新疆三级综合医院护士长工作倦怠现状及相关因素的研究
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摘要
目的:了解新疆三级综合医院护士长工作倦怠的现状,探讨护士长人口学特征、角色冲突与角色模糊、应对方式及工作满意度与工作倦怠的关系,为进一步干预研究提供理论依据。方法:采用普查法,于2007年3月～10月对新疆13家三级综合医院445名护士长进行问卷调查,包括护士工作倦怠问卷、角色冲突与角色模糊量表、应付方式问卷以及护士工作满意度量表。结果:1)护士长工作倦怠三个维度得分分别为,情感衰竭25.87±9.10,去人性化8.76±4.24,个人成就感33.72±10.21;2)不同年龄、民族、护龄、任职年限、科室的护士长情感衰竭维度得分有差异(P<0.05)。沟通技能培训与管理知识培训经历不同的护士长,工作倦怠有差异(P<0.05);3)护士长情感衰竭与年龄、科室、护龄、任职年限负相关(P<0.01),与民族、沟通技能培训、管理知识培训与否正相关(P<0.05);去人性化与管理知识培训与否正相关(P<0.05),个人成就感与管理知识培训与否负相关(P<0.05)。角色冲突、角色模糊与护士长情感衰竭、去人性化正相关(P<0.01),角色模糊与个人成就感负相关(P<0.01)。解决问题的应对方式与情感衰竭、去人性化负相关(P<0.05),与个人成就感正相关(P<0.01),自责、退避等消极应对方式与情感衰竭、去人性化正相关(P<0.01)。护士长工作满意度与情感衰竭、去人性化负相关(P<0.01),与个人成就感正相关(P<0.01);4)护士长情感衰竭的主要影响因素为总满意度、自责和退避的应对方式、角色冲突;去人性化的主要影响因素为自责的应对方式、总满意度、角色模糊和角色冲突;个人成就感的主要影响因素为角色模糊、解决问题的应对方式、专业发展机会和工作科室。结论:1)护士长工作倦怠呈中高度水平;2)35～39岁年龄组、护龄20年以下、任职5年以下的护士长情感衰竭水平较高;少数民族护士长、儿科护士长情感衰竭水平较高;接受过沟通技能、管理知识培训的护士长情感衰竭水平较低;3)工作满意度、自责的应对方式、角色冲突与角色模糊是护士长工作倦怠的重要预测因子;4)本研究结果提示,管理者应关注护士长高工作倦怠的现状,加强护士长管理技能的培训,提高护士长工作满意度,改善护士长身心健康状况,提高护理管理质量。
Objective: To investigate the job burnout status of head nurses in the third grade hospitals in Xinjiang, and analyze the relationship between job burnout and demographic characteristics, role confliction and role ambiguous, coping style and job satisfaction , so that to provide theoretical support to further interventional research. Methods: 445 head nurses who had appointed more than half a year in 13 third grade hospitals in Xinjiang were surveyed, by using Nurse Job Burnout Scale, Role Confliction and Role Ambiguous Questionnaire, Coping Style Scale and McCloskey/Mueller Satisfaction Scale (MMSS). Result: Each score of 3 criterions of job burnout was EE25.87±9.10, DP8.76±4.24, and PA33.72±10.21. The status of job burnout of head nurses was different in demographic characteristics (P<0.05). Head nurses who had been trained in communication and administration were in lower level of EE and DP, and in higher level of PA. Correlative analysis revealed that, age, work time and appoint time were negatively correlated with EE(P<0.01), nationality, training of communication and administration were positively correlated with EE(P<0.05), training of administration was also positively correlated with DP and negatively correlated with PA(P<0.05). Role confliction and role ambiguous were positively correlated with EE and DP, role ambiguous was also negatively correlated with PA(P<0.01).The coping style of problem resolution was negatively correlated with EE and DP and positively correlated with PA(P<0.01).The coping style of condemn and escapement were positively correlated with EE and DP(P<0.01).Job satisfaction was negatively correlated with EE and DP and positively correlated with PA(P<0.01).The major influential factors of EE were general job satisfaction, condemn and escapement coping style, role conflict, nationality and appoint time; the major influential factors of DP were condemn coping style, general job satisfaction, role confliction and role ambiguous; the major influential factors of PA were role ambiguous, problem resolution coping style, chances of professional development and work departments. Conclusion: (1) Head nurses were experiencing middle and high degree of job burnout. (2) Job burnout of head nurses was correlated with their demographic characteristics. The degree of EE was higher in head nurses who were 35~39 years old, and whose work time were less than 20 years, and appoint time were less than 5 years. (3) Role confliction and role ambiguous, coping style of condemn and job satisfaction were significant predictors of job burnout. (4) It indicated that administrators should put more attentions on job burnout of head nurses, enforce their ability of management, increase the level of their job satisfaction and lower their job burnout, then improve the quality of nursing management.
