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.     

Relationships among leadership practices, work environments, staff communication and outcomes in long-term care

tourangeau a., cranley l., laschinger h. & pachis j. (2010) Journal of Nursing Management 18, 1060–1072
Relationships among leadership practices, work environments, staff communication and outcomes in long-term care Aim To examine the role that work relationships have on two long-term care outcomes: job satisfaction and turnover intention. Background It is easy to overlook the impact that human relations have in shaping work environments that are conducive to organizational effectiveness. Employee job satisfaction and retention are important organizational outcomes. Methods Six hundred and seventy-five nursing and other staff from 26 long-term care facilities were surveyed about their work environments, work group relationships, observed leadership practices, organizational support, job satisfaction and turnover intention. Results Higher job satisfaction was associated with lower emotional exhaustion burnout, higher global empowerment, higher organizational support, higher psychological empowerment, stronger work group cohesion and higher personal accomplishment. Higher turnover intention was associated with lower job satisfaction, higher emotional exhaustion burnout, more outside job opportunities, weaker work group cohesion, lower personal accomplishment and higher depersonalization. Conclusions No relationship was found between leadership practices and job satisfaction or turnover intention. Stronger work group relationships, stronger sense of personal accomplishment and lower emotional exhaustion have direct effects on increasing job satisfaction and lowering turnover intention. Implications To retain long-term care staff, attention should be paid to fostering positive work group cohesion, supporting and acknowledging staff accomplishments and minimizing staff burnout.     

Predictors of burnout and job satisfaction among Turkish physicians

BACKGROUND: Burnout is associated with decreased job performance and low career satisfaction. It has a special significance in health care, where staff experience both psychological-emotional and physical stress. AIM: To investigate levels of job satisfaction and burnout among Istanbul physicians, and the relationships between demographic characteristics, job characteristics, job satisfaction and burnout. DESIGN: Questionnaire-based survey. METHODS: We collected data from a randomly selected sample group of 598 physicians from different health-care institutions in Istanbul. A questionnaire regarding sociodemographic characteristics of the physicians, the Maslach Burnout Inventory (MBI) and the Minnesota Job Satisfaction Questionnaire (MSQ) were all administered during face-to-face interviews. RESULTS: Job satisfaction was inversely correlated with emotional exhaustion and depersonalization, and positively correlated with personal accomplishment. Under multilevel regression, the most significant and common predictors of all burnout dimensions and job satisfaction were the number of vacations at individual level, and public ownership of healthcare facilities at group level. Number of shifts per month was also a significant predictor of all burnout dimensions. DISCUSSION: Organizational efforts aimed at increasing the level of job satisfaction among physicians could help to prevent burnout.     

Job satisfaction among nurses: a predictor of burnout levels

OBJECTIVE: This study assessed the impact of differential levels of job satisfaction on burnout among nurses, hypothesizing that higher levels of job satisfaction predict lower levels of burnout. BACKGROUND: Social environmental factors of the workplace arising from organizational restructuring cost containment strategies, diminishing resources, and increasing responsibilities, cause highly stressed, burned out nurses to leave the profession. METHODS: This study used the Maslach Burnout Inventory (MBI) to measure emotional exhaustion, depersonalization, and personal accomplishment. The job satisfaction scale of Katzell et al was used to measure overall job satisfaction. Statistical tests for significance used were Confirmatory Factor Analysis, Structural Equation Modeling, the chi statistic, Root Mean Square Error of Approximation, Goodness of Fit Index, and Comparative Fit Index. RESULTS: The findings show that job satisfaction has a significant direct negative effect on emotional exhaustion, whereas emotional exhaustion has a direct positive effect on depersonalization. A significant indirect effect was seen of job satisfaction on depersonalization via exhaustion. The path coefficient shows that job satisfaction has both direct and indirect effects on burnout, confirming job satisfaction as a significant predictor of burnout. IMPLICATIONS: Collaborative efforts between nurses, administrators, and educators to research and test practical models to improve job satisfaction may work as an antidote to burnout.     

