Job satisfaction in mainland China: comparing critical care nurses and general ward nurses

COVID-19: The effects of perceived organizational justice, job engagement, and perceived job alternatives on turnover intention among frontline nurses

Nurses' turnover intention has become a concern for medical institutions because nurses are more needed than ever under the prevalence of COVID-19. This research sought to investigate the effects of the four dimensions of organizational justice on COVID-19 frontline nurses' turnover intention through the mediating role of job engagement. We also tested the extent to which perceived job alternatives could moderate the relationship between job engagement and turnover intention. This descriptive cross-sectional study used an online survey to collect data from 650 frontline nurses working in appointed hospitals in Jiangsu province, China. Hierarchical regression was used to analyze the hypothesized relationships. Findings revealed that all organizational justice components significantly influenced job engagement and turnover intention. Job engagement also significantly affected nurses' turnover intention and mediated the relationships between organizational justice components and turnover intention. Besides, perceived job alternatives moderated the relationships between job engagement and turnover intention. The implications of this study include demonstrating that healthcare authorities should respect human rights through effective organizational justice as this approach could encourage nurses to appreciate their job and be more devoted to staying and achieving their institutional duties, especially under challenging circumstances.

Factors influencing intention to stay of male nurses: A descriptive predictive study

Nurse shortages and nurse attrition are high in many countries, and there is also a dearth of male nurses in the profession. This study aimed to examine the level of intention to stay and ten predictors of this among male nurses in China. A descriptive, predictive study was administered to 480 registered male nurses. Eight research instruments were used to collect data. Descriptive statistics and binary logistic regression were employed to analyze the data. The overall intention to stay in the nursing profession as perceived by male nurses was at a moderate level. Binary logistic regression demonstrated that work group cohesion, transformational leadership, career growth, and job satisfaction were significant predictors, explaining 32.2% of the total variance for intention to stay. The findings of this study provide suggestions for nursing administrators and policymakers to develop appropriate strategies or interventions to increase the intention to stay for male nurses to stay in the profession, based on the four predictors.

Assessing the effect of nursing stress factors on turnover intention among newly recruited nurses in hospitals in China

Aim

This study sought to investigate some possible job stress factors that could influence newly recruited nurses’ behaviour to either continue or discontinue their job with their organization.

Design

A cross‐sectional study design was adopted for this study.

Method

Using 654 responses from novice nurses working in 20 county Chinese hospitals, we estimated the effects of six job stressors from the perceived stress scale on the turnover intention with a structural equation model in AMOS version 21 software.

Results

The results showed that four stressors, stress from taking care of patients (β = 0.111, p < .01), stress from roles and workload (β = 0.129, p < .001), stress from co‐workers and daily life (β = 0.323, p < .001) and stress from lack of professional knowledge and skills (β = 0.137, p < .001), from the perceived stress scale had a significant impact on turnover intention among nurses.

A psychological health support scheme for medical teams in COVID-19 outbreak and its effectiveness

Background

Medical staff fighting the COVID-19 pandemic are experiencing stress from high occupational risk, panic in the community and the extreme workload. Maintaining the psychological health of a medical team is essential for efficient functioning, but psychological intervention models for emergency medical teams are rare.

Aims

To design a systematic, full-coverage psychological health support scheme for medical teams serving large-scale emergent situations, and demonstrate its effectiveness in a real-world study in Leishenshan Hospital during the COVID-19 epidemic in Wuhan, China.

Methods

The scheme integrates onsite and online mental health resources and features team-based psychosocial support and evidence-based interventions. It contained five modules, including a daily measurement of mood, a daily mood broadcast that promotes positive affirmation, a daily online peer-group activity with themes based on the challenges reported by the team, Balint groups and an after-work support team. The daily mood measurement provides information to the other modules. The scheme also respects the special psychological characteristics of medical staff by promoting their strengths.

Results

The scheme economically supported a special medical team of 156 members with only one onsite psychiatrist. Our data reflected that the entire medical team maintained an overall positive outlook (7–9 out of 10 in a Daily Mood Index, DMI) for nearly 6 weeks of continuous working. Since the scheme promoted self-strengths and positive self-affirmation, the number of self-reports of life-related gains were high and played a significant effect on the DMI. Our follow-up investigations also revealed that multiple modules of the scheme received high attention and evaluation levels.

