Varner-Perez Shelley E, Mathis Kelly A L, Banks Sarah K, Burke Emily S, Slaven James E, Morse Gregory J, Whitaker Myra K, Cottingham Ann H, Ahmed Rami A
Indiana University (IU) Health, Indianapolis, IN, USA.
IU Center for Aging Research, Regenstrief Institute, Inc., Indianapolis, IN, USA.
Resusc Plus. 2023 Jan 6;13:100349. doi: 10.1016/j.resplu.2022.100349. eCollection 2023 Mar.
In-hospital resuscitation events have complex and enduring effects on clinicians, with implications for job satisfaction, performance, and burnout. Ethically ambiguous cases are associated with increased moral distress. We aim to quantitatively describe the multidisciplinary resuscitation experience.
Multidisciplinary in-hospital healthcare professionals at an adult academic health center in the Midwestern United States completed surveys one and six weeks after a resuscitation event. Surveys included demographic data, task load (NASA-TLX), overall and moral distress, anxiety, depression, and spiritual peace. Spearman's rank correlation was computed to assess task load and distress.
During the 5-month study period, the study included 12 resuscitation events across six inpatient units. Of 82 in-hospital healthcare professionals eligible for recruitment, 44 (53.7%) completed the one-week post-resuscitation event survey. Of those, 37 (84.1%) completed the six-week survey. Highest median task load burden at one week was seen for temporal demand, effort, and mental demand. Median moral distress scores were low, while "at peace" median scores tended to be high. There were no significant non-zero changes in task load or distress scores from weeks 1-6. Mental demand ( = 0.545, < 0.001), physical demand ( = 0.464, = 0.005), performance ( = -0.539, < 0.001), and frustration ( = 0.545, < 0.001) significantly correlated with overall distress. Performance ( = -0.371, = 0.028) and frustration ( = 0.480, = 0.004) also significantly correlated with moral distress.
In-hospital healthcare professionals' experiences of resuscitation events are varied and complex. Aspects of task load burden including mental and physical demand, performance, and frustration contribute to overall and moral distress, deserving greater attention in clinical contexts.
医院内的复苏事件对临床医生有着复杂且持久的影响,关乎工作满意度、工作表现及职业倦怠。伦理上模棱两可的案例会导致道德困扰加剧。我们旨在定量描述多学科的复苏体验。
美国中西部一家成人学术医疗中心的多学科医院医护人员在复苏事件发生后的1周和6周完成了调查。调查内容包括人口统计学数据、任务负荷(NASA - TLX)、总体困扰和道德困扰、焦虑、抑郁以及精神安宁程度。计算斯皮尔曼等级相关性以评估任务负荷和困扰程度。
在为期5个月的研究期间,该研究涵盖了6个住院科室的12次复苏事件。在82名符合招募条件的医院医护人员中,44人(53.7%)完成了复苏事件后1周的调查。其中,37人(84.1%)完成了6周的调查。1周时任务负荷负担中位数最高的是时间需求、努力程度和精神需求。道德困扰得分中位数较低,而“安宁”得分中位数往往较高。从第1周到第6周,任务负荷或困扰得分没有显著的非零变化。精神需求(r = 0.545,P < 0.001)、身体需求(r = 0.464,P = 0.005)、工作表现(r = -0.539,P < 0.001)和挫折感(r = 0.545,P < 0.001)与总体困扰显著相关。工作表现(r = -0.371,P = 0.028)和挫折感(r = 0.480,P = 0.004)也与道德困扰显著相关。
医院医护人员对复苏事件的体验多样且复杂。任务负荷负担的各个方面,包括精神和身体需求、工作表现及挫折感,都会导致总体困扰和道德困扰,在临床环境中应予以更多关注。