Stressors, burnout and social support: nurses in acute mental health settings

AIMS: This paper reports a study which aims (1) to investigate and compare levels of stressors and burnout of qualified and unqualified nursing staff in acute mental health settings; (2) to examine the relationships between stressors and burnout and (3) to assess the impact of social support on burnout and stressor-burnout relationships. BACKGROUND: Several studies have noted that the work of mental health nurses can be highly stressful, but relatively few have focused specifically on staff working in acute inpatient settings. Although many of the pressures faced by this group are similar to those in other nursing specialties, a number of demands relate specifically to mental health settings, including the often intense nature of nurse-patient interaction and dealing with difficult and challenging patient behaviours on a regular basis. METHODS: A convenience sample of 93 nursing staff from 11 acute adult mental health wards completed the Mental Health Professionals Stress Scale, Maslach Burnout Inventory and House and Wells Social Support Scale. RESULTS: Lack of adequate staffing was the main stressor reported by qualified staff, while dealing with physically threatening, difficult or demanding patients was the most stressful aspect for unqualified staff. Qualified nurses reported significantly higher workload stress than unqualified staff. Approximately half of all nursing staff showed signs of high burnout in terms of emotional exhaustion. A variety of stressors were positively correlated with emotional exhaustion and depersonalization. Higher levels of support from co-workers were related to lower levels of emotional exhaustion. Higher stressor scores were associated with higher levels of depersonalization for staff reporting high levels of social support, but not for those reporting low levels of support (a reverse buffering effect). CONCLUSIONS: Qualified and unqualified nursing staff differed in terms of the prominence given to individual stressors in their work environment. The findings were consistent with the notion of burnout developing in response to job-related stressors. While staff support groups may be useful in alleviating feelings of burnout, the reverse buffering effect suggests that they should be structured in a way that minimizes negative communication and encourages staff to discuss their concerns in a constructive way.     

济宁护士工作倦怠的现状及影响因素分析

目的了解济宁地区三甲医院护士的工作倦怠现状并探讨影响因素。方法采用工作倦怠问卷、护士工作压力源量表对184名护士进行调查。结果护士的工作倦怠检出率较高（89．1％）;情感衰竭、去人格化与护士工作压力源存在正相关（P〈0．001,P〈0．01）,个人成就感与护士工作压力源3个方面（护理专业及工作、病人护理、管理及人际关系）呈负相关（P〈0．05或P〈0．01）;副主任护师职称、管理及人际关系方面的压力对情感衰竭和去人格化有稳定的正向预测作用,子女情况对去人格化维度有稳定的负向预测作用,病人护理方面的工作压力对情感衰竭有正向预测作用。结论不同的个人背景和工作压力源对护士工作倦怠的3个维度具有不同的预测作用,改善相关影响因素,有助于减轻护士的工作倦怠感。     

临床护理人员工作倦怠与家庭功能的相关性研究

目的调查临床护理人员工作倦怠的现状,分析家庭功能与工作倦怠之间的关系。方法采用整群抽样的方法,应用工作倦怠感量表、家庭功能评定量表对165名临床一线护理人员进行调查。结果护理人员的去人性化、个人成就感呈高度倦怠,情绪耗竭呈中度倦怠,家庭总的功能处于健康水平。情绪耗竭与家庭角色呈正相关（P〈0．05）,去人性化与角色、行为控制、总的功能呈正相关（P〈0．01）。结论家庭功能对护士工作倦怠有显著的影响,护理管理者应重视对护理人员家庭的支持,从而预防和降低护理人员的工作倦怠,维护其身心健康。     

护士心理授权与工作倦怠的相关性研究

目的探讨护士心理授权与工作倦怠的相关性。方法选取湖北省襄阳市3所三级甲等综合性医院的437名护士,采用心理授权量表、工作倦怠量表进行调查。结果分层回归表明,心理授权所解释工作倦怠的方差变异量,在情感衰竭、去人格化以及个人成就感3个维度分别为20．2％、13．9％、19．2％,心理授权中的工作意义对情感衰竭、去人格化以及个人成就感3个维度都有显著预测作用,自我效能和工作影响对个人成就感维度有显著预测作用,自主性对情感衰竭维度有显著预测作用。结论心理授权能够有效预测护士工作倦怠,提高护士心理授权水平,对于有效缓解护士工作倦怠具有重要作用。     

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。     

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.     

Job demands-resources, burnout and intention to leave the nursing profession: A questionnaire survey

Objectives

The aims of the paper are to examine the role of burnout in the relationship between stress factors related to nurses’ work and social environment and intention to leave the profession and to investigate the nature of the relationship between burnout and intention to leave the nursing profession.

Background

A postulate of the job demands-resources model is that two distinct yet related processes contribute to the development of burnout. The energetic process originates from demands and is mainly centered on emotional exhaustion; the motivational process originates from resources and is mainly centered on depersonalization. Moreover, we postulated that the two components of burnout are linked indirectly to intention to leave the profession via psychosomatic complaints, associated with the energetic process, and via professional commitment, associated with the motivational process.

