Entorno laboral,satisfacción y burnout de las enfermeras de unidades de cuidados críticos y unidades de hospitalización. Proyecto RN4CAST-España

ObjectiveTo know if there are differences between the critical care units and the medical-surgical care units regarding the perception of the nurses working in National Health System hospitals about their work environment, burnout level and job satisfaction.MethodA cross-sectional study was conducted with 6,417 nurses from the medical-surgical care units and with 1,122 nurses from critical care units of 59 Spanish hospitals with more than 150 beds. Socio-demographic, job satisfaction, perception of work environment (Practice Environment Scale of the Nursing Work Index [PES-NWI questionnaire]) and burnout measured with the Maslach Burnout Inventory (MBI) data were collected.ResultsThe PES-NWI showed differences in 4 out of its 5 factors. It showed better values in medical-surgical units in all the factors, except for Staffing and resource adequacy (P<.001), where critical care units showed a mean level of agreement of 2.41 versus 2.19 for the medical-surgical units. Regarding burnout, this was higher in the medical-surgical care units (P=.039) where 23% (952) of the nurses had high levels. Job satisfaction was lower in the critical care units (P=.044) with 70% (578) of nurses being very or strongly satisfied.ConclusionsThe opinion of the nurses, working in critical care units about their hospital is unfavorable. They showed lower levels of burnout than those working in medical-surgical units.     

Work-related stress,job satisfaction,and quality of work life among cardiovascular nurses in Italy: Structural equation modeling

AimTo investigate the simultaneous effects of work-related stress and job satisfaction on cardiovascular nurses' quality of work life.BackgroundPrior research has investigated nurses' work-related stress, job satisfaction, and quality of work life as separate aspects and not in specific nursing settings, such as cardiovascular wards. Cardiovascular care settings can be particularly stressful for nurses, who are often faced with distress, depression and patients and caregivers' physical and psychological exhaustion.MethodsA multicenter cross-sectional study was conducted among 1126 cardiovascular nurses from 10 hospitals in Italy. Work-related stress, job satisfaction, and quality of work life were measured using valid and reliable questionnaires. Structural equation modeling was performed.ResultsNurses working in critical cardiac care units experienced more stress than their colleagues working in other cardiac units. Nurses working in cardiac outpatient clinics reported lower quality of work life than those working in other cardiac settings. There was a negative relationship between work-related stress and nurses' quality of work life, which was partially mediated by job satisfaction, indicating that stress generated by the work environment negatively affect nurses' quality of work life by reducing their job satisfaction.ConclusionCardiovascular nurses' quality of work life is negatively affected by work-related stress. The work-related stress is mediated through job satisfaction. Nurse managers should maximize nurses' job satisfaction by providing comfort at work, supporting professional development opportunities, sharing organizational objectives, and actively listening and addressing nurses' concerns. When cardiovascular nurses' quality of work life is elevated, patients' care quality and outcomes are improved.     

医院聘用护士职业倦怠与应对方式的关系

目的探讨医院聘用护士职业倦怠与应对方式的关系。方法 2011年6月,采用应对方式问卷(simplified copingstyle questionnaire,SCSQ)和职业倦怠感量表(maslach burnout inventory,MBI)对解放军第91中心医院的320名聘用护士进行问卷调查,并分析其应对方式与职业倦怠的相关性。结果 MBI量表中情感耗竭感、去个性化、个人成就感3个维度的平均得分分别为(26.68±6.52)、(8.08±3.86)、(32.89±9.65)分。医院聘用护士职业倦怠与应对方式的相关分析显示,职业倦怠总分和各因子分与SCSQ各因子分之间存在相关性(P<0.05或0.01)。在婚姻、工龄、职称、工作满意度及经济状况方面,聘用护士的MBI评分的差异有统计学意义(P<0.05)。自责、幻想、退避、职务、从业时间、工作满意度、婚姻状况及经济状况是聘用护士发生职业倦怠的影响因素。结论医院聘用护士存在严重职业倦怠,培养其积极的应对方式,调整好职业心态,有利于减轻职业倦怠感。     

