Abstract | Stres je stanje poremećene psihofizičke ravnoteže pojedinca nastalo zbog fizičke, psihičke ili socijalne ugroženosti njega ili njemu bliske osobe. Zbog naravi posla, medicinske sestre i tehničari su trajno izloženi stresu. Glavni uzroci stresa, tzv. stresori, u sestrinstvu su suočavanje sa smrću i umiranjem, konflikt s liječnicima, nedostatne mogućnosti zadovoljavanja emocionalnih potreba bolesnika i njihovih obitelji, nedostatak podrške na poslu, konflikt s kolegicama, radno opterećenje i nedostatne mogućnosti pomoći bolesniku. Ego se stresu odupire nesvjesnim mehanizmima obrane koji se mogu podijeliti u psihotične, nezrele, neurotične i zrele. U ovom radu smo pomoću DSQ-40 upitnika ispitali korištenje mehanizama obrane u 68 medicinskih sestara i tehničara zaposlenih na hematologiji i oftalmologiji. Korelirali smo dobivene rezultate s radnim mjestom, dobi, godinama staža, godinama staža na sadašnjem radilištu, stručnom spremom, radom u smjenama, radom u poliklinici ili stacionaru, bračnim stanjem i brojem djece. Rezultati pokazuju da medicinske sestre i tehničari češće koriste zreli stil obrane nego neurotski, a potonji nešto češće od nezrelog. Hematološke sestre i tehničari rjeđe koriste negiranje (p=0,023) i pseudoaltruizam (p=0,013), a češće raščlanjivanje (p=0,037) od oftalmoloških. Starije sestre i tehničari te one s dužim stažem češće koriste negiranje (p=0,038 i 0,042) i neurotski stil obrane (p=0,048 i 0,048). One s dužim stažem na sadašnjem radilištu češće koriste neurotski stil obrane (p=0,048). Sestre i tehničari srednje stručne spreme rjeđe koriste humor (p=0,008) i racionalizaciju (p=0,016), a granično rjeđe zrele mehanizme obrane (p=0,079). Sestre i tehničari koje rade u smjenama češće koriste supresiju (p=0,009), reaktivnu formaciju (p=0,037), disocijaciju (p=0,015) i neurotske mehanizme obrane (p=0,036), a one koje rade u stacionaru sublimaciju (p=0,016), negiranje (p=0,020) i disocijaciju (p=0,034). Rastavljene medicinske sestre i udovice češće koriste sublimaciju (p=0,04) i anticipaciju (p=0,02). Broj djece ne utječe na mehanizme obrane. Naši rezultati pokazuju da su medicinske sestre i tehničari uglavnom dobro prilagođeni, da je radno mjesto značajniji prediktor korištenja pojedinačnih mehanizama obrane od obiteljskih značajki, ali ne i od školovanja te da rad s težim bolesnicima ne rezultira automatski korištenjem nezrelijih mehanizama obrane. |
Abstract (english) | Stress is a condition of deranged psychophysical balance caused by physical, psychological or social threats to an individual or a close person. Due to the nature of their profession, nurses are continuously exposed to stress. Major stressors in nursing are: facing death and dying, conflict with physicians, insufficient possibilities to satisfy emotional needs of patients and their families, insufficient support at work, conflict with peers, work load and insufficient possibilities to help patients. Ego is defending itself from stress using unconsious defense mechanisms which can be classified as psychotic, immature, neurotic and mature. We used the DSQ-40 questionnaire to study the use of defense mechanisms in 68 nurses working on hematology and ophtalmology departments. The results were correlated with place and duration of work (general and at current department), age, education level, working in shifts, working with outpatients or inpatients, marital status and number of children. Nurses use mature defense styles more frequently than neurotic and the latter somewhat more frequently than immature. Hematology nurses use denial (p=0,023) and pseudoaltruism (p=0,013) less, and splitting (p=0,037) more frequently than those working on ophtalmology. Older nurses and those with longer work experience use more frequently denial (p=0,038 and 0,042) and neurotic defense styles (p=0,048 and 0,048). Those with longer work experience on the current department use neurotic defense styles (p=0,048) more frequently. Nurses with secondary school use humor (p=0,008) and rationalization (p=0,016) less frequently. There is a trend for their less frequent use of mature defense mechanisms (p=0,079). Nurses working in shifts use more frequently suppression (p=0,009), reactive formation (p=0,037), dissociation (p=0,015) and neurotic defense styles (p=0,036); and those working with inpatients sublimation (p=0,016), denial (p=0,020) and dissociation (p=0,034). Divorced and widowed nurses use more frequently sublimation (p=0,04) and anticipation (p=0,02). Number of children is not related to use of defense mechanisms. Our results indicate that nurses are mostly well adjusted; that the place of work is a stronger predictor of defense mechanisms use than family conditions but not education and that working with more seriously ill patients does not by itself result in more frequent use of less mature defense mechanisms. |