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Rafiei S, Souri S, Nejatifar Z, Amerzadeh M. The moderating role of self-efficacy in the relationship between occupational stress and mental health issues among nurses. Sci Rep 2024; 14:15913. [PMID: 38987325 PMCID: PMC11237126 DOI: 10.1038/s41598-024-66357-7] [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: 01/25/2024] [Accepted: 07/01/2024] [Indexed: 07/12/2024] Open
Abstract
Occupational stress is a complex concept resulting from interaction among personnel, work environment, and cultural contexts. It can cause mental health issues, including clinical mental disorders, as well as emotional challenges like depression, anxiety, cognitive difficulties, and feeling sad. As a vulnerable group, healthcare professionals, especially nurses, experience a high rate of occupational stress. Therefore, we aimed to study the relationship between occupational stress, mental health problems, and self-efficacy among the nursing population. A cross-sectional study was conducted among 365 nurses selected through a two-stage sampling process from tertiary hospitals in Qazvin, Iran, between July and September 2022. Study variables included occupational stress measured by the persian version of the health and safety executive management standards revised indicator tool (MS-RIT), the general health questionnaire containing 28 questions measuring psychological distress in four primary areas of somatic and anxiety symptoms, sleep disorders, social dysfunction, and depression [GHQ-28], and general self-efficacy [GSE-10]. The mentioned variables and some of the nurses' demographic characteristics, including age, gender, education, and work experience, were analyzed using moderated multiple regression, descriptive statistics, and the Pearson correlation coefficient.The Pearson correlation analysis revealed a statistically significant association between self-efficacy and occupational stress (r = 0.62, P = 0.000) and self-efficacy and mental health (r = 0.67, P = 0.01). Regression analysis demonstrated that occupational stress accounted for 42% of the variation in mental health (R2 = 0.42, P < 0.01). The results also showed that self-efficacy moderates the relationship between occupational stress and mental health, with a significant effect (P < 0.01). The elevated prevalence of occupational stress and the concerning state of mental health among nurses highlight the need for the implementation of intervention programs, including stress prevention strategies at the workplace through organizing better working shifts, as well as increasing nurses' self-efficacy and their effective participation in work-related tasks aiming to enhance working conditions for nurses.
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Affiliation(s)
- Sima Rafiei
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Saber Souri
- Student Research Committee, School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Zahra Nejatifar
- Student Research Committee, School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Amerzadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
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Rudberg I, Olsson A, Thunborg C, Salzmann-Erikson M. Interprofessional communication in a psychiatric outpatient unit - an ethnographic study. BMC Nurs 2023; 22:286. [PMID: 37626326 PMCID: PMC10463438 DOI: 10.1186/s12912-023-01446-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Communication in healthcare has been extensively studied, but most research has focused on miscommunication and the importance of communication for patient safety. Previous research on interprofessional communication has mainly focused on relationships between physicians and nurses in non-psychiatric settings. Since communication is one of the core competencies in psychiatric care, more research on interprofessional communication between other clinicians is needed, and should be explored from a broader perspective. This study aimed to explore and describe interprofessional communication in a psychiatric outpatient unit. METHOD During spring 2022, data consisting of over 100 h of fieldwork were collected from observations, formal semi-structured interviews and informal conversations inspired by the focused ethnography method. Data was collected at an outpatient unit in central Sweden, and various clinicians participated in the study. The data analysis was a back-and-forth process between initial codes and emerging themes, but also cyclical as the data analysis process was ongoing and repeated and took place simultaneously with the data collection. RESULTS We found that a workplace's history, clinicians´ workload, responsibilities and hierarchies influence interprofessional communication. The results showed that the prerequisites for interprofessional communication were created through the unit's code of conduct, clear and engaging leadership, and trust in the ability of the various clinicians to perform new tasks. CONCLUSION Our results indicate that leadership, an involving working style, and an environment where speaking up is encouraged and valued can foster interprofessional communication and respect for each other´s professional roles is key to achieving this. Interprofessional communication between different clinicians is an important part of psychiatric outpatient work, where efficiency, insufficient staffing and long patient queues are commonplace. Research can help shed light on these parts by highlighting aspects influencing communication.
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Affiliation(s)
- Ingela Rudberg
- Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, SE-801 76, Sweden.
| | - Annakarin Olsson
- Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, SE-801 76, Sweden
| | - Charlotta Thunborg
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Health and Welfare, Mälardalen University, Västerås, Sweden
| | - Martin Salzmann-Erikson
- Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, SE-801 76, Sweden
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Claponea RM, Iorga M. Burnout, Organizational Justice, Workload, and Emotional Regulation among Medical and Non-Medical Personnel Working in Romanian Healthcare Units. Behav Sci (Basel) 2023; 13:bs13030225. [PMID: 36975250 PMCID: PMC10045892 DOI: 10.3390/bs13030225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 02/25/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
Background and objectives: The goal of this study was to evaluate the levels of organizational justice, emotional regulation, and workload associated with the level of burnout experienced in medical and non-medical staff from public and private medical units. Materials and Methods: A cross-sectional study was conducted on a sample of 230 healthcare professionals, including 139 medical personnel and 91 non-medical staff respondents. The collected socio-demographic and organizational data and psychological tools were the Maslach Burnout Inventory (MBI HSS), the ECO System, and the emotional regulation questionnaire (ERQ). Results: For medical staff, burnout was measured in terms of emotional exhaustion (M = 27.05 ± 12.34), depersonalization (M = 8.26 ± 3.95), and personal accomplishment (M = 47.35 ± 6.78). The scores for non-medical staff were emotional exhaustion (M = 35.84 ± 14.71), depersonalization (M = 11.79 ± 6.30), and personal accomplishment (M = 44 ± 7.37). In terms of workload, higher scores were observed for non-medical staff (M = 25.43 ± 7.87), while medical staff recorded lower values (M = 20.35 ± 7.65). The scores for the cognitive reappraisal dimension were as follows: medical personnel (M = 32.02 ± 5.37) and non-medical staff (M = 31.67 ± 6.19). In terms of the expressive suppression dimension, medical staff registered at M = 17.99 ± 5.61, and non-medical staff registered at M = 17.19 ± 5.53. For organizational justice, higher scores were registered for medical staff (M = 25.87 ± 6.02) and lower scores for non-medical staff (M = 21.34 ± 5.72). Conclusions: Medical staff felt a higher sense of organizational justice than non-medical staff, as is also evidenced by the level of the workload dimension, which registers higher values for non-medical personnel. In the case of burnout, higher levels of emotional exhaustion and depersonalization dimensions were also revealed for non-medical staff and, in the case of the professional fulfillment dimension, higher scores were registered for medical staff.
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Affiliation(s)
- Roxana Mihaela Claponea
- Faculty of Psychology and Education Sciences, “Alexandru Ioan Cuza” University of Iasi, 700554 Iasi, Romania
| | - Magdalena Iorga
- Faculty of Psychology and Education Sciences, “Alexandru Ioan Cuza” University of Iasi, 700554 Iasi, Romania
- Behavioral Sciences Department, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Correspondence:
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Li Y, Fan R, Lu Y, Li H, Liu X, Kong G, Wang J, Yang F, Zhou J, Wang J. Prevalence of psychological symptoms and associated risk factors among nurses in 30 provinces during the COVID-19 pandemic in China. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 30:100618. [PMID: 36276987 PMCID: PMC9576138 DOI: 10.1016/j.lanwpc.2022.100618] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND With the outbreak of the coronavirus disease 2019 (COVID-19), nurses have won well-deserved recognition for their indispensable roles in providing humane and professional healthcare for patients. However, by the nature of their role working at the forefront of patient care, nurses are prone to experiencing mental health consequences. Therefore, we pay attention to measuring the magnitude of psychological symptoms and identifying associated factors among nurses in China. METHODS We launched a nationwide, cross-sectional survey of nurses who worked in secondary or tertiary hospitals and public or private hospitals from 30 provinces in China. The prevalence and severity of symptoms of burnout, depression, and anxiety were investigated, respectively. Multivariable logistic regression analyses were performed to identify factors associated with each psychological symptom. FINDINGS A total of 138 279 respondents who worked in 243 hospitals completed this survey. A substantial proportion of nurses reported symptoms of burnout (34%), depression (55·5%), and anxiety (41·8%). In line with the disproportionality of economic development, we noted that the middle or western region was an independent risk factor for depression and anxiety. Compared with those working in the secondary hospital, nurses who worked in tertiary hospitals were associated with a higher likelihood of burnout and depression. INTERPRETATION Nurses are experiencing emotional, physical, and mental exhaustion during the COVID-19 epidemic. Governments and health policymakers need to draw attention to reinforcing prevention and ameliorating countermeasures to safeguard nurses' health. FUNDING The strategic consulting project of the Chinese Academy of Engineering [2021-32-5]. Advanced Institute of Infomation Technology, Peking University, Zhejiang Province [2020-Z-17].
