不同民族的护士工作压力源与应对方式及其心理状况的研究

目的了解延边地区朝鲜族与汉族护士工作压力源与应对方式、心理健康的相关性。方法应用护士工作压力源量表、症状自评量表、简易应对方式问卷,对延边地区122名朝鲜族护士和73名汉族护士进行调查和比较研究。结果朝鲜族和汉族护士在专业及工作、工作环境与资源、管理及人际关系方面压力源和总均分方面差异具有统计学意义（P〈0．05）;两个民族的护士的症状自评量表总均分和各因子分、应对方式分差异无统计学意义;部分压力源与护士心理健康、应对方式呈正相关。结论延边地区朝鲜族与汉族护士工作压力源及程度不同,对其心理健康产生的影响也不同,医院和社会应给予重视,采取相应的措施,使其保持身心健康,提高工作效率。     

Distressed and stress resistant nurses

This study examines the relative contribution of personality, coping, and family support to adaptation to stress in nursing. The sample (N = 1,043, mean age = 33.8 years) were nurses from three large public hospitals in Singapore. The findings indicated that stress resistant nurses who adapted to high work stress with good mental health status as measured by the General Health Questionnaire (GHQ-12) developed by Goldberg (1972) had a higher self-esteem and were more internal in locus of control than the distressed nurses who reported poor mental health status under high work stress. The use of negative emotion focused coping was less frequent among the stress-resistant nurses who also had greater supports from family relationships. Discriminant function analysis revealed that behavioral coping (e.g., enhancement of ability and physical health) had greater contribution to stress resistance than cognitive coping (e.g., acceptance of situations or change of perspectives). The findings were discussed with reference to the high level of performance demanded by nursing.     

The importance of mental health to the experience of job strain: an evidence-guided approach to improve retention

Aims  The purpose of this study was to evaluate the causal relationships between job strain, the practice environment and the use of coping skills in order to assist in the prediction of nurses who are at risk for voluntary turnover and identify potential intervention strategies.
Background  Analysis of the US nurse workforce indicates that it will be necessary to identify new strategies that will promote a healthy workforce and retain nurses in the workplace.
Methods  Exploratory cross-sectional survey of 1235 staff nurses resulted in 308 usable surveys (25%). Data were analysed using multivariate statistical techniques (SEM).
Results  It was determined that diminished mental health status as a component of job strain was predictive of propensity to leave as was a diminished assessment of the professional practice environment. Mental health was favourably influenced by coping behaviour.
Conclusions  Evidence-based strategies which support mental health and reinforce the positive role of coping as a mediating factor may aid in nurse retention efforts.
Implications for nursing management  This study expands the literature by offering a theoretically supported model to evaluate the response of individuals to the experience of job strain in the work environment. The model demonstrated that the health consequences of job strain are modified through the use of active coping behaviour, and that those nurses with elevated self-assessed health had a lower propensity to leave. As active coping may be taught, the model suggests a means to identify those at risk and support manager intervention.     

Resilience and mental health nursing: An integrative review of international literature

Mental health nurses work in challenging and potentially high stress settings. Stressors can occur in the context of consumer, family, and/or staff relationships, as well as the work environment and organization. The cumulative effects of stress and professional challenges can lead to harmful impacts for mental health nurses including burnout and poorer physical and mental health. Resilience involves a process of positive adaptation to stress and adversity. The aims of this integrative review were to examine understandings and perspectives on resilience, and explore and synthesize the state of knowledge on resilience in mental health nursing. Following systematic search processes, screening, and data extraction, 12 articles were included. Constant comparative analysis and synthesis of the data resulted in two key categories: Theoretical concepts of resilience and Knowledge on mental health nurses’ resilience. In mental health nursing, resilience has been variously constructed as an individual ability, collective capacity, or as an interactive person–environment process. Resilience was most often reported as low‐moderate, with positive correlations with hardiness, self‐esteem, life and job satisfaction, and negative correlations with depression and burnout. A resilience programme improved mental health nurses’ coping self‐efficacy and capacity to regulate thoughts and emotions and developed their resilient practice. Use of contemporary resilience definitions will inform more consistent investigation and progressively scaffold knowledge of this emergent construct in mental health nursing. Future research on the implementation of resilience programmes and resilience‐building strategies for mental health nurses at the individual, work unit, and organizational levels is needed.     

