一种新的评估儿童临终关怀工作压力源和回报的量表。

A new scale assessing the stressors and rewards of children's hospice work.

机构信息

School for Business and Society, University of York, York, YO10 5DD, UK.

Department of Health Sciences, University of York, York, YO10 5DD, UK.

出版信息

BMC Palliat Care. 2023 Sep 13;22(1):136. doi: 10.1186/s12904-023-01246-w.

DOI:10.1186/s12904-023-01246-w

PMID:37705048

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10498554/

Abstract

BACKGROUND

There is a workforce shortage in the children's hospice sector, but there has been little research on the specific challenges of working in this setting and on how these challenges might be alleviated. To identify appropriate interventions to improve staff wellbeing, the drivers of wellbeing in children's hospices need to be known and measured. This paper reports on the development of two measures, one for work-related rewards and one for work-related stressors, for use in children's hospice care teams.

METHODS

A mixed-methods, four-stage study; the first three phases focused on the development of the scales, and the last stage focused on the validation of the scales. Participants of all stages were children's hospice care team staff members in the UK. Stage 1: survey assessing the relevance and comprehensiveness of the original scale items (N = 60); Stages 2 (focus groups; N = 16) and 3 (cognitive interviews; N = 14) to assess content validity; Stage 4: UK-wide survey (N = 414) to validate the final version of the new, children's hospice-specific scales using Rasch Analysis (RA) and Confirmatory Factor Analysis (CFA).

RESULTS

Due to poor fitting indices shown in the results from the RA, five items (out of 36) were removed from the new rewards scale used in the UK-wide survey and 20 (out of 62) were removed from the new stressors scale. CFA also supported the removal of the items and showed a one-factor structure for the rewards scale and a three-factor structure for the stressors scale were adequate-the sub-scales for the stressors scale related to caring for an ill or dying child ("Child" sub-scale), working with parents and families ("Parent" sub-scale), and stressors related to organisational factors, such as team conflict and workload ("Organisation" sub-scale).

CONCLUSIONS

Both of the new scales showed good psychometric properties and can be useful in clinical settings and research to assess the perceived intensity of the work-related rewards and stressors for children's hospice staff.

摘要

背景

儿童临终关怀领域存在劳动力短缺问题，但对于在这种环境下工作的具体挑战以及如何缓解这些挑战的研究甚少。为了确定改善员工福祉的适当干预措施，需要了解和衡量儿童临终关怀机构员工福祉的驱动因素。本文报告了两种衡量标准的制定过程，一种用于工作相关回报，另一种用于工作相关压力源，旨在用于儿童临终关怀护理团队。

方法

这是一项混合方法、四阶段研究；前三个阶段专注于量表的开发，最后一个阶段专注于量表的验证。所有阶段的参与者均为英国儿童临终关怀护理团队的工作人员。第 1 阶段：调查评估原始量表项目的相关性和全面性（N=60）；第 2 阶段（焦点小组；N=16）和第 3 阶段（认知访谈；N=14）评估内容效度；第 4 阶段：在英国进行的一项广泛调查（N=414），使用 Rasch 分析（RA）和验证性因子分析（CFA）对新的、特定于儿童临终关怀的量表的最终版本进行验证。

结果

由于 RA 结果显示拟合指数较差，从新的奖励量表中删除了 5 个项目（36 个中的 5 个），从新的压力源量表中删除了 20 个项目（62 个中的 20 个）。CFA 也支持删除这些项目，并显示奖励量表的单因素结构和压力源量表的三因素结构是合理的——压力源量表的子量表与照顾患病或垂死儿童有关（“儿童”子量表）、与父母和家庭合作（“父母”子量表）以及与组织因素相关的压力源，例如团队冲突和工作量（“组织”子量表）。