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Owens RA, Burwell PM, Petros T. Nurses' and nursing students' intent to stay: The impact of quality of life, work environment, and work satisfaction. Nurs Manag (Harrow) 2022; 53:34-43. [PMID: 35913816 DOI: 10.1097/01.numa.0000853236.32160.d2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Rhoda A Owens
- Rhoda A. Owens is an associate professor of nursing at the University of North Dakota College of Nursing and Professional Disciplines in Grand Forks, ND. Patricia Moulton Burwell is the director of the National Forum of State Nursing Workforce Centers in Northwood, ND. Thomas Petros is a professor of psychology at the University of North Dakota College of Arts and Sciences in Grand Forks, ND
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Chang PY, Chiou ST, Lo WY, Huang N, Chien LY. Stressors and level of stress among different nursing positions and the associations with hyperlipidemia, hyperglycemia, and hypertension: a national questionnaire survey. BMC Nurs 2021; 20:250. [PMID: 34903232 PMCID: PMC8667416 DOI: 10.1186/s12912-021-00777-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/30/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Nurses are faced with varying job stressors depending on their positions and duties. Few previous studies have compared job stress and related chronic conditions among different nursing positions. The objectives were to compare job stressors among clinical registered nurses, nurse practitioners, and head nurses and explore the impact of job stressors and stress level on hyperlipidemia, hyperglycemia, and hypertension. METHODS Secondary data extracted from a survey of health-care workers conducted from May to July 2014 across 113 hospitals in Taiwan was used. This analysis included 17,152 clinical registered nurses, 1438 nurse practitioners, and 2406 head nurses. Socio-demographic characteristics, job stressors, stress levels, and hyperlipidemia, hyperglycemia, and hypertension variables were extracted. RESULTS Perceived stressors differed among clinical registered nurses, nurse practitioners, and head nurses, but overall stress level did not. Nurse practitioners and head nurses showed significantly higher prevalence of hyperlipidemia, hyperglycemia, and hypertension than clinical registered nurses. Higher stress levels, age, body mass index, work hours, and caring for family members were positively associated with hyperlipidemia, hyperglycemia, and hypertension. After adjustment for these variables, risk of hyperlipidemia, hyperglycemia, and hypertension did not differ across the nursing positions. CONCLUSIONS Although stressors vary by different nursing positions, overall stress level does not. Hyperlipidemia, hyperglycemia, and hypertension are related to stress level, age, body mass index, weekly working hours, and caring for family members. Hence, alleviating job stress and avoiding long working hours are likely to reduce the risk of hyperlipidemia, hyperglycemia, and hypertension in nurses.
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Affiliation(s)
- Po-Ya Chang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Shu-Ti Chiou
- Institute of Public Health, National Yang Ming Chaio Tung University, Yang-Ming Campus, Taipei, Taiwan.,Center for Healthcare Quality Management, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Wen-Yen Lo
- Department of Nursing, National Yang Ming Chiao Tung University, Yang-Ming Campus, Taipei, Taiwan
| | - Nicole Huang
- Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Yang-Ming Campus, Taipei, Taiwan
| | - Li-Yin Chien
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Yang-Ming Campus, 155 Li-Nong Street, Section 2, Bei-Tou, Taipei, 11221, Taiwan.
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Examining Job Satisfaction and Intent to Stay for Neonatal Nurse Practitioners: The Impact of Mentoring. Adv Neonatal Care 2021; 22:341-351. [PMID: 34596086 DOI: 10.1097/anc.0000000000000931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In 2017, the National Association of Neonatal Nurse Practitioners (NANNP) recommended that organizations implement formalized mentoring programs for neonatal nurse practitioners (NNPs). There is significant evidence to support that mentoring positively impacts nurse practitioners' job satisfaction and retention. However, there is a lack of evidence-based literature specific to NNP mentoring. PURPOSE Determine the impact of participation in the NANNP formalized mentoring program on job satisfaction and retention for novice and experienced NNPs in an academic medical center in Tennessee. METHODS This quality improvement project utilized a secure online survey that included the Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS) and 2 intent-to-stay items prior to implementation of a 6-month mentoring program. Neonatal intensive care unit nurse practitioners completed the same electronic survey at 3 intervals after program implementation to determine the impact of the mentoring program on job satisfaction and intent to stay. RESULTS Project results identified a significant difference in MNPJSS scores for participants in a 6-month formal mentoring program using the NANNP tool kit. The MNPJSS scores moderately correlated with intent to stay at 1 year and strongly correlated with intent to stay at 3 years. IMPLICATIONS FOR PRACTICE The results of this project support the positive impact of a formalized mentoring program on job satisfaction for new graduate nurse practitioners. Recognizing the challenge to recruit and retain NNPs, organizations should explore creative solutions to develop and support formalized mentoring programs. IMPLICATIONS FOR RESEARCH Further research is warranted to validate use of the NANNP tool kit in the establishment and evaluation of a formalized mentoring program.Video abstract available at:https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx.
