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Odnos med izgorelostjo, spoprijemanjem s stresom in zadovoljstvom na delovnem mestu pri medicinskih sestrah na intenzivni negi
ID Friganović, Adriano (Avtor), ID Selič - Zupančič, Polona (Mentor) Več o mentorju... Povezava se odpre v novem oknu

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Izvleček
Izhodišča Izgorelost je psihološki, z delom povezan sindrom, ki nastane zaradi dolgotrajne izpostavljenosti čustvenim in medosebnim stresorjem na delovnem mestu. Kaže se kot negativna samopodoba, negativni odnos do dela in zmanjšano zanimanje za stranke/paciente. Opisane so bile tri dimenzije izgorelosti - čustvena izčrpanost (ČI), depersonalizacija (DP) in zmanjšana osebna izpolnitev (OI). Medicinske sestre, ki delajo na področjih z visokimi obremenitvami - kot je intenzivna nega, poročajo o večji izgorelosti. Zaradi čustvenih in organizacijskih zahtev, ki ustvarjajo občutek prevelike delovne obremenitve, in stresorjev, povezanih s fizičnimi in psihičnimi pritiski iz okolja, je izgorelost pri teh pomembno bolj izražena, kot pri onih iz drugih delovnih okolij in področij zdravstvene nege. Cilji moje raziskave so bili raziskati odnos med sindromom izgorelosti, strategijami spoprijemanja s stresom in zadovoljstvom pri delu pri medicinskih sestrah na intenzivni negi ter poglobljeno raziskati stališča in poznavanje sindroma izgorelosti pri tistih medicinskih sestrah na intenzivni negi, pri katerih je že bila prepoznana izgorelost (skupno število točk na Vprašalniku izgorelosti Maslachove (MBITOT)). Dosegel sem naslednje cilje: (i) določil sem pogostnost sindroma izgorelosti pri medicinskih sestrah na intenzivni negi (ii) raziskal sem povezavo med spolom in izgorelostjo ter povezave med sindromom izgorelosti, zadovoljstvom pri delu in strategijami spoprijemanja s stresom (iii) predstavil sem odnos med sindromom izgorelosti in prej omenjenimi značilnostmi z multivariatnim modeliranjem (iv) pri že izgorelih medicinskih sestrah na intenzivni negi sem raziskal stališča in poznavanje dejavnikov, za katere je iz znanstvene literature znano, da so povezani z izgorelostjo. Metode Na podlagi mešanega raziskovalnega modela sem najprej izvedel kvantitativno presečno multicentrično raziskavo, v kvalitativnem delu pa sem uporabil fenomenološki teoretični okvir z delno strukturiranimi intervjuji. Sodelujoči in postopek V kvantitativni raziskavi je bilo uporabljeno priložnostno vzorčenje; ciljna populacija so bile medicinske sestre, zaposlene v enotah intenzivne nege v petih hrvaških univerzitetnih bolnišnicah, ki sem jih prosil za prostovoljno sodelovanje. Zbiranje podatkov je potekalo od aprila do septembra 2017, sodelovalo je 620 oseb (544 žensk (87,7 %) in 76 moških (12,3 %)). Vključitveno merilo pri prostovoljno sodelujočih je bilo več kot šest mesecev delovnih izkušenj. V letu zbiranja podatkov je na intenzivni negi delalo približno 3500 medicinskih sester, od katerih je bilo približno 13,0 % moških, tako da struktura vzorca odraža spolno strukturo populacije medicinskih sester na intenzivni negi na Hrvaškem. Kvalitativna raziskava je bila izvedena v letu 2017. Medicinske sestre na enotah intenzivne nege s prepoznano izgorelostjo glede na rezultat na Vprašalniku izgorelosti Maslachove so bile izbrane naključno iz vseh petih bolnišnic in so sodelovale prostovoljno. Od 28 sodelujočih je bilo 86 % žensk (n = 24) in 14 % moških (n = 4), starih med 36 in 45 let (n = 11 (40 %)) oziroma med 26 in 35 let (n = 10 (36 %)). Pripomočki Poleg vprašanj o demografskih značilnostih (starost, spol, izobrazba, trajanje delovnih izkušenj na enoti intenzivne nege in vrsta intenzivne nege) so bili v kvantitativnem delu raziskave uporabljeni Vprašalnik izgorelosti Maslachove (MBI), Lestvica spoprijemanja s stresom (WOC) in Lestvica zadovoljstva pri delu (JSS); rezultati MBI so pokazali dobro notranjo konsistentnost s Cronbachovim koeficientom ? z vrednostmi od 0,74 do 0,90 za vsako podlestvico; vse lestvice WOC so pokazale zmerno notranjo konsistentnost (Cronbach ? med 0,6 in 0,7), pri lestvici JSS pa je bil Chronbach ? < 0,80. V kvalitativnem delu raziskave so bili opravljeni delno strukturirani intervjuji do zasičenosti vzorca, pogovori pa so bili zvočno posneti in dobesedno prepisani. Analiza podatkov Analize so bile opravljene z IBM-ovim programom SPSS Statistics for Windows (različica 22.0). Deskriptivne statistike (frekvence, odstotki, aritmetična sredina in standardni odklon) so bile uporabljene za prikaz glavnih značilnosti vzorca. Razlike med MBI, WSC in JSS so bile ocenjene z neodvisnim t-testom, Mann-Whitneyjevim U-testom in s testom Kruskal-Wallis. Normalnost podatkov je bila preizkušena s Kolmogorov-Smirnov testom. Pri lestvici WOC je merjenje ustreznosti vzorčenja podalo visoko vrednost (KMO = 0,876), tudi Bartlettov test sferičnosti je bil statistično pomemben (p < 0,001) in je pokazal na primernost faktorske analize. Z rotiranjem je F1 (aktivno spoprijemanje) pojasnil 25,9 % začetne variance in F2 (pasivno spoprijemanje) 24,5 % začetne variance; oba faktorja skupaj sta pojasnila 50,4 % začetne variance. Notranja konsistentnost za aktivno spoprijemanje je bila po Chronbach ? = 0,80 ter za pasivno spoprijemanje ? = 0,75. Povezave med spolom in izgorelostjo, strategijami spoprijemanja stresom in zadovoljstvom pri delu so bile preverjene s hi-kvadrat testom. Neodvisne spremenljivke pri logistični regresiji so bile spol, starost in rezultati na lestvicah spoprijemanja ter zadovoljstva pri delu, izgorelost (MBITOT in posamezne dimenzije ČI, DP in OI) pa je predstavljala odvisno spremenljivko. Meja statistične pomembnosti je bila p < 0,05. Pri kvalitativni analizi so bile začetne kode generirane v prvi fazi odprtega kodiranja, podatki pa so bili obravnavani skupinsko in potrdilno; pozneje so bile na podlagi kod in z organizacijo podatkov v smiselne skupine oblikovane teme. Pregled začetnih kod in njihovo ponovno združevanje v prejšnje/nove teme se je odvijalo pred oblikovanjem in opredelitvijo imen tem. Vsaka tema je zajela nekaj pomembnega o podatkih v odnosu do raziskovalnega vprašanja in je predstavljala določeno stopnjo vzorca v odzivu ali pomena iz nabora podatkov, kar ustreza postopku osnega kodiranja. Končno je bilo število tem zmanjšano na bolj obvladljiv nabor glavnih tem, ki mu je v zadnji fazi sledila interpretacija. Rezultati V kvantitativni raziskavi so večino v vzorcu predstavljale ženske medicinske sestre (87,7 %), stare med 26 in 35 let (38,9 %), vsi sodelujoči pa so bili stari 33,5 ± 7,7 let. Večina je imela manj kot pet let delovnih izkušenj (39,4 %), delovne izkušnje vseh pa so segale od 1 do 38 let. Najpogosteje so delali na intenzivni negi splošne kirurgije (36,3 %) v Univerzitetnem kliničnem centru Zagreb (51,8 %). Od vseh sodelujočih jih je 137 (22,1 %) doseglo