Predictors and outcomes of work-family conflict among nurses

Patient mistreatment, emotional exhaustion and work-family conflict among nurses: a moderated mediation model of social sharing of negative work events and perceived organizational support

BACKGROUND

Nursing literature suggested that patient mistreatment has significant impacts on nurses' emotions and job burnout. Yet, further research is needed to understand the underlying mechanism and the spillover effect on nurses' families. Leveraging the goal progress theory, this study aimed to examine the association between patient mistreatment, nurses' emotional exhaustion, and work-family conflict, as well as the mediating role of social sharing of negative work events and the moderating role of perceived organizational support.

METHODS

During the COVID-19 pandemic in China, a cross-sectional study was conducted with a sample of 1627 nurses from the Hematology Specialist Alliance of Chongqing from October to November 2022. Questionnaires were administered to measure patient mistreatment, perceived organizational support, social sharing of negative work events, emotional exhaustion, and work-family conflict. Hierarchical linear regression and conditional processes were used for statistical analyses.

RESULTS

Patient mistreatment was positively associated with emotional exhaustion (β = 0.354, p < 0.001) and work-family conflict (β = 0.314, p < 0.001). Social sharing of negative work events played a partial mediating role in the relationship between patient mistreatment and emotional exhaustion (effect = 0.067, SE = 0.013), and work-family conflict (effect = 0.077, SE = 0.014). Moderated mediation analysis found that the mediation effect was stronger when the perceived organizational support was high.

CONCLUSION

Our findings reveal the amplifying effect of social sharing of negative work events on nurses' emotional exhaustion and work-family conflict. Perceived organizational support strengthens the positive effect of patient mistreatment on the social sharing of negative work events, thus resulting in increased emotional exhaustion and work-family conflict. We also discuss practical implications, limitations, and directions for future research.

Relationship between nurses' mood at work and work engagement: Work morale as a mediator

AIM

To determine the effect of nurses' mood at work (positive and negative) on work engagement and whether work morale mediates this relationship.

BACKGROUND

Nurses' work engagement is a key research area, yet limited data regarding the relationship between nurses' mood at work and work engagement are available. Therefore, how nurses' positive or negative mood at work affects their work engagement remains unclear.

METHODS

This study analyzed nurses from a medical center in Taipei City. A total of 279 completed questionnaires were returned. The data were analyzed using two-stage structural equation modeling to test the hypothesized relationships.

FINDINGS

Nurses' positive mood had a significantly positive effect on work morale, whereas their negative mood had a significantly negative effect on work morale. Additionally, work morale played a mediating role in the relationship between mood at work and work engagement.

CONCLUSION

The results revealed that nurses' moods affected their work engagement and that this relationship was affected by work morale.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Healthcare institutions and hospitals could develop a positive work environment to help nurses maintain their good mood and reduce negative affectivity. They should also provide nurses with counseling services, offer morale-boosting activities, and adopt an inspirational leadership style to maintain their work morale.

Linking Toxic Leadership With Work Satisfaction and Psychological Distress in Emergency Nurses: The Mediating Role of Work-Family Conflict

INTRODUCTION

Toxic leadership is a prevalent issue within health care organizations, including emergency departments. No studies have been found specifically examining these issues among emergency nurses. This study examined the mediating effects of work-family conflict on the relationship between toxic leadership behaviors of nurse managers and psychological distress and work satisfaction among emergency nurses.

METHODS

A cross-sectional survey was used to gather data from 285 Filipino emergency nurses, using 4 validated measures. Mediation analyses were conducted using the PROCESS Macro with Model 4.

RESULTS

Toxic leadership had a direct negative effect on work satisfaction (β = -0.3313, P < .001) and a direct positive effect on psychological distress (β = 0.0945, P = .0491). Work-family conflict partially mediated the relationship between toxic leadership and both psychological distress (β = 0.0217, SE = .0141, 95% CI = 0.0002-0.0538) and work satisfaction (β = -0.0438, SE = 0.0216, 95% CI = -0.0884 to -0.0049).

DISCUSSION

The study findings highlighted the negative influence of toxic leadership behaviors on the overall work satisfaction and psychological well-being of emergency nurses. In addition, this study identified work-family conflict as a mechanism that explained how the toxic leadership behaviors of nurse managers influenced the psychological well-being and job satisfaction of emergency nurses. The results of this study underscore the need for interventions and strategies to address toxic leadership and mitigate the negative consequences it poses to emergency nurses' well-being.

Analysis of turnover intention and influencing factors among female nurses with two children in Grade A tertiary public hospitals in Sichuan province: a cross-sectional study

Objective

This study aims to examine the current status of turnover intention among female nurses with two children and explore the factors influencing their decision to resign, ultimately providing a basis for reducing nurses' turnover intention and stabilizing the nursing workforce.

Methods

A convenience sampling method was used to select 1,370 in-service female nurses with two children from 65 Grade A tertiary public hospitals in Sichuan Province from September to December 2023. Data was collected through a general information questionnaire, work-family behavioral role conflict scale, regulatory emotional self-efficacy, and turnover intention scale.

