Heim E
Psychiatrische Universitätsklinik, Bern.
Psychother Psychosom Med Psychol. 1993 Sep-Oct;43(9-10):307-14.
A model of coping with job stressors is presented, whereby the mediating effect of coping always is goal directed. There exists a variety of stressors in health professions which call for flexible adaptation. Results of studies by this author on coping with job stressors in nursing and dentists are presented. Coping strategies of nurses are not always optimal: in factor analysis coping by will and problem solving was followed by social support; less favourable is diversion and compensation by consumption, fatalistic-depressed withdrawal or aggressive acting out. Religions support seems to be especially helpful in a subgroup. Job satisfaction remains high (80% satisfied), with progressive satisfaction going with little stress values, but poor satisfaction with high stress. In the coping process of doctors and dentists there is a better correspondence between stressors and coping strategies. Quite in contrast to the rich literature on stressors there are few studies on coping of healthcare professionals, so that it is difficult to derive general conclusions. Nevertheless, based on qualitative analysis (repertory grid by Kelly) certain typical patterns were elaborated like "manager; denier; pleaser; problem seeker". Finally intervention strategies to improve coping of health professionals are reviewed.
本文提出了一个应对工作压力源的模型,其中应对的中介作用始终是目标导向的。卫生行业存在各种压力源,需要灵活适应。本文作者介绍了关于护士和牙医应对工作压力源的研究结果。护士的应对策略并不总是最佳的:在因素分析中,意志和解决问题的应对方式之后是社会支持;不太有利的是通过消费转移和补偿、宿命论-抑郁退缩或攻击性行为。宗教支持在一个亚组中似乎特别有帮助。工作满意度仍然很高(80%满意),压力值低时满意度逐渐提高,但压力高时满意度较低。在医生和牙医的应对过程中,压力源和应对策略之间的对应关系更好。与关于压力源的丰富文献形成鲜明对比的是,关于医疗保健专业人员应对的研究很少,因此很难得出一般性结论。然而,基于定性分析(凯利的 repertory grid),阐述了某些典型模式,如“管理者;否认者;取悦者;问题寻求者”。最后回顾了改善医疗保健专业人员应对能力的干预策略。