团体心理干预对护士群体睡眠与情绪状态的整合性效果：基于SMILE干预方案的本土化实证研究

Integrative Effects of Group Psychological Intervention on Sleep and Emotional States in Nurses: An Empirical Study Based on the Localized SMILE Intervention Protocol

摘要: 目的：探讨基于SMILE干预方案的团体心理干预对护士群体睡眠质量与情绪状态的整合性效果。方法：采用准实验设计，从2025年7月至10月连续纳入某三级甲等医院在职护士120名，随机分为干预组(n = 60)和对照组(n = 60)。干预组接受为期8周的SMILE团体心理干预；对照组接受常规心理健康宣教。于干预前后分别采用匹兹堡睡眠质量指数(PSQI)、广泛性焦虑障碍量表(GAD-7)、患者健康问卷抑郁量表(PHQ-9)及Maslach职业倦怠量表(MBI)进行评估。结果：干预组PSQI、GAD-7、PHQ-9及MBI各维度评分均显著优于对照组(P < 0.001)。相关分析显示，睡眠改善与焦虑改善(r = 0.52)、抑郁改善(r = 0.58)、情感耗竭改善(r = 0.44)呈正相关，与个人成就感改善呈负相关(r = −0.26)。亚组分析显示，夜班频率 ≥ 6次/月及工龄 ≤ 5年的护士从干预中获益更为显著(交互效应P < 0.05)。结论：SMILE团体心理干预能有效改善护士的睡眠质量、情绪状态及职业倦怠，高夜班频率和低年资护士是重点获益人群。

Abstract: Objective: To explore the integrative effects of a group psychological intervention based on the SMILE intervention protocol on sleep quality and emotional states in nurses. Methods: A quasi-experimental design was adopted. From July to October 2025, 120 nurses from a tertiary first-class hospital were continuously enrolled and randomly divided into an intervention group (n = 60) and a control group (n = 60). The intervention group received an 8-week SMILE group psychological intervention; the control group received routine mental health education. The Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Maslach Burnout Inventory (MBI) were used to assess the participants before and after the intervention. Results: The scores for the PSQI, GAD-7, PHQ-9, and all dimensions of the MBI in the intervention group were significantly better than those in the control group after the intervention (P < 0.001). Correlation analysis showed that sleep improvement was positively correlated with improvements in anxiety (r = 0.52), depression (r = 0.58), and emotional exhaustion (r = 0.44), but negatively correlated with improvement in personal accomplishment (r = −0.26). Subgroup analysis indicated that nurses with a night shift frequency of ≥6 times per month and those with ≤5 years of work experience benefited more significantly from the intervention (interaction effects, P < 0.05). Conclusion: The SMILE group psychological intervention can effectively improve sleep quality, emotional states, and job burnout in nurses. Nurses with a high frequency of night shifts and those with fewer years of work experience are the key beneficiary populations.