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Shao Y, Shan X, Li S, Zhang X, Chi K, Xu Y, Wei H. Mediating Role of Rumination in Second Victim Experience to Turnover Intention in Psychiatric Nurses. Nurs Res 2024; 73:E21-E30. [PMID: 38300627 DOI: 10.1097/nnr.0000000000000715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
BACKGROUND Psychiatric nurses often face patient safety incidents that can cause physical and emotional harm, even leading to s econd victim syndrome and staff shortages. Rumination-a common response after nurses suffer a patient safety event-may play a specific role between the second victim experience and turnover intention. Understanding these mechanisms is crucial for supporting psychiatric nurses and retaining psychiatric nursing resources. OBJECTIVES The study aimed to explore the associations among second victim experience, rumination, and turnover intention in psychiatric nurses and confirm how second victim experience influences turnover intention through rumination and its subtypes. METHODS A descriptive, cross-sectional study was adapted to survey 252 psychiatric nurses who experienced a patient safety incident at three hospitals in China between March and April 2023. We used the Sociodemographic and Patient Safety Incident Characteristics Questionnaire (the Chinese version of the Second Victim Experience and Support Tool), the Event-Related Rumination Inventory, and the Turnover Intention Scale. Path analysis with bootstrapping was employed to accurately analyze and estimate relationships among the study variables. RESULTS There was a positive association between second victim experience and turnover intention. In addition, both invasive and deliberate rumination showed significant associations with second victim experience and turnover intention. Notably, our results revealed that invasive and deliberate rumination played partial mediating roles in the relationship between second victim experience and turnover intention in psychiatric nurses. DISCUSSION The negative experience and turnover intention of the psychiatric nurse second victims are at a high level. Our results showed that invasive rumination positively mediated the relationship between second victim experience and turnover intention, and deliberate rumination could weaken this effect. This study expands the knowledge of the mechanisms underlying the effect of the second victim experience on turnover intention. Organizations must attach importance to the professional dilemmas of the psychiatric nurses' second victims. Nurse managers can reduce nurses' turnover intention by taking measures to reduce invasive rumination and fostering deliberate meditation to help second victims recover from negative experiences.
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Ren Z, Sun Y, Li X, He M, Shi H, Zhao H, Li Y, Pu Y, Liu H, Zhang X. How Do Presenteeism and Family Functioning Affect the Association Between Chinese Nurses' Job Stress and Intention to Stay? J Am Psychiatr Nurses Assoc 2024; 30:559-568. [PMID: 36457173 DOI: 10.1177/10783903221140329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Despite a great deal of existing research on nurses' job stress and intention to stay, it is still unclear how the association between Chinese nurses' job stress and intention to stay is affected by presenteeism and family functioning. AIMS This study aimed to investigate the correlations of Chinese nurses' job stress, presenteeism, and family functioning with their intention to stay and clarify the mediating effect of presenteeism and the moderating effect of family functioning on the association between their job stress and intention to stay. METHOD A cross-sectional study of 1,008 nurses was performed in a major general hospital in Qiqihar City, Heilongjiang Province, China. The participants were invited to engage in a questionnaire survey regarding job stress, presenteeism, family functioning, and intention to stay. A moderated mediation analysis was conducted through multiple linear regression analysis and the PROCESS macro. RESULTS Job stress and presenteeism were negatively correlated with intention to stay, whereas family functioning was positively correlated with intention to stay. The effect of job stress on intention to stay was partially mediated by presenteeism (Effect = -0.147, 95% CI = [-0.305, -0.003]). In addition, family functioning moderated the direct effect of job stress on intention to stay (Index = -0.134, 95% CI = [-0.274, -0.001]). CONCLUSIONS Presenteeism and family functioning were found to play mediating and moderating roles, respectively, in the relationship between job stress and intention to stay. Relevant interventions or family-friendly programs should be developed to enhance nurses' intention to stay.
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Affiliation(s)
- Zheng Ren
- Zheng Ren, PhD, Jilin University, Changchun, China
| | - Yan Sun
- Yan Sun, MD, RN, Jilin University, Changchun, China; The First Hospital of Qiqihar City, Qiqihar, China
| | - Xiangrong Li
- Xiangrong Li, PhD, Jilin University, Changchun, China
| | - Minfu He
- Minfu He, PhD, Jilin University, Changchun, China
| | - Hong Shi
- Hong Shi, PhD, Jilin University, Changchun, China
| | - Hanfang Zhao
- Hanfang Zhao, MD, Jilin University, Changchun, China
| | - Yuyu Li
- Yuyu Li, MD, Jilin University, Changchun, China
| | - Yajiao Pu
- Yajiao Pu, MD, Jilin University, Changchun, China
| | - Hongjian Liu
- Hongjian Liu, PhD, Jilin University, Changchun, China
| | - Xiumin Zhang
- Xiumin Zhang, PhD, Jilin University, Changchun, China
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Huang H, Wang L, Qian R, Zhang Y. A cross-sectional study on turnover intention of nurses in eastern China. BMC Health Serv Res 2024; 24:425. [PMID: 38570847 PMCID: PMC10993491 DOI: 10.1186/s12913-024-10849-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 03/11/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND This study aimed to investigate the turnover intention among nurses in eastern China and explore the association between turnover intention and personal characteristics, family factors, and work-related factors. METHODS A total of 2504 nurses participated in a cross-sectional survey administered in 26 hospitals in Eastern China from October to November 2017. In December 2021, a survey was conducted on nurses who resigned between December 2017 and November 2021. RESULTS The turnover intention score of in-service nurses was 15 (12-17), and 43% of nurses had a high turnover intention, which was mainly due to the following reasons: age < 40 years, raising two or more children, monthly income of USD786.10-1572.20 or < USD786.10, occupation was assigned or selected according to parental wishes, ≤ 1 or ≥ 2-night shifts per week, contractual or third-party personnel agents, full-time nurses with part-time jobs, and high job stress. Among 102 retired nurses, 80.4% reported family reasons for leaving, 39.2% for work reasons, and 21.6% for other personal reasons. CONCLUSION Nurses' intention to leave their occupation is high in Eastern China. Age < 40 years old, > 1 child, low income, involuntary career selection, frequent night shifts, informal employment, part-time, and high job stress are significant factors associated with nurses' willingness to leave. Government and hospital administrators should consider ways to address these factors to retain nurses in hospitals in eastern China and improve the quality of nursing services.
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Affiliation(s)
- Haolian Huang
- Department of Nursing, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Liping Wang
- Department of Geriatric Neurology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Ruilian Qian
- Department of Nursing, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.
| | - Yanhong Zhang
- Department of Nursing, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.
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Sun M, Zhou H, Li Y, Wang J, Yang W, Gong Y, Xu J, Zhang J, Yang X, Bueber M, Phillips MR, Zhou L. Professional characteristics, numbers, distribution and training of China's mental health workforce from 2000 to 2020: a scoping review. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 45:100992. [PMID: 38699293 PMCID: PMC11064725 DOI: 10.1016/j.lanwpc.2023.100992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/25/2023] [Accepted: 12/05/2023] [Indexed: 05/05/2024]
Abstract
Over the last 20 years, the numbers, types, distribution, and qualifications of mental health professionals in China have changed dramatically. However, there has been no systematic attempt to collect information about this transformation in the human resources available to provide mental health services-information that needs to be regularly updated to improve the country's coordination of these services. This scoping review compiles current details about China's mental health workforce and identifies critical gaps in available research and reporting. We reviewed all relevant studies and reports published between 1 January 2000 and 30 June 2021 in two English-language and four Chinese-language databases, the website of China's National Health Commission, and national and provincial health services yearbooks. In addition to summarising data from government yearbooks, we integrated relevant results from 82 peer-reviewed publications and two government reports. From 2000 to 2020, the number of psychiatrists in the country increased by 139%, and the number of psychiatric nurses increased by 340%. However, the much higher ratio of mental health professionals per 100,000 population and the better quality of training of mental health professionals in urban, eastern provinces compared to rural, western provinces has not changed. Progress has been made in standardising the training of psychiatrists, but there are no standardised training programs for psychiatric nurses, clinical psychologists, or psychiatric social workers. Future research needs to address several issues that limit the effectiveness of policies aimed at increasing the size, quality and equitable distribution of China's mental health workforce: 1) limited data available about the numbers and characteristics of professionals who provide mental health services, 2) absence of nationally standardised training programs for non-psychiatric medical professionals and non-medical personnel who provide essential monitoring and supportive care to persons with mental illnesses, and 3) failure to scientifically assess the outcomes of currently available training programs.
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Affiliation(s)
- Meng Sun
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hongling Zhou
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yue Li
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiali Wang
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wenjuan Yang
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yi Gong
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiahuan Xu
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiawen Zhang
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xinhu Yang
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Marlys Bueber
- Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Michael R. Phillips
- Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Departments of Psychiatry and Epidemiology, Columbia University, New York, NY, USA
| | - Liang Zhou
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
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Hamaideh S, Abu Khait A, Al-Modallal H, Masa’deh R, Hamdan-Mansour A, AlBashtawy M. Professional Quality of Life, Job Satisfaction, and Intention to Leave among Psychiatric Nurses: A Cross-Sectional Study. NURSING REPORTS 2024; 14:719-732. [PMID: 38651467 PMCID: PMC11036228 DOI: 10.3390/nursrep14020055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/25/2024] Open
Abstract
Psychiatric nurses are challenged with high levels of stress, which, in turn, lower their professional quality of life (ProQoL) and job satisfaction and increase their intention to leave jobs in psychiatric settings. An adequate level of ProQoL improves patient care provision. The purpose of this study is to assess the levels, relationships, and predictors of the professional quality of life of Jordanian psychiatric nurses and their job satisfaction and intention to leave their job. A descriptive cross-sectional design was used to collect data using the Professional Quality of Life Scale-5 from a convenience sample. Data were collected from 144 psychiatric nurses working in the largest psychiatric hospitals run by Ministry of Health, military, and university-affiliated hospitals. The results showed that the mean scores for compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) were 35.21, 27.0, and 26.36, respectively. The mean scores for intention to leave and job satisfaction were 2.33 and 3.7, respectively. The income level, educational level, intention to leave, and job satisfaction significantly differed in the CS dimension. Nurses' age, intention to leave, and job satisfaction significantly differed in BO. Nurses' age, years of experience, frequent C-shifts worked, and work affiliation were different in STS. Burnout, STS, and educational level predicted CS. CS, STS, job satisfaction, and level of education predicted BO. BO, CS, and frequently working night C-shifts predicted STS. Due to the presence of nurses reporting low levels of ProQoL, job satisfaction, and intension to leave, more studies are needed to assess the factors that affect ProQoL among psychiatric nurses and to evaluate interventional programs that improve the quality of life of psychiatric nurses. This is important in retaining nurses and increasing their job satisfaction. There is a need for interventions that enhance ProQoL. Also, longitudinal studies that measure ProQoL overtime are recommended. This study was not registered.
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Affiliation(s)
- Shaher Hamaideh
- Community and Mental Health Nursing Department, Faculty of Nursing, The Hashemite University, Zarqa 13133, Jordan; (A.A.K.); (H.A.-M.)
| | - Abdallah Abu Khait
- Community and Mental Health Nursing Department, Faculty of Nursing, The Hashemite University, Zarqa 13133, Jordan; (A.A.K.); (H.A.-M.)
| | - Hanan Al-Modallal
- Community and Mental Health Nursing Department, Faculty of Nursing, The Hashemite University, Zarqa 13133, Jordan; (A.A.K.); (H.A.-M.)
| | - Rami Masa’deh
- School of Nursing, Applied Science Private University, Amman 11937, Jordan;
| | - Ayman Hamdan-Mansour
- Community Health Department, School of Nursing, The University of Jordan, Amman 11942, Jordan;
| | - Mohammed AlBashtawy
- Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq 25113, Jordan
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Aras FM, Gümüşsoy S. Emotional burnout, job satisfaction, and intention to leave among pre-hospital emergency healthcare workers during the COVID-19 pandemic. Work 2024:WOR230589. [PMID: 38489210 DOI: 10.3233/wor-230589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND With the onset of the COVID-19 pandemic, pre-hospital emergency healthcare workers (PHEHW) assumed critical responsibilities in controlling and preventing the spread of the virus. OBJECTIVE This descriptive study aimed to explore the emotional burnout, job satisfaction, and intention to leave among PHEHW during the COVID-19 pandemic. METHODS The study was conducted with 401 emergency medical technicians and paramedics. The Sociodemographic Data Form, the Emotional Burnout Scale, the Job Satisfaction Scale, the Intention to Leave the Profession Scale were used to collect data. The findings were assessed with a significance level set at p < 0.05 and a 95% confidence interval. RESULTS The participants demonstrated moderate scores in emotional burnout, job satisfaction, and intention to leave the profession. The analysis revealed a negative correlation, indicating that as emotional burnout increased, job satisfaction decreased, and the intention to leave the profession heightened. Notably, the participants who had 6-9 years of service, lacked knowledge about COVID-19, had no COVID-19 training, underwent COVID-19 testing, and experienced the loss of a healthcare worker due to COVID-19 exhibited higher levels of burnout. Furthermore, those who had 6-9 years of service, lacked knowledge about COVID-19, had no COVID-19 training, and lost a healthcare worker due to COVID-19 reported lower levels of job satisfaction. Additionally, participants who had 6-9 years of service, lacked knowledge about COVID-19, had no COVID-19 training, and experienced the loss of a healthcare worker due to COVID-19 displayed a greater intention to leave the profession. CONCLUSIONS It is important to implement improvement initiatives that will increase the motivation and job satisfaction of PHEHW. These include the regulation of working hours and shifts, augmenting staff numbers, enhancing working conditions, improving salaries, and implementing strategies aimed at fostering motivation and job satisfaction.
