Japan Journal of Nursing Science最新文献_第2页

Association between self-stigma and self-compassion in patients with schizophrenia: A longitudinal study from hospital admission to first follow-up after discharge 精神分裂症患者自我耻感与自我同情的关系：一项从入院到出院后第一次随访的纵向研究

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2025-01-15 DOI: 10.1111/jjns.12648

Keita Toshi, Miharu Nakanishi, Mai Sakai, Hatsumi Yoshii

Aim

Self-stigma is a major factor preventing the recovery of individuals with schizophrenia. Psychosocial interventions can reduce self-stigma, and mental health nurses may play a crucial role in leading them, but little is known about the modifiable factors that should be targeted. We aimed to investigate the association between self-stigma and self-compassion in patients with schizophrenia from admission to the first follow-up after discharge.

Methods

Twenty-three patients with schizophrenia were recruited from an acute psychiatric ward in a private psychiatric hospital in Japan. Participants filled out the Japanese versions of the Internalized Stigma of Mental Illness (ISMI) scale, the Self-Compassion Scale (SCS), and the Positive and Negative Syndrome Scale (PANSS) at the following three time points: 1 month after admission, discharge, and first follow-up after discharge at outpatient care. We used a linear mixed model to examine the association between self-stigma, self-compassion, and the symptoms. In the first model, we used self-stigma as a dependent variable and included time of assessment and positive and negative symptoms as independent variables. In the second model, we added self-compassion to the independent variables.

Results

Self-stigma did not change over time. Regarding the linear mixed model, the first model showed that participants with more positive symptoms tended to report worse self-stigma (p = .052). The second model showed a significant association between increasing self-stigma and higher over-identification (p = .001).

Conclusions

Our results suggest that interventions focusing on over-identification can reduce self-stigma. Nurse-led intervention programs with a focus on over-identification should be further developed for effectiveness.

目的：自我耻辱感是阻碍精神分裂症患者康复的主要因素。社会心理干预可以减少自我耻辱感，精神卫生护士可能在引导他们方面发挥关键作用，但对于应该针对的可改变因素知之甚少。本研究旨在探讨精神分裂症患者自入院至出院后第一次随访期间自我耻感与自我同情的关系。方法：从日本一家私立精神病院的急性精神病病房招募23例精神分裂症患者。被试分别在入院后1个月、出院后1个月、门诊出院后第一次随访3个时间点填写了日文版精神疾病内化污名（ISMI）量表、自我同情量表（SCS）和正负综合征量表（PANSS）。我们使用线性混合模型来检验自我耻辱、自我同情和症状之间的关系。在第一个模型中，我们将自我耻辱作为因变量，并将评估时间和阳性和阴性症状作为自变量。在第二个模型中，我们在自变量中加入了自我同情。结果：自我耻辱感不随时间变化。对于线性混合模型，第一个模型显示阳性症状越多的参与者倾向于报告更严重的自我耻辱感（p = 0.052）。第二个模型显示了自我耻辱感的增加和过度认同的增加之间的显著关联（p = .001）。结论：我们的研究结果表明，关注过度认同的干预措施可以减少自我耻辱感。护士主导的干预方案，重点是过度识别应进一步发展的有效性。

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引用次数: 0

Effectiveness of breast pumps in early postpartum breastfeeding for women after cesarean section: A systematic review 吸奶器在剖宫产术后早期产后母乳喂养中的有效性：一项系统综述。

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2025-01-10 DOI: 10.1111/jjns.12643

Ai Miyauchi, Mayumi Uchimura, Myori Takahashi, Shigeko Horiuchi, Erika Ota

Aim

We sought to assess the effectiveness of using a breast pump for nipple stimulation to promote breastfeeding in the early postpartum period after c-section in women with full-term infants.

