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

Effect of occupational stress and resilience on insomnia among nurses during COVID-19 in China: a structural equation modelling analysis

OBJECTIVES

To explore the effects of occupational stress and resilience on insomnia among Chinese nurses during the COVID-19 pandemic.

DESIGN, SETTINGS AND PARTICIPANTS

A quantitative description study. The data were collected via a cross-sectional survey. A total of 725 front-line nurses at three tertiary hospitals in western China were included from December 2022 to January 2023. The Connor-Davidson Resilience Scale, Job Content Questionnaire, and Athens Insomnia Scale were used to collect data from a self-reported online questionnaire.

OUTCOME MEASURES

The outcome variable was insomnia, and structural equation modelling was used to assess the associations among resilience, occupational stress and insomnia.

RESULTS

The prevalence of insomnia among the participants was 58.76%. The structural equation model showed that resilience had a negative direct effect on insomnia and occupational stress, and occupational stress had a positive direct effect on insomnia. Involvement in COVID-19-related work has a positive effect on insomnia through occupational stress. In contrast, higher education levels improved insomnia through increased resilience.

CONCLUSION

A significantly higher prevalence of insomnia has been observed among Chinese nurses during the COVID-19 pandemic. Our study suggests that better resilience may improve insomnia by relieving occupational stress, and implementing measures to promote resilience is essential to reduce occupational stress in nurses and improve their sleep quality.

Latent class analysis of the sleep quality of night shift nurses and impact of shift-related factors on the occupational stress and anxiety

AIMS

The objective of this study is to explore the various latent categories within the sleep quality of night shift nurses and to investigate whether shift-related factors predispose nurses to higher levels of occupational stress and anxiety.

DESIGN

This is a cross-sectional study.

METHODS

From November to December 2020, registered nurses from 18 tertiary hospitals and 16 secondary hospitals in Chongqing were selected through convenience sampling for this study. Latent class analysis was used to investigate the sleep quality of nurses working night shifts. Furthermore, univariate analysis and logistic multivariate analysis were utilized to identify the contributing factors to occupational stress and anxiety.

RESULTS

The four latent categories of Pittsburgh Sleep Quality Index for night shift nurses were identified as 'Low Sleep Disorder Group' (56.34%), 'Moderate Sleep Disorder Group' (37.27%), 'High Sleep Disorder Non-Reliant on Sleeping medication Group' (4.89%) and 'High Sleep Disorder Reliant on Sleeping medication Group' (1.50%). The results showed that having a night-shift frequency of 3-4 times per month, night-shift durations of 9-12 h, sleep time delay after night shift (≥2 h), total sleep time after night shift less than 4 h were shift-related factors that increased the levels of occupational stress and anxiety.

CONCLUSION

The sleep quality of night shift nurses demonstrates heterogeneity and can be classified into four latent categories. Higher frequency of night shifts, extended work hours and insufficient rest time are all associated with increased levels of occupational stress and anxiety.

IMPACT

By identifying the four latent categories of sleep quality among night shift nurses, this study sheds light on the relationship between sleep patterns and levels of occupational stress and anxiety. These findings have important implications for healthcare institutions in the management of nurse well-being and work schedules.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

More Than a Game: Building a Workplace Culture of Positivity and Belonging Among Nurses

This performance improvement project introduced a mobile social gaming app for sharing positive feedback from patients and coworkers with nurses. After deployment, the app supported creating improvements as a supportive structure for engaging nurses in peer recognition to build a workplace culture of positivity and belonging. The authors discuss findings from the app's adoption and use among nurses and offer recommendations for leaders.

Exploring the concept and management strategies of caring stress among clinical nurses: a scoping review

Objective

The concept of caring stress and its specific management has received less attention than other dimensions of stress in nurses. Therefore, to clarify the concept of caring stress, a scoping review study was designed. This scoping review aimed to investigate the concept of caring stress among clinical nurses and examine the strategies used for its management.

Methods

This review employed a scoping review methodology to comprehensively map the essential concepts and attributes of the phenomenon by drawing on a wide range of sources. International databases including PubMed, Scopus, Web of Science, Google Scholar, and Scientific Information Database (SID) were searched to gather relevant studies published until October 1, 2023. MESH terms included "caring stress", "care", "stress", "nurse", and "stress management" were used. Two reviewers independently collected data from full-text papers, ensuring that each paper underwent assessment by at least two reviewers.

Results

Out of 104,094 articles initially searched, 22 articles were included in this study. High workloads, transmitting the infection, stressful thoughts, stressful emotions, and stressful communications were the significant concepts and factors of caring stress among nurses. Also, rest breaks during patient care shifts, playing music in the ward, and denial of critical situations were examples of positive and negative coping and management ways to reduce caring stress.

Conclusion

Effective stress management strategies can lead to better patient care and safety. Stressed nurses are more likely to make errors or become less vigilant in their duties, impacting patient outcomes. By addressing caring stress, clinical practice can prioritize patient well-being. Further research is required to delve deeper into this critical issue concerning nurses in the future.

The relationship between psychological capital, burnout and perceived stress in junior nurses: a latent profile analysis

Background

Psychological capital, an intrinsic personal asset, enhances junior nurses' ability to navigate transition and sustain superior job performance. This study aimed to classify junior nurses into distinct psychological capital profiles and examine their associations with burnout and perceived stress levels.

Methods

A cross-sectional study involving 480 junior nurses from three hospitals in Beijing assessed psychological capital, stress, and burnout using e-questionnaires, from July 2021 to August 2022. We employed exploratory latent profile analysis for psychological capital profiling and logistic regression with the best subset method to identify the influential factors.

