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Huang L, Zhang Q, Wu H, Lan Y, Jiang F, Zhang Y. Work-related violence, occupational stress and psychological distress among medical staff in China: A structural equation modeling analysis. Work 2024:WOR240323. [PMID: 39121150 DOI: 10.3233/wor-240323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND Psychological issues and work-related violence are the main challenges faced by medical staff. The situation has become even more prevalent during the COVID-19 pandemic. OBJECTIVE This research aimed to analyze the relationships among work-related violence, occupational stress and psychological distress and to further identify the direct or indirect effects of violence on psychological distress. METHODS A total of 1,765 medical staff members were surveyed using the Kessler Psychological Distress Scale and Revised Occupational Stress Inventory. Work-related violence was assessed using a self-made 5-question questionnaire. STATA 14.0 and Amos 21.0 software were used for correlation analysis, variance analysis, and structural equation modeling analysis. RESULTS A total of 66.1% of the medical staff suffered workplace violence, and 61.2% witnessed workplace violence. The psychological distress score (Kessler 10 Scale) of the medical staff was 22.7±7.67. The psychological strain score and physical strain score were 26.8±7.14 and 24.2±6.51, respectively. Work-related violence (suffered: β= 0.467; witnessed: β= 0.258) and occupational stress (psychological strain: β= 0.269; physical strain: β= 0.317) were predictors of psychological distress, and social support (β= -0.265) was a protective factor. Work-related violence and social support had both direct and indirect effects on psychological distress, and the intermediate factor was occupational stress. The total effects of suffered workplace violence and witnessed workplace violence were 0.181 and 0.092, respectively, and the total effect of social support was -0.262. CONCLUSIONS Work-related violence may exacerbate symptoms of occupational stress and psychological distress. Reducing workplace violence and protecting medical staff from work-related violence are extremely important aspects of mental health prevention.
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Affiliation(s)
- Lei Huang
- Department of Postgraduate Students, West China Hospital and West China School of Medicine, Sichuan University, Chengdu, China
| | - Qin Zhang
- Department of Postgraduate Students, West China Hospital and West China School of Medicine, Sichuan University, Chengdu, China
| | - Huiyi Wu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yajia Lan
- Department of Environmental Health and Occupational Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Fugui Jiang
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Yang Zhang
- Department of Periodical Press and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
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Qiu H, Lu H, Wang X, Guo Z, Xing C, Zhang Y. A moderated chain mediation model examining the relation between smartphone addiction and intolerance of uncertainty among master's and PhD students. Heliyon 2024; 10:e30994. [PMID: 38770334 PMCID: PMC11103524 DOI: 10.1016/j.heliyon.2024.e30994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 04/28/2024] [Accepted: 05/09/2024] [Indexed: 05/22/2024] Open
Abstract
The theories of relational regulation and compensatory Internet use suggest that intolerance of uncertainty influences smartphone addiction (SPA), which in turn is influenced by other aspects. This study used previous results to examine how intolerance of uncertainty affects SPA in PhD and master's degree programs. A convenience sample comprising 1727 master's and PhD students (99.9 %; 50.7 % female; Mage = 27.71; SD = 3.80; range = 21-43) was recruited. Using established questionnaires, we measured SPA, anxiety, positive coping style, perceived social support, and intolerance of uncertainty. The results demonstrated that intolerance of uncertainty positively affects SPA in terms of predictive power. Furthermore, anxiety and positive coping style mediate that link in a cascade fashion. A greater SPA indicates that the individual is less likely to use a positive coping style, has a higher anxiety level, and has a lower tolerance for uncertainty. While thinking about how intolerance of uncertainty affects anxiety and positive coping style, perceived social support mediates the relationship. Intolerance of uncertainty has less impact on anxiety and positive coping style when perceived social support is high. These results indicate the possibility of examining SPA prevention and intervention from several angles. Therefore, emotional regulation, which modifies anxiety and the tendency to use a positive coping style, may reduce the impact of intolerance of uncertainty on SPA. Another successful strategy for reducing smartphone addiction is to provide social support from loved ones and the community at large.
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Affiliation(s)
| | | | | | - Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, No. 169 West Changle Road, Xi'an, Shaanxi Province, 710032, China
| | - Chen Xing
- Department of Military Medical Psychology, Air Force Medical University, No. 169 West Changle Road, Xi'an, Shaanxi Province, 710032, China
| | - Yan Zhang
- Department of Military Medical Psychology, Air Force Medical University, No. 169 West Changle Road, Xi'an, Shaanxi Province, 710032, China
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Xiao Y, Chen TT, Zhu SY, Li CY, Zong L. Factors associated with workplace violence against Chinese healthcare workers: an online cross-sectional survey. Front Public Health 2024; 12:1295975. [PMID: 38550327 PMCID: PMC10977601 DOI: 10.3389/fpubh.2024.1295975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 03/06/2024] [Indexed: 04/02/2024] Open
Abstract
Objectives Workplace violence (WPV) against healthcare workers (HCWs) has reached significant levels globally, impeding the quality and accessibility of healthcare systems. However, there is limited available knowledge regarding the determinants linked with WPV among HCWs and the discrepancies observed across various levels of hospitals in China. The objective of the present research was to investigate the factors linked to WPV and job satisfaction among HCWs in China. Methods A self-developed questionnaire based on WeChat was employed to collect data. The questionnaire consisted of demographic information as well as occupational factors. To measure WPV, the Chinese version of the Workplace Violence Scale was utilized. Career satisfaction was assessed through two questions regarding career choices. The collected data was analyzed using descriptive analyses, chi-square tests, and multivariate logistic regressions. Results A total of 3,781 valid questionnaires (1,029 doctors and 2,752 nurses) were collected. Among all participants, 2,201 (58.2%) reported experiencing at least one form of WPV in the past year, with emotional abuse being the most frequent occurrence (49.7%), followed by threats (27.9%). The multivariate logistic regression analysis revealed several risk factors associated with WPV, including male gender, shift work, senior professional title, bachelor's degree education, employment in secondary-level hospitals, and working over 50 h per week (p < 0.05). Career satisfaction among HCWs who experienced high levels of WPV was low, with only 11.2% remaining confident in their profession, and a mere 2.0% supporting their children pursuing careers in healthcare. Conclusion WPV poses a significant challenge within the Chinese healthcare system. Efforts should be made to address the identified risk factors and promote a safe and satisfying working environment for HCWs.
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Affiliation(s)
- Yu Xiao
- Psychosomatic Medical Center, The Fourth People’s Hospital of Chengdu, Chengdu, China
- Psychosomatic Medical Center, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Ting-ting Chen
- Nursing Department, West China Hospital of Sichuan University, Chengdu, China
| | - Shao-yi Zhu
- Department of Psychiatry, Shantou University Mental Health Center, Shantou, China
| | - Chun-ya Li
- Psychosomatic Medical Center, The Fourth People’s Hospital of Chengdu, Chengdu, China
| | - Ling Zong
- Department of Judicial Expertise, Zhongshan Third People’s Hospital, Zhongshan, China
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Zhang J, Yang X, Zhang X, Liu Y, Liu M, Fang Y, Liu M, Wu M. Mediating effects of social support and presenteeism on turnover intention and post-traumatic stress disorder among Chinese nurses in the post-pandemic era: a cross-sectional study. Front Public Health 2024; 12:1323126. [PMID: 38420027 PMCID: PMC10899410 DOI: 10.3389/fpubh.2024.1323126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/30/2024] [Indexed: 03/02/2024] Open
Abstract
Background The shift in national policies for epidemic prevention and control in the post-pandemic era is undoubtedly a challenge for health care professionals. Nurses, as an important part of the health care professional population, have an even greater impact on their mental health and occupational safety. This may expose nurses to post-traumatic stress disorder (PTSD) and presenteeism, and ultimately lead to their turnover. Objective This study aimed to investigate the relationship between turnover intention and post-traumatic stress disorder among Chinese nurses during post-pandemic era, and the mediating role of social support and presenteeism. Methods In this study, a multicentre cross-sectional survey was conducted in April 2023 among nursing staff in several tertiary general hospitals in northern China, with online data collection using the Turnover intention Scale (PTSD), the Impact of Events Scale (IES), the Social Support Scale (SSS), and the Stanford presenteeism Scale (STAS) and the relationship between variables was analyzed using hierarchical multivariate regression, and Structural Equation Modeling (SEM) was used to analyze the relationship between post-traumatic stress disorder and the Turnover intention from the pathway between. Results Data were collected from 2,513 nurses who met the inclusion criteria, in which general information such as age, department, specific department, Professional title, history of alcohol consumption, form of employment, Years of working, and Average working hours per day were statistically significant with the difference in the turnover intention. The results of the study showed a 32% high turnover intention among nurses in the post-pandemic era, which was lower than the turnover intention during the pandemic. The results of hierarchical multiple regression analysis showed that post-traumatic stress disorder, social support, and presenteeism were significant predictors of turnover intention. The total effect of post-traumatic stress disorder on turnover intention to work was 0.472 [bias modified 95% confidence interval (0.415-0.483), p < 0.001]. Social support and attendance played a partially intermediate role in post-traumatic stress disorder and propensity to leave (an indirect effect of 26% of the total effect). Conclusion Turnover intention and post-traumatic stress disorder levels are high and social support plays an important role in the tendency to leave the job and post-traumatic stress disorder, healthcare institution can be achieved by strengthening social support for nurses in the post-epidemic era and preventing the occurrence of presenteeism.