Methods

Selection criteria were individual and cluster randomized control trials and quasi-randomized control trials that compared using a breast pump combined with standard care to promote breastfeeding in the early postpartum period after c-section with standard care. In this systematic review, guided by the Cochrane Handbook, we conducted comprehensive searches across databases such as Medline, Embase, CINAHL, Cochrane Library, and PsycINFO (Search: April 22, 2024). We used the PRISMA flowchart for data extraction. Three review authors independently assessed trials for inclusion and risk of bias, outcome synthesis for Review Manager, and evidence quality evaluation for GRADE.

Results

We included four trials with 318 women and their infants. The trials took place in four countries. Women using a breast pump for nipple stimulation from the early postpartum period had an earlier onset of lactation of 19.57 h than women in standard care (mean difference [MD] −19.57 h, 95% confidential interval [CI] −26.18 to −12.96; participants = 143; studies = two; I² = 20%; GRADE: moderate certainty of evidence).

Conclusion

Evidence supports the use of a breast pump to promote breastfeeding in the early postpartum period after c-section because it is effective in accelerating the timing of onset of lactation. Studies with large sample sizes focusing on feasibility and implementation in clinical practice are necessary to determine the ways of promoting breastfeeding after c-section.

目的：我们试图评估使用吸乳器乳头刺激促进足月婴儿剖腹产后产后早期母乳喂养的有效性。方法：选择标准为个体和集群随机对照试验和准随机对照试验，比较使用吸奶器联合标准护理促进产后早期剖腹产后母乳喂养与标准护理的效果。在这篇系统综述中，我们以Cochrane手册为指导，在Medline、Embase、CINAHL、Cochrane Library和PsycINFO等数据库中进行了全面的检索（检索：April 22, 2024）。我们使用PRISMA流程图进行数据提取。三位综述作者独立评估了试验的纳入和偏倚风险、综述管理器的结果综合和GRADE的证据质量评价。结果：我们纳入了4项试验，涉及318名妇女及其婴儿。试验在四个国家进行。产后早期使用吸奶器刺激乳头的妇女比采用标准护理的妇女早泌乳19.57小时(平均差[MD] -19.57小时，95%可信区间[CI] -26.18至-12.96；参与者= 143人；研究= 2；i2 = 20%；等级：证据确定性中等)。结论：有证据支持在剖腹产后产后早期使用吸奶器促进母乳喂养，因为它能有效地加速泌乳的开始时间。确定促进剖宫产后母乳喂养的方式，有必要进行大样本量的研究，重点研究临床实践中的可行性和可实施性。

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引用次数: 0

The transition process of perceptions of hygiene care practices among nurses in acute-care wards: A grounded theory study 急症病房护士对卫生护理实践认知的转变过程：一项有根据的理论研究。

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2025-01-09 DOI: 10.1111/jjns.12645

Kotone Nishiya, Risa Takashima, Rika Yano

Aim

To explore how perceptions of hygiene care practices among nurses in acute-care wards change over their clinical experience.

Methods

Based on symbolic interactionism, we employed a grounded theory methodology to explore interrelationships of meaning arising from actors' perceptions and interactions. Thirty-three nurses working in acute-care wards for >3 years were selected by purposive snowball and theoretical sampling; semi-structured individual interviews were conducted from October 2023 to February 2024. Data were analyzed for 32 participants who provided consent.

Results

The core category was “adjusting care channels”; seven other categories also emerged. Care channels refer to options for hygiene care practices. When nurses are first assigned to a ward, they regard hygiene care as the “bare task under organization rules.” However, through repeated processes of “emerging caring with patient resonance” and “internalizing the meaning of care,” they can “form care channels.” Subsequently, nurses become practitioners who can transform practices of hygiene care into “care to be restricted” or “wealth of ‘life behind the curtain’” by “adjusting care channels” according to the patient and ward organization situation. In contrast, if nurses fail to internalize the meaning of care, they end up performing “pro forma activities.”

Conclusions

Our findings highlight the importance of nurses to improve their ability to “adjust care channels,” which would allow them to provide hygiene care in a manner appropriate to the patient and organizational context. These results contribute to the development of educational strategies that foster nurses' values of hygiene care and support strategies by nursing managers.

