Slaba vest in izgorelost medicinskih sester v enotah intenzivne nege in terapije
DOI:
https://doi.org/10.14528/snr.2021.55.3.3007Ključne besede:
stres na delovnem mestu, izgorevanje na delovnem mestu, intenzivna zdravstvena nega, duševno zdravjePovzetek
Uvod: Vest je večdimenzionalni koncept, zaradi katerega se medicinska sestra more zavedati manj kakovostne oskrbe bolnika in lastnih omejitev. Delovanje v nasprotju z lastno vestjo lahko vodi v izgorelost. Namen raziskave je bil prikazati povezanost bremena vesti in izgorelosti med zaposlenimi v intenzivni zdravstveni negi.
Metode: Izvedena je bila presečna raziskava na priložnostnem vzorcu 46 medicinskih sester. Uporabljen je bil vprašalnik Stress of Conscience (slovensko »Slaba vest«). Vprašalnik je pokazal visoko notranjo skladnost (Cronbach α = 0,875). Podatki so bili zbrani v decembru 2017 in obdelani s programsko opremo IBM SPSS Statistics 23. Analizirani so bili z opisno in bivariatno statistiko. Uporabljeni so bili Fisherjev natančni test, T-test dveh neodvisnih vzorcev oziroma Mann-Whitneyev U-test ter enosmerna ANOVA.
Rezultati: Starost in spol statistično značilno vplivata na breme vesti (p = 0,048 za starost oziroma p = 0,005 za spol). Statistično značilnih vplivov spola, starosti, trajanja zaposlitve ali izobrazbe na prisotnost števila simptomov izgorelosti raziskava ni pokazala. Z izgorelostjo je najbolj povezan (r = 0,503, p < 0,001) vpliv delovnega okolja na zasebno življenje.
Diskusija in zaključek: Slaba vest je prisotna med medicinskimi sestrami v enotah intenzivne nege in terapije. Medicinskim sestram povzročajo slabo vest številni dejavniki. Raziskava je pokazala, da večje breme vesti povečuje število simptomov izgorelosti. Nadaljnje raziskovalno delo je smiselno usmeriti v zmanjševanje bremena vesti in izgorelosti.
Prenosi
Metrike
Literatura
American Nurses Association. (2005). Code of ethics for nurses with interpretive statements. Silver Spring: American Nurses Association.
American Nurses Association. (2020). Principles for nurse staffing. Silver Spring: American Nurses Association.
Bienertova-Vasku, J., Lenart, P., & Scheringer, M. (2020). Eustress and distress: Neither good nor bad, but rather the same. BioEssays, 42(7), Article 1900238. https://doi.org/10.1002/bies.201900238 PMid:32302008
Churchill, L. R. (2019). Conscience, moral reasoning, and skepticism. Perspectives in Biology and Medicine, 62(3), 519–526. https://doi.org/10.1353/pbm.2019.0030 PMid:31495795
Cleary, M., & Lees, D. (2019). The role of conscience in nursing practice. Issues in Mental Health Nursing, 40(3), 281–283. https://doi.org/10.1080/01612840.2019.1548852 PMid:30633604
Conradie, M., Erwee, D., Serfontein, I., Visser, M., Calitz, F. J., & Joubert, G. (2017). A profile of perceived stress factors among nursing staff working with intellectually disabled in-patients at the Free State Psychiatric Complex, South Africa. Curationis, 40(1), e1–e8. https://doi.org/10.4102/curationis.v40i1.1578 PMid:28397510; PMCid:PMC6091609
Čuk, V., & Klemen, J. (2010). Izgorevanje osebja v zdravstveni negi na psihiatričnem področju. Obzornik zdravstvene nege, 44(3), 179–187. Retrieved April 29, 2020 from https://obzornik.zbornica-zveza.si/index.php/ObzorZdravNeg/article/view/2771
Edvardsson, D., Sandman, P. O., & Borell, L. (2014). Implementing national guidelines for person–centered care of people with dementia in residential aged care: Effect on perceived person–centeredness, staff strain, and stress of conscience. International Psychogeriatrics, 26(7), 1171–1179. https://doi.org/10.1017/S1041610214000258 PMid:24576607
