目的 探讨综合性医院高年资护士的工作应激体验，以更好地发挥其引领作用，提升职业使命感。方法 运用现象学研究方法，目的抽样法选取上海市5所三级甲等综合性医院的13名高年资护士为研究对象，进行半结构式访谈，通过Colaizzi 7步法分析资料并提炼主题。结果 共提炼出3个主题和10个亚主题：与个人特征相关的工作应激（身体机能下降、多重家庭角色、自我形象管理顾虑）、与工作角色相关的工作应激（多重角色任务的累积压力、多方沟通协调的压力、人力资源不足导致管理困境、组织支持力度不够延缓职业发展）和与职业认同相关的工作应激（社会刻板印象、医疗纠纷网络舆情预防压力、突发公共卫生事件中的责任担当）。结论 高年资护士面临多重工作应激，各单位应重视其身心健康，拓展职业发展空间，充分发挥临床经验与专业引领的价值，以维护整个护理团队的稳定。

Objective To explore the work stress experience of senior nurses in general hospitals,aiming to better leverage their leading role and enhance professional sense of mission.Methods With phenomenological research methodology and purposive sampling,13 senior nurses from 5 general hospitals were selected for semi-structured interviews.Data were analyzed and themes were extracted using Colaizzi’s 7-step method.Results Three main themes and 10 sub-themes were extracted:work stress related to personal characteristics (declining physical function,multiple family roles,concerns about self-image management);work stress related to work roles (cumulative pressure from multiple roles and tasks,pressure from multi-party communication and coordination,management difficulties due to insufficient human resources,insufficient organizational support hindering career development);work stress related to professional identity (social stereotypes,pressure from preventing medical disputes and online public opinion,responsibility in public health emergencies).Conclusions Senior nurses face multiple work stresses.Institutions should pay attention to their physical and mental health,expand career development opportunities,and fully utilize the value of their clinical experience and professional leadership to maintain the stability of the entire nursing team.

R47

海军军医大学基础医学研究课题（社科培育基金）；海军军医大学教学研究与改革项目（重点项目）