Causes of nursing staff burnout: Exploring the effects of emotional exhaustion, work-family conflict, and supervisor support

Association between occupational burnout and psychological symptoms among Chinese medical staff: moderating role of social support

This study aimed to examine the association between occupational burnout and psychological symptoms among Chinese medical staff, assuming social support to play a moderating role in the aforementioned relationship. The survey was conducted online from May 1 to June 28, 2022, and the questionnaires were distributed and retrieved through a web-based platform. The final sample was comprised of 1461 Chinese medical staff in this cross-sectional study. Several multiple linear regressions were performed to analyze the data. After controlling for potential confounding factors, all three dimensions of occupational burnout were associated with poorer psychological symptoms. Emotional exhaustion (β = 0.33; 95% confidence interval [CI], 1.018, 1.479) had the strongest association with psychological symptoms, followed by depersonalization and diminished personal accomplishment. Moreover, medical staff with higher levels of friend support (β =  -0.11; 95% CI, -4.063, -0.573) and significant other support (β =  -0.10; 95% CI, -3.965, -0.168) were less likely to suffer from psychological symptoms when faced with occupational burnout. The results suggested that interventions aimed at lessening occupational burnout and boosting social support can be an effective way to promote the psychological health of medical staff.

Perceived ambidextrous leadership and nurses' mental health: a work-family perspective

BACKGROUND

Nurses are particularly at risk from stress-related problems and face high mental health problems during the COVID-19 pandemic. It is critical to pay attention to their mental health status and determine which factors are positively associated with nursing staff mental health from the perspective of work-family. The purpose of this paper is to investigate the impact of perceived ambidextrous leadership on nurses' mental health mediated by work-to-family enrichment and moderated by work climate for sharing family concerns.

METHODS

One time-lagged study with three waves was conducted. A total of 358 questionnaires were distributed to registered nurses working at 10 hospitals in Guangzhou, China, and 265 valid questionnaires were returned. The quantitative approach to test hypotheses involves hierarchical regression analyses, the bootstrapping method and the simple slope test.

RESULTS

The research indicated that (a) perceived ambidextrous leadership had a positive influence on nurses' work-to-family enrichment; (b) nurses' work-to-family enrichment mediated the relationship between perceived ambidextrous leadership and nurses' mental health; (c) work climate for sharing family concerns moderated the relationship between perceived ambidextrous leadership and nurses' work-to-family enrichment.

CONCLUSION

Nursing supervisors' ambidextrous leadership interacted with work climate for sharing family concerns benefit the conservation of nurses' personal resources, which in turn facilitates nurses' work-to-family enrichment and improve their mental health.

Work-family conflict categories and support strategies for married female nurses: a latent profile analysis

Objective

To clarify subgroups of married female nurses experiencing work-family conflict (WFC), explore the factors associated with the subgroups, and determine how desired support strategies differ among the subgroups.

Methods

Data was collected from a sample of 646 married female nurses from public hospitals in Zhejiang Province, China, in December 2021. Latent profile analysis was used to group the participants, and multiple logistic regression was used to identify factors associated with higher WFC. The STROBE criteria were used to report results.

Results

According to latent profile analysis, there were three distinct profiles of WFC among married female nurses: "low-conflict type," "work-dominant-conflict type," and "high-conflict type." These profiles differed in the number of children, night shifts, family economic burden, childcare during working hours, family harmony, colleague support, and nurse-patient relationships. Nurses with multiple children, higher pressures in childcare during working hours, heavier family economic burdens, lower family harmony, lower colleague support, and poorer nurse-patient relationships are more likely to be classified as "high-conflict type" nurses.

Conclusion

This study found that married female nurses experience different types of WFCs. The structure of these WFCs and their associated factors suggests that customized intervention strategies can be developed to address the specific needs of married female nurses.

Structural and psychological empowerment and burnout among nurses: A systematic review and meta-analysis

AIM

This study aims to review available evidence about the relationship between structural and psychological empowerment and burnout among nurses.

BACKGROUND

Nurses are key healthcare providers, who experience higher levels of burnout due to uncertainty and role conflicts about nursing roles and responsibilities and poor management. Nurse empowerment is an effective approach to reduce nurse burnout and enhance patient care quality.

INTRODUCTION

Positive working conditions along with positive attitudes and perceptions for nurses are crucial in the workplace. Nurse empowerment in the workplace results in quality improvements in work life and the provision of healthcare.

METHOD

We conducted a systematic review in accordance with the recommendations of the Joanna Briggs Institute and the PRISMA guideline. Relevant studies published between 2007 and 2022 were identified via PubMed, CINAHL, Web of Science, Scopus, Cochrane Library, Ovid MEDLINE (R), Science Direct and Turkish scientific literature databases. Studies that reported correlation coefficients were pooled to conduct a meta-analysis.

RESULTS

Random-effects meta-analyses showed a negative association between structural and psychological empowerment and emotional exhaustion. The overall findings showed a moderate and negative association between the six dimensions of structural empowerment and depersonalization. There was a positive association between structural empowerment and personal accomplishment.