Objective: To investigate the job burnout status of head nurses in the third grade hospitals in Xinjiang, and analyze the relationship between job burnout and demographic characteristics, role confliction and role ambiguous, coping style and job satisfaction , so that to provide theoretical support to further interventional research. Methods: 445 head nurses who had appointed more than half a year in 13 third grade hospitals in Xinjiang were surveyed, by using Nurse Job Burnout Scale, Role Confliction and Role Ambiguous Questionnaire, Coping Style Scale and McCloskey/Mueller Satisfaction Scale (MMSS). Result: Each score of 3 criterions of job burnout was EE25.87±9.10, DP8.76±4.24, and PA33.72±10.21. The status of job burnout of head nurses was different in demographic characteristics (P<0.05). Head nurses who had been trained in communication and administration were in lower level of EE and DP, and in higher level of PA. Correlative analysis revealed that, age, work time and appoint time were negatively correlated with EE(P<0.01), nationality, training of communication and administration were positively correlated with EE(P<0.05), training of administration was also positively correlated with DP and negatively correlated with PA(P<0.05). Role confliction and role ambiguous were positively correlated with EE and DP, role ambiguous was also negatively correlated with PA(P<0.01).The coping style of problem resolution was negatively correlated with EE and DP and positively correlated with PA(P<0.01).The coping style of condemn and escapement were positively correlated with EE and DP(P<0.01).Job satisfaction was negatively correlated with EE and DP and positively correlated with PA(P<0.01).The major influential factors of EE were general job satisfaction, condemn and escapement coping style, role conflict, nationality and appoint time; the major influential factors of DP were condemn coping style, general job satisfaction, role confliction and role ambiguous; the major influential factors of PA were role ambiguous, problem resolution coping style, chances of professional development and work departments. Conclusion: (1) Head nurses were experiencing middle and high degree of job burnout. (2) Job burnout of head nurses was correlated with their demographic characteristics. The degree of EE was higher in head nurses who were 35~39 years old, and whose work time were less than 20 years, and appoint time were less than 5 years. (3) Role confliction and role ambiguous, coping style of condemn and job satisfaction were significant predictors of job burnout. (4) It indicated that administrators should put more attentions on job burnout of head nurses, enforce their ability of management, increase the level of their job satisfaction and lower their job burnout, then improve the quality of nursing management.
引文
[1] Williams S, Cooper CL.Measuring occupational stress: development of the pressure management indicator[J].J Occup Health, 1998, 3(4):300-321.
[2] Maslach C, Schaufeli WB, Leiter MP.Job burnout[J].Annual Review of Psychology, 2001,52:397-422.
[3] Freudenberger HJ. Staff burnout[J].Journal of Social Issues, 1974, 30(1):159-165.
[4] Maslach C, Jackson SE. The measurement of experienced burnout[J].J Occup Behav, 1981, 2: 99-113.
[5]陈素坤.临床心理护理指导[M].北京:科学技术文献出版社,2000:207-218.
[6]李靖.枯竭研究进展[J].北京大学学报(自然科学版) ,2003 ,39 (2) :286– 290
[7]李小妹,刘彦君.护士工作压力源及工作疲溃感的调查研究[J].中华护理杂志,2000,35(11):645-648.
[8] Vahey DC, Aiken LH, Sloane DM, et al. Nurse burnout and patient satisfaction[J].Med Care, 2004, 42(2Suppl):1157-1166.
[9] Piko BF. Burnout, role conflict, job satisfaction and psychosocial health among Hungarian health care staff: a questionnaire survey[J]. Int J Nurs Stud.2006, 43 (3) : 311-318.
[10]谢文,张振路,郑志惠,等.护士工作疲溃感与工作压力源及应对方式的相关研究[J].中国行为医学科学,2005,14(5):462-463.
[11]李永鑫,时金献,李艺敏.医院护士工作倦怠及其影响因素的调查研究[J].护理研究,2007,21(3A):602-604.
[12]冯莺,骆宏,叶志弘. MBI量表在护士工作倦怠研究中测试[J].中国心理卫生杂志,2004,18(7):477-479.
[13]刘双红,张芳.随州市护士工作倦怠状况及其与工作压力源和控制感的相关性研究[J].护理学报,2007,14(12):3-5.
[14]骆宏,叶志弘,冯莺.护士职业倦怠与工作领域心理社会因素的相关研究[J].中华护理杂志,2005,40(1):12-14.
[15]Payne N. Occupational Stressors and Coping as Determinants of Burnout in Female Hospice Nurses[J].Journal of Advanced Nursing, 2001,33(3):396-405.
[16]周彧,张黎明.护士工作倦怠与应付方式的相关性研究[J].护理研究,2006,20(3B):772-773.
[17]Kalliath T, Morris R. Job Satisfaction Among Nurses: A Predictor of Burnout Levels[J].J Nurs Adm. 2002, 32(12):648-654.
