Klein Sabine D, Bucher Hans Ulrich, Hendriks Manya J, Baumann-Hölzle Ruth, Streuli Jürg C, Berger Thomas M, Fauchère Jean-Claude
Department of Neonatology, Perinatal Centre, University Hospital Zurich, University of Zurich, Switzerland.
Department of Neonatology, Perinatal Centre, University Hospital Zurich, University of Zurich, Switzerland; Institute of Biomedical Ethics and History of Medicine, University of Zurich, Switzerland.
Swiss Med Wkly. 2017 Aug 3;147:w14477. doi: 10.4414/smw.2017.14477. eCollection 2017.
Medical personnel working in intensive care often face difficult ethical dilemmas. These may represent important sources of distress and may lead to a diminished self-perceived quality of care and eventually to burnout.
The aim of this study was to identify work-related sources of distress and to assess symptoms of burnout among physicians and nurses working in Swiss neonatal intensive care units (NICUs).
In summer 2015, we conducted an anonymous online survey comprising 140 questions about difficult ethical decisions concerning extremely preterm infants. Of these 140 questions, 12 questions related to sources of distress and 10 to burnout. All physicians and nurses (n = 552) working in the nine NICUs in Switzerland were invited to participate.
The response rate was 72% (398). The aspects of work most commonly identified as sources of distress were: lack of regular staff meetings, lack of time for routine discussion of difficult cases, lack of psychological support for the NICU staff and families, and missing transmission of important information within the caregiver team. Differences between physicians' and nurses' perceptions became apparent: for example, nurses were more dissatisfied with the quality of the decision-making process. Different perceptions were also noted between staff in the German- and French- speaking parts of Switzerland: for example, respondents from the French part rated lack of regular staff meetings as being more problematic. On the other hand, personnel in the French part were more satisfied with their accomplishments in the job. On average, low levels of burnout symptoms were revealed, and only 6% of respondents answered that the work-related burden often affected their private life.
Perceived sources of distress in Swiss NICUs were similar to those in ICU studies. Despite rare symptoms of burnout, communication measures such as regular staff meetings and psychological support to prevent distress were clearly requested.
在重症监护室工作的医护人员经常面临棘手的伦理困境。这些困境可能是困扰的重要来源，可能导致自我认知的护理质量下降，并最终导致职业倦怠。
本研究的目的是确定与工作相关的困扰来源，并评估瑞士新生儿重症监护病房（NICU）的医生和护士的职业倦怠症状。
2015年夏天，我们进行了一项匿名在线调查，包含140个关于极早产儿艰难伦理决策的问题。在这140个问题中，12个与困扰来源相关，10个与职业倦怠相关。邀请了瑞士九个新生儿重症监护病房的所有医生和护士（n = 552）参与。
回复率为72%（398人）。最常被认为是困扰来源的工作方面包括：缺乏定期员工会议、缺乏对疑难病例进行常规讨论的时间、对新生儿重症监护病房工作人员和家属缺乏心理支持，以及护理团队内部重要信息传递缺失。医生和护士的看法存在明显差异：例如，护士对决策过程的质量更不满意。瑞士德语区和法语区的工作人员之间也存在不同看法：例如，来自法语区的受访者认为缺乏定期员工会议问题更大。另一方面，法语区的人员对自己工作中的成就更满意。平均而言，职业倦怠症状水平较低，只有6%的受访者表示与工作相关的负担经常影响他们的私人生活。
瑞士新生儿重症监护病房中感知到的困扰来源与重症监护室研究中的类似。尽管职业倦怠症状罕见，但显然需要采取沟通措施，如定期员工会议和心理支持，以防止困扰。
