新冠疫情期间保护瑞士护士健康的因素：一项纵向研究
Factors protecting Swiss nurses' health during the COVID-19 pandemic: a longitudinal study.
作者信息
Jubin Jonathan, Delmas Philippe, Gilles Ingrid, Oulevey Bachmann Annie, Ortoleva Bucher Claudia
机构信息
La Source School of Nursing, HES-SO University of Applied Sciences and Arts Western Switzerland, Av. Vinet 30, Lausanne, 1004, Switzerland.
Lausanne University Hospital, Rue de Bugnon 21, Lausanne, CH-1011, Switzerland.
出版信息
BMC Nurs. 2023 Sep 7;22(1):306. doi: 10.1186/s12912-023-01468-6.
BACKGROUND
The COVID-19 pandemic reached Europe in early 2020 and impacted nurses over a prolonged period, notably causing heavy work overloads. Exposure to sources of stress in such situations is inevitable, which can put nurses' health at risk. The present study took a salutogenic approach to investigating nurses' health and the principal factors protecting it found in the literature (i.e., resilience, post-traumatic growth, social support, and certain organizational factors), as well as how those elements evolved from February 2021 to September 2022.
METHODS
All nurses working at eight French-speaking Swiss hospitals who accepted to disseminate the study to their employees were invited to complete an online questionnaire at four time points (February 2021, September 2021, March 2022, and September 2022: T0, T1, T2, and T3, respectively) and respond to items measuring their health, factors protecting their health, and their perceived stress levels. Data were analyzed using random-intercept linear regression models.
RESULTS
A cumulated total of 1013 responses were collected over all measurement points (625 responses at T0; 153 at T1; 146 at T2; 89 at T3). Results revealed that nurses' health had not changed significantly between measurements. However, their perceived stress levels, feelings of being supported by their management hierarchies, and belief that they had the means to deliver a high quality of work all diminished. At every measurement point, nurses' health was negatively associated with perceived stress and positively associated with resilience, perceived social support, and the belief that they were provided with the means to deliver a high quality of work.
CONCLUSION
Despite the difficult conditions caused by the pandemic, the factors recognized as protective of nurses' health played their role. The lack of improvements in nurses' health in periods when the pandemic's effects lessened suggests that the pressure they were experiencing did not drop during these moments. This phenomenon may have been due to the need to clear backlogs in scheduled surgery and the work overloads caused by prolonged staff absences and nurses quitting the profession. Monitoring changes in nurses' health is thus crucial, as is establishing measures that promote factors protective of their health. Organizational factors influencing nurses' working conditions are also key and should not be neglected.
背景
2020年初，新冠疫情蔓延至欧洲，在较长一段时间内对护士产生了影响，尤其导致了严重的工作负担过重。在这种情况下，接触压力源是不可避免的，这可能会危及护士的健康。本研究采用健康生成法，调查护士的健康状况以及文献中发现的保护其健康的主要因素（即心理韧性、创伤后成长、社会支持和某些组织因素），以及这些因素在2021年2月至2022年9月期间是如何演变的。
方法
邀请在瑞士八家法语医院工作且同意向其员工传播该研究的所有护士，在四个时间点（分别为2021年2月、2021年9月、2022年3月和2022年9月：即T0、T1、T2和T3）完成一份在线问卷，并回答有关其健康状况、保护其健康的因素以及他们感知到的压力水平的问题。使用随机截距线性回归模型对数据进行分析。
结果
在所有测量点共收集到1013份回复（T0时625份；T1时153份；T2时146份；T3时89份）。结果显示，各次测量之间护士的健康状况没有显著变化。然而，他们感知到的压力水平、对管理层支持的感受以及认为自己有能力提供高质量工作的信念均有所下降。在每个测量点，护士的健康状况与感知到的压力呈负相关，与心理韧性、感知到的社会支持以及认为自己有能力提供高质量工作的信念呈正相关。
结论
尽管疫情造成了困难局面，但被认为对护士健康有保护作用的因素发挥了作用。在疫情影响减弱期间，护士的健康状况没有改善，这表明他们在这些时期所承受的压力并未减轻。这种现象可能是由于需要清理择期手术积压以及长期员工缺勤和护士离职导致的工作负担过重。因此，监测护士健康状况的变化至关重要，制定促进保护其健康因素的措施也同样重要。影响护士工作条件的组织因素也是关键，不应被忽视。
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