ارزشیابی اثر خودگویی مثبت بر استرس شغلی پرستاران در بخش‌های اورژانس

زمینه و هدف: در پرستاران بخش اورژانس استرس شغلی می‌تواند موجب بروز واکنش‌هایی مانند اضطراب، بی قراری، بیزاری از کار، غیبت و بیماری شود. خودگویی یکی از مهارت‌های روان شناختی است. در خودگویی مثبت فرد به ذهن خود دستور می‌دهد تا رفتار و تفکرات خود را جهت دهد و همه منابع را برای موفقیت فراهم کند. مطالعه حاضر با هدف ارزشیابی اثر خودگویی مثبت بر استرس شغلی پرستاران در بخش‌های اورژانس انجام شد.روش بررسی: در این مطالعه ارزشیابی، 62 نفر از پرستاران بخش‌های اورژانس مراکز آموزشی در مانی دانشگاه علوم پزشکی ایران شامل حضرت رسول اکرم (ص)، فیروزگر، شهدای هفتم تیر شرکت کردند. جمع آوری داده‌ها از مهر ماه 98 آغاز و پایان آذر ماه به اتمام رسید. از هر مرکز 11 نفر در گروه کنترل و 11 نفر در گروه آزمون به طور تصادفی و به شیوه قرعه کشی انتخاب شدند. در نهایت 33 نفر در گروه آزمون و 33 نفر در گروه کنترل قرار داده شدند و با ریزش جزئی 32 نفر در گروه کنترل و 30 نفر در گروه آزمون تا پایان مطالعه مشارکت کردند. شرکت کنندگان در مطالعه فرم مشخصات جمعیت شناختی و مقیاس استرس شغلی پرستاران(enss) را تکمیل کردند. برای گروه کنترل مداخله‌ای انجام نشد. سه هفته بعد از پیش آزمون، مقیاس استرس پرستاران (پس آزمون) مجدداّ توسط گروه کنترل تکمیل شد. بعد از اتمام نمونه‌گیری در گروه کنترل پرستاران گروه آزمون انتخاب و پس از تکمیل ابزارهای گردآوری داده‌ها به مدت دو هفته (یک جلسه در هفته) از ساعت 148 در کارگاه خودگویی مثبت شرکت کردند. یک هفته پس از برگزاری کارگاه، مجدداّ ابزار گردآوری داده‌ها توسط گروه آزمون تکمیل شد. تجزیه و تحلیل داده‌ها با استفاده از آزمون‌های تی مستقل،تی زوجی وکای دو در نرم افزار spss نسخه 16 انجام شد.یافته‌ها: یافته‌ها نشان داد میانگین نمره استرس در گروه آزمون بعد از مداخله (40.08 ± 95.86) به طور معنی‌داری کمتر از گروه کنترل (40.52 ± 129.06) می‌باشد که نشان می دهد با آموزش خودگوئی مثبت، استرس گروه آزمون کاهش یافته است و این کاهش از نظر آماری معنی‌داراست (0.002=p). همچنین نتایج آزمون تی مستقل نشان داد بین دو گروه از نظر خرده مقیاس‌های استرس شغلی تفاوت معنی‌دار آماری وجود دارد (0.05>p) که نشانگر تاثیر خودگوئی مثبت بر کاهش استرس شغلی می‌باشد.نتیجه گیری کلی: خودگویی مثبت موجب کاهش استرس شغلی پرستاران بخش‌های اورژانس شد. پیشنهاد می‌شود مدیران و مسئولین پرستاری نسبت به برگزاری کارگاه‌های مدیریت شناختی رفتاری استرس از جمله خودگویی مثبت اقدام نموده و به نوعی به ارتقاء کیفیت خدمات پرستاری کمک کنند.

