摘要
目的 了解急诊科护士遭遇不文明行为发生的现状，探讨其影响因素及对职业倦怠及工作满意度的影响，方法 2024年1-4月期间，采取便利抽样法抽取广东、广西、湖南、江西等多家二级甲等以上医院急诊科189名护士作为调查对象，采用自制一般资料调查问卷、护士遭遇不文明行为量表、明尼苏达满意度问卷、哥本哈根职业倦怠量表进行调查并分析。结果 急诊科护士遭遇不文明行为总分为（109.54±27.12）分，工作满意度总分为(70.10±11.58）分，职业倦怠总分为（57.81±15.75）分，护士遭遇不文明行为量表与职业倦怠量存在正相关（r=0.502，P＜0.01），护士遭遇不文明行为与工作满意度存在负相关（r=-0.405，P<0.01）。85.2%的护士遭遇过不文明行为，其中患者不文明行为最为常见，家庭支持和工作岗位是重要影响因素。结论 研究显示急诊科护士面临严重的不文明行为问题，其中家庭支持及不同工作岗位对不文明行为有重要的影响作用，遭遇不文明行为越频繁的急诊科护士职业倦怠程度越严重，其工作满意度越低，建议医院管理者需加强安保措施，建立心理支持系统，实施岗位轮换制度，并通过定期培训提升护士的沟通与冲突处理能力，从而构建更加安全、和谐的工作环境。
关键词： 急诊科护士；不文明行为；职业倦怠；工作满意度
Abstract
Objective This cross-sectional study aimed to investigate the prevalence and characteristics of workplace incivility experienced by emergency department nurses, and to examine its relationships with job burnout and satisfaction. Methods January to April 2024, A convenience sample of 189 nurses was recruited from secondary-level and above hospitals in Guangdong, Guangxi, Hunan, and Jiangxi provinces. The self-made general information questionnaire, nurses’uncivilized behavior scale, Minnesota satisfaction questionnaire and Copenhagen job burnout scale were used for investigation and analysis. Results The total score of uncivilized behavior towards emergency department nurses were109.54±27.12, the total score of work satisfaction were 70.10±11.58, and the total score of job burnout was57.81±15.75. and there was a positive correlation between the scale of uncivilized behavior towards nurses and job burnout r=0.502, P＜0.01, and a negative correlation between uncivilized behavior and work satisfaction r=-0.405, P<0.01 85.2 % of nurses had experienced uncivilized behavior. Among them, patients’ uncivilized behavior is the most common, and family support and job position are important influencing factors. Conclusion This study reveals that emergency department nurses face significant challenges related to incivility, with family support and specific job positions identified as critical influencing factors. Nurses experiencing higher exposure to such incivility demonstrate more severe occupational burnout and lower job satisfaction. Hospital administrators are recommended to enhance security protocols, establish psychological support systems, implement structured job rotation policies, and conduct regular training sessions focused on communication enhancement and conflict resolution skills. These interventions aim to foster a safer, more harmonious clinical environment through comprehensive organizational reforms.
Key words： Emergency department nurses; Incivility; Burnout; Job satisfaction
参考文献 References
[1] 王介文,孙艳侠,严谨. 护士遭遇不文明行为量表的汉化及信度效度检验[J].中国护理管理,2022,12:1798-1804.
[2] Woo, CH, Kim, C. Impact of workplace incivility on compassion competence of Korean nurses: Moderating effect of psychological capital. J NURS MANAGE. 2020; 28 (3): 682-689.
[3] Bambi, S, Foà, C, De Felippis, C, et al. Workplace incivility, lateral violence and bullying among nurses. A review about their prevalence and related factors. Acta Biomed. 2018; 89 (6-S): 51-79.
[4] Garth, K, Todd, D, Byers, D, et al. Incivility in the Emergency Department: Implications for Nurse Leaders. J NURS ADMIN. 2018; 48 (1): 8-10.
[5] Weiss D J, Davis R V. Manual for the Minnesota Satisfaction Questionnaire[J]. Minneapolis MN:The University of Minnesota Press, 1967: 10-23.
[6] Layne, DM, Anderson, E, Henderson, S. Examining the presence and sources of incivility within nursing. J NURS MANAGE. 2019; 27 J NURS MANAGE.
[7] 纪红梅,潘春艳,吴莹莹,等.肿瘤医院护士遭遇不文明行为现状及影响因素研究[J].护理学杂志,2023,38(16):10-13.
[8] 邱洁,刘涛,陈迪平,等.上海市院前急救一线人员工作满意度及影响因素分析[J/OL].健康发展与政策研究:1-9[2025-09-21]. http://kns.cnki.net/kcms/detail/31.2200.R.20250623.1257.002.html.
[9] Zhang, S, Ma, C, Meng, D, et al. Impact of workplace incivility in hospitals on the work ability, career expectations and job performance of Chinese nurses: a cross-sectional survey. BMJ Open. 2018; 8 (12): e021874.
[10] 刘思妤,周秋红,龚志成,等.新型冠状病毒感染的肺炎疫情下某大型三甲医院员工援助计划的心理干预实践[J].国际精神病学杂志,2020,47(02):193-196.
[11] 赵亮亮. 护理工作环境健康促进行为与护士评价护理质量的关系研究[D].中国人民解放军空军军医大学, 2024.
[12] 王欢欢,韩继明.急诊护理人员遭受医院场所暴力探讨[J].医学与哲学,2020,41(21):58-60.
[13] 王晓晔,胡珊珊,李争,等.我国急诊科护士职业倦怠发生率及影响因素的系统评价[J].中华现代护理杂志,2020, 26(10):1324-1330.
[14] 罗玲霞,李婧,吴芳,等.基于MBI-GS量表调查急诊科医务人员职业倦怠现状及影响因素[J].中南大学学报(医学版),2024,49(06):981-988.
[15] 曹丽,郭伟.护士工作场所不文明行为、工作满意度及其对离职意愿的影响[J].中西医结合护理(中英文),2019, 5(02):152-154.
[16] 陈佳颖.患者不文明行为与工作满意度的关系[D]. 上海财经大学,2023.