Indiana University School of Social Work.
Department of Psychology, Indiana University-Purdue University Indianapolis.
Psychiatr Rehabil J. 2021 Sep;44(3):204-211. doi: 10.1037/prj0000469. Epub 2021 Feb 4.
High-quality, person-centered care is a priority for mental health services. The current study conducted secondary data analysis to examine the impact of job stress (i.e., interaction with high-risk consumer cases, increased caseload, emotional exhaustion) and resources (i.e., increased organizational and supervisory support, autonomy, role clarity) on providers' perceived quality of care. Data consisted of 145 direct care providers from an urban community mental health center. Structural equation modeling was used for testing the hierarchical regression model, sequentially adding job stress and resource variables in the prediction models for the quality of care (i.e., person-centered care, discordant care [conflict with consumers and tardiness]). Person-centered care was positively associated with increased role clarity, organizational support, and larger caseload size, while a lower level of discordant care was associated with lower emotional exhaustion, smaller caseload size, less interaction with high-risk consumer cases, and with increased role clarity. Resources on the job may be particularly important for improved person-centered care, and lowering job stress may help reduce discordant care. The current study suggests the need for the mental health organizations to attend to both job stress and resources for providers to improve the quality of care. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
高质量、以患者为中心的护理是精神卫生服务的重点。本研究对二次数据分析，以检验工作压力（即与高风险消费者案例的互动、增加病例量、情绪疲惫）和资源（即增加组织和监督支持、自主性、角色明确）对提供者感知的护理质量的影响。数据来自城市社区心理健康中心的 145 名直接护理提供者。结构方程模型用于检验分层回归模型，在预测护理质量（即以人为中心的护理、不和谐护理[与消费者冲突和迟到]）的模型中，依次加入工作压力和资源变量。以人为中心的护理与角色清晰度的提高、组织支持的增加和更大的病例量呈正相关，而不和谐护理的水平较低与情绪疲惫程度较低、病例量较小、与高风险消费者案例的互动较少以及角色清晰度的提高有关。工作上的资源对于改善以患者为中心的护理可能特别重要，降低工作压力可能有助于减少不和谐的护理。本研究表明，精神卫生组织需要关注提供者的工作压力和资源，以提高护理质量。
