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Abstract Objective To understand the psychological pressure faced by pediatric nurses and their ways of coping with it, so as to provide a reliable basis for reducing the psychological pressure of pediatric nurses. Methods A self-designed questionnaire and a questionnaire on psychological stressors and coping styles of nursing staff were used to investigate 104 nurses, including 51 nurses working in adult departments (adult group) and 55 nurses working in pediatric departments (pediatric group). Results The pediatric group had significantly higher stress in social, work nature and intensity, and interpersonal coping than the adult group (all P<0.05); the pediatric group was able to cope positively and proactively in their coping styles. Conclusion Pediatric nurses have greater psychological pressure, a good working life environment should be created, support systems should be established, and the level of business skills should be improved to help pediatric nurses reduce and eliminate psychological pressure.
Keywords: pediatrics; nurses; psychological stress; coping methods; data collection
Nursing is a service work dedicated to human health. With the transformation of the medical model, the quality of nursing care is required to be higher [1]. Due to the special nature of the profession and other factors, nurses are under great mental and psychological pressure in the intense and heavy work, which has a great negative impact on physical and mental health and quality of work [2]. Pediatric nurses are more prone to various psychological problems than other nurses because of the combination of special work objects, urgent family expectations, and strong social concerns, but there are not many studies in this area yet. In this study, we used a self-designed general information questionnaire and nursing staff psychological stressors and intervention methods questionnaire [3] to investigate 55 pediatric and 55 adult nurses working in three teaching hospitals in our city, and the results are reported as follows.
1 Objects and Methods
1.1 Objects
Selected 110 working nurses in 3 teaching hospitals in Xi'an City, among them 55 pediatric workers (pediatric group) and 55 adult department workers (adult group), aged 20-45 years old, with an average of 28.60 years old. Education: 30 secondary school, 80 college and above; title: 30 nurses, 63 nurse practitioners, 17 nurse supervisors. They had been engaged in nursing work for 2 to 20 years, with an average of 9.60 years. None of them had physical or mental diseases. Comparison of age, education, title, length of service of the two groups, the difference is not significant (all P>0.05), comparable.
1.2 Methods
The questionnaire was designed by the researcher based on the relevant literature, and included three parts: general information, psychological stress of nursing staff and intervention methods. The general information included nursing staff's department, age, length of service, title, education and marital status. The nursing staff's psychological stressor questionnaire contained 41 test items in 5 areas, namely, 6 items in the social aspect, 9 items in the nature and intensity of work, 8 items in the aspect of continuing education and vocational needs, 9 items in the aspect of interpersonal relationships, and 9 items in the aspect of the family; and the degree of its degree was rated on a scale of 0 to 4, with the scores of 0, 1, 2, 3, and 4 indicating that the stressor was nonexistent, that it existed but did not produce psychological stress, mild psychological stress, moderate psychological stress, and moderate psychological stress. The higher the score, the greater the stress. Coping styles include self-blame, withdrawal, fantasy, rationalization, seeking help, and solving the problem on one's own; coping effects are based on the scores, and the effects are classified as fully effective (elimination of stress after adopting coping styles), partially effective (relief of stress after adopting coping styles), and ineffective (no relief or increase in stress after adopting coping styles). ***110 questionnaires were distributed and 106 valid questionnaires were collected (51 in the adult group and 55 in the pediatric group) with a valid recovery rate of 96.36%. Data data were analyzed and processed by nature by statistical professionals applying SPSS 10.0 statistical software. Statistical description and t-test were used.
2 Results
2.1 Comparison of psychological stressor scores between the two groups
See Table 1.Table 1 Comparison of psychological stressor scores between the two groups compared with the adult group *P<0.05
2.2 Coping styles adopted by the pediatric nurses and their effects
56.40% of the pediatric nurses adopted a more positive way of coping in daily work, while 43.60% adopted a negative way of coping. 86.00% of the pediatric nurses believed that the coping styles they adopted could effectively reduce their psychological stress in their daily work. The coping methods and their effects are shown in Table 2.
