Job burnout and its influencing factors among newly graduated nurses: A cross-sectional study

Factors associated with chronotype, job burnout, and perceived stress among nurses in Chinese tertiary hospitals: A multicenter cross-sectional study

Shift work is a recognized work pattern for nurses worldwide. The disruption of shift workers' biological clocks usually leads to sleep disorders and affects their awareness at work. Eveningness and occupational stress might be effective in causing burnout syndrome. Therefore, this study aimed to evaluate the chronotype, job burnout and perceived stress among Chinese tertiary hospital nurses, and understand the predictors of circadian rhythm in this group. Between July and September 2020, 23 hospitals were randomly selected from 113 tertiary hospitals in Hunan Province. Twenty-five percent of the nurses working in each hospital were targeted for selection. 28.1% and 17.6% of nurses reported eveningness type and morningness type, respectively. The scores for emotional exhaustion, depersonalization, and perceived stress of eveningness nurses were higher than those of morningness counterparts. Eveningness nurses also reported a lower sense of personal accomplishment. Risk factors of eveningness included being under 30 years old, never exercising, having the stressors of late-night shifts and career development, higher levels of emotional exhaustion, sleep latency, sleep duration, and hypnotic use. Shifts may be unavoidable for nurses, nevertheless, understanding the predictors and related factors of chronotype for nurses is necessary for nursing educators and managers to develop a reasonable shift system and appropriate measures to assist nurses in adjusting their work.

The effect of perceived organizational justice on workplace deviant behavior of new nurses: the role of emotional labor and psychological capital

BACKGROUND

New nurses are prone to workplace deviant behavior in the constrained hospital environment, which will not only directly affect the safety of patients, but also reduce the work efficiency of nurses and bring negative results to the hospital. The purpose of this study was to investigate the relationship between perceived organizational justice, emotional labor, psychological capital, and workplace deviant behavior of new nurses.

METHODS

A cross-sectional study was used in this study. A survey was conducted in 5 hospitals in Henan Province, Chain from February to April 2023. The sample size was 546. The questionnaire included general information, perceived organizational justice scale, emotional labor scale, psychological capital scale, and workplace deviant behavior scale. SPSS 26.0 and PROCESS Macro were used for data analysis. PROCESS Model 4 and Model 14 were used to verify the model.

RESULTS

This study displays that perceived organizational justice was negatively correlated with emotional labor and workplace deviant behavior, and emotional labor was positively correlated with workplace deviant behavior. Meanwhile, emotional labor plays a partial mediating role between perceived organizational justice and workplace deviant behavior, accounting for 32.7% of the total effect. Moreover, the path of emotional labor on workplace deviant behavior is moderated by psychological capital.

CONCLUSION

This study further understood the workplace deviant behavior of new nurses, and provided a new perspective for solving this problem. Nurse managers can reduce workplace deviant behavior by enhancing the perceived organizational justice and psychological capital of new nurses and improving emotional labor.

Gaining acceptance, insight and ability to act: A process evaluation of a preventive stress intervention as part of a transition-to-practice programme for newly graduated nurses

AIM

To investigate how NGNs perceived and applied an intervention for preventing stress-related ill health embedded in a transition-to-practice programme when entering their professional life.

DESIGN

A qualitative exploratory descriptive design was selected for this study to gain insights and perspectives on the adoption and utilization of the intervention.

METHODS

In this qualitative methodology process evaluation, semi-structured and audio-recorded interviews were conducted with a sample of 49 nurses. Data were collected between December 2016 and July 2017, and were sorted in NVivo 12 Plus, followed by thematic analysis.

RESULTS

The analysis resulted in three change processes stimulated by the intervention: (a) Building acceptance of being new; (b) Gaining insight into professional development and health and (c) Practical steps for skills development, healthy habits and better-organized work. In addition to the three themes, barriers that hindered the progression of the processes were also described. Each process influenced the development of the others by stimulating a deeper understanding, motivation to change and courage to act. Several barriers were identified, including the use of cognitively demanding intervention tools, fatigue, high work demands, inconvenient work hours and a hostile social climate on the ward.

CONCLUSION

This process evaluation showed that newly graduated nurses used knowledge from the intervention and adopted new behaviours largely in accordance with how the intervention was intended to work.

IMPACT

When entering a new profession, it is crucial to receive a well-thought-out, structured and targeted introduction to the new professional role, tasks and work group. Nurses stated that the intervention increased their understanding of the role as new nurses and their insight into how to develop skills that promoted better functioning and recovery. The intervention also stimulated the development of new health behaviour and some new learning strategies.

