Forandring af sygeplejerskers psykosociale arbejdsmiljø - Et speciale omhandlende hvordan sygeplejerskers oplevelse af ubalance mellem krav og kontrol kan mindskes.

Abstract

Resumé Titel: Forandring af sygeplejerskers psykosociale arbejdsmiljø - Et speciale omhandlende hvordan sygeplejerskers oplevelse af ubalance mellem krav og kontrol kan mindskes. Baggrund: Sygeplejersker er udsat for mange arbejdsmiljørisici, hvor psykosociale risici er den mest markante arbejdsmiljørisici for sygeplejersker i Danmark. Sygeplejerskernes psykosociale arbejdsmiljø har gennemgået en negativ udvikling i perioden 2012 til 2015. Derudover vurderes det, at der er risiko for en yderligere forværring, grundet et stigende pres på sundhedsvæsenet. Et dårligt psykosocialt arbejdsmiljø kan få negative konsekvenser for den enkelte sygeplejerskes helbred og trivsel samt for patientsikkerheden. Formål: Specialets formål er at udvikle et forandringstiltag, der har til formål at mindske sygeplejerskers oplevelse af ubalance mellem krav og kontrol for derigennem at forbedre sygeplejerskers psykosociale arbejdsmiljø. Metode: Forskellige metoder inddrages, for at besvare specialets problemformulering. I specialet anvendes et litteraturstudie samt to semistrukturerede interviewundersøgelser. Der anvendes en deduktiv tilgang, hvor Robert Karasek og Töres Theorells krav-kontrol model samt John Kotters teori om forandringsledelse inddrages. Resultater: Specialets resultater viser, at elementer som medinddragelse, social støtte fra medarbejderne, social støtte fra ledelsen, kompetenceløft og forudsigelighed, alle har betydning for for, hvordan sygeplejerskerne oplever ubalance mellem krav og kontrol. Forbedring af sygeplejerskernes psykosociale arbejdsmiljø kan ske igennem tiltag som miks-møder, fælles pauser, vagtplanlægning, tavle-personalemøder, forbedringstavle, morgentavlemøder, sociale og faglige arrangementer, synlig og anerkendende ledelse, kompetenceløft i hverdagen samt planlægning og koordinering i form af blandt andet prioriteringstrekanten, da alle tiltag kan bidrage til at modificere sygeplejerskernes oplevelse af ubalance mellem krav og kontrol. Konklusion: Et forandringstiltag, der har til sigte at mindske sygeplejerskers ubalance mellem krav og kontrol, kan med fordel indeholde elementerne undervisningsseancer, supervision, faglige sociale arrangementer og miks-møder. Nøgleord: Forandring, udvikling, sygeplejerske, psykosocialt arbejdsmiljø, krav, kontrol, social støtte, indflydelse, kommunikation og kompetenceudvikling.

Abstract Title: Change in nurses’ psychosocial work environment - A thesis concerning how nurses experience imbalance between demand and control can be reduced. Background: Nurses are exposed to many work environment risks with the psychosocial risks being the most significant in Denmark. The nurses’ psychosocial work environment has undergone a negative development from 2012-2015. It is estimated that there is a risk of further deterioration due to increasing pressure on healthcare. A poor psychosocial work environment can have negative consequences for the individual nurse's health and wellbeing as well as for patient safety. Objective: The aim of this thesis is to develop an intervention, which aims to reduce nurses’ experience imbalance between demand and control in order to improve their psychosocial work environment. Method: Various methods are included, in order to answer the research question. The thesis used a literature study and two qualitative semi-structured interviews. Using a deductive approach, Robert Karasek and Töres Theorells demand-control model and John Kotter's theory leading change is included. Results: The thesis results show that elements such as participation, social support from the employees, social support from the management, skills development and predictability, all have an impact on how nurses experience the imbalance between demand and control. Improving nurses' psychosocial work environment can be done through initiatives such as mix-meetings, joint breaks, shift planning, board-staff meetings, improving blackboard, morning board meetings, social and professional events, visible and appreciative leadership, skills development during the work day as well as planning and coordination in the form of priorities triangle. These are all initiatives that can contribute to modify the nurses’ experience of the imbalance between demand and control. Conclusion: An intervention that aims to reduce nurses’ imbalance between demand and control, may advantageously contain elements such as training sessions, supervision, professional social events and mix-meetings. Keywords: Change, development, nurse, psychosocial work environment, demand, control, social support, influence, communication and skills development.

A master thesis from Aalborg University

Forandring af sygeplejerskers psykosociale arbejdsmiljø - Et speciale omhandlende hvordan sygeplejerskers oplevelse af ubalance mellem krav og kontrol kan mindskes.

[Change in nurses’ psychosocial work environment - A thesis concerning how nurses experience imbalance between demand and control can be reduced.]