Job satisfaction among hospital nurses: A literature review

The straw that broke the nurse's back-Using psychological contract breach to understand why nurses leave

AIM

To deepen our understanding of why nurses decide to leave their occupation instead of changing jobs, we examined the antecedents that led to this decision through the theoretical lens of psychological contract breach.

DESIGN

A qualitative design with semi-structured interviews.

METHODS

We collected 28 interviewees from our social networks and a social media platform. We included professional nurses who had decided to leave or had left the occupation. We analysed our data with reflexive thematic analysis, thereby giving space for the interviewee voices to rise.

RESULTS

We identified various experiences of dissonance between interviewee expectations and reality. The interviewees expressed unfulfilled expectations or psychological contract breaches in relation to their occupation on different levels and over extended time periods. The psychological contract breaches and decisions to leave the occupation were built up over time because of continuous disappointment and dissonance between expectations and reality. The frustration, dissonance and unfulfilled expectations were expressed towards the institution of nursing rather than a specific employer or organization.

CONCLUSION

Unfulfilled expectations over a longer period might cause psychological contract breach, leading to turnover intentions. Our research brings novel insights into the psychological contract, as our findings indicate that the psychological contract can be formed and breached, also between the employee and the occupation. This means that turnover intentions might result in nurses leaving the profession rather than seeking work in new organizations.

IMPACT

The study addresses the problem of nurse shortage by showing the root reasons for deciding to leave the occupation. Our findings show how psychological contract breaches over time erupt as turnover intentions regarding the occupation rather than a job. The results guide healthcare managers and decision-makers to recognize factors leading to a psychological contract breach, thereby enabling the retention of nurses.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

The impact of a climate of perceived organizational support on nurses' well-being and healthcare-unit performance: A longitudinal questionnaire study

AIM

To investigate the relationship between nurses' climate of perceived organizational support, and their well-being and healthcare-unit performance.

DESIGN

A two-wave cohort questionnaire study among nurses within six hospitals in Sweden.

METHODS

Hypotheses were tested using cross-lagged path models on the individual (organizational support, job satisfaction, burnout, intention to stay) and aggregate levels (care-unit organizational support, team effectiveness, patient safety climate and patient safety). Analyses were based on 1.817 nurses in 228 care-units (T1), 1.362 nurses in 213 care-units (T2) and longitudinal samples of 711 nurses and 140 care-units.

RESULTS

Organizational support (T1) positively influenced job satisfaction (T2) and tended to decrease burnout (T2) but did not affect turnover intent. Reversed relationships were also found. No statistically significant prospective effects were found on the aggregate level.

CONCLUSION

The results indicated a prospective reciprocally reinforcing relationship between organizational support and job satisfaction. Burnout and intention to stay were predictors rather than outcomes of the organizational support climate.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

A climate where nurses perceive that their organization values their contributions and cares about their well-being is beneficial for their job satisfaction and health, which, according to previous research, may influence nurse retention.

IMPACT

The study addressed perceived organizational support as a potential predictor of nurses' well-being and healthcare-unit performance. A mutually reinforcing relation was indicated between organizational support and nurses' job satisfaction and health. Job dissatisfaction, burnout symptoms and turnover intentions were prospectively negatively related to the organizational support. Identifying and implementing a variety of practical measures to support perceptions of organizational support may be an effective way for healthcare management to start and sustain the development of a healthier work environment for healthcare professionals.

REPORTING METHOD

STROBE statement for cohort studies.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

The Relationship Between Missed Nursing Care and Nurse Job Satisfaction: A Systematic Review and Meta-Analysis

BACKGROUND

Missed nursing care is a global issue that refers to any aspect of patient care that is partially or entirely omitted or delayed. Although many studies have examined the relationship between missed nursing care and nurse job satisfaction, there is no synthesized evidence of these findings.

OBJECTIVE

To evaluate the relationship between missed nursing care and nurse job satisfaction.

METHODS

A systematic review and meta-analysis was carried out by searching the following databases: Web of Science, Scopus, EBSCO, PubMed, Science Direct, Cochrane, and Springer Link. The risk of bias was assessed using the Quality Assessment and Validity Tool for Correlational Studies. A random-effects model was used in the meta-analysis.

RESULTS

Out of 13 619 identified reports, 8 studies involving 10 418 nurses were identified as eligible for the meta-analysis. A significant negative relationship between missed nursing care and nurse job satisfaction was identified, with the summary effect size of r = -0.294 (95% CI: -0.364 to -0.219, P < .001).

CONCLUSIONS

The meta-analysis presented evidence regarding the significance of missed care in influencing nurse job satisfaction. As missed nursing care decreases, nurses' job satisfaction may increase.

[Should I Stay or Should I go? Resilience, Intention to Quit and Job Satisfaction among Nurses in Intensive Care Units]

AIM

Addressing the global nursing shortage is crucial to both national and international public health efforts. This paper aims to highlight the importance of resilience and its impact on primary care nurses' job satisfaction and intentions to quit, especially in the face of current challenges.

METHODS

The study utilized a mixed methods design involving nurses in intensive care units of a university hospital in Austria. In the first phase of data collection, qualitative focus group interviews were conducted to gather insights on the current challenges and stressors faced by nursing professionals. Building on relevant literature, a quantitative survey was then administered to all nurses, using scales measuring resilience, intention to quit, and job satisfaction in order to examine the relationships between these variables. In addition, a data structuring of the resilience scale by factors was achieved with the help of confirmatory factor analysis. Subsequently, the correlations of the resilience factors with the other variables were examined by means of an additional correlation, regression and mediation analysis.

RESULTS

The results showed negative correlations with regard to resilience and intention to quit as well as with regard to job satisfaction and intention to quit. In contrast, job satisfaction and resilience correlated significantly positively with each other. The negative correlation between resilience and the intention to quit was confirmed, but only for the factors "goal focus" and "pride and commitment". A closer examination of the two factors and their associated items revealed a connection to both professional identity and organizational identity.

CONCLUSION

This study provides valuable insights for health care leaders and health care decision makers to effectively lead, develop, and thereby retain primary care nurses. The authors argue that improving resilience and strengthening organizational identity are important influencing factors in increasing job satisfaction and reducing nurses' intention to quit.

Factors Influencing Job Satisfaction among Mental Health Nurses: A Systematic Review

BACKGROUND/OBJECTIVES

Job satisfaction is crucial for healthcare professionals, and understanding its influencing factors is essential for fostering a positive work environment, reducing turnover rates, and improving the overall quality of patient care. This systematic review examined the factors linked to nurse job satisfaction in psychiatric hospitals and diverse psychiatric settings, analyzing the findings through the lens of Herzberg's theory. Despite existing evidence, gaps remain in understanding the differences in factors affecting job satisfaction across various settings.

METHODS

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, we conducted a comprehensive systematic review by searching six databases, namely PubMed, CINAHL, Cochrane Library, PsycINFO, Scopus, and APA PsycNet. Our search yielded an initial 567 studies published between January 2014 and February 2024, which were subsequently screened and evaluated based on predetermined inclusion criteria. Following this process, a total of 16 studies were deemed eligible for final analysis. Each of these selected studies underwent an independent review by two authors, utilizing the Joanna Briggs Institute checklist tool to ensure rigorous assessment.

RESULTS

The findings revealed that interpersonal relationships, working conditions, and recognition were the most frequently reported factors associated with nurse job satisfaction, along with various extrinsic, intrinsic, personal, emotional, and psychosocial factors. Notably, psychiatric hospitals showed a mix of personal, extrinsic, intrinsic, and psychosocial factors influencing job satisfaction, with demographic factors being the most frequently examined. In contrast, diverse psychiatric settings focused more on external aspects impacting job satisfaction.

CONCLUSIONS

The review highlights the importance of both intrinsic and extrinsic factors and suggests that future research should employ more robust methods and consider psychiatric hospitals and other mental health contexts. Herzberg's theory provides a valuable framework for understanding the factors associated with nurse job satisfaction.

Understanding Career Adapt Abilities, Career Stress, Work Stress, Career Regret, Job Satisfaction Among Nursing Professionals

AIM

This study aims to conduct a comprehensive analysis of the interrelationships among career stress, work stress, career regret, job satisfaction and career adapt abilities within the nursing profession.

DESIGN

The research involved a sample of 576 nurses from ten urban hospitals, distributed across five distinct cities in Turkiye, between December 2023 and January 2024. The study employed regression models to systematically test hypotheses, providing nuanced insights into the complex dynamics of the variables under investigation.

METHODS

Regression models were utilized to test the hypotheses systematically, considering the moderating role of career adapt abilities. The study included a sample of 576 nurses from 10 urban hospitals in Turkey, distributed across five distinct cities. This approach allowed for a detailed examination of the intricate relationships between career stress, work stress, career regret, job satisfaction and career adapt abilities within the nursing profession.

RESULTS

The findings underscore the delicate balance between the positive gains of job satisfaction and the challenges posed by career stress, work stress and career regret in the multifaceted landscape of nursing.

CONCLUSION

In nursing, the relationship between career stress, work stress, career regret and job satisfaction include progress, resilience and obstacles. Developing strategies requires a cooperative effort from health care organizations, nursing leaders and individual nurses.

