Prevalence of and Factors Associated With Nurse Burnout in the US.
Prevalence of and Factors Associated With Nurse Burnout in the US.
复制标题
与美国护士倦怠有关的患病率和因素。
DOI：
10.1001/jamanetworkopen.2020.36469
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发表时间：
2021-02-01
影响因子：
13.8
通讯作者：
Ali MK
中科院分区：
文献类型：
--
作者：
Shah MK;Gandrakota N;Cimiotti JP;Ghose N;Moore M;Ali MK
美国国家对护士倦怠的最新估计以及可能使护士面临倦怠风险的相关因素是什么？对超过 390 万名美国注册护士的横断面调查数据进行二次分析发现，在报告离职的护士中（占样本的 9.5%），2018 年有 31.5% 的护士报告因职业倦怠而离职。医院环境和每周工作超过 20 小时与职业倦怠的发生率较高有关。随着 2019 年冠状病毒病大流行期间对一线护士的要求不断增加，这些发现表明迫切需要解决护士倦怠问题的解决方案。这项横断面调查的二次分析测量了职业倦怠率，并研究了美国护士因职业倦怠而离职或考虑离职的相关因素。临床医生倦怠是美国健康的主要风险。护士占医疗保健劳动力的大部分，估计护理倦怠和相关因素对于解决倦怠的原因至关重要。衡量护士倦怠率并检查与因倦怠而离职或考虑离职相关的因素。这项二次分析使用了 2018 年 4 月 30 日至 10 月 12 日在美国注册护士全国抽样调查中收集的横断面调查数据。所有做出回应的护士都被包括在内（N = 3 957 661）。数据分析时间为2020年6月5日至10月1日。按自我报告的调查问题、家庭收入和地理区域对年龄、性别、种族和民族进行分类。数据按工作场所环境、工作时间和工作中的主导职能（直接患者护理、其他职能、无主导职能）进行分层。主要结果是去年因倦怠而离职或因倦怠而考虑离职的可能性。 3 957 661 名做出回应的护士主要是女性 (90.4%) 和白人 (80.7%)；平均（加权标准差）年龄为 48.7 (0.04) 岁。在 2017 年报告离职的护士中 (n = 418 769)，31.5% 的护士表示职业倦怠是一个原因，西部地区护士报告职业倦怠的比例较低 (16.6%)，东南部比例较高 (30.0%)。与每周工作时间少于 20 小时相比，每周工作时间超过 40 小时的护士更有可能将职业倦怠视为离职原因（比值比，3.28；95% CI，1.61-6.67）。因倦怠而离职或考虑离职的受访者表示，工作环境压力大（分别为 68.6% 和 59.5%），人员配备不足（分别为 63.0% 和 60.9%）。这些发现表明，职业倦怠是离职或考虑离职的美国护士中的一个严重问题。卫生系统应重点实施已知的缓解倦怠的策略，包括配备充足的护士人员和限制每班工作的小时数。
What were the most recent US national estimates of nurse burnout and associated factors that may put nurses at risk for burnout? This secondary analysis of cross-sectional survey data from more than 3.9 million US registered nurses found that among nurses who reported leaving their current employment (9.5% of sample), 31.5% reported leaving because of burnout in 2018. The hospital setting and working more than 20 hours per week were associated with greater odds of burnout. With increasing demands placed on frontline nurses during the coronavirus disease 2019 pandemic, these findings suggest an urgent need for solutions to address burnout among nurses. This secondary analysis of a cross-sectional survey measures burnout rates and examines factors associated with leaving or considering leaving employment owing to burnout among US nurses. Clinician burnout is a major risk to the health of the US. Nurses make up most of the health care workforce, and estimating nursing burnout and associated factors is vital for addressing the causes of burnout. To measure rates of nurse burnout and examine factors associated with leaving or considering leaving employment owing to burnout. This secondary analysis used cross-sectional survey data collected from April 30 to October 12, 2018, in the National Sample Survey of Registered Nurses in the US. All nurses who responded were included (N = 3 957 661). Data were analyzed from June 5 to October 1, 2020. Age, sex, race and ethnicity categorized by self-reported survey question, household income, and geographic region. Data were stratified by workplace setting, hours worked, and dominant function (direct patient care, other function, no dominant function) at work. The primary outcomes were the likelihood of leaving employment in the last year owing to burnout or considering leaving employment owing to burnout. The 3 957 661 responding nurses were predominantly female (90.4%) and White (80.7%); the mean (weighted SD) age was 48.7 (0.04) years. Among nurses who reported leaving their job in 2017 (n = 418 769), 31.5% reported burnout as a reason, with lower proportions of nurses reporting burnout in the West (16.6%) and higher proportions in the Southeast (30.0%). Compared with working less than 20 h/wk, nurses who worked more than 40 h/wk had a higher likelihood identifying burnout as a reason they left their job (odds ratio, 3.28; 95% CI, 1.61-6.67). Respondents who reported leaving or considering leaving their job owing to burnout reported a stressful work environment (68.6% and 59.5%, respectively) and inadequate staffing (63.0% and 60.9%, respectively). These findings suggest that burnout is a significant problem among US nurses who leave their job or consider leaving their job. Health systems should focus on implementing known strategies to alleviate burnout, including adequate nurse staffing and limiting the number of hours worked per shift.
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