Method

The research model was tested on cross-sectional data collected in 2005 from 1636 registered nurses working in hospitals who responded to a self-administrated questionnaire.

Results

Demands are the most important determinants of emotional exhaustion and indirectly induce depersonalization via emotional exhaustion, whereas resources mainly predict depersonalization. Moreover, emotional exhaustion and depersonalization are linked to psychosomatic complaints and professional commitment, which are in turn associated with intention to leave the profession.

Conclusion

The results suggest that a dual strategy is needed in order to retain nurses within the profession: a decrease in job demands, coupled with an increase in available job resources. In particular, nurses’ tasks and role should be restructured to reduce work overload and increase the meaning of their work.     

医护人员职业倦怠与应对方式相关性研究

目的 探讨医护人员职业倦怠和应对方式状况及其相关性,为改善医护人员职业倦怠,提高心身健康水平提供依据.方法 对某示范医院487名医护人员采用职业倦怠问卷通用版和特质应对方式问卷进行测评分析.结果 医护人员职业倦怠总体检出率为14.78%,其中低成就感维度检出率最高(7.39%),其次为情感耗竭(5.75%)、人格解体(3.90%);职业倦怠问卷通用版情感耗竭和低成就感维度评分显著低于Maslach常模(P＜0.01),人格解体维度评分显著高于Maslach常模(P＜0.01);72.07%的医护人员倾向于采用积极的应对方式,但其特质应对方式问卷积极应对维度评分显著低于全国常模(P＜0.01);医护人员职业倦怠者消极应对维度评分显著高于非职业倦怠者(P＜0.01),应对倾向维度评分显著低于非职业倦怠者(P＜0.01),积极应对维度评分与非职业倦怠者比较差异无显著性(P＞0.05);特质应对方式问卷积极应对和应对倾向维度评分与职业倦怠问卷通用版各维度评分呈显著负相关(P＜0.01),消极应对维度评分与职业倦怠问卷通用版各维度呈显著正相关(P＜0.01).结论 医护人员存在一定程度的职业倦怠,个体对应对方式的选择可影响并预测职业倦怠的发生、发展,选择积极应对方式可有效降低职业倦怠的发生率,而选择消极应对方式则容易导致职业倦怠.     

北京市养老院护士工作满意度及其与工作倦怠关系的研究

目的:调查北京市养老院护士工作满意度及工作倦怠状况,并分析二者关系。方法:采用工作满意度量表和工作倦怠问卷,对106名养老院护士进行调查。结果 :养老院护士工作满意度得分为(3.08±0.55)分,对福利待遇和专业发展机会的满意度低;护士在情绪衰竭(55.6%)、工作冷漠感(33.9%)、个人成就感(63.2%)方面处于中高度倦怠;对福利待遇满意度是情绪衰竭的影响因素,被称赞和认可的满意度是工作冷漠感和个人成就感的影响因素,对排班满意度是工作冷漠感的影响因素。结论:养老院护士对福利待遇和专业发展机会的满意度低,普遍存在工作倦怠,应提高其福利待遇,并帮助其做好职业规划。     

Changes in Burnout and Satisfaction With Work-Life Integration in Physicians During the First 2 Years of the COVID-19 Pandemic

ObjectiveTo evaluate the prevalence of burnout and satisfaction with work-life integration (WLI) in US physicians at the end of 2021, roughly 21 months into the COVID-19 pandemic, with comparison to 2020, 2017, 2014, and 2011.MethodsBetween December 9, 2021, and January 24, 2022, we surveyed US physicians using methods similar to those of our prior studies. Burnout, WLI, depression, and professional fulfillment were assessed with standard instruments.ResultsThere were 2440 physicians who participated in the 2021 survey. Mean emotional exhaustion and depersonalization scores were higher in 2021 than those observed in 2020, 2017, 2014, and 2011 (all P<.001). Mean emotional exhaustion scores increased 38.6% (2020 mean, 21.0; 2021 mean, 29.1; P<.001), whereas mean depersonalization scores increased 60.7% (2020 mean, 6.1; 2021 mean, 9.8; P<.001). Overall, 62.8% of physicians had at least 1 manifestation of burnout in 2021 compared with 38.2% in 2020, 43.9% in 2017, 54.4% in 2014, and 45.5% in 2011 (all P<.001). Although these trends were consistent across nearly all specialties, substantial variability by specialty was observed. Satisfaction with WLI declined from 46.1% in 2020 to 30.2% in 2021 (P<.001). Mean scores for depression increased 6.1% (2020 mean, 49.54; 2021 mean, 52.59; P<.001).ConclusionA dramatic increase in burnout and decrease in satisfaction with WLI occurred in US physicians between 2020 and 2021. Differences in mean depression scores were modest, suggesting that the increase in physician distress was overwhelmingly work related. Given the association of physician burnout with quality of care, turnover, and reductions in work effort, these findings have profound implications for the US health care system.     