IMPACT

The research provides valuable insights into the interplay of these factors and emphasizes the moderating role played by career adapt abilities. The implications of the study extend to healthcare organizations, nursing leaders and individual nurses. The research advocates for collaborative strategies aimed at enhancing job satisfaction, alleviating stressors and addressing career regret. The ultimate goal is to contribute to the retention of a resilient nursing workforce, emphasizing the importance of strategies that support the well-being and satisfaction of nurses in their careers.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Less smartphone and more physical activity for a better work satisfaction, motivation, work-life balance, and mental health: An experimental intervention study

Employees' work satisfaction and mental health are crucial for an organization's productivity. The current experimental study on employees (Ntotal = 278) from different professional sectors and workplaces in Germany investigated how to improve both by changes of daily non-work-related smartphone use time and physical activity time. For one week, the smartphone group (N = 73) reduced its daily smartphone use by one hour, the physical activity group (N = 69) increased its daily physical activity by 30 minutes, the combination group (N = 72) followed both interventions, the control group (N = 64) did not change its behavior. Online surveys assessed work-related and mental health-related variables at three measurement time points (baseline; post-intervention; two-week follow-up). The reduction of smartphone use time and the combination of both interventions increased work satisfaction, work motivation, work-life balance, and positive mental health significantly; experience of work overload and problematic smartphone use significantly decreased. All interventions decreased depressive symptoms and enhanced sense of control significantly. Following the present findings, a conscious and controlled reduction of non-work-related smartphone use time and its combination with more physical activity could improve employees' work satisfaction and mental health in the organizational context either as an addition to established training programs or as a separate time- and cost-efficient low threshold program.

The implementation of telemedicine in wound care: a qualitative study of nurses' and patients' experiences

BACKGROUND

The increasing use of telemedicine (TM) represents a major shift for health workers and patients alike. Thus, there is a need for more knowledge on how these interventions work and are implemented. We conducted a qualitative process-evaluation alongside a larger randomized controlled trial designed to evaluate a telemedicine follow-up intervention for patients with a leg- or foot-ulcer, who either have or do not have diabetes. Accordingly, the aim of this study was to explore how both health care professionals and patients experienced the implementation of TM follow-up in primary care.

METHODS

The intervention comprised an interactive TM platform facilitating guidance and counselling regarding wound care between nurses in primary care and nurses in specialist health care in Norway. Nurses and patients from seven clusters in the intervention arm were included in the study. We conducted 26 individual interviews (14 patients and 12 nurses) in primary care between December 2021 and March 2022. Thematic analyses were conducted.

RESULTS

The analyses revealed the following themes: (1) enhancing professional self-efficacy for wound care, (2) a need to redesign the approach to implementing TM technology and (3) challenging to facilitate behavioral changes in relation to preventive care. As to patients' experiences with taking part in the intervention, we found the following three themes: (1) experience with TM promotes a feeling of security over time, (2) patients' preferences and individual needs on user participation in TM are not met, and (3) experiencing limited focus on prevention of re-ulceration.

CONCLUSIONS

TM presents both opportunities and challenges. Future implementation should focus on providing nurses with improved technological equipment and work on how to facilitate the use of TM in regular practice in order to fully capitalize on this new technology. Future TM interventions need to tailor the level of information and integrate a more systematic approach for working with preventive strategies.

CLINICAL TRIAL REGISTRATION

NCT01710774. Registration Date 2012-10-17.

Understanding Nurse Retention at a Mental Health and Addictions Facility During a Dual Pandemic

BACKGROUND

The COVID-19 pandemic exposed nurses to new and more severe workplace stressors; exposure to these workplace stressors has exacerbated nurse turnover. Nurses working in mental health and substance use (MHSU) have also experienced the unique stressor of the overdose crisis in British Columbia (BC). MHSU nurses have been at the forefront of working to manage these dual emergencies. There is limited evidence related to the compounding effect of COVID-19 and the overdose crisis on nursing turnover. Understanding the unique conditions that MHSU nurses are currently experiencing and what factors influence a nurse's intention to stay in or leave a healthcare facility is essential in developing strategies to minimize turnover and maximize retention.

PURPOSE

To explore the factors that affect nurse turnover while working through the dual emergencies within a MHSU facility in BC, Canada.

METHODS

A qualitative descriptive approach with an inductive, descriptive thematic analysis guided this quality improvement project.

RESULTS

Findings were grouped into two main themes: reasons for leaving and reasons for staying. Reasons for leaving included workplace safety, seeking new opportunities, lack of support, and being short-staffed. Reasons to stay encompassed connections with clients, leaders and colleagues, support from colleagues and leaders, and feeling valued, safe, and heard.

CONCLUSIONS

Perceived personal safety and protection from workplace violence were found to increase the likelihood of intent to leave and turnover among nurses. Further, psychosocial safety and connection among nurses and health leaders were found to decrease the likelihood of turnover.

Relationship between structural empowerment and job satisfaction among nurses: A meta-analysis

AIM

To investigate the relationship between structural empowerment and job satisfaction among nurses.

BACKGROUND

Job satisfaction is considered to be a global concern. It is also essential to improve the quality of patient care and promote nurse retention. Structural empowerment of nurses can be an important factor in ensuring nurses' job satisfaction.

METHODS

This meta-analysis was conducted ensuring compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Using seven databases, including PubMed, Science Direct, Scopus, Web of Science, Springer, CINAHL, and Cochrane Library, the relevant articles were identified. Two independent reviewers screened articles and extracted data. The meta-analysis was performed using Jamovi statistical software.

RESULTS

In total, 29 studies involving 30 cohorts (N = 11,078) were identified as eligible for the meta-analysis. A significant positive relationship between nurse structural empowerment and job satisfaction was identified, with the summary effect size of r = 0.559 (95% CI: 0.494-0.618).

CONCLUSION

There was a strong positive relationship between structural empowerment and job satisfaction in nurses. Exploring the relationship between structural empowerment and job satisfaction can provide strategies to promote nurse retention and prevent nursing shortage.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

The results of this study confirmed a strong positive relationship between nurses' job satisfaction and structural empowerment. Implementing interventions that enhance the structural empowerment of nurses will contribute to increasing their job satisfaction, thereby assisting in both nurse retention and optimizing their potential to provide quality patient care. Healthcare organizations and nurse managers should create work environments that provide nurses with access to information, resources, support, and opportunities to empower them and to enhance their job satisfaction.

Personal strength use and job satisfaction in Chinese nurses: The mediating roles of basic psychological needs satisfaction and resilience

AIM

This study aimed to investigate the association of personal strength use with job satisfaction among Chinese nurses and to examine the mediating roles of basic psychological needs satisfaction and resilience in this association.

BACKGROUND

The topic of nurses' job satisfaction has been extensively studied worldwide because of its significant effects on nurse turnover, recruitment, and quality of care.

METHODS

A sample of 417 nurses completed a multi-section questionnaire that included established scales to measure personal strength use, basic psychological needs satisfaction, resilience, and job satisfaction.

RESULTS

The results revealed that personal strength use was positively linked to nurses' job satisfaction. Additionally, basic psychological needs satisfaction and resilience mediated the association of personal strength use with job satisfaction both independently and serially.

CONCLUSION

Personal strength use increases nurses' job satisfaction by satisfying their basic psychological needs and improving their resilience.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Creating a culture that supports the use of personal strengths among nurses is a promising strategy that hospital managers could consider to enhance nurses' job satisfaction. Furthermore, implementing programs and interventions to improve nurses' basic psychological needs satisfaction and resilience could further boost their job satisfaction.

What has the appraisal for hospitals brought to job satisfaction of healthcare professionals? A cross-sectional survey in China

OBJECTIVE

The purpose of this study is to evaluate the effectiveness of hospital appraisals, specifically the Performance Appraisal for Tertiary Public Hospitals (PATPH), and to examine its impact on the job satisfaction of healthcare professionals in tertiary public hospitals in China.

DESIGN

A cross-sectional study using a multistage sampling method. Improvements induced by PATPH in the working environment, job satisfaction and other covariates were measured. A series of weighted linear regressions with weights from the inverse probability-of-treatment weighting method were used to examine the effect of PATPH on job satisfaction.

SETTING

Nine tertiary public hospitals across three economic and geographic regions in China.

PARTICIPANTS

In August 2020, a total of 13 211 hospital employees were surveyed, and 8417 doctors and nurses fully completed questionnaires forming the primary dataset for analysis. Of these respondents, males comprised 18.64% and doctors constituted 28.15%.

RESULTS

This study revealed that PATPH had a positive impact on the job satisfaction of healthcare professionals. A 'more effective' PATPH working environment resulted in an improvement of 9.57 points (95% CI 8.99 to 10.16) in job satisfaction scores, controlling for all other variables. The finding persisted consistently through a series of sensitivity analyses.

CONCLUSION

The findings offered insights and inspiration for improving the job satisfaction of healthcare professionals, especially in the development of macrolevel policies targeted towards organisational enhancement.

Career decisions and aspirations of early-career nurses: Insights from a qualitative interpretative description study

AIM

To explore the career decisions and aspirations of early-career registered nurses in New Brunswick, Canada.

DESIGN

A qualitative study using an interpretive description approach was conducted.

METHODS

Semi-structured one-on-one interviews were conducted with a purposive sample of nurses (n = 22) currently working in New Brunswick, Canada, with up to 5 years of experience from February to April 2022.

RESULTS

Participants described diverse career paths and aspirations. Personal factors affecting these included the desire for meaningful work, career satisfaction, work-life balance, spending time with family, working in a preferred location, and finances. Professionally, working conditions were the dominant factor influencing early-career nurses' career decisions and aspirations. Participants described how short staffing, safety, support, and scheduling influenced their day-to-day work, mental and physical health, job and career satisfaction, and intent to leave.