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Affiliation(s)
- Yun Li
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Rongrong Fan
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Yunwei Lu
- Peking University People's Hospital, Beijing, China
| | - Huayan Li
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Xianping Liu
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Guilan Kong
- National Institute of Health Data Science at Peking University, Beijing, China
| | - Jiayu Wang
- National Institute of Health Data Science at Peking University, Beijing, China
| | - Fan Yang
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
- Corresponding authors at: Department of Thoracic Surgery, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing 100044, China.
| | - Jian Zhou
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
- Corresponding authors at: Department of Thoracic Surgery, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing 100044, China.
| | - Jun Wang
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
- Corresponding authors at: Department of Thoracic Surgery, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing 100044, China.
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Fischer L, Dadaczynski K, Rathmann K. Psychosoziale Arbeitsbedingungen und Burnout-Symptome in der stationären somatischen und psychiatrischen Gesundheits- und Krankenpflege. Pflege 2020; 33:93-104. [PMID: 32208900 DOI: 10.1024/1012-5302/a000720] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Psychosocial working conditions and symptoms of burnout in somatic and psychiatric nursing Abstract. Background: While mental workload and stress among nurses are generally well-documented, differences within the nursing profession have hardly been investigated so far. Aim: This study aims to examine the differences and associations between psychosocial working conditions and symptoms of burnout of nurses working in somatic and psychiatric settings. Methods: A cross-sectional study has been conducted with employees in one somatic and one psychiatric hospital (n = 576). The Copenhagen Psychosocial Questionnaire and the Copenhagen Burnout Inventory were used to assess psychosocial workloads and burnout symptoms. The data analysis was carried out by univariate, bivariate and multivariate (regression) analyses. Results: About 50 % of respondents report at least a moderate level of symptoms of burnout with somatic nurses more frequently affected. While quantitative and physical demands are higher in somatic nursing, psychiatric nurses have a higher degree of emotional demands, socialβ = 0.33) in somatic nursing and emotional demands (β = 0.29) in psychiatric nursing serve as strongest predictors of burnout symptoms. Conclusions: Findings suggest specific profiles of psychosocial workload in somatic and psychiatric nursing as well as a high need for differentiated approaches for occupational health promotion.
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Affiliation(s)
- Lisa Fischer
- Fachbereich Pflege und Gesundheit, Hochschule Fulda.,Geteilte Erstautorenschaf
| | - Kevin Dadaczynski
- Fachbereich Pflege und Gesundheit, Hochschule Fulda.,Zentrum für Angewandte Gesundheitswissenschaften (ZAG), Leuphana Universität Lüneburg.,Geteilte Erstautorenschaf
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Exploring Perceptions of the Work Environment among Psychiatric Nursing Staff in France: A Qualitative Study Using Hierarchical Clustering Methods. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010142. [PMID: 31878162 PMCID: PMC6981531 DOI: 10.3390/ijerph17010142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/15/2019] [Accepted: 12/19/2019] [Indexed: 01/16/2023]
Abstract
Most studies on workers’ health are based on non-specific models of occupational stress, thereby limiting the understanding and research on efficient interventions. This qualitative approach aimed to explore the structure of resources and constraints in the working environment of nurses in a deliberately open approach. Semi-structured interviews were conducted with 37 nurses working in closed and open inpatient psychiatric wards in a French university hospital. The data were statistically analyzed using a hierarchical clustering method. Our model highlighted a systemic structure, describing the interactions, including patients, nurses, doctors, and managers in a specific material, communicational, and organizational environment. The results show a discursive structure organized around dimensions pertaining to “environment”, “patients”, “medical-care group”, and “the individual”. Our model showed interest in an interdisciplinary approach that encompasses occupational medicine and social psychology.
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Berry S, Robertson N. Burnout within forensic psychiatric nursing: Its relationship with ward environment and effective clinical supervision? J Psychiatr Ment Health Nurs 2019; 26:212-222. [PMID: 31209980 DOI: 10.1111/jpm.12538] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 05/27/2019] [Accepted: 06/13/2019] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN ABOUT THIS SUBJECT?: Burnout is a prominent issue in psychiatric nursing and associated with significant adverse consequences for staff, service users and at an organizational level. Exploration of the extent and predictors of burnout in secure settings has received little research attention. It is not fully understood why prevalence rates of burnout in forensic settings are not elevated in comparison to other settings, despite the presence of known risk-related correlates. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: In contrast to previous research, findings suggest that clinical supervision may not be an effective, stand-alone intervention to support staff experiencing burnout. Thus, the current focus on clinical supervision to mitigate burnout may be insufficient in forensic services. The ward environment (specifically how safe staff feel, how therapeutic the ward feels and how well service users relate to one another) was found to be more important than clinical supervision in terms of burnout for forensic psychiatric nursing staff. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Policies regarding staff health and well-being should be developed with due consideration given to the association between burnout and the working environment. It should not be assumed that clinical supervision is sufficient to mitigate burnout in practice. Further research assessing all types of support and the ward environment is needed to gain a better understanding of its relationship to burnout. ABSTRACT: Introduction Despite extensive research examining burnout in psychiatric nursing staff, literature exploring key predictors of burnout in secure psychiatric settings has been relatively neglected. Research has yet to explore burnout in these settings by adopting previously identified predictors such as support or the ward environment. Aim The current study aimed to reduce this gap by exploring burnout, the perceived effectiveness of clinical supervision and ward environment. Method In 2014, nursing staff working in a medium secure forensic psychiatric unit in the United Kingdom (N = 137) provided demographic information and completed the measures assessing: Burnout, clinical supervision and the ward environment. Results Approximately 10% of nursing staff could be classed as "burnt-out". The main predictors of burnout were age and ward environment. Clinical supervision had minimal association with burnout. Discussion The current study sheds doubt on clinical supervision as a potential intervention for burnout and results appear comparable to research within other settings. The implications of the ward environment, supervision and burnout are discussed herein. Implication for Practice Interventions may need to focus on a positive ward environment (including patient cohesion, experienced safety and enhancing the therapeutic atmosphere). Organizations should support younger nursing staff as they appear particularly vulnerable to burnout.
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Integrating Self-Determination and Job Demands-Resources Theory in Predicting Mental Health Provider Burnout. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2019; 45:121-130. [PMID: 27783240 DOI: 10.1007/s10488-016-0772-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Limited progress has been made in reducing burnout in mental health professionals. Accordingly, we identified factors that might protect against burnout and could be productive focal areas for future interventions. Guided by self-determination theory, we examined whether supervisor autonomy support, self-efficacy, and staff cohesion predict provider burnout. 358 staff from 13 agencies completed surveys. Higher levels of supervisor autonomy support, self-efficacy, and staff cohesion were predictive of lower burnout, even after accounting for job demands. Although administrators may be limited in their ability to reduce job demands, our findings suggest that increasing core job resources may be a viable alternative.
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9
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Deldar K, Froutan R, Dalvand S, Gheshlagh RG, Mazloum SR. The Relationship between Resiliency and Burnout in Iranian Nurses: A Systematic Review and Meta-Analysis. Open Access Maced J Med Sci 2018; 6:2250-2256. [PMID: 30559897 PMCID: PMC6290412 DOI: 10.3889/oamjms.2018.428] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 10/20/2018] [Accepted: 10/30/2018] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND: The impact of resiliency on professional burnout in nurses has been evaluated in several studies. AIM: This meta-analysis was conducted to examine the effect of resiliency on different aspects of nurses’ professional burnout. MATERIAL AND METHODS: Publications were identified through targeted literature review in national and international databases between 1980-2017, in Persian and English. Two independent coders assessed and extracted articles. Data analysis was done by a random effects model. Study heterogeneity was measured by the I2 test. The data were analysed by STATA software v. 14. RESULTS: Initially, 227 articles were extracted. After titles and abstract screening, 108 articles were selected for full-text review. Only five of them had the necessary inclusion criteria for analysis. The meta-analysis performed on these observational studies showed that the correlation between resiliency and burnout was -0.57 with a 95% confidence interval of -0.354 to -0.726. CONCLUSION: Regarding the inverse relationship between resiliency and burnout, it is recommended to plan for the interventions that can improve the resilience of nurses against burnout. Conducting interventional and resilient training courses for nurses in nursing education can be considered.
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Affiliation(s)
- Kolsoum Deldar
- Faculty of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Razieh Froutan
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sahar Dalvand
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Ghanei Gheshlagh
- Clinical Care Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Seyed Reza Mazloum
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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Burnout in mental health professionals: A systematic review and meta-analysis of prevalence and determinants. Eur Psychiatry 2018; 53:74-99. [PMID: 29957371 DOI: 10.1016/j.eurpsy.2018.06.003] [Citation(s) in RCA: 213] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 06/12/2018] [Accepted: 06/13/2018] [Indexed: 11/23/2022] Open
Abstract
This study aimed to estimate the level of burnout in mental health professionals and to identify specific determinants of burnout in this population. A systematic search of MEDLINE/PubMed, PsychINFO/Ovid, Embase, CINAHL/EBSCO and Web of Science was conducted for original research published between 1997 and 2017. Sixty-two studies were identified as meeting the study criteria for the systematic review. Data on the means, standard deviations, and prevalence of the dimensions of burnout were extracted from 33 studies and included in the meta-analysis (n = 9409). The overall estimated pooled prevalence for emotional exhaustion was 40% (CI 31%-48%) for depersonalisation was 22% (CI 15%-29%) and for low levels of personal accomplishment was 19% (CI 13%-25%). The random effects estimate of the mean scores on the Maslach Burnout Inventory indicate that the average mental health professional has high levels of emotional exhaustion [mean 21.11 (95% CI 19.98, 22.24)], moderate levels of depersonalisation [mean 6.76 (95% CI 6.11, 7.42)] but retains reasonable levels of personal accomplishment [mean 34.60 (95% CI 32.99, 36.21)]. Increasing age was found to be associated with an increased risk of depersonalisation but also a heightened sense of personal accomplishment. Work-related factors such as workload and relationships at work, are key determinants for burnout, while role clarity, a sense of professional autonomy, a sense of being fairly treated, and access to regular clinical supervision appear to be protective. Staff working in community mental health teams may be more vulnerable to burnout than those working in some specialist community teams, e.g., assertive outreach, crisis teams.
