我国重症监护室护士职业倦怠发生率的meta分析

摘要/Abstract

摘要： 目的通过meta分析方法综合评估我国重症监护病房（intensive careunit,ICU）护士中重度职业倦怠的发生率,为制定相应干预策略提供参考依据。方法系统地检索PubMed、Web of Science、Embase、Cochrane Library、中国知网（CNKI）、维普（VIP）、万方数据库以及中国生物医学文献数据库中有关中国ICU护士职业倦怠的文献,时间范围从各数据库建库至2024年8月9日。两位研究者独立进行文献筛选、质量评估和数据提取,采用Stata 17.0软件进行meta分析。结果共有18篇文献符合纳入标准,涵盖5 290名ICU护士的总样本量。Meta分析结果显示,ICU护士中重度情感耗竭的发生率估计为50.8%（95%CI：44.1%~57.4%）,重度去人格化的发生率为42.4%（95%CI：34.1%~51.0%）,重度个人成就感缺乏的发生率为59.9%（95%CI：46.9%~72.3%）。进一步的亚组分析显示,年龄18~30岁、专科学历、ICU工作年限1~<5年、来自东部地区的护士以及2011—2017年的研究中,ICU护士的重度职业倦怠发生率相对较高。结论我国ICU护士的职业倦怠现象较为普遍,受到多重因素的影响,包括年龄、教育背景、工作年限及地理位置等。医疗管理者和护理领导者应重点关注特定亚群体的ICU护士,并实施针对性的干预策略,以降低其职业倦怠水平。

关键词: 职业倦怠, 重症监护室护士, Meta分析, 横断面研究

Abstract: Objective To comprehensively evaluate the prevalence of severe burnout among intensive care unit(ICU) nurses in China using meta-analytic methods,providing a scientific foundation for future intervention strategies. Methods A systematic search was conducted to identify literature on burnout among ICU nurses in China. Databases included PubMed,Web of Science,Embase,Cochrane Library,China National Knowledge Infrastructure(CNKI),VIP,Wanfang database,and China Biomedical Literature Database. The search covered studies published from the inception of each database up to August 9,2024. Two researchers independently performed literature screening,quality assessment,and data extraction,followed by meta-analysis using Stata 17.0 software. Results A total of 18 papers met the inclusion criteria,covering a total sample size of 5 290 ICU nurses. Meta-analysis showed that the estimated prevalence of severe emotional exhaustion among ICU nurses was 50.8%(95%CI：44.1%-57.4%),the prevalence of severe depersonalization was 42.4%(95%CI：34.1%-51.0%),and the prevalence of severe personal accomplishment deficiency was 59.9%(95%CI：46.9%-72.3%). Further subgroup analyses showed that ICU nurses aged 18-30 years,with a specialist degree,1-<5 years of ICU experience,from the eastern region,and in studies conducted from 2011 to 2017 had a relatively high prevalence of severe burnout. Conclusion Burnout among ICU nurses in China is relatively common and is influenced by multiple factors,including age,educational background,years of experience,and geographic location. Healthcare administrators and nursing leaders should focus on specific subgroups of ICU nurses and implement targeted intervention strategies to reduce their burnout levels.

Key words: Burnout, Intensive care unit nurses, Meta-analysis, Cross-sectional study

中图分类号:

R181.2

谭茜瑾, 陈秋霞. 我国重症监护室护士职业倦怠发生率的meta分析. [J]职业与健康, 2025, 41(22): 3138-3142.

TAN Xijin, CHEN Qiuxia. Meta-analysis of the prevalence of burnout among intensive care unit nurses in China. [J]OCCUPATION AND HEALTH, 2025, 41(22): 3138-3142.