Results

This study revealed that the average score for turnover intention among female nurses with two children was (13.11 ± 3.93). There was a positive correlation between work-family behavioral role conflict and turnover intention (r = 0.485, p < 0.01), while regulatory emotional self-efficacy showed a negative correlation with turnover intention (r = -0.382, p < 0.01). The main influencing factors for resignation among these nurses included age, number of night shifts per month, average monthly income, primary caregiver for children, work-to-family conflict and family-to-work conflict, and the ability to express positive emotions (POS), the capacity to regulate negative emotions such as despondency/distress (DES), and the skill to manage anger/irritation (ANG). Collectively, these factors explained 29.5% of the total variance in turnover intention scores.

Conclusion

Turnover intention among female nurses with two children is relatively high. To address this issue, hospital managers shall implement effective measures through various channels to settle work-family conflict, enhance nurses' regulatory emotional self-efficacy, and reduce turnover intention resulting from work-family conflict. Together, these efforts will reduce nurse turnover and foster a stable nursing workforce.

The mediating role of perceived social support between work-family conflict and presenteeism among ICU nurses working shift work in Chinese public hospitals: A cross-sectional investigation

OBJECTIVE

Relative to explicit absenteeism, nurses' presenteeism has a more lasting impact and is more harmful and costly. This study aimed to explore the relationship between work-family conflict, perceived social support, and presenteeism and whether perceived social support mediates the relationship between work-family conflict and presenteeism among ICU nurses working on shifts in Chinese public hospitals.

MATERIALS AND METHODS

A cross-sectional research design was conducted from January to April 2023 in Sichuan Province, China. A total of 609 valid questionnaires were collected. The questionnaires contained information on demographic characteristics, the Work-Family Conflict (WFC) scale, the Perceived Social Support Scale (PSSS), and Stanford Presenteeism Scale-6 (SPS-6). Multiple stratified regression was used to explore the mediating role of perceived social support between work-family conflict and presenteeism. The mediating effect of perceived social support in work-family conflict and presenteeism was tested by Model 4 in the PROCESS 4.1 macro program in SPSS.

RESULTS

A total of 609 nurses were included in this study, and the mean presenteeism score for ICU nurses working on shifts was 16.01 ± 4.293 (Mean ± SD), with high presenteeism accounting for 58.46%. After controlling for sociodemographic characteristic variables, work-family conflict was positively associated with presenteeism, explaining 7.7% of the variance. High perceived social support was related to low presenteeism, explaining 11.5% of the variance. Perceived social support mediated the association between work-family conflict and presenteeism among ICU nurses working on shifts.

CONCLUSIONS

Chinese shift-work ICU nurses' high presenteeism scores deserve managers' attention. Work-family conflict is a significant predictor of nurses' presenteeism. Perceived social support is essential in improving nurses' work-family conflict and mediates the relationship between work-family conflict and presenteeism. Improving social support can reduce the impact of work-family conflict on presenteeism among nurses working shifts.

Nurse burnout: deep connections and solutions revealed by network analysis

BACKGROUND

Burnout is very important to nurses' physical and mental health and career development. Current approaches to assessing nurse burnout tend to use a total score modeling paradigm to explore the impact of external factors on burnout. The purpose of this study is to delve into the item-level relationship between nurse burnout and its influencing factors at both the social and psychological levels using a network analysis approach.

METHODS

This study was conducted in June 2023 and 1,005 nurses from 4 hospitals out of 8 tertiary care hospitals in Harbin were selected to participate in this study using whole cluster sampling method. Measurements included a general demographic questionnaire, Trait coping styles questionnaire, Organizational commitment questionnaire, Work-family conflict scale, Transformational leadership questionnaire, and Maslach Burnout Inventory-General Survey.

RESULTS

Our results suggest that "C1 Time-Based work interference with family" showed the strongest centrality and bridging in the overall network. This finding underscores its centrality to burnout. Other strongest bridge symptoms included "E2 Reduced personal accomplishment" and "A1 Positive coping styles" indicating their strongest connections to other clusters.

CONCLUSIONS

Nurse administrators should be encouraged to pay more attention to nurses' work situations and family distress, and to help nurses in a flexible way.

A Bayesian approach to reveal the role of psychological factors on turnover intention among nurses during the COVID-19 pandemic

BACKGROUND

Turnover intention is considered a significant challenge for healthcare and treatment organizations. The challenging conditions of treating COVID-19 patients and the physical and mental stress imposed on nurses during the pandemic may lead them to leave their jobs. The present study aimed to determine the role of psychological factors (general health, mental workload, work-family conflicts, and resilience) on turnover intention using a Bayesian approach during the COVID-19 pandemic.

METHODS

The present cross-sectional study was carried out during the winter of 2021 at three hospitals in Khuzestan Province, Iran. To collect data for this investigation, 300 nurses were chosen based on Cochran's formula and random sampling technique. Seven questionnaires, including General Health, Mental Workload, Work-Family Conflict, Resilience, Job Stress, Fear of COVID-19, and Turnover Intention Questionnaires. Bayesian Networks (BNs) were used to draw probabilistic and graphical models. A sensitivity analysis also was performed to study the effects of the variables. The GeNIe academic software, version 2.3, facilitated the examination of the Bayesian network.

RESULTS

The statistically significant associations occurred between the variables of fear of COVID-19 and job stress (0.313), job stress and turnover intention (0.302), and resilience and job stress (0.298), respectively. Job stress had the highest association with the fear of COVID-19 (0.313), and resilience had the greatest association with the work-family conflict (0.296). Also, the association between turnover intention and job stress (0.302) was higher than the association between this variable and resilience (0.219). At the low resilience and high job stress with the probability of 100%, the turnover intention variable increased by 20%, while at high resilience and low job stress with the probability of 100%, turnover intention was found to decrease by 32%.

