School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
Division of Nursing, Department of Neurobiology, Care Science and Society Karolinska Institute, Stockholm, Sweden.
BMC Health Serv Res. 2023 Nov 28;23(1):1312. doi: 10.1186/s12913-023-10320-1.
In Sweden, older people in residential care had the highest mortality rates, followed by those who received home care, during the coronavirus disease 2019 (COVID-19) pandemic. Staff working in the care of older people assumed responsibility for preventing the spread of the virus despite lacking the prerequisites and training. This study aimed to investigate the psychosocial work environment during the COVID-19 pandemic among staff in the care of older people and examine the factors associated with staff's perceptions of the clarity of instructions and the ability to follow them.
A cross-sectional study design was employed using a web survey. The staff's perceptions of their psychosocial environment were analysed using descriptive statistics. The association between organisational and individual factors, as well as the degree of clarity of the instructions and the staff's ability to follow them, were assessed using multivariate (ordinal) regression analysis.
The main findings show that perceptions of the clarity and adaptability of the instructions were primarily correlated with organisational factors, as higher responses (positive) for the subscales focusing on role clarity, support and encouragement in leadership at work were associated with the belief that the instructions were clear. Similarly, those indicating high job demands and high individual learning demands were less likely to report that the instructions were clear. Regarding adaptability, high scores for demands on learning and psychological demands were correlated with lower adaptability, while high scores for role clarity, encouraging leadership and social support, were associated with higher adaptability.
High job demands and individual learning demands were demonstrated to decrease the staff's understanding and adoption of instructions. These findings are significant on an organisational level since the work environment must be prepared for potential future pandemics to promote quality improvement and generally increase patient safety and staff health.
在新冠疫情期间，瑞典居住在养老院的老年人和接受家庭护理的老年人的死亡率最高。尽管缺乏必要的前提条件和培训，负责照顾老年人的工作人员仍承担着预防病毒传播的责任。本研究旨在调查新冠疫情期间老年人护理人员的心理社会工作环境，并探讨与工作人员对指令清晰度和遵循能力的看法相关的因素。
采用横断面研究设计，使用网络调查。使用描述性统计方法分析工作人员对其心理社会环境的看法。使用多元（有序）回归分析评估组织和个体因素与指令清晰度和工作人员遵循能力之间的关联。
主要发现表明，对指令清晰度和适应性的看法主要与组织因素相关，对注重角色清晰度、工作中领导力的支持和鼓励的子量表的较高反应（积极）与认为指令清晰相关。同样，那些表示工作要求高和个人学习要求高的人不太可能报告指令清晰。关于适应性，学习要求和心理需求高与适应性较低相关，而角色清晰度、鼓励领导力和社会支持高与适应性较高相关。
高工作要求和个人学习要求被证明降低了工作人员对指令的理解和采用。这些发现具有组织层面的意义，因为必须为未来可能的大流行做好工作环境的准备，以促进质量改进，并普遍提高患者安全和工作人员健康。