Attitudes toward patient aggression amongst mental health nurses in the 'zero tolerance' era: associations with burnout and length of experience

UK government policy now officially encourages an attitude of 'zero tolerance' towards aggression against health care staff. This study examines levels of such tolerance amongst a group of mental health care staff and associations between tolerance and other occupational and stress factors. Thirty-seven staff completed a Tolerance Scale (from the Perceptions of Aggression Scale) and the Maslach Burnout Inventory. Tolerance for aggression was higher amongst more experienced staff (P < 0.01) and high tolerance was associated with low emotional exhaustion, low depersonalization and high personal accomplishment (P < 0.01). Some staff endorse positive statements about patient aggression and a tolerant attitude may be linked to low burnout. Nurse attitudes to patient aggression therefore are complex and do not necessarily equate with an approach of 'zero tolerance'.     

Influence of organizational context on nursing home staff burnout: A cross-sectional survey of care aides in Western Canada

PurposeOur study examined care aide characteristics, organizational context, and frequency of dementia-related resident responsive behaviours associated with burnout. Burnout is the experience of emotional exhaustion, cynicism, and professional inefficacy. Care aide burnout has implications for turnover, staff health, and quality of care.Design and methodsWe used surveys collected from 1194 care aides from 30 urban nursing homes in three Western Canadian provinces. We used a mixed-effects regression analysis to assess care aide characteristics, dementia-related responsive behaviours, unit and facility characteristics, and organizational context predictors of care aide burnout. We measured burnout using the Maslach Burnout Inventory, Short Form.ResultsWe found that care aides were at high risk for emotional exhaustion and cynicism, but report high professional efficacy. Statistically significant predictors of emotional exhaustion included English as a second language, medium facility size, organizational slack-staff, organizational slack-space, health (mental and physical) and dementia-related responsive behaviours. Statistically significant predictors of cynicism were care aide age, English as a second language, unit culture, evaluation (feedback of data), formal interactions, health (mental and physical) and dementia-related responsive behaviours. Statistically significant predictors of professional efficacy were unit culture and structural resources. Greater care aide job satisfaction was significantly associated with increased professional efficacy.ImplicationsThis study suggests that individual care aide and organization features are both predictive of care aide burnout. Unlike care aide or structural characteristics of the facility elements of the organizational context are potentially modifiable, and therefore amenable to intervention.     

Burnout contagion among intensive care nurses

AIM: This paper reports a study investigating whether burnout is contagious. BACKGROUND: Burnout has been recognized as a problem in intensive care units for a long time. Previous research has focused primarily on its organizational antecedents, such as excessive workload or high patient care demands, time pressure and intensive use of sophisticated technology. The present study took a totally different perspective by hypothesizing that--in intensive care units--burnout is communicated from one nurse to another. METHODS: A questionnaire on work and well-being was completed by 1849 intensive care unit nurses working in one of 80 intensive care units in 12 different European countries in 1994. The results are being reported now because they formed part of a larger study that was only finally analysed recently. The questionnaire was translated from English to the language of each of these countries, and then back-translated to English. Respondents indicated the prevalence of burnout among their colleagues, and completed scales to assess working conditions and job burnout. RESULTS: Analysis of variance indicated that the between-unit variance on a measure of perceived burnout complaints among colleagues was statistically significant and substantially larger than the within-unit variance. This implies that there is considerable agreement (consensus) within intensive care units regarding the prevalence of burnout. In addition, the results of multilevel analyses showed that burnout complaints among colleagues in intensive care units made a statistically significant and unique contribution to explaining variance in individual nurses' and whole units' experiences of burnout, i.e. emotional exhaustion, depersonalization and reduced personal accomplishment. Moreover, for both emotional exhaustion and depersonalization, perceived burnout complaints among colleagues was the most important predictor of burnout at the individual and unit levels, even after controlling for the impact of well-known organizational stressors as conceptualized in the demand-control model. CONCLUSION: Burnout is contagious: it may cross over from one nurse to another.