The role of aggressions suffered by healthcare workers as predictors of burnout
The role of aggressions suffered by healthcare workers as predictors of burnout
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DOI：
10.1111/j.1365-2702.2012.04255.x
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发表时间：
2013-11-01
影响因子：
4.2
通讯作者：
Martinez-Jarreta, Begona
中科院分区：
文献类型：
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作者：
Gascon, Santiago;Leiter, Michael P.;Martinez-Jarreta, Begona
目的和目标。调查针对医疗专业人员的攻击行为的普遍性，并确定暴力事件对医疗专业人员在失去工作热情和投入方面可能产生的影响。目的是分析在不同类型的医疗保健服务中职业攻击与专业人员攻击的百分比，区分身体攻击和语言攻击作为检测医生和护理专业人员倦怠的可能变量。Leiter和Maslach探索了一个双重过程倦怠模型，该模型不仅基于超负荷导致的疲劳，还基于个人和组织的价值冲突（社区、奖励或价值观）。此外，Whittington还获得了关于心理健康护士的暴力与倦怠之间可能存在的关系的结论性结果。回顾性研究在西班牙的3家医院和22个初级保健中心进行（n=1.826）。通过不同的问卷调查，我们探讨了医护人员所遭受的攻击与职业倦怠之间的关系。11%的受访者至少一次受到人身攻击，34.4%的受访者至少一次受到威胁和恐吓，36.6%的受访者遭受侮辱。两种形式的暴力，身体和非身体攻击，都显示出与倦怠症状（情绪衰竭、人格解体和无能）的显著相关性。调查显示了双重过程的证据：(1)过度的工作量有助于预测倦怠；(2)价值观一致性的不匹配，或人际冲突，以有意义的方式促进了倦怠的每个维度，增加了精疲力竭-玩世不恭-缺乏实现的过程的开销。与临床实践相关。研究表明，卫生专业人员是最容易受到心理社会风险和高合并症影响的人群：焦虑、抑郁等。显然需要准确的评估工具，不仅要发现倦怠，还要发现导致倦怠的领域。由攻击性或其他因素引起的职业倦怠可以反映出医疗关系的恶化。
Aims and objectives. To examine the prevalence of aggression against healthcare professionals and to determine the possible impact that violent episodes have on healthcare professionals in terms of loss of enthusiasm and involvement towards work. The objective was to analyse the percentage of occupational assault against professionals' aggression in different types of healthcare services, differentiating between physical and verbal aggression as a possible variable in detecting burnout in doctors and nursing professionals.Background. Leiter and Maslach have explored a double process model of burnout not only based on exhaustion by overload, but also based on personal and organisational value conflicts (community, rewards or values). Moreover, Whittington has obtained conclusive results about the possible relationship between violence and burnout in mental health nurses.Design. A retrospective study was performed in three hospitals and 22 primary care centres in Spain (n=1.826).Methods. Through different questionnaires, we have explored the relationship between aggression suffered by healthcare workers and burnout.Results. Eleven percent of respondents had been physically assaulted on at least one occasion, whilst 34.4% had suffered threats and intimidation on at least one occasion and 36.6% had been subjected to insults. Both forms of violence, physical and non-physical aggression, showed significant correlations with symptoms of burnout (emotional exhaustion, depersonalisation and inefficacy).Conclusions. The survey showed evidence of a double process: (1) by which excess workload helps predict burnout, and (2) by which a mismatch in the congruence of values, or interpersonal conflict, contributes in a meaningful way to each of the dimensions of burnout, adding overhead to the process of exhaustion-cynicism-lack of realisation.Relevance to clinical practice. Studies indicate that health professionals are some of the most exposed to disorders steaming from psychosocial risks and a high comorbidity: anxiety, depression, etc. There is a clear need for accurate instruments of evaluation to detect not only the burnout but also the areas that cause it. Professional exhaustion caused by aggression or other factors can reflect a deterioration in the healthcare relationship.