Gray-Toft P A, Anderson J G
Health Serv Res. 1985 Feb;19(6 Pt 1):753-74.
A model of organizational stress in the hospital was developed and tested. The model utilized measures of organizational climate, supervisory practices, and work group relations as predictors of the amount of role conflict and ambiguity that nurses perceived in providing patient care. Role conflict and ambiguity were treated as variables that intervene between organizational variables and the level of stress that the nursing staff experienced. Nursing stress was viewed as a direct cause of job dissatisfaction and as an indirect cause of absenteeism among the nursing staff. Data from 158 registered nurses, licensed practical nurses, and nursing assistants on seven nursing units in a 1,160-bed private teaching hospital were used to estimate the parameters of a structural equation model. The model was used to predict the results of a survey feedback project designed to change the supervisory style used on the units. Pre- and posttest data from four surgical units were used to validate the model. The findings suggest that, as predicted, supervisory practices that led to more open expression of views and joint problem solving resulted in reduced role conflict, ambiguity, and stress; increased job satisfaction; and lower levels of absenteeism among the nursing staff.
一个医院组织压力模型被开发并测试。该模型利用组织氛围、监督实践和工作小组关系的测量指标，作为护士在提供患者护理时所感知的角色冲突和模糊程度的预测因素。角色冲突和模糊被视为介于组织变量和护理人员所经历的压力水平之间的干预变量。护理压力被视为工作不满的直接原因和护理人员旷工的间接原因。来自一家拥有1160张床位的私立教学医院七个护理单元的158名注册护士、执业护士和护理助理的数据，被用于估计一个结构方程模型的参数。该模型被用于预测一个旨在改变各单元所采用监督方式的调查反馈项目的结果。来自四个外科单元的测试前和测试后数据被用于验证该模型。研究结果表明，正如所预测的那样，那些能促使更多观点公开表达和联合解决问题的监督实践，会导致角色冲突、模糊和压力减少；工作满意度提高；以及护理人员旷工率降低。