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Schirle L, Norful AA, Rudner N, Poghosyan L. Organizational facilitators and barriers to optimal APRN practice: An integrative review. Health Care Manage Rev 2021; 45:311-320. [PMID: 32865939 PMCID: PMC7467399 DOI: 10.1097/hmr.0000000000000229] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The organizational environment can foster or impede full deployment of advance practice registered nurses (APRNs), affecting the quality of care and patient outcomes. Given the critical role APRNs play in health care, it is important to understand organizational factors that promote or hinder APRN practice to maximize the potential of this workforce in health care systems. PURPOSE The aim of this study was to synthesize evidence about APRN practice environments, identify organizational facilitators and barriers, and make recommendations for better APRN utilization. METHODS A literature search was conducted in CINAHL, PubMed, and PsychInfo, yielding 366 studies. No time or geographic limitations were applied. Study quality was appraised using the National Institutes of Health National Heart, Lung, and Blood Institute Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Studies. RESULTS Thirty studies conducted in the United States, Canada, and the Netherlands met inclusion criteria. The majority of the studies involved nurse practitioners. Facilitators to optimal practice environment were autonomy/independent practice and positive physician/APRN relations. Barriers included policy restrictions on practice, poor physician relations, poor administrator relations, and others' lack of understanding of the APRN role. Barriers correlate with job dissatisfaction and increased intent to leave job. PRACTICE IMPLICATIONS The review highlights the importance of physician and administration relations, organizational-level policies, and colleagues' understanding of the APRN role in promoting effective practice environments. Organizations should align policy reform efforts with factors that foster positive APRN practice environments to efficiently and effectively utilize this increasingly vital workforce. Future research is warranted.
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Affiliation(s)
- Lori Schirle
- Lori Schirle, PhD, CRNA, is Assistant Professor, Vanderbilt University School of Nursing, Nashville, Tennessee. E-mail: . Allison A. Norful, PhD, RN, ANP-BC, is Post-Doctoral Fellow, Columbia University School of Nursing and Columbia University Medical Center Irving Institute for Clinical and Translational Research, New York, New York. Nancy Rudner, DrPH, APRN, is Graduate Faculty, George Washington University, Washington, DC. Lusine Poghosyan PhD, MPH, RN, FAAN, is Associate Professor of Nursing, Columbia University School of Nursing, New York, New York
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Clinician experience, perceptions, and acceptance of paediatric complex care nurse practitioner roles. Collegian 2021. [DOI: 10.1016/j.colegn.2020.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Luo PY, Tung HH, Huang SS, Kau K, Chang SC, Shiu SY, Tsay SL. Organizational empowerment and practice outcomes of acute care nurse practitioners in Taiwan: A national survey. J Am Assoc Nurse Pract 2021; 34:89-99. [PMID: 33859076 DOI: 10.1097/jxx.0000000000000592] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 01/25/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nurse practitioners (NPs) play an important role in addressing growing health care needs. Among NPs, organizational empowerment is positively associated with overall practice outcomes. Therefore, efforts to promote organizational empowerment in practice are necessary to increase job satisfaction among NPs as well as decrease the stress and intention to leave. PURPOSE This study investigated the relationships of organizational empowerment and practice outcomes of job satisfaction, work stress, and intention to leave in acute care practices. METHODOLOGICAL ORIENTATION This study was conducted as a cross-sectional design with a national survey of 946 acute care NPs. Questionnaires contained demographic and practice characteristics, Misener Nurse Practitioner Job Satisfaction Scale, Condition for Work Effectiveness Questionnaire II, and the work stress VAS scale. Hierarchical Linear Model (HLM) was used to investigate individual NP-level or organization-level effects on job satisfaction. The factors associated with job satisfaction were examined by stepwise multiple regression. RESULTS The organizational empowerment was low, work stress was moderately high, and job satisfaction was between slightly unsatisfied and slightly satisfied. The HLM results indicated that organization-level effects did not affect the job satisfaction of NPs. Nurse practitioners with greater formal power, resources, and informal power had higher job satisfaction. Conversely, NPs with an intention to leave and a higher level of stress showed lower job satisfaction. CONCLUSIONS Organizational empowerment, intention to leave, and stress affect job satisfaction of acute care NPs in Taiwan. IMPLICATIONS FOR PRACTIC To enhance the job satisfaction of NPs, health care administrators should empower NPs by providing access to opportunity, support, information, and resources in the health care delivery system.
