Resilience as a Moderator of Psychological Health in Situations of Chronic Stress (Burnout) in a Sample of Hospital Nurses

Compassion fatigue and loneliness at work in nurses - the mediating role of resilience: a cross-sectional study

Background

Heavy workload, job stress and lack of colleague support can lead to loneliness and burnout in nurses. Caring for a patient with constant pain can cause compassion fatigue. Loneliness at work and compassion fatigue also negatively affect the quality of patient care.

Aim

This study aims to determine the effect of resilience on loneliness at work and compassion fatigue in nurses.

Method

This is a descriptive cross-sectional study. The study was conducted with a total of 214 nurses.

Results

A statistically significant negative relationship was found between the level of loneliness at work and resilience, and between resilience and compassion fatigue in nurses. The mediating role of resilience was found to be significant in the effect of loneliness at work on compassion fatigue in nurses.

Conclusions

The results of this study suggest empowering nurses who have loneliness at work and compassion fatigue. Compassion fatigue is seen as occupational deformation. Nurses need to learn how to manage compassion fatigue, develop coping skills and receive support to ensure job satisfaction. In addition, nurse managers should create a reasonable workload for nurses. These efforts can increase the job satisfaction and patient care quality of nursing departments.

Exploring the Care Experiences Among Clinical Staffing During Emerging Infectious Disease: From the COVID-19 Pandemic Approach

PURPOSE

The coronavirus disease 2019 (COVID-19), one of the most significant recent emerging infectious diseases, has evolved into a global pandemic, resulting in an unprecedented public health crisis with substantial morbidity. The aim of this study was to investigate the care experiences of nursing staff during the COVID-19 pandemic.

METHODS

A qualitative, exploratory interview study. This study was conducted from August 2022 to January 2023. Participants were recruited from a medical center in northern Taiwan. A purposive sampling approach was employed to select the participants, and in-depth interviews were conducted with a total of 30 individuals. The collected data were analyzed using content analysis.

RESULTS

The findings of this study revealed five themes that summarized the care experiences of participants during the COVID-19 pandemic, enhanced nursing competence in pandemic mitigation, adherence to clear safety measures, effective adaptation to the stress of the "unknown," and recognition of the meaning of the pandemic mitigation experience.

CONCLUSION

This study informs pandemic readiness for nurses and policy enhancement. Medical institutions and governments must prioritize policies ensuring staffing, PPE access, and mental health support. Educators and administrators should elevate on-the-job crisis management training. Future planning should cater to Taiwanese nurses' needs during unforeseen crises such as COVID-19.

Social media use for work during non-work hours and turnover intention: the mediating role of burnout and the moderating role of resilience

Introduction

This study uses survey data from 504 Chinese teachers to investigate the relationship between social media use for work during non-work hours (SMUNW) and turnover intention, focusing on the mediating role of burnout and the moderating role of resilience in this relationship.

Methods

In November 2023, online survey links were sent to 529 teachers from Shandong Province, China, asking them to report their perceptions of SMUNW, burnout, resilience, and turnover intention. A sample of 504 valid responses was obtained. The analysis was performed using SPSS 26.0 and Hayes' PROCESS MACRO for SPSS for testing the hypotheses.

Results

The results revealed that burnout acts as a mediator in the relationship between SMUNW and turnover intention. In addition, resilience moderated the relationship between SMUNW and burnout such that when resilience was higher, the relationship between SMUNW and burnout was alleviated. Moreover, resilience moderated the indirect relationship between SMUNW and turnover intention through burnout such that when resilience was higher, the indirect relationship was alleviated.

Discussion

The results of this study indicate that SMUNW is related to turnover intention through the mediating role of burnout. Furthermore, resilience moderates the influence of SMUNW on burnout and thus weakens the influence of SMUNW on turnover intention through burnout. This study expands our knowledge of the nuanced influence mechanisms of social media use in the context of increasing technostress among public employees. Practically, it suggests that managers should pay due attention to the impairments brought about by social media use, especially from the perspectives of preventing burnout and fostering resilience.

Effectiveness of yoga and laughter yoga in improving psychological resilience of mothers with babies hospitalized in neonatal intensive care unit

This randomized controlled study aimed to determine the effectiveness of yoga and laughter yoga approaches in enhancing psychological resilience of mothers with babies hospitalized in the neonatal intensive care unit. The Mothers were randomized into three groups as yoga, laughter yoga, and control groups. The mothers received a total of 10 yoga/laughter yoga sessions for 45 minutes twice a week as home-based exercises. Depression, anxiety, stress, and psychological resilience outcomes were evaluated at baseline and after 5th and 10th sessions. The study was completed with 60 mothers including 20 mothers in the yoga group, 19 mothers in the laughter yoga group, and 21 mothers in the control group. There were statistically significant differences between the groups in terms of depression, anxiety, stress, and psychological resilience after 5th and 10th sessions. Yoga and laughter yoga was effective for increasing psychological resilience and alleviating depression, anxiety, stress.

Protective role of resilience on the associations between childhood maltreatment and internalising and externalising problems

Different types of childhood maltreatment have negative effects on individual mental and behavioural outcomes. However, most of previous studies investigated their effects separately. Little is known about the effects of co-occurring maltreatment profiles on adolescents' developmental outcomes and the potential protective factor. The current study sought to identify distinct profiles of childhood maltreatment and examine the effects of profiles of childhood maltreatment on internalising and externalising problems and the protective role of resilience based on two-wave longitudinal data, which was collected from a sample of 670 Chinese adolescents (Mage = 15.50, SDage = 0.75, 48.4% boys). Four profiles of childhood maltreatment, that is, No maltreatment (67.9%), High neglect (23.0%), High abuse and neglect/Low sexual abuse (5.0%), and Multi-maltreatment (4.1%), were identified. Adolescents in High neglect, High abuse and neglect/Low sexual abuse, and Multi-maltreatment profiles were more likely to report internalising and externalising problems. Further, significant moderating effects of resilience only emerged for the association between the High neglect profile and internalising problems, such that high levels of resilience may weaken the association between the High neglect profile and internalising problems. Our findings revealed the importance and utility of identifying maltreatment profiles to tailor treatment based on specific maltreatment experiences. Resilience-oriented intervention could be considered for Chinese adolescents who have experienced high neglect.