visok rezultat pri čustveni izčrpanosti; 49 (7,9 %) pri depersonalizaciji, medtem ko je bil pri 214 (34,5 %) nizek rezultat pri osebni izpolnitvi. V celoti je bilo 72 sodelujočih (11,6 %) glede na skupni rezultat MBITOT izgorelih. Med sodelujočimi s 5 do 10 leti delovnih izkušenj je nižji delež poročal o visoki depersonalizaciji (15,5 %), deleža z nizko osebno izpolnitvijo in srednjo depersonalizacijo pa sta bila 20,6 % in 17,6 % (p = 0,003). Spol ni bil povezan ne z zadovoljstvom pri delu (p < 0,443) ne s strategijami spoprijemanja (aktivno spoprijemanje p < 0,927 in pasivno spoprijemanje p < 0,144). Nekaj aktivnega spoprijemanja je bilo zabeleženega pri 340 (62,5 %) ženskah in 48 (63,2 %) moških. Tisti, ki so dosegali visoke vrednosti pri čustveni izčrpanosti, so v večji meri (28,5 %) precej uporabljali pasivno spoprijemanje, sicer je bil delež pasivnega spoprijemanja 14,0 % za nizko in 16,2 % za srednjo čustveno izčrpanost (p = 0,005). Več moških je doseglo srednje (17,2 %) in visoke (16,3 %) vrednosti depersonalizacije, več žensk pa nizke vrednosti depersonalizacije (p = 0,045). Kdor je dosegel visoko vrednost depersonalizacije, je na lestvici JSS bolj verjetno izbral oceno zadovoljen(a) (38,8 %), vendar je bila ocena zadovoljen(a) na lestvici JSS še pogosteje izbrana pri tistih, ki so dosegli nizke (63,8 %) in srednje vrednosti (64,3 %) depersonalizacije (p < 0,001). Kdor je dosegel visoko vrednost na dimenziji depersonalizacija, je kar precej (34,7 %) uporabljal pasivno spoprijemanje - in sicer 12,9 % za nizko in 26,5 % za srednjo vrednost na dimenziji depersonalizacija (p < 0,001). Sodelujoči z manj izraženo depersonalizacijo so izbirali višje ocene zadovoljstva na lestvici JSS (p < 0,001). Ocena zadovoljen(a) (OR = 4,04; 95 % CI = 1,81–9,03; p = 0,001) in zelo zadovoljen(a) na lestvici JSS (OR = 10,40; 95 % CI = 1,81–9,03; p < 0,001) sta bila povezana z višjo osebno izpolnitvijo, pet do deset let delovnih izkušenj (OR = 0,56; 95 % CI = 0,33–0,95; p = 0,032) pa z nižjo osebno izpolnitvijo. Moški so v večji meri dosegali srednjo in visoko depersonalizacijo v primerjavi z ženskami (p = 0,045). Pri dimenzijah izgorelosti čustvena izčrpanost in osebna izpolnitev in v skupni vrednosti izgorelosti (MBITOT) se spol ni pokazal kot statistnično pomemben dejavnik. Celokupna izgorelost MBITOT je bila v logistični regresiji odvisna spremenljivka. Nižje vrednosti MBITOT so bile na lestvici za samo-oceno zadovoljstva pri delu povezane z ocenami nevtralno (OR = 0,22; 95 % CI = 0,10–0,52; p = 0,001), zadovoljen(a) (OR = 0,04; 95 % CI = 0,02–0,09; p < 0,001) in zelo zadovoljen(a) (OR = 0,01; 95 % CI = 0,00–0,02; p < 0,001). Višje vrednosti izgorelosti MBITOT so bile povezane s pasivnim spoprijemanjem, opredeljenim z nekoliko uporabljam (OR = 3,08; 95 % CI = 1,39–6,83; p = 0,006), kar precej uporabljam (OR = 9,93; 95 % CI = 4,01–24,61; p < 0,001) in petimi do desetimi leti delovnih izkušenj (OR = 1,99; 95 % CI = 1,10–3,60; p = 0,024). Z uporabo MBITOT kot mere izgorelosti v procesu modeliranja sem pojasnil 36 % variance (Nagelkerke R2 = 0,359). Pri upoštevanju pojavnosti sindroma izgorelosti pri medicinskih sestrah na intenzivni negi so rezultati te raziskave primerljivi z objavljenimi rezultati za druge poklice, zato je bila H1 potrjena. Pojavnost izgorelosti v moji raziskavi je bila za 22,1 % za čustveno izčrpnost, 7,9 % za depersonalizacijo in 34,5 % za osebno