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The Relationship Between Post-Traumatic Stress Disorder And Fatigue In Nurses From Grade A Tertiary Hospitals:the Mediating Role Of Self-Efficacy

Posted on:2024-01-28Degree:MasterType:Thesis
Country:ChinaCandidate:H Y WanFull Text:PDF
GTID:2544306920481084Subject:Public health
Abstract/Summary:PDF Full Text Request
ObjectiveDue to the nature of their work,nurses often work night shifts,have high work stress,and work in a relatively high risk,which may lead to poor physical and mental health conditions among nurses.However,after the outbreak of infectious diseases,the number of patients with infectious diseases in hospitals increases sharply,which magnifies the health risks and may aggravate the post-traumatic stress disorder and fatigue.Therefore,this study will describe the distribution status and influencing factors of post-traumatic stress disorder and fatigue among nurses in Jinan third-class A hospital.To analyze the mediating effect of self-efficacy on the relationship between post-traumatic stress disorder and fatigue.This study provides a scientific basis for alleviating the post-traumatic stress disorder and fatigue of nursing staff in the thirdclass A hospital of Jinan City,identifying high-risk groups and implementing targeted health intervention measures.Materials and methodsIn January 2023,this study adopted the cross-sectional survey method,and the typical sampling method was used to select six third-class A hospitals in Jinan City that treated COVID-19 patients and their departments,and then the whole group of nurses in each department was sampled.The study ended up looking at 900 nurses in third-class A hospitals,and 785 valid questionnaires were collected,and the effective rate was 87.2%.In this study,only 703 nurses who had not experienced traumatic events unrelated to COVID-19 were included,and the investigation contents included sociodemographic characteristics,health behaviors,health status,occupational status,factors related to COVID-19,General Self-Efficacy Scale,Post Traumatic Stress Syndrome 10Questions Inventory and Fatigue Scale.Cronbach’s a coefficient and factor analysis results were used in this study to describe the reliability and validity of the scale.Oneway analysis of variance and t-test statistical methods were used to compare the differences between post-traumatic stress disorder and fatigue scores in different population characteristics,and Pearson correlation analysis was used to analyze the correlation between continuous variables.Multiple linear regression model was used to analyze the influencing factors of post-traumatic stress disorder and fatigue,and to verify the mediating effect of self-efficacy on the relationship between post-traumatic stress disorder and fatigue.Results(1)Cronbach’s a coefficients of the three scales in this study were all greater than 0.800.The comparative fit index(CFI),Tucker-Lewis index(TLI),the root mean square error of approximation(RMSEA)and Standardized root mean square residual(SRMR)of each scale were reasonable,indicating that the scale could be used to measure posttraumatic stress disorder,self-efficacy and fatigue in this survey.The score of posttraumatic stress disorder was 31.68±13.24 points(total score:70 points),and the score of fatigue scale was 8.66±3.52 points(total score:14 points).The average score of physiological fatigue was 5.91±2.32 points(total score:8 points),and the average score of psychological fatigue was 2.76±1.72 points(total score:6 points).(2)In this study,female nurses(31.96±13.14 points)had higher post-traumatic stress disorder scores.Nurses who had bachelor degree(32.22±13.09 points),earned 5,00110,000 RMB per month(33.08±13.80 points),had more than two night shifts per week(33.94±13.26 points),never exercising(35.13±13.77 points),and had more than two diseases(38.70±14.25 points)had higher post-traumatic stress disorder scores.Nurses with a bachelor’s degree(8.86±3.42 points),married(8.90±3.46 points),worked for 6 to 10 years(9.27±3.06 points),worked more than 40 hours per week(9.61±3.00 points),never exercising(9.56±3.13 points),and had at least two diseases(9.97±3.27 points)had higher fatigue scores.(3)Multiple linear regression models were used to analyze the influencing factors of post-traumatic stress disorder.The results showed that relative to the reference groups,Nurses who exercised less frequently(β=4.56),had a higher number of illnesses(β=4.31),had severe self-rated COVID-19 symptoms(β=8.12),returned to work longer(β=0.17),experienced more COVID-19 related traumatic events(β=9.84),experienced patient or family verbal threats/aggression(β=4.06),and had more severe COVID-19 sequelae(β=8.90)showed more severe symptoms of PTSD(all P<0.05).Nurses with higher income(β=-2.01),better health status(β=-13.51)and higher satisfaction with hospital psychological interventions(β=-5.94)had milder PTSD symptoms(all P<0.05).(4)Multiple linear regression models were used to analyze the influencing factors of fatigue.Results showed relative to the reference group,nurses who worked longer hours per week(β=0.86),had less frequent physical exercise(β=1.50),rated themselves as having severe neocon symptoms(β=2.32),experienced more neocon related traumatic events(β=3.06),had infections at work(β=0.56),experienced verbal patient or family threats/aggression(β=1.46),and had more severe sequelae(β=1.69)had more severe fatigue symptoms(all P<0.05),while nurses in good health had less severe fatigue symptoms(β=-3.15).(5)After adjusting for confounding factors such as gender,age,education,monthly income and marital status,post-traumatic stress disorder had a significant predictive effect on fatigue(β=0.15;P<0.001).Post-traumatic stress disorder was significant in predicting self-efficacy(β=-0.10;P<0.001);In addition,post-traumatic stress disorder and self-efficacy had significant predictive effects on fatigue,but the predictive effect of post-traumatic stress disorder was weakened(β=0.13;P<0.001),showing that selfefficacy has a partial mediating effect on the effect of post-traumatic stress disorder on fatigue,and the mediating effect accounts for 6%of the total effect.In addition,selfefficacy had a partial mediating effect on physical fatigue(partial mediating effect accounted for 1.0%of the total effect)and psychological fatigue(partial mediating effect accounted for 8.3%of the total effect).Conclusions(1)The post-traumatic stress disorder and fatigue of nurses are worse than those of nurses in other provinces and cities.For the high-risk groups of post-traumatic stress disorder and fatigue,we should focus on and timely intervene related risk factors to meet the current needs of nurses,implement psychological support and intervention for nurses,prevent the occurrence of traumatic events,so as to protect the physical and mental health of these people.(2)This study found that the mediating effect of self-efficacy in the association between traumatic stress disorder and fatigue,post-traumatic stress disorder can aggravate nurses’ fatigue by decreasing self-efficacy,in which the mediating effect of self-efficacy between post-traumatic stress disorder and psychological fatigue is partially higher than that of physical fatigue.This provides a scientific basis for improving nurses’ selfefficacy,and medical institutions can improve employees’ self-efficacy to buffer the impact of high-risk events such as traumatic events on nurses’ health status.
Keywords/Search Tags:Nurse, Self-efficacy, Fatigue, Post-traumatic stress disorder, Mediating effects
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