探討護理人員照顧COVID-19病人的工作壓力與復原力

Work Stress and Resilience in Nurses Caring for Patients With COVID-19

10.6142/VGHN.202212_39(4).0008

陳淑純(Shu-Chun Chen)；陳美華(Mei-Hua Chen)；張倩蜜(Chien-Mi Chang)；康美玉(Mei-Yu Kang)；謝孟蓁(Meng-Chen Hsieh)；張翠芬(Tsui-Fen Chang)；粘沛琳(Pei-Lin Nien)；錢美容(Mei-Jung Chien)；李雅文(Ya-Wen Lee)

新型冠狀病毒疾病 ； 護理人員 ； 工作壓力 ； 復原力 ； COVID-19 ； nurses ； work stress ； resilience

榮總護理

39卷4期（2022 / 12 / 01）

400 - 411

繁體中文

在台灣，2019年新型冠狀病毒疾病（COVID-19）的爆發增加了護理工作的壓力。在壓力大的情況下，有必要關注復原力對照顧COVID-19病人的第一線護理人員的影響。本研究的目的是探討照顧COVID-19病人的護理人員在工作中的壓力和復原力。採橫斷面研究設計，調查中部某醫學中心及五家分院之護理人員共333位。使用三種結構性問卷，包括（一）護理人員基本資料；（二）醫護人員照顧高危險性傳染疾病病人之壓力量表；（三）醫療人員復原力量表。以描述性統計和卡方檢定進行分析。結果顯示，工作壓力前三名是害怕自己被感染；感控措施等相關資訊常常變動，適應不及；戴上防護面板及紙帽後，視線受影響。復原力排名前三名分別為：我知道我的工作是有意義的；我知道我的工作任務可以直接或間接的幫助到一些人及在工作上遇到困難時，我會嘗試想方法來克服它們。護理人員的教育程度與工作壓力構面的擔心與社會隔絕的壓力（p＝.009）、防護裝備引起的不適（p＝.013），教育程度與復原力構面的工作意義（p＝.046）；平時有無與家人同住與工作壓力構面的擔心與社會隔絕的壓力（p＝.03）等均達顯著相關性；工作壓力四個構面及復原力兩個構面進行分析，結果顯示工作壓力中的照顧病人的負擔與復原力中的情緒調適達到顯著相關係數（p＝.045）。本研究結果可提供行政管理者在COVID-19大流行再次來臨時，擬定有關減輕護理人員工作壓力及提高護理人員復原力等決策之參考。

In Taiwan, the outbreak of Coronavirus disease in 2019 (COVID-19) has increased nurses' stress levels, requiring a study of work-related stress and resilience of front-line nurses caring for patients with COVID-19. Therefore, this study is to investigate the stress and resilience of nurses in caring for COVID-19 patients. This cross-sectional study was conducted in a medical center and its five branch hospitals in central Taiwan and enrolled 333 nurses. There are three structured questionnaires, including a demographic survey questionnaire, a stress-related questionnaire for healthcare workers caring for patients with highly infectious diseases, and a questionnaire to evaluate the resilience levels of health-care workers. Descriptive statistics and chi-square tests revealed that the top three reasons for work-related stress were fear of infection; frequent changes in relevant guidelines, such as infection control policies, which were considered difficult to adapt to; and a compromised sightline due to the use of protective clothing and paper caps. Furthermore, the top three reasons for resilience were as follows: I know that my job is meaningful; I know my position can help people directly or indirectly; and when I face difficulties, I try to overcome them. Significantly correlations were observed between education level and stress related to social isolation (p= .009), education level and discomfort induced by protective equipment (p= .013), education level and resilience for the meaning of the job (p= .046), and living status and social isolation-related stress (p= .03). To further analyze four dimensions of work stress and the two dimensions of resilience, the results showed that the burden of caring for patients in work stress and emotional adjustment in resilience significant correlate (p= .045). Our findings may help administration managers develop policies to reduce work-related stress and increase nurses' resilience.