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Affiliation(s)
- Jingshuo Zhang
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xin Yang
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xiaoman Zhang
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yuping Liu
- The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Mengshi Liu
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yu Fang
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Mengjie Liu
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Min Wu
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
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Zambrano-Chumo L, Guevara R. Psychological Capital and Turnover Intention: The Mediating Role of Burnout among Healthcare Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:185. [PMID: 38397676 PMCID: PMC10888532 DOI: 10.3390/ijerph21020185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/25/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024]
Abstract
Psychological capital (PsyCap) has been identified as an individual's positive psychological state of development that can help to reduce negative organizational outcomes. However, there is still a gap in understanding how PsyCap influences different aspects of organizations. This study investigates the mediating role of burnout in the relationship between PsyCap and turnover intentions among healthcare professionals. A cross-sectional survey was conducted among 320 healthcare professionals. The estimation of the relationships between PsyCap, burnout, and turnover intentions was obtained through structural equation modelling (SEM). A mediation analysis was carried out using bootstrapping procedures. The results show that burnout has a significant and positive effect on turnover intention and PsyCap has a significant and negative effect on burnout. Moreover, burnout fully mediates the relationship between PsyCap and turnover intention. These findings suggest that PsyCap can effectively reduce negative outcomes like burnout, but its positive impact may be limited when considering other outcomes such as turnover intention.
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Affiliation(s)
- Laura Zambrano-Chumo
- CENTRUM Catolica Graduate Business School, Pontificia Universidad Catolica del Peru, Lima 15023, Peru
| | - Ruben Guevara
- CENTRUM Catolica Graduate Business School, Pontificia Universidad Catolica del Peru, Lima 15023, Peru
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DePierro JM, Chan CC, Mohamed N, Starkweather S, Ripp J, Peccoralo LA. Determinants of Staff Intent to Leave Health Care During the COVID-19 Pandemic. Am J Public Health 2024; 114:200-203. [PMID: 38354356 PMCID: PMC10916731 DOI: 10.2105/ajph.2024.307574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 02/16/2024]
Abstract
Objectives. To identify potential drivers of health care worker attrition. Methods. We conducted a survey of 1083 nonphysician health care workers in a large urban health system in New York City from September to October 2022. Results. The results of a multivariable logistic regression analysis revealed that higher odds of intending to leave health care were significantly associated with male gender, registered nurse profession, burnout, self-perceived mental health service need, and verbal abuse from patients or visitors, whereas lower odds were seen among those reporting greater emotional well-being and a better workplace culture. A relative importance analysis indicated that burnout was the strongest correlate of intention to leave (22.5% relative variance explained [RVE]), followed by subjective emotional well-being (16.7% RVE), being a registered nurse (12.3% RVE), poorer perceived workplace culture (9.5% RVE), and male gender (5.9% RVE). Conclusions. Overall, our findings suggest the need for well-coordinated interventions that address both individual- and system-level factors in an effort to improve retention. Public Health Implications. Our results indicate a need for interventions targeting workplace culture, staff burnout, and mental health service provision. (Am J Public Health. 2024;114(S2):S200-S203. https://doi.org/10.2105/AJPH.2024.307574).
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Affiliation(s)
- Jonathan M DePierro
- Jonathan M. DePierro and Sydney Starkweather are with the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. Chi C. Chan, Jonathan Ripp, and Lauren A. Peccoralo are with the Office of Well-being and Resilience, Mount Sinai Health System, New York, NY. Nihal Mohamed is with the Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Chi C Chan
- Jonathan M. DePierro and Sydney Starkweather are with the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. Chi C. Chan, Jonathan Ripp, and Lauren A. Peccoralo are with the Office of Well-being and Resilience, Mount Sinai Health System, New York, NY. Nihal Mohamed is with the Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Nihal Mohamed
- Jonathan M. DePierro and Sydney Starkweather are with the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. Chi C. Chan, Jonathan Ripp, and Lauren A. Peccoralo are with the Office of Well-being and Resilience, Mount Sinai Health System, New York, NY. Nihal Mohamed is with the Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Sydney Starkweather
- Jonathan M. DePierro and Sydney Starkweather are with the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. Chi C. Chan, Jonathan Ripp, and Lauren A. Peccoralo are with the Office of Well-being and Resilience, Mount Sinai Health System, New York, NY. Nihal Mohamed is with the Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jonathan Ripp
- Jonathan M. DePierro and Sydney Starkweather are with the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. Chi C. Chan, Jonathan Ripp, and Lauren A. Peccoralo are with the Office of Well-being and Resilience, Mount Sinai Health System, New York, NY. Nihal Mohamed is with the Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Lauren A Peccoralo
- Jonathan M. DePierro and Sydney Starkweather are with the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. Chi C. Chan, Jonathan Ripp, and Lauren A. Peccoralo are with the Office of Well-being and Resilience, Mount Sinai Health System, New York, NY. Nihal Mohamed is with the Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
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Nam S, Wong JYH, Wang T, An B, Fong DYT. Psychological distress as a mediator between workplace violence and turnover intention with caring for patients with COVID-19. Front Psychol 2024; 14:1321957. [PMID: 38259558 PMCID: PMC10801077 DOI: 10.3389/fpsyg.2023.1321957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/14/2023] [Indexed: 01/24/2024] Open
Abstract
The Coronavirus Disease 2019 (COVID-19) outbreak exacerbated workplace violence and turnover intention among nurses, particularly affecting greater levels of psychological distress. This study aimed to examine psychological distress as a mediator of the relationship between workplace violence and turnover intention among clinical nurses, and to investigate whether caring for patients with COVID-19 moderates this relationship through the lens of the affective events theory. We conducted an online survey of 325 Korean registered nurses (mean age = 30.75; female = 92.6%) who work in clinical settings between August and October 2021 using the convenience sampling method. Psychological distress was measured using the 21-item Depression Anxiety Stress Scale and workplace violence using one dichotomous item adopted from the Workplace violence questionnaire. We measured turnover intention using the six-item Anticipated Turnover Scale. Caring for patients with COVID-19 was determined using one dichotomous item. The research hypotheses assume that the relationship between workplace violence and turnover intention could be mediated by psychological distress and moderated by caring for patients with COVID-19 among Korean nurses. We performed a moderated mediation analysis with workplace violence as the independent variable, turnover intention as the dependent variable, psychological distress as a potential mediator, and caring for patients with COVID-19 as a potential moderator. The analysis revealed that nurses' psychological distress among 308 nurses had a statistically significant mediating effect on the relationship between workplace violence and turnover intention. Furthermore, caring for patients with COVID-19 had a significant further moderating effect on this relationship. These findings highlight the need for psychological support services for clinical nurses at institutional and organizational levels amidst the ongoing COVID-19 pandemic. It is hoped that these findings can contribute to the development of tailored interventions for nurses caring for patients with COVID-19 to attenuate their psychological distress in a timely and effective manner.
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Affiliation(s)
- Sujin Nam
- School of Health and Environmental Science, College of Health Science, Korea University, Seoul, Republic of Korea
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Janet Yuen Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, Hong Kong SAR, China
| | - Tingxuan Wang
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Bomi An
- College of Nursing, Hannam University, Daejeon, Republic of Korea
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Huang S, Zhai J, Lu X, Liang Y, Li Q, Lilenga HS. Prevalence of workplace violence in Chinese obstetric nurses under the new situation and its correlation with violence prevention knowledge-attitude-practice and climate perception: a cross-sectional study. BMC Nurs 2023; 22:473. [PMID: 38093351 PMCID: PMC10717719 DOI: 10.1186/s12912-023-01637-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Workplace violence severely impacts individual nurses. With the three-child opening policy of China and the impact of the COVID-19 epidemic in the recently years, obstetric nurses face the double attack of heavy workload and staffing shortage. This study aimed to evaluate the current situation of workplace violence among Chinese obstetric nurses under the new situation, assess the level of violence prevention knowledge-attitude-practice and climate perception in Chinese obstetric nurses and explore the correlation between workplace violence and the level of violence prevention knowledge-attitude-practice and climate perception. METHODS A cross-sectional survey on the workplace violence for Chinese obstetric nurses was conducted from August to February 2023. All the questionnaires came from 10 provinces and 3 autonomous regions in China. The basic characteristics of obstetric nurse's workplace violence, workplace violence prevention knowledge-attitude-practice scale and workplace violence climate perception scale were collected. RESULTS Totally, 522 Chinese obstetric nurses were included. 55.0% of obstetric nurses (287) had experienced workplace violence in the past 12 months, including verbal assault (40.4%), physical assault (34.1%), and sexual assault (31.0%). The overall level of obstetric nurses' workplace violence prevention knowledge-attitude-practice and climate perception of workplace violence was low. Multiple linear regression analysis showed that the violence prevention knowledge dimension significantly influenced obstetric nurses' workplace violence (B = -0.278, P < .001), attitude dimension (B = -0.241, P < .001), behavior dimension (B = -0.216, P < .001) and the violence climate perception's organizational management (B = -0.177, P < .001), organizational training (B = -0.175, P < .001), organizational support (B = -0.143, p < .001) and the violence handling (B = -0.165, P < .001). CONCLUSION The incidence of workplace violence among obstetric nurses in the new situation is high. However, the overall violence prevention knowledge-attitude-practice and climate perception levels are low. Therefore, nursing managers should take targeted measures according to the relevant influencing factors and the characteristics of obstetrics to improve the level of obstetric nurses' violence prevention knowledge-attitude-practice and climate perception to reduce workplace violence among obstetric nurses.
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Affiliation(s)
- Shan Huang
- School of Nursing, Southern Medical University, Guangzhou, 510515, China
| | - Jinguo Zhai
- School of Nursing, Southern Medical University, Guangzhou, 510515, China.