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Affiliation(s)
- Pei-Ying Luo
- Department of Nursing, Chi-Yi Christian Hospital, Chiayi, Taiwan
| | - Heng-Hsin Tung
- College of Nursing, National Yang Ming University, Taipei, Taiwan
| | - Sheng-Shiung Huang
- Department of Biomedical Engineering, Da-Yeh University, Dacun, Taiwan
- College of Nursing and Health Sciences, Da-Yeh University, Dacun, Taiwan
| | - Kevin Kau
- Academic Writing Education Center, National Taiwan University, Taipei, Taiwan
| | - Shu-Chen Chang
- College of Nursing and Health Sciences, Da-Yeh University, Dacun, Taiwan
- Department of Nursing, Chunghua Christian Hospital, Changhua City, Taiwan
| | - Shu-Ying Shiu
- Department of Nursing, Chunghua Christian Hospital, Changhua City, Taiwan
| | - Shiow-Luan Tsay
- College of Nursing and Health Sciences, Da-Yeh University, Dacun, Taiwan
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Comparison of Rural and Urban Utilization of Nurse Practitioners in States With Full Practice Authority. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2020.12.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Meng H, Bai S, Cao Q. Risk factors of role stress and professional burnout among nurse anesthetists: A multicenter cross-sectional study. Jpn J Nurs Sci 2021; 18:e12413. [PMID: 33682336 DOI: 10.1111/jjns.12413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/06/2021] [Accepted: 01/31/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND In China, there is no unified standard for the responsibilities and authority of nurse anesthetists, resulting in different professional expectations from anesthesiologists and nursing managers, which may result in high levels of role stress and burnout in nurse anesthetists. Additional factors such as high occupational risk and heavy work may also contribute to role stress and burnout. METHODS In this multicenter cross-sectional study, an online questionnaire survey was conducted among 198 nurses from six tertiary hospitals in Shandong Province. The t test, analysis of variance, linear regression, and logistic regression were used to analyze the risk factors for role stress and professional burnout. RESULTS The scores of role conflict and role ambiguity in role stress were 30.61 ± 9.53 and 31.89 ± 9.56, respectively; satisfaction with income and the working environment, the hospital's attention, years of experience as a nurse, clarity concerning the nurse anesthetist's occupational scope, and attitude to career prospects were independent risk factors for role stress. The burnout data were non-normally distributed and were expressed as medians and quartiles. The scores of emotional exhaustion, depersonalization, and personal achievement in professional burnout were 30 (26-34), 11 (8-14), and 23 (20-26) respectively. The number of working hours per week, attitude to career prospects, satisfaction with the working environment and income, physical health, gender, and education were independent risk factors for burnout. CONCLUSIONS Chinese nurse anesthetists were found to be in danger of high role stress and professional burnout, a situation requiring the attention of managers.
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Affiliation(s)
- Haihong Meng
- Affiliated Hospital of Jining Medical University, Jining City, China
| | - Shuling Bai
- Affiliated Hospital of Jining Medical University, Jining City, China
| | - Qinqin Cao
- Affiliated Hospital of Jining Medical University, Jining City, China
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Wood E, King R, Robertson S, Senek M, Tod A, Ryan T. Sources of satisfaction, dissatisfaction and well-being for UK advanced practice nurses: A qualitative study. J Nurs Manag 2021; 29:1073-1080. [PMID: 33404130 DOI: 10.1111/jonm.13245] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/07/2020] [Accepted: 12/30/2020] [Indexed: 10/22/2022]
Abstract
AIMS To examine and explore organisational and role conditions that promote or inhibit job satisfaction and workplace well-being for advanced practice nurses. BACKGROUND The advanced practice role is common across the world. Research shows it is well regarded by patients and improves patient outcomes, but there is little evidence about what the role is like for nurses. METHODS A subsample of an existing cohort of advanced practice nurses were invited for interview. Twenty-two nurses were interviewed over the phone. Interviews transcripts were analysed using thematic analysis. RESULTS Four themes were derived from the data; 'the advanced nurse role and professional identity', 'feeling exposed', 'support for the advancement of the role' and 'demonstrating impact'. CONCLUSION Nurses report considerable dissatisfaction with role identity and concerns relating to isolation on a daily basis, and these negatively affect well-being. However, they also identified significant satisfaction with the role, particularly when well supported and able to recognize the unique contribution that they made to the lives of patients and to their organisations. IMPLICATIONS FOR NURSING MANAGEMENT Clear role definitions, provision of high-quality clinical supervision and addressing issues of isolation are likely to improve the job satisfaction of advanced practice nurses.
