护士认知情绪调节策略、社会支持与知觉压力的关系
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摘要
目的探讨护士群体在知觉压力得分正常组和危险组间的认知性情绪调节策略选择的差异,以及认知情绪调节策略和社会支持对于知觉压力的预测作用。方法使用知觉压力量表(Chinese perceived stress scale,CPSS)、认知情绪调节问卷(cognitive emotion regulation questionnaire,CERQ)和社会支持评定量表(social support rating scale,SSRS)对1 354名护士进行调查,采用结构方程模型和Bootstrap法,考察社会支持在护士认知情绪调节策略与知觉压力之间的中介作用。结果压力正常组和压力危险组的认知情绪调节策略和社会支持的各维度得分均存在差异,且差异具有统计学意义(P<0.01)。皮尔逊相关分析显示:知觉压力[(24.82±8.39)分]与积极情绪调节策略[(65.76±10.06)分]、主观支持[(24.02±4.77)分]、客观支持[(9.55±2.99)分]和对支持的利用度[(7.94±1.84)分]呈负相关(r=-0.295,P<0.01;r=-0.306,P<0.01:r=-0.196,P<0.01;r=-0.306,P<0.01),与消极情绪调节策略[(42.53±8.75)分]呈正相关(r=0.472,P<0.01)。多元回归分析表明:认知性情绪调节策略和社会支持的多数维度对知觉压力的水平具有显著预测性。中介作用分析显示:社会支持对认知情绪调节策略及知觉压力关系的中介效应均为部分中介效应,在自我责备与知觉压力之间的中介效应占总效应的9.8%,在灾难化与知觉压力之间的中介效应占总效应的12.9%,在积极重新关注与知觉压力之间的中介效应占总效应的21.1%,在积极重新评价与知觉压力之间的中介效应占总效应的19.0%(P均<0.05)。结论选择积极情绪调节策略和社会支持情况较好的护士,其知觉压力水平较低;倾向采用消极情绪调节策略的护士,更可能具有较高的知觉压力水平。认知情绪调节策略和社会支持对知觉压力具有显著的预测作用。
Objective To explore the differences in the selection of cognitive-emotional regulation strategies between nurses with normal perceived stress scores and those with at-risk scores,and explore the predictive effects of cognitive emotion regulation strategies and social support on perceived stress in the nursing staff.Methods We surveyed a total of 1 354 nurses using the Chinese Perceived Stress Scale,Cognitive Emotion Regulation Questionnaire,and Social Support Rating Scale.Mediation analysis with structural equation modeling was conducted to test the mediating effect of social support on the relationship between cognitive emotion regulation strategy and perceived stress.Results The nurses with normal and hazardous stress scores showed significant differences in the scores for all the dimensions of cognitive emotion regulation strategies and social support(P<0.01).Pearson correlation analysis showed that the perceived stress scores(24.82±8.39) were negatively correlated with the scores of positive emotion regulation strategy(65.76±10.06;r=-0.295,P<0.01),subjective support(24.02±4.77;r=-0.306,P<0.01),objective support(9.55±2.99;r=-0.196,P<0.01) and utilization of support(7.94±1.84;r=-0.306,P<0.01),and positively correlated with the score of negative emotional regulation strategy(42.53±8.75;r=0.472,P<0.01).Multivariate regression analysis showed that most of the dimensions of cognitive emotion regulation strategies and social support were predictive of the level of perceived stress.Mediation analysis indicated a partial mediating effect of social support on the relationship between cognitive emotion regulation strategies and perceived stress:The mediating effect between self-blame and perceived stress accounted for9.8% of the total effect,that between catastrophization and perceived stress accounted for 12.9%,that between positive re-focus and perceived stress accounted for 21.1%,and that between positive re-evaluation and perceived stress accounted for 19.0%(All P<0.05).Conclusion The nurses who choose positive emotion regulation strategy and with a good social support condition have lower levels of perceived stress,and a negative emotion regulation strategy is associated with an increased level of perceived stress.Cognitive emotional regulation strategies and social support have significant predictive effects on perceived stress.
