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

The Relationship Between Psychological Empowerment and Clinical Decision-Making Among Staff Nurses in Governmental Hospital in Al-Baha, Saudi Arabia

Background The Saudi Arabian government has published its 2030 vision for improving health care to meet worldwide standards for the nursing profession. To fulfill this vision, building large-scale healthcare facilities is necessary. Among the most common occupations, nursing is vital to health care systems. Although working in health care institutions is challenging, demanding, and comprehensive, they are created to save lives and enhance patient satisfaction. Therefore, health care organizations must seek to develop psychologically empowered and decision-making nurses who can help meet clients' demands and enhance patient care, safety, quality, and outcomes. This study aims to determine the association between psychological empowerment (PE) and clinical decision-making (CDM) among staff nurses. Methods This study employed a quantitative cross-sectional correlation design. Three Saudi Ministry of Health-affiliated hospitals in the Al-Baha region were included. The sample size was calculated using the Raosoft online sample size calculator, with a total of 318 participants. The study sample included nurses working in inpatient, outpatient, and critical care departments. Convenience sampling techniques with inclusion and exclusion criteria were employed. An online survey with three sections was used for data collection: sociodemographic characteristics, the psychological empowerment instrument, and the nursing decision-making instrument. Data collection began at the beginning of February 2023 and was completed by the beginning of April 2023. Results The participants were 318 nurses working in critical areas, inpatient, and outpatient departments at three governmental hospitals in the Al-Baha region. Overall, 285 participants (89.6%) had a high level of PE, and the majority, 263 participants (82.7%), exhibited flexible-oriented decision-making. Approximately three-quarters of the sample, 281 participants (88.4%), were female, and more than half of the staff nurses, 187 participants (58.8%), were married. The majority of participants, 250 (78.6%), had a bachelor's degree. Regarding professional experience, most staff nurses, 134 participants (42.1%), had between one and five years of experience, and the majority worked in inpatient units, 160 participants (50.3%), while 104 (32.7%) worked in critical care. Conclusion The current study found a significant association between nurses' PE and CDM. Nurses with the highest PE were the most flexible in their CDM. Moreover, the findings of this study offer some points that nurse managers and leaders can use to generate empowerment and make their staff better decision-makers. One recommendation is to develop training and coaching programs to enhance PE among staff nurses, thereby raising their work meaningfulness, which would reflect in better CDM. Additionally, this study recommends that future research be conducted to examine how PE affects CDM.

Burnout Syndrome Among Critical Care Health Providers in Saudi Arabia

Background

Burnout Syndrome constitutes a critical concern in healthcare, particularly among practitioners operating in high-stress, critical care settings. Understanding the multifaceted factors contributing to burnout in this context is pivotal for devising effective interventions and promoting the well-being of critical care professionals.

Objective

To investigate the prevalence, contributing factors, and potential interventions related to Burnout Syndrome among critical care health providers in Saudi Arabia.

Methods

A cross-sectional research design was employed, gathering data from a sample of critical care health providers, including medical practitioners. A self-administered structured electronic questionnaire was used, incorporating the Maslach Burnout Inventory (MBI) with its three subscales: emotional exhaustion, depersonalization, and personal accomplishment. The target population was male and female critical care health providers over 18 years age, most participants lies between 25 years to 34 years.

Results

Statistical analysis shows significant disparities in response distribution (p<0.05), highlighting the importance of understanding encounters with emotional exhaustion, personal accomplishment, and depersonalization. The Durbin-Watson statistic indicated limited autocorrelation, and collinearity tolerance values suggested nominal intercorrelations among predictors. A significant positive correlation was found between the "Depersonalization Loss of Empathy MBI" factor and the outcome variables, indicating complex relationships between emotional exhaustion, personal accomplishment, and depersonalization.

Conclusion

The study highlights the multifaceted nature of burnout, revealing intricate relationships between emotional exhaustion, personal accomplishment, and depersonalization. These findings collectively form an important foundation for future guidelines and interventions to enhance the well-being of healthcare professionals.

Psychometric evaluation of the Chinese version of the burnout syndrome assessment scale in nurses

Objective

This study aimed to translate the Burnout Syndrome Assessment Scale (BOSAS) into Chinese and validate its reliability and validity among Chinese emergency department and ICU nurses.

Methods

The scale was translated into Chinese using Brislin's translation principle. A total of 626 nurses from Jiangxi, Zhejiang, and Fujian provinces in China participated in an online questionnaire survey. The survey included the general information questionnaire for nurses developed by the research team and the Chinese version of the Burnout Syndrome Assessment Scale. Reliability and validity of the Chinese version of the scale were analyzed using SPSS.25 and AMOS.24 software.

