| [Objective]1.To explore the status and correlation of mental health,work pressure and working environment of ICU nurses,clarify the influence of work pressure and working environment on nurses’mental health,understand the mental health status of ICU nurses and the needs of EAP,and evaluate the needs of EAP services.2.The ROC curve is used to determine the early warning index and its boundary value of ICU nurses,and to explore a simple and quick tool for nurses’psychological early warning,which can provide the basis for early recognition of nurses’psychological abnormality.3.Design the EAP implementation plan based on the survey and needs assessment results,which mainly include four categories:team building,environmental construction,intervention plan,and effect evaluation,and provide practical guidance for the whole process of implementing EAP in the hospital[Method]Using the purpose sampling method,from December 2019 to January 2020,352ICU nurses from a tertiary A hospital in Nanjing were selected as the research subjects to conduct a questionnaire survey,and 350 valid questionnaires were collected.The questionnaires include:Symptom Self-Rating Scale,Nursing Work Environment Scale,Chinese Nurses’Work Stressor Scale,and EAP Needs Questionnaire.SPSS 24.0 was used to analyze the results.The measurement data used the mean and standard deviation,and the count data used the frequency and percentage statistical description;the t test and the analysis of variance were used for single factor analysis.The Person correlation analysis method was used to calculate the correlation between the symptom self-assessment score,work stressor and work environment scores.Multivariate linear stepwise regression was used to analyze the influence of multiple measurement indicators on symptom self-assessment scoring.In order to further obtain the needs of the survey respondents,and taking account the confidentiality principle of EAP,the interview method was used to interview ICU nurses to fully understand the current psychological problems faced by ICU nurses and their needs for EAP services.Finally,based on the survey results of the"Nurse Symptom Self-rating Scale",the participants were divided into negative group(normal mental group)and positive group(psychological abnormality group).The positive index is counted as 1,and the negative index is counted as 0.Draw the ROC curve:use the Area Under Curve(AUC)to evaluate the effect and determine the cut-off value:take the inflection point with the largest Youden index as the best cut-off point,and use the cut-off value corresponding to the best cut-off point as the ICU Simple cut-off value of early warning indicators for nurses’mental health.[Results]1.Status quoThe total score of symptom self-evaluation of nurses was(162.70±65.01),of which the compulsive symptoms were the most prominent(2.14±0.81);the total score of stress sources of ICU nurses was(77.95±15.80),the highest score of workload and time was(2.60±0.66),the lowest score of interpersonal management was(1.87±0.56);the overall score of ICU nursing environment was(2.98±0.37),and the highest quality score was(2.98±0.37)The highest score of nursing service was(3.11±0.35),and the lowest score of sufficient manpower and material resources was(2.76±0.51).2.Influencing factorsThe difference of mental health scores was most significant in ICU nurses in different departments,ages,night shift times and monthly income.Other social demography factors had no significant difference in mental health.The work stress sources of ICU nurses are positively correlated with the mental health of nurses,and the correlation coefficient is 0.219-0.545,that is,the higher the work pressure is,the higher the mental health self-evaluation score is,the worse the health level is;the negative correlation between the working environment dimensions and the mental health of nurses in ICU is-0.246～-0.353,that is,the better the working environment,the lower the mental health self-evaluation score,the worse the health status Good.Regression equation model shows that R~2=0.322,R~2=0.3122 is adjusted,and the fitting degree of equation is the best.The Department,night shift,the basic of nursing service and nursing service,interpersonal management and working environment and resources can explain 31.22%variation of nurses’mental health.3.Nurses’cognition and demand for EAP214(61.4%)of the respondents who had never known EAP;only 8(20.6%)knew and experienced EAP project;332(94.86%)thought that the hospital provided nurses with benefits to carry out EAP;240(68.57%)wanted to find professionals to solve the problem;38(10.86%)had negative attitude towards EAP implementation,and nurses in cardiothoracic surgery guardianship had the least knowledge of EAP.To relieve the work pressure and mental health consultation is the most important demand of ICU nurses for EAP service;in terms of service mode,more tend to receive face-to-face consultation and professional training in hospitals.In the service demand survey,the departments ranked first in relieving the work pressure.In the integrated ICU and CCU,the family care needs are relatively large,and in EICU,there is a certain demand for professional skills training.The interviewee’s demand for EAP service extracted four aspects of demand topics:the need to relieve the work pressure,the need to solve the work family contradiction,the need to improve the career development path,and the need to deal with crisis events.4.Warning index and its boundary valueThe evaluation results were obtained by using area under curve(AUC).The results showed that the area under the curve was 0.818,and the evaluation effect was at the middle level.Determine the boundary value:take the turning point of the Youden index as the best critical point,and take the boundary value corresponding to the best critical point as the simple threshold value of the early warning index of ICU nurses’mental health.The results show that the maximum of the index is 0.591 and the pressure value measured by the corresponding bracelet is 44.8.[Conclusion]1.The mental health level of ICU nurses needs to be improved,and there is high work pressure,which needs to improve their working environment effectively.2.The difference of mental health scores was most significant in ICU nurses’different departments,ages,night shift times and monthly income;the higher the work pressure of ICU nurses,the higher the score of mental health self-evaluation,the worse the health level;the better the working environment of ICU nurses,the lower the score of mental health self-evaluation,the better the health status;the Department,night shift,participating in hospital affairs and high-quality nursing services The change of mental health of nurses can be explained by the basic management,interpersonal relationship,working environment and resources.3.214(61.4%)of the respondents who had never known EAP;only 8(20.6%)knew and experienced EAP project;some people were negative about implementing EAP.To relieve the work pressure and mental health consultation is the most important demand of ICU nurses for EAP service;in terms of service mode,more tend to receive face-to-face consultation and professional training in hospitals.In the integrated ICU and CCU,the family care needs a lot,in EICU,there is a certain demand for professional skills training.The interviewee has four main topics for EAP service:the demand to relieve the work pressure,the need to solve the work family contradiction,the need to improve the career development path,and the need to deal with crisis events.4.The area under the ROC curve is 0.818,the evaluation effect is at a medium level,the maximum Youden index is 0.591,and the corresponding pressure value measured by the bracelet is 44.8.5.The implementation plan of EAP mainly includes four categories:team building,environmental construction,intervention plan,and effect evaluation. |
PDF Full Text Request