Objective: To investigate the functional somatic discomfort status, and to analyze the effect of job stress, hostile attribution bias and ego depletion on functional somatic discomfort in clinical nurses. Methods: In May 2019, 10 cities in Henan Province and Fujian Province were randomly selected as sampling cities. Using the stratified cluster sampling method, nurses of clinical nursing posts in 22 third class hospitals and 23 second class hospitals were selected as the research objects. The general information, job stress, hostile attribution bias, ego depletion and functional somatic discomfort of clinical nurses were investigated by self-designed general information questionnaire, Perceived Stress Scale, Social Information Processing-attribution Bias Questionnaire, Self-regulatory Fatigue Scale, Patient Health Questionnaire-15. 1200 clinical nurses included, and a total of 1159 valid questionnaires were collected, the effective rate of questionnaire collection was 96.6%. The t test was used to compare the difference of the functional somatic discomfort scores of clinical nurses with different demographic characteristicst. The influence of job stress, hostile attribution bias and ego depletion on functional somatic discomfort of clinical nurses were analyzed with Bootstrap. Results: The functional somatic discomfort score of clinical nurses was (8.95±4.38), of which 859 (74.12%) had functional somatic discomfort symptom. The functional somatic discomfort score of clinical nurses aged 36-50 years old was higher than that of 19-35 years old, the functional somatic discomfort score of clinical nurses with service age ≥5 years was higher than that of <5 years, the functional somatic discomfort score of non-permanent clinical nurses was higher than that of permanent clinical nurses, the functional somatic discomfort score of clinical nurses in tertiary hospitals was higher than that of secondary hospitals, the functional somatic discomfort score of clinical nurses in surgical departments were higher than those in non-surgical departments, and the differences were statistically significant (P<0.05). Job stress affected functional somatic discomfort through the single mediating role of hostile attribution bias, the single mediating role of ego depletion, and the chain mediating role of hostile attribution bias and ego depletion (β=0.17, 95%CI: 0.10-0.20; β=0.16, 95%CI: 0.10-0.20; β=0.07, 95%CI: 0.03-0.10; P<0.05) . Conclusion: The functional somatic discomfort symptoms of clinical nurses are significant and varied among different age, working age, employment form, hospital grade and department groups. They are affected by work stress directly and through the separate mediating effect of hostile attribution bias and ego depletion, and the chain mediating effect of hostile attribution bias and ego depletion.
目的： 探讨临床护士功能性躯体不适的状况，分析工作压力、敌意归因偏向和自我损耗对功能性躯体不适的影响。 方法： 于2019年5月，随机选取河南省、福建省10个城市为采样城市，采用分层整群抽样方法，抽取22个三甲医院、23个二甲医院的临床护理工作岗位护士作为研究对象，采用自行设计的基本情况调查表、《知觉压力量表》、《社会信息加工-归因偏向问卷》、《自我调节疲劳量表》、《健康问卷身体症状群量表-15》调查研究对象基本情况、工作压力、敌意归因偏向、自我损耗以及功能性躯体不适情况，共纳入1 200名临床护士，收回有效问卷1 159份问卷，有效回收率为96.6%。采用t检验比较不同人口学特征临床护士功能性躯体不适的得分差异，用Bootstrap分析工作压力、敌意归因偏向、自我损耗对临床护士功能性躯体不适的影响。 结果： 临床护士功能性躯体不适得分为（8.95±4.38）分，859人（74.12%）有功能性躯体不适症状。年龄36~50岁临床护士功能性躯体不适得分高于19~35岁者，工龄≥5年临床护士功能性躯体不适得分高于工龄<5年者，非在编临床护士功能性躯体不适得分高于编制者，三级医院临床护士功能性躯体不适得分高于二级医院者，手术科室临床护士功能性躯体不适得分高于非手术科室者，差异均有统计学意义（P<0.05）。工作压力通过敌意归因偏向、自我损耗的单独中介效应以及敌意归因偏向-自我损耗的链式中介效应影响临床护士的功能性躯体不适（β=0.17, 95%CI：0.10~0.20；β=0.16，95%CI：0.10~0.19；β=0.07, 95%CI：0.03~0.10；P<0.05）。 结论： 临床护士的功能性躯体不适症状显著，在不同年龄、工龄、受聘形式、医院等级、科室组间存在差异性，受工作压力直接以及通过敌意归因偏向、自我损耗的单独中介效应和敌意归因偏向与自我损耗的链式中介效应的影响。.
Keywords: Ego depletion; Functional somatic discomfort; Hostile attribution bias; Job stress; Nurses.