izpolnitev pri MBItot 11,6 %. Ob tem literatura navaja izgorelost pri vojakih 16,3 % za ČI, 8,64 % za DP in 30,7 % za OI, pri zdravnikih pa 42,4 % za ČI, 16,0 % za DP in 15,2 % za OI. Potrdil sem tudi H2, da izgorelost in zadovoljstvo pri delu nista povezana s spolom, in H3, da so strategije spoprijemanja s stresom in samo-ocena zadovoljstva pri delu povezani s sindromom izgorelosti. V kvalitativni analizi sem izluščil več tem, ki kažejo različne izkušnje, odnos in vedenje izgorelih medicinskih sester na intenzivni negi - okrnjeno zasebno življenje, stres pri delu, možnosti za zmanjševanje stresa, zaščitni ukrepi na delovnem mestu in prepoznavanje (izgorelosti). Medicinske sestre z izgorelostjo so mi omogočile globlji vpogled v njihove izkušnje in težave, ki jih prinaša izgorelost. Zaključki Rezultati kvantitativnega dela moje raziskave o izgorelosti in njenih povezavah so primerljivi z rezultati raziskav v drugih poklicih, nekoliko pa se razlikujejo zaradi vzorca in pogojev dela v različnih državah. V delovnih okoljih, kjer že imajo preventivne programe, je bila pojavnost izgorelosti manjša. Kvalitativna analiza je pokazala nezadostno znanje o izgorelosti pri hrvaških medicinskih sestrah na intenzivni negi in potrebo po uvedbi izobraževanja o izgorelosti v učne načrte zdravstvenih šol. Glede na to, da aktivno spoprijemanje s stresom zmanjša pojavnost izgorelosti, bi kazalo zaposlene podpreti s programi za konstruktivno (aktivno) spoprijemanje. Spoznanja moje raziskave, da potrebujejo medicinske sestre znanje, osveščenost in usmeritve za preprečevanje, prepoznavanje in spoprijemanje z izgorelostjo, bi kazalo uporabiti v modelih socialnega učenja, kar bi lahko bil nov in uresničljiv način obravnave tega vprašanja. Ker se je pokazalo, da je višina izobrazbe povezana z nižjo pojavnostjo osebne izpolnitve, bi vodje lahko spodbujale medicinske sestre k sodelovanju v nadaljnjem/stalnem izobraževanju. Krepitev dejavnikov, povezanih z zadovoljstvom pri delu, lahko zmanjša izgorelost pri medicinskih sestrah v intenzivni negi. Glede na odnos med zadovoljstvom pri delu in pojavnostjo izgorelosti bi vodstva bolnišnic lahko ukrepala v smeri izboljšav delovnega okolja. Preventivni modeli bi ne smeli biti vzpostavljeni samo za medicinske sestre na intenzivni negi, ampak za vse medicinske sestre v zdravstvenih ustanovah, pa tudi za druge zdravstvene delavce - npr. zdravnike, fizioterapevte in delovne terapevte. Moji izsledki pomenijo za zdravstveno nego kot stroko pomemben prispevek, saj potrjujejo pomen konstruktivnega spoprijemanja s stresom. Glede na to, da aktivno spoprijemanje zmanjša pojavnost izgorelosti, bi kazalo to ugotovitev uporabiti kot osnovo za načrtovanje izobraževanj in usposabljanj in tako krepiti zmogljivosti medicinskih sester – tako na intenzivni negi kot tudi na drugih deloviščih. Predstavljene informacije lahko pomagajo razumeti medicinskim sestram v intenzivni negi in medicinskim sestram nasploh, kako izgorelost vpliva na njihovo profesionalno in družinsko življenje. Poleg tega predstavljam različne izkušnje, koristne pri odpravljanju posledic izgorelosti in zmanjšanju škodljivih učinkov. Končno lahko izsledki motivirajo zdravstvene strokovnjake z omejenimi veščinami in/ali znanjem s področja izgorelosti, da prepoznajo potrebo po spreminjanju svojih strategij za spoprijemanje s stresom tako, da bodo bolj problemsko usmerjene in s tem bolj konstruktivne.

