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急性精神科护理中压力和职业倦怠的来源:住院部工作人员与社区工作人员对比

Sources of stress and burnout in acute psychiatric care: inpatient vs. community staff.

作者信息

Sørgaard Knut W, Ryan Peter, Hill Robert, Dawson Ian

机构信息

Nordland Hospital Trust, 8092, Bodø, Norway.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2007 Oct;42(10):794-802. doi: 10.1007/s00127-007-0228-6. Epub 2007 Aug 13.

Abstract

BACKGROUND

Professionals who work alone or in small teams often provide services for people with serious mental health problems in community settings. Stress is common in community teams and this may cause burnout and threaten the quality and stability of the services. This study compares levels of burnout and sources of stress among community and acute ward staff in six European centres.

METHODS

A total of 6 acute ward (N = 204) and community staff (N = 209) in 5 different European countries filled out the Maslach Burnout Inventory (MBI), the Mental Health Professional Scale (MHPSS) the Agervold Questionnaire for psychosocial work environment (QPWES) in addition to a comprehensive demographic questionnaire.

RESULTS

In the univariate analyses, except for Emotional Exhaustion (MBI), there were no differences in burnout between the two groups of staff. Community teams reported more organisational problems, higher work demands, less contact with colleagues, but also better social relations and more control over their work. The ward staff was more satisfied with the organisational structure and access to colleagues, but complained about lack of control over operating conditions at work. The multivariate analyses identified four groups of staff: (1) a Control-dissatisfied and Contact satisfied group (N = 184) with 2/3 coming from the wards. (2) A Contact-satisfied and Work-demand dissatisfied group (N = 147) with (3/4) from the community staff. (3) A Control- and Contact dissatisfied group (N = 47) with a majority from community teams, and (4) a Contact- and Work demand satisfied group (N = 37) with a majority from the wards.

CONCLUSION

Burnout as measured was not a serious problem among community and ward staff members, and did not differentiate between the two groups. Acute ward working implied lack of control but much contact with colleagues, whereas community work entailed more control but demanding work in terms of difficult task and hard-to-find-solutions.

摘要

背景

在社区环境中,独自工作或在小团队中工作的专业人员经常为有严重心理健康问题的人提供服务。压力在社区团队中很常见,这可能导致倦怠,并威胁到服务的质量和稳定性。本研究比较了六个欧洲中心的社区和急症病房工作人员的倦怠水平及压力来源。

方法

来自欧洲5个不同国家的总共6个急症病房的204名工作人员和209名社区工作人员填写了马氏倦怠量表(MBI)、心理健康专业人员量表(MHPSS)、阿格沃尔德心理社会工作环境问卷(QPWES),此外还填写了一份全面的人口统计学问卷。

结果

在单变量分析中,除情感耗竭(MBI)外,两组工作人员的倦怠情况没有差异。社区团队报告了更多的组织问题、更高的工作要求、与同事的接触较少,但也有更好的社会关系以及对工作的更多掌控。病房工作人员对组织结构和与同事的联系更满意,但抱怨对工作操作条件缺乏掌控。多变量分析确定了四组工作人员:(1)对掌控不满意但对接触满意的组(N = 184),其中三分之二来自病房。(2)对接触满意但对工作要求不满意的组(N = 147),其中四分之三来自社区工作人员。(3)对掌控和接触都不满意的组(N = 47),大多数来自社区团队,以及(4)对接触和工作要求都满意的组(N = 37),大多数来自病房。

结论

所测量的倦怠在社区和病房工作人员中并非严重问题,且两组之间没有差异。急症病房工作意味着缺乏掌控但与同事接触较多,而社区工作则需要更多掌控,但在任务艰巨且难以找到解决方案方面工作要求较高。

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