Conclusion

Our quantitative data from Leishenshan hospital, Wuhan, China, show that the programme is adequate to support the continuous high workload of medical teams. This scheme could be applied to medical teams dealing with emergent situations.

Greek nurses' perceptions on empathy and empathic care in the Intensive Care Unit

BACKGROUND

Empathy is a fundamental component of nursing practice impacting positively on the therapeutic process. Understanding the concepts of empathy and empathic care in the context of Intensive Care Units is essential for providing better care in high challenging environments. However, research on empathy in the ICU is scarce and mostly quantitative.

OBJECTIVES

To explore how ICU nurses perceive the concepts of empathy and empathic care.

DESIGN AND SETTING

A descriptive qualitative research design was applied using an inductive content analysis approach. Semi-structured interviews were conducted with nineteen ICU nurses in two hospitals in Greece.

FINDINGS

Data analysis revealed three main themes namely: "To become one of them", "Empathic Care" and "Integration of empathic care in practice". Findings corroborated the affective, cognitive and behavioral components of empathy. Nurses underlined that understaffing, increased workload and professional burnout impeded empathic care.

CONCLUSION

Empathy and empathic care in the ICU were perceived as closely related to patients' outcomes and quality care. Empathic care was arduous due to organisational issues. Despite that, ICU nurses appeared to promote empathic care in practice and sought ways to enhance it.

Job satisfaction of the nursing team in intensive care units

Objective:

to evaluate job satisfaction and its relationship with the personal and professional characteristics of the nursing team.

Method:

a descriptive and cross-sectional study with 163 nursing workers from the intensive care units of a teaching hospital. For data collection, the Brazilian version of the Job Satisfaction Survey and a personal and professional characterization form were used. Data were analyzed using descriptive statistics, comparisons and correlations.

Results:

the professionals demonstrated ambivalence for job satisfaction in a global way and concerning the communication domain. They were satisfied with the supervision, co-workers, and nature of work, while dissatisfied with other domains. There was a correlation between the intention to stay in the job and the majority of the Job Satisfaction Survey domains, except for co-workers and operating procedures, and a correlation between time working at the unit and at the institution with the domains pay, contingent rewards, and supervision.

Conclusion:

there was an ambivalence regarding job satisfaction and the variables intention of stay in the job and time working at the unit and at the institution were correlated with job satisfaction concerning the domains pay, contingent rewards, and supervision.

Burnout syndrome in intensive care professionals: relationships with health status and wellbeing

OBJECTIVES

To determine the predictive models that include the dimensions of burnout that are predictors for physical/mental health, and subjective/psychological wellbeing perceived in intensive care professionals; to analyse the relationships between burnout syndrome, health status and wellbeing experienced by these professionals; and to establish sociodemographic differences in the variables evaluated.

METHOD

A correlational and cross-sectional study was conducted. A total of 52 critical care professionals, mainly nurses, were recruited from an intensive care unit of Madrid. All participants were assessed with the questionnaires: Maslach Burnout Inventory-Human Services Survey, Short Form-12 Health Survey, Satisfaction With Life Scale, Positive and Negative Affect Schedule, and Psychological Well-Being Scales.

RESULTS

No significant sociodemographic differences were found. High levels in the three burnout dimensions were associated with poor physical/mental health and subjective/psychological wellbeing. High scores in emotional exhaustion and depersonalization, and low in personal accomplishment negatively predicted subjective and psychological well-being scales. The self-acceptance scale had the highest predictive validity. Emotional exhaustion was the only burnout dimension that negatively predicted physical and mental health.

CONCLUSIONS

Health status and levels of subjective/psychological wellbeing can be negatively influenced by the burnout syndrome experienced by intensive care professionals. As a result, the implementation of programmes to prevent and treat this syndrome is needed. These preventive interventions can positively impact not only the health and wellbeing of these professionals, but can also improve their ability to practice effectively, improve healthcare quality and patient security, and reduce the economic costs of health institutions. It is therefore imperative to implement burnout preventive programmes for intensive care professionals from universities to health institutions.

