Department of Internal Medicine, University Hospital of Zurich, Switzerland / Centre of Competence Multimorbidity, University of Zurich, Switzerland.
Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland.
Swiss Med Wkly. 2020 Feb 21;150:w20175. doi: 10.4414/smw.2020.20175. eCollection 2020 Feb 10.
Working in a hospital can be both rewarding and stressful. Whether one or the other is dominant depends on a number of factors ranging from shift work, physical demands, responsibilities and time pressure to job autonomy, work climate and leisure time.
This study aimed to examine associations between temporal work stressors and satisfaction with work, life and health among health professionals in general, and nurses and physicians in particular. Associations were further investigated for possible mediating and intervening factors.
Cross-sectional survey data on 1232 health professionals at three public hospitals and two rehabilitation clinics were collected in 2015/2016. Stepwise multiple linear regression analyses were used to estimate the standardised effects (beta coefficients) of temporal work stressors (overtime and time pressure), and organisational and personal resources (job autonomy, work climate, internal control belief) on general stress as the assumed mediator and finally on satisfaction with work, life and health.
Temporal work stressors were found to strongly predict general stress symptoms among health professionals (β = 0.25) and particularly physicians (β = 0.30), independently of the observed stress-buffering effects of organisational resources such as job autonomy (β = −0.09) or work climate (β = −0.22). Associations between temporal work stressors (as predictors) and satisfaction with work, life and health (as outcomes) turned out to be mostly indirect, mediated by general stress. General stress in turn was observed to be the strongest predictor of domain-specific satisfaction (β = −0.17 to −0.34), sometimes only surpassed by resources such as work climate or internal control belief. Explained variance of the three satisfaction outcomes in the fully specified regression or explanatory models ranged between 14% and 45% depending on the (sub-)sample (nurses, physicians, all health professionals) or the outcome. Control belief was revealed to be a strong and independent personal resource, particularly regarding satisfaction with life and health in general (β = 0.25/0.21).
Satisfaction and well-being of health professionals are strongly affected by job stressors such as frequent or excessive overtime work or permanent time pressure at work. Negative consequences of temporal work stressors are attenuated by organisational and personal resources such as a high level of job autonomy, a good work climate or a strong internal control belief.
在医院工作既有收获又有压力。无论是奖励还是压力占主导地位取决于许多因素，包括轮班工作、体力要求、责任和时间压力，以及工作自主性、工作氛围和休闲时间。
本研究旨在检查一般卫生专业人员（尤其是护士和医生）的时间性工作压力源与对工作、生活和健康的满意度之间的关联。进一步调查了可能的中介和干预因素。
2015/2016 年，在三家公立医院和两家康复诊所收集了 1232 名卫生专业人员的横断面调查数据。逐步多元线性回归分析用于估计时间性工作压力源（加班和时间压力）以及组织和个人资源（工作自主性、工作氛围、内部控制信念）对一般压力的标准化效应（β 系数），最后对工作、生活和健康的满意度进行估计。
时间性工作压力源被发现与卫生专业人员的一般压力症状密切相关（β=0.25），尤其是医生（β=0.30），独立于组织资源（如工作自主性[β=−0.09]或工作氛围[β=−0.22]）的观察到的压力缓冲效应。时间性工作压力源（作为预测因素）与工作、生活和健康满意度（作为结果）之间的关联主要是间接的，由一般压力介导。一般压力反过来又是特定领域满意度的最强预测因素（β=−0.17 至−0.34），有时仅被工作氛围或内部控制信念等资源所超越。在完全指定的回归或解释模型中，三个满意度结果的解释方差在不同（子）样本（护士、医生、所有卫生专业人员）或结果之间的范围在 14%至 45%之间。控制信念被证明是一种强大而独立的个人资源，特别是在总体上对生活和健康的满意度方面（β=0.25/0.21）。
健康专业人员的满意度和幸福感受到工作压力源的强烈影响，例如频繁或过度加班或工作中的永久时间压力。时间性工作压力源的负面影响通过组织和个人资源（如高水平的工作自主性、良好的工作氛围或强烈的内部控制信念）得到缓解。