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Affiliation(s)
- Fatih Mehmet Aras
- Pre-Hospital Emergency Health Services And Disaster Management Graduate Program, Health Sciences Institute, Department of Disaster Medicine, Ege University, Bornova, Türkiye
| | - Süreyya Gümüşsoy
- Atatürk Health Care Vocational School, Ege University, Bornova, Türkiye
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Zhong Y, Ma H, Zhang CC, Jiang QY, Li J, Liao CJ, Liang YF, Shu L. Professional identity, job satisfaction, and turnover intention among Chinese novice nurses: A cross-sectional study. Medicine (Baltimore) 2024; 103:e36903. [PMID: 38241583 PMCID: PMC10798701 DOI: 10.1097/md.0000000000036903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 12/18/2023] [Indexed: 01/21/2024] Open
Abstract
The world is faced with challenges due to a growing aging population and the increasing burden of chronic disease. The acute shortage of nurses and high turnover rates, particularly among novice nurses, are of great concern in many countries. Several studies have shown that turnover intention among nurses is influenced by professional identity and job satisfaction. However, to the best of our knowledge, no studies have examined this issue in the context of novice nurses. Thus, the present study aimed to explore the relationship between professional identity, job satisfaction, and turnover intention among novice nurses in China. From March 18 to April 23, 2022, a cross-sectional survey was carried out involving 532 novice nurses recruited from four public hospitals in Sichuan Province, China. Among the sample, 526 questionnaires were retrieved, with an effective response rate of 98.87%. The mean scores for turnover intention, professional identity, and job satisfaction were 13.02 ± 3.94, 36.17 ± 7.98, and 111.02 ± 21.46, respectively. High turnover intention was observed among novice nurses, of whom 54.37% (286/526) had high or very high turnover intention. Professional identity and job satisfaction among novice nurses were moderate. In terms of demographic characteristics, "Whether living with relatives" and "Monthly income" had a statistically significant impact on the turnover intention of novice nurses (P < .05). Both professional identity (r = -0.459) and job satisfaction (r = -0.517) were significantly and moderately negatively correlated with turnover intention (P < .01). The results of the multivariate linear regression analysis revealed that variables including "Whether living with relatives," "Professional identity," "Control and responsibility for work," and "Benefits" jointly accounted for 29.9% of the variance related to turnover intention among novice nurses. "Whether living with relatives," "Professional identity," "Control and responsibility for work," and "Benefits" were highly predictive of turnover intention levels among novice nurses. Hence, potential predictors of turnover intention should be considered, and intervention research should be conducted to reduce the level of turnover intention among novice nurses.
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Affiliation(s)
- Ying Zhong
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Huan Ma
- School of Nursing, Sichuan Vocational College of Health and Rehabilitation, Sichuan, China
| | - Cui-Cui Zhang
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Qin-Ying Jiang
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Jun Li
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Chang-Ju Liao
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Yu-Fen Liang
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Li Shu
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
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Gu M, Zheng L, Gu J, Wang S, Shi Y, Jiang F, Liu H, Tang YL. Would you choose to be a psychiatrist again? A large-sample nationwide survey of psychiatrists and psychiatry residents in China. Int J Ment Health Syst 2023; 17:43. [PMID: 38053204 DOI: 10.1186/s13033-023-00614-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/22/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND The mental health workforce sustainability in China suffers high rates of attrition and the intention to leave. Among current professionals, the intention to choose the same career is an interesting way to gauge their job satisfaction and other factors, and it may affect the career choices of younger generations. We aimed to survey the intention of psychiatrists and psychiatry residents to choose the same career if they could start over and to identify associated factors. METHODS We conducted an anonymous survey of psychiatrists in 41 tertiary psychiatric hospitals in China. We collected demographic data, work-related information, the sense of professional identity, job satisfaction, and burnout (Maslach Burnout Inventory), and we specifically asked each participant whether they would choose to be a psychiatrist again if they could. RESULTS Among 3,783 psychiatrists we surveyed, one-quarter responded that they would not choose to be a psychiatrist again if they had a choice, with less than half (47.2%) saying they would. Those who would not choose psychiatry again were more likely to have a negative (relative to positive) professional identity (OR = 7.47, P<0.001, 95%CI: 4.587-12.164); experience job burnout (OR = 2.945, P<0.001, 95%CI: 2.356-3.681); be dissatisfied with their job (OR = 2.739, P<0.001, 95%CI: 2.102-3.569) and excessive regulation (OR = 1.819, P<0.001, 95%CI: 1.487-2.226); have a heavy workload (OR = 1.749, P<0.001, 95%CI: 1.423-2.149) or a lower income (OR = 1.748, P<0.001, 95%CI: 1.415-2.161); be married (relative to single) (OR = 1.604, P = 0.004, 95%CI: 1.165-2.208); be dissatisfied with strained doctor-patient relationship (OR = 1.333, P = 0.005, 95%CI: 1.089-1.632); have more night shifts per month (OR = 1.055, P = 0.021, 95%CI: 1.008-1.104) or work longer hours per week (OR = 1.016, P = 0.001, 95%CI: 1.006-1.025). CONCLUSION Among psychiatrists in tertiary hospitals in China, those with a heavier workload, poor sense of professional identity, job dissatisfaction, and burnout were less likely to choose psychiatry again. Policymakers and hospital administrators need to take effective measures to improve psychiatrists' sense of professional identity and increase their intention to stay.
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Affiliation(s)
- Mengyue Gu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Liucheng Zheng
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Jingyang Gu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Song Wang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yudong Shi
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Feng Jiang
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China.
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
- Atlanta VA Medical Center, Decatur, Georgia, USA
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Zangiabadi S, Ali-Hassan H. Effect of mode of healthcare delivery on job satisfaction and intention to quit among nurses in Canada during the COVID-19 pandemic. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002675. [PMID: 38051737 PMCID: PMC10697541 DOI: 10.1371/journal.pgph.0002675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 11/08/2023] [Indexed: 12/07/2023]
Abstract
The COVID-19 pandemic resulted in a major shift in the delivery of healthcare services with the adoption of care modalities to address the diverse needs of patients. Besides, nurses, the largest profession in the healthcare sector, were imposed with challenges caused by the pandemic that influenced their intention to leave their profession. The aim of the study was to examine the influence of mode of healthcare delivery on nurses' intention to quit job due to lack of satisfaction during the pandemic in Canada. This cross-sectional study utilized data from the Health Care Workers' Experiences During the Pandemic (SHCWEP) survey, conducted by Statistics Canada, that targeted healthcare workers aged 18 and over who resided in the ten provinces of Canada during the COVID-19 pandemic. The main outcome of the study was nurses' intention to quit within two years due to lack of job satisfaction. The mode of healthcare delivery was categorized into; in-person, online, or blended. Multivariable logistic regression was performed to examine the association between mode of healthcare delivery and intention to quit job after adjusting for sociodemographic, job-, and health-related factors. Analysis for the present study was restricted to 3,430 nurses, weighted to represent 353,980 Canadian nurses. Intention to quit job, within the next two years, due to lack of satisfaction was reported by 16.4% of the nurses. Results showed that when compared to participants who provided in-person healthcare services, those who delivered online or blended healthcare services were at decreased odds of intention to quit their job due to lack of job satisfaction (OR = 0.47, 95% CI: 0.43-0.50 and OR = 0.64, 95% CI: 0.61-0.67, respectively). Findings from this study can inform interventions and policy reforms to address nurses' needs and provide organizational support to enhance their retention and improve patient care during times of crisis.
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Affiliation(s)
- Safoura Zangiabadi
- School of Kinesiology and Health Sciences, Keele campus, York University, Toronto, Canada
| | - Hossam Ali-Hassan
- Department of International Studies, Glendon campus, York University, Toronto, Canada
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10
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Afoko V, Hewison A, Newham R, Neilson S. Moral distress in nurses in developing economies: an integrative literature review. J Res Nurs 2023; 28:609-627. [PMID: 38162718 PMCID: PMC10756174 DOI: 10.1177/17449871231216606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Background Moral distress has been extensively studied in developed economies; however, not much in terms of studies has been carried out in developing economies. Objective To review the literature reporting the experience of moral distress in nurses in health care settings in developing economies. Design An integrative literataure review was used. Method Cumulative Index of Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online Cochrane and Psych INFO were searched to retrieve titles and abstracts of papers on the experience of moral distress in nurses in developing economies. Results Sixteen articles reporting the experience of moral distress in nurses in developing economies published between 1984 and March 2019 were used for the review. Analysis of the findings revealed seven themes, nurses' experience of moral distress, inadequate material and human resources, end-of-life challenges, cultural and religious beliefs as a source of moral distress, perceived inactions of medical and nursing staff, impact of moral distress on nurses in developing economies and coping strategies. Conclusion There is paucity of empirical studies on moral distress in nurses in developing economies. More qualitative studies are needed in various cultural settings to enhance its understanding in nurses working in developing economies.
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Affiliation(s)
- Vivian Afoko
- Lecturer, School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | - Alistair Hewison
- Professor, School of Nursing and Midwifery, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Roger Newham
- Associate Professor, School of Nursing and Midwifery, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Susan Neilson
- Senior Lecturer, School of Nursing and Midwifery, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
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Villagran CA, Dalmolin GDL, Barlem ELD, Greco PBT, Lanes TC, Andolhe R. Associação do Sofrimento Moral e Síndrome de Burnout em enfermeiros de hospital universitário. Rev Lat Am Enfermagem 2023. [DOI: 10.1590/1518-8345.6071.3748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Resumo Objetivo: analisar a associação entre sofrimento moral e síndrome de Burnout em enfermeiros de hospital universitário. Método: estudo descritivo-analítico, realizado com 269 enfermeiros atuantes em um hospital universitário localizado no Rio Grande do Sul, Brasil. A coleta de dados ocorreu de maneira presencial no ano de 2019 por coletadores previamente capacitados. Aplicaram-se questionário sociodemográfico e laboral, Escala Brasileira de Distresse Moral em Enfermeiros e o Inventário Maslach de Burnout. Empregou-se análise estatística descritiva e analítica. Resultados: identificou-se associação entre intensidade e frequência de sofrimento moral e suas dimensões com a síndrome de Burnout e suas dimensões. Enfermeiros em baixa realização profissional e alta exaustão emocional apresentaram prevalências mais elevadas para sofrimento moral. Conclusão: evidenciou-se a associação entre sofrimento moral e síndrome de Burnout bem como entre suas dimensões. Os resultados sinalizam a necessidade de investigar intervenções urgentes para amenizar as situações e as manifestações do sofrimento moral e a síndrome de Burnout, elaborando estratégias para a saúde dos trabalhadores.
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Villagran CA, Dalmolin GDL, Barlem ELD, Greco PBT, Lanes TC, Andolhe R. Asociación del Sufrimiento Moral y Síndrome de Burnout en enfermeros de un hospital universitario. Rev Lat Am Enfermagem 2023. [DOI: 10.1590/1518-8345.6071.3746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Resumen Objetivo: analizar la asociación entre sufrimiento moral y síndrome de Burnout en enfermeros de un hospital universitario. Método: estudio descriptivo y analítico, realizado en 269 enfermeros que actuaban en un hospital universitario localizado en el estado de Rio Grande del Sur, en Brasil. La recogida de datos se realizó de manera presencial en el año de 2019 por colectores previamente capacitados. Se aplicaron el cuestionario sociodemográfico y laboral, la Escala Brasileña de Estrés Moral en Enfermeros y el Inventario Maslach de Burnout. Se empleó el análisis estadístico descriptivo y analítico. Resultados: se identificó asociación entre intensidad y frecuencia de sufrimiento moral y sus dimensiones con el síndrome de Burnout y sus dimensiones. Los enfermeros que tuvieron baja realización profesional y alta extenuación emocional, presentaron prevalencias más elevadas para el sufrimiento moral. Conclusión: se evidenció asociación entre sufrimiento moral y síndrome de Burnout así como entre sus dimensiones. Los resultados señalan la necesidad urgente de investigar intervenciones para amenizar las situaciones y las manifestaciones del sufrimiento moral y el síndrome de Burnout, elaborando estrategias para la salud de los trabajadores.