Work-related behaviour and experience pattern in nurses: impact on physical and mental health

Nursing is associated with high levels of emotional strain and heavy workloads. Changing working conditions raise the importance of investigating job satisfaction, stress and burnout and its consequences for nurses. The aim of the study was to investigate whether work-related behaviour and experience patterns are associated with mental and physical health status in nurses. A sample of 356 nurses in four German hospitals were interviewed using questionnaires regarding work-related behaviour and experience patterns, work stress, depression, anxiety and physical symptoms ('Work-related Behaviour and Experience Pattern'--AVEM and ERI). The main result of this study is that unhealthy work-related behaviour and experience patterns (i.e. the excessive ambitious type and the resigned type) are associated with reduced mental and physical health. Preventive, as well as intervention, strategies are needed that focus both on the individual as well as on working conditions.     

护士职业倦怠状况及其与社会支持、工作压力源的相关性研究

目的探讨护士职业倦怠与工作压力源、社会支持的相关性。方法对4家综合医院的医生（138人）、护士（162人）分别进行量表测查，其中对护士进行工作倦怠量表（MBI）、领悟社会支持量表（PSSS）、中国护士工作压力源量表的测查，医生仅进行工作倦怠量表的测查，并对结果进行分析。结果护士的MBI测查结果显示情绪衰竭、非人性化评分显著高于医生，而工作成就感评分则显著低于医生；护士职业倦怠水平明显高于医生，2者比较差异有统计学意义。护士职业倦怠程度高者，其社会支持评分低于职业倦怠程度低者；而其工作压力源评分均显著高于职业倦怠程度低者。护士职业倦怠情绪衰竭、非人性化评分与社会支持、工作压力源呈负相关，而工作成就感评分与社会支持、工作压力源呈正相关。结论护士职业倦怠状况应引起护理管理者的重视，及时采取相应措施提高其心理健康水平。     

工作压力在护士职业倦怠与工作特征的中介作用

目的了解护士职业倦怠、工作特征与工作压力的现状并评估三者的关系。方法采用一般情况调查表、中文版护士职业倦怠量表(maslach burnout inventory,MBI)、护士压力源量表、工作特征量表(job characteristics inventory)对423名护士进行调查。采用Pearson相关分析探讨护士工作特征、工作压力与职业倦怠三者的关系,根据Pearson相关分析,建立路径关系模型,对护士职业倦怠、工作特征与工作压力三者之间的关系进行路径分析。结果职业倦怠量表中护士情感耗竭维度的得分(26.04±11.64)分、工作冷漠感维度(7.39±2.14)分、个人无成就感维度(33.87±8.64)分,三者高度倦怠感分别占50.83%、39.01%、49.41%;护士工作特征总分(104.52±15.51)分;工作压力总分(109.32±18.93)分。工作压力在工作特征与职业倦怠之间有部分中介作用,中介效应占总效应的54.40%。结论护士职业倦怠较严重。护理管理者应采取有效的措施降低护士的工作压力感,从多个维度改善护士的工作特征,从而降低护士职业倦怠水平。     

护士职业倦怠状况及其与社会支持、工作压力源的相关性研究

目的 探讨护士职业倦怠与工作压力源、社会支持的相关性.方法 对4家综合医院的医生(138人)、护士(162人)分别进行量表测查,其中对护士进行工作倦怠量表(MBI)、领悟社会支持量表(PSSS)、中国护士工作压力源量表的测查,医生仅进行工作倦怠量表的测查,并对结果进行分析.结果 护士的MBI测查结果显示情绪衰竭、非人性化评分显著高于医生,而工作成就感评分则显著低于医生;护士职业倦怠水平明显高于医生,2者比较差异有统计学意义.护士职业倦怠程度高者,其社会支持评分低于职业倦怠程度低者;而其工作压力源评分均显著高于职业倦怠程度低者.护士职业倦怠情绪衰竭、非人性化评分与社会支持、工作压力源呈负相关,而工作成就感评分与社会支持、工作压力源呈正相关.结论 护士职业倦怠状况应引起护理管理者的重视,及时采取相应措施提高其心理健康水平.     

