标题：ارتباط کیفیت زندگی کاری پرستاران شاغل در بیمارستانهای آموزشی-درمانی شهر کرمانشاه با میزان درک و ارزیابی آنان از بار کاری در سال 1396
其他标题：The relationship between quality of working life of nurses in educational hospitals of Kermanshah with their perception and evaluation of workload in 2017
摘要：زمینه و هدف: کیفیت زندگی کاری به‌عنوان برنامه ای جامع و فراگیر، به ارتقای رضایتمندی و بهبود کیفیت زندگی کارکنان در محیط کار اختصاص می یابد، پرستاران یکی از مهم ترین ارکان بخش درمان هستند که با توجه به وضعیت شغلی، مسئول وظایف مهمی از قبیل مراقبتهای روحی و روانی و نیز فیزیکی بیمار می باشند که فعالیتهای فوق در صورت عدم رعایت اصول ایمنی و نیز آرامش و رفاه کاری، در بروز اختلالات جسمانی و روحی این قشر نقش بسزایی دارد. یکی دیگر از مهمترین مشکلات کاری پرستاران، بارکاری می باشد، بارکاری زیاد یکی از مهمترین علل ایجاد استرس در پرستاران می باشد. هدف از مطالعه حاضر تعیین ارتباط کیفیت زندگی کاری پرستاران شاغل در بیمارستان های آموزشی – درمانی شهر کرمانشاه با میزان درک و ارزیابی آنان از بار کاری بود. روش بررسی: این مطالعه به‌صورت توصیفی-تحلیلی و به‌صورت مقطعی در سال 1396 بر روی 873 نفر از پرستاران بیمارستانهای آموزشی-درمانی شهر کرمانشاه انجام‌شد. نمونه گیری به‌صورت تصادفی طبقه ای متناسب با حجم نمونه و با توجه به تعداد پرستاران شاغل در هر بیمارستان انجام شد. پرستاران شاغل در هر بیمارستان به صورت نمونه گیری تصادفی انتخاب شدند. برای جمع آوری داده ها از اطلاعات دموگرافیک محقق ساخته، پرسشنامه کیفیت زندگی کاری درن ون لار (Darren Van Laar) و پرسشنامه بارکاری ناسا استفاده شد. برای تجزیه و تحلیل دادهها از نرمافزار SPSS-18 و آزمون ضریب همبستگی اسپیرمن، آزمون کروسکال-والیس و آزمون دقیق فیشر استفاده شد. یافتهها: سن افراد شرکت داده شده در مطالعه 88/5± 44/32 سال بود. در بین نمونه مورد مطالعه 5/40% را مردان و 5/59% را زنان تشکیل دادند. رابطه معناداری بین کلیه ابعاد بارکاری با یکدیگر مشاهده شد (05/0>p). بین بعد وضعیت عمومی با کلیه ابعاد بارکاری (05/0>p) غیر از عملکرد و بازدهی (05/0<p) ارتباط وجود داشت. بین کیفیت کلی زندگی با بعد بار زمانی (0.027p=)، میزان تلاش و کوشش (046/0p=) و احساس ناکامی و دلسردی (015/0 p=) رابطه معناداری وجود داشت، اما بین کیفیت کلی زندگی کاری با خرده مقیاس‌های بار فکری و ذهنی (17/0=p)، بار فیزیکی (181/0=p) و عملکرد و بازدهی (852/0=p) ارتباط معناداری مشاهده نشد. رابطه معناداری بین کیفیت کلی زندگی پرستاران با تعداد شیفت (107/0=p) و تعداد بیماران در هر شیفت (618/0=p) مشاهده نشد. ارتباط معناداری بین کیفیت کلی زندگی پرستاران با ساعات اضافه‌کاری (001/0=p) در بین پرستاران مورد مطالعه مشاهده شد. رابطه معناداری بین کیفیت زندگی و بخش بیمارستانی مورد مطالعه وجود داشت؛ به طوری که کمترین کیفیت زندگی کاری در بخش داخلی جراحی و بالاترین کیفیت زندگی کاری مربوط به بخش اطفال بود. نتیجه گیری: با توجه به نتایج به‌دست‌آمده از این پژوهش مبنی بر تأثیر بارکاری بر کاهش کیفیت زندگی کاری، اتخاذ تدابیری در راستای ارتقای کیفیت زندگی کاری، رفع عوامل زمینه‌ساز، پیشگیری، درمان و آموزش روشها و مهارتهای صحیح تطابقی و ارتباطی از ضروریات کنونی سیاستگذاری در امر بهداشت و درمان در چنین محیطهایی میباشد. همچنین نقش و تأثیر مدیریت و سرپرستان جهت انجام مداخلات مؤثر در جهت بهبود کیفیت زندگی کاری و بارکاری را مشخص کرده و انجام مطالعات بیشتر در آینده در جهت شناسایی دیگر فاکتورهای تأثیرگذار بر کیفیت زندگی و بارکاری پیشنهاد میگردد.
