背景:姑息治疗和肿瘤学在专业人员中产生倦怠和心理困扰的风险。这项研究的目的是确定与工作中的心理健康有关的精神病理学和积极因素。它旨在(i)探索这些专业人员面临苦难的程度,疾病,和死亡;并探讨心理困扰和/或倦怠的患病率,(ii)确定工作中倦怠和心理健康的潜在决定因素,(iii)建立心理健康的综合模型;并确定与死亡对抗的频率和影响,和(Iv)确定专业人员的概况有发展为精神健康障碍的风险,或相反,以幸福为特征。
方法:在姑息治疗和肿瘤学中进行了横断面问卷调查研究,评估与死亡的对抗,应对,倦怠,心理困扰,个性,自尊,工作中的幸福和意义。回归,聚类,并进行了结构方程建模分析。
结果:109名专业人员参与(58%来自肿瘤学,42%来自姑息治疗),其中79%是女性,65%的人年龄在30至49岁之间。目标i:30%的人每月至少目睹9次无法忍受的痛苦,45%的人报告有中度到高度的倦怠,39%患有焦虑症,11%患有抑郁症。目的二:职业倦怠的决定因素是人格特征的责任心和神经质,工作意义低,和低健康(R2=0.44)。幸福的决定因素是工作意义,去个性化,自尊,满足和低情绪耗竭(R2=0.71)。目标三:整合模型既包括幸福感(自尊,尽责)和精神病理学(神经质,焦虑)参数,并强烈满足标准的SEM拟合优度指数(例如,CFI,If,和TLI≥0.95)。目标iv:确定了三个配置文件:(a)大多数专业人员在患者床边的“痛苦配置文件”,(b)与专业人员担任二线顾问的“脱离简介”,(c)“福祉概况”包含对心理困扰不敏感的护理人员的概况,对抗对其生活的不同领域产生了高度积极的影响。
结论:综合方法对于了解专业人员的所有心理健康问题至关重要。工作的意义是专业干预的关键因素,应主要影响经验有限的一线专业人员。
BACKGROUND: Palliative care and oncology generate a risk of burnout and psychological distress in professionals. The purpose of this
study is to identify both psychopathological and positive factors related to mental health at work. It aims (i) to explore the extent to which these professionals are confronted with suffering, illness, and death; and to explore the prevalence of psychological distress and/or burnout, (ii) to identify potential determinants of burnout and psychological wellbeing at work, (iii) to develop an integrative model of mental health; and to identify frequency and impact of confrontations with death, and (iv) to identify profiles of professionals are at risk of developing a mental health disorder or, conversely, characterized by wellbeing.
METHODS: A cross-sectional questionnaire
study was conducted in palliative care and oncology evaluating confrontations with death, coping, burnout, psychological distress, personality, self-esteem, well-being and meaning at work. Regressions, clustering, and structural equation modeling analyses were performed.
RESULTS: 109 professionals participated (58% from oncology and 42% from palliative care), of which 79% were female, and 65% were between 30 and 49 years old. Aim i: 30% witnessed an intolerable suffering at least 9 times a month, 45% reported moderate to high levels of burnout, 39% suffered from anxiety and 11% from depression. Aim ii: the determinants of burnout were the personality traits conscientiousness and neuroticism, low meaning of work, and low wellbeing (R2 = 0.44). The determinants of wellbeing were work meaning, depersonalization, self-esteem, fulfillment and low emotional exhaustion (R2 = 0.71). Aim iii: the integrative model included both well-being (self-esteem, conscientiousness) and psychopathology (neuroticism, anxiety) parameters, and strongly satisfied the standard SEM goodness of fit indices (e.g., CFI, IFI, and TLI ≥ 0.95). Aim iv: three profiles were identified: (a) a \"distressed profile\" with a majority of professionals at the patient\'s bedside, (b) a \"disengaged profile\" with professionals working as second-line consultants, (c) a \"wellbeing profile\" contains profiles of caregivers insensitive to psychological distress and with a high level of positive Impact of confrontation on different areas of their lives.
CONCLUSIONS: An integrative approach is essential to understand the full range of mental health issues for professionals. Meaning of work is a key factor in professional interventions that should primarily affect front-line professionals with limited experience.