- School of Nursing, Southern Medical University, No.1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong Province, 510515, China.
| | - Xiaoqin Lu
- Nursing Department, Guangzhou University of Traditional Chinese Medicine Dongguan Hospital, No. 3, Dongcheng section, Songshan Lake Avenue, Dongguan City, Guangdong Province, 523000, China
| | - Yulian Liang
- Nursing Department, Guangzhou University of Traditional Chinese Medicine Dongguan Hospital, No. 3, Dongcheng section, Songshan Lake Avenue, Dongguan City, Guangdong Province, 523000, China
| | - Qiumei Li
- Department of Obstetrics and Gynecology, Songshan Lake Central Hospital, No. 1, Xianglong Road, Dongguan City, Guangdong Province, 523000, China
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Gedik Ö, Ülke Şimdi R, Kıbrıs Ş, (Sivuk) DK. The relationship between workplace violence, emotional exhaustion, job satisfaction and turnover intention among nurses during the COVID-19 pandemic. J Res Nurs 2023; 28:448-466. [PMID: 38144966 PMCID: PMC10741263 DOI: 10.1177/17449871231182837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023] Open
Abstract
Objectives Workplace violence is a major issue in society, business and healthcare settings. It adversely affects both employee safety and their ability to provide healthcare services. Aim This study examined the association between workplace violence, emotional exhaustion, job satisfaction and turnover intention among nurses during the COVID-19 pandemic. Methods We collected data from 513 nurses. We conducted 'Process Macro' analysis. Firstly, we included three mediators in the model: job satisfaction, workplace violence and emotional exhaustion. Secondly, we used work hours and anxiety as moderators of the relationship between workplace violence and turnover intention. Results The findings revealed statistical significance that job satisfaction and workplace violence mediated the relationship between emotional exhaustion and nurse turnover intentions. Work hours and anxiety also moderated the relationship between workplace violence and nurses' turnover intention. Conclusion Respondents indicated that they were most affected by verbal violence during this time. Workplace violence is a negative factor that affects nurses' work, affecting them physically and psychologically. This occupational risk should be considered when evaluating nurses exposed to violence, as it affects job satisfaction and turnover intentions. The main theoretical contribution of this research is the identification of the association between workplace violence, emotional exhaustion, job satisfaction and turnover intention among nurses during the COVID-19 pandemic. It is clear that the research findings will be useful for healthcare professionals. The findings may have practical implications for healthcare administrators and their staff.
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Affiliation(s)
- Özlem Gedik
- Research Assistant, Healthcare Management, Faculty of Health Sciences, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Refika Ülke Şimdi
- Research Assistant, Healthcare Management, Faculty of Economics and Administrative Sciences, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Şerife Kıbrıs
- Instructor, Medical Documentation and Secretarial, Arac Rafet Vergili Vocational School, Kastamonu University, Kastamonu, Turkey
| | - Derya Kara (Sivuk)
- Professor, Healthcare Management, Faculty of Economics and Administrative Sciences, Ankara Hacı Bayram Veli University, Ankara, Turkey
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D'Alessandro-Lowe AM, Ritchie K, Brown A, Easterbrook B, Xue Y, Pichtikova M, Altman M, Beech I, Millman H, Foster F, Hassall K, Levy Y, Streiner DL, Hosseiny F, Rodrigues S, Heber A, O'Connor C, Schielke H, Malain A, McCabe RE, Lanius RA, McKinnon MC. Canadian respiratory therapists who considered leaving their clinical position experienced elevated moral distress and adverse psychological and functional outcomes during the COVID-19 pandemic. Health Promot Chronic Dis Prev Can 2023; 43:460-471. [PMID: 37991889 PMCID: PMC10753904 DOI: 10.24095/hpcdp.43.10/11.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
INTRODUCTION Respiratory therapists (RTs) faced morally distressing situations throughout the COVID-19 pandemic, including working with limited resources and facilitating video calls for families of dying patients. Moral distress is associated with a host of adverse psychological and functional outcomes (e.g. depression, anxiety, symptoms of posttraumatic stress disorder [PTSD] and functional impairment) and consideration of position departure. The purpose of this study was to understand the impact of moral distress and its associated psychological and functional outcomes on consideration to leave a clinical position among Canadian RTs during the COVID-19 pandemic. METHODS Canadian RTs (N = 213) completed an online survey between February and June 2021. Basic demographic information (e.g. age, sex, gender) and psychometrically validated measures of moral distress, depression, anxiety, stress, PTSD, dissociation, functional impairment, resilience and adverse childhood experiences were collected. RESULTS One in four RTs reported considering leaving their position. RTs considering leaving reported elevated levels of moral distress and adverse psychological and functional outcomes compared to RTs not considering leaving. Over half (54.5%) of those considering leaving scored above the cut-off for potential diagnosis of PTSD. Previous consideration to leave a position and having left a position in the past each significantly increased the odds of currently considering leaving, along with system-related moral distress and symptoms of PTSD, but the contribution of these latter factors was small. CONCLUSIONS Canadian RTs considering leaving their position reported elevated levels of distress and adverse psychological and functional outcomes, yet these individual-level factors appear unlikely to be the primary factors underlying RTs' consideration to leave, because their effects were small. Further research is required to identify broader, organizational factors that may contribute to consideration of position departure among Canadian RTs.
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Affiliation(s)
| | - Kimberly Ritchie
- McMaster University, Hamilton, Ontario, Canada
- Homewood Research Institute, Guelph, Ontario, Canada
| | | | | | - Yuanxin Xue
- McMaster University, Hamilton, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Mina Pichtikova
- McMaster University, Hamilton, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Max Altman
- McMaster University, Hamilton, Ontario, Canada
| | - Isaac Beech
- McMaster University, Hamilton, Ontario, Canada
- Homewood Research Institute, Guelph, Ontario, Canada
| | | | - Fatima Foster
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Kelly Hassall
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Yarden Levy
- McMaster University, Hamilton, Ontario, Canada
| | - David L Streiner
- McMaster University, Hamilton, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Fardous Hosseiny
- Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada
- Institute of Mental Health Research at the Royal, University of Ottawa, Ottawa, Ontario, Canada
| | - Sara Rodrigues
- Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada
- Institute of Mental Health Research at the Royal, University of Ottawa, Ottawa, Ontario, Canada
| | - Alexandra Heber
- McMaster University, Hamilton, Ontario, Canada
- Veterans Affairs Canada, Ottawa, Ontario, Canada
| | | | | | - Ann Malain
- Homewood Health Centre, Guelph, Ontario, Canada
| | - Randi E McCabe
- McMaster University, Hamilton, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Ruth A Lanius
- Homewood Research Institute, Guelph, Ontario, Canada
- University of Western Ontario, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Margaret C McKinnon
- McMaster University, Hamilton, Ontario, Canada
- Homewood Research Institute, Guelph, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
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11
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Yun JY, Myung SJ, Kim KS. Associations among the workplace violence, burnout, depressive symptoms, suicidality, and turnover intention in training physicians: a network analysis of nationwide survey. Sci Rep 2023; 13:16804. [PMID: 37798353 PMCID: PMC10556140 DOI: 10.1038/s41598-023-44119-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 10/04/2023] [Indexed: 10/07/2023] Open
Abstract
Depression and anxiety are the most common mental disorders among physicians, who have a greater risk of suicide than those in other professional occupations. Relationships among a demanding workload, workplace violence, burnout, and intention to turnover have also been reported. The current study examined the principal components and propagating patterns of mental health and working environment interactions in training physicians. A total of 1981 training physicians completed online self-report questionnaires during September-October (midpoint of the training year) 2020. Regularized partial correlations in a mixed graphical model (MGM) and joint probability distributions (directed acyclic graph; DAG) were estimated for four subtypes of workplace violence (verbal abuse/physical violence perpetrated by clients/hospital staff), three burnout subdomains (Maslach Burnout Inventory), thoughts about quitting, and nine depressive symptoms, including suicidality, comprising the DSM-5 diagnostic criteria for major depressive disorder (assessed using the Patient Health Questionnaire-9). Thoughts of death/self-harm showed directional dependencies on the joint probability distributions of psychomotor agitation/retardation, concentration difficulty, self-reproach, and sadness in the DAG. In the MGM, a partial correlation with psychomotor agitation/retardation (r = 0.196) accounted for 56.5% of the variance in thoughts of death/self-harm. Partial correlations with concentration difficulties (r = 0.294), self-reproach (r = 0.257), changes in appetite (r = 0.184), and worker-on-worker physical violence (r = 0.240) in the MGM accounted for 54.4% of the variance in psychomotor agitation/retardation. Thoughts about quitting were partially correlated with and dependent upon the joint probability distributions of emotional exhaustion (r = 0.222), fatigue (r = 0.142), anhedonia (r = 0.178), and sadness (r = 0.237). In contrast, worker-on-worker (r = 0.417) and client-on-physician (r = 0.167) verbal abuse had regularized partial correlations with directional dependencies on thoughts about quitting. Organization-level interventions aiming to reduce the worker-on-worker violence and individual-level approaches of clinical screening program and psychiatric counseling clinic are required. Follow-up studies to verify the effectiveness of these interventions for training physicians are needed.
