The Study On Professional Burnout And Relevent Factors Of Pre-Hospital Emergency Nurses

A.BACKGROUNDPrompt and effective pre-hospital emergency care is imperative for saving the patients' life and reducing the death rate and disability rate of the pre-hospital patients. All kinds of sudden emergency affairs contribute to the high intensity and high pressure of the emergent treatment.These all will bring some sorts of effects on the pre-hospital emergency nurses' physical and mental healthiness,which in sure affect the quality of emergency care.Professional burnout,usually occurring on the personnel who are engaged in the interpersonal work,is a phenomenon of emotion-tiredness,job-indifferency and work-achievement-lowemess.The pre-hospital emergency caring is a kind of career that working everyday in and out of the hospital,getting in touch with each kind of person under each emergency,in which high intensity and high pressure lead to high professional burnout.It not only causes the physical and mental suffering of the pre-hospital emergency nurses,but also affects the quality of pre-hospital emergency nursing,if not treated correctly.Its relevant factors,e.g.pre-hospital emergency nurses' pressure,social support,the way of response,personal characteristics etc.all can influence the professional burnout lever of nursing personnel and the quality of emergency treatment.In recent years,there are abundant theoretical researches on the field of professional burnout in abroad,but relatively few in research of real examples.In domestic the achievement in this field is few,rare in research of real instance,and not many of the relevant research reports and questionnaires.Because of lack of questionnaire aiming directly at professional burnout of the nurses,especially the pre-hospital emergency nurses,it can not provide some constructive suggestion on how to effectively solve the problem of professional burnout of pre-hospital emergency nurses.B.OBJECTIVE1.Research whether there are differences in professional burnout lever between the pre-hospital emergency nurses and nurses in the other section offices(ordinary internal medicine department etc.).2.Research the differences between the pre-hospital emergency nurses and nurses in other section offices in the source of pressure,the way of response,social support, personal characteristics.3.Research whether the professional burnout lever of pre-hospital emergency nurses is relevant with the work pressure,the way of response,social support, personal characteristics.4.Supply foundation to improve professional burnout lever,increase working activity and effectiveness,enhance life and work quality of pre-hospital emergency nurses.C.METHODSBy stratified sampling method,120 pre-hospital emergency paramedics from Jinan pre-hospital emergency system have been taken,forming the observation group, by comparison,100 general internal medical nurses have been chosen taxonomically from 6 third-class hospitals in Jinan.Based on surveys and semi-structured interviews conducted mainly with the combination of qualitative and quantitative methods,the variance analysis has been conducted among the pre-hospital emergency nurses and general intemal medical nurses in the professional burnout,response style,social support,personal characteristics,stress sources and other aspects,and a stepwise multiple regression analysis has been also taken on the relativity between the pre-hospital emergency nurses and the general situation of professional burnout,job stress,response style,personality characteristics as well as social support.Statistical results of the questionnaire has been recorded by SPSS13.0 software and analysed statistically.Specific statistical methods:descriptive analysis,correlation analysis,and stepwise multiple regression analysis,u test,t-test and chi-square test,etc..D.RESULTS1.There is some professional burnout among pre-hospital emergency nurses in Jinan.68.7%of pre-hospital emergency nurses have medium and heavy emotion exhaustion,55.6%present depersonalization tendency,and 57.6%present burnout in decreased personal accomplishment.2.Pre-hospital emergency nurses and general internal medical nurses in the professional burnout aspect are significantly higher than those who are after traced.68.7%of pre-hospital emergency nurses have emotion exhaustion,which is higher than general internal medical nurses(51.9%);55.6%of the former have various degrees of depersonalization,lower than ordinary nurses(62%);57.6%of the former work with decreased personal accomplishment,lower the latter(58.2%).But pre-hospital emergency nurses and general internal medical nurses have obvious differences that have statistical significance only on emotion exhaustion.3.The different ways to cope are correlated with the burnout level of pre-hospital emergency nurses and general internal medical ones.And emotion exhaustion have positive correlation with negative coping(P＜0.01);decreased personal accomplishment have positive correlation with positive coping(P＜0.01).4.Pre-hospital emergency nurses and general internal medical ones have obvious differences that have statistical significance on nursing stress(P=0.000).The special pressure source from pre-hospital emergency medical care that is different from what general internal medical nurses face also affects the professional burnout.Above 90% of pre-hospital emergency nurses think that pre-hospital emergency nursing have high-grade work risk and laboring intension,and the women in gestation can not be competent for pre-hospital emergency nursing.5.Good personality characteristics are important to assuage the professional burnout as well as to maintain the mental health,whether they are pre-hospital emergency nurses or general internal medical ones.Psychoticism have significant negative correlation with decreased personal accomplishment(P=0.001).Neuroticism have significant positive correlation with emotion exhaustion and depersonalization (P=0.001).Extroversion have significant negative correlation with emotion exhaustion (P=0.001).6.The level of social support correlates the professional burnout level, particularly for pre-emergency nurses,who obtains much less subjective social support than general internal medical nurses.Emotion exhaustion have significant positive correlation with support utilization(P=0.028).7.Multiple stepwise regression analysis by using professional burnout as dependent variables,and work stress,coping strategy,personality characteristics, social support,emergency work years,the title of technical post,education,etc as independent variables.On the level ofα=0.05,five factors can jointly predict 30.3% variation of emotion exhaustion,personal prediction power of work stress is the strongest and its explanation power is 15.2%.;five factors can jointly predict 19% variation of depersonalization,personal prediction power of work stress is the strongest and its explanation power is 8.7%;four factors can jointly predict 32% variation of decreased personal accomplishment,personal prediction power of positive coping is the strongest and its explanation power is 23.2%.E.CONCLUSIONSThe emergence of the burnout is due to the failure of facing work pressure.The study find that five major sources of stress,consisted of the professional status,the physician-patient relationship,the professional knowledge,the organizational atmosphere and the work load,result in the professional burnout of nurses.The professional burnout is caused by a variety of factors,furthermore,different factors on the three dimensions have different influences on it. 1.All of pre-hospital emergency nurses and general internal medical nurses have different degrees of professional burnout.But the degree of emotion exhaustion in pre-hospital emergency nurses is obviously higher than that in general internal medical nurses,because of the high risk,high intention,high stress of pre-hospital emergency work.2.Emotion exhaustion have significantly positive correlation with negative coping,work stress,neuroticism,support utilization;significantly negative correlation with extroversion.Depersonalization have significantly positive correlation with work stress, neuroticism.Decreased personal accomplishment have significantly positive correlation with positive coping;significantly negative correlation with psychoticism.As pre-hospital emergency nurses face all kinds of occasional conditions,tough personality,a positive response,and full use of limited community support can effectively reduce the degree of professional burnout.