Iranian Nurses' Attitudes Toward Nurse-Physician Collaboration and its Relationship with Job Satisfaction

Introduction: Although nurses and physicians are known to share the common goal of improving the quality of health care, there has traditionally been a relational gap between them. The aim of the present study was to investigate the attitude of Iranian nurses about physician-nurse collaboration and its relationship with their job satisfaction. Methods: In this cross-sectional study, a total of 232 nurses were recruited from three educational hospitals of Zanjan University of medical sciences. Three questionnaires were used in this study; (a) Demographic data questionnaire, (2) Jefferson Scale of Attitudes toward Physician-Nurse Collaboration (JSAPNC), and (3) Minnesota Satisfaction Questionnaire. Results: In this study, the mean age of the participants was 33.22(SD= 6.13) years, 83.8% of nurses were female, 90.8% had a baccalaureate degree in nursing, and 82.5 % had rotational work shifts. The mean score of physician-nurse collaboration was found to be 48.07 (SD= 8.95) (ranged from 15 to 60), and the mean score of job satisfaction scale was 57.78 (SD = 14.67) (ranged from 20 to 100). There was a significant positive correlation between the attitudes toward physician-nurse collaboration and job satisfaction among the nurses (r=0.59, P≤0.001). Conclusion: The results indicated that the collaboration between nurses and physicians increases the job satisfaction of nurses working in clinical settings. Therefore, nurses and physicians should develop a new culture of collaboration with each other with the mutual goal of high quality patient care. Moreover, health care administrators should implement the strategies that strengthen the development of physician-nurse collaboration.

Job satisfaction and related factors among Iranian intensive care unit nurses

Objectives

The aim of this study is to determine the levels of job satisfaction and to collect information about the factors affecting job satisfaction of Iranian ICU hospital nurses.

Results

The participants included 124 nurses working in the ICU section of hospitals in the city of Amol in Iran, who were selected by census method. The instruments for gathering the information included Demographic Information Questionnaire and also the Minnesota Satisfaction Questionnaire. The results revealed that the average score of job satisfaction among ICU nurses was 2.50 ± 0.51. Also job satisfaction among women was higher than men (P = 0.03, t = 0.4). One way analysis of variance showed a significant relation between job satisfaction level with employment status and overtime work. Also older nurses had higher levels of job satisfaction. Hospital directors and managers, can use the results of this study in order to have a deeper understanding of job satisfaction among nurses, and the factors affecting it.

Job satisfaction among critical care nurses: A systematic review

BACKGROUND

Nursing shortages, particularly in critical care units, are a major concern worldwide. Job satisfaction is a key factor associated with the high turnover of critical care nurses.

OBJECTIVES

The purpose of this systematic review was to synthesize the evidence on critical care nurses' job satisfaction. Specific research questions were: 1. How is job satisfaction defined and measured in studies of critical care nurses? 2a. What is the level of job satisfaction among critical care nurses? 2b. How has it changed over time? 2c. Do nurses' levels of job satisfaction differ by type of critical care unit? 3. What factors are associated with critical care nurses' job satisfaction?

DESIGN

Systematic review.

DATA SOURCES

We searched five electronic databases from January 1980 to May 2015: MEDLINE, CINAHL, PsychINFO, EMBASE, and Proquest Nursing & Allied Health Source.

REVIEW METHODS

Two team members independently screened all titles and abstracts and extracted data and assessed methodological quality on all included papers. A narrative synthesis with vote counting was undertaken.

RESULTS

A total of 1995 titles were identified, of which 61 satisfied our inclusion criteria. Only 24 (39%) of the included studies reported a conceptual definition of job satisfaction. Forty-two different quantitative measures of job satisfaction were identified, of which only 10 (24%) were used in multiple studies. The weighted mean job satisfaction score for critical care nurses across all studies was 56% satisfied and demonstrated fluctuations over time. Four factors showed significant positive relationships to job satisfaction: 1. shift worked - rotating 8- to 12-h and rotating days, evenings or nights; 2. Autonomy; 3. personnel resources and staffing; and 4. teamwork and cohesion; while two factors showed significant negative relationships to job satisfaction: 1. job stress; and 2. burnout-emotional exhaustion.

