北京市三级综合医院产科病房护士角色认知对离职意愿的影响

目的:了解北京市三级综合医院产科护士离职意愿现状,探讨角色认知状况对离职意愿的影响。方法:采用问卷调查法对170名病房护士进行调查研究。结果:北京市三级综合医院产科护士的离职意愿得分处于较高水平;相关分析结果显示:角色冲突和角色模糊与离职意愿呈显著正相关,对工作的期望匹配度与其离职意愿总分呈显著负相关;进一步多元分析显示:角色冲突(β=0.339)、职称(β=-0.218)、期望匹配度(β=-0.165)和薪酬(β=0.162)等4个因素进入方程。结论:北京市三级综合医院产科护士的离职意愿水平较高,护理管理者应关注到这一群体的情况,并应考虑到角色认知等变量对离职意愿的影响,以减轻其离职意愿,稳定产科护士队伍,提高管理水平。     

Assertiveness affecting burnout of novice nurses at university hospitals

Aim: This prospective cohort study aimed to clarify the relationship between the level of assertiveness and the incidence of burnout in novice nurses in their first year at university hospitals and to obtain indices of assertion training in order for them to avoid burnout. Methods: The subjects were 1203 novice nurses working at 20 university hospitals in Japan who gave informed consent to participate in this research. The questionnaires were completed by 949 novice nurses in June 2003, and they were divided into two cohorts to observe the incidence of burnout, which was investigated in June 2004. Results: At the baseline, we obtained responses from 1030 novice nurses (85.6%) who had agreed to join the study. Ninety‐two (20.5%) of the novice nurses experienced burnout and 43 (7.2%) experienced serious burnout. Both high and low levels of assertiveness score tended to high incidence rates of burnout. Multiple logistic regression analyses showed that the factors affecting burnout were lack of senior nursing staff support and very low and low levels of assertiveness, and those affecting serious burnout were male gender, hospital location in Tokyo, and very low and low levels of assertiveness. Conclusions: Novice nurses tend to burn out easily when their assertiveness scores are too low or too high. The ideal value of the assertiveness score seems to be medium.     

肿瘤专科医院护士工作倦怠状况的调查分析

[目的]了解肿瘤专科医院护士工作倦怠状况,分析其人口学因素对工作倦怠的影响。[方法]采用一般人口学资料调查表和Maslach工作倦怠量表(MBI)对496名肿瘤专科医院护士进行护士工作倦怠状况的问卷调查。[结果]肿瘤专科医院护士的工作倦怠中情绪枯竭维度得分为20.78分±9.86分,属于中等倦怠;去人格化倾向维度得分为4.66分±5.05分,属于低度倦怠;个人成就感维度得分33.48分±9.23分,属于高度倦怠,其中去人格化倾向及个人成就感维度均低于Maslach常模(P<0.05);不同劳动人事关系的护士在去人格化倾向维度得分差异有统计学意义(P<0.05);不同职称的护士在个人成就感维度得分差异有统计学意义(P<0.05)。[结论]合同制、初级职称的肿瘤专科医院护士工作倦怠较严重;护理管理者应重视肿瘤专科医院护士的工作倦怠情况,积极改善工作倦怠。     

儿童医院护理人员工作压力源及工作倦怠感的调查

目的了解儿童医院护理人员工作的主要压力源及工作倦怠现状,分析工作压力源对工作倦怠的影响。方法采用便利抽样方法,应用护士工作压力源量表、工作倦怠感量表对某儿童医院758名护理人员进行问卷调查。结果儿童医院护理人员的工作压力主要来自工作量及时间分配、专业及工作和患儿护理方面。儿童医院护理人员的倦怠得分明显高于常模及综合医院护理人员,差异具有统计学意义(P0.01)。回归分析显示,工作压力源是影响工作倦怠的重要因素。结论医院及护理者应根据儿童医院护理人员工作压力源及工作压力倦怠感的关系,采取积极措施加以干预,保障护理人员的身心健康。     

医护人员时间管理倾向工作家庭冲突与工作倦怠相关性研究

目的 探讨医护人员时间管理倾向、工作一家庭冲突和工作倦怠的关系.方法对141名医护人员采用时间管理倾向量表、工作一家庭冲突量表和工作倦怠问卷进行测评分析.结果 医护人员工作一家庭冲突量表、工作倦怠问卷评分均与时间管理倾向总分及目标设置、时间安排、时间自控维度评分呈显著负相关(P<0.05或0.01),工作一家庭冲突量表与工作倦怠问卷评分呈显著正相关(P<0.01);时间管理倾向与工作一家庭冲突对工作倦怠有显著预测作用(F=60.720,P<0.01);工作-家庭冲突在时间管理与工作倦怠之间起完全中介作用.结论 提高医护人员时间管理倾向水平,能够降低工作、家庭冲突,有效地预防和缓解工作倦怠.     

