An Exploratory Study of the Influence of Perceived Organizational Support, Coworker Social Support, the Nursing Practice Environment, and Nurse Demographics on Burnout in Palliative Care Nurses

More Than a Game: Building a Workplace Culture of Positivity and Belonging Among Nurses

This performance improvement project introduced a mobile social gaming app for sharing positive feedback from patients and coworkers with nurses. After deployment, the app supported creating improvements as a supportive structure for engaging nurses in peer recognition to build a workplace culture of positivity and belonging. The authors discuss findings from the app's adoption and use among nurses and offer recommendations for leaders.

The Nursing Work Environment, Supervisory Support, Nurse Characteristics, and Burnout as Predictors of Intent to Stay among Hospital Nurses in the Republic of Korea: A Path Analysis

This study aimed to examine the comprehensive impact of five aspects of the nursing work environment as well as supervisory support, nurse characteristics, and burnout on intent to stay (ITS) among Korean hospital nurses. A cross-sectional questionnaire was distributed in seven general hospitals from May to July of 2019. Data were collected from a sample of 631 Korean nurses. The hypothesized model was evaluated using the STATA program for path models. Findings demonstrated that burnout played a mediating role on the relationships between the nursing work environment, supervisory support, nurse characteristics, and ITS. Burnout was the most influential predictor of ITS (β = -0.36, p < 0.001). Nurse participation in hospital affairs (β = 0.10, p = 0.044) and collegial nurse-physician relationships (β = 0.08, p = 0.038) had a direct effect on ITS. Supervisory support had a significant direct effect on ITS (β = 0.19, p < 0.001). Therefore, to increase nurses' ITS, it is necessary to improve their participation in hospital affairs and collegial relationships, as well as strengthen support from supervisors and reduce burnout.

Nurses' sense of organizational support, Self-esteem and perceived professional benefits: A mediating model

AIM

To explore the mediating role of self-esteem in the relationship between perceived organizational support and professional benefits among Registered Nurses in China.

DESIGN

This was an online, cross-sectional study involving 1850 nurses from six hospitals in China.

METHODS

Data were collected using a 4-part questionnaire including a sociodemographic questionnaire, perceived organizational support scale, self-esteem scale and brief nurses' perceived professional benefits questionnaire from September to November 2021. Structural equation modelling (SEM) was used to explore the associations among them.

RESULTS

Perceived organizational support was positively correlated with self-esteem and perceived professional benefits among nurses, whereas self-esteem positively predicted nurses' perceived professional benefits . Self-esteem partially mediated the relationship between the two variables. The ratio of the mediating effect to the total effect was 16.7%.

The 2023-2026 Hospice and Palliative Nurses Association Research Agenda

The Hospice and Palliative Nursing Association established the triannual research agenda to ( a ) provide focus for researchers to conduct meaningful scientific and quality improvement initiatives and inform evidence-based practice, ( b ) guide organizational funding, and ( c ) illustrate to other stakeholders the importance of nursing research foci. HPNA Research Agendas are developed to give direction for future research to continue advancing expert care in serious illness and ensure equitable delivery of hospice and palliative care.

Another Piece of the Practice Environment Puzzle: Development and Validation of a Team Virtuousness Instrument

The Practice Environment Scale of the Nursing Work Index, a widely used practice environment instrument, does not measure vital coworker interrelations. Team virtuousness measures coworker interrelations, yet the literature lacks a comprehensive instrument built from a theoretical foundation that captures the structure. This study sought to develop a comprehensive measure of team virtuousness built from Aquinas' Virtue Ethics Theory that captures the underlying structure. Subjects included nursing unit staff and master of business administration (MBA) students. A total of 114 items were generated and administered to MBA students. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were run on randomly split halves. Based on analyses, 33 items were subsequently administered to nursing unit staff. EFA and CFA were repeated on randomly split halves; CFA item loadings replicated EFA. Three components emerged from the MBA student data: integrity, α = .96; group benevolence, α = .70; and excellence, α = .91. Two components emerged from the nursing unit data: wisdom, α = .97; and excellence, α = .94. Team virtuousness varied significantly among units and correlated significantly with engagement. The two component instrument, named the Perceived Trustworthiness Indicator, is a comprehensive measure of team virtuousness built from a theoretical framework that captures the underlying structure, demonstrates adequate reliability and validity, and measures coworker interrelations on nursing units. Forgiveness and relational and inner harmony emerged as elements of team virtuousness, broadening understanding.

The relationship between psychiatric nurses' perceived organizational support and job burnout: Mediating role of psychological capital

Background

Psychiatric nurses need to keep close contact with patients suffering from mental illness. Because of the special nature of their profession, there is an increasing incidence of job burnout among psychiatric nurses.

Aim

This study examined the relationship between psychiatric nurses' perceived organizational support, job burnout, and psychological capital. It also investigated the mediating role of psychological capital in the relationship between their perceived organizational support and job burnout.

Methods

A total of 916 psychiatric nurses were recruited from 6 grade-III mental facilities in Shandong Province using the stratified sampling approach. Their data were collected and examined using a general demographic data questionnaire, The Maslach Burnout Inventory, the Perceived Organizational Support Scale, and the Psychological Capital Questionnaire.

