Patient-related stressful situations and stress-related outcomes in emergency nurses: A cross-sectional study on the role of work factors and recovery during leisure time
Patient-related stressful situations and stress-related outcomes in emergency nurses: A cross-sectional study on the role of work factors and recovery during leisure time
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急诊护士与病人相关的压力情况和压力相关的结果：一项关于工作因素和闲暇时间恢复作用的横断面研究
DOI：
10.1016/j.ijnurstu.2020.103579
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发表时间：
2020-07-01
影响因子：
8.1
通讯作者：
van der Doef, M. P.
中科院分区：
文献类型：
--
作者：
de Wijn, A. N.;van der Doef, M. P.
背景：急诊护士经常暴露在与病人有关的压力情况下，使他们容易情绪衰竭和创伤后应激障碍的症状。本研究旨在评估病人相关压力情境（情绪要求情境、攻击/冲突情境和重大事件）对急诊护士压力相关结果的差异影响，并基于工作需求-资源模型和努力-恢复模型（工作需求、工作资源和休闲时间的恢复体验），找出调节因素。方法：对荷兰19家医院急诊科护士进行横断面调查（N = 692，有效率73%）。数据是通过在线调查收集的。在控制社会人口变量的情况下，进行了多层次回归分析。结果：患者相关应激情境暴露频率与应激相关结局呈正相关，其中情绪苛求情境和攻击/冲突情境主要解释情绪耗竭的变异（beta = 0.16, p < 0.01, δ R-2 = 0.08, δ R-2 = 0.22, p < 0.01, δ r (R2) = 0.13），而关键事件主要解释创伤后应激症状的变异（beta = 0.29, p < 0.01, δ R-2 = 0.11）。工作时间内的恢复和闲暇时间的恢复均有调节作用。工作时间要求、自主性和来自上级的社会支持对压力相关结果具有预测作用，而与患者压力相关情况的暴露无关。结论：由于在急诊科环境中，与患者相关的压力情况很难减少，如果不是不可能的话，研究结果表明，在工作时间内刺激恢复以及在闲暇时间的恢复体验，以保护急诊护士免受情绪衰竭和创伤后应激症状的影响是值得的。此外，本研究强调了减少工作时间需求和增加工作资源以解决急诊护士压力相关结果的重要性。讨论了实际意义、优势和局限性。(c) 2020 Elsevier Ltd.版权所有。
Background: Emergency nurses are frequently exposed to patient-related stressful situations, making them susceptible to emotional exhaustion and symptoms of post-traumatic stress disorder. The current study aims to assess differential effects of patient-related stressful situations (emotionally demanding situations, aggression/conflict situations, and critical events) on stress-related outcomes in emergency nurses, and to identify moderating factors based on the Job Demands-Resources model and the Effort-Recovery model (job demands, job resources, and recovery experiences during leisure time).Method: A cross-sectional study was carried out among nurses working in the emergency departments of 19 hospitals in the Netherlands (N = 692, response rate 73%). Data were collected by means of an online survey. Multiple hierarchical regression analyses were performed, controlling for sociodemographic variables.Results: The frequency of exposure to patient-related stressful situations was positively related to stress-related outcomes, with emotionally demanding situations and aggression/conflict situations mainly explaining variance in emotional exhaustion (beta = 0.16, p < .01, Delta R-2 = 0.08, and beta = 0.22, p < .01, Delta(R2) = 0.13), whereas critical events mainly explained variance in post-traumatic stress symptoms (beta = 0.29, p < .01, Delta R-2 = 0.11). Moderating effects were found for within worktime recovery and recovery during leisure time. Work-time demands, autonomy and social support from the supervisor were predictive of stress-related outcomes irrespectively of exposure to patient-related stressful situations.Conclusion: As patient-related stressful situations are difficult if not impossible to reduce in an emergency department setting, the findings suggest it would be worthwhile to stimulate within worktime recovery as well as recovery experiences during leisure time, to protect emergency nurses from emotional exhaustion and symptoms of post-traumatic stress. Furthermore, this study underscores the importance of reducing work-time demands and enhancing job resources to address stress-related outcomes in emergency nurses. Practical implications, strengths and limitations are discussed. (c) 2020 Elsevier Ltd. All rights reserved.