Purohit Bhaskar, Vasava Paul
Indian Institute of Public Health Gandhinagar (IIPHG), Opposite Air Force Head Quarters, Near Lekawada Bus Stop, Gandhinagar Chiloda Road, Lekawada, CRPF P.O, Gandhinagar, 382042, Gujarat, India.
Medical Officer, Department of Health, Gujarat, India.
BMC Health Serv Res. 2017 Jan 23;17(1):69. doi: 10.1186/s12913-017-2033-6.
Understanding Role Stress is important as health service providers, especially nurses experience high levels of Role Stress which is linked to burnout, poor quality of care and high turnover. The current study explicates the concept of Role Stress and assesses the Role Stress experienced by the Auxiliary Nurse Midwives (ANMs) working with rural government health centres from Gujarat, India.
The study included 84 ANMs working with government health centres from one district in India. A structured instrument with established reliability and validity was used to measure 10 dimensions of Role Stress namely: Inter-role distance, role stagnation, role expectation conflict, role erosion: role overload, role isolation, personal inadequacy, self-role distance, role ambiguity and resource inadequacy. The study instrument was based on 5 point Likert rating scale that contained 50 unidirectional negative statements, 5 for each dimension. Kolmogorov-Smirnov and Shapiro-Wilk test were carried out to assess if the data were normally distributed. Cronbach's alpha test was carried out to assess reliability of the instrument. The study data was analyzed using descriptive statistics mainly using mean scores with higher scores indicating higher Role Stress and vice versa. The data was analyzed using SPSS version 19.
Kolmogorov-Smirnov and Shapiro-Wilk test indicated that the data were normally distributed. Cronbach's alpha test indicated values of 0.852 suggesting high reliability of the tool. The highest Role Stress among ANMs was experienced for resource inadequacy. Role overload, role stagnation and inter-role distance were among the other important role stressors for ANMs. The study results suggests that ANMs frequently feel that: they do not have adequate amount of resources, facilities and financial support from the high levels authorities; people have too many expectations from their roles and as result they are overloaded with work and have very limited opportunities for future growth.
The current study has the potential to provide a useful and a comprehensive framework to understand the Role Stress among the health service providers that could be further useful in designing interventions specifically aimed at reducing Role Stress in order to prevent burnout thereby addressing the productivity and retention.
作为医疗服务提供者，理解角色压力很重要，尤其是护士，他们承受着高水平的角色压力，这与职业倦怠、护理质量差和高离职率有关。本研究阐述了角色压力的概念，并评估了印度古吉拉特邦农村政府卫生中心的助理护士助产士（ANM）所经历的角色压力。
该研究纳入了印度一个地区政府卫生中心的84名ANM。使用一种具有既定信效度的结构化工具来测量角色压力的10个维度，即：角色间距离、角色停滞、角色期望冲突、角色侵蚀、角色过载、角色孤立、个人能力不足、自我角色距离、角色模糊和资源不足。研究工具基于5点李克特量表，包含50条单向负面陈述，每个维度5条。进行柯尔莫哥洛夫-斯米尔诺夫检验和夏皮罗-威尔克检验以评估数据是否呈正态分布。进行克朗巴哈α检验以评估工具的信度。主要使用描述性统计分析研究数据，以平均得分表示，得分越高表明角色压力越大，反之亦然。使用SPSS 19版软件分析数据。
柯尔莫哥洛夫-斯米尔诺夫检验和夏皮罗-威尔克检验表明数据呈正态分布。克朗巴哈α检验表明值为0.852，表明该工具具有高信度。ANM中资源不足方面的角色压力最高。角色过载、角色停滞和角色间距离是ANM其他重要的角色压力源。研究结果表明，ANM经常感到：他们没有从上级获得足够的资源、设施和财政支持；人们对他们的角色期望过高，结果他们工作负担过重，未来成长机会非常有限。
本研究有可能提供一个有用且全面的框架来理解医疗服务提供者中的角色压力，这在设计专门旨在减轻角色压力以预防职业倦怠从而提高生产力和留住员工的干预措施方面可能会更有用。
