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医护人员的福祉、职业倦怠与患者安全:一项系统综述。

Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review.

作者信息

Hall Louise H, Johnson Judith, Watt Ian, Tsipa Anastasia, O'Connor Daryl B

机构信息

School of Psychology, University of Leeds, Leeds, West Yorkshire, England.

Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, West Yorkshire, England.

出版信息

PLoS One. 2016 Jul 8;11(7):e0159015. doi: 10.1371/journal.pone.0159015. eCollection 2016.

Abstract

OBJECTIVE

To determine whether there is an association between healthcare professionals' wellbeing and burnout, with patient safety.

DESIGN

Systematic research review.

DATA SOURCES

PsychInfo (1806 to July 2015), Medline (1946 to July 2015), Embase (1947 to July 2015) and Scopus (1823 to July 2015) were searched, along with reference lists of eligible articles.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Quantitative, empirical studies that included i) either a measure of wellbeing or burnout, and ii) patient safety, in healthcare staff populations.

RESULTS

Forty-six studies were identified. Sixteen out of the 27 studies that measured wellbeing found a significant correlation between poor wellbeing and worse patient safety, with six additional studies finding an association with some but not all scales used, and one study finding a significant association but in the opposite direction to the majority of studies. Twenty-one out of the 30 studies that measured burnout found a significant association between burnout and patient safety, whilst a further four studies found an association between one or more (but not all) subscales of the burnout measures employed, and patient safety.

CONCLUSIONS

Poor wellbeing and moderate to high levels of burnout are associated, in the majority of studies reviewed, with poor patient safety outcomes such as medical errors, however the lack of prospective studies reduces the ability to determine causality. Further prospective studies, research in primary care, conducted within the UK, and a clearer definition of healthcare staff wellbeing are needed.

IMPLICATIONS

This review illustrates the need for healthcare organisations to consider improving employees' mental health as well as creating safer work environments when planning interventions to improve patient safety.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration number: CRD42015023340.

摘要

目的

确定医疗保健专业人员的幸福感与职业倦怠和患者安全之间是否存在关联。

设计

系统研究综述。

数据来源

检索了PsychInfo(1806年至2015年7月)、Medline(1946年至2015年7月)、Embase(1947年至2015年7月)和Scopus(1823年至2015年7月),以及符合条件文章的参考文献列表。

选择研究的合格标准

定量实证研究,包括:i)幸福感或职业倦怠的测量;ii)医疗保健人员群体中的患者安全。

结果

共识别出46项研究。在27项测量幸福感的研究中,有16项发现幸福感差与患者安全状况较差之间存在显著相关性,另有6项研究发现与部分而非全部使用的量表存在关联,1项研究发现存在显著关联,但方向与大多数研究相反。在30项测量职业倦怠的研究中,有21项发现职业倦怠与患者安全之间存在显著关联,另有4项研究发现所采用的职业倦怠测量的一个或多个(但非全部)子量表与患者安全之间存在关联。

结论

在大多数综述研究中,幸福感差以及中度至高度职业倦怠与医疗差错等患者安全不良结果相关,但前瞻性研究的缺乏降低了确定因果关系的能力。需要进一步开展前瞻性研究、在英国进行初级保健研究,并更明确地界定医疗保健人员的幸福感。

启示

本综述表明,医疗保健组织在规划改善患者安全的干预措施时,需要考虑改善员工心理健康以及营造更安全的工作环境。

系统综述注册

PROSPERO注册号:CRD42015023340。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1281/4938539/d6633a99e712/pone.0159015.g001.jpg

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