护士工作环境与应激生物标志物：对患者结局的可能影响。
Nurse Work Environment and Stress Biomarkers: Possible Implications for Patient Outcomes.
机构信息
Department of Family Medicine (Dr Arnetz, Mr Sudan, Ms Goetz, Dr Counts, Dr Arnetz); Department of Translational Science and Molecular Medicine (Dr Counts), Michigan State University College of Human Medicine, Grand Rapids, Michigan.
出版信息
J Occup Environ Med. 2019 Aug;61(8):676-681. doi: 10.1097/JOM.0000000000001642.
OBJECTIVE
To examine associations between nurse work environment, serum biomarkers, and patient outcomes in a large hospital.
METHODS
A work environment questionnaire was administered in 2017 to the total sample of nurses in a Midwestern hospital. A subsample of nurses (n = 83) provided blood samples. Correlation analyses examined associations between work environment ratings, biomarkers (dehydroepiandrosterone-sulphate [DHEA-S] and interleukin-6 [IL-6]), and unit-level patient outcomes.
RESULTS
Work stress was negatively correlated with DHEA-S (r = -0.23) and positively correlated with IL-6 (r = 0.31; P < 0.05). Psychological safety (r = 0.22) and competence development (r = 0.25) were both positively correlated with DHEA-S (P < 0.05). DHEA-S was negatively correlated with central line-associated bloodstream infections (rho = -0.61; P < 0.05).
CONCLUSIONS
Work environment-associated physiological mechanisms might adversely impact patient safety, in addition to nurse health.
目的
在一家大型医院中研究护士工作环境、血清生物标志物与患者结局之间的关联。
方法
2017 年，对中西部一家医院的全体护士进行了工作环境问卷调查。抽取了其中 83 名护士的血样。相关性分析考察了工作环境评分、生物标志物（脱氢表雄酮硫酸酯[DHEA-S]和白细胞介素 6 [IL-6]）与单位级患者结局之间的关联。
结果
工作压力与 DHEA-S 呈负相关（r=-0.23），与 IL-6 呈正相关（r=0.31；P<0.05）。心理安全感（r=0.22）和能力发展（r=0.25）均与 DHEA-S 呈正相关（P<0.05）。DHEA-S 与中心静脉相关血流感染呈负相关（rho=-0.61；P<0.05）。
结论
除了对护士健康的影响外，与工作环境相关的生理机制可能对患者安全产生不利影响。
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