Translation and psychometric validation of the Chinese version of the Emotional Labour Scale for nurses

Organizational display rules in nursing: Impacts on caring behaviors and emotional exhaustion through emotional labor

AIM

To examine the impact of display rules on nurses' caring behaviors and emotional exhaustion and the mediating role of emotional labor (surface/deep acting).

BACKGROUND

Hospitals often implement emotional display rules for nurses with the expectation of performance benefits. However, these rules may have an impact on nurses' caring behaviors and emotional exhaustion.

METHODS

This cross-sectional correlational study included a sample of 746 nurses from five hospitals and used the STROBE checklist. Relationships between display rules, emotional labor, caring behaviors, and emotional exhaustion were analyzed using structural equation modeling.

RESULTS

Display rules did not directly affect caring behaviors or emotional exhaustion. Emotional labor mediated the relationships. Display rules were associated more with surface acting. Deep acting increased caring behaviors and reduced emotional exhaustion; surface acting had the opposite effect.

CONCLUSIONS

Findings challenge the assumption that display rules effectively promote caring behaviors. Display rules lead to emotional labor and emotional exhaustion. Reducing display rules, emotional labor, and surface acting while supporting deep acting may alleviate emotional exhaustion.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Nurse managers should review the nature and implementation of emotional display rules and explore ways to reduce emotional labor, encourage deep acting, mitigate the negative impact of surface acting, and ultimately improve nursing caring behaviors.

Competence in managing workplace violence among nursing interns: Application of latent class analysis

AIM

To identify subtypes of competence in managing workplace violence (WPV) among nursing interns and to assess between-group differences.

BACKGROUND

Nursing interns are reported to be a vulnerable population for experiencing workplace violence during their clinical placement. Although WPV could have a negative impact on nursing interns' health and attitudes towards the nursing profession, little is known about nursing interns' competence in workplace violence management or its influencing factors.

DESIGN

A cross-sectional study.

METHODS

Between March to April 2023, nursing interns at three tertiary general hospitals in Anhui Province, China, completed questionnaires including a general information questionnaire, the Management of Workplace Violence Competence Scale (MWVCS), the Utrecht Work Engagement Scale (UWES-9), the Emotional Labour Scale for Nurses (ELSN) and were classified into subtypes by latent class analysis. Subsequently, univariate analysis and multivariate logistic regression were performed to identify the influencing factors by subtypes.

RESULTS

A total of 264 questionnaires were valid and the overall mean age of the participants was 21.06 ±1.41 years. Four classes were identified: low competency group (15.5%), low cognition-low coping competency group (18.2%), low cognition-medium to high competency group (21.6%) and high competency group (44.7%). The results of multinomial logistic regression analysis showed that placement hospitals with a WPV management department, emotional control effort in profession dimension and emotional pretense by norms dimension in the Emotional Labour Scale for Nurses, pursuing further education and vigour dimension in the Utrecht Work Engagement Scale were influencing factors of the potential categories of WPV management competence.

CONCLUSIONS

Four classes were identified and there was competence variability among nursing interns. More attention should be given to nursing interns who did not receive WPV-related training in their school or placement hospital.

Chinese version of the stressor scale for emergency nurse: A methodological study design

AIM

The aim of this study was to modify and test the psychometric properties of the Chinese version of the stressor scale for emergency nurses.

DESIGN

The methodological design was carried out in two phases: (a) form the Chinese version by Delphi method and (b) test the psychometric properties by cross-sectional survey.

METHODS

The translated scale was administered to 420 nurses in Qingdao. Validity was assessed in terms of content validity, calibration correlation validity and construct validity using exploratory factor analysis and confirmatory factor analysis. Internal consistency was estimated using Cronbach α coefficients.

RESULTS

The Chinese version of the SSEN retains 27 items, four common factors were extracted by exploratory factor analysis, and the factor cumulative variance contribution rate was 78.463%. The fitting indexes of the four-factor model of CFA were all in the acceptable range[χ²  = 711.30, df = 312, p < 0.001, χ² /df = 2.280, CFI = 0.933, TLI = 0.924, IFI = 0.933, RMSEA = 0.079 (90% confidence interval = 0.071-0.086)].The item-level content validity index of the Chinese SSEN is 0.89 ~ 1.00; the scale-level content validity index is 0.98; the Cronbach α coefficient of the total table is 0.971 and the split-half reliability is 0.877.

PATIENT OR PUBLIC CONTRIBUTION

The C-SSEN can be used to help nursing managers accurately formulate management measures to improve the stress coping ability of nurses in the ED, stabilize the nursing team and ensure nursing safety.

Measurement Invariance and Latent Mean Differences in the Nurses' Emotional Labour Scale

BACKGROUND

The measurement invariance and latent mean differences in emotional labor across different hospital and monthly salary levels among registered nurses have never been confirmed for the Emotional Labour Scale. These issues may influence the application and efficacy of this scale in practice.