目的：探讨急诊病房护士对卫生护理实践的看法如何随着临床经验的变化而变化。方法：以符号互动主义为基础，运用扎根理论方法，探讨行为者感知与互动所产生的意义的相互关系。采用有目的滚雪球法和理论抽样法，选取33名在急症病房工作3年的护士；半结构化个人访谈于2023年10月至2024年2月进行。对32名提供同意的参与者的数据进行了分析。结果：核心类别为“调整护理渠道”；另外还出现了7个类别。护理渠道是指卫生保健实践的选择。当护士第一次被分配到一个病房时，她们认为卫生护理是“组织规则下的简单任务”。然而，通过“与患者共鸣的新兴关怀”和“关怀意义的内化”的反复过程，他们可以“形成关怀渠道”。随后，护士成为实践者，根据患者和病房组织情况，通过“调整护理渠道”，将卫生保健实践转化为“受限护理”或“幕后生活财富”。相反，如果护士不能内化护理的意义，他们最终会进行“形式活动”。结论：我们的研究结果强调了护士提高“调整护理渠道”能力的重要性，这将使他们能够以适合患者和组织环境的方式提供卫生保健。这些结果有助于制定教育策略，以培养护士的卫生保健价值观和护理管理者的支持策略。

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引用次数: 0

Using voice recognition and machine learning techniques for detecting patient-reported outcomes from conversational voice in palliative care patients 使用语音识别和机器学习技术来检测姑息治疗患者会话语音的患者报告结果。

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2025-01-07 DOI: 10.1111/jjns.12644

Lei Dong, Hideyuki Hirayama, XueJiao Zheng, Kento Masukawa, Mitsunori Miyashita

Aim

Patient-reported outcome measures (PROMs) are increasingly used in palliative care to evaluate patients' symptoms and conditions. Healthcare providers often collect PROMs through conversations. However, the manual entry of these data into electronic medical records can be burdensome for healthcare providers. Voice recognition technology has been explored as a potential solution for alleviating this burden. However, research on voice recognition technology for palliative care is lacking. This study aimed to verify the use of voice recognition and machine learning to automatically evaluate PROMs using clinical conversation voice data.

Methods

We recruited 100 home-based palliative care patients from February to May 2023, conducted interviews using the Integrated Palliative Care Outcome Scale (IPOS), and transcribed their voice data using an existing voice recognition tool. We calculated the recognition rate and developed a machine learning model for symptom detection. Model performance was primarily evaluated using the F1 score, harmonic mean of the model's positive predictive value, and recall.

Results

The mean age of the patients was 80.6 years (SD, 10.8 years), and 34.0% were men. Thirteen patients had cancer, and 87 did not. The patient voice recognition rate of 55.6% (SD, 12.1%) was significantly lower than the overall recognition rate of 76.1% (SD, 6.4%). The F1 scores for the five total symptoms ranged from 0.31 to 0.46.

Conclusion

Although further improvements are necessary to enhance our model's performance, this study provides valuable insights into voice recognition and machine learning in clinical settings. We expect our findings will reduce the burden of recording PROMs on healthcare providers, increasing the wider use of PROMs.

