看護と患者ケアのジャーナル

プロフェッショナルとしての生活の質を高める方法: 共感疲労、ストレス、燃え尽き症候群の軽減

ジェニファー・シップマン

看護師の仕事関連のストレスは、燃え尽き症候群の発生率を高め、患者のケアに支障をきたし、米国の医療機関に年間数十億ドルの損害を与えています。看護師は、燃え尽き症候群、仕事への不満、対人関係の問題の増加、健康上の苦情の増加、睡眠パターンの乱れ、臨床的うつ病や不安など、ストレスに関連するいくつかの影響を受けやすいです。看護師が受けるストレスにどう対処すればよいのでしょうか。疲労に適応できるように看護師の回復力を高めるには、セルフケアが効果的な方法だと言われています。看護師の性格特性（楽観主義、信念、自己効力感、制御、対処スタイル）と心理的弾力性のレベルには直接的な相関関係があります。葛藤に否定的に対処することが多い人は、回復力が低い傾向があります。自己制御能力があり、否定的な要因に直面してもうまく対応できる明るい看護師は、通常、回復力が高いです。私たちは、看護仲間がストレス レベルを管理および軽減するのに役立つツールについて説明します。

キーワード:ストレス、仕事のパフォーマンス、燃え尽き症候群、仕事の過負荷

抽象的な

私たちは日常生活の大半を仕事に費やしています。実際、アメリカ人は飲食に費やす時間の約 8 倍を仕事に費やしています (米国労働統計局、2013 年)。アメリカ人の約 10 人に 7 人がストレスの症状を経験していると報告しています (Anderson、Belar、Breckler、Nordal、Ballard、Bufka、Bossolo & Bethune、2013 年)。ストレスは、仕事、住居、社会的交流、および従事する活動に関連するさまざまな心理的刺激によって引き起こされます (p. 249、Franken、2007 年)。多くのアメリカ人は、ストレスの多い職場だけでなく、満足のいかない仕事の重荷を抱えて生活しています。アメリカ心理学会が米国の 1,848 人を対象に実施したオンライン調査では、74 パーセントの人が仕事が主なストレスの原因であると回答しました (p. 284、Schultz および Schultz、

職場では、ストレスは生産性の低下、モチベーションの低下、ミスや事故の増加として現れます（p. 284、Schultz and Schultz、2010）。過度のストレスは多くの悪影響をもたらす可能性があります。人々が過度のストレスを経験すると、うつ病や睡眠障害などの心理的影響にも悩まされる可能性があります。

 

（p. 191、Griffin & Moorhead、2014）。研究によると、ストレスは心臓病、脳卒中、肥満などの重大な病気の発症に寄与するだけでなく、既存の病気を悪化させる可能性もあることがわかっています（Anderson et al.、2013）。

Nursing is recognized as an occupation that is under stress on both professional and personal levels. In recent years, increasing amount of nursing disputes cause the shortage of nurses currently threatens health care globally. One of the reasons of this shortage is that nurses experience high levels of stress and work load in acute care settings. Although all professions are susceptible to work-related stress, researchers have determined that the nursing profession is particularly stressful (Villani, Grassi, Cognetta, Toniolo, Cipresso, & Riva, 2013). Some argue that because of increasing demands, nurses are more susceptible to exhaustion, anxiety and stress (Aarons, & Sawitzky, 2006).

How we can deal with the compassion fatigue of nurses. It is argued that the self-care is an effective way to increase the resilience of nurse so as to adapt to the fatigues. The first propriety for nurses’ self-care is to establish a proper environment in nurses’ workplace and home for their self-care. Normally nurses will be fully devoted to work with full and high enthusiasm. However, the fatigue reduces the enthusiasm and the compassion. The conflicts between nurses and patients is generally caused by pool mental conditions of nurse rather than by lack of nurses’ occupational ethics. Therefore, when the disputes happen, a flexible environment should be given to the nurses first rather than blaming the nurses for their false. Tolerant from the hospital management, doctors and all the patients are the base for self-care of nurses.

Another way to support the self-care of nurses is to increase the salary and provide high economic incentives to nurses. Care managers should eliminate factors that can cause fatigue of nurses through clarifying the nurse duties, improving the social status of nurses, reducing workload and increasing the incomes. Managers should focus on nurse’s objective, visible, practical support, such as benefits, work environment. It is also necessary to make nurses experience the emotional support, such as encouragement and recognition and so on. By creating a good and warm atmosphere between nurses and their manager, nurses are more likely to self-care and reduce the fatigue.

Self-care is to train nurses to cope with the stress by themselves in face of pressure. The pressure and fatigue will not disappear naturally, nurses must actively intervene pressure by correct understanding of stress and active restraint discontent. The nurses can self-care themselves through appreciating their work, looking for more advantages, reducing psychological comparisons etc. Having the necessary knowledge of mental health, science and arrange a time, living a regular, moderate exercise sports, a healthy physique to cope with stress. Learning to cope with the pressure of psychological defense skills, find their own decompression methods: such as singing, listening to music, chat, talk, humor, transfer, take a deep breath to relax more. Learning a set of communication skills , learn to communicate between people think, feel , ways and means of exchanging general information and precautions, flexibility, improve surrounding relationships and deal with family.

It is also important to build a mental health supporting system to nurses, including the friends, colleagues, families, and psychological counseling experts. When in the depressed impenetrable to nurses, complaining to the system and seek psychological help. Such as mental stress, limited mental capacity, nurses need specialized psychological counseling or treatment. After concentrating on work, to make reasonable arrangements for the pace of life, by forming a degree of relaxation lifestyle, timely adjustment and vent their negative emotions, improve work efficiency, enhance interpersonal and problem-solving skills. Nurses cannot give up learning, reducing worries for the future by learning skills.

There is a direct correlation between nurses’ personality characteristics (optimism, faith, self-efficacy, control and coping style) and their psychological level of elasticity. Individuals who often deal with conflict in a negative way, tend to have a low resilience. Cheerful nurses, with self -control ability, better able to work in the face of negative factors, usually have a high level of resilience. In addition, high self-efficacy are more likely to exhibit a positive and optimistic and strong self-confidence. Self-confidence makes nurses more positive appeal in clinical work and can also help to establish a good relationship between the nurses and the patient 's families. It is also helpful to improve comfort of their work environment and increase their job satisfaction. Nurses with high scores character strengths can better cushion the negative effects of work stress on mental elasticity. Managers therefore able to detect from the details of the negative experience of expression within the nurses and help them establish a positive attitude and positive belief, as well as the right way to deal with conflicts. This can assist nurses in building better character.

結論として、ストレスの多い労働条件と高い仕事量のため、看護はリスクの高い職業です。プレッシャーは看護師の精神的健康に悪影響を及ぼし、適切に対処しないと辞職につながる可能性があります。看護師がストレスの多い労働環境に適応し、緊急事態に対処する際の困難を克服するには、適応力と回復力が求められます。

略歴:

経歴: ジェニファー・シップマンは、ランドスタッド・ジェネラル・スタッフィング・ベネット・カレッジの退職プラン・マネージャーとして働いています。

第54回世界看護・ヘルスケア会議、2020年5月13日〜14日。

抄録引用:

ジェニファー・シップマン、「プロフェッショナルとしての生活の質を高める方法：共感疲労、ストレス、燃え尽き症候群の軽減」、世界看護会議 2020、第 54 回世界看護・医療会議、2020 年 5 月 13 日〜14 日