CONCLUSION

The findings highlighted the abundant and diverse career opportunities available to nurses early in their careers. Early-career nurses are interested in finding nursing positions with a high degree of person-job fit and value opportunities for ongoing professional education and growth.

IMPACT

This study in New Brunswick, Canada, explores early-career nurses' career decisions and aspirations during nursing shortages and the pandemic, emphasizing the importance of person-job fit. Recommendations include improving working conditions and career pathways to enhance the sustainability of the nursing profession.

REPORTING METHOD

Standards for Reporting Qualitative Research (SRQR).

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Clinical nurses' work procrastination and smartphone addiction: a potential profile study

Background

In the medical field, effective time management by clinical nurses is crucial for enhancing the quality of patient care. However, in recent years, with increasing work pressure for clinical nurses, procrastination has become a prevalent issue. Many nurses use smartphones as a way to alleviate stress and manage emotions, but excessive smartphone use could exacerbate procrastination, thereby jeopardizing patient safety and healthcare quality. Therefore, understanding the current state of work procrastination among clinical nurses, its heterogeneity, and exploring the impact of smartphone addiction and demographic factors on different aspects of nurse procrastination hold significant importance for improving patient care quality.

Objective

This study aims to explore the current state of work procrastination among clinical nurses and identify potential profile categories. It further analyzes the impact of mobile phone addiction and demographic factors on work procrastination among clinical nurses.

Methods

Convenience sampling was employed to recruit participants from three tertiary hospitals in central China from October to November 2023. Surveys measuring nurses' work procrastination and smartphone addiction were distributed and collected through online platforms. A total of 1,536 nurses participated in this study. Mplus 8.3 statistical software was used for latent profile analysis of clinical nurses' work procrastination, and SPSS 26.0 software was utilized for chi-square tests, rank-sum tests, and multi-classification logistic regression analyses.

Results

The median total score for clinical nurses' work procrastination was 21.00 (17.00, 28.00), and three subgroups were identified: low procrastination (66.93%), medium-low procrastination (20.66%), and medium-high procrastination (12.41%). Additionally, logistic regression analysis revealed that smartphone addiction and department atmosphere were common influencing factors for medium-low and medium-high work procrastination. Hospitals with stricter management and nurses holding the position of head nurse were more likely to belong to the low work procrastination group. Nurses with higher incomes or those holding intermediate titles were more prone to medium-low work procrastination, while those experiencing career advancement difficulties were more likely to exhibit medium-high work procrastination (p < 0.05).

Conclusion

Clinical nurses' work procrastination is generally at a medium-to-low level, with three subgroups identified: low procrastination, medium-low procrastination, and medium-high procrastination. Additionally, clinical nurses in surgical departments or those with intermediate titles exhibit higher levels of procrastination. Factors such as smartphone addiction, higher monthly income, tense departmental atmosphere, and unsuccessful career advancement are more likely to lead to work procrastination. Conversely, nurses in hospitals with strict management or those holding the position of head nurse exhibit lower levels of work procrastination. Therefore, nursing managers should pay close attention to the work procrastination behaviors of clinical nurses, actively monitor predictive factors among different groups, and provide psychological counseling and relevant training based on individual nurse circumstances. Additionally, it is also essential to focus on and improve departmental atmosphere and nurse smartphone addiction to enhance clinical nurses' work efficiency and reduce work procrastination.

Factors Affecting the Field Adaptation of Early-Stage Nurses in South Korea

Supporting early-stage nurses to adapt to the field and become proficient in nursing is important to improve the quality of patient care. This study aimed to determine the effects of the nursing work environment, nursing practice readiness, and optimism on the field adaptation of early-stage nurses. A descriptive survey was conducted among 209 early-stage nurses with ≤3 years of work experience at hospitals. The collected data were analyzed using descriptive statistics, the t-test, ANOVA, Pearson's correlation coefficients, and regression analysis with the SPSS Program. The participating nurses' mean field adaptation score was 2.90 ± 0.40 (total score = 5) and a significant positive correlation was found between nursing work environment (r = 0.61, p < 0.001), nursing practice readiness (r = 0.41, p < 0.001), and optimism (r = 0.26, p < 0.001). The regression analysis revealed that the nursing work environment (β = 0.38, p < 0.001), job satisfaction (β = 0.33, p < 0.001), nursing practice readiness (β = 0.24, p < 0.001), and turnover intention (β = 0.17, p = 0.001) significantly affect the field adaptation of early stage nurses; the explanatory power was 56.1% (F = 27.55, p < 0.001). The results suggest that to facilitate the field adaptation of early-stage nurses, the nursing work environment, job satisfaction, and nursing practice readiness should be improved. Improvement in the nursing work environment and the development of additional training for field adaptation would enhance the ability of early-stage nurses to adapt to the field and, consequently, improve the quality of nursing care.

Empowering Nurse Health Education: Linguistic and Cultural Validation of the Nurse Health Education Competence Instrument (NHECI) in the Italian Context

BACKGROUND

Nurses worldwide are acknowledged for their role in health education across various settings. However, doubts often arise regarding their competence in this domain. This study aims to validate the Nurse Health Education Competence Instrument (NHECI) linguistically and culturally in the Italian context.

METHODS

Following Beaton et al.'s (2000) guidelines, we conducted cross-cultural adaptation to develop the Italian version of the questionnaire.

RESULTS

The Italian version demonstrates a good internal consistency and stability, making it suitable for assessing nursing students during clinical internships and practicing nurses. The availability of Italian tools promotes healthcare research, ensuring patient-centric care.

CONCLUSIONS

The validity and reliability of the Italian version of the instrument for assessing health education competencies, essential for self-assessment among health education nurses, are established.

Relationship among group learning, individuals' and groups' internalization of evidence-based practice, and nurses' sustainment of the practice: a cross-sectional study

PURPOSE

This study, by applying the feedback process of the organizational learning model, examined the relationships among group learning, individuals' and groups' internalization of institutionalized evidence-based practice (I-EBP), and nurses' sustainment of I-EBP.

DESIGN/METHODOLOGY/APPROACH

Twelve hospitals were included in this cross-sectional study, with 1,741 nurses from 59 wards. Anonymous questionnaires were administered from October to December 2021. Participants self-reported their wards' group learning, internalization of I-EBP, sustainment of I-EBP, EBP beliefs, intra-hospital transfers, and nursing research experiences. The number of nurses and I-EBP introduction length and type of I-EBP were assessed. Internalization of I-EBP of nurses and groups was considered the mediating variable, while group learning and nurses' sustainment of I-EBP were the independent and dependent variables, respectively. Significant variables in bivariate analyses were used as control variables. Multi-level Mediation Analysis and a significance test of indirect effect using the bootstrap method were conducted.

FINDINGS

Responses from 360 nurses in 48 wards from 12 hospitals were analyzed. Groups' internalization of I-EBP significantly mediated the relationship between group learning and nurses' sustainment of I-EBP. In contrast, no significant mediating effect of nurses' internalization of I-EBP was observed.

ORIGINALITY/VALUE

In the feedback process of organizational learning, group learning and its subsequent effects on individuals and groups have not been previously examined. Regardless of the nurses' degree of internalization of I-EBP, those who belong to the ward with a high degree of internalization of I-EBP are more likely to sustain it. Conducting group learning may prevent superficial practice, resulting in its sustainability.

Effects of work environments on satisfaction of nurses working for integrated care system in South Korea: a multisite cross-sectional investigation

BACKGROUND

Nurses' satisfaction has an impact on organizational and patient outcomes. Integrated care system in South Korea was established in 2015 to improve care quality and decrease caregiving burden. Since then, nurses' satisfaction has increased due to an increase in nursing staffing. However, besides nurse staffing, various work environments still affect nurse satisfaction.

METHODS

Individual online surveys were conducted with participants to determine their personal characteristics, work environments, and hospital characteristics. We used mixed-effects linear regression equation contained both fixed and random effects.

RESULTS

This study included 2,913 nurses from 119 hospitals. Their average job satisfaction was less than 6 points out of 10 points. Age, shift type, perceived workload, and delegation criteria were significant factors influencing nurses' satisfaction. There was no significant factor among hospital characteristics. The satisfaction level of nurses was high for no-night rotating shift, low perceived workload, and clear delegation criteria.

CONCLUSIONS

Nurses' satisfaction is affected by several work environmental factors. Low nurse satisfaction has a substantial impact on both patients and nurses. Therefore, nurse managers and hospitals should determine factors influencing their satisfaction and develop strategies to improve their satisfaction.

A dimensional analysis of nursing unit culture

AIM(S)

Organizational culture has been studied for over four decades among nurses, across countries and contexts. However, wide variation exists in how the concept has been defined and at what level of the organization it is measured. The aim of this study was to use a dimensional analysis to conduct a conceptual synthesis of unit culture from a nursing perspective.

DESIGN

Dimensional analysis, rooted in grounded theory methodology, was used to describe unit culture from a nursing perspective.

METHODS

A literature search was conducted in April 2022. Inclusion criteria were (1) peer review publications, (2) used the term 'unit culture' or 'ward culture', (3) references nurses' role in unit culture, (4) published in the last 20 years and (5) written in English. One hundred fifteen articles met inclusion criteria, but dimensional saturation was researched after coding 24 articles.

