Vachon M L
Sunnybrook Health Science Centre and Toronto-Sunnybrook Regional Cancer Centre, Ontario, Canada.
Palliat Med. 1995 Apr;9(2):91-122. doi: 10.1177/026921639500900202.
A review of the research in the area of staff stress in hospice/palliative care since the start of the modern hospice movement shows that, while high stress was identified as a problem in the early days of the movement, later studies have shown that stress and burnout in palliative care are by no means universal. Staff stress and burnout in hospice/palliative care has been demonstrated to be less than in professionals in many other settings. However, other studies have noted suicidal ideation, increased alcohol and drug usage, anxiety, depression, and difficulty in dealing with issues of death and dying. It is hypothesized that part of the reason that stress may be lower than expected in some settings was the early recognition of the potential stress inherent in this field and the development of appropriate organizational and personal coping strategies to deal with the identified stressors. Staff in hospice/palliative care have been found to have increased stress when mechanisms such as social support, involvement in work and decision-making, and a realistic work-load are not available. The stress that exists in palliative care is due in large measure to organizational and societal issues, although personal variables were also found to have an influence. Suggestions are given for the direction of future research in the field.
对现代临终关怀运动开始以来临终关怀/姑息治疗领域员工压力研究的回顾表明，虽然在该运动早期，高压力就被认定为一个问题，但后来的研究表明，姑息治疗中的压力和职业倦怠绝非普遍现象。临终关怀/姑息治疗中的员工压力和职业倦怠已被证明低于许多其他环境中的专业人员。然而，其他研究指出了自杀念头、酒精和药物使用增加、焦虑、抑郁以及处理死亡问题时的困难。据推测，在某些环境中压力可能低于预期的部分原因是该领域早期就认识到潜在的固有压力，并制定了适当的组织和个人应对策略来处理已确定的压力源。当社会支持、参与工作和决策以及合理工作量等机制不存在时，临终关怀/姑息治疗中的员工压力会增加。姑息治疗中存在的压力在很大程度上归因于组织和社会问题，尽管也发现个人变量有影响。文中还给出了该领域未来研究方向的建议。