PURPOSE

This study was developed to evaluate the factor structure of the nurses' Emotional Labour Scale and to examine the measurement invariance and latent mean differences for this scale across different hospital and monthly salary levels.

METHODS

Data were collected from 461 registered nurses working in four general hospitals and 12 long-term care hospitals. Confirmatory factor analysis and a multigroup confirmatory factor analysis were performed to determine the internal structure and measurement invariance of the Emotional Labour Scale.

RESULTS

The results of the confirmatory factor analysis indicate that the factor structure model proposed by the original scale fits well with our data as well as configural invariance, factor loading invariance, intercept invariance, and uniqueness invariance. Moreover, factor variance/covariance invariance across two hospital levels as well as configural invariance, factor loading invariance, and intercept invariance across two monthly salary levels were supported. The mean score for emotional control effort in the profession of general hospital nurses was lower than that for long-term care hospital nurses. No statistically significant latent mean differences were found across monthly salary levels.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The findings show the Emotional Labour Scale to be a valid and reliable tool for assessing registered nurses and also comparing the mean score for emotional labor across hospital and monthly salary levels to be feasible. The scale may contribute to the development of human resource strategies.

Relationship between perceived organizational support and professional values of nurses: mediating effect of emotional labor

Objectives

Perceived organizational support was a benefit for the work performance of nurses, which may affect emotional labor and the development of professional values. This study aimed to explore the relationship between nurses’ perceived organizational support and professional values, and investigate the mediating role of emotional labor.

Methods

This was a cross-sectional study. The study was conducted in 3 tertiary hospitals in Wuhan from October 2020 to January 2021. The data were collected by a questionnaire consisting of demographic characteristics, the Emotional Labor Scale for Nurses, the nurses’ Perceived Organizational Support Scale, and the Nursing Professional Values Scale (NPVS-R). A convenience sample of 1017 nurses responded to the questionnaire survey. Pearson’s correlation analysis was used to test the relationship between variables. Predictor effects were tested using hierarchical multiple regressions. The structural equation model (SEM) was used to test the mediation effect of emotional labor on the pathway from perceived organizational support to professional values.

Results

A positive moderate correlation was observed between the perceived organizational support and emotional labor (r = 0.524, P < 0.01), and a positive strong correlation was observed between perceived organizational support and professional values (r = 0.609, P < 0.01). Emotional labor and perceived organizational support were positive predictors of professional values (B = 0.531, 95%CI = 0.414 ~ 0.649; B = 0.808, 95%CI = 0.715 ~ 0.901, respectively). The association between perceived organizational support and professional values was mediated by emotional labor.

Conclusions

Results showed that perceived organizational support was positively related to nurses’ emotional labor, which was in turn associated with high professional values. For nurses, improving organizational support and training nurses to engage in emotional labor through providing multiple support systems, establishing appropriate incentive mechanisms, and training nurses to regulate emotions can be effective ways to promote nurses’ professional values.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-022-00927-w.

Curvilinear relationship between emotional labour and work engagement in nurses: A correlational study

AIMS AND OBJECTIVES

To examine if there was a curvilinear relationship between emotional labour and work engagement in Chinese nurses.

BACKGROUND

Emotional labour has both positive and negative effects on work engagement, but the curve relationship between the two has not been tested.

DESIGN

Correlational design.

METHODS

Multi-stage stratified random sampling was used to recruit samples, and 528 nurses from 5 tertiary first-class general hospitals were recruited in Henan Province. Data were collected by using Hong and Kim's Emotional Labor Scale for nurse and the Utrecht Work Engagement Scale-9. Curve estimation was used to explore the functional model between emotional labour and work engagement. Results were reported according to the STROBE Statement.

RESULTS

The three dimensions of emotional labour, 'emotional control effort in profession', 'patient-focused emotional suppression' and 'emotional pretense by norms', had a function relationship of quadratic (R²  = .57, p < .001), quadratic (R²  = .569, p < .001) and cubic (R²  = .238, p < .001), respectively, with work engagement.

CONCLUSIONS

There was a one-way increasing quadratic function relationship between 'emotional control effort in profession' and work engagement. However, 'patient-focused emotion suppression' and 'emotional pretense by norms' had an inverted U-shaped curve relationship with work engagement. Below the moderate level, 'patient-focused emotion suppression' and 'emotional pretense by norms' were positively related to work engagement. After a certain level, they were negatively related to work engagement.

RELEVANCE TO CLINICAL PRACTICE

Our results may provide evidences to manage nurses' emotional labour and improve their work engagement. It seems that encouraging or training nurses to learn and master more strategies of emotional control may improve work engagement. Moreover, nursing managers should fully recognise the positive and negative effects of different levels of emotional suppression and emotional pretense on work engagement, so as to develop targeted management strategies.