其他摘要：Background and Aim: Nurses are the most important support of treatment that is responsible for important tasks such as the patientchr('39')s psychological and physical care. Due to the working conditions of nurses, the occurrence of physical and mental disorders of nurses plays an important role. Quality of work life is one of the most important issues in any organization that is the key to the success of any organization. Quality of work life was first highlighted with emphasis on different aspects of work and productivity of the organization. The quality of working life describes employee satisfaction in a safe environment with regard to promotion of the organization. Quality of Work Life, as a comprehensive program, is dedicated to enhancing the satisfaction and improvement of the quality of life of employees in the workplace, as it is a vital element in recruiting, retaining and enhancing the quality of human resources of any organization. Nurses are one of the most important pillars of the health care sector, which, depending on their occupational status, are responsible for important tasks such as mental and physical care of the patient. These activities play a significant role in the development of physical and mental disorders in the case of non-compliance with the principles of safety, tranquility and work welfare. Another major problem for nurses is high workload, which affects their attention capacity and increases medical errors. Several studies have shown that high workload can compromise the quality and safety of patient care, increase medical errors, increase the length of hospital stay, and ultimately reduce quality of service. High workload is highly correlated with poor quality of care and is one of the most important causes of stress in nurses. The purpose of this study was to determine the relationship between the quality of work life of nurses working in Kermanshah educational hospitals with their perception and evaluation of workload. Materials and Methods: This descriptive-analytical cross-sectional study was conducted on 873 nurses in Kermanshah educational hospitals in 2017. The stratified random sampling was performed according to the sample size and the number of nurses employed in each hospital. Nurses working in each hospital were selected by random sampling. Demographic data, Darren Van Laar Quality of Work Life Questionnaire and NASA TLX Workload Questionnaire were used for data collection. Generalized questionnaire designed to collect demographic data including sections of age, sex, marital status, work sector, work experience, average number of shifts per month, average number of patients per shift, and number of overtime hours per month. The validity and reliability of the NASA-TLX Questionnaire for the Iranian population were assessed by Mazloomi et al. and its Cronbachchr('39')s alpha was estimated to be 0.897. NASA-TLX is a multidimensional method that provides a total score of workload based on the weighted average of six subscales of mental demand, physical demand, temporal demand, performance, effort, and frustration. This method has high validity and general acceptance and can be used to identify sources with high workload. Mean scores below 50 are considered acceptable and the score above 50 is considered as high. The Daren van Laar Quality of Life Questionnaire is a multidimensional tool for assessing the quality of work life that was designed and used in 2007 to assess the quality of work life in the health sector. The Darren Van Lar Questionnaire is a reliable and reliable tool for assessing the quality of work life in the health sector. The questionnaire consisted of 24 5-point Likert scale questions (5-1) with 5 indicating "strongly agree" and 1 indicating "strongly disagree" and 6 factors including job satisfaction, working conditions, general health status. , Examines work-home communication, stress at work, and control at work. SPSS 18 software and Spearman correlation coefficient, Kruskal-Wallis test and Fisher exact test were used for data analysis. Results: The mean age of participants was 32.44 5 5.88 years. 40.5% of the sample were men and 59.5% were women. Significant relationship was observed between all dimensions of workload (p <0.05). There was a relationship between general status dimension with all dimensions of workload (p <0.05) except performance and efficiency (p <0.05). There was a significant relationship between overall quality of life with time dimension (p = 0.027), effort (p = 0.046), and frustration (p = 0.015), but between overall quality of work life and subscales. There was no significant relationship between mental and mental load (p = 0.17), physical load (p = 0.181) and performance and efficiency (p = 0.852). There was no significant relationship between the overall quality of life of nurses with the number of shifts (p = 0.107) and the number of patients per shift (p = 0.618). There was a significant relationship between nurseschr('39') overall quality of life and overtime (p = 0.001). Based on Fisher exact test results, there was no significant relationship between gender and marital status with overall quality of life of nurses. There was a significant relationship between the quality of life and the hospital ward studied, with the lowest quality of work life in the surgical ward and the highest quality of work life in the pediatric ward. Conclusion: According to the results of this study, the effect of workload on decreasing the quality of working life, adopting measures to improve the quality of working life, removing the underlying factors, preventing, treating and training appropriate coping methods and skills, and Communication is one of the current essentials of health policy making in such environments. It also identifies the role and impact of management and supervisors on effective interventions to improve the quality of work and work life, and further studies are suggested to identify other factors affecting the quality of life and work.
关键词：کیفیت زندگی کاری; بارکاری; پرستار; بیمارستان; کرمانشاه
其他关键词：Quality of working life; workload; nurse; hospital; Kermanshah