Evaluating the Effect of Positive Self-Talk on Job Stress among Nurses Working in the Emergency Wards

Background Aims: Nursing, by its nature is ranked as one of the most stressful jobs. Emergency nurses are exposed to more stress. A lot of studies have shown that nurses who work in critical care environments; such as emergency departments experience high levels of occupational stress during working time. Job stress may result in anxiety, restlessness, hate of working, absenteeism, and even a lot of illnesses. Interventions to manage nurses rsquo; stress are required in order to improve patient care. Positive selftalk is a psychological skill. In this technique, the person commands the mind to direct its own thoughts and behaviors and to prepare all sources in order to achieve success. This study was carried out to evaluate the impact of positive selftalk on the job stress of nurses working in emergency wards.Materials Methods: In this evaluation study, 62 nurses working in emergency wards of three teaching hospitals affiliated to Iran University of Medical Sciences, including Hazrat Rasoole Akram (PBUH), Firoozgar, and Shohadaye Hafte Tir hospitals participated in this study and were divided into two groups; control group and intervention group. Data collection was started in September and finished at the end of December 2019. At first, the list of nurses working in the emergency department was prepared by referring to the nursing offices of each center, and then, considering the inclusion criteria (at least one year of experience in the emergency department), the list was reviewed again. Then, based on the final list of samples from each center, 11 were randomly assigned to the control group and 11 to the intervention group using lottery. Finally, 33 were placed in the intervention group and 33 in the control group. Towards the end of the study, 32 were in the control group and 30 in the intervention group due to attrition. After identifying the groups, the researcher first introduced himself / herself to the samples of the control group of all 3 centers, and after explaining the objectives of the study and ensuring the confidentiality of information and obtaining informed written consent, asked them to fill the demographics questionnaire form and Expanded Nursing Stress Scale (ENSS) (French et al, 2000). No intervention was provided to the control group. 3 weeks after the pretest, ENSS (posttest) was completed again by the control group. In the next stage, the nurses of the intervention group were selected and after completing the data collection tools, the experimental group participated in a positive selftalk workshop at the School of Midwifery Nursing for two weeks (one session per week) from 8 am to 2 pm. The workshop was administered through lecturing about positive selftalk with presenting scenarios and group discussion as well as role play. One week after the workshop, the data collection tools were completed again by the intervention group. Data analysis was performed using independent ttest and chisquare in SPSS software version 16. The Expanded Nursing Stress Scale (ENSS) (French et al., 2000) was used in this study. This is a selfadministered instrument. The ENSS is an expanded and updated version of the classic Nursing Stress Scale (NSS), which contains 57 items in 9 subscales related to physical, psychological, and social working environments. 9 subscales include: death and dying, conflict with physicians, inadequate emotional preparation, problems with peers, problems with supervisors, work load, uncertainty concerning treatment, patients and their families, and discrimination. The 57 items were arranged in a 5 point Likert scale including lsquo;does not apply rsquo; (0) , ldquo;never stressful rdquo; (1), ldquo;occasionally stressful rdquo; (2), ldquo;Frequently stressful rdquo; (3), ldquo;extremely stressful rdquo; (4). The total and subscale mean score was derived from this instrument which ranged from 04. The score range was 0228. The higher scores indicated that the situation was highly stressful.Results: Findings showed no statistically significant difference between the two groups in terms of demographic characteristics. The results of paired ttest indicated a statistically significant difference between stress and its 5 dimensions in the intervention group before and after the intervention, so that the total stress before the intervention was (119.5 ± 36.02) which decreased to (95.86 ± 40.08) after the intervention (P = 0.001). The results also showed that the mean stress score in the intervention group after the intervention (95.86 ± 40.08) was significantly lower than the control group (129.06 ±40.52), indicating that with positive selftalk training, the stress of the intervention group is reduced significantly (P = 0.002). Also, the results of independent ttest showed a statistically significant difference between the two groups in terms of subscales of job stress, which indicates the effect of positive selftalk on reducing job stress.Conclusion: It is important to know that stress might be to some extent productive, whereas higher stress in staff costs a lot in terms of individual well being and quality of health care services. Therefore, it must be managed effectively. Positive selftalk reduced nurses #39; job stress in emergency departments. Given the significant decrease in the nurses rsquo; stress using positive selftalk strategies, this approach can be suggested to nurses in critical care units in order to reduce their stress and increase their efficiency. It is suggested that managers and nursing officials hold cognitivebehavioral stress management workshops, including positive selftalk for nurses working in different wards, and help them to improve the quality of nursing services. Researchers suggest that future studies investigate the comparative effect of positive selftalk with other psychological intervention on problemsolving and decision making skills in nurses working in emergency departments.