“后疫情时期”武汉市某三甲医院护理人员创伤后应激障碍、职业倦怠与离职倾向分析

  目的  分析“后疫情时期”护理人员创伤后应激障碍、职业倦怠情况和离职倾向。
  方法  便利抽取武汉市某三甲医院护理人员299名,采用一般资料问卷、创伤后应激障碍量表平民版（PCL-C）、职业倦怠量表（MBI）、护士离职倾向量表（TIQ）调查护理人员的人口学特征及创伤后应激障碍、职业倦怠与离职意愿情况,采用多元线性回归分析护理人员离职倾向的影响因素。
  结果  护理人员创伤后应激障碍阳性症状检出率为39.1%。职业倦怠量表中,87.2%的护理人员存在不同程度的情感耗竭,82.6%的护理人员存在不同程度的去人格化,83.9%的护理人员存在不同程度的个人成就感低下。护士离职倾向量表得分显示,25.8%的护理人员离职倾向较低,60.2%的离职倾向较高,13.0%的离职倾向很高。多元线性回归结果显示:工作年限、用工类型、情感耗竭、去人格化能够解释护士离职倾向的27.9%,其中工作年限越长、合同制的护理人员有较低的离职倾向;情感耗竭与去人格化对离职倾向有正向影响（调整R2=0.279,F=29.891,P < 0.01）。
  结论  该三甲医院护理人员存在创伤后应激障碍和职业倦怠,且离职倾向较高;创伤后应激障碍与职业倦怠是离职倾向的影响因素。护理管理部门应该关注护士的身心健康,及时给予心理干预,注重人文关怀。
     

Prevalence of dietitian burnout

Background: Burnout is the result of unmanaged stress that has been shown to affect those working in the healthcare professions. Although much research has been conducted on burnout among nurses, physicians and other health professionals, there is limited documentation on the phenomenon among dietitians. The purpose of this study was to establish the prevalence of burnout among dietitians in Ontario, Canada, determine the demographic variables associated with burnout, and compare these results with burnout data for other healthcare professionals. Methods: The Maslach Burnout Inventory–Human Services Survey and a demographic questionnaire were emailed to registered dietitians. Results: The dietitians surveyed experienced a moderate amount of emotional exhaustion (mean = 19.96), a low level of depersonalisation (mean = 4.31) and a moderate sense of personal accomplishment (mean = 38.61). Statistically significant relationships were found between years as a dietitian and personal accomplishment (r = 0.16; P = 0.05), age and personal accomplishment (r = 0.15; P = 0.01), hours worked per week and emotional exhaustion (r = 0.17; P = 0.01) and hours worked per week and depersonalisation (r = 0.14; P = 0.01). There were no significant differences in mean burnout scores across the five areas of practice. Over 57% of dietitians had scores indicative of moderate to high levels of burnout overall. Conclusions: Although dietitians have lower levels of burnout compared to other healthcare professionals, moderate levels of emotional exhaustion and only moderate levels of personal accomplishment remain workplace issues for this professional group.     

Psychometric properties of a Dutch version of the Maslach Burnout Inventory General Survey (MBI‐DV) in individuals with and without clinical burnout

Psychometric properties of the Dutch version of the Maslach Burnout Inventory General Survey, the MBI‐DV, were examined in individuals with and without clinical burnout. The factor structure, the utility of the MBI‐DV as a screening instrument in addition to a clinical interview for diagnosing clinical burnout, as well as construct validity and reliability (internal consistency) were investigated. Individuals underwent a clinical interview and completed the MBI‐DV as well as the Symptom Checklist (SCL‐90). Confirmatory factor analysis, correlational analyses, and Cronbach alphas were computed and used to examine the objectives of the present study. A three‐factor model of the MBI‐DV best fitted the data in both individuals with and without clinical burnout. The Emotional Exhaustion subscale was highly associated with clinical diagnosis of burnout even when controlling for depression and general psychopathology. Construct validity of the MBI‐DV was supported by modest correlations with the SCL‐90 and subscales of the MBI‐DV showed good internal consistency in individuals with and without clinical burnout. The MBI‐DV is a valid and reliable multidimensional construct of which the Emotional Exhaustion subscale may be particularly useful as a screening tool in addition to a clinical interview for determining the presence of clinical burnout. Copyright © 2004 John Wiley & Sons, Ltd.     

