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放射治疗领域中医师、放射技师、护士和物理学家的工作压力与工作满意度:DEGRO生活质量工作组的多中心分析

Job stress and job satisfaction of physicians, radiographers, nurses and physicists working in radiotherapy: a multicenter analysis by the DEGRO Quality of Life Work Group.

作者信息

Sehlen Susanne, Vordermark Dirk, Schäfer Christof, Herschbach Peter, Bayerl Anja, Pigorsch Steffi, Rittweger Jutta, Dormin Claudia, Bölling Tobias, Wypior Hans Joachim, Zehentmayr Franz, Schulze Wolfgang, Geinitz Hans

机构信息

Department of Radiotherapy and Radiooncology, University Munich, Munich, Germany.

出版信息

Radiat Oncol. 2009 Feb 6;4:6. doi: 10.1186/1748-717X-4-6.

Abstract

BACKGROUND

Ongoing changes in cancer care cause an increase in the complexity of cases which is characterized by modern treatment techniques and a higher demand for patient information about the underlying disease and therapeutic options. At the same time, the restructuring of health services and reduced funding have led to the downsizing of hospital care services. These trends strongly influence the workplace environment and are a potential source of stress and burnout among professionals working in radiotherapy.

METHODS AND PATIENTS

A postal survey was sent to members of the workgroup "Quality of Life" which is part of DEGRO (German Society for Radiooncology). Thus far, 11 departments have answered the survey. 406 (76.1%) out of 534 cancer care workers (23% physicians, 35% radiographers, 31% nurses, 11% physicists) from 8 university hospitals and 3 general hospitals completed the FBAS form (Stress Questionnaire of Physicians and Nurses; 42 items, 7 scales), and a self-designed questionnaire regarding work situation and one question on global job satisfaction. Furthermore, the participants could make voluntary suggestions about how to improve their situation.

RESULTS

Nurses and physicians showed the highest level of job stress (total score 2.2 and 2.1). The greatest source of job stress (physicians, nurses and radiographers) stemmed from structural conditions (e.g. underpayment, ringing of the telephone) a "stress by compassion" (e.g. "long suffering of patients", "patients will be kept alive using all available resources against the conviction of staff"). In multivariate analyses professional group (p < 0.001), working night shifts (p = 0.001), age group (p = 0.012) and free time compensation (p = 0.024) gained significance for total FBAS score. Global job satisfaction was 4.1 on a 9-point scale (from 1 - very satisfied to 9 - not satisfied). Comparing the total stress scores of the hospitals and job groups we found significant differences in nurses (p = 0.005) and physicists (p = 0.042) and a borderline significance in physicians (p = 0.052).In multivariate analyses "professional group" (p = 0.006) and "vocational experience" (p = 0.036) were associated with job satisfaction (cancer care workers with < 2 years of vocational experience having a higher global job satisfaction). The total FBAS score correlated with job satisfaction (Spearman-Rho = 0.40; p < 0.001).

CONCLUSION

Current workplace environments have a negative impact on stress levels and the satisfaction of radiotherapy staff. Identification and removal of the above-mentioned critical points requires various changes which should lead to the reduction of stress.

摘要

背景

癌症护理领域的持续变革导致病例复杂性增加,其特点是现代治疗技术以及患者对基础疾病和治疗选择信息的更高需求。与此同时,卫生服务的重组和资金削减导致医院护理服务规模缩小。这些趋势强烈影响工作场所环境,是放疗专业人员压力和职业倦怠的潜在来源。

方法与患者

向德国放射肿瘤学会(DEGRO)下属“生活质量”工作组的成员发送了邮政调查问卷。到目前为止,已有11个科室回复了调查。来自8所大学医院和3所综合医院的534名癌症护理人员(23%为医生,35%为放射技师,31%为护士,11%为物理学家)中的406人(76.1%)完成了FBAS表格(医生和护士压力问卷;42个项目,7个量表),以及一份关于工作情况的自行设计问卷和一个关于总体工作满意度的问题。此外,参与者可以就如何改善他们的状况提出自愿建议。

结果

护士和医生的工作压力水平最高(总分分别为2.2和2.1)。工作压力的最大来源(医生、护士和放射技师)源于结构条件(如报酬过低、电话铃声)以及“同情引发的压力”(如“患者的长期痛苦”、“不顾工作人员的信念使用所有可用资源维持患者生命”)。在多变量分析中,职业组(p < 0.001)、值夜班(p = 0.001)、年龄组(p = 0.012)和自由时间补偿(p = 0.024)对FBAS总分具有显著意义。总体工作满意度在9分制量表上为4.1分(从1 - 非常满意到9 - 不满意)。比较医院和工作群体的总压力得分,我们发现护士(p = 0.005)和物理学家(p = 0.042)存在显著差异,医生存在临界显著差异(p = 0.052)。在多变量分析中,“职业组”(p = 0.006)和“职业经验”(p = 0.036)与工作满意度相关(职业经验少于2年的癌症护理人员总体工作满意度更高)。FBAS总分与工作满意度相关(斯皮尔曼等级相关系数 = 0.40;p < 0.001)。

结论

当前的工作场所环境对放疗工作人员的压力水平和满意度有负面影响。识别并消除上述关键点需要进行各种变革,这应能减轻压力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b23/2661891/70a407795a85/1748-717X-4-6-1.jpg

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