背景

倦怠在护士和助产士中很常见。本研究探索了职业生涯初期的倦怠是否会对护士毕业后十年的认知功能、抑郁症状、失眠产生长期影响；

方法

对三个国家注册护士（RNs）的倦怠症状进行纵向观察性研究。在瑞典26个护理项目中招募护理专业学生。随后通过毕业后前三年的年度评估对倦怠进行测量，并在毕业后的11-15年进行长期随访。共有2474名护士（62％）同意参加随访。使用Oldenburg倦怠量表中的条目测量倦怠，自行设计工具测量认知功能，Major DepressionInventory的抑郁症状和Karolinska睡眠问卷中的睡眠问题来测量抑郁和失眠。使用Logistics回归分析确定与早期职业倦怠与后果相关的因素，并在随访中调整混杂因素。

发现

在工作前三年中，至少报告一个高倦怠症状的护士患病人数为299（12.3％）。在考虑到当前的倦怠水平后，早期的高倦怠症状与十年后认知功能障碍，抑郁症和睡眠障碍等更常见的症状显著相关。在控制了当前的倦怠症状和其他结局变量后，早期职业倦怠的护士仍然报告更为频繁的认知功能和睡眠问题。

解释

本研究的结果表明，由疲倦或长期压力引起的有害过程在护士的职业生涯中就已经开始，因此最好在早期就采取预防措施（例如，作为护理教育和入职计划的一部分）。

Abstract

Background

Burnoutis common among nurses and midwives. We examined whether an early careerepisode of burnout has long-term consequences on; a) cognitive functions, b)symptoms of depression, and/or c) insomnia for nurses a decade aftergraduation.

Methods

Symptomsof burnout were investigated in an observational longitudinal study of threenational cohorts of registered nurses (RNs). Nursing students were recruitedfrom all 26 of Sweden's nursing programs. Burnout was subsequently measuredthrough annual assessment over the first three years post graduation, with onelong-term follow-up 11–15 years after graduation. A total of 2474 nurses (62%)consented to participate at follow-up. Burnout was measured using items fromthe Oldenburg Burnout Inventory, cognitive function by a study specificinstrument, depressive symptoms by the Major Depression Inventory, and sleepproblems using items from the Karolinska Sleep Questionnaire. We used logisticregression to identify factors associated with consequences of early career burnout,adjusting for concurrent levels at follow up.

Findings

Theprevalence of nurses reporting high levels of burnout symptoms at least one ofthe first three years of working life was 299 (12·3%). High levels of burnoutsymptoms in early working life were significantly related to more frequentsymptoms of cognitive dysfunction, depression, and impaired sleep a decadelater when taking current burnout levels into account. After controlling forboth current symptoms of burnout and the other outcome variables, nurses withearly career burnout still reported more frequent problems with cognitivefunctions and sleep but not depression.

Interpretation

Theresults of this study show that the detrimental processes caused byoverwhelming or chronic stress start early on in nurses’ careers and thuspreventive efforts should preferably be introduced early on (e.g. as part ofnursing education and onboarding programs).