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首页> 外文期刊>Journal of Nursing Education and Practice >Stress and cortisol as predictors of fatigue in medical/surgical nurses and nurse leaders: A biobehavioral approach
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Stress and cortisol as predictors of fatigue in medical/surgical nurses and nurse leaders: A biobehavioral approach

机译：压力和皮质醇可预测医疗/外科护士和护士长的疲劳：一种生物行为学方法

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Objective: High acuity and long work hours are significant contributors to nurses’ stress. Studies evaluating consecutive workdays with the use of biobehavioral methods are limited in the US. The aim of this study was to assess changes in and the relationship between stress, fatigue, and cortisol.Methods: In an observational within-subject design, we studied stress, fatigue and cortisol before and after 2 consecutive 12-hour day shifts in an acute care setting. Specifically, the study was designed to: (1) assess the effect of stress on fatigue; (2) examine the effect of stress on cortisol; (3) compare the levels of stress, fatigue, and cortisol; and (4) compare the responses of stress, fatigue, and cortisol between acute care, day shift staff nurses and nurse leaders.Results: Stress, fatigue, and cortisol increased significantly from baseline to Day 2 (p = .001, .004, and .010, respectively; paired t-test). In a comparison of nurses and nurse leaders, stress and fatigue at baseline were significantly higher in acute care nurses than in nurse leaders (p ≥ .00 and .05, respectively; independent t-test). At the end of 2 consecutive shifts, cortisol was significantly higher in staff nurses than in nurse leaders (p = .001).Conclusions: Competing initiatives pressure nurse leaders to work long hours to support organizational goals, sometimes at the expense of a healthy work environment. Nurses from direct care staff to executives should be educated in and demonstrate best practices in relation to endorsements from the American Nurses Association on fatigue and interventions to lessen the risks to patient safety.
机译：目的：高敏锐度和长工作时间是造成护士压力的重要原因。在美国，使用生物行为方法评估连续工作日的研究非常有限。这项研究的目的是评估压力，疲劳和皮质醇的变化及其之间的关系。方法：在观察对象内部设计中，我们研究了在连续2个12小时的日班班轮班前后，压力，疲劳和皮质醇急性护理环境。具体而言，该研究旨在：（1）评估压力对疲劳的影响; （2）检查压力对皮质醇的影响; （3）比较压力，疲劳和皮质醇的水平; （4）比较急性护理，日班职员护士和护士长之间的压力，疲劳和皮质醇反应。结果：从基线到第二天，压力，疲劳和皮质醇显着增加（p = .001，.004，和.010;配对的t检验）。通过比较护士和护士长，急性护理护士的基线压力和疲劳程度显着高于护士长（分别为p≥.00和.05;独立t检验）。在连续两次轮班结束时，职员护士的皮质醇水平显着高于护士领导者（p = .001）。结论：竞争性举措迫使护士领导者长时间工作以支持组织目标，有时以牺牲健康工作为代价环境。从直接护理人员到高管的护士都应接受教育，并示范与美国护士协会认可的最佳做法有关的疲劳和干预措施，以减少患者安全的风险。

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