Effects of nurse work environment on job dissatisfaction, burnout, intention to leave

Growth mindset mediates the effect of core self-evaluation on professional self-efficacy for nursing interns: A cross-sectional study

BACKGROUND

Professional self-efficacy is a key factor in nurses' career development and is associated with individual mindset and self-perception. However, research on the potential influence mechanism of professional self-efficacy in clinical nursing interns from the perspective of individual mindset and self-perception in China, or internationally, is limited.

OBJECTIVES

This study aimed to explore the relationship between core self-evaluation, growth mindset, and professional self-efficacy among nursing interns, and the mediating effect of growth mindset on the relationship between core self-evaluation and professional self-efficacy.

DESIGN

A cross-sectional survey design was used.

SETTINGS AND PARTICIPANTS

Considering the ready accessibility for collecting samples and meeting with the purpose of this study, this study was conducted using a convenience sample of 266 clinical nursing interns from three general hospitals in Hangzhou, China, from March to July 2023.

METHODS

Convenience sampling was used to recruit 266 nursing students [236 female, 30 male] from three comprehensive tertiary hospitals in the provincial capital city of Zhejiang, China. The data were collected using the Core Self-Evaluation Scale, Growth Mindset Scale, and Professional Self-Efficacy Questionnaire from March to July 2023. Data were analyzed using IBM SPSS Statistics (version 26.0; IBM, Armonk, NY, USA). Descriptive analyses of the demographic characteristics, correlation analyses and multivariate linear regressions of the three variables were performed. The PROCESS macro for SPSS (Model 4) was used to examine the relationship between core self-evaluation, professional self-efficacy, and the mediating effect of growth mindset.

RESULTS

The average professional self-efficacy score was (87.95 ± 17.84). Core self-evaluation and a growth mindset were found to have a statistically significant relationship to professional self-efficacy. Growth mindset mediated the relationship between core self-evaluation and professional self-efficacy (β = 0.491, P < 0.001). The results of the nonparametric bootstrapping method confirmed the significance of the indirect effect of core self-evaluation through growth mindset (95 % bootstrap CI = 0.093, 0.241). The indirect effect of growth mindset accounted for 32.6 % of the total variance in professional self-efficacy.

CONCLUSION

The professional self-efficacy of Chinese nursing interns was at a low to medium level and demand extensive attention. On the one hand, clinical nursing managers and teachers should focus on cultivating the core self-evaluation of nursing interns to improve their professional self-efficacy. On the other hand, growth mindset offers a mediating variable between the core self-evaluation and professional self-efficacy of nursing interns. Therefore, it is recommended that growth mindset be developed by incorporating growth mindset training into the curriculum and using school and clinical co-education to enhance students' professional self-efficacy.

Factors associated with burnout among internationally educated nurses: A scoping review

BACKGROUND

The increasing nursing shortage in the healthcare industry has become a concern in many countries. Recruiting certified nurses from outside a country is one strategy to address this shortage. While the hiring of internationally educated nurses (IENs) fills the labor gap, a supportive work environment is necessary to retain IENs in the field.

METHODS

We conducted this scoping review based on the Joanna Briggs Institute (JBI) and PRISMA-ScR guidelines. It is reported along with the PRISMA-ScR checklist. A literature search was conducted across six electronic databases (PubMed, Web of Science, CINAHL, PsycINFO, Ichushi, and CNKI) on September 8, 2023, from which 722 articles were identified. Titles and abstracts were initially screened based on inclusion and exclusion criteria, followed by a full-text review of the selected articles. Eight articles satisfied the search criteria.

FINDINGS

From the characteristics of the factors related to nurses' burnout, all the components were categorized into organizational and individual factors. Organizational factors that contribute to higher burnout include poor professional-practice environment, high patient-to-nurse ratios, lower job satisfaction, and working in hospital wards and private hospitals. Individual factors include being younger IENs, being single (not married), being female, possessing higher educational degrees, short duration of employment, religion (Muslim), job title as a staff nurse, high stress, poor local-language capability, and first-time employment in a host country.

DISCUSSION

Individual factors are more specific to IENs' backgrounds, whereas organizational factors are common to both internationally educated and host-country nurses. Both factors should be considered to reduce burnout among IENs.

IMPLICATIONS FOR NURSING

Healthcare organizations and administrators can develop targeted strategies to prevent and address the burnout experienced by IENs. Also providing understanding and support for religious backgrounds and language proficiency is crucial for alleviating intercultural stress. Through these measures, it is essential to create a work environment where internationally educated nurses can feel secure and comfortable.

Mindfulness Bundle Toolkit's Impact on Nurse Burnout

BACKGROUND

Nurse burnout is a widespread problem affecting nurses' physical and mental health and patients' satisfaction. Nurses in intensive care units designated for patients with COVID-19 during the pandemic reported experiencing higher levels of emotional exhaustion, depersonalization, and stress and exhaustion and lower levels of personal accomplishment. The current literature does not have a solution to combat burnout.

OBJECTIVE

To test the effectiveness of a mindfulness bundle toolkit on burnout for nurses caring for patients with COVID-19.

METHODS

A quantitative quasi-experimental design was used. Participants were 52 frontline registered nurses caring for patients with COVID-19. A mindfulness bundle toolkit was provided with the goal of decreasing burnout in a 6-week period. Data were collected before intervention, immediately after intervention, and 6 weeks after intervention using the Maslach Burnout Inventory-Human Services Survey for Medical Personnel, the Nursing Work Index-Revised, and the Stress/Arousal Adjective Checklist. Results The analysis indicated a statistically significant effect from the mindfulness bundle toolkit in 3 areas pertaining to burnout: emotional exhaustion (Wilks Λ = .66; F1,41 = 19.02; P = .001; η2 = .31), depersonalization (Wilks Λ = .70; F1,41 = 7.93; P = .007; η2 = .16), and stress (Wilks Λ = .81; F1,41 = 8.81; P = .005; η2 = .17).

CONCLUSIONS

The results suggest that the use of a 6-week mindfulness bundle toolkit is an effective intervention to mitigate emotional exhaustion, depersonalization, and stress associated with burnout in critical care nurses caring for patients with COVID-19.

Connections between job satisfaction and depression, anxiety, and stress among nurses

Introduction

As a cornerstone of overall wellbeing, mental health significantly influences job satisfaction, vital for employee retention and organizational success. Recognizing this, managers prioritize initiatives to enhance job satisfaction and promote a healthy, productive work environment.

Aims

The study aims to explore the connections between depression, anxiety, stress, and job satisfaction among nurses, providing insights to improve their wellbeing and retention in the profession.

Methods

This quantitative survey study was conducted from June to September 2024, involving 643 nurses from healthcare facilities in Klaipėda County. Data were collected using two validated instruments: the Depression, Anxiety Stress Scales (DASS-42) and the Paul Spector Job Satisfaction Survey (JSS). Statistical analysis was performed using IBM SPSS Statistics Version 29.0.1.0.

Results

The study found that while the average levels of depression, anxiety, and stress among nurses were within normal limits, a significant portion of participants exhibited compromised mental health. Nearly one-third of the nurses experienced stress and/or depression, and almost half reported anxiety. Over one-sixth of the participants experienced high or very high levels of anxiety, while severe depression or stress was less common. Factors such as years of experience, workload, and work schedule were identified as significant influences on nurses' psychoemotional state. Moderate to strong positive correlations were observed between depression, anxiety, and stress levels. Additionally, the nurses' mental health was statistically significantly and negatively associated with most components of job satisfaction.

Conclusion

Despite average levels of depression, anxiety, and stress being within normal limits, many nurses face significant mental health challenges, particularly anxiety. Factors like workload and work schedules strongly influence their wellbeing. The negative link between mental health and job satisfaction highlights the need for better support to improve nurses' wellbeing and job satisfaction.

Variables that predict nurses' job stress and intention to leave during the COVID-19 pandemic in Turkey

AIM

To investigate the variables predicting job stress and intention to leave the job among nurses during the COVID-19 pandemic in Turkey.

DESIGN

This research was designed as an analytical cross-sectional study.

METHODS

The population of the study consisted of 450 nurses working in a training and research hospital (N = 450). The study sample consisted of 178 nurses who worked in that hospital between February and July 2021. The Nurse Information Form, Job Stress Scale, and Intention to Leave Scale were used as data collection tools. The independent-sample t-test, one-way analysis of variance, and Pearson correlation analysis were applied for univariate analysis while multiple regression analysis was used for multivariate analysis.

RESULTS

It was determined that the main factors predicting nurses' job stress levels were their Intention to Leave Scale scores, level of organizational satisfaction. The main factors predicting intention to leave were their Job Stress Scale scores, working conditions, and job satisfaction. A positive moderate correlation was found between job stress and intention to leave.

CONCLUSION

This study demostares that among nurses during the COVID-19 pandemic, the predictors of job stress were intention to leave and organizational satisfaction, while the predictors of turnover intention included job stress, working conditions, and job satisfaction. Hospital managers, especially nursing services managers, should develop strategies for extraordinary situations such as pandemics and evaluate the professional satisfaction of nurses while providing a healthy working environment.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contributions.

The interplay between organizational culture and burnout among ICU professionals: A cross-sectional multicenter study

PURPOSE

Organizational culture is considered a protective factor against burnout among ICU professionals. The aim of this study is to study the association between organizational culture as a potential antecedent to previously found mediating risk factors for burnout, namely, work-life balance and moral distress.

MATERIALS AND METHODS

Multicenter cross sectional study in eleven Dutch ICUs. The primary outcome measure was the core symptom of burnout, emotional exhaustion, measured using the validated Dutch version of the Maslach Burnout Inventory. Organizational culture was assessed using the Culture of Care Barometer, which measures five aspects of organizational culture. Moral distress and work-life balance were measured with validated questionnaires.

