护理实习生与注册护士的心理韧性与职业倦怠：系统综述与荟萃分析。
完整摘要 · 中文译文
背景：职业倦怠是护理领域中常见且严重的职业心理健康问题，心理弹性是一个可改变的因素，可能与较低的倦怠水平相关。这种关联在从实习护士到注册护士的教育到实践过渡过程中是否同样成立尚不清楚，而最具可比性的既往荟萃分析排除了护生和中文文献。 目的：我们旨在汇总护士和护理实习生中心理弹性与职业倦怠的关联。预先设定两个共同主要结局：心理弹性与情绪耗竭（EE）的相关性，以及概念匹配的实习护士与注册护士在总体倦怠上的比较。次要结局为去人格化和个人成就感。 方法：检索九个数据库，其中五个英文数据库和四个中文数据库，检索时间自建库至2026年，各数据库内未施加语言筛选；纳入资格限于以英文或中文发表的报告。符合条件的研究为横断面研究，并报告了经过验证的心理弹性测量工具与护士或护理实习生职业倦怠之间的相关性。两名评价者独立筛选、提取数据并评价质量（AHRQ 11条目）。在随机效应模型（REML；metafor）下通过Fisher z合并相关性，并进行亚组、敏感性和小样本研究分析。 结果：分析了78项职业倦怠研究（29，292名参与者）；五项学业倦怠研究不在范围内。心理弹性与情绪耗竭呈负相关（r = - 0.36，95% CI = - 0.4 -0.31 至 2；k = 49；I² = 95%），与总体倦怠（-0.44）和人格解体（-0.30）呈负相关，与个人成就感（+0.43）呈正相关。在概念匹配比较（总体倦怠）中，注册护士显示出在数值上强于实习医师的关联（r = -0.46 对 -0.28；Q_between p = 0.025）；由于仅有五项实习医师研究且敏感性分析不稳定，该差异为初步性。估计值在逐一剔除、模型选择和PET-PEESE分析中保持稳定，且在九项AHRQ评分≥ 8的研究中并未减弱（r = -0.43，-0.59 至 -0.24）；未检测到漏斗图不对称（Egger's p = 0.49）。 结论：心理弹性是护士倦怠的中等程度、一致的保护性相关因素，但反映高异质性的宽预测区间意味着其实际获益可能因环境而异。弹性建设应补充而非替代组织层面的措施。该相关因素在注册护士中是否强于实习医师仍为初步性。 系统综述注册：https://www.crd.york.ac.uk/PROSPERO/view/CRD420261427008，标识符 CRD420261427008。
完整摘要 · 英文原文
BACKGROUND: Burnout is a common, serious occupational mental-health problem in nursing, and psychological resilience is a modifiable factor that may be associated with lower burnout. Whether this association holds equally across the education-to-practice transition, from interns to registered nurses, is unclear, and the most comparable prior meta-analysis excluded nursing students and the Chinese-language literature. OBJECTIVE: We aimed to pool the resilience-burnout association in nurses and nursing interns. Two coprimary outcomes were prespecified: the resilience-emotional-exhaustion (EE) correlation, and a concept-matched intern-versus-registered-nurse comparison on total burnout. Secondary outcomes were depersonalization and personal accomplishment. METHODS: Nine databases, five English-language and four Chinese-language, were searched from inception to 2026 with no language filter applied inside any database; eligibility was limited to reports published in English or Chinese. Eligible studies were cross-sectional and reported a correlation between a validated resilience measure and burnout in nurses or nursing interns. Two reviewers independently screened, extracted data, and appraised quality (AHRQ 11-item). Correlations were pooled via Fisher's z under random-effects models (REML; metafor), with subgroup, sensitivity, and small-study analyses. RESULTS: Seventy-eight occupational-burnout studies were analyzed (29,292 participants); five academic-burnout studies were out of scope. Resilience was inversely associated with emotional exhaustion (r = - 0.36, 95% CI = - 0.42 to - 0.31; k = 49; I 2 = 95%), total burnout (- 0.44), and depersonalization (- 0.30), and positively associated with personal accomplishment (+ 0.43). On the concept-matched comparison (total burnout), registered nurses showed a numerically stronger association than interns (r = - 0.46 vs. - 0.28; Q_between p = 0.025); with only five intern studies and instability in sensitivity analyses, this difference is preliminary. Estimates were stable across leave-one-out, model-choice, and PET-PEESE analyses, and no weaker in the nine studies scoring AHRQ ≥ 8 (r = - 0.43, - 0.59 to - 0.24); no funnel-plot asymmetry was detected (Egger's p = 0.49). CONCLUSIONS: Psychological resilience is a moderate, consistent protective correlate of nurse burnout, but a wide prediction interval reflecting high heterogeneity means its practical benefit likely varies across settings. Resilience-building should complement, not replace, organizational measures. Whether the correlate is stronger in registered nurses than in interns remains preliminary. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261427008, identifier CRD420261427008.