Understanding the Role of Empathy and Gender on EMS Clinician Occupational Stress and Mental Health Outcomes

BACKGROUND

Emergency Medical Service (EMS) clinicians experience high levels of occupational stress due to long hours, short staffing, and patient deaths, among other factors. While gender has been partially examined, little is known regarding the role of empathy on occupational stress and mental health (MH) outcomes among EMS clinicians. Therefore, the current study examines the moderating role of empathy and, separately, gender on associations between occupational stress and mental health.

METHODS

A cross-sectional examination of EMS clinician occupational and personal wellbeing was conducted via an anonymous, electronic survey. Information on clinician demographics, and validated measures of occupational stress, burnout, and MH outcomes were collected. Empathy was assessed using the Toronto Empathy Scale (TEQ). Descriptive/bivariate statistics were conducted for variables of interest. Separate multivariable regression models evaluated associations between occupational stress and mental health outcomes. Empathy and gender were examined as potential moderators using interactions.

RESULTS

A total of 568 EMS clinicians completed the survey. High levels of mental health difficulties were reported (34.0% anxiety, 29.2% depression, 48.6% burnout). Increased occupational stress was associated with increased anxiety (OR =1.08, 95% CI 1.05-1.10), depression (OR = 1.09, 95% CI 1.06-1.10), and burnout (OR = 1.10, 95% CI 1.07-1.12). No moderation analyses were significant. Greater resilience was associated with lower depression, anxiety, and burnout.

CONCLUSION

EMS clinicians, much like other first responders, experience considerable occupational stress, of which is associated with mental health difficulties and burnout. Findings underscore the need for intervention programs aimed at reducing the impact of occupational stress and the promotion of resilience. Continuing to understand the full scope of EMS mental health, including the role of resilience, is imperative, particularly in light of future public emergencies.

Relation and effect of resilience on burnout in nurses: A literature review and meta-analysis

AIM

To study the relation between burnout and resilience and to identify the profile of nurses presenting this quality.

BACKGROUND AND INTRODUCTION

Healthcare professionals are subject to high rates of burnout. Resilience could be an important factor in preventing or alleviating this condition.

METHODS

The PubMed, ProQuest, Scopus and ScienceDirect databases were consulted in February 2022 using the equation 'burnout AND resilience AND nurs*'. The inclusion criteria applied were that the texts should describe quantitative studies, be published in English or Spanish, in any year, and be directly related to the question considered. The meta-analysis was performed using StatsDirect statistical software.

RESULTS

Analysis of the 29 studies shows that among the dimensions of burnout, nurses are especially prone to emotional exhaustion, and are less affected by depersonalisation and low personal accomplishment. Those who score highly for resilience tend to have longer service experience, acceptable salaries and less work overload. Meta-analysis reveals an inverse correlation between resilience and burnout (r = -0.41; n = 2750), exhaustion (r = -0.27; n = 6966) and depersonalisation (r = -0.23; n = 6115).

CONCLUSION

Many nurses present low levels of resilience and suffer from burnout syndrome. The application of programmes to enhance their resilience would help prevent burnout and optimise the potential to provide quality health care.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Resilience is inversely correlated with burnout, depersonalisation and emotional exhaustion. Accordingly, healthcare organisations should develop and implement evidence-based programmes to foster nurses' resilience and thus reduce their susceptibility to burnout.

Stress begets stress: The moderating role of childhood adversity in the relationship between job stress and sleep quality among nurses

BACKGROUND

Nurses exhibit considerable variations in sleep quality and experience high job stress levels. Distal factors, such as childhood adversity, and proximal factors, both influence sleep quality. We investigated the moderating role of childhood adversity with job stress and sleep quality, and whether this aligns with the stress-sensitization or stress-amplification models.

METHODS

The impact of job stressors' total score and its dimensions on sleep quality was analyzed using traditional linear regression models and the extreme gradient boosting machine learning algorithm. The hierarchical regression examined the moderating role of childhood adversity in the relationship between job stress and sleep quality. An interactive tool was used to visualize the results.

RESULTS

Among the dimensions of job stress, "time allocation and workload" strongly correlated with sleep quality, followed by "nursing profession and work problems," "patient care issues," "management and interpersonal problems," and "working environment and equipment problems." The moderating role of childhood adversity in the relationship between different dimensions of job stressors (except working environment and equipment problems) and sleep quality aligns with the stress-sensitization model.

LIMITATIONS

This study was susceptible to recall bias and objective sleep data were unavailable. Cross-sectional study design was used, thus limiting causal inferences. Finally, the moderating effect of childhood adversity on subsequent stress among nurses remains unclear.

CONCLUSION

Childhood adversity and job stress were integrated into a stress-sensitization model, providing a nuanced and specific examination of sleep quality. Healthcare policymakers should focus on job stress and childhood adversity, improve nurses' sleep quality, and ultimately benefit patient care and outcomes.