3 Discussion
3.1 Influencing factors of pediatric nurses' psychological stress
3.1.1 Social aspects: At present, the society does not have enough understanding of the importance of nursing work, and the phenomenon of exclusive medical care and not recognizing the fruits of nurses' labor is more common. After the child is sick, the family is anxious, plus the child's fear makes the nursing difficulty increase, the parents often angry at the nurses; There are also some family members do not understand the hospital rules and procedures, do not know enough about the disease, produce all kinds of complaints, and the nurses often become the object of bad feelings; Compared with the doctors, the nurses in the title promotion, further training, welfare treatment and so on
Table 2 Pediatrics group to deal with the problems there are many unreasonable There are many irrational phenomena in the way of coping and effect. Pediatric nurses working for a long time in such an environment full of stressors are prone to increased psychological load and physical fatigue, psychological imbalance, and a sense of loss [4].
3.1.2 The nature and intensity of the work: the high level of technical requirements is one of the main factors of psychological stress of pediatric nurses. Due to the special characteristics of children's physiology, such as children's small blood vessels, puncture difficulty, not easy to fix, coupled with the children's fear, crying and resistance, some parents in the infusion treatment often give a variety of bad words and behavior, to the implementation of the infusion operation of the nurses to create a great deal of psychological pressure. Inexperienced young parents, because they are not good at watching over the infusion of children, often pull out the needle or touch the needle to make the liquid seepage and other events, not only to intensify the parents' negative emotions, but also increase the labor intensity of pediatric nurses. Pediatrics, a wide range of diseases, rapid changes in condition, children's ability to communicate with their own language is poor, requiring nurses to have a wealth of theoretical knowledge and keen observation, which puts forward a higher demand for the sense of responsibility of pediatric nurses, increasing the psychological pressure on nurses.
3.1.3 The relationship between doctors and nurses: in the work of the upper and lower levels, between doctors and nurses, between nurses and patients and nursing staff may occur between a variety of contradictions and conflicts, especially nurse-patient conflict, which involves the rights and interests of both sides, health and economic issues, as well as personality and legal responsibility [5], a little mishandled, will be in trouble, this intricate interpersonal relationships will bring the nurse This kind of intricate interpersonal relationship will bring certain psychological pressure to nurses. In the new nursing model, pediatric nurses not only have to communicate with parents and children at any time, but also have to pay more tolerance and love [6]. Inappropriate use of patient complaint mechanism, such as scalp venipuncture failure, parents think that the nurse level is not high, ignoring the rules and regulations to be observed and the obligation to cooperate with the treatment and care, resulting in cognitive contrast, blind complaints, thus increasing the difficulty of the work of nurses and psychological pressure [7]. Pediatric nurses must remain calm and peaceful even when they encounter malicious misrepresentation of facts, unjustified accusations or even scolding and other impolite words and behaviors, not only to understand the children and their parents, but also to help the children to solve the problem. When nurses do not understand, feel threatened or experience emotional harm and are unable to express it, they will feel low status, lack of personal safety and decreased job satisfaction. Pediatric nurses face children and different psychological state, different levels of children's parents, coupled with heavy workload and lack of understanding and support, prone to negative psychological performance, which makes pediatric nurses in the doctor-patient relationship of psychological pressure than adult nurses.
3.1.4 Other factors: the transformation of the medical model, the wide application of high, precise and sharp technology, so that the scope of nursing services continue to expand, and its functions gradually broaden, forcing nursing staff to update the knowledge structure, resulting in an increase in the pressure to update the demand for knowledge. But the nursing staff to continue further education and title promotion opportunities are fewer, the business level requirements and career stability of the pressure to increase.
