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.     

Efficacy of Chinese auriculotherapy for stress in nursing staff: a randomized clinical trial

Objective

this randomized single blind clinical study aimed to evaluate the efficacy of auriculotherapy with and without a protocol for reducing stress levels among nursing staff.

Method

a total of 175 nursing professionals with medium and high scores according to Vasconcelos'' Stress Symptoms List were divided into 3 groups: Control (58), Group with protocol (58), Group with no protocol (59). They were assessed at the baseline, after 12 sessions, and at the follow-up (30 days).

Results

in the analysis of variance, statistically significant differences between the Control and Intervention groups were found in the two evaluations (p<0.05) with greater size of effect indices (Cohen) for the No protocol group. The Yang Liver 1 and 2, Kidney, Brain Stem and Shen Men were the points most used.

Conclusion

individualized auriculotherapy, with no protocol, could expand the scope of the technique for stress reduction compared with auriculotherapy with a protocol. NCT: 01420835     

Long-term effects of a tailored mindfulness-based program for Chinese intensive care unit nurses: A randomized parallel-group trial

AimThis study investigated the direct and long-term improvements that mindfulness-based interventions exert on intensive care unit nurses. We assessed an abbreviated four-week, twice-weekly mindfulness-based intervention program’s effect on work-related mental health variables and examined whether the intervention impact was maintained at two- and six-month follow-up assessments. We also examined the training program’s effects on work and life.BackgroundPrevious research has shown that mindfulness interventions exert positive effects immediately after treatment. However, few studies have examined whether treatment effects are maintained over time or under different circumstances. Moreover, treatment effects among Chinese intensive care unit nurses have rarely been examined.DesignWe conducted a randomized, non-blinded, parallel-group trial.MethodsParticipants included 90 intensive care unit nurses, divided into two cohorts, who participated in the program in October 2016 and April 2017. They completed validated measures of mindfulness, burnout syndromes, anxiety and depressive symptoms and well-being at baseline (T₁), immediately after intervention (T₂), two months after (T₃) and six months after (T₄) the intervention.ResultsWe observed a significant group effect (1) immediately post-intervention and two months after intervention for mindfulness; (2) at two months after intervention for anxiety, depression and subjective well-being and (3) at post-intervention, two months after and six months after for emotional exhaustion.ConclusionsThese findings suggest that the tailored four-week mindfulness-based intervention program improved intensive care unit nurses’ mental health, although further research is needed to verify its feasibility in a clinical working environment.     

Evidence-Based vs Informal Suicide Training: Nurse Confidence and Comfort With Suicidal Patient Care

IntroductionEmergency nurses are on the front line of patient care for suicidal persons, yet many nurses report feeling unprepared to effectively manage suicidal patients owing to a lack of suicide-specific training. The purpose of this study was to examine the suicide-specific training experiences of emergency nurses and evaluate how training relates to burnout, confidence, and comfort working with suicidal patients.MethodsEmergency nurses at critical access and community hospitals completed an anonymous online survey during work hours. The survey included questions about training experiences, burnout, confidence, and comfort working with suicidal patients, perceptions of the quality and interactive nature of training, and desires for future suicide-specific intervention training.ResultsGroup comparisons among the 117 emergency nurses revealed that those who received evidence-based/expert-delivered training reported greater confidence, comfort, and perceived ability to treat suicidal patients and lower burnout than those who received informal or no training. Those with informal training reported greater confidence and ability to treat suicidal patients, but similar levels of comfort and burnout as those with no training. Mediation analyses showed that training was associated with greater comfort working with suicidal patients through its effect on increased confidence. A majority desired additional suicide-specific training.DiscussionEvidence-based/expert-delivered professional training in suicide intervention is associated with improved confidence, comfort, and perceived ability to care for suicidal patients and lower burnout. Providing evidence-based suicide intervention training may improve quality of care for suicidal patients by improving emergency nurse confidence and comfort for treating these high-risk patients.     

Work-Related Psychosocial Hazards Among Emergency Medical Responders (EMRs) in Mansoura City

Purpose:

This research was done to assess levels of psychosocial stress and related hazards [(burnout, depression, and posttraumatic stress disorder (PTSD)] among emergency medical responders (EMRs).

Materials and Methods:

A comparative cross-sectional study was conducted upon (140) EMRs and a comparative group composed of (140) nonemergency workers. The groups studied were subjected to semistructured questionnaire including demographic data, survey for job stressors, Maslach burn out inventory (MBI), Beck depression inventory (BDI), and Davidson Trauma scale for PTSD.

