Fatigue in new registered nurses: A 12‐month cross‐lagged analysis of its association with work motivation, engagement, sickness absence and turnover intention

Psychological detachment from work during nonwork time as a moderator and mediator of the relationship of workload with fatigue and sleep in hospital nurses

OBJECTIVES

To examine differences in psychological detachment from work during nonwork time by nurses' personal and work-related characteristics, and to examine the moderating and mediating effects of psychological detachment on the relationships between nursing workload and fatigue and sleep.

METHODS

This study employed a cross-sectional design with a self-administered online survey. Survey data from 827 hospital nurses providing direct patient care in the United States were used. Moderating and mediating effects of psychological detachment between workload and fatigue/sleep relationships were assessed using Hayes' PROCESS macro in SPSS.

RESULTS

There were significant differences in psychological detachment from work based on age, highest nursing degree, work experience, shift length, weekly work hours, and frequency of providing care to patients with COVID-19. The associations of workload with physical fatigue, mental fatigue, and sleep quality were weakened when psychological detachment was high. Psychological detachment statistically mediated the associations between workload and fatigue and sleep problems.

CONCLUSION

Healthcare organizations are encouraged to facilitate nurses' psychological detachment during time-off to protect them from fatigue and sleep problems.

Investigating the relationship between nurses' workplace behaviour and perceived levels of ethical leadership in managers

BACKGROUND

There is increasing research interest in the relationship between ethical leadership and deviant workplace behaviour. Ethical leadership encompasses altruism, courage, ethical orientation, integrity and fairness. Examples of deviant workplace behaviours include theft, fraud, sabotage, assault, abuse, manipulation and bullying. It appears that when leaders are fair and emphasise ethical conduct, followers are less inclined to engage in deviant workplace behaviour.

AIM

To investigate the relationship between nurses' self-rated levels of deviant workplace behaviour and perceived levels of ethical leadership in managers.

METHOD

For this descriptive correlational study, 355 nurses from one university hospital in Egypt responded to an online questionnaire comprising the Ethical Leadership Scale and the Workplace Deviance Behavior Scale. Descriptive and inferential statistics were used to explore results and examine the relationships between study variables.

RESULTS

There was a statistically significant negative relationship between respondents' self-rated levels of deviant workplace behaviour and their perceptions of levels of ethical leadership in managers. The results appeared to confirm previous research. Nurses who feel that they are treated fairly by their managers tend to have positive attitudes towards work, colleagues and management.

CONCLUSION

Ethical leadership on the part of managers is a significant determinant of nurses' behaviour in the workplace and should therefore be fostered by healthcare organisations.

Occupational fatigue, compassion competence and caring behaviours of intensive care nurses: A structural equation modelling approach

BACKGROUND

No previous study has examined the direct effect of occupational fatigue, inter-shift recovery and compassion competence on caring behaviours, including assurance, knowledge-skill, respect and commitment in intensive care nurses.

AIM

We studied the direct effect of participating nurses' occupational fatigue, inter-shift recovery and compassion competence levels on their caring behaviours and the relationship among these variables.

STUDY DESIGN

This was a descriptive correlational study. All nurses who were registered members of the Turkish Intensive Care Nurses Association were invited to participate in this online survey. This study was conducted with 315 intensive care nurses using convenience sampling between April and July 2022. The data were collected using the Occupational Fatigue Exhaustion/Recovery Scale, which consists of three subscales: acute fatigue, chronic fatigue and inter-shift recovery; the Compassion Competence Scale, including communication, sensitivity and insight subscales; and the Caring Behaviours Inventory-24. In addition, a structural equation model was established using variables correlating with caring behaviours. Independent variables were occupational fatigue, inter-ship recovery and compassion competence; and the dependent variable was caring behaviours in this hypothesized model.

RESULTS

Three hundred and fifteen nurses completed the survey (315/1000) with a response rate of 31.5%. The increase in the inter-shift recovery levels of participants was statistically and positively associated with caring behaviours (95% confidence interval [CI]: 0.001-0.011, β = .154 [moderate effect size], p < .05). The sub-dimensions of the Compassion Competence Scale, that is, communication (95% CI: 0.110-0.443, β = .251 [moderate effect size]) and sensitivity (95% CI: 0.084-0.427, β = .241 [moderate effect size]), were statistically and positively associated with the caring behaviours of participants (p < .05). In addition, independent variables accounted for 35% (large effect size) of the total change in caring behaviours (R2 = 0.350).

