| BackgroundFatigue is a common non-specific symptom. It not only can be a normal physiological reaction to the discomfort, but also can be a clinical manifestation of certain diseases, or a sub-health status which lies between the disease and the non-disease. Fatigue is often ignored in daily life since the adverse effects of fatigue on human body are not as significant as other diseases; however, long-lasting fatigue will cause physical and mental illnesses, chronic fatigue syndrome and even sudden death. In recent years, there are extensive researches on fatigue by various scholars and some valuable results have been made, but there are few studies on the fatigue of clinical nurses, in particular, the quantitative studies. Clinical nurses are a special group of people, who have to face a wide variety of patients. In addition to doing routine treatments for the patients, the clinical nurses need to offer psychological support and thus become a group that are apt to fatigue.A few studies have shown that the fatigue is related to the long-term stressful working. The impact of continued stress on the nurses is disastrous. Therefore, we include the stress in this study in order to understand the stress level of clinical nurses and its impact on the fatigue; include response methods and life satisfaction level in order to understand their relevance with fatigue; and finally sort the main problems that the clinical nurses have to encounter in their daily work, explore what clinical nurses are most concerned about and provide a theoretical evidence for the clinical nurses to develop appropriate intervention methods.ObjectiveThis research is to understand the fatigue status of clinical nurses, stress, life satisfaction, response method, and the main problems clinical nurses encounter in the daily work; to explore the relationships between the fatigue of nurses and stress, life satisfaction, response method; to provide theoretical evidence of exploring ways for clinical nurses to reduce fatigue.Objects and MethodsUsing the random cluster sampling method, fatigue, stress, response method, life satisfaction, and the main issues in the daily work, etc. of the clinical nurses in two municipal hospitals in one city were investigated through questionnaires. A total of 350 questionnaires were issued, 306 valid questionnaires were received, with a response rate of 87.4%. The questionnaires include"FS-14 Scale Table","Table for Nurse Stress Scale","WHO-5 Questionnaire on Quality of Life","Questionnaire on Styles of Coping with Trait"and"Sorting for The Critical Problems to Be Solved". SPSS11.5 software was used for data processing. The statistical methods include: descriptive statistics analysis, single-factor variance analysis, Pearson correlation analysis, t test, rank sum test, multi-factor logistic regression model, etc.Results1. The fatigue status of clinical nurses306 nurses have a total fatigue score of 7.17±3.406; a physical fatigue score of 4.84±2.190; and a mental fatigue score of 2.33±1.673. 130 of them score below 7, with a percentage of 42.5%; 176 people score above 7(including 7), with a percentage of 57.5%.2.Stress origin analysis of clinical nursesIn the surveyed 306 nurses, the stress origins have a minimum score of 47, a maximum score of 140, and the average score of 84.7, which is at a moderate stress level. Among the 360 nurses, 50 nurses (16.3%) score 35-70 with a light stress; 235 (76.8%) nurses score 71-105 with a moderate stress; 21 (6.5%) nurses score 106-140 with a severe stress. Among the five dimensions of the stress, we sorted by stress level as follows: workload and time allocation, health care professional and work, working environment and equipment issues, patient care, management and interpersonal skills. Among them, the low salary and other benefits, frequent shifts, heavy workload, low social status of nursing work, redundant paperwork, no independence in the work, limited number of nurses, redundant non-nursing type of work, worrying about errors and accidents in the work, and poor working environment are ranked top 10 of 35 items.3.Response methods of clinical nursesFrom the overall response point of view, the negative response score (31.97±7.45) is higher than the positive response score (23.22±6.790), shows that the overall response of clinical nurses is not optimistic. The difference among the active responses from nurses in different departments is significant in statistics (P <0.05), the nurses from department of surgery, operating room and pediatrics have better response capability than the nurses from department of internal medicine.4.Life satisfaction of clinical nurses59.2% of the surveyed nurses have a life satisfaction level greater than 12 while the rest of the nurses have a life satisfaction level equal to or less than 12. After statistical analysis, it is shown that the life satisfaction of nurses is affected by age, departments, working age, job position and job title; Educational level has no statistical significance in life satisfaction of nurses. Multi-variant regression analysis showed that the OR values of gross fatigue value, gross stress value, negative response value are 1.279, 1.024, 1.048, respectively, which are the risk factors for nurses'life satisfaction.5.The main problems encountered in the daily work of clinical nursesThe surveyed nurses claim that the main problems encountered in their work of are sorted as follows:①improve salary;②take care of nurses'life and work;③improve the hospital's management system;④reduce workload;⑤have the opportunity to further their studies or training. It can be observed from the results, the most concerned problem in clinical nurses'work is the low salary.6. Fatigue analysis of clinical nurses with individual charactersThe clinical nurses were grouped by age, job position, job title, education level, marital status, shift situation then the fatigue is compared, the results showed that the difference between the groups is not statistically significant. The fatigue of clinical nurses was compared according to the working age and the difference in physical fatigue scores is significant in statistics (P <0.05). Nurses with 5-20 years of working age have highest physical fatigue level, nurses with more than 20 years of experiences have lowest physical fatigue level, nurses with different working age show no statistical difference in total fatigue score and mental fatigue score; By analyzing total fatigue score, physical fatigue score, mental fatigue score of the nurses from different departments, nurses in different departments all have statistically significant (P <0.05) differences in total fatigue score, physical fatigue score and mental fatigue score, the scores of the nurses in ICU are highest in either total fatigue, physical fatigue or mental fatigue, while the nurses in department of pediatrics have lowest total fatigue score and physical fatigue; nurses in department of Gynecology have the lowest mental fatigue score.7. Correlation analysis of fatigue factorsThe correlation analysis of fatigue factors showed that total fatigue score, total stress score and its various dimensions, response method, life satisfaction level are correlated (P <0.05). Among them, positive response (r = -0.032), life satisfaction level (r = - 0.049) and fatigue are negatively related. Negative response (r = 0.229) and fatigue are positively correlated.8. Multi-variant regression analysis of fatigue factorsMulti-variant regression analysis of fatigue factors showed that the OR values corresponding to the total stress score and the negative response are 1.068, 1.059, respectively; OR value of positive response is 0.939. Compared to the department of ICU, the OR values of departments of internal medicine, gynecology, and pediatrics are 0.09, 0.021, and 0.005, respectively.Conclusions1. Clinical nurses undergo great stress in work, and the stressors are complicated. Low salary and benefits, frequent shifts, heavy workload, low social status of nursing work, redundant paperwork, no independence in the work, limited number of nurses, too much non-nursing type of work, worrying about errors and accidents in the work, and poor working environment are ranked top 10 of clinical nurses stress origins. Clinical nurses react negatively when encountering the stress; the negative response score is greater than the active response score.2. The main factors leading to the fatigue of clinical nurses are stress, response method. Clinical nurses'negative response to the stress will increase the fatigue level; on the contrary, positive response to the stress will reduce their fatigue.3. The satisfaction of clinical nurses with their life is not optimistic, 40.8% of nurses have low life satisfaction. Life satisfaction level is affected by fatigue, stress, response method: life satisfaction level is positively related to the positive response; however negatively related to the stress, the negative response, and the fatigue.
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