Nurses' burnout and unmet nursing care needs of patients' relatives in a Turkish State Hospital

One of the biggest problems of work life today is burnout. With burnout, satisfaction of clients and service givers reduces. In this study, burnout levels of nurses working in the internal, surgical and intensive care units of a university hospital and the unmet needs of the patients' relatives related to nursing care were investigated. In the study, 225 nurses and 222 relatives of patients constituted the sample group of this study. Three separate forms were used in the study, namely, Nurse and Patient Relative Identification Form, the Maslach Burnout Inventory and the Nursing Services Satisfaction Inventory. In the study, burnout levels of the nurses were found to be high. Conditions like younger ages, scarcity of experience in the profession, lower levels of education, having chosen the profession and the unit they work in not willingly and working in environments like intensive care increase the burnout and as a result, expectations of the relatives of patients from nursing care are not fully met. Some suggestions have been made to make some regulations to prevent the burnout of nurses and to increase the satisfaction of relatives.     

Percepción del entorno laboral de las enfermeras españolas en los hospitales del Sistema Nacional de Salud. Proyecto RN4CAST-España

ObjectiveTo appraise the perception of Registered Nurses working at Spanish National Health System (SNHS) hospitals about work environment, quality of care and burnout.MethodCross-sectional study addressed to 7539 nurses in 59 Spanish public hospitals over 150 beds belonging to the NHS between 2009 and 2010. Data was collected on: socio-demographic and academic background, job satisfaction, perception of work environment (PES-NWI) and burnout (MBI).ResultsAmong 7539 questionnaires, 5654 were collected (75%). The nurses’ average age was 37,5 (SD = 9,5) years old, 88% (4929) were female and they had a median of 12 years of experience. The patient/nurse ratio was 11/1. 26% of nurses (1468) showed their intention to leave the hospital. 55% of nurses (3080) showed moderate job satisfaction. The work environment was unfavorable for 48% (2729) of nurses. 22% (1091) showed high burnout levels.ConclusionsThe results show a high nurses’ participation, who relate moderate job satisfaction. However, on PES-NWI, nearly half of nurses show an unfavorable work environment.     

Efficacy of clinical supervision: influence on job satisfaction, burnout and quality of care

AIM: This paper reports a study to determine how supervisees' backgrounds and surrounding infrastructure predict the efficacy of clinical supervision among Finnish nursing staff, their job satisfaction, levels of burnout and perceptions of the quality of care. BACKGROUND: Several studies have described the effects of clinical supervision, but few have focused on evaluating it. Until recently, no studies have examined how clinical supervision evaluations are related to supervisees' backgrounds, surrounding infrastructure or respondents' levels of burnout, job satisfaction and perceptions of the quality of care. METHODS: The survey involved supervisees completing a range of standardized and validated evaluation measures. The respondents were identified from 12 regional, central and university hospitals across Finland (n = 799). The data collection took place from October 2000 to February 2001. FINDINGS: The evaluations varied statistically significantly and were associated with statistically significant variations in the respondents' backgrounds. Clinical supervision infrastructure was also strongly related to evaluation scores. Supervisees' age, education, gender, employment status, area of specialty, working hours, work experience and experience as a supervisor were statistically significant predictors for evaluations of the efficacy of clinical supervision. These evaluations of clinical supervision were also found to predict the respondents' job satisfaction, levels of burnout and assessments of good nursing. CONCLUSION: Nursing staff, especially those who have over 10 years' work experience, work in general care, have a nursing diploma, are non-tenured, work part-time and work 24-hour rotating shifts can benefit from clinical supervision. However, resources need to be invested in supervisor education and nursing staff need to be encouraged to start working in both supervisor and supervisee roles because of the positive effects on job satisfaction and quality of care.     