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Affiliation(s)
- Je-Yeon Yun
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sun Jung Myung
- Office of Medical Education, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Kyung Sik Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
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12
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Hoseinzadeh E, Ebadi A, Ashktorab T, Sharif-Nia H. Nurses' intention to care for patients with infectious disease: a content analysis study. BMC Nurs 2023; 22:349. [PMID: 37789361 PMCID: PMC10548695 DOI: 10.1186/s12912-023-01538-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/26/2023] [Indexed: 10/05/2023] Open
Abstract
OBJECTIVE This present study was designed to explain the concept of nurses intention to care of patients with infectious diseases. METHODS This study is a deductive content analysis study that was performed from May 2022 to Jun 2022 in three hospitals in Iran. In total 21 nurses were chosen by purposive sampling and for deta collection used semi-structured interviews. Data analysis was done using Elo and Kingas method. RESULTS This study have revealed the formation of seven distinct themes, namely Job satisfaction, Professional ethics, Personal values, Standard precautions, Preserving health, Support, and Attitude of patients and their families. These themes are comprised of 17 categories and 59 subcategories. CONCLUSION By comprehending the dimensions of nurses' intentions to care for patients with infectious diseases, it is possible to develop suitable planning and strategies to meet the healthcare requirements of such patients. Managers can take action by examining the issues and demands of nurses, and by providing job security, they can establish a Healthcare service systems with high security that can effectively respond during an outbreak of infectious diseases. Additionally, Nursing managers can prevent nurses from leaving their jobs by taking appropriate intervention, increasing their motivation, and enhancing their satisfaction.
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Affiliation(s)
- Esmaeil Hoseinzadeh
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
- Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Tahereh Ashktorab
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Hamid Sharif-Nia
- Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
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13
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Li T, Guan L, Zhang R, Han Y, Guo R, Li J, Ma C, Zhang N, Fan Y, Huang Y. Roles of doctor-patient relationship perception and job satisfaction in the impact of workplace violence on medical professionals' turnover intentions in the early phase of COVID-19: a cross-sectional study in China. BMJ Open 2023; 13:e074744. [PMID: 37666559 PMCID: PMC10481753 DOI: 10.1136/bmjopen-2023-074744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 08/09/2023] [Indexed: 09/06/2023] Open
Abstract
OBJECTIVE This study aimed to explore the role of the doctor-patient relationship (DPR) perception from the perspective of medical professionals in the association between workplace violence (WPV), job satisfaction and turnover intention in the early stages of the COVID-19 pandemic based on the affective events theory (AET). DESIGN A cross-sectional study. SETTING Nine medical institutions in Beijing were enrolled in this study. PARTICIPANTS In total, 792 medical professionals participated in the study, excluding administrators and logisticians. RESULTS The structural equation model was well adapted (comparative fit index (CFI) = 0.933; root mean square error of approximation (RMSEA) = 0.060). DPR mediated the association between WPV and job satisfaction, with an indirect effect of 0.247 (p<0.001). DPR perception mediated the effect of WPV on turnover intention, with an indirect effect of 0.090 (p<0.001). It also played a chain-mediating role in job satisfaction between WPV and turnover intention, with a mediation value of 0.117 (p<0.001), accounting for 53.42% of the total effect. CONCLUSIONS This study developed a stable model using AET. DPR perception plays an important role in the relationship between WPV and job satisfaction and turnover intention, suggesting the key impact of emotional factors. This has strong practical implications for maintaining the stability of medical teams. Therefore, medical institutions should improve the level of DPR perception from the perspective of medical professionals to effectively prevent mental health problems following WPV.
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Affiliation(s)
- Tiantian Li
- Capital Medical University, School of Public Health, Beijing, China
| | - Lizheng Guan
- Capital Medical University, School of Public Health, Beijing, China
| | - Rui Zhang
- Department of Hospital Infection Control, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Youli Han
- Capital Medical University, School of Public Health, Beijing, China
| | - Rui Guo
- Capital Medical University, School of Public Health, Beijing, China
| | - Jun Li
- Capital Medical University, School of Public Health, Beijing, China
| | - Chengyu Ma
- Capital Medical University, School of Public Health, Beijing, China
| | - Ning Zhang
- Capital Medical University, School of Public Health, Beijing, China
| | - Yezhi Fan
- Capital Medical University, School of Public Health, Beijing, China
| | - Yumei Huang
- Capital Medical University, School of Public Health, Beijing, China
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14
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Dong Y, Zhu Q, Chang R, Wang R, Cai Y, Huang H. Association between work stress and mental health in Chinese public health workers during the COVID-19 epidemic: mediating role of social support and self-efficacy. Front Public Health 2023; 11:1236645. [PMID: 37575107 PMCID: PMC10415911 DOI: 10.3389/fpubh.2023.1236645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 07/05/2023] [Indexed: 08/15/2023] Open
Abstract
Background Little is known about the mediating mechanisms underlying the association between work stress and mental health, especially among primary public health workers (PHWs). We aimed to evaluated the association between work stress and mental health among PHWs, and explore the mediating roles of social support and self-efficacy. Methods A large-scale cross-sectional survey was conducted among 3,809 PHWs from all 249 community health centers in 16 administrative districts throughout Shanghai, China. Pearson correlation and hierarchical linear regression were used to explore the associations among work stress, social support, self-efficacy and mental health. Structural equation modeling (SEM) was conducted to examine the mediation effects. Results The prevalence of depression and anxiety symptoms among primary PHWs was 67.3 and 55.5%, respectively. There is a significant positive direct effect of work stress on mental health (β = 0.325, p < 0.001). Social support and self-efficacy partially mediated the relationship between work stress and mental health, respectively. Meanwhile, the chained mediating effects of social support and self-efficacy also buffered the predictive effects of work stress on anxiety and depression symptoms (β = 0.372, p < 0.001). Conclusion Work stress has significant direct and indirect effects on mental health among primary PHWs. Enhancing social support and self-efficacy may be effective psychological interventions to mitigate the effects of work-related stress on mental health. These findings highlight the severity of mental health problems among primary public health workers and provide new evidence for early prevention and effective intervention strategies.
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Affiliation(s)
- Yinqiao Dong
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qianqian Zhu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruijie Chang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rongxi Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Cai
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong Univeristy School of Medicine, Shanghai, China
| | - Hong Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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15
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Ding C, Li L, Li G, Li X, Xie L, Duan Z. Impact of workplace violence against psychological health among nurse staff from Yunnan-Myanmar Chinese border region: propensity score matching analysis. BMC Nurs 2023; 22:242. [PMID: 37495998 PMCID: PMC10369719 DOI: 10.1186/s12912-023-01402-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 07/19/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Owing to different social background factor in Yunnan-Myanmar Chinese border region, stressful working environment may lead to extra psychological burden among nurse staff in China. However, the prevalence of workplace violence and its effect on psychological characteristics among nurse staff are still unclear. This study aims to explore the effect of workplace violence against psychological health among nurse staff from Yunnan-Myanmar Chinese border region. METHODS A cross-sectional survey was conducted among 18 local governmental hospitals in Dehong districts. Participants were 1,774 nurses. Psychosocial characteristics were screened by sleep quality, the 9-item Patient Health Questionnaire for depressive symptoms, the generalized anxiety disorder-7 for anxiety symptoms, the Connor Davidson Resilience Scale - 10 item for resilience, the multidimensional scale of perceived social support for social support, the Chinese version of Work place Violence Scale for workplace violence. Propensity score matching and multivariate linear regression were applied to analyze the data. RESULTS The nurse staff with workplace violence have a higher risk of bad sleep quality (b = -0.883, 95%CI = [-1.171, -0.595]), anxiety symptoms (b = 2.531, 95%CI = [2.031, 3.031]) and depressive symptoms (b = 3.227, 95%CI = [2.635, 3.819]), loneliness (b = 0.683, 95%CI = [0.503, 0.863]), perceived cognitive deficits (b = 1.629, 95%CI = [1.131, 2.127]), poor resilience (b = -2.012, 95%CI = [-2.963, -1.061]), and poor social support (b = -5.659, 95%CI = [-7.307, -4.011]). CONCLUSIONS Preventing workplace violence can improve mental health outcomes significantly among nurse staff, including loneliness, perceived cognitive deficits, anxiety symptoms, depressive symptoms, sleep quality, resilience and social support.
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Affiliation(s)
- Changmian Ding
- The Medical Record Management Department, Dehong People's Hospital, Yunnan, China
| | - Lidan Li
- The Nursing Department, Dehong People's Hospital, Yunnan, China
| | - Guizhi Li
- The Medical Record Management Department, Dehong People's Hospital, Yunnan, China
| | - Xuehua Li
- The Medical Record Management Department, Dehong People's Hospital, Yunnan, China
| | - Linli Xie
- The Nursing Department, Dehong People's Hospital, Yunnan, China
| | - Zhizhou Duan
- Preventive health service, Jiangxi provincial people's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China.
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16
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Zhang HL, Wu C, Yan JR, Liu JH, Wang P, Hu MY, Liu F, Qu HM, Lang HJ. The relationship between role ambiguity, emotional exhaustion and work alienation among chinese nurses two years after COVID-19 pandemic: a cross-sectional study. BMC Psychiatry 2023; 23:516. [PMID: 37464335 DOI: 10.1186/s12888-023-04923-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/03/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND work alienation is receiving increasing attention as a psychological risk at work, and little is known about the mechanisms of role ambiguity and work alienation in nurses in the context of the COVID-19 pandemic. This article aims to examine how role ambiguity affects work alienation among Chinese nurses during the two years after COVID-19 pandemic and verify emotional exhaustion as mediators. METHODS A cross-sectional study design was used to recruit 281 Chinese nurses. Nurses completed online questionnaires containing demographic characteristics, role ambiguity, emotional exhaustion, and work alienation, and SPSS 26.0 and AMOS 24.0 were used for data analysis and structural equation modelling. RESULTS work alienation scores were (34.64 ± 10.09), work alienation was correlated with role ambiguity and emotional exhaustion (r1 = 0.521, r2 = 0.755; p < .01), and role ambiguity was positively correlated with emotional exhaustion (r = 0.512; p < .01). A mediating effect of emotional exhaustion between role ambiguity and work alienation held (mediating effect of 0.288, 95% CI: 0.221-0.369, accounting for 74.8% of the total effect). CONCLUSION Role ambiguity has a significant direct effect on nurses' feelings of alienation and exacerbates alienation through emotional exhaustion. Clarifying roles at work and being less emotionally drained are effective ways to reduce nurses' feelings of alienation.