"Discovering shine through feedback seeking"---feedback seeking among new graduate nurses: a qualitative study

BACKGROUND

Feedback is critical to improving practitioners' clinical practice and professional growth. Although they are still considered junior practitioners, their feedback-seeking experiences have yet to be investigated. This study aimed to understand the fundamental thoughts and experiences of new graduate nurses regarding feedback-seeking and to identify the main factors that influence their feedback-seeking behaviors.

METHODS

Conducting a descriptive phenomenological study, semi-structured in-depth interviews with newly graduated nurses from four hospitals in Zhejiang Province, China, face-to-face or via video call in the hospital conference room through purposive and snowball sampling. Interview data were evaluated using Colaizzi's 7-step phenomenological data analysis. The COREQ checklist was followed.

RESULTS

A total of 15 new graduate nurses were interviewed as a sample, and 13 categories emerged from our data. They were categorized into four central elements: (1) perceptions and attitudes, (2) drivers, (3) dilemmas and needs, and (4) transformation and growth.

CONCLUSIONS

This study found that new graduate nurses have various needs but face dilemmas in the feedback-seeking process. Nursing managers should be proficient at providing positive leadership, collaborating with clinical mentors to foster an atmosphere where new graduate nurses may obtain honest, transparent, and fair feedback, and exercising caution when providing negative feedback.

Job burnout among primary healthcare workers during COVID-19 pandemic: cross-sectional study in China

Objective

This study evaluated job burnout among primary healthcare workers (PHCWs) in China during the COVID-19 pandemic, explored its influencing factors, and examined PHCWs' preferences for reducing job burnout.

Method

We conducted a multicenter cross-sectional study in Heilongjiang, Sichuan, Anhui, Gansu, and Shandong Provinces. An electronic questionnaire survey was conducted through convenience sampling in communities from May to July 2022. We collected sociodemographic characteristics, job burnout level, job satisfaction, and preferred ways to reduce job burnout among PHCWs.

Results

The job burnout rate among PHCWs in China was 59.87% (937/1565). Scores for each dimension of job burnout were lower among PHCWs who had a better work environment (emotional exhaustion OR: 0.60; depersonalization OR: 0.73; personal accomplishment OR: 0.76) and higher professional pride (emotional exhaustion OR: 0.63; depersonalization OR: 0.70; personal accomplishment OR: 0.44). PHCWs with higher work intensity (emotional exhaustion OR: 2.37; depersonalization OR: 1.34; personal accomplishment OR: 1.19) had higher scores in all job burnout dimensions. Improving work environments and raising salaries were the preferred ways for PHCWs to reduce job burnout.

Conclusion

Strategies should be developed to improve job satisfaction among PHCWs, enhance their professional identity, and alleviate burnout to ensure the effective operation of the healthcare system, especially during periods of overwork.

Secondary traumatic stress and posttraumatic growth in newly graduated nurses: the mediating role of compassion satisfaction

BACKGROUND

Nurses' secondary traumatic stress, compassion satisfaction and posttraumatic growth are closely related, but for newly graduated nurses, there are few reports to evaluate the specific path between these three. The aim of this study was to investigate examine the mediating role of compassion satisfaction in secondary traumatic stress and posttraumatic growth among newly graduated nurses.

METHODS

From March 2021 to May 2021, a total of 330 newly graduated nurses from five tertiary hospitals in China were enrolled, and asked to complete questionnaires regarding secondary traumatic stress, compassion satisfaction and posttraumatic growth. Descriptive statistics, independent-samples T-test, one-way analysis of variance (ANOVA), Pearson correlation analysis and structural equation model were used in this study. A STROBE checklist was used to report findings.

RESULTS

The scores of secondary traumatic stress, compassion satisfaction and posttraumatic growth of newly graduated nurses were 27.11 ± 4.94 (score range: 10-50), 31.89 ± 6.22 (score range: 10-50) and 56.47 ± 20.41 (score range: 0-100), respectively. Additionally, structural equation modeling showed that compassion satisfaction mediated the relationship between secondary traumatic stress and posttraumatic growth with the partial mediating effect of 0.089.

CONCLUSIONS

Newly graduated nurses may experience moderate secondary traumatic stress, but their posttraumatic growth is at a low level, and compassion satisfaction significantly affects the relationship between the two. Nursing managers should strengthen psychological evaluation, and promote their posttraumatic growth by improving their level of compassion satisfaction.

