护士心理弹性现状及影响因素的Meta分析

Meta-Analysis of the Current Status and Influencing Factors of Nurse Psychological Resilience

摘要: 目的：通过Meta分析明确护士心理弹性现状及其相关影响因素。方法：计算机检索中国知网(CNKI)、万方数据库(WANFANG)、中国生物医学文献数据库(CBM)、Embase、Web of Science、PubMed、The Cochrane Library、Ebsco等数据库关于护士心理弹性现状及影响因素的相关文章。检索时限为建库至2025年5月。采用Stata 18.0进行Meta分析。结果：共纳入18篇文献，包括7739名护士，提取到6个相关影响因素，Meta分析结果显示心理弹性得分为66.53 (95% CI: 64.58~68.48)，处于中等偏下水平。各研究间存在高异质性(I² = 97.7%)，亚组分析提示科室类型可能为异质性来源之一。漏斗图视觉检查呈现不对称，提示潜在的发表偏倚，虽Egger’s检验未提示显著统计学偏倚(P > 0.05)，但鉴于纳入研究数量有限，不能完全排除偏倚对合并结果的潜在影响。相关性分析显示，职业倦怠、工作压力和共情疲劳与心理弹性呈显著负相关；积极应对方式、职业认同及社会支持与心理弹性呈显著正相关。结论：当前护士群体的心理弹性处于中等偏下水平，护理管理者应根据相应的相关影响因素制定针对性干预措施，提升护士的心理弹性。

Abstract: Objective: To clarify the current status and influencing factors of nurse psychological resilience through Meta-analysis. Methods: Computer searches were conducted on literature related to the current status and influencing factors of nurse psychological resilience in databases, such as CNKI, WANFANG, CBM, Embase, Web of Science, PubMed, The Cochrane Library, Ebsco. The search period was from the establishment of each database until May 2025. A Meta-analysis was conducted using Stata 18.0. Results: A total of 18 articles, 7739 nurses were included, and 6 influencing factors were extracted. The Meta-analysis results showed that the psychological resilience score was 66.53 (95% CI: 64.58~68.48), which was at the lower moderate level. There was high heterogeneity among studies (I² = 97.7%), and subgroup analysis suggested that the type of department may be one of the sources of heterogeneity. The visual examination of the funnel plot showed asymmetry, suggesting potential publication bias. Although the Egger’s test did not indicate significant statistical bias (P > 0.05), the potential impact of bias on the combined results could not be completely excluded due to the limited number of included studies. Correlation analysis showed that job burnout, job stress and empathy fatigue were significantly negatively correlated with resilience. Positive coping style, professional identity and social support were significantly positively correlated with psychological resilience. Conclusion: At present, the psychological resilience of nurses was at a general level. Nursing managers should formulate intervention measures according to the corresponding influencing factors to improve the psychological resilience of nurses.