Resilience and its relationship with occupational stress and professional quality of life during COVID-19 pandemic

This study aimed to assess resilience and its relationship with occupational stress (OS) and PQOL among nurses in COVID-19 isolation wards. This is a descriptive-analytical research design involving 158 frontline nurses in the Iran. Four standardized scales were used for data collection. The total mean scores of resilience and OS were 26.19 ± 6.2 and 73.3 ± 14.5, respectively. The mean scores of participants' resilience and OS had no significant relationship with their demographic characteristics (P > 0.05). Resilience had significant negative relationship with OS (r = - 0.376, P < 0.001) and significant positive relationship with the compassion satisfaction dimension of PQOL (r = 0.373; P < 0.001). Resilience was also a significant predictor of OS and the compassion satisfaction dimension of PQOL (P < 0.001). Nurses' OS can be reduced through resilience-promoting strategies such as development of their social support network, improvement of their optimism, and provision of resilient role models and quality resilience-related education.

Early life stress, depression and epigenetics

Different factors are essential in increasing the vulnerability to psychiatric disorders, such as genetics. Among these factors, early life stress (ELS), including sexual, physical, emotional abuse, and emotional and physical neglect, enhances the odds of having menial conditions throughout life. Exhaustive research has shown that ELS leads to physiological changes, such as alteration in the HPA axis. During the most critical development period (childhood and adolescence), these changes increase the risk of having child-onset psychiatric disorders. Furthermore, research has suggested a relationship between early life stress and depression, particularly more prolonged episodes of depression with treatment-resistant outcomes. Molecular studies indicate that, in general, the hereditary character of psychiatric disorders is polygenic, multifactorial and highly complex, with innumerable low-effect genetic variants interacting with each other. However, whether there are independent effects among subtypes of ELS remains unclear. This article provides an overview of the interplay of epigenetics, the HPA axis, early life stress and the development of depression. Advances in our knowledge of epigenetics in the context of early life stress and depression provide a new understanding of the genetic influence on psychopathology. Furthermore, they could lead to identifying new targets for clinical intervention.

The impact of emotional intelligence on life satisfaction among Chinese nurses: A chain mediating model

Introduction

Nurses' life satisfaction exerts a positive impact on their professional careers, and it seriously affects their physical and mental health. Low life satisfaction has become a key factor in the global shortage of nurses. Emotional intelligence may protect nurses from negative emotions that can affect the care they provide, as well as their life satisfaction. In this study, we aims to explore the impact of emotional intelligence on life satisfaction, and even verify the chain mediating effect of self-efficacy and resilience on this relationship among Chineses nurses.

Method

The Emotional Intelligence Scale, the General Self, Efficacy Scale, the Connor-Davidson Resilience Scale, and the Satisfaction with Life Scale were used to survey 709 nurses in southwest China. To analyze mediating effects, SPSS 26.0 and Process V3.3 were used for statistical processing.

Result

Emotional intelligence positively predicted life satisfaction. Meanwhile, it was also found that emotional intelligence and life satisfaction were continuously mediated by self-efficacy and resilience, and the indirect effect value was 0.033, accounting for 17.37%.

Conclusion

This study reveals how emotional intelligence affects nurses' life satisfaction. The results of this study have certain implications for nurses to better balance their career and life. Nursing managers should provide nurses with a favorable working environment from the perspective of positive psychology, improve their sense of self-efficacy and resilience, ultimately improve their life satisfaction.

Psychological Distress, Burnout, and Business Student Turnover: The Role of Resilience as a Coping Mechanism

This study's purpose is to examine whether resilience, conceptualized by Connor and Davidson (2003) as one's capacity to persevere and rebound under adversity, was a potential mitigating and/or moderating factor in the dynamic between both psychological distress and academic burnout, and student attrition. We concurrently distributed a survey containing a series of psychometric instruments to a convenience sample of 1,119 students pursuing various business majors at four geographically diverse U.S. universities. Via structural equations modeling analysis, we measured the associations between psychological distress, academic burnout, and departure intentions, and investigated whether student resilience levels are associated with lower distress, burnout, and departure intentions levels. The results indicated significant positive associations between psychological distress and each of the elements of academic burnout, and significant positive associations between the academic burnout elements and departure intentions. However, while resilience did not moderate those associations, it did attenuate them through its direct negative associations with both psychological distress and the cynicism and academic inefficacy elements of academic burnout. Based on these findings, we discuss implications for business educators seeking to enhance individual resilience levels as a coping strategy to combat voluntary student turnover, and better prepare students for the demands of the workplace.

The Mediation Chain Effect of Cognitive Crafting and Personal Resources on the Relationship between Role Ambiguity and Dentists' Emotional Exhaustion

Based on Job Demands-Resources (JD-R), Conservation of Resources (COR) and self-regulation theories integration, this study investigated the association between role ambiguity and emotional exhaustion among 191 Romanian dentists, as well as the chain mediating role of cognitive crafting and three personal resources (resilience, optimism, and self-efficacy). Three conceptual models which included, separately, the three personal resources were proposed. PROCESS macros were used to verify the hypotheses related to the testing of the path mediation models. The results indicated that role ambiguity was directly and positively associated with dentists' burnout. More importantly, the sequential indirect effect of role ambiguity on burnout via mediators in chains (cognitive crafting and resilience for the first model; cognitive crafting and optimism for the second model; cognitive crafting and self-efficacy for the third model) was significant. The findings provide a direction for dentists' health intervention because it reveals how the negative impact of role ambiguity on emotional exhaustion increasing can be buffered by the cumulative effect of cognitive crafting and different personal resources, as a result of their chain reinforcement.

