Nurses' intention to remain employed in hospitals: Understanding the shortage in the context of Myanmar

Organizational Climate of the COVID-19 Intensive Care Units: A Qualitative Content Analysis Study

Introduction

To manage the psychological consequences of providing services in the COVID-19 intensive care units (ICUs), it is necessary to identify the experience of nurses from the organizational climate. The current study was conducted to explain the nurses' experience of the organizational climate of the COVID-19 ICUs.

Methods

This qualitative study was conducted in three teaching hospitals affiliated to Isfahan University of Medical Sciences. 17 individual and semi-structured interviews with 12 nurses working in three selected COVID-19 centers were included in the data analysis. The participants were selected by purposive sampling and interviewed in one or more sessions at a suitable time and place. Interviews lasted for 45 to 90 minutes and continued with conventional content analysis until data saturation. Data analysis was done using conventional content analysis of Graham and Leideman model. Guba and Lincoln criteria (including validity, transferability, consistency, and reliability) were used to ensure reliability and accuracy.

Results

The results of data analysis were classified into 82 primary concept codes and 10 sub-categories in the form of 3 categories: "positive climate of attachment and professional commitment", "emotional resonance in the work environment" and "supportive environment of the organization".

Conclusion

This study led to the identification of nurses' experiences of the organizational climate during the COVID-19 which provides appropriate information to nursing managers to create a favorable organizational climate and increase the quality of work-life of nurses.

Nurses' Qualitative Descriptions of the Organizational Climate of Hospitals

PURPOSE

To explore nurses' perceptions of the organizational climate in general hospitals in Myanmar.

DESIGN AND METHODS

Using a qualitative descriptive design, data were purposively collected from all levels of registered nurses in eight general hospitals across Myanmar during August to October 2019. Seventeen individual in-depth interviews and eight focus group discussions with 65 nurses were undertaken and analyzed using Graneheim and Lundman's qualitative content analysis.

FINDINGS

Four categories of organizational climate from a Myanmar nursing context emerged: organizational uniqueness, organizational alignment, sense of empowerment, and the reinforcing organization. Organizational uniqueness included the subcategories of perception of features and orientation of the organization, whilst organizational alignment comprised the three subcategories of the values inherent in the management process, the criteria of success, and strategic emphasis. The sense of empowerment category embraced the subcategories of the perceptions of the decision making and roles of leaders or managers; the last category, the reinforcing organization, incorporated the subcategories of bonding and recognition of the organization.

CONCLUSIONS

This was the first qualitative nursing study on nurses' perceptions of organizational climate in Myanmar hospitals. Participants revealed a rich source of information that needs to be considered by hospital administrators and other policymakers to enhance quality clinical care by nurses, and their overall well-being and working conditions. The emphasis on the holistic nature of this concept points to further investigations of working conditions, the lives of nurses, and management of nurses within the hospital environments in Myanmar hospitals, and can inform other countries.

CLINICAL RELEVANCE

Nurses revealed a rich understanding of what an organizational climate represents or should represent, and they need to work with hospital administrators and managers to contribute to the development of positive organizational climate, which in turn should increase nurse retention and the efficacy of health care provided in hospitals.

Internal consistency reliability, construct validity, and item response characteristics of the Kessler 6 scale among hospital nurses in Vietnam

The present study investigated the internal consistency reliability, construct validity, and item response characteristics of a newly developed Vietnamese version of the Kessler 6 (K6) scale among hospital nurses in Hanoi, Vietnam. The K6 was translated into the Vietnamese language following a standard procedure. A survey was conducted of nurses in a large general hospital in Hanoi, Vietnam, using a questionnaire including the Vietnamese K6, other scales (DASS21, health-related QOL, self-rated health, and psychosocial work environment), and questions about demographic variables. Internal consistency reliability (Cronbach's alpha coefficient) was calculated. A confirmatory factor analysis was conducted. Eleven hypotheses were tested (as Pearson's correlations with the K6) to assess the scale's construct validity. Item response theory (IRT) analysis was conducted to identify the item response characteristics. The Cronbach's alpha coefficient was 0.864. The explanatory and confirmatory factor analyses indicated a one-factor structure. Most hypotheses tested for construct validity were supported. IRT analysis indicated that response categories were located in order according to severity. K6 provided reliable information regarding higher levels of psychological distress. The findings suggest that the Vietnamese version of the K6 is a reliable and valid instrument to measure psychological distress among hospital nurses in Vietnam.

