护士工作压力源及工作疲溃感的调查研究

目的 :了解护士工作的主要压力源及工作疲溃感 ,并明确压力源与工作疲溃感之间的关系 ,以帮助管理层及护士本人正确的认识工作压力 ,设法减少工作压力 ,从而提高护士的工作效率及护理质量。方法 :采用问卷调查法 ,对西安市 4所教学医院临床护士的工作压力源、工作疲溃感以及他们之间的关系进行了探讨。结果 :临床护士的工作压力源依次为 :护理专业及工作方面的问题 ;工作量及时间分配问题 ;环境及资源方面的问题 ;病人护理方面的问题 ;管理及人际关系方面的问题。工作高度疲溃感的护士占 5 9.1% ,工作压力源与工作疲溃感之间呈显著性相关。结论 :建议从管理角度减少或消除护士工作压力源 ,并对护士进行减轻工作压力的训练     

团体正念疗法对护士睡眠质量及工作倦怠的影响

目的探讨团体正念疗法对护士睡眠质量及工作倦怠的影响。方法在心理学专家指导的基础上，以Segal的正念团体训练为框架制定8周的训练计划，包括12rain呼吸空间、躯体扫描、葡萄干练习、瑜伽练习、家庭作业和小组心得交流等内容，比较干预前后护士的睡眠质量和工作倦怠状况。结果经过团体正念疗法干预，护士的睡眠质量、入睡时间、睡眠效率、日间功能障碍和总分与干预前相比差异有显著意义（P〈O．05）；职业倦息总分及检出率与干预前相比差异有显著意义（P〈O．05）。结论团体正念疗法可提升护士睡眠质量，减轻工作倦怠，值得在临床上推广。     

Prevalence and Predictors of Burnout Among Hospice and Palliative Care Clinicians in the U.S.

ContextMany clinical disciplines report high rates of burnout, which leads to low quality of care. Palliative care clinicians routinely manage patients with significant suffering, aiming to improve quality of life. As a major role of palliative care clinicians involves educating patients and caregivers regarding identifying priorities and balancing stress, we wondered how clinician self-management of burnout matches against the emotionally exhaustive nature of the work.ObjectivesWe sought to understand the prevalence and predictors of burnout using a discipline-wide survey.MethodsWe asked American Academy of Hospice and Palliative Medicine clinician members to complete an electronic survey querying demographic factors, job responsibilities, and the Maslach Burnout Inventory. We performed univariate and multivariable regression analyses to identify predictors of high rates of burnout.ResultsWe received 1357 responses (response rate 30%). Overall, we observed a burnout rate of 38.7%, with higher rates reported by nonphysician clinicians. Most burnout stemmed from emotional exhaustion, with depersonalization comprising a minor portion. Factors associated with higher odds of burnout include nonphysician clinical roles, working in smaller organizations, working longer hours, being younger than 50 years of age, and working weekends. We did not observe different rates between palliative care clinicians and hospice clinicians. Higher rated self-management activities to mitigate burnout include participating in interpersonal relationships and taking vacations.ConclusionBurnout is a major issue facing the palliative care clinician workforce. Strategies at the discipline-wide and individual levels are needed to sustain the delivery of responsive, available, high-quality palliative care for all patients with serious illness.     

重症监护室护士职业倦怠感的现状调查

目的 调查上海市某三级甲等医院重症监护室护士职业倦怠感的现状。方法 采用问卷调查法进行调查,共发出94份,有效收回87份,回收率为92.55 %。并对结果进行分析。结果 重症监护室护士在情绪耗竭的平均分为(4.67±1.21))分,人格分离的平均分为(4.21±1.13)分,个人成就感的平均分为(3.42±1.23)分。结论 重症监护室护士职业倦怠情况比较明显,应引起广大管理者的重视。     