CONCLUSION

In general, the results showed that four psychological factors affect job turnover intention. However, the greatest impact was related to job stress and resilience. These results can be used to manage job turnover intention in medical environments, especially in critical situations such as COVID-19.

Association between perceived overqualification, work engagement, job satisfaction among nurses: a cross-sectional study

OBJECTIVES

This cross-sectional correlational study aimed to understand nurses' perceived overqualification and work engagement, explore their effects on job satisfaction and provide a theoretical basis for hospital management policies in a public comprehensive tertiary hospital in China.

DESIGN

Cross-sectional correlational study.

SETTING

The study was conducted in a public comprehensive tertiary hospital in China. The specific location is not disclosed.

PARTICIPANTS

584 nurses participated in the study, with a completion rate of 97.3%. The average age of participants was 34.8±6.7 years, with 96.4% being women. 67.8% held a bachelor's degree or higher, and 71.6% had over 5 years of work experience.

PRIMARY AND SECONDARY OUTCOME MEASURES

The Scale of Perceived Overqualification was used to assess nurses' perceptions of their qualifications, demonstrating a high level of reliability with a Cronbach's alpha coefficient of 0.832. Utrecht Work Engagement Scale was used to assess nurses' work engagement, showing internal consistency coefficients (Cronbach's alpha) of 0.683 for the vigour dimension, 0.693 for the dedication dimension and 0.834 for the absorption dimension. Minnesota Satisfaction Questionnaire was used to evaluate nurses' job satisfaction, with internal consistency coefficients (Cronbach's alpha) of 0.765 for the intrinsic satisfaction scale and 0.734 for the extrinsic satisfaction scale. The primary outcome measures included perceived overqualification, work engagement and job satisfaction.

RESULTS

The average scores for perceived overqualification, work engagement and job satisfaction were 26.38±3.44, 65.36±14.92 and 74.29±15.04, respectively. Perceived overqualification showed negative correlations with work engagement (r=-0.562, p<0.05) and job satisfaction (r=-0.674, p<0.05). However, work engagement was positively correlated with job satisfaction (r=0.519, p<0.05). Path analysis indicated that perceived overqualification had both a direct (β=-0.06, p<0.001) and an indirect effect (β=-0.35, p=0.015) on job satisfaction, with work engagement partially mediating this relationship.

CONCLUSION

The perception of overqualification among nurses shows a significant correlation with both their work engagement and job satisfaction. This finding suggests that hospital administrators should pay attention to nurses' perceptions of their qualifications and take measures to enhance their job satisfaction. Furthermore, work engagement acts as a mediator between the perception of overqualification and job satisfaction, emphasising the importance of increasing work engagement. Overall, hospitals can improve nurses' work engagement and job satisfaction by providing career development opportunities, establishing feedback mechanisms and fostering work-life balance. Comprehensive management measures focusing on nurses' career development opportunities and levels of work engagement are necessary. Future research could expand the sample size, employ more diverse research designs and integrate qualitative research methods to further explore the factors influencing nurses' job satisfaction and happiness.

Exploring anesthesiology nurse' presenteeism in China: cross-sectional study

BACKGROUND

The department of anesthesiology is the main battlefield for the treatment of acute and critical patients, with high work risk and high work pressure. Due to the particularity of the working environment and nature of work, medical staff have become a group with a high incidence of occupational exhaustion and presenteeism.

OBJECTIVE

To investigate the current status of presenteeism among anesthesiology nurses in China and to analyze the related influencing factors.

METHODS

Three hundred twelve anesthesiology nurses in Sichuan Province were surveyed by means of general data questionnaire, presenteeism scale, work-family conflict scale, perceived social support scale, occupational commitment scale and stress resistance scale from September to November 2023 by convenience sampling method.

RESULTS

The total score of presenteeism was (14.67 ± 3.92), the score of work-family conflict was (45.44 ± 15.90), the score of professional commitment was (87.28 ± 14.30), and the score of perceived social support was (66.04 ± 12.78). The evaluation score of stress resistance was (73.35 ± 11.54). The results of multivariate analysis showed that age, education, mode of employment, position, overtime hours per week, work-family conflict, perceived social support and stress resistance were the factors that affected the presenteeism of anesthesiology nurses, which could explain 44.1% of the total variation. The position ( β = 0.296, P < 0.001), overtime hours per week (h) ( β = 0.271, P < 0.001), perceived social support ( β = -0.279, P < 0.001) turned out as the stronger predictors of presenteeism.

CONCLUSION

The presenteeism of anesthesiology nurses is at a high level and needs to be further improved. Clinical nursing managers should pay attention to the physical and mental health and special needs of anesthesiology nurses. Interventions are made according to the main influencing factors, so as to reduce the incidence of presenteeism and improve the quality and safety of surgery.

Transitioning experiences of internationally educated nurses in host countries: A narrative systematic review

Background

The shortage of nurses worldwide is a well-known issue that has changed the health and social workforce picture. Increased recruitment and migration of internationally educated nurses in the health and social care workforce pose many risks to successful integration into the healthcare system. Understanding the barriers and enablers affecting their integration in their host countries is imperative.

