Chamberlain Stephanie A, Gruneir Andrea, Hoben Matthias, Squires Janet E, Cummings Greta G, Estabrooks Carole A
Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada.
Int J Nurs Stud. 2017 Jun;71:60-69. doi: 10.1016/j.ijnurstu.2017.02.024. Epub 2017 Mar 6.
Our study examined care aide characteristics, organizational context, and frequency of dementia-related resident responsive behaviours associated with burnout. Burnout is the experience of emotional exhaustion, cynicism, and professional inefficacy. Care aide burnout has implications for turnover, staff health, and quality of care.
We used surveys collected from 1194 care aides from 30 urban nursing homes in three Western Canadian provinces. We used a mixed-effects regression analysis to assess care aide characteristics, dementia-related responsive behaviours, unit and facility characteristics, and organizational context predictors of care aide burnout. We measured burnout using the Maslach Burnout Inventory, Short Form.
We found that care aides were at high risk for emotional exhaustion and cynicism, but report high professional efficacy. Statistically significant predictors of emotional exhaustion included English as a second language, medium facility size, organizational slack-staff, organizational slack-space, health (mental and physical) and dementia-related responsive behaviours. Statistically significant predictors of cynicism were care aide age, English as a second language, unit culture, evaluation (feedback of data), formal interactions, health (mental and physical) and dementia-related responsive behaviours. Statistically significant predictors of professional efficacy were unit culture and structural resources. Greater care aide job satisfaction was significantly associated with increased professional efficacy.
This study suggests that individual care aide and organization features are both predictive of care aide burnout. Unlike care aide or structural characteristics of the facility elements of the organizational context are potentially modifiable, and therefore amenable to intervention.
我们的研究考察了护理助理的特征、组织环境以及与倦怠相关的痴呆症患者反应性行为的频率。倦怠是指情感耗竭、玩世不恭和职业效能感缺失的体验。护理助理的倦怠会对人员流动、员工健康和护理质量产生影响。
我们使用了从加拿大西部三个省份30家城市养老院的1194名护理助理收集的调查问卷。我们采用混合效应回归分析来评估护理助理的特征、与痴呆症相关的反应性行为、单位和机构特征以及护理助理倦怠的组织环境预测因素。我们使用马氏倦怠量表简版来测量倦怠。
我们发现护理助理存在情感耗竭和玩世不恭的高风险，但职业效能感较高。情感耗竭的统计学显著预测因素包括英语作为第二语言、中等规模的机构、组织人员冗余、组织空间冗余、健康状况（心理和身体）以及与痴呆症相关的反应性行为。玩世不恭的统计学显著预测因素包括护理助理年龄、英语作为第二语言、单位文化、评估（数据反馈）、正式互动、健康状况（心理和身体）以及与痴呆症相关的反应性行为。职业效能感的统计学显著预测因素是单位文化和结构资源。护理助理更高的工作满意度与职业效能感的提高显著相关。
本研究表明，个体护理助理和组织特征都可预测护理助理的倦怠。与护理助理或机构的结构特征不同，组织环境因素有可能被改变，因此适合进行干预。
