Wykes T, Stevens W, Everitt B
Department of Psychology, Institute of Psychiatry, London, UK.
Soc Psychiatry Psychiatr Epidemiol. 1997 Oct;32(7):398-407. doi: 10.1007/BF00788180.
The study investigated whether community care is sustainable by examining the levels of stress and burnout that affect community mental health staff. Six teams from around Great Britain were chosen to take part, representing a number of different facets of care: the type of community model, whether it was in an inner city or suburban area and whether the team had been part of a scientific evaluation of care, in which case it may have contained more experienced and more highly trained staff. The results indicated that community care staff experienced high levels of burnout as a result of the work stressors. These levels were higher than those found in any published study of health professionals within hospitals, but are similar to those found in community teams recently. There was no evidence that any particular model of community care produced less burnout, but working in an inner city did seem to produce the highest levels. There did seem to be some benefit from a moderate staff turnover within teams. These results mirror those of other recent studies. Models of community care can only be sustained by reducing their toxicity on the staff who have to make them work. Therefore, levels of stress and burnout should be included in any evaluation of the cost-effectiveness of service models. The alleviation of these high levels through individual and organisational interventions should now be a high priority.
该研究通过调查影响社区心理健康工作人员的压力和倦怠程度，来探究社区护理是否可持续。从英国各地挑选了六个团队参与研究，这些团队代表了护理的多个不同方面：社区模式的类型、是位于市中心还是郊区，以及该团队是否参与过护理的科学评估，若是这种情况，团队可能会有更多经验丰富、训练有素的工作人员。结果表明，由于工作压力源，社区护理人员经历了高度的倦怠。这些倦怠程度高于医院内任何已发表的关于卫生专业人员的研究中所发现的程度，但与最近在社区团队中发现的程度相似。没有证据表明任何特定的社区护理模式会产生较少的倦怠，但在市中心工作似乎确实会导致最高程度的倦怠。团队内部适度的人员流动似乎确实有一些益处。这些结果与其他近期研究的结果一致。只有通过降低社区护理模式对必须使其运转的工作人员的有害影响，才能维持这些模式。因此，在对服务模式的成本效益进行任何评估时，都应纳入压力和倦怠程度。现在，通过个人和组织干预来缓解这些高度的压力和倦怠应成为高度优先事项。
