某军队医院护士工作压力及应对方式

目的在军队编制体制改革期,探讨某军队医院护士的工作压力、应对方式的现状及其关系。方法采用一般资料调查表、护士工作压力源量表、简易应对方式问卷,对266名某军队医院护士进行调查。结果①某军队医院护士工作压力源总均分为(2.08±0.14),工作量及时间分配得分为(2.55±0.33),位于首位;②应对方式与常模比较,消极应对方式低于常模(t=-36.093,P0.01);③工作压力与消极应对方式呈显著负相关(r=-0.280,P0.01)。结论军队医院护士采用消极应对方式较少,采取积极应对方式越多,工作压力越小。     

儿科护士压力源、应对方式及与社会支持的相关因素分析

目的 对比儿科护士与骨科护士的工作压力源、应对方式,以及应对方式与社会支持的相关性分析,帮助护士采取有效的应对方式,给予护士更多的社会支持,减轻护士的压力.方法 采用护士工作压力源量表,应对方式量表及社会支持量表对2家规模、管理方式一致的专科医院儿科护士和骨科护士进行对比调查.结果 儿科护士和骨科护士压力源中得分及排序,工作量负荷,处理死亡或濒死患者、与医生冲突居于护士工作压力源的前3位.结论 找出工作压力源,针对压力源找出合理的应对方式,寻求更多的社会支特,减少护士流动性.     

专科与综合医院护士职业倦怠,职业压力及人格因素的比较

目的 了解精神专科医院与综合医院护士职业倦怠,职业压力及人格因素的差异及影响因素.方法 应用护士工作压力源量表、职业倦怠量表、艾森克人格问卷,对173名精神专科医院护士和139名综合医院护士进行抽样测试研究.结果 ①专科医院护士与综合医院护士的职业倦怠程度差异不明显,含情感衰竭维度(F=-0.028,P＞0.05),去人格化维度(F=1.750,P＞0.05),成就感维度(F=-1.546,P＞0.05);②专科医院护士与综合医院护士的职业压力差异显著(F=1.494,P＜0.001);专科医院护士与综合医院护士的人格特征有差异,专科医院护士在精神质与情绪稳定性2个维度上的得分均高于综合医院护士,且差异显著(分别为P＜0.01、P＜0.05).结论 精神专科医院与综合医院护士职业倦怠感尽管差异不明显,但是专科医院护士的压力更大,情绪更加不稳定.     

护士工作压力、A型行为类型与主观幸福感的关系

目的:了解护士的工作压力、A型行为类型和主观幸福感的特点及三者间的关系.方法:以中国护士工作压力量表、Campbell幸福感量表和A型行为类型问卷对杭州市三级甲等医院、社区医院和民营医院(每种类型各取2家医院)的279名在职护士进行调查.结果:民营医院护士工作压力得分和主观幸福感得分[(89.8±22.8),(6.5±1.6)]均低于三甲医院[(97.0±17.4),(8.6±1.3)]和社区医院[(100.8±16.6),(8.3±1.8),均P＜0.01];极端中间型的护士主观幸福感总分最高(9.4±2.1),B型护士得分最低(6.7±1.5),A型护士的压力总分最高(108.4±23.4);时间匆忙感、争强好胜及敌意、A型行为总分与主观幸福感正相关(r=0.36,0.34,0.42;P＜0.05),工作压力总分与主观幸福感负相关(r=-0.22),进一步回归分析显示工作压力和A型行为类型总分均进入主观幸福感的回归方程,它们共同解释主观幸福感总分的28%,总体情感指数的14.5%和生活满意度的24.2%.结论:民营医院护士的工作压力和主观幸福感低于三甲医院和社区医院,A型行为类型护士工作压力高,极端中间型的护士主观幸福感总分最高,B型护士得分最低;工作压力和A型行为类型总分对主观幸福感有影响,但不是主要影响因素.     