RESULTS

Findings were synthesized into four core dimensions and 10 subdimensions. Dimensions of unit culture included customs (practice norms, communication and prioritization), shared beliefs (assumptions, values and attitudes), hierarchy (social and informational) and atmosphere (emotional climate and collaboration). Conditions that shape unit culture include individual nurse characteristics, working conditions, unit policies/procedures and leadership. Unit culture impacts nurse work experiences and decision-making processes, which can affect outcomes including nurse wellbeing, practice behaviours and adherence to unit policies.

CONCLUSIONS

Identifying the dimensions of unit culture helps to bring clarity to a concept that is not well defined in existing literature.

IMPACT

This model of unit culture can be used to guide development of new instruments to measure unit culture or guide researchers in utilizing existing measures. Developing measures specific to unit culture are warranted to strengthen researchers' ability to assess how changing conditions of a unit (e.g. leadership, workload) changes unit culture and its related outcomes.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Latent class analysis of the sleep quality of night shift nurses and impact of shift-related factors on the occupational stress and anxiety

AIMS

The objective of this study is to explore the various latent categories within the sleep quality of night shift nurses and to investigate whether shift-related factors predispose nurses to higher levels of occupational stress and anxiety.

DESIGN

This is a cross-sectional study.

METHODS

From November to December 2020, registered nurses from 18 tertiary hospitals and 16 secondary hospitals in Chongqing were selected through convenience sampling for this study. Latent class analysis was used to investigate the sleep quality of nurses working night shifts. Furthermore, univariate analysis and logistic multivariate analysis were utilized to identify the contributing factors to occupational stress and anxiety.

RESULTS

The four latent categories of Pittsburgh Sleep Quality Index for night shift nurses were identified as 'Low Sleep Disorder Group' (56.34%), 'Moderate Sleep Disorder Group' (37.27%), 'High Sleep Disorder Non-Reliant on Sleeping medication Group' (4.89%) and 'High Sleep Disorder Reliant on Sleeping medication Group' (1.50%). The results showed that having a night-shift frequency of 3-4 times per month, night-shift durations of 9-12 h, sleep time delay after night shift (≥2 h), total sleep time after night shift less than 4 h were shift-related factors that increased the levels of occupational stress and anxiety.

CONCLUSION

The sleep quality of night shift nurses demonstrates heterogeneity and can be classified into four latent categories. Higher frequency of night shifts, extended work hours and insufficient rest time are all associated with increased levels of occupational stress and anxiety.

IMPACT

By identifying the four latent categories of sleep quality among night shift nurses, this study sheds light on the relationship between sleep patterns and levels of occupational stress and anxiety. These findings have important implications for healthcare institutions in the management of nurse well-being and work schedules.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Human rights among Korean dental hygiene students in hospital clinical practice

BACKGROUND

The human rights of dental hygiene students should be guaranteed during practice at medical institutions for their mental and physical health as well as professionalism, for patient safety. Safe and well guaranteed clinicians can perform their work in a more stable way. This study investigated the human rights circumstances of dental hygiene students during their hospital clinical practice at dental institutions.

METHODS

This study used a cross-sectional survey design. Convenience sampling was conducted on 121 third- and fourth-year dental hygiene students from universities in Seoul, Gyeonggi, and Gangwon. The survey used the Human Rights Indicators for Dental Hygiene Students to investigate the rights to safety, equality, and personality to understand participants' experiences of guaranteed fundamental rights. Data were collected from October 31 to November 8, 2019. A chi-square test was used to assess differences in experience according to general characteristics.

RESULTS

During dental hygiene practice at dental institutions, less than 50% of students felt safe. When human rights violations occurred in dental institutions, only 42.4% of students received guidance on response measures from their universities. While 72.1% of students who practiced at dental university hospitals were given information on first aid supplies (facilities) within dental institutions, only approximately 45% of students who practiced at lower-scale dental institutions were given this information (p < 0.05). Regarding equality rights, only 52.5% of trainees reported that they had received equal treatment from healthcare workers during hospital clinical practice.

CONCLUSIONS

During dental practice at dental institutions, Korean dental hygiene students confirmed that human rights (including safety rights, equality rights, and personality rights) were guaranteed to varying degrees. Dental hygiene students' rights during hospital clinical practice in dental institutions should be guaranteed across institutions regardless of their scale. This is necessary for dental hygiene students' human rights and safe policies and guidelines in dental institution clinical practice and regular monitoring systems.

Experiences and attitudes of clinical and academic nurses about infection prevention and control nursing curriculum and duties - a qualitative study

BACKGROUND

Infectious diseases are becoming more widespread and re-emerging, causing psychological, social, economic, and health effects at both national and international levels. Specialist nurses can help prevent and control these infections. However, in Iran, there are currently no specialist infection prevention and control (IPC) nurses to manage and control infections. This study aims to explore clinical and academic nurses' attitudes toward IPC nursing curriculum and duties.

METHODS

The study used a qualitative content analysis approach. Thirty-six participants, including clinical and academic nurses, were selected using a purposeful sampling method. Data was collected through seven focused group discussions. The accuracy and validity of the research tools were measured using the Four-Dimension Criteria developed by Lincoln and Guba. Data analysis was conducted using directed content analysis.

RESULTS

The data analysis of the discussions held in the seven focus groups extracted 628 codes. Three themes were developed from the qualitative analysis: "Core characteristics of the curriculum", "Expected competencies and skills", and "Evaluation." These themes were derived from nine main categories and 25 subcategories.

CONCLUSIONS

Specialist IPC nurses can play important roles in various positions and environments. Therefore, educational policymakers in Iran should consider establishing IPC nursing courses. It is also recommended that policymakers and decision-makers in the nursing field of other less developed countries should prioritize this issue.

Exploring the relationships between stress, resilience and job performance among nurses in Jordan

BACKGROUND

Nurses are a crucial part of healthcare organisations, constituting around half of the global healthcare workforce. Therefore, it is important to examine the factors that may affect their job performance, which is central to the delivery of effective healthcare services.

AIM

To examine the relationships between stress, resilience and job performance within the nursing context in Jordan.

METHOD

A cross-sectional descriptive correlational design was used. A self-administered questionnaire comprising stress, resilience and job performance scales was completed by a convenience sample of 207 nurses working in five hospitals in the northern and middle regions of Jordan.

RESULTS

Overall, respondents self-reported moderate stress levels, normal resilience levels and moderate job performance. The study identified: a moderate positive correlation between stress and resilience; a weak negative correlation between stress and job performance; and a weak positive correlation between resilience and job performance.

CONCLUSION

It is essential that nurse managers, leaders and policymakers implement measures to mitigate the stressors encountered by nurses, increase resilience and foster effective coping mechanisms. Such measures could enhance nurses' resilience and job performance, ultimately improving patient care.

Job satisfaction and burnout syndrome among intensive-care unit nurses: A systematic review and meta-analysis

INTRODUCTION

The severe conditions often experienced in an intensive care unit, combined with poor working conditions, increase stress and therefore decrease job satisfaction. Sustained stress in the workplace leads to the development of burnout, a syndrome characterised by three dimensions: emotional exhaustion, depersonalisation and perceived lack of personal fulfilment.

OBJECTIVE

To analyse the relationship between burnout syndrome and job satisfaction among ICU personnel.

DATA SOURCES

The PubMed, CINAHL and Scopus databases were used.

STUDY DESIGN

A systematic review and meta-analysis. The study sample consisted of 18 quantitative primary studies conducted in the last five years. Validated questionnaires were used to assess burnout in ICU healthcare workers, the most commonly used being the Maslach Burnout Inventory.

EXTRACTION METHODS

The search equation applied was: "job satisfaction AND nurs* AND burnout AND (ICU OR intensive care units)". The search was performed in October 2022.

PRINCIPAL FINDINGS

The search returned 514 results. Only 73 articles met the eligibility criteria. After reading the title and abstract, 20 articles were selected. After reading the full texts, 12 articles remained and after the reverse search, 18 articles were finally selected. The studies reported a 50% prevalence of burnout, all three dimensions of which were heightened by the COVID-19 pandemic. Analysis of the study findings revealed an inverse association between burnout and job satisfaction.

CONCLUSIONS

Job dissatisfaction of ICU nurses depends on lack of experience, working conditions or working environment among others. ICU nurses with lower job satisfaction have higher levels of burnout.

IMPLICATIONS FOR CLINICAL PRACTICE

This meta-analysis shows the potential value of job satisfaction on improving health outcomes related to burnout syndrome for nursing professional in Intensive Care Units. Different factors that could increase job satisfaction and consequently protect them from suffering high levels of burnout, such as salary, permanence in the service, mental health care are the responsibility of the hospital supervisor and, finally, of the own Health System. Knowledge of a risk profile based on the factors influencing job dissatisfaction would enable the implementation of effective workplace interventions to reduce or prevent the risk of burnout. Health policies should focus on protecting the worker, so in addition to improving working conditions, it would be interesting to promote coping skills in order to improve the quality of care and patient safety.

