A Multicenter Investigation of Caring Behaviors and Burnout Among Oncology Nurses in China

Job satisfaction and psychological factors influence the caring behavior in nurses in Sierra Leone: a cross-sectional study

Objective

Identifying the status of caring behavior and its influencing factors in nurses is crucial for improving the quality of care for patients. However, there is a lack of studies on this in Sierra Leone. This study explored the status of caring behavior and associated factors in nurses working in Sierra Leone.

Study design

A cross-sectional descriptive survey was conducted from October 3 to December 15, 2022, with clinical nurses recruited through convenience sampling.

Methods

The participants included 360 nurses from various nursing departments from 12 hospitals in Sierra Leone. Measurements included a general information questionnaire, the Caring Behavior Inventory, Connor-Davidson Resilience Scale, McCloskey/Mueller Satisfaction Scale and Zung's Self-Rating Anxiety Scale. Descriptive statistics, one-way analysis of variance and independent-sample t-tests, Pearson's correlation analyses, and multiple regression analyses were performed.

Results

Caring behavior score was 128.97 (SD 11.967); it significantly and positively correlated with job satisfaction and resilience and negatively correlated with anxiety. Linear regression analysis showed that resilience, job satisfaction, anxiety, daily working time, and position were the main predictors of caring behavior.

Conclusion

The level of caring behavior in nurses in Sierra Leone was moderate. Resilience and job satisfaction significantly and positively predicted nurses' caring behavior. Anxiety, daily working time, and position are important factors of caring behaviors.

Implications for practice

It is suggested to create a conducive working environment, reduce the excessive workload of nurses, enhance their positive psychological state, and their job satisfaction by providing recognition and rewards to improve the level of nurses' caring behavior.

Impact of narrative nursing cognition, self-efficacy, and social support on the practices of registered nurses in China: a structural equation modeling analysis

BACKGROUND

Narrative nursing is a novel approach according with humanistic care, which has been shown to be effective in improving health outcomes for both patients and nurses. Nevertheless, few studies have investigated the status of narrative nursing practice among nurses, and a comprehensive understanding of factors influencing this practice remains elusive.

DESIGN

This was an observational, cross-sectional study using convenience sampling method.

METHODS

After obtaining the informed consent, a total of 931 registered nurses from three hospitals in China were investigated. Data were collected using the Social Support Rating Scale, the General Self-efficacy Scale, and the Knowledge-Attitude-Practice Survey of Clinical Nurses on Narrative Nursing. All the scales were validated in the Chinese population. The questionnaire results were verified by an independent investigator. Factors influencing narrative nursing practice were determined through a series of analyses, including independent sample t-tests, one-way ANOVA, and Pearson correlations. Subsequently, path analysis was performed and a structural equation model was established.

RESULTS

The score of narrative nursing practice in this study was 30.26 ± 5.32. The structural equation model showed a good fit, with a Root Mean Square Error of Approximation (RMSEA) of 0.007 (90%CI: 0.000, 0.047). Both social support and narrative nursing attitude could directly affect narrative nursing practice (βsocial support = 0.08, P < 0.001; βattitude = 0.54, P < 0.001) and indirectly influence it via self-efficacy (βsocial support = 0.04, P < 0.001; βattitude = 0.06, P < 0.001). In addition, narrative nursing knowledge (β = 0.08, P < 0.001) and the nurses' growth environment (β=-0.06, P < 0.001) also affected the practice of narrative nursing.

CONCLUSION

Narrative nursing in China is at a medium level and could be influenced by several personal and environmental factors. This study highlighted the critical role of nursing management in the advancement of narrative nursing practices. Nurse managers should prioritize specialized training and cultivate supportive environments for nurses to improve their narrative nursing practices.

Impact of nurse-patient interaction levels on nurses' humanistic practice: A cross-sectional, descriptive, and correlational study

OBJECTIVE

The aim of this study is to analyze the levels of nurses-patients interaction, as well as the humanistic practices in the field of nurse´s care.

METHOD

This cross-sectional and correlational study was conducted with 291 nurses in Istanbul between May-August 2022. The los datos were collected using the Personal Information Form, Caring Nurse-Patient Interaction-Short Form (CNPI), and Humanistic Practice Ability of Nursing (HPAN).

