幸福感指数在美国护士中识别痛苦与幸福感的效能

Efficacy of the Well-Being Index to Identify Distress and Well-Being in U.S. Nurses.

作者信息

Dyrbye Liselotte N, Johnson Pamela O, Johnson LeAnn M, Satele Daniel V, Shanafelt Tait D

机构信息

Liselotte N. Dyrbye, MD, MHPE, is Professor of Medicine and Medical Education and co-Director of the Program on Physician Well-Being, Mayo Clinic, Rochester, Minnesota. Pamela O. Johnson, MS, RN, is Chief Nursing Officer, Mayo Clinic, Rochester, Minnesota. LeAnn M. Johnson, MS, RN, is Vice Chair, Department of Nursing, Mayo Clinic, Rochester, Minnesota. Daniel V. Satele, BA, is Statistician, Mayo Clinic, Rochester, Minnesota. Tait D. Shanafelt, MD, is Jeanie & Stewart Ritchie Professor of Medicine, Chief Wellness Officer, Associate Dean, Stanford School of Medicine, Stanford, California. At the time this research was completed, he was a Professor of Medicine, Mayo Clinic, Rochester, Minnesota.

出版信息

Nurs Res. 2018 Nov/Dec;67(6):447-455. doi: 10.1097/NNR.0000000000000313.

DOI:10.1097/NNR.0000000000000313

PMID:30138124

Abstract

BACKGROUND

Studies suggest there is a high prevalence of burnout and depression among U.S. nurses.

OBJECTIVES

The aim of the study was to gauge the capability of the Well-Being Index (WBI) to stratify nurse distress (e.g., low quality of life [QOL], extreme fatigue, burnout, recent suicidal ideation) and well-being (high QOL) and detect those whose level of distress may negatively affect retention or work performance.

METHODS

In 2016, we conducted a cross-sectional survey of 3,147 U.S. nurses. The survey included the WBI and standard instruments to assess overall QOL, fatigue, burnout, recent suicidal ideation, patient care errors, and intent to leave current job. We used Fisher exact test and Wilcoxon/two-sample t-test procedures with a 5% Type I error rate and a two-sided alternative.

RESULTS

Of the 812 (26%) nurses who completed the survey, 637 were eligible for the present analysis. Nurses with low mental QOL, extreme fatigue, recent suicidal ideation, or burnout had a higher total score (all ps < .001), resulting in less favorable WBI scores. With a 17% pretest probability of low overall QOL, the WBI score can decrease the posttest probability of low QOL to 2% or increase it to 72%. The likelihood of high overall QOL decreased in a stepwise fashion from 3.38 to 0.04, as the WBI score increased. WBI score also stratified nurses' likelihood of reporting a recent patient care error and/or intent to leave current job.

DISCUSSION

The WBI is a useful screening tool to stratify both distress and well-being across a variety of domains in nurses and identify those nurses whose severity of distress may negatively affect patient care and retention.

摘要

背景

研究表明，美国护士中职业倦怠和抑郁的患病率很高。

目的

本研究的目的是评估幸福感指数（WBI）对护士痛苦程度（如生活质量[QOL]低、极度疲劳、职业倦怠、近期自杀意念）和幸福感（高QOL）进行分层的能力，并检测出那些痛苦程度可能对留职率或工作表现产生负面影响的护士。

方法

2016年，我们对3147名美国护士进行了横断面调查。该调查包括WBI以及评估总体QOL、疲劳、职业倦怠、近期自杀意念、患者护理失误和离职意愿的标准工具。我们使用了Fisher精确检验和Wilcoxon/双样本t检验程序，I类错误率为5%，采用双侧检验。

结果

在完成调查的812名（26%）护士中，637名符合本分析的条件。心理QOL低、极度疲劳、近期有自杀意念或职业倦怠的护士总分较高（所有p值<0.001），导致WBI得分较低。在总体QOL低的预测试概率为17%的情况下，WBI得分可将低QOL的后测试概率降至2%或升至72%。随着WBI得分的增加，总体QOL高的可能性呈逐步下降趋势，从3.38降至0.04。WBI得分还对护士报告近期患者护理失误和/或离职意愿的可能性进行了分层。