Division of Nursing and Midwifery Science, Antwerp University, Universiteitsplein 1, Wilrijk, Belgium.
J Adv Nurs. 2013 Jul;69(7):1515-24. doi: 10.1111/jan.12010. Epub 2012 Sep 19.
To study the relationships between nurse practice environment, workload, burnout, job outcomes and nurse-reported quality of care in psychiatric hospital staff.
Nurses' practice environments in general hospitals have been extensively investigated. Potential variations across practice settings, for instance in psychiatric hospitals, have been much less studied.
A cross-sectional design with a survey.
A structural equation model previously tested in acute hospitals was evaluated using survey data from a sample of 357 registered nurses, licensed practical nurses, and non-registered caregivers from two psychiatric hospitals in Belgium between December 2010-April 2011. The model included paths between practice environment dimensions and outcome variables, with burnout in a mediating position. A workload measure was also tested as a potential mediator between the practice environment and outcome variables.
An improved model, slightly modified from the one validated earlier in samples of acute care nurses, was confirmed. This model explained 50% and 38% of the variance in job outcomes and nurse-reported quality of care respectively. In addition, workload was found to play a mediating role in accounting for job outcomes and significantly improved a model that ultimately explained 60% of the variance in these variables.
In psychiatric hospitals as in general hospitals, nurse-physician relationship and other organizational dimensions such as nursing and hospital management were closely associated with perceptions of workload and with burnout and job satisfaction, turnover intentions, and nurse-reported quality of care. Mechanisms linking key variables and differences across settings in these relationships merit attention by managers and researchers.
研究精神病院工作人员的护士实践环境、工作负荷、倦怠、工作结果和护士报告的护理质量之间的关系。
已经广泛研究了综合医院护士的实践环境。与实践环境有关的潜在差异，例如在精神病医院，研究得要少得多。
横断面设计与调查。
使用 2010 年 12 月至 2011 年 4 月期间从比利时两家精神病院的 357 名注册护士、执业护士和非注册护理人员中抽取的样本，对先前在急症医院测试过的结构方程模型进行评估。该模型包括实践环境维度与结果变量之间的路径，以倦怠为中介变量。还测试了工作负荷作为实践环境与结果变量之间的潜在中介变量。
从先前在急症护理护士样本中验证过的模型中稍作修改，确认了一个改进的模型。该模型分别解释了工作结果和护士报告的护理质量 50%和 38%的方差。此外，工作负荷被发现在解释工作结果方面起着中介作用，并显著改进了一个最终解释这些变量 60%方差的模型。
与综合医院一样，精神病医院中护士与医生的关系以及其他组织维度，如护理和医院管理，与对工作负荷以及倦怠、工作满意度、离职意向和护士报告的护理质量的看法密切相关。管理者和研究人员应关注这些关系中关键变量之间的联系和不同环境中的差异机制。