Jezik:Slovenski jezik
Ključne besede:medicinske sestre, intenzivna nega, sindrom izgorelosti, spoprijemanje s stresom, zadovoljstvo pri delu
Vrsta gradiva:Doktorsko delo/naloga
Organizacija:MF - Medicinska fakulteta
Leto izida:2021
PID:20.500.12556/RUL-128442 Povezava se odpre v novem oknu
Datum objave v RUL:14.07.2021
Število ogledov:2431
Število prenosov:401
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Sekundarni jezik

Jezik:Angleški jezik
Naslov:Burnout syndrome and its associations with coping and job satisfaction in critical care nurses
Izvleček:
Background Burnout is a psychological, work-related syndrome; a result of long-term exposure to emotional and interpersonal stressors in the workplace, manifested as negative self-esteem, a negative attitude towards work, and diminished interest in the clients/patients. Within the syndrome, three dimensions have been identified: emotional exhaustion (EE), depersonalization (D), and personal accomplishment (PA). Nurses working in high-stress areas, such as critical care, report high levels of burnout. Hospital nurses have higher burnout scores than those working in other settings, due to the emotional and organisational demands creating the perception of a excessive workload, and stressors associated with characteristics related to the work environment. The aims of my research were to explore the associations between burnout syndrome, coping mechanisms and job satisfaction in critical care nurses, and to explore attitudes towards and a sense of knowledge about burnout syndrome in critical care nurses who had been identified as burnt out (as shown by their total MBI score). The following goals were reached: (i) to determine the incidence of burnout syndrome in critical care nurses; (ii) to explore the associations between gender and burnout, and between burnout syndrome, job satisfaction and coping mechanisms in critical care nurses; (iii) to present the associations between burnout syndrome and all these characteristics in a multivariate modelling process; and (iv) to explore attitudes towards and knowledge of the factors known to be related to burnout in burnt out critical care nurses.   Methods A quantitative cross-sectional multi-centre study was conducted and a phenomenological theoretical framework was used in the qualitative part of the study, with semi-structured interviews. Participants and procedure The nurses were asked to voluntarily participate in the study. In the quantitative part, a convenience sampling method was used, and the target population was critical care nurses employed in the Intensive Care Units (ICUs) of five Croatian university hospitals. Data collection was carried out from April to September 2017, and 620 participants were recruited (544 female (87.7%) and 76 male (12.3%)). The inclusion criterion for this study was more than six months of work experience. During the year that the data were collected, the approximate number of critical care nurses in Croatia was 3500, of which approximately 13.0% were male nurses. It is therefore safe to conclude that the gender structure of this study sample reflects the gender structure of the population of critical care nurses in Croatia. The qualitative part of the study had an exploratory phenomenological design, and was carried out in several Croatian ICUs in 2017. A sample of ICU nurses with burnout, according to their score on the Maslach Burnout Inventory, were chosen randomly from five hospitals and participated voluntarily. Of the 28 participants, 86% were women (n=24) and 14% men (n=4), most aged 36-45 (n=11 (40%)) and 26-35 years (n=10 (36 %)). Instruments Several demographic characteristics were collected, i.e. age, gender, education, duration of work in the ICU, and type of ICU. Aside from these, in the quantitative part of the study, the Maslach Burnout Inventory (MBI), the Ways of Coping Scale (WOC) and the Job Satisfaction Scale (JSS) were administered; the MBI showed good internal consistency reliability with the Cronbach α, ranging from 0.74 to 0.90 for each subscale; all the WOC scales showed moderate reliability of internal consistency (Cronbach α between 0.6 and 0.7); and for the JSS the Cronbach α was<0.80. In the qualitative part of my research, semi-structured interviews