医护人员的职业倦怠及其应对策略

本文介绍了医护人员职业倦怠的现状及特点,并分析医护人员职业倦怠的压力源及影响因素,提出了减少职业倦怠的策略,即建构起有利而健全的社会支持体系;提供良好的组织和工作氛围;加强学习,提高医医护人员的知识水平和心理素质等。     

护士职业倦怠原因与调节

职业倦怠是指在以人为服务对象的职业领域中,个体的一种情感耗竭、人格解体和个人成就感降低的症状。由于护士是一种典型的以人为服务对象的职业,因此,护士是职业倦怠的高发人群,也一直是职业倦怠研究中重点关注的职业人群之一,医护人员发生职业倦怠机会高,尤其以护士更为突出,影响护士职业倦怠主要相关因素有年龄、护龄、婚姻、工作之余的家务劳动、学历、职称、劳动关系、收入、工作量、工作岗位和轮班等因素,由于护理模式向整体护理的转变,以患者为中心,护理角色职能发生质的改变,对护士提出了更高的要求,加重护士职业倦怠的发生。作者就护理职业倦怠的概念及内涵、危害、原因、职业倦怠现状及预防,同时指出干预医护人员职业倦怠的不同影响因素探索有效的方法。     

谈护士职业倦怠的干预对策

职业倦怠是在以人为服务对象的职业领域中,个体的一种情感耗竭、人格解体、和个人成就感降低的症状[1].在我国,行业的激烈竞争、技术挑战、繁重的工作压力、工资及其福利待遇低、工作环境差、晋升机会少等因素成为护士职业倦怠的潜在根源.护士职业倦怠成为一种普遍现象,尽管只发生在个人身上,但绝不是一个单纯的个人问题,是个体、组织、社会多方面共同交互作用的结果.有针对性地干预护士的职业倦怠,对于改变其工作的倦怠现状、提高工作效率、促进护理服务质量的提升具有重要现实意义.     

医护人员的职业倦怠及其应对策略

本文介绍了医护人员职业倦怠的现状及特点，并分析医护人员职业倦怠的压力源及影响因素，提出了减少职业倦怠的策略，即建构起有利而健全的社会支持体系；提供良好的组织和工作氛围；加强学习，提高医医护人员的知识水平和心理素质等。     

高校教师职业倦怠与心理干预

目的 探讨高校教师职业倦怠与心理健康及社会支持之间的关系,提出教师心理干预措施,促进教师心理健康.方法 采用职业倦怠问卷、症状自评量表和社会支持评定量表对10所高校296名教师进行调查.结果 职业倦怠中情感耗竭和人格解体维度与SCL-90各因素有极其显著的正相关;人格解体、成就感低落与社会支持利用度呈显著负相关.结论 高校教师的心理健康是多因素相互作用的结果,需要降低教师职业倦怠程度,提高社会支持水平的心理干预,达到社会层面、学校管理层面、婚姻家庭和个人层面的协调,进而提高心理健康水平.     

高校教师职业倦怠与心理干预

目的探讨高校教师职业倦怠与心理健康及社会支持之间的关系,提出教师心理干预措施,促进教师心理健康。方法采用职业倦怠问卷、症状自评量表和社会支持评定量表对10所高校296名教师进行调查。结果职业倦怠中情感耗竭和人格解体维度与SCL-90各因素有极其显著的正相关;人格解体、成就感低落与社会支持利用度呈显著负相关。结论高校教师的心理健康是多因素相互作用的结果,需要降低教师职业倦怠程度,提高社会支持水平的心理干预,达到社会层面、学校管理层面、婚姻家庭和个人层面的协调,进而提高心理健康水平。     