Results

The Chinese version of the Burnout Syndrome Assessment Scale consists of a total of 20 items, encompassing two dimensions: personal burnout and job burnout. This structure is consistent with the original English version of the scale. The Chinese version of BOSAS demonstrated high internal consistency, with a Cronbach's α coefficient of 0.941. Additionally, the scale exhibited good split-half reliability (0.765) and test-retest reliability (0.871). The content validity index (S-CVI) was 0.971, indicating strong content validity. Exploratory factor analysis confirmed the same 2-factor structure as the original scale, and confirmatory factor analysis further validated this structure, with all fit indices indicating appropriateness.

Conclusion

The Burnout Syndrome Assessment Scale has been successfully introduced and its reliability and validity have been verified in Chinese emergency department and ICU nurses.

Predictors of Compassion Satisfaction, Compassion Fatigue, and Burnout Among Nursing Professionals in a Medical City in Saudi Arabia

Purpose

The present study aims to evaluate compassion satisfaction (CS), compassion fatigue (CF), and burnout levels in a population of nurses employed at medical city in Riyadh City, Saudi Arabia.

Patients and Methods

A self-report survey was employed to gather data from 300 nurses at the selected medical city in Riyadh. The survey incorporated a demographic inquiry along with the utilization of the Professional Quality of Life Scale version 5 (ProQOL 5). The ProQOL scale is one of the most widely used measures of CS, CF, and burnout. The ProQOL scale assesses multiple domains of work experiences (ie CS, CF, and burnout). This survey was disseminated through email channels, and it garnered participation from 177 nurses, culminating in a response rate of 59%.

Results

The study's findings reveal that nurses displayed average mean levels of CS, CF, and burnout. Interestingly, the participants aged 18-56 reported higher levels of burnout, particularly those in the age groups of 18-25, 26-35, and 36-56. Moreover, those with under 10 years' experience exhibited higher degrees of burnout and less CS compared to their more experienced counterparts. Additionally, nurses with professional qualifications demonstrated better scores on CS, CF, and burnout compared to those without such qualifications.

Conclusion

The experience of CF and CS among nurses appears to be influenced by multiple variables, such as length of experience, age, and professional qualifications. Nurses in certain age groups and with less experience are more prone to experiencing burnout, while having professional qualifications seems to protect against adverse outcomes to some extent.

Professional Quality of Life, Work-Related Stress, and Job Satisfaction among Nurses in Saudi Arabia: A Structural Equation Modelling Approach

Objective

To examine the interrelated impacts of work-related stress, compassion satisfaction (CS), and job satisfaction on burnout (BO) and secondary traumatic stress (STS) among nurses using structural equation modelling (SEM).

Methods

A cross-sectional design was used to survey 727 nurses at a teaching hospital in eastern Saudi Arabia. Three scales were used: the Quality of Life (ProQOL) scale, the Nursing Stress Scale (NSS), and the Job Satisfaction Survey (JSS). Data were analysed using SPSS and Analysis of Moment Structures (AMOS), and SEM analysis was conducted to confirm the interrelations among variables.

Results

The final model had a good fit for the obtained data (X ² = 2.726, RMSEA = 0.032). Stress is directly related to BO and STS, and the following variables were directly related to STS: job satisfaction, BO, and CS. Lastly, BO mediated the relationship between stress and STS.

Conclusion

It is crucial to analyze the effect of stress, CS, and job satisfaction which seems to have a positive and negative impact on nurses' BO and STS. Therefore, implementing a management strategy to manage stress and satisfaction can enhance nurses' quality of life, support the maintenance of positive attitudes, and enhance the standard of patient care.

Key determinates of job satisfaction for acute care nurse practitioners in Taiwan

BACKGROUND

Taiwan is a super-aged society, and the shortage of hospital doctors; nurse practitioners (NPs) became vital healthcare providers to fulfill the healthcare demands of the population. The purpose of this study was to explore the key determinates of job satisfaction for NPs in acute care practices using significant practice variables, such as empowerment and burnout.

METHODS

Participants of this descriptive survey study were recruited from a national sample of NPs with membership in the Taiwan Association of Nurse Practitioners. The data were collected utilizing an online questionnaire based on demographic and practice variables, the Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS), the Condition for Work Effectiveness Questionnaire II (CWEQ II), and the Copenhagen Burnout Inventory (CBI). A total of 1,211 NPs completed the online survey. A multiple regression model with the stepwise selection was used to explore job satisfaction.

RESULTS

The mean overall satisfaction score indicated that the level of satisfaction was between slightly dissatisfied and slightly satisfied. Regression results indicated that formal power, work-related burnout, access to information, and needed resources were critical components of job satisfaction, and accounted for 63% of the variance. Moreover, NPs who were married, had a higher annual salary, worked only during the day shift, and had lower patients-related burnout showed better job satisfaction.

CONCLUSIONS

This study provides evidence for healthcare organizations to formulate policies to strengthen NP job satisfaction. Empowerment and burnout are vital factors in NPs' job satisfaction. Healthcare organizations have an obligation to implement policies to empower NPs in practice and provide interventions to mitigate burnout. Implementing these changes will improve job satisfaction and with it the quality of patient care.