Engert, V., Linz, R., & Grant, J. A. (2019). Embodied stress: the physiological resonance of psychosocial stress. Psychoneuroendocrinology, 105, 138–146. https://doi.org/10.1016/j.psyneuen.2018.12.221 PMid:30594324
Garcia, C. D. L., Abreu, L. C. D., Ramos, J. L. S., Castro, C. F. D. D., Smiderle, F. R. N., Santos, J. A. D., & Bezerra, I. M. P. (2019). Influence of burnout on patient safety: Systematic review and meta-analysis. Medicina, 55(9), 553. https://doi.org/10.3390/medicina55090553 PMid:31480365; PMCid:PMC6780563
Genuis, S. J., & Lipp, C. (2013). Ethical diversity and the role of conscience in clinical medicine. International Journal of Family Medicine, 2013, Article 587541. https://doi.org/10.1155/2013/587541 PMid:24455248; PMCid:PMC3876678
Glasberg, A.L., Eriksson, S., & Norberg, A. (2007). Burnout and 'stress of conscience'among healthcare personnel. Journal of Advanced Nursing, 57(4), 392–403. https://doi.org/10.1111/j.1365-2648.2007.04111.x PMid:17291203
Glasberg, A. L., Eriksson, S., & Norberg, A. (2008). Factors associated with ‘stress of conscience’in healthcare. Scandinavian Journal of Caring Sciences, 22(2), 249–258. https://doi.org/10.1111/j.1471-6712.2007.00522.x PMid:18489696
Glasberg, A. L., Eriksson, S., Dahlqvist, V., Lindahl, E., Strandberg, G., Söderberg, A. ... Norberg, A. (2006). Development and initial validation of the stress of conscience questionnaire. Nursing Ethics, 13(6), 633–648. https://doi.org/10.1177/0969733006069698 PMid:17193804
Hafner, M., & Ihan, A. (2014), Prebujanje: Psiha v iskanju izgubljenega Erosa - psihonevroimunologija (pp. 83–470). Ljubljana: Alpha center.
Hoogendoorn, M. E., Margadant, C. C., Brinkman, S., Haringman, J. J., Spijkstra, J. J., & de Keizer, N. F. (2020). Workload scoring systems in the intensive care and their ability to quantify the need for nursing time: A systematic literature review. International Journal of Nursing Studies, 101, Article 103408. https://doi.org/10.1016/j.ijnurstu.2019.103408 PMid:31670169
Inštitut za razvoj človeških virov. Stopnje izgorelosti: Simptomi. Retrieved April 14, 2019 from https://www.burnout.si/izgorelost–sai/sindrom–adrenalne–izgorelosti/stopnje–izgorelosti–simptomi
Juthberg, C., Eriksson, S., Norberg, A., & Sundin, K. (2010). Perceptions of conscience, stress of conscience and burnout among nursing staff in residential elder care. Journal of Advanced Nursing, 66(8), pp. 1708–1718. https://doi.org/10.1111/j.1365-2648.2010.05288.x PMid:20557396
Kaldjian, L. C. (2019). Understanding conscience as integrity: Why some physicians will not refer patients for ethically controversial practices. Perspectives in Biology and Medicine, 62(3), 383–400. https://doi.org/10.1353/pbm.2019.0022 PMid:31495787
Kavšak, A., & Prosen, M. (2021). Vpliv zadovoljstva z delom na pojav izgorelosti med medicinskimi sestrami: Kvalitativna opisna raziskava. Obzornik zdravstvene nege, 55(1), 7–15. https://doi.org/10.14528/snr.2021.55.1.3018
Kim, L. Y., Rose, D. E., Ganz, D. A., Giannitrapani, K. F., Yano, E. M., Rubenstein, L. V., & Stockdale, S. E. (2020). Elements of the healthy work environment associated with lower primary care nurse burnout. Nursing Outlook, 68(1), 14–25. https://doi.org/10.1016/j.outlook.2019.06.018 PMid:31477313
Kodila, V., & Trobec, A. (2008). Osnovni vodnik po kirurški enoti intenzivnega zdravljenja: Priročnik za medicinske sestre in zdravstvene tehnike. Ljubljana: Univerzitetni klinični center, Kirurška klinika, Klinični oddelek za anesteziologijo in intenzivno terapijo operativnih strok.
