关键词: 重症监护室；护士；谵妄；工作压力；工作要求；工作控制；结构方程模型

Abstract: Objective: The Job Demand-Control-Support (JDCS) model was used as a theoretical framework to develop the structural equation model for strain of care for delirium in ICU nurses and explore its current status and influencing factors. Methods: A total of 268 ICU nurses from three tertiary grade A hospitals in Anhui province were selected by convenient sampling from February to August 2023. The Moral Distress Scale, the Psychological Empowerment Scale, the Perceived Organizational Support Scale, and the Strain of Care for Delirium Index were used to collect data. The structural equation model was used to establish and revise the strain of care for delirium model. Results: The strain of care for delirium of the participants was 56.32±14.68. The structural equation model fitted well (χ2/df=2.497, CFI=0.953, GFI=0.914, RMSEA=0.075, NFI=0.925, TLI=0.939, IFI=0.954). Nurses' moral distress had a direct positive influence on the strain of care for delirium (β=0.336). Psychological empowerment had a direct negative impact on the strain of care for delirium (β=-0.276), while psychological empowerment also indirectly affected the strain of care for delirium by influencing moral distress (β=-0.078, 95%CI:-0.171, -0.025). Organizational support had a direct negative effect on the strain of care for delirium (β=-0.195), while organizational support indirectly affected the strain of care for delirium through psychological empowerment and moral distress (β=-0.254, 95%CI: -0.382, -0.151). Conclusion: The strain of care for delirium among ICU nurses is at a high level. Nursing managers can reduce their moral distress by strengthening nurses' organizational support and psychological empowerment level, which is an effective way to cope with the strain of care for delirium.

Key words: Intensive Care Unit; nurse; delirium; job stress; job demand; job control; structural equation model