Clinical supervision and burnout: the influence of clinical supervision for community mental health nurses
Clinical supervision and burnout: the influence of clinical supervision for community mental health nurses
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DOI：
10.1111/j.1365-2702.2006.01370.x
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发表时间：
2006-08-01
影响因子：
4.2
通讯作者：
Coyle, Dave
中科院分区：
文献类型：
--
作者：
Edwards, Deborah;Burnard, Philip;Coyle, Dave
目标。本研究的目的是确定临床监督对英国威尔士社区精神卫生护士报告的职业倦怠水平的影响程度。使用的研究工具是Maslach职业倦怠量表和曼彻斯特临床监督量表。据报道，在调查期间，有817名社区精神卫生护士在威尔士境内工作。260名(32%)在11家国民保健服务信托基金工作的社区精神卫生护士回答了调查。189名(73%)的社区精神卫生护士在目前的岗位上有临床督导经验，105名(40%)在以前的岗位上有临床督导经验。Maslach职业倦怠量表的调查结果显示，36%的社区心理健康护士的情绪衰竭程度较高，12%的护士人格解体程度较高，10%的社区心理健康护士的个人成就感水平较低。单因素分析显示，年轻、男性、未接受过6次或6次以上临床监督的社区心理健康护士对客户持冷淡态度的可能性较大，Maslach职业倦怠量表的去人格化分量表得分较高。166名社区心理健康护士经历了六次或六次以上的临床监督，并完成了马斯拉赫职业倦怠量表。曼彻斯特临床监督量表总分与职业倦怠程度呈显著负相关(r=-0.148，P=0.050)，与马斯拉赫倦怠量表中的去人格化分量表呈显著负相关(r=-0.220，P=0.003)。这些发现表明，如果临床监督是有效的，那么社区精神卫生护士可能会报告较低的情绪衰竭和去人格化水平。这项研究的结果表明，如果临床监督是有效的，那么社区心理健康护士报告的职业倦怠水平较低。需要进一步的研究来确定实施临床督导的长期益处，并确定哪些其他因素对这类护士的职业倦怠水平有影响。卫生服务组织有责任确保所有个人从业者都能得到有效的临床监督，护士和助产士理事会可以将注册护士的个人责任扩大到包括--在必要时寻求临床监督。
Aims. The aim of this study was to establish the degree to which clinical supervision might influence levels of reported burnout in community mental health nurses in Wales, UK.Methods. The research instruments used were the Maslach Burnout Inventory and the Manchester Clinical Supervision Scale. At the time of the survey 817 community mental health nurses were reported to work within Wales. Two hundred and sixty (32%) community mental heath nurses working in 11 NHS Trusts responded to the survey.Results. One hundred and eighty-nine (73%) community mental heath nurses had experience of clinical supervision in their present posts and 105 (40%) in their previous posts. The findings from the Maslach Burnout Inventory indicated high levels of emotional exhaustion for 36%, high levels of depersonalization for 12% and low levels of personal accomplishment for 10% of the community mental heath nurses surveyed. Univariate analysis showed that those community mental heath nurses who were younger, male and who had not experienced six or more sessions of clinical supervision were more likely to report cold negative attitudes towards their clients as indicated by higher scores on the depersonalization subscale of the Maslach Burnout Inventory. One hundred and sixty-six community mental heath nurses had experienced six or more sessions of clinical supervision and had completed the Maslach Burnout Inventory. Higher scores on the Manchester Clinical Supervision Scale were also associated with lower levels of measured burnout, with significant negative correlations between the total Manchester Clinical Supervision Scale score and the emotional exhaustion subscale (r = -0.148, P = 0.050) and the depersonalization subscale (r = -0.220, P = 0.003) of the Maslach Burnout Inventory. These findings suggest that if clinical supervision is effective then community mental heath nurses are likely to report lower levels of emotional exhaustion and depersonalization.Conclusions. The findings from this study suggest that if clinical supervision is effective then community mental heath nurses report lower levels of burnout. Further research is required to determine the long-term benefits of implementing clinical supervision and to determine which other factors have an influence on levels of burnout for this group of nurses.Relevance to clinical practice. Health service organizations have a responsibility for ensuring that all individual practitioners have access to effective clinical supervision and the Nursing and Midwifery Council could extend the registered nurses personal accountability to include - to seek clinical supervision as and when necessary.