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Affiliation(s)
- Emily Wood
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, UK
| | - Rachel King
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, UK
| | - Steve Robertson
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, UK.,Leeds Beckett University, Leeds, UK.,Waterford Institute of Technology, Waterford City, Ireland
| | - Michaela Senek
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, UK
| | - Angela Tod
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, UK
| | - Tony Ryan
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, UK
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Graduating Nursing Student and Practicing Nurse Perceptions on Promoting Recruitment, Work Satisfaction, and Intent to Stay: A Qualitative Study. JOURNAL OF NURSING REGULATION 2021. [DOI: 10.1016/s2155-8256(20)30177-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Harris MD, Williams LM, Duke R. The millennial engagement, resiliency and retention study: What does your millennial advanced practice registered nurse workforce really want? J Am Assoc Nurse Pract 2020; 33:924-930. [PMID: 33208609 DOI: 10.1097/jxx.0000000000000535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 09/14/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Increasing the use of advanced practice nurses may be one of the most viable options to meeting the burgeoning health care demands of older Americans and impending provider shortage over the next two decades. However, keeping the millennial workforce engaged and retained continues to be a significant challenge for health care administrators. PURPOSE The purpose of this study was to understand the intergenerational advanced practice registered nurse (APRN) workforce and assess what job satisfaction factors impact APRN intention to stay, and explore how variables such as resiliency style and age affect retention in these young careerists. METHODS This was a single-center, cross-sectional descriptive study using survey methodology. A total of 405 APRNs from all specialties and practice sites from a large Midwestern Academic Medical Center were eligible to participate. A total of 165 APRNs completed the survey, which was a 41% response rate. RESULTS There were no significant differences in mean resiliency scores by age cohort (p > .05) or a higher intention to leave in millennial-aged APRNs versus older APRNs (p > .05); however, there were significant mean differences in job satisfaction responses that warrant consideration in millennial versus older "baby boomer" APRNs on items such as professional growth, compensation, monetary bonuses, and expanding procedures and skills within scope of practice. IMPLICATIONS FOR PRACTICE Understanding generational differences in APRN job satisfaction assists hospital leaders to develop strategies to support, engage, and retain younger careerists, which may help mitigate turnover.
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Affiliation(s)
- Marianne D Harris
- Northwestern Memorial Hospital, Bluhm Cardiovascular Institute, Chicago, Illinois
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Arthur E, Brom H, Browning J, Bell S, Schueler A, Rosselet R. Supporting Advanced Practice Providers' Professional Advancement: The Implementation of a Professional Advancement Model at an Academic Medical Center. J Nurse Pract 2020; 16:504-508. [PMID: 32863799 DOI: 10.1016/j.nurpra.2020.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Organizational commitment to a structured professional advancement model (PAM) is critical for advanced practice provider (APP) development in order to promote and reward excellence, enhance job satisfaction and improve retention and recruitment. A PAM may also serve as a motivational tool for personal and professional growth by developing and promoting a professional, evidence-based collaborative practice environment. A voluntary PAM was implemented at a large Midwestern academic medical center to recognize experienced APPs including certified nurse practitioners, certified nurse-midwives and physician assistants. This manuscript describes the case for creating a PAM, implementation and evaluation.
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Affiliation(s)
- Elizabeth Arthur
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard. J. Solove Research Institute, 460 W 10 Ave., Room B160, Columbus, OH 43210
| | - Heather Brom
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, 418 Curie Blvd, Rm 388R, Philadelphia, PA 19102
| | - Jennifer Browning
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard. J. Solove Research Institute, 460 W 10 Ave., Room B160, Columbus, OH 43210
| | - Susan Bell
- The Ohio State University Wexner Medical Center, 410 W. 10 Ave., Columbus, OH 43210
| | - Amy Schueler
- The Ohio State University Wexner Medical Center, 410 W. 10 Ave., Columbus, OH 43210
| | - Robin Rosselet
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard. J. Solove Research Institute, 460 W 10 Ave., Room B160, Columbus, OH 43210
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Bourdeanu L, Skalski K, Shen Y, Wang S, Mai S, Sun H, Morrissey K, Langdon D. Job satisfaction among oncology nurse practitioners. J Am Assoc Nurse Pract 2020; 33:133-142. [PMID: 31567838 DOI: 10.1097/jxx.0000000000000291] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 06/27/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND One proposed solution to the predicted shortage of oncology nurse practitioners (NPs) is expanding the role of the oncology NP. However, role expansion may lead to an increase in work-related stress and a decrease in job satisfaction. It is important to understand oncology NPs' job satisfaction and stress and their intent to leave their job or profession in order to further develop and potentially expand the role. PURPOSE The purpose of this study is to determine the main factors that affect job satisfaction, especially the relationship with stress and the intent to leave the oncology specialty. METHODS A convenience sample of responses to a series of surveys administered by the Oncology Nursing Society and residing in the ONS database was used for this analysis. Exploratory data analysis, principal component analysis, and regression models were applied to explore characteristics of the questionnaires, assess the reliability of the Coping Skills Questionnaire, and find out main factors for their intent to leave. RESULTS Items in the Coping Skills Questionnaire were internally consistent, and stress had a positive effect on NPs' intent to leave. Satisfaction and coping skills were also significant in some models; higher levels of satisfaction and coping skills resulted in lower levels of intent to leave. Moreover, several demographic factors such as having children, schedule days off, and patient population also affected the response significantly. IMPLICATIONS FOR PRACTICE This study provides nursing leaders with information to guide retention of NPs.