目的：患者报告的结果测量（PROMs）越来越多地用于姑息治疗来评估患者的症状和状况。医疗保健提供者通常通过对话收集prom。但是，将这些数据手动输入到电子医疗记录中对于医疗保健提供者来说是一项繁重的工作。语音识别技术已被探索作为减轻这一负担的潜在解决方案。然而，语音识别技术在姑息治疗方面的研究还很缺乏。本研究旨在验证使用语音识别和机器学习来使用临床对话语音数据自动评估prom。方法：我们于2023年2月至5月招募了100名家庭姑息治疗患者，使用综合姑息治疗结局量表（IPOS）进行访谈，并使用现有的语音识别工具转录他们的语音数据。我们计算了识别率，并开发了一个用于症状检测的机器学习模型。模型性能主要使用F1分数、模型正预测值的调和平均值和召回率来评估。结果：患者平均年龄80.6岁（SD， 10.8岁），男性占34.0%。13名患者患有癌症，87名没有。患者语音识别率为55.6% (SD, 12.1%)，明显低于整体识别率76.1% （SD, 6.4%）。5种症状的F1评分范围为0.31 ~ 0.46。结论：虽然需要进一步改进以提高模型的性能，但本研究为临床环境中的语音识别和机器学习提供了有价值的见解。我们期望我们的研究结果将减轻医疗保健提供者记录PROMs的负担，增加PROMs的广泛使用。

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引用次数: 0

How did home care nurses support COVID-19 patients in Japan? A qualitative study 日本家庭护理护士如何支持新冠肺炎患者？定性研究。

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2025-01-07 DOI: 10.1111/jjns.12646

Mana Shirouchi, Yuka Sumikawa, Kyoko Yoshioka-Maeda, Noriko Yamamoto-Mitani

Aim

Home care nurses support patients with COVID-19 with mild to moderate symptoms at home due to the lack of community-based support. Little is known about how nurses initiated and maintained support for patients with COVID-19. This study explored the experiences of home care nurses in supporting patients with COVID-19 at home.

Methods

Using snowball sampling, 21 home care nurses participated in semi-structured interviews conducted either in person or online between September 2021 and February 2023. A qualitative study using a grounded theory approach was conducted.

Results

Home care nurses faced a situation where “suffering patients are overflowing” due to inadequate support from public health centers and designated hospitals. Despite their anxiety, they acted as a “flexible safety net by quickly compensating for uncertain support systems” for patients, families, and local health workers. They “built tentative support systems immediately” and “updated tentative support systems, own knowledge, skills, and mindset.” Home care nurses also “rushed to patient/family” to provide timely support and “avoided preventable death.”

Conclusions

Home care nurses act as a flexible safety net, preventing patient deaths by quickly compensating for uncertain support systems before and after initiating care. Their efforts complemented the inadequacies of traditional infectious disease control systems, typically managed by public health centers. Strengthening secondary and tertiary prevention systems is essential for home care nurses to save lives while delivering individualized care during the COVID-19 pandemic.

目的：由于缺乏社区支持，家庭护理护士在家中支持轻至中度症状的COVID-19患者。关于护士如何发起并维持对COVID-19患者的支持，人们知之甚少。本研究探讨了家庭护理护士在家为COVID-19患者提供支持的经验。方法：采用滚雪球抽样法，于2021年9月至2023年2月对21名家庭护理护士进行半结构化访谈或在线访谈。采用扎根理论的方法进行了定性研究。结果：由于公共卫生中心和定点医院的支持不足，家庭护理护士面临“病人泛滥”的局面。尽管他们感到焦虑，但他们通过迅速补偿不确定的支持系统，为患者、家属和当地卫生工作者提供了“灵活的安全网”。他们“立即建立了初步的支持系统”，并“更新了初步的支持系统，拥有自己的知识、技能和心态”。家庭护理护士也“赶到病人/家属”，提供及时的支持，“避免可预防的死亡”。结论：家庭护理护士作为一个灵活的安全网，通过在开始护理前后迅速补偿不确定的支持系统来防止患者死亡。他们的努力弥补了通常由公共卫生中心管理的传统传染病控制系统的不足。加强二级和三级预防系统对于家庭护理护士在COVID-19大流行期间拯救生命并提供个性化护理至关重要。

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引用次数: 0

Effects of a self-efficacy-centered self-management program on neurogenic bladder after spinal cord injury: A randomized controlled trial 以自我效能为中心的自我管理计划对脊髓损伤后神经源性膀胱的影响：一项随机对照试验。

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2025-01-02 DOI: 10.1111/jjns.12642

Xiangxiang Tang, Qian Liu, Xiaoping Su, Zepeng Yu

Purpose

The present research aimed to investigate the effects of a self-efficacy-centered self-management program on persons with neurogenic bladder (NGB) after spinal cord injury (SCI).