were conducted up to the saturation point, and the conversations were audio-recorded and transcribed verbatim. Data Analysis The data analyses were carried out using IBM SPSS Statistics for Windows (version 22.0). Descriptive statistics (frequency, percentage, mean, standard deviation) were used to summarise the main characteristics of the sample. The differences in the MBI, WOC and JSS were assessed using the independent t-test, the Mann-Whitney U test, and the Kruskal-Wallis test. Data normality was tested by the Kolmogorov-Smirnov test. For the WOC, the Kaiser-Meyer-Olkin measure of sampling adequacy gave a high value (KMO=0.876), and the Bartlett's test of sphericity was statistically significant (p<0.001), indicating the suitability of a factor analysis; by the rotated solution, F1 explained 25.9% of the initial variance, and F2 explained 24.5% of the initial variance; both factors cumulatively explained 50.4% of the initial variance. The internal consistency reliability for active coping (F1) was 0.80 and for passive coping (F2) was 0.75. The associations between gender and burnout, coping mechanism and job satisfaction were examined using the Chi-square test. Gender, age and the coping and job satisfaction scales’ total scores were independent variables in the logistic regression modelling, with burnout (each dimension of MBI) being the dependent variable. Significance was set at p<0.05. In the qualitative analysis, the initial codes were generated in the first stage of open coding, and the data were dealt with collaboratively and corroboratively; afterwards themes based on the codes were constructed, by organising the data into meaningful groups. A review of the initial codes and (re)combining them into previous/new themes took place before developing and defining the names of the themes. Each theme captured something important about the data in relation to the research question, and represented some level of patterned response or meaning within the data set, with the process corresponding to axial coding procedure. Finally, the number of themes was reduced to a more manageable set of main themes and followed by interpretation at the final stage. Results In the quantitative part of the study, the majority of the sample were female nursing staff (87.7%), aged 26-35 (38.9%) with less than 5 years of work experience (39.4%); the primary work department was general surgical ICU (36.3%), and the major location was UHC Zagreb (51.8%). The participants were aged 33.5±7.7 and their work experience ranged from 1 to 389.5 years. Of all the participants, 137 (22.1%) had a high score on EE; 49 (7.9%) had a high score on DP; 214 (34.5%) had a low score on PA; and 72 (11.6%) had burnout according to the total score of burnout (MBItot). A lower proportion of people with 5-10 years of work experience reported a high DP (15.5%), while the proportions with low PA and medium DP were 20.6% and 17.6%, respectively (p=0.003). Gender was not related to job satisfaction (p˂0.443), or to coping mechanisms (active coping p˂0.927 and passive coping p˂0.144). Active coping used somewhat was identified in 340 (62.5%) women and 48 (63.2%) men. Where the participants reported high EE, passive coping was reportedly used quite a bit by a higher proportion (28.5%); otherwise 14.0% for low and 16.2% for medium EE (p=0.005) was found. More men reported medium (17.2%) or high (16.3%) DP, while more women reported low DP (p=0.045). Where the participants reported high DP, their JSS was likely to be satisfied (38.8%), but satisfied for JSS was reported even more often for those with low (63.8%) and medium (64.3%) DP (p<0.001). Where the participants reported high DP, passive coping was reportedly used quite a bit by a greater proportion (34.7%); otherwise 12.9% for low and 26.5% for medium DP (p<0.001) was found. Participants who scored lower on DP reported a higher JSS (p<0.001). A satisfied JSS (OR=4.04, 95% CI=1.81-9.03, p=0.001) and a very satisfied JSS (OR=10.40, 95% CI=1.81-9.03, p<0.001) were associated with a higher PA. Five to ten years of work experience (OR=0.56, 95% CI=0.33-0.95, p=0.032) were associated with a lower PA. Men reported a higher percentage of medium and high DP in comparison to women (p=0.045). Gender did not