护士健康的影响因素——考虑德国个体和组织决定因素的回归分析。
Influencing factors on the health of nurses-a regression analysis considering individual and organizational determinants in Germany.
机构信息
Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany.
Institute for Workplace Health Promotion, Cologne, Germany.
出版信息
BMC Health Serv Res. 2023 Jan 31;23(1):100. doi: 10.1186/s12913-023-09106-2.
BACKGROUND
The care sector is characterized by high absenteeism of nursing care employees due to illness. Organizational determinants that can affect the mental health of nurses are known. Although nurses are confronted with different framework conditions in different care settings, there is a lack of comparative data in Germany.
METHODS
The purpose of this study was to examined the relationship between work demands and employee health in different care settings. This cross-sectional survey was conducted between June and October 2021 in four acute care hospitals, seven inpatient care facilities, and five outpatient care services in Germany. 528 nursing care employees (acute care hospitals n = 234; inpatient care facilities n = 152; outpatient care services n = 142) participated in the survey (participation rate: 22.6%-27.9%). For each care setting, data was collected via questionnaire on individual determinants (gender, age, profession, working time), organizational work demands (quantitative workload, qualitative workload, organization of work, social work climate, after work situation, verbal violence, threats, physical violence) and employee health (subjective health status and work ability). Descriptive statistics and binary logistic regressions were performed.
RESULTS
Increasing age (OR = 0.650, 95% CI = 0.424-0.996) as an individual determinant and organization of work (OR = 0.595, CI = 0.362-0.978) as an organizational determinant were negatively associated with subjective health. Furthermore, age (OR = 0.555, 95% CI = 0.353-0.875), a demanding organization of work (OR = 0.520, CI = 0.315-0.858), increasing quantitative workloads (OR = 0.565, CI = 0.343-0.930) and a poorer perceived social work climate (OR = 0.610, CI = 0.376-0.991) were associated with lower work ability.
CONCLUSIONS
Based on the study results, health programs should target both individual and organizational factors. The findings seem to support the importance to include nursing care employees in the planning process, as it can have an impact on their health.
TRIAL REGISTRATION
The project was registered in the German Clinical Trial Register (DRKS00024961, 09/04/2021).
背景
护理行业的特点是护理员工因病缺勤率高。已知影响护士心理健康的组织决定因素。尽管护士在不同的护理环境中面临不同的框架条件，但德国缺乏比较数据。
方法
本研究旨在探讨不同护理环境中的工作需求与员工健康之间的关系。这是一项横断面调查，于 2021 年 6 月至 10 月在德国的四家急性护理医院、七家住院护理机构和五家门诊护理服务机构进行。共有 528 名护理员工（急性护理医院 n=234；住院护理机构 n=152；门诊护理服务 n=142）参与了调查（参与率：22.6%-27.9%）。对于每个护理环境，通过问卷收集个体决定因素（性别、年龄、职业、工作时间）、组织工作需求（定量工作量、定性工作量、工作组织、社会工作氛围、工作后情况、言语暴力、威胁、身体暴力）和员工健康（主观健康状况和工作能力）的数据。进行描述性统计和二项逻辑回归分析。
结果
作为个体决定因素的年龄增长（OR=0.650，95%CI=0.424-0.996）和作为组织决定因素的工作组织（OR=0.595，CI=0.362-0.978）与主观健康呈负相关。此外，年龄（OR=0.555，95%CI=0.353-0.875）、要求苛刻的工作组织（OR=0.520，CI=0.315-0.858）、定量工作量增加（OR=0.565，CI=0.343-0.930）和较差的感知社会工作氛围（OR=0.610，CI=0.376-0.991）与工作能力降低相关。
结论
基于研究结果，健康计划应针对个人和组织因素。研究结果似乎支持将护理员工纳入规划过程的重要性，因为这会对他们的健康产生影响。
试验注册
该项目在德国临床试验注册中心（DRKS00024961，2021 年 9 月 4 日）注册。
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