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Affiliation(s)
| | | | - Yuan Shen
- George Washington University, Washington, D.C
| | - Suya Wang
- George Washington University, Washington, D.C
| | - Shiyun Mai
- George Washington University, Washington, D.C
| | - Haoqi Sun
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
| | | | - David Langdon
- University of Texas Health San Antonio, San Antonio, Texas
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Hwa YL, Shelly JL, Zblewski DL, Spychalla MT, Udenberg DM, Cieslak KR, Nowakowski GS, Lacy MQ, Marshall AL. Mayo Clinic Hematology Fellowship for Advanced Practice Providers. J Adv Pract Oncol 2020; 11:395-400. [PMID: 33604099 PMCID: PMC7863122 DOI: 10.6004/jadpro.2020.11.4.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Advanced practice providers (APPs), including nurse practitioners (NPs) and physician assistants (PAs), are part of a growing cancer care workforce. Current hematology-specific education provided by most graduate NP and PA school educations is limited. Mayo Clinic School of Health Sciences launched a hematology-specific fellowship in 2018 to provide APPs with the skills and knowledge required to deliver high-quality specialty care in hematology and blood and marrow transplant (BMT). The fellowship curriculum was developed based on a needs-based assessment study as well as the qualitative reported experiences of current hematology-specific APPs. The curriculum contains didactic in-class education, research opportunities, and mentored clinical rotations in both inpatient and outpatient practice in hematology and BMT. This 12-month fellowship, one of the only postgraduate training programs dedicated to benign and malignant hematology practice, provides structured training for highly qualified graduate APPs interested in developing a rewarding career in hematology.
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Affiliation(s)
- Yi L Hwa
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota
| | - Jessica L Shelly
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota
| | - Darci L Zblewski
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota
| | - Megan T Spychalla
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota
| | - Dawn M Udenberg
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota
| | - Kathryn R Cieslak
- Mayo Clinic School of Health Sciences Education Administration, Rochester, Minnesota
| | - Grzegorz S Nowakowski
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota
| | - Martha Q Lacy
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota
| | - Ariela L Marshall
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota.,Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
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An Outcomes Evaluation of an Innovation Studio on Interprofessional Learning, Job Satisfaction, and Intent to Stay Among Clinicians. ACTA ACUST UNITED AC 2020; 50:109-114. [DOI: 10.1097/nna.0000000000000850] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Avery-Desmarais S, Sethares KA, Stover C, Batchelder A, McCurry MK. Substance Use and Minority Stress in a Population of Lesbian, Gay and Bisexual Nurses. Subst Use Misuse 2020; 55:1958-1967. [PMID: 32631168 DOI: 10.1080/10826084.2020.1784946] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim of this study was to explore the incidence of problematic substance use (PSU) and the relationship between level of substance use, minority stress, and general stressors in a population of lesbian, gay and bisexual (LGB) identified nurses. Methods: A national, convenience sample of 394 self-identified LGB nurses completed an online survey in March 2019. Using data from the ASSIST V3.1 measurement tool, the incidence of problematic and non-problematic tobacco, alcohol and illicit substance use was described as a percentage of respondents in each group. Hierarchical regression assessed the impact of demographic variables, sexual orientation, gender identity, race/ethnicity, and level of substance use. Multiple regression assessed the impact of general stressors, minority stress processes, including coping and social support and internalized homophobia, on level of substance use. Results: The incidence of PSU was higher in this population of LGB-identified nurses than previously described in either the general population of nurses or the general LGB population. Demographic variables and minority status had variable associations with level of tobacco, alcohol and illicit substance use. Components of Meyer's minority stress model had a stronger and more consistent association with level of tobacco, alcohol and illicit substance use than general stress. Predictors of level of substance use across groups suggest community involvement may be significant. These results have potential implications for public health and the prevention and treatment of substance use in LGB-identified nurses.
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Affiliation(s)
- Shannon Avery-Desmarais
- College of Nursing and Health Sciences, University of Massachusetts Dartmouth, Dartmouth, Massachusetts, USA
| | - Kristen A Sethares
- College of Nursing and Health Sciences, University of Massachusetts Dartmouth, Dartmouth, Massachusetts, USA
| | - Caitlin Stover
- School of Nursing, Assumption College, Worcester, Massachusetts, USA
| | - Abigail Batchelder
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Fenway Health, USA The Fenway Institute, Boston, Massachusetts, USA
| | - Mary K McCurry
- College of Nursing and Health Sciences, University of Massachusetts Dartmouth, Dartmouth, Massachusetts, USA
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Klein CJ, Weinzimmer LG, Cooling M, Lizer S, Pierce L, Dalstrom M. Exploring burnout and job stressors among advanced practice providers. Nurs Outlook 2019; 68:145-154. [PMID: 31708107 DOI: 10.1016/j.outlook.2019.09.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 09/04/2019] [Accepted: 09/18/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Minimal research exists on how engagement, burnout, work-family balance, and job stressors impact advanced practice nurses and physician assistants, collectively referred to advanced practice providers (APPs). PURPOSE To investigate the interrelationships among burnout, job stressors, work-family balance, and engagement with APPs. METHODS An online questionnaire was distributed to APPs working in four healthcare systems. A total of 1,216 APPs completed the survey. A hypothesized model was tested using structural equation modeling. FINDINGS There was a high correlation of job stressors with development of burnout. A significant negative effect between job stress and work engagement was supported; however, indirect effects of stress through job burnout had a stronger impact on work engagement. Higher levels of work-family balance contributed to a lower level of stress experienced by providers. DISCUSSION Organizational leaders desiring to improve employee engagement and reduce burnout need to focus on the significance of work-family balance to job stressors.
