| ObjectiveThis study was to investigate the present situation of ICU nurses' psychological resilience,perceived organizational support,professional quality of life and work engagement,as well as to analyze the influencing factors of ICU nurses' work engagement and establish a structural equation model to explore the interaction among the four variables of ICU nurses.It provides reference basis for nursing managers to improve nurses' mental health,to mobilize nurses' enthusiasm fully and to improve the quality of nursing service continuously.MethodsTotally 345 nurses from five tertiary hospitals in Qingdao were investigated using cluster sampling.Self-designed demographic questionnaire,psychological resilience scale,perceived organizational support scale,professional quality of life scale and work engagement scale were used for data collection.All data were analyzed by SPSS 22.0and AMOS 22.0.The demographic date was described using frequency and percentage.The dimensions and total scores of ICU nurses' psychological resilience,perceived organizational support,professional quality of life and work engagement were described by mean and standard deviation.Independent-Samples T-test or one-way variance method was used to compare and analyze the differences in psychological resilience,perceived organizational support,professional quality of life and work engagement.The items with statistically significant difference were compared in pairwise.Pearson correlation analysis was used to analyze the correlation among the four variables of ICU nurses.Analysis of the influencing factors of ICU nurses' work engagement was used by multiple stepwise regression analysis.Based on the relevant analysis and professional foundation,the structural equation hypothesis model was established,and the statistical software was used for model verification and analysis.Results1.The total score of ICU nurses' psychological resilience was 60.70±12.42,the average scores of all dimensions range from high to low in order of self-improvement2.55±0.55,tenacity 2.39±0.56,optimism 2.33±0.48.The results of univariate analysis showed that ICU nurses' psychological resilience had statistical significance in terms of age and working years(P<0.05).2.The total score of ICU nurses' perceived organizational support was 42.34±8.75,the score of emotional support was 3.15±0.71 and the score of instrument score was3.59±0.70.The results of univariate analysis showed that ICU nurses' perceived organizational support had statistical significance in terms of age and marital(P<0.05).3.The original score of compassion satisfaction,job burnout,secondary traumatic stress were 31.20±5.82,25.90±4.88 and 25.56±4.45 respectively in the professional quality of life scale.The percentage of ICU nurses in intermediate to high level of compassion satisfaction,job burnout,secondary trauma stress were 74.2%,76.2% and76.2%.The results of univariate analysis showed that age,educational background,marital,years of nursing,title,employment nature and monthly income influenced compassion satisfaction significantly(P<0.05).Age,years of nursing,clinical department influenced job burnout significantly(P<0.05).Age,years of nursing,title influenced secondary traumatic stress significantly(P<0.05).4.The total score of ICU nurses' work engagement was 48.41±9.56.The average scores of all dimensions range from high to low in order of vitality 3.39±0.81,dedication3.20±0.81,absorption 3.06±0.62.The results of univariate analysis showed that ICU nurses' work engagement had statistical significance in terms of age,years of nursing and title(P<0.05).Multiple stepwise regression analysis showed that psychological resilience,perceived organizational support,compassion satisfaction,job burnout,secondary traumatic stress were important influencing factors of work engagement,they can explain57.3% variation of ICU nurse's work engagement.5.ICU nurses' psychological resilience was positively correlated with perceived organizational support,compassion satisfaction and work engagement(r=0.542,0.408,0.609,P<0.01),negatively correlated with job burnout and secondary traumatic stress(r=-0.547,-0.385,P<0.01);ICU nurses' perceived organizational support was positively correlated with compassion satisfaction and work engagement(r=0.405,0.592,P<0.01),and negatively correlated with job burnout and secondary traumatic stress(r=-0.543,-0.380,P<0.01);ICU nurses' compassion satisfaction was positivelycorrelated with work engagement(r=0.539,P<0.01);job burnout and secondary traumatic stress were negatively correlated with work engagement(r=-0.605,-0.507,P<0.01).6.The resulted of structural equation model were as follows:(1)Psychological resilience had a partial intermediary role between perceived organizational support and work engagement,the mediation effect accounted for 44.93% of the total effect.(2)Nurses' professional quality of life which have three dimensions of compassion satisfaction,job burnout and secondary traumatic stress had a partial intermediary role between perceived organizational support and work engagement,the mediation effect accounted for 45.71% of the total effect.(3)The multiple mediation effect of psychological resilience and professional quality of life were found on the relationship between perceived organizational support and work engagement.There were a chain-mediation effect among the four variables.ConclusionICU nurses have a low level of psychological resilience,perceived organizational support and work engagement;the professional quality of life is not optimistic.There is high space to improve.Further analysis shows that psychological resilience can mediate the relationship between perceive organizational support and work engagement;professional quality of life can mediate the relationship between perceived organizational support and work engagement.There is a chain mediation effect between the the four variables by the structural equation model.Perceived organizational support can directly affect work engagement,but also through psychological resilience and professional quality of life indirectly affect work engagement. |
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