Work environment for hospital nurses in Japan: The relationships between nurses' perceptions of their work environment and nursing outcomes

Why work in another country? Japanese nurses' experience and their reasons for staying in Australia

AIM

Many Japanese nurses have moved to Australia, yet their experiences and perceived reasons for staying in Australia are understudied. This study identified why Japanese nurses who moved internationally to Australia continued to stay and work in Australia.

METHODS

Semi-structured interviews were conducted with 15 Japanese nurses who hold Japanese nursing licenses and are registered as nurses in Australia. The transcripts were analyzed using thematic analysis.

RESULTS

Five themes emerged: (1) capability to take leave and holidays without feeling guilty, (2) set shifts creates a better work-life balance, (3) incentives give motivation to work hard, (4) safe and protective workplace for nurses, and (5) positive environment for pursuing a career.

CONCLUSIONS

Japanese nurses were satisfied with the Australian work environment where their profession is well-protected and highly respected, with more chances of career advancements. It suggests the need for a better working environment for nurses in Japan.

Retention of international nurses in receiving country: Voices of Indonesian nurses in Japanese healthcare facilities

Objectives

This study aimed to explore the voices of Indonesian migrant nurses on their retention in Japanese healthcare facilities.

Methods

A descriptive qualitative study was conducted between June and September 2023. The snowball sampling method was utilized to recruit 22 Indonesian nurses working in healthcare facilities in seven prefectures of Japan. Semi-structured interviews were conducted based on their shared experiences. All interview data were audio-recorded, transcribed verbatim, and analyzed using thematic analysis.

Results

Six prominent themes and 15 subthemes emerged: 1) organizational factors (caring leader, involvement in decision making, career development, and participation in training); 2) social support systems (group support, colleagues support and friend support); 3) individual drive (lifelong learning and persistent); 4) national policies (government support in public service and flexibility in finding a comfortable placement); 5) family factors (positive support of child education and development and maintaining relationship with spouse); and 6) economic factors (staying due to high salary and increasing income streams).

Conclusions

Retention of Indonesian migrant nurses in Japan is a multifaceted challenge that hinges on various interconnected factors. This study has gone some way toward enhancing our understanding of international nurse retention in the receiving countries. Corresponding supports at the individual, family, organizational, economic, social, and national policy levels should be considered to keep them in their destination countries.

A cross-sectional study examining the relationship between nursing practice environment and nurses' psychological empowerment

The nursing practice environment is essential for improving the quality of nursing practice and patient service. Performing secondary analysis of data from the work environment for hospital nurses in Japan (WENS-J) study, this research investigated whether an improved, healthier work environment could enhance nurses' psychological empowerment. Self-administered questionnaire responses of 2,438 participants from 23 participating general hospitals with over 200 beds in municipalities with a population of 200,000 or more were analyzed. The questionnaire recorded participating nurses' demographic characteristics and utilized two scales: the Practice Environment Scale of the Nursing Work Index (PES-NWI) and the Psychological Empowerment Instrument (PEI), which identified adequate work environments and measured the internalization of organizational goals and objectives, respectively. Most participants (93.7%) were female nurses with a mean age of 33.7 years. Multilevel analysis (hierarchical linear models) revealed that the total PEI score was significantly related to the PES-NWI composite score and all subscales after adjusting for nurses' demographic characteristics, such as age (coefficient 0.33-0.72, all p < .001). The results suggest that a work environment such as that presented in the PES-NWI may contribute to nurses' psychological empowerment. These findings could provide insight for creating healthier work environments.

Influence of nurse work environment and psychological distress on resignation from hospitals: a prospective study

With the global nurse shortage, identifying nurse work environments that allow nurses to continue working is a common concern worldwide. This study examined whether a better nurse work environment (1) is associated with reducing nurses' psychological distress; (2) reduces nurse resignations; (3) weakens the influence of psychological distress on their resignation through interaction effect; and (4) whether psychological distress increases nurse turnover. Multilevel logistic regression analyses were performed using data obtained in 2014 from 2,123 staff nurses from a prospective longitudinal survey project of Japanese hospitals. The nurse work environment was measured by the Practice Environment Scale of the Nursing Work Index (PES-NWI) consisting of five subscales and a composite, and psychological distress by K6. All the PES-NWI subscales and composite (ORs 0.679-0.834) were related to K6, significantly. Regarding nurse turnover, K6 had a consistent effect (ORs 1.834-1.937), and only subscale 2 of the PES-NWI had a direct effect (OR 0.754), but there was no effect due to the interaction term. That is, (1) and (4) were validated, (2) was partly validated, but (3) was not. As better work environment reduces K6 and a lower K6 decreases nurses' resignation, high-level hospital managers need to continue improving the nurse work environment.