封闭性巴林特小组活动对精神科医护人员职业倦怠、人格特征的影响

目的探讨封闭性巴林特小组活动对精神科医护人员职业倦怠、人格特征的影响。方法选取2017年2月至2018年3月就职于珠海市慢性病防治中心精神科的24名医护人员作为观察组,组织其开展封闭性巴林特小组活动12次,另选取同期20名实施常规干预的精神科医护人员作为对照组。采用职业倦怠问卷、艾森克个性问卷评估精神科医护人员的职业倦怠、人格特征。结果活动后,与对照组比较,观察组的情感衰竭、去人性化倾向评分较低,个人成就感消失评分较高,艾森克个性评分较低(P均<0.05)。结论封闭性巴林特小组活动有利于改善精神科医护人员的职业倦怠,促进其形成良好的人格特征。     

儿科医护人员职业倦怠现状及其影响因素分析

目的了解并掌握儿科医护人员职业倦怠的现状及相关影响因素,以期为医院制定相应干预措施提供依据。方法于2020年3—5月通过基本信息问卷、职业倦怠量表对我院4个院区的儿科192名医护人员开展调查,基于结果评估儿科医护人员的职业倦怠情况,分析职业倦怠有关影响因素。结果通过调查,192名医护人员中83名存在不同程度职业倦怠,发生率为43.23%,以轻度为主;单因素及多因素logistic回归分析表明,值夜班、用工性质及工作年限是儿科医护人员职业倦怠独立影响因素(P<0.05)。结论儿科医护人员职业倦怠发生率较高,医院管理者应掌握相关因素,制定针对性干预措施,以减小儿科医护人员的职业倦怠感,稳定医护队伍。     

基于文献计量法的我国医护人员职业倦怠研究现状分析

目的分析我国医护人员职业倦怠的研究现状,为推动职业倦怠研究和促进医院人才建设提供建议和参考。方法本研究运用文献计量法,以"倦怠"和"医"或"护"或"卫生"为关键词或篇名,利用Note Express软件在CNKI中国知网和万方数据库中,检索从建库以来到2016年9月10日的文献1526篇,在此基础上进行文献计量统计分析。结果我国医护人员职业倦怠的相关文章数量逐年递增,主要研究对象为护士;关于医护人员职业倦怠的相关分析研究最多(594篇,占31.6%),其中工作压力源、社会支持、应对方式与职业倦怠的相关性研究居前3位。结论医护人员职业倦怠问题日益受到重视,但是缺乏适合我国国情的职业倦怠研究理论,且干预实证研究较少,多为短期研究,建议对医护人员的职业倦怠干预研究进行长期跟踪与随访。     

艾滋病防治医护人员职业倦怠与医患关系调查研究

目的探讨艾滋病防治医护人员职业倦怠与医患关系的影响。方法采用中国职业倦怠问卷和医患关系问卷对346名艾滋病防治医护人员进行调查。结果艾滋病防治医护人员轻度、中度和重度职业倦怠的检出率分别为70.23%、29.19%、3.47%,差异有统计学意义(χ~2=228.781,P0.01)。艾滋病防治医护人员职业倦怠与医患关系存在相关性(r=-0.321～0.354)。在支持性互动关系上,职业倦怠高分组得分低于职业倦怠低分组,差异有统计学意义(t=-4.229,P0.01)。在抑制性互动关系上,职业倦怠高分组得分高于职业倦怠低分组,差异有统计学意义(t=6.907,P0.01)。结论艾滋病防治医护人员职业倦怠较严重,是影响艾滋病防治医护人员医患关系的重要因素。     

基层疾病预防控制人员职业倦怠与工作压力、自尊、社会支持的相关研究

目的探讨基层疾病预防控制人员职业倦怠与工作压力、应对策略、自尊及社会支持的关系。方法采用职业倦怠量表、工作压力量表、工作压力应对策略调查表、自尊量表、社会支持量表,对200名疾病预防控制人员进行调查。结果疾病预防控制人员职业倦怠评分为(54.97±12.02)分,其职业倦怠与工作压力、应对策略呈正相关;与自尊、社会支持呈负相关。结论疾病预防控制人员职业倦怠发生率较高,主要因突发公共事件的增多,导致工作量大且风险高而致,高自尊、积极的应对策略、有效的社会支持对缓解职业倦怠起到重要的作用。     