精神科护士的职业倦怠与职业压力

目的 探讨精神科护士职业倦怠水平及与职业压力的关系.方法 采用Maslach工作倦怠量表—人类服务版和中国护士工作压力源量表对河北省精神病医院的107名护士进行调查.结果 精神科护士存在较高程度的职业倦怠;精神科护士职业倦怠各维度及总分与职业压力各维度间存在不同程度的相关(r=0.184～0.428,P＜0.05);倦怠水平不同的精神科护士在管理及人际关系方面存在显著差异(t=-4.460,P＜0.01).结论 精神科护士职业倦怠较高,并受管理及人际关方面的压力影响.     

护士工作压力、心理一致感与心理健康

目的:探讨护士心理一致感、工作压力与心理健康的关系。方法:采用心理一致感量表,护士工作压力源量表及SCL-90量表,对唐山市三级医院的270名护士进行问卷调查。结果:1SCL-90总分≥70分的人数有138例,阳性率占总人数的51.11%。排名前3位的阳性因子为:强迫症状、躯体化和敌对;2护士的心理一致感总分处于较低水平;3心理一致感与心理健康呈显著负相关(r=-0.224,P0.01);工作压力与心理健康呈显著正相关(r=0.172,P0.01);心理一致感与工作压力呈显著负相关(r=-0.148,P0.01),且护士心理一致感在工作压力和心理健康之间具有中介作用(P0.05)。结论:心理一致感与工作压力显著影响护士群体的心理健康水平。     

精神科护士焦虑状况及压力源对照研究

目的了解精神科护士的焦虑状况及职业压力源,为精神科护理管理者提供科学的理论依据。方法应用焦虑自评量表、护士工作压力源量表,同时对精神病专科医院护士与综合医院护士进行评定,并作对照研究。结果精神病专科医院护士焦虑问题比较严重,焦虑总分均值明显高于综合医院护士,存在显著差异(t=41.12、37.06;P0.01);在护理工作压力源的5个方面,精神病专科医院护士的压力源主要表现在护理专业及工作、管理及人际关系和病人护理三方面,与综合医院护士比较也有显著差异(t=2.441、2.727;P0.05和P0.01)。结论精神科护士在人群中工作压力较大,普遍存在焦虑情绪,管理者对此应予以关注。加强护士的行为心理管理,协助护士正确认识和舒缓工作压力,可以保证护理工作健康、有序发展。     

独生子女护士工作压力与心理健康水平相关性研究

目的　探索独生子女护士工作压力源与心理健康水平的关系 ,识别影响独生子女护士心理健康的主要因素。方法　通过整群抽样 ,采用护士工作压力量表和 SCL— 90症状自评量表对锦州地区 4所综合性医院的青年独生子女护士进行调查。结果　独生子女护士工作压力呈中等水平 ,独生子女护士与非独生子女护士工作压力总分差异无显著性 ,独生子女护士心理健康水平低于女性常模 ,低于非独生子女护士 ,独生子女护士较非独生子女护士存在较多的心理问题 ,独生子女护士工作压力源与心理健康水平显著相关 (P<0 .0 5 )。结论　独生子女护士工作压力与心理健康密切相关 ,建议应采取切实有效的措施维护独生子女护士的心理健康。     

中小学教师工作压力、应对方式与幸福感的关系

目的探讨中小学教师工作压力、应对方式与幸福感的关系及应对方式的中介作用。方法采用教师职业幸福感调查问卷、应付方式问卷、中小学教师工作压力量表对湖南省1555名中小学教师进行问卷调查。结果①幸福感与工作压力的得分呈显著负相关(r=-0.410,P0.01);②自责、幻想、退避和合理化的消极应对方式与幸福感的得分呈显著负相关(r=-0.383,-0.169,-0.242,-0.250;P0.01),与压力的得分显著正相关(r=0.270,0.220,0.255,0.213;P0.01);③应对方式在工作压力与幸福感之间起部分中介作用。结论压力既可以直接影响中小学教师职业幸福感,也可以通过应对方式间接影响职业幸福感。     

护士职业倦怠与工作压力的相关研究

目的对护士的职业倦怠、工作压力情况做探讨,揭示压力对职业倦怠的影响。方法对唐山市3家医院的200名护士,运用护士职业倦怠量表和生活满意度量表进行调查,回收有效问卷168份。使用SPSS 11.5进行统计分析,主要的统计方法有描述分析,单因素方差分析,差异检验,相关分析。结果①护士的职业倦怠整体水平较高;②护士的年龄、人事关系等人口学变量对其职业倦怠水平的影响存在显著性差异(P<0.05);③护士的职业压力与职业倦怠有显著的相关(r=0.415,P<0.01)。结论唐山护士工作压力越大,职业倦怠水平越高。     