Design

A randomized controlled trial.

Materials and Methods

Eighty-two individuals with NGB after spinal cord injury (SCI) were randomized into either the control or intervention group. The control group received standard admission and discharge education and follow-up. The intervention group received the self-efficacy-centered self-management program. Self-efficacy was assessed at preintervention, 4, 8, and 12 weeks post-intervention. Self-management ability, the incidence of urinary tract infection (UTI), residual urine volume, bladder safety capacity, and quality of life were assessed at 12 weeks post-intervention.

Results

Of the 82 recruited participants, only 79 participants (control group: n = 39, 67% males, intervention group: n = 40, 58% males) received the full intervention. A significant difference was observed in self-efficacy score between the control and intervention groups (2.54 ± .247 versus 2.71 ± .218, mean difference = .174, 95% confidential interval: .070–.278, p = .001) at 12 weeks post-intervention. The intervention group demonstrated significantly better outcomes than the control group at 12 weeks post-intervention in self-management ability, urinary tract infection (UTI) incidence, residual urine volume and bladder safety capacity. There were significant differences in quality of life (vitality [VT] and mental health [MH] subscales) between the two groups.

Conclusions

The self-efficacy-centered self-management program developed in this study can significantly increase participants' self-efficacy and bladder self-management ability, thereby improving their bladder functional status and quality of life.

目的：探讨以自我效能感为中心的自我管理方案对脊髓损伤（SCI）后神经源性膀胱（NGB）的影响。设计：随机对照试验。材料与方法：将82例脊髓损伤后NGB患者随机分为对照组和干预组。对照组接受标准入院、出院教育及随访。干预组接受以自我效能感为中心的自我管理方案。自我效能在干预前、干预后4周、8周和12周进行评估。干预后12周评估自我管理能力、尿路感染（UTI）发生率、剩余尿量、膀胱安全容量和生活质量。结果：在招募的82名参与者中，只有79名参与者（对照组：n = 39，男性67%，干预组：n = 40，男性58%）接受了完整的干预。对照组与干预组的自我效能评分差异有统计学意义(2.54±。247对2.71±。平均差=。174, 95%保密区间：0.070 -。278, p = .001)。干预组在干预后12周的自我管理能力、尿路感染发生率、剩余尿量和膀胱安全容量均明显优于对照组。两组患者的生活质量（活力量表[VT]和心理健康量表[MH]）存在显著差异。结论：本研究开发的以自我效能感为中心的自我管理方案能显著提高被试的自我效能感和膀胱自我管理能力，从而改善膀胱功能状态和生活质量。

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引用次数: 0

Observational study of the third delay in emergency obstetric triage at the referral national hospital in Tanzania: Baseline survey 坦桑尼亚国家转诊医院产科急诊分诊第三次延误的观察研究：基线调查。

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2024-12-29 DOI: 10.1111/jjns.12639

Mugara Joseph Mahungururo, Shigeko Horiuchi, Eri Shishido

Aim

This study aimed to grasp the third delay using an observational method of actual nurses/midwives' practice overtime during care provision to emergency obstetric patients in a tertiary referral national hospital.

Methods

A prospective quantitative design was employed to observe the 24-h obstetric triage process from February 4 to March 7, 2023.