The influence factors of tour guides' professional identity and professional decision before and after the COVID-19 pandemic

The COVID-19 pandemic has significantly impacted the tourism sector, particularly tour guides (TGs), affecting their professional identity (TGPI) and intentions to return to work. As China strives to revive its tourism industry, it is crucial to understand the current state of TGPI, its evolution, influencing factors, and its impact on TGs' return intentions. This study employed a quantitative approach, using comparative analysis and binary logistic regression, to investigate these issues among frontline TGs in China, pre- and post-pandemic. Cross-sectional surveys were conducted with 422 participants in 2019 and 398 in 2022, yielding 370 and 342 valid responses, respectively. The questionnaire utilized a five-point Likert scale. Findings reveal that (1) The overall TGPI level in 2022 post-pandemic is medium (3.93), showing a significant decrease from the pre-pandemic level in 2019 (4.15). (2) Influencing factors of TGPI are predominantly material, reflected in social insurance and income changes pre- and post-pandemic. (3) This study presents a novel definition and scale of TGPI, encompassing tour guides' professional value identity (TGPVI), emotion identity (TGPEI), relationship identity (TGPRI), and behavior tendency (TGPBT). (4) The two dimensions of the TGPI, TGPVI and TGPRI, income and education level, significantly influence TGs' return intentions. The study provides valuable academic and practical insights into TGPI and offers significant implications for enhancing TGs' return intentions and policymaking for post-pandemic tourism industry development.

Turnover intention and its associated factors among nurses in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Nurses turnover intention, representing the extent to which nurses express a desire to leave their current positions, is a critical global public health challenge. This issue significantly affects the healthcare workforce, contributing to disruptions in healthcare delivery and organizational stability. In Ethiopia, a country facing its own unique set of healthcare challenges, understanding and mitigating nursing turnover are of paramount importance. Hence, the objectives of this systematic review and meta-analysis were to determine the pooled proportion ofturnover intention among nurses and to identify factors associated to it in Ethiopia.

METHODS

A comprehensive search carried out for studies with full document and written in English language through an electronic web-based search strategy from databases including PubMed, CINAHL, Cochrane Library, Embase, Google Scholar and Ethiopian University Repository online. Checklist from the Joanna Briggs Institute (JBI) was used to assess the studies' quality. STATA version 17 software was used for statistical analyses. Meta-analysis was done using a random-effects method. Heterogeneity between the primary studies was assessed by Cochran Q and I-square tests. Subgroup and sensitivity analyses were carried out to clarify the source of heterogeneity.

RESULT

This systematic review and meta-analysis incorporated 8 articles, involving 3033 nurses in the analysis. The pooled proportion of turnover intention among nurses in Ethiopia was 53.35% (95% CI (41.64, 65.05%)), with significant heterogeneity between studies (I2 = 97.9, P = 0.001). Significant association of turnover intention among nurses was found with autonomous decision-making (OR: 0.28, CI: 0.14, 0.70) and promotion/development (OR: 0.67, C.I: 0.46, 0.89).

CONCLUSION AND RECOMMENDATION

Our meta-analysis on turnover intention among Ethiopian nurses highlights a significant challenge, with a pooled proportion of 53.35%. Regional variations, such as the highest turnover in Addis Ababa and the lowest in Sidama, underscore the need for tailored interventions. The findings reveal a strong link between turnover intention and factors like autonomous decision-making and promotion/development. Recommendations for stakeholders and concerned bodies involve formulating targeted retention strategies, addressing regional variations, collaborating for nurse welfare advocacy, prioritizing career advancement, reviewing policies for nurse retention improvement.

Status of the midwifery workforce and childbirth services and the impact of midwife staffing on birth outcomes in China: a multicentre cross-sectional study

OBJECTIVE

To investigate the status of the midwifery workforce and childbirth services in China and to identify the association between midwife staffing and childbirth outcomes.

DESIGN

A descriptive, multicentre cross-sectional survey.

SETTING

Maternity hospitals from the eastern, central and western regions of China.

PARTICIPANTS

Stratified sampling of maternity hospitals between 1 July and 31 December 2021.The sample hospitals received a package of questionnaires, and the head midwives from the participating hospitals were invited to fill in the questionnaires.

RESULTS

A total of 180 hospitals were selected and investigated, staffed with 4159 midwives, 412 obstetric nurses and 1007 obstetricians at the labour and delivery units. The average efficiency index of annual midwifery services was 272 deliveries per midwife. In the sample hospitals, 44.9% of women had a caesarean delivery and 21.4% had an episiotomy. Improved midwife staffing was associated with reduced rates of instrumental vaginal delivery (adjusted β -0.032, 95% CI -0.115 to -0.012, p<0.05) and episiotomy (adjusted β -0.171, 95% CI -0.190 to -0.056, p<0.001).

CONCLUSION

The rates of childbirth interventions including the overall caesarean section in China and the episiotomy rate, especially in the central region, remain relatively high. Improved midwife staffing was associated with reduced rates of instrumental vaginal delivery and episiotomy, indicating that further investments in the midwifery workforce could produce better childbirth outcomes.

Strategies and Interventions to Support Quality Outcomes in the Home Care Setting: A Longitudinal Multilevel Study

BACKGROUND

The relationship between the practice environment, empowerment, and outcomes such as quality of care, job satisfaction, and intent to stay has been extensively studied in healthcare settings, including hospitals and long-term care facilities. Research consistently demonstrates that a positive practice environment, characterized by supportive leadership, adequate resources, and opportunities for professional growth, are associated with better quality of care, increased job satisfaction, and higher intent to stay among healthcare professionals. Limited knowledge exists regarding the specific relationship between the practice environment, empowerment, and these outcomes within home care organizations.

OBJECTIVE

This study assesses the impact of strategies on nurse practice environment, social capital, decision latitude, workload, care quality, job satisfaction, and retention in a Belgian home healthcare organization.

METHODS

A longitudinal survey was conducted in a home healthcare organization, with data collected at 3 time points: baseline (T1) (2015), T2 (2018), and T3 (2021).

RESULTS

In T3, respondents reported significantly higher scores for departmental and general management compared with T1. The interventions led to significant improvements in social capital and decision latitude. Self-reported quality of care at the department level showed a significant increase, whereas no significant change was observed for quality of care during the last round.

CONCLUSION

The implementation of strategies and interventions as part of a broader healthcare transformation process had a positive impact. Improvements were observed in nurse-reported quality of care, job satisfaction, and intent to stay in nursing. These findings emphasize the effectiveness of the implemented measures in enhancing nursing practice and creating a positive work environment. Continuous efforts to implement and evaluate such strategies are essential for enhancing the satisfaction and retention of nursing teams within healthcare organizations.

How are new nurses satisfied with their jobs? From the work value perspective of Generations Y and Z nurses

BACKGROUND

Job satisfaction has garnered significant interest across multiple disciplines as it plays a vital role in shaping human resource strategies. In the field of nursing, enhancing job satisfaction can help prevent workforce shortages. Work values and job-related characteristics are significant predictors of job satisfaction. However, the influence of factors may change as younger generations join the nursing workforce. Although research on generational commonalities and differences in work values is increasing, there is insufficient information on generational differences in the interplay between work values and job satisfaction. This study investigated the factors associated with job satisfaction of new nurses in each generational group based on a work value perspective.

METHODS

A total of 280 new nurses (151 from Generation Y and 129 from Generation Z) were selected from the Graduates Occupational Mobility Survey. Multiple linear regression analyses were performed to determine the factors associated with job satisfaction in both groups.

RESULTS

Most participants graduated with a diploma (61.1%), were paid less than the average salary of each group (60.4%), and conducted shift (72.9%) and overtime work (64.3%). Work values and job satisfaction levels were not significantly different between the two groups. Multiple linear regression analyses showed that career growth and task work values were associated with job satisfaction for Generation Z, while task, reputation, and environment work values were associated with job satisfaction for Generation Y. Among the job-related characteristics, nurses' job tenure was associated with job satisfaction in both groups; salary and overtime had varying relationships with job satisfaction between the two generations.

CONCLUSIONS

Understanding generational differences is crucial for improving the effective management of new generational nurses. Our study findings support that different work value dimensions and job-related characteristics were associated with job satisfaction in each generation. Accordingly, it is essential to develop distinct initiatives, such as a well-structured program, to support the continued career growth of the new Generation Z nurses, thereby enhancing their job satisfaction. Furthermore, providing a conducive working environment that helps new-generation nurses overcome challenges and ensures personal lives should be considered.

Areas of professional life and job satisfaction of nurses

Introduction

Job satisfaction among nurses is closely related to work environment as well as organizational and professional commitment. Satisfaction is a concept derived from Latin, where "satis" means "enough," as much as is needed to fully satisfy expectations, needs, aspirations, in such a way that there is no room for complaint. Job satisfaction, on the other hand, is formulated as a positive attitude of employees toward the duties of the job, the work environment and other employees. The aim of this paper was to demonstrate how the different areas of nurses' professional life, i.e., workload, control, rewards, community, sense of justice and values, correlate with their perceived job satisfaction.

Materials and methods

A cross-sectional study was conducted in a group of 509 nurses working in a public hospital in Poland. Data were collected using a survey questionnaire, which consisted of a section containing sociodemographic data and standardized instruments: The Minnesota Satisfaction Questionnaire (MSQ) and The Areas of Worklife Survey (AWS) developed by Maslach and Leiter. Correlations were made using Spearman's rho coefficient. The calculations also used stepwise linear regression analysis after checking certain assumptions, including checking the assumption of normality of residuals and the Durbin-Watson Test.

Results

The mean score for the 20 items of the MSQ questionnaire ranged from 3.05 to 3.43 on a 5-point Likert scale. Support from the interdisciplinary team, which concerned assessing the quality of the social environment in the workplace, cooperation and showing positive feelings received the highest rating among respondents (3.51 ± 0.76). The sense of fair treatment at work averaged 3.26 ± 0.58. The area of value conflict within the organization itself or between the employee's values and those of the organization, respondents rated an average of 3.26 ± 0.65. The mean score for all areas of professional work in the surveyed group was 3.09 ± 0.45.