DISTRESSED AND STRESS RESISTANT NURSES

This study examines the relative contribution of personality, coping, and family support to adaptation to stress in nursing. The sample (N = 1,043, mean age = 33.8 years) were nurses from three large public hospitals in Singapore. The findings indicated that stress resistant nurses who adapted to high work stress with good mental health status as measured by the General Health Questionnaire (GHQ-12) developed by Goldberg (1972) had a higher self-esteem and were more internal in locus of control than the distressed nurses who reported poor mental health status under high work stress. The use of negative emotion focused coping was less frequent among the stress-resistant nurses who also had greater supports from family relationships. Discriminant function analysis revealed that behavioral coping (e.g., enhancement of ability and physical health) had greater contribution to stress resistance than cognitive coping (e.g., acceptance of situations or change of perspectives). The findings were discussed with reference to the high level of performance demanded by nursing.     

护士长工作压力源、心理健康状况及应对方式的研究

目的探讨护士长工作压力源、心理健康状况、应对方式及其关系。方法对北京市4所二级综合医院的92名护士长工作压力源、心理健康状况、应对方式进行问卷调查。结果护士长工作主要压力源来自工作量及时间分配方面,最大的压力源为担心工作中出现差错事故;护士长心理健康水平较低;护士长工作压力源除病人护理方面的问题与人际关系敏感、敌对、偏执因子无相关性外,其余均与SCL-90各因子呈正相关;护士长积极应对得分高于常模,消极应对得分低于常模;护士长消极应对方式与SCL-90各因子呈正相关,而积极应对方式与SCL-90各因子无明显相关。结论护理管理部门应重视护士长工作压力源,采取切实可行的方法,引导护士长采用积极的应对方式减轻工作压力,提高心理健康水平。     

Verbal and physical abuse against nurses in Turkey

AIM: This study of verbal and physical abuse against nurses in Turkey aimed to describe prevalence, sources, important effects on work, family and social life of the nurses, coping methods and factors. METHODS: A sample of 622 nurses working in eight hospitals located in the capital city of Turkey was surveyed using verbal and physical abuse questionnaires. RESULTS: The prevalence of verbal and physical abuse against nurses in the sample of this study were found to be as 91.1% and 33.0% respectively. Colleagues were found to be the most important source of verbally abusive behaviours while patients and patients' relatives were the important sources of physically abusive behaviours. Disturbed mental health, decreased job performance and headache were the more frequently reported negative effects of verbal and physical abuses on nurses. The most common reactions against abusive behaviours were anger, helplessness, humiliation and depression. It is interesting to find that 'did nothing' was the most reported coping method with verbal abuse. The findings also suggested that working in inpatient units and increasing work experience in the nursing profession were statistically significant variables increasing the likelihood of being abused physically. DISCUSSION: All the results on sources, negative effects, feelings and coping methods on verbally and physically abusive behaviours lead us to discuss that lower working status and power of the nurses at the work, poor working conditions in healthcare settings and insufficient administrative mechanisms as well as law and regulations against the abusers are the important factors forcing the nurses to work in an inappropriate work environment in Turkey.     

