工作环境相关因素与护士的健康结果：黎巴嫩医院的一项横断面研究。
Work environment-related factors and nurses' health outcomes: a cross-sectional study in Lebanese hospitals.
作者信息
Elbejjani Martine, Abed Al Ahad Mary, Simon Michael, Ausserhofer Dietmar, Dumit Nuhad, Abu-Saad Huijer Huda, Dhaini Suzanne R
机构信息
Clinical Research Institute, and Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
Hariri School of Nursing, American University of Beirut, Beirut, Lebanon.
出版信息
BMC Nurs. 2020 Oct 8;19:95. doi: 10.1186/s12912-020-00485-z. eCollection 2020.
BACKGROUND
Worldwide, studies show a relationship between nurses' health and some work environment factors; however, data on nurses' health and self-perceived workload and nursing task allocation are lacking, particularly for Lebanese nurses. We assessed the relationship of several work environment factors: overall workload and specific temporal, physical, mental, effort, frustration, and performance demands (NASA Task Load Index), staffing resources and adequacy and leadership (Practice Environment Scale of Nursing Work Index), teamwork climate (Safety Attitudes Questionnaire), and nursing task allocation (Basel Extent of Rationing of Nursing Care)) with self-reported musculoskeletal, cardiovascular, skin, and mental health diseases (Work Ability Index) and emotional exhaustion (Maslach Burnout Inventory) among Lebanese nurses.
METHODS
A cross-sectional self-report survey was distributed to all 289 registered nurses (RNs) in the medical, surgical, and pediatric units in two Lebanese university-affiliated hospitals; 170 RNs had complete data. Adjusted multivariable logistic regression models were used to estimate the association between work environment factors and health outcomes.
RESULTS
The most prevalent outcomes were musculoskeletal disease (69%), emotional exhaustion (59%), and mental health problems (56%); 70% of RNs had ≥2 and 35.29% had ≥4 co-occurring health problems. Musculoskeletal disease was associated with higher overall (OR = 1.36 (95%CI = 1.03, 1.80)), temporal (OR = 1.30 (95%CI = 1.09, 1.55)), and physical demands (OR = 1.20 (95%CI = 1.03, 1.49)), higher task allocation to RNs (OR = 1.11 (95%CI = 1.01, 1.23)) and lower teamwork climate (OR = 0.60 (95%CI = 0.36, 0.98). Higher odds of mental/emotional problems were associated with higher overall, temporal, frustration, and effort demands, and lower teamwork climate, performance satisfaction, and resources adequacy (increased odds ranging from 18 to 88%). Work environment indicators were associated with higher co-occurrence of health problems.
CONCLUSIONS
Results show elevated health burden and co-morbidity among Lebanese RNs and highlight the value of comprehensive approaches that can simultaneously improve several work environment factors (namely self-perceived workload, teamwork,, resources, and nursing task allocation) to reduce this burden.
背景
全球范围内的研究表明护士的健康与一些工作环境因素之间存在关联；然而，关于护士健康与自我感知工作量以及护理任务分配的数据却很缺乏，尤其是黎巴嫩护士的数据。我们评估了几个工作环境因素之间的关系：总体工作量、特定的时间、身体、心理、努力、挫折和绩效需求（NASA任务负荷指数）、人员配备资源、充足性和领导力（护理工作实践环境量表）、团队合作氛围（安全态度问卷）以及护理任务分配（巴塞尔护理配给程度）与黎巴嫩护士自我报告的肌肉骨骼、心血管、皮肤和心理健康疾病（工作能力指数）以及情绪耗竭（马氏倦怠量表）之间的关系。
方法
我们向黎巴嫩两所大学附属医院的内科、外科和儿科病房的所有289名注册护士发放了一份横断面自我报告调查问卷；170名护士有完整数据。使用调整后的多变量逻辑回归模型来估计工作环境因素与健康结果之间的关联。
结果
最常见的结果是肌肉骨骼疾病（69%）、情绪耗竭（59%）和心理健康问题（56%）；70%的护士有≥2种同时出现的健康问题，35.29%的护士有≥4种。肌肉骨骼疾病与更高的总体（比值比[OR]=1.36[95%置信区间（CI）=1.03,1.80]）、时间（OR=1.30[95%CI=1.09,1.55]）和身体需求（OR=1.20[95%CI=1.03,1.49]）、分配给注册护士的更高任务量（OR=1.11[95%CI=1.01,1.23]）以及更低的团队合作氛围（OR=0.60[95%CI=0.36,0.98]）相关。更高的心理/情绪问题几率与更高的总体、时间、挫折和努力需求以及更低的团队合作氛围、绩效满意度和资源充足性相关（几率增加范围为18%至88%）。工作环境指标与更高的健康问题共现率相关。
结论
结果显示黎巴嫩注册护士的健康负担和共病率有所升高，并突出了综合方法的价值，这些方法可以同时改善几个工作环境因素（即自我感知工作量、团队合作、资源和护理任务分配）以减轻这种负担。
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