合肥市5所三级甲等医院肿瘤科护士死亡应对能力现状及其影响因素分析

目的 调查合肥市5所三级甲等医院肿瘤科护士的死亡应对能力现状并分析其影响因素。方法 采用一般资料调查表、死亡应对能力量表、死亡态度描绘量表对206名肿瘤科护士进行问卷调查。结果 肿瘤科护士死亡应对能力总分为（135.79±27.28）分，单因素分析显示:不同年龄、基础学历、肿瘤护理年限、身体健康状况和心理健康状况的护士死亡应对能力得分具有统计学差异（P<0.01)；Pearson相关分析显示:死亡恐惧（r=-0.392，P<0.001)、死亡逃避（r=-0.361，P<0.001）与死亡应对能力呈负相关；多元逐步回归分析显示:肿瘤护理年限、心理健康状况、死亡态度是肿瘤科护士死亡应对能力的主要影响因素。结论 肿瘤科护士的死亡应对能力不容乐观，护理管理者应结合护士死亡应对能力特点，构建并开展个体化死亡教育，促进死亡态度的正向转变，提升死亡应对能力。     

The role of resilience and coping among Italian healthcare workers during the COVID-19 pandemic

Objective:To evaluate the psychological state of healthcare workers (HCWs) in the field of rehabilitation during the COVID-19 pandemic.Methods:Cross-sectional observational study. Sample of 334 HCWs including: nurses, medical doctors, therapists, scientists, and clerical workers working at the IRCCS San Raffaele Roma rehabilitation hospital during the second wave of the COVID-19 pandemic. Anonymous web-based questionnaire included 14-item Resilience Scale, Brief-COPE, Hospital Anxiety Depression Scale, Fear of COVID-19 Scale. Occupational and sociodemographic characteristics.Results:High levels of resilience, low levels of anxiety, depression, and fear were observed in the study population; the most frequently used coping strategies in the Brief-COPE were acceptance, planning, and active coping. Specifically, 87% of the participants reported a moderate to high level of resilience, with the highest level observed in nurses while physicians show the lowest level. HCWs showed symptoms of anxiety (29%), depressive symptoms (10%), and fear caused by the COVID-19 pandemic (44%). Statistically significant differences were observed between different occupations for fear (p <0.05) and resilience (p <0.01). Levels of anxiety and fear appeared to be higher in female and younger workers. The latter group - who also reported higher levels of depression - showed lower levels of resilience.Conclusions:In our study hospital and non-hospital workers show different emotional, cognitive, and behavioural resources when facing stressful situations, like in the case of the SARS-CoV-2 pandemics. Our results support the role of resilience and the proper use of problem-focused and emotion-focused coping strategies as protective factors from psychological distress.     

Up Front

ABSTRACT

Folkman and Lazarus's transactional theory of emotion and coping was used to explain how humor influences job satisfaction among health care providers. One hundred forty-two nurses completed measures of humor orientation (HO), coping efficacy, job satisfaction, and open-ended questions about their use of humor to relieve job tensions. This produced 9 categories of strategies of producing humor and 8 types of work situations identified in which humor was used to cope. Nurses (21.4%) reported using humor the most often during “patient care” situations (e.g., providing medicines, moving patients, physical therapy, and so on). More than one third (38.66%) of the nurses reported using “word-play/language” as a humorous coping strategy.

Higher HO was associated with higher ratings of humor effectiveness, greater self-perceived coping efficacy, and higher emotional expressivity. Path analysis demonstrated that, as the transactional theory would predict, trait HO influences job satisfaction through its effect on heightened coping efficacy.

Study limitations include the use of self-report methods and the limited number of responses to the open-ended items. Subsequent research in this area should attempt to validate the categories identified in this study and determine the most effective means of coping. Researchers also should explore differences in health care providers’ coping communication based on gender, years of experience, and profession.     

普外科护士工作压力、应对策略与主观幸福感的差异及相互关系

目的 普外科护士在医院上承受大量的工作压力,而心理健康与主观幸福感能帮助护士改善精神状态。本文旨在探讨普外科护士的工作压力、应对策略、主观幸福感的评分及相互关系。方法 采用横断面调查方案,以本地区普外科护士为主要母群体,采用分层抽样法选出2家医院普外科护士人员为研究对象。结果 普外科护士工作压力与对应策略呈低度正相关;工作压力与主观幸福感呈低度负相关;对应策略与主观幸福感呈中度正相关。普外科护士工作压力、对应策略与主观幸福感各年龄群及教育程度皆有统计学意义,大学教育程度普外科护士工作压力较大,对应策略最低,幸福感最低。不同护龄的对应策略与主观幸福感有统计学意义;其中对应策略以6~10年护龄护士高于11~20年护龄护士;主观幸福感得分在1~5年护龄及超过21年护龄的护士高于6~10护龄者。结论 创造良好的组织气氛、合理的护理人力配置、加强自我的肯定,提供面对压力的对应策略等措施,可以有效提升普外科护士的主观幸福感。     

