Effect of Web-based Career Identity and Assertion Training for Stress Management among Japanese Nurses-A Randomized Controlled Trial-

本研究旨在透过网站研究日本医院护士的压力应对与主张方法，以减轻护士的压力，并改善护士的心理健康状况。护士网络学习课程是参照正规员工压力管理课程设计的。该程序由护士职业认同（CI）和断言（AS）技能组成。采用随机对照试验（RCT）对护士进行CI学习效果评价。参与者被随机分为干预组和对照组，并在研究前后和研究后一个月分别填写问卷。干预组在3周内接受了70分钟的网络学习课程，之后再接受对照组的学习。因此，研究结束后，干预组有几个CI有所改善，而对照组有几个CI恶化。2 .压力源的“人际关系困难”在干预组有所改善，而在对照组则有所恶化。采用随机对照试验（RCT）对护士进行AS项目的学习效果评价。结果，在研究结束后，“对阿斯伯格综合症的认知”上升了，但一个月后，干预组的“认知”下降了。对照组在阿斯伯格综合症的思维和行为方面没有发现任何变化，尽管干预组在一个月后“坦率度”有所上升。在压力和心理健康状况方面，干预组的“刺激”在研究刚结束后就有所下降，一个月后“定量负荷”也有所下降。经ANCOVA分析，干预组的“AS知识”显著高于对照组，“抑郁”有改善的趋势。这些结果表明，日本医院护士的CI、AS、工作压力和心理健康状况在网络学习后有所改善。

The purpose of this study is to reduce the stress among Japanese hospital nurses by studying stress coping and assertion methods on a web-site, and to improve nurses' mental health status.1. The web-based learning program for nurses was made referring to the stress management program for regular workers. The program was composed of nurse's career identity (CI) and assertion (AS) skill.2. The learning effect of the CI program was evaluated with randomized control trial (RCT) for nurses. Participants were randomly assigned to the intervention and the control groups, and given a questionnaire before and after study, and one month post-study. A seventy-minute web-based learning session was given to the intervention group over 3 weeks and thereafter to the control group. As a result, several CI improved in the intervention group after study, while several CI worsened in the control group. Though "Interpersonal relationship difficulty" among stressors improved in the intervention group, it worsened in the control group.3. The learning effect of the AS program was evaluated with RCT for nurses. As a result, "Knowledge of AS" rose just after study, but decreased one month later in the intervention group. No change was recognized in the control group regarding AS mind and action, though "Frankness" rose in the intervention group one month later. Concerning stress and mental health status, "Irritation" decreased just after the study, and "Quantitative load" decreased one month later in the intervention group. Using ANCOVA, "Knowledge of AS" in the intervention group was found to be significantly higher than that in the control group, and "Depression" in the intervention group tended to improve.These results indicate that CI, AS, job stress, and mental health status improved after web-based learning program among Japanese hospital nurses.