Results

The results of the latent profile analysis supported the models of two latent profiles, which were defined as low psychological capital (224, 46.5%) and high psychological capital (256, 53.5%). Logistic regression revealed that introverted nurses and those experiencing moderate to high levels of burnout and stress were more likely to exhibit low psychological capital.

Conclusion

Nursing management should proactively identify and support junior nurses with low psychological capital, with a focus on introverted individuals, to mitigate the impact of stress and burnout.

Correlation analysis between occupational stress and metabolic syndrome in workers of a petrochemical enterprise: based on two assessment models of occupational stress

BACKGROUND

Occupational stress is becoming a common phenomenon around the world. Being in a high occupational stress state for a long time may destroy the metabolic balance of the body, thereby increasing the risk of metabolic diseases. There is limited evidence regarding the correlation between occupational stress and metabolic syndrome (MetS), particularly in the petrochemical workers.

METHODS

A total of 1683 workers of a petrochemical enterprise in China were included in the survey by cluster sampling method. The occupational stress assessment was carried out by the Job Content Questionnaire and the Effort-Reward Imbalance Questionnaire, and the general demographic characteristics, work characteristics, occupational hazards, lifestyle and health examination data of the participants were collected. Logistic regression and multiple linear regression were used to analyze the correlations and influencing factors between occupational stress and its dimensions with MetS and its components.

RESULTS

A total of 1683 questionnaires were sent out, and 1608 were effectively collected, with an effective recovery rate of 95.54%. The detection rates of occupational stress in Job Demand-Control (JDC) and Effort-Reward Imbalance (ERI) models were 28.4% and 27.2%, respectively. In this study, 257 participants (16.0%) were diagnosed with MetS. Compared with the non-MetS group, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG) and fasting blood-glucose (FBG) levels were significantly higher in the MetS group, and high density lipoprotein-cholesterol (HDL-C) levels were significantly lower (P < 0.001). The results of multiple linear regression showed that after adjusting for nation, marital status, education, work system, smoking and drinking, and further adjusting for occupational hazards, the D/C ratio was significantly negatively correlated with SBP in the JDC model. Social support was negatively correlated with WC. In the ERI model, there was a significant positive correlation between over-commitment and FBG.

CONCLUSIONS

The detection rates of occupational stress and MetS were high in workers of a petrochemical enterprise. In the JDC model, occupational stress was negatively correlated with SBP, and social support was negatively correlated with WC. In the ERI model, there was a significantly positive correlation between over-commitment and FBG.

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.

Moral distress, psychological capital, and burnout in registered nurses

AIMS

This study aimed to explore the relationship among moral distress, psychological capital, and burnout in registered nurses.

ETHICAL CONSIDERATION

The study was approved by the Ethics Committee of the School of Nursing, Hangzhou Normal University (Approval no. 2022001).

METHODS

A cross-sectional descriptive survey was conducted with a convenience sample of 397 nurses from three Grade-A tertiary hospitals in Zhejiang Province, China. Participants completed demographic information, the Nurses' Moral Distress Scale, the Nurses' Psychological Capital Scale, and the Maslach Burnout Inventory Scale. The data were analyzed using Pearson's correlation analysis, structural equation modeling, and hierarchical multiple regression analysis.

RESULTS

The study found that moral distress and burnout are positively correlated, while psychological capital is negatively correlated with both moral distress and burnout. The path analysis in structural equation modeling revealed that moral distress has a significant direct effect on psychological capital, while psychological capital has a significant direct effect on burnout. In addition, moral distress also had a significant indirect effect on burnout through psychological capital. Moreover, both the direct effect of moral distress on burnout and the total effect of moral distress on burnout were significant.

CONCLUSION

The findings suggest that psychological capital plays an important role in the relationship between moral distress and burnout. Promoting psychological capital among nurses may be a promising strategy for preventing moral distress and burnout in the workplace.

Mediating effects of social support and presenteeism on turnover intention and post-traumatic stress disorder among Chinese nurses in the post-pandemic era: a cross-sectional study

Background

The shift in national policies for epidemic prevention and control in the post-pandemic era is undoubtedly a challenge for health care professionals. Nurses, as an important part of the health care professional population, have an even greater impact on their mental health and occupational safety. This may expose nurses to post-traumatic stress disorder (PTSD) and presenteeism, and ultimately lead to their turnover.

Objective

This study aimed to investigate the relationship between turnover intention and post-traumatic stress disorder among Chinese nurses during post-pandemic era, and the mediating role of social support and presenteeism.

Methods

In this study, a multicentre cross-sectional survey was conducted in April 2023 among nursing staff in several tertiary general hospitals in northern China, with online data collection using the Turnover intention Scale (PTSD), the Impact of Events Scale (IES), the Social Support Scale (SSS), and the Stanford presenteeism Scale (STAS) and the relationship between variables was analyzed using hierarchical multivariate regression, and Structural Equation Modeling (SEM) was used to analyze the relationship between post-traumatic stress disorder and the Turnover intention from the pathway between.

Results

Data were collected from 2,513 nurses who met the inclusion criteria, in which general information such as age, department, specific department, Professional title, history of alcohol consumption, form of employment, Years of working, and Average working hours per day were statistically significant with the difference in the turnover intention. The results of the study showed a 32% high turnover intention among nurses in the post-pandemic era, which was lower than the turnover intention during the pandemic. The results of hierarchical multiple regression analysis showed that post-traumatic stress disorder, social support, and presenteeism were significant predictors of turnover intention. The total effect of post-traumatic stress disorder on turnover intention to work was 0.472 [bias modified 95% confidence interval (0.415-0.483), p < 0.001]. Social support and attendance played a partially intermediate role in post-traumatic stress disorder and propensity to leave (an indirect effect of 26% of the total effect).