Results

The total score of job burnout was 53.71 ± 16.37. Specifically, 73.69% of the nurses had moderate to severe emotional exhaustion, 76.75% had moderate to severe job burnout pertaining to depersonalization, and 98.80% had moderate to severe job burnout pertaining to personal accomplishment. Spearman's correlation analysis showed that both psychological capital (r = -0.35, p < 0.01) and perceived organizational support (r = -0.31, p < 0.01) were adversely related to job burnout. Additionally, psychological capital somewhat mediated the relationship between perceived organizational support and job burnout. Its mediating impact accounted for 33.20% of the overall effect.

Conclusion

This study's participants had a moderate to severe level of job burnout. However, organizational support and psychological capital can be crucial in alleviating this problem among psychiatric nurses. Therefore, nursing managers and medical institutions should undertake timely and positive interventions to improve psychiatric nurses' mental health and prevent job burnout. While exploring the impact of organizational support and psychological capital on job burnout, future studies should consider other effective influencing factors, and the relationship between the different factors should be explored in depth. This would provide a basis for developing a job burnout prevention mechanism.

Status and related factors of burnout among palliative nurses in China: a cross-sectional study

Background

Burnout occurs frequently in nurses and seems more common in nurses providing palliative care. However, to our knowledge, there is a lack of understanding regarding the factors influencing burnout among palliative nurses in China.

Methods

A cross-sectional design was conducted. A total of 331 palliative nurses from 25 hospitals participated in this study. Anonymous data were collected through a self-designed social-demographic questionnaire, the Nursing Burnout Scale, the Perceived Social Support Scale, the General Self-Efficacy Scale, the Connor-Davidson Resilience Scale, and the Simplified Coping Style Questionnaire. Independent sample t tests, one-way ANOVA, Pearson correlations, and multiple linear regressions were performed to identify the related factors of the three dimensions of burnout.

Results

In the results of multiple linear regression, resilience, health condition, coping style, and pessimistic personality were common related factors; in addition, end-of-life care training, social support, and income satisfaction were statistically significantly associated with burnout. These factors could explain 38.6%, 27.8%, and 34.5% of the total variance in emotional exhaustion, depersonalization, and reduced personal accomplishment, respectively.

Conclusions

The findings of this study help policy makers and nurse managers better understand burnout among palliative nurses in China. The results highlighted the importance of implementing culture-oriented training programs, providing perceived organizational support, and building a reasonable salary system to decrease burnout among palliative nurses, increase the quality of nursing and promote the development of Chinese palliative care.

Mediating effect of resilience on the relationship between perceived social support and burnout among Chinese palliative nurses

AIMS AND OBJECTIVES

To detect the mediating effect of resilience on the relationship between perceived social support and burnout in Chinese palliative nurses.

BACKGROUND

Palliative nurses are a group that is vulnerable to burnout. Perceived social support may contribute to decreasing palliative nurses' burnout and facilitating their personal resilience, and resilience may be associated with lower levels of burnout. However, these relationships were unclear in the Chinese context.

DESIGN

A cross-sectional design.

METHODS

The STROBE guideline was performed to report this study. A mixed sampling method including convenience sampling and stratified sampling was used to recruit participants, and a total of 319 palliative nurses completed the Nursing Burnout Scale, the Perceived Social Support Scale and the Connor-Davidson Resilience Scale from May 2021 to September 2021. Influencing factors were primarily identified using independent-sample t tests and one-way ANOVA. Bootstrap method was used to detect the mediating effect of resilience.

RESULTS

The level of burnout in palliative nurses (23.4 ± 7.68) was higher than that of general nurses in China. Education level, health condition and monthly income were influencing factors of burnout. Resilience was detected as a mediator in the relationships between perceived social support and dimensions of burnout.

CONCLUSIONS

Chinese palliative nurses experience a relatively high level of burnout, which may be influenced by several sociodemographic variables. Resilience could mediate the effect of perceived social support on the dimensions of burnout. Problem-oriented and palliative-tailored strategies should be developed to further address burnout in Chinese palliative nurses.

RELEVANCE TO CLINICAL PRACTICE

Nurse managers and policy makers should support nurse ongoing education, adopt health-promoting interventions and optimise salary systems. In addition, perceived social support resources and resilience training programmes are also warranted.

PATIENT OR PUBLIC CONTRIBUTION

All participants were invited to complete the informed consent form and paper questionnaires. Human resource managers helped us collect some subjective data through the personnel management system. Nurse managers of palliative units conducted regular staff meetings to promote the data collection process.

