Influence of Stress Resiliency on RN Job Satisfaction and Intent to Stay

How Do Presenteeism and Family Functioning Affect the Association Between Chinese Nurses' Job Stress and Intention to Stay?

BACKGROUND

Despite a great deal of existing research on nurses' job stress and intention to stay, it is still unclear how the association between Chinese nurses' job stress and intention to stay is affected by presenteeism and family functioning.

AIMS

This study aimed to investigate the correlations of Chinese nurses' job stress, presenteeism, and family functioning with their intention to stay and clarify the mediating effect of presenteeism and the moderating effect of family functioning on the association between their job stress and intention to stay.

METHOD

A cross-sectional study of 1,008 nurses was performed in a major general hospital in Qiqihar City, Heilongjiang Province, China. The participants were invited to engage in a questionnaire survey regarding job stress, presenteeism, family functioning, and intention to stay. A moderated mediation analysis was conducted through multiple linear regression analysis and the PROCESS macro.

RESULTS

Job stress and presenteeism were negatively correlated with intention to stay, whereas family functioning was positively correlated with intention to stay. The effect of job stress on intention to stay was partially mediated by presenteeism (Effect = -0.147, 95% CI = [-0.305, -0.003]). In addition, family functioning moderated the direct effect of job stress on intention to stay (Index = -0.134, 95% CI = [-0.274, -0.001]).

CONCLUSIONS

Presenteeism and family functioning were found to play mediating and moderating roles, respectively, in the relationship between job stress and intention to stay. Relevant interventions or family-friendly programs should be developed to enhance nurses' intention to stay.

Effect of total quality management intervention on nurse commitment and nurse performance: A quasi-experimental study

BACKGROUND

The purpose of this study is to design, implement, and evaluate the impact of a total quality management intervention on job performance and commitment among Jordanian nurses working in government hospitals.

METHODS

A quasi-experimental multiple time series was conducted starting in September 2017 and ending in June 2018. 140 nurses were sampled using the proportionate stratified random sampling technique; 132 were completed the study 67 the intervention group, while 65 in the control group.

RESULTS

There were no significant differences in nurses' job performance or commitment between the 2 groups (control and intervention). A repeated measure MANOVA test for both groups revealed that the interaction between group and time was statistically significant (F (4, 127) = 144.841; P = .001; Wilk's Λ = 0.180; η2 = .820), indicating that groups had a significantly different pattern of job performance and commitment over time. A repeated test The MANCOVA test for both groups across time revealed significant differences in nurses' job performance and nurses' commitment at a less than 0.05 significance level (F (2127) = 320.724; P = .001; Wilk's Λ = 0.165; η2 = 0.835), and the overall effect of time was significant for all dependent variables (F (4125) = 36.879; P = .001; Wilk's Λ = 0.459; η2 = 0.541).

CONCLUSION

The educational intervention was effective in improving nursing job performance among the study sample. The improved commitment of respondents in the intervention group was attributed to the improvement in job performance.

How local, first-line nurse leaders can positively influence nurse intent to stay and retention: A realist review

AIMS AND OBJECTIVES

To explore evidence on how local nurse leaders can positively influence nurse retention.

BACKGROUND

Nurse turnover and retention is a wicked problem with multiple interrelated factors and no one solution. Local nurse leadership has the potential to positively influence nurse intent to stay directly or via various factors.

DESIGN

A realist review.

METHODS

Having designed a search strategy based on a tentive programme theory, 1386 initial hits in three databases were screened and reduced to 48 research articles published between 2010-2021. The articles' content were coded for findings that supported, refined or contradicted four ContextMechanismOutcome configurations.

RESULTS

Sufficient evidence was found to support four guiding lights encouraging local nurse leaders to: (1) foster relational connectedness; (2) enable professional practice autonomy; (3) cultivate healthful workplace cultures; (4) support professional growth and development. Mutuality and reciprocity is also key if leaders themselves are to experience wellbeing and growth.

CONCLUSIONS

Person-centred, transformational and resonant local nurse leaders can positively influence nurse intent to stay within the workplace or organisation.

