The Work Environment and Job-related Stress among Home Healthcare Nurses

描述（由申请人提供）：有证据表明，家庭护理护士的工作相关压力因机构工作环境属性而异。虽然护士在医院环境的工作环境已被广泛研究，家庭护理护士的环境是完全不同的，因为它延伸到病人的家庭和组织资源和支持是远程的。家庭护理人员的工作环境对工作压力的影响尚不清楚。本研究的目的是描述家庭医疗工作环境对护士工作压力的影响，以确定有效干预的机会。具体目标是： 1.确定家庭护理护士描述为特定于其实践和工作环境的压力源 2.确定工作环境的特点，这些特点使与工作有关的 家庭护理护士的压力 3.阐述护士工作自主性和工作环境适应性与工作压力的关系 4.寻求理解为什么全职工作的家庭护理护士， 终身教职员工工作压力更大 一个嵌入式的多案例研究设计将被用于拟议的研究，以对比两个家庭医疗机构的工作环境，从一个新英格兰国家。这项研究将指导的理论模型来自整合的工作压力理论，家庭健康护理实践的尼尔理论，并提出，护士工作的机构，支持专业的护理实践环境的经验较少的压力。数据将通过半结构化访谈、直接观察和焦点小组访谈收集。将使用模式匹配和扎根理论方法分析数据。这项研究与公共卫生有关，因为与工作有关的压力会对病人护理的质量、护士对工作的感觉以及他们是否会继续工作产生不利影响。这对获得护理和护理质量产生了影响。据信，这项研究的结果将有助于确定工作环境的干预措施，适度的家庭护理护士所经历的压力水平。

DESCRIPTION (provided by the applicant): There is evidence that job-related stress among home healthcare nurses is variable based on agency work environment attributes. Although the work environment of nurses in hospital settings has been studied extensively, the environment of home healthcare nurses is quite different as it extends into patients' homes and organizational resources and support are remote. Little is known about the effect of the home healthcare nurses' work environment on job-related stress. The purpose of this proposed study is to describe the effect of the home healthcare work environment on job-related stress experienced by nurses in an effort to identify opportunities for effective intervention. The specific aims are to: 1. identify stressors that home healthcare nurses describe as specific to their practice and work environments 2. identify the characteristics of the work environment that moderate the levels of job-related stress experienced by home healthcare nurses 3. explicate the ways nurse autonomy and adaptation in the work environment relate to job stress 4. seek to understand why home healthcare nurses who work full time and have more years of tenure report higher levels of job-related stress An embedded multiple case study design will be used in the proposed study to contrast the work environments of two home healthcare agencies from one New England state. The study will be guided by a theoretical model derived from an integration of job stress theory, the Neal Theory of home health nursing practice, and proposes that nurses working in agencies that support a professional nursing practice environment experience less stress. Data will be collected by semi-structured interviews, direct observation and focus group interviews. Data will be analyzed using pattern matching and grounded theory methodology. This study is relevant to public health in that job-related stress adversely affects the quality of patient care, how nurses feel about their jobs, and whether they will remain in their jobs. This has implications for access and quality of care. It is believed that the findings from this study will help to identify work environment interventions that moderate levels of stress experienced by home healthcare nurses.