1. 呂旻瑾、翁玲子、張瓈方、潘雪幸(2022)．北部某醫學中心照顧新冠肺炎護理人員自覺壓力之相關因素探討．源遠護理，16(2)，67-74。
   連結：
2. 李美秀、許欽津(2022) ．工作與生命意義的實踐：急重症護理師的疫起挑戰．台灣公共衛生雜誌，41(3)，301-311。
   連結：
3. 林春珍、廖玉美、武香君、李佳倫、吳秀悅、陳麗琴(2020)．護理的力量－高醫護理防疫作為．領導護理，21(4)，1-8。
   連結：
4. 張朔衽、張倩蜜、曾麗卿、趙岑恩、陳淑純、張艾玲、張淑真、李雅文(2022) ．新冠肺炎(COVID-19)期間護理人力整備及應變計畫之成效．醫管新冠肺炎防疫專刊(第二刊)，70-83。
   連結：
5. 莊寶玉、羅美芳(2005)．醫護人員照顧高危險性傳染疾病病患之壓力量表的發展與測試-以SARS為例．台灣公共衛生雜誌，24(5)，420-430。
   連結：
6. 蕭維真、李志謙、楊昕禕、姚秀靜(2019)．醫療人員復原力之現況調查及問卷編制－以台灣南部某醫院為樣本．醫務管理期刊，20(4)，325-341。
   連結：
7. Al Maqbali, M., Al Sinani, M., & Al-Lenjawi, B. (2021). Prevalence of stress, depression, anxiety and sleep disturbance among nurses during the COVID-19 pandemic: A systematic review and meta-analysis. Journal of Psychosomatic Research, 141, 110343.
   連結：
8. Arnetz, J. E., Goetz, C. M., Arnetz, B. B., & Arble, E. (2020). Nurse Reports of Stressful Situations during the COVID-19 Pandemic: Qualitative analysis of survey responses. International Journal of Environmental Research and Public Health, 17(21), 8126.
   連結：
9. Babić, R., Babić, M., Rastović, P., Ćurlin, M., Šimić, J., Mandić, K., & Pavlović, K. (2020). Resilience in health and illness. Psychiatria Danubina, 32(suppl. 2), 226-232.
   連結：
10. Comrey, A. L. (1988). Factor-analytic methods of scale development in personality and clinical psychology. Journal of Consulting and Clinical Psychology, 56(5), 754-761.
    連結：
11. Cooper, A. L., Brown, J. A., & Leslie, G. D. (2021). Nurse resilience for clinical practice: An integrative review. Journal of Advanced Nursing, 77(6), 2623-2640.
    連結：
12. Cooper, A. L., Brown, J. A., Rees, C. S., & Leslie, G. D. (2020). Nurse resilience: A concept analysis. International Journal of Mental Health Nursing, 29(4), 553-575.
    連結：
13. Gillespie, B. M., Chaboyer, W., & Wallis, M. (2009). The influence of personal characteristics on the resilience of operating room nurses: A predictor study. International Journal of Nursing Studies, 46(7), 968-976.
    連結：
14. Guo, Y.-F., Cross, W., Plummer, V., Lam, L., Luo, Y.-H., & Zhang, J.-P. (2017). Exploring resilience in Chinese nurses: A cross-sectional study. Journal of Nursing Management, 25(3), 223-230.
    連結：
15. Holmes, E. A., O'Connor, R. C., Perry, V. H., Tracey, I., Wessely, S., Arseneault, L., Ballard, C., Christensen, H., Silver, R. C., Everall, I., Ford, T., John, A., Kabir, T., King, K., Madan, I., Michie, S., Przybylski, A. K., Shafran, R., & Bullmore, E. (2020). Multidisciplinary research priorities for the COVID-19 pandemic: A call for action for mental health science. The Lancet Psychiatry, 7(6), 547-560.
    連結：
16. Hossain, M. M., Tasnim, S., Sultana, A., Faizah, F., Mazumder, H., Zou, L., McKyer, E. L. J., Ahmed, H. U., & Ma, P. (2020). Epidemiology of mental health problems in COVID-19: A review. F1000Research, 9. 636.
    連結：
17. Labrague, L. J. (2021). Psychological resilience, coping behaviours and social support among health care workers during the COVID‐19 pandemic: A systematic review of quantitative studies. Journal of Nursing Management, 29(7), 1893-1905.
    連結：
18. Lavoie-Tremblay, M., Gélinas, C., Aubé, T., Tchouaket, E., Tremblay, D., Gagnon, M. P., & Côté, J. (2022). Influence of caring for COVID‐19 patients on nurse's turnover, work satisfaction and quality of care. Journal of Nursing Management, 30(1), 33-43.
    連結：
19. Leng, M., Wei, L., Shi, X., Cao, G., Wei, Y., Xu, H., Zhang, X., Zhang, W., Xing, S., & Wei, H. (2021). Mental distress and influencing factors in nurses caring for patients with COVID‐19. Nursing in Critical Care, 26(2), 94-101.
    連結：
20. Mills, J., Woods, C., Harrison, H., Chamberlain-Salaun, J., & Spencer, B. (2017). Retention of early career registered nurses: The influence of self-concept, practice environment and resilience in the first five years post-graduation. Journal of Research in Nursing, 22(5), 372-385.
    連結：
21. Ripp, J., Peccoralo, L., & Charney, D. (2020). Attending to the emotional well-being of the health care workforce in a New York city health system during the COVID-19 pandemic. Academic Medicine, 95(8), 1136-1139.
    連結：
22. Rodríguez, B. O., & Sánchez, T. L. (2020). The psychosocial impact of COVID-19 on health care workers. International Brazilian Journal Urology, 46(suppl 1), 195-200.
    連結：
23. Tan, E. J., Meyer, D., Neill, E., Phillipou, A., Toh, W. L., Van Rheenen, T. E., & Rossell, S. L. (2020). Considerations for assessing the impact of the COVID-19 pandemic on mental health in Australia. Australian & New Zealand Journal of Psychiatry, 54(11), 1067-1071.
    連結：
24. Turale, S., Meechamnan, C., & Kunaviktikul, W. (2020). Challenging times: ethics, nursing and the COVID‐19 pandemic. International Nursing Review, 67(2), 164-167.
    連結：
25. Yu, M., & Lee, H. (2018). Impact of resilience and job involvement on turnover intention of new graduate nurses using structural equation modeling. Japan Journal of Nursing Science, 15(4), 351-362.
    連結：
26. 黃子芹(2022)．臨床護理師面對新興傳染病疫情時壓力、復原力及社會支持之研究[碩士論文，元培醫事科技大學]．https://hdl.handle.net/11296/dpz588
27. 衛生福利部疾病管制署(2022，5月30日)．新型冠狀病毒(SARS-CoV-2)感染臨床處置指引。https://www.cdc.gov.tw/Category/Page/xCSwc5oznwcqunujPc-qmQ
28. Nunnally, J. C. (1978). Psychometric theory(2nd ed.). McGraw-Hill.

1. 陳秋曲(Chiu-Chu CHEN);李姿月(Tzu-Yueh LEE);趙麗玫(Li-Mei CHAO);吳姿蓉(Tzu-Jung WU)(2024)。後疫情時代護理人員的工作壓力、工作滿意度與韌性之相關性與預測因子。護理雜誌。71(4)。44-56。