[18]Aiken LH, Clarke SP, Sloane DM, et al. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction[J].JAMA, 2002,288(16):1987-1993.
[19]Sheward L, Hunt J, Hagen S, et al. The relationship between UK hospital nurse staffing and emotional exhaustion and job dissatisfaction[J].J Nurs Manag, 2005, 13(1): 51-60.
[20]张铁山,李殿富.医务人员工作倦怠[J].中国医院管理,2004,24(9):5-7.
[21]李小光,徐娅霞.角色冲突和角色模糊对护士工作倦怠的影响[J].长江大学学报,2006,29(4):110-113.
[22]AbuAIRub RF. Job stress, job performance, and social support among hospital nurses[J].J Nurs Scholarsh, 2004, 36 (1) : 73-78
[23]Garrett D K, McDaniel AM. A new look at nurse burnout[J].J Nurs Adm, 2001, 31(2) : 91-96.
[24]Stordeur S, Dhoore W, Vandenberghe C. Leadership, organizational stress, and emotional exhaustion among hospital nursing staff[J].J Adv Nurs, 2001, 35 (4) : 533-542.
[25]许燕,王芳,蒋奖.职业枯竭研究现状与展望[J].西南师范大学学报(人文社会科学版),32(5):7-11.
[26]陆昌勤.工作倦怠感研究及展望[J].中国心理卫生杂志,2004,18(3):206-207.
[27]于勇,张震巍.工作倦怠对医疗安全的危害及其对策[J].中华医院管理杂志,2006,22(3):187-189.
[28]李继平.护理管理学[M].第2版.北京:人民卫生出版社,2006:42-45.
[29]杨红梅,王林菊,张宝惠.护士长和临床护士工作压力源与压力程度对比研究[J].国际护理杂志,2006,25(10):787-789.
[30]梁碧宁.广州部分三级甲等医院护士长工作压力源的调查分析[J].南方护理学报,2005,12(7):26-28.
[31]韩金红,孙宏玉,韩金香.护士长工作压力源?心理健康状况及应对方式的研究[J].护理管理杂志,2007,7(4):1-3.
[32]潘淑琴,徐波,潘琦.北京市216名护士长的心理卫生状况及其影响因素调查[J].中华护理杂志,2006,41(7):662-663.
[33]Laschinger HK, Almost J, Purdy N, et al. Predictors of nurse managers′health in Canadian restructured healthcare settings[J].Can J Leadersh, 2004,17(4):88-105.
[34]谢文,张振路,林细吟,等.护士长工作疲溃感与工作压力源及应对方式的相关研究[J].中华护理杂志,2005,40(5):339-341.
[35]陈素坤,王秋霞.护士职业压力与心理适应的调查研究[J].中华护理杂志,2002,37(9):659-662.
[36]谢文,叶建红,陈志群.护士长工作压力及其影响因素[J].中国行为医学科学,2007,16(4):347-349.
[37]余华.工作疲溃感问卷在我国护理人员中的测试研究[J].护理学杂志,2007,22(24):50-52.
[38]余善法,张锐,马良庆,等.职业紧张测量工具研究[J].河南医学研究,2000,9(2):171-174.
[39]汪向东,王希林,马弘.心理卫生评定量表手册[M].中国心理卫生杂志:1999(12)(增刊):122-124.
[40]何淑贞.太原市城区二级以上综合医院护士工作满意度调查分析[D].山西医科大学,2003:8.
[41]王群.临床护士工作满意度的调查分析[J].中华护理杂志,2002,37(8): 593-594.
[42]鞠风,杨秋兰,侯峰.精神科护士心理健康状况及工作满意度调查分析[J].护理管理杂志,2004,4(6):4-6.
[43]唐吉荣,张雪岚,陈毅怡.影响护士工作满意度的相关因素分析[J].护理研究,2007,21 (6B):1532-1533.
[44]叶志弘,骆宏,姜安丽.杭州地区护士群体职业倦怠常模与诊断标准的研究[J].中华护理杂志,2008 ,43 (3 ):207-209.
[45]Lee V,Henderson MC. Occupational Stress and Organizational Commitment in Nurse Administrators[J]. J Nurs Adm. 26(5):21-28, May 1996.
[46]隋树杰,邹红,朱雪梅.护士长心理压力调查[J].护理研究,2005,19(8B):1524-1525.
[47]李丹.论护士长自我实现中的压力及其应对[J].护理学杂志,2007,22(16):72-74.
[48]王健,朱莉.对254名护理人员心身耗竭综合征的调查[J].护理研究,2004,18(2A):218-220.
[49]王慧馨.护士长人格?社会支持?应对方式与工作倦怠的关系研究[D].河北医科大学,2007,16.
[50]李超平,时勘,罗正学,等.医护人员工作家庭冲突与工作倦怠的关系[J].中国心理卫生杂志,2003,17(12): 807-809.
[51]郑一宁.我院护士长工作压力源与心理健康状况的调查研究[J].护理管理杂志,2007,7(5):3-6.