RESULTS

696 ICU professionals (39.7 %) responded. All aspects of the CoCB were negatively associated with the emotional exhaustion component of burnout, both in univariable and multivariable models. Four aspects of organizational culture were significantly associated to the serial association between moral distress, work-to-home spillovers, and emotional exhaustion. For these aspects, the total indirect association was equal or larger than the total direct association.

CONCLUSIONS

Multiple aspects of organizational culture reduce burnout among ICU professionals in a largely indirect manner, via moral distress and work-life balance. Improving organizational culture can mitigate burnout symptoms among ICU clinicians.

Can Emotionally Intelligent Mental Health Nurse Leaders Influence Workforce Sustainability? A Scoping Review

Due to a global shortage of nursing staff, there is renewed attention on the impact of leadership and management styles on the sustainability of the nursing workforce. Emotional intelligence (EI), the ability to manage both your own emotions and to perceive and understand the emotions of others, has been implicated as a nursing management style impacting reduced turnover and greater nurse wellbeing. Despite these promising findings, there is a dearth of research on the role of emotionally intelligent leadership on the retention of mental health nurses. This scoping review aimed to (1) explore whether the findings from EI leadership in general nursing settings can be contextualised to mental health nurse leaders and (2) whether emotional intelligent leadership can influence the retention of mental health nurses. We used Arksey and O'Malley's framework to conduct this scoping review, locating 987 papers in our initial search. After screening, 30 papers remained; most methodologies were quantitative (n = 20), followed by qualitative (n = 8) and mixed methods (n = 2). This review found that while this concept has been studied extensively in the general nursing context, there is a lack of research into EI as a leadership style in mental health nursing. Where EI was the dominant leadership style, turnover intention was lower. However, despite showing promise in other settings, because of distinct differences between nursing contexts and workforce characteristics, it is difficult to state that emotionally intelligent leadership would be effective in mental health settings. There is therefore an urgent need identified to explore leadership styles in mental health settings to determine whether they impact retention and turnover, which will have significant implications for organisations, staff and consumers. We recommend that mental health nurse leaders be provided with EI training and education to ensure that they are equipped to provide the necessary support and leadership to sustain and grow the mental health nursing workforce.

The mediating effect of job burnout on the relationship between practice environment and workplace deviance behavior of nurses in China: a cross-sectional study

BACKGROUND

Faced with a shortage of nurses in China, the factors affecting the stability of the nursing workforce require urgent attention. The workplace deviance behavior of nurses is considered an important behavior in clinical practice, which will bring negative effects and affect the development of nurse team. However, no research has been done to examine the associations among workplace deviance behavior of nurses, practice environment and job burnout. Thus, this study aimed to determine the influence of practice environment on nurses' workplace deviance behavior and confirm the mediating role of job burnout.

METHODS

This study was designed as a multicentre cross-sectional study, and recruited 598 nurses in China to complete a survey of the general information questionnaire, Scale of Workplace Deviance Behavior of Nurses, Practice Environment Scale, and Maslach Burnout Inventory General Survey. The model was examined using descriptive analysis, Pearson's correlation analysis, and the PROCESS Macro in SPSS 26.0.

RESULTS

The results of the correlation analysis demonstrated a significant relationship between the practice environment and work deviance behavior of nurses, as well as a negative relationship between job burnout and these two factors. Moreover, the relationship between practice environment and work deviance behavior among nurses was partially mediated by job burnout.

CONCLUSION

A healthy practice environment and a decrease in job burnout could directly lower the work deviant behavior of nurses. Hospital managers must actively endeavor to improve the practice environment for nurses by fostering a just, fair, and supportive practice environment and by keeping lines of communication open and strong with the nursing staff. Furthermore, managers can also reduce nurses' work deviance behavior by lower their job burnout.

Impact of the Practice Environment on Oncology and Hematology Nurses: A Scoping Review

BACKGROUND

Practice environments have a significant impact on nurses' practice and their retention within the oncology and hematology specialty. Understanding how specific elements of the practice environment impact nurse outcomes is important for creating supportive and safe practice environments.

OBJECTIVE

To evaluate the impact of the practice environment on oncology and hematology nurses.

METHODS

A scoping review was conducted according to the PRISMA-ScR Statement Guidelines. Electronic databases (MEDLINE, CINAHL, PsychINFO, Google Scholar, and Scopus) were searched using key terms. Articles were assessed according to the eligibility criteria. Data extraction was conducted with results explained through descriptive analysis.

RESULTS

One thousand seventy-eight publications were screened with 32 publications meeting the inclusion criteria. The 6 elements of the practice environment (workload, leadership, collegial relations, participation, foundations, and resources) were found to significantly impact nurses' job satisfaction, psychological well-being, levels of burnout, and intention to leave. Negative practice environment elements were linked to increased levels of job dissatisfaction, higher levels of burnout, greater prevalence of psychological distress, and greater intention to leave both oncology and hematology nursing and the nursing profession.

CONCLUSIONS

The practice environment has a significant impact on nurses, their job satisfaction, well-being, and intention to stay. This review will inform future research and forthcoming practice change to provide oncology and hematology nurses with practice environments that are safe and lead to positive nurse outcomes.

IMPLICATIONS FOR PRACTICE

This review provides a foundation upon which to develop and implement tailored interventions that best support oncology and hematology nurses to remain in practice and provide high-quality care.

Addressing Registered Nurse Retention and Attrition in Thailand Hospitals: An Integrative Review

Thailand is one of the Southeast Asia countries that has been significantly impacted by Registered Nurse (RN) workforce shortages. This integrative review aimed to critically analyze factors influencing the attrition and retention of RNs practicing in Thailand's hospital sector. The databases searched included CINAHL (via EBSCOhost), EMBASE, Nursing Allied (via ProQuest), Ovid, Scopus, Web of Science, and Medline. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were utilized to record the search strategy findings in compliance with the review standards, while the Mixed-Methods Appraisal Tool (MMAT) was used to appraise quality. Sources for review totaled 35, using quantitative methods (n = 30), qualitative methods (n = 3), and mixed methods (n = 2). Thematic analysis revealed factors that challenge RNs' job motivation fueled by a lack of autonomy, a loss of confidence and sense of competence, and negative workplace relations with co-workers, resulting in poor job satisfaction. Future research is needed to elicit an understanding of "how" Thai RNs sense of autonomy, competence, and relatedness in their workplace practice provides insight into "why" they choose to remain employed or leave the nursing workforce.

Coping Measures for Hospital Nurses' Turnover: A Qualitative Meta-Aggregation (2018-2023)

AIM

To identify and synthesise the qualitative evidence that is available regarding reducing the turnover of hospital nurses from their own perspectives.

DESIGN

A qualitative systematic review using the meta-aggregation design.

DATA SOURCES

Qualitative studies either in English or in Chinese, dating from 2018 to 2023, were obtained from eight databases, including CINAHL, PubMed, Web of Science, Embase, Ovid, and Chinese National Knowledge Infrastructure (CNKI), Wanfang Database and the China Biomedical Database.

METHODS

Studies were screened using pre-determined inclusion and exclusion criteria. Quality assessment was done using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. The study was reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines.

RESULTS

Sixteen papers were included that explored nurses' perspectives on enhancing their retention or reducing staff turnover. We developed three synthesised findings and 12 categories from 64 identified findings, including (1) individual adjustment strategy: professional pride, self-growth and psychological adjustment; (2) social support strategy: constructive workplace relationships, balancing work life and recognition of nursing and (3) organisational change strategy: embracing management and leadership, promote nursing professionalisation, workload management and support, flexible work patterns and opportunities, supporting personal career development and competitive salary.

CONCLUSION

This review provides an in-depth and meaningful understanding of nurses' own perceptions and suggestions for enhancing nursing turnover, which will call for a wide range of measures targeting the individual, social and organisational levels.

IMPLICATIONS FOR NURSING MANAGEMENT

This study contributes important knowledge to help improve hospital nurse's turnover, which can provide evidence to support nurse managers, other stakeholders and policymakers in correspondingly developing effective measures to address nurse turnover.

PATIENT OR PUBLIC CONTRIBUTION

There was no direct contribution from patient or caregiver to this study because the data of this study originated from published papers.

Interventions to support the psychological empowerment of nurses: a scoping review

Background

Establishing an empowering work environment is significantly contributing to nurse's job satisfaction, performance, retention, and organizational success. This study aimed to conduct a scoping review to chart and synthesize current research on interventions to support nurses' psychological empowerment.

Methods

Ten databases were searched, including PubMed/Medline, Web of Science, Scopus, Embase, EBSCOhost, Cochrane Library, CNKI, Wanfang, VIP, and OpenGrey, following the Joanna Briggs Institute's methodology for scoping reviews. The search encompassed literature from its inception to 5 September 2024. The selection of studies followed predetermined inclusion and exclusion criteria. A manualized systematic quality assessment method was applied to the included studies, and the extracted data were charted using a series of tables.

Results

Eleven studies were included. Seven studies reported the theoretical framework used. The interventions are all educational and are divided into two main sections: theoretical learning and applied practice. The duration of the interventions spanned a wide range of hours. The intervention format was based on offline training. The participants included both nurse managers and nurses. The evaluation measures were mostly multiple time points using the Spreitzer Psychological Empowerment Instrument. The interventions were generally effective, although some studies reported different results.

Conclusion

Research on psychological empowerment interventions for nurses is still in the developmental phase, with preliminary evidence validating their positive effects. Future research should focus on conducting randomized controlled studies with larger sample sizes, selecting appropriate theoretical frameworks to design interventions, enriching the content and form of interventions, and strengthening evaluation measures to improve the quality of psychological empowerment interventions for nurses.

Systematic review registration

OSF, https://doi.org/10.17605/OSF.IO/W7ZG6.

