Ercolani Giacomo, Varani Silvia, Peghetti Barbara, Franchini Luca, Malerba Maria Beatrice, Messana Rossana, Sichi Vittoria, Pannuti Raffaella, Pannuti Franco
Psycho-Oncology Unit, Fondazione ANT Italia ONLUS, Bologna, Italy.
Department of Psychology, University of Bologna, Bologna, Italy.
J Palliat Care. 2020 Jan;35(1):46-52. doi: 10.1177/0825859719827591. Epub 2019 Feb 6.
The study examines psychophysical distress of health-care professionals providing home-based palliative care. The aim is to investigate potential correlations between dimensions of burnout and different coping strategies.
The present study is an observational cross-sectional investigation. The study involved all the home palliative care teams of an Italian nonprofit organization. Of a total of 275 practitioners working for the organization, 207 (75%) decided to participate in the study and complete questionnaires. Questionnaires employed were Maslach Burnout Inventory, General Health Questionnaire 12, Psychophysiological Questionnaire of CBA 2.0, and Coping Orientation to Problems Experienced. Professionals were physicians (50%), nurses (36%), and psychologists (14%). There were no exclusion criteria. Data were processed by SPSS 23 and analyses employed were Spearman ρ, Mann-Whitney test, and 1-way analysis of variance on ranks.
Among participants, a low number of professionals were emotionally exhausted (11%) or not fulfilled at work (20%), whereas most of them complained of depersonalization symptoms (67%). Emotional exhaustion and depersonalization were found to be associated with avoidance coping strategies, whereas problem-solving and positive attitude were negatively associated with emotional exhaustion and positively with personal accomplishment. Moreover, using avoidance strategies was related to a worse psychological and physical condition.
Findings suggest the need to provide professionals training programs about coping and communication skills tailored to fit the professionals' needs according to their work experience in palliative care and aimed at improving the approach to patients and relatives.
本研究考察提供居家姑息治疗的医护人员的心理困扰。目的是调查职业倦怠各维度与不同应对策略之间的潜在相关性。
本研究为观察性横断面调查。该研究纳入了意大利一家非营利组织的所有居家姑息治疗团队。在为该组织工作的总共275名从业者中，207名（75%）决定参与研究并完成问卷。所使用的问卷包括马氏职业倦怠量表、一般健康问卷12项、CBA 2.0心理生理问卷以及对所经历问题的应对取向问卷。专业人员包括医生（50%）、护士（36%）和心理学家（14%）。没有排除标准。数据用SPSS 23进行处理，所采用的分析方法包括斯皮尔曼ρ相关分析、曼-惠特尼检验以及单向秩方差分析。
在参与者中，情绪衰竭的专业人员数量较少（11%），工作未达满足感的人员数量也较少（20%），而他们中的大多数人抱怨有去个性化症状（67%）。发现情绪衰竭和去个性化与回避应对策略相关，而解决问题和积极态度与情绪衰竭呈负相关，与个人成就感呈正相关。此外，使用回避策略与更差的心理和身体状况相关。
研究结果表明，有必要根据专业人员在姑息治疗方面的工作经验，为他们提供针对其需求的应对和沟通技能培训项目，旨在改善对患者及其亲属的护理方式。