[52]古丽巴哈尔·卡,阿斯木古丽,韩英,等.新疆部分高校维吾尔族与汉族女大学生心理健康状况[J].中国学校卫生,2003 , 24(6):630.
[53]齐香玉,韩峰,汤艳清.临床护士长工作压力及影响因素分析[J].中国行为医学科学,2007,16(6):528-529.
[54]李超平,时勘,罗学正,等.医护人员工作倦怠的调查.中国临床心理学杂志,2003,11(3):170-172.
[55]朱伟,王治明,王绵珍,等.护士工作倦怠及其影响因素评价[J].四川大学学报(医学版), 2006, 37 (4) : 632-635.
[56]金海燕,倪萍.国内儿科护理人员职业压力的现状研究[J].上海护理,5(5):58-60.
[57]郭小红.新时期护士长管理压力与应对的调查研究[J].中华护理杂志,志,2003,38(10):797-799.
[58]Mumford M, Zaccaro SJ, Johnson JF. Patterns of leader characteristics: implications for performance and development[J] .The Leadership Quarterly ,2000,11(1):115-13.
[59]岳树锦,成翼娟.护理管理者领导技能需求的测评研究[J].中华护理杂志,2005, 40 (8):607-609.
[60]李晓波,苏兰若,王爱萍,等.护理管理者应具备的管理技能调查分析[J].护理学杂志,2006,21(2):1-3.
[61]宋琼莹.某院护士长沟通能力调查分析[J].护理学报,2007,14(2):27-29.
[62]付沫,陈红宇,丁永艳,等.荆州市综合医院护士长工作现状调查与对策[J].护理学报,2007,14(10):14-16.
[63]Wu L, Norman IJ. An investigation of job satisfaction, organizational commitment and role conflict and ambiguity in a sample of Chinese undergraduate nursing students[J]. Nurse Educ Today. 2006 ,26(4):304-314.
[64]王慧馨,赵玲,陈海英.护士角色冲突的研究现状及对策[J].中华医院管理杂志,2007,23(2):117-118.
[65]杨莘,邵文利,花蕾,等.护士长非专业角色与工作负荷研究[J].护理学杂志,2007,22(5):7-9.
[66]杨春红,孙柏霞,李雅芬.医生护士对护士长角色期望的比较[J].护理学杂志,2003,18(4):293-294.
[67]Fried Y. The interactive effect of role conflict and role ambiguity on job performance .Journal of occupational and organizational psychology, 1998, 71 :1927
[68]Scalzi CC. Role stress and coping strategies of nurse executives[J].J Nurs Adm. 1988,18(3):34-8.
[69]鲜于云艳,何小俊,范湘鸿.护士长工作压力源?应对方式与身心健康水平的相关性调查[J].中华护理杂志,2006 ,41 (9):849-851.
[70]王佳琳,李继平.影响护士长心理应对方式的相关因素分析[J].中国实用护理杂志,2004,20(6A):71-72.
[71]斯蒂芬·P·罗宾逊.组织行为学[M].孙建敏,李原译.北京:中国人民大学出版社,1997:144-151.
[72] Duxbury ML, Armstrong GD, Drew DJ, et al.Head nurse leadership style with staff nurse burnout and job satisfaction in neonatal intensive care units[J].Nurs Res, 1984, 33 (2) : 97-101.
[73]Chen YM, Chen SH, Tsai CY, Lo LY.Role stress and job satisfaction for nurse specialists[J].J Adv Nurs. 2007 ,59(5):497-509.
[74]李文东,时勘,何丹.工作满意度?情感承诺和工作投入对工作技能评价结果的影响[J].心理学报,2007, 39 (1) : 146-154.
[75]陈梅芳.护士工作倦怠及其与工作压力?工作满意度的关系研究[D].浙江大学,2005.97.
[76]贾晓波,陈凤荣.工作倦怠的测量及其干预研究综述[J].心理与行为研究,2006, 4(1):55-60.
[77]Gould D, Kelly D, Goldstone L, et al. The changing training needs of clinical managers: exploring issues for continuing professional development[J]. J Adv Nurs, 2001, 34(1): 7-17.
[78]王菊香,叶志弘.应用同事支持系统缓解护士心理压力[J].中华护理杂志,2004, 39(9):685-687.
[79]Coffey M, Coleman M. The relationship between support and stress in forensic community mental health nursing[J]. Adv Nurs, 2001, 34(3):397.
[1]李小妹,刘彦君.护士工作压力源及工作疲溃感的调查研究.中华护理杂志,2000,35(11):645-648.
[2] Vahey DC, Aiken LH, Sloane DM, et al. Nurse burnout and patient satisfaction. Med Care, 2004, 42(2Suppl):1157-1166.
[3]陆昌勤.工作倦怠感研究及展望.中国心理卫生杂志,2004,18(3):206-207.