An Analysis of Burnout among Female Nurse Educators in Saudi Arabia Using K-Means Clustering

Nurse educators are often burnt out and suffer from depression due to their demanding job settings. Biochemical markers of burnout can provide insights into the physiological changes that lead to burnout and may help us prevent burnout symptoms. Research was conducted using a descriptive cross-sectional survey design and a multi-stage sampling method. The ministry of education website provides a list of Saudi Arabian nursing education programs that offer bachelor of science in nursing programs (BSN). The study consisted of 299 qualified participants. Malsach Burnout Inventory (MBI) was used to measure burnout as the dependent variable. The MBI is a 22-item scale that measures depersonalization, accomplishment, and emotional exhaustion during work. Bootstrapping with 5000 replicas was used to address potential non-normality. During this framework, four deep neural networks are created. They all have the same number of layers but differ in the number of neurons they have in the hidden layers. The number of female nurse educators experiencing burnout is moderate (mean = 1.92 ± 0.63). Burnout is also moderately observed in terms of emotional exhaustion (mean = 2.13 ± 0.63), depersonalization (mean = 2.12 ± 0.50), and personal achievement scores (mean = 12 2.38 ± 1.13). It has been shown that stacking the clusters at the end of a column increases their accuracy, which can be considered an important feature when classifying.

Psychological Empowerment of Nurses Working in Pediatric Units in Saudi Arabia

Background: This study investigated the psychological empowerment (PE) of nurses in pediatric units and examined the significant difference between the level of PE and the personal work profiles of nurses working in pediatric units in Saudi Arabia. Methods: A quantitative descriptive study design was employed between May and July 2020 using a self-administered electronic survey that collected personal work profile data and applied the Psychological Empowerment Scale. The data were analyzed using SPSS 22.0 software for descriptive statistics, t-tests, and ANOVA. Results: Most of the study participants (69.6%) were non-Saudi nurses, and 71.9% worked in specialized areas. The mean PE score of the four dimensions across the 12 items was high. The mean score for the dimension meaning was the highest, whereas the lowest mean score was for the dimension self-determination. Nurses from different nationalities had significantly different PE levels. Conclusions: Expatriate nurses were more psychologically empowered. The findings will be of interest to all who wish to attract and retain local nurses by fostering PE in the work environment and involving nurses in decision-making processes, thus enabling them to act as leaders for increased work motivation.

Documentation Burden in Nursing and Its Role in Clinician Burnout Syndrome

OBJECTIVES

The purpose of this study is to understand the relationship between documentation burden and clinician burnout syndrome in nurses working in direct patient care. The Office of the National Coordinator considers documentation burden a high priority problem. However, the presence of documentation burden in nurses working in direct patient care is not well known. Furthermore, the presence of documentation burden has not been linked to the development of clinician burnout syndrome.

METHODS

This paper reports that the results of a cross-sectional survey study comprised of three tools: (1) The burden of documentation for nurses and mid-wives survey, (2) the system usability scale, and (3) Maslach's burnout inventory for medical professionals.

RESULTS

Documentation burden has a weak to moderate correlation to clinician burnout syndrome. Furthermore, poor usability of the electronic health record (EHR) is also associated with documentation burden and clinician burnout syndrome.

CONCLUSION

This study suggests that there is a relationship between documentation burden and clinician burnout syndrome. The correlation of poor usability and domains of clinician burnout syndrome implies the need for more work on improving the usability of EHR for nursing documentation. Further study regarding the presence of documentation burden and its correlation to clinician burnout syndrome should focus on specific areas of nursing to understand the drivers of documentation burden variation within and across specialty domains.

Attitudes and job satisfaction of intensive care nurses regarding their caregiver roles

Objective: This study was conducted to evaluate the attitudes and job satisfaction of intensive care nurses towards their caregiver roles. Methods: The descriptive study was completed between 28 August 2021 and 28 October 2021 with 200 intensive care nurses. "Nurse Introductory Information Form", "Nurses' Attitudes towards Caregiver Roles" and "Nurse Job Satisfaction Scale" were used as data collection forms. Data were collected online in electronic form (Google Forms). Data analysis was done in SPSS 25.0 package program. A p

"Burnout syndrome and association with work stress in nursing staff in public hospital of the northern border of Mexico"

Currently in Mexico, there is a lack of published research assessing nursing burnout in a consistent manner. The pressure of having to provide quality care to low income patients can be a serious factor triggering work stress in the nursing professional. The aim of this study was to establish the connection between burnout, work stress and both demographic and labor factors in nursing staff. A sample of 424 nurses participated in the descriptive and cross-sectional study. Each of the participants answered a questionnaire with two validated instruments, the Maslach Burnout Inventory-Human Services Survey and the Nursing Stress Scale, both in their Spanish version, as well as a demographic and labor survey of the authors' own creation. A bivariate logistic regression analysis was used to determine any significant association between the variables. We found a prevalence of 65.09% in mid-level burnout syndrome among the female sex. Men, on the other hand, featured a high level of emotional exhaustion and depersonalization, whereas the female sex showed significantly lower levels of depersonalization. Most of the staff showed acute stress levels. Some factors found in the potential development of burnout were work shift, position, department and gender.