团体沙盘游戏对护士职业倦怠的影响研究

目的观察团体沙盘游戏对护士职业倦怠的影响。方法对43名护士行团体沙盘游戏;应用中文版M氏职业倦怠量表在干预前后测评护士职业倦怠情况。结果干预后护士情绪衰竭、去人格化评分下降,个人成就感评分提高,与干预前比较有统计学意义,P〈0.01。结论团体沙盘游戏能有效减轻护士群体的职业倦怠。     

Burnout as a developmental process among Japanese nurses: Investigation of Leiter's model

Aim: The first object of the present study was to compare Leiter and Maslach's original model (1988) and the revised model (proposed by Leiter in 1991). The second object was to ascertain whether the process model of burnout proposed by Leiter in 1993 is applicable to Japanese nurses. Workload demand, role conflict, and interpersonal conflict were selected as organizational demands, and supervisor support, coworker support, and occupational decision authority as resources. Methods: The subjects were Japanese clinical nurses (n = 238) working at a municipal general hospital. One hundred and eighty‐three effective data was obtained. The hypotheses were tested using structural equation analysis. Results: The results supported the revised model which maintained the sequential link from exhaustion to cynicism, but recast the relationship of professional efficacy with another two components of burnout. The hypothesized model was revised based on findings and re‐analysed. The organizational demands exhibited a significant positive correlation to exhaustion. Cynicism exhibited a negative correlation to supervisor support. The job decision authority exhibited a positive correlation to professional efficacy. However, the hypothesis that supervisor support exhibits a positive correlation to professional efficacy was not supported. Conclusions: Leiter's process model of burnout is conceptualized based on the conservation of resources (COR) theory. The results of the present study were reasonably in line with the COR theory. It was suggested that Leiter's model should be applicable to Japanese nurses.     

武警某部医院护士职业倦怠状态的调查分析

目的 了解武警某部医院护士职业倦怠的状况.方法 便利抽取武警某部医院护士126名作为主要研究对象,便利抽取地方某二级甲等医院各科室护士142名作为对比研究对象.采用Maslach职业调查通用量表(MBI-GS)进行调查.结果 武警某部医院护士在情绪衰竭和情感疏离维度上存在中等程度的倦怠水平,但在低自我价值感维度上未达到倦怠水平.在低自我价值感维度上,部队医院护士倦怠水平低于地方护士(P＜0.05);而在情感疏离维度上,部队护士倦怠水平高于地方护士(P＜0.05).不同岗位、工龄、职称的部队医院护士职业倦怠比较,差异有统计学意义;临床科护士在情绪衰竭和情感疏离维度上的倦怠水平高于非临床科室(P＜0.05);在低个人成就感维度上,小于5年工龄的护士职业倦怠水平高于其他工龄组的护士(P＜0.05);在情感衰竭及低自我价值感维度上,初级职称的护士职业倦怠水平高于高级职称的护士(P＜0.05).结论 针对武警部队医院护士职业倦怠水平的状况,应该有针对性地采取干预措施解决护士的职业倦怠问题,从而提高护士的心理健康水平.     

Prevalencia de burnout entre las enfermeras de cuidados intensivos en Argentina

PurposeBurnout syndrome among intensive care professionals has been widely documented internationally. Few studies address the incidence and prevalence in Latin America. And there are no validated studies about the situation in Argentina. Our goal was to determine burnout prevalence among intensive care nurses in Argentina and related risk factors.Materials and methodsOnline self-administered survey evaluating demographic variables and the Maslach Burnout Inventory in 486 critical care nurses between June and September 2016.ResultsA percentage of 84.4 of participants show moderate or high levels of burnout syndrome (95% CI 80.8 to 87.4). No significant association was found between burnout and gender, age, years of practice, academic degree, role or multiplicity of jobs. There was no statistical difference in burnout prevalence among different types of populations of care (neonatal, paediatric or adult care). Nurse to patient ratios of 1:3 or higher was found to be a statistically significant risk factor for emotional exhaustion and depersonalization sub-scales (P = .002 and .0039, respectively).ConclusionMore than 80% of nurses caring for critically ill patients in Argentina show moderate or high levels of burnout syndrome and this is related to a high nurse:patient ratio (1:3 or higher).     