CONCLUSION

From this review, we did not find any evidence to support relationships between individual (socio-demographic) factors and critical care nurses' job satisfaction. We did however find evidence to support relationships between several employment and organizational factors and job satisfaction. Several of these factors are different from those reported among general hospital nurses and long-term care nursing staff, supporting the need for differential strategies to improve critical care nurses' job satisfaction. While the findings from this review hold promise as potential targets of future job satisfaction interventions, there were several methodological problems inherent in many of the studies.

The perceived and experienced role of the nurse unit manager in supporting the wellbeing of intensive care unit nurses: An integrative literature review

INTRODUCTION

The number of patients requiring admission into intensive care units (ICUs) is increasing worldwide. Concurrently, recruitment and retention of the ICU nursing workforce is becoming a major challenge due to the high intensity environment, heavy workloads, and decreasing nurse wellbeing. Nurse unit managers play a vital role in promoting and supporting ICU nurse wellbeing, yet little is known about perceptions and experiences of this role.

OBJECTIVES

To examine the perceived and experienced role of the nurse unit manager in supporting the wellbeing of ICU nurses.

REVIEW METHODS

A comprehensive review of the literature was undertaken using Whittemore and Knafl's five stage approach: (i) problem identification, (ii) literature search, (iii) quality appraisal, (iv) data analysis, and (v) presentation of findings.

DATA SOURCES

The following databases were searched for literature published between January 2007 and December 2017: Cumulative Index to Nursing and Allied Health Literature, Cochrane, Informit, Joanna Briggs Institute Library of Systematic Review, ProQuest, PubMed, Scopus, and Wiley online library digital databases. Variations and synonyms of key words included: nurse unit manager, ICU, compassion fatigue, burnout, stress, job satisfaction, bullying, wellbeing, and work environment.

RESULTS

Rigour and trustworthiness of the included studies were assessed using the Critical Appraisal Skills Program qualitative research checklist,⁷¹ a modified Critical Appraisal Skills Program Cohort study checklist for quantitative research,⁷² and the Mixed Methods Appraisal Tool for mixed-method studies.⁷³ The critical review guidelines by Shenton⁷⁴ and Polit and Beck⁷⁵ were also used to make judgements about the worth of the evidence. All of the 11 qualitative studies provided moderate to strong evidence. The overall quality of the quantitative studies was lower, with three of seven studies providing only adequate evidence. The majority of the 19 included studies represented the voices of ICU nurses. Three major themes emerged from the analysis; '1) building professional relationships', '2) leading the way' and '3) satisfying the needs of ICU nurses'.

CONCLUSION

Nurse unit manager behaviours clearly affect the wellbeing of ICU nurses. However, the role of supporting ICU nurses is complex and challenging. More research is needed to investigate the needs of ICU nurses and the facilitators and barriers nurse unit managers face when supporting the wellbeing of nurses in their unit.

Use of assessment scales, turnover and job strain in nursing staff: A study in a Colombian hospital

AIM

To evaluate the association between job strain and socio-demographic characteristics, social support, job insecurity, use of patient assessment scales, and turnover of nursing staff in a Colombian hospital.

BACKGROUND

Nursing is an occupation with high probability of job strain. Use of patient assessment scales and turnover of nursing staff could increase exposure to psychosocial risk.

METHOD

A cross-sectional study of 222 nurses was conducted. A survey and the Job Content Questionnaire were used to obtain data at the individual level and free lists and institutional records were used at the hospital unit level. The associations of interest were evaluated with a logistic regression model with robust variance estimator.

RESULTS

Many nurses (50.9%) nurses reported job strain, which was positively associated with high use of patient assessment scales (OR = 2.73; 95% CI = 1.35-5.51) but negatively associated with social support (OR = 0.89; 95% CI = 0.80-0.98). Turnover was not statistically associated with job strain.

CONCLUSION

Job strain among nurses was associated with a high use of patient assessment scales, but not with turnover of nursing staff.

IMPLICATIONS FOR NURSING MANAGEMENT

The findings of this study suggest possible opportunities for managers to improve nursing processes, the work conditions of nursing staff, and the quality of institutions.