CONCLUSIONS

This study suggests that the high inter-shift recovery and compassion competence levels of intensive care nurses are positively associated with their caring behaviours.

RELEVANCE TO CLINICAL PRACTICE

Nursing managers should consider the direct effect of occupational fatigue, inter-shift recovery and the compassion competence levels of intensive care nurses on their caring behaviours to provide high-quality care.

Assessment of the effectiveness of the BOPPPS model combined with case-based learning on nursing residency education for newly recruited nurses in China: a mixed methods study

BACKGROUND

Expanding new nurse training and education is a priority for nursing educators as well as a critical initiative to stabilize the nursing workforce. Given that there is currently no standardized program for the training of new nurses in China, we investigated the effectiveness of the bridge-in, objective, pre-assessment, participatory learning, post-assessment, and summary model combined with case-based learning ((BOPPPS-CBL) for the standardized training of new nurses.

METHODS

The mixed method approach with explanatory sequential (quantitative-qualitative) method was used. A questionnaire was used to compare the impact of the BOPPPS-CBL model and the Traditional Learning Model (TLM) on the core competencies of 185 new nurses for two years of standardized training. Quantitative data were analyzed using SPSS 22.0. Focus group interviews were used with four groups of new nurses and perceptions of BOPPPS-CBL training were recorded. Qualitative data were analyzed thematically.

RESULTS

According to the quantitative data, more new nurses agreed that the BOPPPS-CBL model stimulated their learning and improved their core nursing competencies than the TLM. The BOPPPS-CBL group outperformed the TLM group on theoretical knowledge tests. Qualitative data revealed that 87.5% of new nurses agreed on the value of BOPPPS-CBL training, and three themes were extracted: (1) role promotion; (2) formation of new thinking to solve clinical problems; and (3) suggestions for improvement.

CONCLUSION

BOPPPS-CBL training had a significant impact on improving new nurses' core competencies and promoting the transition of new nurses to clinical practice nurses in China. The study recommends BOPPPS-CBL training as an effective teaching model for the standardized training and education of new nurses.

Utility of salivary cortisol profile as a predictive biomarker in nurses' turnover risk: a preliminary study

BACKGROUND

Predicting nurse turnover risk is crucial due to the global nursing shortage; however, existing predictors, such as fatigue and burnout, lack objectivity. Salivary cortisol is a non-invasive marker of stress and fatigue, but its utility in predicting nurse turnover risk is unknown. We examined whether salivary cortisol profiles across three different day shifts in a month are predictors of the extent of nurses' reluctance to stay in their current jobs.

METHODS

This preliminary longitudinal study followed forty female nurses who engaged in shift work at a university hospital for 3 months. Data at enrollment were collected including demographics, working conditions, chronic fatigue (the Japanese version of the Occupational Fatigue/Exhaustion Recovery Scale), and burnout (Japanese Burnout scale). Salivary cortisol was measured before the three different day shifts (after awakening) during the first month, and the means of these measurements were used as the cortisol profile. The extent of reluctance to stay was assessed using the numerical rating scale at 3 months.

RESULTS

Among the forty female nurses (mean [SD] age, 28.3 [5.1]), all completed follow-up and were included in the analysis. The cortisol profile was associated with the extent of reluctance to stay (P = 0.017), and this association was significant despite adjustments for chronic fatigue and burnout (P = 0.005). A multiple regression model with chronic fatigue, burnout, and job tenure explained 41.5% of the variation in reluctance to stay. When the cortisol profile was added to this model, the association of the cortisol profile was significant (P = 0.006) with an R2 of 0.529 (ΔR2 = 0.114).

CONCLUSIONS

This preliminary study conducted in an actual clinical setting indicated the potential of the salivary cortisol profile across three different day shifts in a month to predict nurses' reluctance to stay in their current jobs. The combination of subjective indicators and the cortisol profile would be useful in predicting nurses' turnover risk.

Relationship between nurses' perception of professional shared governance and their career motivation: A cross-sectional study

Objectives

This study aimed to investigate the level of professional shared governance and career motivation and their relationship among nurses in Egypt.

Methods

A cross-sectional survey was conducted. A total of 724 nurses working in inpatient medical, surgical, and critical care units in Alexandria Main University Hospital were recruited from May to August 2022. The Index of Professional Nursing Governance (IPNG) version 3.0 and the Career Motivation Scale were used for evaluation.