[4] Maslach C, Jackson SE. The measurement of experienced burnout. Journal of Occupational Behavior, 1981, 2: 99-113.
[5]李靖.枯竭研究进展[J ] .北京大学学报(自然科学版) ,2003 ,39 (2) :286– 290)
[6]陈素坤.临床心理护理指导[M].北京:科学技术文献出版社,2000:207-218.
[7]冯莺,骆宏,叶志弘. MBI量表在护士工作倦怠研究中测试.中国心理卫生杂志,2004,18(7):477-479.
[8]王健,朱莉.对254名护理人员心身耗竭综合征的调查.护理研究,2004,18(2A):218-220.
[9]谢文,张振路,郑志惠,等.护士工作疲溃感与工作压力源及应对方式的相关研究.中国行为医学科学,2005,14(5):462-463.
[10]陈素坤,王秋霞.护士职业压力与心理适应的调查研究.中华护理杂志,2002,37(9):659-662.
[11]李永鑫.工作倦怠及其测量.心理科学,2003(3):556-557.
[12]黄华兰,应文娟,肖惠兰,等.护士群体疲劳综合征状况调查及防范干预.南方护理学报,2004,11(7):3-5.
[13]骆宏,叶志弘,冯莺.护士职业倦怠与工作领域心理社会因素的相关研究.中华护理杂志,2005,40(1):12-14.
[14]刘宇,张嘉阳.手术室护士工作疲溃感的调查与分析.中国护理管理,2005,5(1):44-46.
[15]李超平,时勘,罗学正,等.医护人员工作倦怠的调查.中国临床心理学杂志,2003,11(3):170-172.
[16]于卫华,许红艳.不同环境下医护人员身心耗竭情况的测量与分析.现代护理,2005,11(6):474-475.
[17]胡小丽,李小麟,蔡英,等.护士职业耗竭相关因素研究.调查研究,2005,11(19):1595-1597.
[18]李兆良,高燕,冯晓黎,等.论医护人员职业倦怠的原因与对策.医学与社会,2005,18(6):26-27.
[19]Collins MA. The relation of work stress, hardiness, and burnout among full-time hospital staff nurses. J Nurs Staff Dev, 1996,12 (2): 81-85.
[20]周彧,张黎明.护士工作倦怠与应付方式的相关性研究.护理研究,2006,20(3B):772-773.
[21]张铁山,李殿富.医务人员工作倦怠.中国医院管理,2004,24(9):5-7.
[22]张萍.护理人员“职业枯竭”的现状与对策.护理研究,2005,19(12A):260-2602.
[23]Piko BF. Burnout, role conflict, job satisfaction and psychosocial health among Hungarian health care staff: a questionnaire survey. Int J Nurs Stud. 2006, 43 (3) : 311-318.
[24]AbuAIRub RF. Job stress, job performance, and social support among hospital nurses. J Nurs Scholarsh, 2004, 36 (1) : 73-78
[25]Garrett D K, McDaniel A M. A new look at nurse burnout. J Nurs Adm, 2001, 31(2) : 91-96.
[26]Duxbury ML, Armstrong GD, Drew DJ, et al. Head nurse leadership style with staff nurse burnout and job satisfaction in neonatal intensive care units. Nurs Res, 1984, 33 (2) : 97-101.
[27]Stordeur S, Dhoore W, Vandenberghe C. Leadership, organizational stress, and emotional exhaustion among hospital nursing staff. J Adv Nurs, 2001, 35 (4) : 533-542.
[28]Hatcher S, Laschinger HK. Staff nurses′perception of job empowerment and level of burnout: a test of Kanter′s theory of structural power in organizations. Can J Nurs Adm, 1996, 9 (2) : 74-94.
[2] Maslach C, Schaufeli WB, Leiter MP.Job burnout[J].Annual Review of Psychology, 2001,52:397-422.
[3] Freudenberger HJ. Staff burnout[J].Journal of Social Issues, 1974, 30(1):159-165.
[4] Maslach C, Jackson SE. The measurement of experienced burnout[J].J Occup Behav, 1981, 2: 99-113.
[5]陈素坤.临床心理护理指导[M].北京:科学技术文献出版社,2000:207-218.
[6]李靖.枯竭研究进展[J].北京大学学报(自然科学版) ,2003 ,39 (2) :286– 290
[7]李小妹,刘彦君.护士工作压力源及工作疲溃感的调查研究[J].中华护理杂志,2000,35(11):645-648.
[8] Vahey DC, Aiken LH, Sloane DM, et al. Nurse burnout and patient satisfaction[J].Med Care, 2004, 42(2Suppl):1157-1166.
[9] Piko BF. Burnout, role conflict, job satisfaction and psychosocial health among Hungarian health care staff: a questionnaire survey[J]. Int J Nurs Stud.2006, 43 (3) : 311-318.
[10]谢文,张振路,郑志惠,等.护士工作疲溃感与工作压力源及应对方式的相关研究[J].中国行为医学科学,2005,14(5):462-463.
