急诊急救专科护士死亡应对能力在双元工作压力与离职意愿间的中介效应研究

doi:10.3761/j.issn.2096-7446.2026.11.015

摘要/Abstract

摘要：

目的探讨急诊急救专科护士死亡应对能力在双元工作压力与离职意愿间的中介效应。方法采用便利抽样法，2023年6月至2025年5月选取上海市3所三级甲等医院109名急诊急救专科护士作为研究对象，使用一般资料调查表、双元工作压力量表、中文版死亡应对能力量表与离职意愿量表进行调查。采用Pearson相关性分析双元工作压力、死亡应对能力与离职意愿关系；采用多元线性回归模型分析离职意愿的影响因素；采用中介效应分析死亡应对能力的中介作用。结果急诊急救专科护士挑战性工作压力得分为（20.42±5.13）分，阻碍性工作压力得分为（16.85±4.67）分，死亡应对能力总分为（116.34±24.18）分，离职意愿总分为（16.58±4.32）分。Pearson相关性分析显示，挑战性工作压力与离职意愿呈负相关（r=-0.218，P<0.05），阻碍性工作压力与离职意愿呈正相关（r=0.416，P<0.05），死亡应对能力与离职意愿呈负相关（r=-0.382，P<0.05）。中介效应分析表明，死亡应对能力在挑战性工作压力与离职意愿间起部分中介作用，间接效应值为-0.060；在阻碍性工作压力与离职意愿间起部分中介作用，间接效应值为0.081。结论死亡应对能力在双元工作压力与离职意愿间起部分中介作用。建议护理管理者识别并区分工作压力类型，同时通过提升护士的死亡应对能力，降低其离职意愿。

关键词: 急诊急救, 专科护士, 双元工作压力, 死亡应对能力, 离职意愿, 结构方程模型

Abstract:

Objective To explore the mediating effect of death coping ability among emergency and first-aid specialist nurses between dual work stress and turnover intention. Methods A total of 109 emergency and first aid nurses in the emergency departments of three tertiary grade-A hospitals in Shanghai from June 2023 to May 2025 were selected as the research subjects by convenience sampling method. The general information questionnaire，dual work stress scale，Chinese version of death coping ability scale and turnover intention scale were used for investigation. Pearson correlation was used to analyze the relationship between dual work stress，death coping ability and turnover intention. A multiple linear regression model was used to analyze the influencing factors of turnover intention. The mediating effect was used to analyze the mediating effect of death coping ability. Results The score of challenge work stress of emergency and first aid specialist nurses was （20.42±5.13），the score of hindrance work stress was （16.85±4.67），the total score of death coping ability was（116.34±24.18），and the total score of turnover intention was （16.58±4.32）. Pearson correlation analysis showed that challenge work stress was negatively correlated with turnover intention（r=-0.218，P<0.05），hindrance work stress was positively correlated with turnover intention （r=0.416，P<0.05），and death coping ability was negatively correlated with turnover intention（r=-0.382，P<0.05）. The mediating effect test showed that death coping ability played a partial mediating role between challenging work stress and turnover intention，and the indirect effect value is-0.060；it also plays a partial mediating role between hindrance work stress and turnover intention，and the indirect effect value is 0.081. Conclusion Death coping ability plays a partial mediating role in the relationship between the dual work stress and turnover intention. It is suggested that nursing managers should identify and distinguish the types of work stress and reduce the turnover intention of nurses by improving their ability to cope with death.

Key words: Emergency First Aid, Specialist Nurses, Dual Working Stress, Death Coping Ability, Turnover Intention, Structural Equation Model

刘丽, 张丽霞, 卢跃, 吕君. 急诊急救专科护士死亡应对能力在双元工作压力与离职意愿间的中介效应研究[J]. 中华急危重症护理杂志, 2026, 7(11): 1365-1370.

LIU Li, ZHANG Lixia, LU Yue, LÜ Jun. Mediating effect of death coping ability between dual work stress and turnover intention among emergency and first aid specialist nurses[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(11): 1365-1370.

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