Results

The IPNG version 3.0 total score was 109.18 ± 22.76, that nurses perceived had a low level of professional shared governance; the access to information dimension achieved the highest average mean score (2.81 ± 0.76), followed by the ability to set goals and conflict resolution dimension (2.75 ± 0.53). On the other hand, the dimension of participation in the committee structure achieved the lowest average mean score (1.65 ± 0.37). The total score of career motivation was 69.82 ± 9.70 this reflects that nurses perceived a moderate level of career motivation. The career insight dimension achieved the highest average mean score (3.56 ± 0.34), while the career resilience dimension achieved the lowest average mean score (3.07 ± 0.49). Male nurses, less than 30 years old, had a bachelor's degree in nursing sciences, and worked in the ICU had higher total scores of the IPNG and career motivation (P < 0.001). There was a positive correlation between the IPNG version 3.0 score and the Career Motivation Scale score (r = 0.239, P = 0.003).

Conclusions

The study's findings can serve as a theoretical foundation for nursing managers to re-plan the management model and develop appropriate methods to give better career planning for nurses.

The relation between routines for shiftwork scheduling and sickness absence at a Norwegian hospital: A cross-sectional study

BACKGROUND

Shift work is associated with negative health outcomes. Routines for scheduling of shift work can help reduce negative health outcomes of shift work and improve work-life balance and social well-being for nurses working shift work.

OBJECTIVE

To investigate the association between organizational units' routines for shift work scheduling and nurses' sickness absence at the unit level.

DESIGN

Cross-sectional study design combining quantitative questionnaire data on shift work scheduling routines with data of mean percentage of sickness absence at the unit, mean level of exhaustion at the unit, mean age and percentage of women working at the unit.

PARTICIPANTS

A total of 126 leaders at organizational units with nurses working shift work schedule at Oslo University Hospital answered a questionnaire about shift work scheduling.

MEASURES

Three aspects of health-promoting shift work scheduling (fatigue-reducing scheduling, organizational health measures, and individual adaptation) and the extent to which operational considerations were made during shift work scheduling were used as independent variables. Covariates were mean age of nurses at each unit, mean percent female nurses, and mean exhaustion at unit level. Percent sickness absence was used as a dependent variable.

METHODS

Questionnaire data on shift work scheduling routines was merged with information on average age of employees in the unit, ratio female nurses, and units' average score on exhaustion. Multivariable linear regression analyses were used to assess the contribution of routines for shift work scheduling after controlling for mean level of exhaustion, average age, and proportion of women at each unit.

RESULTS

The factors "fatigue reducing scheduling", "organizational health measures" and "operational considerations" had no observed total effect on mean sickness absence. Individual adjustment in shift work scheduling had a direct negative association with sickness absence after controlling for other shift work scheduling routines, exhaustion, age, and gender.

CONCLUSIONS

There is a relationship between the units' routines for shift work scheduling and mean sickness absence at the unit, and the possibility of individual adjustment was the only aspect of shift work scheduling that had an above-zero association with sickness absence.

The Effect of Work Engagement and Perceived Organizational Support on Turnover Intention among Nurses: A Meta-Analysis Based on the Price–Mueller Model

Aim. To elaborate on the relationship between work engagement, perceived organizational support, and the turnover intention of nurses by analysing some potential moderators. Background. Nurses’ turnover intention is negatively impacted by their level of work engagement and perceptions of organizational support. However, it is challenging to reach a consistent conclusion. Methods. Data were acquired from six electronic databases. Each study was evaluated using the quality assessment tool for cross-sectional studies of the Agency for Healthcare Research and Quality (AHRQ). STATA 15.0 was used to analyse the data, and a random effects model was used. The groups that included two or more studies were added to the moderator analysis. Results. A total of 40 study articles involving 23,451 participants were included. The turnover intention of nurses was inversely associated with work engagement (coefficient: −0.42) and perceived organizational support (coefficient: −0.32). A substantial moderating role was played by cultural background, economic status, working years, and investigation time ( $P<0.05$ ). Conclusion. Work engagement and organizational support significantly reduced turnover intention among nurses. Considering the acute shortage of nurses worldwide, nurses with lower wages, fewer working years, and lower levels of work engagement should be given more attention and support from their organizations. Implications for Nursing Management. The meta-analysis suggested that managers should give their employees a more organizational support and promote their work engagement to motivate nurses’ retention intention and maintain a stable workforce with little employee turnover.