[11]李永鑫,时金献,李艺敏.医院护士工作倦怠及其影响因素的调查研究[J].护理研究,2007,21(3A):602-604.
[12]冯莺,骆宏,叶志弘. MBI量表在护士工作倦怠研究中测试[J].中国心理卫生杂志,2004,18(7):477-479.
[13]刘双红,张芳.随州市护士工作倦怠状况及其与工作压力源和控制感的相关性研究[J].护理学报,2007,14(12):3-5.
[14]骆宏,叶志弘,冯莺.护士职业倦怠与工作领域心理社会因素的相关研究[J].中华护理杂志,2005,40(1):12-14.
[15]Payne N. Occupational Stressors and Coping as Determinants of Burnout in Female Hospice Nurses[J].Journal of Advanced Nursing, 2001,33(3):396-405.
[16]周彧,张黎明.护士工作倦怠与应付方式的相关性研究[J].护理研究,2006,20(3B):772-773.
[17]Kalliath T, Morris R. Job Satisfaction Among Nurses: A Predictor of Burnout Levels[J].J Nurs Adm. 2002, 32(12):648-654.
[18]Aiken LH, Clarke SP, Sloane DM, et al. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction[J].JAMA, 2002,288(16):1987-1993.
[19]Sheward L, Hunt J, Hagen S, et al. The relationship between UK hospital nurse staffing and emotional exhaustion and job dissatisfaction[J].J Nurs Manag, 2005, 13(1): 51-60.
[20]张铁山,李殿富.医务人员工作倦怠[J].中国医院管理,2004,24(9):5-7.
[21]李小光,徐娅霞.角色冲突和角色模糊对护士工作倦怠的影响[J].长江大学学报,2006,29(4):110-113.
[22]AbuAIRub RF. Job stress, job performance, and social support among hospital nurses[J].J Nurs Scholarsh, 2004, 36 (1) : 73-78
[23]Garrett D K, McDaniel AM. A new look at nurse burnout[J].J Nurs Adm, 2001, 31(2) : 91-96.
[24]Stordeur S, Dhoore W, Vandenberghe C. Leadership, organizational stress, and emotional exhaustion among hospital nursing staff[J].J Adv Nurs, 2001, 35 (4) : 533-542.
[25]许燕,王芳,蒋奖.职业枯竭研究现状与展望[J].西南师范大学学报(人文社会科学版),32(5):7-11.
[26]陆昌勤.工作倦怠感研究及展望[J].中国心理卫生杂志,2004,18(3):206-207.
[27]于勇,张震巍.工作倦怠对医疗安全的危害及其对策[J].中华医院管理杂志,2006,22(3):187-189.
[28]李继平.护理管理学[M].第2版.北京:人民卫生出版社,2006:42-45.
[29]杨红梅,王林菊,张宝惠.护士长和临床护士工作压力源与压力程度对比研究[J].国际护理杂志,2006,25(10):787-789.
[30]梁碧宁.广州部分三级甲等医院护士长工作压力源的调查分析[J].南方护理学报,2005,12(7):26-28.
[31]韩金红,孙宏玉,韩金香.护士长工作压力源?心理健康状况及应对方式的研究[J].护理管理杂志,2007,7(4):1-3.
[32]潘淑琴,徐波,潘琦.北京市216名护士长的心理卫生状况及其影响因素调查[J].中华护理杂志,2006,41(7):662-663.
[33]Laschinger HK, Almost J, Purdy N, et al. Predictors of nurse managers′health in Canadian restructured healthcare settings[J].Can J Leadersh, 2004,17(4):88-105.
[34]谢文,张振路,林细吟,等.护士长工作疲溃感与工作压力源及应对方式的相关研究[J].中华护理杂志,2005,40(5):339-341.
[35]陈素坤,王秋霞.护士职业压力与心理适应的调查研究[J].中华护理杂志,2002,37(9):659-662.
[36]谢文,叶建红,陈志群.护士长工作压力及其影响因素[J].中国行为医学科学,2007,16(4):347-349.
[37]余华.工作疲溃感问卷在我国护理人员中的测试研究[J].护理学杂志,2007,22(24):50-52.
[38]余善法,张锐,马良庆,等.职业紧张测量工具研究[J].河南医学研究,2000,9(2):171-174.
[39]汪向东,王希林,马弘.心理卫生评定量表手册[M].中国心理卫生杂志:1999(12)(增刊):122-124.
[40]何淑贞.太原市城区二级以上综合医院护士工作满意度调查分析[D].山西医科大学,2003:8.
[41]王群.临床护士工作满意度的调查分析[J].中华护理杂志,2002,37(8): 593-594.
[42]鞠风,杨秋兰,侯峰.精神科护士心理健康状况及工作满意度调查分析[J].护理管理杂志,2004,4(6):4-6.