The influence of mobile phone addiction and work procrastination on burnout among newly graduated Chinese nurses

PURPOSE

The study was conducted to explore the relationship between mobile phone addiction, work procrastination, and burnout among newly graduated nurses.

DESIGN AND METHODS

A cross-sectional survey involving 220 newly graduated nurses in China was conducted from June to July 2020.

FINDINGS

Approximately 60.9% of newly graduated nurses experienced occupational burnout; 72.7% of newly graduated nurses were characterized by moderate or greater procrastination and mobile phone addiction was at a moderate level. Mobile phone addiction and work procrastination were significant factors leading to emotional exhaustion and cynicism. Work procrastination was also an independent predictor of reduced professional efficacy.

PRACTICE IMPLICATIONS

Reducing the level of mobile phone addiction and work procrastination among newly graduated nurses might be effective for burnout prevention.

Nurses' job satisfaction assessment by areas of care

OBJECTIVE

To analyze the level of nurses' job satisfaction according to the area of care provided in a Local Health Unit, in Portugal.

METHOD

This is a quantitative, descriptive, analytical study, with observational and cross-sectional design. The Job Satisfaction Assessment Instrument was used for data collection.

RESULTS

Sample (n = 218), predominantly female (84.6%), with a mean age of 33 years. The area of care delivery influences total job satisfaction (p < 0.05) and some of the dimensions studied (p < 0.05). Nurses from Community Care Units show greater job satisfaction, followed by nurses from Indirect Care. Critical Care nurses show lower job satisfaction, followed by those who work in outpatient's units. Most nurses show lower satisfaction level in the aspect Management Bodies and in the dimension Quality of Care Delivery.

CONCLUSION

The most satisfied nurses are those from the Community Care Units and the nurses with the lowest level of job satisfaction are those from Critical Care.

Burnout and job satisfaction among critical care nurses in Saudi Arabia and their contributing factors: A scoping review

AIM

Nurses working in highly demanding areas, such as intensive care units, are more likely to experience burnout and low job satisfaction than nurses working in less demanding areas. This review aims to assess the degree of well-being of nurses working in critical care settings in Saudi Arabia by evaluating their levels of burnout and job satisfaction, as well as the factors that contribute to them.

DESIGN

A scoping review.

METHOD

Seven databases were searched for published research that examined the levels and factors of burnout and job satisfaction in intensive care units nurses in the Kingdom of Saudi Arabia, as well as literature in which terminology other than "burnout" or terms related to burnout (such as "stress," "compassion fatigue" and "moral distress") were used that were conducted within Saudi Arabia. Data extraction and synthesis were performed by one reviewer and verified by a second reviewer. The present review was undertaken between January 2020 and December 2020.

RESULTS

Eleven studies related to burnout and job satisfaction, and their contributing factors were identified. Evidence from this review indicated that intensive care units nurses in Saudi Arabia are suffering from moderate to high levels of burnout while experiencing only moderate levels of job satisfaction. Three categories of factors were found to be associated with burnout and nursing job satisfaction: intrapersonal, interpersonal and extra-personal factors. The review highlights important findings for policy and nursing practice that can inform future studies and the development of burnout management strategies.

Nurse Motivation, Engagement and Well-Being before an Electronic Medical Record System Implementation: A Mixed Methods Study

Implementation of an electronic medical record (EMR) is a significant workplace event for nurses in hospitals. Understanding nurses' key concerns can inform EMR implementation and ongoing optimisation strategies to increase the likelihood of nurses remaining in the nursing workforce. This concurrent mixed-methods study included surveys from 540 nurses (response rate 15.5%), and interviews with 63 nurses to examine their perceptions of using a new EMR prior to implementation at a single healthcare organisation. Survey findings revealed 32.2% (n = 174) of nurses reported low well-being scores and 28.7% (n = 155) were experiencing burnout symptoms. In contrast, 40.3% (n = 216) of nurses reported high work satisfaction, 62.3% (n = 334) had high intentions of staying in their role, and 34.3% (n = 185) were engaged in their work. Nearly half (n = 250, 46.3%) reported intrinsic motivation towards EMR use. Thematic analysis of focus group interviews revealed two themes, each with three subthemes: (1) Us and Them, detailed the juxtaposition between nurses' professional role and anticipated changes imposed on them and their work with the EMR implementation; and (2) Stuck in the middle, revealed nurses' expectations and anticipations about how the EMR may affect the quality of nurse-patient relationships. In conclusion, anticipation of the EMR implementation emerged as a stressor for nursing staff, with some groups of nurses particularly vulnerable to negative consequences to their well-being.