Worrying About Finances During COVID-19: Resiliency Enhances the Effect of Worrying on Both Proactive Behavior and Stress

Amidst the COVID-19 pandemic and resulting economic instability, many people are contending with financial insecurity. Guided by Conservation of Resources Theory (Hobfoll, American Psychologist 44:513-524, 1989; Hobfoll et al., Annual Review of Organizational Psychology and Organizational Behavior 5:103-128, 2018), the current research explores the consequences of experiencing financial insecurity during a pandemic, with a focus on individuals who report relatively higher rates of financial insecurity, performance challenges, and stress during such experiences: working parents (American Psychological Association, 2022). This research also examines the role that personal resources, in the form of trait resiliency, play in the relationships between financial insecurity and behavioral and psychological outcomes including worrying, proactive behaviors, and stress. In a study of 636 working parents and their children, we find that financial insecurity heightens worrying, underscoring the threatening nature of the loss or anticipated loss of material resources. Worrying, in turn, promotes proactive behaviors at work-an effect that is more pronounced among high-resiliency individuals. However, worrying is also associated with elevated stress among high-resiliency individuals, providing support for a trait activation perspective (rather than buffering hypotheses) on ongoing, uncontrollable adversities. Taken together, our results help to (1) illuminate the impact of financial insecurity on work and well-being, (2) reveal a mechanism (i.e., worrying) that helps explain the links between financial insecurity and work and personal outcomes, and (3) expand our knowledge of the implications trait resiliency has for both psychological and behavioral reactions to ongoing crises.

Stress of conscience and burnout among nurses in Turkey

PURPOSE

To investigate the validity and reliability of the Turkish version of the Stress of Conscience Questionnaire (SCQ) and to determine its relationship to burnout among Turkish nurses.

DESIGN AND METHODS

The sample of this study with a cross-sectional design comprised 375 nurses. The data were collected using the Maslach Burnout Inventory (MBI) and SCQ.

FINDINGS

The mean score of the nurses obtained from the overall SCQ was 85.36 ± 39.3 (min: 0; max: 225). The highest scored item by the nurses was related to "lack of energy to devote themselves to their families." There was a significant positive correlation between the Emotional Exhaustion-MBI scores and SCQ scores (r = 0.414, p < 0.001).

PRACTICE IMPLICATIONS

The Turkish version of SCQ is a valid and reliable tool among Turkish nurses and is associated with emotional exhaustion.

Developing an integrated framework of healthcare leaders’ resilience

Healthcare institutions have been under pressure for years now, climaxing in the COVID-19 crisis. Even if they are not operating at a trouble spot of the current COVID-19 pandemic, healthcare leaders need to be highly resilient to remain effective as well as staying healthy themselves. The purpose of this study is to shed light on healthcare leaders’ challenges and, more important, their specific resilience factors. By doing so, we can expand the knowledge of this fragmented research field and deliver an integrated framework that has so far been lacking. We conducted 20 in-depth interviews with healthcare leaders. More precisely, 35% (7) of our interviewees were physicians, 55% (11) worked in nursing, and 10% (2) were nonclinical professionals, with 50% (10) of our participants working in upper, 40% (8) in middle, and 10% (2) in lower leadership positions. Based on a qualitative content analysis approach, we identified main healthcare leaders’ challenges as well as crucial resilience factors (i.e., individual, situational, and behavioral factors). By integrating insights from contemporary leadership and work-related resilience research, we were able to develop an integrated framework of healthcare leaders’ resilience. Considering resilience as a context-dependent construct, we are contributing to the resilience and healthcare literature by investigating the specialty of healthcare leaders’ resilience. This study is contributing to the future development of resilience interventions in healthcare organizations that might help not only healthcare leaders to better cope with critical situations but also promote resilience development among their followers and organizations.

Trait resilience as a moderator between personality dysfunction and caregiving stress in caregivers of children and adults with developmental disabilities

Background

Long-term care of a relative with a disability is associated with negative consequences on the caregiver's mental health. Therefore, investigating how some personality traits, such as resilience, protect caregivers with dysfunctional personality traits from caregiving stress is necessary. This study examines the moderating role of resilience in the relationship between caregiver's personality dysfunction and care stress.

Methods

A total of 224 family caregivers of children and adults with developmental disabilities participated in this cross-sectional research. They completed self-report measures of resilience, personality dysfunction, and care stress.

Results

The results show that medium and high levels of resilience protect familial caregivers from the adverse effects of personality dysfunction on stress. The relationship is maintained for three of the five dysfunctional personality traits (antagonism, disinhibition, and psychoticism).

Conclusions

From a theoretical point of view, the results show the contribution of the dimensional personality model to the study of caregiving stress. From a practical standpoint, the results can be used to optimise the resilience of familial caregivers, providing them with tools to take better care of their relatives.

Resilience, Mentalizing and Burnout Syndrome among Healthcare Workers during the COVID-19 Pandemic in Serbia

The aim of this study was to examine whether the capacity for mentalizing and resilience among healthcare workers (HCWs) explains the degree of burnout syndrome during the COVID-19 pandemic in Serbia. The research was conducted on a sample of 406 healthcare workers (141 doctors and 265 nurses), aged 19 to 65 years (M = 40.11, SD = 9.41)—203 worked on the COVID-19 frontline, and 203 in regular clinical conditions. The Maslach Burnout Inventory was used to measure the burnout syndrome. Capacity for mentalizing was examined using the Reflective Functioning Questionnaire. The Brief Resilience Scale was used to measure resilience. The results indicated that there were negative correlations between resilience and the dimensions of burnout—emotional exhaustion (r = −0.38; p < 0.01) and depersonalization (r = −0.11; p < 0.05), and a positive correlation between resilience and personal accomplishment (r = 0.27; p < 0.01), as was expected. The analyses of hierarchical linear regression showed that hypomentalizing was a significant positive predictor of emotional exhaustion (ß = 0.12; p < 005) and depersonalization (ß = 0.15; p < 0.05), resilience was a significant negative predictor of emotional exhaustion (ß = −0.28, p < 0.01) and positive predictor of personal accomplishment (ß = 0.20; p < 0.01), and that the degree of explained variance of burnout dimensions was higher when resilience and hypomentalizing were included in regression models, in addition to sociodemographic variables. The findings suggest that being a woman and working on the COVID-19 frontline implies a higher burnout, while the level of burnout decreases with better socioeconomic status and more children. Resilience, capacity for mentalizing, and burnout syndrome among HCWs are interrelated phenomena, which have important professional implications.