Job Satisfaction and Associated Factors among Medical Staff in Tertiary Public Hospitals: Results from a National Cross-Sectional Survey in China

Medical staff in China’s tertiary public hospitals are responsible for providing healthcare to a considerable number of patients, and their job satisfaction needs attention. The aim of this study is to investigate the job satisfaction of medical staff in tertiary public hospitals and to explore its associated factors. Based on a national survey conducted in 2016, this study included 43,645 physicians and nurses nested in 136 tertiary public hospitals in 31 provinces of China. Multi-level logistic regression was used to examine job satisfaction and its association with individual characteristics and job-related factors. Results showed that 48.22% respondents were satisfied with their job, and they were least satisfied with their compensation. Individual characteristics including occupation, gender, education background, alcohol drinking and self-reported health status, as well as job-related factors regarding professional title, work years, income, workload, doctor-patient relationship and practice setting were found to be significantly associated with job satisfaction. Given that some of these factors may be amenable to interventions, we suggest that government and hospital administrators could take some measures to promote continuing education, improve personal health, balance workload and compensation for medical staff, in order to improve the job satisfaction of medical staff in tertiary public hospitals.

Burnout and health among critical care professionals: The mediational role of resilience

OBJECTIVES

To analyse the mediational role of resilience in relationships between burnout and health in critical care professionals; to determine relationships among resilience level, three burnout dimensions, and physical/mental health; and to establish demographic differences in psychological variables evaluated.

DESIGN

Cross-sectional study.

PARTICIPANTS/SETTING

A total of 52 critical care professionals, mainly nurses, were recruited from an intensive care unit of Madrid (Spain).

METHOD

All participants were assessed with the questionnaires 10-item Connor-Davidson Resilience Scale, Maslach Burnout Inventory-Human Services Survey, and Short Form-12 Health Survey.

RESULTS

No demographic differences were found. Three burnout dimensions were negatively associated with mental health and resilience. Mediational analyses revealed resilience mediated 1) the relationships between emotional exhaustion and depersonalisation with mental health (partial mediations) and 2) the relationship between personal accomplishment and mental health (total mediation).

CONCLUSIONS

Resilience minimises and buffers the impact of negative outcomes of workplace stress on mental health of critical care professionals. As a result, resilience prevents the occurrence of burnout syndrome. Resilience improves not only their mental health, but also their ability to practice effectively. It is therefore imperative to develop resilience programs for critical care nurses in nursing schools, universities and health centres.

The factors influencing burnout and job satisfaction among critical care nurses: a study of Saudi critical care nurses

AIM

The aim of the study was to explore the prevalence of burnout and job satisfaction among Saudi national critical care nurses.

BACKGROUND

Burnout is caused by a number of factors, including personal, organisational and professional issues. Previous literature reports a strong relationship between burnout and job satisfaction among critical care nurses. Little is known about this phenomenon among Saudi national critical care nurses.

METHODS

A convenience sample of 150 Saudi national critical care nurses from three hospitals in Hail, Saudi Arabia were included in a cross-sectional survey.

RESULTS

Saudi national critical care registered nurses reported moderate to high levels of burnout in the areas of emotional exhaustion and depersonalisation. Participants also reported a feeling of ambivalence and dissatisfaction with their jobs but were satisfied with the nature of their work.

CONCLUSIONS

Saudi national critical care nurses experience moderate to high levels of burnout and low levels of job satisfaction. Burnout is a predictor of job satisfaction for Saudi national critical care nurses.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

These results provide clear evidence of the need for nurse managers and policy makers to devise strategies to help nurses better cope with a stressful work environment, thereby also improving job satisfaction among Saudi national critical care nurses.

Positive practice environments influence job satisfaction of primary health care clinic nursing managers in two South African provinces

BACKGROUND

Nurses constitute the majority of the health workforce in South Africa and they play a major role in providing primary health care (PHC) services. Job satisfaction influences nurse retention and successful implementation of health system reforms. This study was conducted in light of renewed government commitment to reforms at the PHC level, and to contribute to the development of solutions to the challenges faced by the South African nursing workforce. The objective of the study was to determine overall job satisfaction of PHC clinic nursing managers and the predictors of their job satisfaction in two South African provinces.