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Zaninotto L, Rossi G, Danieli A, Frasson A, Meneghetti L, Zordan M, Tito P, Salvetti B, Conca A, Ferranti R, Salcuni S, Solmi M. Exploring the relationships among personality traits, burnout dimensions and stigma in a sample of mental health professionals. Psychiatry Res 2018; 264:327-333. [PMID: 29665563 DOI: 10.1016/j.psychres.2018.03.076] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 02/11/2018] [Accepted: 03/28/2018] [Indexed: 11/15/2022]
Abstract
A sample of mental health professionals (n = 215) from six Community Mental Health Services was examined using a short version of the Attribution Questionnaire-27, the Maslach Burnout Inventory and the Ten Items Personality Inventory to detect possible associations among stigma, burnout dimensions and personality traits. The role of demographic and professional variables was also explored. Perception of workplace safety resulted to significantly affect attitudes toward patients. The concern about being assaulted and a low level of Personal Accomplishment were both related to avoidant attitudes, while the presence of procedures for managing the violent patient was associated with a higher level of Personal Accomplishment. Conversely, Emotional Stability and Openness to new experiences were inversely correlated with burnout dimensions and avoidant attitudes, respectively. Overall, our study supports the view of a significant association among some dimensions of stigma, burnout and personality factors. In particular, avoidant attitudes toward patients may be influenced by Personal Accomplishment and Openness to new experiences.
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Affiliation(s)
- Leonardo Zaninotto
- Department of Mental Health, Local Health Unit n. 6 ("Euganea"), Via dei Colli n. 6/4, 35143, Padova, Italy.
| | - Genny Rossi
- Department of Mental Health, Local Health Unit n. 7 ("Pedemontana"), Via Cereria n. 14/B, 36061, Bassano del Grappa (VI), Italy
| | - Andrea Danieli
- Department of Mental Health, Local Health Unit n. 8 ("Berica"), Contrà Mure Corpus Domini n. 19, 36100, Vicenza, Italy
| | - Alberto Frasson
- Department of Mental Health, Local Health Unit n. 6 ("Euganea"), Via dei Colli n. 6/4, 35143, Padova, Italy
| | - Leonardo Meneghetti
- Department of Mental Health, Local Health Unit n. 6 ("Euganea"), Via dei Colli n. 6/4, 35143, Padova, Italy
| | - Maria Zordan
- Department of Mental Health, Local Health Unit n. 7 ("Pedemontana"), Via Cereria n. 14/B, 36061, Bassano del Grappa (VI), Italy
| | - Paolo Tito
- Department of Mental Health, Local Health Unit n. 7 ("Pedemontana"), Via Cereria n. 14/B, 36061, Bassano del Grappa (VI), Italy
| | - Beatrice Salvetti
- Department of Mental Health, Local Health Unit of Südtirol, Via Lorenz Böhler n. 5, 39100, Bolzano, Italy
| | - Andreas Conca
- Department of Mental Health, Local Health Unit of Südtirol, Via Lorenz Böhler n. 5, 39100, Bolzano, Italy
| | - Roberta Ferranti
- Department of Mental Health, Local Health Unit n. 6 ("Euganea"), Via dei Colli n. 6/4, 35143, Padova, Italy
| | - Silvia Salcuni
- Department of Developmental Psychology and Socialisation, University of Padova, Via Venezia n. 8, 35131, Padova, Italy
| | - Marco Solmi
- Department of Neurosciences, University of Padova, Via Giustiniani n. 2, 35128, Padova, Italy
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Edward KL, Hercelinskyj G, Giandinoto JA. Emotional labour in mental health nursing: An integrative systematic review. Int J Ment Health Nurs 2017; 26:215-225. [PMID: 28374961 DOI: 10.1111/inm.12330] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2017] [Indexed: 11/30/2022]
Abstract
Emotional labour is the effort consumed by suppressing one's own emotions to care for others effectively while also caring for oneself. Mental health nurses are required to engage in effective therapeutic interactions in emotionally-intense situations. The aim of the present integrative systematic review was to investigate the emotional labour of mental health work and how this manifested, the impacts, and the ways to mitigate these impacts. In June 2016, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, a systematic search of the bibliographic databases was undertaken to identify relevant literature. Screening, data extraction, and synthesis were performed by three reviewers. The inclusion criteria included any original research that investigated the emotional work of mental health nurses. We identified a total of 20 papers to be included in this review. Thematic synthesis of the findings revealed three emergent themes: emotional labour and caring, emotional exhaustion, and self-protection (expressed as emotional intelligence). Emotional labour, emotional exhaustion, and emotional intelligence were considered to be intrinsically linked, where they were both the influencing factor for burnout and a contributor to attrition. The results highlighted that emotional labour could inspire the development and personal growth of emotional intelligence in mental health nurses. In light of these findings, recommendations for clinical practice were considered; they included supportive work environments, involving nurses in shared decision-making, and the provision of ongoing professional development opportunities that facilitate the development of emotional intelligence and resilience.
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Affiliation(s)
- Karen-Leigh Edward
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,Nursing Research Unit, St Vincent's Private Hospital, Melbourne, Victoria, Australia
| | - Gylo Hercelinskyj
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,Nursing Research Unit, St Vincent's Private Hospital, Melbourne, Victoria, Australia
| | - Jo-Ann Giandinoto
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,Nursing Research Unit, St Vincent's Private Hospital, Melbourne, Victoria, Australia
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Ríos-Risquez MI, García-Izquierdo M. Patient satisfaction, stress and burnout in nursing personnel in emergency departments: A cross-sectional study. Int J Nurs Stud 2016; 59:60-7. [PMID: 27222451 DOI: 10.1016/j.ijnurstu.2016.02.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 02/05/2016] [Accepted: 02/10/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Patient satisfaction is considered a measure of the status of the interaction between health- care professionals and service users. The level of this measure indicates the quality of the care received. Burnout is a common phenomenon in nursing professionals and it is a response to the chronic occupational stress. Different studies have shown a link between patient satisfaction and stress and burnout syndrome experienced by nursing personnel in various hospital units. OBJECTIVES The main objective of this study was to analyze the associations between patients' satisfaction with emergency services and perception of work stress and burnout by the nursing professionals who looked after these patients at a group level. DESIGN The study followed a descriptive and cross-sectional design; the data were collected by means of questionnaires. SETTING Emergency services at two general hospitals in Murcia (Spain). PARTICIPANTS Two samples, one formed of emergency service nursing professionals (n=148) and the other formed by patients (n=390), who were grouped in 48 units of analysis. METHODS To evaluate perception of stress and burnout of the nursing personnel, we used the Spanish adaptation of the Nursing Stress Scale for hospital emergency nursing personnel, and the Spanish adaptation of the Maslach Burnout Inventory, respectively. A Spanish adaptation of the La Mónica-Obsert Patient Satisfaction Scale was used to define the patients' feelings about their nursing care. Moreover, some socio-demographic variables and the length of stay in the emergency unit were included in the protocol. Before statistical analysis, the data were collated at a group level. The intraclass correlation coefficients and the Average Deviation Index support the aggregation of these data at a unit level. RESULTS Neither perception of stress nor the various elements of burnout experienced by nursing staff were related to patients' levels of satisfaction. We observed a significant and positive association between stress perception among the nurses and two of the burnout dimensions, namely emotional exhaustion and cynicism. The length of stay of the patients in the emergency department was negatively related to the frequency of nurses experiencing perceived stress as well as the burnout dimension of cynicism. CONCLUSIONS No significant association was observed between experiences of stress and burnout dimensions by nursing professionals and the satisfaction with care received reported by their patients. These findings could be explained by the professional and organizational characteristics of the unit. Finally, the limitations and implications of the study are discussed, as well as future research questions related to research of the associations between occupational stress, burnout and patient satisfaction.
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Affiliation(s)
- M Isabel Ríos-Risquez
- University of Murcia, University Hospital Morales Meseguer, Marqués de los Vélez, 30008 Murcia, Spain.
| | - Mariano García-Izquierdo
- Department of Psychiatry and Social Psychology, Faculty of Psychology, University of Murcia, ENAE Business School, Campus Universitario de Espinardo, 30100 Espinardo, Murcia, Spain.