The mediating role of professional identity between work environment and caring behavior: a cross-sectional survey among hospice nurses in China

BACKGROUND

As core members of hospice care team, the hospice nurses' ability to care for patients not only directly affects the standard of patient care, but also significantly impacts patient quality of life. It can be seen that it is very meaningful for patients to improve the caring behavior of hospice nurses. Therefore, it is necessary to deeply explore the influencing factors of nurses' caring behavior and further clarify the mechanism between them.

METHODS

The STROBE guideline was performed to report this study. We conducted a cross-sectional survey from December 2023 to February 2024. In this study, 392 hospice nurses were recruited from tertiary public hospitals in East China by convenient sampling method. Participants were investigated using the Practice Environment Scale, Professional Identity Scale, and Caring Behaviors Inventory. Structural equation modelling was utilized to verify the research hypotheses.

RESULTS

The results revealed that there were significant and positive correlations between work environment, professional identity and caring behavior. Furthermore, professional identity partially mediated the relationship between work environment and caring behavior.

CONCLUSION

Work environment is critical to improving hospice nurses' caring behavior. Professional identity plays an intermediary role impacting how work environment promotes caring behavior among Chinese hospice nurses. Nursing managers should have a correct understanding of the relationship between them. Targeted measures and coping strategies need to be actively taken to create a better working environment for hospice nurses. This would enhance professional identity, and thereby promote caring behavior.

Impact of the COVID-19 pandemic on clinical care and patient-focused outcomes of advanced nursing practice: A cross-sectional study

BACKGROUND

The COVID-19 pandemic has significantly impacted advanced practice nurses' practice and posed great challenges in patient care delivery.

PURPOSE

The aim of this study was to investigate the impact of the COVID-19 pandemic on the practice of advanced practice nurses in mainland China and Hong Kong Special Administrative Region (SAR). Methods A cross-sectional descriptive survey was conducted March 2021 and January 2022. Advanced practice nurses were invited to participate in an online survey. The questionnaire described the socio-demographic characteristics, the impact of the COVID-19 pandemic on advanced nursing practice, patient outcomes, education needs about COVID-19, and the challenges, support, and concerns related to the advanced practice nurse practice during the pandemic. Wilcoxon signed-rank test or McNemar test were applied to measure the practice of APNs before and during the COVID-19 pandemic.

RESULTS

Respondents (N = 336) were from mainland China (n = 234) and Hong Kong SAR (n = 102). Participants reported increased practice-related workload during the pandemic. The proportions of advanced practice nurses focused on disease prevention (36.9%) and psychosocial well-being (15.5%) for patient-focused outcomes during the pandemic were higher compared to before the pandemic. Key challenges and concerns during the pandemic included heavy workloads and health concerns for themselves and their families. Despite difficulties, there were reports of positive changes since the outbreak including implementation of innovative measures to facilitate the advanced practice nursing and education about COVID-19.

CONCLUSION

The study findings highlight that advanced practice nurses' work and responsibilities have changed in response to the pandemic. Providing education about COVID-19, innovative measures to facilitate advanced practice nursing, and understanding advanced practice nurses' concerns and challenges in providing patient care may inform future developments for improving their professional practice.

The impact of self-reported burnout and work-related quality of life on nurses' intention to leave the profession during the COVID-19 pandemic: A cross-sectional study

The challenges of maintaining an effective and sustainable healthcare workforce include the recruitment and retention of skilled nurses. COVID-19 exacerbated these challenges, but they persist beyond the pandemic. We explored the impact of work-related quality of life and burnout on reported intentions to leave a variety of healthcare professions including nursing. We collected data at five time-points from November 2020 to February 2023 via an online survey. The validated measures used included the Copenhagen Burnout Inventory and Work-Related Quality of Life (WRQoL) scale; with subscales for Job-Career Satisfaction, General Wellbeing, Control at work, Stress at work, Working conditions, and Home-work interface. Our findings showed that 47.6% of nursing respondents (n = 1780) had considered changing their profession throughout the study period, with the 30-39-year age group most likely to express intentions to leave. Regression analysis reveale that for WRQoL, lower general wellbeing and job-career satisfaction scores predicted intentions to leave when controlling for demographic variables (p < 0.001). When burnout was added to the regression model, both work-related and client-related burnout were predictive of intentions to leave (p < 0.001). These findings highlighted that significant numbers of nurses considered leaving their profession during and shortly after the pandemic and the need for interventions to improve nurses' wellbeing and reduce burnout to improve their retention.

The psychological empowerment and quality of work life among Jordanian primary care nurses and midwives

Introduction

The healthcare industry, particularly in the context of primary care, presents various challenges to nurses and midwives, influencing their psychological empowerment (PE) and quality of work life (QWL).

Objective

This study's objective is to assess the levels of PE and QWL among Jordanian primary care nurses and midwives and explore the relationship between PE and QWL.

Methods

Utilizing a descriptive correlational design, the study included 273 Jordanian primary care nurses and midwives through convenience sampling. The Psychological Empowerment Instrument and Brook's Quality of Nursing Work Life Survey were used to measure PE and QWL. Data was analyzed using descriptive statistics to describe the study participant's characteristics and inferential analysis such as Pearson correlation, and multiple regression to examine relationships and identify predictors of study variables.

Results

The study found that the QWL scale had high reliability (Cronbach's alpha = 0.954), and similarly, the PE scale demonstrated strong reliability (Cronbach's alpha = 0.948). Moving on to the core findings, significant positive correlations were identified between PE and QWL, with a correlation coefficient of r = 0.568 (p < 0.01), indicating that higher levels of psychological empowerment were associated with better quality of work life. Furthermore, the regression analysis revealed that PE accounted for approximately 32.3% of the variability in QWL scores. Interestingly, participants holding diplomas reported the highest QWL scores (mean = 136.14), while those contemplating leaving the nursing profession displayed significantly lower QWL scores (mean = 114.14). No significant correlations were found between PE and sociodemographic variables such as age, income, and years of experience.

Conclusion

This study reveals a crucial need to enhance PE and QWL. Key findings show moderate PE and QWL levels, with variations based on educational background and workplace. The positive correlation between PE and QWL identifies the benefits of fostering empowerment through professional development, job autonomy, and decision-making. These insights are vital for improving nursing practice and policy and enhancing nurse satisfaction and patient care.

Psychometric properties of the Persian version of the workplace fun scale among nurses: a cross-sectional study

Previous research has highlighted the importance of workplace fun in enhancing employee satisfaction and performance, particularly in high-stress professions like nursing. However, a notable gap exists in understanding how workplace fun is perceived and measured among nurses in Persian-speaking countries. This study addresses this gap by translating the Workplace Fun Scale and assessing its psychometric properties among nurses. The findings will provide insights into the scale's applicability in these contexts and pave the way for healthcare organizations to significantly explore ways to enhance nurses' enjoyment of work in Persian-speaking countries. This survey, which involved 321 nurses from medical education centers in Ardabil, was conducted with a meticulous and rigorous methodology. Standard questionnaires collected the data, including a demographic form and the translated Workplace Fun Scale. The study examined the three aspects of workplace fun: fun activities, coworker socializing, and manager support for fun. Confirmatory factor analysis was used to validate the structure, and reliability was assessed through retest coefficients, Cronbach's alpha coefficients, and composite reliability coefficients. The data were analyzed using SPSS version 14 and LISREL version 8.8, ensuring the highest research standards. The validity of both form and content was confirmed through translation and reverse translation. The Workplace Fun Scale showed high internal consistency and reliability, with significant Cronbach's alpha coefficients, composite reliability, and two-week retest coefficients of 0.859, 0.885, and 0.459, respectively (all at the p < 0.01 level). Fit indices, including GFI (0.97), AGFI (0.94), CFI (0.99), NFI (0.98), TLI (0.97), and SRMR (0.04), indicated a good fit of the measurement model, confirming the validity of the scale in assessing workplace fun. The confirmatory factor analysis results indicated that the translated version of the workplace fun scale, adapted from Tews, exhibited a robust factor structure and internal homogeneity within the Iranian sample. Furthermore, the scale demonstrated positive internal validity and reliability in Persian translation. These findings suggest that the scale possesses acceptable psychometric properties, making it a valuable tool for assessing workplace fun among nurses in Persian-speaking countries.

The impact of the nursing work environment on compassion fatigue: The mediating role of general self-efficacy

AIM

To explore the interplay between the perceived nursing work environment, general self-efficacy, and compassion fatigue among registered nurses in Chinese hospitals.

BACKGROUND

Compassion fatigue emerges as a significant occupational stress response globally, with the nursing work environment being a pivotal influencer. There is a knowledge gap in understanding how the nursing work environment and general self-efficacy interrelate to affect compassion fatigue, particularly among Chinese nurses.

METHODS

Employing a cross-sectional, descriptive design, this study utilized validated questionnaires to gather data from 7085 nurses across public and private hospitals in China. The analysis focused on assessing the interrelations among the perceived nursing work environment, general self-efficacy, and different dimensions of compassion fatigue.

FINDING

More than half (65.67%) of the participants experienced moderate or high burnout levels, with 76.43% experiencing secondary traumatic stress. The lowest rating in the nursing work environment was for nurse/physician collaboration (10 ± 2.07), while general self-efficacy scored higher (27.54 ± 6.26). A positive relationship existed between the work environment and both general self-efficacy and compassion satisfaction, with a negative correlation to burnout and traumatic stress. General self-efficacy was a partial mediator in the link between work environment and compassion fatigue, suggesting that improving the work environment can decrease compassion fatigue by boosting nurses' self-efficacy.

CONCLUSION

This study underscores the profound impact of the nursing work environment on compassion fatigue, mediated by general self-efficacy. It highlights the necessity of fostering a supportive work environment to enhance nurses' self-efficacy and overall well-being.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Healthcare managers and institutions must create supportive work environments to reduce compassion fatigue among nurses. This includes professional development programs to enhance self-efficacy and job satisfaction. Policies should address high workloads and inadequate support. Nurse leaders should foster environments that promote psychological well-being, improving outcomes for both nurses and patients. Regular assessments and adjustments of work conditions are essential to maintain a healthy work environment.