A Longitudinal Study of the Impact of Personal and Professional Resources on Nurses' Work Engagement: A Comparison of Early-Career and Mid-Later-Career Nurses

To predict and ensure a healthy and high-performing nursing workforce, it is necessary to identify the antecedents that promote work engagement, especially among early-career nurses. To date no study has focused on this. This longitudinal survey, administered to 1204 nurses working in seven general hospitals with 200 or more beds in four prefectures in Japan at two different times in 2019, aims to examine the causal relationship between the personal and professional resources for nurses to work vigorously (PPR-N) and work engagement among nurses in the early stages of their careers, considering time as a key mediating factor. The analysis of structural equation modeling using the cross-lagged effect model supported that PPR-N had significant and positive effects on work engagement after 3 months among early-career nurses with less than 10 years of nursing experience. The PPR-N is a reliable antecedent of work engagement, which is typical of early-career nurses. These results may be provided guidance for managers in overseeing the work environment to ensure a thriving sustainable nursing workforce.

On the global and specific nature of psychological need satisfaction and work motivation in predicting employees' wellbeing: a self-determination theory perspective

Using data from 708 French-Canadian nurses, the present study relies on self-determination theory (SDT) and its proposed motivation mediation model to examine the associations between need satisfaction, work motivation, and various manifestations of psychological wellbeing (work satisfaction, emotional exhaustion, and turnover intentions). To increase the precision and accuracy of these analyses, we relied on analytic approaches that explicitly account for the dual global/specific nature of both work motivation and need satisfaction. Results revealed that nurses' global psychological need satisfaction, and their specific autonomy and competence satisfaction, were positively associated with their global self-determined work motivation and specific intrinsic motivation. In turn, global self-determined work motivation and specific intrinsic motivation were associated with more desirable outcome levels. Nurses' global need satisfaction and specific autonomy satisfaction were also directly associated with more desirable outcome levels. Our results provided support for a partially mediated version of SDT's motivation mediation model.

Relationship between Psychological Ownership of the Nursing Profession and Turnover Intention: A Correlational Survey among Taiwanese Nurses

AIMS

To examine the relationship between psychological ownership of the nursing profession and turnover intention.

BACKGROUND

There is a severe shortage of nurses worldwide. Research is needed to understand how nurses' intention to leave hospitals and the nursing profession can be alleviated.

METHODS

This study adopted a cross-sectional design and a survey method. Proportionate random sampling was used to ensure sample representativeness. This study surveyed 430 registered nurses in a medical center in Taiwan between December 2021 and January 2022. We used Turnover Scale and Self-Efficacy Scale, and developed Having a Place Scale.

RESULTS

Psychological ownership comprises three dimensions: self-efficacy, nurse identity, and "having a place" in the nursing profession. This research is the first to examine how these three dimensions of psychological ownership of the nursing profession are related to the intention to leave a hospital or the nursing profession. Self-efficacy and "having a place" are negatively related to nurses' intention to leave a hospital (r=-.23 and -.31, p<.001). Nurse identity is negatively related to nurses' intention to leave the nursing profession (r=-.38, p<.001). Intention to leave a hospital is positively related to nurses' intention to leave the profession (r=.76, p<.001).

CONCLUSION

The findings provide novel insights for retaining nurses. Nurse managers could use strategies such as including nurses in making workplace decisions and encouraging them to personalize their workspace. Implications for Nursing Management Nurse managers can enhance nurses' self-efficacy and sense of "having a place" to retain nurses in hospitals, while enhance nurse identity to retain nurses in the profession.

Going the Extra Mile (or Not): A Moderated Mediation Analysis of Job Resources, Abusive Leadership, Autonomous Motivation, and Extra-Role Performance

Abusive leadership is particularly prevalent in nursing and it can have multiple adverse effects on performance at work. However, little research has examined whether and under what conditions abusive leadership may be detrimental to nurses’ extra-role performance. This cross-sectional study explores whether abusive leadership intensifies the effects of emotional job resources on autonomous motivation, a psychological mechanism that could be responsible for extra-role performance. Data were collected from dyads of registered French-Canadian nurses and their immediate supervisors (n = 99 dyads). The models were tested with path analysis using Mplus. Our results show that extra-role performance is positively associated with nurses’ job emotional resources and autonomous motivation, but negatively associated with abusive leadership. Nurses’ cynicism is also negatively associated with autonomous motivation. Importantly, the indirect relation between emotional resources and extra-role performance through autonomous motivation is moderated by abusive leadership, providing support for a moderated mediation effect. These results add to those supporting a similar moderated mediation mechanism to explain employee attitudes and demonstrate the relevance of self-determination theory in a work context. These findings reinforce the need to focus on the quality of leadership practices as well as interventions aimed at promoting the performance of nurses at work.

