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肿瘤科护士共情疲劳的水平、流行率及相关因素:系统评价和荟萃分析。

The levels, prevalence and related factors of compassion fatigue among oncology nurses: a systematic review and meta-analysis.

机构信息

College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu City, Sichuan province, China.

Department of Periodical Press and National Clinical Research Center for Geriatrics, Nursing Key Laboratory of Sichuan Province, Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China.

出版信息

J Clin Nurs. 2021 Mar;30(5-6):615-632. doi: 10.1111/jocn.15565. Epub 2021 Feb 1.

Abstract

BACKGROUND

Compassion fatigue is described as the phenomenon of exhaustion and dysfunction in healthcare workers resulting from prolonged exposure to work-related stress and compassion stress. Oncology nurses are at high risk for compassion fatigue.

AIMS

Our study aims to estimate the levels, prevalence and related factors of compassion fatigue dimension in oncology nurses.

DESIGN

Systematic review and meta-analysis.

METHOD

Ten electronic databases were conducted in the systematic review and meta-analysis. Time frame of the searches is from inception up to 31 January 2020. The research team independently conducted study selection, quality assessments, data extractions and analysis of all included studies. The means, standard deviations and prevalence of three dimensions of compassion fatigue were pooled using random-effects meta-analysis. The PRISMA guideline was used to report the systematic review and meta-analysis. PROSPERO registration number: CRD42020205521.

RESULTS

The systematic review included 21 studies, involving 6533 oncology nurses across 6 different countries. In our studies, the pooled mean scores of compassion satisfaction (CS), burnout (BO) and secondary traumatic stress (STS) were 35.47 (95% CI: 33.54-37.41), 24.94 (95% CI: 23.47-26.41) and 24.48 (95% CI: 23.36-25.60), respectively; the pooled prevalence of "low" rates of CS, "high" rates of BO and STS were 20% (CI 13%-28%), 22% (CI 18%-26%) and 22% (CI 17%-28%), respectively; furthermore, geographical regions (Asia) significantly affect the prevalence of compassion fatigue among oncology nurses. The compassion fatigue variables considered were demographic (age, marital status, education background, health condition and gender), work-related (job satisfaction, income satisfaction, years of working experience, professional title, position and work environment) and other variables (social support, coping strategy, self-compassion, professional cognition and psychological training).

CONCLUSION

Oncology nurses were at "moderate" level of compassion satisfaction, burnout and secondary traumatic stress, and 22% of oncology nurses suffered from "high" risk of compassion fatigue. Hospital administrators should develop interventions to address compassion fatigue phenomenon, and enhance the mental health of oncology nurses and nursing care results.

RELEVANCE TO CLINICAL PRACTICE

Oncology unit warrants special attention, and oncology nurses are at high risk for compassion fatigue. However, the reported prevalence rates and oncology nurses with different characteristics vary considerably. The review provides a preliminary framework for nursing administrators to develop interventions to address compassion fatigue phenomenon, and enhance the psychological health of oncology nurses.

摘要

背景

同情疲劳是指医护人员因长期暴露于工作相关压力和同情压力而导致的疲惫和功能障碍现象。肿瘤护士面临同情疲劳的高风险。

目的

我们的研究旨在评估肿瘤护士同情疲劳维度的水平、患病率和相关因素。

设计

系统评价和荟萃分析。

方法

在系统评价和荟萃分析中进行了 10 个电子数据库检索。检索时间从成立到 2020 年 1 月 31 日。研究小组独立进行了所有纳入研究的研究选择、质量评估、数据提取和分析。使用随机效应荟萃分析汇总同情疲劳三个维度的平均值、标准差和患病率。采用 PRISMA 指南报告系统评价和荟萃分析。PROSPERO 注册号:CRD42020205521。

结果

系统评价纳入 21 项研究,涉及 6 个不同国家的 6533 名肿瘤护士。在我们的研究中,同情满足(CS)、倦怠(BO)和二次创伤应激(STS)的汇总平均得分为 35.47(95%CI:33.54-37.41)、24.94(95%CI:23.47-26.41)和 24.48(95%CI:23.36-25.60);“低”CS 率、“高”BO 和 STS 率的汇总患病率分别为 20%(CI 13%-28%)、22%(CI 18%-26%)和 22%(CI 17%-28%);此外,地理区域(亚洲)显著影响肿瘤护士同情疲劳的患病率。考虑到的同情疲劳变量包括人口统计学(年龄、婚姻状况、教育背景、健康状况和性别)、工作相关(工作满意度、收入满意度、工作经验年限、职称、职位和工作环境)和其他变量(社会支持、应对策略、自我同情、专业认知和心理训练)。

结论

肿瘤护士在同情满足、倦怠和二次创伤应激方面处于“中等”水平,22%的肿瘤护士面临“高”风险的同情疲劳。医院管理人员应制定干预措施来应对同情疲劳现象,并提高肿瘤护士的心理健康和护理效果。

相关性到临床实践

肿瘤病房需要特别关注,肿瘤护士面临较高的同情疲劳风险。然而,报告的患病率和具有不同特征的肿瘤护士差异很大。该综述为护理管理人员制定干预措施以应对同情疲劳现象,提高肿瘤护士的心理健康水平提供了初步框架。

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