Objective To explore the differences in the selection of cognitive-emotional regulation strategies between nurses with normal perceived stress scores and those with at-risk scores,and explore the predictive effects of cognitive emotion regulation strategies and social support on perceived stress in the nursing staff.Methods We surveyed a total of 1 354 nurses using the Chinese Perceived Stress Scale,Cognitive Emotion Regulation Questionnaire,and Social Support Rating Scale.Mediation analysis with structural equation modeling was conducted to test the mediating effect of social support on the relationship between cognitive emotion regulation strategy and perceived stress.Results The nurses with normal and hazardous stress scores showed significant differences in the scores for all the dimensions of cognitive emotion regulation strategies and social support(P<0.01).Pearson correlation analysis showed that the perceived stress scores(24.82±8.39) were negatively correlated with the scores of positive emotion regulation strategy(65.76±10.06;r=-0.295,P<0.01),subjective support(24.02±4.77;r=-0.306,P<0.01),objective support(9.55±2.99;r=-0.196,P<0.01) and utilization of support(7.94±1.84;r=-0.306,P<0.01),and positively correlated with the score of negative emotional regulation strategy(42.53±8.75;r=0.472,P<0.01).Multivariate regression analysis showed that most of the dimensions of cognitive emotion regulation strategies and social support were predictive of the level of perceived stress.Mediation analysis indicated a partial mediating effect of social support on the relationship between cognitive emotion regulation strategies and perceived stress:The mediating effect between self-blame and perceived stress accounted for9.8% of the total effect,that between catastrophization and perceived stress accounted for 12.9%,that between positive re-focus and perceived stress accounted for 21.1%,and that between positive re-evaluation and perceived stress accounted for 19.0%(All P<0.05).Conclusion The nurses who choose positive emotion regulation strategy and with a good social support condition have lower levels of perceived stress,and a negative emotion regulation strategy is associated with an increased level of perceived stress.Cognitive emotional regulation strategies and social support have significant predictive effects on perceived stress.
引文
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[14]赵薇,玄英哲.护生生活事件、认知情绪调节与心理韧性关系的研究[J].护理研究,2013,27(8):2323-2325.DOI:10.3969/j.issn.1009-6493.2013.22.007.ZHAO W,XUAN Y Z.Study on relationship between nursing students'life events,cognitive emotion regulation and resilience[J].Chin Nurs Res,2013,27(8):2323-2325.DOI:10.3969/j.issn.1009-6493.2013.22.007.
[15]靳玲,马晓华.新疆某综合医院临床护士认知情绪调节策略的现状分析[J].护理学报,2012,19(10A):68-70.DOI:10.16460/j.issn 1008-9969.2012.19.021.JIN L,MA X H.Status of cognitive emotion regulation stracties of clinical nurses[J].J Nurs,2012,19(10A):68-70.DOI:10.16460/j.issn 1008-9969.2012.19.021.
[16]王萍.浅析弗洛伊德与荣格的潜意识理论差异[J].太原大学教育学院学报,2011,29(3):11-14.DOI:10.14152/j.cnki.1673-7016.2011.03.013.WANG P.An analysis of the differences between Freud's and Jung's subconsciousness theory[J].J Edu Coll Taiyuan Univ,2010,29(3):11-14.DOI:10.14152/j.cnki.1673-7016.2011.03.013.
[17]刘翯,杨东泉,宋雁鸿,等.400名医护人员社会支持评定量表测试结果分析[J].中国民康医学,2011,23(19):2412-2414.DOI:10.3969/j.issn.1672-0369.2011.19.028.LIU H,YANG D Q,SONG Y H,et al.Analysis of test results of Social Support Rating Scale for 400 medical staff[J].China Minkang Med,2011,23(19):2412-2414.DOI:10.3969/j.issn.1672-0369.2011.19.028.
[18]杰拉尔德S.格林伯格.化解压力的艺术[M],张璇,译.北京:机械工业出版社,2014:275-276.JERROLD S.GREENBERG.Comprehensive stress management[M].ZHANG X,Translated.Beijing:China Machine Press,2014:275-276.
[2]徐奕旻,吴瑛,张艳,等.全国医院护士工作状态的调查分析[J].中华护理杂志,2016,51(8):947-950.XU Y M,WU Y,ZHANG Y,et al.Investigation of nursing work status in Chinese hospitals[J].Chin J Nurs,2016,51(8):947-950.
[3]刘颖,张曼华,杨璐.自我效能感对医生知觉压力与工作幸福感关系的中介作用[J].中华行为医学与脑科学杂志,2017,26(9):852-855.DOI:10.3760/cma.j.issn.1674-6554.2017.09.017.LIU Y,ZHANG M H,YANG L.The mediating effect of selfefficacy between the perceived stress and work well-being of doctors[J].Chin J Behav Med Brain Sci,2017,26(9):852-855.DOI:10.3760/cma.j.issn.1674-6554.2017.09.017.
[4]GAMEFSKI N,VAN DEN KOMMER T N,KRAAIJ V,et al.The relationship between cognitive emotion regulation strategies and emotional problems:comparison between a clinical and a non-clinical sample[J].Eur J Personal,2010,16(5):403-420.DOI:10.1002/per.458.
