The Study On Sub-Health Status And Associated Factors Of Nurses In General Hospital In Guangzhou

BACKGROUNDWith the development of social economy, accelerating pace of life, improvement of the awareness of competition, as well as changing of life style, sub-health population is gradually increasing, which is a greater health challenges human beings are going to face. By the21st century, sub-health has been considered as one of the greatest health threats to human beings in medicine. By now, extensive research has been carried out on sub-health all over the world. Sub-health state, essential factor diseases, refers to a kind of suboptimal health status at which the physical and mental conditions of patient is in the period between healthy conditions and unhealthy conditions. At this state, patient experience reduction in his or her physiological and mental functions and sociability, featured as vitality and adaptability deterioration although there is no defined disease diagnosed. Sub-health condition, a kind of transitional and reversible state, can become diseases if it is not taken seriously or become health if it is well handled.For the particular occupational characteristics, nurse practitioners have to stay highly focused, maintain good patience and keep strong sense of responsibility when taking on patients, besides, they have to take turns on night shift which are going to influence their regular life and may also come across occupational hazard factors. So nurse practitioners are vulnerable to sub-health for the reasons that they suffer much heavier physical and mental stress than who engage in other occupations. Thus, not only sub-health is an affecting factor for the health of nurse practitioners, but also a cause of incompetent nursing and instability of the nursing team. Sub-health problems for nurse practitioners in Guangzhou, the third-largest city of china, are obvious serious due to large in population, patients and fast in pace of work of this city. Owing to large numbers of hospital and nurse practitioners in Guangzhou, it is necessary and significant to study the sub-health conditions of nurse practitioners in this city and investigate the related influencing factors that may lead to sub-health. So we hope this work could provide valuable information that can prevent from sub-health to sickness and hope this study could be instructive to nurse practitioners in Guangzhou and the whole country and appropriate authority.Currently the research on sub-health of nurses is increasing year after year, but the research is major of cross-sectional survey with low quality. The sample amounts of investigation are small which lack of representativeness. Most research focuses on investigating the sub-health status of nurses who work in a specialist department (such as psychiatry)or a certain level of general hospital (such as tertiary hospital). The research which aims to investigate the sub-health status of nurses from different level of general hospital is rare. Also convenience sampling are used in most studies instead of using scientific random sampling method. As the survey questionnaires which used in research on sub-health are mostly self-designed scale and not widely used in the crowed, the validity and reliability of research result is commonly poor which might be affected by all kinds of bias.To provide a scientific basis for taking measures to relieve the sub-health status of nurses. This study used the sub-health questionnaire which was made up of sub-health measurement scale version1.0with high validity and reliability, social demographic character, lifestyle and working condition to investigate the sub-health status of nurses and related factors from different level of general hospital in Guangzhou.ObjectiveTo investigate the sub-health status of nurses in general hospital and explore the related factors that affect the sub-health status of nurses in general hospital in Guangzhou. According to the related factors of the survey to provide scientific guidance for developing prevention and control measures of nurses and provide a scientific basis for further research. MethodsA stratified cluster sampling method was used, in accordance with the different个level of hospital, to select1552on-the-job nurses who come from three third-class hospitals, six second-class hospitals and twelve first-level hospitals as the research subjects during the period from October2012to January2013. Inclusion criteria:the nurses and nurse administrators who took part in the clinical nursing work more than1year and held nurse practitioner qualification. Exclusion criteria:the nurses who took part in clinical nursing work less than1year or diagnosed with acute or chronic disease, or at postpartum or after delivery in a period of6months.This study used the sub-health questionnaire for nurses which was made up of sub-health measurement scale version1.0and the condition of social demographic character, lifestyle and working to investigate. All data were input into computer to establish a database using EpiData3.02and processed using SPSS13.0software package. Measurement data were expressed with the mean and standard deviation, count data expressed with constituent ratio. The statistical methods were descriptive statistic, Mest, one-way ANOVA, regression analysis and logistic regression analysis, et al.Result1645copies of questionnaire were recycled in the survey which released1800copies with the recovery