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Affiliation(s)
| | - Laurence G Weinzimmer
- Caterpillar Inc. Professor of Management, Foster College of Business, Bradley University, Peoria, IL
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Pediatric nurse practitioner's perceived organizational support in academic and nonacademic institutions. J Am Assoc Nurse Pract 2019; 32:45-51. [PMID: 31567836 DOI: 10.1097/jxx.0000000000000292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The role of the pediatric nurse practitioner (PNP) has changed since its inception over 50 years ago. Pediatric nurse practitioner practice has evolved from providing outpatient primary care to children to providing complex care in the acute practice environment. PURPOSE The purpose of this study was to describe whether a difference existed in perceptions of organizational support (POS) of PNPs working in academic and nonacademic institutions and to describe the differences between PNP reporting structures and POS. METHODS A quantitative cross-sectional design was used with a convenience sample (n = 86) of PNPs from the membership list of the Pediatric Nurse Credentialing Board (PNCB). A formal written request was sent to the PNCB to access their membership after which institutional review board approval was obtained from Case Western Reserve University. Participants received an online cover letter with links to the surveys to be completed. The PNPs were asked to complete a demographic/institution characteristic survey and Eisenberger Perceived Organizational Support Survey (POS). RESULTS More than 63% of the PNPs participating in this national survey, practicing in both academic and nonacademic affiliated hospitals, had positive perceptions of organizational support. No differences were found between the academic and the nonacademic affiliations. IMPLICATIONS FOR PRACTICE Because PNPs are integral to the provision of care to children, providing opportunities for PNPs to continue to enhance their clinical skills and practice to the full extent of their scope of practice will only enhance their perceptions of organizational support. This dynamic creates a win-win for the PNP, the institution, the patients they care for, and the US health care system.
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Professional Satisfaction of Advanced Practice Providers in Primary Care Specialties. J Healthc Manag 2019; 64:279-290. [PMID: 31498204 DOI: 10.1097/jhm-d-18-00070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
EXECUTIVE SUMMARY This prospective study focuses on professional satisfaction among advanced practice providers (APPs) in primary care. We aimed to determine whether incorporating specialty care clinics within primary care practices increases professional satisfaction. We administered the validated Misener Nurse Practitioner Job Satisfaction Scale and a self-developed demographic questionnaire to all primary care APPs before and one year after implementation of a gynecology practice within the primary care setting. APPs practicing in a dual-role specialty practice reported higher overall professional satisfaction; professional growth; intrapractice partnership/collegiality; professional, social, and community interaction; and benefits than their primary care-only counterparts. We concluded that professional satisfaction among APPs may contribute to staff retention.
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Hwa YL, Marshall AL, Shelly JL, Colborn LK, Nowakowski GS, Lacy MQ. Assessment of the Need for a Hematology-Specific Fellowship Curriculum for Advanced Practice Providers Using a Needs-Based Survey. J Oncol Pract 2019; 15:e593-e599. [DOI: 10.1200/jop.18.00697] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE: Subspecialty training programs rarely are available for advanced practice providers (APPs). New curricula are needed to prepare APPs with the skills and knowledge required to deliver high-quality care in hematology and blood and marrow transplantation (BMT). METHODS: A Web-based needs assessment survey was distributed to APPs currently working in hematology and BMT at three Mayo Clinic sites (Rochester, MN; Scottsdale, AZ; and Jacksonville, FL). The survey assessed participants’ perceptions of readiness to practice in hematology after completion of their APP education and identified APP learning needs. RESULTS: Of 68 APPs, 49 (72%; 34 nurse practitioners, 15 physician assistants) completed the survey. Twenty-eight APPs (57%) were new graduates, and 17 (35%) had no prior experience in hematology/BMT. All APPs held a master’s degree or higher (doctorate, 31%). Thirty-nine (80%) reported that less than 5% of their APP school curriculum was hematology focused. More than 90% felt unprepared to practice in hematology or BMT after their APP education and believed that hematology-specific training could improve their competency as providers and positively affect job satisfaction. APPs reported that they would like more formal training in the following areas of clinical focus: malignant and benign hematologic disorders, hematopathology, palliative care, transfusion medicine, infectious disease, and hematology-related pharmacology. They also preferred the following learning strategies: active learning from patient care, case-based teaching, and experience during hospital rounds. CONCLUSION: This needs-based assessment project confirmed the necessity to develop a hematology-specific fellowship for APPs and helped to optimize the curriculum.
