目的 了解精神科护士感知病房气氛现状并分析影响因素,为优化病房气氛提供依据。方法 2024年7-10月采用便利抽样法选取21个省49所医院的1460名精神科护士为研究对象,用中文版埃森-病房气氛量表(the Essen climate evaluation schema,EssenCES)和工作场所暴力量表(workplace violence scale,WVS)等进行调查。采用分层多元线性回归分析等方法分析影响因素。结果 1460名精神科护士EssenCES、WVS总分分别为(37.44±6.80)分和5.00(2.00,9.00)分,两者呈负相关(r=-0.313,P<0.01);精神科护士的EssenCES总分在性别、年龄、受教育程度、职称、有无接受过情绪调节和暴力预防相关培训或教育等项目上差异均有统计学意义(均P<0.05)。分层回归分析表明,性别、职称、医院等级、情绪调节培训、工作场所暴力及暴力后慰问保障是病房气氛的主要影响因素(均P<0.05)。结论 精神科护士感知病房气氛呈高治疗支持、高患者凝聚力、低安全体验的特征。管理者应优先缓解安全感危机,构建“评估-预防-应对-支持”的暴力防控体系,以改善病房气氛。

Objective To explore the status quo of perceived ward climate among psychiatric nurses and analyze its influencing factors, so as to provide evidence for optimizing ward climate. Methods From July to October 2024, 1460 psychiatric nurses from 49 hospitals in 21 provinces were selected by the convenience sampling method. They were investigated using the Chinese version of the Essen climate evaluation schema (EssenCES), and the workplace violence scale (WVS). Hierarchical multiple linear regression was used to analyze influencing factors. Results The total scores of ward climate and WVS among 1460 psychiatric nurses were 37.44±6.80 and 5.00(2.00,9.00), respectively, showing a negative correlation (r=-0.313, P<0.01). There were significant differences in the total ward climate score by gender, age, education level, professional title, and participation in training on emotion regulation and violence prevention (all P<0.05). Hierarchical regression analysis showed that gender, professional title, hospital grade, emotion regulation training, workplace violence (WPV), and post-violence support were the main influencing factors of ward climate (P<0.05). Conclusions Perceived ward climate among psychiatric nurses is characterized by high therapeutic support, high patient cohesion, and low safety experience. Administrators should prioritize alleviating the safety crisis and establish a violence prevention and control system of "assessment-prevention-response-support" to improve ward climate.

R471

湖南省第十一批创新型省份建设专项资金项目(2023ZK4096)；湘雅护理青年教师联合基金(2025XYHLQNLHJJ04)