Conclusion

Turnover intention and post-traumatic stress disorder levels are high and social support plays an important role in the tendency to leave the job and post-traumatic stress disorder, healthcare institution can be achieved by strengthening social support for nurses in the post-epidemic era and preventing the occurrence of presenteeism.

Psychological Capital and Turnover Intention: The Mediating Role of Burnout among Healthcare Professionals

Psychological capital (PsyCap) has been identified as an individual's positive psychological state of development that can help to reduce negative organizational outcomes. However, there is still a gap in understanding how PsyCap influences different aspects of organizations. This study investigates the mediating role of burnout in the relationship between PsyCap and turnover intentions among healthcare professionals. A cross-sectional survey was conducted among 320 healthcare professionals. The estimation of the relationships between PsyCap, burnout, and turnover intentions was obtained through structural equation modelling (SEM). A mediation analysis was carried out using bootstrapping procedures. The results show that burnout has a significant and positive effect on turnover intention and PsyCap has a significant and negative effect on burnout. Moreover, burnout fully mediates the relationship between PsyCap and turnover intention. These findings suggest that PsyCap can effectively reduce negative outcomes like burnout, but its positive impact may be limited when considering other outcomes such as turnover intention.

Psychological capital among clinical nurses: A latent profile analysis

AIM

To determine the psychological capital level of nurses and explore the latent profiles of nurses regarding their psychological capital scores.

BACKGROUND

The use of individual-centered analysis for the connotation of nurses' psychological capital structure is less studied and still needs to be further explored.

METHODS

By the convenience sampling method, 494 clinical nurses from 7 general hospitals in Sichuan province were selected. The study was conducted from December 2022 to February 2023. Latent profile analysis was used for data analysis. We followed STROBE guidelines in this research.

RESULTS

The total mean score of nurses' psychological capital is 5.17 (SD = 0.8). The following four latent profiles were identified: "poor" (4.5%), "medium" (22.9%), "well-off" (41.5%), and "rich" (31.1%). Multiple logistic regression showed that the number of hours worked per day and the number of night shifts per month were negative predictors of psychological capital, and psychological training and job satisfaction were protective factors of psychological capital.

DISCUSSION

Our study found that the four profiles can be distinguished by "poor," "well-off," "medium," and "rich" levels of psychological capital. Among them, more than 70% of the nurses belonged to the well-off and rich profiles, and the number of the poor profile was the lowest.

CONCLUSION

The overall psychological capital of clinical nurses is at a medium-high level. Each profile is influenced by multiple sociodemographic factors (i.e., age, working hours, monthly income, psychological training, and job satisfaction).

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Administrators should develop enhancement strategies to improve the mental health of nurses based on the characteristics of their psychological capital profiles.

Registered nurses' psychological capital: A scoping review

AIMS

The aim was to examine the extent and scope of empirical research concerning registered nurses' psychological capital.

BACKGROUND

In a time of global nursing shortage, identifying variables that could positively contribute to the retention of the nursing workforce is essential. Prior research has shown that psychological capital correlates positively with employees' better performance and well-being.

DESIGN

A scoping review.

DATA SOURCES

A systematic literature search was conducted in the following databases: PubMed, CINAHL, PsycINFO, Web of Science and Scopus covering the period from 1 January 2005 to 7 May 2023.

REVIEW METHODS

The JBI methodological guidance for scoping reviews was followed. The results were summarized narratively.

RESULTS

A total of 111 studies reported in 114 peer-reviewed articles were included. Studies were carried out across 20 countries, with the majority from China (45), Australia (nine), Pakistan (nine), Canada (eight), South Korea (eight) and the United States (eight). A positive correlation was found between registered nurses' psychological capital and desirable work-related outcomes, such as work engagement, commitment and retention intention.

CONCLUSION

A comprehensive overview of research evidence suggests that psychological capital is associated with many positive work-related outcomes and might therefore be a valuable resource for reducing nurse turnover.

The Symptom Network Structure of Teachers' Burnout and Its Connection to Psychological Capital

Background

Teacher burnout is characterized by emotional and physical exhaustion resulting from excessive work-related stress. Previous research based on traditional latent variable theory has revealed a significant negative relationship between TB and psychological capital (PsyCap). This study explored the complex symptoms of TB and the contact points of PsyCap in reducing TB using psychometric network analysis.

Methods

A total of 3991 teachers completed the burnout subscale of the Professional Quality of Life and Psychological Capital Scale.

Results

The results showed that: (a) In the TB network, the core symptoms displayed by teachers due to burnout are difficulty feeling "I am a very caring person", "I am happy", and "I am the person I always wanted to be"; (b) The TB-PsyCap network was closely connected, and the symptoms affected each other. PsyCap affected the TB network through "I feel optimistic and happy almost every day" and "I often feel that there is a future as a teacher"; (c) PsyCap's bridge symptoms had a negative impact on TB, and PsyCap may reduce TB primarily through optimistic, hopeful dimensions.

Conclusion and Implications

Psychometric network analysis helps us understand the complex symptoms of TB and the contact points of PsyCap in reducing TB. This study offers valuable insights into the prevention of, and intervention in, burnout within the teaching community.