Conclusion

As satisfaction in particular areas of work life increases, so does the level of satisfaction in such aspects of work as achievement and a sense of fairness. The higher the level of satisfaction in the area of control, the more the sense of satisfaction with independence increases. The higher the satisfaction of respondents in the areas of values, workload and control, the higher the level of satisfaction with working conditions occurs.

The potential influences of professional identity for undergraduate nursing students during the COVID-19 pandemic: A cross-sectional study

AIM

We aimed to investigate the level of undergraduate nursing students' professional identity (PI) during the COVID-19 pandemic and its potential influences.

METHODS

This cross-sectional study included 742 undergraduate nursing students from Chengdu Medical College. Basic demographics, personal characteristics and PI score were collected. Chi-squared test, one-way analysis of variance, and multivariable logistic regression analysis were used to analyze the data.

RESULTS

In the classes of 2019, 2020, and 2021, the PI score was 96.85 ± 18.26, 105.37 ± 17.46, 106.67 ± 22.08 (P < .001). PI score was the independent predictive factor for both "want to be a nurse" and "willingness to serve during COVID-19 or other pandemics".

CONCLUSIONS

PI contributes greatly to nursing students' willingness to be a nurse and overcome pandemics. The challenge of culturing PI during COVID-19 pandemic revealed the necessity of developing individual management strategies for nursing education.

How does gratitude relate to nurses' job satisfaction? The mediating role of resilience and stress

BACKGROUND

Nurse job satisfaction is a critical area of study with far-reaching implications for healthcare organizations, patient care, and the retention of nursing staff.

AIMS

This study aimed to investigate the association of gratitude with job satisfaction among Chinese nurses and examine the potential mediating roles of resilience and stress in this relationship.

METHODS

Two separate studies were conducted to examine our research hypotheses. In Study 1, a total of 460 nurses completed the questionnaire related to gratitude, resilience, stress, and job satisfaction. A validation study was conducted in Study 2, which consisted of 709 nurses who also completed the same measures of gratitude, resilience, and stress to ensure the repeatability of the Study 1 results. Furthermore, a different scale was used to measure nurses' job satisfaction.

RESULTS

The two studies consistently found that both resilience and stress mediated gratitude-job satisfaction independently among Chinese nurses. Furthermore, resilience was found to be a significantly stronger mediator than stress in the association of gratitude with job satisfaction. Finally, we found that gratitude predicted nurses' job satisfaction via the serial mediating effects of resilience and stress.

CONCLUSION

These findings highlight the complex interplay between gratitude, resilience, stress, and job satisfaction by demonstrating that resilience and stress act as parallel and sequential mediators between nurses' gratitude and job satisfaction. The healthcare sector can improve nurses' job satisfaction by increasing gratitude, building resilience, and reducing feelings of stress.

LINKING EVIDENCE TO ACTION

Nurse managers have the potential to enhance job satisfaction among nurses by implementing measures that increase gratitude, build resilience, and reduce stress levels.

Development and Validation of a Scale to Measure Job Satisfaction Among Human Resources for Health in Morocco

This study aims to develop and validate a job satisfaction scale for human resources for health (HRH) who are employed by the Ministry of Health. The scale was developed through a comprehensive literature review, and its validity and reliability were assessed using several psychometric properties, including expert evaluation, a pilot survey, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). A large sample psychometric evaluation was made by all kinds of HRH staff (n = 2122), and the final version of the job satisfaction scale included 25 items. The EFA revealed seven factors with modest internal consistency ranging from 0.68 to 0.85. The goodness of fit of the model was found to be satisfactory, with root mean square error approximation (RMSEA) = 0.05, chi-square/df = 6.4, and both Tucker-Lewis Index (TLI) = 0.92 and CFI = 0.93 being higher than 0.9. The standardized root mean square residual had a value of 0.035. This instrument proved to be a reliable and valid tool for measuring job satisfaction in health institutions.

"The supreme discipline of Nursing"-A qualitative content analysis of nurses' opinions on caring for people eighty years of age and older

Introduction

Nurses often experience stress and feel under time pressure when working with older people, increasing their job dissatisfaction. Especially people 80 years of age and older often require more complex and a greater measure of care, as the risk of care dependency is higher in this age group. This study was conducted to collect nurses' experiences and opinions regarding the care of people 80 years of age and older, as well as to learn more about how nurses perceive this care.

Method

We analysed narratives collected in an Austrian nationwide, cross-sectional online study to investigate nurses' attitudes towards people 80 years of age and older and their perceptions regarding their care (N = 1197). Data were collected from May-October 2021 by using a convenience sampling method. In total, 149 participants filled in the free text field; these texts were analysed using a qualitative content analysis method.

Results

Three main themes emerged from the analysis of the nurses' narratives: (1) 'opinions on people in need of care', (2) 'reputation of nursing profession', and (3) 'criticism of current nursing practice'. Most narratives were assigned to the subthemes 'positive opinions on nursing', 'ideal image of nursing', and 'shortage of staff'.

Conclusion

Nurses considered their work with people aged 80 years and older to be meaningful and important, but they criticised working conditions which need to be improved. This could be achieved by offering further education and increasing nursing staff. Further research is needed to investigate nurses' needs and wishes regarding the care of people aged 80 years and older.

Stress and job satisfaction over time, the influence of the managerial position: A bivariate longitudinal modelling of Wittyfit data

BACKGROUND

The managerial position affects stress and job satisfaction of workers, but these influences have always been studied separately.

OBJECTIVE

We aimed to assess bivariate influence of the managerial position on workers' stress and job satisfaction and the inter-relationship of these indicators over time.

METHODS

We have analyzed data from workers who use the Wittyfit software, collected annually between 2018 and 2021. Stress and job satisfaction were evaluated by self-report questionnaires. Job position (manager or employee) was provided by the software's client companies.

RESULTS

Data of 704 workers were included in the study. Cross-sectional and longitudinal multivariate analyses revealed that managerial position improves job satisfaction (p<0.001), but not stress (p = 0.4). Overall, while workers' job satisfaction has improved (p<0.001), stress has remained stable over time (p = 0.3). Three latent groups, with specific evolutionary multi-trajectory of stress and job satisfaction were identified in the sample (entropy = 0.80). Age and seniority, but not gender tended to influence managers' and employees' indicators. Over time, stress and job satisfaction have tended to negatively interconnect, in cross-section and in a cross-lagged manner (p<0.001).

CONCLUSIONS

The managerial position improves workers' job satisfaction but has no effect on stress. Sociodemographics including age and seniority, but not gender, can affect this relationship. Stress and job satisfaction can influence each other, both cross-sectionally and over time. To be more effective, organizations should implement holistic strategies targeting multiple indicators.

TRIAL REGISTRATION

Clinicaltrials.gov: NCT02596737.

The effectiveness of a training program on perceptions of caring culture among Turkish nurses: A quasi-experimental trial

AIM

To assess the effectiveness of a training program on perceptions of caring culture among Turkish nurses and investigate the relationships among caring culture, job satisfaction, and intention to leave.

BACKGROUND

Every organisation has its on culture with its vairous components including values, symbols, practices and policies. Healthcare organizations need a favorable caring culture to support nurses and other professional working in the organisation.

METHODS

This was a quasi-experimental trial of an educational intervention conducted between October and December 2020 at a university hospital in Turkey. The sample of the study consisted of 86 nurses. A four-week training program based on caring culture was provided for the training group. The data were collected using a Personal Information Form, the Turkish version of the Caring Culture Survey, and the Job Satisfaction Scale. Intention to leave was measured with a single question.

FINDINGS

The mean total caring culture and personal caring scores of the training group were significantly higher after the training than before (p < 0.05). There were significant positive correlations between the mean caring culture total and subscale scores of the participants and their total job satisfaction scores. Besides, there were significant negative correlations between the caring culture total and subscale scores of the participants and their intentions to leave, but these relationships were weak or moderate (p < 0.05).

CONCLUSION

This training program based on caring culture can contribute to improving the caring culture perceptions of nurses. Caring culture is positively related to job satisfaction and negatively related to intentions to leave.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Healthcare organizations should prioritize creating a caring culture and designing initiatives that focus on caring culture. The perceptions of nurses about caring culture should be measured and identified regularly.

Predicting post-traumatic stress disorder: The complex relationship between burnout, intentions to leave and emotional support among health care professionals

BACKGROUND

Health care professionals working in delivery rooms often encounter stressful situations. Understanding their challenges and the support they receive is essential for improving their well-being and consequently patient care.

PURPOSE

Examining the relationship between burnout, intentions to leave, post-traumatic stress disorder (PTSD) symptoms, and complex PTSD among health care professionals, and identifying their predictors.

METHODS

A mixed methods design, including a survey among 196 midwives and gynecologists assessing burnout, intentions to leave, exposure to negative work experiences and PTSD, as well as 15 semi-structured interviews.

DISCUSSION

Most participants experienced multiple difficult events in the delivery room, reporting insufficient emotional support. Burnout and lack of emotional support were significant predictors of PTSD symptoms. Participants expressed a need for emotional support to cope with complex situations.

CONCLUSION

Burnout among midwives must be addressed through prevention and intervention programs. Emotional support is essential in mitigating PTSD symptoms among midwives and gynecologists, enhancing their resilience and well-being.

