| ObjectivesTo investigate the situation of nurses' job burnout in tertiary hospital of Lanzhou,and analyze the influence of general socio-demographic characteristics on nurses' job burnout,and explore the mechanism of job burnout between psychological capital and work stress.Based on these results,the Balint group model was used to intervene in nurses with job burnout,and the effects of the Balint Group on nurses' job burnout,psychological capital,and work stress were evaluated,providing valuable basis for nursing managers to improve the physical and mental health of nurses and quality of nursing work.Methods1.Investigation and research on the job burnout of nursesA cross-sectional study was used to facilitate the questionnaire survey of 773 clinical registered nurses from a tertiary hospital in Lanzhou.Research tools included general information questionnaire,MBI-Human Service Survey(MBI-SS),Chinese Revision of Nurses' Psychological Capital Questionnaire(PCQ-R),Chinese Nurses Stressor Scale(CNSS).The collected data was analyzed by SPSS 22.0 software,and the statistical methods included descriptive statistics analysis,t-test,single factor analysis,Pearson correlation analysis,and structural equation model.Understand the current situation and analyze the influence of general demographic characteristics on nurses' burnout,and explore and verify the mechanism of job burnout between psychological capital and work stress.2.Intervention study of balint group on nurses' job burnoutBased on the previous situation survey,67 nurses with job burnout were randomly selected as the research object and randomly assigned to the experimental group(n=33)and the control group(n=34).Among them,the nurses in the experimental group were trained in the Balint group,and the nurses in the control group were used in the routine psychological training.The nurses in the two groupswere trained 8 times,once every 2 weeks.Before and after intervention,the two groups of nurses were measured using the MBI-GS,PCQ-R,CNSS.The collected data was analyzed by SPSS 22.0 software and the statistical methods included descriptive statistics analysis,t-test and Chi-square test,and the "generic analysis" was used to conduct a qualitative analysis of the cases discussed by the Balint group.Results1.Results of current situation survey and researchA total of 860 questionnaires were distributed and 773 were effectively recovered,with a recovery rate of 89.9%.There were 322 nurses without burnout(41.7%),and451 nurses with different levels of burnout(58.3%),of whom 217 were mild burnout(28.1%),183 were moderate(23.7%),and 51 were severe(6.5%).The nurse's mean scores of subscales of emotional exhaustion,depersonalization and personal accomplishment were,respectively,23.88(SD 9.80),6.95(SD 4.07)and 32.79(SD8.74).Job burnout in some demographic variables such as age,nursing age,education backgrounds,departments,job titles,work shifts,and human relations have significant differences(P<0.05).There was a correlation between job burnout and psychological capital and work stress(r =-0.351~0.888,P<0.05).The dimensions of emotional exhaustion and depersonalization were negatively correlated with psychological capital and it were positively correlated with work stress.The dimension of personal accomplishment was positively correlated with psychological capital and it was negatively correlated with work stress.And work stress and psychological capital were negatively correlated.The structural equation model showed that psychological capital had a direct negative effect on emotional exhaustion and depersonalization,with path coefficients of-0.18(P<0.01)and-0.15(P<0.01),and it had a direct positive effect on personal achievement,with path coefficient of 0.45(P<0.01).Work stress directly predicted emotional exhaustion and depersonalization,with path coefficients were 0.57(P<0.01)and 0.41(P<0.01),and it directly predicted personal achievement,with path coefficient of-0.12(P<0.01).Psychological capital had an indirect negative effect on emotional exhaustion and depersonalization with the work stress as an intermediary variable,with path coefficients were-0.11(P<0.01)and-0.08(P<0.01),and it had an indirect positive effect on personal accomplishment,with path coefficient of 0.02(P<0.01).2.Findings of the Baint Group intervention on nurses' job burnout(1)The comparison of two groups nurses' job burnout scores before and after theinterventionThe comparison results within the group showed that the emotional exhaustion dimension scores of the nurses in the experimental group before and after intervention were 29.21(SD 5.61)and 22.52(SD 2.72),the depersonalization dimensions were9.93(SD 2.42)and 5.36(SD 1.27),the personal accomplishment were 28.45(SD 5.79)and 35.33(SD 5.26),and the differences were statistically significant(P<0.01).There was no difference in the control group of job burnout compared with that before the intervention(P>0.05).The comparison results between the groups showed that after the intervention,the nurses in the experimental group had significantly lower scores on emotional exhaustion and depersonalization than the control group,and their scores on personal accomplishment were significantly higher than those in the control group,and the difference was statistically significant(P<0.01).(2)The comparison of two groups nurses' psychological capital scores before and after the interventionThe comparison results within the group showed that the total psychological capital score and the scores of all dimensions in the experimental group were higher than the scores before the intervention,and the total psychological capital score increased from 83.55(SD 10.09)before the intervention to 92.09(SD 8.81).The difference was statistically significant(P<0.01).The total score of psychological capital and each dimension scores in the control group were not statistically significant compared with those before the intervention(P>0.05).The comparison results between the groups showed that after the intervention,the total psychological capital score and each dimension scores in the experimental group were higher than those in the control group,and the difference was statistically significant(P<0.01).(3)The comparison of two groups nurses' work stress scores before and after the interventionThe comparison results within the group showed that the total scores of the working stress and the dimensions of the nurses in the experimental group were lower than the pre-intervention measurement scores.Among them,the total working stress score was reduced from 95.91(SD 12.91)points before the intervention to 79.15(SD 12.48)points.The difference was statistically significant(P<0.01).In the control group,the overall scores of nurses' work stress,nursing profession and work,and patient care were lower than those before intervention,and the differences were statistically significant(P<0.05).But there was no significant difference in workloadand time allocation,working environment and equipment,management and interpersonal relationship(P>0.05).The comparison results between the groups showed that after the intervention,the total work stress scores and each dimension scores in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.01).(4)Qualitative research resultsThis study presented a total of 24 cases,and each case summarized the key words from five aspects: case conflict situations,trigger conflict events,nurses' emotional reactions,group discussion topics,nurses' experience and perceptions.The conflict situations in the case mainly included: conflicts between nurses and patients,unharmonious organizational environment,and conflicts in social relationships.Triggering conflicts included patient mistrust,conflict between rules and emotions,lack of medical resources,unsatisfactory treatment results,unsatisfied the patient needs,unreasonable requests from patients,medical cost disputes,uncoordinated cooperation with doctors,high standards leadership styles of managers and conflicting social relationships.Emotional reactions mainly included grievances,fear,helplessness,boredom and so on.The topics of discussion mainly include the role experience related to patients,the emotional support of colleagues,and the perspective perception of managers.The nurse's perception and experience were mainly refined into changing professional attitudes,increasing the warmth of work,improving professional skills,experiencing professional benefits,and actively adjusting psychologically.Conclusions1.The degree of job burnout among nurses in tertiary hospital of Lanzhou was mainly mild and moderate,and the score of job burnout is in the middle and high level nationwide.Age,nursing age,education backgrounds,department,job title,work shift,and human relationship had an impact on nurses' job burnout.Job burnout of nurses was significantly correlated with psychological capital and work stress.2.As an effective training course,Balint group activities could alleviate the level of nurses' job burnout to a certain extent,improve psychological capital,and reduce work pressure.This can provide a reference and basis for nursing managers to maintain nurses' mental health and improve the quality of nursing services. |
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