[5]苗丹民,石茹.心身疾病预防机制、预防与康复[J].现代康复,1999(10):1154-1155.MIAO D M,SHI R.Psychosomatic disease prevention mechanism,prevention and rehabilitation[J].Mod Rehabil,1999(10):1154-1155.
[6]陈力.医学心理学[M].北京:北京大学医学出版社,2012:78-80.CHEN L.Medical Psychology[M].Beijing:Peking University Medical Press,2012:78-80.
[7]LEE E H.Review of the psychometric evidence of the Perceived Stress Scale[J].Asian Nurs Res,2012,6(4):121-127.DOI:10.1016/j.anr.2012.08.004.
[8]杨廷忠,黄汉腾.社会转型中城市居民心理压力的流行病学研究[J].中华流行病学杂志,2003,24(09):11-15.YANG T Z,HUANG H T.An epidemiological study on stress among urban residents in social transition period[J].Chin JEpidemiol,2003,24(09):11-15.
[9]GARNEFSKI N,KRAAIJ V,SPINHOVEN P.Negative life events,cognitive emotion regulation and emotional problems[J].Pers Indiv Differ,2001,30(8):1311-1327.
[10]董光恒,朱艳新,杨丽珠,等.认知情绪调节问卷中文版的应用[J].中国健康心理学杂志,2008,16(4):456-458.DOI:10.13342/j.cnki.cjhp.2008.04.025.DONG G H,ZHU Y X,YANG L Z,et al.Practice of the Chinese version on the Cognitive Emotion Regulation Questionaire(CERQ)[J].Chin J Health Pshchol,DOI:10.13342/j.cnki.cjhp.2008.04.025.
[11]肖水源.《社会支持评定量表》的理论基础与研究应用[J].临床精神医学杂志,1994,4(2):98-100.XIAO S Y.The theoretical basis and research application of Social Support Rating Scale[J].J Clin Psychiatry,1994,4(2):98-100.
[12]赵丽红,赵小平,张丽芳,等.护士认知情绪调节与抑郁关系[J].中国公共卫生,2013,29(6):887-889.ZHAO L H,ZHAO X P,ZHANG L F,et al,Association of cognitive emotion regulation with depression among nurses[J].Chin J Public Health,2013,29(6):887-889.
[13]李莲,张立力.护士认知情绪调节策略调查分析[J].护士学杂志,2010,25(11):55-57.DOI:10.3870/hlxzz.2010.11.055.LI L,ZHANG L L.Survey on cognitive emotion regulation strategies among nursing students[J].J Nurs Sci,2010,25(11):55-57.DOI:10.3870/hlxzz.2010.11.055.
[14]赵薇,玄英哲.护生生活事件、认知情绪调节与心理韧性关系的研究[J].护理研究,2013,27(8):2323-2325.DOI:10.3969/j.issn.1009-6493.2013.22.007.ZHAO W,XUAN Y Z.Study on relationship between nursing students'life events,cognitive emotion regulation and resilience[J].Chin Nurs Res,2013,27(8):2323-2325.DOI:10.3969/j.issn.1009-6493.2013.22.007.
[15]靳玲,马晓华.新疆某综合医院临床护士认知情绪调节策略的现状分析[J].护理学报,2012,19(10A):68-70.DOI:10.16460/j.issn 1008-9969.2012.19.021.JIN L,MA X H.Status of cognitive emotion regulation stracties of clinical nurses[J].J Nurs,2012,19(10A):68-70.DOI:10.16460/j.issn 1008-9969.2012.19.021.
[16]王萍.浅析弗洛伊德与荣格的潜意识理论差异[J].太原大学教育学院学报,2011,29(3):11-14.DOI:10.14152/j.cnki.1673-7016.2011.03.013.WANG P.An analysis of the differences between Freud's and Jung's subconsciousness theory[J].J Edu Coll Taiyuan Univ,2010,29(3):11-14.DOI:10.14152/j.cnki.1673-7016.2011.03.013.
[17]刘翯,杨东泉,宋雁鸿,等.400名医护人员社会支持评定量表测试结果分析[J].中国民康医学,2011,23(19):2412-2414.DOI:10.3969/j.issn.1672-0369.2011.19.028.LIU H,YANG D Q,SONG Y H,et al.Analysis of test results of Social Support Rating Scale for 400 medical staff[J].China Minkang Med,2011,23(19):2412-2414.DOI:10.3969/j.issn.1672-0369.2011.19.028.
[18]杰拉尔德S.格林伯格.化解压力的艺术[M],张璇,译.北京:机械工业出版社,2014:275-276.JERROLD S.GREENBERG.Comprehensive stress management[M].ZHANG X,Translated.Beijing:China Machine Press,2014:275-276.