单中心产科护士职业压力与工作满意度现状及影响因素

A single-center investigation of occupational stress and job satisfaction among obstetric nurses and analysis of influencing factors

摘要

目的 三孩政策实施后,高龄高危产妇比例攀升,产科护理风险与工作强度双重增加,护士职业压力与工作满意度直接关联母婴安全,本研究旨在分析当前产科护士压力与工作满意度现状及其关键影响因素,以期为产科护理管理干预提供依据。方法 选自郑州大学第三附属医院于2024年6月至2025年6月在职的249名产科护士,采用中国护士职业压力源量表(CNSS)及自制工作满意度调查问卷分别统计其职业压力与工作满意度情况。同时采集其一般资料,比较不同人口学特征产科护士的工作满意度差异,对影响其工作满意度的相关因素进行多因素logistic回归分析。结果 249名产科护士CNSS量表总分(105.01±3.40)分,其中重度压力156例(62.65%),中度压力73例(29.32%),轻度压力20例(8.03%)。不同职称、婚姻情况、学历、用工形式、月均收入及职业压力的产科护士工作满意度差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,低级职称(OR=1.669,95%CI:1.225~6.032,P=0.008)、已婚(OR=1.829,95%CI:1.404~5.997,P=0.014)、本科学历(OR=1.579,95%CI:1.120~6.004,P=0.011)、合同制聘用(OR=1.880,95%CI:1.306~10.985,P=0.002)、月均收入≤5 000元(OR=1.992,95%CI:1.403~12.352,P=0.001)、重度职业压力(OR=1.747,95%CI:1.239~11.197,P=0.002)是影响产科护士工作满意度的危险因素。结论 产科护士职业压力高、满意度低,职称、职业压力等6项因素为主要影响因子。需从薪酬激励、职称晋升及家庭支持等多维度构建针对性干预策略,以稳定产科护理队伍。

Abstract

Objective Following the implementation of the three-child policy,the proportion of elderly and high-risk parturients has risen markedly,leading to a dual increase in obstetric nursing risks and workload intensity. Occupational stress and job satisfaction among obstetric nurses are directly associated with maternal and infant safety. This study aimed to investigate the current status of occupational stress and job satisfaction among obstetric nurses,and to identify their key influencing factors,so as to provide evidence for targeted nursing management interventions in obstetrics. Methods A total of 249 obstetric nurses employed at the Third Affiliated Hospital of Zhengzhou University between June 2024 and June 2025 were enrolled. The Chinese Nurse Stressor Scale (CNSS) and a self-developed job satisfaction questionnaire were used to assess occupational stress and job satisfaction,respectively. General demographic data were collected,and differences in job satisfaction among nurses with different characteristics were compared. Multivariate logistic regression analysis was performed to identify factors associated with job satisfaction. Results The mean total CNSS score among the 249 obstetric nurses was 105.01±3.40. 156 (62.65%) reported severe occupational stress,73 (29.32%) moderate stress,and 20 (8.03%) mild stress among them. Differences in job satisfaction were statistically significant across groups stratified by professional title,marital status,educational level,employment form,average monthly income,and occupational stress level (all P<0.05). Multivariate logistic regression analysis demonstrated that primary professional title (OR=1.669,95%CI:1.225~6.032,P=0.008),married status (OR=1.829,95%CI:1.404~5.997,P=0.014),bachelor′s degree (OR=1.579,95%CI:1.120~6.004,P=0.011),contract employment (OR=1.880,95%CI:1.306~10.985,P=0.002),average monthly income≤5 000 RMB (OR=1.992,95%CI:1.403~12.352,P=0.001),and severe occupational stress (OR=1.747,95%CI:1.239~11.197,P=0.002) were independent factors for reduced job satisfaction. Conclusion Obstetric nurses experience high levels of occupational stress and low job satisfaction. Six variables,including professional title and occupational stress,are the main influencing factors. Targeted intervention strategies should be developed across multiple dimensions,such as salary incentives,professional promotion pathways,and family support,to stabilize the obstetric nursing workforce.

关键词

产科护士 / 职业压力 / 工作满意度 / CNSS量表 / 护理管理

Key words

Obstetric nurses / Occupational stress / Job satisfaction / Chinese Nurse Stressor Scale (CNSS) / Nursing management

参考文献

[1] 叶琦琦, 黄黛苑, 钟可夫, 等 . 基于压力-评价-应对理论分析妇产科护士压力负荷现状及影响因素[J]. 职业与健康, 2024, 40(23): 3243-3247.

[2] 程贤鹦, 王园园, 张朋辉, 等 . 三孩政策后孕产妇妊娠特征、分娩方式和围生儿结局的临床研究[J]. 中华全科医学, 2024, 22(3): 451-454, 477.DOI: 10.16766/j.cnki.issn.1674-4152.003424.

[3] 赵建舒 . 云南省不同等级医院护士职业倦怠、工作满意度与离职意愿现状及其影响因素研究[D]. 昆明: 昆明医科大学, 2025.