Results:

The most severe acute stressors among EMRs were dealing with traumatic events (88.57%), followed by dealing with serious accidents (87.8%) and young victims (87.14%). Chronic stressors were more commonly reported among EMRs with statistically significant differences (P < 0.05) except for social support with colleagues and supervisors. EMRs had statistically significant higher levels of emotional exhaustion (EE) (20%) and depersonalization (DP) (9.3%) compared with comparative group (4.3%, 1.4% respectively). Also, there was no statistically significant difference between two groups as regards lower personal achievement or depression symptoms (P > 0.05). There was increased risk of PTSD for those who had higher stress levels from death of colleagues [odds ratio (OR) [95% confidence interval (CI)] = 2.2 (0.7-7.6), exposure to verbal or physical assault OR (95% CI) = 1.6 (0.5-4.4) and dealing with psychiatric OR (95% CI) 1.4 (0.53.7) (P > 0.05)

Conclusion:

EMRs group had more frequent exposure to both acute and chronic work-related stressors than comparative group. Also, EMRs had higher levels of EE, DP, and PTSD compared with comparative group. EMRs are in need for stress management program for prevention these of stress related hazards on health and work performance.     

¿Han llegado los millennials a la Facultad de Medicina? Perfil de personalidad de estudiantes de Medicina 1999-2014

ObjectiveMedical training not only requires the acquisition of knowledge and clinical skills, but also the development of attitudes and values, characteristics related to the personality profile. The present study focuses on assessing the personality profile of medical students, in relation to sociodemographic variables and generational change.Material and methodsCross-sectional observational study performed on 675 medical students,from 1999 to 2014. A sociodemographic questionnaire and the NEO-PI-R questionnaireto assess the personality profile was administrated.ResultsIn the present study, the highest mean scores were in the responsibility dimension, followed by kindness and openness to the experience. The lowest was neuroticism. As regards gender, women had higher scores in neuroticism, extraversion, kindness, and responsibility. The millennial students obtained significantly higher scores in the dimension of extraversion, kindness, and responsibility. These students are more assertive, sociable, compassionate, and more likely to fulfil their duty, organisation, order, and self-discipline. But this group also has a higher score in anxiety and obsessive traits, assuming an increased risk of stress and burn-out.ConclusionsSignificant differences have been found in the personality profiles between gender and among the millennial medical students, consistent with the personality profiles described in the literature on the millennium generation.     

我国高校教师职业倦怠的元分析

目的考察高校教师的职业倦怠状况是否随年代变化,为高校和教育主管部门干预职业倦怠提供理论参考。方法通过检索中国知识资源总库-CNKI系列数据库,采用元分析方法对我国教师职业倦怠情况进行研究。结果年代与高校教师职业倦怠的情绪衰竭因子、非人性化因子和低成就感因子呈显著正相关(r=0.11,0.151,0.136;P0.01),年代可以解释3个因子1.2%、2.2%和2.1%的变异;不同性别在职业倦怠的情绪衰竭、去个性化因子上有统计学意义,95%的置信区间分别为(-0.03,-0.02)、(0.06,0.11)和(-0.03,0.02);高校教师与中小学教师相比,情绪衰竭、去个性化和低个人成就感因子差异均有统计学意义,95%的置信区间分别为(-0.08,-0.02)、(-0.03,-0.01)和(-0.04,-0.01);(-0.07,-0.04)、(-0.04,-0.02)和(-0.06,-0.02)。结论高校教师的职业倦怠情况逐年增加;男性教师的去个性化情况较女性教师严重,女性教师的情绪衰竭较男性教师严重;高校教师的职业倦怠显著轻于中小学教师。     

Burnout and Resilience After a Decade in Palliative Care: What Survivors Have to Teach Us. A Qualitative Study of Palliative Care Clinicians With More Than 10 Years of Experience

ContextBurnout is common among palliative care clinicians (PCCs). Resilience helps to reduce burnout, compassion fatigue, and is associated with longevity in palliative care.ObjectivesWe aimed to study PCCs who have remained in the field for longer than 10 years to deepen our understanding on their views on burnout and resilience.MethodsWe conducted a qualitative study using semistructured interviews and purposive sampling on 18 PCCs – five doctors, 10 nurses, and three social workers who worked in various palliative care settings (hospital palliative care team, home hospice, and inpatient hospice). The mean age of the interviewees was 52 years, and the mean number of years practicing palliative care was 15.7 years (range 10–25). The interviews were recorded verbatim, transcribed, and analyzed using a grounded theory approach.ResultsFour major themes emerged from our analysis – struggling, changing mindset, adapting, and resilience. Intervening conditions, such as self-awareness, reflection, and evolution, were also important factors. The core phenomenon of our study was that of transformational growth – a process that PCCs have to go through before they achieve resilience. We also further classified resilience into both personal and collective resilience.ConclusionOur findings highlight the evolving process of transformational growth that PCCs must repeatedly undergo as they strive toward sustained resilience and longevity. It also stresses the importance of taking individual and collective responsibility toward building a culture of personal and team resilience.