Relationship between coping strategies, burnout, bullying, and distress in intensive and progressive care nurses: A single-centre cross-sectional survey

IF 2.6 3区医学 Q2 CRITICAL CARE MEDICINE

Australian Critical Care Pub Date : 2025-07-03 DOI:10.1016/j.aucc.2025.101288

Leah H. Hackney RN, BN, MHealSc, FNZCCN , Lois J. Surgenor PhD, DipClinPsych, FNZCCPsych

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引用次数: 0

Abstract

Background

Critical care nurses are exposed to challenging work situations and experience high rates of occupational stress and burnout, potentially aggravated by exposure to bullying. Specific coping strategies may alleviate the risk of adverse psychological outcomes such as these.

Aim/objective

The aim of this study was to investigate the association between coping strategies, burnout, bullying, and psychological distress.

Methods

Intensive/progressive care registered nurses (n = 116) from a single centre completed a cross-sectional survey incorporating (i) demographic and work characteristics and (ii) standardised questionnaires including Coping Orientations to Problems Experienced Inventory (Brief-COPE), Maslach Burnout Inventory, General Health Questionnaire-12, and Negative Acts Questionnaire-Revised. Univariate and linear regression analyses explored the associations between demographic and work characteristics and the questionnaires. Stepwise multiple regression explored the degree to which coping strategies, bullying, and demographic and work variables (independent variables) predicted burnout and psychological distress (dependent variables).

Results

Gender (t = 3.34, p = 0.001) was associated with Emotion-Focused Coping, while ethnicity was associated with both Emotion-Focused (ƞ² = 0.12, p = <0.001) and Problem-Focused coping (ƞ² = 0.07, p = 0.018). Working in the Progressive Care Unit was associated with higher Emotional Exhaustion (t = 4.74, p = <0.001) and higher Depersonalisation (t = 3.61, p < 0.001) than working in the Intensive Care Unit. Less experienced nurses reported higher Emotional Exhaustion (t = 3.14, p = 0.002), higher Depersonalisation (t = 3.75, p < 0.001), and lower Personal Accomplishment (t = 2.42. p = 0.017). After controlling for associations between independent covariables, the regression analysis showed that all three Brief-COPE scales contributed significantly (F = 9.22–21.71, p < 0.001) to Emotional Exhaustion and Depersonalisation subscales.

Conclusion

The study largely supports previous findings of associations between workforce factors, exposure to bullying, and deleterious effects such as burnout symptoms and psychological distress. After controlling for significant moderating factors, coping responses independently contribute to emotional exhaustion and depersonalisation. Understanding how coping responses are activated or are affected by adverse psychological states and events remains important. While interventions that specifically focus on protective coping responses may be especially helpful in alleviating particular components of burnout, nuances of the relationship require further investigation.

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重症监护和进步护理护士应对策略、倦怠、欺凌和痛苦的关系：一项单中心横断面调查

重症监护护士面临具有挑战性的工作环境，职业压力和倦怠率很高，暴露于欺凌可能会加剧这种情况。具体的应对策略可以减轻这些不良心理结果的风险。目的/目的本研究的目的是探讨应对策略、倦怠、欺凌和心理困扰之间的关系。方法对116名重症/渐进式护理注册护士进行横断面调查，调查内容包括：(1)人口统计学和工作特征；(2)标准化问卷，包括问题应对倾向经验量表（briefo - cope）、Maslach倦怠量表、一般健康问卷-12和负面行为问卷-修订。单变量和线性回归分析探讨了人口统计学和工作特征与问卷的关系。逐步多元回归探讨了应对策略、欺凌、人口统计和工作变量（自变量）对倦怠和心理困扰（因变量）的预测程度。结果性别（t = 3.34, p = 0.001）与情绪导向型应对相关，种族（ƞ2 = 0.12, p = <0.001）与情绪导向型应对和问题导向型应对相关（ƞ2 = 0.07, p = 0.018）。在进步护理病房工作与较高的情绪耗竭（t = 4.74, p = <0.001）和较高的人格解体(t = 3.61, p <；0.001)，比在重症监护室工作的死亡率高。经验不足的护士的情绪耗竭程度较高（t = 3.14, p = 0.002），人格解体程度较高(t = 3.75, p <；0.001)，个人成就感较低（t = 2.42）。P = 0.017)。在控制了独立协变量之间的关联后，回归分析显示三个Brief-COPE量表均有显著贡献(F = 9.22-21.71, p <；0.001)至情绪耗竭和人格解体子量表。结论本研究在很大程度上支持了先前的研究结果，即工作因素、暴露于欺凌和有害影响（如倦怠症状和心理困扰）之间存在关联。在控制了显著的调节因素后，应对反应独立地促进了情绪耗竭和人格解体。了解应对反应是如何被不良心理状态和事件激活或影响的仍然很重要。虽然专门关注保护性应对反应的干预措施可能特别有助于减轻倦怠的特定组成部分，但这种关系的细微差别需要进一步研究。

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来源期刊

Australian Critical Care NURSING-NURSING

CiteScore

4.90

自引率

9.10%

发文量

148

审稿时长

>12 weeks

期刊介绍： Australian Critical Care is the official journal of the Australian College of Critical Care Nurses (ACCCN). It is a bi-monthly peer-reviewed journal, providing clinically relevant research, reviews and articles of interest to the critical care community. Australian Critical Care publishes peer-reviewed scholarly papers that report research findings, research-based reviews, discussion papers and commentaries which are of interest to an international readership of critical care practitioners, educators, administrators and researchers. Interprofessional articles are welcomed.