Potential Categories And Influencing Factors Of Psychosomatic Symptoms Of Psychiatric Nurses And Their Relationship With Nursing Adverse Events

Objective:(1)To investigate the current status of psychiatric nurses’ psychosomatic symptoms(anxiety symptoms,depressive symptoms,somatic subhealth symptoms);(2)To identify the types of psychiatric nurses’ psychosomatic symptoms using Latent Profile Analysis(LPA);(3)To explore the magnitude of the effects of adverse experiences(exposure to workplace psychological violence,recent negative life events,childhood traumatic events)on psychiatric nurses’ psychosomatic symptom subtypes;(4)To clarify the relationship between psychiatric nurses’ psychosomatic symptom subtypes and adverse nursing events.Methods:In this study,a multi-stage stratified whole-group sampling method was used to select psychiatric nurses from four prefectural and municipal psychiatric hospitals in Shandong Province from December 2020 to March 2021 as the study population.A self-designed general information questionnaire,the Generalized Anxiety Disorder-7(GAD-7),the 9-item depression module of the Patient Health Questionnaire-9(PHQ-9),Somatic Complaints of Subheath Status Questionnaire(SC-SS-Q),the Chinese version of the Workplace Psychologically Violent Behaviors Instrument(WPVB)and the Life Events Questionnaire were used to assess psychiatric nurses’ anxiety symptoms,depressive symptoms,somatic subhealth symptoms and workplace psychological violence,and negative life events(recent life events,childhood traumatic events)respectively.SPSS 21.0 and Mplus 8.3 software were used for statistical analysis.LPA was used to identify potential categories of psychiatric nurses’ psychosomatic symptoms,dominance analysis was used to compare the magnitude of the effect of different adverse experiences on psychiatric nurses’ psychosomatic symptom subtypes,and binary logistic regression analysis was used to explore the relationship between different psychosomatic symptom subtypes and adverse nursing events.Results:1.In this study,800 questionnaires were distributed and 742 valid questionnaires were returned,with a valid return rate of 92.8%.The positive rate of anxiety symptoms among psychiatric nurses was 24.1%;the positive rate of depressive symptoms was 35.3%;and the positive rate of somatic subtype symptoms was 38.8%.2.The results of the potential profile analysis of psychiatric nurses’ psychosomatic symptom types showed that the psychiatric nurses’ psychosomatic symptom types in this study could be divided into three categories,named as "low level psychosomatic"(67.6%),"medium level psychosomatic"(26%)and "high level psychosomatic"(6.4%).3.The differences in the distribution of different potential categories of psychosomatic symptoms among psychiatric nurses were statistically significant across demographic characteristics(age,mean monthly income,history of illness),work-related characteristics(years of experience,mode of employment,job title,weekly working hours)and traumatic experiences(exposure to psychological violence in the workplace,recent negative life events,traumatic childhood events)(all p<0.05).4.The results of the dominance analysis of the impact of psychiatric nurses’ adverse experiences on the potential categories of psychosomatic symptoms showed that psychiatric nurses’ exposure to psychological violence in the workplace predicted the largest relative contribution to the potential categories of psychosomatic symptoms at 88.4%,while recent negative life events and childhood traumatic events predicted 6.7%and 4.9%of the relative contribution to the potential categories of psychosomatic symptoms,respectively.5.After controlling for general information related to the potential category of psychosomatic symptoms in psychiatric nurses,nurses with "medium level psychosomatic symptoms" had a 75.5%increased risk of adverse nursing events compared to psychiatric nurses with "low level psychosomatic symptoms"(OR=1.755,95%CI:1.126-2.735)and 3.827 times higher for ’high level psychosomatic’ nurses(OR=4.827,95%CI:2.544-9.157).Conclusions:1.Psychiatric nurses had higher levels of anxiety,depressive symptoms and somatic subhealth symptoms.2.The types of psychosomatic symptoms among psychiatric nurses were classified into three categories:"low level psychosomatic","medium level psychosomatic" and "high level psychosomatic".3.Among the adverse experiences,exposure to psychological violence in the workplace had the greatest impact on the potential categories of psychosomatic symptoms among psychiatric nurses,followed by recent negative life events and childhood traumatic events.4.Psychiatric nurses in the "high level of psychosomatic symptoms" category are at highest risk for adverse nursing events and should be concerned.Nursing managers should pay attention to the early screening of psychiatric nurses for psychosomatic symptoms in order to identify at an early stage those who are at high risk of developing adverse nursing events and provide targeted psychological guidance and support.