| Objective:To assess perceived discrimination,psychological distress,physical sub-health and quality of life in bedside male nurses,examine the effects of perceived discrimination,psychological distress,physical sub-health on life quality,and explore the mediating effects of psychological distress and physical sub-health in the relationship between discrimination perception and quality of life,so as to provide evidence for improving the quality of life of male nurses.Methods:A total of 611 male nurses were selected by convenience sampling method.A series of questionnaires,including general demographic scale,Perceived Discrimination Scale for Male Nurses,Psychological Distress Scale,Physical SubHealth Scale,and Quality of Life SF-8 scale were used to examine perceived discrimination,psychological distress,physical health and life quality.SPSS22.0 and AMOS23.0 software were used for statistical analysis.Analysis methods included descriptive statistical analysis,independent sample t-test,analysis of variance,linear hierarchical regression,Pearson correlation analysis and structural equation model.Results:1.Sociodemographic information of male nursesThe 611 male nurses aged 20 to 51 years old,with an average age of 29.16±4.66.The worked as bedside nurses 1 to 33 years,with an average of 6.76±4.66.Most of the male nurses were from the country(71.7%),with bachelor’s degree(75.8%).They mostly acquired professional titles of nurses(44.8%),mainly working in ICU(26.7%)and operating room(23.7%),and earned an average monthly income of 5000～7999 yuan(36.5%).2.Perceived discrimination,psychological distress,physical sub-health and quality of life of male nursesThe average score of male nurses’ perceived discrimination was 21.54±4.48,and the average score per item was 2.39±0.50.The average score was highest for the dimension of acquaintance discrimination(2.49±0.71),followed by the dimension of public discrimination(2.44±0.76),the dimension of patient discrimination(2.35±0.55),and lowest for the dimension of self-discrimination(2.33±0.60).The score of psychological distress of male nurses was 23.17±6.82,and the average score of items was 2.32±0.68.A total of 87 male nurses ranked in grade Ⅰ of psychological distress(14.2%),193 were in grade Ⅱ(31.6%),208 were in grade Ⅲ(34.0%),and 123 were in grade Ⅳ(20.1%).Indicating that most male nurses were in poor mental health and at high risk of mental disease.The average score of physical sub-health was 9.44±2.87,and the average score per item was 2.36±0.72.The average score of quality of life was 66.58±16.78 for overall,68.49±18.16 for physiological dimension and 64.66±18.14for psychological dimension.Among the 8 factors of quality of life from high to low were as follows:the highest score was for physical pain,and followed by physical fuction,physical function,emotional function,social function,mental health,vitality and finally by general health.3.Differences of perceived discrimination,psychological distress,physical subhealth and quality of life according to socio demographic status among male nursesUnivariate analysis showed that male nurses’ perceived discrimination had significant differences between age groups(F=-3.176,P<0.05),number of night shifts per month(F=4.551,P<0.01),overtime hours per month(F=2.708,P<0.05)and selfperceived work stress(F=10.348,P<0.001).There were significant differences in male nurses’ psychological distress according to the number of night shifts(F=5.793,P<0.01)and self-perceived work stress(F=37.319,P<0.001).For physical sub-health,there were significant differences according to marital status(F=3.811,P<0.05),number of night shifts per month(F=4.152,P<0.01),overtime hours per month(F=4.147,P<0.01)and self-perceived work stress(F=14.377,P<0.001).There were significant differences in physical sub-health dimension of male nurses’quality of life between groups of age(F=3.148,P<0.05),monthly average income(F=3.222,P<0.05)and self-perceived work stress(F=13.829,P<0.001).And for mental health dimension of the quality of life between groups of age(F=3.050,P<0.05),monthly average income(F=4.206,P<0.01)and self-perceived work stress(F=21.969,P<0.001).The overall quality of life of male nurses was significantly different according to age(F=3.631,P<0.05),monthly average income(F=2.795,P<0.05),number of night shifts per month(F=3.269,P<0.05),overtime hours per month(F=2.944,P<0.05),selfperceived work stress(F=20.772,P<0.001).4.Correlation analysis of perceived discrimination,psychological distress,physical sub-health and quality of life among male nursesPearson correlation analysis showed that perceived discrimination was positively correlated with psychological distress(r=0.286,P<0.01)and physical sub-health(r=0.213,P<0.01),and negatively correlated with quality of life(r=-0.258,P<0.01).Psychological distress was positively correlated with physical sub-health(r=0.429,P<0.01),and negatively correlated with quality of life(r=-0.601,P<0.01).Physical subhealth(r=0.544,P<0.01)was negatively correlated with quality of life.5.The association of perceived discrimination,psychological distress and physical sub-health with quality of life among male nursesThe results of linear hierarchical regression showed that sociodemographic factors,perceived discrimination,psychological distress and physical sub-health could explain 7.9%,5.7%,15.0%and 7.6%of the variation of physical health dimension of male nurses’ quality of life,respectively,and all variables explained 36.2%of the variation.In particular,public discrimination(β=0.121,P<0.05),self-discrimination(β==-0.084,P<0.05),psychological distress(β=-0.335,P<0.001),physical sub-health(β=-0.316,P<0.001)could significantly predict the physical dimension of quality of life of male nurses.For mental health dimension of male nurses’ quality of life sociodemographic factors,perceived discrimination,psychological distress,and physical sub-health could explain 12.0%,7.2%,22.7%,and 6.0%of the variation respectively,and all variables explained 47.9%of the variation.Stratified by dimensions,self-discrimination(β=0.113,P<0.01),psychological distress(β=-0.456,P<0.001)and physical sub-health(β=0.282,P<0.001)could significantly predict the psychological dimension of quality of life of male nurses.When quality of life was examined overall,sociodemographic factors,perceived discrimination,psychological distress,and physical sub-health could explain 13.4%,7.4%,21.3%,and 6.8%of the variation in male nurses,respectively,and all variables explained 48.9%of the variation.The number of night shifts per month(β=-0.062,P<0.05),self-discrimination dimension(β=-0.109,P<0.01),psychological distress(β=-0.433,P<0.001)and physical sub-health(β=-0.303,P<0.001)could significantly predict the overall quality of life of male nurses.6.Mediating effects of psychological distress and physical sub-health on the association of perceived discrimination and quality of life among male nursesThe results of structural equation model showed that the revised model fitted well(P<0.001,x2/df=2.926,GFI=0.899,IFI=0.931,TLI=0.922,CFI=0.931,RMSEA=0.056).Perceived discrimination could significantly increase psychological distress(β=0.46,P<0.001),while psychological distress could reduce quality of life(β=-0.50,P<0.001).In addition,perceived discrimination significantly increased physical sub-health(β=0.43,P<0.001),while physical sub-health decreased quality of life(β=-0.45,P<0.001).The direct effect of perceived discrimination on quality of life was-0.034(95%CI:-0.130,0.078),and the indirect effect was-0.419(95%CI:-0.568,-0.303).Psychological distress and physical sub-health completely mediated the negative effect of perceived discrimination on quality of life.Conclusion:1.Among bedside male nurses,the psychological distress is prevalent,the perceived discrimination is at the medium level,whereas the quality of life and physical health is well.2.Perceived discrimination,psychological distress and physical sub-health are risk factors for quality of life of male nurses.3.Psychological distress and physical sub-health play a complete mediating role in the relationship between perceived discrimination and quality of life. |
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