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Zhang W, Ma X, Yu S, Zhang X, Mu Y, Li Y, Xiao Q, Ji M. Occupational stress, respect, and the need for psychological counselling in Chinese nurses: a nationwide cross-sectional study. Public Health 2023; 225:72-78. [PMID: 37922589 DOI: 10.1016/j.puhe.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/11/2023] [Accepted: 09/06/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVES This study aimed to explore occupational stress, perceived respect, and the need for psychological counselling among nurses in China. STUDY DESIGN This was a nationwide cross-sectional study. METHODS Chinese nurses from 311 cities were randomly selected through a simple random sampling method. Occupational stress, perceived respect, and psychological counselling need were assessed using an online questionnaire validated by experts. The underlying associated factors were analysed using multiple logistic regression analyses. RESULTS We collected and analysed 51,406 valid online questionnaires. Family factors and low income were the most commonly cited sources of occupational stress, and 91.9% and 80.0% of nurses, respectively, perceived that individuals in society and patients did not give adequate respect. Furthermore, 75.5% and 79.7%, respectively, believed they were not respected by clinical managers and doctors. As a result, 64.7% nurses believed they had a moderate or high need for psychological counselling. However, 80.7% indicated that receiving adequate respect could decrease the need for stress-related psychological counselling. Indeed, multiple logistic regression analyses showed that lower respect perceived by nurses was associated with higher need for psychological counselling, particularly regarding criticism that nurses perceived from nursing managers (a little: odds ratio [OR], 1.597; 95% confidence interval [CI], 1.176-2.170; P = 0.003; moderately: OR, 1.433; 95% CI, 1.180-1.741; P < 0.001) and the difficulty of receiving respect from patients and their families (a little: OR, 1.389; 95% CI, 1.044-1.850; P = 0.024). CONCLUSIONS Nurses in China perceive high levels of occupational stress and low levels of respect and often seek psychological counselling.
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Affiliation(s)
- W Zhang
- Capital Medical University, Beijing, China
| | - X Ma
- Medical School of Chinese PLA, Beijing, China
| | - S Yu
- Medical Security Center, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
| | - X Zhang
- Department of Nursing Network, Beijing, China
| | - Y Mu
- Beijing College of Social Administration, Beijing, China
| | - Y Li
- Capital Medical University, Beijing, China
| | - Q Xiao
- Capital Medical University, Beijing, China.
| | - M Ji
- Capital Medical University, Beijing, China.
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Zhang L, Li Z, Li M, Yang Y, Hsu M, Xia L, Liu T, Liu Y, Jiang F, Liu H, Tang YL. Mental health symptoms and their associated factors among pharmacists in psychiatric hospitals during the early stage of the COVID-19 pandemic. Glob Ment Health (Camb) 2023; 10:e77. [PMID: 38161747 PMCID: PMC10755378 DOI: 10.1017/gmh.2023.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 10/28/2023] [Accepted: 11/01/2023] [Indexed: 01/03/2024] Open
Abstract
As frontline workers, pharmacists often face significant work stress, especially in psychiatric settings. A multicenter cross-sectional design was conducted in 41 psychiatric hospitals. The Depression, Anxiety and Stress Scale-21 (DASS-21) was used to measure the mental health of 636 pharmacists. We also collected demographic data and work-related variables. The prevalence of depression, anxiety and stress was 20.60%, 22.96% and 8.96%, respectively. Multivariate logistic regression showed that several common factors were associated with depression, anxiety and stress, including professional identity (odds ratio [OR] = 0.132, 0.381 and 0.352) and verbal violence (OR = 2.068, 2.615 and 2.490). Those who were satisfied with their job were less likely to develop depression (OR = 0.234) or anxiety (OR = 0.328). We found specific factors associated with mental health. Older age (OR = 1.038) and perceived negative impact (OR = 2.398) of COVID-19 on medical work were associated with anxiety, and those with frontline experience with COVID-19 patients (OR = 2.306) were more likely to experience stress. More than one-fifth of pharmacists in psychiatric hospitals experienced symptoms of depression or anxiety during the pandemic, highlighting the need for policy change to improve workplace conditions and psychological well-being for this professional group.
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Affiliation(s)
- Ling Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Zhenkuo Li
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China
- Department of Psychiatry, The Fifth People’s Hospital of Xiangtan City, Xiangtan, China
| | - Mengdie Li
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yating Yang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Michael Hsu
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, USA
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Tingfang Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Feng Jiang
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yi-lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, USA
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Zhang F, Lin C, Li X, Li M, Jia R, Guo X, Bai H. The relationships between burnout, general wellbeing, and psychological detachment with turnover intention in Chinese nurses: a cross-sectional study. Front Public Health 2023; 11:1216810. [PMID: 37546331 PMCID: PMC10399590 DOI: 10.3389/fpubh.2023.1216810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/30/2023] [Indexed: 08/08/2023] Open
Abstract
Background It is critical to minimize nurse turnover to improve the quality of care and patient safety. In-depth investigation is required to better understand the factors related to nurses' turnover intentions. Aim This study aimed to determine the relationships between burnout, general wellbeing, and psychological detachment with turnover intention among nurses in China. Methods A cross-sectional survey using convenience sampling was conducted in one hospital in China between January 2023 and March 2023. A total of 536 nurses were surveyed using the General Wellbeing Schedule (GWB), the Maslach Burnout Inventory scale (MBI), the Psychological Detachment scale, and the Turnover Intention scale. The collected data were analyzed using SPSS 26.0 statistical software. The chi-square test and binary logistic regression analysis were used to explore the factors related to turnover intention. Results Our data demonstrated that the turnover intention scores were 13 (10, 15.75), with 56% of nurses exhibiting a high level of turnover intention. Binary logistic regression analysis results indicated that being on a contract (OR = 4.385, 95% CI = 2.196-8.754), working in the pediatrics (OR = 2.392, 95% CI = 1.267-4.514) or obstetrics (OR = 2.423, 95% CI = 1.145-5.126) department, and experiencing burnout (OR = 1.024, 95% CI = 1.008-1.041) were associated with a heightened level of turnover intention. Conversely, organizational satisfaction (OR = 0.162, 95% CI = 0.033-0.787) and general wellbeing (OR = 0.967, 95% CI = 0.946-0.989) were identified as factors that hindered the intention to leave. Conclusions Findings from this study suggest that nurses were employed on a contract basis, working in pediatric or obstetric departments, expressing dissatisfaction with the organization, reporting low general wellbeing, and experiencing high levels of burnout that require special attention. The identification of these risk factors can inform targeted interventions and support programs aimed at improving the wellbeing and retention of nurses in these settings.
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Affiliation(s)
- Fengzhi Zhang
- Department of Nursing, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chunhui Lin
- Department of Nursing, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoxue Li
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Manman Li
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruolin Jia
- Department of Reproduction, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoli Guo
- Department of Administration Office, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hua Bai
- Department of Infection Control, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Gümüşsoy S, Kıratlı D. Burnout status, occupational satisfaction, and intention to leave the profession of nurses during the COVID-19 pandemic period; The Case of Turkey. Health Care Women Int 2023; 44:950-967. [PMID: 36256479 DOI: 10.1080/07399332.2022.2134392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 09/23/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022]
Abstract
We examined the burnout status, professional satisfaction and intention to leave the profession of nurses who are actively working in Turkey during the COVID-19 pandemic period. We conducted the descriptive study with 371 nurses and collected using Copenhagen Burnout Scale (CBS), Occupational satisfaction scale (OSS) and Intention to leave the profession scale (ILPS). In this study, nurses showed a high level of exhaustion and intention to leave work, and a low level of occupational satisfaction. In the fight against COVID-19, the continuity of health services, at the same time, in order to provide adequate quality and safe health care, reducing working hours, bringing the shifts to an appropriate and reasonable time, improving the working environment and approaches that will increase their motivation and professional satisfaction are important to prevent nurses from experiencing burnout and to keep them in their professions and workplaces.
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Affiliation(s)
- Süreyya Gümüşsoy
- Atatürk Health Care Vocational School, Ege University, Izmir, Turkey
| | - Didem Kıratlı
- University of Health Sciences, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Izmir, Turkey
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Sihvola S, Nurmeksela A, Mikkonen S, Peltokoski J, Kvist T. Resilience, job satisfaction, intentions to leave nursing and quality of care among nurses during the COVID-19 pandemic - a questionnaire study. BMC Health Serv Res 2023; 23:632. [PMID: 37316918 DOI: 10.1186/s12913-023-09648-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 06/05/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has challenged nurses and healthcare systems globally and raised major concerns for nurses' wellbeing and working conditions. This cross-sectional and correlational study design aims to describe nurses' resilience, job satisfaction, intentions to leave and quality of care, and explain their relationships during the COVID-19 pandemic. METHODS Data were collected from Registered Nurses (N = 437) in Finland through an electronic survey between February 2021 and June 2021. The questionnaire covered background characteristics (seven questions), resilience (four questions), job satisfaction (one question), intention to leave nursing (two questions), quality of care (one question), and requiring factors of the work (eight questions). The background variables and dependent variables were analyzed and presented using descriptive statistics. Structural equation modeling was used to explain dependent variables relationships. The study followed procedures recommended in the STROBE Statement for cross-sectional studies in efforts to maximize the quality of reporting results. RESULTS The surveyed nurses evaluated their resilience by mean score 3.92, more nurses had considered leaving nursing during the pandemic (16%) than before (2%). Nurses´ mean score of requiring factors of the work was 2.56 and overall job satisfaction 5.8. Structural equation modeling revealed that resilience affected their job satisfaction, which also influenced the quality of care, that was rated moderate (7.46 out of 10). Structural equation modeling indices of goodness of fit were NFI = 0.988, RFI = 0.954, IFI = 0.992, TLI = 0.97, CFI = 0.992, and RMSEA = 0.064. No direct relationship was found between resilience and intention to leave nursing. CONCLUSIONS Good resilience promoted delivery of high-quality care by nurses during the pandemic and enhanced their job satisfaction, which reduced their intention to leave nursing. The results indicate that it is important to develop interventions that support nurses' resilience. IMPACT The study highlights the importance of nurses' resilience during the pandemic, while job satisfaction may decrease and requiring factors of the work increase. Given the number of nurses who consider leaving nursing, there are clear needs to develop effective strategies to maintain quality healthcare with resilient, committed nursing staff.
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Affiliation(s)
- Saija Sihvola
- Faculty of Health Sciences, Department of Nursing Science, University of Eastern Finland, Kuopio Campus, Yliopistonranta 1 C, Canthia, P.O. Box 1627, Kuopio, FI-70211, Finland.
| | - Anu Nurmeksela
- Faculty of Health Sciences, Department of Nursing Science, University of Eastern Finland, Kuopio Campus, Yliopistonranta 1 C, Canthia, P.O. Box 1627, Kuopio, FI-70211, Finland
| | - Santtu Mikkonen
- Faculty of Science and Forestry, Department of Applied Physics, University of Eastern Finland, Kuopio Campus, Yliopistonranta 1 C, Canthia, P.O. Box 1627, Kuopio, FI-70211, Finland
| | - Jaana Peltokoski
- Information Management, Wellbeing Services County of Central Finland, Viitaniementie 1, Jyväskylä, 40720, Finland
| | - Tarja Kvist
- Faculty of Health Sciences, Department of Nursing Science, University of Eastern Finland, Kuopio Campus, Yliopistonranta 1 C, Canthia, P.O. Box 1627, Kuopio, FI-70211, Finland
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Jiang N, Zhou X, Gong Y, Tian M, Wu Y, Zhang J, Chen Z, Wang J, Wu J, Yin X, Lv C. Factors related to turnover intention among emergency department nurses in China: A nationwide cross-sectional study. Nurs Crit Care 2023; 28:236-244. [PMID: 35384173 DOI: 10.1111/nicc.12770] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Turnover intention among nurses is high, especially in the emergency department. However, factors that are associated with Chinese emergency department nurses' turnover intention have been scarcely studied. AIMS The present study examined relationships between turnover intention and demographic characteristics, job-related factors, depressive symptoms, and organizational commitment among emergency department nurses. STUDY DESIGN A cross-sectional study of emergency department nurses was conducted in China between July and August 2018. The questionnaire included demographic characteristics (age, gender, level of education, and self-rated health status), job-related factors (qualification title, job seniority, night shifts, and workplace violence), depressive symptoms, organizational commitment, and turnover intention. A hierarchical linear regression model was used to identify factors that are associated with turnover intention among emergency department nurses. RESULTS A total of 17 582 emergency department nurses participated in the study. The response rate was 68.9%. The findings indicated that poor self-rated health status (β = 0.25, p < .001), working more than 11 night shifts per month (β = 0.14, p < .01), experiencing workplace violence in the past year (β = 0.08, p < .05), and higher depressive symptom scores (β = 0.07, p < .001) positively correlated with turnover intention. More years of service (β = -0.38, p < .001) and higher organizational commitment scores (β = -0.45, p < .001) negatively correlated with turnover intention. CONCLUSIONS Health status, job seniority, night shift frequency per month, workplace violence, depressive symptoms, and organizational commitment were significantly associated with emergency department nurses' turnover intention. RELEVANCE TO CLINICAL PRACTICE To reduce turnover intention in the emergency department nurses, hospital administrators and managers should implement measures to improve their physical and mental health, increase organizational commitment, develop staff acceptable shift schedules, and reduce incidences of workplace violence.
