intention scored the highest,with the score rate of 92.80%.In general,there were significant differences in career status scores among PICC specialist nurses with different educational background,title,position,hospital level,whether they were professional PICC specialist nurses,operation,teaching,scientific research and Article Publication(P < 0.05).(3)The average score of challenging stressors,obstructive stressors and occupational self-efficacy of PICC nurses was(2.77±0.77),(2.58±0.73)and(2.42 ±0.66).Challenging stressors(r = 0.16,P < 0.05),career self-efficacy(r = 0.56,P < 0.01)were positively correlated with career status,while obstructive stressors(r =-0.28,P < 0.01)were negatively correlated with career status.(4)Challenge-impediment stressors,occupational self-efficacy and career status had significant differences in PICC qualified nurses’ academic qualifications and articles publication;besides occupational self-efficacy,there were also significant differences in other professional titles,hospital level and whether full-time PICC nurses were employed;occupational self-efficacy had significant differences in age,working years and years of obtaining PICC qualifications;There are significant differences in position,operation and participation in teaching.(5)Path analysis showed that career self-efficacy was a complete mediator between obstructive stressors faced by PICC specialist nurses and their perception of career status,while it partially mediated between challenging stressors and career status.(6)The pressure experienced by PICC specialist nurses in their work mainly includes time conflict,role conflict,family and career development conflict,pressure of self-development needs,pressure of challenging work tasks;PICC specialist nurses tend to alleviate pressure through active communication,self-learning and negative emotional release.Research conclusions:(1)PICC specialist nurses scored better in their career status,challenging-hindrance stressors,and occupational self-efficacy perception was at a moderate level.(2)Occupational self-efficacy is an intermediary variable between stressors and career status of PICC specialist nurses,and also an important predictor of career status.At the same time,the qualitative study also found that optimistic and positive personality is an important psychological factor for PICC specialist nurses to successfully cope with and transform stressors.(3)PICC specialist nurses and managers take the initiative to cope with the obstacles that can directly affect nurses’ work and career development experience,including improving the objective environment,organizational atmosphere,and providing more learning and training opportunities.(4)PICC specialist nurses and managers should actively seek compensation mechanism for pressure,do a good job of stress management,and do a good job of career planning,through continuous learning to face the challenging pressure of work itself,obtain potential resources behind pressure,and do a good job of career sustainable development. |
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