make a difference to burnout (MBITOT), EI or PA levels. MBItot was used as a dependent variable in the logistic regression. Lower scores of MBItot were associated with job satisfaction assessed as neutral (OR=0.22, 95% CI=0.10-0.52, p=0.001), satisfied (OR=0.04, 95% CI=0.02-0.09, p<0.001) and very satisfied (OR=0.01, 95% CI=0.00-0.02, p<0.001). Higher scores on MBItot were associated with passive coping described as used somewhat (OR=3.08, 95% CI=1.39-6.83, p=0.006), used quite a bit (OR=9.93, 95% CI=4.01-24.61, p<0.001) and five to ten years of work experience (OR=1.99, 95% CI=1.10-3.60, p=0.024). Using MBItot as a measure of burnout in the modelling process was shown to be useful, and nearly 36% of the variance was explained (Nagelkerke R2=0.359). With regard to burnout syndrome incidence in critical care nurses, the results of this study are comparable to the published research findings of other professions, so H1 was confirmed. The incidence in this study was EE 22.1%, D 7.9%, PA 34.5%, and TS 11.6%, while the literature shows it to vary between soldiers, EE 16.3%, D 8.64%, PA 30.7%, and physicians, EE 42.4%, D 16.0%, PA 15.2%. The H2 that burnout and job satisfaction are not gender-related was also confirmed, as was H3 that coping mechanisms and job satisfaction are associated with burnout syndrome. In the qualitative analysis, several emergent themes, compromised private life, stressful work demands, stress reduction options, protective workplace measures and a sense of knowledge reflected a variety of experience, attitudes and knowledge of burnout. Nurses with burnout provided an insight into their experience and attitudes, and the problems burnout creates. Conclusions The results of the quantitative part of my research concerning burnout and the total score on the MBI are comparable with the results of studies of other professions, but they vary with regard to the sample and the work conditions of the countries involved. A work environment with preventive programmes showed less incidence of burnout. The qualitative analysis showed an insufficient sense of knowledge about burnout in Croatian critical care nurses, and a need to implement education on burnout in the curriculums of nursing schools. Given that active coping may decrease the incidence of burnout, training and capacity building should acknowledge this finding. This study brought new knowledge and gave new direction for curriculum programmes in nursing education, which should include knowledge of and skills in burnout and coping strategies, i.e. information, awareness-raising, and specific guidelines on coping, burnout detection and prevention. Approaching burnout prevention through attitudes/social learning may be a novel and feasible model for addressing this issue. Since level of education was found to be associated with a lower incidence of personal accomplishment, nurse management should encourage nurses to take part in further/continuous education. Strengthening the job-satisfaction-related factors may reduce the impact of burnout in critical care nurses. With regard to the association between job satisfaction and the incidence of burnout, hospital management should consider improvements in the work environment. Preventive strategies should not be only for critical care nurses, but for all nurses in healthcare institutions, as well as other healthcare professionals, e.g. physicians, physiotherapists, and occupational therapists. The professional benefit of this study includes the potential to introduce and adopt functional coping strategies. Given that active coping may decrease the incidence of burnout, training and capacity building should acknowledge this finding. The information provided can help ICU nurses and nurses in general to understand how burnout affects their professional and family lives, and offers a variety of methods aimed at mitigating these harmful effects. Finally, the findings can motivate healthcare professionals with limited skills and/or knowledge of burnout to at least accept the necessity for modifying their coping strategies to be more problem-oriented and constructive.

Ključne besede:nurses, critical care, burnout syndrome, coping mechanism, job satisfaction

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