目的:描述,通过综合文献综述,在重症监护病房工作的护理专业人员中,导致职业倦怠和道德困扰发展的因素,并确定最常用于评估职业倦怠和道德困扰的评估工具。
方法:进行了综合文献综述。PubMed,CINAHL,PsycINFO,SciELO,Dialnet,WebofScience,Scopus,和Cochrane数据库在2012年1月至2023年2月进行了审查。此外,使用雪球采样。采用综合综合法对结果进行了分析,正如Whittemore等人提出的那样。,用于文献综述的关键评估技能计划,加强流行病学中的观察研究报告,定量观察研究指南,和JoannaBriggs研究所的定性研究清单被用来评估证据质量。
结果:选择了41篇文章进行审查:36篇是横截面描述性文章,五是文献综述。文章分为五个因素类别:1)个人因素,2)组织因素,3)劳动关系因素,4)临终关怀因素,和5)与2019年冠状病毒病(COVID-19)相关的因素。Maslach倦怠清单-人类服务调查和道德困扰调查-修订的工具是最常用的衡量倦怠和道德困扰的工具。
结论:这篇综述强调了多个人,组织,关系,情境,以及导致重症监护护士职业倦怠和道德困扰的临终因素。在这些领域的干预措施是必要的,以实现护士的工作满意度和保留,同时提高护士的护理质量。
OBJECTIVE: To describe, through an integrative literature review, the factors contributing to the development of burnout and moral distress in nursing professionals working in intensive care units and to identify the assessment tools used most frequently to assess burnout and moral distress.
METHODS: An integrative literature review was carried out. PubMed, CINAHL, PsycINFO, SciELO, Dialnet, Web of Science, Scopus, and Cochrane databases were reviewed from January 2012 to February 2023. Additionally, snowball sampling was used. The results were analysed by using integrative synthesis, as proposed by Whittemore et al., the Critical Appraisal Skills Programme for literature reviews, the Strengthening the Reporting of Observational Studies in Epidemiology guidelines for quantitative observational studies, and the Joanna Briggs Institute checklist for qualitative research were used to evaluate evidence quality.
RESULTS: Forty-one articles were selected for review: 36 were cross-sectional descriptive articles, and five were literature reviews. The articles were grouped into five-factor categories: 1) personal factors, 2) organisational factors, 3) labour relations factors, 4) end-of-life care factors, and 5) factors related to coronavirus disease 2019 (COVID-19). The Maslach Burnout Inventory-Human Services Survey and the Moral Distress Survey-Revised instruments were the most commonly used to measure burnout and moral distress.
CONCLUSIONS: This review highlights the multiple personal, organisational, relational, situational, and end-of-life factors promoting burnout and moral distress among critical care nurses. Interventions in these areas are necessary to achieve nurses\' job satisfaction and retention while improving nurses\' quality of care.