Factors affecting rapid turnover of novice nurses in university hospitals

Rapid turnover of novice nurses eventually results in a shortage of veteran nurses. This study aimed to clarify the factors affecting rapid turnover of novice nurses in a prospective manner. We carried out an investigation in 20 university hospitals whose directors of nursing service departments accepted our request to cooperate with our research program. These hospitals were selected from all of the 102 university hospitals listed in The Hospital Catalog of Japan. The subjects were 1,203 novice hospital nurses who gave their informed consent for participation in our study. The questionnaires, which dealt with burnout, assertiveness, stressful life events, reality shock, ward assignment preference, transfer preference, job satisfaction (workplace, salary, workload, and overtime), social support and coping mechanisms were completed by 923 novice nurses in June 2003. Then, their turnover was investigated in December 2003. Thirty-seven novice nurses (4.0%) quit during this period. Multiple logistic regression analysis showed that the factors affecting rapid turnover were 1) graduation from vocational nursing schools, 2) dissatisfaction with assignment to a ward contrary to their desire, and 3) no peers for support. Assignment of novice nurses to wards they choose as far as possible, avoidance of assigning novice nurses to wards alone, and establishment of a support system for nurses who graduate from vocational nursing schools seem to be important for preventing rapid turnover of novice nurses.     

门诊护理人员职业倦怠相关性因素分析

目的 探讨分析门诊护理人员职业倦怠的相关性因素及其应对策略.方法 随机选取医院门诊工作时间超过12个月的30名护士作为研究对象,并对其采用护士职业倦怠量表(nurse burnout scale,NBS)进行调查,总结职业倦怠相关性因素并制定应对策略.结果 门诊护士均有不同程度职业倦怠,分别有:工作负担、工作压力、心理...     

基于随机森林算法的肿瘤科护士工作倦怠影响因素分析:一项多中心研究

目的 采用随机森林算法探讨肿瘤科护士工作倦怠的影响因素。 方法 于2018年3—8月对广西全区25所三级综合医院和专科医院1253名肿瘤科护士采用一般资料问卷、工作倦怠量表、心理资本量表进行横断面调查,分析其工作倦怠现状及其影响因素,使用随机森林分析对可能影响肿瘤科护士工作倦怠的自变量进行重要性排序,将袋外估算误差率最小的变量集纳入logistic回归模型,分析自变量的作用方向和相对危险度。 结果 逐步随机森林分析显示,变量数为8时的袋外估算误差率最低,重要性排名前8的变量依次为收入状况满意度、护患关系满意度、从事肿瘤科护理工作年限、心理资本、年龄、参加院级以上培训次数、群众认可与尊重程度、夜班频次;Logistic回归分析显示,收入状况满意度为一般（OR=1.228,95%CI:1.019~1.497）和不满意或很不满意（OR=1.276,95%CI:1.005~1.621）、护患关系满意度为一般（OR=1.158,95%CI:1.036~1.295）和不满意或很不满意组（OR=1.196,95%CI:1.020~1.402）、从事肿瘤科护理工作5~10年（OR=1.365,95%CI:1.001~1.860）和>10年（OR=1.702,95%CI:1.222~2.371）、心理资本（OR=0.904,95%CI:0.824~0.991）、年龄25~30岁（OR=1.347, 95%CI:1.010~1.797）和>30岁（OR=1.397,95%CI:1.007~1.937）、参加院级以上培训次数1~2次/年（OR=1.107,95%CI:1.008~1.217）、群众认可与尊重程度为一般（OR=1.105,95%CI:1.008~1.212）和不尊重（OR=1.260,95%CI:1.010~1.572）、夜班频次<1次/周（OR=1.115,95%CI:1.025~1.213）和≥1次/周（OR=1.397,95%CI:1.146~1.702）是肿瘤科护士工作倦怠的独立危险因素（P<0.05）。 结论 影响肿瘤科护士工作倦怠的前8位因素依次为收入状况满意度、护患关系满意度、从事肿瘤科护理工作年限、心理资本、年龄、参加院级以上培训次数、群众认可与尊重程度、夜班频次,建议医院和护理管理者应制定相应策略,减少肿瘤科护士工作倦怠。     

How Parents Cope With the Experience of Neonatal Intensive Care

Thirty-two mothers and 25 fathers described their coping efforts during the initial weeks of their preterm infants' hospitalization in a neonatal intensive care unit. Utilizing procedures developed by Lazarus and Folkman (1984) in which coping is linked with a specific stressful event, parents reported what they did to cope with the stressor they perceived to be the most stressful. They also completed the Ways of Coping Questionnaire (Folkman & Lazarus, 1988). Results showed that there were similarities and differences in the types of coping strategies used by mothers and fathers. In addition, factors such as neonatal morbidity and appraisal of control were differentially associated with the use of certain types of coping strategies. Implications for future research and clinical practice are discussed.     