of91.39%. There were totally1552effective questionnaires without93invalid questionnaires in the survey. Among1552collected effective questionnaires, there were780of Class3hospital,513of Class2hospital,259of Class1hospital. In the survey, there were42men and1510women; the age of nurses ranged from18to51, average age was26.51±4.656, the average working year was5.81±4.888.163nurses were randomly selected from the retest samples after a week to compare the consistency of the questionnaires which were filled before a week, with the stability coefficient of0.812.1. The analysis of the sub-health status of nurses in Guangzhou(1) The standard mean of physiological, psychological and social subscale of SHMS V1.0among nurses of general hospital in Guangzhou respectively were61.04±9.896,59.48±13.733,63.87±14.071. And their total mean scores were61.23±10.214. To ordered the rank of every dimension score, the score of body movement function was highest with65.61±12.298, followed by social adaptation, organ, social resources and social support, positive emotions, psychological symptoms, physical symptoms, cognitive, and the score of energy was lowest with47.56±14.468.(2) In this survey, a total of1113nurses were in sub-health state, the overall prevalence of sub-health of nurses was71.7%. The prevalence of sub-health of nurses from Class3, Class2and Class1general hospital were respectively68.9%(178/259),72.8%(373/513),72.1%(562/780). The result of chi square test showed that there was statistically significant difference on the prevalence of severe sub-health between the Class3and the Class1general hospital. 2. Analysis on one-factor that affects the sub-health of nurses in Guangzhou(1) There was significant difference in subscale, scores in physical sub-health and overall sub-health when the subjects were divided into groups according to age and working time (P<0.05), but the scores in factors of psychological sub-health and social sub-health had no significant difference.(2) There was significant difference in subscale, scores in physical sub-health, psychological sub-health and overall sub-health when the subjects were divided into groups according to academic degree (P<0.05), but the scores in factors of social sub-health had no significant difference.(3) Scores in physical sub-health when the subjects were divided into groups according to their marriage status had significant difference (P<0.05), but the scores in factors of psychological sub-health, social sub-health and overall sub-health had no significant difference.(4) Scores in physical sub-health and overall sub-health when the subjects were divided into groups according to their monthly wage had significant difference (P<0.05), but the scores in factors of psychological sub-health and social sub-health had no significant difference. Scores in physical sub-health, social sub-health and overall sub-health when the subjects were divided into groups according to their title had significant difference (P<0.05), but the scores in factors of psychological sub-health had no significant difference.(5) The influence of diet and lifestyle on sub-health1) The result showed that the scores in physical sub-health, social sub-health, psychological sub-health and overall sub-health had significant difference (P<0.05), when the subjects were divided into groups according to the situation of physical exercise, eating breakfast and having dinner regularly.2) The scores of subscales and the overall scores of the sub-health of nurses in Guangzhou showed significant statistical difference (P<0.05), in the aspects of dietary behavior such as consumption of fruits and vegetable, eating soy products, eating fish, consumption of meat and dairy, eating salt food, eating smoke BBQ food and daily water consumption. The scores of social sub-health, psychological sub-health and overall sub-health had significant difference in the aspect of eating food rich in fat (P<0.05). The scores of physical sub-health, social sub-health and overall sub-health had significant difference in the aspect of consumption of processed food (such as cookies, chips)(P<0.05), the social sub-health scores had no significant difference.3) The result showed that the scores in physical sub-health, psychological sub-health and overall sub-health had significant difference (P<0.05), when the subjects were divided into groups according to the situation of breathing secondhand smoke, but the scores in factors of social sub-health had no significant difference.4) The scores in drinking or not of psychological sub-health and overall sub-health had significant difference (P<0.05), but the scores in factors of physical sub-health and social sub-health had no significant difference.(6) On the analysis of life events impacting on nurses’s sub-health in Guangzhou, the scores of subscales and the overall scores showed significant statistical difference (P<0.05), in the aspects of experiencing" unsmooth promotion","serious working accident","marriage obstacle" and "child problem" event. The scores of psychological sub-health and overall sub-health had significant difference in the aspect of experiencing "lovelorn" event (P<0.05), the physical sub-health and social sub-health scores had no significant difference. The scores of psychological sub-health had significant difference in the aspect of experiencing "large amount borrowing" event (P<0.05), the physical sub-health, social sub-health and overall sub-health scores had no significant difference. The scores of physical sub-health, psychological sub-health, social sub-health and overall sub-health scores had no significant difference in the aspects of experiencing "the sick or death of family" and "criminal or administrative punishment of family" event.