Effect of work stressors, personal strain, and coping resources on burnout in chinese medical professionals: a structural equation model

The present study analyzes the effect of work stressors, personal strain and coping resources on burnout among Chinese medical professionals. A total of 2,721 medical professionals were selected using the stratified cluster sampling method. A Chinese version of the Maslach Burnout Inventory-General Survey was used to measure burnout, whereas the Occupation Stress Inventory-Revised Edition was used to evaluate work stressors, personal strain, and coping resources. The structural equation model (SEM) was established to test the effect of work stressors, personal strain, and coping resources on burnout. Among the predictive factors for burnout, work stressors and personal strain were the primary risk factors, whereas coping resources make up the important protective factor. The result from SEM indicated that work stressors had both direct and indirect effects on burnout, with the indirect effect mediated by both personal strain and coping resources. Coping resources only affected burnout indirectly, as mediated by personal strain, whereas personal strain affected burnout independently. The results suggest that work stressors, personal strain, and coping resources play important roles in burnout among medical professionals. To prevent burnout, such countermeasures as controlling the work stressors, reducing personal strain, and strengthening coping resources are recommended.     

医务人员职业倦怠影响因素及对策研究

阐述了医务人员职业倦怠的界定及主要表现,对产生职业倦怠的因素从职业、医院、个人、患者四方面进行了系统分析,最后提出建议：正确认识医学发展的不确定性,建立良好的社会支持系统;优化医院管理;医务人员自身需要努力。     

COVID-19疫情背景下医务工作人员职业倦怠情况及其影响因素的分析

  目的  了解COVID-19疫情背景下定州市和青岛市两地医务工作人员发生职业倦怠情况及其影响因素。  方法  2021年7月―2021年8月对定州市和青岛市的医务工作者进行横断面调查。利用职业倦怠调查普适量表(maslach burnout inventory general survey, MBI-GS)评价职业倦怠水平,采用Kruskal-Wallis H秩和检验和二分类logistic回归分析模型分析医务工作者职业倦怠水平的影响因素。  结果  982名被调查者中,发生职业倦怠的比例为91.1%,其中达到轻中度、重度的比例分别为71.5%和19.6%。多因素分析显示工作满意度感觉一般或者比较不满意(OR=3.108, 95% CI: 1.653~5.843)、应对方式为消极应对(OR=1.129, 95% CI: 1.071~1.191)人群发生重度职业倦怠者风险更高;同时睡眠时间缩短(OR=0.331, 95% CI: 0.166~0.662)的人群发生重度职业倦怠者风险更低。Spearman相关分析中,医务工作者的积极应对方式、消极应对方式与职业倦怠呈正相关(P < 0.001),社会支持情况、生活满意度情况与职业倦怠呈负相关(P < 0.001)。  结论  定州市和青岛市大部分的医务工作人员职业倦怠水平较高,需提高工作和生活满意度等关怀和社会支持力度,同时也要考虑适当增加防疫工作中的认同感和积极性以促进职业健康水平。     

The contribution of work characteristics,home characteristics and gender to burnout in medical residents

Burnout is highly prevalent in medical residents. In order to prevent or reduce burnout in medical residents, we should gain a better understanding of contributing and protective factors of burnout. Therefore we examined the associations of job demands and resources, home demands and resources, and work–home interferences with burnout in male and female medical residents. This study was conducted on a nation-wide sample of medical residents. In 2005, all Dutch medical residents (n = 5245) received a self-report questionnaire on burnout, job and home demands and resources and work–home interference. Path analysis was used to examine the associations between job and home characteristics and work–home interference and burnout in both males and females. In total, 2115 (41.1 %) residents completed the questionnaire. In both sexes emotional demands at work and the interference between work and home were important contributors to burnout, especially when work interferes with home life. Opportunities for job development appeared to be an important protective factor. Other contributing and protective factors were different for male and female residents. In females, social support from family or partner seemed protective against burnout. In males, social support from colleagues and participation in decision-making at work seemed important. Effectively handling emotional demands at work, dealing with the interference between work and home, and having opportunities for job development are the most essential factors which should be addressed. However it is important to take gender differences into consideration when implementing preventive or therapeutic interventions for burnout in medical residents.     

