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基于数字平台的实施策略对预防医疗机构工作压力的有效性:一项为期 12 个月的随访对照试验。

Effectiveness of a digital platform-based implementation strategy to prevent work stress in a healthcare organization: a 12-month follow-up controlled trial.

机构信息

Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, PO box 7057, 1007 MB, Amsterdam, The Netherlands.

出版信息

Scand J Work Environ Health. 2018 Nov 1;44(6):613-621. doi: 10.5271/sjweh.3758. Epub 2018 Jul 23.

Abstract

Objectives Healthcare workers frequently deal with work stress. This is a risk factor for adverse mental and physical health effects. The objective of this study was to investigate the effectiveness of a digital platform-based implementation strategy - compared to a control group - on stress, work stress determinants (ie. psychosocial work factors) and the level of implementation among healthcare workers. Methods By way of matching, 30 teams from a healthcare organization were assigned to the experimental (15 teams; N=252) or wait-list control (15 teams; N=221) group. The experimental group received access to the strategy for 12 months. They were asked to complete the 5-step protocol within six months. The primary outcome was stress (DASS-21) and secondary outcomes were psychological demands, social support, autonomy, and the level of implementation. Questionnaire-based data were collected at baseline, and at 6- and 12-months follow-up. Linear mixed model analyses were used to test differences between the two groups. Results In total, 210 participants completed the baseline questionnaire and at least one follow-up questionnaire. There was a significant effect of the strategy on stress in favor of the experimental group [B=-0.95, 95% confidence interval (CI) -1.81 - -0.09]. No statistically significant differences were found for any secondary outcomes. Conclusions The strategy showed potential for primary prevention of work stress, mainly explained by an increase in stress in the control group that was prevented in the experimental group. More research is necessary to assess the full potential of the strategy.

摘要

目的

医护人员经常面临工作压力。这是导致身心健康不良的一个风险因素。本研究的目的是调查一种基于数字平台的实施策略(与对照组相比)对医护人员压力、工作压力决定因素(即心理社会工作因素)和实施水平的有效性。

方法

通过匹配,将一家医疗机构的 30 个团队分配到实验组(15 个团队;N=252)或候补对照组(15 个团队;N=221)。实验组在 12 个月内获得该策略的访问权限。他们被要求在六个月内完成五步方案。主要结果是压力(DASS-21),次要结果是心理需求、社会支持、自主性和实施水平。在基线、6 个月和 12 个月的随访时收集基于问卷的数据。使用线性混合模型分析来检验两组之间的差异。

结果

共有 210 名参与者完成了基线问卷和至少一次随访问卷。该策略对压力有显著影响,实验组更有利[B=-0.95,95%置信区间(CI)-1.81 - -0.09]。对于任何次要结果,都没有发现统计学上的显著差异。

结论

该策略对工作压力的一级预防显示出了潜力,主要是通过对照组的压力增加来解释,而实验组则可以预防这种压力增加。需要进一步研究来评估该策略的全部潜力。

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