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新冠疫情阴影下 ICU 护士职业功能的体验及心理社会预测因素:一项混合方法研究。

Experiences and psychosocial predictors of professional function among intensive care nurses under the shadow of Covid-19: A mixed-methods study.

机构信息

Nursing Department, Ashkelon Academic College, Ashkelon, Israel.

Nursing Coordinator, Quality of Care, Rabin Medical Center, Clalit Health Services, Tel Aviv-Yafo, Israel.

出版信息

J Nurs Scholarsh. 2022 Nov;54(6):787-798. doi: 10.1111/jnu.12796. Epub 2022 Jun 25.

Abstract

BACKGROUND

The outbreak of the Corona virus (COVID-19) pandemic led to a sharp rise in morbidity and hospitalizations, and a significant therapeutic burden fell on intensive care units (ICUs). Intensive care nurses reported physical and emotional stress in response to the extra workload caused by caring for critically ill COVID-19 patients. However, at the time of publication of the study, to the best of our knowledge there have been no studies that examined uncertainty, stress, or hope in the context of functioning among intensive care nurses.

AIM

To examine: (a) the challenges of operating and managing intensive care units during the COVID-19 pandemic among nurse managers in intensive care units, and (b) the relationships between uncertainty, stress, burnout, hope, and professional functioning among intensive care nurses during the COVID-19 pandemic.

DESIGN

This mixed-methods study was conducted in intensive care units (ICUs) at a large tertiary medical center in Israel, during February-May 2021.

METHODS

The data were collected in two phases. In the first phase, qualitative data were collected from focus groups attended by 15 senior managerial nurses. The second phase involved a cross-sectional study among 100 staff nurses working in 5 ICUs. The data were collected using a structured questionnaire.

RESULTS

Qualitative data analysis revealed two main themes: (a) challenges of the COVID-19 pandemic and (b) positive aspects of the COVID-19 pandemic. The nurses reported high levels of burnout, emotional stress and uncertainty, but moderate State Hope Scale scores, and moderate levels of professional functioning. There were no statistical differences in study variables by exposure to COVID-19 patients. State Hope Scale levels, uncertainty, and burnout variables contributed significantly and explained 46% of the variance of the professional functioning.

CONCLUSIONS

The intensity of the experiences and psych-social phenomena, is not affected by exposure to treatment of COVID-19 patients. The relationships between the study variables emphasize the importance of initiated and ongoing interventions to reduce uncertainty, address burnout, and strengthen hope. Improvement in these indices may lead to better ICU nurses' professional functioning and their work life well-being.

摘要

背景

冠状病毒(COVID-19)疫情的爆发导致发病率和住院率急剧上升,重症监护病房(ICU)面临着巨大的治疗负担。重症监护护士报告说,由于照顾 COVID-19 重症患者而导致额外的工作量,他们感到身体和情绪上的压力。然而,在本研究发表之时,据我们所知,尚无研究在重症监护护士的功能背景下检查不确定性、压力或希望。

目的

检查:(a)在 COVID-19 大流行期间,重症监护病房护士经理在重症监护病房的运营和管理方面面临的挑战,以及(b)COVID-19 大流行期间重症监护护士的不确定性、压力、倦怠、希望和专业功能之间的关系。

设计

这项混合方法研究是在以色列一家大型三级医疗中心的重症监护病房进行的,数据收集于 2021 年 2 月至 5 月。

方法

数据分两个阶段收集。在第一阶段,从参加 15 名高级护士长焦点小组的会议中收集定性数据。第二阶段涉及在 5 个 ICU 工作的 100 名员工护士进行横断面研究。数据收集使用结构化问卷。

结果

定性数据分析揭示了两个主要主题:(a)COVID-19 大流行的挑战,以及(b)COVID-19 大流行的积极方面。护士报告说倦怠、情绪压力和不确定性程度较高,但状态希望量表得分中等,专业功能水平中等。接触 COVID-19 患者的研究变量没有统计学差异。状态希望量表水平、不确定性和倦怠变量对专业功能的变异有显著贡献,解释了 46%。

结论

体验和心理社会现象的强度不受接触 COVID-19 患者治疗的影响。研究变量之间的关系强调了开展和持续干预的重要性,以减少不确定性,解决倦怠问题,增强希望。这些指标的改善可能会导致 ICU 护士更好的专业功能和工作生活幸福感。

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