Cusack Lynette, Smith Morgan, Hegney Desley, Rees Clare S, Breen Lauren J, Witt Regina R, Rogers Cath, Williams Allison, Cross Wendy, Cheung Kin
Faculty Health Sciences, School of Nursing, University of Adelaide Adelaide, SA, Australia.
Faculty Health Sciences, School of Nursing, University of AdelaideAdelaide, SA, Australia; School of Nursing and Midwifery, The University of Southern QueenslandToowoomba, QLD, Australia.
Front Psychol. 2016 May 13;7:600. doi: 10.3389/fpsyg.2016.00600. eCollection 2016.
Building nurses' resilience to complex and stressful practice environments is necessary to keep skilled nurses in the workplace and ensuring safe patient care. A unified theoretical framework titled Health Services Workplace Environmental Resilience Model (HSWERM), is presented to explain the environmental factors in the workplace that promote nurses' resilience. The framework builds on a previously-published theoretical model of individual resilience, which identified the key constructs of psychological resilience as self-efficacy, coping and mindfulness, but did not examine environmental factors in the workplace that promote nurses' resilience. This unified theoretical framework was developed using a literary synthesis drawing on data from international studies and literature reviews on the nursing workforce in hospitals. The most frequent workplace environmental factors were identified, extracted and clustered in alignment with key constructs for psychological resilience. Six major organizational concepts emerged that related to a positive resilience-building workplace and formed the foundation of the theoretical model. Three concepts related to nursing staff support (professional, practice, personal) and three related to nursing staff development (professional, practice, personal) within the workplace environment. The unified theoretical model incorporates these concepts within the workplace context, linking to the nurse, and then impacting on personal resilience and workplace outcomes, and its use has the potential to increase staff retention and quality of patient care.
培养护士应对复杂且压力大的工作环境的适应能力，对于留住工作场所中的熟练护士并确保患者安全护理至关重要。本文提出了一个名为健康服务工作场所环境适应能力模型（HSWERM）的统一理论框架，以解释工作场所中促进护士适应能力的环境因素。该框架基于先前发表的个人适应能力理论模型构建，该模型确定了心理适应能力的关键构成要素为自我效能感、应对能力和正念，但未考察工作场所中促进护士适应能力的环境因素。这个统一的理论框架是通过文献综合法开发的，借鉴了来自国际研究的数据以及关于医院护理人员的文献综述。最常见的工作场所环境因素被识别、提取并根据心理适应能力的关键构成要素进行聚类。出现了六个与积极的适应能力建设工作场所相关的主要组织概念，并构成了该理论模型的基础。三个概念与工作场所环境中的护理人员支持（专业、实践、个人）相关，另外三个与护理人员发展（专业、实践、个人）相关。这个统一的理论模型在工作场所背景下纳入了这些概念，与护士相联系，进而影响个人适应能力和工作场所成果，其应用有可能提高员工留存率和患者护理质量。