Fibre type proportion and fibre size in trapezius muscle biopsies from cleaners with and without myalgia and its correlation with ragged red fibres, cytochrome-c-oxidase-negative fibres, biomechanical output, perception of fatigue, and surface electromyography during repetitive forward flexions

In the literature enlarged/increased cross-sectional area (CSA) of type I muscle fibres has been reported as a morphological mark of work-related localised myalgia in the descending part of the trapezius muscle of women. These studies did not use enough subjects or lacked an adequate control group. The recording of surface electromyograms (EMG) is central to the research field of work-related myalgia. However, the influence of intrinsic muscle properties – such as the effect of muscle fibre distribution upon surface EMG – has to be better understood in order properly to evaluate this method as a possible diagnostic and preventive tool. This study had two aims. Firstly, it investigated the muscle fibre distribution and CSA in work-related myalgia in trapezius muscles. Secondly, the multivariate relationships among muscle morphology and histochemistry [ragged-red (RR) fibres, and cytochrome-c-oxidase-negative-fibre changes] EMG, perceived fatigue, and biomechanical output of shoulder flexions were analysed. The raw data have been presented in an earlier study. The participants in this study were 25 female cleaners with work-related myalgia of the trapezius muscle and 25 female cleaners not experiencing work-related myalgia of this muscle. The control group comprised 21 healthy female teachers who had not been exposed to highly repetitive work or static muscle work. Smaller CSA of type II fibres were found in cleaners compared to teachers. In this study the CSA of type I fibres of the trapezius muscles associated with myalgia were no greater than in muscles without myalgia. The prevalence of RR fibres together with age, fibre type proportions, CSA and working as a cleaner correlated with the ability to relax as recorded electromyographically. The relative mean frequency of the EMG of the trapezius muscle correlated with the prevalence of RR fibres, but it did not correlate with the proportions and CSA of different fibre types. Low biomechanical outputs and low signal amplitude increases of the EMG during the test were associated with high proportions of type IIB fibres. The smaller CSA of type II fibres in cleaners might have reflected a different muscle activation pattern due to different occupational demands in cleaners than in teachers. Morphological or histopathological variables can influence the three EMG variables investigated. Electronic Publication     

Comparative assessment of study groups of elderly female computer users from four European countries: questionnaires used in the NEW study

There is a lack of consistent and comprehensive questionnaire forms for the studies of factors associated with work-related musculoskeletal disorders at the European level. One of the results of the EU-funded project, neuromuscular assessment in the elderly worker (NEW), is a set of questionnaires for the screening of musculoskeletal status and the studies of factors that are believed to affect musculoskeletal health. The questionnaires have been used among elderly women (45+) in different occupations and organisations in Denmark, The Netherlands, Sweden and Switzerland. The aim of this short communication is to present the questionnaires used in the NEW study and to evaluate the appropriateness of pooling data gathered in each participating country into a common database. It is concluded that although differences exist among the study samples, these are not of such a magnitude or pattern that data from the four groups cannot be pooled. The questionnaires are available in Danish, Dutch, English, German and Swedish.     

Work-Related Asthma in Korea - Findings from the Korea Work-Related Asthma Surveillance (KOWAS) program, 2004-2009

Purpose

To determine the incidence and epidemiological characteristics of work-related asthma in Korea.

Methods

During 2004-2009, the Korea Work-Related Asthma Surveillance (KOWAS) program collected data on new cases of work-related asthma from occupational physicians, allergy and chest physicians, regional surveillance systems, and workers'' compensation schemes. The incidence was calculated on the basis of industry, occupation, sex, age, and region. In addition, the distribution of causal agents was determined.