The meaning of work for hospital unit nurses: a scoping review

Over the years, work has become a meaningful activity in the lives of professionals, contributing to social inclusion and personal fulfillment and influencing quality of life. This is particularly true for nurses, for whom work has significant meaning. This study aims to explore how nurses' recognition of the meaning of their work is critical to their job performance. This scoping review was conducted using the Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Health Sciences Literature, Medical Literature Analysis and Retrieval System Online, and American Psychological Association databases. The review included studies in Portuguese, English and Spanish published between 2016 and 2022. The final sample included 10 studies that reported characteristics related to the meaning of work: 56% were qualitative descriptive studies, 22% were cross-sectional, and 22% did not report their design. Most studies were conducted in Brazil (n = 6), followed by China, Japan, and Namibia. Articles were classified and analyzed according to the following categories: sample, description of values or attributes of the meaning of work, and hospital context. The study concludes that nurses perceive meaning in their work through affirmation; exchange of esteem; sharing of information; trust; autonomy; interpersonal relationships; communication; interpersonal relationships with patients; reciprocity; involvement; job satisfaction; opportunities for learning and development; recognition and moral integrity; affective commitment; and stress related to work hours.

Relationship between work engagement and healthy work environment among Chinese ICU nurses: The mediating role of psychological capital

AIM

To evaluate the relationship between healthy work environment and work engagement considering the effect of psychological capital among ICU nurses.

DESIGN

The study was cross-sectional design.

METHODS

The subjects were 671 registered nurses from 20 ICUs in 18 general hospitals in Shandong province between October 2021 and December 2021. The questionnaires testing nurses' perception of healthy work environment, their work engagement, and psychological capital were used. Structural equation modeling was used to explore their relationship.

RESULTS

Work engagement was positively affected by a healthy work environment and psychological capital. The structural equation modeling showed psychological capital mediated the relationship between healthy work environment and their work engagement.

PATIENT OR PUBLIC CONTRIBUTION

There were 681 clinical nurses reported at public contribution for responding to the questionnaires and providing valuable data for the study and there was no patient contribution in this study.

The association between burnout and multiple roles at work and in the family among female Japanese nurses: a cross-sectional study

Female nurses experience work-family conflict due to performing multiple roles, leading to burnout. Thus, this study aimed to verify the association between burnout and the multiple work and family roles performed among Japanese female nurses. The data for 2,255 nurses at 23 Japanese hospitals obtained from the Work Environment for Nurses Study in Japan were used. The variables included burnout, demographic information, additional work roles, and child-rearing or caregiving. Half of the nurses were categorized under the "no-role" group (NRG), approximately a quarter under the "work-role" group (WRG), 16% under the "family-role" group (FRG), and 7.3% under the "multiple-role" group (MRG). Compared to the NRG, the FRG and MRG showed statistically lower emotional exhaustion (B=-0.79, p<0.05; B=-0.94, p<0.05, respectively) and depersonalization (B=-0.80, p<0.05; B=-1.09, p<0.05, respectively). Personal accomplishment was not statistically different among the four groups. Burnout was relatively low among nurses with family roles, suggesting that family roles may have a positive spillover effect on work-related emotions.

How nurses' job characteristics affect their self-assessed work environment in hospitals- Slovenian use of the practice environment scale of the nursing work index

BACKGROUND

Nurses' work environment influences nursing practice. Inappropriate working conditions are the result of underdeveloped workplace infrastructure, poor work organisation, inadequate education, and inappropriate staffing norms. The aim of this study was to describe and examine the predictors that affect nurses' work environment using the Practice Environment Scale of the Nursing Work Index (PES-NWI).

METHODS

The validation of the PES-NWI was made. Nurse-reported job characteristics were used as independent variables. The sample included 1,010 nurses from adult surgical and medical units at 10 Slovenian hospitals. The Nurse Forecasting (RN4CAST) protocol was used. Permission to conduct the study was obtained from the National Medical Ethics Committee.

RESULTS

The PES-NWI mean (2.64) was low, as were job and career satisfaction at 2.96 and 2.89, respectively. The PES-NWI can be explained in 48% with 'Opportunities for advancement', 'Educational opportunities', 'Satisfaction with current job', 'Professional status', 'Study leave', and 'Level of education'. A three-factor solution of PES-NWI yielded eight distinct variables.