RESULTS

Nurses' mean scores from the importance, competence, and feasibility variables of the CNPI were 104.33 ± 12.56, 99.66 ± 13.99, and 96.90 ± 15.26, respectively. The mean score from the HPAN was 133.75 ± 11.75.

CONCLUSION

Based on the correlation, the importance, competence, and feasibility variables of CNPI were significantly associated with humanistic practice ability.

Mindful self-care among oncology nurses in China: a latent profile analysis

BACKGROUND

Oncology nurses are considered the group with the highest risk for moral distress, compassion fatigue and burnout. Mindful self-care may help oncology nurses improve their well-being and solve psychological problems. However, the investigation and in-depth analysis of mindful self-care among oncology nurses in China is lacking.

OBJECTIVES

To identify heterogeneity groups of oncology nurses on mindful self-care ability and examine the sociodemographic correlation to these profiles.

DESIGN

Cross-sectional descriptive study.

PARTICIPANTS

The study was carried out among oncology nurses in two affiliated comprehensive hospitals and one affiliated oncology hospital. A total of 839 oncology nurses were enrolled in this survey.

METHODS

From January to May 2023, a cross-sectional study was carried out among oncology nurses using convenient sampling. The subjects were given the brief Mindful Self-Care Scale (B-MSCS) and the General Demographic Information Questionnaire. Latent profile analysis using the Mplus 7.4 program was used to separate oncology nurses' mindful self-care into a variety of subgroups. The SPSS 25.0 statistical program was used to analyze the data. One-way ANOVA and the chi-square test were performed to compare the score of B-MSCS in each class and the difference in sociodemographic characteristics among the subgroups. Multinomial logistic regression was used to examine the influence of the sociodemographic variables on each class.

RESULTS

The total score of the B-MSCS was 76.40 ± 13.19. The support structure dimension had the highest score, with an average mean value of 3.60, and physical care had the lowest score at 2.57. The findings of the latent profile analysis showed that respondents were divided into three classes, moderate mindful self-care(51.2%), low-low mindful relaxation(14.8%), and high-high mindfulness self-awareness(34.0%). Across scale scores and dimensions, three groups demonstrated statistically significant differences (p < 0.05). Univariate analysis revealed significant differences between the three profiles in terms of professional title, position, concern about self-care, interest in mindfulness, and experience with meditation (p < 0.05). Profile membership was predicted by 3 factors, namely, self-care status, interest in mindfulness, and experience with meditation.

CONCLUSION

The mindful self-care among oncology nurses can be categorized into three latent profiles: moderate mindful self-care, low-low mindful relaxation, and high-high mindfulness self-awareness. Multinomial logistic regression results indicated that whether oncology nurses concern about self-care, interest in mindfulness and have experience with meditation influenced different latent profiles. Nursing manager should develop targeted intervention based on the typological characteristics of the oncology nurses to improve their mindful self-care ability and mental health.

Does fear of compassion effect nurses' caring behaviours? a cross-sectional study

Aims: The aim of this study is to determine the levels of nurses' fear of compassion for others, fear of compassion from others, and fear of self-compassion and to examine the effect of fear of compassion on caring behaviors. Design: A cross-sectional, quantitative design was used. Participants and research context: The study was conducted between October 2022 and April 2023 with 304 nurses working in two public hospitals. Data collection tools were the "Fears of Compassion Scales" and the "Caring Behaviors Inventory." Data were analyzed using a t test, one-way ANOVA, Pearson correlation analysis, and stepwise multiple regression model. Ethical considerations: Ethics committee approval of the research was obtained from the non-invasive ethics committee of Kütahya Health Sciences University (Reference No: 25.05.2022/2022/06-19). The principles of the Declaration of Helsinki were followed in the study. The purpose of the research was explained to all participants, and their verbal/written informed consent was obtained. Results: The mean scores of nurses on fear of compassion for others and from others were at a moderate level, and their scores on fear of self-compassion were close to a moderate level. It was found that the level of nurses' fear of compassion was related to their sociodemographic and professional variables. Fear of self-compassion, fear of compassion for others, and fear of compassion from others explained 33.5% of the total variance in caring behaviors. Conclusions: Nurses' caring behaviors were shown to be more associated with fear of self-compassion than fear of compassion for others. Fear of compassion may be one of the barriers to compassionate care. Interventions that will reduce nurses' fear of compassion may be one way to provide compassionate care. It is recommended to conduct awareness studies on self-compassion and accepting compassion from others in nurses.