DISCUSSION

There is a relationship between decreased burnout levels and nurse empowerment. The causal relationship between empowerment and burnout levels needs to be investigated in various healthcare settings in several countries.

CONCLUSION

The relationship between structural and psychological empowerment and burnout levels emphasizes that empowerment can reduce nurse burnout. Nurse empowerment is a critical management strategy for improving the quality of life for nurses, increasing the quality and effectiveness of patient care and achieving positive outcomes.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

The encouragement and empowerment of nurses for prompt decision-making and effective resource utilization, reduces nurse burnout, enhancing nurses' job commitment, productivity, satisfaction and competence along with increased quality of care. The encouragement of nurses as empowered managers at the macro, meso and institutional levels not only improves the overall quality of health services but also helps to find solutions for the issues concerning healthcare service users and the health system environment.

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.

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

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

The association between burnout and multiple roles at work and in the family among female Japanese nurses: a cross-sectional study

Female nurses experience work-family conflict due to performing multiple roles, leading to burnout. Thus, this study aimed to verify the association between burnout and the multiple work and family roles performed among Japanese female nurses. The data for 2,255 nurses at 23 Japanese hospitals obtained from the Work Environment for Nurses Study in Japan were used. The variables included burnout, demographic information, additional work roles, and child-rearing or caregiving. Half of the nurses were categorized under the "no-role" group (NRG), approximately a quarter under the "work-role" group (WRG), 16% under the "family-role" group (FRG), and 7.3% under the "multiple-role" group (MRG). Compared to the NRG, the FRG and MRG showed statistically lower emotional exhaustion (B=-0.79, p<0.05; B=-0.94, p<0.05, respectively) and depersonalization (B=-0.80, p<0.05; B=-1.09, p<0.05, respectively). Personal accomplishment was not statistically different among the four groups. Burnout was relatively low among nurses with family roles, suggesting that family roles may have a positive spillover effect on work-related emotions.

Nurses' emotional exhaustion: Prevalence, psychosocial risk factors and association to sick leave depending on care setting-A quantitative secondary analysis

AIMS

To explore differences in the prevalence, psychosocial risk factors and the connection to annual sick leave of nurses' emotional exhaustion depending on the care setting.

DESIGN

Quantitative study.

METHODS

We conducted a secondary data analysis of a cross-sectional, representative survey with German nurses (BIBB/BAuA-Employment Survey 2018). We analysed data from three groups of nurses (hospital care HC: n = 333, nursing homes NH: n = 143, home health care HHC: n = 109). We calculated prevalence estimates for all psychosocial risk factors and emotional exhaustion and utilized Χ² -tests to explore differences relating to the care setting. We calculated risk estimates using logistic regression analyses.

RESULTS

Forty-four per cent of all nurses reported symptoms of emotional exhaustion. Care settings did not affect prevalence estimates (HC: 45.3%, NH: 37.8%, HHC: 50.5%). Weekend work was a risk factor for exhaustion. Being at the limit of efficiency was the only work-related psychosocial risk factor being independent of the care setting. Emotional demands were a significant risk factor for nurses working in HC and NH, and low team cooperation was a risk factor for nurses working in NH. Nurses' emotional exhaustion is associated with more sick leave days.

CONCLUSIONS

The high prevalence of nurses' emotional exhaustion is independent of the care setting. This threatens nurses' health and negatively affects the organization and society due to the relation to sick leave. Weekend work and quantitative demands relate to exhaustion independently of the care context. Emotional demands and low team cooperation show context-specific correlations.

IMPACT

Organizational interventions that limit quantitative demands are needed to prevent exhaustion among nurses. In HC and NH, measures are needed to improve coping with emotional demands and to strengthen team cooperation. Policymakers and nursing managers should take action to address nurses' emotional exhaustion.

NO PATIENT OR PUBLIC CONTRIBUTION

Due to the study design.

The effect of sleep disturbance on the association between work-family conflict and burnout in nurses: a cross-sectional study from South Korea

BACKGROUND

Sleep disturbances can lead to work-family conflicts and affect the mental health of nurses. This study aimed to investigate the mediating effect of sleep disturbance on the association between work-family conflict (WFC) and burnout in nurses.

METHODS

Responses to a questionnaire from 156 nurses working in a hospital in South Korea were analyzed. Multiple linear regression analysis and PROCESS Macro Model 4 were used to analyze the mediating effect of sleep disturbance on the relationship between WFC and burnout. A bootstrapping approach was used to test the statistical significance of the indirect parameter effects.

RESULTS

The WFC of nurses had a positive correlation with sleep disturbance and burnout. Moreover, sleep disturbance completely mediated the association between WFC and burnout.

CONCLUSIONS

Nursing administrators should pay careful attention to WFCs that interfere with nurses' sleep and reduce their sleep quality, and design suitable working schedules that minimize the effects of WFC. In addition, hospital administrators should improve shift scheduling to ensure good sleep quality and reduce the health effects of WFC among nurses.

