The Relationship Between Workload,Life Events And Anxiety,Depression In Emergency Nurses

Background:Emergency department nurses often need face diverse critically ill patients,undertake various rescue and treatment tasks.They are often in the status of work overload,hence.emergency nurses need bear significantly higher pressure than ordinary ward nurses,resulting they are more prone to anxiety,depression mood.However,for emergency nurses.the job is only one part of the daily life,they also need to take on responsibilities as parents or spouses.They may experience a number of life events in their personal and family lives,including recent negative life events and childhood traumatic events,which are the risk factors of anxiety and depression in emergency nurses.Objective:Using a larger sample,we aimed to understand the current situation of anxiety and depression among emergency nurses,and examine the relationship between workload,life events(recent negative life events and childhood traumatic events)and anxiety and depression among emergency nurses.Our research may provide reference for nursing managers to identify high-risk groups of anxiety and depression in early stage,as well as design or take targeted interventions.Methods:A sample of 302 emergency nurses from eight comprehensive hospitals of tertiary level A in Jinan City were enrolled.The Generalized Anxiety Disorder-7(GAD-7)was conducted to measure the anxiety mood of emergency nurses.The research showed that when GAD-7?10,the questionnaire had good sensitivity and specificity for identifying generalized anxiety emotion.Therefore,this study adopted 10 as the cutoff for positive screening of anxiety.The 9-item depression module of the Patient Health Questionnaire-9(PHQ-9)was used to assess the depression mood of emergency nurses.The research showed that when PHQ-9?10,the sensitivity and specificity for identifving depression emotion up to 88%.As a result,this study adopted 10 as the cutoff for positive screening of depression.In this study,the anxiety and depression were only based on the scale screening,those emergency nurses who scored higher than the cut-off point of anxiety and depression only represented the existence of anxiety and depression symptoms to a certain degree,which were different from anxiety and depression in the diagnosis of mental diseases.Role Overload Questionnaire and Life Events Questionnaire were conducted for the measurement of workload and life events.Moreover,we also used self-made questionnaire to collect the general demographic information of emergency nurses.A total of 350 questionnaires were distributed,and 316 questionnaires were returned.after deleting the cases with missing questions more than 50%and individuals with incomplete data in major variables(anxiety,depression),302 emergency nurses were included into current analysis,the valid return rate was 86.3%.SPSS 21.0 was applied for data input and analysis.The statistical analysis methods used in this study included descriptive statistical analysis,independent-samples T test,one-way ANOVA,?2-test,Pearson correlation analysis and hierarchical linear regression analysis.Results:1.The general demographic infonnation of emergency nurses:Among 302 emergency nurses,the mean age was(29.40±5.63)years old.Young nurses were predominated,192(63.6%)were aged 20-29 years.228 nurses were female,accounting for 75.5%of the sample.196(64.9%)nurses lived with a partner.253(83.8%)emergency nurses had bachelor's degree or above.The emergency nurses who got bachelor's degree as first degree accounted for 46.7%of the total.The contract nurses counted for 85.4%.The subjects with titles of nurses and nurse practitioners accounted for 45.4%and 52.6%of the total sample respectively.And the emergency nurses with monthly income more than 6000 RMB accounted for 44.0%.2.The scores of anxiety and depression among emergency nurses:The score range of anxiety among emergency nurses was 0-21,with an average score of(5.93±4.78).The score range of depression among emergency nurses was 0-27.with an average score of(7.38±5.66).A score of 10 was used as the cut-off score of screening for anxiety and depression 20.5%of emergency nurses had anxiety,and 29.1%emergency nurses had depression in this research(Screening based only on scales,which were different from anxiety and depression in psychiatric diagnosis).3.Differences in scores of anxiety and depression among emergency nurses with different general information:The results indicated that the anxiety scores of emergency nurses with difference age were statistically different(P=0.033).Post hoc test showed that emergency nurses aged 30-39 years had higher anxiety scores than those nurses aged 20-29 years(P=0.009).Female emergency nurses had a higher anxiety scores than male nurses(P=0.03 1).Emergency nurses lived with a partner had higher anxiety scores than those nurses lived without a partner(P=0.009).There were statistically significant differences in anxiety and depression scores across nurses with different first degree(all P=0.001).The emergency department nurses with technical secondary school education as first degree had the highest anxiety scores,which is followed by those with associate degree as first degree.Meanwhile,the emergency nurses with technical secondary school education and associate degree as first degree had higher depression scores than those nurses with bachelor's degree as first degree(all P<0.05)4.Differences in positive rate of anxiety and depression among emergency nurses with different general information:The results of ?