| BackgroundWith the continuous development of the era,people put forward higher requirements for nursing service,the connotation of humanistic nursing is innovated accordingly.In the outline of China's nursing development plan during 2016-2020,the former National Health and Family Planning Commission of China proposed that nursing service should strengthen the construction of nursing connotation,deepen the patient-centered service concept,and vigorously promote quality nursing service.For actually,humanistic care has become an indispensable theme in modern nursing.As the place for the treatment of critically ill patients,Intensive Care Unit(ICU)requires nurses to have higher humanistic care ability.However,the closed,depressed and high-load special working environment in the ICU has a negative impact on the physical and mental health of nurses,resulting in different degrees of empathy fatigue among nurses,which is not conducive to the development of quality nursing services.Thus,it's of great theoretical value and practical guidance to understand the current situation of caring ability and compassion fatigue of nurses in the ICU and to find out the relationship between them,which could lay a theoretical foundation for hospital managers to make more scientific nursing management decisions,and provide efficient and high-quality nursing services to improve the relationship between nurses and patients.ObjectiveThrough investigating the status quo of humanistic caring ability and compassion fatigue of ICU nurses,we analyzed the differences of humanistic care ability and compassion fatigue among nurses with different characteristics.The structural equation model was applied to analyze the correlation between the caring ability and compassion fatigue of nurses in the ICU,we explored the factors that affect humanistic care ability and compassion fatigue and put forward the corresponding improvement measures and management strategies.MethodIn this study,we chose the Caring Ability Inventory and Professional Quality of Life scale as tools to obtain the information about ICU nurses' current status of caring ability and compassion fatigue in 6 tertiary general hospitals in Jinan and Qingdao in Shandong province.In the later period of the study,semi-structured interviews were conducted with the nursing department directors and head nurses of ICU of 6 hospitals(12 persons in total).We used SPSS25.0 for data entry and analysis,including descriptive analysis and single-factor comparative analysis.In addition,Amos23.0 was also used to build a structural equation model to analyze the relationship between the caring ability and the degree of compassion fatigue.Finally,according to the previous research results,we put forward the corresponding countermeasures and implicationsResults(1)General situation of caring ability and compassion fatigue of ICU nursesThe caring ability of 583 ICU nurses was generally at a medium level,and the scores of each dimension are unbalanced.The total CAI score was 199.31±21.91,among which,the scores and items of cognition,courage and patience are 76.90±9.41,61.90±9.80,62.00(58.00,65.00)respectively.The phenomenon of compassion fatigue of ICU nurses is relatively common.More than 75%of nurses have moderate or higher degree of burnout and secondary traumatic stress.The scores of empathy satisfaction,secondary traumatic stress and burnout in ProQOL scale are 31.77±8.57,23.00(20.00,27.00)and 25.30±6.17 respectively.(2)Characteristics of caring ability of ICU nursesIn terms of demographic information,there are statistically significant differences in the total CAI scores and scores of each dimension among nurses in the intensive care unit with different gender,age,educational background,position and personnel nature(P<0.05).Among which,the score of female nurses' courage dimension and CAI are higher than that of male nurses;the score of cognition,courage,patience and CAI of older nurses are higher than that of younger nurses;the score of CAI and all dimensions of nurses with graduate education are higher than that of nurses with college and undergraduate education;the score of cognition,patience and CAI of head nurses are higher than that of general clinical nurses and teachersFor the aspect of workload and income,there are statistically significant differences in the total score of CAI and the scores of all dimensions among nurses in different care rooms who were different in the number of nursing awake patients,the number of nursing coma patients,and the monthly average pre-tax income(P<0.05).Among which,when the number of awake patients was 3 per day,the score of cognition dimension of nurses in the ICU was the lowest;when the number of nursing coma patients per day was more than 3,the patient dimension score and total CAI score of nurses in the ICU are the highest.On the whole,there is no difference between the total CAI score and the score of each dimension for nurses in different ICU with the number of patients cared for today or yesterday,the average number of working hours per week,the scheduling,and the number of night hours per week.(3)Characteristics of compassion fatigue of ICU nursesIn terms of demographic information,there are statistically significant differences in scores of different dimensions of ProQOL scale among nurses in the ICU with different educational background,professional title,position and personnel nature(P<0.05).Among which,the nurses with graduate education background,professional title as supervisor or chief nurse,and position as head nurse scored the highest in the dimension of empathy satisfaction,and the lowest in the dimension of burnout;formally enrolled nurses in the intensive care unit had the lowest scores in the secondary traumatic stress dimension.In the aspect of workload and income,there are statistically significant differences(P<0.05)in the dimension scores of ProQOL scale among ICU nurses with different numbers of daily nursing patients,nursing coma patients,shift arrangement,weekly working hours,weekly night shift hours and monthly average pre-tax income.Among which,the nurse with fewer than 3 patients a day had the lowest scores in burnout dimension;the nurse in the 8-hour and 12 hour shifts had lower scores of the secondary traumatic stress dimension;the nurse who worked more than 50 hours a week scored lowest on the empathy satisfaction dimension and highest on the burnout dimension;the nurse who worked nights of less than 12 hours a week scored highest on the empathy satisfaction dimension and lowest on the burnout dimension;the nurse with pre-tax income of less than 10,000 yuan had the highest score in the empathy satisfaction dimension and the lowest score in the secondary traumatic stress dimension(4)The Relationship between caring ability and compassion fatigue of ICU nursesThrough the structural equation model analysis,we found the relationship between the dimensions of the two scales which as follows:cognition positively affected empathy satisfaction and secondary traumatic stress(?=0.698,P<0.001,?=0.766,P<0.01),and negatively affects burnout(?=-0.157,P<0.001);courage negatively affects empathy satisfaction and secondary traumatic stress(?=-0.336,P<0.01;?=-0.677,P<0.001),and positively affects burnout(?=0.367,P<0.05);patience negatively affects empathy satisfaction and secondary traumatic stress(?=-0.005,P<0.001,?=-0.663,P<0.01).In brief,caring ability positively affected compassion fatigue(?=0.614,P<0.001),that is,for every standard deviation of caring ability increased,compassion fatigue increased by 0.614 standard deviations.ConclusionThe care ability of ICU nurses is in the middle level,and the score of cognition,courage and patience is unbalanced.Besides,the phenomenon of compassion fatigue of nurses in ICU is common and serious.There are significant differences in caring ability and degree of empathy fatigue among nurses in the ICU with different educational background,position,workload and monthly average pre-tax income.Furthermore,the caring ability of nurses in ICU has a positive effect on compassion fatigueThe implications are as follows:1.The nursing management should carry out the humanistic care concept and give full attention and respect to the reasonable individual needs of the nurses in the ICU2.Appropriately raise the salary level of nurses in the ICU.3.Increase the allocation of nursing staff and reduce the workload of nurses.4.Stimulate nurses in the ICU to improve education level5.Head nurse try to play a supporting role in the department management. |
PDF Full Text Request