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Fanneran T, Brimblecombe N, Bradley E, Gregory S. Using workload measurement tools in diverse care contexts: the experience of staff in mental health and learning disability inpatient settings. J Psychiatr Ment Health Nurs 2015; 22:764-72. [PMID: 26608674 DOI: 10.1111/jpm.12263] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2015] [Indexed: 11/30/2022]
Abstract
ACCESSIBLE SUMMARY What is known on the subject? Difficulties with the recruitment and retention of qualified nursing staff have resulted in nursing shortages worldwide with a consequential impact on the quality of care. It is increasingly recommended that evidence-based staffing levels are central to the development of workforce plans. Due to a paucity of empirical research in mental health and learning disability services the staffing needs and requirements for these settings are undefined and the availability of tools to aid staffing decisions is limited. What this paper adds to existing knowledge? This paper provides a valuable insight into the practical uses of these tools as perceived by staff members with day-to-day experience of the requirements of mental health and learning disability wards. It reveals that while workload measurement tools are considered a valuable aid for the development of workforce plans, they are limited in their ability to capture all aspects of care provision in these settings. It further emphasizes the inapplicability of a one-shoe-fits-all approach for determining nurse staffing levels and the need for individual and customized workforce plans. What are the implications for practice? This study demonstrates that the development of tools for use in mental health and learning disability services is in its infancy, yet no tool that has been validated as such. It highlights the potential for workload measurement tools to aid staffing decisions; however, a more holistic approach that considers additional factors is needed to ensure robust workforce planning models are developed for these services. INTRODUCTION The critical challenge of determining the correct level and skill mix of nursing staff required to deliver safe and effective health care has become an international concern. It is recommended that evidence-based staffing decisions are central to the development of future workforce plans. Workforce planning in mental health and learning disability nursing is largely under-researched with few tools available to aid the development of evidence-based staffing levels in these environments. AIM It was the aim of this study to explore the experience of staff using the Safer Nursing Care Tool and the Mental Health and Learning Disability Workload Tool in mental health and learning disability environments. METHOD Following a 4-week trial period of both tools, a survey was distributed via Qualtrics online survey software to staff members who used the tools during this time. RESULTS The results of the survey revealed that the tools were considered a useful resource to aid staffing decisions; however, specific criticisms were highlighted regarding their suitability to psychiatric intensive care units and learning disability wards. DISCUSSION This study highlights that further development of workload measurement tools is required to support the implementation of effective workforce planning strategies within mental health and learning disability services. IMPLICATIONS FOR PRACTICE With increasing fiscal pressures, the need to provide cost-effective care is paramount within the services of the National Health Service. Evidence-based workforce planning is therefore necessary to ensure that appropriate levels of staff are determined. This is of particular importance within mental health and learning disability services due to the reduction in the number of available beds and an increasing focus on purposeful admission and discharge.
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Affiliation(s)
- T Fanneran
- Research & Innovation, South Staffordshire & Shropshire Healthcare NHS Foundation Trust, Trust Headquarters, Stafford
| | | | - E Bradley
- Research & Innovation, South Staffordshire & Shropshire Healthcare NHS Foundation Trust, Trust Headquarters, Stafford
| | - S Gregory
- Shropshire Community Health NHS Trust, Shrewsbury, United Kingdom
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Nejati A, Shepley M, Rodiek S, Lee C, Varni J. Restorative Design Features for Hospital Staff Break Areas. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2015; 9:16-35. [DOI: 10.1177/1937586715592632] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: The study investigated the main restorative components of staff break areas in healthcare facilities, by assessing usage patterns, verbal/visual preferences, and perceived restorative qualities of specific design features found in break areas for hospital staff. Background: Nurses are extremely important to the healthcare industry, and maintaining the quality of nursing care is a central concern for healthcare administrators. While healthcare leaders are concerned about improving nurses’ satisfaction, performance, and job retention, they may overlook the importance of respite for nurses and underestimate the value of designing staff break areas to maximize their restorative potential. Methods: A multi-method approach combined qualitative explorations (focused interviews and narrative survey questions) with quantitative measurements (discrete survey questions and a visual ranking of break-room spaces), and the results were compared and triangulated. Results: It was found that staff break areas are more likely to be used if they are in close proximity to nurses’ work areas, if they have complete privacy from patients and families, and if they provide opportunities for individual privacy as well as socialization with coworkers. Having physical access to private outdoor spaces (e.g., balconies or porches) was shown to have significantly greater perceived restorative potential, in comparison with window views, artwork, or indoor plants. Conclusions: The results of this empirical study support the conclusion that improvements in the restorative quality of break areas may significantly improve nurses’ satisfaction and stress reduction, potentially leading to improved care for the patients they serve.
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Affiliation(s)
- Adeleh Nejati
- Department of Architecture, Center for Health Systems & Design, Texas A&M University, College Station, TX, USA
| | | | - Susan Rodiek
- Department of Architecture, Center for Health Systems & Design, Texas A&M University, College Station, TX, USA
| | - Chanam Lee
- Department of Landscape Architecture & Urban Planning, Center for Health Systems & Design, Texas A&M University, College Station, TX, USA
| | - James Varni
- Department of Landscape Architecture & Urban Planning, Center for Health Systems & Design, Texas A&M University, College Station, TX, USA
- Department of Pediatrics, College of Medicine, Texas A&M University, College Station, TX, USA
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Hashemian SMR, Farzanegan B, Fathi M, Ardehali SH, Vahedian-Azimi A, Asghari-Jafarabadi M, Hajiesmaeili M. Stress Among Iranian Nurses in Critical Wards. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e22612. [PMID: 26380798 PMCID: PMC4568573 DOI: 10.5812/ircmj.22612v2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 02/08/2015] [Accepted: 03/25/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Stress has been recognized as a significant psychosocial and physiologic component in educational and practical processes. OBJECTIVES The purpose of present study was to survey stress among Iranian nurses in critical wards. PATIENTS AND METHODS In this cross-sectional study, 3643 anonymous questionnaires were disseminated among nurses in different hospitals in Tehran, Iran, by utilizing multistage random sampling. The questionnaire consisted of two sections: demographic characteristics and a 22-item list on a five-point Likert scale. The association of variables with stress was evaluated using hierarchical logistic regression. RESULTS A total of 3043 completed questionnaires were completed and returned (response rate, 83.53%). Age (> 33 years, 1571 (51.63%); < 33 years old, 1472 (48.37%)), marital status (single, 188 (6.18%); married, 2685 (88.24%); and widow, 170 (5.59%)), working shift (morning, 605 (19.88%); evening, 631 (20.74%); night, 603 (19.82%); and rotation, 1204 (39.57%)), and the years of experience of nurses (1 - 5 years, 413 (13.57%); 6 - 10 years, 589 (19.36%); 11 - 15 years, 832 (27.34%); 16 - 20 years, 758 (24.91%); and 21-25 years, 451 (14.82%)) had significant association with the level of stress (P < 0.05 for all parameters). However, sex (male, 937 (30.79%); and female, 2106 (69.21%)), education (associate, 444 (14.59%); baccalaureate, 2250 (73.94%); and master, 349 (11.47%)), and body mass index (> 24.6 kg/m(2), 2514 (49.75%); and < 24.6 kg/m(2), 1529 (50.25%)) showed no significant association with the level of stress (P > 0.05 for all parameters). CONCLUSIONS Considering the personal and background characteristics of personnel and understanding their association with stress and stressful situations encompasses the ability to persevere and adapt to contextual stressors.
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Affiliation(s)
- Seyed Mohammad Reza Hashemian
- Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Behrooz Farzanegan
- Tracheal Diseases Research Center (TDRC), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Mohammad Fathi
- Shahid Modares Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Seyed Hossein Ardehali
- Anesthesiology Research Center, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Amir Vahedian-Azimi
- Behavioral Sciences Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Mohammad Asghari-Jafarabadi
- Traffic Injury Prevention Research Center, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Mohammadreza Hajiesmaeili
- Clinical Research Development Center, Loghman Hakim Hospital , Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Mohammadreza Hajiesmaeili, Clinical Research Development Center, Loghman Hakim Hospital , Shahid Beheshti University of Medical Sciences, P.O. Box: 1333635445, Tehran, IR Iran. Tel: +98-2151025343, Fax: +98-2155424040, E-mail:
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Khamisa N, Oldenburg B, Peltzer K, Ilic D. Work related stress, burnout, job satisfaction and general health of nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:652-66. [PMID: 25588157 PMCID: PMC4306884 DOI: 10.3390/ijerph120100652] [Citation(s) in RCA: 320] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 12/25/2014] [Indexed: 11/17/2022]
Abstract
Gaps in research focusing on work related stress, burnout, job satisfaction and general health of nurses is evident within developing contexts like South Africa. This study identified the relationship between work related stress, burnout, job satisfaction and general health of nurses. A total of 1200 nurses from four hospitals were invited to participate in this cross-sectional study (75% response rate). Participants completed five questionnaires and multiple linear regression analysis was used to determine significant relationships between variables. Staff issues are best associated with burnout as well as job satisfaction. Burnout explained the highest amount of variance in mental health of nurses. These are known to compromise productivity and performance, as well as affect the quality of patient care. Issues, such as security risks in the workplace, affect job satisfaction and health of nurses. Although this is more salient to developing contexts it is important in developing strategies and intervention programs towards improving nurse and patient related outcomes.