Socioeconomic factors, perceived stress, and social support effect on neonatal nurse burnout in China: a cross-sectional study

BACKGROUND

Neonatal nurses' working environments are highly stressful, and burnout is common. This study examines the effect of socioeconomic factors, perceived stress, and social support on neonatal nurse burnout.

METHODS

A total of 311 neonatal nurses participated in this study. They were administered a validated Maslach Burnout Inventory. The study employed a 14-item perceived stress scale (PSS-14) and a social support rate scale (SSRS) to examine stress, socioeconomic factors, and lifestyles.

RESULTS

Of the neonatal nurses, 40.19% had burnout, 89.60% had mild burnout, and 10.40% had moderate burnout; no neonatal nurse experienced severe burnout. Young nurses and those with low technical skills, poor interpersonal relationships, irregular diet, and insufficient rest were exposed to burnout (all p < 0.05).Most burnout nurses experienced moderate-severe perceived stress, and their PSS-14 scores were higher (all p < 0.05).The scores for objective social support, subjective social support, utilization of social support, total SSRS scores, and the level of social support were all lower in burnout nurses (all p < 0.05). Perceived stress was correlated positively and significantly with emotional exhaustion and personal accomplishment (all p < 0.05). Social support correlated significantly with and reduced personal accomplishments (p < 0.05). Age, poor interpersonal relationships, perceived stress, and social support were all independent factors associated with neonatal nurse burnout (all p < 0.05).

CONCLUSION

The prevalence of burnout in neonatal nurses was higher than average. Socioeconomic factors, higher perceived stress, and lower social support contribute to neonatal nurse burnout. Nursing managers should pay attention to socioeconomic factors, perceived stress, and social support among neonatal nurses and employ strategies to reduce neonatal nurse burnout.

Psychological capital and alienation among patients with COVID-19 infection: the mediating role of social support

BACKGROUND

COVID-19 infection continues all over the world, causing serious physical and psychological impacts to patients. Patients with COVID-19 infection suffer from various negative emotional experiences such as anxiety, depression, mania, and alienation, which seriously affect their normal life and is detrimental to the prognosis. Our study is aimed to investigate the effect of psychological capital on alienation among patients with COVID-19 and the mediating role of social support in this relationship.

METHODS

The data were collected in China by the convenient sampling. A sample of 259 COVID-19 patients completed the psychological capital, social support and social alienation scale and the structural equation model was adopted to verify the research hypotheses.

RESULTS

Psychological capital was significantly and negatively related to the COVID-19 patients' social alienation (p < .01). And social support partially mediated the correlation between psychological capital and patients' social alienation (p < .01).

CONCLUSION

Psychological capital is critical to predicting COVID-19 patients' social alienation. Social support plays an intermediary role and explains how psychological capital alleviates the sense of social alienation among patients with COVID-19 infection.

Association between hopelessness and job burnout among Chinese nurses during the COVID-19 epidemic: The mediating role of career calling and the moderating role of social isolation

Background

The COVID-19 pandemic has led to an increased workload and work pressure on nurses owing to the unpredictable changes during this challenging situation. Herein, we explored the relationship between hopelessness and job burnout in nurses working in China against the backdrop of the COVID-19 outbreak.

Method

This was a cross-sectional study involving 1216 nurses in two hospitals in Anhui Province. The data was collected using an online survey. The mediation and moderation model was constructed, and the data was analyzed using SPSS PROCESS macro software.

Results

Our results showed that the nurses had an average job burnout score of 1.75 ± 0.85. Further analysis revealed a negative correlation between hopelessness and career calling (r = -0.551, P < 0.01) and a positive correlation between hopelessness and job burnout (r = 0.133, P < 0.01). Additionally, a negative correlation was demonstrated between career calling and job burnout (r = -0.138, P < 0.01). Moreover, career calling strongly mediated (by 40.9%) the relationship between hopelessness and job burnout in the nurses. Finally, social isolation in the nurses was a moderating factor for the association between hopelessness and job burnout (β = 0.028, t = 2.851, P < 0.01).

Conclusion

Burnout severity in nurses increased during the COVID-19 pandemic. Career calling mediated the relationship between hopelessness and burnout, with greater burnout levels in nurses who experienced social isolation. Therefore, we suggest that job burnout in nurses can be improved by mitigating the effects of hopelessness and social isolation through psychological interventions and enhancing their sense of career calling through education to strengthen their professional identity.

Virtual Leadership and Nurses' Psychological Stress during COVID-19 in the Tertiary Hospitals of Pakistan: The Role of Emotional Intelligence

Although intelligence has been widely examined in the literature, the correlation of emotional intelligence (EI) has with virtual leadership, work stress, work burnout, and job performance in the nursing profession needs further consideration. Prior studies have confirmed that leadership style and emotional intelligence massively contribute to better outcomes in the nursing profession. Based on these confirmations, this research intended to explore the impact of virtual leadership and EI on work stress, work burnout, and job performance among nurses during the COVID-19 pandemic. A convenient sampling technique was adopted to select the data sample. To analyze our hypotheses, 274 self-reported surveys were distributed in five tertiary hospitals in Pakistan through a cross-sectional quantitative research design. The hypotheses were tested with SmartPLS-3.3.9. Our findings revealed that virtual leadership and EI have considerably influenced nurses' work stress, burnout level, and job performance. The study concludes that EI significantly moderates virtual leadership and psychological stress among nurses.