Moral distress and moral resilience of nurse managers

BACKGROUND

Moral distress is a phenomenon that can lead to an imbalance of the mind and body. There are many coping strategies to overcome the obstacles that lead the subject to this condition. Some coping strategies are capable of being achieved through the cultivation of moral resilience.

AIM

The aim is to identify the strategies of moral resilience in the nursing management of University Hospitals in Brazil.

RESEARCH DESIGN

The research design is the qualitative study with discursive textual analysis.

PARTICIPANTS AND RESEARCH CONTEXT

: 44 nurse managers and nurses in leadership positions participated in a total of 30 University Hospitals in Brazil. Data were collected online, using a questionnaire with open questions.

ETHICAL CONSIDERATIONS

The Ethics Committee approved the study. Participants received information about the research, agreed to respond to the questionnaire, and were guaranteed anonymity.

FINDINGS

Personal adaptive strategies (intrapersonal and interpersonal) and organizational collaborative strategies (intrinsic and transformational management) emerged from this process. The intrapersonal strategies involved elements of rationality, flexibility, rebalancing practices, moral courage, and detachment. The interpersonal strategies addressed support networks, team involvement, and dialog. Organizational strategies dealt with actions which reorient ethical infrastructure, ethical education, and psychological protection, as well as fostering dialogical relationships, empowerment, and cooperation.

CONCLUSION

From the perspective of social historical construction, it is understood that developing personal and organizational strategies is essential to cultivating moral resilience.

Development of a Conceptual Model of Occupational Stress for Athletic Directors in Sport Contexts

Previous studies have reported that occupational stress is a determinant risk factor for both chronic diseases and job performance among organizational leaders. Every occupation has its own culture and occupational climate influencing organizations within the industries. Thus, due to the idiosyncratic features inherent in sports, athletic directors may experience different occupational stressors. To date, there has been no comprehensive review of the occupational stress in athletic director contexts. Thus, based on the literature on both occupational stress and sport leadership, this study proposes a conceptual framework of occupational stress in sport leadership. The model identifies the five higher-order themes of occupational stressors and their associations with the first-level outcomes of individuals and the second-level outcomes of organizations. It also includes the two higher-order moderators of personal and organizational factors. It is hoped that this initiative can invoke interest in this topic to provide health-enhancing environments for athletic directors and quality sport services to society.

Cultivating joy: Improving nurse resilience through use of a practice playbook

PURPOSE/AIMS

The purpose of this study was to determine whether resiliency activities, compiled into a practice playbook designed for implementation by nurse leaders and self-initiation by clinical nurses, improves resilience in both the nurse leaders and direct care nurses who implement them.

BACKGROUND

Evidence indicates strengthening nurse resilience increases well-being, protects against burnout, improves retention and increases patient safety.

METHODS

A resilience playbook was assembled to include stress-reduction activities. Resilience was measured at baseline and after two phases during which participants engaged in leader-led and self-initiated activities. The Connor-Davidson Resilience Scale (CD-RISC) was used to measure resilience.

RESULTS

A total of 118 nurses completed both phases; 17 leaders and 101 clinical nurses. A significant increase in mean CD-RISC scores was detected among those who participated in self-initiated activities (p = 0.01). Initiating or participating in leader-led activities did not positively impact resilience scores. Further, clinical nurses who participated in leader-led activities were not more likely to participate in self-initiated activities.

CONCLUSIONS

This study supports self-initiated resilience-strengthening activities as beneficial to nurses, but not leader-led initiatives. These results are especially important for nursing leaders as they strive to reduce burnout, improve nurse retention and achieve exceptional practice quality.

The relationship between the paternal participation and psychological resilience of mothers in children with particular mental needs

PURPOSE

This descriptive study was performed to determine the relationship between the paternal participation and psychological resilience of mothers in children with particular mental needs.

DESIGN AND METHODS

The study was conducted with the parents of 120 children who had particular mental needs. Data were collected using psychological resilience scale for adults, and paternal participation scale.

FINDINGS

Mothers' psychological resilience level was high while paternal participation level was moderate, there was a weakly significant relationship between mothers' psychological resilience and paternal participation (r = 0.021; p < 0.01).

PRACTICE IMPLICATIONS

Nurses' knowledge and sensitivity about mentally special needs children and their families should be increased. It should be ensured that families can easily ask questions to the healthcare personnel, receive counseling, and information from nurses with a positive approach.

Investigating the Consequences of the Socio-Instrumental Use of Enterprise Social Media on Employee Work Efficiency: A Work-Stress Environment

Enterprise social media (ESM) has been widely adopted by firms for employee work-related communication. However, it is still debatable how such usage benefits work stress and employee work efficiency. Applying the transactional theory of stress, this study examined the impact of resilience as a moderator on the link between work stressors and individual work efficiency. A total of 285 entries were used to analyze the proposed hypothesis, using structural equation modeling (SEM) technique and hierarchical regression analysis on SPSS 21.0 and AMOS 21.0 software. According to the findings, ESM use has a considerable impact on work stresses (challenge and hindrance). The findings also revealed that challenge stressors have a beneficial influence on employee work efficiency, while hindrance stressors have a negative impact on it. Furthermore, the results also indicated that resilience strengthens the positive relationship between challenge-stressed employees and work efficiency. However, the findings also revealed that resilience reduces the negative association between hindrance-stress and work efficiency. Finally, the author also explored the study's implications for theory and management.

