Jenkins Richard, Elliott Peter
FOCUS, College Research Unit, Royal College of Psychiatrists, London, UK.
J Adv Nurs. 2004 Dec;48(6):622-31. doi: 10.1111/j.1365-2648.2004.03240.x.
This paper reports a study which aims (1) to investigate and compare levels of stressors and burnout of qualified and unqualified nursing staff in acute mental health settings; (2) to examine the relationships between stressors and burnout and (3) to assess the impact of social support on burnout and stressor-burnout relationships.
Several studies have noted that the work of mental health nurses can be highly stressful, but relatively few have focused specifically on staff working in acute inpatient settings. Although many of the pressures faced by this group are similar to those in other nursing specialties, a number of demands relate specifically to mental health settings, including the often intense nature of nurse-patient interaction and dealing with difficult and challenging patient behaviours on a regular basis.
A convenience sample of 93 nursing staff from 11 acute adult mental health wards completed the Mental Health Professionals Stress Scale, Maslach Burnout Inventory and House and Wells Social Support Scale.
Lack of adequate staffing was the main stressor reported by qualified staff, while dealing with physically threatening, difficult or demanding patients was the most stressful aspect for unqualified staff. Qualified nurses reported significantly higher workload stress than unqualified staff. Approximately half of all nursing staff showed signs of high burnout in terms of emotional exhaustion. A variety of stressors were positively correlated with emotional exhaustion and depersonalization. Higher levels of support from co-workers were related to lower levels of emotional exhaustion. Higher stressor scores were associated with higher levels of depersonalization for staff reporting high levels of social support, but not for those reporting low levels of support (a reverse buffering effect).
Qualified and unqualified nursing staff differed in terms of the prominence given to individual stressors in their work environment. The findings were consistent with the notion of burnout developing in response to job-related stressors. While staff support groups may be useful in alleviating feelings of burnout, the reverse buffering effect suggests that they should be structured in a way that minimizes negative communication and encourages staff to discuss their concerns in a constructive way.
本文报告了一项研究，其目的在于：（1）调查并比较急性心理健康机构中合格与不合格护理人员的压力源水平及职业倦怠程度；（2）检验压力源与职业倦怠之间的关系；（3）评估社会支持对职业倦怠及压力源 - 职业倦怠关系的影响。
多项研究指出，心理健康护士的工作压力可能很大，但专门针对急性住院环境中工作人员的研究相对较少。尽管该群体面临的许多压力与其他护理专业类似，但一些需求特别与心理健康环境相关，包括护士与患者互动通常较为激烈的性质以及定期应对困难和具有挑战性的患者行为。
从11个成人急性心理健康病房中选取93名护理人员作为便利样本，他们完成了心理健康专业人员压力量表、马氏职业倦怠量表和豪斯与韦尔斯社会支持量表。
合格员工报告的主要压力源是人员配备不足，而对于不合格员工来说，应对身体上有威胁、困难或要求高的患者是最具压力的方面。合格护士报告的工作量压力显著高于不合格员工。约一半的护理人员在情感耗竭方面表现出高职业倦怠的迹象。多种压力源与情感耗竭和去个性化呈正相关。同事给予的更高水平支持与更低的情感耗竭水平相关。对于报告高水平社会支持的员工，更高的压力源得分与更高的去个性化水平相关，但对于报告低水平支持的员工则不然（反向缓冲效应）。
合格与不合格护理人员在工作环境中对个别压力源的重视程度方面存在差异。研究结果与因工作相关压力源而产生职业倦怠的概念一致。虽然员工支持小组可能有助于减轻职业倦怠感，但反向缓冲效应表明，其组织方式应尽量减少负面沟通，并鼓励员工以建设性的方式讨论他们的担忧。
