Johnson Judith, Louch Gemma, Dunning Alice, Johnson Olivia, Grange Angela, Reynolds Caroline, Hall Louise, O'Hara Jane
School of Psychology, University of Leeds, UK.
Bradford Institute for Health Research, Bradford Royal Infirmary, UK.
J Adv Nurs. 2017 Jul;73(7):1667-1680. doi: 10.1111/jan.13251. Epub 2017 Feb 16.
The aim of this study was to investigate the relationships between depressive symptoms, burnout and perceptions of patient safety. A mediation model was proposed whereby the association between symptoms of depression and patient safety perceptions was mediated by burnout.
There is growing interest in the relationships between depressive symptoms and burnout in healthcare staff and the safety of patient care. Depressive symptoms are higher in healthcare staff than the general population and overlap conceptually with burnout. However, minimal research has investigated these variables in nurses. Given the conceptual overlap between depressive symptoms and burnout, there is also a need for an explanatory model outlining the relative contributions of these factors to patient safety.
A cross-sectional questionnaire was distributed at three acute NHS Trusts.
Three-hundred and twenty-three hospital nursing staff completed measures of depressive symptoms, burnout and patient safety perceptions (including measures at the level of the individual and the work area/unit) between December 2015 - February 2016.
When tested in separate analyses, depressive symptoms and burnout facets were each associated with both patient safety measures. Furthermore, the proposed mediation model was supported, with associations between depressive symptoms and patient safety perceptions fully mediated by burnout.
These results suggest that symptoms of depression and burnout in hospital nurses may have implications for patient safety. However, interventions to improve patient safety may be best targeted at improving burnout in particular, with burnout interventions known to be most effective when focused at both the individual and the organisational level.
本研究旨在调查抑郁症状、职业倦怠与患者安全认知之间的关系。提出了一个中介模型，即抑郁症状与患者安全认知之间的关联由职业倦怠介导。
医护人员的抑郁症状与职业倦怠以及患者护理安全之间的关系越来越受到关注。医护人员的抑郁症状高于普通人群，并且在概念上与职业倦怠重叠。然而，针对护士群体对这些变量进行的研究极少。鉴于抑郁症状和职业倦怠在概念上的重叠，还需要一个解释模型来概述这些因素对患者安全的相对影响。
在三个英国国民健康服务体系（NHS）急性信托机构进行了横断面问卷调查。
2015年12月至2016年2月期间，323名医院护理人员完成了抑郁症状、职业倦怠和患者安全认知的测量（包括个人层面和工作区域/单位层面的测量）。
在单独分析中进行测试时，抑郁症状和职业倦怠的各个方面均与两种患者安全测量指标相关。此外，所提出的中介模型得到了支持，抑郁症状与患者安全认知之间的关联完全由职业倦怠介导。
这些结果表明，医院护士的抑郁症状和职业倦怠可能对患者安全产生影响。然而，改善患者安全的干预措施可能最好特别针对改善职业倦怠，已知针对个人和组织层面的职业倦怠干预最为有效。