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Affiliation(s)
- Nan Jiang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuan Zhou
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengge Tian
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yafei Wu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiali Zhang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhenyuan Chen
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianxiong Wu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chuanzhu Lv
- Department of Emergency Medicine Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.,Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No.2019RU013), Hainan Medical University, Haikou, China.,Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, China
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Chang T, Jiang X, Wei J, Zhao J, Li Z, Li H. Mediating effects of psychological capital on the relationship between workplace violence and professional identity among nurses working in Chinese public psychiatric hospitals: a cross-sectional study. BMJ Open 2023; 13:e065037. [PMID: 36599638 PMCID: PMC9815003 DOI: 10.1136/bmjopen-2022-065037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To examine the relationship between workplace violence (WPV) and professional identity among Chinese psychiatric nurses and the mediating effects of psychological capital (PsyCap) from this association. SETTING Seven public tertiary psychiatric hospitals in Liaoning Province, China. PARTICIPANTS A total of 952 psychiatric nurses were recruited for this study. Registered nurses who have been engaged in psychiatric nursing for more than 1 year were eligible as participants in this investigation. OUTCOME MEASURES Questionnaires consisting of the Workplace Violence Scale, the Occupational Identity Scale, the Psychological Capital Questionnaire and a demographic data sheet were used to collect participant information. We used hierarchical multiple regression and asymptotic and resampling strategies to examine the mediating role of PsyCap in the relationship between WPV and professional identity. RESULTS WPV was negatively associated with professional identity after controlling for demographic factors (β=-0.353; p<0.001). PsyCap mediated the relationship between WPV and professional identity, according to the mediation analysis (a×b=-0.150, bias-corrected and accelerated 95% CI (BCa 95% CI) (-0.185 to -0.115); p<0.001). In addition, two dimensions of PsyCap: hope (a×b=-0.075, BCa 95% CI (-0.104 to -0.049); p<0.001) and resilience (a×b=-0.064, BCa 95% CI (-0.090 to -0.039); p<0.001) mediated the association between WPV and professional identity. For professional identity, hope, resilience and PsyCap mediation accounted for 21.6%, 18.1% and 42.4%, respectively. CONCLUSIONS Based on these findings, PsyCap could partially mediate the relationship between WPV and professional identity. Therefore, hospital administrators should implement measures to prevent and reduce WPV and provide nurses with skills training programmes to improve the PsyCap such as hope and resilience.
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Affiliation(s)
- Tiantian Chang
- China Medical University School of Nursing, Shenyang, Liaoning Province, China
| | - Xiaoyu Jiang
- China Medical University School of Nursing, Shenyang, Liaoning Province, China
| | - Junlin Wei
- Qingdao Hiser Hospital, Rehabilitation Department, Qingdao Hospital of Traditional Chinese Medicine, Qingdao, Shandong Province, China
| | - Jinghua Zhao
- Department of Nursing Research, Shenyang Anning Hospital, Shenyang, Liaoning Province, China
| | - Zhiqiang Li
- China Medical University School of Public Health, Shenyang, Liaoning Province, China
| | - Hongli Li
- China Medical University School of Nursing, Shenyang, Liaoning Province, China
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Villagran CA, Dalmolin GDL, Barlem ELD, Greco PBT, Lanes TC, Andolhe R. Association between Moral Distress and Burnout Syndrome in university-hospital nurses. Rev Lat Am Enfermagem 2023; 31:e3747. [PMID: 36722633 PMCID: PMC9886076 DOI: 10.1590/1518-8345.6071.3747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/14/2022] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE to analyze the association between moral distress and Burnout Syndrome among nurses in a university hospital. METHOD descriptive, analytical study conducted with 269 nurses working in a university hospital located in Rio Grande do Sul, Brazil. Data were collected in person in 2019 by previously trained collectors. A sociodemographic and employment questionnaire, the Brazilian Scale of Moral Distress in Nurses and the Maslach Burnout Inventory were applied. Descriptive and analytical statistical analysis was used. RESULTS an association was identified between moral distress intensity and frequency and its dimensions with Burnout Syndrome and its dimensions. Nurses with low professional achievement and high emotional exhaustion showed a higher prevalence of moral distress. CONCLUSION an association between moral distress and Burnout Syndrome, as well as between their dimensions, was evidenced. The results suggest the need to investigate urgent interventions to mitigate the situations and manifestations of moral distress and Burnout Syndrome by developing strategies for workers' health.
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Affiliation(s)
| | - Graziele de Lima Dalmolin
- Universidade Federal de Santa Maria, Departamento de Enfermagem, Santa Maria, RS, Brazil. , Graziele de Lima Dalmolin E-mail:
| | | | | | - Taís Carpes Lanes
- Universidade Federal de Santa Maria, Departamento de Enfermagem, Santa Maria, RS, Brazil.
| | - Rafaela Andolhe
- Universidade Federal de Santa Maria, Departamento de Enfermagem, Santa Maria, RS, Brazil.
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Peng P, Yang WF, Liu Y, Chen S, Wang Y, Yang Q, Wang X, Li M, Wang Y, Hao Y, He L, Wang Q, Zhang J, Ma Y, He H, Zhou Y, Long J, Qi C, Tang YY, Liao Y, Tang J, Wu Q, Liu T. High prevalence and risk factors of dropout intention among Chinese medical postgraduates. MEDICAL EDUCATION ONLINE 2022; 27:2058866. [PMID: 35356865 PMCID: PMC8979499 DOI: 10.1080/10872981.2022.2058866] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND A high attrition rate in medical students has exacerbated the physician shortage in China. However, few studies have explored the risk factors of dropout intention in medical postgraduates. This study compared the prevalence of dropout intention and mental distress between medical and non-medical postgraduates in China and investigated risk factors for dropout intention. This study also explored the impact of medical postgraduates' perception of the Chinese healthcare environment on their mental status and dropout intention. METHODS This cross-sectional study was conducted using online questionnaires from October 2020 to April 2021. Convenience sampling was used to recruit postgraduates in different majors. Outcomes included dropout intention and potential risk factors, including mental distress, quality of life, and fatigue. Medical postgraduates were additionally assessed for healthcare environment satisfaction, burnout, career choice regret, and experiences of workplace violence. A logistic regression model was constructed to evaluate the association between dissatisfaction, mental distress, and turnover intention. RESULTS A total of 740 medical and 670 non-medical postgraduates participated in the survey. The rates of depression symptoms (33.8% vs. 39.0%, p < 0.001), anxiety symptoms (22.2% vs. 32.4%, p < 0.001), and somatic symptoms (34.7% vs. 42.4%, p = 0.004) were lower in medical postgraduates, while more medical postgraduates (58.4% vs. 48.4%, p < 0.001) reported dropout intention. Dissatisfaction with the healthcare environment (odds ratio [OR]: 1.65; 95% confidence interval [CI]: 1.17-2.34, p = 0.005), career choice regret (OR: 6.23; 95% CI: 4.42-8.78, p < 0.001), and high perceived stress (OR: 2.74; 95%CI: 1.90-3.94, p < 0.001) remained independently associated with turnover intention. CONCLUSIONS Mental distress is common among postgraduates, calling for timely interventions. Medical postgraduates reported higher turnover intention. Healthcare environment perception also affected the mental health and dropout intentions of medical students. A decent future income, reduced workload, shorter duration medical training, and better doctor-patient relationships are urgently needed.
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Affiliation(s)
- Pu Peng
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Winson Fuzun Yang
- Department of Psychological Sciences, Texas Tech University, Lubbock, Tx, USA
| | - Yueheng Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Shubao Chen
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Yunfei Wang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Qian Yang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Xin Wang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Manyun Li
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Yingying Wang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Yuzhu Hao
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Li He
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Qianjin Wang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Junhong Zhang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Yuejiao Ma
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Haoyu He
- Department of Psycholoy, College of Education, Hunan First Normol University, Changsha, China
| | - Yanan Zhou
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
- Department of Psychiatry, Hunan Brain Hospital (Hunan Second People’s Hospital, Changsha, China
| | - Jiang Long
- Institute of Mental Health Management (SJTU/CHDI), Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chang Qi
- Department of Psychiatry, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College Hangzhou, . Zhejiang, P.RChina
| | - Yi-Yuan Tang
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang UniversityHangzhou, Zhejiang, P. RChina
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang UniversityHangzhou, Zhejiang, P. RChina
| | - Qiuxia Wu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
- CONTACT Qiuxia Wu, Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011China
| | - Tieqiao Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
- Tieqiao Liu, Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011China
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22
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Boateng AB, Opoku DA, Ayisi-Boateng NK, Sulemana A, Mohammed A, Osarfo J, Hogarh JN. Factors Influencing Turnover Intention among Nurses and Midwives in Ghana. Nurs Res Pract 2022; 2022:4299702. [PMID: 36439941 PMCID: PMC9683982 DOI: 10.1155/2022/4299702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/29/2022] [Accepted: 11/08/2022] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Nurse turnover intention, defined as a measure of nurses' desire to leave their positions, is a global public health issue with a grave impact on the healthcare workforce. However, literature on it is limited in sub-Saharan Africa, an at-risk region. This study aimed to determine the predictors of turnover intention among nursing staff at a tertiary hospital in Kumasi, Ghana. METHODS This was an institution-basedcross-sectional study conducted among 226 randomly selected nurses and midwives working at a tertiary healthcare center in Kumasi, Ghana. Data were collected by using a structured questionnaire. Significant predictors of turnover intention were analyzed by using multivariate logistic regression analysis. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) and p value <0.05 was used. RESULTS The prevalence of turnover intention among study participants was 87.2% (197/226). About two-thirds (61.5%, 139/226) of the participants were exposed to a high level of workplace hazards. Management support (AOR = 3.09, 95% CI = 1.09-8.75), salary (AOR = 0.07, 95% CI = 0.01-0.46), inadequate number of staff on duty per shift (AOR = 3.36, 95% CI = 1.08-10.47) and participants' rank (AOR = 6.81, 95% CI = 1.18-39.16) were significantly associated with turnover intention. CONCLUSION Overall, the turnover intention was high. Hence, there is a need for policymakers, health administrators, and nurse managers to implement strategies such as increasing staff strength, providing adequate support, incentives, and other forms of motivation for nurses and midwives to help reduce the rate of turnover intention.
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Affiliation(s)
- Angelina Boatemaa Boateng
- Department of Occupational and Environmental Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Douglas Aninng Opoku
- Department of Occupational and Environmental Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Allen Clinic, Family Healthcare Services, Kumasi, Ghana
| | - Nana Kwame Ayisi-Boateng
- Department of Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alhassan Sulemana
- Department of Environmental Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Aliyu Mohammed
- Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joseph Osarfo
- Department of Community Medicine, School of Medicine, University of Health and Allied Health Science, Ho, Ghana
| | - Jonathan N. Hogarh
- Department of Environmental Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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23
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Wang T, Chen Y, He Y, Shen L, Wang P, Zhu M, Zhu J, Li M. Stressors, coping strategies and intention to leave the nursing profession: A cross-sectional nationwide study in China. J Nurs Manag 2022; 30:4398-4408. [PMID: 36208138 DOI: 10.1111/jonm.13865] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 08/04/2022] [Accepted: 10/02/2022] [Indexed: 12/30/2022]
Abstract
AIMS This study aims to investigate the association between stressors, coping strategies and intention to leave the nursing profession among nurses. BACKGROUND Job stressors and coping strategies are believed to affect turnover intention among nurses, but no large-scale study has been conducted on these associations in China yet. METHOD A cross-sectional secondary analysis was conducted among 51,406 nurses from 1858 hospitals. Univariable and multivariable logistic regression analyses were carried out, and odds ratios were reported. RESULTS Overall, 49.58% nurses had an intention to leave the profession. It is found that stress from health condition, family, occupational injuries, nurse-patient tension, high job demands, strict leaders and colleague relationships were significantly associated with higher intention to leave. Coping strategies such as talking to family and friends, talking to leaders, doing outdoor activities, engaging in hobbies and attending on-the-job training were significantly associated with lower intention, but social gathering, psychological counselling and suffering in silence had an opposite effect. CONCLUSIONS Our study provides new insights into the association between stressors, coping strategies and turnover intention among nurses in China. IMPLICATIONS FOR NURSING MANAGEMENT Evidence from this study indicates that policies promoting a safe and supportive work environment should be developed to help nurses cope with stress.