School climate and academic burnout in medical students: a moderated mediation model of collective self-esteem and psychological capital

BACKGROUND

The study burnout of medical students is more and more serious, which directly affects the study style of university and the learning quality of students. This has aroused the high attention of researchers and universities. This study aimed to explore the mechanism of the influence of school climate on academic burnout among medical students in Chinese cultural context.

METHODS

2411 medical students (50.52% female; mean age = 19.55, SD = 1.41, rang = 17-24 years) were investigated with psychological environment questionnaire, collective self-esteem scale, psychological capital scale and academic burnout scale. The data were analyzed by using a moderated mediation model with SPSS and the Process 4.0 macro.

RESULTS

The results revealed that: (1) school climate had a significant negative predictive effect on academic burnout among medical students controlling for gender, grade and age (B = -0.40, p < 0.001). (2) Collective self-esteem played a partial mediating role in school climate and academic burnout (indirect effect = -0.28, 95% CI = [-0.32,-0.25], accounting for 52.83%). (3) The first and second half of the indirect effect of school climate on medical students' academic burnout were moderated by psychological capital (B = 0.03, p < 0.01; B = -0.09, p < 0.001).High level of psychological capital can enhance the link between school climate and collective self-esteem as well as the link between self-esteem and academic burnout.

CONCLUSION

Creating a good school atmosphere and improving the level of collective self-esteem and psychological capital are beneficial to improve the academic burnout of medical students.

Symptoms of depression, perceived social support, and medical coping modes among middle-aged and elderly patients with type 2 diabetes

Objective: To understand the prevalence of depression in diabetes population, explore the relationship between diabetes and depression, and the impact of comprehensive psychological and behavioral intervention on depression related to diabetes and glucose metabolism.

Methods: 71 middle-aged and elderly patients with type 2 diabetes were investigated and evaluated with Self Rating Depression Scale (SDS), Medical Coping Scale (MCWQ) and Social Support Scale (PSSS). Patients who met the research criteria were randomly divided into an experimental group and a control group. The number of effective cases in the two groups was 36 and 35 respectively. In addition to conventional diabetes drug treatment, the experimental group was supplemented with comprehensive psychological and behavioral intervention, while the control group was only given conventional treatment. The fasting blood glucose, 2-h postprandial blood glucose, body weight and depression index were measured before and after treatment in the two groups.

Results: The prevalence of depression in patients with diabetes was as high as 60%, and that in the elderly control group was 5%; In type 2 diabetes population, depression is negatively related to the total score of social support and medical coping surface, and positively related to avoidance, blood sugar, women, course of disease, education level below junior high school, body mass index, and number of complications in medical coping; The fasting blood glucose, 2-h postprandial blood glucose, body mass index, and depression index of the two groups decreased, and the range and speed of decline in the experimental group were higher than those in the control group; There were significant differences between the two groups in fasting blood glucose, 2-h postprandial blood glucose and depression index; During the follow-up period, the blood glucose and depression index of the experimental group increased.

Conclusion: Depression has a high prevalence rate in middle-aged and elderly people with type 2 diabetes, and has a negative impact on blood sugar control in diabetes patients; Psychological and behavioral comprehensive intervention can improve the glucose metabolism and depressive symptoms of middle-aged and elderly patients with type 2 diabetes.

Work Experience of Chinese Male Nurses Based on the Job Demands-Resources Model: A Cross-Sectional Study

Aim. This study aimed to quantitatively compare the effects of perceived social support, resilience, and task load on occupational burnout and flow at work in male nurses, as well as the complex relationships among these variables. Background. Male nurses play a vital role in the healthcare system. However, little is known about the key factors that may improve the work experience of male nurses. Methods. A cross-sectional study was conducted from June to December 2021. A convenience sample of 356 male nurses completed measures of general information, burnout, flow at work, perceived social support, resilience, and task load. Dominance analysis and network analysis were used to explore the associations between the variables studied. Results. Among the variables studied, perceived social support most strongly predicted burnout, while perceived social support and resilience had equal predictive weights in flow at work. The network analysis found that resilience was the bridge indicator with the strongest connections to other variables. Conclusion. The interventions focused on the perceived social support and resilience of male nurses could help improve their work experience. Implications for Nursing Management. Nursing administrators should give male nurses more support and understanding to reduce burnout at work. At the same time, administrators can conduct psychological lectures to improve male nurses’ resilience, thereby increasing their flow at work. Providing challenging tasks that match male nurses’ skills could also help improve their work experience.

Building Solidarity with Black Nurses to Dismantle Systemic and Structural Racism in Nursing

Systemic and structural racism in nursing have profound impacts on Black People, Indigenous Peoples, and People of Color. They contributed to underrepresentation in faculty, senior nurse executives, and presidents' positions in academic and healthcare organizations, physical and mental health issues in racialized groups. This quality improvement study described ways in which the Black Nurses Task Force of the Registered Nurses Association of Ontario can build solidarity with nursing and government organizations to dismantle systemic and structural racism in nursing. This study used a structured online survey, comprised of quantitative and qualitative questions. The qualitative data were analyzed using interpretative thematic analysis and the quantitative data were analyzed with descriptive statistics. Findings showed that 88% of participants experienced racism and 63% said racism affected their mental health. Three themes emerged from the qualitative data: Social support for Black nurses, accountability of leaders and solidarity with Black nurses. These findings demonstrated the urgent need to dismantle systemic and structural racism in nursing.

