A systematic review of stress and stress management interventions for mental health nurses

BACKGROUND: Health care professionals in the United Kingdom (UK) appear to have higher absence and sickness rates than staff in other sectors, and stress may be a reason for nurses leaving their jobs. These problems need to be addressed, particularly in the mental health field, if current service provision is to be maintained. AIM: The aim was to identify stressors, moderators and stress outcomes (i.e. measures included those related to stress, burnout and job satisfaction) for mental health nurses, as these have clear implications for stress management strategies. METHOD: A systematic review of research published in English between 1966 and 2000 and undertaken in the UK that specifically identified participants as mental health nurses was carried out to determine the effectiveness of stress management interventions for those working in mental health nursing. Studies from non-UK countries were examined as potential models of good practice. The study was limited to primary research papers that specifically involved mental health nurses, where the health outcomes measured were stressors, moderators and stress outcomes and where sufficient data was provided. RESULTS: The initial search identified 176 papers, of these 70 met the inclusion criteria. Seven studies have been reported since the completion of the review and have been included in this article. Sixty-nine focused on the stressors, moderators and stress outcomes and eight papers identified stress management techniques. Relaxation techniques, training in behavioural techniques, stress management workshops and training in therapeutic skills were effective stress management techniques for mental health nurses. Methodological flaws however, were detracted from the rigour of many of the studies. CONCLUSIONS: The review demonstrated that a great deal is known about the sources of stress at work, about how to measure it and about the impact on a range of outcome indicators. What was found to be lacking was a translation of these results into practice, into research that assessed the impact of interventions that attempt to moderate, minimize or eliminate some of these stressors.     

重症监护室护士工作压力调查

目的了解重症监护室（ICU）护士工作中主要的压力源及主要的工作压力,为护理管理者有效地帮助ICU护士减轻工作压力提供依据。方法采用问卷调查法对87名ICU护士、83名病房护士的工作压力进行调查分析。结果在护理专业及工作方面的问题、工作量及时间分配问题和患者护理方面的问题有明显差异;主要工作压力均比病房护士高;工作压力随工龄增加明显升高。结论建议管理者减少或消除护士压力源,并对护士进行业务培训和心理压力承受训练,减轻ICU护士各方面负担,提高工作效率。     

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.     

新入职护士参加CCU规范化培训的现况调查及分析

目的了解新入职护士参加CCU规范化培训的现状及影响因素。方法 2015年7月至2016年7月对109名新入职临床护士进行问卷调查。结果新入职护士参加CCU规范化培训现状总分为(70.36±9.48)分,年龄、学历为主要影响因素。结论新入职护士参加CCU规范化培训现状处于中等水平,建议依据影响因素分析进行干预,制订一套科学的新护士规范化培训体系,提高新入职护士的满意度与稳定性,提升护理质量。     

应用岗前培训创新体系提高新护士岗位胜任力的效果评价

目的探讨岗前培训创新体系对新护士岗位胜任力的应用及效果。方法应用随机数字表法将220名新入职护士分为对照组和实验组各110名。对照组采用常规岗前培训,实验组采用岗前培训创新体系,培训结束后对两组新护士进行理论、操作考核成绩比较;采用新护士岗位胜任力基线调查表对两组护士岗位胜任力进行比较。结果实验组护士考核成绩高于对照组(P0.01或P0.05);岗位胜任力总均分高于对照组(P0.01)。结论创新模式下的岗前培训体系是一种新模式,其更适应现代护理学科发展需要,对提高新护士岗位胜任力,具有较强的应用性。     

Disordered eating and job stress among nurses

Aim  The purpose of this study was to examine disordered eating behaviours among nurses in the state of Ohio.
Background  Individuals involved in disordered eating tend to report more frequent and higher levels of perceived stress than their counterparts. As nurses regularly perform stressful roles and responsibilities within a high-stress environment, this group may be at elevated risk of disordered eating.
Method  A 65-item survey was mailed to a random sample of 1000 nurses in the state of Ohio.
Results  A total of 435 nurses (47%) returned completed surveys. Most (93%) were registered nurses (RNs) and 87% were over 31 years old. Results indicated that disordered eating differed significantly based on perceived job stress and perceived body satisfaction. Nurses with high levels of perceived job stress and low levels of body satisfaction had higher disordered eating involvement.
Conclusions  Nurses reporting high levels of job stress are at increased risk of disordered eating behaviours. Recommendations for future research are offered.
Implications for nursing management  Employee wellness programmes should be developed that educate and support nurses to make healthy lifestyle choices.     

手术室护士规范化岗位培训及资格认证实践

目的加强手术室护理人员的专科理论知识和技术能力,规范手术室护理操作,强化职业意识,提高手术室护理质量及服务质量,为专科护士进一步发展奠定坚实的基础。方法通过科内集中培训和个人自学理论知识,技能操作采取演示、示教、考核等形式,对56名从事手术室工作10年以内的护理人员进行为期半年的手术室理论知识和技能操作培训,考核合格者颁发证书。结果 56名学员通过考核,获得手术室"院级岗位资格认证书"。结论经过半年多的实践和探索,强化了手术室护士的专科理论知识及相关知识,规范了专科基本技能和核心技能操作,提高了手术室专科水平及服务质量,减少了医护矛盾,完善了手术室护理临床教学体系,培养了一批基础扎实、技术过硬的手术室专业人员,是一种值得探索的手术室护士培养模式。     

高端人群健康管理护理人员岗位培训的效果

目的 探讨高端人群健康管理护理人员岗位培训的方法与效果.方法 对护理人员进行为期3个月的知识培训、技能培训及规范化礼仪培训.结果 实施岗位培训后,护理人员的主动服务意识、医师、患者满意度及理论成绩和操作技能均提高（P＜0.01）.结论 高端人群健康管理护理人员岗位培训,可提高护理人员综合素质,更加胜任高端人群健康管理工作,促进高端人群护理管理工作的发展.     