Nurses' self-regulation after engaging in end-of-life conversations with advanced cancer patients: a qualitative study

BACKGROUND

Self-regulation is crucial for nurses who engage in in-depth end-of-life conversations with advanced cancer patients, especially in cultural contexts featuring death taboos. An improved understanding of the self-regulation process of nurses can help them address negative emotions and promote self-growth more effectively. Therefore, this study aimed to explore nurses' self-regulation process after end-of-life conversations with advanced cancer patients.

METHODS

This study employed a descriptive, qualitative approach. Seventeen nurses from four hospitals and a hospice unit in mainland China were interviewed between September 2022 and June 2023. Data were collected through face-to-face semistructured interviews. A thematic analysis method was used to analyse the data following the guidance of regulatory focus theory.

RESULTS

Three main themes were developed: self-regulation antecedents include personality, experience, and support; promotion or prevention is a possible self-regulation process for nurses; both self-exhaustion and self-growth may be the outcomes of self-regulation, as did seven subthemes. Personality tendencies, life experience, and perceived support may affect nurses' self-regulation, thereby affecting their self-regulation outcomes.

CONCLUSIONS

Nurses exhibit different self-regulatory tendencies and self-regulation outcomes. The provision of peer support and counselling support to nurses is highly important with regard to achieving good self-regulation outcomes.

The prevalence, related factors and interventions of oncology nurses' burnout in different continents: A systematic review and meta-analysis

BACKGROUND

Burnout is a significant occupational problem among oncology nurses, affecting their physical and mental health and the quality of medical care. Besides, there is a gradually increasing trend that we should pay more attention to.

OBJECTIVES

To investigate the prevalence, influencing factors and interventions of oncology nurses' burnout among different continents.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

English literature in PubMed, EMBASE, MEDLINE/EBSCOhost, CINAHL Complete and Web and of Science were searched before 1 March 2022.

RESULTS

Twenty studies included 5904 oncology nurses in this review. Meta-analysis was performed in 19 of the studies. First, the pooled mean scores estimate for emotional exhaustion (EE) was 22.13 (95% CI: 19.69-24.58), depersonalization (DP) was 6.89 (95% CI: 5.67-8.10) and personal accomplishment (PA) was 32.86 (95% CI: 29.34-36.37). A high level of burnout was defined as a high level of EE (score ≥ 27), a high level of DP (score ≥ 10), and a low level of PA (score ≤ 33). Of these, 36.40% of nurses reported high EE, 28.26% reported high DP and 28.68% reported low levels of PA. Furthermore, there are differences in the prevalence, influencing factors and intervention measures of burnout among oncology nurses in different regions. The highest pooled mean scores for EE and DP were found in Asia. And the highest pooled mean scores for PA were found in the Americas. The factors that influence burnout among Asian oncology nurses are mostly personal-related factors such as empathy and personality traits, while the factors that influence burnout among European oncology nurses are work-related factors. This review included three intervention studies from Europe and the Americas, with fewer intervention studies on burnout in oncology nurses in Asia.

CONCLUSION

Oncology nurses in Asia had the highest pooled mean scores for EE and DP, and the highest mean scores for the PA pool in the Americas. There are regional differences in the prevalence and factors influencing burnout among oncology nurses, but there are few interventions for it. Therefore, future interventions should be developed to address the differences that exist in different regions.

RELEVANCE TO CLINICAL PRACTICE

Burnout among oncology nurses in different regions is a concern, and this review may provide a reference for managers to target interventions to alleviate burnout among oncology nurses.

Relationships between depression, self-efficacy, and professional values among Chinese oncology nurses: a multicenter cross-sectional study

OBJECTIVES

Many factors are related to oncology nurses' professional values. However, the evidence on the relevance of professional values among oncology nurses in China remains sparse. This study aims to investigate the relationship between depression, self-efficacy, and professional values among Chinese oncology nurses and analyze the mediating effect of self-efficacy on this association.