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Affiliation(s)
- Natasha Khamisa
- Department of Public Health, School of Health Sciences, Monash South Africa, 144 Peter Road, Roodepoort, 1725 Johannesburg, South Africa.
| | - Brian Oldenburg
- School of Population and Global Health, University of Melbourne, Victoria, 3010 Melbourne, Australia.
| | - Karl Peltzer
- Department of Psychology, University of Free State, Bloemfontein 9300, South Africa.
| | - Dragan Ilic
- Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, 3004 Melbourne, Australia.
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van der Colff JJ, Rothmann S. Occupational stress of professional nurses in South Africa. JOURNAL OF PSYCHOLOGY IN AFRICA 2014. [DOI: 10.1080/14330237.2014.980626] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
| | - Sebastiaan Rothmann
- Optentia Research Focus Area, North-West University, Vanderbijlpark, South Africa
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Yoshizawa K, Sugawara N, Yasui-Furukori N, Danjo K, Furukori H, Sato Y, Tomita T, Fujii A, Nakagam T, Sasaki M, Nakamura K. Relationship between occupational stress and depression among psychiatric nurses in Japan. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2014; 71:10-15. [PMID: 25148581 DOI: 10.1080/19338244.2014.927345] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Psychiatric nursing is a stressful area of nursing practice. The purpose of this study was to examine occupational stress among psychiatric nurses in Japan. In this cross-sectional study, 238 psychiatric nurses were recruited from 7 hospitals. Data regarding the Generic Job Stress Questionnaire (GJSQ), the Center for Epidemiologic Studies for Depression Scale (CES-D), and the Health Practice Index (HPI) were obtained via self-report questionnaires. After adjusting for all the variables, CES-D scores were associated with job stress, but social support reduced the effect of stress on depression among psychiatric nurses. However, the interpretation of these results was hampered by the lack of data concerning important occupational factors, such as working position, personal income, and working hours. Further longitudinal investigation into the factors associated with depression may yield useful information for administrative and psychological interventions.
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Affiliation(s)
- Kaori Yoshizawa
- a Department of Neuropsychiatry , Hirosaki University School of Medicine , Hirosaki , Japan
| | - Norio Sugawara
- a Department of Neuropsychiatry , Hirosaki University School of Medicine , Hirosaki , Japan
| | - Norio Yasui-Furukori
- a Department of Neuropsychiatry , Hirosaki University School of Medicine , Hirosaki , Japan
| | | | - Hanako Furukori
- c Department of Psychiatry , Kuroishi-Akebono Hospital , Kuroishi , Japan
| | - Yasushi Sato
- a Department of Neuropsychiatry , Hirosaki University School of Medicine , Hirosaki , Japan
- d Department of Psychiatry , Mutsu General Hospital , Mutsu , Japan
| | - Tetsu Tomita
- a Department of Neuropsychiatry , Hirosaki University School of Medicine , Hirosaki , Japan
- e Department of Psychiatry , Hirosaki-Aiseikai Hospital , Hirosaki , Japan
| | - Akira Fujii
- f Department of Psychiatry , Seihoku-Chuoh Hospital , Goshogawara , Japan
| | - Taku Nakagam
- a Department of Neuropsychiatry , Hirosaki University School of Medicine , Hirosaki , Japan
- g Department of Psychiatry , Odate Municipal General Hospital , Odate , Japan
| | - Masahide Sasaki
- a Department of Neuropsychiatry , Hirosaki University School of Medicine , Hirosaki , Japan
| | - Kazuhiko Nakamura
- a Department of Neuropsychiatry , Hirosaki University School of Medicine , Hirosaki , Japan
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Farmakas A, Papastavrou E, Siskou O, Karayiannis G, Theodorou M. Challenges in mental health nursing: working in institutional or community settings? J Psychiatr Ment Health Nurs 2014; 21:39-45. [PMID: 23413921 DOI: 10.1111/jpm.12045] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/07/2013] [Indexed: 11/30/2022]
Abstract
Professional environments likely affect patient safety, quality of care provided, and nurses' satisfaction and retention. The aim of this study was to explore mental health nurses' perceptions of their professional practice environment and examine differences in perceptions between nurses working at institutions and those practising in community care. The methodology used was descriptive and comparative. The sample consisted of 248 mental health nurses working within the public sector (76% response rate) drawn from a psychiatric hospital (n = 163) and community settings (n = 85). We administered the Revised Professional Practice Environment (RPPE) questionnaire. Comparisons of the two groups were made using eight subscales of the RPPE. The results indicated that mental health nurses' ratings of their practice environment were slightly positive (M = 2.69; range = 1-4). Nurses working in a psychiatric hospital perceived the professional practice environment more negatively (M = 2.66) than their colleagues in community care (M = 2.73). A t-test comparison revealed statistically significant differences between the two groups within subcategories of work motivation (P = 0.04) and leadership and autonomy (P = 0.03). Nurses working in the community gave higher ratings in comparison with their colleagues working in institutional settings. In conclusions, an in-depth analysis of differences in practice environments is required to define causes of these differences and how they might influence nurses' abilities to provide quality care.
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Affiliation(s)
- A Farmakas
- Ministry of Health, European University, Nicosia, Cyprus; Nursing Program, Department of Health Sciences, School of Sciences, European University, Nicosia, Cyprus
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Roelen C, van Rhenen W, Schaufeli W, van der Klink J, Magerøy N, Moen B, Bjorvatn B, Pallesen S. Mental and physical health-related functioning mediates between psychological job demands and sickness absence among nurses. J Adv Nurs 2013; 70:1780-92. [DOI: 10.1111/jan.12335] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2013] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - Jac van der Klink
- Department of Health Sciences; University Medical Center Groningen; The Netherlands
| | | | - Bente Moen
- Department of Global Public Health and Primary Care; University of Bergen; Norway
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care; University of Bergen; Norway
| | - Ståle Pallesen
- Department of Psychosocial Science; University of Bergen; Norway
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Johnson S, Osborn DPJ, Araya R, Wearn E, Paul M, Stafford M, Wellman N, Nolan F, Killaspy H, Lloyd-Evans B, Anderson E, Wood SJ. Morale in the English mental health workforce: questionnaire survey. Br J Psychiatry 2012; 201:239-46. [PMID: 22790677 DOI: 10.1192/bjp.bp.111.098970] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND High-quality evidence on morale in the mental health workforce is lacking. AIMS To describe staff well-being and satisfaction in a multicentre UK National Health Service (NHS) sample and explore associated factors. METHOD A questionnaire-based survey (n = 2258) was conducted in 100 wards and 36 community teams in England. Measures included a set of frequently used indicators of staff morale, and measures of perceived job characteristics based on Karasek's demand-control-support model. RESULTS Staff well-being and job satisfaction were fairly good on most indicators, but emotional exhaustion was high among acute general ward and community mental health team (CMHT) staff and among social workers. Most morale indicators were moderately but significantly intercorrelated. Principal components analysis yielded two components, one appearing to reflect emotional strain, the other positive engagement with work. In multilevel regression analyses factors associated with greater emotional strain included working in a CMHT or psychiatric intensive care unit (PICU), high job demands, low autonomy, limited support from managers and colleagues, age under 45 years and junior grade. Greater positive engagement was associated with high job demands, autonomy and support from managers and colleagues, Black or Asian ethnic group, being a psychiatrist or service manager and shorter length of service. CONCLUSIONS Potential foci for interventions to increase morale include CMHTs, PICUs and general acute wards. The explanatory value of the demand-support-control model was confirmed, but job characteristics did not fully explain differences in morale indicators across service types and professions.
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Affiliation(s)
- Sonia Johnson
- Mental Health Sciences Unit, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EY, UK.
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Abstract
AIM The aims of this study were to validate the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) for registered nurses in South Africa and to analyse the differences between the levels of burnout of different biographical groups. BACKGROUND The nursing profession is seen as a stressful and emotionally demanding profession, which makes nurses susceptible to burnout. METHOD A cross-sectional survey design with a stratified random sample (n = 818) was used. The MBI-HSS and a biographical questionnaire were administered. RESULTS Exploratory factor analysis resulted in a three-factor structure of burnout, consisting of emotional exhaustion, depersonalization and personal accomplishment. Construct equivalence and reliability of the three factors were confirmed. Significant differences were found in burnout levels with regard to language, age, rank, job satisfaction, reciprocity, full-time employment and specialised training. CONCLUSIONS The MBI-HSS showed acceptable validity and reliability for South African nurses. Burnout is associated with specific factors, including language, age, rank, job satisfaction, reciprocity, full-time employment and specialised training. IMPLICATIONS FOR NURSING MANAGEMENT The use of the MBI-HSS is recommended to assess burnout of nurses in South Africa. Organisations employing nurses should intervene to prevent and/or manage burnout.