Moderating Roles of Resilience and Social Support on Psychiatric and Practice Outcomes in Nurses Working During the COVID-19 Pandemic

Introduction

Staff and equipment shortages and an easily transmissible virus make working in the COVID-19 pandemic demanding physically and psychologically. Nurses on the frontlines are particularly vulnerable to the adversity of working under these conditions, particularly with regard to mental health. Thus, understanding risk and protective factors for this vulnerable and essential group is critical for identifying potential targets of interventions. We had two aims for the current study: (a) to examine work functioning and symptoms of depression, anxiety, and posttraumatic stress (PTSD) among nurses who did and did not care for patients with COVID-19; and (b) to determine if resilience and social support moderate these relationships.

Methods

For three weeks in July 2020, nurses across the United States were invited to participate in an online survey collecting data on demographics, resilience, social support, and screening measures of depression, PTSD, anxiety, and distracted practice. Data were analyzed using descriptive statistics and hierarchical regression for each outcome measure.

Conclusions

Our findings support a growing body of research reporting that nurses are experiencing mental health sequelae during the COVID-19 pandemic, especially those providing direct care to patients with the virus. We found that compared to nurses who did not care for patients with COVID-19, those who did reported increased symptoms of PTSD, depression, and anxiety. A novel contribution is our finding that nurses providing direct COVID-19 care also experienced increased levels of distracted practice, a behavioral measure of distraction linking to a potential impact on patient care. We also found that resilience and social support acted as moderators of some of these relationships. Fostering resilience and social support may help buffer the effects of providing care to patients with COVID-19 and could potentially decrease nurse vulnerability to developing psychological symptoms and impairment on the job.

The Effects of Emergency Room Violence toward Nurse's Intention to Leave-Resilience as a Mediator

(1) Background: Healthcare workplace violence has been a focused issue in the whole world. The rate of the occurrence is pretty high in every country. The emergency room is a high risk and high frequency place for violence to occur. Under the medical service demands from people, it is quite easy to bring about conflicts. This leads to serious physical and mental harm to nurses. When suffering from physical and mental injuries, resilience is a protective factor away from negative influence. It is rare to explore and study how the nurses' resilience ability, workplace violence and turnover intention are related. Thus, the aim of this study is to understand resilience as a mediator effect in emergency nurses toward the workplace violence. (2) Methods: A cross-sectional survey study was used to collect information from emergency room nurses of a medical center in northern Taiwan. There were 132 samples in total. Three research instruments were included as follows: Hospital Workplace Violence Prevention Questionnaire, Connor-Davidson Resilience Scale, and Turnover Intention Scale. Statistical analysis using t-test, ANOVA, Correlation, as well as Sobel test were used in this study. (3) Results: The results revealed that the average age was 29.5 ± 5.6. Almost 58% of nurses experienced workplace violence. Twelve percent of nurse had experienced physical violence and 53.8% had experienced mental violence. There was significant relationship between shift personnel and religious believers. To the people who suffered physical violence, there was a significant relationship between emergency room working years and the total working years. There was significant difference between those who had suffered mental violence and religious believers. Female nurses suffered mental violence to a much higher extent than male nurses. There was a significant relationship between nurses' working years, the total working years, resilience, and turnover intention. Resilience was not the mediator for workplace violence toward turnover intention in this study. (4) Conclusions: The outcome of this study suggested that on an individual level, nurses can enhance self-protection and communication skills to decrease workplace violence. For emergency environment settings, designing a good working environment, visitors' restriction, avoiding working alone, and enhancing supervising alarm system are recommended. As for hospital administrators, fitness for work and to set up a project team is necessary. These can be references in planning prevention on workplace violence and promoting quality of workplace and patient safety in the future.

Job Stress, Psychological Capital, Perceived Social Support, and Occupational Burnout Among Hospital Nurses

PURPOSE

To determine the structural relationships among nurses' occupational burnout, job stress, psychological capital, and perceived support from society.

DESIGN

A cross-sectional design was performed to collect data from 766 registered nurses in three general tertiary Class A hospitals from March to August 2018.

METHODS

Structural equation modeling was performed to examine the proposed model.

FINDINGS

The research data supported the proposed model. Psychological capital, job stress, and perceived social support significantly influenced occupational burnout. Job stress indirectly influenced burnout through perceived social support and psychological capital. The influencing factors accounted for 49% of the variance in explaining burnout.

CONCLUSIONS

The findings identified structural relationships among the four studied variables. This study provides new information regarding the preventive role of perceived social support and psychological capital, which perform the mediating role between job stress and occupational burnout.

CLINICAL RELEVANCE

Nursing administrators should provide a healthy work environment, effective psychological capital training, and assistance to reduce nurses' occupational burnout.