Burnout and impostor phenomenon in nursing and newly licensed registered nurses: A scoping review

AIMS AND OBJECTIVE

To identify the prevalence and severity of impostor phenomenon and burnout in newly licensed registered nurses, map the current literature on impostor phenomenon in nursing, and identify related factors affecting the new nurse's transition to practice.

BACKGROUND

Impostor phenomenon is an internalised intellectual phoniness resulting in persistent self-doubt despite prior success. It can evoke feelings of emotional exhaustion associated with burnout, negatively affecting employee retention. Due to changes in nursing education resulting from COVID-19, self-doubt and uncertainty among new nurses are expected to be heightened, leading to burnout which adversely effects nurse well-being, patient care and retention.

DESIGN

The scoping review follows the methodological framework developed by Arksey and O'Malley (2005) and the Reporting Checklist for Scoping Reviews (PRISMA-ScR) guidelines.

METHODS

The literature search was conducted utilising PubMed, CINAHL and PsycINFO. Inclusion criteria were studies published between 2011 and 2021, written in English, peer-reviewed, and focused on newly licensed registered nurses. Eighteen articles were reviewed.

RESULTS

Studies on impostor phenomenon in nursing are limited to nursing students and clinical nurse specialists. Prevalence of impostor feelings in these populations range from 36% to 75%, and 12.3% to 46% of new nurses report burnout. Impostor feelings arise from role ambiguity, lack of self-compassion, transitions, and minimal clinical experience. Burnout was associated with stress, feeling unprepared, inadequate socialisation, and lack of self-compassion. Overlap in these factors could increase impostor feelings and burnout in new nurses.

CONCLUSIONS

Effects of impostor phenomenon and burnout can negatively impact the well-being of the new nurse. Currently, no studies simultaneously examine impostor phenomenon and burnout in new nurses. Further research on the relationship between these phenomena should be conducted.

RELEVANCE TO CLINICAL PRACTICE

Understanding the impact of impostor phenomenon and burnout on new nurses could help mitigate challenges they face transitioning into practice.

Mental health status of mental health nurses in China: Results from a national survey

INTRODUCTION

It has been acknowledged in China that actions should be taken immediately to ease the critical shortage of psychiatric nurses. However, with national data lacking, little is known about nurses' mental health status.

AIM

To evaluate psychiatric nurses' mental health status by measuring their burnout, depression, anxiety and stress.

METHODS

All psychiatric nurses in the 41 selected hospitals in China were invited to participate in the survey. The Maslach Burnout Inventory-Human Service Survey and Depression Anxiety Stress Scale were used to assess variables of interest.

RESULTS

38.6% of psychiatric nurses met the criteria for burnout. The rates of depression, anxiety and stress were 26.3%, 36.4% and 12.5%, respectively. It was found that workplace region, educational level, working years, longer working hours and night shifts were associated with risk of burnout and DASS.

CONCLUSIONS

More than a quarter of psychiatric nurses are suffering from burnout, depression or anxiety in China. Policymakers and hospital administrators should design a flexible schedule and restrict working hours for psychiatric nurses to achieve work-life balance.

IMPLICATIONS FOR PRACTICE

The study informs policymakers and administrators on addressing the nursing shortage by identifying nurses immersed in negative emotions and preventing mental health problems.

Associations of job satisfaction and burnout with psychological distress among Chinese nurses

Nurses' mental health is related to the quality of medical care and the outcome of treatment, and has become an important issue in nursing management. However, the role of burnout in the relationship between job satisfaction and psychological distress have not been evaluated. This study aimed to examine the prevalence of psychological distress among Chinese nurses and explore the associations of job satisfaction and burnout with psychological distress. A cross-sectional survey of 866 nurses was conducted in Qiqihar City, Heilongjiang Province of China. Job satisfaction, burnout, and psychological distress were assessed via the single-item, the Maslach Burnout Inventory-Human Services Survey, and the 12-item General Health Questionnaire respectively, followed by a mediation analysis through the multiple regression analysis and a PROCESS macro method. The prevalence of psychological distress was 35.2% among the participants. After controlling the potential confounding factors, job satisfaction and burnout were found to be still associated with psychological distress (P < 0.001). Furthermore, psychological distress was negatively correlated with both job satisfaction (r = -0.312) and personal accomplishment (r = -0.422) but positively correlated with both emotional exhaustion (r = 0.491) and depersonalization (r = 0.449). Burnout may mediate the association between job satisfaction and psychological distress (B = 0.139, β = 0.440, P < 0.001 for emotional exhaustion; B = 0.226, β = 0.382, P < 0.001 for depersonalization; and B = -0.105, β = -0.368, P < 0.001 for personal accomplishment). The mental health status of Chinese nurses remains to be improved. Low job satisfaction and burnout could increase the risk of psychological distress among Chinese nurses. Moreover, job satisfaction may partially affect psychological distress among Chinese nurses through emotional exhaustion, personal accomplishment, and depersonalization.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-04006-w.