"If we didn't use humor, we'd cry": humorous coping communication in health care settings

Folkman and Lazarus's transactional theory of emotion and coping was used to explain how humor influences job satisfaction among health care providers. One hundred forty-two nurses completed measures of humor orientation (HO), coping efficacy, job satisfaction, and open-ended questions about their use of humor to relieve job tensions. This produced 9 categories of producing humor and 8 types of work situations identified in which humor was used to cope. Nurses (21.4%) reported using humor the most often during "patient care" situations (e.g., providing medicines, moving patients, physical therapy, and so on). More than one third (38.66%) of the nurses reported using "word-play/language" as a humorous coping strategy. Higher HO was associated with higher ratings of humor effectiveness, greater self-perceived coping efficacy, and higher emotional expressivity. Path analysis demonstrated that, as the transactional theory would predict, trait HO influences job satisfaction through its effect on heightened coping efficacy. Study limitations include the use of self-report methods and the limited number of responses to the open-ended items. Subsequent research in this area should attempt to validate the categories identified in this study and determine the most effective means of coping. Researchers also should explore differences in health care providers' coping communication based on gender, years of experience, and profession.     

Helping Hospitalized Preschoolers Manage Stressful Situations: The Mother's Role

This study examined mothers perceptions of the most stressful situation their children experienced during hospitalization and how they and the children responded in these situations The mothers described four types of situations, the most prevalent were intiusive procedures and separation events The most frequent coping behaviors they described were seeking others, eliciting help controlling, and self protection behaviors The predominant strategies the mothers used to help their children were Providing Comfort and Providing lnformation The mothers emotional responses to their childrens behaviors included both pleasant and unpleasant affective states Implications for practice and research are addressed.     

Helping Hospitalized Preschoolers Manage Stressful Situations: The Mother's Role

This study examined mothers perceptions of the most stressful situation their children experienced during hospitalization and how they and the children responded in these situations The mothers described four types of situations, the most prevalent were intiusive procedures and separation events The most frequent coping behaviors they described were seeking others, eliciting help controlling, and self protection behaviors The predominant strategies the mothers used to help their children were Providing Comfort and Providing lnformation The mothers emotional responses to their childrens behaviors included both pleasant and unpleasant affective states Implications for practice and research are addressed.     

Considering the employee point of view: perceptions of job satisfaction and stress among nursing staff in nursing homes

OBJECTIVE: To document job satisfaction and sources of stress among nursing staff working in nursing homes and to evaluate the extent to which the reasons of stress differ by type of nursing staff. DESIGN: Cross-sectional study. SETTING: Twenty-five nursing homes in North Carolina participating in a demonstration project of a new model of long-term care pharmacy. PARTICIPANTS: Nurses and nursing assistants employed at the time of the survey in the spring and summer of 2002 (n = 1283). MEASUREMENTS: Health Professional Stress Inventory modified for use in the nursing home setting and ratings of job satisfaction. RESULTS: The situations most stressful for nurses were not having enough staff, having too much work to do, interruptions, having non-health professionals determine how to do their job, poor pay, and ultimately being responsible for patient outcomes. The top most stressful situations for nursing assistants included poor pay, not enough staff, and too much work to do. Nursing assistants were more likely than nurses to report stress because they do not have adequate information regarding a patient's condition. Nurses were more likely than nursing assistants to report stress because non-health professionals (eg, surveyors) determine how they must do their job. CONCLUSIONS: The findings of this study support the need to improve recognition for nursing, improve staffing, and provide competitive compensation in nursing homes.     

Uncovering Common Stressful Factors and Coping Strategies Among Childcare Providers

The purpose of this study was to identify the common stress factors among childcare providers and the coping strategies they use to relieve work stress feelings throughout the day. Qualitative data was gathered from a random sample of ten local childcare providers across different races, years of experience, and licensed childcare centers who participated in in-depth focus group interviews. The stressful work factors described by childcare providers included work conditions, work events, client factors and external factors. Childcare providers also describe several coping strategies such as walking, prayer and meditation or planning for stressful moments. Results from this study provide practical approaches for relieving work stress among childcare providers.     

