目的 基于付出-回报失衡系统探索急诊科护士职业疲劳情况并分析其风险因素,为探索有效的急诊科疲劳风险管理策略提供参考。方法 以付出-回报失衡模型的三因子,即内在驱动、外在付出和外在回报为指导构建访谈提纲,采用半结构式访谈法,于2022年8月—10月对昆明市2所三级甲等医院12名急诊科护士进行深度访谈,运用Colaizzi的现象学资料7步分析法对收集资料进行分析。结果 提取主题包括3个维度共6个因素。2个内在驱动因素为高效的团队协作、个人能力快速提升;3个外在付出因素为高强度的工作负荷、与患者的冲突性经历、过度的培训投入;1个外在回报因素为有意义的认可。结论 高效的团队协作、个人能力快速提升及有意义的认可能促进急诊科护士在急诊科持续工作,但高强度的工作负荷、与患者的冲突性经历、过度的培训投入会加重急诊科护士的职业疲劳体验,因此需及时识别护士职业疲劳情况及影响因素,以便采取针对性防控策略,促进护士身心健康、增加共情,减少急诊科人才流失。
Objective To explore the occupational fatigue of nurses in emergency departments based on the effort-reward imbalance system,analyze its risk factors,and provide reference for exploring effective risk management strategies for fatigue in emergency department. Methods The interview outline was constructed under the guidance of the three factors of the effort-reward imbalance model,namely intrinsic drive,extrinsic effort and extrinsic reward. The semi-structured interview method was adopted to conduct in-depth interviews with 12 emergency department nurses from two tertiary class A hospitals in Kunming from August to October 2022,and the collected data were analyzed using Colaizzi's 7-step analysis method for phenomenological data. Results The extracted topic included three dimensions and a total of 6 factors. There are two internal driving factors：efficient team cooperation and rapid improvement of personal ability. There are three external factors：intense work load,conflicting experience with patients,and excessive training input. And it has an extrinsic reward,meaningful recognition. Conclusion The study found that efficient teamwork,rapid improvement of personal ability and meaningful recognition can promote the continuous work of emergency department nurses,but high intensity of workload,conflict experience with patients,and excessive training investment will aggravate the occupational fatigue experience of emergency department nurses. It is necessary to identify the occupational fatigue of nurses in time and understand the influencing factors,so as to adopt targeted pre-control strategies to promote the physical and mental health of nurses,increase the empathy,and reduce the brain drain of emergency department.
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