PDF(Pubmed)
Abstract：
BACKGROUND: Aging populations and nursing workforce issues are causing challenges for long-term care globally, and therefore, improving the work-related wellbeing and retention of nurses is crucial. As such, gaining a further understanding of the factors that affect work strain in long-term care is important. Previously, the effect of job demands on the wellbeing of nurses has been researched principally by subjective instruments. In this study, we examined the relationship between indirectly measured workday characteristics and perceived stress and time pressure among nurses working in Finnish long-term care (assisted living facilities with 24-hour assistance).
METHODS: A total of 503 nurses from 44 assisted living facilities across Finland completed time measurement surveys and wellbeing questionnaires. The data were linked with client characteristics from the Resident Assessment Instrument register. The relationships between the measured number of care events during the workday, clients\' care needs, and the amount of breaktime and perceived stress and time pressure were analyzed using multivariate logistic regression.
RESULTS: Nurses who had more care events and clients with greater care needs were at higher odds of having high stress. More care events and reduced breaktime were associated with high time pressure. Disruptions during the workday were strongly associated with both high stress and time pressure. Last, nurses who were under high stress and time pressure worked more often in teams with lower team autonomy.
CONCLUSIONS: Our findings on indirectly measured job demands indicate that dividing the workload equally among nurses through better work division can help reduce the stress and time pressure of nurses in long-term care. In addition, ensuring sufficient breaktime and preventing unnecessary disruptions is important. To help recruit and retain the care workforce, fair management of work that accounts for varying client care needs and workload is needed. In addition, legislative and governance tools, such as staffing level regulation, and further consideration of job demands might aid in reducing the job strain of nurses.
UNASSIGNED: Patients or nurses were not involved in the design of the study, analysis, or interpretation of the results, or in the preparation of the manuscript.
METHODS: A total of 503 nurses from 44 assisted living facilities across Finland completed time measurement surveys and wellbeing questionnaires. The data were linked with client characteristics from the Resident Assessment Instrument register. The relationships between the measured number of care events during the workday, clients\' care needs, and the amount of breaktime and perceived stress and time pressure were analyzed using multivariate logistic regression.
RESULTS: Nurses who had more care events and clients with greater care needs were at higher odds of having high stress. More care events and reduced breaktime were associated with high time pressure. Disruptions during the workday were strongly associated with both high stress and time pressure. Last, nurses who were under high stress and time pressure worked more often in teams with lower team autonomy.
CONCLUSIONS: Our findings on indirectly measured job demands indicate that dividing the workload equally among nurses through better work division can help reduce the stress and time pressure of nurses in long-term care. In addition, ensuring sufficient breaktime and preventing unnecessary disruptions is important. To help recruit and retain the care workforce, fair management of work that accounts for varying client care needs and workload is needed. In addition, legislative and governance tools, such as staffing level regulation, and further consideration of job demands might aid in reducing the job strain of nurses.
UNASSIGNED: Patients or nurses were not involved in the design of the study, analysis, or interpretation of the results, or in the preparation of the manuscript.
摘要：
背景：人口老龄化和护理劳动力问题正在给全球长期护理带来挑战，因此,改善与工作相关的健康和护士的保留至关重要。因此，进一步了解影响长期护理工作压力的因素很重要。以前,主要通过主观工具研究了工作需求对护士健康的影响。在这项研究中,我们研究了在芬兰长期护理(24小时辅助生活设施)工作的护士间接测量的工作日特征与感知压力和时间压力之间的关系.
方法：来自芬兰44个辅助生活设施的503名护士完成了时间测量调查和幸福感问卷。数据与居民评估工具登记册中的客户特征相关联。工作日期间测量的护理事件数量之间的关系，客户的护理需求，并使用多因素logistic回归分析了休息时间，感知压力和时间压力的量。
结果：有更多护理事件和有更大护理需求的客户的护士有更高的压力。更多的护理事件和减少的休息时间与高时间压力相关。工作日的中断与高压力和时间压力密切相关。最后,处于高压力和时间压力下的护士在团队自主性较低的团队中工作更频繁。
结论：我们对间接测量的工作需求的研究结果表明，通过更好的工作分工在护士之间平均分配工作量有助于减少护士在长期护理中的压力和时间压力。此外,确保足够的中断时间和防止不必要的中断是重要的。为了帮助招聘和留住护理人员，需要公平的管理工作，以满足不同的客户护理需求和工作量。此外,立法和治理工具，如人员编制水平规定，进一步考虑工作需求可能有助于减少护士的工作压力。
■患者或护士没有参与研究的设计，分析,或对结果的解释，或在准备手稿时。
方法：来自芬兰44个辅助生活设施的503名护士完成了时间测量调查和幸福感问卷。数据与居民评估工具登记册中的客户特征相关联。工作日期间测量的护理事件数量之间的关系，客户的护理需求，并使用多因素logistic回归分析了休息时间，感知压力和时间压力的量。
结果：有更多护理事件和有更大护理需求的客户的护士有更高的压力。更多的护理事件和减少的休息时间与高时间压力相关。工作日的中断与高压力和时间压力密切相关。最后,处于高压力和时间压力下的护士在团队自主性较低的团队中工作更频繁。
结论：我们对间接测量的工作需求的研究结果表明，通过更好的工作分工在护士之间平均分配工作量有助于减少护士在长期护理中的压力和时间压力。此外,确保足够的中断时间和防止不必要的中断是重要的。为了帮助招聘和留住护理人员，需要公平的管理工作，以满足不同的客户护理需求和工作量。此外,立法和治理工具，如人员编制水平规定，进一步考虑工作需求可能有助于减少护士的工作压力。
■患者或护士没有参与研究的设计，分析,或对结果的解释，或在准备手稿时。