Nurses' adherence to patient safety protocols and its relationship with adverse patient events

INTRODUCTION

Ensuring patient safety is a critical component of healthcare delivery, and nurses play a vital role in adhering to patient safety protocols to prevent adverse events. However, studies linking nurses' adherence to these protocols with patient outcomes is scarce. This study has two-fold purposes: (1) to examine determinants of nurses' adherence to patient safety protocols, and (2) to investigate the relationship between nurses' adherence to patient safety protocols and adverse patient events.

DESIGN

A cross-sectional design.

METHODS

A total of 343 clinical nurses from five hospitals in the Philippines were included in this study. Two standardized scales were used to collect data, including the Patient Safety Adherence Scale and the Adverse Patient Events Scale. Data collection took place from April 2022 to August 2022.

RESULTS

Adherence to patient safety protocols was generally moderate to high (M = 4.483), while nurse-reported adverse events occurred at a lower frequency (M = 1.150). Lower adherence rates were identified in areas such as reporting safety errors (M = 3.950), conducting fall risk assessments (M = 4.299), and adhering to pressure ulcer prevention guidelines (M = 3.979). Patients' and their families' complaints (M = 2.129) and abuses (M = 1.475) were the most frequently reported adverse events. Increased adherence to safety protocols was associated with higher reporting of adverse patient events (β = 0.115, p < 0.001).

CONCLUSION

Higher adherence to patient safety protocols resulted in an increased reporting of adverse patient events. The factors identified that contributed to nurses' adherence to patient safety protocols can be utilized in the development of strategies aimed at improving compliance, especially in areas where adherence is currently low.

CLINICAL RELEVANCE

Healthcare organizations should prioritize efforts to enhance adherence to patient safety protocols, particularly in areas with lower compliance rates, through relevant trainings, resource provision, and support systems. Promoting a culture of open communication and reporting can significantly contribute to reducing adverse events and improving patient safety.

The effect of perceived professional benefits on health professionals' job engagement: the role of psychological availability and future perceived professional benefits

BACKGROUND

Improving the job engagement of health professionals can effectively enhance the quality of their medical services. However, few studies have investigated whether and how perceived professional benefits affect job engagement. Based on resource conservation theory, this study explored the effect of the influence of perceived professional benefits on job engagement, and also examined the mediating role of psychological availability and the moderating role of future perceived professional benefits.

METHODS

A cross-sectional study was conducted in six tertiary hospitals and seven secondary hospitals in Liu Panshui, a city in western China. A total of 1,406 valid questionnaires were obtained and analysed by using correlation analysis, hierarchical regression analysis, and bootstrap tests.

RESULT

The study found a significant positive association between health professionals' perceived professional benefits and their job engagement. Additionally, psychological availability was found to mediate this relationship. Future perceived professional benefits not only positively moderate this relationship between perceived professional benefits on health professionals' psychological availability but also positively moderate the mediating role of psychological availability between perceived professional benefits and job engagement.

CONCLUSION

Improving health professionals' perceived professional benefits can enhance their job engagement by increasing their psychological availability. However, for health professionals with low future perceived professional benefits, this improvement may disappear. Therefore, it is important to enhance both their current and future perceived professional benefits to improve their job engagement.

The role of professional identity and job satisfaction in paediatric nurses' intention to remain employed amidst the COVID-19 pandemic

The COVID-19 pandemic has significantly affected nursing, as nurses are crucial in providing healthcare services. Understanding the factors influencing nurse retention is essential for maintaining a strong and long-lasting workforce because nurse retention is becoming increasingly complex. This study aimed to investigate the influence of professional identity and job satisfaction on the intention to remain employed while also evaluating the levels of professional identity, job satisfaction, and intention to stay among paediatric nurses amidst the COVID-19 pandemic. This correlational and descriptive study included a stratified sample of 257 paediatric nurses and was guided by the STROBE checklist. Data were collected through valid and reliable questionnaires, which included a nurses' professional identity scale, job satisfaction survey, intention to stay scale, and a demographic questionnaire. Data collection was conducted from January to April 2022. The study was approved by the ethical research committee at the Nursing Faculty - Mansoura University, ensuring adherence to the Helsinki Declaration. The paediatric nurses reported elevated professional identity, moderate job satisfaction, and moderate intention to stay employed with mean scores of 80.35 ± 13.22, 113.70 ± 19.58, and 8.40 ± 3.55, respectively. Multiple regression explained 13.0% of the variation in paediatric nurses' intention to remain employed (F = 18.50, p < 0.001). Professional identity positively correlated with the intention to stay (β = 2.69, p = 0.008). Job satisfaction also had a positive relationship with the intention to stay (β = 3.49, p < 0.001). Healthcare managers should focus on professional identity strategies such as supportive work environments, growth opportunities, and valuing paediatric nurses' contributions. Implementing interventions such as fair compensation, support, and rewards can enhance paediatric nurses' retention and quality of patient care.

The Managerial Role and Psychosocial Factors of Job Satisfaction: A Cross-sectional Study Among Wittyfit's Users

OBJECTIVE

Job satisfaction is an emerging indicator for measuring workers' occupational well-being; however, this has been poorly studied in managers. We aimed to explore job satisfaction between managers and employees and assess its factors.

METHODS

Data from Wittyfit's users were collected between January 2018 and February 2020. Volunteers anonymously provided their sociodemographic profile, their sense of job satisfaction, and their psychosocial feelings (ambiance, meaning, organization, recognition, values, work-life balance).

RESULTS

Data of 10,484 employees and 836 managers were collected. Job satisfaction was higher in managers than employees. All psychosocial factors had an impact on job satisfaction in workers. There was a higher prevalence of satisfied managers than employees. Managerial position and other sociodemographic variables influenced this prevalence.

CONCLUSIONS

Managers seem to be more satisfied than employees. Psychosocial and sociodemographic factors can influence workers' job satisfaction.

Engaging leadership and nurse well-being: the role of the work environment and work motivation-a cross-sectional study

BACKGROUND

Healthcare literature suggests that leadership behavior has a profound impact on nurse work-related well-being. Yet, more research is needed to better conceptualize, measure, and analyse the concepts of leadership and well-being, and to understand the psychological mechanisms underlying this association. Combining Self-Determination and Job Demands-Resources theory, this study aims to investigate the association between engaging leadership and burnout and work engagement among nurses by focusing on two explanatory mechanisms: perceived job characteristics (job demands and resources) and intrinsic motivation.

METHODS

A cross-sectional survey of 1117 direct care nurses (response rate = 25%) from 13 general acute care hospitals in Belgium. Validated instruments were used to measure nurses' perceptions of engaging leadership, burnout, work engagement, intrinsic motivation and job demands and job resources. Structural equation modeling was performed to test the hypothesised model which assumed a serial mediation of job characteristics and intrinsic motivation in the relationship of engaging leadership with nurse work-related well-being.

RESULTS

Confirmatory factor analysis indicated a good fit of the measurement model. The findings offer support for the hypothesized model, indicating that engaging leadership is linked to enhanced well-being, as reflected in increased work engagement, and reduced burnout. The results further showed that this association is mediated by nurses' perceptions of job resources and intrinsic motivation. Notably, while job demands mediated the relationship between EL and nurses' well-being, the relationship became unsignificant when including intrinsic motivation as second mediator.

CONCLUSIONS

Engaging leaders foster a favourable work environment for nursing staff which is not only beneficial for their work motivation but also for their work-related well-being. Engaging leadership and job resources are modifiable aspects of healthcare organisations. Interventions aimed at developing engaging leadership behaviours among nursing leaders and building job resources will help healthcare organisations to create favourable working conditions for their nurses.

TRIAL REGISTRATION

The study described herein is funded under the European Union's Horizon 2020 Research and Innovation programme from 2020 to 2023 (Grant Agreement 848031). The protocol of Magnet4Europe is registered in the ISRCTN registry (ISRCTN10196901).

Professional Commitment of 8-Year Medical Doctoral Degree Program Students in China: The Mediating Role of Self-Efficacy, Learning Engagement, and Academic Performance

BACKGROUND

Studying the professional commitment of a student in an 8-year medical training program of China, especially its association with academic performance, can enhance the understanding of professional loyalty in future doctors. This study aimed to investigate the self-efficacy, academic performance, professional commitment, and learning engagement of 8-year program medical students, and explore the mediating roles of professional commitment and learning engagement on the associations between self-efficacy and academic performance.

METHODS

We conducted a cross-sectional study in a Chinese medical university and collected the General Self-Efficacy Scale, Professional Commitment of Undergraduates Scales, and the Utrecht Work Engagement Scale-Student from self-reported students. Academic performance was ascertained using course examination scores in the most recent year. We conducted a structural equation model (SEM) analysis to examine the mediating roles of professional commitment and learning engagement on the relationship between self-efficacy and academic performance.

RESULTS

A total number of 402 medical students were included in this study. Students in the clinical practice stage had significantly lower professional commitment and learning engagement than students in the pre-medical and medical course stages. The professional commitment of students from low-income families was significantly lower than that of students from high-income families. Professional commitment and learning engagement were mediators in the relationship between self-efficacy and academic performance.

CONCLUSIONS

This study is the first to investigate professional commitment among students in the China 8-year medical program. Professional commitment plays an intermediary role between self-efficacy and academic performance.

Examination of the role of the rotating nursing department in the training of nursing staff based on SWOT analysis

BACKGROUND

The implementation of the rotation system in the Chinese medical industry has achieved significant results.

