Pandemi koşullarında sağlık çalışanlarının iş sağlığı ve güvenliği önlemlerinin fonksiyonel rezonans analiz metoduyla modellenmesi
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Dosyalar
Tarih
2022
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Yayıncı
İstanbul Gedik Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Dünya genelinde sağlık çalışanları ve sağlık sistemleri üzerinde büyük baskılara neden olan Covid-19 pandemisi ile sağlık çalışanlarında çalışma koşullarının ciddi ölçüde etkilendiği görülmektedir. Sağlık çalışanları çalışma ortamlarında maruz kaldıkları biyolojik, kimyasal, ergonomik, fiziksel, psikososyal vb. risk etmenlerinin yanı sıra COVID-19 pandemisi ile ciddi ölçüde enfekte riskiyle de karşı karşıya kalmışlardır. Dolayısıyla pandemi ile yürütülen mücadelede ön saflarda yer alan sağlık çalışanlarında iş sağlığı güvenliğinin öneminin arttığı görülmektedir. Yürütülen çalışmada sağlık çalışanlarında iş sağlığı güvenliği algısı, tükenmişlik ve şiddet maruziyetinin incelenmesi ve ayrıca iş sağlığı ve güvenliği önlemlerinin Fonksiyonel Rezonans Analizi Metodu (FRAM) ile modellenmesi amaçlanmıştır. Bu amaçla öncelikle kolayda örnekleme yöntemiyle seçilen 440 sağlık çalışanından anket tekniğiyle ile elde edilen veriler SPSS 24 ve Lisrel programlarıyla analiz edilmiştir. Veri toplama araçlarından İş Güvenliği Ölçeği'ne ilişkin yapılan DFA sonucunda X2/df 2,95; RMSEA 0,07; GFI 0,93; CFI 0,96 değerleri ile kabul edilebilir veya iyi uyum değerlerinin sağlandığı görülmüştür. 11 sorudan oluşan tükenmişlik ölçeğine ilişkin yapılan KFA sonucunda ise 2 ifadenin düşük faktör yükleri sebebiyle analiz dışı bırakılması sonrasında yapılan DFA ile X2/df 4,51; RMSEA 0,09; GFI 0,95; CFI 0,97 değerleri gerekli uyum iyiliği değerlerine ulaşılmıştır. Şiddet Algısı Ölçeğine ilişkin yapılan KFA ile ölçeğin Şiddete Maruziyet, Güvenlik ve Dayanıklılık olmak üzere 3 alt boyutlu bir yapıya sahip olduğu görülmüş olup DFA ile elde edilen X2/df 4,89; RMSEA 0,09; GFI 0,92; CFI 0,94 değerlerinin kabul edilebilir veya iyi uyum değerlerini karşıladığı görülmüştür. Yapılan t-Testi ve Anova analizleri sonucunda şiddete maruziyet ve iş güvenliği algısı ile tükenmişliğin yaş, eğitim düzeyi, meslek, mesleki deneyim süresi, vardiyalı çalışma, haftalık çalışma süresi, kronik hastalık ve aylık gelir durumu değişkenlerine göre farklılık gösterdiği ortaya konmuştur. Sonrasında sağlık sektörü çalışanlarının Covid-19 ile ilgili olarak karşılaştıkları tehlike ve risklerin bertaraf edilmesi amacıyla alınması gereken önlemler belirlenerek elde edilen sonuçlar Fonksiyonel Rezonans Analiz Metoduyla incelenmiş ve olası senaryolar FRAM yönteminde değerlendirilip bulgular ortaya konmuştur. Güvenlik analizi yöntemi olan FRAM karmaşık sistemdeki yapıları anlamayı hedeflemektedir. Sağlık hizmetleri, işlerin hızla gerçekleştiği veya değiştiği karmaşık bir sistemdir. Bu çalışmada sağlık kurumlarındaki çalışma koşullarından kaynaklı tehlike, riskler ve çalışanların günlük yaptıkları işler gözlemlenip FRAM modelde yapılandırılmış olup yapılan saha çalışması ve gözlemler sonucunda sistem koşullarından kaynaklı tehlike ve risklerin sağlık çalışanlarını nasıl olumsuz ve istenmeyen bir şekilde etkilediği ortaya konulmuştur. Araştırmanın sonucunda sistem fonksiyonlarındaki değişkenliklerin hastanelerde ve sağlık çalışanlarında istenmeyen ve beklenilmeyen sonuçların oluşma nedenini belirlemek için FRAM analizi uygulanmış ve modellenmiştir. Analiz sonucunda bu istenmeyen sonuçların (rezonansların) nasıl önleneceğine dair önerilerde bulunulmuştur.