Objective

To critically and systematically review the current literature to explore the transitioning experiences of internationally educated nurses to understand the enabling influences affecting their workforce integration into their host countries.

Design

A narrative systematic literature review was conducted. This study was registered in the International Prospective Register of Systematic Reviews (Registered Number: CRD42023401090). The study results were reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Methods

A comprehensive literature search using the search engines CINAHL, MEDLINE, PsycINFO, Academic Search, and PubMed was conducted. Only peer-reviewed papers written in the English language were included. Primary research studies published between 2019 and 2023, which explored the lived experiences of internationally educated nurses, were considered for review.

Results

Seventeen studies (16 qualitative and one quantitative) were included in the review. Three main themes were developed: (1) push and pull factors that mediated internationally educated nurses' migration experiences, (2) one-way integration logic, and (3) expectations versus reality.

Conclusions

There is a need for a comprehensive and collaborative organisational approach to enhance the integration experiences of internationally educated nurses into their host countries. This can also ensure their contribution is recognised and will help them fulfil the responsibilities of their role and become influential team members within their organisations. This comprehensive and collaborative approach is also required to tackle discrimination, racism, communication and language barriers. Addressing these challenges can improve internationally educated nurses' job satisfaction and, thereby, improve retention.

Tweetable abstract

A new systematic review study explores barriers and enablers for optimising internationally educated nurses' experiences of working in their host country @cathy_Henshall @clairmerriman9 @annemarieraffer.

Factors influencing the thriving of emergency department nurses in China

INTRODUCTION

Thriving is a positive feeling arising from nurses' work and is increasingly valued by managers. Given their demanding workloads and various duties, it is necessary to research the determinants of ED nurses' thriving. This study aimed to investigate the factors influencing thriving and the mechanisms of interaction between the factors among ED nurses.

METHODS

380 ED nurses from six tertiary hospitals in Shandong Province, China, participated in this cross-sectional study. The instruments used were the General Information Questionnaire, Challenge-Hindrance Stressors Scale, Psychological Detachment Scale, and Thriving at Work Scale. Data analysis methods included univariate analysis, Pearson correlation, PROCESS 4.0, and hierarchical multiple regression.

RESULTS

Weekly working hours affected nurses' thriving. Challenge stressors and psychological detachment were positively related to thriving. Hindrance stressors had a negative link with thriving. Psychological detachment suppressed the relationship between challenge stressors and thriving; however, it mediated the relationship between hindrance stressors and thriving.

CONCLUSION

Challenge-hindrance stressors and psychological detachment are significant elements influencing ED nurses' thriving. Nursing administrators should help ED nurses properly address stressors with different attributes and adopt appropriate strategies to improve nurses' thriving by enhancing psychological detachment.

How is work-family conflict linked to nurse-assessed patient safety among intensive care unit nurses? A serial multiple mediation analysis

AIM

The aim of this study was to test whether rumination and negative affectivity mediate the relationship between work-family conflict and nurse-assessed patient safety among intensive care unit nurses.

BACKGROUND

Most intensive care unit nurses experience work-family conflicts that jeopardise patient safety. Although prior studies have explored the effect of work-family conflict on patient safety, few have investigated whether work-family conflict is associated with patient safety through rumination and negative affectivity among intensive care unit nurses.

DESIGN

Cross-sectional study.

METHODS

This study included 209 intensive care unit nurses from five general hospitals. The Work-Family Conflict Scale, the Ruminative Response Scale, the Positive and Negative Affect Schedule-Negative Affectivity, and three items indicating nurses' perception of overall patient safety were used to gather data. Associations between work-family conflict, rumination, negative affectivity, and nurse-assessed patient safety were assessed using correlation and serial multiple mediation analysis.

RESULTS

Work-family conflict, rumination, negative affectivity, and nurse-assessed patient safety were significantly correlated (p < 0.01). Work-family conflict can have not only a direct negative impact on the nurse-assessed patient safety (effect = -0.0234; standard error [SE] = 0.0116; 95% confidence interval [CI]: lower limit [LL] = -0.0464, upper limit [UL] = -0.0005) but also an indirect impact on nurse-assessed patient safety through three paths: the independent mediating role of rumination (effect = -0.0118; SE = 0.0063; 95% CI: LL = -0.0251, UL = -0.0006), the independent mediating role of negative affectivity (effect = -0.0055; SE = 0.0039; 95% CI: LL = -0.0153, UL = -0.0001), and the chain-mediating role of rumination and negative affectivity (effect = -0.0078; SE = 0.0031; 95% CI: LL = -0.0152, UL = -0.0027).

CONCLUSION

Our findings indicated that work-family conflict could influence nurse-assessed patient safety through increasing rumination and negative affectivity among intensive care unit nurses. Based on the results, interventions aimed at decreasing work-family conflict would be beneficial for intensive care unit nurses' emotional stability and patient safety.

How Do Presenteeism and Family Functioning Affect the Association Between Chinese Nurses' Job Stress and Intention to Stay?

BACKGROUND

Despite a great deal of existing research on nurses' job stress and intention to stay, it is still unclear how the association between Chinese nurses' job stress and intention to stay is affected by presenteeism and family functioning.