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Affiliation(s)
- Tingting Wang
- School of Nursing, Peking University, Beijing, China.,China-Japan Friendship Hospital, Beijing, China
| | - Yanhua Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China.,School of Medicine, Tsinghua University, Beijing, China
| | - Yanrong He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Lijun Shen
- Vanke School of Public Health, Tsinghua University, Beijing, China.,School of Medicine, Tsinghua University, Beijing, China
| | - Peicheng Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China.,School of Medicine, Tsinghua University, Beijing, China
| | - Mingzhen Zhu
- School of Nursing, Peking University, Beijing, China.,China-Japan Friendship Hospital, Beijing, China
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, China.,Institute for Healthy China, Tsinghua University, Beijing, China
| | - Mingzi Li
- School of Nursing, Peking University, Beijing, China
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24
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Wang XX, Wang LP, Wang QQ, Fang YY, Lv WJ, Huang HL, Yang TT, Qian RL, Zhang YH. Related factors influencing Chinese psychiatric nurses' turnover: A cross-sectional study. J Psychiatr Ment Health Nurs 2022; 29:698-708. [PMID: 35716343 DOI: 10.1111/jpm.12852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 05/05/2022] [Accepted: 06/10/2022] [Indexed: 12/01/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT Because of increasingly stressful, dangerous and unpredictable psychiatric nursing work, psychiatric nurses have experienced higher job stress than general ward nurses. Little is known about the factors that affect the turnover intention of Chinese psychiatric nurses. Understanding the influencing factors of nurses' turnover intention will help to formulate targeted measures to stabilize psychiatric nursing teams. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE The results showed that 70.2% of psychiatric nurses had higher turnover intention. The strong turnover intention of Chinese psychiatric nurses is a problem that needs to be considered by managers. The results showed that having more children, between 31 and 39 years old, and having a part-time job were strongly associated with turnover intention. In addition, "job stress" was also an important factor, psychiatric nurses' turnover intention decreased as their job stress level decreased. WHAT ARE THE IMPLICATIONS FOR PRACTICE Nursing managers should pay attention to nurses who have more children, between 31 and 39 years old, and take on part-time jobs. Additionally, nursing managers should reduce job stress and implement targeted programmes to prevent psychiatric nurses' turnover. Experience-sharing meetings and mindfulness-based stress reduction training are also useful to improve the mental health status of psychiatric nurses with great job stress. Nursing managers should arrange human resources and shifts appropriately to give nurses with more children more time with their families. Provide more development opportunities for psychiatric nurses between 31 and 39 years old. Managers explore the reasons why nurses take on part-time jobs and take targeted interventions (such as increasing income) to reduce the behaviour that happens. ABSTRACT Introduction Nurses' turnover is the main cause of nursing shortages, greatly affected by nurses' intention to leave. Nurses' turnover rate is particularly high in psychiatric wards. Several factors influencing the turnover intention of psychiatric nurses have not been well identified in China, and the association between job stress and turnover intention is still limited. Aims To examine the relationship between job stress and turnover intention and identify the influencing factors of psychiatric nurses' turnover intention. Methods Data were collected from 2355 psychiatric Chinese nurses using a cross-sectional design with an online questionnaire investigation. Results Psychiatric nurses had higher turnover intention. Significant factors influencing their turnover intention were job stress, having more children, age between 31 and 39 years old, part-time jobs, education, income and patient-to-nurse ratio. Discussion Demographics and job-related factors should be considered when developing strategies to reduce the turnover intention of psychiatric nurses. Implications for practice Nursing managers should pay attention to nurses with higher job stress levels and different demographic characteristics. Effective measures should be taken to reduce psychiatric nurses' job stress and turnover intention, such as arranging reasonable shifts, implementing targeted family-friendly policies, increasing their occupational possibilities and promoting mental health.
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Affiliation(s)
- Xiao-Xiao Wang
- Department of Nursing, Nanjing Brain Hospital, Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China
| | - Li-Ping Wang
- Geriatrics Department, Nanjing Brain Hospital, Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qing-Qing Wang
- Department of Nursing, Nanjing Brain Hospital, Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuan-Yuan Fang
- Nanjing Brain Hospital, Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wen-Jun Lv
- Department of Nursing, Nanjing Brain Hospital, Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hao-Lian Huang
- Department of Nursing, Nanjing Brain Hospital, Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China
| | - Tian-Ting Yang
- Department of Nursing, Nanjing Brain Hospital, Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China
| | - Rui-Lian Qian
- Department of Nursing, Nanjing Brain Hospital, Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yan-Hong Zhang
- Department of Nursing, Nanjing Brain Hospital, Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China
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25
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Pang Y, Dan H, Jeong H, Kim O. Impact of workplace violence on South Korean nurses' turnover intention: Mediating and moderating roles of depressive symptoms. Int Nurs Rev 2022; 70:211-218. [PMID: 35947607 DOI: 10.1111/inr.12798] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 07/17/2022] [Indexed: 12/01/2022]
Abstract
AIM To identify the mediating and moderating roles of depressive symptoms in the relationship between workplace violence and nurses' turnover intention in South Korea. BACKGROUND Workplace violence and depressive symptoms are known to influence turnover intentionsof employees. INTRODUCTION Among healthcare workers, nurses may be at the greatest risk of exposure to workplace violence because they have frequent contact with patients and families of patients. Depressive symptoms reported to be related to workplace violence are one set of factors affecting turnover intention. METHODS A cross-sectional study was designed and employed to investigate mediation and moderation roles of depressive symptoms between workplace violence and turnover intention. RESULTS Verbal violence and sexual harassment increased depressive symptoms, which in turn increased turnover intentions in a sample of Korean nurses. Depressive symptoms showed partial mediation effects between verbal violence and sexual harassment and turnover intention. Depressive symptoms showed moderating effects on sexual harassment and turnover intention. DISCUSSION It is necessary to reduce turnover intention not only by preventing violence but also by managing depressive symptoms in nurses who have experienced verbal violence and sexual harassment. CONCLUSION Depressive symptoms were shown to have a mediating and moderation roles on the relationship between WPV and turnover intention. IMPLICATIONS FOR NURSING AND HEALTH POLICY Hospital managers such as hospital and nursing directors should provide effective policies to prevent verbal violence and sexual harassment to reduce turnover intention in the workplace. It is needed to educate patients and patient caregivers about the importance of preventing violence against nurses. Policies should be established to provide regular check-ups for depressive symptoms and psychological support for nurses who have experienced WPV.
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Affiliation(s)
- Yanghee Pang
- Department of Nursing, Baekseok Culture University, Cheonan, Republic of Korea
| | - Hyunju Dan
- Department of Nursing, Gangdong University, Eumseong, Republic of Korea
| | - Hyunseon Jeong
- Seoul Women's College of Nursing, Seoul, Republic of Korea
| | - Oksoo Kim
- College of Nursing, Ewha Research Institute of Nursing Science, Ewha Womans University, Seodaemun-gu, Seoul, Republic of Korea
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26
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Ki J, Choi-Kwon S. Health problems, turnover intention, and actual turnover among shift work female nurses: Analyzing data from a prospective longitudinal study. PLoS One 2022; 17:e0270958. [PMID: 35802575 PMCID: PMC9269367 DOI: 10.1371/journal.pone.0270958] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 06/22/2022] [Indexed: 11/18/2022] Open
Abstract
Aims
This study investigated health problems, turnover intention, and actual turnover among shift work nurses. While turnover intention is often used as a proxy variable for turnover, the relationship between these variables requires clarification. This study tested for relevant associations using prospective longitudinal data with a time lag of 12 months. We also tested for associations between health problems (sleep disturbance, fatigue, and depression) and turnover intentions/turnover, with a focus on the mediating role of turnover intention.
Methods
This study conducted a secondary analysis of data from the Shift Work Nurses’ Health and Turnover project, which is a prospective longitudinal cohort study. We analyzed health problems, turnover intention, and actual turnover. The data were analyzed via descriptive statistics, the Pearson’s chi-squared test, independent t-test, univariable logistic regression, multiple logistic regression, and causal mediation.
Results
Participants included 491 shift work female nurses. Of these, 112 (22.8%) had turnover intention, while 38 (7.7%) left their jobs within the 12-month period of investigation. Of the 112 with turnover intention, 22 left their jobs (OR 5.68. 95% CI 2.84–11.36). The logistic regression analysis showed that sleep disturbance and fatigue were associated with turnover intentions and actual turnover, while depression was only associated with turnover intention. The causal mediation analysis showed that turnover intention mediated the relationship between health problems (sleep disturbance and fatigue) and actual turnover (sleep disturbance OR 1.31, 95%CI = 1.02–1.60; fatigue OR 2.11, 95%CI = 1.50–2.68); sleep disturbance had a natural direct effect on actual turnover (OR 2.66, 95%CI,2.07–3.21).
Conclusion
Turnover intention strongly predicted actual turnover. Sleep disturbances may result in turnover, even in cases without existing turnover intention. These findings highlight the need for early interventions aimed at preventing and alleviating sleep disturbances for shift work female nurses.
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Affiliation(s)
- Jison Ki
- The Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
| | - Smi Choi-Kwon
- College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
- * E-mail:
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27
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Yang Y, Zhang L, Li M, Wu X, Xia L, Liu DY, Liu T, Liu Y, Jiang F, Tang YL, Liu H, Kalow NJ. Turnover Intention and Its Associated Factors Among Psychiatrists in 41 Tertiary Hospitals in China During the COVID-19 Pandemic. Front Psychol 2022; 13:899358. [PMID: 35756286 PMCID: PMC9226451 DOI: 10.3389/fpsyg.2022.899358] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/18/2022] [Indexed: 11/24/2022] Open
Abstract
Background Turnover intention, an employee’s intention to voluntarily leave their jobs, affects workforce sustainability. However, scarce data are available about turnover intention and its associated factors among psychiatrists in China, especially during the COVID-19 pandemic. The current research was designed to address this gap. Methods An anonymous, nationwide online survey was disseminated to psychiatrists in 41 psychiatric hospitals in China. We collected demographic data, job-related information (duration of employment, history of participation in the frontline work against COVID-19, job satisfaction), and participants’ turnover intention in the next 12 months. Results In total, 3,973 psychiatrists completed the survey. The sample was predominantly female (58.8%) and married (79.5%), and nearly three-fourths (73.5%) had children. More than one-third (35.6%) had a master’s or doctoral degree in addition to their medical degree. The overall level of job satisfaction was moderate. The rate of turnover intention was 22.0% and was comparable in males and females (22.9% in males and 21.3% in females, respectively). Psychiatrists who had participated in the frontline work of COVID-19 were more likely to report an intention to leave their current job. Multiple regression analyses suggested that turnover intention was significantly associated with having insomnia, longer working hours, and more working days per week. Conclusion During the pandemic period, approximately one-fifth of psychiatrists in China reported turnover intention. Factors associated with turnover intention included high job-related burdens, low job satisfaction, participation in the frontline work against COVID-19, and insomnia. To improve psychiatric workforce sustainability, policymakers and hospital administrators need to be aware of this potential challenge and address the concerns of psychiatrists in China.
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Affiliation(s)
- Yating Yang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Ling Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Mengdie Li
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Xiaodong Wu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Daphne Y Liu
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States.,Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States
| | - Tingfang Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.,Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States.,Atlanta VA Medical Center, Decatur, GA, United States
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Nadine J Kalow
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
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28
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Li J, Wang Q, Guan C, Luo L, Hu X. Compassion fatigue and compassion satisfaction among Chinese palliative care nurses: A province-wide cross-sectional survey. J Nurs Manag 2022; 30:3060-3073. [PMID: 35689416 DOI: 10.1111/jonm.13708] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/02/2022] [Accepted: 06/09/2022] [Indexed: 02/05/2023]
Abstract
AIMS We aim to explore the prevalence and potential facilitators and inhibitors of compassion fatigue and compassion satisfaction among Chinese palliative care nurses. BACKGROUND Nurses with compassion fatigue may suffer from health-related problems, causing decreased work efficiency and quality of care. Palliative care nurses are especially at risk of compassion fatigue due to close contact with terminal patients. METHODS A province-wide cross-sectional survey using convenience sampling was conducted among 318 palliative care nurses at 25 hospitals and healthcare institutions in Sichuan Province, China. Data were collected using demographic questionnaire and five scales: Professional Quality of Life Scale, General Self-Efficacy Scale, Perceived Social Support Scale, Simplified Coping Style Questionnaire, and Connor-Davison Resilience Scale. Data analyses including descriptive statistics, t-test, one-way ANOVA, simple linear regression, and multiple linear regression. RESULTS Mean scores (SD) for burnout, secondary traumatic stress, and compassion satisfaction were 25.42 (4.75), 26.08 (5.72), and 35.67 (5.77), respectively. Related factors predicted 40.30%, 27.10%, and 35.4% of the variance in the model of burnout, secondary traumatic stress, and compassion satisfaction, respectively (all p < .001). CONCLUSIONS The levels of burnout and secondary traumatic stress among Chinese palliative care nurses were higher than those among other types of nurses. Social support, resilience, positive coping, family recognition of work, and income satisfaction are inhibitors of compassion fatigue among palliative care nurses. IMPLICATIONS FOR NURSING MANAGEMENT Nursing administrators and educators should consider providing effective and targeted strategies (e.g. ongoing training and psychological interventions) to decrease compassion fatigue among palliative care nurses based on the cultural and ethical settings.
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Affiliation(s)
- Juejin Li
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Qi Wang
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Chang Guan
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Lin Luo
- Human Resource Department, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaolin Hu
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, China
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29
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Han X, Jiang F, Shen L, Liu Y, Liu T, Liu H, Wang P, Yang Z, Tang YL, Zhu J. Workplace Violence, Workforce Stability, and Well-being in China's Psychiatric Hospitals. Am J Prev Med 2022; 62:e265-e273. [PMID: 34865934 DOI: 10.1016/j.amepre.2021.09.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/10/2021] [Accepted: 09/17/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Workplace violence against psychiatric professionals is a growing problem, yet nationally representative data in China are lacking. This study examines workplace violence against psychiatrists and psychiatric nurses in China as well as its association with workforce stability and well-being . METHODS Data came from a 2019 national survey of 14,264 participants (including 4,520 psychiatrists and 9,744 nurses) from 41 psychiatric hospitals across China. The occurrence of physical and verbal assaults among psychiatrists and psychiatric nurses was reported. Logistic regression models were constructed to examine the participants' characteristics associated with encountering workplace violence and the association of encountering violence with self-reported quality of life, health status, turnover intention, and career satisfaction. Analyses were performed during 2020. RESULTS In 2019, among 14,264 psychiatrists and psychiatric nurses in China, 81% reported encountering workplace violence during the past year. Psychiatrists were 0.68 (95% CI=0.55, 0.83) times less likely to report an encounter of violence than nurses. Male and younger nurses were 2.20 (95% CI=1.72, 2.81) and 1.21 (95% CI=1.01, 1.45) times more likely to report violence. Psychiatrists who had a higher educational degree or a higher professional rank were more vulnerable to violence. Encountering violence was significantly associated with poor quality of life, less satisfaction with health status, greater intention to leave the current job, and career dissatisfaction. CONCLUSIONS Workplace violence against psychiatrists and psychiatric nurses are common in China, indicating that China's psychiatric professionals are facing a significant threat to occupational safety. To maintain psychiatric workforce stability, actions are needed to reduce the prevalence of workplace violence at the system, institutional, and individual levels.
