Gencer Deniz, Meffert Cornelia, Herschbach Peter, Hipp Matthias, Becker Gerhild
III. Medizinische Klinik für Hämatologie und Onkologie, Universitätsmedizin Mannheim, Mannheim.
Klinik für Palliativmedizin, Universitätsklinikum Freiburg, Freiburg.
Gesundheitswesen. 2019 Feb;81(2):92-98. doi: 10.1055/s-0043-109429. Epub 2017 Jun 14.
Due to the aging population in Germany, the need for palliative care institutions will increase. Considering the lack of resources, work stress of palliative care nurses could increase significantly. It was the aim of this study to identify risk factors for job overload and work stress of palliative care nurses in the inpatient and outpatient setting.
In cooperation with the KOMPACT Working Group, we conducted an anonymous survey of palliative care givers in Baden-Württemberg, Germany. We used a paper questionnaire to inquire about job stress and workload, self-assessment of health condition and aspects about mental and emotional well-being. 167 palliative care nurses from 34 different institutions participated in the survey.
The results showed a significant difference between inpatient and outpatient palliative care workers regarding the type and intensity of work stress. The overall stress level was significantly higher for the nurses in inpatient palliative care units (p<0.001). A high weekly working time combined with missing work experience in the field of palliative care led to a poorer compatibility of job and family. Higher stress levels resulted in a lower satisfaction with the work. Dissatisfaction with the working conditions was associated with a worse health status defined by self-assessment. Mental and emotional condition of palliative care nurses was significantly worse in comparison with the norm sample, many nurses showed "strikingly" or even "seriously" high values. The survey also showed that the structural conditions in inpatient palliative care units were not optimal.
Compared to outpatient palliative care services, working conditions seem to be worse in inpatient palliative care setting, which could result in higher stress for the nurses. Interventions to reduce work-related stress appear not to be well implemented in the daily work of palliative care nurses. Standards for care as well as advanced training programs for palliative care nurses should be reevaluated.
由于德国人口老龄化，对姑息治疗机构的需求将会增加。考虑到资源短缺，姑息治疗护士的工作压力可能会显著增加。本研究的目的是确定住院和门诊环境下姑息治疗护士工作负荷过重和工作压力的风险因素。
我们与KOMPACT工作组合作，对德国巴登-符腾堡州的姑息治疗提供者进行了一项匿名调查。我们使用纸质问卷询问工作压力和工作量、健康状况自我评估以及心理和情绪健康方面的情况。来自34个不同机构的167名姑息治疗护士参与了调查。
结果显示，住院和门诊姑息治疗工作者在工作压力的类型和强度方面存在显著差异。住院姑息治疗病房护士的总体压力水平显著更高（p<0.001）。每周工作时间长且缺乏姑息治疗领域的工作经验导致工作与家庭的兼容性较差。压力水平越高，对工作的满意度越低。对工作条件的不满与自我评估所定义的较差健康状况相关。与正常样本相比，姑息治疗护士的心理和情绪状况明显更差，许多护士表现出“显著”甚至“严重”的高值。调查还显示，住院姑息治疗病房的结构条件并非最佳。
与门诊姑息治疗服务相比，住院姑息治疗环境中的工作条件似乎更差，这可能给护士带来更高的压力。减轻工作相关压力的干预措施在姑息治疗护士的日常工作中似乎没有得到很好的实施。应重新评估护理标准以及姑息治疗护士的进阶培训项目。