Reduced Anxiety Associated to Adaptive and Mindful Coping Strategies in General Practitioners Compared With Hospital Nurses in Response to COVID-19 Pandemic Primary Care Reorganization

COVID-19 pandemic imposed psychosocial stress increasing in frontline healthcare workers, who managed by responding with different coping strategies. General practitioners were targeted by an extraordinary increase in the demand for reception, diagnosis and treatment from all patients even if working in solo. In Italy, the emergency changed risk assumption and roles in between primary care, unraveling the emotional distress of general practitioners, who suffered not only for isolation, but also emotional threatens. In this correlational study we wanted to evaluate trait anxiety and stress as perceived by general practitioners working in individual ambulatory practice room, and by hospital ward nurses working in group, during a chronic phase (February-May 2021) of COVID-19 pandemic. Our hypothesis is that a different work social organization in clinic contest as for general practitioners compared with nurses could induce adaptive or non-adaptive coping to stress under emergency and mindful attitude could be crucial. A number of 37 general practitioners, and 36 nurses were taken from the sanitary district of ASL1 Avezzano-Sulmona-L'Aquila in Italy. For our analyses we used the Health Professions Stress and Coping Scale to assess the risk of burn-out, and detect the coping strategies. We also used the Cognitive and Affective Mindfulness Scale-Revised, investigating whether clinicians used an eventual mindful attitude to prevent anxiety and responding with adaptive coping strategies. General practitioners reported high levels of anxiety, associated to an increased use of emotional distress. Mindful attitude was protective for anxiety in both general practitioners and nurses. As anxiety increased, it was coped by increasing the demand for social support. This coping strategy correlated with emotional distress and when enhanced, it corresponded to avoidance of the problem. Mindful attitude addressed general practitioners to adaptive coping strategies as the solution of the problem. On the other side, nurses accepted the problem but addressed it to others, by avoiding solving it themselves as beyond their role and organizational responsibility. In conclusion, mindful attitude can prevent dysfunctional reactive behaviors among clinicians at the forefront of emergency and reduce emotional distress for isolation as suffered by general practitioners.

Effects of mobile-based mindfulness meditation for mental health of nurses: a protocol for systematic review and meta-analysis

INTRODUCTION

Existing studies have shown that mobile-based mindfulness meditation (MMM) can have a certain impact on nurses' mental health problems, but its specific effect and the effect on specific mental health problems such as stress, anxiety, depression, mindfulness, well-being and resilience are not clear.

METHODS AND ANALYSIS

This study protocol follows the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols guidelines. Electronic search through PubMed, Web of Science, EBSCO, Cochrane Library, CINAHL, PsycINFO, ERIC, Embase and three Chinese databases namely CNKI, Wan Fang and Chinese Biology Medicine disc. The inclusion criteria follow the PICO principle, which is defined translate the question into a searchable and answerable question . P (patient/population): clinical characteristics of patients; I (intervention or exposure): treatment measures or exposure factors of concern; C (comparison): control measure.; O (outcome): outcome indicator of concern. Registered nurses, preregistered nurses, midwives and nursing students will all be included, studies using MMM as intervention to improve mental health of nurses, compared with waitlist controls or traditional methods groups, outcomes assessment of stress, anxiety, depression, mindfulness, well-being and resilience will meet the inclusion criteria. Studies designed randomised controlled trails (RCTs) of quasiexperimental and written in English or Chinese will be eligible. Search time was from inception of each database to July 2022. Two reviewers screen and assess studies for inclusion and extract data independently; any dispute will be settled through discussion. If the discussion still fails, the third author will make a decision. For RCT, risk of bias will be assessed using Cochrane risk-of-bias tool for randomised trials (RoB 2), and for non-RCT studies, risk of bias in non-randomised studies of interventions (ROBINS-I) tool will be performed. Meta-analysis will be performed using RevMan software if sufficient number of comparable studies are retrieved.

ETHICS AND DISSEMINATION

This is a study protocol of meta-analysis; no primary data will be collected, and no ethics assessment is required. The study results will be presented in a peer-reviewed scientific publication.

PROSPERO REGISTRATION NUMBER

CRD42021277932.

The Work Environment of Immigrant Employees in Sweden—a Systematic Review

The aim of this systematic review was to summarize and synthesize research results focusing on the work environment of employees with an immigrant background in Sweden. We focus on the main conditions identified in the working environment of immigrant employees and how these conditions may affect their health and well-being. The concept of “minority stress” and the attachment theory are used to understand and interpret the findings. We systematically searched for literature published between the years of 1990 and 2020 in four databases, Web of Science, PubMed, SocIndex, and Academic Search Elite. We started the selection process by reading title and abstracts, then proceeded to read a selection of full-text studies and eliminated those that did not fulfil the inclusion criteria. We did a quality assessment on the full-text studies based on the MMAT-tool, and then performed a narrative synthesis of the results. The results show that immigrants experience several stressors in their work environment, including physical, psychological, and social risks. These risks are, among other things, associated with the nature of the jobs that immigrants are overrepresented in, with minority-related stressors such as discrimination, harassment, and threats on the basis of ethnic background, and with the lack of social support from managers and colleagues. Results also highlight beneficial factors in the immigrants’ working environment and show the importance of a supportive, inclusive, and empowering management. Our main conclusion is that Swedish workplaces need to introduce more active measures to raise awareness of and combat workplace discrimination, work harder to promote inclusion at the workplace, and eliminate physical, psychological, and social health hazards specific to immigrant employees. The leadership and management have an important role to play here, as does the employees’ trade unions and its special functions.