OBJECTIVES

The present study aims to 1) explore the strengths, weaknesses, opportunities and challenges of rotational nursing department implementation and 2) provide references for developing nursing staff's competencies in leadership, performance evaluation, quality of care, communication in relationships and human resources.

METHODS

A total of 16 rotational nursing department staff members from a tertiary tuberculosis specialist hospital in Beijing were interviewed, and the interview data were analysed using a strengths, weaknesses, opportunities and threats analysis and class analysis.

RESULTS

The advantages of the rotational nursing department included: (1) stimulating the nursing staff's enthusiasm and creativity; (2) strengthening the communication and collaboration between departments; (3) improving the detailed management of nursing quality; and (4) enhancing the nursing staff's comprehensive abilities. The disadvantages included: (1) the design of the rotation programme focusing on practice; (2) a lack of personalisation; and (3) imperfect performance assessment of the rotating staff. Opportunities included: (1) deepening the connotation of nursing job management and (2) developing the construction of nursing discipline and the need for personal career development and value realisation. Threats included the lack of a sound rotation management model to draw on.

CONCLUSION

A rotational nursing department is conducive to enhancing the competence of nursing staff in management positions and providing new ideas for hospitals to select and train nursing management talents. By taking full advantage of the benefits of vertical nursing management, designing personalised rotation training programmes, building a diversified learning and training platform and developing a positive performance incentive mechanism is recommended to fully engage the role of rotation in nursing management talent training.

Experiences of Nurses and Midwives With Indecorously Structured Duty Rosters at Selected Health Facilities in Ho, Volta Region of Ghana: A Qualitative Study

Introduction

Decent working time in the health sector is critical to providing quality care, and balancing health workers' well-being with the requirements of 24/7 healthcare provision. Nursing and midwifery staff, comprising the largest group in the health workforce, play a crucial role. Understanding their experiences and challenges related to duty rosters is essential for improving work conditions, job satisfaction, and ultimately, the quality of care.

Objective

This study aims to explore the experiences of nurses and midwives with the hospital duty roster at selected health facilities in Ho, the Volta Region of Ghana.

Method

A qualitative research method with a phenomenological approach was employed to capture the nuanced experiences of nurses and midwives regarding the hospital duty roster. A semistructured interview guide facilitated data collection, ensuring a comprehensive exploration of participants' experiences. Three selected health facilities in Ho, the Volta Region of Ghana, served as the study's location. The study recruited 20 participants (nurses and midwives) to reach data saturation. The collected data were transcribed verbatim and analyzed through thematic content analysis, using a deductive approach. Researchers reviewed the raw data, generating initial codes to capture new concepts of interest.

Results

The duty roster often demonstrated organizational flaws negatively impacting the health, well-being, and job performance of nurses and midwives, consequently affecting patient care quality. The study identified that these healthcare professionals faced significant risks of work-related stress, burnout, and mental health problems due to ineffective coping strategies toward the hospital duty roster. Findings from the study also demonstrated that nurses and midwives prefer day shift because of its short time and the availability of all groups of professionals to help manage cases as compared to a night shift.

Conclusions

The findings underscore factors influencing nurses' choice of shift patterns, emphasizing the need for further research to explore the extent to which nurses' preferences are considered when designing hospital duty rosters. Such insights can contribute to improving both the working conditions of healthcare professionals and the overall quality of patient care.

Job Satisfaction and Associated Factors among Scrub Nurses: Beyond the Surface

BACKGROUND

Job satisfaction is essential, especially among healthcare professionals like scrub nurses, who often face unique professional challenges. This study aimed to evaluate job satisfaction and its related factors among scrub nurses, shedding light on areas of improvement and highlighting the positive aspects of their roles.

METHODS

A detailed study was conducted among a cohort of 31 scrub nurses using a 28-question survey. The questionnaire gauged various aspects of job satisfaction, from work conditions to professional growth opportunities.

RESULTS

Notably, the participants showed the least satisfaction with hazard allowances (1.8 ± 1.1) and break durations (1.9 ± 1.3). However, high satisfaction was observed regarding resource availability (3.9 ± 1.0) and the quality of protective equipment (3.7 ± 1.0). The data also revealed that those with 6-10 years of experience were the most satisfied (3.5), while those with 16-20 years were less content (2.7).

CONCLUSION

The study indicates the need for improvements in hazard allowances and break periods. Experience significantly influenced satisfaction, with mid-career nurses showing the highest contentment. Such insights can guide future policy and practice adjustments in healthcare settings.

Construction and evaluation of a predictive model for compassion fatigue among emergency department nurses: A cross-sectional study

BACKGROUND

Compassion fatigue is a syndrome resulting from long-term work-related traumatic event stress exposure of medical staff. The emergency department is considered to be a high-risk, high-intensity and high-stress work environment, with a high prevalence of trauma and violence. Nurses in the emergency department are more prone to compassion fatigue than nurses in other departments. Compassion fatigue not only affects the physical and mental health, and job satisfaction of emergency department nurses, but also causes serious consequences for patients, such as poor patient outcome, medical errors, and increased patient mortality during hospitalization.

OBJECTIVES

Our study aims to develop and evaluate a predictive model for compassion fatigue among emergency department nurses.

DESIGN

A cross-sectional study.

DATA SOURCES

The emergency department nurses (N = 1014) were recruited from 21 tertiary hospitals (from Chengdu, Chongqing, Guiyang, Guangzhou and Shanghai) in central, southwestern, southern, and eastern China from July 25, 2022 to October 30, 2022.

METHODS

Univariate and multiple logistic regression analyses were used to determine the potential predictive factors associated with compassion fatigue in emergency department nurses. A nomogram was built based on the predictive factors and internally evaluated using a bootstrap resampling method (1000 bootstrap resamples). The performance of the predictive model was evaluated by measuring the Hosmer-Lemeshow goodness of fit test and calibration curve.

RESULTS

The prevalence of compassion fatigue among emergency department nurses was 75.9 %. The multiple logistic regression analysis revealed that the independent predictive factors for compassion fatigue among emergency department nurses were working position, job satisfaction, diet habit, sleep hours per day, occupational stress, physical harassment and the level of workplace violence, all of which were identified to create the nomogram. The Hosmer-Lemeshow goodness of fit test indicated that the predictive model was well calibrated (χ2 = 11.520, P = 0.174). The bootstrap-corrected concordance index of nomogram was 0.821 (95 % CI: 0.791-0.851). The calibration curve of the nomogram showed good consistency between the predicted and actual probabilities.

CONCLUSIONS

A predictive model of compassion fatigue among emergency department nurses has been developed, based on the general demographic, work-related and lifestyle characteristics, occupational stress, and workplace violence, with satisfactory predictive ability. This model can identify emergency department nurses who are at high risk of compassion fatigue. Our study provides an empirical basis for early detection, early diagnosis and early intervention of emergency department nurses at high risk of compassion fatigue.

Social Support and Its Impact on Job Satisfaction and Emotional Exhaustion

Social support at work has demonstrated itself to be an important variable for predicting desirable outcomes and helping to buffer the effects of adverse events. The main objective of this research is to understand the impact of social support on job satisfaction on the one hand and emotional exhaustion on the other. Furthermore, in order to gain a deeper understanding of intricate organizational relationships, the mediating effects of work recovery experiences are taken into consideration. The sample was composed of 496 workers (41.5% men and 58.5% women). The mean age was 42 years (SD = 9.82). A cross-sectional design was used. The results, both direct (r = 0.43; R2 = 0.19; p < 0.001) and indirect (B = 0.04; SE = 0.02; 95% C.I. = 0.01, 0.09), of the model relating social support to job satisfaction were statistically significant. On the other hand, in the model that links social support to emotional exhaustion, we observed statistically significant direct (r = 0.26; R2 = 0.07; p < 0.001) and indirect effects (B = -0.05; SE = 0.02; 95% C.I. = -0.10, -0.01). Only the relaxation factor was a significant mediator of these variables. Implications, limitations, and future research recommendations are discussed.

Professional commitment and related factors among nursing undergraduates: A latent profile analysis

OBJECTIVE

To identify different subgroups of nursing professional commitment among nursing undergraduates and to analyze the related factors of the different subgroups.

METHODS

A cross-sectional study using the professional commitment scale with 430 nursing undergraduates was conducted. Latent profile analysis was used to explore the nursing students' professional commitment subgroups and using multivariate logistic regression to analyze the related factors of nursing professional commitment.

RESULTS

The overall mean score for professional commitment in nursing was (75.07 ± 14.715). There were three different subgroups of professional commitment characteristics, namely the "high professional commitment group" (20.465 %), the "medium professional commitment group" (66.279 %), and the "low professional commitment group" (13.256 %). Dissatisfaction with clinical placement (OR = 3.556, p = 0.008) and self-enrollment (OR = 0.186, p = 0.002) were significantly related factors for low-level and medium-level nursing commitment groups. Students' origin in western China (OR = 1.869, p = 0.042) significantly influenced the medium-level specialty commitment group.

CONCLUSIONS

Most nursing undergraduates have been categorized in the "medium professional commitment group". Students who were dissatisfied with their clinical experience and chose the nursing profession involuntarily were the main factors for low-level and medium-level nursing professional commitment. The clinical practice environment should be further improved to enhance the clinical experience satisfaction of nursing undergraduates; at the same time, the professional value cultivation of students whose choice of nursing profession was not made by themselves should be strengthened to improve the level of professional commitment of nursing undergraduates.