Psychometric properties of Copenhagen Burnout Inventory among nurses

Worldwide, nurses have been reporting high levels of burnout. Given the high prevalence of nurse burnout, measurements of burnout need to be carefully considered for their validity and reliability. Our research team used a relatively new instrument to measure burnout among nurses: the Copenhagen Burnout Inventory (CBI). This 19-item instrument measures burnout in three dimensions: Personal, Work-related, and Client-related Burnout. However, the psychometric properties of the CBI have not been examined in nurses. Thus, the purpose of this study was to determine the psychometric properties of the CBI in a state-wide survey of inpatient staff nurses. A total of 928 registered nurses working in Alabama-area hospitals (N = 42 hospitals) participated in this study. Confirmatory factor analysis resulted in an adequate fit to the data and supported construct validity. As evidence of convergent validity, the CBI was moderately to highly correlated with measures of the overall work environment, job satisfaction, and intent to leave, in the anticipated directions. The Cronbach's alphas for Personal Burnout, Work-related Burnout, and Client-related Burnout were 0.91, 0.89, and 0.92, respectively, demonstrating excellent internal consistency reliability for the subscales. Based on our data, the CBI demonstrates adequate validity and reliability for measuring burnout among frontline nurses. As nurses provide care to the most vulnerable patients in healthcare systems, their psychological well-being is important due to the impact on quality of care on patient outcomes. The availability of the CBI on its website allows nurses, nurse managers, and researchers to evaluate burnout in a variety of nursing populations with no licensing costs.

Relationships between workload perception, burnout, and intent to leave among medical-surgical nurses

AIM

These are turbulent times for hospitals, patients, and nurses. Nurse turnover is a global issue across all specialties but are exacerbated in medical-surgical areas where high nurse-patient ratios, use of point-of-care technologies, and stressful working conditions require sufficient numbers of highly trained nurses. These workload factors are further exaggerated by the current nursing shortage. The current nursing shortage crisis makes nursing job conditions more important than ever to examine. Despite heavy emphasis on promoting healthy work environments, job satisfaction, and retention of nurses working in intensive care and emergency room settings, limited research is available about the workload perception, burnout, and intent to leave among medical-surgical nurses. This study aimed to describe the relationships between workload perception, burnout, and intent to leave among medical-surgical nurses at two teaching hospitals in Southeastern United States.

METHODS

A survey design and convenience sampling method was used. A sample of 58 medical-surgical staff nurses participated in the study. A 42-item questionnaire composed of a demographic survey, Individual Workload Perception Scale, and Maslach Burnout Inventory Scale were used. Simple descriptive statistics, Pearson's product-moment correlations, and multiple regression analysis procedures were used to analyze the data.

RESULTS

More than half of the respondents reported high workloads and intentions to leave their current position. The overall burnout level for the sample was moderate to high. Moderate-to-strong intercorrelations were found between workload perception and intent to leave (r = 0.513, P < 0.0001), burnout and intent to leave (r = -0.435, P < 0.0006), and workload perception and burnout (r = -0.588, P < 0.0001). Workload perception and burnout among medical-surgical nurses both factored significantly on the intent to leave a current job (P < 0.05).

CONCLUSION

The current study provides new insights about the relationships between workload perception, burnout, and intent to leave among medical-surgical nurses. The findings indicate the higher the nurses' workload perception, the more likely they will leave their current job. Nurse managers should consider these findings when developing strategies to improve the work environment and nurse retention. Additional research is needed to gain more insight into the causality among workload perception, burnout, and intent to leave a current job among medical-surgical nurses.

Perceived Stress and Life Satisfaction Among Chinese Clinical Nursing Teachers: A Moderated Mediation Model of Burnout and Emotion Regulation

Our previous study indicated that clinical teaching nurses in China suffered high levels of perceived stress and burnout, mainly because they were taking double responsibilities of nursing and teaching at the same time. The study aimed to investigate the underlying mechanisms of how and when perceived stress increased the risk of burnout and decreased life satisfaction among clinical teaching nurses. Questionnaires about perceived stress, burnout, emotion regulation, and life satisfaction were self-administered to 1,372 teaching nurses from eight tertiary military hospitals in China. Correlation and hierarchical multiple regressions were employed for data analysis. The results revealed that perceived stress had direct and indirect impacts on life satisfaction, with the principal element of burnout-emotional exhaustion-acting as a mediator. Moreover, the association between perceived stress and emotional exhaustion was moderated by emotion suppression-a key emotion regulation strategy. The negative impact of perceived stress on burnout was stronger among teaching nurses with high emotion suppression than among those with low emotion suppression. The present study contributed to a deeper understanding of the relationship between perceived stress and life satisfaction and also suggested further research into emotion regulation interventions to alleviate or eliminate the impact of perceived stress on burnout and eventually improve the life satisfaction for Chinese clinical nursing teachers.