重型颅脑损伤患者早期康复护理效果分析

目的探讨对重型颅脑损伤患者拟定早期康复护理方案应用于术后偏瘫肢体护理中的可行性。方法选择本院2016年9月—2018年9月收治的100例重型颅脑损伤患者作为实验对象;数字奇偶法分组后探究每组拟定的术后偏瘫肢体护理方案;比照组(50例):拟定传统常规护理干预方案展开;试验组(50例):拟定传统常规护理干预方案+早期康复护理干预方案展开;就组间改良巴氏指数(Modified Barthel Index,MBI)评分以及总并发症比例展开对比。结果护理前,试验组重型颅脑损伤患者MBI评分同比照组比较差异无统计学意义(P>0.05);护理后,试验组MBI评分明显高于比照组,差异有统计学意义(P<0.05);试验组重型颅脑损伤患者总并发症比例(6.00%)明显低于比照组(52.00%),差异有统计学意义(P<0.05)。结论重型颅脑损伤患者于临床接受早期康复护理干预后,利于MBI评分提升以及总并发症比例的降低,最终促进重型颅脑损伤患者的疾病转归。     

精神科和综合科护士工作疲溃感与应对方式调查研究

目的　了解精神科及综合科护士如何应对工作疲溃感 ,并探讨应对方式与工作疲溃感之间的关系。方法　采用工作疲溃感量表 (包括 3个因子 )和简易应对方式问卷 (包括 2个因子 ) ,分别对北京某三级甲等精神科医院 96名护士和北京某三级甲等综合科医院 110名护士 ,进行了工作疲溃感及应对方式的调查。结果　综合科护士工作疲溃感总分及情绪疲倦因子得分均高于精神科护士 (P <0 .0 1) ;精神科和综合科护士应对方式总分及两个因子得分 ,结果无统计学意义 (P <0 .0 5 ) ;应对方式总分与工作疲溃感总分呈显著正相关。其中积极应对方式与工作成就感、消极应对方式与情绪疲倦感和去人格化呈显著正相关。结论　护士面对各样的工作压力 ,很容易产生工作的疲溃感。应对方式与工作疲溃感有密切的关系 ,因此提高护士对多方面的认知 ,采取有效防治工作疲溃感的措施 ,加强护士积极应对方式的培训工作是很必要的 ,尤其应加强对综合科护士工作疲溃感的防治工作。     

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.     

Physical Activity,Quality of Life,and Burnout Among Physician Trainees: The Effect of a Team-Based,Incentivized Exercise Program

ObjectiveTo prospectively study the effects of an incentivized exercise program on physical activity (PA), quality of life (QOL), and burnout among residents and fellows (RFs) in a large academic medical center.Participants and MethodsIn January 2011, all RFs at Mayo Clinic in Rochester, Minnesota (N=1060), were invited to participate in an elective, team-based, 12-week, incentivized exercise program. Both participants and nonparticipants had access to the same institutional exercise facilities. Regardless of participation, all RFs were invited to complete baseline and follow-up (3-month) assessments of PA, QOL, and burnout.ResultsOf the 628 RFs who completed the baseline survey (59%), only 194 (31%) met the US Department of Health and Human Services recommendations for PA. Median reported QOL was 70 on a scale of 1 to 100, and 182 (29%) reported at least weekly burnout symptoms. A total of 245 individuals (23%) enrolled in the exercise program. No significant differences were found between program participants and nonparticipants with regard to baseline demographic characteristics, medical training level, PA, QOL, or burnout. At study completion, program participants were more likely than nonparticipants to meet the Department of Health and Human Services recommendations for exercise (48% vs 23%; P<.001). Quality of life was higher in program participants than in nonparticipants (median, 75 vs 68; P<.001). Burnout was lower in participants than in nonparticipants, although the difference was not statistically significant (24% vs 29%; P=.17).ConclusionA team-based, incentivized exercise program engaged 23% of RFs at our institution. After the program, participants had higher PA and QOL than nonparticipants who had equal exercise facility access. Residents and fellows may be much more sedentary than previously reported.