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Affiliation(s)
- Hong-Li Zhang
- School of Nursing, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Chao Wu
- Department of Nursing, Fourth Military Medical University, No.169 Changle West Road, Xi'an, 710032, Shaanxi, China
| | - Jia-Ran Yan
- Department of Nursing, Fourth Military Medical University, No.169 Changle West Road, Xi'an, 710032, Shaanxi, China
| | - Jun-Hua Liu
- Department of Nursing, Qufu Traditional Chinese Medicine Hospital, Shandong, China
| | - Pei Wang
- Department of Nursing, Fourth Military Medical University, No.169 Changle West Road, Xi'an, 710032, Shaanxi, China
| | - Meng-Yi Hu
- School of Nursing, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Fang Liu
- School of Nursing, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Huan-Min Qu
- Human Resources Department, Tangdu Hospital, Air Force Medical University, Shaanxi, 710032, Xian, China.
| | - Hong-Juan Lang
- Department of Nursing, Fourth Military Medical University, No.169 Changle West Road, Xi'an, 710032, Shaanxi, China.
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17
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Park CG. Implementing alternative estimation methods to test the construct validity of Likert-scale instruments. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2023; 29:85-90. [PMID: 37415477 DOI: 10.4069/kjwhn.2023.06.14.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 06/14/2023] [Indexed: 07/08/2023] Open
Affiliation(s)
- Chang Gi Park
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
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18
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Zhang S, Zhao Z, Zhang H, Zhu Y, Xi Z, Xiang K. Workplace violence against healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-27317-2. [PMID: 37209334 DOI: 10.1007/s11356-023-27317-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 04/26/2023] [Indexed: 05/22/2023]
Abstract
Workplace violence (WPV) is a prevalent phenomenon, especially in the healthcare setting. WPV against healthcare workers (HCWs) has increased during the COVID-19 epidemic. This meta-analysis determined the prevalence and risk factors of WPV. A database search was conducted across six databases in May 2022, which was updated in October 2022. WPV prevalence among HCWs was the main outcome. Data were stratified by WPV/HCW type, pandemic period (early, mid, late), and medical specialty. WPV risk factors were the secondary outcome. All analyses were conducted through STATA. Newcastle Ottawa Scale evaluated the quality. Sensitivity analysis identified effect estimate changes. A total of 38 studies (63,672 HCWs) were analyzed. The prevalence of WPV of any kind (43%), physical (9%), verbal (48%), and emotional (26%) was high. From mid-pandemic to late-pandemic, WPV (40-47%), physical violence (12-23%), and verbal violence (45-58%) increased. Nurses had more than double the rate of physical violence (13% vs. 5%) than physicians, while WPV and verbal violence were equal. Gender, profession, and COVID-19 timing did not affect WPV, physical, or verbal violence risk. COVID-19 HCWs were more likely to be physically assaulted (logOR = 0.54; 95% CI: 0.10: 0.97). Most healthcare employees suffer verbal violence, followed by emotional, bullying, sexual harassment, and physical assault. Pandemic-related workplace violence increased. Nurses were twice as violent as doctors. COVID-19 healthcare employees had a higher risk of physical and workplace violence.
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Affiliation(s)
- Shuisheng Zhang
- Department of Geriatrics, Jilin Academy of Chinese Medical Sciences, No. 1745, Gongnongda Road, Changchun, 130012, Jilin, China
| | - Zhen Zhao
- Department of Geriatrics, Jilin Academy of Chinese Medical Sciences, No. 1745, Gongnongda Road, Changchun, 130012, Jilin, China
| | - Huan Zhang
- Nursing Department, Changchun Children's Hospital, Changchun, 130061, Jilin, China
| | - Yanhua Zhu
- Department of Geriatrics, Jilin Academy of Chinese Medical Sciences, No. 1745, Gongnongda Road, Changchun, 130012, Jilin, China
| | - Zhongyuan Xi
- Department of Pulmonary Disease, Jilin Academy of Chinese Medical Sciences, Changchun, 130012, Jilin, China
| | - Ke Xiang
- Department of Geriatrics, Jilin Academy of Chinese Medical Sciences, No. 1745, Gongnongda Road, Changchun, 130012, Jilin, China.
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Wu J, Xia Q, Miao Y, Yu C, Tarimo CS, Yang Y. Self-perception and COVID-19 vaccination self-efficacy among Chinese adults: A moderated mediation model of mental health and trust. J Affect Disord 2023; 333:313-320. [PMID: 37084973 PMCID: PMC10116156 DOI: 10.1016/j.jad.2023.04.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/31/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Optimal COVID-19 vaccination coverage is necessary to achieve community protection, and self-efficacy independently predict vaccination behavior. The current study examined the effect of self-perception on COVID-19 vaccination self-efficacy as well as potential mechanisms among Chinese adults. METHODS A cross-sectional survey was conducted from four cities in China (n = 6781). Models 4 and 8 in Hayes' PROCESS macro were used to test models. RESULTS Self-perception (β = 0.128, 95 % CI: 0.093-0.163) and self-perception ∗ mental health (β = 0.009, 95 % CI: 0.003-0.014) were positively associated with trust in doctors and vaccine developers, while mental health was negatively related to trust in doctors and vaccine developers (β = -0.483, 95 % CI: -0.629-0.337). Self-perception (β = 0.149, 95 % CI: 0.138-0.161), trust in doctors and vaccine developers (β = 0.185, 95 % CI: 0.177-0.194) and self-perception ∗ mental health (β = 0.003, 95 % CI: 0.002-0.005) were positively associated with COVID-19 vaccination self-efficacy. Mental health was negatively related to COVID-19 vaccination self-efficacy (β = -0.101, 95 % CI: -0.151-0.051). LIMITATIONS This cross-sectional study collected data through online questionnaires. CONCLUSIONS Our results demonstrated that the relationship between self-perception and COVID-19 vaccination self-efficacy was partially mediated by trust in doctors and vaccine developers. Both the correlation between self-perception and COVID-19 vaccination self-efficacy, and the relationship between self-perception and trust in doctors and vaccine developers were moderated by mental health. Findings confirm that increasing COVID-19 vaccination self-efficacy would be facilitated by improvements in self-perception, mental health, and trust in doctors and vaccine developers.
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Affiliation(s)
- Jian Wu
- Department of Health management, College of Public Health, Zhengzhou University, 100 Kexue Road, Gaoxin district, Zhengzhou 450001, China
| | - Qingyun Xia
- Department of Health management, College of Public Health, Zhengzhou University, 100 Kexue Road, Gaoxin district, Zhengzhou 450001, China
| | - Yudong Miao
- Department of Health management, College of Public Health, Zhengzhou University, 100 Kexue Road, Gaoxin district, Zhengzhou 450001, China
| | - Chengcheng Yu
- Department of Health management, College of Public Health, Zhengzhou University, 100 Kexue Road, Gaoxin district, Zhengzhou 450001, China
| | - Clifford Silver Tarimo
- Department of Health management, College of Public Health, Zhengzhou University, 100 Kexue Road, Gaoxin district, Zhengzhou 450001, China
| | - Yinmei Yang
- Department of Health management, College of Public Health, Zhengzhou University, 100 Kexue Road, Gaoxin district, Zhengzhou 450001, China.
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20
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Yin M, Zhang W, Evans R, Zhu C, Wang L, Song J. Violence on the front line: a qualitative comparative analysis of the causes of patient violence towards medical staff in China during the COVID-19 pandemic. CURRENT PSYCHOLOGY 2023:1-21. [PMID: 37359625 PMCID: PMC9979127 DOI: 10.1007/s12144-023-04456-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 03/06/2023]
Abstract
COVID-19, reduced funding and a shortage of healthcare workers has led to growing international concern about patient violence towards medical staff in medical settings. As the number of reported physical and verbal assaults increases, many medical staff are considering leaving their positions due to the resulting impact on their mental and physical wellbeing, creating a critical need to understand the causes for violence towards medical staff working on the front line. This study aims to examine the causes for patient violence towards medical staff in China during the COVID-19 pandemic. A case library was created containing twenty reported incidents of patient violence towards medical staff during the pandemic in China. Based on the Triadic Reciprocal Determinism (TRD) theory, we identify the personal, environmental, and behavioral factors, that cause incidents of violence towards medical staff. The outcome was set as 'Medical Staff Casualties', referring to whether, due to the violence experienced, the medical staff member was injured or died, or only experienced threatening or insulting behavior. Data was analyzed using Qualitative Comparative Analysis (QCA) to clarify the relationship between the different conditions and their relationship with the outcome. The study's results reveal that Relationship Closeness is a necessary condition for patient violence in the presence of outcome. Secondly, four distinct types of causes for patient violence towards medical staff were identified: Strong Relationship Oriented Violence, Healthcare Resources and Services Mismatched Violence, Violence caused by Ineffective Patient-Physician Communication, and Ineffective Communication Superimposed Low Patient Compliance Violence. Scientific guidance is provided for the creation of measures to prevent future violence towards medical staff from occurring. Strict precautions should be taken for preventing violence to protect a healthy society and harmonious medical environment, emphasizing the need for joint governance of multiple participants.
