一项参与式干预措施对医院环境中心理社会工作因素预防心理健康问题的有效性。
Effectiveness of a participative intervention on psychosocial work factors to prevent mental health problems in a hospital setting.
作者信息
Bourbonnais R, Brisson C, Vinet A, Vézina M, Abdous B, Gaudet M
机构信息
Rehabilitation Department, Medecine Faculty, Laval University, Québec, QC, Canada.
出版信息
Occup Environ Med. 2006 May;63(5):335-42. doi: 10.1136/oem.2004.018077.
OBJECTIVES
To assess the effectiveness of a workplace intervention aimed at reducing adverse psychosocial work factors (psychological demands, decision latitude, social support, and effort-reward imbalance) and mental health problems among care providers.
METHODS
A quasi-experimental design with a control group was used. Pre-intervention (71% response rate), and one-year post-intervention measures (69% response rate) were collected by telephone interviews.
RESULTS
One year after the intervention, there was a reduction of several adverse psychosocial factors in the experimental group, whereas no such reduction was found in the control group. However, there was a significant deterioration of decision latitude and social support from supervisors in both experimental and control groups. There was also a significant reduction in sleeping problems and work related burnout in the experimental hospital, whereas only sleeping problems decreased in the control group while both client related and personal burnout increased in this hospital. The comparison between the experimental and control groups, after adjusting for pre-intervention measures, showed a significant difference in the means of all psychosocial factors except decision latitude. All other factors were better in the experimental group.
CONCLUSION
Results suggest positive effects of the intervention, even though only 12 months have passed since the beginning of the intervention. Follow up at 36 months is necessary to evaluate whether observed effects are maintained over time. In light of these results, we believe that continuing the participative process in the experimental hospital will foster the achievement of a more important reduction of adverse psychosocial factors at work. It is expected that the intensity of the intervention will be directly related to its beneficial effects. Long term effects will however depend on the willingness of management and of staff to appropriate the process of identifying what contributes to adverse psychosocial factors at work and to adopt means to reduce them.
目的
评估一项旨在减少护理人员不良心理社会工作因素（心理需求、决策自由度、社会支持和努力-回报失衡）及心理健康问题的工作场所干预措施的有效性。
方法
采用带有对照组的准实验设计。通过电话访谈收集干预前（回复率71%）和干预后一年的测量数据（回复率69%）。
结果
干预一年后，实验组的几个不良心理社会因素有所减少，而对照组未出现此类减少情况。然而，实验组和对照组中，来自上级的决策自由度和社会支持均显著恶化。实验医院的睡眠问题和工作相关倦怠也显著减少，而对照组仅睡眠问题有所减少，同时该医院与客户相关的倦怠和个人倦怠均有所增加。在对干预前测量数据进行调整后，实验组和对照组之间的比较显示，除决策自由度外，所有心理社会因素的均值存在显著差异。实验组的所有其他因素情况更佳。
结论
结果表明该干预措施具有积极效果，尽管自干预开始仅过去12个月。有必要在36个月时进行随访，以评估观察到的效果是否能随时间持续保持。鉴于这些结果，我们认为在实验医院继续参与过程将有助于更显著地减少工作中的不良心理社会因素。预计干预强度将与其有益效果直接相关。然而，长期效果将取决于管理层和员工是否愿意认同识别工作中不良心理社会因素成因的过程，并采取措施减少这些因素。
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