比較精神專科醫院不同班別護理人員的生理指標、心理健康、睡眠品質與職場疲勞之差異

背景：臨床護理人員是健康照護的第一線主要提供者，唯有先強壯自己的健康，才能提供民眾健康相關照護。回顧過去台灣對護理人員的研究調查，多數明確指出輪班工作對生理與心理健康的影響，但卻鮮少研究專注在護理人員身上，特別是精神科護理人員。目的：本研究將探討精神專科醫院不同班別護理人員生理指標、心理健康、睡眠品質以及職場疲勞之關係。方法：研究設計為橫斷式研究法，採方便取樣，以南部一間精神專科醫院的固定白班、固定小夜班、固定大夜班及輪班護理人員為研究對象，運用「人口學基本資料表」、「流行病學研究中心之憂鬱量表」、「曾氏焦慮量表」、「匹茲堡睡眠量表」、「職場疲勞量表」來分析不同班別受試者的生理健康、心理健康、睡眠品質與職場疲勞之關係。結果：本研究共161位完成問卷調查，分別為9名男性及152名女性，平均年齡為平均年齡為34.87 ±8.40歲，以ANOVA統計分析人口學資料，發現在精神專科醫院不同班別「年齡」的護理人員間達顯著差異(F=4.871, P=.003*)。「護理年資」在精神專科醫院不同班別的護理人員間達顯著差異(F=4.184, P=.007＊)。不同班別之護理人員在心理健康及睡眠品質未達顯著，但不同班別的護理人員間都有睡眠品質不良及接近憂鬱症狀的情形。進一步分析，大夜班護理人員相對固定白班護理人員躺床時間較久才能入睡、大夜班護理人員相對輪班護理人員也需要花費較久的躺床時間才能入睡。輪班的護理人員工作過度投入程度最高，而固定小夜班的護理人員工作過度投入的程度最低。討論：本研究發現，除了固定小夜班外，其他班別的護理人員其BMI值都大於24，屬於過重的情形，可能因為固定白班、大夜班及輪班護理人員可能因為受到睡眠時數較少以及容易攝取高熱量或是速食導致BMI容易過高。發現精神專科醫院不同班別之護理人員接近憂鬱症狀，可能精神科護理人員長期與情緒障礙的病人接觸，加上工作環境與條件、醫療糾紛頻傳及精神科特殊職場壓力有關。而且精神科的護理人員多數皆呈現睡眠品質不良的情形，可能與職場壓力及輪班因素有關。另外，精神專科醫院不同班別護理人員在工作過度投入上，輪班的護理人員工作過度投入高於其他班別的護理人員，可能與排班方式有關。

關鍵字

精神科護理人員；輪班；生理指標；心理健康；睡眠品質；職場疲勞

並列摘要

Background: Nurses are front-line service healthcare providers. They Should Take Care of their body and health well then they will provide health care for people . In Taiwan, many surveys’ studies found that shift work would impact their physical and mental health, but only few studies focused on shift work nurses’ health, especially psychiatric ward nurses. Purpose: The purpose of this study was to investigate the relationship among physiological index, mental health, quality of sleep and burnout on psychiatric ward (PW) nurses at a psychiatric hospital in Taiwan. Method: A cross-sectional and convenient sampling study was conducted on the association among physiological index, mental health, quality of sleep and burnout on PWat a psychiatric hospital in southern Taiwan. The shift work nurses including regular shift, regular evening shift, regular night shift, and shift nurses as research participants. We using the structured questionnaires to collect data, including demographic data, the Center for Epidemiologic Studies Depression Scale (CES-D), the Zung Anxiety Scale, the Pittsburgh Sleep Quality Index (PSQI), and the Occupational Burnout Inventory. A One Way ANOVA is used to analyze the relationship among physiological index, mental health, quality of sleep and burnout in different working shift. Results: A total of 161 PW nurses were completed all questionnaires in this study. There were 9 males and 152 females, with an average age of 34.87 ± 8.40 years old. We analyzed the demographic data and found that there were statistically significant difference on age (F=4.871, P=.003*), and working experience (F=4.184, P=.007*) in each shift work of PW nurses. There were no significant differences among mental health, quality of sleep and different shift work PW nurses, but all of PW nurses showed that they did close to depressive symptoms and have poor quality of sleep. Further, the night shift work nurses need more time to fall asleep than day shifts work and shift work nurses. Shift work nurses have the highest over-commitment, butnurses with regular evening shifts work have the lowest over-commitment. Conclusions: The study found that there was only the regular evening shift work nurses’ BMI value lower than 24, whereas other regular shift work nurses more than 24 and theses PW nurses being overweight or obese. The possible reason is that regular day shifts, night shifts and shift nurses have fewer sleeping hours and easy to take high calories or fast food, which makes BMI value easily to be too high. It is found that nurses in different working shift of psychiatric hospitals have close to depressive symptoms, it may be because of contact with emotional disorders patients for a long time, work environment and conditions, frequent medical disputes, and psychiatric special occupational burnout. Almost all nursing staff in psychiatric hospitals have poor sleep quality, which may be related to workplace stress and shift work. The nurses in the psychiatric hospital who work shifts have highest over-commitment than the nursing staff in other shift, it may be because the working shift method.