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Affiliation(s)
- Mengmeng Yin
- School of Medicine and Health Management, Huazhong University of Science and Technology, 13# Hangkong Road, Qiaokou District, Wuhan, China
| | - Wei Zhang
- School of Medicine and Health Management, Huazhong University of Science and Technology, 13# Hangkong Road, Qiaokou District, Wuhan, China
| | - Richard Evans
- Faculty of Computer Science, Dalhousie University, 6050 University Avenue, PO BOX 15000, B3H 4R2 Halifax, NS Canada
| | - Chengyan Zhu
- School of Political Science and Public Administration, Wuhan University, 299# Bayi Road, Wuchang District, Wuhan, Hubei Province China
| | - Longwen Wang
- School of International Studies, Sichuan University, 24# South Section 1, Yihuan Road, Chengdu, Sichuan China
| | - Jun Song
- Xiangyang Hospital of Traditional Chinese Medicine, 24 # Changzheng Road, Xiangyang, Hubei China
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21
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Jiang N, Zhou X, Gong Y, Tian M, Wu Y, Zhang J, Chen Z, Wang J, Wu J, Yin X, Lv C. Factors related to turnover intention among emergency department nurses in China: A nationwide cross-sectional study. Nurs Crit Care 2023; 28:236-244. [PMID: 35384173 DOI: 10.1111/nicc.12770] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Turnover intention among nurses is high, especially in the emergency department. However, factors that are associated with Chinese emergency department nurses' turnover intention have been scarcely studied. AIMS The present study examined relationships between turnover intention and demographic characteristics, job-related factors, depressive symptoms, and organizational commitment among emergency department nurses. STUDY DESIGN A cross-sectional study of emergency department nurses was conducted in China between July and August 2018. The questionnaire included demographic characteristics (age, gender, level of education, and self-rated health status), job-related factors (qualification title, job seniority, night shifts, and workplace violence), depressive symptoms, organizational commitment, and turnover intention. A hierarchical linear regression model was used to identify factors that are associated with turnover intention among emergency department nurses. RESULTS A total of 17 582 emergency department nurses participated in the study. The response rate was 68.9%. The findings indicated that poor self-rated health status (β = 0.25, p < .001), working more than 11 night shifts per month (β = 0.14, p < .01), experiencing workplace violence in the past year (β = 0.08, p < .05), and higher depressive symptom scores (β = 0.07, p < .001) positively correlated with turnover intention. More years of service (β = -0.38, p < .001) and higher organizational commitment scores (β = -0.45, p < .001) negatively correlated with turnover intention. CONCLUSIONS Health status, job seniority, night shift frequency per month, workplace violence, depressive symptoms, and organizational commitment were significantly associated with emergency department nurses' turnover intention. RELEVANCE TO CLINICAL PRACTICE To reduce turnover intention in the emergency department nurses, hospital administrators and managers should implement measures to improve their physical and mental health, increase organizational commitment, develop staff acceptable shift schedules, and reduce incidences of workplace violence.
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Affiliation(s)
- Nan Jiang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuan Zhou
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengge Tian
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yafei Wu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiali Zhang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhenyuan Chen
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianxiong Wu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chuanzhu Lv
- Department of Emergency Medicine Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.,Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No.2019RU013), Hainan Medical University, Haikou, China.,Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, China
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22
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Li Z, Liu J, Li H, Huang Y, Xi X. Primary Healthcare Pharmacists' Perceived Organizational Support and Turnover Intention: Do Gender Differences Exist? Psychol Res Behav Manag 2023; 16:1181-1193. [PMID: 37082527 PMCID: PMC10112469 DOI: 10.2147/prbm.s406942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/05/2023] [Indexed: 04/22/2023] Open
Abstract
Purpose This study aims to explore the relationship between the four-dimensional structured perceived organizational support (emotional support, instrumental support, supervisor support, and coworker support) and the turnover intention of pharmacists in primary healthcare institutions. The gender differences between perceived organizational support and turnover intention will also be examined. Methods A cross-sectional study was conducted in primary healthcare institutions of 31 cities in China from 2 July to 1 September 2021. And the binary logistic regression model was employed for data analysis. Results 937 valid questionnaires are allocated from pharmacists in primary healthcare institutions. The regression results indicated that emotional support (b=0.073, p<0.001) has a significant influence on pharmacists' turnover intention, and the effect of supervisor support (b=0.173, p=0.046) on pharmacists' turnover intention differs by gender. Conclusion These findings offer suggestions for the management and stabilization of pharmacists in primary healthcare institutions. It is suggested that specific measures should be taken to increase pharmacists' perceived organizational support and reduce their turnover intention. At the same time, gender differences need to be taken into consideration by the managers when providing perceived organizational support to reduce their turnover intention through adaptive management.
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Affiliation(s)
- Ziqing Li
- The Research Center of National Drug Policy and Ecosystem, China Pharmaceutical University, Nanjing, People’s Republic of China
| | - Jiayuan Liu
- The Research Center of National Drug Policy and Ecosystem, China Pharmaceutical University, Nanjing, People’s Republic of China
| | - Haotao Li
- The Research Center of National Drug Policy and Ecosystem, China Pharmaceutical University, Nanjing, People’s Republic of China
| | - Yuankai Huang
- The Research Center of National Drug Policy and Ecosystem, China Pharmaceutical University, Nanjing, People’s Republic of China
- Correspondence: Yuankai Huang; Xiaoyu Xi, The Research Center of National Drug Policy and Ecosystem, China Pharmaceutical University, Longmian Avenue 639, Jiangning District, Nanjing, 211198, People’s Republic of China, Email ;
| | - Xiaoyu Xi
- The Research Center of National Drug Policy and Ecosystem, China Pharmaceutical University, Nanjing, People’s Republic of China
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23
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Li Q, Zhou J, Chen L. More exposure to medical injury news, better doctor-patient communication, but less doctors' professional identity: A moderated chain mediation model. Front Public Health 2022; 10:1045014. [PMID: 36620286 PMCID: PMC9814165 DOI: 10.3389/fpubh.2022.1045014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives In recent years, news of medical malignant injury events has become common in China. However, it is unclear how exposure to this news affects medical staff. Methods The present study collected data from a sample of 311 medical staff in China. It explored the effect of exposure to such news on medical staff's communication and willingness to let their children be doctors, which was an attitude that reflects their professional identity well. In addition, this study also examined the mediating roles of outgroup attribution and anxiety, and the moderating role of social support. Results The results showed that exposure to news of medical injury could positively and directly predict the quality of doctor-patient communication, but negatively and indirectly predict medical staff's willingness to let their children become doctors. These effects existed through the mediating role of anxiety and the chain mediating role of both outgroup attribution and anxiety. In addition, social support could mitigate the negative correlation between news exposure and outgroup attribution. Conclusions These results suggest that news of medical malignant injury events may incentivize medical staff to improve the quality of communication in the short term, but it is not conducive to medical staff's long-term mental health. That is, exposure to news of medical injury is likely to lead to a negative influence on their professional identity, although social support can alleviate this negative influence.
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Affiliation(s)
- Qiwei Li
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jie Zhou
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,*Correspondence: Jie Zhou ✉
| | - Lei Chen
- Department of Ultrasound, Peking University First Hospital, Beijing, China
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24
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Poon YSR, Lin YP, Griffiths P, Yong KK, Seah B, Liaw SY. A global overview of healthcare workers' turnover intention amid COVID-19 pandemic: a systematic review with future directions. HUMAN RESOURCES FOR HEALTH 2022; 20:70. [PMID: 36153534 PMCID: PMC9509627 DOI: 10.1186/s12960-022-00764-7] [Citation(s) in RCA: 101] [Impact Index Per Article: 50.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/29/2022] [Indexed: 05/06/2023]
Abstract
BACKGROUND Globally, the health workforce has long suffered from labour shortages. This has been exacerbated by the workload increase caused by the COVID-19 pandemic. Major collapses in healthcare systems across the world during the peak of the pandemic led to calls for strategies to alleviate the increasing job attrition problem within the healthcare sector. This turnover may worsen given the overwhelming pressures experienced by the health workforce during the pandemic, and proactive measures should be taken to retain healthcare workers. This review aims to examine the factors affecting turnover intention among healthcare workers during the COVID-19 pandemic. METHODS A mixed studies systematic review was conducted. The PubMed, Embase, Scopus, CINAHL, Web of Science and PsycINFO databases were searched from January 2020 to March 2022. The Joanna Briggs Institute's Critical Appraisal Tools and the Mixed Methods Appraisal Tool version 2018 were applied by two independent researchers to critically appraise the methodological quality. Findings were synthesised using a convergent integrated approach and categorised thematically. RESULTS Forty-three studies, including 39 quantitative, two qualitative and two mixed methods studies were included in this review. Eighteen were conducted in the Middle East, ten in the Americas, nine in the Asia-Pacific region and six in Europe. Nurses (n = 35) were included in the majority of the studies, while physicians (n = 13), allied health workers (n = 11) and healthcare administrative or management staff (n = 7) were included in a smaller proportion. Five themes emerged from the data synthesis: (1) fear of COVID-19 exposure, (2) psychological responses to stress, (3) socio-demographic characteristics, (4) adverse working conditions, and (5) organisational support. CONCLUSIONS A wide range of factors influence healthcare workers' turnover intention in times of pandemic. Future research should be more focused on specific factors, such as working conditions or burnout, and specific vulnerable groups, including migrant healthcare workers and healthcare profession minorities, to aid policymakers in adopting strategies to support and incentivise them to retain them in their healthcare jobs.