Factors influencing satisfaction and anticipated turnover for nurses in an academic medical center

OBJECTIVES: The purpose of this study was to examine the relationships between work satisfaction, stress, age, cohesion, work schedule, and anticipated turnover in an academic medical center. BACKGROUND DATA: Nurse turnover is a costly problem that will continue as healthcare faces the impending nursing shortage, a new generation of nurses enter the workforce, and incentives provided to nurses to work for institutions increase. A variety of factors influence the retention of nurses in adult care settings, including work satisfaction, group cohesion, job stress, and work schedule. In general, previous research has documented positive relationships between work satisfaction, group cohesion, strong leadership, and retention rates and a negative relationship between stress, work schedule, and retention. In addition, age and experience in nursing are related to job satisfaction. METHODS: This study used a cross-sectional survey design in which nurses from 12 units in a 908-bed university hospital in the Southeast completed questionnaires on one occasion. The following factors were measured using self-report questionnaires: nurse perception of job stress, work satisfaction, group cohesion, and anticipated turnover. RESULTS: The more job stress, the lower group cohesion, the lower work satisfaction, and the higher the anticipated turnover. The higher the work satisfaction, the higher group cohesion and the lower anticipated turnover. The more stable the work schedule, the less work-related stress, the lower anticipated turnover, the higher group cohesion, and the higher work satisfaction. Job Stress, work satisfaction, group cohesion, and weekend overtime were all predictors of anticipated turnover. There are differences in the factors predicting anticipated turnover for different age groups. CONCLUSIONS: As healthcare institutions face a nursing shortage and a new generation of nurses enter the workforce, consideration of the factors that influence turnover is essential to creating a working environment that retains the nurse.     

精神科护士职业倦怠的影响因素分析

目的 了解精神科护士职业倦怠的影响因素.方法 采用护士职业倦怠量表、角色认知量表、问题解决评价问卷对183名精神科护士进行测评.结果 精神科护士职业倦怠问卷的情绪耗竭因子得分为中度耗竭、去人格化因子得分为中度耗竭、低个人成就感因子得分高度耗竭.进一步相关和逐步回归分析均表明,职业倦怠量表的各个因子与角色认知和问题解决能力的各个因子相关密切,影响精神科护士情绪耗竭水平的因素依次是问题解决评价总分、接近-回避风格、角色冲突,总贡献率为15.2%;影响去人格化水平的因素依次是问题解决评价总分、角色模糊, 总贡献率为22.7%;影响低个人成就感的因素依次是问题解决评价总分、角色冲突、工作年限、角色模糊, 总贡献率为21.2%.结论 充分提高个体的角色认知能力和解决问题能力,可以作为预防精神科护士职业倦怠的一个有效策略.     

Influence of stress and nursing leadership on job satisfaction of pediatric intensive care unit nurses.

BACKGROUND: High levels of stress and the challenges of meeting the complex needs of critically ill children and their families can threaten job satisfaction and cause turnover in nurses. OBJECTIVE: To explore the influences of nurses' attributes, unit characteristics, and elements of the work environment on the job satisfaction of nurses in pediatric critical care units and to determine stressors that are unique to nurses working in pediatric critical care. METHOD: A cross-sectional survey design was used. The sample consisted of 1973 staff nurses in pediatric critical care units in 65 institutions in the United States and Canada. The following variables were measured: nurses' perceptions of group cohesion, job stress, nurse-physician collaboration, nursing leadership, professional job satisfaction, and organizational work satisfaction. RESULTS: Significant associations (r = -0.37 to r = -0.56) were found between job stress and group cohesion, professional job satisfaction, nurse-physician collaboration, nursing leadership behaviors, and organizational work satisfaction. Organizational work satisfaction was positively correlated (r = 0.35 to r = 0.56) with group cohesion, professional job satisfaction, nurse-physician collaboration, and nursing leadership behaviors. Job stress, group cohesion, job satisfaction, nurse-physician collaboration, and nursing leadership behaviors explained 52% of the variance in organizational work satisfaction. Dealing with patients' families was the most frequently cited job stressor. CONCLUSIONS: Job stress and nursing leadership are the most influential variables in the explanation of job satisfaction. Retention efforts targeted toward management strategies that empower staff to provide quality care along with focal interventions related to the diminishment of stress caused by nurse-family interactions are warranted.     