参考文献

[1] FREUDENBERGER H J.The issues of staff burnout in therapeutic communities[J].J Psychoactive Drugs,1986,18(3):247-251.
[2] CLARK R,LAKE E.Burnout,job dissatisfaction and missed care among maternity nurses[J].J Nurs Manag,2020,28(8):2001-2006.
[3] DYRBYE L N,JOHNSON P O,JOHNSON L M,et al.Efficacy of the well-being index to identify distress and well-being in U.S.nurses[J].Nurs Res,2018,67(6):447-455.
[4] LUAN X,WANG P,HOU W,et al.Job stress and burnout:A comparative study of senior and head nurses in China[J].Nurs Health Sci,2017
19(2):163-169.
[5] MOSS M,GOOD V S,GOZAL D,et al.A critical care societies collaborative statement:Burnout syndrome in critical care health-care professionals.A call for action[J].Am J Respir Crit Care Med,2016,194(1):106-113.
[6] POGHOSYAN L,CLARKE S P,FINLAYSON M,et al.Nurse burnout and quality of care:Cross-national investigation in six countries[J].Res Nurs Health,2010,33(4):288-298.
[7] CIMIOTTI J P,AIKEN L H,SLOANE D M,et al.Nurse staffing,burnout,and health care-associated infection[J].Am J InfectControl,2012,40(6):486-490.
[8] 曾宪涛,刘慧,陈曦,等.Meta分析系列之四:观察性研究的质量评价工具[J].中国循证心血管医学杂志,2012,4(4):297-299.
[9] 陈丽羚,赵惠芬,蔡丽吟,等.泉州市ICU护士工作倦怠及其对离职意愿的影响[J].中华护理教育,2011,8(7):320-322.
[10] 卜敏.杭州市5家三级医院ICU护士职业倦怠感研究[J].中国农村卫生事业管理,2017,37(12):1537-1539.
[11] 范晓婷,孟庆慧,徐雁,等.ICU护士科研能力与工作压力源及工作倦怠的相关性研究[J].护理学杂志,2014,29(15):64-66.
[12] 李丽,阮洪,姜虹,等.上海市5所三级甲等综合性医院ICU护士职业倦怠影响因素探讨[J].中国护理管理,2013,13(11):48-51.
[13] 梁馨之,孙运波,尤薇,等.ICU护士职业倦怠与隐性缺勤的相关性研究[J].中国护理管理,2017,17(7):933-937.
[14] 卢巧梅,陈华珍,高祥.福州市某三甲医院ICU护士职业倦怠状况调查[J].当代护士(中旬刊),2017(10):96-97.
[15] 王静,宋慧敏,彭志勇,等.中国大陆中南地区ICU医护职业倦怠现状及危险因素[J].中华重症医学电子杂志,2020,6(4):418-423.
[16] 王艳丽.ICU护士职业倦怠的现状及对策研究[J].中国现代药物应用,2013,7(24):248-249.
[17] 张红辉,刘怡素,何国平,等.长沙市省级综合三级甲等医院ICU护士职业倦怠现状及其影响因素分析[J].护理管理杂志,2013,13(4):229-231.
[18] 张华芳,李瑜,宋志平.ICU护士职业倦怠影响因素及其对护理质量影响分析及干预[C]//中国中药杂志/专集.北京:中国中药杂志社,2016:1.
[19] 王少平,郑丽华,赵柳容.108名ICU护士职业倦怠的现状与对策[J].当代护士(下旬刊),2016(10):32-34.
[20] 张云芳,宋意,李丹卉.深圳市三级甲等综合医院ICU护士职业倦怠程度及其影响因素的研究[J].全科护理,2012,10(17):1609-1611.
[21] 宿艳琴,智慧,刘春旭.重症医学科(ICU)护士职业倦怠的质性研究[J].中国实用神经疾病杂志,2016,19(17):138-139.
[22] DING S,HUANG X,SUN R,et al.The relationship between alarm fatigue and burnout among critical care nurses:A cross-sectional study[J].Nurs Crit Care,2023,28(6):940-947.
[23] HU Z,WANG H,XIE J,et al.Burnout in ICU doctors and nurses in mainland China-a national cross-sectional study[J].J Crit Care,2021
62:265-270.
[24] ZHANG X C,HUANG D S,GUAN P.Job burnout among critical care nurses from 14 adult intensive care units in northeastern China:a cross-sectional survey[J].BMJ Open,2014,4(6):e004813.
[25] LIU Y E,WHILE A,LI S J,et al.Job satisfaction and work related variables in Chinese cardiac critical care nurses[J].J Nurs Manag,2015
23(4):487-497.
[26] LIU J,ZHENG J,LIU K,et al.Relationship between work environments,nurse outcomes,and quality of care in ICUs:Mediating role of nursing care left undone[J].J Nurs Care Qual,2019,34(3):250-255.
[27] 夏磊.我国精神科专业人员工作场所暴力和职业倦怠现况调查及影响因素研究[D].合肥:安徽医科大学,2022.
[28] 王晓晔,胡珊珊,李争,等.我国急诊科护士职业倦怠发生率及影响因素的系统评价[J].中华现代护理杂志,2020,26(10):1324-1330.
[29] 林书球,张淋淋,张悦,等.中国手术室护士职业倦怠发生率的meta分析[J].职业与健康,2024,40(7):964-968.
[30] 刘晔,杨敏,陈菲菲.ICU年轻护士角色冲突和角色模糊、工作疲溃感对离职意愿的影响[J].中华护理杂志,2013,48(6):533-535.
[31] PONCET M C,TOULLIC P,PAPAZIAN L,et al.Burnout syndrome in critical care nursing staff[J].Am J Respir Crit Care Med,2007,175(7):698-704.
[32] 付莉莉,汪本奎,马媛,等.我国护理人才分布及评价导向效果分析[J].护理研究,2021,35(21):3792-3795.
[33] MCCARTHY P.Burnout in psychiatric nursing[J].J Adv Nurs,1985,10(4):305-310.
[34] 章志伟,王霞,王建宁,等.重症监护室护士道德困境与职业倦怠的相关性研究[J].上海交通大学学报(医学版),2014,34(7):1073-1077.
[35] 岳铭坤,黄超,李凯,等.全国医疗卫生资源公平性分析——基于GIS技术和基尼系数[J].中医药管理杂志,2024,32(9):16-20.
[36] 沈立.我国医疗卫生资源空间配置现状及对策研究[J].发展研究,2021,38(3):68-76.
[37] 魏萱,魏颖,陈麒麟,等.2018—2021年我国医疗卫生机构卫生人力资源配置公平性分析[J].中国初级卫生保健,2024,38(5):8-12.
[38] 尚文涵,吴志军,张海燕,等.2015年—2017年全国三级医院护理质量分析[J].中国卫生质量管理,2020,27(1):19-24.
[39] TWIGG D E,WHITEHEAD L,DOLEMAN G,et al.The impact of nurse staffing methodologies on nurse and patient outcomes:A systematic review[J].J Adv Nurs,2021,77(12):4599-4611.