Sense of coherence and burnout in nursing home workers during the COVID-19 pandemic in Spain

Care staff in nursing homes work in a challenging environment, and the COVID-19 pandemic has exacerbated those challenges in an unprecedented way. On the other hand, the sense of coherence (SOC) is a competence that could help these professionals perceive the situation as understandable, manageable and meaningful. This study aims to analyse the extent to which potential risk and protective factors against burnout have affected nursing home workers during the COVID-19 pandemic and to assess the contribution of these factors to their burnout. Three hundred forty professionals who worked in nursing homes in Spain completed a survey and reported on their sociodemographic characteristics and their organisational characteristics of the job related to COVID-19, SOC and burnout. Multiple linear regression analyses were performed. The results showed that the SOC is highly related to the dimensions of burnout and is a protective factor against this. In addition, the increase in hours has a negative effect, facilitating inadequate responses to stressful situations; and whereas perceived social support and availability of resources have a protective effect, the deterioration in mental and physical health is the most important risk factor. This study could help better understand the psychological consequences of the effort that nursing home workers and can also help design mental health prevention and care interventions for workers that provide them with resources and supports that foster their coping skills.     

Anxiety generating situations among nurses and strategies to control it: preliminary study

The purposes of this study were: to identify situations that are considered sources of anxiety in nurse's daily activities and to identify the conscious strategies these nurses use in order to lower the level of anxiety. The sample was composed of 54 nurses from a larger general teaching hospital that answered a questionnaire with open and closed questions. The answers pointed situations, both quotidian and unsuspected, that generate anxiety in the following areas: direct care, management and teaching. Nurses also pointed the activities they usually do in order to cope with stress, during the crisis or in their quotidian life. Findings demonstrate that even though the nurses are exposed to stressing situations that generate anxiety, they also use adequate coping strategies. We observe that more studies are needed, in order to propose new alternatives to improve nurses' quality of life.     

Stress among emergency unit nurses

Stress is clearly present in nursing work. This article presents an exploratory study carried out among emergency unit nurses from hospital institutions, and aimed at determining these professionals' stress level. The sample consisted of 73 emergency unit nurses who work for public and private institutions in the city of S?o Paulo. The data was collected through a structured questionnaire. The results indicated that emergency unit nurses present a medium stress level, and that participants considered E--Work Conditions to perform nursing activities, and F - Activities related to personnel administration, as the most stressful areas. For emergency unit nurses, in spite of the ready and effective action towards the instability of the patient's situation, conditions external to this situation are more stressful than the emergency. Hospitals need to analyze these requisites to allow for decreased stress among emergency nurses.     

某二级甲等综合医院护士核心能力现状调查

目的对二级甲等综合医院护士核心能力现状进行调查并分析影响因素,为相关部门制定有效措施提供科学依据。方法以青岛市某二甲综合医院350名临床护理人员为研究对象,采用中国注册护士核心能力量表(CIRN)进行问卷调查,应用SPSS 23.0软件对数据进行统计分析。结果护士核心能力总分(136.39±36.19),均值(2.48±0.66);各维度均分由高到低依次为:伦理与法律实践能力(2.57±0.72)、领导能力(2.57±0.69)、人际关系能力(2.54±0.68)、专业发展能力(2.50±0.70)、教育与咨询能力(2.42±0.73)、临床护理能力(2.42±0.69)、评判性思维与科研能力(2.32±0.72);多元线性回归分析结果显示工作年限、所在科室与护士核心能力有明显相关性(P<0.05)。结论青岛某二甲综合医院护士核心能力处于中等水平,工作年限、年龄、所在科室是影响护士核心能力的重要因素。医院管理者应有针对性制定措施,提升护士核心能力,从而提高护理服务质量。     

重庆市区县医院肿瘤科护士职业倦怠的现状分析

目的了解重庆市区县级医院肿瘤科护理人员职业倦怠的现状,并分析影响因素。方法采用李超平职业倦怠问卷对重庆市区县级医院在肿瘤科工作的86名护士采用便利抽样法进行调查分析,并将结果进行处理和分析。结果区县医院肿瘤科护士情绪衰竭者得分(3.24±1.27)分,玩世不恭得分(2.76±1.63)分,成就感低落得分(3.38±1.39)分;检出在较高水平的比列分别是情绪衰竭者占59.3%,玩世不恭者占44.1%,成就感低落者占37.2%。文化程度不同职业倦怠各维度不同,差别有统计学意义(P<0.05);不同特征的肿瘤科护士成就感低落不同,差异有统计学意义(P<0.05)。结论区县医院肿瘤科护士职业倦怠处于较高水平,特别是情绪衰竭项最为突出,提示我们应当多关注肿瘤科护士的身心健康,提高工作的活力和激情。