Care erosion in sedation assessment: A prospective comparison of usual care Richmond Agitation-Sedation Scale assessment with protocolized assessment for medical intensive care unit patients

OBJECTIVES

To determine concordance between an explicit protocolized assessment of the Richmond Agitation-Sedation Scale and an assessment performed during usual care nursing practice.

RESEARCH DESIGN

In an urban, safety-net hospital, intensive care nurses previously trained in sedation assessment recorded a bedside Richmond Agitation-Sedation Scale assessment, while study investigators used an explicit script to perform the assessment at a similar time point. Kappa indices determined concordance of the assessments. Bivariate analyses explored factors associated with discordance and unresponsiveness.

RESULTS

Twenty-one subjects with 38 observations were analysed. Bedside nursing assessment was poorly concordant with protocolized assessment (ƙ = 0.21) with the former reporting significantly lighter sedation (median -2 vs. -5, p = .01). Bedside assessment was significantly less likely than protocolized assessment to categorize subjects as unresponsive (29 vs. 50%, p = .02).

CONCLUSION

Methods used in usual clinical practice to assess adequacy of sedation frequently led to oversedation. We propose that care erosion, the deterioration of skills over time, may help explain this finding.

IMPLICATIONS FOR NURSING MANAGEMENT

Results suggest sedation assessment may be particularly vulnerable to care erosion. Nurse managers should monitor for signs of care erosion and consider utilization of explicit scripts during sedation assessment and/or frequent education to ensure sedation assessment accuracy.

Nurses' job satisfaction during the mass gathering of the Hajj 2018 in Saudi Arabia

AIM

To explore job satisfaction of nurses during the Hajj season 2018 in Saudi Arabia, determine predictors of nurses' job satisfaction and inform future healthcare provision and policy.

BACKGROUND

Mass gatherings of large numbers of people inevitably pose unique public health concerns and challenges for organizers. A mass gathering happens annually in Saudi Arabia during the Hajj pilgrimage. There was a paucity of evidence regarding nurses' experiences during Hajj. This gap in knowledge needed to be addressed.

METHODS

A cross-sectional survey was conducted in 198 nurses across 12 healthcare settings along the Hajj pilgrimage route. A 24-item Nurses' Job Satisfaction Questionnaire was developed exploring six domains: supervision, nature of work, retention, communication, workload and co-workers.

RESULTS

Nurses reported a high level of job satisfaction. All six domains were strong predictors of job satisfaction. Nurses reported the lowest level of job satisfaction when assessed against the items 'multiple policies and procedures that were perceived as complicating nursing work', 'incompetence of other people they work with' and 'too much burden at work'.

CONCLUSION

Job satisfaction levels for nurses during Hajj 2018 appeared higher than during previous Hajj pilgrimages, probably influenced by the additional healthcare measures put in place during Hajj 2018, such as improved technology.

IMPLICATIONS FOR NURSING POLICY AND PRACTICE

Hajj-specific skills training must be designed to enhance the knowledge, competencies and capabilities of nurses. Policies and procedures must prevent heavy workloads and avoid complicating nurses' work during Hajj. Improvements to the nurse work environment should focus on evidence-based interventions promoting effective resource planning, interprofessional relationships and communication, for instance via innovative, technological approaches. These findings can be shared with organizers of other mass gatherings worldwide.

Analysis of nurses' job burnout and coping strategies in hemodialysis centers

In recent years, nursing has come to be considered a high-risk and high-pressure profession, given the fast-paced working environment and constant need to handle emergencies, especially for nurses working in hemodialysis centers. Nearly every day, nurses are confronted with life and death situations and are required to provide skilled, high quality care for their patients, in fast-paced and demanding environments. Thus, nurses are susceptible to both psychological stress and other mental health problems, making them more vulnerable to burnout when compared against other healthcare professions.An anonymous online questionnaire was completed by a group of participating nurses, using the web-based survey platform WeChat. Registered nurses working in hemodialysis centers were randomly selected from 5 comprehensive tertiary level hospitals in Sichuan Province, China. The data collection instrument comprised two parts: demographic data and a nurse burnout questionnaire-the Maslach Burnout Inventory. Overall, 70 nurses were invited to participate, with 65 returning completed questionnaires, giving a response rate of 92.9%. In this survey, the burnout level was set at28.15 ± 12.39 for emotional exhaustion (EE), 10.23 ± 5.47 for depersonalization (DP), and 37.19 ± 8.31 for personal accomplishment (PA)-EE and DP levels are found to be high at the level of burnout.Job burnout was found to exist widely among the nurses of hemodialysis centers, which may then result in adverse effects on their physical and mental health. Active interventions can significantly reduce job burnout and also help maintain the stability of nursing workforce levels.