[43]唐吉荣,张雪岚,陈毅怡.影响护士工作满意度的相关因素分析[J].护理研究,2007,21 (6B):1532-1533.
[44]叶志弘,骆宏,姜安丽.杭州地区护士群体职业倦怠常模与诊断标准的研究[J].中华护理杂志,2008 ,43 (3 ):207-209.
[45]Lee V,Henderson MC. Occupational Stress and Organizational Commitment in Nurse Administrators[J]. J Nurs Adm. 26(5):21-28, May 1996.
[46]隋树杰,邹红,朱雪梅.护士长心理压力调查[J].护理研究,2005,19(8B):1524-1525.
[47]李丹.论护士长自我实现中的压力及其应对[J].护理学杂志,2007,22(16):72-74.
[48]王健,朱莉.对254名护理人员心身耗竭综合征的调查[J].护理研究,2004,18(2A):218-220.
[49]王慧馨.护士长人格?社会支持?应对方式与工作倦怠的关系研究[D].河北医科大学,2007,16.
[50]李超平,时勘,罗正学,等.医护人员工作家庭冲突与工作倦怠的关系[J].中国心理卫生杂志,2003,17(12): 807-809.
[51]郑一宁.我院护士长工作压力源与心理健康状况的调查研究[J].护理管理杂志,2007,7(5):3-6.
[52]古丽巴哈尔·卡,阿斯木古丽,韩英,等.新疆部分高校维吾尔族与汉族女大学生心理健康状况[J].中国学校卫生,2003 , 24(6):630.
[53]齐香玉,韩峰,汤艳清.临床护士长工作压力及影响因素分析[J].中国行为医学科学,2007,16(6):528-529.
[54]李超平,时勘,罗学正,等.医护人员工作倦怠的调查.中国临床心理学杂志,2003,11(3):170-172.
[55]朱伟,王治明,王绵珍,等.护士工作倦怠及其影响因素评价[J].四川大学学报(医学版), 2006, 37 (4) : 632-635.
[56]金海燕,倪萍.国内儿科护理人员职业压力的现状研究[J].上海护理,5(5):58-60.
[57]郭小红.新时期护士长管理压力与应对的调查研究[J].中华护理杂志,志,2003,38(10):797-799.
[58]Mumford M, Zaccaro SJ, Johnson JF. Patterns of leader characteristics: implications for performance and development[J] .The Leadership Quarterly ,2000,11(1):115-13.
[59]岳树锦,成翼娟.护理管理者领导技能需求的测评研究[J].中华护理杂志,2005, 40 (8):607-609.
[60]李晓波,苏兰若,王爱萍,等.护理管理者应具备的管理技能调查分析[J].护理学杂志,2006,21(2):1-3.
[61]宋琼莹.某院护士长沟通能力调查分析[J].护理学报,2007,14(2):27-29.
[62]付沫,陈红宇,丁永艳,等.荆州市综合医院护士长工作现状调查与对策[J].护理学报,2007,14(10):14-16.
[63]Wu L, Norman IJ. An investigation of job satisfaction, organizational commitment and role conflict and ambiguity in a sample of Chinese undergraduate nursing students[J]. Nurse Educ Today. 2006 ,26(4):304-314.
[64]王慧馨,赵玲,陈海英.护士角色冲突的研究现状及对策[J].中华医院管理杂志,2007,23(2):117-118.
[65]杨莘,邵文利,花蕾,等.护士长非专业角色与工作负荷研究[J].护理学杂志,2007,22(5):7-9.
[66]杨春红,孙柏霞,李雅芬.医生护士对护士长角色期望的比较[J].护理学杂志,2003,18(4):293-294.
[67]Fried Y. The interactive effect of role conflict and role ambiguity on job performance .Journal of occupational and organizational psychology, 1998, 71 :1927
[68]Scalzi CC. Role stress and coping strategies of nurse executives[J].J Nurs Adm. 1988,18(3):34-8.
[69]鲜于云艳,何小俊,范湘鸿.护士长工作压力源?应对方式与身心健康水平的相关性调查[J].中华护理杂志,2006 ,41 (9):849-851.
[70]王佳琳,李继平.影响护士长心理应对方式的相关因素分析[J].中国实用护理杂志,2004,20(6A):71-72.
[71]斯蒂芬·P·罗宾逊.组织行为学[M].孙建敏,李原译.北京:中国人民大学出版社,1997:144-151.
[72] Duxbury ML, Armstrong GD, Drew DJ, et al.Head nurse leadership style with staff nurse burnout and job satisfaction in neonatal intensive care units[J].Nurs Res, 1984, 33 (2) : 97-101.
[73]Chen YM, Chen SH, Tsai CY, Lo LY.Role stress and job satisfaction for nurse specialists[J].J Adv Nurs. 2007 ,59(5):497-509.
[74]李文东,时勘,何丹.工作满意度?情感承诺和工作投入对工作技能评价结果的影响[J].心理学报,2007, 39 (1) : 146-154.