Impact of work-family support on job burnout among primary health workers and the mediating role of career identity: A cross-sectional study

Objective

In China, medical workers in the primary sector shoulder the task of providing people with the basic medical and public health services, and are the "gatekeepers" of the public health. This study aims to analyze the current situation of job burnout among primary health workers of China, and shed light on the effect of work-family support and career identity on job burnout among them and their relationships. This may provide a new perspective for primary health care institutions and health administrative departments so as to formulate policies to "attract, retain and stabilize" primary health workers.

Methods

A multi-stage sampling method was adopted to select 8,135 primary health workers from 320 primary health care institutions in a province of central China. A descriptive statistical analysis, univariate analysis, Pearson correlation analysis, and mediation effect analysis were applied to analyze the effects of work-family support and career identity on job burnout among primary health workers as well as the mediating role of career identity.

Results

Among 8,135 primary health workers, 4,911 (60.4%) participants had mild to moderate levels of job burnout, 181 (2.2%) participants had severe job burnout, and the burnout detection rate is 62.6%. Work-family support was negatively correlated with job burnout (r = -0.46, p < 0.01) and positively correlated with career identity (r = 0.42, p < 0.01). Work-family support (β = -0.346, p < 0.01) and career identity (β = -0.574, p < 0.01) were negative predictors of job burnout respectively. In addition, career identity had a mediating effect between work-family support and job burnout, with the mediating effect contributing 33.7% to the overall effect.

Conclusions

The findings of this study demonstrate that work-family support is a protective factor against job burnout in primary health workers and reveal that career identity is a critical mediating mechanism linking work-family support to burnout. We propose to reduce job burnout by strengthening work-family support (especially work support), enhancing career identity, increasing the number of primary health workers and reducing the workload of existing incumbents, which can provide important practical implications for the future prevention and intervention programs.

More exposure to medical injury news, better doctor-patient communication, but less doctors' professional identity: A moderated chain mediation model

Objectives

In recent years, news of medical malignant injury events has become common in China. However, it is unclear how exposure to this news affects medical staff.

Methods

The present study collected data from a sample of 311 medical staff in China. It explored the effect of exposure to such news on medical staff's communication and willingness to let their children be doctors, which was an attitude that reflects their professional identity well. In addition, this study also examined the mediating roles of outgroup attribution and anxiety, and the moderating role of social support.

Results

The results showed that exposure to news of medical injury could positively and directly predict the quality of doctor-patient communication, but negatively and indirectly predict medical staff's willingness to let their children become doctors. These effects existed through the mediating role of anxiety and the chain mediating role of both outgroup attribution and anxiety. In addition, social support could mitigate the negative correlation between news exposure and outgroup attribution.

Conclusions

These results suggest that news of medical malignant injury events may incentivize medical staff to improve the quality of communication in the short term, but it is not conducive to medical staff's long-term mental health. That is, exposure to news of medical injury is likely to lead to a negative influence on their professional identity, although social support can alleviate this negative influence.

Moderated Role of Social Support in the Relationship between Job Strain, Burnout, and Organizational Commitment among Operating Room Nurses: A Cross-Sectional Study

Unique environment, coupled with overload, low job control, and high risk might put operating room (OR) nurses in a state of high job strain, which might have negative influences on burnout and organizational commitment. Based on the Job Demand-Control-Support model and previous studies, we hypothesized that the relationship between job strain (determined by job demand and control) and organizational commitment could be mediated by burnout (emotional exhaustion and depersonalization), the effect of job strain on burnout and organizational commitment could be moderated by social support. To verify the hypothesis, a quantitative cross-sectional survey was conducted, 509 OR nurses from 30 tertiary hospitals in Beijing were recruited. Multiple-group path analysis was used to test the moderated role of social support. Propensity score matching was applied to match job strain in different groups. Our research found that in the low social support group, job strain was not related to organizational commitment, while in the high social support group, depersonalization was not related to organizational commitment. Furthermore, nurses in the low social support group were more likely to have depersonalization under job strain compared to the high social support group. Social support should be provided to alleviate the negative impact of job strain.

Mediating effect of circadian rhythm between work stress and sleep quality in Chinese shift-working nurses: A cross-sectional survey

AIM

This study examined the mediating effect of circadian rhythm amplitude (LV) and stability (FR) between work stress and sleep quality among Chinese shift-working nurses (SWNs).

DESIGN

A cross-sectional study.

METHODS

Three-hundred and seventy-nine nurses working in shifts were investigated by convenient sampling from six hospitals in Shanghai, China. The mediating effect was analysed using the structural equation model with bootstrapping procedures.

RESULTS

Work stress could directly affect shift nurses' sleep quality and indirectly affect sleep quality through circadian rhythm amplitude and stability. The total indirect effects of work stress on sleep quality accounted for 36.7% of the total effect. The study revealed that poor sleep quality is very common among SWNs, which deserves attention. The mediating effect of the circadian rhythm provides new insights to improve sleep quality, not only by lightening the work stress but also by improving circadian rhythm in SWNs.

Nursing in Primary Health Care: association between leadership, psychological capital, and burnout implications

OBJECTIVES

to verify the association between authentic leadership and burnout syndrome in Primary Health Care nursing professionals and analyze the relationship between positive psychological capital and burnout syndrome in subordinate nursing professionals.

METHODS

a field, descriptive-exploratory, cross-sectional study with a quantitative approach, developed with the nursing team, in Basic Health Units in the city of São Paulo, with the application of the sociodemographic questionnaires, Burnout Characterization Scale [Escala de Caracterização do Burnout], Authentic Leadership Questionnaire and Psychological Capital Questionnaire.