Results

This study involved observations of 120 obstetric patients with mean maternal age of 29.1 years (SD = 5.5); 81.6% were between 20 and 35 years, 14.2% were over 35 years, and 4.2% were under 20 years. There were 99 (82.5%) pregnant women: 67.7% were preterm, 29.3% term, and 3% postdate, and there were 21 (17.5%) postpartum women. Initial diagnoses were postpartum hemorrhage, 9 (7.5%), antepartum hemorrhage, 15 (12.5%), eclampsia, 13 (10.8), severe preeclampsia, 19 (15.9), preeclampsia, 12 (10%), obstructed labor, 3 (2.5%), previous scar, 13 (10.8%), and others, 36 (30%). Waiting time was within 15 minutes for 30.8% of the observations. Median waiting time from registration to consultation was 9 min. Interquartile range (IQR) for postpartum hemorrhage was 3.5–23.5 min, and IQR for eclampsia was 11.5–117.5. There were no maternal deaths during the 24-h observation of each obstetric patient.

Conclusion

The obstetric triage process requires additional training for triaging time-sensitive obstetric complications; the wide IQR of waiting time indicated management misalignments thus causing the third delay. The clinical priority of obstetric patients with leading risk factors for morbidity and mortality, such as hypertensive disorders of pregnancy and hemorrhage, needs to be approached within a continuum of care.

目的：本研究旨在通过观察一家国立三级转诊医院的护士/助产士在为产科急诊病人提供护理时的实际加班情况，掌握第三次延误的情况：方法：采用前瞻性定量设计，观察2023年2月4日至3月7日的24小时产科分诊过程：本研究共观察了 120 名产科病人，产妇平均年龄为 29.1 岁（SD = 5.5）；81.6% 的产妇年龄在 20 至 35 岁之间，14.2% 的产妇年龄在 35 岁以上，4.2% 的产妇年龄在 20 岁以下。共有 99 名（82.5%）孕妇：67.7% 为早产，29.3% 为足月，3% 为过期，还有 21 名（17.5%）产后妇女。初步诊断为产后出血 9 例（7.5%）、产前出血 15 例（12.5%）、子痫 13 例（10.8%）、重度子痫前期 19 例（15.9%）、子痫前期 12 例（10%）、难产 3 例（2.5%）、既往疤痕 13 例（10.8%）和其他 36 例（30%）。30.8%的观察对象的候诊时间在 15 分钟以内。从登记到就诊的等候时间中位数为 9 分钟。产后出血的四分位数间距（IQR）为 3.5-23.5 分钟，子痫的四分位数间距（IQR）为 11.5-117.5 分钟。在对每位产科病人进行 24 小时观察期间，没有产妇死亡：结论：产科分诊过程需要额外的培训，以便对时间敏感的产科并发症进行分诊；等待时间的IQR较宽，表明管理上存在偏差，从而导致了第三次延误。产科病人具有发病和死亡的主要风险因素，如妊娠高血压疾病和大出血，其临床优先次序需要在连续护理中加以处理。

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引用次数: 0

Perceptions and attitudes about advance care planning among healthcare professionals of cardiac care: A Q methodology study

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2024-12-29 DOI: 10.1111/jjns.12641

Hana Ko, Yoon Young Hwang, Seongkum Heo, KyungAh Cho, Mi-Seung Shin, Mi Yeong Kim, JinShil Kim

Aim

Healthcare professionals' perspectives on advance care planning (ACP) remain unclear, particularly among those who care for cardiac patients. Therefore, this study aimed to explore perspectives on ACP among healthcare professionals who provide care to patients with cardiovascular diseases.

Method

Using Q methodology, 40-Q sample statements were derived from an extensive literature review and an in-depth qualitative interview. The P-sample (Q sorters) comprised 10 physicians and 14 nurses. The P-sample filled each grid with a statement on the Q-sorting table. The data were analyzed using the PQMethod.

Results

Four factors with 18 Q sorters emerged and explained 71% of the variance, each contributing 5%–53%. Four factors were labeled: healthcare professional-led, communication-focused ACP (n = 5); early application-weighted, burden-reducing ACP (n = 5); prognostic uncertainty-based, negotiation-focused ACP (n = 5); and patient-value-based, comprehensiveness-focused ACP (n = 3); six Q sorters fell into either confounded or nonsignificant categories. Common perspectives on ACP across all factors emerged, including the conceptual definition of ACP, early employment of ACP as the right time, and needs for educational support and training.

