心理弹性在专科护士希望水平与睡眠质量间的中介效应研究-现代医学

心理弹性在专科护士希望水平与睡眠质量间的中介效应研究

单位：1. 南京医科大学第一附属医院消化内科, 江苏南京 210029;
2. 南京医科大学第一附属医院消化内镜中心, 江苏南京 210029;
3. 南京医科大学第一附属医院护理部, 江苏南京 210029

分类号：R395.6

出版年·卷·期（页码）：2023·51·第十二期（1679-1684）

摘要：

目的：调查专科护士心理弹性、希望水平、睡眠质量现况，探讨三者之间的关系。方法：收集146名专科护士作为研究对象，应用心理弹性量表(CD-RISC)、Herth希望量表(HHI)、匹兹堡睡眠质量指数(PSQI)测量其心理弹性、希望水平及睡眠质量。采用Pearson相关分析探讨心理弹性、希望水平及睡眠质量之间的关系，以希望水平为自变量，睡眠质量为因变量，心理弹性为中介变量，使用AMOS建立结构方程模型，采用Bootstrap法验证心理弹性中介效应的显著性。结果：146名专科护士PSQI得分为(6.68±3.03)分，>7分53人，占总人数36.3%；HHI得分为(35.95±3.28)分，中等希望水平81人(55.5%)，高希望水平65人(44.5%)；CD-RISC得分为(63.03±13.81)分。HHI得分与PSQI得分呈负相关(r=-0.185，P<0.05)；CD-RISC得分与HHI得分呈正相关(r=0.462，P<0.05)，与PSQI得分呈负相关(r=-0.434，P<0.05)。模型各项拟合指标良好，模型构建成立。希望水平对睡眠质量影响的总效应β=-0.26(P<0.05)，设置中介变量后希望水平对睡眠质量的直接效应β=0.013(P=0.898)，间接效应β=-0.27(P＜0.05)，95%CI为(-0.419，-0.162)。心理弹性在希望水平与睡眠质量间起完全中介作用。结论：心理弹性在希望水平与睡眠质量之间具有完全中介效应，希望水平可通过心理弹性影响睡眠质量，提示护理管理者在专科护士培养阶段即应加强对希望水平或心理弹性较差的专科护士进行一定的干预，以提升希望水平和心理弹性，有助于改善睡眠质量。

Objective: To investigate the relationship between mental resilience, hope level and sleep quality in clinical nurse specialists. Methods: A total of 146 clinical nurse specialists were recruited and investigated with Connor-Davidson Resilience Scale(CD-RICS), Herth Hope Index(HHI) and Pittsburgh Sleep Quality Index(PSQI). Pearson correlation analysis was used to explore the relationship between resilience, hope level and sleep quality. AMOS was used to establish structural equation model, and Bootstrap method was used to verify the significance of the mediating effect of resilience. The hope level was used as independent variable, sleep quality as dependent variable, and resilience was used as mediating variable. Results: PSQI score of 146 nurses was(6.68±3.03), of which 53 nurses were >7, accounting for 36.3%. CD-RISC and HHI scores of 146 nurses were(63.03±13.81) and(35.95±3.28), respectively. Eighty-one(55.5%) nurses were of medium hope level and 65(44.5%) were of high level. HHI score was negatively correlated with that of PSQI(r=-0.185, P<0.05).CD-RICS score was positively correlated with that of HHI score(r=0.462, P＜0.01) and negatively correlated with PSQI score(r=-0.434, P<0.01).The path coefficient of total effect of hope level on sleep quality was -0.26(P<0.05), and that of direct effect and indirect effect of hope level on sleep quality was 0.013(P=0.898) and-0.27(P<0.05),respectively after setting variables. The 95% confidence interval was(-0.419,-0.162), indicating the complete mediating effect of resilience on hope level and sleep quality. Conclusion: Resilience exerts a full mediating effect on the relationship between hope level and sleep quality, which affect sleep quality by resilience indirectly. Nursing managers should strengthen the hope level or resilience in the training period to improve the nurses' hope level, resilience and the quality of sleep.

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