Büssing Arndt, Falkenberg Zarah, Schoppe Carina, Recchia Daniela Rodrigues, Poier Désirée
Quality of Life, Spirituality and Coping, Institute of Integrative Medicine, Witten/Herdecke University, Gerhard-Kienle-Weg 4, D-58313, Herdecke, Germany.
BMC Health Serv Res. 2017 Aug 10;17(1):551. doi: 10.1186/s12913-017-2445-3.
Hospital staff experience high level of work stress and they have to find strategies to adapt and react to it. When they perceive emotional exhaustion and job dissatisfaction in response to constant work stress, one reaction might be emotional withdrawal. This emotional distancing can be seen as an adaptive strategy to keep 'functionality' in the job. Both, perception of emotional exhaustion and emotional distancing as a strategy, can be operationalized as 'Cool Down'. We assume that work stress associated variables are positively associated with Cool Down reactions, while internal and external resources are negatively associated and might function as a buffer against emotional distancing. Moreover, we assume that the perception of stress and work burden might be different between nurses and physicians and women and men, but not their cool down reactions as a strategy.
Anonymous cross-sectional survey with standardized instruments among 1384 health care professionals (66% nurses, 34% hospital physicians). Analyses of variance, correlation and also stepwise regression analyses were performed to analyze the influence of demands and resources on Cool Down reactions.
As measured with the Cool Down Index (CDI), frequency and strength of Cool Down reactions did not significantly differ between women and men, while women and men differ significantly for their burnout symptoms, stress perception and perceived work burden. With respect to profession, Cool Down and stress perception were not significantly different, but burnout and work burden. For nurses, "Emotional Exhaustion" was the best CDI predictor (51% explained variance), while in physicians it was "Depersonalization" (44% explained variance). Among putative resources which might buffer against Cool Down reactions, only team satisfaction and situational awareness had some influence, but not self-efficacy expectation.
The perceptions of emotional exhaustion and distancing of nurses and physicians (and women and men) seems to be different, but not their adaptive Cool Down reactions. Data would support the notion that a structural approach of support would require first to control and eliminate work stressors, and second a multifaceted approach to strengthen and support hospital staff's resources and resilience.
医院工作人员承受着高水平的工作压力，他们必须找到适应和应对压力的策略。当他们因持续的工作压力而感到情绪耗竭和工作不满时，一种反应可能是情感退缩。这种情感疏离可被视为一种在工作中保持“功能正常”的适应性策略。情感耗竭的感知以及作为一种策略的情感疏离都可被操作化为“冷静下来”。我们假设与工作压力相关的变量与“冷静下来”反应呈正相关，而内部和外部资源与之呈负相关，并可能起到缓冲情感疏离的作用。此外，我们假设护士与医生以及女性与男性对压力和工作负担的感知可能不同，但作为一种策略的“冷静下来”反应并无差异。
对1384名医疗保健专业人员（66%为护士，34%为医院医生）进行了使用标准化工具的匿名横断面调查。进行方差分析、相关性分析以及逐步回归分析，以分析需求和资源对“冷静下来”反应的影响。
用“冷静下来”指数（CDI）衡量，“冷静下来”反应的频率和强度在女性和男性之间并无显著差异，而女性和男性在职业倦怠症状、压力感知和感知到的工作负担方面存在显著差异。就职业而言，“冷静下来”和压力感知并无显著差异，但职业倦怠和工作负担存在差异。对于护士来说，“情感耗竭”是最佳的CDI预测指标（解释方差为51%），而对于医生来说则是“去个性化”（解释方差为44%）。在可能缓冲“冷静下来”反应的假定资源中，只有团队满意度和情境意识有一定影响，而自我效能期望则没有。
护士和医生（以及女性和男性）对情感耗竭和疏离的感知似乎不同，但他们适应性的“冷静下来”反应并无差异。数据支持这样一种观点，即结构性的支持方法首先需要控制和消除工作压力源，其次需要采取多方面的方法来加强和支持医院工作人员的资源及恢复力。