Influence of nurse work environment and psychological distress on resignation from hospitals: a prospective study

With the global nurse shortage, identifying nurse work environments that allow nurses to continue working is a common concern worldwide. This study examined whether a better nurse work environment (1) is associated with reducing nurses' psychological distress; (2) reduces nurse resignations; (3) weakens the influence of psychological distress on their resignation through interaction effect; and (4) whether psychological distress increases nurse turnover. Multilevel logistic regression analyses were performed using data obtained in 2014 from 2,123 staff nurses from a prospective longitudinal survey project of Japanese hospitals. The nurse work environment was measured by the Practice Environment Scale of the Nursing Work Index (PES-NWI) consisting of five subscales and a composite, and psychological distress by K6. All the PES-NWI subscales and composite (ORs 0.679-0.834) were related to K6, significantly. Regarding nurse turnover, K6 had a consistent effect (ORs 1.834-1.937), and only subscale 2 of the PES-NWI had a direct effect (OR 0.754), but there was no effect due to the interaction term. That is, (1) and (4) were validated, (2) was partly validated, but (3) was not. As better work environment reduces K6 and a lower K6 decreases nurses' resignation, high-level hospital managers need to continue improving the nurse work environment.

Effects of job demands, job resources, personal resources on night-shift alertness of ICU shift nurses: a cross‑sectional survey study based on the job demands-resources model

BACKGROUND

A positive work environment can enhance nursing safety and patient satisfaction while alleviating nurse stress. Conversely, a poor work environment can harm nurses' physical and mental health and compromise the quality of care, particularly in the high-intensity and shift-based setting of the ICU.

OBJECTIVES

Based on the Job demands-resources (JD-R) model, this study examined the effects of job demands and job resources in the work environment, as well as personal resources, on the night-shift alertness of ICU shift nurses.

METHODS

This cross-sectional correlational exploratory study, conducted from July to September 2022, recruited 291 ICU shift nurses from a hospital in Beijing, China. The Copenhagen Psychosocial Questionnaire (COPSOQ), the Self-resilience scale, the General Self-Efficacy Scale (GSES), and the Psychomotor Vigilance Task (PVT) were used to subjectively and objectively measure the job demands, job resources, personal resources, and night-shift alertness. SPSS 26.0 and Mplus 8.3 were used to analyze the data and construct the structural equation model.

RESULTS

The night-shift reaction time was 251.0 ms (Median), indicating a relatively high level of alertness. Job demands were negatively correlated with both job resources (r=-0.570, P < 0.001) and personal resources (r=-0.462, P < 0.001), while a positive correlation existed between job resources and personal resources (r = 0.554, P < 0.001). The results show that increased job demands can lead to higher levels of nurse strain (β = 0.955, P < 0.001), whereas job resources were found that it can decrease strain (β=-0.477, P = 0.047). Adequate job resources can enhance motivation directly (β = 0.874, P < 0.001), subsequently reducing reaction time (β=-0.148, P = 0.044) and improving night-shift alertness among ICU shift nurses.

CONCLUSION

Enhancing ICU shift nurses' work motivation through bolstering job resources can boost night-shift alertness. However, it is noteworthy that, in this study, neither strain nor individual resources significantly influenced nurses' night-shift alertness. This may be attributed to the complexity of the ICU environment and individual differences. Future research should explore the relationship between these factors and nurses' work alertness.

Supporting and Retaining Nurses in Trying Times

The nursing profession has witnessed its share of challenging and trying times including toxic or unhealthy work environments, unsustainable workloads, an aging workforce, inadequate staffing, nurse burnout, staff retention, inadequately trained staff, an increase in workplace violence, and several pandemics. Both individually and collectively, these thorny issues have placed a heavy burden on nurses. Unfortunately, many capable and competent nurses have left the profession altogether, which further compounds an already problematic situation. This article highlights several important strategies for recruiting, retaining, and supporting a high functioning nursing workforce in challenging and trying times.

The humanistic care ability of nurses in 27 provinces in China: a multi-center cross-sectional study

Background

Currently, studies found that the humanistic care ability of nurses is at low level in China, resulting in patients' concerns and dissatisfaction regarding the lack of empathy among nurses. We aimed to explore the factors that influence nurses' humanistic care ability, providing a new perspective on improving patient satisfaction and promote high quality medical services.

Methods

A multi-center cross-sectional study recruited nurses from tertiary and secondary hospitals in China between July 2022 and August 2022. Data concerning self-developed questions on nurses' socio-demographic data and Caring Ability Inventory (CAI) were collected through the Questionnaire Star Platform, using a multi-stage sampling method.

Results

The total score for the level of caring ability among the 15,653 surveyed Chinese nurses was 192.16 ± 24.94. Various factors significantly influence the level of humanistic care ability, including professional title, department, degree of passion for the job, job satisfaction, emphasis on self-care, participation in humanistic care training, support from family for the job, relationships with colleagues, satisfaction with salary, and previous experience working in pilot wards emphasizing humanistic care (p < 0.01).

Conclusion

At present, nurses exhibit a comparatively modest proficiency in humanistic care ability. Numerous factors contribute to this situation. Nursing administrators ought to enhance the scope of humanistic care practices, conduct consistent professional training sessions, advocate for the implementation of model wards emphasizing humanistic care, foster a supportive organizational culture conducive to nurses, and underscore the significance of both nurturing nurses and promoting self-care among them.

Learning from a crisis: a qualitative study on how nurses reshaped their work environment during the COVID-19 pandemic

BACKGROUND

The global nursing shortages exacerbated by the COVID-19 pandemic necessitated a drastic reorganization in nursing practices. Work routines, the composition of teams and subsequently mundane nursing practices were all altered to sustain the accessibility and quality of care. These dramatic changes demanded a reshaping of the nurses' work environment. The aim of this study was to explore how nurses reshaped their work environment in the early stages of the COVID-19 pandemic.

METHODS

A descriptive study comprising 26 semi-structured interviews conducted in a large Dutch teaching hospital between June and September 2020. Participants were nurses (including intensive care unit nurses), outpatient clinic assistants, nurse managers, and management (including one member of the Nurse Practice Council). The interviews were analysed with open, axial, and selective coding.

RESULTS

We identified five themes: 1) the Nursing Staff Deployment Plan created new micro-teams with complementary roles to meet the care needs of COVID-19 infected patients; 2) nurse-led adaptations effectively managed the increased workload, thereby ensuring the quality of care; 3) continuous professional development ensured adequate competence levels for all roles; 4) interprofessional collaboration resulted in experienced solidarity, a positive atmosphere, and increased autonomy for nurses; and, 5) supportive managers reduced nurses' stress and improved work conditions.

CONCLUSIONS

This study showed that nurses positively reshaped their work environment during the COVID-19 pandemic. They contributed to innovative solutions in an environment of equal interprofessional collaboration, which led to greater respect for their knowledge and competencies, enhanced their autonomy and improved management support.

Exploring the Relationship between Surface Acting, Job Stress, and Emotional Exhaustion in Health Professionals: The Moderating Role of LMX

Rapid organizational changes due to technological advancements, high-efficiency expectations, and uncertainties, particularly in healthcare, have led to a global stress epidemic among em-ployees. This has been exacerbated by the COVID-19 pandemic and evolving workplace practices. Surface acting, or the suppression and faking of emotions, significantly contributes to this stress and burnout, impacting not only individual healthcare professionals but also healthcare systems' overall effectiveness and sustainability. Providing adequate resources in high-demand work environments is, thus, essential to mitigate these negative experiences. Leader-member exchange (LMX) can play a pivotal role in understanding and addressing the needs and expectations of healthcare professionals. Drawing on Conservation of Resources (COR), Job Demands-Resources (JD-R), Social Exchange theories, and Grandey's Emotional Regulation Model, this study analyzed data from a convenience sample of 350 healthcare professionals. The results reveal that surface acting intensifies healthcare professionals' experiences of job stress and emotional exhaustion. Notably, the study empirically demonstrated that high levels of LMX in healthcare professionals' relationships with their leaders can mitigate the impact of surface acting on job stress and emotional exhaustion. These findings offer valuable insights for managers and policymakers, highlighting the importance of LMX in maintaining sustainable management practices in complex and stressful healthcare organizations.

New nurses' practice environment, job stress, and patient safety attitudes: a cross-sectional study based on the job demands-resources model

BACKGROUND

Patient safety is paramount for all healthcare agencies. Health professionals' lack of patient safety competencies threaten patients' lives, and increase patients, families, hospitals, and social burdens. The new nurse-related patient safety issues have particularly attracted much attention. The aim of this study was to examine the impacts of practice environment and job stress on new nurses' patient safety attitudes by employing the job demands-resources model.

METHODS

The study used a cross-sectional structural equation modeling (SEM). A convenience sample of 370 new nurses was recruited from seven tertiary hospitals in Anhui province, China, from April 2022 to August 2022. Data were collected using self-report questionnaires including the Chinese version of the Nurse Job Stressors Scale, the Practice Environment Scale, and the Safety Attitudes Questionnaire.

RESULTS

New nurses' patient safety attitudes scores were moderate (126.99 ± 14.39). Practice environment had a significant direct effect on job stress (β = -0.337, t = 6.120), patient safety attitudes (β = 0.604, t = 13.766), practice environment had an indirect effect on patient safety attitudes through job stress (β = 0.066, t = 3.690), and the indirect effect accounted for 9.9% of the total effect. This model was able to explain 48.3% of patient safety attitudes with moderate prediction accuracy.

CONCLUSIONS

This study emphasizes the importance of improving new nurses' attitudes toward patient safety. Hospital administrators should develop policies and strategies to address job characteristics, and establish a favorable work environment to reduce new nurses' job stress as well as to improve patient safety.

