A comparative study of organisational characteristics, work characteristics and nurses' psychological work reactions in a hospital and nursing home setting

OBJECTIVES: The aim of the current study was twofold. First, we explored whether there were any differences concerning organisational characteristics, work characteristics and psychological work reactions in two types of health care setting, hospitals and nursing homes. Second, it was investigated and validated whether relationships between organisational characteristics, work characteristics and psychological work reactions found in research on hospital nursing are also present in nursing homes. METHODS: The variables were assessed by questionnaires that were distributed among nurses and caregivers in 15 randomly selected general hospitals and 14 nursing homes in the Netherlands. Manova and hierarchical regression analyses were carried out to explore differences in the variables and in relationships between the variables. RESULTS AND CONCLUSION: Results show that the major difference in hospital-based and nursing home practice is in the work organisation as assessed by the organisational characteristics "environmental uncertainty" and "decision authority". Relations found between variables are in majority in line with the JDC-model and confirm the applicability of this theory in different types of health care settings.     

Factor structure of the Maslach Burnout Inventory among Finnish nursing staff

The purpose of the study was to investigate the factor structure of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) among Finnish nursing staff. Although the factorial validity of the MBI-HSS has been studied across different countries, the factor structure has never been investigated among Finnish nursing staff. The data were gathered by postal questionnaires from nursing staff working in health-care organizations around Finland. The sample consisted of 627 nurses and nurse managers. The factor structure was studied by using exploratory and confirmatory factor analysis. The fit of the hypothesized three-factor model to the data was superior to the alternative one-factor and two-factor models. The three-factor structure (emotional exhaustion, depersonalization, reduced personal accomplishment) showed the best fit, while the internal consistencies of the subscales were satisfactory. The MBI-HSS is a highly suitable instrument for measuring burnout among nursing staff and it is very applicable to Finnish health-care research.     

The association between burnout and physical illness in the general population--results from the Finnish Health 2000 Study

OBJECTIVE: The association between burnout and physical diseases has been studied very little. The purpose of this study was to examine the relationship between burnout and physical illness in a representative nationwide population health study. METHODS: As a part of the "Health 2000 Study" in Finland, 3368 employees aged 30-64 years were studied. Burnout was assessed with the Maslach Burnout Inventory-General Survey. Physical diseases were diagnosed in a comprehensive health examination by research physicians. RESULTS: Physical illness was more common among subjects with burnout than others (64% vs. 54%, P<.0001), and the prevalence of diseases increased with the severity of burnout (P<.0001). Burnout was an important correlate of cardiovascular diseases among men (OR=1.35; 95% CI, 1.13-1.61) and musculoskeletal disorders among women (OR=1.22, 95% CI, 1.07-1.38) when adjusted for age, marital status, education, socioeconomic status, physical strenuousness of work, smoking, physical activity, alcohol consumption, body mass index, and depressive symptoms. The prevalence of musculoskeletal disorders and cardiovascular diseases increased with the severity of all three dimensions of burnout, that is, exhaustion (P<.0001 and P<.001, respectively), cynicism (P=.0001 and P<.001, respectively), and lack of professional efficacy (P<.01 and P<.0001, respectively). CONCLUSIONS: Burnout is associated with musculoskeletal diseases among women and with cardiovascular diseases among men. These associations are not explained by sociodemographic factors, health behavior, or depression. Physical illnesses are associated with all three dimensions of burnout and not only with the exhaustion dimension. In the future, the causal relationships between burnout and physical diseases need to be investigated in prospective studies.     

Academic report on burnout among Japanese nurses

Aim: Japanese nurses have increasingly experienced “burnout” in the past several years. Studies on Japanese nurses are required in order to explore how to prevent nursing burnout. The objectives of this report were to: (i) introduce the concept, definition, and measurement of burnout; (ii) look at an overview of the prevalence, possible causes, and consequences of burnout among Japanese nurses; and (iii) explore how to prevent burnout among nurses. Methods: The authors and co‐researchers have been studying burnout among Japanese workers for more than 15 years. Therefore, previously performed studies were reviewed and summarized. Results: In Japan, approximately 36% of human services professionals, such as nurses, were burned out compared to 18% of civil servants, and 12% of company employees. It was quite obvious that nurses are prone to burnout. The possible causes and consequences of burnout among Japanese nurses were reviewed. Excessive workloads and interpersonal conflict in the workplace were possible causes of burnout among Japanese nurses. The consequences of nurse burnout are potentially very serious, including medical accidents/errors. Issues to prevent nursing burnout were then reviewed. Enhancement of cognitive coping skills for female nurses and problem‐solving skills for male nurses could contribute to prevention of burnout in nurses. Conclusion: The authors' previous study revealed that the new model of the organizational context of burnout developed by Leiter and Maslach could be applied to Japanese. Further examination is needed. This report supports the call to scale up burnout prevention strategy for Japanese nurses.     

