Efficacy of the Well-Being Index to Identify Distress and Well-Being in US Nurses
Efficacy of the Well-Being Index to Identify Distress and Well-Being in US Nurses
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DOI：
10.1097/nnr.0000000000000313
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发表时间：
2018-11-01
期刊：
影响因子：
2.5
通讯作者：
Shanafelt, Tait D.
中科院分区：
文献类型：
--
作者：
Dyrbye, Liselotte N.;Johnson, Pamela O.;Shanafelt, Tait D.
背景研究表明，职业倦怠和抑郁在美国护士中普遍存在。目的本研究的目的是评估幸福感指数(WBI)对护士苦恼(如低生活质量[QOL]、极度疲劳、倦怠、近期自杀意念)和幸福感(高QOL)的分层能力，并检测其苦恼程度可能对留任或工作表现产生负面影响的人。调查包括WBI和标准工具，用于评估总体生活质量、疲劳、倦怠、最近的自杀意念、病人护理失误和离开当前工作的意图。采用Fisher精确检验和Wilcoxon/Two-Sample t检验，I类错误率为5%，双侧交替。结果完成调查的812名护士(26%)中，637名护士符合本次分析要求。心理生活质量低、极度疲劳、最近有自杀意念或职业倦怠的护士总分较高(均为PS<；.001)，导致WBI得分较低。在总体生活质量低的17%的前测概率下，WBI评分可以将低生活质量的后测概率降低到2%或增加到72%。随着WBI得分的增加，总体生活质量高的可能性以逐步的方式从3.38下降到0.04。WBI评分还对护士报告最近的病人护理失误和/或打算离开当前工作的可能性进行分层。讨论WBI是一种有用的筛查工具，可以对护士在不同领域的痛苦和幸福感进行分层，并确定其痛苦的严重程度可能对病人的护理和保留产生负面影响的护士。
Background Studies suggest there is a high prevalence of burnout and depression among U.S. nurses.Objectives The aim of the study was to gauge the capability of the Well-Being Index (WBI) to stratify nurse distress (e.g., low quality of life [QOL], extreme fatigue, burnout, recent suicidal ideation) and well-being (high QOL) and detect those whose level of distress may negatively affect retention or work performance.Methods In 2016, we conducted a cross-sectional survey of 3,147 U.S. nurses. The survey included the WBI and standard instruments to assess overall QOL, fatigue, burnout, recent suicidal ideation, patient care errors, and intent to leave current job. We used Fisher exact test and Wilcoxon/two-sample t-test procedures with a 5% Type I error rate and a two-sided alternative.Results Of the 812 (26%) nurses who completed the survey, 637 were eligible for the present analysis. Nurses with low mental QOL, extreme fatigue, recent suicidal ideation, or burnout had a higher total score (all ps < .001), resulting in less favorable WBI scores. With a 17% pretest probability of low overall QOL, the WBI score can decrease the posttest probability of low QOL to 2% or increase it to 72%. The likelihood of high overall QOL decreased in a stepwise fashion from 3.38 to 0.04, as the WBI score increased. WBI score also stratified nurses' likelihood of reporting a recent patient care error and/or intent to leave current job.Discussion The WBI is a useful screening tool to stratify both distress and well-being across a variety of domains in nurses and identify those nurses whose severity of distress may negatively affect patient care and retention.