Effects of work environments on satisfaction of nurses working for integrated care system in South Korea: a multisite cross-sectional investigation

BACKGROUND

Nurses' satisfaction has an impact on organizational and patient outcomes. Integrated care system in South Korea was established in 2015 to improve care quality and decrease caregiving burden. Since then, nurses' satisfaction has increased due to an increase in nursing staffing. However, besides nurse staffing, various work environments still affect nurse satisfaction.

METHODS

Individual online surveys were conducted with participants to determine their personal characteristics, work environments, and hospital characteristics. We used mixed-effects linear regression equation contained both fixed and random effects.

RESULTS

This study included 2,913 nurses from 119 hospitals. Their average job satisfaction was less than 6 points out of 10 points. Age, shift type, perceived workload, and delegation criteria were significant factors influencing nurses' satisfaction. There was no significant factor among hospital characteristics. The satisfaction level of nurses was high for no-night rotating shift, low perceived workload, and clear delegation criteria.

CONCLUSIONS

Nurses' satisfaction is affected by several work environmental factors. Low nurse satisfaction has a substantial impact on both patients and nurses. Therefore, nurse managers and hospitals should determine factors influencing their satisfaction and develop strategies to improve their satisfaction.

Exploring nurses' experiences: Abandoning the profession and migrating for improved opportunities

AIM

This study explores nurses' experiences in migration for employment and professional abandonment in Barcelona (Spain).

METHODS

Employing a mixed-design approach comprising 1) a qualitative descriptive phenomenological study, followed by 2) a subsequent cross-sectional study, 20 and 225 nurses participated in each study, respectively. Qualitative data, gathered through 4 focus group discussions, underwent inductive thematic analysis, following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines, while quantitative data were descriptively analyzed.

FINDINGS

Three qualitative themes emerged: 1) Migration motives, such as improved job opportunities, permanent contracts, continuous training, and professional recognition; 2) Reasons for leaving or contemplating leaving the profession, including excessive workload, lack of recognition, limited development, and exhaustion; 3) Nurses' needs, encompassing more staffing, improved remuneration, permanent contracts, flexible schedules, greater autonomy, and career growth. The cross-sectional study revealed a 13.5 % professional abandonment rate at some point across all demographics and seniority levels. Migration trends varied by professional experience, with younger nurses seeking better conditions and opportunities elsewhere.

CONCLUSIONS

Multifactorial causes underlie job migration and professional abandonment, necessitating comprehensive interventions to improve nurses' working and professional conditions.

Factors that contribute to turnover and retention amongst emergency department nurses: A scoping review

BACKGROUND

Internationally, the emergency nursing workforce shortage is of critical concern.

AIM

To synthesise the evidence and assess the scope of literature regarding factors that contribute to turnover and retention amongst emergency nurses.

METHOD

A scoping review using the Joanna Briggs Institute approach was undertaken. Fivedatabases (Embase, MEDLINE, PsycINFO, CINAHL, and Business Source Complete) were searched for papers published in English between January 2011 and June 2023 where the population was nurses, context was the emergency department, and the concept was turnover or retention. A quality appraisal was performed on included studies.

RESULTS

A total of 31 articles met the inclusion criteria. Twenty-six studies focussed on turnover and five studies focussed on retention. Factors that contribute to ED nursing turnover included workplace violence, personal aspects (e.g., burnout or depression), organisational characteristics, and environmental/ job characteristics. Factors that contributed to ED nursing retention included mentoring programs, the advancement in nursing skills, and the transition to practice speciality (emergency) programs.

CONCLUSIONS

A large body of literature exists regarding ED nurses' reasons for leaving their area of practice, yet limited evidence exist on retention. Research exploring factors that promote retention of emergency nurses that leads to subsequent stability and growth in the emergency nursing workforce is needed.

Turnover intention and its associated factors among nurses in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Nurses turnover intention, representing the extent to which nurses express a desire to leave their current positions, is a critical global public health challenge. This issue significantly affects the healthcare workforce, contributing to disruptions in healthcare delivery and organizational stability. In Ethiopia, a country facing its own unique set of healthcare challenges, understanding and mitigating nursing turnover are of paramount importance. Hence, the objectives of this systematic review and meta-analysis were to determine the pooled proportion ofturnover intention among nurses and to identify factors associated to it in Ethiopia.

METHODS

A comprehensive search carried out for studies with full document and written in English language through an electronic web-based search strategy from databases including PubMed, CINAHL, Cochrane Library, Embase, Google Scholar and Ethiopian University Repository online. Checklist from the Joanna Briggs Institute (JBI) was used to assess the studies' quality. STATA version 17 software was used for statistical analyses. Meta-analysis was done using a random-effects method. Heterogeneity between the primary studies was assessed by Cochran Q and I-square tests. Subgroup and sensitivity analyses were carried out to clarify the source of heterogeneity.

RESULT

This systematic review and meta-analysis incorporated 8 articles, involving 3033 nurses in the analysis. The pooled proportion of turnover intention among nurses in Ethiopia was 53.35% (95% CI (41.64, 65.05%)), with significant heterogeneity between studies (I2 = 97.9, P = 0.001). Significant association of turnover intention among nurses was found with autonomous decision-making (OR: 0.28, CI: 0.14, 0.70) and promotion/development (OR: 0.67, C.I: 0.46, 0.89).

CONCLUSION AND RECOMMENDATION

Our meta-analysis on turnover intention among Ethiopian nurses highlights a significant challenge, with a pooled proportion of 53.35%. Regional variations, such as the highest turnover in Addis Ababa and the lowest in Sidama, underscore the need for tailored interventions. The findings reveal a strong link between turnover intention and factors like autonomous decision-making and promotion/development. Recommendations for stakeholders and concerned bodies involve formulating targeted retention strategies, addressing regional variations, collaborating for nurse welfare advocacy, prioritizing career advancement, reviewing policies for nurse retention improvement.

The Architectural Layout of Long-Term Care Units: Relationships between Support for Residents' Well-Being and for Caregivers' Burnout and Resilience

With a growing need for long-term care facilities in general, and for specialized dementia units in particular, it is important to ensure that the architectural layouts of such facilities support the well-being of both the residents and the unit caregivers. This study aimed to investigate correlations between the support provided by the architectural layout of long-term care units for enhancing residents' well-being and for decreasing unit caregivers' burnout and increasing their resilience-as layouts may impact each party differently. The Psycho Spatial Evaluation Tool was utilized to assess the support provided by the layouts of seventeen long-term care units (ten regular nursing units and seven specialized dementia units) for the residents' physical and social well-being (five dimensions); a questionnaire was used to measure the unit caregivers' burnout and resilience. When analyzing layouts' support for residents' physical and social well-being, inconsistencies emerged regarding correlations with caregivers' burnout and resilience across the two types of long-term care units. Supporting residents' physical well-being was correlated with increased caregiver resilience in dementia units, and with increased burnout and decreased resilience in regular nursing units. Layouts supporting social well-being showed inconsistent correlations with caregivers' resilience indexes in dementia units, and with burnout and resilience indexes in regular nursing units. The findings underscore the role of the architectural layout of long-term care units in enhancing residents' well-being; the results also highlight the possible unintentional yet negative impact of the layout on the caregivers' burnout and resilience. This study emphasizes the need to identify and rectify design shortcomings as a means of enhancing residents' well-being, while increasing the unit caregivers' resilience and decreasing their burnout. These insights should be addressed when developing strategies and interventions for ensuring optimal care environments for all parties involved.

Exploring the relationships between resilience, burnout, work engagement, and intention to leave among nurses in the context of the COVID-19 pandemic: a cross-sectional study

BACKGROUND

Nurses have faced significant personal and professional stressors during the COVID-19 pandemic that have contributed to increased rates of burnout, intention to leave, and poorer work engagement. Resilience has been identified as a critical factor influencing job outcomes; however, the dynamics of this association have not yet been investigated within the context of the Thai workforce. The study objective was to determine the associations between resilience and job outcomes, including burnout, intention to leave, and work engagement among nurses working in Thailand during the COVID-19 pandemic.

METHODS

This cross-sectional study gathered data from a sample of 394 registered nurses employed across 12 hospitals. The research instruments comprised the Connor-Davidson Resilience Scale (CD-RISC), the Maslach Burnout Inventory-Health Services Survey (MBI-HSS), a questionnaire assessing the intention to leave the job, and the Utrecht Work Engagement Scale (UWES). To determine the associations among the measured variables, multivariate logistic regression analyses were conducted.

RESULTS

One-third of nurses experienced emotional exhaustion and depersonalization, and about half experienced reduced personal accomplishment; one-tenth of nurses intended to leave their job. Nurses who exhibited higher levels of resilience were found to have a significantly reduced likelihood of experiencing high emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment. Conversely, these nurses were more likely to report higher levels of work engagement than their less resilience.

CONCLUSION

The COVID-19 pandemic offers important lessons learned about promoting the well-being of the nursing workforce and protecting against adverse job outcomes. While we identified resilience as a significant predictor of several nurse outcomes, other work environment factors should be considered. Government and hospital administrations should allocate resources for individual and organizational-level interventions to promote resilience among frontline nurses so that hospitals will be better prepared for the next public health emergency and patient and nurse outcomes can be optimized.

Systematic RADaR analysis of responses to the open-ended question in the Culture of Care Barometer survey of a Dutch hospital

OBJECTIVES

Systematically measuring the work environment of healthcare employees is key to continuously improving the quality of care and addressing staff shortages. In this study, we systematically analyse the responses to the one open-ended question posed in the Dutch version of the Culture of Care Barometer (CoCB-NL) to examine (1) if the responses offered new insights into healthcare employees' perceptions of their work environment and (2) if the original CoCB had any themes missing.

DESIGN

Retrospective text analysis using Rigorous and Accelerated Data Reduction technique.

