Application Of Balint Group Activities In The Work Stress And Self-care Ability Of Psychiatric Nurse

Objective:To explore the effect of the combined"online+offline"Balint group activity on psychiatric nurses’mental health,and to evaluate the effect of this approach on their work stress and self-care.To provide clinical reference for nursing managers to use Balint group intervention to maintain psychiatric nurses’psychological health.Methods:A randomized controlled trial was used.From September 2021 to September 2022,68cases of psychiatric nurses from a tertiary general hospital in Hunan Province were selected as study subjects using convenience sampling method and divided into intervention group（n=34）and control group（n=34）according to random number table method.The control group was given the conventional training of basic skills training and psychological knowledge training;in addition to the conventional training,the intervention group was given the offline Balint group activities in the first 6 months,and based on the offline activities in the first 6 months,the psychiatric nurses had fully understood the requirements and ideas of the training,and considering the geographical,scheduling and epidemic restrictions,the online Balint group activities training was carried out in the 7th-12th months.The Chinese Nurses Stressor Scale（CNSS）,Pittsburgh Sleep Quality Inventory（PSQI）,and Work Fatigue Inventory（MBI）,and Self-Care Scale（SCS）were used to assess the psychiatric nurses before the intervention（T₀）,at the end of the 6th month of intervention（T₁）,and at the end of the 12th month of intervention（T₂）.SPSS 26.0 was used for testing,t-test,repeated measures variance,and other data analysis to compare the differences between the two groups.Results:1.A total of 4 cases were missed,and 64 cases were finally completed,including 31 cases in the intervention group and 33 cases in the control group.The general information,CNSS,PSQI,MBI,SCS total score and each dimension score of psychiatric nurses in the two groups before the intervention were compared,and the differences were not statistically significant（p>0.05）and comparable.2.Comparison of CNSS scores of psychiatric nurses in the two groups（1）Intervention group psychiatric nurses had statistically significant（p<0.05）effects of between-group factor main effect,time-factor main effect,and group-time-interaction on total stressor scores,nursing professional and work problems,patient care,management,and interpersonal relationships,while between-group factor main effect,time-factor main effect,and group-time-interaction on workload and time allocation,work environment,and resources had no statistically significant（P>0.05）.（2）In the comparison at different time points,the scores of psychiatric nurses in the intervention group at the end of the 6th month of intervention（T₁）and at the end of the 12th month of intervention（T₂）for total stressor scores,nursing professional and work problems,patient care,management and interpersonal relationships showed a decreasing trend over time and lower scores than the control group compared to the base comparison,and the difference was statistically significant（P<0.05）,while the workload and time allocation problems,the work environment and resources dimensions were not statistically significant（p>0.05）.3.Comparison of MBI scores of psychiatric nurses in the two groups（1）The effects of between-group factor main effect,time factor main effect,and the interaction of group and time on the scores of emotional exhaustion,work apathy,and work unfulfillment among psychiatric nurses in the intervention group were statistically significant（P<0.05）.（2）In the comparison at different time points,psychiatric nurses in the intervention group at the end of the 6th month（T₁）and the end of the 12th month（T₂）of the intervention showed a decreasing trend and lower scores than the control group in emotional exhaustion and work apathy over time compared with the baseline comparison,and showed an increasing trend and higher scores than the control group in work unfulfillment over time compared with the baseline comparison,with statistically significant differences（P<0.05）.4.Comparison of PSQI scores of psychiatric nurses in the two groups（1）The effects of between-group factor main effect,time-factor main effect,and group-time-interaction on total PSQI score,sleep quality,sleep efficiency,and hypnotic medication score of psychiatric nurses in the intervention group were statistically significant（P<0.05）,but the effects on time to sleep,sleep duration,sleep disturbance,and daytime functional dimensions were not statistically significant（P>0.05）.（2）In the comparison at different time points,the psychiatric nurses in the intervention group at the end of the 6th month of intervention（T₁）and at the end of the 12th month of intervention（T₂）showed a decreasing trend and lower scores than the control group over time in the total PSQI scores and sleep quality,sleep efficiency,and hypnotic medication scores compared with the base comparison,which was statistically significant（P<0.05）;the psychiatric nurses in the intervention group at different time points had a statistically significant effect on the sleep onset There was no statistically significant difference in time to sleep,sleep duration,sleep disturbance,and daytime function scores among psychiatric nurses in different time points（P>0.05）.5.Comparison of the SCS scores of psychiatric nurses in the two groups（1）The effects of between-group factor main effect,time-factor main effect,and group-time-interaction on the total self-care score and each dimension score of psychiatric nurses in the intervention group were statistically significant（P<0.05）.（2）In the comparison at different time points,the psychiatric nurses in the intervention group at the end of the 6th month（T₁）and the end of the 12th month（T₂）showed a statistically significant increase in the total score of self-care and the scores of each dimension compared with the baseline comparison,and the difference was statistically significant（P>0.05）.Conclusion:The combined"online+offline"Balint group intervention for psychiatric nurses can reduce work stress and burnout,improve sleep quality,and have a significant impact on psychiatric nurses’ability to enhance self-care.