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Affiliation(s)
- Xinxin Han
- Vanke School of Public Health, Tsinghua University, Beijing, China; School of Medicine, Tsinghua University, Beijing, China
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China; Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Lijun Shen
- Vanke School of Public Health, Tsinghua University, Beijing, China; School of Medicine, Tsinghua University, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tingfang Liu
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China; Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Peicheng Wang
- School of Medicine, Tsinghua University, Beijing, China; Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Zimo Yang
- School of Medicine, Tsinghua University, Beijing, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia; Mental Health Service Line, Atlanta, Georgia
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, China.
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Feng J, Li L, Wang C, Ke P, Jiang H, Yin X, Lu Z. The prevalence of turnover intention and influencing factors among emergency physicians: A national observation. J Glob Health 2022; 12:04005. [PMID: 35136597 PMCID: PMC8818293 DOI: 10.7189/jogh.12.04005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND High turnover among physicians in emergency department is a great challenge in China. However, the rate and the reasons why physicians intend to leave have not been extensively studied yet. Therefore, this study aimed to identify the risk factors of turnover intention among physicians in emergency department. METHODS A national cross-sectional survey was conducted from July to August 2018 in China. A total of 10 457 physicians in emergency department were investigated using a structured self-administered questionnaire, which included demographic characteristics, work-related factors, turnover intention, the Patient Health Questionnaire and Positive and Negative Affect Scale. The stepwise logistic regression analysis was applied to identify the risk factors of turnover intention among physicians. RESULTS A total of 55.18% of the physicians in emergency department reported turnover intention in China. Turnover intention were more likely to be reported among physicians who were male (odds ratio (OR) = 1.25, 95% confidence interval (CI) = 1.13-1.38); who perceived medical errors (OR = 1.35, 95% CI = 1.23-1.47); who had a lower average monthly income; who provided out-of-hospital resuscitation services; who experienced physical violence (OR = 1.39, 95% CI = 1.26-1.54) and who reported higher score on negative affect and depressive tendency (OR = 1.06, 95% CI = 1.05-1.08; OR = 1.10, 95% CI = 1.09-1.12). Conversely, physicians who perceived shortage of manpower (OR = 0.74, 95% CI = 0.66-0.81), or reported higher score on positive affect (OR = 0.96, 95% CI = 0.94-0.97) were inclined to stay in emergency department. CONCLUSION This study shows that turnover intention among physicians in emergency department is high in China and was significantly associated with gender, average monthly income, perceived shortage of physicians, the times for provide out-of-hospital resuscitation services, exposure to workplace violence, depressive tendency, positive affect and negative affect. Targeted interventions are required to improve the retention rate among physicians in emergency department from the comprehensive aspects.
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Affiliation(s)
- Jie Feng
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liqing Li
- Department of Management Science and Engineering, School of Economics and Management, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Chao Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pan Ke
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Heng Jiang
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Feng J, Li L, Wang C, Ke P, Jiang H, Yin X, Lu Z. The prevalence of turnover intention and influencing factors among emergency physicians: A national observation. J Glob Health 2022. [PMID: 35136597 PMCID: PMC8818293 DOI: 10.7189/jogh.12..04005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Jie Feng
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liqing Li
- Department of Management Science and Engineering, School of Economics and Management, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Chao Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pan Ke
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Heng Jiang
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Santos KMD, Tracera GMP, Sousa KHJF, Palheta AMDS, Marion da Silva R, Zeitoune RCG. Estilos de gestão no trabalho de enfermagem ambulatorial: impactos na saúde do trabalhador. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2022-0127pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
RESUMO Objetivo: Analisar os estilos de gestão em ambulatórios de hospitais universitários e seus impactos na saúde dos trabalhadores de enfermagem. Método: Estudo quantitativo, transversal, participaram 388 profissionais de enfermagem atuantes em 11 ambulatórios vinculados a universidades públicas no Rio de Janeiro. Utilizamos a Escala de Estilos de Gestão, a Escala de Sofrimento Patogênico no Trabalho e a Escala de Danos Físicos e Psicossociais relacionados ao Trabalho. Resultados: Os estilos de gestão gerencialista e coletivo apresentaram presença moderada para a equipe de enfermagem dos ambulatórios. As características do estilo de gestão predominantemente gerencialista, evidenciadas pela falta de participação na tomada de decisão, o trabalho fortemente hierarquizado, focado nas normas e controle, atuaram como preditores das vivências de sofrimento e dos danos físicos, psíquicos e sociais apresentados pelos profissionais atuantes nesse contexto. Conclusão A análise dos estilos de gestão permitiu elucidar características que têm potencial para impactar negativamente a saúde dos trabalhadores destacando-se a necessidade de rever os modelos de gestão atualmente adotados para a equipe de enfermagem ambulatorial.
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Affiliation(s)
- Katerine Moraes dos Santos
- Universidade Federal do Rio de Janeiro, Brazil; Universidade Federal do Estado do Rio de Janeiro, Brazil
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Santos KMD, Tracera GMP, Sousa KHJF, Palheta AMDS, Marion da Silva R, Zeitoune RCG. Management styles in outpatient nursing work: impacts on the worker’s health. Rev Esc Enferm USP 2022; 56:e20220127. [PMID: 36346186 PMCID: PMC10081619 DOI: 10.1590/1980-220x-reeusp-2022-0127en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 09/08/2022] [Indexed: 11/09/2022] Open
Abstract
ABSTRACT Objective: To analyze management styles in outpatient clinics of university hospitals and their impacts on the nursing workers’ health. Method: Quantitative, cross-sectional study with 388 nursing professionals working in 11 outpatient clinics linked to public universities in Rio de Janeiro. The Management Styles Scale, the Pathogenic Suffering at Work Scale, and the Work-Related Physical and Psychosocial Harms Scale were used. Results: The managerial and collective management styles showed a moderate presence for the outpatient clinics nursing staff. The characteristics of the predominantly managerial management style, evidenced by the lack of participation in decision-making, the strongly hierarchical work, focused on norms and control, acted as predictors of the experiences of suffering and of the physical, psychological, and social damages presented by the professionals working in this context. Conclusion: The analysis of management styles allowed elucidating characteristics that have the potential to negatively impact the workers’ health, highlighting the need to review the management models currently adopted for the outpatient nursing team.
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Affiliation(s)
- Katerine Moraes dos Santos
- Universidade Federal do Rio de Janeiro, Brazil; Universidade Federal do Estado do Rio de Janeiro, Brazil
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Romero-García M, Delgado-Hito P, Gálvez-Herrer M, Antonio Ángel-Sesmero J, Raquel Velasco-Sanz T, Benito-Aracil L, Heras-La Calle G. Moral distress, emotional impact and coping in intensive care units staff during the outbreack of COVID-19. Intensive Crit Care Nurs 2022; 70:103206. [PMID: 35120794 PMCID: PMC8776502 DOI: 10.1016/j.iccn.2022.103206] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/13/2022] [Accepted: 01/16/2022] [Indexed: 12/27/2022]
Abstract
Background From the beginning, the COVID-19 pandemic increased ICU workloads and created exceptionally difficult ethical dilemmas. ICU staff around the world have been subject to high levels of moral stress, potentially leading to mental health problems. There is only limited evidence on moral distress levels and coping styles among Spanish ICU staff, and how they influenced health professionals’ mental health during the pandemic. Objectives To assess moral distress, related mental health problems (anxiety and depression), and coping styles among ICU staff during the first wave of the COVID-19 pandemic in Spain. Design Cross-sectional. Settings and participants The study setting consisted of intensive care unit and areas converted into intensive care units in public and private hospitals. A total of 434 permanent and temporary intensive care staff (reassigned due to the pandemic from other departments to units) answered an online questionnaire between March and June 2020. Methods Sociodemographic and job variables, moral distress, anxiety, depression, and coping mechanisms were anonymously evaluated through a self-reported questionnaire. Descriptive and correlation analyses were conducted and multivariate linear regression models were developed to explore the predictive ability of moral distress and coping on anxiety and depression. Results Moral distress during the pandemic is determined by situations related to the patient and family, the intensive care unit, and resource management of the organisations themselves. intensive care unit staff already reached moderate levels of moral distress, anxiety, and depression during the first wave of the pandemic. Temporary staff (redeployed from other units) obtained higher scores in these variables (p = 0.04, p = 0.038, and p = 0.009, respectively) than permanent staff, as well as in greater intention to leave their current position (p = 0.03). This intention was also stronger in health staff working in areas converted into intensive care units (45.2%) than in normal intensive care units (40.2%) (p = 0.02). Moral distress, coupled with primarily avoidance-oriented coping styles, explains 37% (AdR2) of the variance in anxiety and 38% (AdR2) of the variance in depression. Conclusions Our study reveals that the emotional well-being of intensive care unit staff was already at risk during the first wave of the pandemic. The moral distress they experienced was related to anxiety and depression issues, as well as the desire to leave the profession, and should be addressed, not only in permanent staff, but also in temporary staff, redeployed to these units as reinforcement workers.
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Chen Y, Wang P, Zhao L, He Y, Chen N, Liu H, Liu Y, Liu T, Tang YL, Jiang F, Zhu J. Workplace Violence and Turnover Intention Among Psychiatrists in a National Sample in China: The Mediating Effects of Mental Health. Front Psychiatry 2022; 13:855584. [PMID: 35782425 PMCID: PMC9240432 DOI: 10.3389/fpsyt.2022.855584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 05/13/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Workplace violence (WPV) in healthcare has received much attention worldwide. However, scarce data are available on its impact on turnover intention among psychiatrists, and the possible mechanisms between WPV and turnover intention have not been explored in China. METHODS A cross-sectional survey was conducted among psychiatrists in 41 tertiary psychiatric hospitals from 29 provinces and autonomous regions in China. A stress-strain-outcome (SSO) model was adopted to examine the effects of WPV on mental health and turnover intention. The association and mediation by burnout and stress were examined by multivariate logistic regression (MLR) and generalized structure equation modeling (GSEM). RESULTS We invited 6,986 psychiatrists to participate, and 4,520 completed the survey (64.7% response rate). The prevalence of verbal and physical violence against psychiatrist in China was 78.0 and 30.7%, respectively. MLR analysis showed that psychiatrists who experienced verbal violence (OR = 1.15, 95% CI = 1.10-1.21) and physical violence (OR = 1.15, 95% CI = 1.07-1.24) were more likely to report turnover intention. GSEM analysis showed that burnout (β = 4.00, p < 0.001) and stress (β = 1.15, p < 0.001) mediated the association between verbal violence and turnover intention; similarly, burnout (β = 4.92, p < 0.001) and stress (β = 1.80, p < 0.001) also mediated the association between physical violence and turnover intention. CONCLUSIONS Experience of WPV is a significant contributor to turnover intention among psychiatrists. Mental health status, such as burnout and stress level significantly mediated the association. Policy makers and hospital administrators need to be aware of this association. Action is needed to promote mental health among the psychiatrists to improve morale and workforce sustainability.
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Affiliation(s)
- Yanhua Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China.,School of Medicine, Tsinghua University, Beijing, China
| | - Peicheng Wang
- School of Medicine, Tsinghua University, Beijing, China
| | - Lina Zhao
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Yanrong He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Nuoya Chen
- Health Related Activity Recognition System Based on IoT Project, University of Macerata, Macerata, Italy
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Tingfang Liu
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Yi-Lang Tang
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, United States.,Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.,Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, China.,Institute for Healthy China, Tsinghua University, Beijing, China
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Yan S, Shen X, Wang R, Luo Z, Han X, Gan Y, Lv C. The prevalence of turnover intention and influencing factors among emergency physicians: a national observation. HUMAN RESOURCES FOR HEALTH 2021; 19:149. [PMID: 34863197 PMCID: PMC8642760 DOI: 10.1186/s12960-021-00688-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/04/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND Adverse consequences of physician turnover include financial losses, reduced patient satisfaction, and organizational instability. However, no study has reported the prevalence among emergency physicians. This study explore the rate and influencing factors of this community, which could provide a reference for preventing the loss of emergency physicians. METHODS A nationally representative cross-sectional survey of 15,243 emergency physicians was conducted in 31 provinces across China between July and September 2019. Multivariable logistic regression analysis was performed to identify predictors of turnover intention. RESULTS There were 49.75% of emergency physicians having turnover intention. Logistic regression analysis model showed that emergency physicians who were male (OR = 0.87) and older [> 37 and ≤ 43 (OR = 0.78) or > 43 (OR = 0.64)], worked in eastern China (OR = 0.88) and higher level of hospital [two-grade level (OR = 0.71) or three-grade level (OR = 0.56)], and had high (OR = 0.75) or middle (OR = 0.81) level income were not more likely to have less turnover intention, while those who had higher education level [bachelor degree (OR = 1.55) or master degree or higher (OR = 1.63)], long work tenure [> 3 and ≤ 6 (OR = 1.29) or > 6 and ≤ 11 (OR = 1.41) or > 11 (OR = 1.25)], poorer health status [fair (OR = 1.55) or poor (OR = 2.12)] and sleep quality [fair (OR = 1.16) or poor (OR = 1.43)], history of coronary heart disease (OR = 1.29), depression (OR = 2.77) and experienced the shift work (OR = 1.37) and workplace violence (OR = 1.78) were more likely to intend to leave. CONCLUSION Nearly half of emergency physicians in China have turnover intention. Targeted intervening measures should be taken to reduce the turnover intention, so as to avoid the shortage of physicians and thus hinder the supply of emergency medical services.