RESULTS

in leaders' perception, there was no evidence of significant associations between burnout and authentic leadership scales. There was a significant negative association of the burnout scale dimensions with the leadership dimensions regarding the subordinates. There was evidence of significant negative associations in the burnout scores with the scores of the psychological questionnaire dimensions.

CONCLUSIONS

in nursing, burnout is associated with authentic leadership and psychological capital.

Compassion fatigue and compassion satisfaction among Chinese palliative care nurses: A province-wide cross-sectional survey

AIMS

We aim to explore the prevalence and potential facilitators and inhibitors of compassion fatigue and compassion satisfaction among Chinese palliative care nurses.

BACKGROUND

Nurses with compassion fatigue may suffer from health-related problems, causing decreased work efficiency and quality of care. Palliative care nurses are especially at risk of compassion fatigue due to close contact with terminal patients.

METHODS

A province-wide cross-sectional survey using convenience sampling was conducted among 318 palliative care nurses at 25 hospitals and healthcare institutions in Sichuan Province, China. Data were collected using demographic questionnaire and five scales: Professional Quality of Life Scale, General Self-Efficacy Scale, Perceived Social Support Scale, Simplified Coping Style Questionnaire, and Connor-Davison Resilience Scale. Data analyses including descriptive statistics, t-test, one-way ANOVA, simple linear regression, and multiple linear regression.

RESULTS

Mean scores (SD) for burnout, secondary traumatic stress, and compassion satisfaction were 25.42 (4.75), 26.08 (5.72), and 35.67 (5.77), respectively. Related factors predicted 40.30%, 27.10%, and 35.4% of the variance in the model of burnout, secondary traumatic stress, and compassion satisfaction, respectively (all p < .001).

CONCLUSIONS

The levels of burnout and secondary traumatic stress among Chinese palliative care nurses were higher than those among other types of nurses. Social support, resilience, positive coping, family recognition of work, and income satisfaction are inhibitors of compassion fatigue among palliative care nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing administrators and educators should consider providing effective and targeted strategies (e.g. ongoing training and psychological interventions) to decrease compassion fatigue among palliative care nurses based on the cultural and ethical settings.

The Relationship Between Workplace Incivility and Psychological Distress: The Moderating Role of Servant Leadership

BACKGROUND

The relationship between workplace incivility and psychological distress among nurses has been well-documented in the nursing literature. Management practices to reduce the negative impact are less clear. This study aimed to examine perceived servant leadership as a moderator between workplace incivility and psychological distress among nurses in Chinese hospitals.

METHODS

This study used a cross-sectional design and was conducted between September and October 2020. We recruited 1,604 nurses from 13 Chinese hospitals across different regions in China ranging from 18 to 55 years in age (M = 28.48 years, SD = 6.53 years). Multiple linear regression was used to analyze the data.

FINDINGS

The results showed that workplace incivility (β = 0.40, p < .001) and perceived servant leadership (β = -0.13, p < .001), as well as their interaction (β = -0.11, p = .002), predicted nurses' psychological distress. Perceived servant leadership moderates the relationship between workplace incivility and psychological distress.

CONCLUSIONS/APPLICATION TO PRACTICE

Servant leaders can create an ethical work climate, display empathy and compassion, and facilitate resilience. Our findings can assist hospital management with support from occupational health providers to recruit, train, and assess nursing supervisors. Also, occupational health providers in collaboration with nursing administration can monitor incivility, psychological distress, servant leadership levels, and impact.

Chronic Fatigue Predicts Hospital Nurse Turnover Intentions

OBJECTIVE

The objective of this study was to determine the impact of workforce engagement factors on hospital nurse turnover intentions.

BACKGROUND

Nurse turnover intentions are impacted by occupational fatigue and burnout, which are differentially impacted by fatigue, meaning and joy in work, and work-related resilience.

METHODS

One hundred fifty-one nurses from a southwestern hospital completed online surveys. Path analyses evaluated relationships among variables.

RESULTS

Chronic occupational fatigue was the only significant predictor of turnover intentions among nurses. Although strongly associated with emotional exhaustion and depersonalization (burnout components), burnout did not predict turnover intention. High levels of chronic fatigue predicted lower meaning and joy in work and lower work-related resilience. Although significantly correlated, meaning and joy in work and resilience did not predict total burnout scores when analyzed in causal models.

CONCLUSIONS

Nurse administrators should focus efforts on factors such as chronic occupational fatigue that are likely to impact nurses' decisions to leave their positions.

Determining levels of nurse burnout during the COVID-19 pandemic and Lebanon's political and financial collapse

Background

The COVID-19 pandemic compounded political and financial pressures on the nursing workforce in Lebanon. The government resigned in October 2019 in response to the popular uprising that called for an end to corruption and economic mismanagement 5 months before the first COVID-19 case appeared in the country. The continuing crises and the added stress of COVID-19 has increased the risk of occupational burnout and turnover in the nursing workforce. Therefore, valid and reliable measurement is imperative to determine burnout levels, prioritize intervention, and inform evidence-based workforce policy and practice. The primary aim of the study was to delineate burnout levels and cut-points in a national sample of nurses to inform workforce policies and prioritize interventions.

Methods

Multidimensional and unidimensional Rasch analyses of burnout data collected from a national convenience sample of 457 hospital nurses 9–12 months after Lebanon’s political and economic collapse began. The data were collected in July–October 2020.