工作压力对护士身心健康的影响

适度的压力能激发个体的潜能去应对日常生活的挑战，但持久的高压力会影响护士的身心健康、工作效率和护理质量，从而间接影响患者的康复。通过分析影响护士压力感受和身心健康的因素以及工作压力对护士身心健康的影响，从护士的个人应对、医疗机构的干预、卫生行政部门的管理及社会和媒体的正面宣传等方面提出维护和改善护士身心健康的建议，以利于提高护理质量和促进护理事业的发展。     

肿瘤科护士工作压力及应对方式的调查

目的调查肿瘤科护士工作压力来源和应对方式。方法对48名肿瘤科护士采用护士压力源量表、压力应对方式问卷调查。结果肿瘤科护士总体压力水平为中度,压力主要来源于“工作量及时间分配”、“病人护理”、“工作环境及仪器设备”方面：在“工作量及时间分配”方面,中高级职称及较高学历护士压力高于初级职称及低学历护士,在“护理专业及工作方面”,高学历护士压力高于低学历护士;78．72％的肿瘤科护士采用积极的成熟型应对方式应对压力,21．28％采用消极的或中间型方式应对压力。结论制定有效措施降低肿瘤科护士压力源水平,减轻应激程度,对确保护士身心健康和良好的护理质量是必要的。     

The association of Chinese hospital work environment with nurse burnout,job satisfaction,and intention to leave

The purpose of this study was to describe nurse burnout, job satisfaction, and intention to leave and to explore the relationship of work environment to nursing outcomes in a sample of 9,698 nurses from 181 hospitals in China. Nurses reported moderate levels of emotional exhaustion and depersonalization and high levels of reduced personal accomplishment. Nearly one-fifth of the nurses reported high levels of burnout on all three dimensions. Forty-five percent of the nurses were dissatisfied with their current job; these nurses were most dissatisfied with their salary. Five percent of nurses reported an intention to leave. Nurses reporting mixed and good work environments were less likely to report high burnout, job dissatisfaction, and intention to leave compared with those in poor work environments. The results suggest that high burnout and low job satisfaction are prominent problems for Chinese nurses, and improving work environment might be an effective strategy for better nursing outcomes in Chinese hospitals.     

护士长工作状况调查及相关因素研究

目的调查护士长工作状况,分析护士长工作压力、应对方式以及与身心健康的相互关系。方法采用问卷调查法对2所大型医院86名护士长工作疲溃感、工作压力、应对方式以及身心健康水平进行调查分析。结果护士长情绪疲溃感与工作无成就感均为高度;工作量负荷、缺乏支持、处理死亡或濒死的病人是护士长最主要的工作压力源;护士长积极的再评估、有计划的解决问题和采取自我控制来处理压力事件;工作量负荷、采取逃避与回避与护士长的躯体健康水平和心理健康水平呈负相关,与医生的冲突与护士长的心理健康水平呈负相关。结论护士长工作压力大,身心健康存在较多问题,应引起管理部门的高度重视,寻求各种途径缓解护士长的工作压力,提高其身心健康水平,有利于提高护理管理质量。     

Managing job stress in nursing: what kind of resources do we need?

Title. Managing job stress in nursing: what kind of resources do we need? Aim. This paper is a report of a study to investigate the functionality of different kinds of job resources for managing job stress in nursing. Background. There is increasing recognition that healthcare staff, and especially nurses, are at high risk for burnout and physical complaints. Several researchers have proposed that job resources moderate the relationship between job demands and job-related outcomes, particularly when there is a match between the type of demands, resources, and outcomes. Method. Based on the Demand-Induced Strain Compensation Model, cross-sectional survey data were collected between November 2006 and February 2007 by a paper-and-pencil questionnaire. The final sample consisted of 69 nurses from a Dutch nursing home (response rate 59·4%). Data were analyzed by hierarchical regression analyses. Results. High physical demands had adverse effects on both physical complaints and emotional exhaustion (i.e. burnout), unless employees had high physical resources. A similar pattern was found for high physical demands and emotional resources in predicting emotional exhaustion. The likelihood of finding theoretically-valid moderating effects was related to the degree of match between demands, resources, and outcomes. Conclusion. Job resources do not randomly moderate the relationship between job demands and job-related outcomes. Both physical and emotional resources seem to be important stress buffers for human service employees such as nurses, and their moderating effects underline the importance of specific job resources in healthcare work. Job redesign in nursing homes should therefore primarily focus on matching job resources to job demands in order to diminish poor health and ill-being.     