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Efficacy of the Well-Being Index to identify distress and stratify well-being in nurse practitioners and physician assistants. J Am Assoc Nurse Pract 2019; 31:403-412. [DOI: 10.1097/jxx.0000000000000179] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
BackgroundTraditional models of clinical nursing education do not deliver the most effective learning experiences to undergraduate nursing students. An innovative way to clinically prepare nursing students is the use of dedicated education units (DEUs). This model utilizes staff nurses to provide supervision and hands-on teaching to students.ObjectiveThe purpose of this project was to evaluate an evidence-based change from a traditional model of clinical instruction to a DEU.MethodsDEUs were implemented on three adult medical–surgical units. Two unpaired identical pre-DEU and post-DEU questionnaires were used to evaluate the practice change in both nursing students and staff nurse mentors.ResultsA total of 41 students and 22 nurses participated in the project. Students reported feeling comfortable, engaged, and satisfied in their clinical experiences on the DEU. Nurses' responses revealed the DEU to be a rewarding experience and found satisfaction in their role.ConclusionsThe paradigm shift from traditional to DEU models has enhanced the quality of learning experiences for students and improved the professional environment for nurses at large academic medical institutions located in central Ohio.Implications for NursingImplications for future inquiry include standardizing educational training/orientation programs for DEU staff nurse mentors.
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Abstract
There is a critical shortage of neonatal nurse practitioners (NNPs) in the United States. The NNP shortage increases workload and negatively affects job satisfaction, which ultimately impacts patient safety. Therefore, it is imperative to identify strategies to improve job satisfaction and retention. Authors of current evidence supported the connection between mentoring and role transition, job satisfaction, and intent to stay. Mentorship is key to the success of new graduate nurse practitioners as they develop confidence in the nurse practitioner (NP) role. The aim of this integrative review is to examine the existing evidence regarding mentoring of advanced practice nurses and the potential impact on the NNP workforce.
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Vong LTN, Ngan HFB, Lo PCP. Does organizational climate moderate the relationship between job stress and intent to stay? JOURNAL OF CHINESE HUMAN RESOURCES MANAGEMENT 2018. [DOI: 10.1108/jchrm-09-2017-0022] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to investigate the moderating influence of organizational climate in the relationship between job stress and intent to stay.
Design/methodology/approach
This study has used a non-probability sampling design for data collection. A semi-structured questionnaire has been prepared and a street survey has been carried out at popular public places in Macau.
Findings
This study shows that stressful employees working in organizations characterized by unsupportive organizational climate had far less desire to stay with the organization than those working in organizations with supportive organizational climate.
Research limitations/implications
Street intercept survey is a technique of convenience sampling. This makes it difficult to generalize the study’s findings to the entire population.
Originality/value
Few studies to date have paid attention to the influence of organizational climate between job stress and intent to stay. The multi-industry context from which the data are collected suggests that the results and findings are useful to managers and practitioners from across a broad range of business sectors.
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Wang-Romjue P. Meta-synthesis on nurse practitioner autonomy and roles in ambulatory care. Nurs Forum 2017; 53:148-155. [PMID: 29077202 DOI: 10.1111/nuf.12236] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Many healthcare stakeholders view nurse practitioners (NPs) as an important workforce resource to help fill the anticipated shortage of 20,400 ambulatory care physicians that is expected by 2020. Multiple quantitative studies revealed the attributes of NPs' practice autonomy and roles. However, there is no qualitative meta-synthesis that describes the experiences of NPs' practice autonomy and roles. AIM To describe and understand the experiences of NPs regarding their practice autonomy and roles in various ambulatory settings through the exploration of existing qualitative studies: meta-synthesis. DESIGN A qualitative meta-synthesis was conducted to gain insight into ambulatory NPs' practice autonomy and roles through content analysis and reciprocal translation. METHODS Articles published between 2000 and 2017 were retrieved by searching 7 databases using the following key words: U.S. qualitative studies, advance practice nurses, NP role in ambulatory care, NP autonomy, and outpatient care. RESULTS Autonomy, NPs' roles and responsibilities, practice relationships, and organizational work environment pressures are the four main themes that emerged from the content analysis of the nine selected qualitative studies. CONCLUSION Within and between states, NPs' experiences with autonomy and NPs' roles are multifaceted depending on state regulations, practice relationships, and organizational work environments.