Occupational fatigue, individualized nursing care, and quality of nursing care among hospital nurses

PURPOSE

This study aimed to evaluate the relationships among nurse fatigue, individualized nursing care, and nurse-reported quality of care.

DESIGN

The study used a cross-sectional design. Data from 858 registered nurses providing bedside care in hospitals were collected between March and April 2021 in the United States.

METHODS

Participants completed a self-administered online survey, including the Occupational Fatigue Exhaustion Recovery scale, the Individualized Care Scale-Nurse version, and a single item assessing nursing care quality. Relationships among the study variables were examined using multiple linear and logistic regression models.

FINDINGS

Nurses' higher levels of acute fatigue were significantly associated with decreased perceptions of individualized nursing activities provided to patients on their last shifts, specifically related to personal life condition and decision-making control. Nurses' higher levels of chronic fatigue were significantly associated with decreased perception of individualized nursing activities provided to patients on their last shifts related to clinical condition, personal life condition, and decision-making control. Nurses with higher levels of acute or chronic fatigue, and who perceived their nursing care activities as less individualized were less likely to assess their quality of care as excellent.

CONCLUSION

These findings suggest that addressing hospital nurses' acute and chronic fatigue may contribute to promoting the delivery of individualized nursing care and in improving patients' quality of care.

CLINICAL RELEVANCE

Healthcare institutions are encouraged to regularly monitor and manage nurse fatigue to improve the delivery of individualized and quality nursing care to their patients.

The influence of workplace incivility on the fatigue of female nurses:the mediating effect of engagement

AIMS

To identify the associations of workplace incivility, engagement and fatigue among Chinese female nurses, and further explore whether engagement can play a mediating role.

BACKGROUND

Nurses are at a high risk of fatigue. However, no research has been done to examine the associations among nurses' workplace incivility, engagement and fatigue.

METHODS

The cross-sectional study was conducted in Jiangsu Province, China. Self-administered questionnaires were distributed to 1,200 female nurses, including The Fatigue Scale, Workplace Incivility Scale, Gallup Workplace Questionnaire and demographic variables. Valid responses were obtained from 1,035 (86.3%) of participants. Hierarchical multiple regression analysis was performed to examine the associations among workplace incivility, engagement and fatigue.

RESULTS

The mean fatigue score was 6.54±3.07. Workplace incivility and engagement were related to fatigue (P<0.01). Engagement partly mediated the association between workplace incivility and fatigue (a*b =0.086, bias-corrected 95% CI: 0.059, 0.116; P<0.01), and the proportion of the mediating effect accounted for by engagement was 33.0%.

CONCLUSION

Chinese female nurses suffered from high level of fatigue. The improvement of female nurses' engagement may be helpful to alleviate the impact of workplace incivility on fatigue.

IMPLICATIONS FOR NURSING MANAGEMENT

Managers should reduce workplace incivility of female nurses by promoting engagement to reduce fatigue.

Subtypes of nurses' mental workload and interaction patterns with fatigue and work engagement during coronavirus disease 2019 (COVID-19) outbreak: A latent class analysis

BACKGROUND

Nurses play critical roles when providing health care in high-risk situations, such as during the COVID-19 outbreak. However, no previous study had systematically assessed nurses' mental workloads and its interaction patterns with fatigue, work engagement and COVID-19 exposure risk.

METHODS

A cross-sectional study was conducted via online questionnaire. The NASA Task Load Index, Fatigue Scale-14, and Utrecht Work Engagement Scale were used to assess nurses' mental workload, fatigue and work engagement, respectively. A total of 1337 valid questionnaires were received and analyzed. Nurses were categorized into different subgroups of mental workload via latent class analysis (LCA). Cross-sectional comparisons, analysis of covariance (ANCOVA), and multivariate (or logistic) regression were subsequently performed to examine how demographic variables, fatigue and work engagement differ among nurses belonging to different subgroups.