Burnout and imposter syndrome among Saudi young adults. The strings in the puppet show of psychological morbidity

OBJECTIVES

To determine the prevalence of imposter syndrome (IS) among Saudi adults and its association with burnout.

METHODS

Using non-probability convenience sampling, we carried out a cross-sectional analytical study among adults in Northern Saudi Arabia. Data collection toll was a self-administered questionnaire containing young imposter scale (YIS), Maslach burnout inventory (MBI) and depression, anxiety, and stress scale 21 (DASS 21). These 3 scales are valid and reliable measurement tools for measuring IS, burnout, and psychological morbidity.

RESULTS

In the study sample (n=384), imposterism was present among 222 adults (57.8%). Moderate and severe symptoms of depression were present in 217 (56.5%), symptoms of stress in 210 (54.7%), and symptoms of anxiety in 126 (32.8%). Burnout was measured in 3 domains of depersonalization, emotion exhaustion, and personal accomplishments. High degree of depersonalization was found in 221 (57.6%), higher emotional exhaustion in 246 (64.1%) while lower personal accomplishment was present in 126 (32.8%). We found statistical association between IS and gender (p less than 0.01), depression (p less than 0.001) stress (p less than 0.001) and all 3 domains of burnout (p less than 0.01). Imposter syndrome was not found associated with anxiety (p=0.97). Young imposter scale score was associated with all the 3 domains of burnout even after controlling for depression, anxiety, and stress.

CONCLUSION

Imposter syndrome is frequent among Saudi adults and associated with all 3 burnout domains. Mental health domains like burnout, depression, stress, and anxiety were found associated with IS.

Burnout among healthcare providers in the complex environment of the Middle East: a systematic review

BACKGROUND

Burnout is a syndrome characterized by emotional exhaustion, increased depersonalization, and a diminished sense of personal accomplishment due to chronic emotional stress at work. Burnout impacts job satisfaction, job performance, vulnerability to illnesses, and interpersonal relationships. There is a gap in the systematic data on the burden of burnout among healthcare professionals from different sectors of healthcare in Middle Eastern countries. Our objective was to examine the burden of burnout among healthcare providers in the Middle East, how it was assessed, which sectors were included, and what interventions have been used.

METHODS

Articles were found through a systematic review of search results including PubMed, Web of Science (Thomson Reuters), and PsycINFO (EBSCO) using search terms reflecting burnout in Middle Eastern countries among populations of healthcare providers. Studies were included if they examined a quantitative measure of burnout among healthcare providers in the Middle East.

RESULTS

There were 138 articles that met our inclusion criteria for this systematic review. Studies focused on burnout in the Middle East among physicians (N = 54 articles), nurses (N = 55), combined populations of healthcare workers (N = 22), and medical students (N = 7). The Maslach Burnout Inventory was the most common tool to measure burnout. Burnout is common among physicians, nurses, and other healthcare professionals, with prevalence estimates predominantly ranging between 40 and 60%. Burnout among healthcare providers in the Middle East is associated with characteristics of their work environments, exposure to violence and terror, and emotional distress and low social support.

CONCLUSIONS

Burnout is highly prevalent among healthcare providers across countries in the Middle East. Previous studies examining burnout in this region have limitations in their methodology. More thoroughly developed epidemiologic studies of burnout are necessary. Health system strengthening is needed in a region that has endured years of ongoing conflict, and there is an urgency to design and implement programs that tackle burnout among health professionals.

Job satisfaction of the nursing team in intensive care units

Objective:

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

Method:

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

Results:

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

Conclusion:

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

Emotional Intelligence, Self-Efficacy and Empathy as Predictors of Overall Self-Esteem in Nursing by Years of Experience

Empirical research on self-esteem has a special interest in nursing professionals, because they work in a challenging environment that requires, in order to continue working during their working age, a strong physical, social and emotional involvement. The objective was to determine the explanatory value of individual variables such as Self-efficacy, Empathy and Emotional Intelligence on Self-esteem in a sample of nursing professionals, to identify which variables have the most explanatory value for overall self-esteem with years of experience. The study sample consisted of a total of 1,601 Spanish nurses aged 22–60, with a mean age of 31.19 (SD = 6.59) years. The emotional intelligence factors in all cases were observed to have positive correlations with overall self-esteem. Mood was still the predictor with the most explanatory weight in all the groups. General Self-Efficacy disappeared in the model of professionals with the most experience. Organizations and management nursing should implement intervention programs that promote wellbeing and satisfaction in workers during their working age. It would be of interest to train nursing professionals in such necessary competences as Empathy, Emotional Intelligence and Self-Efficacy.

Nurse Burnout Revisited: A Comparison of Computational Methods

BACKGROUND AND PURPOSE

To examine computational measures of job-related burnout to determine the best computation to estimate job satisfaction and intent to leave in Brazilian nursing professionals.

METHODS

Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used assess burnout in 452 hospital-based nursing professionals. Adjusted logistic regression models were fit using different computations of burnout to estimate outcomes of interest.

