在高强度环境下工作的护士的职业倦怠与心理韧性

Burnout and Resilience Among Nurses Practicing in High-Intensity Settings.

作者信息

Rushton Cynda Hylton, Batcheller Joyce, Schroeder Kaia, Donohue Pamela

机构信息

Cynda Hylton Rushton is the Anne and George Bunting Professor of Clinical Ethics, a professor of nursing and pediatrics, Johns Hopkins University, Berman Institute of Bioethics and School of Nursing, Baltimore, Maryland. Joyce Batcheller is president, CNO Solutions, Austin, Texas, and former senior vice president/systems chief nursing officer, Seton Healthcare Network, Austin, Texas. Kaia Schroeder is a former staff educator in critical care, Seton Healthcare Network. Pamela Donohue is an associate professor in pediatrics and director of clinical research, Division of Neonatology, Johns Hopkins University, School of Medicine, and Charlotte R. Bloomberg Children's Center, Baltimore, Maryland.

出版信息

Am J Crit Care. 2015 Sep;24(5):412-20. doi: 10.4037/ajcc2015291.

DOI:10.4037/ajcc2015291

PMID:26330434

Abstract

BACKGROUND

The high level of stress experienced by nurses leads to moral distress, burnout, and a host of detrimental effects.

OBJECTIVES

To support creation of healthy work environments and to design a 2-phase project to enhance nurses' resilience while improving retention and reducing turnover.

METHODS

In phase 1, a cross-sectional survey was used to characterize the experiences of a high-stress nursing cohort. A total of 114 nurses in 6 high-intensity units completed 6 survey tools to assess the nurses' characteristics as the context for burnout and to explore factors involved in burnout, moral distress, and resilience. Statistical analysis was used to determine associations between scale measures and to identify independent variables related to burnout.

RESULTS

Moral distress was a significant predictor of all 3 aspects of burnout, and the association between burnout and resilience was strong. Greater resilience protected nurses from emotional exhaustion and contributed to personal accomplishment. Spiritual well-being reduced emotional exhaustion and depersonalization; physical well-being was associated with personal accomplishment. Meaning in patient care and hope were independent predictors of burnout. Higher levels of resilience were associated with increased hope and reduced stress. Resilience scores were relatively flat over years of experience.

CONCLUSIONS

These findings provide the basis for an experimental intervention in phase 2, which is designed to help participants cultivate strategies and practices for renewal, including mindfulness practices and personal resilience plans.

摘要

背景

护士所经历的高度压力会导致道德困扰、职业倦怠以及一系列有害影响。

目的

支持创建健康的工作环境，并设计一个两阶段项目，以增强护士的适应力，同时提高留职率并降低离职率。

方法

在第一阶段，采用横断面调查来描述高压力护理群体的经历。6个高强度科室的114名护士完成了6种调查工具，以评估护士的特征作为职业倦怠的背景，并探索与职业倦怠、道德困扰和适应力相关的因素。使用统计分析来确定量表测量之间的关联，并识别与职业倦怠相关的独立变量。

结果

道德困扰是职业倦怠所有三个方面的重要预测因素，职业倦怠与适应力之间的关联很强。更强的适应力可保护护士免受情感耗竭，并有助于个人成就感。精神幸福感可减轻情感耗竭和去个性化；身体健康与个人成就感相关。患者护理中的意义和希望是职业倦怠的独立预测因素。更高水平的适应力与更高的希望和更低的压力相关。适应力得分在多年的工作经验中相对平稳。