Conclusions

Unique perspectives and common perspectives on ACP across factors emerged among Korean healthcare professionals of cardiac patients. The findings of this study provide initial information on perceptions of and attitudes toward ACP among Korean healthcare providers. Healthcare providers can use these findings to provide educational support and training.

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引用次数: 0

Association between social support from workplace supervisors and symptoms of post-traumatic stress disorder among Japanese midwives who experienced trauma during perinatal care 在围产期护理中经历过创伤的日本助产士中，工作场所主管的社会支持与创伤后应激障碍症状之间的关系

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2024-12-10 DOI: 10.1111/jjns.12636

Chizuru Higashi, Shigemi Iriyama, Yu Mon Saw

Aim

This study examined the association between workplace supervisors' perceptions of social support and the post-traumatic stress disorder (PTSD) symptoms among Japanese midwives who experienced trauma while providing perinatal care.

Methods

We employed a descriptive cross-sectional design and collected data using a self-reported questionnaire. Participants were 144 Japanese midwives working in hospitals. Data were analyzed using descriptive statistics, Spearman's correlation analysis, chi-square tests, and a binomial logistic regression analysis.

Results

Ninety-one midwives had experienced at least one traumatic event in the workplace within the past 12 months. Midwives in the high-PTSD-risk group (Impact of Event Scale–Revised [IES-R] score ≥25) comprised 11% of the sample. The total score of perceived social support from the supervisor was negatively associated with the IES-R total score (r = −0.213, p = .043). Social support from workplace supervisors was not associated with PTSD symptoms when adjusted for midwives experiencing verbal abuse or intimidating behavior from the mother or her family. Although not significant, midwives who had experienced verbal abuse or intimidation from mothers or their families were four times more likely to meet the criteria for the high-PTSD-risk group (odds ratio = 4.188, p = .07).

Conclusions

Perceived social support from workplace supervisors could reduce midwives' PTSD symptoms, but it was not effective for midwives traumatized by verbal abuse or intimidated from expectant mothers or their family members. It is important to establish an organizational and educational system that allows midwives to receive ongoing support from supervisors in the workplace.

目的：本研究考察了日本助产士在提供围产期护理时经历过创伤的工作场所主管对社会支持的感知与创伤后应激障碍（PTSD）症状之间的关系。方法：采用描述性横断面设计，采用自述问卷收集资料。参与者是144名在医院工作的日本助产士。数据分析采用描述性统计、Spearman相关分析、卡方检验和二项logistic回归分析。结果：91名助产士在过去12个月内至少经历过一次工作场所创伤事件。高ptsd风险组（事件影响量表-修订[IES-R]评分≥25）的助产士占样本的11%。主管感知社会支持总分与IES-R总分呈负相关（r = -0.213, p = 0.043）。当助产士经历来自母亲或其家人的言语虐待或恐吓行为时，来自工作场所主管的社会支持与PTSD症状无关。虽然不显著，但经历过母亲或其家人的言语虐待或恐吓的助产士达到高ptsd风险组标准的可能性是其他助产士的四倍（优势比= 4.188,p = 0.07）。结论：来自职场主管的感知社会支持可以减轻助产士的PTSD症状，但对于受到言语虐待或来自准妈妈及其家庭成员恐吓的助产士无效。重要的是要建立一个组织和教育系统，使助产士能够从工作场所的主管那里得到持续的支持。