Helping others not always helps ourselves: the relationship between victim incivility and emergency workers' burnout through work-to-family conflict

Purpose

This study aims to analyse whether and when victim incivility may be related to work-to-family conflict and then burnout among emergency workers.

Design/methodology/approach

A total of 304 Italian emergency workers from five firehouses and six emergency rooms completed questionnaires, examining: victim incivility, work-to-family conflict, social support seeking and burnout symptoms. Descriptive analyses, confirmatory factor analyses and structural equation models were conducted.

Findings

Victim incivility was positively associated with burnout symptoms, both directly and indirectly, as mediated by work-to-family conflict. Additionally, social support seeking exacerbated (rather than mitigated) the impact of work-to-family conflict on burnout symptoms.

Practical implications

Organisations can greatly benefit from implementing family-friendly practices and providing their workers with training programmes on how to deal with difficult victims.

Originality/value

This study contributes to the existing literature on workplace incivility and work–life interface by supporting for the first time the notion that victim incivility can spill over into emergency workers' family domain and by clarifying how and when victim incivility is related to burnout symptoms.

Investigating the association between patient verbal aggression and emotional exhaustion among Italian healthcare professionals during the COVID-19 pandemic

Aims

To analyze whether patient verbal aggression would be related to emotional exhaustion and whether this relationship would be mediated by work–family conflict and moderated by dehumanization and resilience.

Background

Although patient verbal aggression has been identified as one of the most experienced forms of aggression, its effects on Italian health care providers during the pandemic are still poorly known.

Methods

A total of 197 Italian health care professionals completed paper‐and‐pencil questionnaires. Descriptive statistics and moderated mediation analyses were performed.

Results

Patient verbal aggression was positively related to health care professionals' emotional exhaustion, both directly and indirectly, as mediated by work–family conflict. Health care providers were more likely to become emotionally exhausted when they had low resilience and, simultaneously, tended to ascribe patients non‐uniquely human traits.

Conclusions

Patient verbal aggression may spill over onto health care professionals' family lives. Dehumanization represents an ineffective coping strategy that exacerbates the effects of aggression on work–family conflict, whereas resilience represents a protective resource against emotional exhaustion.

Implications for nursing management

Hospital organisations could benefit from providing their staff with stress management interventions, aggression management, psychological support and psychological resilience training programmes. These programmes should incorporate coping skills on establishing work–home boundaries and balancing empathy with cognitive problem‐solving abilities.

Work-Related Factors Associated With Burnout Among Peruvian Nurses

Introduction:

Commonly, burnout in nurses has influenced their performance. The contribution of this study allows to broaden the knowledge of the performance-burnout relationship and identifies the work performance in nurses as a precursor of burnout.

Objective:

The study aimed to examine the factors of work performance of nursing staff that influence burnout.

Methods:

A descriptive cross-sectional design was used and a total of 340 nurses from the department of Puno in Peru participated. Demographic, job performance, and burnout data were collected.

Results:

Job performance factors, such as counterproductive behavior, positively influenced burnout, while task and context performance negatively influenced burnout. These variables explained 28.54% of the variance of burnout among nurses.

Conclusion:

Job performance factors have a significant impact on burnout. To reduce burnout, workforce resources that motivate, engage, and monitor nurse performance must be identified individually or organizationally. There is a need to develop training that promotes the improvement of emotional skills for better performance and the reduction of professional burnout.

Job and family demands and burnout among healthcare workers: The moderating role of workplace flexibility

Burnout is a growing problem among healthcare workers. Whereas there are numerous predictors of burnout, this article explores the compounding effects of job and family demands among nurses and Patient Care Associates (PCA). This study used the 2018 survey data of the Boston Hospital Health Workers Study (BHWHS) to assess the relationship of job and family demands, workplace flexibility, and burnout (N = 874). In addition, it aimed to evaluate the moderating effect of workplace flexibility and job and family demands on burnout. Results of the study demonstrate that active and high strained healthcare workers are associated with higher odds of experiencing burnout as well as workers who reported perceived low workplace flexibility. In addition, workplace flexibility is associated with reduced odds of experiencing burnout. Workplace flexibility moderated the relationship of childless married healthcare workers and burnout. The study shows that workplace flexibility plays a critical role in potentially reducing odds of burnout in the healthcare worker population. Assessing the perception and accessibility to workplace flexibility among workers is imperative to improve worker well-being and the quality of care provided to patients especially the current effects to worker's health during a pandemic.

•

Burnout is an increasing concern among healthcare workers.

•

We examined the buffering effects of workplace flexibility on the compounding effects of job and family demands on burnout.

•

Workplace flexibility is associated with lower odds of burnout.

•

Healthcare workers who are categorized as active and high-strained are associated with higher odds of burnout.

•

Workplace flexibility moderated the relationship of married healthcare workers without children and burnout.