| Purpose:This study regarded the clinical nurses as a whole to investigate the current status and the contributing factors of resilience,and to clarify the causes of high resilience of nurses,so as to improve the level of mental health of nurses in China and maintain the stability of nursing team,.in order to get the general rules of nursing resilience,to provide reference for the establishment of the resilience of nursing norm in China,to establish the resilience criteria for clinical nurses selection,and to provide theoretical basis for the implementation of the resilience training for the nursing staff.Methods:The first stage: using proportional stratified random sampling and cluster sampling combined with quantitative research methods.Firstly,on the stratification of 104 hospitals in Chongqing,which is divided into three layers: first class hospital,secondary hospital and teritary hospital.Using proportional stratified random sampling to select hospitals in each layer,and 1 teritary general hospital,2 secondary general hospitals and 1 first class general hospital were selected eventually during May to September in 2016.Secondly,using cluster sampling to carry out the survey.A total of 2504 clinical nurses were recruited,and 2285 valid questionnaires were returned,the efficiency is 91.25%.The nurses were surveyed respectively with a pre-designed general information questionnaire,the Connor-Davidson resilience scale(CD-RISC),the Survey-Depression Scale(CES-D),the Maslach Burnout Inventory-Human Service Survey(MBI-HSS),the Chinese nurses stressor scale(CNSS),the Nurses' Job Satisfaction Scale,the Perceived Social Support Scale(PSSS)and the Simplified Coping style Questionnaire(SCSQ)to investigate the status and influencing factors of resilience in clinical nurses.Using SPSS version 19.0 to do statistical analysis.Data were expressed as mean±standard deviation.The t-test and One-Way ANOVA were used to analyze the effects of the general personnel information on the overall resilience.Spearman correlation was used to analyze the relationship between depression,job burnout,stress,job satisfaction,perceived social support,copying style and resilience.Multiple linear regression was used to determine the factors contributing to resilience.In all tests,a P?0.05 was interpreted to be statistically significant.The second stage: using qualitative research method.According to the results of the first stage,based on reviewing literature and consulting psychological experts,the screening standard of the nursing staff with high resilience was proposed(the score of the Resilience Scale ?mean + standard deviation,the score of the Survey-Depression Scale ?15 points,the score of the Chinese Nurses Stressor Scale>mean).Then semi-structured interviews were conducted on the method of using Colaizzi's to analyze the data to determine the theme,so as to clarify the reasons for the formation of nurses' high resilience.Results:1.The status of nursing resilienceThe score of nurses' resilience was 10 to 100,and the total score was 63.87±12.96,which was significantly lower than that of the community population in China 65.40 ± 13.90.Resilience scores in three dimensions: tenacity 31.88±7.28,strength 22.32±4.66,optimism 9.67±2.40.The dimensional scores from high to low were as follows: strength 2.79±0.58,tenacity 2.45±0.56 and optimism 2.42±0.60.2.Characteristics of nursing resilienceDifferent demographic variables,such as age,marital status,fertility circumstance,whether the only child,education,academic title,administrative position,work experience,monthly income,shift mode,whether be awarded,hospital grade,intention to stay and self-perceived resilience impact on resilience at statistically significant level(P(27)0.05),However,no difference was found in gender,birth place and form of employment(P>0.05).3.The relationship between depression,job burnout,stress,job satisfaction,social support,coping style and nursing resilienceThe scores of depression,the sub-dimensions of job burnout,stress and its sub-dimensions were significantly correlated with resilience negatively(P(27)0.01).The scores of job satisfaction and its sub-dimensions,perceived social support and its sub-dimensions as well as the positive coping style were significantly correlated with resilience positively(P(27)0.01).4.Regression analysis of nursing resilienceThe administrative position,intention to stay,positive coping style,self-perceived degree of resilience,depression,emotional exhaustion,diminished personal accomplishment,depersonalization,work environment and equipment resources,work status as well as perceived social support contributed to resilience at statistically significant level,which could explain 35.5% of the variance.5.The causes for the formation of high resilienceThe subjects of high resilience quality interviews with nurses were as follows: The individual internal factors,social support and working environment.Among them,the individual internal factors involve: technical ability,effective coping,self regulation,high sense of occupation identity.Social support mainly includes three aspects: family support,friend support and colleague support.The working environment includes: effective security,welfare and job stability.Conclusions:1.The level of nursing resilience is low,which needs to be further improved.2.Demographic variables(age,marital status,fertility circumstance,whether the only child,education,academic title,administrative position,work experience,monthly income,shift mode,whether be awarded,hospital grade,intention to stay and self-perceived resilience)are identified to be the major contributing factors.3.Depression,job burnout,stress,job satisfaction,perceived social support and positive coping have significant effect on resilience.Depression,job burnout and stress are negatively correlated with resilience.Job satisfaction,perceived social support,positive coping are positively correlated with resilience.4.The administrative position,intention to stay,positive coping style,self-perceived degree of resilience,depression,emotional exhaustion,diminished personal accomplishment,depersonalization,work environment and equipment resources,work status as well as perceived social support can predict the level of nursing resilience.5.The main causes for the formation of the high resilience of nurses are individual internal factors,social support and working environment.Therefore,we should pay attention to the positive significance for the development of nursing resilience to the improvement of nurses' mental health status and the quality of nursing service.Enhance the resilience of nurses from different angles,so that nurses can do better and adapt well when facing the pressure of work and life. |
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