Results

During the study period, 236 cases of work-related asthma were reported, with 77 cases from more than 1 source. A total of 22.0% (n=52) were reported by occupational physicians, 52.5% (n=124) by allergy and chest physicians, 24.2% (n=57) by regional surveillance systems, and 43.2% (n=102) by workers'' compensation schemes. The overall average annual incidence was 3.31 cases/million workers, with a rate of 3.78/million among men and 2.58/million among women. The highest incidence was observed in the 50-59-year age group (7.74/million), in the Gyeonggi/Incheon suburb of Seoul (8.50/million), in the furniture and other instrument manufacturing industries (67.62/million), and among craft and related trades workers (17.75/million). The most common causal agents were isocyanates (46.6%), flour/grain (8.5%), metal (5.9%), reactive dyes (5.1%), and solvents (4.2%).

Conclusions

The incidence of work-related asthma in Korea was relatively low, and varied according to industry, occupation, gender, age, and region. Data provided by workers'' compensation schemes and physician reports have been useful for determining the incidence and causes of work-related asthma.     

工作相关社交技能训练对抑郁症患者职业康复的效果

目的 探讨工作相关社交技能训练对抑郁症患者职业康复的影响.方法 将100例患者随机分为研究组和对照组各50例,对照组接受一般门诊咨询和随访服务,研究组在此基础上进行工作相关社交技能训练（WSST）,疗程为10周.在入组前、训练结束后随访3个月时对两组患者采用汉密尔顿抑郁量表（HAMD-24）和工作社交技巧评估量表（WSSS）进行评定,同时统计两组找到竞争性工作岗位的例数.结果 训练前两组在HAMD、WSSS评分差异无统计学差异（P＞0.05）,训练结束后随访3个月两组HAMD、WSSS评分差异有统计学差异（P＜0.01）,研究组有12例找到竞争性工作岗位,对照组有4例找到竞争性工作岗位.结论 工作相关社交技能训练可以改善抑郁症患者的症状,提高就业比率.     

Alterations in cervical muscle activity in functional and stressful tasks in female office workers with neck pain

This study determined differences between computer workers with varying levels of neck pain in terms of work stressors, employee strain, electromyography (EMG) amplitude and heart rate response to various tasks. Participants included 85 workers (33, no pain; 38, mild pain; 14, moderate pain) and 22 non-working controls. Work stressors evaluated were job demands, decision authority, and social support. Heart rate was recorded during three tasks: copy-typing, typing with superimposed stress and a colour word task. Measures included electromyography signals from the sternocleidomastoid (SCM), anterior scalene (AS), cervical extensor (CE) and upper trapezius (UT) muscles bilaterally. Results showed no difference between groups in work stressors or employee strain measures. Workers with and without pain had higher measured levels of EMG amplitude in SCM, AS and CE muscles during the tasks than controls (all P < 0.02). In workers with neck pain, the UT had difficulty in switching off on completion of tasks compared with controls and workers without pain. There was an increase in heart rate, perceived tension and pain and decrease in accuracy for all groups during the stressful tasks with symptomatic workers producing more typing errors than controls and workers without pain. These findings suggest an altered muscle recruitment pattern in the neck flexor and extensor muscles. Whether this is a consequence or source of the musculoskeletal disorder cannot be determined from this study. It is possible that workers currently without symptoms may be at risk of developing a musculoskeletal disorder.     

Limbic brain structures and burnout—A systematic review

More profound understanding of the relationship between the burnout and the limbic system function can provide better insight into brain structures associated with the burnout syndrome. The objective of this review is to explore all evidence of limbic brain structures associated with the burnout syndrome. In total, 13 studies were selected. Four of them applied the neuroimaging technology to investigate the sizes/volumes of the limbic brain structures of burnout patients. Six other studies were to investigate the hypothalamus-pituitary-adrenal (HPA) axis of burnout patients. Based on the results of the studies on the HPA-axis and neuroimaging of the limbic brain structures, one can see great impact of the chronic occupational stress on the limbic structures in terms of HPA dysregulation, a decrease of BDNF, impaired neurogenesis and limbic structures atrophy. It can be concluded that chronic stress inhibits the feedback control pathway in the HPA axis, causes the decrease of brain-derived neurotrophic factor (BDNF), then impaired neurogenesis and eventually neuron atrophy.     