Therapeutic orientations,professional efficacy,and burnout among substance abuse social workers in Israel

This study investigates the therapeutic orientations of substance abuse social workers and the relationship between these orientations and burnout. Ninety-two social workers who provided outpatient treatment to people suffering from substance-related disorders in Israel participated in the study. The results obtained demonstrated that the substance abuse social workers adhere more to the psychodynamic and ecosystemic therapeutic orientations than to the cognitive–behavioral orientation. A greater adherence to the cognitive–behavioral orientation was associated with a higher sense of professional efficacy; a greater adherence to the psychodynamic orientation was associated with a higher level of exhaustion; and greater adherence to the ecosystemic orientation was associated with lower levels of exhaustion and cynicism. Female social workers reported lower levels of exhaustion and cynicism. The cognitive–behavioral orientation mediated the connection between the social workers' experience in the field of substance abuse and two dimensions of burnout—exhaustion and professional efficacy. Significance of the findings for improving the well-being of substance abuse social workers and for the advancement of psychosocial services is discussed.     

如何破解医生的“职业倦怠症”

职业倦怠症困扰着医生,不少医生在职业压力的紧迫之下,有极端不良反应。医生心理健康问题已成为当前我国医生的普遍性问题,认知结构重组,有效时间管理,身体健康措施,社交技能提高,不断学习进取,精神恢复疗法等可以有效缓解医生职业倦怠。     

护士工作压力源及工作疲溃感的调查研究

目的 :了解护士工作的主要压力源及工作疲溃感 ,并明确压力源与工作疲溃感之间的关系 ,以帮助管理层及护士本人正确的认识工作压力 ,设法减少工作压力 ,从而提高护士的工作效率及护理质量。方法 :采用问卷调查法 ,对西安市 4所教学医院临床护士的工作压力源、工作疲溃感以及他们之间的关系进行了探讨。结果 :临床护士的工作压力源依次为 :护理专业及工作方面的问题 ;工作量及时间分配问题 ;环境及资源方面的问题 ;病人护理方面的问题 ;管理及人际关系方面的问题。工作高度疲溃感的护士占 5 9.1% ,工作压力源与工作疲溃感之间呈显著性相关。结论 :建议从管理角度减少或消除护士工作压力源 ,并对护士进行减轻工作压力的训练     

北京市某医院结核科护士压力源调查分析

目的 对结核科护士工作压力源进行调查分析.方法 自行设计调查问卷,采用便利抽样方法,对首都医科大学附属北京胸科医院88名结核科护士工作压力源进行调查.结核科护士平均年龄为（33.04±9.07）岁,工作年限（12.70±9.04）年,每月夜班数（4.25±2.25）个.本研究结核科护士工作压力源问卷分为8个维度,共有61个条目,采用分量法计分.其中,没有压力1分,压力程度一般为2分,压力程度较高为3分,压力程度非常高为4分,可能的得分范围为61～244分,分数越高,表明护士所承受的压力越大.采用问卷调查法,调查前向被调查者说明调查的目的、方法,取得知情同意.由研究者亲自发放调查问卷,30 min后当场收回.本次共发放问卷90份,回收88份,有效88份,有效回收率97.8％.结果 （1）结核科护士压力源总体得分为（154.81±36.03）分.（2）压力源各维度得分从高到低依次是：结核护理专业特殊性的问题（3.07±0.81）分;工作环境及资源方面的问题（2.88±0.81）分;工作量及时间分配问题（2.67±0.78）分;社会环境带来的问题（2.63±0.78）分;护理专业发展方面的问题（2.55±0.74）分;患者护理方面的问题（2.52±0.68）分;护理专业及工作方面的问题（2.45±0.74）分;管理及人际关系方面的问题（1.89±0.64）分.（3）得分排在前10位的压力源条目分别是：长期接触排菌、耐药肺结核患者（3.55±0.78）分;担心自己患上结核病（3.47±0.88）分;同伴被确诊患上结核病（3.36±0.89）;担心消毒防护设施的效果（3.28±0.94）分;担心工作中出现差错事故（3.21±0.95）分;工作环境差（3.18±0.92）分;病区拥挤（3.02±1.07）分;收入差距大（2.98±0.94）分;工作量太大（2.97±0.94）分;经常倒班（2.94±1.03）分.结论 结核科护士承受着较高的工作压力,护理管理者应采取有针对性的措施,指导护士积极应对,减轻护士工作压力.     

太原市三甲医院麻醉医生职业倦怠及相关因素分析

目的了解麻醉医生职业倦怠现状及职业倦怠与年龄、学历、工龄、性别的关系。方法采用马斯勒职业倦怠量表,对78名麻醉医生进行调查。结果麻醉医生的情绪衰竭和去人性化明显高于国内常模,低成就感明显低于国内常模。年龄与职业倦怠成负相关;学历高者情绪衰竭和去人性化要高于学历低者;工龄短者在情绪衰竭和去人性化要高于工龄长者。结论麻醉医生职业倦怠较严重。应重点关注学历高、工龄短的麻醉医生,以提升医疗质量,缓解医患矛盾。