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Chen CH, Wang J, Yang CS, Fan JY. Nurse practitioner job content and stress effects on anxiety and depressive symptoms, and self-perceived health status. J Nurs Manag 2016; 24:695-704. [PMID: 27086775 DOI: 10.1111/jonm.12375] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2016] [Indexed: 11/29/2022]
Abstract
AIM We explored the impact of job content and stress on anxiety, depressive symptoms and self-perceived health status among nurse practitioners (NPs). BACKGROUND Taiwan's NP roles vary between hospitals as a result of the diverse demands and complex tasks that cause job-related stress, potentially affecting the health of the NP. METHODS This study utilised a cross-sectional descriptive design with 161 NPs from regional hospitals participating. Data collection involved demographics, the Taiwan Nurse Stress Checklist, the Job Content Questionnaire, the Beck Anxiety Inventory, the Beck Depression Inventory, a General Health Status Checklist and salivary cortisol tests. RESULTS NPs reported moderate job stress, similar job control to nurses, mild anxiety and depression, and below-average self-perceived health. Being a licensed NP, personal response, competence, and incompleteness of the personal arrangements subscales of job stress, and anxiety predicted self-perceived health after adjusting for other covariates. CONCLUSIONS Job stress and anxiety affect NP health. IMPLICATIONS FOR NURSING MANAGEMENT NPs are a valuable resource, and the healthcare system demand is growing. Reasonable NP staffing, working hours, proper promotion systems, the causes of job stress, job content clarification and practical work shift scheduling need to be considered. The occupational safety and physical and psychological health of NPs are strongly associated with the quality of patient care.
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Affiliation(s)
- Chin-Huang Chen
- Plastics Department, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Jane Wang
- Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan
| | - Cheng-San Yang
- Plastics Department, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Jun-Yu Fan
- Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan.,Nursing Department, Linkou Chang Gung Memorial Hospital, Taiwan
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Garza JL, Dugan AG, Faghri PD, Gorin AA, Huedo-Medina TB, Kenny AM, Cherniack MG, Cavallari JM. Demographic, health-related, and work-related factors associated with body mass index and body fat percentage among workers at six Connecticut manufacturing companies across different age groups: a cohort study. BMC OBESITY 2015; 2:43. [PMID: 26509040 PMCID: PMC4617478 DOI: 10.1186/s40608-015-0073-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 10/08/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Effective workplace interventions that consider the multifactorial nature of obesity are needed to reduce and prevent obesity among adults. Furthermore, the factors associated with obesity may differ for workers across age groups. Therefore, the objective of this study was to identify demographic, health-related, and work-related factors associated with baseline and changes in body mass index (BMI) and body fat percentage (BFP) and among Connecticut manufacturing workers acrossage groups. METHODS BMI and BFPof 758 workers from six Connecticut manufacturing companies were objectively measuredat two time points approximately 36 months apart. Demographic, health-related, and work-related factors wereassessed via questionnaire. All variables were included in linear regression models to identify factors associated with baseline and changes in BMI and BFP for workers in 3 age groups: <45 years (35 %), 45-55 years (37 %), >55 years (28 %). RESULTS There were differences in baseline and changes in BMI and BFP among manufacturing workers across age groups. Being interested in changing weight was significantly (p < 0.01) associated with higher baseline BMI and BFP across all age categories. Other factors associated with higher baseline BMI and BFP differed by age group and included: male gender (BMI p = 0.04), female gender (BFP p < 0.01), not having a college education (BMI p = 0.01, BFP p = 0.04), having childcare responsibilities (BMI p = 0.04), and working less overtime (p = 0.02) among workers in the <45 year age category, male gender (BMI p = 0.02), female gender (BFP p < 0.01) and reporting higher stress in general (BMI p = 0.04) among workers in the 45-55 year age category, and female gender (BFP p < 0.01) and job tenure (BFP p = 0.03) among workers in the >55 year age category. Few factors were associated with change in BMI or BFP across any age category. CONCLUSIONS Among manufacturing workers, we identified associations between individual, health-related, and work-related factors and baseline BMIand BFP that differed by age. Such results support the use of strategies tailored to the challenges faced by workers in specific age groups rather than adopting a one size fits all approach. Effective interventions should consider a full range of individual, health-related, and work-related factors. More work must be done to identify factors or strategies associated with changes in obesity over time.
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Affiliation(s)
- Jennifer L Garza
- Division of Occupational and Environmental Medicine, UConn Health, 263 Farmington Ave, Farmington, CT 06030 USA
| | - Alicia G Dugan
- Division of Occupational and Environmental Medicine, UConn Health, 263 Farmington Ave, Farmington, CT 06030 USA
| | - Pouran D Faghri
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT 06269 USA
| | - Amy A Gorin
- Department of Psychology, University of Connecticut, 2006 Hillside Road, Unit 1248, Storrs, CT 06269 USA
| | - Tania B Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT 06269 USA ; Department of Statistics, UConn Health, 263 Mansfield Road, Unit 1101, Storrs, CT 06269 USA ; Department of Community Medicine and Health Care, UConn Health, 263 Mansfield Road, Unit 1101, Storrs, CT 06269 USA
| | - Anne M Kenny
- Geriatric Medicine, UConn Health, 263 Farmington Ave, Farmington, CT 06030 USA
| | - Martin G Cherniack
- Division of Occupational and Environmental Medicine, UConn Health, 263 Farmington Ave, Farmington, CT 06030 USA
| | - Jennifer M Cavallari
- Department of Community Medicine, UConn Health, 263 Farmington Ave, Farmington, CT 06030 USA
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