Kodeks etike v zdravstveni negi in oskrbi Slovenije in Kodeks etike za babice Slovenije. (2014). Ljubljana: Zbornica zdravstvene in babiške nege Slovenije – Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije.
Kugonič, N. (2013). Sindrom izgorevanja pri zaposlenih v nujni medicinski pomoči. Obzornik zdravstvene nege, 47(3), 268–275. Retrieved August 16, 2021 from https://obzornik.zbornicazveza.si:8443/index.php/ObzorZdravNeg/article/view/2935
Lamb, C., Evans, M., Babenko Mould, Y., Wong, C., & Kirkwood, K. (2019). Nurses' use of conscientious objection and the implications for conscience. Journal of Advanced Nursing, 75(3), 594–602. https://doi.org/10.1111/jan.13869 PMid:30328136
Lee, E. K., & Kim, J. S. (2020). Nursing stress factors affecting turnover intention among hospital nurses. International Journal of Nursing Practice, Article e12819. https://doi.org/10.1111/ijn.12819
Lubbadeh, T. (2020). Job Burnout: A general literature review. International Review of Management and Marketing, 10(3), 7–15. https://doi.org/10.32479/irmm.9398
Lucchini, A., Giani, M., Elli, S., Villa, S., Rona, R., & Foti, G. (2020). Nursing activities score is increased in COVID-19 patients. Intensive & Critical Care Nursing, 59, Article 102876. https://doi.org/10.1016/j.iccn.2020.102876 PMid:32360493; PMCid:PMC7177066
Maslach, C., & Leinter, M. (2016). Understanding the burnout experience: Recent research and its implications for psychiatry. World Psychiatry, 15(2), 103–111. https://doi.org/10.1002/wps.20311 PMid:27265691; PMCid:PMC4911781
Mavsar–Najdenov, B. (2011). Bolnik v enoti intenzivne terapije. Farmacevtski vestnik, 62(5), 249–250. Retrieved August 16, 2021 from http://www.dlib.si/?URN=URN:NBN:SI:DOC-PQA2PLAD
Nemec, U., & Čuček Trifkovič, K. (2017). Stres med zaposlenimi na področju psihiatrične zdravstvene nege. Obzornik zdravstvene nege, 51(1), 9–23. https://doi.org/10.14528/snr.2017.51.1.122
Pahor, M., & Peternelj, K. (2003). Vest, slaba vest in izgorelost pri medicinskih sestrah. Preliminarni rezultati mednarodne raziskave. In D. Klemenc, A. Kvas, M. Pahor & J. Šmitek (Eds.), Zdravstvena nega v luči etike (pp. 368–369). Ljubljana: Društvo medicinskih sester in zdravstvenih tehnikov.
Prosen, M. (2010). Zadovoljstvo z delom v zdravstveni negi: indikatorji zadovoljstva medicinskih sester. Obzornik zdravstvene nege, 44(2), 71–80. Retrieved August 16, 2021 from https://obzornik.zbornica-zveza.si/index.php/ObzorZdravNeg/article/view/2757
Saarnio, R., Sarvimäki, A., Laukkala, H., & Isola, A. (2012). Stress of conscience among staff caring for older persons in Finland. Nursing ethics, 19(1), 104–115. https://doi.org/10.1177/0969733011410094 PMid:22298646
Schalkwijk, F. (2018). A new conceptualisation of the conscience. Frontiers in Psychology, 9, Article 1863. https://doi.org/10.3389/fpsyg.2018.01863 PMid:30349496; PMCid:PMC6187870
Selye, H. (1976). Stress without distress. In G. Serban (Ed.), Psychopathology of human adaptation (pp. 137–146). Boston: Springer https://doi.org/10.1007/978-1-4684-2238-2_9
Skela-Savič, B. (2018). Zdravstveni sistem se bo sesul sam vase zaradi pomanjkanja medicinskih sester in ne zdravnikov. Utrip, 26(9), 3–9. Retrieved January 1, 2020 from https://www.zbornica-zveza.si/wpcontent/uploads/2019/09/UTRIPDECEMBER-2018.pdf
Sotirov, D., & Železnik, D. (2011). Analiza stresa in poznavanje klinične supervizije med zaposlenimi v Zdravstvenem domu Novo mesto in Splošni bolnišnici Novo mesto. Obzornik zdravstvene nege, 45(1), 23–29. Retrieved October 25, 2020 from https://obzornik.zbornica-zveza.si/index.php/ObzorZdravNeg/article/view/2803