Determinants of moral distress in medical and surgical nurses at an adult acute tertiary care hospital

AIM: To determine the prevalence and contributing factors of moral distress in medical and surgical nurses. BACKGROUND: Moral distress from ethical conflicts in the work environment is associated with burnout and job turnovers in nurses. METHOD: A prospective cross-sectional survey using the Moral Distress Scale tool was administered to medical and surgical nurses at an adult acute tertiary care hospital. RESULTS: The survey was completed by 260 nurses (92% response rate). The intensity of moral distress was uniformly high to situations related to physician practice, nursing practice, institutional factors, futile care, deception and euthanasia. Encounter frequencies for situations associated with futile care and deceptions were particularly high. Encounter frequencies increased with years of nursing experience and caring for oncology and transplant patients. CONCLUSION: Moral distress is common among nurses in acute medical and surgical units and can be elicited from different types of situations encountered in the work environment. Nursing experience exacerbated the intensity and frequency of moral distress. IMPLICATIONS FOR NURSING MANAGEMENT: Strategies aimed to minimize exposure to situations of moral distress and augment mechanisms mitigating its effect on nurses are necessary to enhance job satisfaction and retention.     

肿瘤医院护士心理授权和工作疲溃感的相关性研究

目的探讨心理授权对肿瘤医院护士工作疲溃感的影响。方法采用心理授权量表和工作疲溃感量表对668名肿瘤医院临床护士进行调查。结果肿瘤医院护士的心理授权总分为(3.75±0.54)分,工作疲溃感总分为(63.24±8.57)分;护士心理授权中工作自主性和自我效能两个维度是肿瘤医院护士工作疲溃感的主要影响因素(R~2=0.274)。结论肿瘤医院护士的心理授权水平较低,工作疲溃感程度较重,护理管理者应当采取适当措施提高护士心理授权水平可以有效缓解护士工作疲溃感。     

心血管疾病专科医院护士工作倦怠及相关因素分析

目的调查心血管疾病专科医院护士工作倦怠状况,指导临床护理管理。方法选取某二级甲等心血管疾病专科医院护-：100名作为调查对象,应用工作倦怠量表进行调查。结果护士轻度、中度和重度工作倦怠检出率分别为24．00％、64．00％和8．00％。年龄36～45岁组护士的耗竭得分高于其他年龄组（P〈0．05）;工作年限16—25年组护士的耗竭得分高于其他组（P〈0．05）;本科护士成就感降低得分高于大专、中专护士（P〈0．05）;已婚护士的耗竭得分高于未婚护士（P〈0．01）。结论心血管疾病专科医院护士存在工作倦怠,管理者及护士本身应采取相应措施,提高心血管疾病专科医院护士的工作积极性,从而提高临床护理质量。     

Relationship between stress coping and burnout in Japanese hospital nurses

Aim  The purpose of this study was to examine the relationship between stress coping and burnout in Japanese hospital nurses.
Background  Findings on effective stress management training are required in order to reduce nurse's stress and prevent it from becoming chronic.
Methods  The study included 1291 nurses who completed the General Coping Questionnaire and the Japanese version of the Maslach Burnout Inventory-General Survey. The data were analysed using structural equation modelling.
Results  In women, a frequent use of cognitive reinterpretation predicted low exhaustion and cynicism and high professional efficacy. In men, a frequent use of problem solving predicted low cynicism and high professional efficacy. Although for women, a frequent use of problem solving predicted high professional efficacy that was similar to men, there was also a concurrent high exhaustion.
Conclusion  These findings suggested that enhancement of cognitive coping skills for women and problem-solving skills for men could contribute to a reduction of burnout in nurses.
Implications for nursing management  Our findings suggested that effective intervention strategies in order to prevent hospital nurse's stress from becoming chronic might be different between men and women. This difference should be taken into account in nursing management.     

肿瘤医院护士感知组织氛围对职业倦怠的影响

目的了解肿瘤医院护士感知组织氛围与职业倦怠现状,并探讨二者之间的关系。方法对560名肿瘤医院护士运用护理组织氛围量表和职业倦怠普适量表进行调查。结果肿瘤医院护士感知组织氛围得分为(3.46±0.49)分,职业倦怠得分为(4.26±0.64)分;感知组织氛围中人际和谐、支持认同和关心员工3个维度是护士职业倦怠的主要影响因素(P0.01或P0.05)。结论肿瘤医院护理管理者应着重创造良好的组织氛围,降低临床护士职业倦怠水平,提高护理服务质量。     

Occupational burnout in nurses:a concept analysis

Objective:This paper aims to clarify the concept of occupational burnout(OB)as well as develop appropriate methods to relieve or prevent OB in the nursing profession.Methods:Walker and Avant's eight-step approach of concept analysis was applied.Results:OB was defined as a chronic form of work-related stress.Accurately,it was characterized by emotional exhaustion,depersonalization/cynicism,and reduced personal accomplishment/inefficacy.Antecedents of burnout included(a)demographic characteristics;(b)chronic exposure to work-related stressors;(c)quantitative and qualitative job demands;(d)lack of job resources;and(e)personality traits.Consequences involved(a)individual’s unfavorable quality of life;(b)negative impact on the organization;and(c)poor services quality.Although the Maslach Burnout Inventory(MBI)is perceived as an ideal tool to measure burnout and hence,it is used worldwide,whether this instrument fits to measure this concept for nurses has still not yet been verified and thus further research is needed.Conclusions:By proposing a comprehensive definition of the concept,this analysis contributes to recognition of the process of OB of nurses.All nurses are vulnerable to OB.Hence,burnout in nursing needs to be recognized as a critical factor in the delivery of safe patient care.It proposes that the prevention of OB would be achieved through team communication training,mindfulness group,education,etc.     