{"title":"Association between social support from workplace supervisors and symptoms of post-traumatic stress disorder among Japanese midwives who experienced trauma during perinatal care","authors":"Chizuru Higashi, Shigemi Iriyama, Yu Mon Saw","doi":"10.1111/jjns.12636","DOIUrl":"10.1111/jjns.12636","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study examined the association between workplace supervisors' perceptions of social support and the post-traumatic stress disorder (PTSD) symptoms among Japanese midwives who experienced trauma while providing perinatal care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We employed a descriptive cross-sectional design and collected data using a self-reported questionnaire. Participants were 144 Japanese midwives working in hospitals. Data were analyzed using descriptive statistics, Spearman's correlation analysis, chi-square tests, and a binomial logistic regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-one midwives had experienced at least one traumatic event in the workplace within the past 12 months. Midwives in the high-PTSD-risk group (Impact of Event Scale–Revised [IES-R] score ≥25) comprised 11% of the sample. The total score of perceived social support from the supervisor was negatively associated with the IES-R total score (<i>r</i> = −0.213, <i>p</i> = .043). Social support from workplace supervisors was not associated with PTSD symptoms when adjusted for midwives experiencing verbal abuse or intimidating behavior from the mother or her family. Although not significant, midwives who had experienced verbal abuse or intimidation from mothers or their families were four times more likely to meet the criteria for the high-PTSD-risk group (odds ratio = 4.188, <i>p</i> = .07).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Perceived social support from workplace supervisors could reduce midwives' PTSD symptoms, but it was not effective for midwives traumatized by verbal abuse or intimidated from expectant mothers or their family members. It is important to establish an organizational and educational system that allows midwives to receive ongoing support from supervisors in the workplace.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":"22 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Factors affecting turnover intention of nurses in Japanese nursing homes for older adults—A cross-sectional study 日本养老院护士离职意向的影响因素-横断面研究。

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2024-12-10 DOI: 10.1111/jjns.12637

Kaoru Baba, Mana Doi, Azusa Arimoto, Akiko Kaneda, Yuka Kanoya

Aim

This study aimed to clarify factors that affect turnover intention of nurses in Japanese nursing homes (NHs).

Methods

Cross-sectional nationwide self-administered anonymous questionnaire survey was conducted among 2000 nurses and 1000 directors from 1000 NHs. Data were collected between December 2019 and January 2020. The questionnaire contained NH nurses' turnover intention，organizational factors such as work conditions, and so on; individual factors such as self-evaluation of nursing practice and so on. Responses were obtained from 267 nurses and 163 directors (response rates: 13.4% and 16.3%, respectively). This analysis included 196 responses from both nurses and directors from NHs. Univariate analysis and logistic regression analyses were performed to examine factors affecting nurses' turnover intentions.

Results

Regarding the NH nurses' turnover intention, 49.5% responded “no intention to leave,” 50.5% responded “intention to leave.” Of these “intention to leave,” 41.4% responded “I wanted to work in a medical facility.” A stronger burden of on-call shift (OR [odds ratio] = 1.54, 95% CI [confidence interval]: 1.10–2.16) and a lower affective organizational commitment (OR = 0.71, 95% CI: 0.62–0.80) indicated a higher turnover intention of NH nurses.

Conclusions

Retention of NH nurses may be increased by reducing the burden of on-call shifts and enhancing affective organizational commitment.

目的：本研究旨在厘清影响日本养老院护士离职意向的因素。方法：对全国1000家国民保健服务机构的2000名护士和1000名主任进行横断面自我匿名问卷调查。数据收集于2019年12月至2020年1月。问卷内容包括新卫生院护士离职意向、工作条件等组织因素；个体因素如护理实践自我评价等。获得了267名护士和163名主任的回复（回复率分别为13.4%和16.3%）。该分析包括来自NHs护士和主管的196份回复。采用单因素分析和logistic回归分析探讨影响护士离职意向的因素。结果：在护士离职意向方面，49.5%回答“无意离职”，50.5%回答“有离职意向”。在这些“打算离开”的人中，41.4%的人回答“我想在医疗机构工作”。较强的值班负担（OR[比值比]= 1.54,95% CI[置信区间]:1.10-2.16）和较低的情感组织承诺（OR = 0.71, 95% CI: 0.62-0.80）表明NH护士的离职意愿较高。结论：通过减少随叫随到轮班的负担和加强情感组织承诺，可以提高护士的保留率。

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引用次数: 0