长期护理机构中护理助理的工作特征、个人特征和幸福感：混合方法系统回顾与叙事综合。

IF 7.5 1区医学 Q1 NURSING

International Journal of Nursing Studies Pub Date : 2024-10-22 DOI:10.1016/j.ijnurstu.2024.104934

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引用次数: 0

摘要

背景：在长期护理机构中，辅助专业护理助理占医护人员队伍的最大比例，为有复杂护理需求的老年人提供重要的直接护理。目标：借鉴工作需求-资源模型，就长期护理机构中护理助理的工作特点和幸福感建立一个针对特定职业的概念模型：设计：采用乔安娜-布里格斯研究所的混合方法进行系统综述。综述方案已在 PROSPERO 上注册（2023 CRD42023403654）：综述包括符合这些纳入标准的定性、定量和混合方法研究：(1) 经同行评审的实证研究；(2) 涉及长期护理机构中的辅助专业护理助理；(3) 涉及福利结果；(4) 涉及特定职业的工作特征。不包括 (1) 非英文撰写或 (2) 2000 年 1 月 1 日之前发表的研究。采用内容分析法进行聚合综合：进行了数据库检索（即 MEDLINE、PsycINFO、Embase、CINAHL、Web of Science、Scopus 和 Google Scholar）和人工检索。最后一次检索于 2024 年 7 月 31 日进行：结果：根据纳入的 21 项研究，建立了护理助理工作需求-资源模型。由于护理助理的工作特点，他们特别容易出现职业倦怠、心理健康问题以及职业危害。工作时间要求、身体护理任务压力源和情感要求是与职业相关的工作要求，而经济回报、专业发展资源、工作环境和情感资源则是激励性工作资源。与压力相关的个人特征也与护理助理有关。研究结果表明，在长期护理机构的护理助理中，存在着以个人脆弱性、工作质量低下和健康不平等的恶性循环为特征的螺旋式脆弱性：本研究发现，与针对专业人员和所有医护人员的研究相比，有关护理助理的工作特点和幸福感的实证证据还不够充分。我们调整了一个概念模型，并确定了该职业群体特有的工作和个人特征。应制定针对特定职业的宏观、中观和微观策略，以减轻工作要求并培养工作资源，从而解决护理助理在长期护理机构中面临的职业健康不平等问题：本研究方案已在 PROSPERO 上注册（2023 CRD42023403654）。

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Job characteristics, personal characteristics and well-being of nursing assistants in long-term care facilities: A mixed methods systematic review and narrative synthesis

Background

Within long-term care facilities, paraprofessional nursing assistants account for the largest proportion of the health care workforce and provide essential direct care to older people with complex care needs. There is a gap in developing a theory-driven, systematic synthesis of the job characteristics and well-being outcomes specific to this occupational group, as most existing studies evaluate either professional health care workers or both professional and nursing assistants.

Aim

Develop an occupation-specific conceptual model on the job characteristics and well-being of nursing assistants in long-term care facilities drawing upon the job demands-resources model.

Design

Mixed methods systematic review following the Joanna Briggs Institute approach. The review protocol was registered on PROSPERO (2023 CRD42023403654).

Methods

The review included qualitative, quantitative, and mixed-method studies meeting these inclusion criteria: (1) peer-reviewed empirical research; (2) involved paraprofessional nursing assistants in long-term care facilities; (3) addressed well-being outcomes; (4) addressed occupation-specific job characteristics. Studies that are (1) not written in English, or (2) published before 1 January 2000 were excluded. A convergent synthesis approach was conducted using the content analysis method.

Data sources

Database searches (i.e., MEDLINE, PsycINFO, Embase, CINAHL, Web of Science, Scopus, and Google Scholar) and manual searches were conducted. The last search was conducted on July 31st, 2024.

Results

A Nursing Assistants Job Demands-Resources Model was developed based on 21 studies included. Nursing assistants are particularly vulnerable to burnout and mental health conditions, as well as occupational hazards, because of their job characteristics. Working time demands, physical care task stressors, and emotional demands are occupation-relevant job demands, while financial rewards, professional development resources, work environment, and emotional resources are motivational job resources. Strain-related personal characteristics are also relevant to nursing assistants. Findings indicated a spiral of vulnerabilities characterized by the vicious cycle of individual vulnerabilities, poor quality job, and health inequalities among nursing assistants in long-term care facilities.

Conclusion

This study finds that empirical evidence on nursing assistants' job characteristics and well-being is underdeveloped compared to research focusing on professional and all health care workers. We adapt a conceptual model and identify job and personal characteristics specific to the occupation group. Occupational-specific macro, meso, and micro-level strategies that mitigate job demands and nurture job resources should be developed to tackle the occupational health disparities that nursing assistants face in long-term care facilities.

Registration

The protocol of this study was registered on PROSPERO (2023 CRD42023403654).

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来源期刊

International Journal of Nursing Studies 医学-护理

CiteScore

15.00

自引率

2.50%

发文量

181

审稿时长

21 days

期刊介绍： The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).