Investigating the impact of psychosocial risks and occupational stress on psychiatric hospital nurses' mental well-being in Japan

A cross-sectional survey was conducted, with the aim to examine what stressors in the workplace and demographic factors were associated with signs and symptoms of poor well-being among psychiatric nurses. A structured questionnaire was distributed to nurses within six psychiatric hospitals in Japan. Information was collected on demographic information, work characteristics and two dimensions of well-being: feeling uptight and emotional exhaustion. Three hundred and sixty-one questionnaires were completed by participants. High rates of emotional exhaustion in psychiatric nurses were found to be predicted by young age, high psychological demands paired with low social support in the workplace, job strain (a proxy to occupational stress) and job strain paired with low social support. In addition, high rates of being tense/uptight were associated with high psychological job demand, low psychological job control, low social support in the workplace, high job strain and high job strain paired with low social support. The current study has found evidence of significant relationships between demographic factors and several work and organizational stressors and poor mental health among Japanese psychiatric nurses.     

疗养院文职护士工作压力与心理健康状况调查分析

目的调查了解疗养院文职护士工作压力和心理健康状况。方法采用护士工作压力源量表、Maslach职业倦怠调查普适表（MBI-GS）和症状自评量表（SCL-90）进行调查。结果疗养院文职护士的工作压力和倦怠情况均呈中度水平,主要在护理专业及工作问题、管理及人际关系方面和工作成就感低落方面较突出。SCL-90测评结果显示其目前心理健康状况良好。其工作成就感与护理专业及工作和管理及人际关系呈负相关（P〈0.05）;SCL-90中抑郁因子的得分与工作年限呈正相关（P〈0.05）,躯体化、焦虑、睡眠及饮食与护理专业及工作呈正相关（P〈0.05）,躯体化与工作成就感呈负相关（P〈0.05）,焦虑与情绪衰竭呈正相关（P〈0.05）。结论影响疗养院文职护士的工作倦怠和心理健康问题的主要原因是护理工作性质,还与工作年限、工作环境等因素有直接关系。个人应从自我管理方面努力调整心理状态,多方面寻求工作成就感和突破;护理管理者应充分注重以人为本的管理,积极引导和组织,提升文职护士的工作积极性。     

Occupational stress and constructive thinking: health and job satisfaction

BACKGROUND: Occupational stress is associated with specific situations, characteristics of the work environment, and individual perceptions and reactions in the context of the workplace, but many nursing studies of occupational stress have tended to analyse aspects related to the job itself. In Brazil nursing is acknowledged as a stressful occupation whose stresses are generally associated with the job itself, while the effects of personal characteristics on an individual's response to occupational stress are dismissed. AIMS: The aim of this paper is to describe: (1) occupational stress, job satisfaction and state of health in Brazilian nurses, and (2) the relationship of these variables to a constructive thinking coping style. METHODS: A correlational study was performed during 1999 with 461 nurses recruited from the public health and education system in the Federal District of Brazil. Instruments used were the Nursing Stress Inventory, Constructive Thinking Inventory, subscales of the Occupational Stress Indicator, and a researcher-designed questionnaire. RESULTS: Normal distributions were found for occupational stress, state of health (physical and psychological), and job satisfaction. Results suggest that nurses have fewer psychological health problems and similar job satisfaction compared with other Brazilian government white-collar workers. Occupational stress was directly associated with state of health, and inversely associated with global constructive thinking and job satisfaction. CONCLUSIONS: Brazilian nurses in this study seem to have adapted satisfactorily to their profession, but the finding that constructive thinking was significantly related to psychological ill-health, occupational stress and physical ill-health highlights a need to value individual coping styles in the work environment.     

