Kelsey Elizabeth A, West Colin P, Cipriano Pamela F, Peterson Cheryl, Satele Daniel, Shanafelt Tait, Dyrbye Liselotte N
Elizabeth A. Kelsey is an NP and assistant professor at Mayo Clinic Minnesota in Rochester, where Colin P. West and Liselotte N. Dyrbye are professors and codirectors of the Mayo Clinic Program on Physician Well-Being and Daniel Satele is a statistician. Pamela F. Cipriano is first vice president of the International Council of Nurses and dean of the University of Virginia School of Nursing, Charlottesville; she is also a former president of the American Nurses Association (ANA). Cheryl Peterson is vice president-nursing programs at the ANA in Silver Springs, MD. Tait Shanafelt is chief wellness officer and associate dean at the Stanford University School of Medicine, Stanford, CA. Funding for this study was provided by the Mayo Clinic Program on Physician Well-Being and the ANA and was based on work partially supported by a National Science Foundation (NSF) grant (No. 2041339). Any opinions, findings, and conclusions or recommendations expressed in this article are those of the authors and do not necessarily reflect the views of the NSF. Funding sources had no role in study design; in the collection, analysis, and interpretation of data; or in the writing and publication of this article. Contact author: Elizabeth A. Kelsey,
Am J Nurs. 2021 Nov 1;121(11):24-36. doi: 10.1097/01.NAJ.0000798056.73563.fa.
Although previous studies have revealed professional consequences of burnout among nurses, less is known about the potential personal consequences. This study investigated the prevalence of suicidal ideation and attitudes toward help seeking among U.S. nurses relative to other workers, and the extent to which personal and professional factors, including burnout, were related to suicidal ideation.
In November 2017, a cross-sectional survey was sent to 86,858 nurses who were members of the American Nurses Association and to a probability-based sample of 5,198 U.S. workers. The survey included questions regarding suicidal ideation, burnout, symptoms of depression, individual and professional characteristics, and willingness to seek professional help if a serious emotional problem arose. Multivariable logistic regression analyses were conducted to identify factors associated with suicidal ideation after controlling for other factors.
Among the 7,378 nurse respondents, 403 (5.5%) reported having suicidal ideation within the past year. Most nurses (84.2%) indicated willingness to seek professional help for a serious emotional problem. Yet nurses with suicidal ideation were less likely to report that they'd seek such help (72.6%) than nurses without suicidal ideation (85%). In a multivariable analysis of nurses' data, after controlling for other personal and professional characteristics, we found that burnout was strongly associated with suicidal ideation. Adjusted combined multivariable analyses showed that nurses were more likely than other workers to have suicidal ideation. Both nurses and other workers who reported suicidal ideation were less likely to seek help than were those who did not report such ideation.
Compared with other U.S. workers, nurses are at higher risk for suicidal ideation, and nurses with such ideation are more reluctant to seek help than those without it. Burnout contributes to the risk of suicidal ideation. These issues warrant greater attention. Systems- and practice-level interventions must be identified and implemented, both to address the higher prevalences of burnout and suicidal ideation in nurses and to mitigate the stigma about mental health problems and other barriers to seeking help.
尽管先前的研究揭示了护士职业倦怠的专业后果，但对于其潜在的个人后果知之甚少。本研究调查了美国护士相对于其他职业者自杀意念的发生率以及寻求帮助的态度，以及包括职业倦怠在内的个人和职业因素与自杀意念的关联程度。
2017年11月，向86858名美国护士协会成员护士以及5198名美国劳动者的概率样本发送了一项横断面调查。该调查包括有关自杀意念、职业倦怠、抑郁症状、个人和职业特征以及出现严重情绪问题时寻求专业帮助意愿的问题。在控制其他因素后，进行多变量逻辑回归分析以确定与自杀意念相关的因素。
在7378名护士受访者中，403人（5.5%）报告在过去一年中有自杀意念。大多数护士（84.2%）表示愿意为严重的情绪问题寻求专业帮助。然而，有自杀意念的护士报告称他们会寻求此类帮助的可能性（72.6%）低于没有自杀意念的护士（85%）。在对护士数据的多变量分析中，在控制了其他个人和职业特征后，我们发现职业倦怠与自杀意念密切相关。调整后的综合多变量分析表明，护士比其他职业者更有可能有自杀意念。报告有自杀意念的护士和其他职业者比未报告此类意念的人寻求帮助的可能性更小。
与其他美国职业者相比，护士有自杀意念的风险更高，且有此类意念的护士比没有的护士更不愿意寻求帮助。职业倦怠会增加自杀意念的风险。这些问题值得更多关注。必须确定并实施系统和实践层面的干预措施，以解决护士中职业倦怠和自杀意念的较高发生率，并减轻对心理健康问题的污名化以及寻求帮助的其他障碍。