SETTING

University hospital in the Netherlands using the CoCB-NL as part of the annual employee survey.

PARTICIPANTS

All hospital employees were invited to participate in the study (N=14 671). In total, 2287 employees responded to the open-ended question.

RESULTS

2287 comments were analysed. Comments that contained more than one topic were split according to topic, adding to the total (n=2915). Of this total, 372 comments were excluded because they lacked content or respondents indicated they had nothing to add. Subsequently, 2543 comments were allocated to 33 themes. Most comments (n=2113) addressed the 24 themes related to the close-ended questions in the CoCB-NL. The themes most commented on concerned questions on 'organisational support'. The remaining 430 comments covered nine additional themes that addressed concerns about work environment factors (team connectedness, team effectiveness, corporate vision, administrative burden and performance pressure) and themes (diversity and inclusion, legal frameworks and collective bargaining, resilience and work-life balance, and personal matters).

CONCLUSIONS

Analysing responses to the open-ended question in the CoCB-NL led to new insights into relevant elements of the work environment and missing themes in the COCB-NL. Moreover, the analysis revealed important themes that not only require attention from healthcare organisations to ensure adequate improvements in their employees' work environment but should also be considered to further develop the CoCB-NL.

Relationship between workplace violence, job satisfaction, and burnout among healthcare workers in mobile cabin hospitals in China: Effects of perceived stress and work environment

Background

Although workplace violence is prevalent in the healthcare system, the relationship between workplace violence, job satisfaction, and burnout among healthcare workers (HCWs) in mobile cabin hospitals in China during the COVID-19 pandemic has not yet been investigated. This study analyzes the mediating effects of perceived stress and work environment in the relationship between workplace violence, job satisfaction, and burnout.

Methods

A cross-sectional study was conducted in December 2022 on 1,199 frontline HCWs working in mobile cabin hospitals in Chongqing, China, during the COVID-19 pandemic. Multiple linear regression and mediation analysis were performed.

Results

A positive correlation was observed between workplace violence and burnout (r = 0.420, P < 0.01) and perceived stress (r = 0.524, P < 0.01), and a negative correlation was observed with job satisfaction (r = -0.254, P < 0.01). The perceived stress was positively correlated with burnout (r = 0.528, P < 0.01) and negatively with job satisfaction (r = -0.397, P < 0.01). Job satisfaction was negatively correlated with burnout (r = -0.300, P < 0.01). Perceived stress plays a significant mediating role between workplace violence and job burnout and between workplace violence and job satisfaction. The work environment has a significant moderating effect between workplace violence and job burnout and between workplace violence and job satisfaction.

Conclusion

To reduce burnout among HCWs, hospital administrators should focus on reducing the incidence of workplace violence and perceived stress from work and on improving the work environment and job satisfaction.

Surgery, innovation, research and sustainable development

In the healthcare sector, surgery (especially in the operating theatre) is responsible for emission of greenhouse gases, which is a source of global warming. The goal of this largely quantitative assessment is to address three questions on carbon footprint associated with surgery, the role of primary and secondary prevention prior to surgical procedures, and incorporation of the carbon footprint into judgment criteria in research and surgical innovations. It appears that while the impact of surgery on global warming is undeniable, its extent depends on means of treatment and geographical location. Before and after an operation, primary, secondary and tertiary prevention accompanied by surgical sobriety (avoiding unnecessary or unjustified actions) can be virtuous in terms of sustainable development. However, the sanitary benefits of these actions are often opposed to environmental benefit, which has yet to be satisfactorily assessed. Lastly, the carbon footprint has yet to be incorporated into research protocols or the innovations under development. This should impel us not only to sensitize the different healthcare actors to relevant issues, but also to improve working conditions.

Assessment of Nursing Practice Environment and Its Influencing Factors: A Cross-Sectional Study at Shandong Province, Jinan

Objective

To investigate the current nursing practice environment in Jinan, Shandong Province, and to identify the factors influencing the practice environment.

Methods

This study is a cross-sectional study for nurses. From October to December 2022, using the clustering and stratified sampling methods, 2426 nurses from internal Medicine, Surgery, Obstetrics and Gynecology, Outpatient Department and Intensive Care Department of the Provincial Hospital of Shandong Medical University were selected and then investigated and analyzed using the revised Nurse Practice Environment Assessment Scale.

Results

The overall mean evaluation of the practice environment scored 75.13±19.87, with a minimum value of 59.74 and a maximum value of 95.82. The items with higher scores were "the hospital has systematic training for new nurses", "the work system is perfect", and "the hospital can provide continuing education for nurses in accordance with the needs of their positions". The items with lower scores were "nurses enjoy legal benefits", "nurses have the opportunity to participate in hospital management decisions", and "nurses have the opportunity to participate in hospital internal management". The results of the multiple linear regression analysis of the factors influencing nurses' practice environment showed that gender, education, position, and years of work were independent influences on nurses' practice environment scores (p < 0.05), and they explained 48.127% of the variation in the total scores of the nurses' practice environment scale. The estimated values (β) of sex, education, cheif nurse, nurses staff, work experience (year), and whether the only child variables were 3.141, 3.237, 2.713, 5.471, 2.074 and 0.732, respectively.

Conclusion

The nurse practice environment still needs to be improved, mainly in terms of hospital management participation, human resource allocation and salary distribution system.

Influence of the work environment of nurses on the 30-day mortality of patients hospitalized in Polish hospitals. cross-sectional studies

BACKGROUND

An optimal work environment for nurses is characterized primarily by appropriate staffing, good team relations, and support from the management staff. These factors are consistently associated with a positive assessment of patient safety by a hospital's employees and a reduction in hospital mortality rates.

AIM

To understand the relationships between the work environment as perceived by nurses on the 30-day mortality of patients treated in Polish hospitals.

BACKGROUND

An optimal work environment for nurses is characterized primarily by appropriate staffing, good team relations, and support from the management staff. These factors are consistently associated with a positive assessment of patient safety by a hospital's employees and a reduction in hospital mortality rates.

MATERIAL AND METHODS

The analysis used discharge data from 108,284 patients hospitalized in internal medicine and surgery departments in 21 hospitals (with 24/7 operations) in Poland. Administrative data included coded data to estimate 30-day mortality. A Nurses' satisfaction questionnaire, including the PES-NWI scale and the SAQ questionnaire, was used to assess the work environment of nurses (n = 1,929). Correlations between variables were assessed using the Pearson coefficient. The analysis used a Poisson regression model, which belongs to the class of generalized linear models.

RESULTS

A lower 30-day mortality rate amongst patients was found among those treated in hospitals where the personnel feel that they may question the decisions or actions of their superiors regarding the care provided (r = - 0.50); nurses are informed about changes introduced on the basis of reports about negligence and mistakes (r = - 0.50); the ward nurse is a good manager (r = - 0.41); nurses receive timely information from the head of the department that may have an impact on their work (r = - 0.41).

CONCLUSIONS

Factors related to care during hospital stay such as the organization of care at the ward level, analysis of care errors, the number of staff providing direct patient care, informing nurses about mistakes without punishment, and the possibility of nurses challenging the decisions or actions of superiors, which concerns care providing, affect the 30-day mortality of patients after the end of hospitalization in Polish hospitals.

Exploring factors that affect nurse staffing: a descriptive qualitative study from nurse managers' perspective

BACKGROUND

The appropriate nurse staffing reflects the situation of nursing management of human resources. Nurse managers have a pivotal role in determining a competent and sufficient number of nurses. It is important to understand the factors influencing nurse staffing to promote appropriate staffing levels. The study aimed to explore the factors affecting nurse staffing from the perspective of nursing managers.

METHODS

Purposive sampling was adopted to recruit 14 nurse managers from secondary and tertiary hospitals located in the central region of China, and semi-structured interviews via telephone were conducted from April to May 2022. Interview transcripts were analyzed and collated using thematic analysis.

RESULTS

This research identified four themes and ten subthemes influencing nurse staffing. Extracted themes include: government level (inadequacy of mandatory policies, budgetary constraints), hospital level (hospital characteristics, the control of nurse labor costs, inadequate support on nursing), patient level (patient characteristics, increasing care needs), and nurse level (nurse shortage, skill-mix, individual high-level needs).

CONCLUSION

The findings indicate that it is crucial for decision-makers or policymakers to legislate for safe nurse staffing and establish effective supervision and funding incentives. Tailored interventions are also needed to improve the organizational context, address the nurse workforce and balance the structure of nurse staff.

Emotional burnout, job satisfaction, and intention to leave among pre-hospital emergency healthcare workers during the COVID-19 pandemic

BACKGROUND

With the onset of the COVID-19 pandemic, pre-hospital emergency healthcare workers (PHEHW) assumed critical responsibilities in controlling and preventing the spread of the virus.

OBJECTIVE

This descriptive study aimed to explore the emotional burnout, job satisfaction, and intention to leave among PHEHW during the COVID-19 pandemic.

METHODS

The study was conducted with 401 emergency medical technicians and paramedics. The Sociodemographic Data Form, the Emotional Burnout Scale, the Job Satisfaction Scale, the Intention to Leave the Profession Scale were used to collect data. The findings were assessed with a significance level set at p < 0.05 and a 95% confidence interval.

RESULTS

The participants demonstrated moderate scores in emotional burnout, job satisfaction, and intention to leave the profession. The analysis revealed a negative correlation, indicating that as emotional burnout increased, job satisfaction decreased, and the intention to leave the profession heightened. Notably, the participants who had 6-9 years of service, lacked knowledge about COVID-19, had no COVID-19 training, underwent COVID-19 testing, and experienced the loss of a healthcare worker due to COVID-19 exhibited higher levels of burnout. Furthermore, those who had 6-9 years of service, lacked knowledge about COVID-19, had no COVID-19 training, and lost a healthcare worker due to COVID-19 reported lower levels of job satisfaction. Additionally, participants who had 6-9 years of service, lacked knowledge about COVID-19, had no COVID-19 training, and experienced the loss of a healthcare worker due to COVID-19 displayed a greater intention to leave the profession.