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Affiliation(s)
| | | | - Peter Griffiths
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (Wessex), University of Southampton, Southampton, UK
| | - Keng Kwang Yong
- Group Nursing, National Healthcare Group, Singapore, Singapore
| | - Betsy Seah
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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25
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Wang T, Abrantes ACM, Liu Y. Intensive care units nurses' burnout, organizational commitment, turnover intention and hospital workplace violence: A cross-sectional study. Nurs Open 2022; 10:1102-1115. [PMID: 36126210 PMCID: PMC9834521 DOI: 10.1002/nop2.1378] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/31/2022] [Accepted: 09/04/2022] [Indexed: 01/16/2023] Open
Abstract
AIMS This study aimed to (1) assess the relationship between intensive care unit (ICU) nurses' burnout, organizational commitment and turnover intention, (2) examine the moderating effect of the organizational commitment on the relationship between ICU nurses' burnout and turnover intention, and (3) explore the prevalence and influencing factors of hospital workplace violence among ICU nurses. DESIGN Cross-sectional study design. METHODS Data were collected from August to October 2020 and a convenience sample of registered nurses was recruited. To control common method biases, one-month temporal separation, Harman's single-factor analysis and method of latent variables were adopted. The moderating effect was tested by SPSS Hayes PROCESS Macro. Chi-square and logistic regression were used to examine workplace violence data. RESULTS Organizational commitment (β = -.23, 95% confidence interval -.45 to -.03) and continuance commitment (β = -.15, 95% confidence interval -.24 to -.16) have negative moderation effects on the relationship between emotional exhaustion and turnover intention. 77.7% of ICU nurses experienced workplace violence, male and staff nurses, and nurses with lower professional titles and shorter working years have greater odds of experiencing this violence.
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Affiliation(s)
- Tiemei Wang
- Hepato Pancreato Biliary Surgery, Department of General SurgeryThe Third People’s Hospital of Chengdu &The Affiliated Hospital of Southwest Jiaotong UniversityChengduSichuanChina
| | | | - Yan Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University/West China School of Nursing, Sichuan UniversityChengduSichuanChina
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26
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Yang Y, Wang P, Kelifa MO, Wang B, Liu M, Lu L, Wang W. How workplace violence correlates turnover intention among Chinese health care workers in COVID-19 context: The mediating role of perceived social support and mental health. J Nurs Manag 2022; 30:1407-1414. [PMID: 33792990 PMCID: PMC8250348 DOI: 10.1111/jonm.13325] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 03/07/2021] [Accepted: 03/27/2021] [Indexed: 12/11/2022]
Abstract
AIM To elucidate the effects of workplace violence on turnover intention among Chinese health care workers, and to identify the potential mediators in this relationship. BACKGROUND Workplace violence has emerged as a crucial determinant of turnover intention for health care workers. METHODS A cross-sectional survey was conducted among Chinese health care workers (N = 1,063) between 13 and 20 February 2020. Mediation effects were tested using structural equation modelling with weighted least squares mean and variance adjusted (WLSMV) estimator. RESULTS Workplace violence had both direct and indirect effects on turnover intention among Chinese health care workers. Specifically, perceived social support, mental health and perceived social support together with mental health partially mediated the relationship between workplace violence and turnover intention. CONCLUSIONS Chinese health care workers experiencing violence during the COVID-19 outbreak were more likely to report turnover intention. Enhancing social support and reducing mental health problems would be beneficial in decreasing the detrimental effects of workplace violence on turnover intention. IMPLICATIONS FOR NURSING MANAGEMENT Ensuring health care workers' health and safety is vital in reducing turnover intention, which in turn ascertains continuity of health care delivery. Health care managers should develop targeted interventions to improve social support and prevent post-violence mental health problems.
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Affiliation(s)
- Yinmei Yang
- School of Health SciencesWuhan UniversityWuhanChina
| | - Peigang Wang
- School of Health SciencesWuhan UniversityWuhanChina
| | | | - Bo Wang
- Department of Population and Quantitative Health SciencesUniversity of Massachusetts Medical SchoolWorcesterMAUSA
| | - Mingxiu Liu
- School of NursingHubei University of MedicineShiyanChina
| | - Lili Lu
- Department of Gastroenterologythe Affiliated Hospital of Xuzhou Medical UniversityXuzhouChina
| | - Wei Wang
- School of Public HealthXuzhou Medical UniversityXuzhouChina
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27
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Xiao S, Shi L, Lin H, Shihong Z, Ou W, Zhang J, Zhu H, Zhang C. The impact of psychological capital on turnover intention among Chinese nurses: A moderated mediation model. J Nurs Manag 2022; 30:3031-3040. [PMID: 35661464 DOI: 10.1111/jonm.13702] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 05/30/2022] [Accepted: 06/02/2022] [Indexed: 11/27/2022]
Abstract
AIMS This study examined how the mediating effect of psychological distress and the moderating role of social support influence the connection between psychological capital and turnover intention among Chinese nurses. BACKGROUND Nurses play a crucial role in medical and health services, but turnover intentions are common among them. METHODS A cross-sectional survey was conducted involving 4,865 nurses in China. The Chinese Psychological Capital Questionnaire, Depression, Anxiety and Stress Scale, Social Support Rating Scale, and Turnover Intention Scale were used to gather data. Bootstrap and simple slope methods were used to test the mediating effect of psychological distress and the moderating effect of social support. RESULTS Psychological capital had a significant direct impact on turnover intention among nurses (B = -0.040, t = -10.032, P < 0.001). Psychological distress had a mediation effect of 46.89% between psychological capital and turnover intention. Moreover, social support had a moderating role in the relationship between psychological distress and psychological capital and between psychological distress and turnover intention. CONCLUSIONS Psychological capital correlated negatively with psychological distress and turnover intention and indirectly influenced turnover intention through psychological distress. Social support moderated the first and second half of the path in the mediating model of psychological distress. These findings have implications for early intervention for and the prevention of turnover intention in nurses. IMPLICATIONS FOR NURSING MANAGEMENT This study's findings can inform the design of effective nurse support programs to reduce the impact of psychological distress on turnover intention among nurses.
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Affiliation(s)
- Shujuan Xiao
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.,School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Huang Lin
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.,School of Health Management, Southern Medical University, Guangzhou, Guangdong, China.,Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhao Shihong
- The Sixth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Weiyan Ou
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | | | - Hong Zhu
- Nanfang Hospital, Southern Medical University, Guangzhou, China.,Health Commission of Guangdong Province, Guangzhou, China
| | - Chichen Zhang
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.,Nanfang Hospital, Southern Medical University, Guangzhou, China.,Institute of Health Management, Southern Medical University, Guangzhou, Guangdong, China
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28
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Han X, Jiang F, Shen L, Liu Y, Liu T, Liu H, Wang P, Yang Z, Tang YL, Zhu J. Workplace Violence, Workforce Stability, and Well-being in China's Psychiatric Hospitals. Am J Prev Med 2022; 62:e265-e273. [PMID: 34865934 DOI: 10.1016/j.amepre.2021.09.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/10/2021] [Accepted: 09/17/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Workplace violence against psychiatric professionals is a growing problem, yet nationally representative data in China are lacking. This study examines workplace violence against psychiatrists and psychiatric nurses in China as well as its association with workforce stability and well-being . METHODS Data came from a 2019 national survey of 14,264 participants (including 4,520 psychiatrists and 9,744 nurses) from 41 psychiatric hospitals across China. The occurrence of physical and verbal assaults among psychiatrists and psychiatric nurses was reported. Logistic regression models were constructed to examine the participants' characteristics associated with encountering workplace violence and the association of encountering violence with self-reported quality of life, health status, turnover intention, and career satisfaction. Analyses were performed during 2020. RESULTS In 2019, among 14,264 psychiatrists and psychiatric nurses in China, 81% reported encountering workplace violence during the past year. Psychiatrists were 0.68 (95% CI=0.55, 0.83) times less likely to report an encounter of violence than nurses. Male and younger nurses were 2.20 (95% CI=1.72, 2.81) and 1.21 (95% CI=1.01, 1.45) times more likely to report violence. Psychiatrists who had a higher educational degree or a higher professional rank were more vulnerable to violence. Encountering violence was significantly associated with poor quality of life, less satisfaction with health status, greater intention to leave the current job, and career dissatisfaction. CONCLUSIONS Workplace violence against psychiatrists and psychiatric nurses are common in China, indicating that China's psychiatric professionals are facing a significant threat to occupational safety. To maintain psychiatric workforce stability, actions are needed to reduce the prevalence of workplace violence at the system, institutional, and individual levels.
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Affiliation(s)
- Xinxin Han
- Vanke School of Public Health, Tsinghua University, Beijing, China; School of Medicine, Tsinghua University, Beijing, China
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China; Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Lijun Shen
- Vanke School of Public Health, Tsinghua University, Beijing, China; School of Medicine, Tsinghua University, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tingfang Liu
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China; Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Peicheng Wang
- School of Medicine, Tsinghua University, Beijing, China; Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Zimo Yang
- School of Medicine, Tsinghua University, Beijing, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia; Mental Health Service Line, Atlanta, Georgia
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, China.
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29
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Shah SHA, Haider A, Jindong J, Mumtaz A, Rafiq N. The Impact of Job Stress and State Anger on Turnover Intention Among Nurses During COVID-19: The Mediating Role of Emotional Exhaustion. Front Psychol 2022; 12:810378. [PMID: 35222162 PMCID: PMC8863937 DOI: 10.3389/fpsyg.2021.810378] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 12/13/2021] [Indexed: 01/12/2023] Open
Abstract
Based on the social exchange theory, the aim of this study is to identify the association between job stress state anger, emotional exhaustion and job turnover intention. This study postulates that job related stress and state anger among nurses during COVID-19 subsequently leads to their job turnover intentions. In addition, the study also aims to see the mediating role of emotional exhaustion between COVID-19-related job stress, state anger, and turnover intentions. The sample of this study is gathered from 335 registered nurses working in Pakistani hospitals dealing with COVID-19-related patients. The interrelationships between variables are checked by using structural equation modeling through AMOS. Key findings confirm that COVID-19-related job stress and state anger had a significant effect on nurses' turnover intentions. Furthermore, emotional exhaustion mediated the relationship between COVID-19-related job stress, state anger, and turnover intentions. There is a lack of research which has assessed the impact of Novel COVID-19-related job stress and state anger on nurses' turnover intentions in hospitals, providing empirical evidence from a developing country-Pakistan. This study offers managerial implications for hospital management and health policymakers. Moreover, nursing managers need to pay attention to nurses' turnover intentions who are facing the issue at the front line as patients receive their initial treatment from nurses in the COVID-19 outbreak.
