关键词: 安宁疗护；工作投入；安宁疗护知识；自我感知能力；共情疲劳；多重中介模型；影响因素

Abstract: Objective: To investigate the current situation of work engagement and its influencing factors among palliative nurses. Methods: The convenience sampling method was used to recruit nurses from four tertiary grade A hospitals in Beijing and Hangzhou from November 2021 to February 2022. A survey was conducted on their palliative care knowledge, self-perception ability, compassion fatigue, and work engagement. Based on a multiple mediation model, the influencing factors and influencing paths of palliative care nurses' work engagement were analyzed. Results: The score of palliative nurses' work engagement was 37.32±10.38. The knowledge of palliative care significantly positively affected the ability to perceive oneself (β=0.318, P<0.001). There were significant positive impact of self-perception ability on work engagement (β=0.235, P<0.001), and significant negative impact of self-perception ability on compassion fatigue (β=-0.204, P<0.001). The compassion fatigue significantly negatively affected work engagement (β=-0.141, P=0.013). The knowledge of palliative care had a negative and indirect impact on compassion fatigue through self-perception ability (the indirect effect was -0.065, P=0.005), and positive and indirect impact on work engagement and compassion fatigue through self-perception ability (the indirect effect was 0.084, P<0.001). Conclusion: The work engagement of palliative nurses is at a high level, and knowledge of hospice care, self-perception ability, and compassion fatigue are key factors affecting their engagement. The knowledge of palliative care must be transformed into self-perception ability to have an impact on compassion fatigue and work engagement. The process of self-perception ability is a key link in knowledge resistance to fatigue, and its strengthening is beneficial for alleviating compassion fatigue and increasing work engagement. Nursing managers should accelerate the construction of palliative care education system, pay attention to the dynamic evaluation of self-perception ability and compassion fatigue among palliative nurses, optimize manpower allocation, create a good working environment, pay attention to the physical and mental health of nurses, and assist in improving work engagement.

Key words: palliative care; work engagement; palliative care knowledge; self-perception ability; compassion fatigue; multiple mediation model; influencing factor