Factors to predict the knowledge, attitude and practice of nursing interruptions among nurses: A nationwide cross-sectional survey

AIM

To identify the knowledge, attitude and practice of nursing interruptions and related factors among nurses in China.

BACKGROUND

Nursing interruptions are extremely common and have introduced major security risks and harm to hospitalized patients. However, nursing interruptions' factors are not well known.

DESIGN

A nationwide cross-sectional descriptive survey.

METHODS

A multistratified random sampling method was used to obtain nurses from five provinces in China. We collected data by online questionnaires (the Knowledge, Attitude and Practice Questionnaire of Nursing Interruptions, the Chinese Revised Safety Attitude Questionnaire and the Coping Adaptation Processing Scale). We used the Mann-Whitney test, the Kruskal-Wallis test, Spearman's linear correlation analysis and multiple linear stepwise regression to analyze the data. A STROBE checklist was used to report the results.

RESULTS

Of the 14500 questionnaires distributed, 14302 (98.6 %) were returned. The mean score was 79.69 (SD 17.73) and the level was medium. Having attended nursing interruptions training and attended nursing safety training, safety attitude, coping ability and position were positive factors, while age and marital status were negative factors (F=1068.226, p < 0.001, R² =0.374, adjusted R² =0.373).

CONCLUSIONS

Chinese nurses expressed a moderate level of knowledge, attitude and practice of nursing interruptions. Safety attitude, having attended nursing interruptions training, coping ability, having attended nursing safety training, position, age and marital status were predictors.

RELEVANCE TO CLINICAL PRACTICE

Nursing managers should pay attention to the influencing factors of clinical nurses' knowledge, attitude and practice of nursing interruptions and take effective individualized training for clinical nurses with different ages, positions and marital status to improve their coping ability, so as to ensure nursing safety and improve nursing quality.

Registered nurses' perceptions of having a calling to nursing: A mixed‐method study

Aim

To explore how nurses perceived having a calling to nursing.

Design

A mixed‐method study.

Methods

Survey data collected in autumn 2020 and semi‐structured individual interview data collected in spring 2021. The 7925 survey respondents were care professionals and 414 of them were registered nurses. The 23 interview participants were registered nurses who responded to the survey. We examined the survey results using analysis of variance and t‐tests and the interview data with qualitative thematic analysis.

Results

Registered nurses had a lower calling than other care professionals. Based on the interviews, having a calling to nursing produce four key findings. Nurses with a calling experienced their work as meaningful. They also adopted a humane and holistic approach to their work. However, their calling could change during their professional career. Due to its historical roots, having a calling was seen as a risk for the nursing profession, as it meant nurses had an oppressed position in society and nurses associated it with poor working conditions and low pay.

Conclusion

Our study showed that having a calling to nursing had multidimensional benefits for the individual nurse, their patient, colleagues, organization and society, but showed strong association between calling and nurses' poor working conditions and low pay.

Impact

We found that nurses had a lower calling than other care professionals. Calling still exists, but it can produce tension in modern nursing. Organizations and society need to focus on how calling can be seen as a more positive attribute of nursing and improve nurses' working conditions and pay.

Are human resource managers with good listening competency more likely to avoid job burnout?

BACKGROUND

Listening is an important responsibilities of human resource managers, whether it will bring role stress to human resource managers, or lead to the risk of job burnout. This study aims to analyze the impact of listening competency on job burnout among human resource managers, and examine the mediating effect of role stress.

METHODS

This study adopted a cross-sectional method to randomly select 500 human resource managers from China's top ten human resource management cities to conduct an online questionnaire survey, and 232 valid samples were obtained. Descriptive statistical and one-way ANOVA were used to explore the status of job burnout among human resource managers in China. Correlation analysis, multiple linear regression and mediating effect analysis were employed to test the relationship between listening competency and job burnout, as well as the mediating effect of role stress.