(7) The result showed that the scores in physical sub-health, psychological sub-health and overall sub-health had significant difference (P<0.05), when the subjects were divided into groups according to the situation of work time and night shift, but the scores in factors of social sub-health had no significant difference. The result showed that the scores in physical sub-health, psychological sub-health, social sub-health and overall sub-health had significant difference (P<0.05), when the subjects were divided into groups according to the situation of overtime work.(8) On the analysis of occupational injuries events impacting on nurses’s sub-health in Guangzhou, the scores of subscales and the overall scores showed significant statistical difference (P<0.05), in the aspects of experiencing "needle stick injuries " and "body fluids or blood splashed into the eyes, skin and mucous " events. The scores of physical sub-health, psychological sub-health and overall sub-health scores had significant difference in the aspects of experiencing "cutting" and "abuse or assault by the patient and family" event (P<0.05), but the scores of social sub-health had no significant difference.(9) The scores of subscales and the overall scores of the sub-health of nurses showed significant statistical difference (P<0.05), in the aspects of social support, work pressure, promotion pressure, interpersonal relationship pressure, life stress, family stress and sleep time.3. Multiple factors analysis of the sub-health of nurses in Guangzhou(1) Multiple stepwise regression analysis was conducted in the research. The dependent variables were the scores of the subscales and the overall score of the SHMS V1.0of nurses in Guangzhou, while the independent variables were social demographic character (gender, age, marriage), lifestyle, life events, occupational injuries, pressure and sleep and working condition. When a=0.05, the conditions of social support, eating soy products, having dinner regularly, family stress, work stress and sleeping time were found in all four regression equations, but three factors of social demographic character, one factors of exercise, eight factors of dietary habits, four factors of life events, four factors of occupational injuries, and5factors of pressure and sleep were found in different regression equations.(2) Binary logistic regression analysis was conducted in the research. The dependent variable was the sub-health or not, while the independent variables were the factors which have statistical significance in single factor analysis. The results of logistic regression analysis showed that:consumption of pickled smoked food, children problem, working pressure, strained relations with colleagues, living under pressure and family pressure were risk factors of sub-health. Marriage status, having dinner regularly, eating fish, eating lean meat and poultry, and social support were protective factors of sub-health.Conclusion1. The prevalence of sub-health of nurses was71.7%. The scores of physical sub-health, psychological sub-health, social sub-health and overall sub-health which ranged from60to72, suggested that nurses of general hospital in Guangzhou were in a moderate sub-health condition. The prevalence of severe sub-health of nurses from the Class3general hospital was significantly higher than the nurses from the Class1general hospital. The main symptoms of sub-health were cognitive function, energy and mental performance.2. The symptom of nurses’sub-health who were in the age group from25to34and the year of working from5to9years was obvious. The symptom of nurses’ sub-health whose academic degree were college degree and above was obvious. The symptom of physical sub-health in the married nurses was obvious.The symptom of sub-health in nurses whose monthly wage over5000yuan and with the title of senior nurse was obvious.3. The sub-health symptom of those nurses in general hospital who drank, breathed secondhand smoke, lack of exercise, ate dinner irregularly, ate unbalanced nutrition and did not eat breakfast was quite obvious. The sub-health symptom of those nurses who experienced life events or occupational injuries during half a year was obvious. The sub-health symptom of nurses who were in the situation of pressure, lacking of sleep, working overtime and on nigh duty was quite obvious. The health status of nurses who were with a high degree of social support was much better.4. It could be found from the logistic regression analysis that, consumption of pickled smoked food, children problem, working pressure, strained relations with colleagues and life pressure were risk factors of sub-health. Marriage status, having dinner regularly, eating fish, eating lean meat and poultry and social support were protective factors of sub-health.5. According to the results of the survey which investigated the affected factors of sub-health, the status of sub-health among nurses in general hospital could be prevented and improved by taking measures such as strengthen health education, advocating scientific lifestyle, adopting humanized management method and providing a wide range of social support together with nurses’ families.