CONCLUSIONS

It is important to implement improvement initiatives that will increase the motivation and job satisfaction of PHEHW. These include the regulation of working hours and shifts, augmenting staff numbers, enhancing working conditions, improving salaries, and implementing strategies aimed at fostering motivation and job satisfaction.

The Effects of a Participatory Intervention in Mental Health Units on Nurses' Perceptions of the Practice Environment: A Mixed Methods Study

BACKGROUND

The practice environment influences the quality of care and the nursing outcomes achieved in their workplaces.

AIMS

To examine the perception of the clinical practice environment among nurses working in mental health units in the context of their participation in an action research study aimed at improving the nurse-patient relationship.

METHOD

An explanatory sequential mixed methods study was designed. The data were collected in three phases in 18 mental health units (n = 95 nurses). Quantitative data were collected through the Practice Environment Scale of the Nursing Work Index, and qualitative data were collected through reflective diaries and focus groups in the context of participatory action research.

RESULTS

The nurses' assessment of their practice environment shifted from positive to negative. Nurse manager leadership was the aspect that worsened the most. In addition, the perception of their participation in the affairs of the center and nursing foundations for quality of care decreased. The nurses considered it essential to be able to influence decision-making bodies and that the institution should promote a model of care that upholds the therapeutic relationship in actual clinical practice.

CONCLUSIONS

Nurses perceived that they should be involved in organizational decisions and required more presence and understanding from managers. Furthermore, nurses stated that institutions should promote nursing foundations for quality of care. This study contributes to understanding how nurses in mental health units perceive their work environment and how it affects the improvement of the nurse-patient relationship in clinical practice.

Understanding the Workplace-Violence-Related Perceptions and Coping Strategies of Nurses in Emergency Rooms

BACKGROUND

Workplace violence (WPV) is a well-known and serious issue in most countries, and WPV against healthcare providers is of particular concern, especially among nurses working in emergency rooms (ERs).

PURPOSE

We aimed to develop a deeper understanding of nurses' perceptions and coping strategies related to WPV that took place over a 1-year period from the perspective of nursing victims still working in ERs in southern Taiwan.

METHODS

This is a qualitative study with in-depth and semistructured interviews. Nineteen ER nurse victims were recruited from six hospitals in southern Taiwan from June 2015 to April 2016. All of the interview recordings were analyzed using content analysis.

RESULTS

The content analysis identified two themes of perceptions and two themes of coping strategies toward WPV. The two themes of perceptions were "adversity" and "dilemma," with the former covering the three subthemes of "misunderstanding of health policy," "unsafe environment," and "nursing shortage" and the latter covering the two subthemes of "burnout" and "keeping or quitting the job." The two themes of coping strategies were "adjustment" and "resilience," with the former covering the three subthemes of "acceptance of the reality of WPV," "self-regulation," and "culture and belief" and the latter covering the two subthemes of "living with WPV" and "problem solving."

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The findings revealed that ER nurse victims of WPV experienced a complicated journey after encountering WPV. Their coping strategies may be referenced by other ER nurses to better prevent and manage violent events in ERs. To prevent and manage violence in ERs, hospital managers should create a safe working environment through, for example, assigning sufficient security personnel and staff; provide relevant training to ER nurses in communications and other skills; and implement support systems to strengthen nurse resilience.

Professional engagement: Connecting self-efficacy to actual turnover among hospital nurses

AIMS

To examine how nurses' self-efficacy impacts professional engagement (professional opportunities exploration and workplace improvement participation), nurses' turnover intention and further on actual turnover.

BACKGROUND

The problem of nursing shortage has become a common global issue. Nurses' self-efficacy could reduce nurses' turnover intention. However, whether professional engagement could connect nurses' self-efficacy and their actual turnover remains unknown.

DESIGN

This study adopts a three-wave follow-up design.

METHODS

This study uses proportionate random sampling to survey nurses in a large medical centre in Taiwan. Totally, 417 participants were enrolled from December 2021 to January 2022 (first wave) and followed up from February 2022 to March 2022 (second wave). The data of nurses' actual turnover (or not) were traced in May 2022 (third wave). STROBE statement was chosen as the EQUATOR checklist.

RESULTS

Self-efficacy was positively linked to outcome expectation, which is positively linked to professional opportunities exploration. Self-efficacy was positively linked to career interest and workplace improvement participation. Professional engagement was negatively linked to nurses' intention to leave the target hospital, which was positively linked to actual turnover.

CONCLUSION

This study uniquely finds that professional engagement is the key to the mechanism underlying the influence of nurse' self-efficacy on their actual turnover.

IMPACT

Our findings impact nursing management that professional engagement is as well important as nurses' self-efficacy, with an aim to maintain the professional nursing workforce.

PATIENT OR PUBLIC CONTRIBUTION

Nurses complete the questionnaires, return them to the investigators and permit investigators to check their personnel data.

Verbal violence and missed nursing care: A phenomenological study

AIM

To define the missed care experiences of nurses exposed to verbal violence from patients.

BACKGROUND

Verbal violence takes the first place among the types of violence that nurses face in healthcare settings. This can cause negative emotional and physical responses in nurses and issues in patient and nurse interaction. As a result, it may lead to missed nursing care, defined as skipped, postponed or incomplete care during the patient's care.

METHODS

This is a phenomenological study. The study sample included 16 nurses working in inpatient clinics who reported experiencing verbal violence at least once in Turkey. The study was conducted between January and February 2022 with institutional permission and ethics committee approval (09/12/2021-2021/357). A semi-structured interview method was used to collect data. The information gathered from the interviews underwent thematic analysis using an inductive approach. The 'Consolidated Criteria for Reporting Qualitative Research (COREQ)' was used to report this qualitative study based on a comprehensive protocol.

RESULTS

The types of verbal violence most frequently faced by nurses were determined as swearing, insulting, shouting and threats. Study findings were classified into three main themes: (i) response to verbal violence, (ii) missed nursing care experiences and (iii) suggestions to cope with verbal violence. The most felt emotions in the face of verbal violence were feeling sad, unsafe and worthless. Nurses common behaviours, in response to verbal abuse were ignoring, getting used to, and wishing to get away. The examples of missed care included using non-therapeutic communication, postponing care or withdrawing from care.

CONCLUSION

Verbal violence caused negative emotional and behavioural responses in nurses, which, in turn, negatively affected the nurse-patient interaction. These findings mean that verbal violence may pave the way for missed nursing care.

IMPLICATIONS FOR NURSING POLICY

According to these findings, an uninterrupted nursing care process needs to focus on preventive measures against verbal violence and increase the administrative and legal support offered to nurses.

[Effects of Nursing Work Environment on Intention to Stay of Hospital Nurses: A Two-Mediator Serial Mediation Effect of Career Motivation and Job-Esteem]

PURPOSE

This study aimed to identify the mediating effects of career motivation and job-esteem and the effect of the nursing work environment on intention to stay among hospital nurses.

METHODS

Data were collected from 289 nurses working at an advanced general hospital. The research model design was based on the PROCESS macro proposed by Hayes and analyzed using SPSS 24.0 program.

RESULTS

The results showed a positive correlation between intention to stay and nursing work environment (r = .19, p = .001), career motivation (r= .34, p < .001), and job-esteem (r = .37, p < .001). Nursing work environment (B = 0.34 [.09~.59]) and job-esteem (B = 0.27 [.04~.49]) had a direct effect on intention to stay. There was a two-mediator sereal mediation effect of career motivation and job-esteem. The nursing work environment showed a significant effect on the intention to stay among hospital nurses through career motivation and job-esteem.

CONCLUSION

In order to increase the retention rate of hospital nurses, it is suggested that government and medical institutions provide multifaceted support that can increase nurses' motivation for career development and recognition of the nursing profession through improvement of the nursing work environment.

Different Results from Varied Angles: The Positive Impact of Work Connectivity Behavior After-Hours on Work Engagement

With the development of communication technology and the COVID-19 pandemic, it has become increasingly common for employees to maintain work connectivity after-hours, which has a significant impact on their psychological state at work. However, most of the existing studies have not reached a consensus on the impact of work connectivity behavior after-hours on employees' psychological state at work, and the existing studies have led to theoretical and practical disagreements. Based on the Job Demands-Resources model, we built a two-path model of work autonomy and emotional exhaustion to explore the impact of work connectivity behavior after-hours on work engagement. In addition, we compared the differences between different workplace statuses (managers and ordinary employees). Through surveys and analyses of 257 employees, the results show that work connectivity behavior after-hours positively impacts employees' work engagement by increasing managers' work autonomy and reducing ordinary employees' emotional exhaustion. This study not only reveals that work connectivity behavior after-hours positively affects work engagement but also illustrates the differences in impact between managers and ordinary employees; these findings contribute to the development of a consensus on the influence of work connectivity behavior after-hours on employees' psychological state at work, which provides insights for organizations seeking to manage work connectivity behavior after-hours, for example, by adopting different connectivity management strategies for employees with different workplace statuses.

Relationship of the nursing practice environment with the quality of care and patients' safety in primary health care

BACKGROUND

Nursing practice environment has impact on the quality of nursing care and on patients' and nurses' outcomes, namely better performances of these healthcare workers. Improving the nursing practice environment is a low-cost organizational strategy to achieve better patients' outcomes and retain qualified nurses, thus improving nursing care of units, healthcare organizations and healthcare system. This study aims to analyse the relationship between nursing practice environment and the nurses` perception of quality of care, patient safety, and safety culture in Primary Health Care in Portugal.

METHODS

We conducted a descriptive, analytical, and cross-sectional study using data from RN4CAST Portugal. The sample was composed of 1059 nurses from 55 Health Center Groups of the mainland Portugal, 15 Health Centers of the Autonomous Region of Madeira and 6 Health Centers of the Autonomous Region of the Azores. Multivariate analysis and correlation analysis methods were used for data processing.