CONCLUSIONS

The obtained average on the Nursing Work Index was one of the lowest among previously conducted surveys. Nurses should be recognized as equals in the healthcare workforce who need to be empowered to develop the profession and have career development opportunities. Inter-professional relations and equal involvement of nurses in hospital affairs are also very important.

TRIAL REGISTRATION

This is a non-intervention study - retrospectively registered.

Working Conditions Among Chinese Nurses Employed in Japan: A Cross-Sectional Survey-Based Study

Introduction

Although the number of Chinese nurses employed in Japan is increasing, the situation regarding their work conditions has not been clarified. It is necessary to understand such conditions to consider support for Chinese nurses in Japan.

Objective

This study examined the professional nursing practice environment, occupational career, and work engagement of Chinese nurses in Japan.

Methods

Using a cross-sectional study design, 640 paper questionnaires were mailed to 58 Japanese hospitals that employed Chinese nurses and included a QR code for online responses. A survey request form and URL were sent to the Wechat app, where Chinese nurses in Japan communicate. The contents include attribute-related questions, the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Career Scale, and Utrecht Work Engagement Scale. Either Wilcoxon's rank-sum or the Kruskal-Wallis test was performed to compare scores of the study variables between subgroups.

Results

A total of 199 valid responses were obtained, of which 92.5% were female, and 69.3% had a university degree or higher. The PES-NWI score was 2.74, and the work engagement score was 3.10. The group with a university degree or higher had significantly lower scores on PES-NWI and work engagement than those with diplomas. Regarding the subscale of occupational career, scores of forming and coordinating interpersonal relationships, self-development, and accumulating a variety of experience were 3.80, 2.58, and 2.71, respectively. The scores were significantly higher with more than 6 years of nursing experience in Japan than those with 0-3 years or 3-6 years.

Conclusion

Most participants had university degrees or higher, and their scores of PES-NWI and work engagement tended to be lower than those with diploma degrees. Participants showed low self-ratings in self-development and lacked a variety of experience. Understanding Chinese nurses' work conditions in Japan enables hospital administrators to develop measures for continuing education and support.

Work environment and mental health in nurse assistants, nurses and health executives: results from the AMADEUS study

AIM

To explore work environment and mental health in nurse assistants, nurses and health executives in a national large-scale study.

BACKGROUND

We have data for physicians but not for other healthcare workers categories.

METHODS

6935 participants were recruited between 2021 May and June by professional mailings and professional networks.

RESULTS

All professional categories reported high rates of high psychological demand (>90%), low social support (>60%) burnout (50 to 60%), exposure to potentially morally injurious events (>40%) depression (approximately 30%). Surgery nurses reported the highest exposure to potentially morally injurious events. Major depression was identified in approximately 30% of participants in all categories but less than 10% reported consuming antidepressants. 31 to 49% of participants reported sleep disorders and 16 to 21% reported consuming regularly hypnotics. Physicians reported high hazardous drinking behavior and nurse assistant high smoking rates.

CONCLUSIONS AND IMPLICATIONS FOR NURSING MANAGEMENT

Our results suggest that preventing burnout and depression in healthcare workers is a priority. To reach this goal, nursing managers could develop some interventions to reduce psychological demand and increase personal accomplishment and social support between colleagues, prevent sustained bullying at the workplace and health risk behaviors. These interventions should be further developed and evaluated.

Work environment for hospital nurses in Japan: The relationships between nurses' perceptions of their work environment and nursing outcomes

AIM

To investigate nurses' perceptions of their work environment and to investigate the relationships between variables measuring the work environment (WE) and nursing outcomes (NOs ).

DESIGN

A 2-year prospective longitudinal survey (2013-2015).

METHOD(S)

Descriptive statistics of nurse demographics, organizational WE and NOs were calculated by position. The associations between Practice Environment Scale of the Nursing Work Index (PES-NWI) and NOs were examined for each unit.

RESULTS

The participants were 2,992 staff nurses, 137 nurse managers (NMs), and 8 chief nursing officers in Phase 1 and 7,849, 371 and 23 in Phase 2, respectively. The higher the job position, the better the WE was rated. The higher the PES-NWI scores, the better the outcomes. Descriptive statistics about organizational WEs and NOs and the statistically significant associations between the two were identified.