RESULTS

Three latent classes were identified based on the responses to mental workload assessment: Class 1 - low workload perception & high self-evaluation group (n = 41, 3.1%); Class 2 - medium workload perception & medium self-evaluation group (n = 455, 34.0%); and Class 3 - high workload perception & low self-evaluation group (n = 841, `62.9%). Nurses belonging into class 3 were most likely to be older and have longer professional years, and displayed higher scores of fatigue and work engagement compared with the other latent classes (p < 0.05). Multivariate analysis showed that high cognitive workload increased subjective fatigue, and mental workload may be positively associated with work engagement. Group comparison results indicated that COVID-19 exposure contributed to significantly higher mental workload levels.

CONCLUSIONS

The complex scenario for the care of patients with infectious diseases, especially during an epidemic, raises the need for improved consideration of nurses' perceived workload, as well as their physical fatigue, work engagement and personal safety when working in public health emergencies.

Workplace violence and turnover intentions among nurses: The moderating roles of invulnerability and organisational Support - A cross-sectional study

AIMS AND OBJECTIVES

To investigate whether internal and external violence are associated with turnover intentions among nurses during demanding periods of work.

BACKGROUND

Workplace violence can negatively impact upon mental and physical health and turnover intentions. Research focusing on how dimensions of workplace violence, internal versus external, influence turnover intentions and the factors that mitigate these effect is lacking.

METHODS

An online cross-sectional survey of multi-item measures was used to collect data from 462 Iranian nurses. We employed path modelling and analysed the data using SPSS and PROCESS macro. A STROBE checklist was used to report findings.

RESULTS

Both dimensions, internal and external, of violence were positively associated with turnover intentions. Moreover, perceived invulnerability and organisational support moderates this association. When individuals perceived invulnerability and perceived organisational support are high, internal violence is no longer indirectly related to turnover intentions via job satisfaction. In a similar vein, when perceived invulnerability and perceived organisational support are low, external violence is not related to intentions to quit. When perceived invulnerability and perceived organisational support are high, however, external violence is indirectly and negatively related to intentions to quit.

CONCLUSIONS

Nurses who regard themselves as invulnerable might be motivated to quit when they experience workplace violence. However, they are motivated to stay on the job when they both perceive themselves as invulnerable and the organisation as supporting.

RELEVANCE TO CLINICAL PRACTICE

Organisations should reconsider their policies and approach towards workplace violence especially during periods of intensive work.

Predicting Nurses' Occupational Commitment and Turnover Intention: The Role of Autonomous Motivation and Supervisor and Coworker Behaviors

AIM

To examine whether supportive supervisor (transformational leadership) and coworker (autonomy-supportive) behaviors predict occupational commitment and turnover intention over time through autonomous motivation.

BACKGROUND

Nurse turnover is a serious issue in several countries, straining the efficiency of the healthcare system and compromising both the quality and accessibility of healthcare.

METHOD

Longitudinal data were collected over 12 months from 387 French-Canadian registered nurses. Structural equation modelling was used to test the hypothesized model.

RESULTS

The relationships between predictors at Time 1 (supervisor and coworker behaviors) and occupational commitment and turnover intention at Time 2 are mediated by autonomous motivation at Time 1.

CONCLUSION

In times of global scarcity, the present findings provide insights into how the healthcare work environment acts on nurses' occupational turnover and commitment.

IMPLICATIONS FOR NURSING MANAGEMENT

Healthcare organizations are advised to foster supportive work environments and promote autonomous motivation to sustain the nursing workforce.

Effects of Organizational Support and Organizational Justice on Police Officers' Work Engagement

The impact of organizational support and organizational justice on work engagement was investigated in a group of police officers. A review of the literature revealed that studies reporting differences between the influence of supervisors and coworker justice and support on work engagement among police officers are grossly insufficient. This study hypothesized that organizational support and organizational justice would positively predict work engagement among police officers. It was also hypothesized that, among police officers, supervisor support is more strongly related to work engagement than coworker support and that supervisor justice is more strongly linked to work engagement than coworker justice. Participants were 170 police officers who worked in police departments in northern Poland. A regression analysis showed that supervisor support and supervisor justice had a positive effect on police officers' work engagement, whereby organizational support coupled with organizational justice accounted for 26% of the variability of work engagement. Theoretical and practical implications are discussed, and directions for future research are suggested.