METHODS

During 2012, a cross-sectional study was conducted in two South African provinces. Stratified random sampling was used to survey a total of 111 nursing managers working in PHC clinics. These managers completed a pre-tested Measure of Job Satisfaction questionnaire with subscales on personal satisfaction, workload, professional support, training, pay, career prospects and standards of care. Mean scores were used to measure overall job satisfaction and various subscales. Predictors of job satisfaction were determined through multiple logistic regression analysis.

RESULTS

A total of 108 nursing managers completed the survey representing a 97% response rate. The mean age of respondents was 49 years (SD = 7.9) and the majority of them (92%) were female. Seventy-six percent had a PHC clinical training qualification. Overall mean job satisfaction scores were 142.80 (SD = 24.3) and 143.41 (SD = 25.6) for Gauteng and Free State provinces respectively out of a maximum possible score of 215. Predictors of job satisfaction were: working in a clinic of choice (RRR = 3.10 (95% CI: 1.11 to 8.62, P = 0.030)), being tired at work (RRR = 0.19 (95% CI: 0.08 to 0.50, P = 0.001)) and experience of verbal abuse (RRR = 0.18 (95% CI: 0.06 to 0.55, P = 0.001).

CONCLUSION

Allowing nurses greater choice of clinic to work in, the prevention of violence and addressing workloads could improve the practice environment and job satisfaction of PHC clinic nursing managers.

Nurses well-being in intensive care units: study of factors promoting team commitment

BACKGROUND

Intensive care units (ICUs) are challenging work environments because of the critical condition of patients, and ICU nurses frequently lament low job satisfaction and high staff turnover. Nevertheless, organizational and work characteristics, and the quality of relationships with staff can help to maintain nurses' enthusiasm and increase job satisfaction.

AIM

The aim of this study was to analyse how nursing work environment factors affect identification and commitment among ICU nurses.

DESIGN

A cross-sectional study was carried out in 12 ICUs from four Italian urban hospitals.

METHOD

A total of 222 nurses participated and completed a self-reported questionnaire.

RESULTS AND CONCLUSION

Results show that nursing work characteristics are directly related to team commitment, and that the nursing work characteristics and team commitment relationship was mediated by both perceived supervisor support and job satisfaction.

RELEVANCE TO CLINICAL PRACTICE

Our findings may concretely contribute to literature and offer additional suggestions to improve nurses' work conditions and patient health in ICUs.

A comparison of job satisfaction of community health workers before and after local comprehensive medical care reform: a typical field investigation in Central China

Background

The government of China promulgated new medical care reform policies in March 2009. After that, provincial-level governments launched new medical care reform which focusing on local comprehensive medical care reform (LCMR). Anhui Province is an example of an area affected by LCMR, in which the LCMR was started in October 2009 and implemented in June 2010. The objective of this study was to compare the job satisfaction (JS) of community health workers (CHWs) before and after the reform in Anhui Province.

Methods

A baseline survey was carried out among 813 community health workers (CHWs) of 57 community health centers (CHCs) (response rate: 94.1%) and an effect evaluation survey among 536 CHWs of 30 CHCs (response rate: 92.3%) in 2009 and 2012 respectively. A self-completion questionnaire was used to assess the JS of the CHWs (by the job satisfaction scale, JSS).

Results

The average scores of total JS and satisfaction with pay, contingent rewards, operating procedures and communication in the effect evaluation survey were statistically significantly higher than those of the baseline survey (P<0.05). The average score of satisfaction with promotion (2.55±1.008) in the effect evaluation survey was statistically significantly lower than that in the baseline survey (2.71±0.730) (P=0.002). In both surveys, the average scores of satisfaction with pay, benefits and promotion were statistically significantly lower than the others (all P<0.05).

Conclusions

After two years’ implementation of the LCMR, CHWs’ total JS have a small improvement. However, CHWs have lower satisfaction in the dimensions of pay, promotion and benefits dimensions before and after the LCMR. Therefore, policy-makers should take corresponding measures to raise work reward of CHWs and pay more attention to CHWs’ professional development to further increase their JS.