RESULTS

(1) 34.5% of the respondents reported mild burnout, while 3.0% respondents showed serious burnout. Emotional exhaustion was the most serious. (2) Those are good at listening could easily avoid job burnout. Among them, listening skills were conducive to reducing the degree of depersonalization of human resource managers, and empathy was more conducive to improving their personal sense of accomplishment. (3) The role stress had a significant mediating role in the relationship between listening competency and job burnout. Which means that listening competency can avoid job burnout by reducing role stress of human resource managers.

CONCLUSIONS

This study revealed the current situation of job burnout among human resource managers in China, and explored the influence of listening competency on job burnout. This study enriched the research content of job burnout, and provided references for preventing and intervening job burnout of human resource managers.

Growth and challenges of China's nursing workforce from 1998 to 2018: A retrospective data analysis

BACKGROUND

Nurses play a vitally important role in promoting equitable and essential care. China undertook bold reforms in its education and healthcare systems since 1990s. The effect of these reforms on the nursing workforce has not been assessed systematically.

OBJECTIVE

This study aims to assess the changing trends and the underlying challenges of the nursing workforce in Mainland China in the period of 1998-2018.

DESIGN

Retrospective data analysis.

METHODS

Data were acquired from the National Health Statistics Yearbook from 1999 to 2019. Descriptive statistics were used to analyze the nature of the nursing workforce in terms of quantity, quality, and structure. Non-parametric tests were used to compare doctors and nurses in terms of number and work experiences. Global Moran's I index and hotspot analysis were applied to compare the equity in distribution of nurses at national and provincial levels.

RESULTS

From 1998 to 2018, the number of nurses increased from 1.22 to 4.10 million with an average rate of increase of 6.3% per annum. The ratio of doctors to nurses changed from 1: 0.61 to 1: 1.14, reaching 1: 1 in 2013. The main educational level of registered nurses elevated to associated degree (48.9%), and nurses with advanced titles increased at the most rapid rate. In 2018, 60.3% of nurses were younger than 35 years old. The Global Moran's I index ranged from 0.211 to 0.198 (Z > 1.96, P < 0.05). Hotspot analysis showed the distribution of nurses was unequally concentrated in the northern region and with the highest distribution in Beijing.

CONCLUSIONS

Great improvement on the scale and the quality of nursing workforce over the past 20 years has been witnessed in China. However, the shortage of nurses, outflow of younger nurses and the imbalance distribution of nursing workforce among the country are emerging challenges. Plans should not be ignored on continuously cultivating more qualified nurses, retaining younger nurses, attracting nurses to work in rural areas and the northeast region. Tweetable abstract: Numbers of Chinese nurses finally outstrip the number of doctors but do limited educational opportunities limits their contribution to the nation's health? New article in @ijnsjournal.

Relationships of organisational justice, psychological capital and professional identity with job burnout among Chinese nurses: A cross-sectional study

AIMS AND OBJECTIVES

The present study was aimed at describing the status of job burnout and exploring the mediating roles of psychological capital and professional identity on the association between organisational justice and job burnout.

BACKGROUND

With the shortage of nurses all over the world, nurses' job burnout has become the focus of studies in recent years. However, limited published research has examined the mediating roles of psychological capital and professional identity on the association between organisational justice and job burnout within hospital contexts in China.

DESIGN

A cross-sectional design.

METHODS

A total of 1,009 nurses were enrolled from a major general hospital located in Qiqihar City in the northeast of China from March-July 2018, and asked to complete questionnaires regarding organisational justice, psychological capital, professional identity and job burnout. The STROBE checklist was adhered to in this study.

RESULTS

It was observed that the overall proportion of nurses with job burnout was 58.8%. All the correlations among organisational justice, psychological capital, professional identity and job burnout were statistically significant, with coefficients ranging between -0.487-0.863. Psychological capital and professional identity had indirect effects equal to -0.072 and -0.142, respectively, on the association between organisational justice and job burnout, taking up 13.7% and 26.9% of the total effect, respectively. The serial indirect effect of psychological capital and professional identity was -0.129, accounting for 24.5% of the total effect.

CONCLUSIONS

This study showed the necessity of addressing the status of job burnout among Chinese nurses. Psychological capital and professional identity may mediate the linkage between organisational justice and job burnout independently and accumulatively.

RELEVANCE TO CLINICAL PRACTICE

Nursing managers should strengthen organisational justice and improve the psychological capital and professional identity of nurses through effective strategies to prevent the job burnout of nurses.