臨床實習護生心理壓力源相關因素及自我效能的應用研究

劉曉茜 徐真 王欣 張文靜 徐顏紅 劉文慧 劉恒

[摘要] 目的 探討護生心理壓力源的相關因素及自我效能的應用。方法 隨機抽樣選取2018年 7月—2019年4月青島市某三甲醫院144名護生，采用相應量表調查其心理壓力、焦慮水平及自我效能感;選取有代表性的10名護生行半結構式深入訪談，進一步了解其心理壓力源的相關因素。結果 護生實習壓力量表表明護理傳染性疾病患者、針刺傷、患者病情急劇變化或死亡時醫護人員不在場是護生心理壓力源的主要因素;焦慮自評量表得分（51.68±11.48）分，提示輕度焦慮;自我效能感總分（2.44±0.46）分，低于常模。質性研究結果表明護生心理壓力源主要體現在實習工作、職業前景及人際關系。結論 護生心理壓力導致其焦慮且自我效能感低。相關人員應及時了解護生心理壓力源，采取措施消除其心理壓力，使之平穩度過實習期。

[關鍵詞] 護生;臨床實習;心理壓力源;焦慮;自我效能

[中圖分類號] R47 [文獻標識碼] A [文章編號] 1672-5654（2020）02（a）-0137-04

Applied Research on Psychological Stress Sources and Self-efficacy of Nursing Students in Clinical Practice

LIU Xiao-qian， XU Zhen， WANG Xin， ZHANG Wen-jing， XU Yan-hong， LIU Wen-hui，LIU Heng

School of Nursing， Qingdao University， Qingdao， Shandong Province， 266021 China

[Abstract] Objective To explore the related factors of psychological stressors of nursing students and the application of self-efficacy. Methods A random sample of 144 nursing students from a top three hospital in Qingdao， from July 2018 to April 2019 was used to investigate their psychological stress， anxiety level and self-efficacy using corresponding scales. A representative 10 nursing students were selected for a semi-structured in-depth interview to learn more about the relevant factors of their psychological stressors. Results The nursing student practice pressure scale showed that nursing infectious diseases patients， acupuncture injuries， sudden changes in the patient's condition， or the absence of medical staff at the time of death were the main factors of the psychological stressors of the nursing students; the self-rating anxiety scale scored （51.68±11.48）points， suggesting mild anxiety; the total score of self-efficacy was （2.44±0.46）points， which was lower than the norm. The qualitative research results show that the psychological stressors of nursing students are mainly reflected in internship， career prospects and interpersonal relationships. Conclusion Nursing students' psychological stress leads to anxiety and low self-efficacy. Relevant personnel should understand the psychological stressors of nursing students in time， take measures to eliminate their psychological stress， and make them pass the internship period smoothly.

[Key words] Nursing students; Clinical practice; Psychological stressors; Anxiety; Self-efficacy

由于護理行業的標準不斷提高，同時人們愈發關注醫療相關服務質量，這也加大了護士的工作負荷。而作為護理行業儲備力量的實習護生不僅承擔巨大的學習任務，而且要面對嚴峻的就業壓力，在雙重壓力之下，臨床實習護生的心理壓力及焦慮情緒更加凸顯，且受到國內外研究者的重點關注[1]。由于當前社會輿論氛圍和醫院的繁重工作等各方面的問題，護理工作人員存在不可避免的巨大心理壓力，尤其對缺乏臨床經驗的實習護生來說更為突出[2]?！?br>