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Affiliation(s)
- Shijiao Yan
- School of Public Health, Hainan Medical University, Haikou, Hainan, China
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
| | - Xin Shen
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Rixing Wang
- Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Zhiqian Luo
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
- Emergency and Trauma College, Hainan Medical University, Haikou, Hainan, China
- Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No. 2019RU013), Hainan Medical University, Haikou, Hainan, China
| | - Xiaotong Han
- Department of Emergency Medicine, Hunan Provincial Institute of Emergency Medicine, Hunan Provincial Key Laboratory of Emergency and Critical Care Metabolomics, Hunan Provincial People's Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, Hunan, China.
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China.
| | - Chuanzhu Lv
- Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No. 2019RU013), Hainan Medical University, Haikou, Hainan, China.
- Department of Emergency Medicine Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
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Adams R, Ryan T, Wood E. Understanding the factors that affect retention within the mental health nursing workforce: a systematic review and thematic synthesis. Int J Ment Health Nurs 2021; 30:1476-1497. [PMID: 34184394 DOI: 10.1111/inm.12904] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/07/2021] [Accepted: 06/15/2021] [Indexed: 12/19/2022]
Abstract
There are over 41 000 vacant nursing posts across the United Kingdom's National Health Service (NHS), with more people leaving the profession that joining it. Despite mental health being acknowledged as a priority area, some of the most significant staff shortages are occurring within mental health services. Urgent action is needed to retain the mental health nurses (MHNs) currently in post to ensure the profession is fit for purpose and aid future recruitment efforts. This review set out to identify the individual factors that affect the retention of MHNs. A systematic search of six databases was conducted (CINAHL, PsychINFO, MEDLINE, Web of Science (Core collection), EMBASE and the British Nursing Index). Studies were systematically screened for inclusion based on predetermined eligibility criteria. The studies were quality assessed using the Mixed Methods Appraisal Tool (MMAT). Findings were synthesized using Thematic Synthesis. A total of 23 studies consisting of a range of study designs were included in the review. Four key themes emerged from the synthesis: Individual characteristics, Working within mental health services, Training and skills and Work environment. The findings from this review suggest that MHNs encounter some factors unique to working in mental health services, which suggests that retention strategies should be specific to each nursing speciality. Beyond nursing speciality, the factors identified vary between clinical settings in mental health due to the differences in work environments and services they provide. Future studies should now set out to explore what factors exist in which clinical settings to inform better tailored retention strategies to generate better outcomes.
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Affiliation(s)
- Rosie Adams
- Health Sciences School, The Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Tony Ryan
- Health Sciences School, The Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Emily Wood
- Health Sciences School, The Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
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Violence against mental health workers in China: Action needed. Asian J Psychiatr 2021; 65:102853. [PMID: 34560570 PMCID: PMC8545907 DOI: 10.1016/j.ajp.2021.102853] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 08/27/2021] [Accepted: 09/03/2021] [Indexed: 11/23/2022]
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Wang YY, Xiong Y, Zhang Y, Li CY, Fu LL, Luo HL, Sun Y. Compassion fatigue among haemodialysis nurses in public and private hospitals in China. Int J Nurs Pract 2021; 28:e13011. [PMID: 34472156 DOI: 10.1111/ijn.13011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 08/09/2021] [Accepted: 08/14/2021] [Indexed: 12/01/2022]
Abstract
AIM This study was conducted to identify and compare the levels of compassion fatigue and job satisfaction among haemodialysis nurses in public and private hospitals in China and explore explanatory factors based on sociodemographic and occupational characteristics. METHODS A descriptive study was conducted using a self-designed demographic questionnaire, the Professional Quality of Life Scale and the Minnesota Satisfaction Questionnaire, with responses from 283 haemodialysis nurses working at six public and private hospitals in China between June and November 2018. RESULTS The compassion fatigue score of public hospital nurses was significantly higher than that of private hospital nurses. Univariate analysis showed that there were significant differences in compassion fatigue among nurses based on the number of years worked, nature of employment, and education level. Correlational analysis showed a negative correlation between overall job satisfaction and compassion fatigue in both public and private hospitals. Multiple regression analysis showed that compassion fatigue among haemodialysis nurses in public hospitals was associated with years worked, type of employment, and intrinsic and extrinsic satisfaction, whereas in private hospitals, education level, years worked, and intrinsic and extrinsic satisfaction were significant. CONCLUSION Haemodialysis nurses in public hospitals are more likely to develop compassion fatigue than those in private hospitals.
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Affiliation(s)
- Yun-Yan Wang
- Department of Nephrology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Xiong
- Department of Nephrology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Zhang
- Department of Nephrology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chun-Yin Li
- Department of Nephrology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li-Li Fu
- Department of Nephrology, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Hua-Li Luo
- Department of Nephrology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yan Sun
- Department of Nephrology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Gu L, Xu D, Yu M. Mediating effects of stigma on the relationship between contact and willingness to care for people with mental illness among nursing students. NURSE EDUCATION TODAY 2021; 103:104973. [PMID: 34049122 DOI: 10.1016/j.nedt.2021.104973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/06/2021] [Accepted: 05/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Previous studies have demonstrated that contact positively impacts nursing students' willingness to care for people with mental illness. However, studies that have explored the mechanism of such a relationship between contact and willingness remain few. OBJECTIVES To examine the direct relationship between contact and nursing students' willingness to care for people with mental illness and to explore the potential mediating roles of stigma. DESIGN This was a cross-sectional study design. SETTINGS The study was conducted in a nursing school in Nanjing city, China. PARTICIPANTS A total of 839 nursing students were recruited in the study through convenience sampling. METHODS Nursing students' stigma, contact, and willingness to care for people with mental illness were measured online through the Stigma toward People with Mental Illness Scale (SPMI), the Level of Contact Report, and one item of "which degree indicates your willingness to provide care for people with mental illness," respectively. The structural equation model was applied to explore the potential mediating roles of stigma. RESULTS Contact with people suffering from mental illness directly affected nursing students' willingness to care for them (β = 0.076, p < 0.05). Meanwhile, stigma partly mediated the effect of students' contact on willingness to care for people with mental illness (β = 0.048, p < 0.05). CONCLUSIONS High level of contact can improve nursing students' willingness to care and the relationship is partly mediated by stigma. Measures to improve the level of contact and reduce stigmatizing attitudes of nursing students are accordingly essential in influencing them to have more willingness to care for people with mental illness.
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Affiliation(s)
- Libin Gu
- School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Qixia District, Nanjing 210023, China.
| | - Deguo Xu
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Qixia District, Nanjing 210023, China.
| | - Mingming Yu
- School of Nursing, Peking University, Beijing, China.
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Alrasheedi O, Schultz TJ, Harvey G. Factors influencing nurses' intention to work in the oncology specialty: multi-institutional cross-sectional study. BMC Palliat Care 2021; 20:72. [PMID: 34016092 PMCID: PMC8136995 DOI: 10.1186/s12904-021-00764-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/06/2021] [Indexed: 11/10/2022] Open
Abstract
Background Nursing care for terminally ill cancer patients is routinely provided by oncology nurses in Saudi Arabia. Shortages and retention of oncology nurses is an important concern for healthcare leaders. Objectives To identify and describe predictors of nurses’ intention toward working in the oncology specialty amongst three groups: undergraduate nursing students, oncology registered nurses and postgraduate oncology nursing students. In particular, the study sought to analyse association between individual characteristics, job-related factors, palliative care knowledge, attitude toward caring for dying patients, general self-efficacy, job satisfaction and intention to work in oncology. Methods A cross-sectional study was conducted involving 477 participants in five major hospitals in Saudi Arabia. The Palliative Care Quiz for Nursing, Frommelt Attitudes Toward Care of the Dying Scale, General Self-Efficacy Scale and Minnesota Satisfaction Questionnaire short form were used for data collection. Multilevel logistic regression analysis was used to identify predictors associated with intention to work in oncology. Results 43.9% (n = 208) of the sample reported an intention to work in oncology. Only one variable was a significant predictor of intention to work in oncology across all three groups studied: a more positive attitude toward caring for dying patients (Odds ratio (OR) = 1.09 [95% confidence interval (CI) 1.04–1.16]), (OR = 1.08 [95% CI 1.04–1.12]), (OR = 1.078 [95% CI 1.053–1.103] with P ≤ 0.001 for undergraduate, registered and postgraduate groups respectively. At post-graduate level, higher levels of palliative care knowledge and general self-efficacy were significantly associated with increased intention, whilst at undergraduate level, general self-efficacy was a significant predictor. Job satisfaction was a significant predictor of intention amongst registered nurses. Conclusions Attitude toward caring for dying patients and general self-efficacy appear to be the most important predictors of intention to work in the oncology nursing specialty. However, the significance of influencing factors varied between the different groups of nurses studied. Perhaps surprisingly, palliative care knowledge was an influential factor amongst the postgraduate group only. The study results provide important insights for nursing leaders and policymakers in Saudi Arabia to inform the future planning of nursing workforce strategies to address shortages and retention of oncology nurses.
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Affiliation(s)
- Omar Alrasheedi
- Adelaide Nursing School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, 5000, Australia. .,College of Nursing, King Saud University, Riyadh, 11451, Saudi Arabia.
| | - Timothy John Schultz
- Adelaide Nursing School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, 5000, Australia.,Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, 5042, Australia
| | - Gillian Harvey
- Adelaide Nursing School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, 5000, Australia.,College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, 5042, Australia
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Huang X, Wang L, Dong X, Li B, Wan Q. Effects of nursing work environment on work-related outcomes among psychiatric nurses: A mediating model. J Psychiatr Ment Health Nurs 2021; 28:186-196. [PMID: 32557979 DOI: 10.1111/jpm.12665] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/20/2020] [Accepted: 06/03/2020] [Indexed: 12/12/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: The shortage of psychiatric nurses has become a focus problem attracting widespread concern. And the continuous improvement of quality of psychiatric care has always been a priority in psychiatric units. Previous studies about nurses from general hospitals indicated nursing work environment was a key factor affecting work-related outcomes, but little attention was paid to psychiatric nurses and few studies focused on the five specific dimensions of nursing work environment. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Nurse participation in hospital affairs was the dimension with the highest proportion of participants dissatisfied. Nursing work environment and all its five dimensions had significant effects on work-related outcomes, which were partly mediated by work engagement. For nurse-perceived quality of care, collegial nurse-physician relations showed the largest effect; while for turnover intention, the two dimensions of nurse participation in hospital affairs and nursing foundations for quality of care showed larger effects. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Corresponding measures should be taken to improve nursing work environment, especially in the aspect of nurse participation in hospital affairs by promoting nurses' ability to participate, arousing their motivation to participate and offering them more opportunities to participate. Harmonious collegial relationship should be built by creating an atmosphere of equality, respect and collaboration, and enhancing the communication between doctors and nurses. Nursing foundations for quality of care need to be further improved through setting appropriate rules and regulations to ensure the quality of care and offering more opportunities to support nursing staff's growth and development. ABSTRACT: Introduction With the increasing demand for high-quality psychiatric care, it is imperative to improve psychiatric nurses' work engagement and work-related outcomes. Nursing work environment has been identified as a protective factor in non-psychiatric nurses, but little was known about psychiatric nurses. Aims To identify the situation of nursing work environment, work engagement, nurse-perceived quality of care and turnover intention among psychiatric nurses, and examine the relationship among them. Methods A cross-sectional design was adopted. Questionnaire investigation was implemented among psychiatric nurses from 43 clinical units. Structural equation modelling and path analysis were used to examine the causal relationship among variables. Results The results showed 19.06% of participants were not satisfied with the overall work environment and 24.34% were not satisfied with the dimension of nurse participation in hospital affairs. Hypothesis testing results indicated that nursing work environment and its five dimensions had positive effects on nurse-perceived quality of care and negative effects on turnover intention, which were both partly mediated by work engagement. Discussion Supportive nursing work environment could improve nurses' work engagement, enhance nurse-perceived quality of care and reduce nurses' turnover intention. Implications for Practice Continuous efforts should be paid to the improvement of nursing work environment in psychiatric hospitals.
