2011年5月17日火曜日

感情労働としての看護労働が職業性ストレスに及ぼす影響

[タイトル]
感情労働としての看護労働が職業性ストレスに及ぼす影響

[著者]
片山 はるみ

[掲載]
日本衛生学

[アブストラクト]
<Objective> : To clarify the effects of factors of emotinal labor, defined as the suppression of own emotions to better maintain other peoples' emotinal condition, on job-related stress responses among hospital nurses, the relationship between emotional labor and job-related stress was analyzed.

<Subjects and Methods> A self-reported questionnaires was distributed among 147 nurses of five hospitals in Japan. Complete answers were collected from 123 nurses (83.7%, 107 females and 16 males). Emotional labor was assessed by the Emotinal Labor Inventory for Nurses (ELIN) (26items), which consisted of five subscales, i.e., "suppressed expression." Job-related stress was evaluated using the Brief Job Stress Questionnaire (BSQ) consiting of 57 items. Stepwise mulitple regression analysis was performed to examine the relationships of stress (BSQ) with ELIN and job stressors (BSQ).

<Results> Subjects working in an inpatient department showed significantly higher total ELIN scores tha those working in an outpatient department. The stepwise multiple regression analysis showed the following: Scores on "anger" and "fatigue" in BSQ positively related to "suppressed expression" scoress in ELIN; those on "anxiety" positively related to "deep adjustmen" scores; and those on "depression" positively related to "surface adjustment" scores. Similarly, scores on negative stress responses (BSQ) such as "anger", "fatigue", "anxiety", "depression", and "somatic stress respons" positively related to scores on job stressors (BSQ), e.g, physical work load, whereas "vigor" scores positively related to "job worhwhileness"in BSQ.

<Conclusion>The aspects of "suppression expression", "deep adjustment", and "surface adjustment" of emotional labor seem to be the major occupational stressors for nurses, as well as job-related stressors measures by BSQ. Working in inpatient department appears to be a potent stressor for nurses.

[キーワード]
感情労働、職業性ストレス、病院看護師、メンタルヘルス

[要約・感想]
看護師を対象とした感情労働に関する研究。
序論部で感情労働について端的にまとめられており勉強になる。
調査結果からは、
(1)感情労働の一つである「表出抑制」(その場にふさわしくないと判断した感情を抑制する意識的な努力)は、イライラ感や疲労感などの複数のストレス反応に影響を及ぼす。
(2)同じく感情労働の一つである「深層適応」(患者にとって適切と判断する感情表現を意図的に喚起させる)や「表層適応」(その時々の状況に応じた表面的な対応をする)も看護師の負担となっている。
(3)一方で、「探索的理解」(対象の理解につとめる)と「ケアの表現」(ケア行動によって優しさなどの感情を伝える)はストレスとは結びつくとはいえない。
ということが分かった。

なんとなく、感情労働は接客業の現場に出る車掌や駅員が当てはまるが、それ以外でも、現場の管理層も当てはまるのではないか。

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