Sadati Ahmad Kalateh, Rahnavard Farnaz, Heydari Seyed Taghi, Hemmati Soroor, Ebrahimzadeh Najmeh, Lankarani Kamran Bagheri
1PhD, Assistant Professor, Department of Sociology, Yazd University, Yazd, Iran, and Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 2MSc, Researcher, Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 3PhD, Assistant Professor, Health Policy Research Center, Shiraz University of Medical Science Shiraz, Iran 4MA, Researcher, Education Organization of Fars Province, Shiraz, Iran 5MA, Researcher, Health Policy Research Center, Shiraz University of Medical Science Shiraz, Iran 6MD, Professor, Internal Medicine, Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
J Nurs Res. 2017 Oct;25(5):368-374. doi: 10.1097/JNR.0000000000000183.
Nursing burnout is affected by various factors, including work overload. Since the inauguration of the Health Sector Evolution Plan (HSEP) in Iran in 2014, government hospitals have been required to provide health services to the public at all levels. This decision, however, has increased the volume of patients admitted to government hospitals. Because nurses are on the front line of health services, they are faced with a greater load of care provision.
This study aimed to evaluate nursing burnout before and after HSEP in Iran, with an emphasis on the differences between government and private hospitals.
This retrospective panel study used Maslach's burnout inventory to evaluate nursing burnout in 371 nurses working in government and private hospitals in Shiraz, Iran, before and 7 months after the health sector reform. Chi-square test and paired t test were used to compare burnout scores.
The results showed that nursing burnout had changed significantly after HSEP was launched (p = .030). A more detailed assessment found that burnout and emotional exhaustion had both increased significantly in the government-hospital group (ps = .014 and .001, respectively). However, no significant change in burnout was found in the private-hospital group over the same period.
CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The findings of this study indicate an increase in nursing burnout in government hospitals. An important issue in every health sector reform is nursing resource management, with a focus on burnout. Accordingly, policymakers should consider the work overload situation of nurses and work to prevent increased burnout, especially emotional exhaustion.
护士职业倦怠受多种因素影响，包括工作负荷过重。自2014年伊朗启动卫生部门发展计划（HSEP）以来，政府医院被要求为各阶层民众提供医疗服务。然而，这一决定增加了政府医院的住院患者数量。由于护士处于医疗服务的第一线，他们面临着更重的护理负担。
本研究旨在评估伊朗实施HSEP前后的护士职业倦怠情况，重点关注政府医院和私立医院之间的差异。
这项回顾性面板研究使用马氏职业倦怠量表，对伊朗设拉子市371名在政府医院和私立医院工作的护士在卫生部门改革前及改革7个月后的职业倦怠情况进行评估。采用卡方检验和配对t检验比较倦怠得分。
结果显示，实施HSEP后护士职业倦怠有显著变化（p = .030）。更详细的评估发现，政府医院组的倦怠和情感耗竭均显著增加（p值分别为.014和.001）。然而，同期私立医院组的倦怠情况未发现显著变化。
结论/实践启示：本研究结果表明政府医院护士职业倦怠有所增加。在每一次卫生部门改革中，一个重要问题是护理资源管理，重点是职业倦怠。因此，政策制定者应考虑护士的工作负荷过重情况，并努力防止职业倦怠加剧，尤其是情感耗竭。