Risky Behaviour among Nurses in Poland: An Analysis of Nurses' Physical Condition, Mental Health, and Resilience

Background: Nursing is a profession where staff are exposed to chronic stress. Mental resilience plays a significant role in the process of coping with these challenges. The aim of this study was to assess nurses' mental and physical wellbeing, as well as resilience, by taking into account the occurrence of risky behaviour among nurses in Poland. Methods: A descriptive study was carried out between June 2017 and May 2018 among nurses (n = 1080) employed in primary healthcare or in training centres in Silesia, Poland. Data were obtained from a number of questionnaires. Results: Over half of the nurses (n = 735; 68%) had an average psychophysical mood level resulting from stress, and 179 (16.6%) nurses had a low psychophysical mood. Those with a lower psychophysical mood showed a greater tendency towards developing improper eating habits (r = -0.23; p < 0.001). Most nurses had an average (n = 649; 60.1%) or low (n = 255; 23.6%) level of resilience. Higher resilience levels were observed in nurses aged over 30 years (p = 0.004) and in those with additional employment (p = 0.008). High resilience was associated with a lower intensity of risky behaviour. Conclusion: Most nurses in Poland display average and low levels of resilience, which can have unfavourable consequences for their health.

The relationship between workload and burnout among nurses: The buffering role of personal, social and organisational resources

Workload in the nursing profession is high, which is associated with poor health. Thus, it is important to get a proper understanding of the working situation and to analyse factors which might be able to mitigate the negative effects of such a high workload. In Germany, many people with serious or life-threatening illnesses are treated in non-specialized palliative care settings such as nursing homes, hospitals and outpatient care. The purpose of the present study was to investigate the buffering role of resources on the relationship between workload and burnout among nurses. A nationwide cross-sectional survey was applied. The questionnaire included parts of the Copenhagen Psychosocial Questionnaire (COPSOQ) (scale 'quantitative demands' measuring workload, scale 'burnout', various scales to resources), the resilience questionnaire RS-13 and single self-developed questions. Bivariate and moderator analyses were performed. Palliative care aspects, such as the 'extent of palliative care', were incorporated to the analyses as covariates. 497 nurses participated. Nurses who reported 'workplace commitment', a 'good working team' and 'recognition from supervisor' conveyed a weaker association between 'quantitative demands' and 'burnout' than those who did not. On average, nurses spend 20% of their working time with palliative care. Spending more time than this was associated with 'burnout'. The results of our study imply a buffering role of different resources on burnout. Additionally, the study reveals that the 'extent of palliative care' may have an impact on nurse burnout, and should be considered in future studies.

The Relationship between Job Stress and Job Satisfaction among Saudi Nurses: A Cross-Sectional Study

Background: The productivity of nurses and patient healthcare is highly influenced by nurses’ stress-related factors and job satisfaction. Nursing is the least preferred career opportunities for Saudi residents as compared to other options. Nurses’ perceptions of intention to quit contributes to their shortage in Saudi health care institutions.Purpose: The study aimed to examine the relationship between work-related stress and job satisfaction among Saudi nurses working at a public hospital.Methods: The research used a cross-sectional design that collected data from samples of 297 nurses working at a specified public hospital and aged over than 20 years old. Convenient sampling was employed to recruit the samples. Data were collected using the Expanded Nursing Stress Scale (ENSS) and Job Satisfaction Scale (JSS). The Statistical Package for Social Sciences (SPSS) version 20.0 was applied, and Pearson’s correlation test was to identify the relationship between variables.Results: The results indicated that the nurses at the hospital where the study took place experienced low levels of stress with a mean value of 2.1995. Besides, the nature of work indicated maximum job satisfaction with a mean value of 15.666, whereas minimum job satisfaction levels (11.569), were related to benefits provided to nurses. A positive correlation was found between the level of stress and satisfaction with a p-value of 0.041.Conclusion: The stress factors were highly correlated with job satisfaction. The identification of stress factors is important as it may create a negative impact on patients’ care and their well-being. It is suggested that changes in managerial affairs and policies are essential for implementing beneficial strategies that may assist in resolving the issue.

The mediating role of coping in the relationship of posttraumatic stress disorder symptoms (PTSS) and job burnout among Chinese firefighters

PURPOSE

The study aims to explore the relationship of posttraumatic stress disorder symptoms (PTSS) and job burnout among firefighters, as well as the mediating effect of coping in the relationship of PTSS and job burnout.

METHODS

A total of 431 firefighters participated in the study by completing a questionnaire package including Maslach Burnout Inventory-General Survey (MBI-GS), PTSD Checklist for DSM-5 (PCL-5), and Coping Strategy Indicator (CSI).

RESULTS

(1) The level of firefighters' emotional exhaustion of job burnout varied significantly by age groups [F (2, 428) = 4.33, p < 0.05], and working years [F (2, 428) = 3.22, p < 0.05]; the level of cynicism of job burnout varied significantly by working years [F (2, 428) = 3.63, p < 0.05]. (2) PTSS was significantly and positively associated with job burnout (β = 0.899, p < 0.001). (3) Both avoidant coping and problem-solving mediated the relationship between PTSS and job burnout (β = 0.212, p < 0.001; β = 0.145, p < 0.001).

CONCLUSIONS

Firefighters with higher level of PTSS are more likely to have job burnout. Avoidant coping and problem-solving play the mediating role in the relationship between PTSS and job burnout. The clinical implications for firefighters' interventions are discussed.

Is It Me or You? A Team Approach to Mitigate Burnout in Critical Care

Burnout-a combination of emotional exhaustion, depersonalization, and a diminished sense of individual accomplishment-is a serious issue for critical care nurses. Burnout has been examined as an individual's emotional state, but burnout is also a social phenomenon that may spread among colleagues through emotional contagion. Current interventions to reduce burnout are either person directed or organization directed; few interventions focus on the critical care nursing team and their social support and interactions. This article reviews burnout in critical care nursing through the lens of emotional contagion. We offer suggestions for team-based interventions to address burnout in critical care nurses.

