van den Berg Tilja I J, Vrijhoef Hubertus J M, Tummers Gladys, Landeweerd Jan A, van Merode Godefridus G
University of Maastricht, Faculty of Health, Medicine & Life Sciences, Department of Health Organisation, Policy and Economics, The Netherlands.
Int J Nurs Stud. 2008 Oct;45(10):1422-32. doi: 10.1016/j.ijnurstu.2007.12.003. Epub 2008 Feb 20.
The aim of this study is to explore whether the work organisation of diabetes specialist nurses (DSNs) differs significantly from nurses working in hospital and nursing home and if so, does this difference result in positive or negative consequences regarding work and health.
In traditional health care settings, nurses exhibit a high level of environmental uncertainty and low decision-making authority, which has a negative effect on psychological reactions towards work. In professional nursing, specialisation, e.g. diabetic nursing, is a current trend in many countries. Therefore, insight into the determinants of the work situation of nursing specialists is becoming increasingly relevant.
Comparisons were made between 3 different samples: 1204 nurses employed by 15 hospitals, 1058 nurses employed by 14 nursing homes, and 350 diabetes nurses working in other health care settings throughout the Netherlands. Data concerning organisation, work aspects, and psychological reactions were measured via questionnaires. Variances between the groups were analysed with ANCOVA, besides hierarchical multiple regression analysis was applied.
Environmental uncertainty scored lower amongst diabetes nurses when compared to nurses working in the other two types of health care settings. Social support and role conflict scored low for diabetes nursing specialists who simultaneously perceived autonomy and role ambiguity highest. Diabetes nursing specialists also scored highest on intrinsic work motivation and job satisfaction and lowest for psychosomatic health.
Except for social support and role ambiguity, diabetic nurses rate their [work] organisation, [work] aspects and psychological [work] reactions more positively than nurses employed in other health care settings.
本研究旨在探讨糖尿病专科护士(DSN)的工作组织方式是否与医院和养老院护士有显著差异;如果存在差异,这种差异对工作和健康会产生积极还是消极影响。
在传统医疗环境中,护士面临高度的环境不确定性和较低的决策自主权,这对其工作心理反应产生负面影响。在专业护理领域,专业化(如糖尿病护理)是许多国家当前的趋势。因此,深入了解护理专科人员工作状况的决定因素变得越来越重要。
对三个不同样本进行比较:15家医院的1204名护士、14家养老院的1058名护士以及荷兰各地其他医疗环境中的350名糖尿病专科护士。通过问卷调查收集有关组织、工作方面和心理反应的数据。除了应用分层多元回归分析外,还使用协方差分析对组间差异进行分析。
与在其他两类医疗环境中工作的护士相比,糖尿病专科护士的环境不确定性得分较低。同时,糖尿病护理专科人员在自主性和角色模糊性方面得分最高,但社会支持和角色冲突得分较低。糖尿病护理专科人员在内在工作动机和工作满意度方面得分也最高,而在身心健康方面得分最低。
除社会支持和角色模糊性外,糖尿病专科护士对其工作组织、工作方面和心理工作反应的评价比其他医疗环境中的护士更为积极。