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Affiliation(s)
- Xiuxiu Huang
- School of Nursing, Peking University, Beijing, China
| | - Limin Wang
- School of Nursing, Peking University, Beijing, China
| | - Xu Dong
- School of Nursing, Peking University, Beijing, China
| | - Bei Li
- School of Nursing, Peking University, Beijing, China
| | - Qiaoqin Wan
- School of Nursing, Peking University, Beijing, China
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Cao J, Jia Z, Zhu C, Li Z, Liu H, Li F, Li J. Nurses' turnover intention and associated factors in general hospitals in China: A cross-sectional study. J Nurs Manag 2021; 29:1613-1622. [PMID: 33639014 DOI: 10.1111/jonm.13295] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 02/17/2021] [Accepted: 02/20/2021] [Indexed: 11/29/2022]
Abstract
AIM To measure nurses' turnover intention and identify associated factors in general hospitals in China. BACKGROUND Understanding nurses' turnover intention is important to retain nurses, but factors associated with turnover intention require elucidation. METHOD A cross-sectional survey was conducted across 23 hospitals in China to investigate nurses' (N = 12,291) turnover intention and its associated factors. Associated factors were explored by univariate and multilevel multiple logistic regression analysis. RESULTS The mean total score for nurses' turnover intention was 13.97 ± 3.63. High proactive personality score, a seriously ill family member, experience of negative workplace events, high work pressure and high work-family conflict increased the risk for turnover intention. A low turnover intention was associated with being a non-local resident nurse, position title, high salary level, good person-organisation fit and person-group fit, and high family-work facilitation. CONCLUSION Nurses with a proactive personality, heavy family care burden, experience of negative workplace events, no position title and a low salary may merit special consideration. IMPLICATIONS FOR NURSING MANAGEMENT Nurses' personality traits should be further focused on, and it is important to build a nurse-oriented organisation atmosphere, including protecting nurses from workplace violence, establishing friendly relationships with their families and expanding career paths.
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Affiliation(s)
- Jing Cao
- School of Public Health, Jilin University, Changchun, China.,Department of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Zhaoxia Jia
- Department of Information and Statistics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Chen Zhu
- Department of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Zhen Li
- Department of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Hongpeng Liu
- Department of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Fangfang Li
- Department of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Jinghua Li
- School of Public Health, Jilin University, Changchun, China
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Xia L, Jiang F, Rakofsky J, Zhang Y, Shi Y, Zhang K, Liu T, Liu Y, Liu H, Tang YL. Resources and Workforce in Top-Tier Psychiatric Hospitals in China: A Nationwide Survey. Front Psychiatry 2021; 12:573333. [PMID: 33716804 PMCID: PMC7943845 DOI: 10.3389/fpsyt.2021.573333] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 02/03/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Mental healthcare has gained momentum and significant attention in China over the past three decades. However, many challenges still exist. This survey aimed to investigate mental health resources and the psychiatric workforce in representative top-tier psychiatric hospitals in China. Methods: A total of 41 top-tier psychiatric hospitals from 29 provinces participated, providing data about numbers and types of psychiatric beds, numbers of mental health professionals, outpatient services and hospitalization information covering the past 3 years, as well as teaching and training program affiliation. Results: Significant variations were found among participating hospitals and across different regions. Most of these hospitals were large, with a median number of psychiatric beds of 660 (range, 169-2,141). Child and geriatric beds accounted for 3.3 and 12.6% of all beds, respectively, and many hospitals had no specialized child or geriatric units. The overall ratios of psychiatrists, psychiatric nurses, and psychologists per bed were 0.16, 0.34, and 0.03, respectively. More than 40% of the hospitals had no clinical social workers. Based on the government's staffing guidelines, less than one third (31.7%) of the hospitals reached the lower limit of the psychiatric staff per bed ratio, and 43.9% of them reached the lower limit of the nurse per bed ratio. Conclusion: Although some progress has been made, mental health resources and the psychiatric workforce in China are still relatively insufficient with uneven geographical distribution and an acute shortage of psychiatric beds for children and elderly patients. In the meantime, the staffing composition needs to be optimized and more psychologists and social workers are needed. While addressing these shortages of mental health resources and the workforce is important, diversifying the psychiatric workforce, promoting community mental health care, and decentralizing mental health services may be equally important.
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Affiliation(s)
- Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Feng Jiang
- Healthcare Management and Evaluation Research Center, Institute of Health Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
- Research Center for Public Health, Tsinghua University, Beijing, China
| | - Jeffrey Rakofsky
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Yulong Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yudong Shi
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Kai Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Tingfang Liu
- Institute for Hospital Management of Tsinghua University, Beijing, China
| | - Yuanli Liu
- Public Health School, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yi-lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
- Atlanta Veterans Affairs Medical Center, Decatur, GA, United States
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Qi W, Sheng M, Shi Z. Professional identity and its work-related factors among psychiatric nurses: A cross-sectional study. Jpn J Nurs Sci 2020; 18:e12380. [PMID: 33140548 DOI: 10.1111/jjns.12380] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 08/10/2020] [Accepted: 08/12/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To investigate the level of professional identity among psychiatric nurses and to explore what work-related factors may affect their professional identity. METHODS Four hundred and twelve nurses were investigated. Two self-report questionnaires were used: (a) Nursing Professional Identity Scale (NPIS, range: 30 ~ 150); and (b) Practice Environment Scale of Nursing Work (PESNW, range: 0 ~ 100) with six dimensions: nursing-related hospital affairs, high-quality nursing care, ability of nursing manager, manpower and material resources, cooperation between nurses and doctors, and salary and social status. Higher scores indicated higher professional identities and better work environments. RESULTS Three hundred and ninety-one of the participants completed the questionnaires and were analyzed. The mean age of the participants was 32.53 years, and 93.3% of them were female. The mean score of NPIS was 100.03 (SD: 17.44). Multiple linear regression showed that professional identity was significantly and positively associated with two dimensions of PESNW: salary and social status and ability of nursing manager. CONCLUSIONS Professional identity among psychiatric nurses was at a moderate level. Salary and social status and ability of nursing manager positively contributed to their professional identity. These results may indicate the directors to construct better work environments for psychiatric nursing to improve professional identity.
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Affiliation(s)
- Wenwen Qi
- Nursing Department, Shanghai Jiao Tong University School of Medicine Affiliated Shanghai Mental Health Center, Shanghai, China
| | - Meiqing Sheng
- Nursing Department, Shanghai Jiao Tong University School of Medicine Affiliated Shanghai Mental Health Center, Shanghai, China
| | - Zhongying Shi
- Nursing Department, Shanghai Jiao Tong University School of Medicine Affiliated Shanghai Mental Health Center, Shanghai, China
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Li Z, Cao J, Wu X, Li F, Zhu C. Intention to leave among newly graduated nurses: A descriptive, multicenter study. J Adv Nurs 2020; 76:3429-3439. [PMID: 32989820 DOI: 10.1111/jan.14545] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/01/2020] [Accepted: 08/19/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Zhen Li
- Department of Nursing Chinese Academy of Medical Sciences ‐ Peking Union Medical College Peking Union Medical College Hospital Beijing China
| | - Jing Cao
- Department of Nursing Chinese Academy of Medical Sciences ‐ Peking Union Medical College Peking Union Medical College Hospital Beijing China
| | - Xinjuan Wu
- Department of Nursing Chinese Academy of Medical Sciences ‐ Peking Union Medical College Peking Union Medical College Hospital Beijing China
| | - Fangfang Li
- Department of Internal Medicine Chinese Academy of Medical Sciences ‐ Peking Union Medical College Peking Union Medical College Hospital Beijing China
| | - Chen Zhu
- Department of Nursing Chinese Academy of Medical Sciences ‐ Peking Union Medical College Peking Union Medical College Hospital Beijing China
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Association between Health Problems and Turnover Intention in Shift Work Nurses: Health Problem Clustering. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124532. [PMID: 32599700 PMCID: PMC7345885 DOI: 10.3390/ijerph17124532] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/20/2020] [Accepted: 06/21/2020] [Indexed: 12/22/2022]
Abstract
Shift work nurses experience multiple health problems due to irregular shifts and heavy job demands. However, the comorbidity patterns of nurses’ health problems and the association between health problems and turnover intention have rarely been studied. This study aimed to identify and cluster shift work nurses’ health problems and to reveal the associations between health problems and turnover intention. In this cross-sectional study, we analyzed data from 500 nurses who worked at two tertiary hospitals in Seoul, South Korea. Data, including turnover intention and nine types of health issues, were collected between March 2018 and April 2019. Hierarchical clustering and multiple ordinal logistic regressions were used for the data analysis. Among the participants, 22.2% expressed turnover intention and the mean number of health problems was 4.5 (range 0–9). Using multiple ordinal logistic regressions analysis, it was shown that sleep disturbance, depression, fatigue, a gastrointestinal disorder, and leg or foot discomfort as a single health problem significantly increased turnover intention. After clustering the health problems, four clusters were identified and only the neuropsychological cluster—sleep disturbance, fatigue, and depression—significantly increased turnover intention. We propose that health problems within the neuropsychological cluster must receive close attention and be addressed simultaneously to decrease nurse’s turnover intentions.
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Xia L, Jiang F, Rakofsky J, Zhang Y, Zhang K, Liu T, Liu Y, Liu H, Tang YL. Cigarette Smoking, Health-Related Behaviors, and Burnout Among Mental Health Professionals in China: A Nationwide Survey. Front Psychiatry 2020; 11:706. [PMID: 32765329 PMCID: PMC7379885 DOI: 10.3389/fpsyt.2020.00706] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/06/2020] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Mental health professionals (MHPs) play an important role in treating patients with nicotine addiction. However, data on MHPs' cigarette smoking habits are scarce. This survey aimed to collect such data and to examine the correlates of smoking among MHPs working in China. METHODS A cross-sectional survey was conducted in all 41 provincial, tertiary psychiatric hospitals, and MHPs from these hospitals were targeted. An anonymous questionnaire was designed to collect socio-demographic and occupational factors, and the Maslach Burnout Inventory-Human Service Survey was used to assess burnout. Data about smoking and other health behaviors were also collected. RESULTS In total, 13,614 MHPs were included in the analysis. The overall rate of current smoking was 8.6% (31.3% in males, and 1.1% in females). A substantial proportion (28.0%) of life-time smokers had abstained for more than 3 months. Those who were male (OR=37.73), older (OR=1.02), divorced or widowed (OR=1.72), working in West (OR=1.45), and Northeast China (OR=1.65), were nurses (OR=1.44), had a high income (OR=1.31), experienced burnout (OR=1.29), frequent insomnia (OR=1.39), and used alcohol (OR=2.76) were significantly more likely to be smokers, while those who had a higher level of education (OR=0.67, 0.47, and 0.43 for college, master, and doctorate degrees, respectively), and exercised regularly (OR=0.73) were significantly less likely to be smokers. CONCLUSION Although lower than that of the general population in China, smoking is still relatively high among MPHs. Efforts to lower smoking rates among MHPs in China should continue and should incorporate strategies that target burnout, sleep, alcohol use, exercise and other factors associated with smoking.
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Affiliation(s)
- Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Feng Jiang
- Public Health School, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Research Center for Public Health, Tsinghua University, Beijing, China
| | - Jeffrey Rakofsky
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Yulong Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Kai Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Tingfang Liu
- Institute for Hospital Management of Tsinghua University, Beijing, China
| | - Yuanli Liu
- Public Health School, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States.,Atlanta Veterans Affairs Medical Center, Decatur, GA, United States
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Bordignon M, Monteiro MI. Predictors of nursing workers' intention to leave the work unit, health institution and profession. Rev Lat Am Enfermagem 2019; 27:e3219. [PMID: 31826161 PMCID: PMC6896814 DOI: 10.1590/1518-8345.3280.3219] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 08/19/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to identify the factors related to the nursing workers' intention to leave the work unit, health institution and profession. METHOD cross-sectional study with quantitative approach was carried out with 267 nursing workers from seven emergency units in Brazil. For data collection, we used the Questionnaire of socio-demographic, life style and work and health aspects as well as the Work Ability Index, Workplace violence questionnaire, questions about intention to leave and the Turnover Intention Scale. The predictors of intentions to leave were evaluated through Poisson regression models. RESULTS workplace violence increased and better satisfaction with current job decreased the probability of greater intention to leave the unit, institution and profession. Better work ability decreased the probability of greater intention to leave the unit and profession. The more qualified workers and those who had been working in the institution longer was more likely to greater intention to leave the profession. CONCLUSION promoting job satisfaction, work ability and a violence-free environment is possible to decrease the workers' intention to leave the job or profession, but nursing managers need to understand the three phenomena of intention to quit individually for retention strategies.
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Affiliation(s)
- Maiara Bordignon
- Universidade Federal da Fronteira Sul, Curso de Enfermagem, Chapecó, SC, Brazil.,Scholarship holder at the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) - Grant # 2016/06128-7, at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) - Grant # 162825/2014-5 and at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) - Grant # 01-P-3481/2014, Brazil
| | - Maria Inês Monteiro
- Universidade Estadual de Campinas, Faculdade de Enfermagem, Campinas, SP, Brazil
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