县级医院骨干护士培训的实践与思考

加强县级医院骨干护士培训,可以有效改善护士队伍的人才结构,促进护理观念、知识和技能的更新,改变基层医院护理发展滞后的现状,为人民群众提供更加优质、高效的护理服务。我院从2011年开始承担县级医院骨干护士培训项目,共培养了262名县级医院骨干护士,为其提供了良好的学习平台,全面提升了学员综合素质,带动了县级医院护理服务水平的提高,为进一步加强湖南省县级医院护理能力及人才建设,起到了很好的指导、推动和示范作用。     

护士个性化在职培训及管理的实践与效果

目的探索护士有效的在职培训及管理方法。方法根据卫生部及省卫生厅护士在职培训要求,结合护士培训需求问卷调查,制订护士的个性化在职培训计划并组织实施。比较实施前后两组护士对培训满意度、护士专业素质及工作质量考核指标及患者对护理服务满意度差异。结果实施个性化在职培训后护士对培训满意度、护士专业素质及工作质量考核指标及住院患者对护理服务满意度均较实施前提高(P0.01)。结论护士个性化在职培训及管理的方法切实可行,易于落实,可提高护士对培训的满意度、护士专业素质及工作质量、患者对护理工作的满意度,也提高了护士对培训的依从性。     

新护士岗前培训方法的探讨及效果评价

目的探讨新护士岗前规范化培训的方法及效果。方法对135名新护士进行规范化的岗前培训,即在传统培训方法基础上增加了情感教育、团队文化教育、护理法律法规教育和护理安全教育。结果新护士对岗前培训课程满意度均在94．8％以上,其中对老师专业背景及课程内容结构的满意度最高,为98．5％。岗前培训前后新护士理论及技能考核成绩比较,均P〈0．05,差异具有统计学意义。结论新护士岗前规范化培训有利于新护士尽快适应临床环境,促进新护士的专业成长与发展。     

分级管理模式下主管护士培训需求调查分析

目的:了解目前主管护士对培训的需求情况,为主管护士培训课程的设置提供依据。方法:采用自行设计的主管护士培训需求调查问卷,对该院的175名主管护士进行调查。结果:主管护士对培训内容中操作技能、教学能力和理论知识的需求程度较高,在需求程度上不同学历、职称、科室的人员有统计学差异(P<0.05)。结论:根据调查结果应对主管护士进行有计划、有目的、有针对性的培训,帮助她们更好地完成临床护理工作,提高整体护理质量。     

护士职业认同感、工作压力和满意度及离职意愿调查

目的：了解北京市护士的职业认同感、工作压力和满意度及离职意愿状况。方法：采用方便抽样法抽取北京市19家不同级别医院的1272名护士,用自行设计的护士职业认同感、工作压力和工作满意度及离职意愿问卷对其进行调查。结果：1272名护士认为目前护士的社会地位平均分为36．5±19．7分（中位数为35．0）,27．8％的护士感觉患者对护士比较尊重或非常尊重,57．2％的护士认为工作压力较大或很大,压力来源主要为职业风险高、工作强度大、社会评价不高,30．7％的护士对工作比较满意或非常满意,不满意的原因主要为收入低、职业风险高、工作强度大;35．2％的护士表示不愿意继续从事护理工作,原因主要为收入低、职业风险高和工作强度大;多元线性逐步回归显示护士职业认同的影响因素有护龄和学历,工作压力的影响因素有婚姻状况和医院级别,工作满意度的影响因素有医院级别、职称和职务;Logistic回归显示护士离职意愿的影响因素为医院级别。结论：目前北京市护士的职业认同感评分低,工作压力大,工作满意度低,离职意愿强烈;相关管理部门应采取有效措施,减轻护士工作压力,提高护士工作满意度和职业认同感,减少有离职意愿护士的数量,以稳定护士队伍,保证临床护理质量。     

精神科男护士焦虑抑郁情绪与工作压力相关性研究

目的 探讨精神科男护士焦虑抑郁情绪与工作压力的相关性,为制定干预措施提供依据.方法 对100名精神科临床男护士采用焦虑自评量表、抑郁自评量表和护士工作压力源量表进行测评分析.结果 精神科临床男护士焦虑、抑郁情绪检出率分别为52.0%、39.0%;有焦虑、抑郁情绪的男护士工作压力源量表各维度评分均显著高于无焦虑、抑郁情绪者(P＜0.05);男护士焦虑自评量表评分与工作压力源量表各维度评分均呈显著正相关,抑郁自评量表评分与工作压力源量表专业及工作、时间及工作量、环境及资源、患者护理4个维度评分呈显著正相关(P＜0.05).结论 精神科男护士焦虑抑郁情绪检出率高,其焦虑抑郁情绪与护理工作压力密切相关,应引起管理者的重视.