Work Fatigue in a Hospital Setting: The Experience at Cheng Hsin General Hospital

We aimed to investigate fatigue and its related factors in a medical professional population aged ≥30 years, as appraised by the implementation of an employee health screening program at Cheng Hsin General Hospital in Taipei, Taiwan. The study participants included a total of 2132 (400 males and 1732 females) healthy medical professionals enrolled in a teaching hospital who underwent physical verification in 2019. Demographic characteristics and fatigue information were collected. The overall prevalence of personal- and work-related fatigue in this study population was 41.4% and 39.1%, respectively. The prevalence of a high risk of work- or personal-related fatigue proved to be substantially greater (p-value for chi-square test <0.0001) than it was for a low or moderate risk of personal-related fatigue. Using multinominal logistic regression analysis, seniority and position were statistically significant in relation to a high risk of personal- and work-related fatigue. Personal- and work-related fatigue were found to be prevalent in physicians and nurses. Lower seniority was also related to severe personal- or work-related fatigue. Providing this population with controlled working environments and health improvements is important.

Workaholism, presenteeism, work-family conflicts and personal and work outcomes: Testing a moderated mediation model

AIMS AND OBJECTIVES

While research suggests that nurses who experience work-family conflicts (WFC) are less satisfied and perform less well, these negative outcomes may be more important for some nurses. This study proposes a mediated moderation model wherein the interaction between two individual characteristics, workaholism and presenteeism, relates to family life satisfaction and work performance with WFC mediating these relationships.

BACKGROUND

Because a limited number of nursing studies have examined the potential outcomes of workaholism and presenteeism, we extend past research to address the question of how workaholism and presenteeism affect nurses' functioning.

DESIGN

We used a cross-sectional questionnaire survey design to test our hypotheses. STROBE guidelines for cross-sectional research were followed in designing and reporting this study.

METHODS

A total of 419 nurses completed measures of workaholism, presenteeism, WFC, family life satisfaction and work performance.

RESULTS

Results revealed that the relationships between workaholism and outcomes (family life satisfaction and work performance) through WFC were stronger among nurses characterised by high levels of presenteeism.

CONCLUSIONS

These results revealed that high presenteeism may exacerbate the negative relationships of workaholism to family life satisfaction and work performance through WFC.

RELEVANCE TO CLINICAL PRACTICE

Healthcare organisations and managers should consider addressing work environment factors in their efforts to reduce the negative outcomes (e.g., low family satisfaction and work performance) of nurses' workaholism, presenteeism and WFC.

Predicting nurse fatigue from measures of work demands

Fatigue arising from excessive work demands is a known safety challenge in hospital nurses. This study aimed to determine which measures of work demands during nursing work are most predictive of hospital nurse fatigue levels at the end of the work shift. Measures of work demands of registered nurses from two hospital units in the United States were collected from organizational data sources, wearable sensors, and questionnaires. Fatigue levels were measured at the start and end of each shift using the Brief Fatigue Inventory. Multilevel linear regression analysis was used to predict end of shift fatigue based on work demand variables. The best fit model included multiple variables from organizational data sources and a physical activity variable measured by a wearable sensor. Organizational data can be used to create dynamic measures of work demands as they occur and predict end of shift fatigue levels in hospital nurses.

The demotivating impact of absenteeism in nursing homes

AIM

The study explores how prevailing absenteeism frustrates or thwarts nurses' and nursing assistants' basic psychological needs (autonomy, competence and relatedness), using self-determination theory.

BACKGROUND

Our study responds to the call to investigate how organisational characteristics influence employees' psychological need, satisfaction and their attitudes and behaviours.

METHOD

We conducted a semantic analysis of the discourse of 42 nurses and nursing assistants working in nursing homes for older dependent people in France.

RESULTS

The analysis subdivides participants' discourse into four themes: short-term absenteeism, lack of competence, lack of recognition and work overload. These themes are all linked to participants' perceived deficits or threats concerning their psychological needs.

CONCLUSIONS

The prevailing absenteeism has a harmful spiral impact on nurses' and nursing assistants' attitudes and behaviours, and, ultimately, on the quality of care received by the patients.

IMPLICATIONS FOR NURSING MANAGEMENT

Our study confirms the need to adopt various managerial actions to address the following interrelated issues: controlling short-term absences, reducing work overload and giving training and recognition.

Newly graduated nurses' evaluation of the received orientation and their perceptions of the clinical environment: An intervention study

BACKGROUND

New graduate nurses (NGN) are the future of healthcare organizations where a shortage of nurses will soon be reality. The transition from a student to a registered nurse can be a demanding and challenging time, and in order to retain new graduate nurses, the transition should be as smooth as possible.