RESULTS

Nurses consider that, in the Portuguese Primary Health Care, there is a mixed and unfavourable nursing practice environment, with a perception of a good quality of care, and both acceptable patients' safety and safety culture. The Collegial Nurse-Physician Relations and Nursing Foundations for Quality of Care dimensions to have the best ratings. The perception of Primary Health Care nurses on the dimension Nurse Participation in Organization Affairs was the one that showed the lowest score, followed by Staffing and Resource Adequacy and Nurse Manager Ability, Leadership, and Support of Nurses. Based on perception of nurses, the relationship between the nursing practice environment and the safety culture is higher, followed by the quality of care and patients' safety.

CONCLUSIONS

The perception of Primary Health Care nurses is that there is an unfavourable and mixed nursing practice environment, with good quality of care, and acceptable patient safety and safety culture. The quality of the nursing practice environments is associated to better quality and safety of care. Thus, improving the nursing practice environments in healthcare organizations is a low-cost organizational strategy to achieve greater patients and nurses' outcomes, improving the quality of nursing care to patients in the Primary Health Care units.

The relationship between healthcare workers' satisfaction level and patients' satisfaction: Results of a path analysis model

INTRODUCTION

Patient and healthcare workers' satisfaction is an important issue in the healthcare sector today. This study aims to evaluate the relationship between healthcare workers and patient satisfaction levels among Turkish individuals, with particular emphasis on the contribution of the former to the latter.

MATERIALS AND METHODS

The current study was conducted in a state hospital in İstanbul, Türkiye. Face-to-face surveys were conducted from January to April 2022 to administer two diverse questionnaires for inpatients and attending healthcare workers in the same clinic. Path analysis was used to examine the relationships.

RESULTS

The path analysis demonstrated that 25.2% of patient satisfaction was constituted by the satisfaction of healthcare workers. The final model had an excellent fit with the data x2 (112.89), x2/df (2.130); SRMR=0.0679, CFI=0.956, RMSEA=0.0798. According to the results of this analysis, healthcare worker satisfaction positively influences patient satisfaction and causes it to increase.

CONCLUSION

Healthcare satisfaction plays a central role in providing patient satisfaction, which in turn helps with the challenges that healthcare faces today.

Direct and Moderating Effects of Work Environment and Structural Empowerment on Job Stress and Job Satisfaction Among Nurses in Oman

Objectives

This study aimed to explore the relationships between nurses' work environment, job stress and job satisfaction, along with the moderating effects of work environment and empowerment on the relationship between job stress and job satisfaction.

Methods

A descriptive correlational design was utilised for this study. The study encompassed a convenience sample of 1,796 hospital nurses from the 11 governorates in Oman. Moreover, a self-report questionnaire that included a set of instruments was used to collect the data.

Results

Nurses who perceived higher levels of job stress reported lower levels of satisfaction and empowerment and perceived their work environment as less favourable and supportive. The findings only confirmed the direct effects of work environment and empowerment on satisfaction, whereas no support was found for indirect or moderating effects. Furthermore, the hierarchical regression model showed that 46.5% of the variation in the level of job satisfaction was explained by the study variables.

Conclusion

The results of this study demonstrate the importance of implementing strategies that empower staff, provide a supportive and positive work environment and tackle job stress to enhance levels of job satisfaction.

Evaluation of a blended training solution for critical care nurses' work environment: Lessons learned from focus groups in four European countries

AIM

The aim of this study was to evaluate a blended pilot training course on Healthy Work Environments (HWEs) for critical care nurses as follows: 1) to explore the experience of trainees and trainers who took part in the training; and 2) to identify the strengths and weaknesses of the training program in its potential transferability to nursing practice in Intensive Care Units (ICUs).

BACKGROUND

Despite the evidence supporting the association between HWEs and job satisfaction, nursing retention, and patient outcomes, nurses still have high rates of burnout, mental health problems and intent to leave. To address this challenge, a blended training was created and piloted with the aim to highlight the relevance and impact of HWEs, enhancing its transferability to daily practice. The training was based on the six standards of HWEs as proposed by the American Association of Critical Care Nurses and created within an Erasmus + project. The pilot was delivered by trainers (critical care nursing educators) to critical care nurses and included six workshops of eight hours each (48 h in total) in each country.

DESIGN

After the pilot testing, a qualitative approach, with focus group discussions was used.

METHODS

All the trainees (n=82), who had attended at least one workshop were invited to participate in the focus groups. Overall, eight focus groups were held with critical care nurses who participated as trainees (n=39) from four testing countries: Cyprus, Croatia, Spain and Poland. One international focus group was held with trainers who conducted the training (n=4). Four more trainers completed the questionnaire online. All focus group were video recorded, and transcribed verbatim. Then, the national transcripts were translated into English. An inductive thematic analysis was carried out.

FINDINGS

Three themes were identified: 1) Valuing the relevance of the training program and a positive learning experience; 2) A powerful insight leading to increased awareness and empowerment in personal and professional life; 3) Challenges identified in terms of training, follow up and management of change. Both trainees and trainers expressed a positive opinion with regard to the content of the training and the didactic methods used. They emphasized the strong influence of the training on their understanding of a HWEs, its impact in an ICU context and the need for action, mainly related to communication issues.

CONCLUSION

The proposed blended training program may be used by trainers, who can enable nurses develop the competencies required to influence their work environment, in a context of shared responsibility.

Health status, resources, and job demands in geriatric nursing staff: A cross-sectional study on determinants and relationships

BACKGROUND

According to current estimates, the number of people needing care will double in the next 40 years. It is expected that between 130,000 and 190,000 additional nurses will be needed by 2030 in Germany. Physical and psychological burdens associated with nursing in long-term care facilities can develop into serious health risk factors and significantly impact occupational factors such as absenteeism, especially when linked to difficult working conditions. However, demands and resources specific to the nursing profession have not been analyzed extensively to preserve and promote nurses' workability and health adequately.

OBJECTIVE

Our study aimed to examine the extent to which perceived health among geriatric nursing staff in Germany is predicted by personal resources, job demands, and job resources. In addition, we analyzed the impact of different behavior and experience patterns on these relationships.

DESIGN, SETTING, AND PARTICIPANTS

An observational study was conducted between August 2018 and February 2020 in 48 nursing home facilities with 854 staff members in Germany as part of the project 'PROCARE - Prevention and occupational health in long-term care'.

METHODS

The survey contained instruments that measure workplace exposure, musculoskeletal complaints, physical and mental well-being, chronic stress, and work-related behavior and experience patterns. In addition, health-related information on physical activity and nutrition was collected. Data were analyzed using structural equation modeling.

RESULTS

The combined physical and mental workload for geriatric nurses is very high, with 75 % showing chronic stress. In the overall model, job and personal resources have a stronger association with mental health than physical health, while job demands have an equal impact on mental and physical health. Coping behavior also plays an important key role that should be assessed and considered. A behavior and experience risk pattern (health-endangering) is more strongly associated with a lower health status than a health-promoting behavior pattern. Results of the multigroup test showed that work-related behavior and experience patterns significantly moderate the relationship between physical health and mental health (χ2 = 392/p ≤ .001/df = 256/RMSEA = 0.028/CFI = 0.958/TLI = 0.931). Only 43 % show a health-friendly coping pattern.

CONCLUSIONS

Our findings underline the importance of holistic health promotion, which not only aims at changes at the behavioral level and the development of coping strategies but also takes on the task of reducing the workload and including measures to improve the working climate.

TRIAL REGISTRATION NUMBER

DRKS.de (DRKS00015241); August 9, 2018.

TWEETABLE ABSTRACT

Healthier coping patterns can benefit geriatric nurses' health. However, this is not a substitute for improving working conditions.

Global prevalence of nursing burnout syndrome and temporal trends for the last 10 years: A meta-analysis of 94 studies covering over 30 countries

AIMS AND OBJECTIVES

To determine the global prevalence of nursing burnout syndrome and time trends for the last 10 years.

BACKGROUND

The prevalence of burnout syndrome varied greatly in different regions in the last 10 years, so the average prevalence and time trends of nursing burnout syndrome for the last 10 years were not completely clear.

DESIGN

A meta-analysis conducted in the PRISMA guidelines.

METHODS

CINAHL, Web of Science, and PubMed were searched for trials on the prevalence of nursing burnout syndrome from 2012 to 2022 systematically. Hoy's quality assessment tool was used to evaluate the risk of bias. The global prevalence of nursing burnout syndrome was estimated, and subgroup analysis was used to explore what caused heterogeneity. Time trends for the last 10 years were evaluated by meta-regression using Stata 11.0.

RESULTS

Ninety-four studies reporting the prevalence of nursing burnout were included. The global prevalence of nursing burnout was 30.0% [95% CI: 26.0%-34.0%]. Subgroup analysis indicated that the specialty (p < .001) and the region (p < .001) and the year (p < .001) were sources of the high heterogeneity. Meta-regression indicated that it tended to increase gradually for the last 10 years (t = 3.71, p = .006). The trends increased in Europe (t = 4.23, p = .006), Africa (t = 3.75, p = .006) and obstetrics (t = 3.66, p = .015). However, no statistical significance was found in ICU (t = -.14, p = .893), oncology (t = -0.44, p = .691) and emergency department (t = -0.30, p = .783).

CONCLUSIONS

A significant number of nurses were found to have moderate-high levels of burnout syndrome for the last 10 years. The meta-analysis also indicated an increased trend over time. Therefore, more attention to the prevalence of nursing burnout syndrome is urgently required.

RELEVANCE TO CLINICAL PRACTICE

High prevalence of nursing burnout may attract more attention from the public. This analysis may serve as an impetus for relevant policy to change nurses' working conditions and reduce the occurrence of burnout.