Effects of two types of smartphone-based stress management programmes on depressive and anxiety symptoms among hospital nurses in Vietnam: a protocol for three-arm randomised controlled trial

INTRODUCTION

Due to an increasing demand for healthcare in low-income and middle-income countries in Asia, it is important to develop a strategy to manage work-related stress in healthcare settings, particularly among nurses in these countries. The purpose of this three-arm randomised controlled trial (RCT) is to examine the effects of a newly developed smartphone-based multimodule stress management programme on reducing severity of depressive and anxiety symptoms as primary outcomes at 3-month and 7-month follow-ups among hospital nurses in Vietnam.

METHODS AND ANALYSIS

The target study population will be registered nurses working in a large general hospital (which employs approximately about 2000 nurses) in Vietnam. They will be invited to participate in this study. Participants who fulfil the eligibility criteria will be randomly allocated to the free-choice, multimodule stress management (intervention group A, n=360), the internet cognitive behavioural therapy (iCBT), that is, fixed-order stress management (intervention group B, n=360), or a treatment as usual control group (n=360). Two types (free-choice and fixed sequential order) of smartphone-based six-module stress management programmes will be developed. Participants in the intervention groups will be required to complete one of the programmes within 10 weeks after the baseline survey. The primary outcomes are depressive and anxiety symptoms, measured by using the Depression Anxiety and Stress Scales (DASS) at 3-month and 7 month follow-ups.

ETHICS AND DISSEMINATION

The study procedures have been approved by the Research Ethics Review Board of Graduate School of Medicine/Faculty of Medicine, the University of Tokyo (no 11991) and the Ethical Review Board for Biomedical Research of Hanoi University of Public Health (no 346/2018/YTCC-HD3). If a significant effect of the intervention programmes will be found in the RCT, the programmes will be made available to all nurses in the hospital including the control group. If the positive effects are found in this RCT, the e-stress management programmes will be disseminated to all nurses in Vietnam.

TRIAL REGISTRATION NUMBER

UMIN000033139; Pre-results.

Burnout among house officers in Myanmar: A cross-sectional study

Background

Burnout can result in a serious negative impact on a doctor's life, the quality of patient care, and the healthcare organization. This study aims to determine the prevalence of burnout and factors affecting burnout among the house officers in Myanmar.

Materials and methods

An exploratory cross-sectional quantitative survey study was conducted using a self-administered, web-based survey. House officers working in any of the government hospitals in Myanmar were invited to participate in the study. The survey link was distributed online via Facebook. To measure burnout, we utilised a non-proprietary single-item measure, validated to serve as a reliable substitute for the Maslach Burnout Inventory Emotional Exhaustion (MBI:EE). To measure global life satisfaction, the validated Satisfaction with Life Scale (SWLS) was used. The questions for the scales regarding the psychosocial environment were extracted from the long version of the validated Copenhagen Psychosocial Questionnaire (COPSOQ II). The scales selected were "possibilities for the development", "meaning of work", "commitment to workplace", "recognition", "social support from colleagues" and "social support from supervisors". Multiple logistic regression method was applied to determine the factors associated with burnout.

Results

Regarding the prevalence of burnout, out of 159 participants, 42.8% (n = 68) of the participants had no symptoms of burnout. 57.2% (n = 91) had one or more symptoms of burnout. Multivariate analysis showed that the only significant factor associated with burnout was "recognition" (OR 0.96, 95% CI: 0.94-0.97, P < 0.001).

Conclusion

From this study, we have determined the relatively high burnout prevalence and that recognition is the only preventive factor; increase in recognition will decrease the odds of burnout. Hence, urgent interventions are recommended to prevent undesirable effects on both health professionals and patients. Recognition for work done should always be in the heart of the health authorities and medical community in Myanmar.