AIMS

This study aimed to investigate the correlations of Chinese nurses' job stress, presenteeism, and family functioning with their intention to stay and clarify the mediating effect of presenteeism and the moderating effect of family functioning on the association between their job stress and intention to stay.

METHOD

A cross-sectional study of 1,008 nurses was performed in a major general hospital in Qiqihar City, Heilongjiang Province, China. The participants were invited to engage in a questionnaire survey regarding job stress, presenteeism, family functioning, and intention to stay. A moderated mediation analysis was conducted through multiple linear regression analysis and the PROCESS macro.

RESULTS

Job stress and presenteeism were negatively correlated with intention to stay, whereas family functioning was positively correlated with intention to stay. The effect of job stress on intention to stay was partially mediated by presenteeism (Effect = -0.147, 95% CI = [-0.305, -0.003]). In addition, family functioning moderated the direct effect of job stress on intention to stay (Index = -0.134, 95% CI = [-0.274, -0.001]).

CONCLUSIONS

Presenteeism and family functioning were found to play mediating and moderating roles, respectively, in the relationship between job stress and intention to stay. Relevant interventions or family-friendly programs should be developed to enhance nurses' intention to stay.

A cross-sectional study on turnover intention of nurses in eastern China

BACKGROUND

This study aimed to investigate the turnover intention among nurses in eastern China and explore the association between turnover intention and personal characteristics, family factors, and work-related factors.

METHODS

A total of 2504 nurses participated in a cross-sectional survey administered in 26 hospitals in Eastern China from October to November 2017. In December 2021, a survey was conducted on nurses who resigned between December 2017 and November 2021.

RESULTS

The turnover intention score of in-service nurses was 15 (12-17), and 43% of nurses had a high turnover intention, which was mainly due to the following reasons: age < 40 years, raising two or more children, monthly income of USD786.10-1572.20 or < USD786.10, occupation was assigned or selected according to parental wishes, ≤ 1 or ≥ 2-night shifts per week, contractual or third-party personnel agents, full-time nurses with part-time jobs, and high job stress. Among 102 retired nurses, 80.4% reported family reasons for leaving, 39.2% for work reasons, and 21.6% for other personal reasons.

CONCLUSION

Nurses' intention to leave their occupation is high in Eastern China. Age < 40 years old, > 1 child, low income, involuntary career selection, frequent night shifts, informal employment, part-time, and high job stress are significant factors associated with nurses' willingness to leave. Government and hospital administrators should consider ways to address these factors to retain nurses in hospitals in eastern China and improve the quality of nursing services.

The relationships between work-family conflict and life satisfaction and happiness among nurses: a moderated mediation model of gratitude and self-compassion

Background

Researchers and practitioners are concerned with the impact of work-family conflict on the well-being of workers, including those in the health care sector, and previous research suggested that nurses were experiencing a range of negative outcomes.

Aim

To investigate the potentially mediating role of self-compassion and moderating role of gratitude in the relationships between work-family conflict and both life satisfaction and happiness among Saudi nurses.

Method

A cross-sectional survey was conducted with 368 nurses (men age = 35.18, SD = 6.67, 70.65% of females). Nurses were recruited via social media using convenience sampling techniques. They completed the Satisfaction with Life Scale, the Subjective Happiness Scale, the Gratitude Questionnaire-6, the Self-Compassion Scale, and the Work-Family Conflict Scale, as well as a set of demographic questions. The data were analyzed using PROCESS MACRO model 4 and 8, and the reporting followed STROBE checklist.

Results

As expected, the study found a negative relationship between work-family conflict and both life satisfaction and happiness. These relationships were mediated by self-compassion. For the relationships between work-family conflict and life satisfaction and happiness, and between family-work conflict and happiness, this mediation was moderated by gratitude.

Conclusion

This study built on positive psychology and demonstrated that the positive personality traits of self-compassion and gratitude can engender enhanced life satisfaction and happiness among Saudi nurses.

Effects of work-family conflict on turnover intention among primary medical staff in Huaihai Economic Zone: a mediation model through burnout

Background

Countries worldwide face the challenge of how medical personnel manage conflicts between work and family. Especially after the challenge of the COVID-19 epidemic, it is necessary to explore the possible mechanisms of work-family conflict, burnout, and turnover intention among primary medical staff.

Objectives

This study aims to observe the turnover intention of Chinese primary medical staff and explore the relationship between work-family conflict, burnout, and turnover intention.

Methods

A cross-sectional study included a turnover intention questionnaire, the Maslach Burnout Inventory-General Survey (MBI-GS), and the Work-Family Conflict Scale (WFCS) to understand turnover intention, burnout, and work-family conflict among primary medical staff in four cities (Xuzhou, Linyi, Huaibei, and Shangqiu cities) within the Huaihai Economic Zone. Spearman correlation analysis and hierarchical multiple regression analysis were used to examine the related factors of turnover intention. Structural equation modeling (SEM) was used to study the mediating role of burnout between work-family conflict and turnover intention.

Results

In this study, there is a positive correlation between work-family conflict and turnover intention (P < 0.01). Demographic characteristics, work-family conflict, and burnout explained 2.3%, 20.3%, and 8.8% of the incremental variances, respectively. Burnout mediated the association between work-family conflict and turnover intention.

