National University Cancer Institute, Singapore.
Int J Evid Based Healthc. 2012 Jun;10(2):126-41. doi: 10.1111/j.1744-1609.2012.00271.x.
AIM: To establish the best available evidence regarding the relationship between the nursing shortage and nurses' job satisfaction, stress and burnout levels in oncology/haematology settings. METHODS: Electronic databases (CINAHL, Medline, Scopus, ScienceDirect, PsycInfo, PsycArticles, Web of Science, The Cochrane Library, Proquest and Mednar) were searched using a three-step strategy in order to identify published and unpublished studies conducted between 1990 and 2010. Grey literature was excluded in the review. The identified studies were evaluated using standardised critical appraisal instruments from the Joanna Briggs Institute-Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). A total of seven descriptive and descriptive-correlational studies published in English were included and data were presented in a narrative summary. RESULTS: Findings revealed a positive bidirectional relationship between the nursing shortage and oncology registered nurses' (RNs') job dissatisfaction, stress and burnout. The extent of the job dissatisfaction, stress and burnout experienced by the oncology RNs and their perception of staffing inadequacy differed according to their demography and work settings. Particularly, nurses who had higher qualifications and positions, who worked full-time and who worked in inpatient settings and non-Magnet hospitals were more likely to attribute staffing inadequacy as one of the main contributing factors for their job dissatisfaction, stress and burnout. This led to a rise in the number of oncology RNs leaving the speciality. CONCLUSION: Within the constraints of the study and the few quality papers available, it appears that oncology RNs who worked in substandard staffing units often express job dissatisfaction, stress and burnout, which prompt them to seek new employment out of the oncology specialty. This entails a pressing need for organisations to ensure sufficient staffing in oncology/haematology settings, in order to ensure that quality patient care is provided. Limited studies that examine the relationship between the nursing shortage and oncology RNs' stress and burnout have been conducted. Also, no studies in the Asian context have previously been conducted. IMPLICATIONS FOR PRACTICE: Organizations need to customize their strategies for the recruitment and retention of oncology nurses. The strategies should take into consideration the specific demographic characteristics of oncology nurses or those of work settings that are experiencing staffing inadequacy and negative nursing outcomes. The strategies should also aim to replicate features of other institutions that are attractive to oncology nurses, and also include training that help oncology nurses better manage their emotions. IMPLICATIONS FOR RESEARCH: Future research needs to examine the relationship between the nursing shortage and oncology nurses' job satisfaction, stress and burnout in bone marrow transplant units, paediatric oncology settings and Asian oncology settings. The characteristics of oncology nurses or workplaces that are more likely to experience negative nursing outcomes due the nursing shortage should also be identified.
目的:确定有关肿瘤/血液学环境中护理短缺与护士工作满意度、压力和倦怠水平之间关系的最佳现有证据。
方法:使用三步策略在电子数据库(CINAHL、Medline、Scopus、ScienceDirect、PsycInfo、PsycArticles、Web of Science、The Cochrane Library、Proquest 和 Mednar)中搜索已发表和未发表的研究,这些研究是在 1990 年至 2010 年间进行的。综述中排除了灰色文献。使用 Joanna Briggs 研究所-荟萃分析统计评估和审查工具(JBI-MAStARI)的标准化批判性评估工具对确定的研究进行评估。共纳入了七项描述性和描述性相关研究,这些研究均以英文发表,并以叙述性摘要的形式呈现数据。
结果:研究结果表明,护理短缺与肿瘤注册护士(RN)的工作不满、压力和倦怠之间存在正相关的双向关系。肿瘤 RN 经历的工作不满、压力和倦怠的程度及其对人员配备不足的看法因人口统计学和工作环境而异。特别是,具有较高学历和职位、全职工作以及在住院环境和非磁铁医院工作的护士更有可能将人员配备不足视为导致其工作不满、压力和倦怠的主要因素之一。这导致了更多的肿瘤 RN 离开该专业。
结论:在研究的限制和可用的高质量论文数量的限制内,似乎在不符合标准人员配备的单位工作的肿瘤 RN 经常表达工作不满、压力和倦怠,这促使他们寻求离开肿瘤专业的新工作。这迫切需要组织确保肿瘤/血液学环境中提供足够的人员配备,以确保提供优质的患者护理。目前已经进行了有限的研究来检查护理短缺与肿瘤 RN 压力和倦怠之间的关系。此外,以前在亚洲背景下没有进行过研究。
实践意义:组织需要为肿瘤护士的招聘和留用制定有针对性的策略。这些策略应考虑到经历人员配备不足和负面护理结果的肿瘤护士的特定人口统计学特征或工作环境特征。这些策略还应旨在复制对肿瘤护士有吸引力的其他机构的特征,并包括帮助肿瘤护士更好地管理情绪的培训。
研究意义:未来的研究需要研究护理短缺与骨髓移植单位、儿科肿瘤环境和亚洲肿瘤环境中肿瘤护士工作满意度、压力和倦怠之间的关系。还应确定由于护理短缺更有可能经历负面护理结果的肿瘤护士或工作场所的特征。
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