Results

Multidimensional Rasch analysis confirmed that the Copenhagen Burnout Inventory has three highly correlated unidimensional scales that measure personal burnout, work-related burnout, and client-related burnout. Except for a ceiling effect of ~ 2%, the three scales have excellent measurement properties. For each scale, Rasch rating scale analysis confirmed five statistically different nurse burnout levels. The mean personal burnout scores and work-related burnout scores (50.24, 51.11 respectively) were not higher than those reported in the international literature. However, the mean client-related burnout score of 50.3 was higher than reported for other countries. Compared with a baseline study conducted at the beginning of Lebanon’s political and economic crises, only client-related burnout scores were higher p. <.01.

Conclusions

The CBI scales are reliable and valid measures for monitoring nurse burnout in crises torn countries. Stakeholders can use the CBI scales to monitor nurse burnout and prioritize burnout interventions. Urgent action is needed to reduce levels of client-related burnout in Lebanon’s nursing workforce.

Perceived stress and symptoms of post-traumatic stress disorder in nurses: A moderated mediation model of maladaptive cognitive emotional regulation and psychological capital

Nurses often face a variety of work-related and life-related stresses that make them more prone to symptoms of post-traumatic stress disorder (PTSD), yet the underlying mechanism of this association is poorly understood. To address this research gap, we investigated the mediating role of maladaptive cognitive emotion regulation strategies in the relationship between perceived stress and PTSD symptoms, and explored whether psychological capital could moderate the direct or indirect effects between perceived stress and PTSD symptoms. Nurses (N = 723) completed a questionnaire about perceived stress, PTSD symptoms, maladaptive cognitive emotion regulation strategies and psychological capital. After controlling for gender, age and work department, perceived stress was positively correlated with PTSD symptoms. Maladaptive cognitive emotion regulation strategies partially mediated this relationship. Psychological capital moderates the effects of perceived stress and maladaptive cognitive emotion regulation strategies on PTSD symptoms. Specifically, the positive correlation between perceived stress and PTSD symptoms was stronger among nurses with low levels of psychological capital than among nurses with high levels of psychological capital. At the same time, the positive correlation between maladaptive cognitive emotion regulation strategies and PTSD symptoms was stronger in nurses with a low level of psychological capital. Therefore, cognitive strategies and interventions oriented toward psychological capital may alleviate the PTSD symptoms of nurses in stressful situations.

Enfermagem na Atenção Primária à Saúde: associação entre liderança, capital psicológico e implicações no burnout

RESUMO Objetivos: verificar a associação entre liderança autêntica e síndrome de burnout em profissionais de enfermagem da Atenção Primária à Saúde e analisar a relação entre capital psicológico positivo e síndrome de burnout em profissionais de enfermagem liderados. Métodos: estudo de campo, descritivo-exploratório, transversal, de abordagem quantitativa, desenvolvido com a equipe de enfermagem, em Unidades Básicas de Saúde do município de São Paulo, com aplicação dos questionários sociodemográfico, Escala de Caracterização do Burnout, Authentic Leadership Questionnaire e Psychological Capital Questionnaire. Resultados: na percepção dos líderes, não houve evidências de associações significantes entre as escalas de burnout e liderança autêntica. Com relação aos liderados, observou-se associação negativa significante das dimensões da escala de burnout com as dimensões de liderança. Nas associações dos escores de burnout com escores do questionário de capital psicológico, observaram se evidências de associações negativas significantes. Conclusões: na enfermagem, o burnout está associado com liderança autêntica e capital psicológico.

Hospital nurses experiencing day-to-day workplace incivility: A diary study on the benefits of daily social support

AIM

The present study investigated the adverse effects of daily experienced incivility and the positive role of daily social support during the workday in predicting daily emotional exhaustion after work and vitality and positive affect at bedtime.

BACKGROUND

Despite the broad knowledge of the impact of experienced incivility in different occupations, little is known about day-to-day nurse incivility, much less in the hospital context.

METHOD

After completing a general questionnaire, hospital nurses (n = 96) completed a diary questionnaire twice a day for five consecutive workdays (n = 480 diary observations). The diary design had two levels: 5-day repeated measures (Level 1, day level) nested in persons (Level 2, person level) using an experience-sampling methodology.

RESULTS

Multilevel hierarchical analyses showed that incivility during the workday increased emotional exhaustion after work (t = 3.00, p = <0.05) and reduced vitality (t = -2.48, p = 0.05) and positive affect (t = -2.23, p = 0.05) at bedtime. However, daily social support during the workday was a crucial job resource that directly benefited hospital nurses' daily wellbeing (t = 5.19, p = 0.01 vitality; t = 4.89, p = 0.01 positive affect) and buffered the adverse effects of daily workplace incivility (t = -2.33, p = 0.05).

CONCLUSION

The within-person approach of our findings suggests that supportive practices can reduce day-to-day incivility spirals.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers can promote a civility culture within their units using in service training programmes at work.

Study on the Formation Mechanism of Medical and Health Organization Staff's Emergency Preparedness Behavioral Intention: From the Perspective of Psychological Capital

Medical and Health Organization (MHO) staff's emergency preparedness awareness and behaviors are essential variables that affect public health emergency response effectiveness. Based on the theory of psychological capital and the theory of planned behavior (TPB), this study discusses the mechanism of the psychological characteristics of MHO staff on their emergency preparedness behavioral intention (EPBI). To verify the research model, we conducted a web-based questionnaire survey among 243 MHO staff from China and analyzed the data using the structural equation modeling software, AMOS 24.0 (IBM, New York, United States). The empirical results reveal that psychological capital significantly affected cognitive processes theorized by TPB. This study suggests that the positive psychological capital of MHO staff should be developed and managed to improve their EPBI.