Investigation On The Work Pressure And Related Factors Of Care Managers

Background and purpose:Work pressure go hand in hand to influence people's behavior and health in the workplace, occupational stress of health care workers is an important variable which not only affecting job performance, but also affect the job satisfaction. Care manager which carry out the important task of leadership and supervision is a special group. Care manager plays an important role in the whole dynamics of the operation of nursing care. However, in previous studies, the choice of indicators of stress responses little attention to nursing administrators, how to reduce the pressure of nurse managers even less. Therefore, research about the work pressure, response status, health status and related factors is necessary. To this end,the pressure of nursing administrators were selected as a research target,following the idea of " reason--intermediate --response", to construct model about nursing administrators occupational stress,coping styles,and self-rated health relational. This study are aim to investigate the work pressure, coping styles and health of care managers in GuangDong area, and to explore the relationship of the work pressure, coping style and the health status of nurse managers. This article study if system of APN scheduling and level management affect nurse managers working pressure, coping style, self-rated health, and analyze the causes. This article aim to control pressure of nursing administrators at the optimal level, to maintain their physical and mental health, and to provide reference for policy-making for the health administrative departments in the current medical system of reform situation. Methods:Investigating from May to September of 2009 take the stratified sampling method in Nanfang Hospital, Zhujiang Hospital, Guangdong Province. Investigators contact the Nursing Department and take questionnaires. Questionnaire included four parts:①general information on the questionnaire used to survey care worker's sex, age, work experience, position, departments, hospital levels etc.②Nurse Working Pressure Source Table is used to investigate care workers stress and stress levels.③Simplified Coping Style Questionnaire is used to investigate the coping styles adopted.④Self-rated Health Measurement Scale Version 1.0. used to investigate the health care workers. A total of 480 questionnaires were sent out,437 questionnaires were usable. This article's recovery 91.04%, in which 216 nursing administrators and 221 nurses. SPSS 13.0 software is used for statistical processing and analysis. Application of descriptive statistical analysis, two independent samplest test, single sample t test, analysis of variance, Spearman correlation analysis. Investigate analysis nursing administrators pressure, coping styles and self-rated health status. Study if system of APN scheduling and level management affect nurse managers working pressure, coping style, self-rated health or not. Study the relationship of stress levels, coping styles and self-rated health.Results:The average age of 216 nurse managers is (34.00±4.93) years. Average working span is (14.21±5.06) years. The average age of 221 nurses is (27.43±3.72) years. Average working span is (6.72±3.99) years. Age, education, departments, hospital-levels affect nursing managers stress, coping style and self-rated health.Work pressure of nurse manager The pressure about distribution of the workload and time is the highest in the five dimensions of the working pressure. Heavy workload is entry care managers feel the largest pressure, followed by writing too much paperwork at work, taking too much non-nursing work. Distribution of the workload and time, management and interpersonal are dimensions that nursing administrators and general nurses get differences working pressure. There are 9 entries that nursing administrators and ordinary nurses scores different. In addition to entries of fewer opportunities for promotion and often shift,the general nurses score higher than that of nursing managers, the other seven entries are the nursing administrators score higher.Coping styles of nurse manager Nursing managers coping mainly with a positive manner, two dimension scores comparison between nursing managers and the norm, nursing managers scores higher than the norm. Two dimension scores compared between the nursing managers and the general nurses, positively coping scores and negative coping scores were not significantly different between two groups.Self-rated health status of care managers There was no difference between care managers scores and general nurses scores about self-rated health scores, physical health sub-scale scores, mental health sub-scale scores and social health sub-scale scores with general nurses. Compared each dimension of self-rated health,care managers scores of the four dimensions were higher than norm.APN scheduling and level management affect work stress, coping style and self-rated health of care managers Nursing administrators with APN scheduling and level management get less pressure than the old model of care managers in dimensions of the work environment and resources, management and interpersonal skills. In other areas, there was no difference between nursing administrators with APN scheduling and level, management and care managers of old model.Care managers of APN scheduling and hierarchical management model scores about actively cope with problems higher than care managers with traditional model of management, but whether if the nursing administrators with new scheduling model or not do not affect negative response to problems. APN scheduling and level management does not effect self-rated health scores. Different times of APN scheduling and level management does not affect the care management scores about individual indicators.Relation about work stress, coping style and self-rated health of care managers Work stress of care managers were negatively correlated with three dimensions of self-rated health and overall self-rated health scores. The positive response is positively related to the various dimensions of self-rated health. Negative coping has negative correlation with self-rated health.Conclusion:Age is the major factor that may affect pressure of nursing managers. Study found that care managers with age of 31-35 work pressure score higher than other care managers. Care managers with age of 31-35 positively coping score wore higher than other care managers. Paediatrics department get the lowest Self-rated health scores. Compared with work pressure of low-level hospital,high-level hospital administrators working pressure score lower,self-rated health scores higher. Significantly, Work pressure scores of nurse managers with vocational education higher than nurse managers of bachelor degree and college degree. The survey also found that nurse managers of master's degree or above score the higher pressure.Characteristics of nurse manager work pressure Work pressure of nurse manage is in the severe level. The survey results also show that the pressure of nursing administrators are derived from the distribution of workload and time pressure. One of the most prominent source of stress as the heavy workload, too many paperwork, too many non-care work. Compared with general nurses work pressure scores, nursing administrators work pressure scores was significantly higher in this several aspects of pressures. The low social status of nursing work and low wages are aspects which belong pressures of the nursing profession and work that score higher. Care managers also scored significantly higher about the work stress about conflict with the managers than general nurses. The two points of pressure that fewer opportunities for promotion and often shift,general nurse score higher than care managers.Characteristics of nurse manager coping Strategies Coping, as an intermediary mechanism between stress of nurse managers and health, plays an important role in physical and mental health. Care managers take a positive manner when cope difficulties encountered, and the positive response rates higher than the general nurses. This may be due to ability of better self-control which is necessary as a care manager. The negative response rates higher than normal, which may be related with the high working pressure.Characteristics of nurse manager self-rated health As care managers, the characteristic of work stress is high strength, health of care managers are not optimistic. The survey found that whether Care workers are care managers or not do not affect the self-rated health. Although care managers score significantly higher than general nurses in the work pressures about allocation of workload and time, because of rich experience and positive way to respond to pressure, care managers have better health. The pressure of nurse managers is less than ordinary care in the aspects of fewer opportunities to promotion and regular shift. Compared with the norm, care managers have better health.APN scheduling and level management affect work stress, coping style and self-rated health of care managers Nursing administrators with APN scheduling and level management get less pressure than the old model of care managers in dimensions of the work environment and resources, management and interpersonal skills. In other aspects of the pressure,two groups score have no difference. Medical care under new model gets greater satisfaction than the medical care under old model.The pressure of critical work and lack of other health workers understand about higher-level care managers has been reduced. Issues about nursing profession and work, pressure declined on the division of not clear of labor and little independence. Workload pressure is the main pressure of care managers. Nursing administrators with APN scheduling and level management get more opportunities for night shifts and extended Christmas duty. Therefore, the new model does not reduce the workload pressure on managers. Nursing administrators with APN scheduling and level management are more inclined to respond to the problems encountered in a positive manner. Because of the new scheduling system, some aspects of the work pressure about nurse managers reduce.Relation about work stress, coping style and self-rated health of care managers Greater work stress accompany with self-rated health. Coping also has a significant impact on health. Useing a positive manner to the pressure from work, self-rated health scores higher. Useing a negative way when response to stress, self-rated health scores lower. Different ways of respond to the stress will directly affect the development of things and people's emotional state, thereby affecting human physical and mental health.