The learning environment and medical student burnout: a multicentre study

Objectives  Little is known about specific personal and professional factors influencing student distress. The authors conducted a comprehensive assessment of how learning environment, clinical rotation factors, workload, demographics and personal life events relate to student burnout.
Methods  All medical students ( n  = 3080) at five medical schools were surveyed in the spring of 2006 using a validated instrument to assess burnout. Students were also asked about the aforementioned factors.
Results  A total of 1701 medical students (response rate 55%) completed the survey. Learning climate factors were associated with student burnout on univariate analysis (odds ratio [OR] 1.36–2.07; all P  ≤ 0.02). Being on a hospital ward rotation or a rotation requiring overnight call was also associated with burnout (ORs 1.69 and 1.48, respectively; both P  ≤ 0.02). Other workload characteristics (e.g. number of admissions) had no relation to student burnout. Students who experienced a positive personal life event had a lower frequency of burnout (OR 0.70; P  ≤ 0.02), whereas those who experienced negative personal life events did not have a higher frequency of burnout than students who did not experience a negative personal life event. On multivariate analysis personal characteristics, learning environment and personal life events were all independently related to student burnout.
Conclusions  Although a complex array of personal and professional factors influence student well-being, student satisfaction with specific characteristics of the learning environment appears to be a critical factor. Studies determining how to create a learning environment that cultivates student well-being are needed.     

Risk Factors Surrounding an Increase in Burnout and Depression Among Health Care Professionals in Taiwan During the COVID-19 Pandemic

ObjectivesThis study aimed to investigate the risk factors surrounding an increase in both burnout levels and depression among health care professionals in Taiwan through use of a longitudinal study design.DesignThis is a 2-year observational study that took place from January 2019 to December 2020.Setting and ParticipantsData among health care professionals were extracted from the Overload Health Control System of a tertiary medical center in central Taiwan.MethodsBurnout was measured through use of the Chinese version of the Copenhagen Burnout Inventory (C-CBI), whereas depression was ascertained by the Taiwanese Depression Questionnaire. Each participant provided both burnout and depression measurements during a nonpandemic period (2019) as well as during the COVID pandemic era (2020). Risk factors surrounding an increase in burnout levels and depression were analyzed through a multivariate logistic regression model with adjusting confounding factors.ResultsTwo thousand nineteen participants completed the questionnaire over 2 consecutive years, including 132 visiting doctors, 105 resident doctors, 1371 nurses, and 411 medical technicians. After adjustments, sleeplessness, daily working hours >8, and stress due to one’s workload were all found to be risk factors for an increase in depression levels, whereas sleeplessness, lack of exercise, and stress due to one’s workload were all found to be risk factors for an increase in personal burnout level. Being a member of the nursing staff, a younger age, sleeplessness, and lack of exercise were all risk factors for an increase in work-related burnout levels.Conclusions and ImplicationsPoor sleep, lack of exercise, long working hours, and being a member of the nursing staff were risk factors regarding an increase in personal burnout, work-related burnout levels and depression among health care professionals. Leaders within the hospital should investigate the working conditions and personal habits of all medical staff regularly and systematically during the COVID-19 pandemic and take any necessary preventive measures, such as improving resilience for nursing staff, in order to best care for their employees.     

县级公立医院改革后医务人员工作满意度调查

目的：了解浙江省县级公立医院综合改革后医务人员的工作满意度现状和相关影响因素,提出改善其满意度有针对性的建议。方法：采用自行设计的调查问卷和定性研究的方法,对3所县级医院655名医务人员进行调查。结果：医务人员总体满意度得分不高,对改革的认知水平和参与改革的积极性不高,相对报酬、执业环境和工作时间有待改善。结论：进一步组织学习和宣传医改,调动医务人员改革的积极性;建议加快支付方式改革,建立合理有效的绩效考核机制;改善医务人员执业环境,减轻医务人员工作负担。