Work related stress,burnout, job satisfaction and general health of nurses: A follow‐up study

Nurses experience high levels of work related stress and burnout as well as low job satisfaction and poor general health owing to the nature of their work. This paper seeks to provide a better understanding of the nature of relationships between work related stress, burnout, job satisfaction and general health of nurses over one year. This study involved a longitudinal design. Two hundred and seventy seven nurses from four hospitals completed a follow up survey consisting of five questionnaires. Data were collected between 2013 and 2014. The data were analysed using generalized estimation equation analysis. Lack of support was associated with burnout, patient care was associated with job satisfaction and staff issues were associated with general health of nurses. Burnout is more strongly related to job satisfaction than general health. The findings of this study could inform evidence based policy and practice through interventions aimed at improving job satisfaction and reducing the impact of burnout on general health of nurses.     

The influence of work characteristics,emotional display rules and affectivity on burnout and job satisfaction: A survey among geriatric care workers

BackgroundPrevious studies have demonstrated that geriatric care employees are exposed to a large number of factors that can affect their levels of job satisfaction and occupational stress. Although working with elderly people is emotionally demanding, little research has been done on the role played by perceptions of emotional display rules, alongside more traditional work characteristics and individual factors, in the prediction of geriatric care employees’ wellbeing.ObjectivesThe aim of the present study was to examine the role played by work characteristics (job demands, job control, emotional display rules) and individual (affectivity) factors to predict job satisfaction and burnout among French geriatric care nurses.Method and participantsQuestionnaires were sent to 891 employees working in 32 geriatric care centers in France. A total of 371 valid questionnaires (response rate: 41.60%) were analyzed using structural equation modeling techniques.ResultsResults revealed two main processes of burnout and job satisfaction among women geriatric care workers, namely a salutogenic process and a pathogenic process. As expected, negative affectivity, low job status, perceived negative display rules and job demands are involved in the pathogenic process; while positive affectivity, perceived positive display rules and job control are implied in the salutogenic one. More specifically, as expected, negative affectivity is a positive predictor of burnout, both directly and indirectly through its impact on perceived negative display rules and job demands. Moreover, negative affectivity was negatively related to job satisfaction. Simultaneously, positive affectivity can predict job satisfaction, both directly and indirectly through its impact on perceived positive display rules and job control. Positive affectivity is also a negative predictor of burnout.ConclusionsPractical implications are discussed to support intervention programs that develop healthy workplaces, and also to inform nurses about how to manage emotional display rules in retirement homes.     

四川省护士长培训班学员职业倦怠现状调查分析

目的调查四川省护士长职业倦怠的现状,分析职业倦怠的影响因素。方法采用中文版的Maslach工作倦怠量表-人类服务版对四川省护士长培训班的126名护士长进行问卷调查。结果护士长的情感耗竭为(17.74±8.86)分,处于中度水平;去人格化(5.51±4.23)分,处于低度水平;个人无效感为(29.64±7.54)分,处于高度水平。情感耗竭的影响因素是年龄、工作满意度和工作强度感受;去人格化的影响因素是工作强度感受;个人无效感的影响因素是年龄、工作年限、工作满意度和工作强度感受。结论四川省护士长的职业倦怠应引起医院管理者重视,应采取有效措施,改善倦怠现状。     

重庆市万州区护士工作家庭冲突现状及其与结果变量关系的研究

目的 了解重庆市万州区护士工作家庭冲突的现状及其与工作压力感、压力症状、工作满意度、工作倦怠、工作绩效等结果变量的关系.方法 采用工作家庭冲突量表、工作压力感量表、压力症状量表、工作满意度量表、工作倦怠量表、工作绩效量表对重庆市万州区的1094名执业护士进行分层抽样问卷调查.结果 重庆市万州区护士面临较高的工作家庭冲突.工作家庭冲突显著影响护士的个人健康(工作压力感、压力症状、工作满意度、工作倦怠),对工作绩效没有显著影响.结论 重视护士群体的工作家庭冲突并采取平衡策略降低冲突水平,对保障护士的个人身心健康有着非常重要的意义.