[4] Rashnoudi P, Soltani E, Mohammadinejad A, et al. Investigating the impact of situational awareness and resilience on occupational stress:a case study of nurses in medical and educational hospitals in Ahvaz[J]. Sci Rep, 2025, 15(1): 22094.DOI: 10.1038/s41598-025-06570-0.

[5] 沈月, 周炜, 肖雅, 等 . 临床护士重度职业倦怠预测模型的构建[J]. 护理管理杂志, 2023, 23(10): 797-802.DOI: 10.3969/j.issn.1671-315x.2023.10.004.

[6] 丛明慧, 刘亚萍, 张嘉峻, 等 . 门诊护士职业压力精神薪酬满意度及其与职业倦怠的关系[J]. 中国妇幼保健, 2025, 40(1): 88-92.DOI: 10.19829/j.zgfybj.issn.1001-4411.2025.01.022.

[7] Fu Y, Qu G, Sun J, et al. Enhancing occupational well-being among Chinese nurses:exploring the mediation of job stress in the relationship between social support and occupational well-being[J]. J Nurs Manag, 2025, 2025: 2140829.DOI: 10.1155/jonm/2140829.

[8] 刘小红, 张岚, 王瑞, 等 . 工作满意度在临床护士情绪劳动与职业幸福感间的中介效应研究[J]. 护理管理杂志, 2025, 25(4): 302-306.DOI: 10.3969/j.issn.1671-315x.2025.04.006.

[9] 曹会鲲, 周珩, 李晓硕, 等 . 产科护士职业倦怠与睡眠质量现状及相关性分析[J]. 成都医学院学报, 2024, 19(3): 530-533.DOI: 10.3969/j.issn.1674-2257.2024.03.033.

[10] 方敏, 甘燕玲, 胡进平, 等 . 心理资本在产科护士不合规任务和职业倦怠间的中介作用[J]. 职业与健康, 2024, 40(20): 2737-2741.

[11] 杨明, 孙佳仪, 柳思成, 等 . 工作-家庭支持对基层卫生人员职业倦怠的影响及职业认同和工作满意度的中介作用[J]. 中华疾病控制杂志, 2025, 29(5): 594-599, 605.DOI: 10.16462/j.cnki.zhjbkz.2025.05.015.

[12] 常亚丽, 张颖唯, 鄢雨英, 等 . 辅助生殖技术专科护士核心能力评价指标体系的构建及验证[J]. 中华护理杂志, 2024, 59(23): 2833-2840.DOI: 10.3761/j.issn.0254-1769.2024.23.003.

[13] 谭剑, 孔雪二, 侯璇璇 . 工作满意度在护士心理弹性与职业倦怠间的中介效应[J]. 护理学报, 2023, 30(8): 69-73.DOI: 10.16460/j.issn1008-9969.2023.08.069.

[14] 任晓慧, 王思钰, 崔延泽, 等 . 护理人员职业倦怠与组织承诺、工作满意度的关系研究[J]. 中国医院管理, 2021, 41(2): 80-83.

[15] 张文馨, 孙育红, 刘丽平, 等 . 临床护士工作压力潜在剖面分析及影响因素研究[J]. 护理管理杂志, 2024, 24(7): 629-633,644.DOI: 10.3969/j.issn.1671-315x.2024.07.015.

[16] 李丽清, 赵玉兰, 李佳文, 等 . 全科医生工作满意度、离职意愿与职业倦怠的结构方程模型研究[J]. 中国卫生统计, 2021, 38(2): 286-289.DOI: 10.3969/j.issn.1002-3674.2021.02.033.

[17] 陈婷婷, 叶征, 郑淑萍, 等 . 上海市普陀区家庭医生工作满意度与职业倦怠状况调查[J]. 中华全科医师杂志, 2021, 20(2): 199-204.DOI: 10.3760/cma.j.cn114798-20200527-00631.

[18] Lu M, Li X, Song K, et al. Mental health disparities between physicians and nurses:analyzing the impact of occupational stress and work environment fitness using random forest algorithm[J]. J Affect Disord, 2024, 350: 350-358.DOI: 10.1016/j.jad.2024.01.113.

[19] 郭员志, 寇洁, 王俊杰, 等 . 护士层级动态管理系统的构建及应用[J]. 中华护理杂志, 2025, 60(15): 1879-1883.DOI: 10.3761/j.issn.0254-1769.2025.15.013.

[20] 蒋莹莹, 许勤, 蒋玲, 等 . 护士职业心理韧性的概念分析[J]. 护士进修杂志, 2024, 39(4): 356-362.DOI: 10.16821/j.cnki.hsjx.2024.04.004.

[21] 杨钻钻, 宋嘉婷, 黄黛苑, 等 . 广东省三级甲等医院妇产科护士工作成瘾、工作时间压力现状及影响因素分析[J]. 职业与健康, 2023, 39(22): 3055-3059, 3066.DOI: 10.13329/j.cnki.zyyjk.2023.0586.

基金资助

河南省医学科技攻关计划项目(LHGJ20220551)