METHODS

It was a multicenter cross-sectional study designed with the STROBE guidelines. An anonymous online questionnaire recruited 2530 oncology nurses from 55 hospitals in six provinces of China between March and June 2021. Measures included self-designed sociodemographic and fully validated instruments. Pearson correlation analysis was employed to explore the associations between depression, self-efficacy, and professional values. Bootstrapping analysis by the PROCESS macro was used to examine the mediating effect of self-efficacy.

RESULTS

The total scores of depression, self-efficacy, and professional values of Chinese oncology nurses were 52.75 ± 12.62, 28.39 ± 6.33, and 101.55 ± 20.43, respectively. About 55.2% of Chinese oncology nurses were depressed. Chinese oncology nurses' professional values were generally intermediate. Their professional values were negatively related to depression and positively correlated with self-efficacy, while depression was negatively related to self-efficacy. Moreover, self-efficacy partially mediated the relationship between depression and professional values, accounting for 24.8% of the total effect.

CONCLUSIONS

Depression negatively predicts self-efficacy and professional values, and self-efficacy positively predicts professional values. Meanwhile, depression in Chinese oncology nurses has an indirect effect on their professional values through self-efficacy. Nursing managers and oncology nurses themselves should develop strategies aimed at relieving depression and improving self-efficacy to strengthen their positive professional values.

Gender similarities and differences in the perception of caring among nurses during the COVID-19 pandemic: a mixed-methods study

BACKGROUND

Caring is the essence and core of nursing. Current studies on the effect of gender on nurses' perception of caring have been inconsistent. Most of these studies were quantitative and conducted before the COVID-19 pandemic. The study aimed to explore the gender similarities and differences in nurses' perception of caring during the COVID-19 pandemic.

METHODS

In 2020, a cross-sectional mixed-method study was conducted in 11 cities in China using structured online questionnaire (n = 8030) and face-to-face individual interview (n = 42). Data collection tools included the Caring Dimensions Inventory and semi-structured interview.

RESULTS

In stepwise multivariable linear regression analysis, female nurses scored 1.93 points higher on caring than male nurses, after completely controlling for the other factors. The interview results showed that both male and female nurses agreed that caring was to deal with three kinds of relationships, namely nurses and people, nurses and themselves, nurses and society. There were gender differences in the connotation of caring between nurses and themselves, but not in the connotations of caring between other relationships. The ranking of the importance of caring connotations among these relationships showed no gender difference except between nurses and themselves.

CONCLUSION

The quantitative findings suggest that gender influences nurses' perception of caring. The qualitative findings demonstrate that nurses regard themselves as both recipients and implementers of caring. The qualitative results indicate nurses of different genders have similarities and differences in their perception of caring, and the biggest difference lies in the relationship between nurses and themselves.

Nursing in oncology ward with intertwined roles: a focused ethnography

BACKGROUND

Characteristics of nursing care in the oncology ward depend on this ward's specific context. This study aimed to investigate the nursing care in the oncology ward regarding the culture of this ward.

METHODS

This qualitative study was conducted in an oncology ward using a focused ethnographic approach. The whole nursing team of the selected ward (N = 16) participated in the study through purposeful sampling. Three methods of observation, interview, and field documents were used for data collection. Data were analyzed by Spradley's (1980) ethnographic method.

RESULTS

'Nursing in the oncology ward with intertwined roles' emerged as the main theme. This theme included the following subthemes: 'Robin Hood nurse,' 'a secretive nurse,' 'a negligent nurse,' 'a snitching nurse,' 'a complaining nurse,' 'an apathetic senior nurse,' 'a stigmatized training nurse,' 'a brazen-bodied nurse,' 'a compassionate nurse,' 'a moonlighting nurse,' and 'a drug bartender.'

CONCLUSION

This study provided a deep cultural insight into nursing care in the oncology ward, considering the particular culture of this ward and emphasizing the nurses' intertwined roles. These roles are on a spectrum, with positive roles, such as compassion, on one side and negative roles, such as negligence, on the other. The results of this study can be provided to nursing managers; therefore, by being aware of nurses' roles considering the specific subculture of the oncology ward, they can provide psychological interventions to improve the mental health of reluctant and complaining nurses and ethics-based training for secretive, negligent, and snitching nurses to provide quality care to the patient.