AIM

The aim of this study was to examine preceptors' education intervention's impact on NGNs' orientation period and their clinical learning environment from NGNs' point of view.

MATERIAL AND METHODS

This survey was a part of a longitudinal quasi-experimental intervention study. Participating units were randomized into intervention group and control group. The intervention group's preceptors (n=174)were provided a face-to-face education about orientation.

RESULTS

NGNs (n=72) were relatively satisfied with the received orientation. However, intervention group was more discontented with their orientation experiences than the control group. The control group's NGNs had longer orientation periods and more feedback discussions. They were also more satisfied with their preceptor's orientation skills and their working environment was more responsive.

DISCUSSION

Even though the impact of the intervention was inconclusive, this study provided us important information about NGNs' first steps towards the nursing profession by giving us clear improvement targets. We need a culture of feedback, individualized orientation and understanding that orientation should be our common interest. Investing in orientation is investing for the future.

CONCLUSION

This study indicated that the increase in knowledge did not translate into everyday practice. This finding will hopefully give rise to discussion within organizations on how to utilize employees' gained knowledge more effectively.

Demonstrating the motivational scale for commitments toward teachers’ turnover intentions using self-determination theory: a case of higher education institutions in Pakistan

Purpose

This paper aims to demonstrate the turnover intentions (TIs) among the academic faculty of higher education institutions (HEIs) in Pakistan through their motivation and commitment toward the concerned institution. It inspects the relationship of dimensions of motivation including an absence of motivation (AM), extrinsic motivation (ExM) and intrinsic motivation (InM) with the dimensions of commitment including affective commitment (AC), continuous commitment (CC) and normative commitment (NC) and finally the academic's TIs.

Design/methodology/approach

The paper used the self-determination theory (SDT), the theory of organizational commitment (OC) and the theory of planned behavior (TPB) for its proposed model. A sample of 500 academics, working under higher education commission recognized public and private universities in Punjab Pakistan. A structural equation modeling (SEM) conducted for analysis using an algorithm, bootstrapping and blindfolding techniques.

Findings

The outcomes of the research are attention-grabbing, as no direct relationship has been observed between the dimensions of motivation and TIs except InM. The dimensions of commitments are mediating the relationship between motivation and TIs with high significance value. The results reveal a significant adverse effect on TIs through two dimensions of commitment.

Research limitations/implications

As it is the case of a developing country like Pakistan therefore the finding cannot generalize to developed countries.

Practical implications

The findings of this research may lead the policymakers and practitioners of HEIs and controlling body to retain their competent teachers.

Social implications

This research can help the private sector to develop strategies about the retention of their competent teachers within the institutions that not just value the institution but also will be much beneficial for the students and society.

Originality/value

This paper is identifying how motivation is related to TIs and the role of commitment in it at HEIs. Still, no research has been conducted considering this avenue of SDT, OC and TPB

Effort-Reward Imbalance, Resilience and Perceived Organizational Support: A Moderated Mediation Model of Fatigue in Chinese Nurses

PURPOSE

Fatigue undermines nurses' well-being and work performance worldwide. Work stress is a critical factor that causes nurses' fatigue, but the solutions are not well known. This study aimed to identify the moderated mediation model of fatigue involving effort-reward imbalance (ERI), resilience and perceived organizational support (POS) in Chinese nurses.

METHODS

In a cross-sectional investigation conducted in Liaoning Province of China, 996 nurses completed the self-administered measurements of fatigue, ERI, resilience and POS. Moderated mediation was tested using the PROCESS procedure. The "pick-a-point" method was adopted to assess conditional effect on fatigue.

RESULTS

The indirect effect of ERI on fatigue through resilience was significant (a×b = 0.119, BCa 95% CI: 0.094 to 0.146), indicating a partial mediation of resilience. POS moderated the association of resilience with fatigue (β = -0.056, p = 0.006). The higher the level of POS was, the stronger the resilience-fatigue association became. Thus, the mediating role of resilience in the ERI-fatigue association was gradually increased with the increase of POS level (low POS: 0.073; moderate POS: 0.095; high POS: 0.116).

CONCLUSION

Resilience could partially mediate the ERI-fatigue association. POS could act as a moderator that enhanced the association of resilience with fatigue. A moderated mediation model of fatigue was demonstrated in Chinese nurses. Managers should establish a balanced social reciprocity, and improve nurses' resilience and POS in order to decrease nurses' fatigue.