دانلود رایگان مقاله انگلیسی کاهش استرس شغلی در پرستاران ثبت شده در استرالیا - الزویر 2018

abstract

Background: Nurses in very remote areas of Australia (RANs), work in complex and isolated settings for which they are often inadequately prepared, and stress levels are high. This paper, based on the ‘Back from the edge’ project, evaluates the development and implementation of an intervention to reduce and prevent the impact of occupational stress in the RAN workforce in the Northern territory. Methods: The methods involved a combined participatory action research/organisational development model, involving seven steps, to develop and implement system changes within the (then) Northern Territory Department of Health and Families (NTDH&F). The development, implementation and evaluation was informed via information from participants collected during workshops and interviews. Pre and post surveys were undertaken to evaluate the study. Results: Occupational stress interventions developed by the workgroups were categorised into four main groups: (1) remote context, (2) workload and scope of practice, (3) poor management, and (4) violence and safety concerns. The main interventions centred on promoting a well educated, stable workforce. There were very few measurable changes as a result of the interventions as many were not able to be implemented in the time period of the study, but implementation is continuing. Conclusion: While the outcome evaluations showed few effects,the study through consensus approaches, provides a blueprint for reducing stress among remote area nurses and evidence which should inform policy and practice with respect to service delivery in remote areas.

6. Conclusions

The ‘Back from the edge: reducing occupational stress among RANs in the Northern Territory’ study used an adapted PAR/OD modelto develop and implement occupational stress interventions. The process evaluations of the workshops were very positive but the outcome evaluations showed low implementation of interventions and low impact on sources and outcomes of occupational stress. Nevertheless, the new knowledge created by the study is useful. The issues relating to creating a stable, well-educated and well-managed workforce with the physical resources required to fulfil a challenging job remain outstanding and will not go away without further intervention.

The new knowledge generated in this study should inform policy and practice with respect to service delivery in remote areas. There are implications in regard to service models. These need to be adequately resourced, staff better prepared and services, especially visiting services, better co-ordinated. To maximise effectiveness, there needs to be greater interdepartmental co-ordination or rationalisation in order to ensure the timely maintenance of essential equipment and infrastructure.