社会网络结构与重症监护室医护人员幸福感的相关性:一项前瞻性观察研究。

IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Ryo Esumi, Asami Ito-Masui, Eiji Kawamoto, Mami Ito, Tomoyo Hayashi, Toru Shinkai, Atsuya Hane, Fumito Okuno, Eun Jeong Park, Ryuji Kaku, Motomu Shimaoka
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引用次数: 0

摘要

背景:有效的沟通策略在重症监护室(ICU)中变得越来越重要,在那里治疗高危患者。分布式领导促进了医疗专业人员之间的有效沟通。此外,除了促进患者护理外,它还可以通过培养团队合作来提高医疗专业人员的幸福感。然而,分布式领导对沟通结构和医疗保健专业人员福祉的影响尚不清楚。目的:我们进行了社会网络分析(SNA),以评估网络中每个医疗专业人员的特征,确定医疗专业人员联系的数量,分析可以衡量医疗专业人员重要性的四个中心,并评估分布式领导结构对医务人员幸福感和沟通结构的影响。方法:使用可穿戴传感器从日本三重大学医院ICU医务人员那里获得面对面的互动数据。所有参与者在工作时间都在衣服前佩戴徽章,以测量面对面互动的总频率。我们使用流行病学研究中心抑郁问卷(CES-D)收集了医务人员的幸福感数据,并使用SNA分析测量了四种集中度。在研究期间进行了CES-D问卷调查,以衡量医疗保健专业人员的幸福感。结果:总体而言,247名ICU工作人员于2016年2月、2017年2月和2018年2月参与了这项为期4周的临床研究。ICU内部于2017年和2018年建立了分布式领导结构。我们将这些结果与2016年使用的传统领导结构进行了比较。在重症监护室里,大多数面对面的互动都是护士或护士与其他专业人员之间的互动。2016年,10名护士可以执行领导任务,2017年显著增加到24和20(结论:使用可穿戴传感器测量了ICU中医护人员的面对面互动,发现护士位于中心位置。然而,分布式领导的引入在组织中创造了协作和非正式领导,改变了医护人员的社交网络结构,提高了组织的幸福感。临床试验:该临床试验在UMIN临床试验注册系统(UMIN000037046)中注册。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Correlation Between the Social Network Structure and Well-Being of Health Care Workers in Intensive Care Units: Prospective Observational Study.

Background: Effective communication strategies are becoming increasingly important in intensive care units (ICUs) where patients at high risk are treated. Distributed leadership promotes effective communication among health care professionals (HCPs). Moreover, beyond facilitating patient care, it may improve well-being among HCPs by fostering teamwork. However, the impact of distributed leadership on the communication structure and well-being of HCPs remains unclear.

Objective: We performed a social network analysis (SNA) to assess the characteristics of each HCP in the network, identify the number of HCP connections, analyze 4 centralities that can measure an HCP's importance, and evaluate the impact of distributed leadership structure on the well-being and communication structure of the medical staff.

Methods: Wearable sensors were used to obtain face-to-face interaction data from the ICU medical staff at Mie University Hospital, Japan. Participants wore a badge on the front of their clothing during working hours to measure the total frequency of face-to-face interactions. We collected data about the well-being of medical staff using the Center for Epidemiological Studies-Depression (CES-D) questionnaire and measured 4 centralities using SNA analysis. A CES-D questionnaire was administered during the study to measure the well-being of the HCPs.

Results: Overall, 247 ICU workers participated in this clinical study for 4 weeks yearly in February 2016, 2017, and 2018. The distributed leadership structure was established within the ICU in 2017 and 2018. We compared these results with those of the traditional leadership structure used in 2016. Most face-to-face interactions in the ICU were among nurses or between nurses and other professionals. In 2016, overall, 10 nurses could perform leadership tasks, which significantly increased to 24 in 2017 (P=.046) and 20 in 2018 (P=.046). Considering the increased number of nurses who could perform leadership duties and the collaboration created within the organization, SNA in 2018 showed that the betweenness (P=.001), degree (P<.001), and closeness (P<.001) centralities significantly increased compared with those in 2016. However, the eigenvector centrality significantly decreased in 2018 compared with that in 2016 (P=.01). The CES-D scores in 2018 also significantly decreased compared with those in 2016 (P=.01). The betweenness (r=0.269; P=.02), degree (r=0.262; P=.03), and eigenvector (r=0.261; P=.03) centralities and CES-D scores were positively correlated in 2016, whereas the closeness centrality and CES-D scores were negatively correlated (r=-0.318; P=.01). In 2018, the degree (r=-0.280; P=.01) and eigenvector (r=-0.284; P=.01) centralities were negatively correlated with CES-D scores.

Conclusions: Face-to-face interactions of HCPs in the ICU were measured using wearable sensors, and nurses were found to be centrally located. However, the introduction of distributed leadership created collaboration and informal leadership in the organization, altering the social network structure of HCPs and increasing organizational well-being.

Trial registration: University Hospital Medical Information Network (UMIN) UMIN000037046; https://center6.umin.ac.jp/cgi-open-bin/icdr_e/ctr_view.cgi?recptno=R000042211.

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Interactive Journal of Medical Research
Interactive Journal of Medical Research MEDICINE, RESEARCH & EXPERIMENTAL-
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