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远程护士工作环境中已识别的障碍和前提条件——一项改良德尔菲研究

Identified obstacles and prerequisites in telenurses' work environment - a modified Delphi study.

作者信息

Bjorkman Annica, Engstrom Maria, Olsson Annakarin, Wahlberg Anna Carin

机构信息

Faculty of Health and Occupational Studies, Caring Science University of Gavle, Gavle, Sweden.

Department of Public Health and Caring Sciences, Uppsala University, Health Services Research, Uppsala, Sweden.

出版信息

BMC Health Serv Res. 2017 May 18;17(1):357. doi: 10.1186/s12913-017-2296-y.

Abstract

BACKGROUND

Telenursing is an expanding part of healthcare, staffed with registered nurses whose work environment is typical of a call centre. Work-related stress has been shown to be a major problem in nurses' work environments and of importance to the outcome of care, patient safety, nurse job satisfaction and burnout. Today, however, we have a limited understanding of and knowledge about the work environment for telenurses. The aim of the present study is to explore and reach consensus on perceived important obstacles and prerequisites in telenurses' work environment.

METHODS

A modified Delphi design, using qualitative as well as quantitative data sequentially through three phases, was taken. Data were initially collected via semi-structured interviews (Phase I) and later using a web survey (Phase II-III) between March 2015 and March 2016.

RESULTS

The findings present a consensus view of telenurses' experiences of important obstacles and prerequisites in their work environment. Central to the findings are the aspects of telenurses having a demanding work, cognitive fatigue and having no opportunity for recovery during the work shift was ranked as important obstacles. Highly ranked prerequisites for managing were being able to focus on one caller at a time, working in a calm and pleasant environment and having technical support 24/7.

CONCLUSIONS

Managers need to enable telenurses to experience control in their work, provided with possibilities to control their work and to recover during work; shortening work time could improve their work environment. Limited possibilities to perform work might contribute to feelings of stress and inability to perform work.

摘要

背景

远程护理是医疗保健领域不断扩展的一部分,由注册护士提供服务,其工作环境类似于呼叫中心。工作相关压力已被证明是护士工作环境中的一个主要问题,对护理结果、患者安全、护士工作满意度和职业倦怠具有重要影响。然而,目前我们对远程护士的工作环境了解有限。本研究的目的是探索远程护士工作环境中被认为重要的障碍和前提条件并达成共识。

方法

采用改良的德尔菲设计,分三个阶段依次使用定性和定量数据。数据最初通过半结构化访谈收集(第一阶段),后来在2015年3月至2016年3月期间使用网络调查(第二至三阶段)。

结果

研究结果呈现了远程护士对其工作环境中重要障碍和前提条件的一致看法。研究结果的核心是远程护士工作要求高、认知疲劳以及在轮班期间没有恢复机会等方面被列为重要障碍。管理方面排名靠前的前提条件是能够一次专注于一个来电者、在平静宜人的环境中工作以及全天候获得技术支持。

结论

管理者需要使远程护士能够在工作中体验到掌控感,为他们提供控制工作和在工作期间恢复的可能性;缩短工作时间可以改善他们的工作环境。工作可能性有限可能会导致压力感和无法开展工作。

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