3.2 Measures to alleviate the psychological pressure of pediatric nurses
3.2.1 Improve the working and living environment, create a good working atmosphere: hospitals in the management should be people-oriented, with people's strengths, tolerate people's shortcomings, timely and correctly deal with a variety of inter-personal conflicts in the work of nursing, and strive to create a united and collaborative working atmosphere. Scientific arrangement of duty, rational allocation of manpower and material resources to reduce the physical exertion of nurses [8]. Try to create a clean and comfortable working environment, and improve the noisy pediatric ward environment for nurses' bad stimulation. Provide nurses with equal promotion and learning opportunities to stimulate nurses' motivation and enhance their sense of self-worth and professional self-confidence. Using rest and other time, organizing nurses to participate in various recreational activities, allowing nurses to reasonably vent negative emotions, in order to effectively alleviate psychological pressure and mental tension, and restore psychological balance.
3.2.2 Set up a positive outlook on life and serious and rigorous work style: positive and pleasant state of mind is the basis of mental health. Strengthen the study of psychology and medical ethics for nurses, improve the conscientiousness of cultivating good psychological quality, first of all, to establish a correct outlook on life and values, self-esteem, self-improvement, self-love, from the perspective of their own duties, objective and reasonable evaluation of their own position in social life, the formation of a reasonable psychological pivot point. Should be good at self-affirmation and self-recognition, try to be the master of emotions, develop a good character, maintain optimism, serenity, pleasant state of mind, healthy and upward spiritual world, devote themselves to work, do not bring negative emotions into the wards, with positive emotions to influence and infect the children, and thus get pleasure [9]. In daily life, we should have a good spirit, warm service attitude, and answer parents' questions with concise and easy-to-understand language. We should put ourselves in the shoes of the children and their families and explain patiently so that the parents can cooperate with us on their own initiative. Children often like others to praise and encouragement, should be kind and friendly attitude in the operation before encouraging the child, its cooperation and progress in the treatment of praise, and encourage its persistence and development, so that most of the children can consciously restrain their own behavior, and actively cooperate with the treatment. With the "think differently" approach and the concept of "tolerance", you can frankly deal with children and parents' concerns or criticism, maintain psychological balance, reduce misunderstanding and conflict with the parents of children, so that you can better do your job.
3.2.3 Efforts to improve the level of business skills and their own comprehensive quality: most of the children's families lack of medical expertise, such as the ability to use easy-to-understand language in a timely manner to introduce them to the causes of the disease, the transition and during the illness of the precautions to be taken, so that the parents have a clear idea of the child's condition, the ability to correctly and calmly deal with the child's crying, actively cooperate with the nurses to carry out a variety of treatments. Nurses can skillfully perform all kinds of skillful operations and minimize children's pain when performing various treatments. For example, when performing scalp venous puncture for children, we will strive to succeed at one time, study the characteristics of the blood vessels of infants and young children, obese children, dehydrated children and critically ill children, experience the needle movement again and again, and observe the operation methods of experienced and skilled people, so as to make the venous puncture technique better and better, which can not only reduce the pain of children, but also increase the family's trust in the nurses to form a virtuous circle of mutual understanding and tolerance. A virtuous cycle of mutual understanding and tolerance is formed. Psychological education should be one of the compulsory courses for the training of nursing professionals, and new nurses assigned to pediatrics should be introduced in detail to the special characteristics of pediatrics before they start work, so that they can be fully prepared psychologically, and be calm and collected when things go wrong. Emphasize that to be an excellent pediatric nurse must have more love, patience, sense of responsibility, only with a motherly heart, will care, love and care for children; only with more patience, can not be in the child's capriciousness, uncooperative, not impatient, orderly completion of the nursing work; only a very strong sense of responsibility, will be in the children's condition changes quickly, timely and accurate observation of the condition. In addition, pediatric nurses should also consciously learn mental health knowledge, consciously cultivate their own healthy personality, stable emotions and positive and optimistic spirit, and constantly improve their own stress capacity and psychological tolerance [10?11].
3.2.4 Other: In addition, a relaxed and good working environment for pediatric nurses also requires the correct guidance of the news media and public opinion and the respect and understanding of the family and society, which are conducive to stimulating the nurses' sense of pride and responsibility, thus improving work efficiency, reducing and eliminating errors and accidents, and easing the conflict between nurses and patients. Promote the development of children's health and the harmony of pediatric medical environment.
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