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Affiliation(s)
| | - Aftab Haider
- Department of Business Studies, Bahria University, Islamabad, Pakistan
| | - Jiang Jindong
- Department of Psychology, Jinhenyi School of Education, Hangzhou Normal University, Hangzhou, China
| | - Ayesha Mumtaz
- College of Public Administration, Zhejiang University, Hangzhou, China
| | - Nosheen Rafiq
- Department of Management Sciences, Bahria University, Islamabad, Pakistan
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30
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Kabir H, Chowdhury SR, Tonmon TT, Roy AK, Akter S, Bhuya MTR, Hossain L, Chowdhury SA, Sanjoy S. Workplace violence and turnover intention among the Bangladeshi female nurses after a year of pandemic: An exploratory cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000187. [PMID: 36962185 PMCID: PMC10021668 DOI: 10.1371/journal.pgph.0000187] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/19/2022] [Indexed: 11/18/2022]
Abstract
During the COVID-19 pandemic, workplace violence was widespread against healthcare personnel. Workplace violence (WPV) against nurses exhilarates their turnover intention (TI). The objective of this study was to investigate the association between workplace violence and turnover intention and also identify other factors associated with TI among Bangladeshi female nurses. An exploratory cross-sectional study was carried out among 881 female nurses between April 26 and July 10, 2021. The TI of the female nurses was the outcome variable of this study. The primary exposure variable was WPV faced by the nurses. Workplace Violence Scale (WPVS) was used to measure the WPV, and Turnover Intention Scale-6 (TIS-6) was used to measure the TI of the nurses. Multiple linear regression model was fitted to find the adjusted association of TI with WPV and other study variables. A stratified analysis by type of job (government vs. private) was also performed. The majority of the nurses (74.46%) faced low to high levels of WPV. The overall mean score of TIS was found 16.33 (± 4.72). Multiple linear regression analysis revealed that compared to government jobholders, the mean score of TIS (15.81 vs. 17.20) was found significantly higher among the private jobholders (p < 0.001). Nurses exposed to the intermediate and high level of WPV had a significantly higher TI score (β = 4.35, 95% CI: 3.36, 5.34) than the non-exposures. The TI of private jobholders was found significantly higher (β = 2.04, 95% CI: 1.09, 3.00) than the government jobholders. Compared to diploma degree holders, significantly higher TI was observed among the B.Sc. degree holders (β = 0.86, 95% CI: 0.22, 1.55) and M.Sc. degree holders (β = 1.46, 95% CI: 0.58, 2.34). Besides, the nurses who did not get timely salaries scored higher TI (β = 1.17, 95% CI: 0.12, 2.22). Moreover, the nurses who did not receive any training against WPV scored significantly higher TI (β = 1.89, 95% CI: 1.03, 2.74). The stratified analysis by type of job also revealed significant factors of TI in government and private settings. This study found a high prevalence of WPV and a high rate of TI among Bangladeshi female nurses. Moreover, this study explored an association between WPV and TI. The study findings could help policymakers facilitate a comfortable working environment by preventing WPV and addressing the factors to reduce nurses' frequent TI.
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Affiliation(s)
- Humayun Kabir
- Department of Public Health, North South University, Dhaka, Bangladesh
| | | | - Tajrin Tahrin Tonmon
- Department of Public Health, North South University, Dhaka, Bangladesh
- Department of Anthropology, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Anjan Kumar Roy
- Department of Nursing and Health Science, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Shimpi Akter
- Department of Medical Studies, Bangladesh University of Professionals, Dhaka, Bangladesh
| | | | - Lukman Hossain
- Department of Sociology, University of Dhaka, Dhaka, Bangladesh
| | | | - Shubrandu Sanjoy
- Research Department, Saskatchewan Health Authority, Regina, Canada
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31
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Chen Y, Wang P, Zhao L, He Y, Chen N, Liu H, Liu Y, Liu T, Tang YL, Jiang F, Zhu J. Workplace Violence and Turnover Intention Among Psychiatrists in a National Sample in China: The Mediating Effects of Mental Health. Front Psychiatry 2022; 13:855584. [PMID: 35782425 PMCID: PMC9240432 DOI: 10.3389/fpsyt.2022.855584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 05/13/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Workplace violence (WPV) in healthcare has received much attention worldwide. However, scarce data are available on its impact on turnover intention among psychiatrists, and the possible mechanisms between WPV and turnover intention have not been explored in China. METHODS A cross-sectional survey was conducted among psychiatrists in 41 tertiary psychiatric hospitals from 29 provinces and autonomous regions in China. A stress-strain-outcome (SSO) model was adopted to examine the effects of WPV on mental health and turnover intention. The association and mediation by burnout and stress were examined by multivariate logistic regression (MLR) and generalized structure equation modeling (GSEM). RESULTS We invited 6,986 psychiatrists to participate, and 4,520 completed the survey (64.7% response rate). The prevalence of verbal and physical violence against psychiatrist in China was 78.0 and 30.7%, respectively. MLR analysis showed that psychiatrists who experienced verbal violence (OR = 1.15, 95% CI = 1.10-1.21) and physical violence (OR = 1.15, 95% CI = 1.07-1.24) were more likely to report turnover intention. GSEM analysis showed that burnout (β = 4.00, p < 0.001) and stress (β = 1.15, p < 0.001) mediated the association between verbal violence and turnover intention; similarly, burnout (β = 4.92, p < 0.001) and stress (β = 1.80, p < 0.001) also mediated the association between physical violence and turnover intention. CONCLUSIONS Experience of WPV is a significant contributor to turnover intention among psychiatrists. Mental health status, such as burnout and stress level significantly mediated the association. Policy makers and hospital administrators need to be aware of this association. Action is needed to promote mental health among the psychiatrists to improve morale and workforce sustainability.
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Affiliation(s)
- Yanhua Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China.,School of Medicine, Tsinghua University, Beijing, China
| | - Peicheng Wang
- School of Medicine, Tsinghua University, Beijing, China
| | - Lina Zhao
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Yanrong He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Nuoya Chen
- Health Related Activity Recognition System Based on IoT Project, University of Macerata, Macerata, Italy
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Tingfang Liu
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Yi-Lang Tang
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, United States.,Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.,Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, China.,Institute for Healthy China, Tsinghua University, Beijing, China
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BAYER N, ÇANKAYA M. THE RELATIONSHIP BETWEEN EMOTIONAL LABOR, ORGANIZATIONAL LOYALTY, AND TURNOVER INTENTION IN NURSES. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.927145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Nashwan AJ, Abujaber AA, Villar RC, Nazarene A, Al-Jabry MM, Fradelos EC. Comparing the Impact of COVID-19 on Nurses' Turnover Intentions before and during the Pandemic in Qatar. J Pers Med 2021; 11:jpm11060456. [PMID: 34073655 PMCID: PMC8225037 DOI: 10.3390/jpm11060456] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/04/2021] [Accepted: 05/20/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Although several studies examining nurses’ turnover intentions have been conducted, few studies have been conducted to explore how COVID-19 contributes to nurses’ turnover intentions. This study aims to compare nurses’ turnover (TO) intentions before and during COVID-19. Methods: The cross-sectional study was conducted using the Turnover Intention Scale (TIS-6) and a convenience sample of participants from the largest healthcare provider in Qatar between August and September 2020. Results: A total of 512 nurses were included in the final analysis. The majority were between 31 and 40 years of age (61.5%), 67.6% were females, 76.4% were married, 79.7% had a BSN, 43% had less than 5 years of experience, and 60.4% had worked in COVID-19 designated facilities. The turnover intentions were higher compared with before COVID-19 (p < 0.01). Conclusion: Nurses in Qatar have higher TO intentions during COVID-19. The participants’ characteristics and stress levels are playing a major role in nurses’ decision to leave during COVID-19. Understanding the factors that contribute to turnover intentions is crucial for workforce planning, especially during pandemics.
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Affiliation(s)
- Abdulqadir J. Nashwan
- Department of Nursing, Hazm Mebaireek General Hospital (HMGH), Hamad Medical Corporation (HMC), Doha 3050, Qatar; (A.A.A.); (R.C.V.); (M.M.A.-J.)
- Faculty of Nursing, University of Calgary in Qatar (UCQ), Doha P.O. Box 23133, Qatar
- Correspondence: ; Tel.: +974-4024-0487 or +974-6647-3549
| | - Ahmad A. Abujaber
- Department of Nursing, Hazm Mebaireek General Hospital (HMGH), Hamad Medical Corporation (HMC), Doha 3050, Qatar; (A.A.A.); (R.C.V.); (M.M.A.-J.)
- Faculty of Nursing, University of Calgary in Qatar (UCQ), Doha P.O. Box 23133, Qatar
| | - Ralph C. Villar
- Department of Nursing, Hazm Mebaireek General Hospital (HMGH), Hamad Medical Corporation (HMC), Doha 3050, Qatar; (A.A.A.); (R.C.V.); (M.M.A.-J.)
| | - Ananth Nazarene
- Department of Nursing, Mental Health Services (MHS), Hamad Medical Corporation (HMC), Doha 3050, Qatar;
| | - Mahmood M. Al-Jabry
- Department of Nursing, Hazm Mebaireek General Hospital (HMGH), Hamad Medical Corporation (HMC), Doha 3050, Qatar; (A.A.A.); (R.C.V.); (M.M.A.-J.)
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