Conclusions

Burnout can be regarded as a mediator between two different variables: work-family conflict and turnover intention. Improving work-family conflict and alleviating burnout may play a key role in reducing the willingness of primary medical staff to resign. Corresponding measures can be taken to balance the conflict between work and family, alleviate burnout, reduce turnover rates, and build a primary medical staff team with higher medical service quality and stability.

An Explanatory Model of Work-family Conflict and Resilience as Predictors of Job Satisfaction in Nurses: The Mediating Role of Work Engagement and Communication Skills

BACKGROUND

The Job Demands and Resources (JD-R) model is used to examine predictors of well-being, work engagement, and individual or organizational outcomes. According to the model, work engagement and communication skills play a mediating role between work-family conflict and resilience to job satisfaction in nurses.

METHODS

A cross-sectional study was conducted considering 431 Peruvian nurses of mean age (M = 40.31 years; SD = 10.94) ranging from 22 to 68 years working in public hospitals in the Lima region. Data were collected using a self-reported form of the Job Satisfaction Scale, communication skills, work engagement, work-family conflict, and resilience. The theoretical model was evaluated using structural equation modeling (SEM).

RESULTS

A theoretical model with adequate fit was obtained [χ²(2) = 6.0, P < .001, CFI = 0.995, RMSEA = 0.068, SRMR = 0.015]. Results indicated an inverse relationship between work-family conflict with communication skills (β = -.24, P < .001) and work engagement (β = -.10, P = .003). Likewise, resilience had an influence on communication skills (β = .55, P < .001) and work engagement (β = .33, P < .001). In addition, the model explains 71% of job satisfaction. Also, the results indicate the influence of work-family conflict and resilience through the mediating role of work engagement and work-family conflict on job satisfaction.

CONCLUSIONS

The model confirmed that work engagement and communication skills are valid moderators to mitigate work-family conflict and strengthen resilience that favors job satisfaction in nurses.

Internal Structure of the Work-Family Conflict Questionnaire (WFCQ) in Teacher Teleworking

The interference between family and work roles has led to the development of scales for their measurement. However, instrumental studies of work-family conflict have not been conducted in the context of teacher teleworking during the COVID-19 pandemic. For this reason, the objectives of this study were set to obtain evidence of the internal structure and fairness of the Blanch and Aluja Work-Family Conflict Questionnaire, as well as its association with job satisfaction and other sociodemographic variables. A total of 235 Peruvian school teachers between the ages of 24 and 72 years (M = 43.79 and SD = 9.67) responded to the scale using the online form. The analysis employed the non-parametric item response theory modeling (Mokken scaling analysis). The structure of two correlated factors was confirmed: work conflict in the family (WCF) and family conflict in the work (FCW). Both dimensions were invariant with respect to sex group and educational level. The association of both dimensions with job satisfaction was theoretically convergent, and the gender of the teachers slightly moderated this relationship. The reliability was adequate for group research. Finally, the instrument can be useful in the organizational context of teachers who telework.

Relationship between turnover intention and workplace personal relations among care workers employed by elder care facilities

BACKGROUND

This study focuses on care workers at elder care facilities to examine what factors (including workplace personal relations) influence turnover intention and to what extent. Based on this analysis, the study discusses the content of workplace personal relations problems in qualitative terms.

METHODS

The study targeted care workers at elder care facilities. There were 406 participants with no missing data who were analyzed. The survey period ranged from September to November 2021. Questions consisted of basic attributes, turnover intention, problems with workplace personal relations, content of personal relation problems, and psychological distress.

RESULTS

Female care workers were 2.25 times more likely than male care workers to have turnover intention. Care workers with workplace personal relation problems were 1.97 times more likely than those without these problems to have high turnover intention. Moreover, with regard to psychological distress, the ratio increased to 4.99 times. The following six categories were extracted from the text data on workplace personal relation problems: insufficient communication, bullying, sense of unfair workload, different attitudes to care work, difficulty in guidance for subordinates/new staff, and labelling.

CONCLUSIONS

Gender, workplace personal relation problems, and psychological distress have shown to affect care workers' turnover intentions. To prevent care worker turnover, future studies should focus on the development and impact of strategies to improve workplace personal relations specific to care workers, targeting the six factors identified in this study.

Work-family conflict, burnout, and related factors among nurses during the COVID-19 pandemic in the Northwest of Iran

BACKGROUND

Nurses, as the largest working group in the hospital, experience many problems, conflicts, and stressors in the workplace and family especially after the widespread distribution of coronavirus 2019 (COVID-19).

OBJECTIVE

The perceived conflict and burnout among nurses, as well as the correlation between these two variables and the associated factors, were the main subjects of this study.

METHODS

This cross-sectional study involved 256 nurses from three COVID-19 referral hospitals in northwest Iran. Participants completed demographic, work-family conflict (WFC), and burnout questionnaires. The nonparametric tests including Mann-Whitney U, Kruskal-Wallis, and Spearman correlation coefficient were applied to statistical analysis.

RESULTS

The overall score of conflict was 55.3 (12.7). The time dimension received the highest score 11.4 (2.9). In terms of intensity 27.6 (8.7) and frequency 27.6(8.8), nurses had the most burnout in the lack of personal accomplishment dimension. All aspects of WFC, emotional exhaustion, and depersonalization characteristics of burnout had statistically significant positive correlations (p < 0.01). The ward, hospital and employment status variables were associated with WFC (p < 0.05). The association between taking the crisis management course and the severity of depersonalization, and the frequency of lack of personal accomplishment was confirmed (p < 0.01). Additionally, the frequency and severity of emotional exhaustion were associated with employment status and work experiences (p < 0.05).