Confirmatory factor analysis of the Maslach Burnout Inventory among Florida nurses

Burnout among human service professionals, such as nurses, has been studied in various countries for years using the Maslach Burnout Inventory (MBI). This paper reports on confirmatory factor analyses using LISREL that examined the factorial validity of the MBI. The sample consisted of 151 registered nurses from west-central Florida. Modifications of the initial hypothesized three-factor structure were necessary to adequately fit the data. Findings are compared to the published normative values for the MBI and to similar studies of European nurses. Recommendations for measurement models of the MBI in future studies that use structural equation modeling techniques are offered.     

Factor structure of the Maslach burnout inventory: An analysis of data from large scale cross-sectional surveys of nurses from eight countries

Background

Job burnout is an important predictor of nurse retention. Reliable and valid measures are required to monitor this phenomenon internationally.

Objective

To evaluate the applicability of the Maslach burnout inventory (MBI) in international nursing research.

Design

Secondary analysis of cross-sectional hospital nurse survey data from eight countries.

Settings

Hospitals in the U.S., Canada, the U.K., Germany, New Zealand, Japan, Russia and Armenia.

Participants

54,738 direct care professional nurses from 646 hospitals in eight countries.

Methods

Confirmatory and exploratory factor analysis were undertaken to identify the factor structure of the MBI. The internal consistencies of the subscales were investigated.

Results

Exploratory factor analysis revealed three factors being extracted from the 22-item Maslach burnout inventory. In nearly all countries the two items (6 and 16) related to the “stress” and “strain” involved in working with people loaded on the depersonalization subscale rather than the emotional exhaustion subscale to which they were initially assigned. The three subscales exhibited high reliability with Cronbach alphas exceeding the critical value of 0.70. The correlation coefficients for the emotional exhaustion and depersonalization subscales were strong and positive.

Conclusions

The 22-item Maslach burnout inventory has a similar factor structure and, with minor modifications, performed similarly across countries. The predictive validity of the emotional exhaustion and depersonalization subscales might be improved by moving the two items related to stress and strain from the emotional exhaustion to the depersonalization subscale. Nevertheless, the MBI can be used with confidence as a burnout measure among nurses internationally to determine the effectiveness of burnout reduction measures generated by institutional and national policies.     

Prevalence and Associated Risk Factors of Burnout Among US Doctors of Chiropractic

Objective

The purpose of this study was to establish the frequency of burnout among doctors of chiropractic in the United States.

Methods

Using a nonprobability convenience sampling methodology, we e-mailed the Maslach Burnout Inventory–Human Services Survey and a sociodemographic questionnaire to a randomized sample of licensed doctors of chiropractic (n = 8000).

Results

The survey return rate was 16.06%. Twenty-one percent of the participants had high emotional exhaustion (EE), 8% had low personal accomplishment, and 8% had high depersonalization.

Discussion

Significant differences (P < .001) were found in the level of EE, depersonalization, and personal accomplishment as a function of sex, time dedicated to clinical care and administrative duties, source of reimbursement, the type of practice setting, the nature of practitioners' therapeutic focus, the location of chiropractic college, self-perception of burnout, the effect of suffering from a work-related injury, the varying chiropractic philosophical perspectives, and the public's opinion of chiropractic.

Conclusion

Although doctors of chiropractic in the United States who responded to the survey had a relatively low frequency of burnout, higher levels of EE remain workplace issues for this professional group.     