A comparative study of work characteristics and reactions between general and mental health nurses: a multi-sample analysis

AIM OF THE STUDY: The first aim of this study was to examine differences in work characteristics (autonomy, social support and workload) and work reactions (emotional exhaustion and job involvement) between general and mental health nurses. The second aim was to validate whether a specific pattern of relationships between work characteristics and reactions was the same for mental health and general nurses. BACKGROUND: Nurses are generally being considered as an above risk group regarding work stress. However, health care is a diverse sector and literature suggests important differences regarding the work of different categories of nursing, such as general and mental health nurses. In addition, little empirical evidence exists about these differences. In order to improve their work situation, more insight is needed regarding differences and similarities in the work of general and mental health nurses. The demand-control-support (DCS) model was used as a research framework. We hypothesized that autonomy, job involvement, and emotional exhaustion are higher in mental health nursing, whereas social support is expected to be lower. Next, in line with the propositions of this model and several recent studies, we hypothesized that emotional exhaustion is primarily predicted by workload and social support, whereas job involvement is primarily predicted by autonomy. In addition, we investigated whether this pattern of relationships was similar in both groups. DESIGN/METHODS: Questionnaires were distributed to nurses working in a general and a psychiatric hospital in the Netherlands. We used MANOVA and MSA (by means of LISREL) to analyse the data. RESULTS AND CONCLUSIONS: Regarding the differences in work characteristics and work reactions between mental health and general nurses, our hypotheses were confirmed, except for social support and job involvement. Autonomy and emotional exhaustion were higher among mental health nurses, whereas their job involvement proved to be significantly lower. Emotional exhaustion was primarily predicted by workload and lack of social support. Contrary to our expectations, the relationship between autonomy and job involvement was not significant in both samples. Finally, we found that the proposed pattern of relationships appeared to be invariant across the two samples.     

An integrative review of the influence of job strain and coping on nurses' work performance: Understanding the gaps in oncology nursing research

Nursing is known to be a stressful profession that can lead to physical and psychological health issues and behavioural problems. In oncology, workload among nurses is believed to be increasing in conjunction with rapidly increasing numbers of patients with cancer and staff shortages worldwide, therefore it is essential to sustain a quality oncology nurse workforce. Numerous studies have presented evidence on job strain, effects of coping strategies, and nurses' work performance within healthcare settings, but few have focused on oncology settings and none of these on nurses working in Saudi Arabia. The purpose of this review was to summarize empirical and theoretical evidence concerning job-related stressors in nurses, particularly oncology nurses, and the interrelationships among job strain, coping strategies, and work performance in this population. Search strategies identified studies published on studies in peer-reviewed journals from 2004 to 2016. Twenty-five nursing studies were found examining the relationships among the concepts of interest. Common job-related stressors among oncology nurses were high job demands, dealing with death/dying, lack of job control, and interpersonal conflicts at work. Job strain was found to be significantly linked to coping strategies, and negatively associated with work performance among nurses in general. There is no existing empirical evidence to support the relationship between coping strategies and work performance among oncology nurses. The present evidence is limited, and a considerable amount of research is required in the future to expand the oncology nursing literature. Research is needed to investigate job-related stressors and their effects on oncology nurses.     

护理工作应激与护士心理健康状况的研究

采用一般健康问卷（ＧＨＱ１２）和麦氏应激问卷（ＭＷＳＱ）对７４７名护士进行了调查。统计分析结果表明，护士人群的心境抑郁、心理紧张和焦虑失眠者发生率较高；心理状况不佳的检出率为１２３％。单因素统计可见，急诊科、儿科护士心理状况不佳检出率最高，分别为３０％和２５％（Ｐ＜０．００１）；三种工作应激因素（应付能力、工作满意感和职业应激源）确对心理健康状况有显著影响（Ｐ＜０．００１）。多因素Ｌｏｇｉｓｔｉｃ回归分析也进一步证明，上述工作应激和急诊科环境对心理状态不佳发生概率影响较大，复相关系数为０６７，并具有统计学意义。从而证明，护理工作应激因素与护士心理健康状况关系密切，进一步加强护士心理卫生工作，提高护士心理素质十分必要