RESULTS

Total mean score of burnout subscales was the best estimate of job satisfaction (Cox-Snell R² = 0.312; Nagelkerke R² = 0.450) and intent to leave (Cox-Snell R² = 0.156; Nagelkerke R² = 0.300), as was high emotional exhaustion (Cox-Snell R² = 0.219; Nagelkerke R² = 0.316).

CONCLUSION

We have provided evidence that different computations of data from the Portuguese (Brazil) MBI-HSS can be used in to estimate the effect of job-related burnout on nurse outcomes.

Analysis of the Mediating Role of Self-Efficacy and Self-Esteem on the Effect of Workload on Burnout's Influence on Nurses' Plans to Work Longer

At the present time, we know that there is a positive relationship between self-efficacy and self-esteem in which positive beliefs about one’s own efficacy increase one’s sense of self-worth as stressful situations of a heavy workload are coped with successfully, and this, in turn, affects the nurses’ plans to work longer. Analyze the mediating role of self-efficacy and self-esteem in the effect of workload, measured as the number of users attended to during a workday, on burnout in nursing professionals. A sample of 1307 nurses aged 22 to 60 years who were administered the Brief Burnout Questionnaire, the General Self-Efficacy Scale, and the Rosenberg Self-Esteem Scale, and workload, measured as the number of users attended to during the workday. The results show that professionals with high levels of self-efficacy also scored higher on global self-esteem. Burnout correlated negatively with both variables (self-efficacy and self-esteem). Three clusters were found with the variables (self-efficacy, self-esteem, and workload) showing significant differences in burnout scores among clusters. Self-efficacy and self-esteem function as buffers of the negative effects of workload on burnout. Organizations should design interventions for promoting the personal resources of their workers through training activities and organizational resources (e.g., redesigning job positions) to promote satisfaction and wellbeing of employees, making their stay at work greater.

The effects of absenteeism on nurses remaining on duty at a tertiary hospital of Limpopo province

BACKGROUND

 Absenteeism is a global problem in the working force and this is no exception in the nursing profession. Much attention has been drawn to factors that contribute to absenteeism; however, little attention has been placed on the effects of absenteeism on nurses remaining on duty by their colleagues. Nurses absent themselves leaving behind their colleagues to execute their part of work.

OBJECTIVES

 To investigate the effects of absenteeism on nurses who remained on duty at a tertiary hospital in Limpopo province.

METHOD

 A quantitative descriptive research approach was chosen to enable the researchers to achieve the research aim. Data collected using structured questionnaires were analysed by descriptive statistics.

RESULTS

 The findings indicated that absenteeism has an effect on both the nurses' psychological and professional well-being, as well as the quality of patient care provided as a result of psychological stress, low morale of nurses and increased workload. The study further revealed the provision of substandard care to patients by those nurses who are remaining on duty, resulting in risk of medical errors that could jeopardise their professional credibility. Therefore, absenteeism creates an unhealthy working environment for nurses remaining on duty.

CONCLUSION

 Nurse managers should provide platforms to address psychological and professional problems experienced by nurses remaining on duty. The study further recommends the introduction of policies that would address absenteeism in the workplace and how nurses who remain on duty could be assisted with the workload of colleagues who continuously absent themselves.

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

INTRODUCTION

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

OBJECTIVES

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

REVIEW METHODS

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

DATA SOURCES

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

RESULTS

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

CONCLUSION

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

Prevalence of and factors associated with burnout among health care professionals in Arab countries: a systematic review

BACKGROUND

Burnout among healthcare professionals is one of the key challenges affecting health care practice and quality of care. This systematic review aims to (1) estimate the prevalence of burnout among health care professionals (HCP) in Arab countries; and (2) explore individual and work-related factors associated with burnout in this population.

METHODS

Multiple electronic databases were searched for studies published in English or Arabic from January 1980 to November 2014 assessing burnout (using the Maslach Burnout Inventory; MBI) amongst health care professionals (HCP) in Arab countries.

RESULTS

Nineteen studies (N = 4108; 49.3% females) conducted on HCP in Bahrain, Egypt, Jordan, Lebanon, Palestine, Saudi Arabia and Yemen were included in this review. There was a wide range of prevalence estimates for the three MBI subscales, high Emotional Exhaustion (20.0-81.0%), high Depersonalization (9.2-80.0%), and low Personal Accomplishment (13.3-85.8%). Gender, nationality, service duration, working hours, and shift patterns were all significantly associated with burnout.

CONCLUSIONS

Within the constraints of the study and the range of quality papers available, our review revealed moderate-to-high estimates of self-reported burnout among HCP in Arab countries that are similar to prevalence estimates in non-Arabic speaking westernized developed countries. In order to develop culturally appropriate interventions, further research using longitudinal designs is needed to confirm the risk factors for burnout in specific HCP settings and specialties in Arab countries.