Nurse and Patient Assessments of COVID-19 Care Quality in China: A Comparative Survey Study

During the COVID-19 pandemic, the quality of nursing care was a concern due to nurses' overwhelming workload. A cross-sectional design was conducted to compare perceptions between nurses and patients about the quality of nursing care for COVID-19 patients and to explore factors associated with these perceptions. Data were collected during the COVID-19 pandemic from 17 March to 13 April 2020 in five hospitals in Wuhan, China. Perceptions of care quality were assessed among nurses and patients using the Caring Behaviors Inventory. Nurses rated the quality of caring behaviors higher than patients. Both nurses and patients rated technical caring behaviors at high levels and rated the item related to "spending time with the patient" the lowest, while patients rated it much lower than nurses. Nurses' sex, participation in ethical training organized by the hospital, professional title, being invited to Wuhan, and length of working experience in years were significantly associated with nurses' self-evaluated caring behaviors. Moreover, inpatient setting and communication mode were significantly associated with patients' self-evaluated caring behaviors.

Oncology nursing on the move: a contemporary issue on Chinese oncology nursing in cancer care

Cancers have become the primary cause of death among Chinese residents, seriously affecting their health and life. Oncology nursing is a specialized nursing practice focusing on cancer education, prevention, screening, early detection, and palliative and hospice care. China has made tremendous progress in developing oncology nursing. However, to ensure more individuals can get cancer care, the country's healthcare system still confronts several problems in oncology nursing that need to be addressed to ensure that more individuals can receive cancer care. This article reviews the current development of oncology nursing in China, especially in pain symptom control, palliative care, end-of-life care, education and training. The challenges faced in oncology nursing in China and the suggestions for developing oncology nursing in China are also discussed and proposed in this review. The growth of research on oncology nursing by Chinese nursing scholars and concerned policymakers is anticipated to ultimately improve oncology nursing and the quality of life of patients with cancer in China.

Job engagement and satisfaction are associated with nurse caring behaviours: A cross-sectional study

BACKGROUND

There is a scarcity of literature assessing the impact of job engagement and satisfaction in the nurse's caring behaviours. This study aims to identify how these factors affect the caring behaviours of nurses.

METHODS

This study used a cross-sectional design and employed self-report questionnaires. A total of 549 nurses from private and government hospitals participated in the survey conducted in the year 2019. Descriptive and inferential statistics were utilized to analyse the data.

RESULTS

Results revealed that the nurses display high caring behaviours and job engagement and moderate sense of satisfaction. Remarkably, there are no profile variables significantly related to the nurse's caring behaviours. Findings suggest that job engagement and satisfaction are significantly associated with the nurses' caring behaviours.

CONCLUSION

Factors such as job engagement and satisfaction affect nurses' caring behaviours.

IMPLICATIONS TO NURSING MANAGEMENT

Health organisations must provide strategies to increase job engagement and satisfaction of nurses to yield high caring behaviours, which is vital to the achievement of patient safety.

Burnout Precursors in Oncology Nurses: A Preliminary Cross-Sectional Study with a Systemic Organizational Analysis

Burnout negatively affects nurses’ health and performance. Healthcare managers have an ethical duty to create healthy organizations that reduce burnout, especially within critical settings such as oncology. The aim of this study was twofold: (1) to measure the presence of nurses’ burnout to formulate organizational strategies to prevent the syndrome onset, and (2) to evaluate the effect of recent organizational changes on the burnout phenomenon. A descriptive, cross-sectional design supported by a systemic organizational analysis was conducted in a Swiss Oncology Institute in 2013. Of 103 nurses working in the Institute, 52 (51.4%) completed the Burnout Potential Inventory (BPI) questionnaire. Data were analyzed using descriptive statistics and Mann–Whitney and Kruskal–Wallis tests. Burnout risk levels were low to moderate. Only 2 nurses out of the 52 showed moderate burnout risk levels. Inpatient nurses showed a higher risk of burnout than outpatient nurses, particularly due to ambiguity and feelings of powerlessness. Nurses with post-basic education showed a higher risk when considering poor teamwork values and ambiguity in the workplace. Poor middle-management was found to negatively influence worker wellbeing. The working environment set by management resulted in low burnout risk levels. Managers must carefully select middle-management because inappropriate leadership might promote the onset of burnout.