CONCLUSION

The findings showed that nurses had WFC and burnout rates that were above average. Regarding the negative effects of these two phenomena on health, and also nurse's clinical practices, rearranging work conditions and providing better organizational support seem necessary.

The association between nurse managers' transformational leadership and quality of patient care: A systematic review

AIM

To examine and summarize the reported association of nurse managers' transformational leadership and quality of patient care based on the perceptions of registered nurses.

BACKGROUND

Transformational leadership behaviors of nurse managers result in staff nurses' satisfaction and retention and patient satisfaction. Patient safety and quality of care are vital to high-performing healthcare organizations. Perceptions of registered nurses are important because nurses are frontline healthcare providers fundamental to patient safety and quality of care and are considered the final line of defense in preventing adverse events and errors and improving the safety of patients.

MATERIALS AND METHODS

We  searched the CINAHL, ProQuest, PubMed, Science Direct, and Web of Science databases for evidence published between 2018 and 2022 in the English language. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in carrying out this meta-analysis.

RESULTS

Nine quantitative studies were appraised using the Joanna Briggs Institute checklists and were included in the final review that involved a total sample of 3633 registered nurses. The included studies were reported across Asian, Middle East, and European countries within the past five years. The association between the transformational leadership behaviors of nurse managers and the quality of patient care was found in varying degrees (i.e., insignificant, weak, indirect, and strong direct association) based on the perceptions of registered nurses.

CONCLUSIONS

There is a direct and indirect association between the transformational leadership behaviors of nurse managers and the quality of patient care internationally. This association is influenced by confounding and mediating factors, including gender, organizational culture, structural empowerment, and job satisfaction.

IMPLICATIONS FOR NURSING AND HEALTH POLICIES

Healthcare organizations need to support nursing leaders to have a stronger transformational leadership style by considering several factors that influence their leadership to improve the quality of patient care their staff nurses provide at the bedside.

Nurses' perceptions of continuing professional development: a qualitative study

BACKGROUND

Continuing professional development is regarded as one of the important approaches to maintaining skills and motivation for work. However, there is a lack of qualitative studies to explore Chinese nurses' continuing professional development. The study aims to explore Chinese nurses' perceptions of continuing professional development and challenges they face.

METHODS

The study was conducted in a tertiary hospital located in the central region of China from July to August 2020. Purposive sampling was used to recruit 14 nurses and face to face semi-structured interviews were conducted from July to August 2020. Then the recorded data were analysed and collated according to the thematic analysis. This study followed the consolidated criteria for reporting qualitative research (COREQ).

RESULTS

Four themes were extracted: improving specialty ability; different development phases; the importance of personal effort; the obstacle of work-family conflict.

CONCLUSIONS

This study contributed to our understandings of nurses' continuing professional development. Nurses held a positive attitude towards continuing professional development and they faced challenges in the meantime. Special attention and targeted supports should be provided to promote the continuing professional development of nursing staff.

Child-rearing experiences of female nurses working three shifts in South Korea: A qualitative study

AIM

To explore the experience of balancing a career with raising school-aged children and working three shifts and to suggest working environment changes to balance these roles BACKGROUND: Female nurses working three-day shift rotations experience irregular life patterns, parenting conflicts, and confusion over nursing roles.

INTRODUCTION

This qualitative study examined nurses with early school-aged children who work three-day shift rotations in South Korea.

METHODS

A descriptive phenomenological approach employed in-depth interviews to collect data from 12 married, female nurses with children aged 4-9 years. Data were analyzed using Colaizzi's phenomenological method, and reporting rigor was demonstrated using the Consolidated Criteria for Reporting Qualitative Research checklist.

FINDINGS

Four themes emerged in our findings: (1) challenging phase: facing a great crisis that completely shatters the axis of life; (2) chaos phase: endless inner conflict between work and parenting; (3) solutions for coping phase: struggling to continue a nursing career; and (4) expanding phase: stepping into the expanded world of care.

CONCLUSION

Nurses working three-day shift rotations try to balance their lives through interactions between nursing and child-rearing. Further research is needed to create an environment that promotes this balance.

IMPLICATIONS FOR NURSING PRACTICE AND POLICY

To provide a better work-life balance, policymakers should foster a participatory and supportive management style, ensure adequate nurse staffing, implement a flexible work system, provide clinical career opportunities, encourage professional autonomy and responsibility, and promote in-service and shared social information or continuing education.

Relationship between work–family conflict, sleep quality, and depressive symptoms among mental health nurses

Background

Nursing has a reputation for being one of the most stressful occupations. As a result of their work, many nurses suffer from anxiety and depression. Nurses are also at risk of poor sleep owing to their work nature. This study aimed to examine the relationship between work–family conflict, sleep quality, and depressive symptoms among mental health nurses. A descriptive cross-sectional study design was utilized in this study. Setting/sample: This study was conducted at El Azazi Hospital for Mental Health, Al-Sharkia Governorate on 139 mental health nurses. Four tools were used in this study: Socio-demographic data sheet, Work–Family Conflict Scale, Arabic Pittsburgh Sleep Quality Index, and Arabic Center for Epidemiologic Studies Depression Scale.