Starc, J. (2018). Stress factors among nurses at the primary and secondary level of public sector health care: The case of Slovenia. Open Access Macedonian Journal of Medical Sciences, 6(2), 416. https://doi.org/10.3889/oamjms.2018.100 PMid:29531616; PMCid:PMC5839460
Strandberg, G., & Jansson, L. (2003). Meaning of dependency on care as narrated by nurses. Scandinavian Journal of Caring Sciences, 17(1), 84–91. https://doi.org/10.1046/j.1471-6712.2003.00213.x PMid:12581300
Thompson, R. A. (2014). Conscience development in early childhood. Handbook of Moral Development, 2, 73–92. Traunmüller, C., Stefitz, R., Gaisbachgrabner, K., Hofmann, P., Roessler, A., & Schwerdtfeger, A. R. (2019). Psychophysiological concomitants of burnout: Evidence for different subtypes. Journal of psychosomatic research, 118, 41–48. https://doi.org/10.1016/j.jpsychores.2019.01.009
Trueland, J. (2013). Breathe new life into your flagging career. Nursing Standard, 27(37), 20–22. https://doi.org/10.7748/ns2013.05.27.37.20.s27
Turk, D. (2015). Vest, slaba vest in izgorelost pri medicinskih sestrah (magistrsko delo). Univerza v Ljubljani, Zdravstvena fakulteta, Ljubljana. Retrieved May 3, 2020 from https://repozitorij.uni-lj.si/Dokument.php?id=72069&lang=slv
Tuvesson, H., Eklund, M., & Wann–Hansson, C. 2012. Stress of conscience among psychiatric nursing staff in relation to environmental and individual factors. Nursing Ethics, 19(2), 208–219. https://doi.org/10.1177/0969733011419239 PMid:22457384
Vaske, J. J., Beaman, J., & Sponarski, C. C. (2017). Rethinking internal consistency in Cronbach's alpha. Leisure Sciences, 39(2), 163–173. https://doi.org/10.1080/01490400.2015.1127189
Wallbank, S., & Hatton, S. (2011). Reducing burnout and stress: The effectiveness of clinical supervision. Community Practitioner, 84(7), 31–36. Retrieved January 16, from https://www.researchgate.net/publication/51669025_Reducing_burnout_and_stress_the_effectiveness_of_clinical_supervision
Woo, T., Ho, R., Tang, A., & Tam, W. (2020). Global prevalence of burnout symptoms among nurses: A systematic review and meta-analysis. Journal of Psychiatric Research, 123, 9–20. https://doi.org/10.1016/j.jpsychires.2019.12.015 PMid:32007680
World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. Journal of the American Medical Association, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053 PMid:24141714
Zbornica zdravstvene in babiške nege Slovenije – Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije. (2013). Zdravstvena nega. Retrieved July 2019, from https://www.zbornica–zveza.si/sl/o–zbornici–zvezi/o–poklicu/zdravstvena–nega
Prenosi
Objavljeno
Kako citirati
Številka
Rubrike
Licenca
Avtorske pravice (c) 2021 Obzornik zdravstvene nege
To delo je licencirano pod Creative Commons Priznanje avtorstva 4.0 mednarodno licenco.
Na Obzornik zdravstvene nege, Ob železnici 30A, 1000 Ljubljana, prenašam naslednje materialne avtorske pravice: pravico reproduciranja v neomejeni količini, in sicer v vseh poznanih oblikah reproduciranja, kar obsega tudi pravico shranitve in reproduciranja v kakršnikoli elektronski obliki (23. čl. Zakona o avtorski in sorodnih pravicah – v nadaljevanju ZASP); pravico distribuiranja (24. čl. ZASP); pravico dajanja na voljo javnosti vključno z dajanjem na voljo javnosti prek svetovnega spleta oz. računalniške mreže (32.a čl. ZASP); pravico predelave, zlasti za namen prevoda (33. čl. ZASP). Prenos pravic velja za članek v celoti (vključno s slikami, razpredelnicami in morebitnimi prilogami). Prenos je izključen ter prostorsko in časovno neomejen.