本科护生实习中后期职业倦怠的调查研究

目的:了解本科护生实习中后期职业倦怠状况及其影响因素。方法:采用职业倦怠调查问卷及职业倦怠影响因素问卷对我院367名本科护生于实习中期和后期进行问卷调查。结果:本科护生在实习的中后期普遍存在职业倦怠感,且实习后期与实习中期相比,职业倦怠感呈现加重趋势;工作环境是护生职业倦怠感最主要的因素,其次为现实与理想的落差、压力应对方式、带教老师影响、人格特征、人际交往、就业与考研压力。结论:本科护生实习中后期职业倦怠状况不容乐观,提示学校和医院应采取有效措施进行干预。     

Shift-Based Emotional Stress Reactions in Emergency Nurses After Traumatizing Events

IntroductionEmergency nurses experience multiple traumatizing events during clinical work. Early identification of work-related tension could lead to a timely intervention supporting well-being. We sought to discover whether there is an immediately measurable effect on emotional stress, as determined by changes between pre- and postshift survey scores, associated with exposure to traumatizing events during a single emergency nursing shift.MethodsThe Emotional Stress Reaction Questionnaire (ESRQ) is a real-time self-assessment tool based on positively, negatively, or neutrally loaded emotions. Participants voluntarily completed pre- and postshift ESRQs over a 6-month period at a quaternary academic emergency department and recorded the number of associated traumatizing events. Associations between number of traumatizing events and ESRQ scores were evaluated using Spearman rank correlation coefficients. Changes in positive-negative balance scores were compared between shifts using a 2-sample t-test.ResultsThere were 203 responses by 94 nurses. The mean preshift ESRQ score was 11.3 (SD = 5.2), mean postshift score 6.8 (SD = 7.4), and mean change −4.4 (SD = 8.2; t = −7.26; P < 0.001). The total number of traumatizing events was correlated with change in ESRQ scores (correlation coefficient of −0.31; P < 0.001). The mean change in positive-negative scores for shifts without traumatizing events was −1.4 (SD = 6.0) compared with −5.0 (SD = 8.5) for shifts with at least 1 event (t = 2.27; P = 0.03).DiscussionOur results suggest that repeated exposure to traumatizing events during a single clinical shift was associated with a measurable effect on negative emotional stress in emergency nurses as determined by ESRQ positive-negative balance scores.     

北京市三级甲等综合医院护士工作倦怠及其影响因素的研究

目的 调查护士工作倦怠现状及其影响因素.方法 便利选取北京市6家三级甲等综合医院725名护士进行问卷调查.结果 护士工作倦怠的情绪耗竭、去人格化、个人成就感维度分别为(27.75±10.86 )分、(7.42±6.41)分、(32.06±9.19)分.组织固素可分别解释工作倦怠各维度40.8%、26.1%、45.4%的变异.结论 北京市三级甲等综合医院护士经历着较高的工作倦息,组织因素是重要预测因素.     

Comparison of mindfulness interventions for healthcare professionals: A mixed-methods study

ObjectivesBurnout is increasingly a concerning problem in US Healthcare systems. Although the causes of burnout are not predominantly due to individual factors, mindfulness instruction is an evidence-based approach to counteracting burnout. Our health system initiated a multi-pronged approach to mindfulness instruction for our employees and community. We aimed to assess the impact of these varied programs.MethodsSeveral mindfulness courses of different lengths were employed. Validated survey instruments were administered to participants before and after the courses to assess stress, mindfulness and burnout. Pre-course and post-course results were compared for each intervention. Free-text responses were also captured and analyzed in a qualitative fashion.ResultsParticipants in MBIs demonstrated statistically significant improvement in burnout and perceived stress on post-course survey results. Several mindfulness domains also showed statistically significant improvement (awareness, non-react and observe). There was no difference in the observed results between the mindfulness interventions. Qualitative analysis yielded three themes: seeking help, symptoms, and changes in mindfulness practice.ConclusionsMBIs designed for employees of an academic medical center were associated with positive quantitative and qualitative results. All MBI participants achieved improvement in perceived stress and mindfulness as well as reduction in burnout, regardless of course length.