Occupational rhinitis

Work-related rhinitis, which includes work-exacerbated rhinitis and occupational rhinoconjunctivitis (OR), is two to three times more common than occupational asthma. High molecular weight proteins and low molecular weight chemicals have been implicated as causes of OR. The diagnosis of work-related rhinitis is established based on occupational history and documentation of immunoglobulin E (IgE) mediated sensitization to the causative agent if possible. Management of work-related rhinitis is similar to that of other causes of rhinitis and includes elimination or reduction of?exposure to causative agents combined with pharmacotherapy. If allergens?are commercially available, allergen immunotherapy can be considered.     

Co-activity of the trapezius and upper arm muscles with finger tapping at different rates and trunk postures

In the context of finding a model that describes the pathophysiological mechanisms leading to muscle pain at low-intensity repetitive work, in this study we investigated whether a simplified finger motor task that requires little mental demand can cause increased muscle activity in the upper arms and neck, and examined the impact of the variation of two parameters, finger tapping rate and body posture. Using the 5th and 95th percentiles from the surface electromyogram of six muscles of the fingers, upper arm and neck, we determined the static and dynamic components of the muscle activity. Correlation methods were used to find a component in the muscle activity that originated from the rhythm of the finger tapping. Further investigations included tapping steadiness and finger force. It was found that in many, but not all subjects, low or even high activity was constantly present in the upper arm and trapezius muscles, sometimes even during relaxation. Fast tapping and a forward-leaning body posture caused considerable increases, while a slightly reclined posture helped to reduce co-activity. However, motor control patterns varied strongly between individuals. Since certain subjects showed no co-activity at all we can assume that trapezius and upper-arm activation is not necessarily required for the completion of a task similar to ours. This may explain why some VDU users develop work-related musculoskeletal disorders while others remain healthy. Accepted: 8 June 2000     

Work-related asthma: a case-based approach to management

The management of work-related asthma has some differences from management of other asthma. Components of management include not only making as accurate a diagnosis as possible, identifying the causative agent or triggers at work, and managing the asthma with pharmacologic treatment as for other patients with asthma, but also advising on the appropriate work changes that may be needed, assisting the worker with appropriate compensation claims, and supporting protective measures for?coworkers. This article discusses the approaches that may be taken for patients with different forms of work-related asthma.     

Motor unit identification in two neighboring recording positions of the human trapezius muscle during prolonged computer work

Work-related shoulder-neck pain is a major health risk in computer operators. To understand the physiological mechanisms behind the development of these disorders, EMG recordings of some minutes up to several hours must be accurately decomposed. For this reason we developed EMG-LODEC, an automatic decomposition software program, especially designed for multi-channel long-term recordings of signals detected during slight muscle movements. The subjects executed a 30-min computer task to simulate real work conditions while working at an ergonomically designed workstation. Six-channel intramuscular EMG signals were recorded from two positions of the upper trapezius muscle. The EMG signals were decomposed into individual motor unit action potential trains using EMG-LODEC. The study design enabled us first to study the dependence of intramuscular analysis on the insertion points and second to test the accuracy of the decomposition technique under laboratory conditions during a real experiment. The two positions yielded 887 motor units – 452 located in position 1 and 435 in position 2. Although the numbers of detected action potentials were strongly correlated between the two insertion positions, different motor units were mostly recorded. In particular, the detection of continuously active motor units is specific for the selected insertion points and may not be representative of a muscle, not even for parts with common functions. The approach for the quantitative evaluation of the decomposition technique was to independently decompose two signals that were simultaneously detected by separate sets of wire electrodes placed close to each other in the muscle. Common trains discovered in each signal were compared for consistency. A cross-correlation analysis was performed to find corresponding motor unit pairs that were concurrently active. Concurrently active motor units were found in six subjects. For these motor units the extent of simultaneous occurrence of motor unit action potentials between the two positions ranged from 23% to 78% depending on the distinction of the single motor units and the number of superimposed motor unit action potentials. High concordance was seen in 3 out of the 15 motor unit pairs. Based on the results, EMG-LODEC is capable of providing reliable decompositions with satisfying accuracy and reasonable processing time. EMG-LODEC is suitable for the study of motor unit discharge patterns and recruitment order in subjects with and without musculoskeletal pain during long-term measurements to study work-related musculoskeletal disorders.