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一种通过每日日志法来考察医院护理工作中的慢性压力、日常困扰及安全认知的方法。

A Daily Diary Approach to the Examination of Chronic Stress, Daily Hassles and Safety Perceptions in Hospital Nursing.

作者信息

Louch Gemma, O'Hara Jane, Gardner Peter, O'Connor Daryl B

机构信息

Bradford Royal Infirmary, Bradford Institute for Health Research, Duckworth Lane, Bradford, BD9 6RJ, UK.

Leeds Institute of Medical Education, University of Leeds, Leeds, LS2 9JT, UK.

出版信息

Int J Behav Med. 2017 Dec;24(6):946-956. doi: 10.1007/s12529-017-9655-2.

Abstract

PURPOSE

Stress is a significant concern for individuals and organisations. Few studies have explored stress, burnout and patient safety in hospital nursing on a daily basis at the individual level. This study aimed to examine the effects of chronic stress and daily hassles on safety perceptions, the effect of chronic stress on daily hassles experienced and chronic stress as a potential moderator.

METHOD

Utilising a daily diary design, 83 UK hospital nurses completed three end-of-shift diaries, yielding 324 person days. Hassles, safety perceptions and workplace cognitive failure were measured daily, and a baseline questionnaire included a measure of chronic stress. Hierarchical multivariate linear modelling was used to analyse the data.

RESULTS

Higher chronic stress was associated with more daily hassles, poorer perceptions of safety and being less able to practise safely, but not more workplace cognitive failure. Reporting more daily hassles was associated with poorer perceptions of safety, being less able to practise safely and more workplace cognitive failure. Chronic stress did not moderate daily associations. The hassles reported illustrate the wide-ranging hassles nurses experienced.

CONCLUSION

The findings demonstrate, in addition to chronic stress, the importance of daily hassles for nurses' perceptions of safety and the hassles experienced by hospital nurses on a daily basis. Nurses perceive chronic stress and daily hassles to contribute to their perceptions of safety. Measuring the number of daily hassles experienced could proactively highlight when patient safety threats may arise, and as a result, interventions could usefully focus on the management of daily hassles.

摘要

目的

压力是个人和组织极为关注的问题。很少有研究在个体层面上每日探讨医院护理工作中的压力、倦怠和患者安全。本研究旨在考察慢性压力和日常困扰对安全认知的影响、慢性压力对所经历的日常困扰的影响以及慢性压力作为潜在调节因素的作用。

方法

采用每日日记设计,83名英国医院护士完成了三份轮班结束时的日记,共产生324人日的数据。每天测量困扰、安全认知和工作场所认知失误,一份基线问卷包含一项慢性压力测量。采用分层多元线性模型分析数据。

结果

较高的慢性压力与更多的日常困扰、较差的安全认知以及更难以安全执业相关,但与更多的工作场所认知失误无关。报告更多的日常困扰与较差的安全认知、更难以安全执业以及更多的工作场所认知失误相关。慢性压力并未调节每日的关联。所报告的困扰说明了护士所经历的广泛困扰。

结论

研究结果表明,除了慢性压力外,日常困扰对护士的安全认知以及医院护士每日所经历的困扰也很重要。护士认为慢性压力和日常困扰会影响他们的安全认知。测量所经历的日常困扰数量可以提前发现患者安全威胁可能出现的时间,因此,干预措施可以有效地集中于日常困扰的管理。

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