[75]陈梅芳.护士工作倦怠及其与工作压力?工作满意度的关系研究[D].浙江大学,2005.97.
[76]贾晓波,陈凤荣.工作倦怠的测量及其干预研究综述[J].心理与行为研究,2006, 4(1):55-60.
[77]Gould D, Kelly D, Goldstone L, et al. The changing training needs of clinical managers: exploring issues for continuing professional development[J]. J Adv Nurs, 2001, 34(1): 7-17.
[78]王菊香,叶志弘.应用同事支持系统缓解护士心理压力[J].中华护理杂志,2004, 39(9):685-687.
[79]Coffey M, Coleman M. The relationship between support and stress in forensic community mental health nursing[J]. Adv Nurs, 2001, 34(3):397.
[1]李小妹,刘彦君.护士工作压力源及工作疲溃感的调查研究.中华护理杂志,2000,35(11):645-648.
[2] Vahey DC, Aiken LH, Sloane DM, et al. Nurse burnout and patient satisfaction. Med Care, 2004, 42(2Suppl):1157-1166.
[3]陆昌勤.工作倦怠感研究及展望.中国心理卫生杂志,2004,18(3):206-207.
[4] Maslach C, Jackson SE. The measurement of experienced burnout. Journal of Occupational Behavior, 1981, 2: 99-113.
[5]李靖.枯竭研究进展[J ] .北京大学学报(自然科学版) ,2003 ,39 (2) :286– 290)
[6]陈素坤.临床心理护理指导[M].北京:科学技术文献出版社,2000:207-218.
[7]冯莺,骆宏,叶志弘. MBI量表在护士工作倦怠研究中测试.中国心理卫生杂志,2004,18(7):477-479.
[8]王健,朱莉.对254名护理人员心身耗竭综合征的调查.护理研究,2004,18(2A):218-220.
[9]谢文,张振路,郑志惠,等.护士工作疲溃感与工作压力源及应对方式的相关研究.中国行为医学科学,2005,14(5):462-463.
[10]陈素坤,王秋霞.护士职业压力与心理适应的调查研究.中华护理杂志,2002,37(9):659-662.
[11]李永鑫.工作倦怠及其测量.心理科学,2003(3):556-557.
[12]黄华兰,应文娟,肖惠兰,等.护士群体疲劳综合征状况调查及防范干预.南方护理学报,2004,11(7):3-5.
[13]骆宏,叶志弘,冯莺.护士职业倦怠与工作领域心理社会因素的相关研究.中华护理杂志,2005,40(1):12-14.
[14]刘宇,张嘉阳.手术室护士工作疲溃感的调查与分析.中国护理管理,2005,5(1):44-46.
[15]李超平,时勘,罗学正,等.医护人员工作倦怠的调查.中国临床心理学杂志,2003,11(3):170-172.
[16]于卫华,许红艳.不同环境下医护人员身心耗竭情况的测量与分析.现代护理,2005,11(6):474-475.
[17]胡小丽,李小麟,蔡英,等.护士职业耗竭相关因素研究.调查研究,2005,11(19):1595-1597.
[18]李兆良,高燕,冯晓黎,等.论医护人员职业倦怠的原因与对策.医学与社会,2005,18(6):26-27.
[19]Collins MA. The relation of work stress, hardiness, and burnout among full-time hospital staff nurses. J Nurs Staff Dev, 1996,12 (2): 81-85.
[20]周彧,张黎明.护士工作倦怠与应付方式的相关性研究.护理研究,2006,20(3B):772-773.
[21]张铁山,李殿富.医务人员工作倦怠.中国医院管理,2004,24(9):5-7.
[22]张萍.护理人员“职业枯竭”的现状与对策.护理研究,2005,19(12A):260-2602.
[23]Piko BF. Burnout, role conflict, job satisfaction and psychosocial health among Hungarian health care staff: a questionnaire survey. Int J Nurs Stud. 2006, 43 (3) : 311-318.
[24]AbuAIRub RF. Job stress, job performance, and social support among hospital nurses. J Nurs Scholarsh, 2004, 36 (1) : 73-78
[25]Garrett D K, McDaniel A M. A new look at nurse burnout. J Nurs Adm, 2001, 31(2) : 91-96.
[26]Duxbury ML, Armstrong GD, Drew DJ, et al. Head nurse leadership style with staff nurse burnout and job satisfaction in neonatal intensive care units. Nurs Res, 1984, 33 (2) : 97-101.
[27]Stordeur S, Dhoore W, Vandenberghe C. Leadership, organizational stress, and emotional exhaustion among hospital nursing staff. J Adv Nurs, 2001, 35 (4) : 533-542.
[28]Hatcher S, Laschinger HK. Staff nurses′perception of job empowerment and level of burnout: a test of Kanter′s theory of structural power in organizations. Can J Nurs Adm, 1996, 9 (2) : 74-94.