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Affiliation(s)
- Johanna J van der Colff
- Fundamental Nursing and Administration, College of Nursing, Sultan Qaboos University, Muscat, Oman
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Demands, control, supportive relationships and well-being amongst British mental health workers. Soc Psychiatry Psychiatr Epidemiol 2011; 46:1055-68. [PMID: 20635075 DOI: 10.1007/s00127-010-0263-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Accepted: 06/23/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE Staff well-being is considered to be a potential problem within mental health occupations, and its variability is in need of investigation. Our starting point is to assess the role of demands, control and supportive relationships that are at the core of Karasek's model. The study aims to assess the relationship amongst mental health workers of job demands, control and support (from peers and superiors) with multiple measures of well-being. METHOD Data were obtained through a self-completion questionnaire from mental health staff in 100 inpatient wards, 18 crisis resolution/home treatment teams and 18 community mental health teams. The data was analysed using multilevel regression analysis. RESULTS Job demands (negatively), control (positively) and supportive relationships (positively) are each uniquely associated with the five measures of well-being included in the study: namely intrinsic satisfaction, anxiety, depression, emotional exhaustion and personal accomplishment. Non-linear and interaction effects involving these demands, control and supportive relationships are found, but vary in type and strength across well-being measures. CONCLUSIONS The combination of low levels of demands and high levels of control and supportive relationships is good for the well-being of mental health staff. Our results suggest that management initiatives in mental health services should be targeted at creating this combination within the working environment, and particularly at increasing levels of job control.
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Pienaar JW, Bester CL. The Impact of Burnout on the Intention to Quit among Professional Nurses in the Free State Region — a National Crisis? SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2011. [DOI: 10.1177/008124631104100112] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Thousands of qualified nurses leave the South African health sector on an annual basis owing to various reasons, including burnout. Research showed that demanding work circumstances could influence employees to consider whether to leave an organisation or not. The aim of this study was to determine the level of burnout among professional nurses and to explore the potential impact of burnout on the intention to quit/change. The sample consisted of 563 professional nurses representing 140 clinics located in five health districts in the Free State region. A total of 542 (97%) questionnaires were completed and returned. Participants in the study were predominantly black (83.8%), female (89.3%), day-shift working (89.8%) and full-time employed (99.8%). The measuring tools included a biographical questionnaire, Maslach's Burnout Inventory to determine the level of burnout of professional nurses, and an Intention to Quit/Change questionnaire. Analysis of variance was used to determine differences regarding burnout between different groups with varying degrees of intention to quit/change. Respondents exhibited high levels of Emotional Exhaustion, Depersonalization and average levels of Personal Accomplishment. Respondents with the highest levels of Emotional Exhaustion and Depersonalization and the lowest levels of Personal Accomplishment displayed a higher degree of intention to quit/change.
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Affiliation(s)
- Jacobus W. Pienaar
- Centre for Health Systems Research and Development, Department of Industrial Psychology, University of the Free State, Bloemfontein, South Africa
| | - Coenraad L. Bester
- Centre for Health Systems Research and Development, Department of Industrial Psychology, University of the Free State, Bloemfontein, South Africa
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Santavirta N, Solovieva S, Theorell T. The association between job strain and emotional exhaustion in a cohort of 1,028 Finnish teachers. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2011; 77:213-28. [PMID: 17411496 DOI: 10.1348/000709905x92045] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Teachers' work overload has been the subject of intense research, and the results of these studies show that a substantial proportion of teachers perceive their job as very stressful. AIMS To investigate how different formulations of high demands and low decision latitude was related to teachers' burnout, and to estimate the possible interaction between these factors. SAMPLE The sample consisted of 1,028 school teachers. METHOD Multivariate covariant analyses (MANCOVA) was used to evaluate the relationship between a high-strain job defined by 3 different cut-off points and burnout. Logistical regression analysis was used to estimate the separate and joint effects of demand and decision authority on emotional exhaustion. Interaction between high demands and low decision authority was analysed using relative excess risk due to interaction (RERI). An attributable proportion (AP) was calculated in order to estimate the proportion of emotionally exhausted teachers among those exposed to both risk factors that was attributable to their synergistic interaction. The group of teachers who perceived their job as a low-strain job was used as the reference group in the analysis. RESULTS The effect of job strain on burnout was proved to be consistent and robust across alternative formulations. The main effect of high demands exceeded that of low decision authority in relation to emotional exhaustion. Furthermore, the 2 factors acted synergistically to increase the risk of burnout. CONCLUSIONS In the case of burnout, teachers who perceived their job as highly demanding and low in control, 69% of the effect could be attributed to the synergism of these 2 factors.
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Roche MA, Duffield CM. A Comparison of the Nursing Practice Environment in Mental Health and Medical-Surgical Settings. J Nurs Scholarsh 2010; 42:195-206. [DOI: 10.1111/j.1547-5069.2010.01348.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
It is widely acknowledged that mental health nursing has undergone considerable change in Australia during recent decades, including the mainstreaming of mental health services into the general health care system. Recruitment problems and high levels of stress and burnout associated with the profession are seen to be indicative of a degree of demise in the status and desirability of this field of practice. However, new nursing roles have developed in response to these changes. The aim of this paper is to focus on three specific roles: mental health consultation-liaison nursing; mental health nurse practitioner; and the mental health nurse incentive program. These new roles present exciting and rewarding career opportunities for mental health nurses and may increase the attractiveness of mental health nursing for new graduates.
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Affiliation(s)
- Brenda Happell
- CQ University of Australia, Institute for Health and Social Sciences, Bruce Highway, Rockhampton, Queensland 4702, Australia.
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Satisfaction and burnout among staff of crisis resolution, assertive outreach and community mental health teams. A multicentre cross sectional survey. Soc Psychiatry Psychiatr Epidemiol 2009; 44:541-9. [PMID: 19082906 DOI: 10.1007/s00127-008-0480-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2008] [Accepted: 11/14/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND The NHS Plan required extensive changes in the configuration of mental health services in the UK, including introduction of crisis resolution teams, CRTs. Little is known about the effects of these changes on mental health staff and their recruitment and retention. AIMS To assess levels of burnout and sources of satisfaction and stress in CRT staff and compare them with assertive outreach team (AOT) and community mental health team (CMHT) staff. METHOD Cross sectional survey using questionnaires, including the Maslach Burnout Inventory, the Minnesota Satisfaction Scale and global job satisfaction item from the Job Diagnostic Survey. All staff in 11 CRTs in 7 London boroughs were included. RESULTS One hundred and sixty-nine questionnaires were received (response rate 78%). CRT staff were moderately satisfied with their jobs and scores for the three components of burnout were low or average. Their sense of personal accomplishment was greater than in the other types of team. CONCLUSION Our results suggest that CRTs may be sustainable from a workforce morale perspective, but longer term effects will need to be assessed.
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Gerolamo AM. An exploratory analysis of the relationship between psychiatric nurses' perceptions of workload and unit activity. Arch Psychiatr Nurs 2009; 23:243-50. [PMID: 19446779 DOI: 10.1016/j.apnu.2008.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2007] [Revised: 01/25/2008] [Accepted: 06/18/2008] [Indexed: 11/15/2022]
Abstract
Although research exists relative to psychiatric nurses' perceptions of their work conditions, the relationship between nurses' perceptions of their workloads and the activities in which they engage has been unexplored. The purpose of this study is to examine the relationship between unit activity and nurses' perceptions of their workloads. The design is a secondary analysis using two data sources: (a) reports from 36 psychiatric nurses consisting of perceptions of their work conditions (n = 383) and (b) the hospital census and activity and acuity 24-hour shift reports (n = 384). Nurses' perceptions of workloads were related to unit activity; the greater the number of heavy and medium-to-heavy workloads, the higher the unit activity. This evidence contributes to the growing body of research demonstrating that nurses accurately provide information related to the hospital environment.
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Buntinx W. The logic of relations and the logic of management. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2008; 52:588-597. [PMID: 18557861 DOI: 10.1111/j.1365-2788.2008.01067.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Increasing emphasis on financial and administrative control processes is affecting service culture in support organisations for persons with intellectual disability. This phenomenon is currently obvious in Dutch service organisations that find themselves in transition towards more community care and at the same time under pressure from new administrative and funding managerial bureaucracy. As a result, the logic of management is becoming more dominant in direct support settings and risk to overshadow the logic of relationships between staff and clients. METHOD The article presents a reflection on this phenomenon, starting from a description of service team characteristics as found in the literature. Next, findings about direct support staff (DSS) continuity are summarised from four Dutch studies. Following up these findings, the concept of 'microsystems' is explored as a possible answer to the organisational challenges demonstrated in the studies. RESULTS Team characteristics, especially team size and membership continuity for DSS, appear relevant factors for assuring supportive relationships and service quality in direct support teams. The structure of the primary support team shows to be of special interest. The organisational concept of 'microsystems' is explored with respect to transcending the present conflict between bureaucratic managerial pressure and the need for supportive relationships. CONCLUSION Service organisations need to create structural conditions for the efficacy of direct support teams in terms of client relationships and relevant client outcomes. At the same time, the need for administrative and control processes can not be denied. The concept of 'microsystems', application of a Quality of Life framework and the use of new instruments, such as the Supports Intensity Scale, can contribute to an organisational solution for the present conflicting logic of relations and management.
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Affiliation(s)
- W Buntinx
- Maastricht University, Maastricht, Netherlands.