Role stress and role ambiguity in new nursing graduates in Australia

The first few months of nursing have the potential to be the most challenging and stressful for new nursing graduates. The purpose of the present study was to examine sources of, and changes in, role stress 2-3 months after employment, and 11-12 months later in new graduate nurses. This study also investigated the relationship between job satisfaction and role stress. A factor analysis demonstrated that role ambiguity was the most salient feature of role stress in the first few months, while 10 months later, role overload was the most important factor explaining variance in role stress scores. There was no significant change in role stress scores over time. For the first survey, job satisfaction was significantly negatively correlated with role ambiguity and role stress. In the second survey there was still a significant negative correlation between role ambiguity and job satisfaction, but no significant correlation between role overload and job satisfaction. The findings are discussed in terms of implications for nursing education, practice and future research.     

Effort–reward imbalance and burnout among German nurses in medical compared with psychiatric hospital settings

The aim of this study was to investigate whether nurses' efforts and rewards, as well as the effort–reward imbalance (ERI) and burnout, differ between subjects working in psychiatric vs. medical hospitals and between nurses under education and examined nurses respectively. Furthermore, the relationship between ERI and burnout was evaluated. Nursing is associated with high levels of emotional strain and heavy workloads. Burnout and a negative ERI can result in high absenteeism and turnover and have been identified as reasons why nurses leave their profession. In the last decade, working conditions of the nursing profession have changed in Germany, but somatic and psychiatric hospitals developed in different ways. This development may lead to different profiles. A sample of 389 nurses (78.8% female) in four German hospitals was investigated. A total of 147 nurses worked in psychiatric hospitals and 236 nurses worked in medical (somatic) hospitals. Fifty participants were still under education. The Effort–Reward Imbalance Inventory measures effort, reward and overcommitment at job and provides an imbalance score between effort and reward. The Maslach Burnout Inventory with the subscales, emotional exhaustion, lack of accomplishment and depersonalization, was also used. Nurses working in medical hospitals reported more burnout and had higher ERI scores. Subjects under education were comparable to examined nurses in terms of burnout but had lower ERI scores. Multiple regression analyses showed all ERI scales to be significant predictors for emotional exhaustion, while age, field of work and educational status further predict effort or ERI respectively. At present, the working situation of nurses in different settings appears to be characterized by a perceived imbalance of effort and reward and is associated with a high risk of developing burnout symptoms.     

The psychosocial work environment and burnout among Swedish registered and assistant nurses: the main, mediating, and moderating role of empowerment

The aim of the present study was to explore: the main effect of empowerment on burnout; empowerment as a mediator between the work environment and burnout; and empowerment as a moderator of the association between the work environment and burnout. In order to explore these effects, multiple regression analyses were performed on questionnaire data from 838 registered nurses and 518 assistant nurses in Sweden. The analyses showed that: empowerment has a negative association to burnout; empowerment has a mediating effect between the work environment (especially for control and social support) and burnout; and the moderating effect of empowerment on the association between the work environment and burnout was weak. The results suggest that: empowerment explains variation with regard to burnout over and above what can be explained by established work situation dimensions; the improvement of the work environment is associated with a higher sense of empowerment which, in turn, is related to lower degrees of burnout; and individual and group differences should be considered in workplace health promotion.     

护士长在防范护患纠纷中的角色及要求

角色是描述一个人在某种位置或状况下被他人期望的行为总和,认识护士长在防范护患纠纷中的角色及要求,有助于护士长更好地发挥 作用,增强防范效果。护士长在防范护患纠纷中有4种角色:①护患矛盾的预见者和转化者;②护理安全质量管理制度的细化者和监督者; ③护患关系健康发展的引导者和关爱氛围的主要营造者;④护理法律、法规的宣传者和保全护理证据的责任人。     

手术室护士工作倦怠症影响因素及干预研究

目的探讨手术室护士工作倦怠症的影响因素及干预效果。方法选择203名护士作为研究对象,采用疲劳量表-14和职业倦怠量表评价干预前后护士躯体、脑力疲劳得分以及倦怠程度。结果干预前后手术室护士脑力疲劳以及躯体疲劳得分均差异显著(P0.05);干预前后的工作倦怠量表三个维度评分之间存在显著差异(P0.05)。结论有效的护理干预手段可以激发手术室护士的工作热情,从而减少和避免工作倦怠症的发生。