The Relationship Between Emotional Adjustment Strategies And Emotional Distress Among Contract Nurses

Objective:This study aims to examine the status of anxiety and depression among contract nurses,and to explore the relationship among mindfulness capability,ruminative responses,emotion regulation,anxiety and depression in contract nurses.This study provides a theoretical basis for the future research on the intervention of anxiety and depression among contract nurses,and also provides a basis for hospital administrators to correctly and reasonably handle human resources management and career planning for contract nurses.Methods:1120 contract nurses were recruited from two top three hospitals in Jinan City,Shandong Province,using a convenient sampling method.Participants were assessed with general information questionnaire,Generalized Anxiety Disorder-7(GAD-7).Patient Health Questionnaire-9(PHQ-9),the Short Inventory of Mindfulness Capability(SIM-C),Ruminative Responses Scale(RRS),and Emotion Regulation Questionnaire(ERQ).All data were analyzed with descriptive statistics,variance analysis,t-test,Pearson correlation analysis,multiple linear regression analysis and other methods using SPSS 24.0 software.Results:1.The age of contract nurses is between 20 and 46 years old,with an average age of(27.414.06)years;most are females 1073(96.5%);the range of medical work years is from 1 to 25 years,and the average age is(5.30±4.60)years;most nurses are unmarried(55.8%);the majority of the first degree is junior college(67.1%);the highest education is undergraduate(80.0%).2.The average score of depression among contract nurses was(6.35±4.33),the average score of anxiety score was(5.50±4.11),the positive rate of depressive symptoms was 62.9%,and the positive rate of anxiety symptoms was 56.8%,the comorbidity rate of depression and anxiety was 9.9%.The scores of depression among contract nurses were statistically significant(P<0.05)in age,working period,working shifts,technical titles.,smoking and drinking.There were no statistical differences in other dimensions;contract nurses were anxious in marriage.The differences in status,working period,working shifts,smoking and drinking were statistically significant(P<0.05),with no statistically significant differences in other dimensions.3.The depression scores of contract nurses were positively correlated with anxiety,ruminative response and expression inhibition scores(r=0.173-0.701,P<0.01),but negatively correlated with the level of mindfulness levels and re-evaluation scores(r=-0.158--0.458,P<0.01).There was a positive correlation between anxiety scores,ruminative responses and expression inhibition(r=0.140-0.631,P<0.01),but negative correlation with mindfulness levels and re-evaluation score(r=-0.147--0.393,P<0.0]).4.The scores of ruminative response(?=0.25,P<0.001)and expression inhibition(?=0.04,P<0.05)could significantly predict the occurrence of depression among contract nurses;while re-evaluation(?=-0.07,P<0.001)and mindfulness levels(??-0.18,P<0.001)could negatively predict the occurrence of depression among contract nurses.Furthermore,mindfulness evels(OR=0.93,95%CI=0.88-0.97)and re-evaluation(OR=0.95,95%CI=0.92-0.98)are both protective factors for depression,while ruminative response(OR=1.18,95%CI=1.14-1.21)was a risk factor for depression among contract nurses.5.The ruminative response(?=0.23,P<0.001)could significantly predict the occurrence of anxiety among contract nurses,while re-evaluation(?=-0.06,P<0.001)and mindfulness levels(?=-0.117,P<0.001)could negatively predict the occurrence of anxiety among contract nurses.The re-evaluation(OR=0.94,95%CI=0.91-0.98)was a protective factor for anxiety,while the ruminative response(OR=1.17,95%CI=1.13-1.20)was a risk factor for anxiety among contract nurses.6.Compared with the non-depression and anxiety group,re-evaluation(OR=0.941,95%CI=0.89-0.99)was a protective factor for anxiety only,while ruminative response(OR=1.16,95%CI=1.11-1.21)was a risk factor for anxiety only;mindfulness levels(OR=0.92.95%CI=0.87-0.98)were a protective factor for depression only.Re-evaluation(OR=0.93,95%CI=0.88-0.97)was a protective factor for the comorbidity group,while ruminative response(OR=1.265 95%CI=1.21-1.31)was a risk factor for the comorbidity group.7.Compared with the depression group only,ruminative response(OR=1.09,95%CI=1.04-1.13)was a risk factor for anxiety and depression comorbidity;similarly,ruminative response(OR=1.08,95%CI=1.03-1.14)is also a risk factor for anxiety and depression comorbidity compared with the anxiety group only.Conclusion:1.Contract nurses have a higher degree of anxiety and depression.2.Both mindfulness levels and re-evaluation are protective factors for depression,while ruminative response is a risk factor for depression.Re-evaluation is a protective factor for anxiety,and ruminative response is a risk factor for anxiety.It was suggested that contract nurses with depression should adopt mindfulness and re-evaluate emotion regulation strategy,while contract nurses with anxiety should adopt re-evaluate emotion regulation strategy.3.Compared with the non-depression and anxiety group,the depression group only,the anxiety group only,ruminative response is a risk factor for the comorbidity of depression and anxiety,re-evaluation is a protective factor for the comorbidity of depression and anxiety.It is suggested that contract nurses with the comorbidity of depression and anxiety should adopt re-evaluation emotion regulation strategy.