Results

Results revealed that, a significant percentage of mental health nurses suffered from poor sleep quality and depressive symptoms, there were highly statistically significantly positive correlations between work–family conflict (WFC) and both of Pittsburgh Sleep Quality Index (PSQI) and depressive symptoms among nurses.

Conclusions

Working with psychiatric patients affected their nurses, which disturbed their sleep quality and led to depressive symptoms. As well, increasing work–family conflict in mental health nurses leads to poor sleep quality and depressive symptoms. Family interference with work, sleep quality, and work interference with family were statistically significant predictors of depressive symptoms.

Perceived privacy in home office and musculoskeletal complaints: a test of family–work conflict, work–family conflict, and relaxation as mediators

Many employees have had to telework all year during the COVID-19 pandemic. Even though working from home has many advantages, there are also some disadvantages worth to consider. Lack of privacy is a relevant factor when it comes to the development of severe musculoskelatal issues. This study investigated the link between perceived privacy in home office and musculoskeletal complaints (MSCs). Family–work conflict (FWC), work–family conflict (WFC), and relaxation were tested as potential mediators for the relationship between perceived privacy and MSCs. The present study’s questionnaire was filled out by 287 teleworking employees. Hypotheses were tested via multiple mediation analyses examining levels of perceived privacy in home office, and its relationship on MSCs. Furthermore, the underlying effect of FWC, WFC, and MSCs were tested with a structural equation model. As assumed, lack of privacy while working at home was linked to individuals more frequently experiencing MSCs. However, the structural equation model showed no significant mediation effect. Work design efforts must address privacy while employees perform telework at home to prevent MSCs.

Work-Family Conflict of Emergency Nurses and Its Related Factors: A National Cross-Sectional Survey in China

The prevalence of work-family conflict (WFC) among nurses was high, especially in the emergency department. WFC has a series of negative influences on emergency nurses, but factors associated with WFC require elucidation. Thus, we conducted a national cross-sectional survey among emergency nurses in China. In this study, we described the current situation of WFC and explored its related factors among emergency nurses in China. We found that the WFC of emergency nurses was severe, and emergency nurses aged 25 to 34, male, married, highly educated, with high professional title and long years of service, perceiving the shortage of nurses, experiencing a high frequency of night shift, tended to have higher WFC. Targeted interventions, such as reasonable work allocation, adequate staffing, and a scientific night shift system should be implemented to alleviate the WFC of emergency nurses.

Implications of Lifestyle and Occupational Factors on the Risk of Breast Cancer in Shiftwork Nurses

Shift work that involves circadian disruption has been highlighted as a likely carcinogenic factor for breast cancer in humans. Also, unhealthy lifestyle habits observed in night work nurses could be causally related to an increase in the incidence of estrogen-positive breast tumours in this population. Assessing baseline risk of breast cancer in nurses is essential. The objective of this study was to analyze the risk of breast cancer that nurses had in relation to their lifestyle and labour factors related to shift work. A cross-sectional descriptive study through a questionnaire about sociodemographic variables, self-perception of health, and working life was designed. The sample consisted of 966 nurses. The relationship between variables was tested. A binary logistic regression and a classification and regression tree were performed. The most significant labour variables in relation to the risk of breast cancer were the number of years worked (more than 16 years; p < 0.01; OR = 8.733, 95% CI = 2.811, 27.134) and the total years performing more than 3 nights per month (10 or more years; p < 0.05; OR = 2.294, 95% CI = 1.008, 5.220). Also, the nights worked throughout life (over 500; OR = 4.190, 95% CI = 2.118, 8.287) were significant in the analysis. Nurses who had or ever had breast cancer valued their self-perceived health more negatively (p < 0.001) and referred a lower quality of sleep (p < 0.001) than the non-cases nurses. The occupational factors derived from night work could have several impacts on nurses' health and their family-work balance. Promoting healthy lifestyles, informing about shift work risks, and adjusting shift work schedules are critical methods to decrease the possible effects of circadian disruption in nurses.

Night Work and Breast Cancer Risk in Nurses: Multifactorial Risk Analysis

Night work has been highlighted by the International Agency for Research on Cancer (IARC) as a likely carcinogenic factor for humans, associated with breast cancer and professions that require continuity of work. Knowing the impact that short and long-term night work has on the nurses' collective seems a priority, therefore, this study aims to analyse the relationship between night work and the development of breast cancer risk factors in nurses. For this, a cross-sectional study through an online questionnaire on breast cancer risk variables and working life was designed. The study was conducted in Spain and the sample consisted of 966 nurses, of whom 502 were healthy participants and 56 were breast cancer patients. These two groups were compared in the analyses. A descriptive analysis was performed, and the relationship was tested using χ2 independence test and OR calculation. The CHAID (Chi Square Automatic Interaction Detection) data mining method allowed for the creation of a segmentation tree for the main risk variables. The most significant risk variables related to working life have been the number of years worked, nights worked throughout life, and years working more than 3 nights per month. Exceeding 16 years of work has been significant for women and men. When the time worked is less than 16 years, the number of cases increases if there is a family history of cancer and if there have been more than 500 nights of work. High-intensity night work seems more harmful at an early age. The accumulation of years and nights worked increase the risk of breast cancer when factors such as sleep disturbance, physical stress, or family responsibilities come together.