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Ulrich RS, Zimring C, Zhu X, DuBose J, Seo HB, Choi YS, Quan X, Joseph A. A Review of the Research Literature on Evidence-Based Healthcare Design. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2008; 1:61-125. [DOI: 10.1177/193758670800100306] [Citation(s) in RCA: 683] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: This report surveys and evaluates the scientific research on evidence-based healthcare design and extracts its implications for designing better and safer hospitals. Background: It builds on a literature review conducted by researchers in 2004. Methods: Research teams conducted a new and more exhaustive search for rigorous empirical studies that link the design of hospital physical environments with healthcare outcomes. The review followed a two-step process, including an extensive search for existing literature and a screening of each identified study for the relevance and quality of evidence. Results: This review found a growing body of rigorous studies to guide healthcare design, especially with respect to reducing the frequency of hospital-acquired infections. Results are organized according to three general types of outcomes: patient safety, other patient outcomes, and staff outcomes. The findings further support the importance of improving outcomes for a range of design characteristics or interventions, including single-bed rooms rather than multibed rooms, effective ventilation systems, a good acoustic environment, nature distractions and daylight, appropriate lighting, better ergonomic design, acuity-adaptable rooms, and improved floor layouts and work settings. Directions for future research are also identified. Conclusions: The state of knowledge of evidence-based healthcare design has grown rapidly in recent years. The evidence indicates that well-designed physical settings play an important role in making hospitals safer and more healing for patients, and better places for staff to work.
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Abstract
AIM This paper reports a study examining factors that may contribute to burnout among healthcare personnel. BACKGROUND The impact on burnout of factors such as workload and interpersonal conflicts is well-documented. However, although health care is a moral endeavour, little is known about the impact of moral strain. Interviews reveal that healthcare personnel experience a troubled conscience when they feel that they cannot provide the good care that they wish - and believe it is their duty - to give. METHODS In this cross-sectional study, conducted in 2003, a sample of 423 healthcare personnel in Sweden completed a battery of questionnaires comprising the Maslach Burnout Inventory, Perception of Conscience Questionnaire, Stress of Conscience Questionnaire, Social Interactions Scale, Resilience Scale and a personal/work demographic form. RESULTS Regression analysis resulted in a model that explained approximately 59% of the total variation in emotional exhaustion. Factors associated with emotional exhaustion were 'having to deaden one's conscience', and 'stress of conscience' from lacking the time to provide the care needed, work being so demanding that it influences one's home life, and not being able to live up to others' expectations. Several additional variables were associated with emotional exhaustion. Factors contributing to depersonalization were 'having to deaden one's conscience', 'stress of conscience' from not being able to live up to others' expectations and from having to lower one's aspirations to provide good care, deficient social support from co-workers, and being a physician; however, the percentage of variation explained was smaller (30%). CONCLUSION Being attentive to our own and others' feelings of troubled conscience is important in preventing burnout in health care, and staff need opportunities to reflect on their troubled conscience. Further research is needed into how a troubled conscience can be eased, particularly focusing on the working environment.
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Affiliation(s)
- A L Glasberg
- Department of Nursing, Umeå University, Umeå, Sweden.
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Bandeira M, Ishara S, Zuardi AW. Satisfação e sobrecarga de profissionais de saúde mental: validade de construto das escalas SATIS-BR e IMPACTO-BR. JORNAL BRASILEIRO DE PSIQUIATRIA 2007. [DOI: 10.1590/s0047-20852007000400007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Os níveis de satisfação e sobrecarga de profissionais em serviços de saúde mental afetam tanto a sua saúde e o bem-estar quanto a qualidade do cuidado prestado aos pacientes. Para avaliar estas dimensões, é necessário ter acesso a escalas de medida válidas e fidedignas. Este artigo visou descrever um estudo da validade de construto de duas escalas de avaliação da satisfação (SATIS-BR) e da sobrecarga (IMPACTO-BR) de profissionais em serviços de saúde mental. MÉTODOS: As escalas foram aplicadas a uma amostra de 172 profissionais, que trabalhavam em seis serviços de psiquiatria de uma cidade de porte médio de São Paulo. A validade de construto foi avaliada a partir do teste da hipótese de que deve haver uma correlação significativa entre dois construtos teoricamente relacionados. Para isso, foram feitas análises estatísticas correlacionais de Spearman entre as escalas de satisfação e sobrecarga, assim como uma comparação de dois subgrupos de sujeitos, com e sem indicativo de estresse, com relação aos seus graus de satisfação e sobrecarga no trabalho. RESULTADOS: Obteve-se correlação significativa negativa esperada entre os escores de satisfação e sobrecarga (r = -0,38). Obteve-se ainda a diferença significativa entre dois grupos de sujeitos, com e sem estresse, com relação ao grau de satisfação e sobrecarga no trabalho, sujeitos com estresse apresentando níveis mais baixos de satisfação no trabalho e grau mais elevado de sobrecarga. CONCLUSÕES: Conclui-se que as escalas analisadas apresentam validade de construto e são adequadas para monitorar a qualidade de serviços de saúde mental. A escala de sobrecarga constituiu um preditor do estresse apresentado pelos trabalhadores em saúde mental.
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Richards DA, Bee P, Barkham M, Gilbody SM, Cahill J, Glanville J. The prevalence of nursing staff stress on adult acute psychiatric in-patient wards. A systematic review. Soc Psychiatry Psychiatr Epidemiol 2006; 41:34-43. [PMID: 16341829 DOI: 10.1007/s00127-005-0998-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/16/2005] [Indexed: 11/26/2022]
Abstract
BACKGROUND Concerns about recent changes in acute in-patient mental health care environments have led to fears about staff stress and poor morale in acute in-patient mental health care staff. AIM To review the prevalence of low staff morale, stress, burnout, job satisfaction and psychological well-being amongst staff working in in-patient psychiatric wards. METHOD Systematic review. RESULTS Of 34 mental health studies identified, 13 were specific to acute in-patient settings, and 21 were specific to other non-specified ward-based samples. Most studies did not find very high levels of staff burnout and poor morale but were mostly small, of poor quality and provided incomplete or non-standardised prevalence data. CONCLUSIONS The prevalence of indicators of low morale on acute in-patient mental health wards has been poorly researched and remains unclear. Multi-site, prospective epidemiological studies using validated measures of stress together with personal and organizational variables influencing staff stress in acute in-patient wards are required.
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Affiliation(s)
- David A Richards
- Dept. of Health Sciences, University of York, Seebohm Rowntree Building, University Road, Heslington, York, YO10 5DD, UK
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Sveinsdóttir H, Biering P, Ramel A. Occupational stress, job satisfaction, and working environment among Icelandic nurses: a cross-sectional questionnaire survey. Int J Nurs Stud 2005; 43:875-89. [PMID: 16360157 DOI: 10.1016/j.ijnurstu.2005.11.002] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2005] [Revised: 11/03/2005] [Accepted: 11/05/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND Nurses' occupational stress decreases job satisfaction, increases turnover rate, and reduces nursing quality. At different workplaces nurses are confronted with different work tasks, working conditions and hence different sources of stress. OBJECTIVES The purpose of this study was to explore what factors contribute to work-related stress among Icelandic nurses working within and outside the hospital environment. DESIGN The study used a cross-sectional survey design. SETTINGS AND PARTICIPANTS The study population was composed of all working nurses registered at the Icelandic Nurses' Association (INA). Approximately 95% (N=2,234) of Icelandic nurses are members of the INA. Questionnaires were posted to 522 (23.4%) randomly selected participants. The response rate was 42% (N=219), representing 9.8% of the population. Data was analyzed from 206 nurses; 35% worked outside the hospital setting and 65% were hospital based. METHODS Data was gathered on demographic information and indicators of working conditions, occupational stress, workload, and job satisfaction. A stepwise, multiple linear regression model was employed to calculate significant predictors of occupational stress. RESULTS The findings suggest that the strenuous conditions of Icelandic nurses are felt more severely among hospital nurses than among nurses working outside hospital settings. The study identified which sources of occupational stress are specific to each of the two groups. CONCLUSIONS The study found several factors that contribute to work-related stress. These findings can be used to guide preventive measures to diminish occupational stress among Icelandic nurses.
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Affiliation(s)
- Herdís Sveinsdóttir
- Department of Nursing & Institute of Nursing Research, University of Iceland, Eiriksgata 34, 101 Reykjavik, Iceland.
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Takase M, Maude P, Manias E. Nurses' job dissatisfaction and turnover intention: Methodological myths and an alternative approach. Nurs Health Sci 2005; 7:209-17. [PMID: 16083484 DOI: 10.1111/j.1442-2018.2005.00232.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Job dissatisfaction and turnover are recurring themes in nursing. The current international nursing shortage has resulted in increased interest in investigating the causes of nurses' job dissatisfaction and turnover, and in developing countermeasures to address these issues. This paper involves a review of quantitative nursing studies, which investigated the causes of nurses' job dissatisfaction and turnover intention, and identifies commonly held myths that may inhibit more nurse-centered strategies from being developed. These myths are based on an assumption that a nurse-environment relationship is a one-way interaction in which nurses passively respond to their environment. The paper introduces the person-environment fit theory as an alternative framework, which challenges the assumption by suggesting it is the relationship between person and environment, rather than environmental characteristics alone, that affects nurses' occupational behavior. This theory enables nurse researchers to develop a more mutual approach involving the nurse and environment.