The working conditions of health workers have been seriously affected by the Covid-19 pandemic, which has caused great pressure on health workers and health systems around the world. Health workers are exposed to biological, chemical, ergonomic, physical, psychosocial, etc. In addition to the risk factors, they also faced the risk of being seriously infected with the COVID-19 pandemic. Therefore, it is seen that the importance of occupational health and safety has increased in healthcare workers who are at the forefront of the fight against the pandemic. In this study, it was aimed to examine the perception of occupational health and safety, burnout and exposure to violence in health workers, and also to model occupational health and safety measures with the Functional Resonance Analysis Method (FRAM). For this purpose, first of all, the data obtained by questionnaire technique from 440 health workers selected by convenience sampling method were analyzed with SPSS 24 and Lisrel programs. As a result of the DFA conducted for the Occupational Safety Scale, one of the data collection tools, X2/df was 2.95; RMSEA 0.07; GFI 0.93; It was seen that acceptable or good fit values were provided with CFI values of 0.96. As a result of the CFA conducted for the burnout scale consisting of 11 questions, the CFA performed after the 2 statements were excluded from the analysis due to their low factor loads were found to be X2/df 4.51; RMSEA 0.09; GFI 0.95; CFI values of 0.97 reached the required goodness-of-fit values. With the CFA on the Perception of Violence Scale, it was seen that the scale had a structure with 3 sub-dimensions as Exposure to Violence, Security and Resilience. X2/df obtained by CFA was 4.89; RMSEA 0.09; GFI 0.92; CFI values of 0.94 were found to meet acceptable or good fit values. As a result of the t-Test and Anova analyzes, it was revealed that exposure to violence and perception of occupational safety and burnout differ according to the variables of age, education level, occupation, professional experience, shift work, weekly working time, chronic illness and monthly income status. Afterwards, the precautions to be taken in order to eliminate the dangers and risks faced by health sector workers regarding Covid-19 were determined and the results were examined with the Functional Resonance Analysis Method and possible scenarios were evaluated in the Fram method and the findings were revealed. FRAM, a security analysis method, aims to understand the structures in complex systems. Healthcare is a complex system where things happen or change rapidly. In this study, the hazards and risks arising from the working conditions in health institutions and the daily work of the employees were observed and structured in the FRAM model, and as a result of the field work and observations, it was revealed how the hazards and risks arising from the system conditions adversely and undesirably affect the health workers. As a result of the research, FRAM analysis was applied and modeled to determine the reason for the undesirable and unexpected results of the variability in the system functions in hospitals and healthcare professionals. As a result of the analysis, suggestions were made on how to prevent these undesirable results (resonances).
The working conditions of health workers have been seriously affected by the Covid-19 pandemic, which has caused great pressure on health workers and health systems around the world. Health workers are exposed to biological, chemical, ergonomic, physical, psychosocial, etc. In addition to the risk factors, they also faced the risk of being seriously infected with the COVID-19 pandemic. Therefore, it is seen that the importance of occupational health and safety has increased in healthcare workers who are at the forefront of the fight against the pandemic. In this study, it was aimed to examine the perception of occupational health and safety, burnout and exposure to violence in health workers, and also to model occupational health and safety measures with the Functional Resonance Analysis Method (FRAM). For this purpose, first of all, the data obtained by questionnaire technique from 440 health workers selected by convenience sampling method were analyzed with SPSS 24 and Lisrel programs. As a result of the DFA conducted for the Occupational Safety Scale, one of the data collection tools, X2/df was 2.95; RMSEA 0.07; GFI 0.93; It was seen that acceptable or good fit values were provided with CFI values of 0.96. As a result of the CFA conducted for the burnout scale consisting of 11 questions, the CFA performed after the 2 statements were excluded from the analysis due to their low factor loads were found to be X2/df 4.51; RMSEA 0.09; GFI 0.95; CFI values of 0.97 reached the required goodness-of-fit values. With the CFA on the Perception of Violence Scale, it was seen that the scale had a structure with 3 sub-dimensions as Exposure to Violence, Security and Resilience. X2/df obtained by CFA was 4.89; RMSEA 0.09; GFI 0.92; CFI values of 0.94 were found to meet acceptable or good fit values. As a result of the t-Test and Anova analyzes, it was revealed that exposure to violence and perception of occupational safety and burnout differ according to the variables of age, education level, occupation, professional experience, shift work, weekly working time, chronic illness and monthly income status. Afterwards, the precautions to be taken in order to eliminate the dangers and risks faced by health sector workers regarding Covid-19 were determined and the results were examined with the Functional Resonance Analysis Method and possible scenarios were evaluated in the Fram method and the findings were revealed. FRAM, a security analysis method, aims to understand the structures in complex systems. Healthcare is a complex system where things happen or change rapidly. In this study, the hazards and risks arising from the working conditions in health institutions and the daily work of the employees were observed and structured in the FRAM model, and as a result of the field work and observations, it was revealed how the hazards and risks arising from the system conditions adversely and undesirably affect the health workers. As a result of the research, FRAM analysis was applied and modeled to determine the reason for the undesirable and unexpected results of the variability in the system functions in hospitals and healthcare professionals. As a result of the analysis, suggestions were made on how to prevent these undesirable results (resonances).
Açıklama
Lisansüstü Eğitim Enstitüsü, İş Sağlığı ve Güvenliği Ana Bilim Dalı, İş Sağlığı ve Güvenliği Bilim Dalı
Anahtar Kelimeler
İş Sağlığı ve Güvenliği, Sağlık Çalışanları, Fonksiyonel Rezonans Analiz Metodu, COVID-19, Şiddet Algısı, Tükenmişlik, Occupational Health and Safety, Healthcare Professionals, Functional Resonance Analysis Method, COVID-19, Perception of Violence, Burnout
