与 COVID-19 大流行期间护士韧性相关的因素。
Factors Associated With the Resilience of Nurses During the COVID-19 Pandemic.
机构信息
College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
Faculty of Health Sciences, Department of Health Management and Policy, American University of Beirut, Beirut, Lebanon.
出版信息
Worldviews Evid Based Nurs. 2021 Dec;18(6):320-331. doi: 10.1111/wvn.12544. Epub 2021 Nov 5.
BACKGROUND
The delivery of health care during the COVID-19 outbreak imposed significant challenges on the global nursing workforce and placed them at a higher risk of occupational burnout and turnover. In Lebanon, the pandemic hit when nurses were already struggling with an economic collapse caused by government failures. Resilience may play a protective factor against adversity and enable effective adaption to the burden of the pandemic.
AIMS
To determine the level of resilience in the nursing workforce and its relationship to burnout, intention to quit, and perceived COVID-19 risk.
METHODS
A cross-sectional study was employed among all registered nurses affiliated with the Order of Nurses in Lebanon and working in patient care positions in hospitals. The online survey questionnaire incorporated the Connor-Davidson Resilience Scale and the Copenhagen Burnout Inventory. Quartile scores were used to differentiate levels of resilience and burnout. Multiple logistic regression identified variables significantly associated with resilience.
RESULTS
Five-hundred and eleven nurses responded to the questionnaire. Nurses had a moderate level of resilience (M = 72 ± 13.5). In multivariate analyses, being male (OR = 3.67; 95% CI [1.46, 9.22]; p = .006) and having a master's degree (OR = 4.082; 95% CI [1.49, 11.20]; p = .006) were independently associated with higher resilience. Resilience levels decreased with higher personal burnout (OR = 0.12; 95% CI [0.03, 0.435]; p = .001), work-related burnout (OR = 0.14; 95% CI [0.04, 0.46]; p = .001), and client-related burnout rates (OR = 0.09; 95% CI [0.03, 0.34]; p < .001). Nurses reporting the intention to quit their job had lower resilience scores (OR = 0.20; 95% CI [0.04, 0.88]; p = .033).
LINKING EVIDENCE TO ACTION
Nursing stakeholders must introduce programs to regularly assess and enhance the resilience of nurses especially at time of crisis. Such programs would protect nurses from the perils of burnout and enhance their retention during times when they are most needed. Protecting nurses from burnout is an ethical imperative as well as an operational requirement.
背景
在 COVID-19 疫情期间，医疗保健服务的提供给全球护理人员带来了巨大的挑战，使他们面临更高的职业倦怠和离职风险。在黎巴嫩，大流行发生在护士们正努力应对政府失败导致的经济崩溃之时。韧性可能是一种抵御逆境的保护因素，并使他们能够有效地适应大流行的负担。
目的
确定护理人员的韧性水平及其与倦怠、离职意愿和感知 COVID-19 风险的关系。
方法
采用横断面研究，对隶属于黎巴嫩护士协会并在医院从事患者护理工作的所有注册护士进行调查。在线问卷调查包括 Connor-Davidson 韧性量表和哥本哈根倦怠量表。四分位数评分用于区分韧性和倦怠水平。多变量逻辑回归确定与韧性显著相关的变量。
结果
511 名护士回答了问卷。护士的韧性水平中等（M = 72 ± 13.5）。在多变量分析中，男性（OR = 3.67；95%CI [1.46, 9.22]；p =.006）和拥有硕士学位（OR = 4.082；95%CI [1.49, 11.20]；p =.006）与更高的韧性独立相关。随着个人倦怠（OR = 0.12；95%CI [0.03, 0.435]；p =.001）、工作相关倦怠（OR = 0.14；95%CI [0.04, 0.46]；p =.001）和与客户相关的倦怠率（OR = 0.09；95%CI [0.03, 0.34]；p <.001）的增加，韧性水平降低。报告离职意向的护士的韧性评分较低（OR = 0.20；95%CI [0.04, 0.88]；p =.033）。
将证据付诸行动
护理利益相关者必须引入定期评估和增强护士韧性的计划，尤其是在危机时期。这样的计划将保护护士免受倦怠的危险，并在他们最需要的时候增强他们的留任率。保护护士免受倦怠既是伦理要求，也是运营要求。
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