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临床督导与职业倦怠:临床督导对社区精神科护士的影响

Clinical supervision and burnout: the influence of clinical supervision for community mental health nurses.

作者信息

Edwards Deborah, Burnard Philip, Hannigan Ben, Cooper Linda, Adams John, Juggessur Tara, Fothergil Anne, Coyle Dave

机构信息

School of Nursing and Midwifery Studies, University of Wales College of Medicine, Cardiff, UK.

出版信息

J Clin Nurs. 2006 Aug;15(8):1007-15. doi: 10.1111/j.1365-2702.2006.01370.x.

Abstract

AIMS

The aim of this study was to establish the degree to which clinical supervision might influence levels of reported burnout in community mental health nurses in Wales, UK.

METHODS

The research instruments used were the Maslach Burnout Inventory and the Manchester Clinical Supervision Scale. At the time of the survey 817 community mental health nurses were reported to work within Wales. Two hundred and sixty (32%) community mental heath nurses working in 11 NHS Trusts responded to the survey.

RESULTS

One hundred and eighty-nine (73%) community mental heath nurses had experience of clinical supervision in their present posts and 105 (40%) in their previous posts. The findings from the Maslach Burnout Inventory indicated high levels of emotional exhaustion for 36%, high levels of depersonalization for 12% and low levels of personal accomplishment for 10% of the community mental heath nurses surveyed. Univariate analysis showed that those community mental heath nurses who were younger, male and who had not experienced six or more sessions of clinical supervision were more likely to report cold negative attitudes towards their clients as indicated by higher scores on the depersonalization subscale of the Maslach Burnout Inventory. One hundred and sixty-six community mental heath nurses had experienced six or more sessions of clinical supervision and had completed the Maslach Burnout Inventory. Higher scores on the Manchester Clinical Supervision Scale were also associated with lower levels of measured burnout, with significant negative correlations between the total Manchester Clinical Supervision Scale score and the emotional exhaustion subscale (r = -0.148, P = 0.050) and the depersonalization subscale (r = -0.220, P = 0.003) of the Maslach Burnout Inventory. These findings suggest that if clinical supervision is effective then community mental heath nurses are likely to report lower levels of emotional exhaustion and depersonalization.

CONCLUSIONS

The findings from this study suggest that if clinical supervision is effective then community mental heath nurses report lower levels of burnout. Further research is required to determine the long-term benefits of implementing clinical supervision and to determine which other factors have an influence on levels of burnout for this group of nurses. Health service organizations have a responsibility for ensuring that all individual practitioners have access to effective clinical supervision and the Nursing and Midwifery Council could extend the registered nurses personal accountability to include - to seek clinical supervision as and when necessary.

摘要

目的

本研究旨在确定临床督导对英国威尔士社区心理健康护士职业倦怠报告水平的影响程度。

方法

使用的研究工具为马氏职业倦怠量表和曼彻斯特临床督导量表。据报告,调查时威尔士有817名社区心理健康护士工作。11个国民健康服务信托机构的260名(32%)社区心理健康护士对调查做出了回应。

结果

189名(73%)社区心理健康护士在现任岗位有临床督导经验,105名(40%)在以前的岗位有过。马氏职业倦怠量表的调查结果显示,在接受调查的社区心理健康护士中,36%有高度的情感耗竭,12%有高度的去个性化,10%有低度的个人成就感。单因素分析表明,那些更年轻、男性且没有经历过六次或更多次临床督导的社区心理健康护士,更有可能如马氏职业倦怠量表去个性化分量表上更高的分数所示,报告对其客户持冷漠消极态度。166名社区心理健康护士经历过六次或更多次临床督导并完成了马氏职业倦怠量表。曼彻斯特临床督导量表上更高的分数也与测量出的较低职业倦怠水平相关,曼彻斯特临床督导量表总分与马氏职业倦怠量表的情感耗竭分量表(r = -0.148,P = 0.050)和去个性化分量表(r = -0.220,P = 0.003)之间存在显著负相关。这些发现表明,如果临床督导有效,那么社区心理健康护士可能会报告较低水平的情感耗竭和去个性化。

结论

本研究结果表明,如果临床督导有效,那么社区心理健康护士报告的职业倦怠水平较低。需要进一步研究以确定实施临床督导的长期益处,并确定其他哪些因素对这群护士的职业倦怠水平有影响。卫生服务机构有责任确保所有个体从业者都能获得有效的临床督导,护理及助产士管理局可以将注册护士的个人责任扩大到包括——在必要时寻求临床督导。

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