Work–life conflict and burnout among working women: a mediated moderated model of support and resilience

Purpose

Using job demand-control-support (JDCS) model as its foundation, the purpose of this paper is to examine the important, but under-explored, relationship between perceptions of work–life conflict and burnout being mediated and moderated by support systems and resilience among female employees in India.

Design/methodology/approach

A total of 270 female employees belonging to various sectors such as Information Technology/ Information Technology enabled services, retail, bank and hospitality located in Northern India were surveyed. The study used stratified sampling method for good coverage from different departments of the organizations. The structural equation method was used to test the direct effect, and for the mediation effects, they were tested by the method of indirect effects (Preacher and Hayes, 2004).

Findings

The results supported the hypothesized model that there exists a significant and positive relationship of work–life conflict with burnout, and work–life conflict has a negative association with both family support and organizational support. The findings also supported the hypothesis that family support and organizational support mediate the relationship of work–life conflict and burnout. This analysis expectedly confirmed that resilience not only displayed a negative relationship with burnout but also exhibited a moderated relationship with organizational and family support.

Research limitations/implications

The research design was co-relational and cross-sectional, so inferring causality is not possible. Future research must incorporate a longitudinal design to investigate the causal effects of work–life conflict on employees’ experiences of burnout and whether it gets buffered by availability of workplace support and family support.

Practical implications

It is imperative for the organizations to take substantial steps to reduce job burden and deadline pressure on the female employees, nurture decision autonomy at all levels of hierarchy and encourage amiable relationships of employees with their supervisors and peers based on mutual trust and support.

Originality/value

Although most of the research studies on work–life conflict have been unidirectional, i.e. investigating spillover of work demands on to family domains (Greenhaus and Beutell, 1985; Byrne and Barling, 2017), these conflicts have been found to be bidirectional, meaning thereby that family issues do spill over into work realm (Makela and Suutari, 2011). This study examines both directions of work–life conflict.

Health and intention to leave the profession of nursing - which individual, social and organisational resources buffer the impact of quantitative demands? A cross-sectional study

Background

The aim of this study was to analyse the buffering effect of individual, social and organisational resources on health and intention to leave the profession in the context of burden due to quantitative job demands.

Methods

In 2017, a cross-sectional survey was carried out anonymously among nurses in palliative care in Germany. One thousand three hundred sixteen nurses responded to the questionnaire (response rate 38.7%), which contained, amongst others, questions from the German version of the Copenhagen Psychosocial Questionnaire (COPSOQ). Moderator analyses were conducted to investigate the buffering effect of different resources on health (‘self-rated health’ and ‘burnout’) and ‘intention to leave’ in the context of quantitative demands.

Results

‘Self-rated health’ was significantly buffered by the resources ‘recognition through salary’ (p = 0.001) and ‘good working team’ (p = 0.004). Additionally, buffering effects of the resources ‘workplace commitment’ and ‘good working team’ on ‘burnout’ (p = 0.001 and p = 0.006, respectively) as well as of the resources ‘degree of freedom’, ‘meeting relatives after death of patients’, ‘recognition from supervisor’ and ‘possibilities for development’ on ‘intention to leave’ (p = 0.014, p = 0.012, p = 0.007 and p = 0.036, respectively) were observed.

Conclusions

The results of our study can be used to develop and implement job (re) design interventions with the goal of reducing the risk of burnout and enhancing job satisfaction among nurses in palliative care. This includes for example adequate payment, communication training and team activities or team events to strengthen the team as well as the implementation of some rituals (such as meeting relatives after the death of patients). As our study was exploratory, the results should be confirmed in further studies.

Psychometric Properties of the French Brief Resilience Scale

Abstract. The Brief Resilience Scale ( BRS) is a reliable and valid assessment of the self-perceived ability to bounce back or recover quickly from stress. The current study translated and validated the French version of the BRS (BRS-F) in a sample of N = 220 midwives. In a confirmatory factor analysis, the unifactorial model fitted acceptably to the data. High levels of Tucker’s φ implied that the component loadings of the BRS-F and of the original BRS are almost equal. The BRS-F demonstrated good levels of reliability and meaningful correlations with mental health symptoms and burnout. The resilience-mental health difficulties link was fully mediated through emotional exhaustion. Thus, the BRS-F is a psychometrically sound assessment of self-perceived resilience, which is now available to researchers and clinicians in French-speaking contexts. The results also suggest that the BRS-F is relevant for use by healthcare professionals who may benefit from interventions aimed at increasing their resilience.

Resilience in nurses in terms of perceived social support, job satisfaction and certain variables

AIM

This study investigated the resilience of nurses, the factors that contribute to resilience, and its relationship with perceptions of social support and job satisfaction.

BACKGROUND

Resilience plays an important role in how nurses cope with work-related stressors.

METHODS

A descriptive study was conducted with 242 nurses working at three public hospitals in Turkey. Data were collected using a descriptive data form, the Resilience Scale for Adults (RSA), the Multidimensional Scale of Perceived Social Support (MSPSS) and the Minnesota Job Satisfaction Scale (MJSS).

RESULTS

Nurses' mean scores on the RSA, MSPSS, and MJSS were 99.80 ± 4.43, 66.66 ± 13.30, and 3.31 ± 0.72, respectively. Statistically significant relationships were detected between resilience and five factors: age, gender, mother's educational level, work experience and working hours (p < 0.05). A statistically significant positive correlation was also observed between MJSS score and both total RSA and family support subscale scores (p < 0.05).

CONCLUSION

The resilience, perceived social support, and job satisfaction of participating nurses were moderate. Significant factors in their resilience were age, gender, mother's educational level, work experience, working hours, perceived social support and job satisfaction.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers can use the results to plan interventions that improve resilience among nurses.