-test indicated that,compared with emergency nurses lived without a partner,those lived with a partner had a higher positive rate of anxiety(P=0.035).The positive rate of anxiety and depression in emergency nurses with different education as first degree were different.Those emergency nurses with technical secondary school education as first degree had a higher positive rate of anxiety and depression than those with bachelor's degree as first degree,which had statistically significant differences(all P<0.05).5.Comparison of workload,life events(recent negative life events and childhood traumatic events)of emergency nurses between positive and negative groups of anxiety and depression:The emergency nurses in anxiety-positive group,had significantly higher scores of workload and life events(recent negative life events and childhood traumatic events)than anxiety-negative group(all P<0.05).There was no statistically difference in workload scores between depression-positive group and depression-negative group nurses(P>0.05),but depression-positive group nurses had significantly higher scores of life events(recent negative life events and childhood traumatic events)than depression-negative group nurses(all P<0.05).6.Correlation analysis of workload,life events(recent negative life events and childhood traumatic events)and anxiety and depression among emergency nurses:The results showed that the workload and life events(recent negative life events and childhood traumatic events)were positively correlated with anxiety of emergency nurses,and the correlation coefficients were 0.259?0.341?0.232(all P<0.001)respectively;The workload and life events(recent negative life events and childhood traumatic events)were positively correlated with depression of emergency nurses,and the correlation coefficients were 0.293?0.297?0.260(all P<0.001)respectively.7.Multivariate hierarchical regression analysis of influencing factors of anxiety and depression among emergency nurses:The anxiety scores of emergency nurses were taken as the dependent variable,general information of significance in the single factor analysis(age,sex.with or without a partner,first degree)was incorporated into the first layer model,and the workload was incorporated into the second layer model,and life events(recent negative life events and childhood traumatic events)were incorporated into the third layer model.The overall regression model could explain 26.8%of anxiety variance,the model was statistically significant(P<0.001).Anong the overall model,workload could explain 5.6%of anxiety variance,while life events(recent negative life events and childhood traumatic events)could explain 15.4%of anxiety variance.The results showed that the workload was a positive predictor of anxiety along emergency nurses,and the standardized regression coefficient is 0.24(P<0.001),and it remained 0.24(P<0.001)after the adjustment of life events.The life events(recent negative life events and childhood traumatic events)could positively predict anxiety of emergency nurses,and the standardized regression coefficients were respectively 0.29?0.18(all P<0.01).The depression scores of emergency nurses were taken as the dependent variable.general information of significance in the single factor analysis(first degree)was incorporated into the first layer lodel,the workload was incorporated into the second layer model,and life events(recent negative life events and childhood traumatic events)were incorporated into the third layer model.The overall regression model could explain 25.9%of depression variance.the model was statistically significant(P<0.001).Among the overall model,workload could explain 8.4%of depression variance,while life events(recent negative life events and childhood traumatic events)could explain 12.7%of depression variance.The results showed that the workload was a positive predictor of depression among emergency nurses,and the standardized.regression coefficient is 0.29(P<0.001),and it remained 0.29(P<0.001)after the adjustment of life events.The life events(recent negative life events and childhood traumatic events)could positively predict depression of emergency nurses,and the standardized regression coefficients were respectively 0.24?0.17(all P<0.01).Conclusion:1.The emergency nurses had relatively serious anxiety and depression symptoms.2.The workload and life events(recent negative life events and childhood traumatic events)were positively correlated with anxiety and depression of emergency nurses,the higher level of workload and life events,the more serious anxiety and depression symptoms.3.The workload and life events(recent negative life events and childhood traumatic events)of emergency nurses could positively predict anxiety and depression.4.This study suggests that nursing managers should pay attention to the workload and life events of emergency nurses to find the high-risk groups with anxiety and depression as early as possible,so as to take effective interventions to reduce the accumulation of negative enotion among emergency nurses,maintain the physical and mental health of nurses,and to improve the quality of care services.