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Affiliation(s)
- Miyuki Takase
- School of Nursing, The University of Melbourne, Level 1, 723 Swanston Street, Carlton, Victoria 3053, Australia.
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van den Berg TIJ, Landeweerd JA, Tummers GER, van Merode GG. A comparative study of organisational characteristics, work characteristics and nurses' psychological work reactions in a hospital and nursing home setting. Int J Nurs Stud 2005; 43:491-505. [PMID: 16126210 DOI: 10.1016/j.ijnurstu.2005.06.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2004] [Revised: 05/25/2005] [Accepted: 06/28/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The aim of the current study was twofold. First, we explored whether there were any differences concerning organisational characteristics, work characteristics and psychological work reactions in two types of health care setting, hospitals and nursing homes. Second, it was investigated and validated whether relationships between organisational characteristics, work characteristics and psychological work reactions found in research on hospital nursing are also present in nursing homes. METHODS The variables were assessed by questionnaires that were distributed among nurses and caregivers in 15 randomly selected general hospitals and 14 nursing homes in the Netherlands. Manova and hierarchical regression analyses were carried out to explore differences in the variables and in relationships between the variables. RESULTS AND CONCLUSION Results show that the major difference in hospital-based and nursing home practice is in the work organisation as assessed by the organisational characteristics "environmental uncertainty" and "decision authority". Relations found between variables are in majority in line with the JDC-model and confirm the applicability of this theory in different types of health care settings.
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Affiliation(s)
- Tilja I J van den Berg
- University of Maastricht, Faculty of Health Sciences, Department of Health Organisation, Policy and Economics, The Netherlands
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41
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Abstract
Reducing occupational stress among nursing staff is a public health priority in many western countries. This study assessed stress differentials between psychiatric nurses (PNs) and general nurses (GNs), and the moderating function of social support. It was expected that PNs would report different (higher) stress levels than GNs given PNs' lower levels of social support. A questionnaire was completed and returned by 73 nurses at several public hospitals in England. Multivariate analysis of variance showed that social support moderated stress differentials between PNs and GNs, albeit not as anticipated; the latter group reported significantly higher and lower stress levels when social support was low and high, respectively. This interaction was applicable to both the quality and quantity of social support. Overall, the benefits of social support seemed to accrue primarily to GNs. Implications of these findings for the development of stress-reduction interventions are considered.
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Affiliation(s)
- Helen Hughes
- Department of Social Sciences, Nottingham Trent University, Burton Street, Nottingham, UK
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42
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Alimoglu MK, Donmez L. Daylight exposure and the other predictors of burnout among nurses in a University Hospital. Int J Nurs Stud 2005; 42:549-55. [PMID: 15921986 DOI: 10.1016/j.ijnurstu.2004.09.001] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2004] [Revised: 06/11/2004] [Accepted: 09/14/2004] [Indexed: 11/24/2022]
Abstract
The purpose of the study was to investigate if daylight exposure in work setting could be placed among the predictors of job burnout. The sample was composed of 141 nurses who work in Akdeniz University Hospital in Antalya, Turkey. All participants were asked to complete a personal data collection form, the Maslach Burnout Inventory, the Work Related Strain Inventory and the Work Satisfaction Questionnaire to collect data about their burnout, work-related stress (WRS) and job satisfaction (JS) levels in addition to personal characteristics. Descriptive statistics, parametric and non-parametric tests and correlation analysis were used in statistical analyses. Daylight exposure showed no direct effect on burnout but it was indirectly effective via WRS and JS. Exposure to daylight at least 3h a day was found to cause less stress and higher satisfaction at work. Suffering from sleep disorders, younger age, job-related health problems and educational level were found to have total or partial direct effects on burnout. Night shifts may lead to burnout via work related strain and working in inpatient services and dissatisfaction with annual income may be effective via job dissatisfaction. This study confirmed some established predictors of burnout and provided data on an unexplored area. Daylight exposure may be effective on job burnout.
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Affiliation(s)
- Mustafa Kemal Alimoglu
- Faculty of Medicine, Department of Medical Education, Akdeniz University, Antalya, Turkey.
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Abstract
The nursing workforce is aging at an unprecedented rate yet little is known about the health and safety of older registered nurses (RNs). The survey reported here examined the relationships between demographic variables, job attributes (job satisfaction, control over practice, and job demands) and the physical and mental health and job-related injuries and health disorders of 308 nurses over the age of 50. Findings indicate that nurses with higher job satisfaction, higher control over practice, and lower job demands experienced increased physical health. Increasing age was positively correlated with mental health. Almost a quarter of older RNs experienced a job-related injury within the past 5 years, and over a third experienced job-related health problems. Nurses with higher job demands and those employed in hospital settings were more likely to have an injury. Overall, older RNs reported higher levels of physical and mental health than the national norm. Efforts must be made to keep older RNs healthy so we can retain them in the workforce.
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Affiliation(s)
- Susan Letvak
- University of North Carolina at Greensboro, School of Nursing, 27402, USA.
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Boumans NPG, Landeweerd JA, Visser M. Differentiated practice, patient-oriented care and quality of work in a hospital in the Netherlands. Scand J Caring Sci 2004; 18:37-48. [PMID: 15005662 DOI: 10.1111/j.1471-6712.2004.00253.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This article describes a quantitative study of the relationship between differentiated practice on the one side and patient-oriented care and quality of work on the other. Nursing wards where differentiated practice has been implemented (intervention group) have been compared with wards where differentiated practice has not been implemented (reference group). The research variables with regard to differentiated practice, patient-oriented care and quality of work have been measured by questionnaires. Subjects were 68 nurses and six supervisors from six nursing wards from one hospital. The results show that the extent to which differentiated practice had been implemented varied between the wards. With regard to patient-oriented care differences have been found between the intervention and reference group on the variables patient assignment and use of the nursing process, but not on the variables of tasks and communication. Concerning quality of work, differences have been found on: social support from the supervisor, social-emotional leadership and health complaints. Rank order correlations between differentiated practice and patient-oriented care and between differentiated practice and quality of work were not significant. Practical implications with regard to the use of differentiated practice and implications for further research are discussed.
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Affiliation(s)
- Nicolle P G Boumans
- Faculty of Health Sciences, Department of Health Organization, Policy and Economics, Maastricht University, Maastricht, The Netherlands.
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Edwards D, Burnard P. A systematic review of stress and stress management interventions for mental health nurses. J Adv Nurs 2003; 42:169-200. [PMID: 12670386 DOI: 10.1046/j.1365-2648.2003.02600.x] [Citation(s) in RCA: 195] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Health care professionals in the United Kingdom (UK) appear to have higher absence and sickness rates than staff in other sectors, and stress may be a reason for nurses leaving their jobs. These problems need to be addressed, particularly in the mental health field, if current service provision is to be maintained. AIM The aim was to identify stressors, moderators and stress outcomes (i.e. measures included those related to stress, burnout and job satisfaction) for mental health nurses, as these have clear implications for stress management strategies. METHOD A systematic review of research published in English between 1966 and 2000 and undertaken in the UK that specifically identified participants as mental health nurses was carried out to determine the effectiveness of stress management interventions for those working in mental health nursing. Studies from non-UK countries were examined as potential models of good practice. The study was limited to primary research papers that specifically involved mental health nurses, where the health outcomes measured were stressors, moderators and stress outcomes and where sufficient data was provided. RESULTS The initial search identified 176 papers, of these 70 met the inclusion criteria. Seven studies have been reported since the completion of the review and have been included in this article. Sixty-nine focused on the stressors, moderators and stress outcomes and eight papers identified stress management techniques. Relaxation techniques, training in behavioural techniques, stress management workshops and training in therapeutic skills were effective stress management techniques for mental health nurses. Methodological flaws however, were detracted from the rigour of many of the studies. CONCLUSIONS The review demonstrated that a great deal is known about the sources of stress at work, about how to measure it and about the impact on a range of outcome indicators. What was found to be lacking was a translation of these results into practice, into research that assessed the impact of interventions that attempt to moderate, minimize or eliminate some of these stressors.
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Affiliation(s)
- D Edwards
- School of Nursing and Midwifery Studies, University of Wales College of Medicine, Cardiff, UK.
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Tummers GER, van Merode GG, Landeweerd JA. The diversity of work: differences, similarities and relationships concerning characteristics of the organisation, the work and psychological work reactions in intensive care and non-intensive care nursing. Int J Nurs Stud 2002; 39:841-55. [PMID: 12379302 DOI: 10.1016/s0020-7489(02)00020-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this study was to examine differences in organisational characteristics, work characteristics and psychological work reactions, and to investigate relationships between these variables in intensive care units (ICUs) and non-ICUs. Questionnaires were distributed to intensive care (n = 184) and non-intensive care nurses (n = 927) working in 15 general hospitals in the Netherlands. MANOVA showed that ICU nurses reported significantly higher uncertainty, higher complexity, and higher decision authority than non-ICU nurses. Emotional exhaustion was significantly lower among ICU nurses. Regarding the pattern of relationships, the LISREL-analyses revealed that the indirect proposed pattern of relationships was invariant across the two samples, which means a validation of our research model.
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Affiliation(s)
- Gladys E R Tummers
- Department of Health Organisation, Policy and Economics, Faculty of Health Sciences, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
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