REPORTING METHOD

Conform JCN guideline 'What to cover in the main tekst by article type' for reviews.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

The job demands-resource model and performance: the mediating role of employee engagement

In case of a major social crisis, such as the coronavirus pandemic, the most important measure is to identify the determinants influencing employee health and well-being, which are directly linked to workplace job performance. Many studies have explored the role of employee engagement in the relationship between job resources, psychological capital, and job performance; however, only a few have investigated the relationships reflecting rapid changes in the work environment represented by digital transformation and a major social crisis. Considering this, this study examines how job autonomy and psychological well-being, which lower employee anxiety about health and welfare, influence in-role performance in the form of proactive employee characteristics as well as extra-role performance in the form of prosocial behavior, as mediated by employee engagement. The results of the data analysis of 1,092 corporate employees in Korea supported this model. Specifically, job autonomy and psychological well-being influence job performance (i.e., personal initiative and prosocial behavior) through improvements in employee engagement. Based on these findings, the study also discusses the implications of the results, future directions, and limitations.

Safeguarding the retention of nurses: A systematic review on determinants of nurse's intentions to stay

AIM

To explore factors that influence registered nurses' intention to stay working in the healthcare sector.

DESIGN

A systematic review and narrative synthesis.

METHODS

CINAHL, Medline and Cochrane library databases were searched from Jan 2010 to Jan 2022 inclusive and research selected using a structured criterion, quality appraisal and data extraction and synthesis were guided by Campbell's Synthesis Without Meta-analysis.

RESULTS

Thirty-four studies identified that nurses stay if they have job satisfaction and/or if they are committed to their organizations. The factors permeating these constructs weigh differently through generations and while not an infallible explanation, demonstrate stark differences in workplace needs by age, which influence the intention to stay, job satisfaction, organizational commitment and ultimately nurse turnover.

PUBLIC CONTRIBUTION

Environmental, relational and individual factors have bearing on improving nurse satisfaction and commitment. Understanding why nurses stay through a generational behavioural and career stage lens can bolster safeguarding nurse retention.

Resilience and job satisfaction among out-of-hospital emergency medical service professionals: A cross-sectional multi-centric study

AIM

We aim to describe the relationship between job satisfaction and compare levels of resilience among out-of-hospital emergency medical service professionals.

BACKGROUND

The study of the impact of the working environment on health professionals has raised great interest. Job-related variables and resilience can be a protective factor against stressful and demanding events at work.

METHODS

A cross-sectional survey comprising sociodemographic and job-related variables was conducted among 406 workers (doctors, nurses, psychologists, and ambulance technicians) from the out-of-hospital emergency medical system in Spain. Resilience was self-reported using the Connor-Davidson Resilience Scale.

RESULTS

Nursing professionals were less resilient compared with ambulance technicians (score difference 1.709, p = .008). As age increased, resilience was lower (r = -.118). Professionals with higher resilience scores were more satisfied in their work (OR = 1.06, 95% CI: 1.02-1.11), and professionals with higher psychological strength, gained from working with other colleagues, also showed greater job satisfaction (OR = 5.47, 95% CI: 2.55-11.73).

CONCLUSION

There was a positive association between resilience, job satisfaction and collaborative work. Professionals with greater psychological strength, gained from working with other colleagues, also showed higher levels of job satisfaction.

IMPLICATIONS FOR NURSING MANAGEMENT

Managers can use these results to influence the work environment to enhance job satisfaction and hence improve the resilience of the out-of-hospital emergency health care professionals.

The nurses' occupational stress components and outcomes, findings from an integrative review

AIM

To identify, evaluate and summarize the components, factors and outcomes of nurses' occupational stress published between 2009-2019.

DESIGN

Integrative literature review.

METHODS

A literature search was conducted on PubMed, CINAHL and PsycINFO databases for articles published in English, between 2009-2019.

RESULTS

The review included 132 studies. Most studies were conducted in the Confucian Asia and Anglo countries, but a growing number of studies were done in other countries. Almost all studies used a quantitative design, and changes in the use of scales indicated an increasing attention to career-related components. Factors were categorized into sociodemographic, work environment and personal resources. Sociodemographic factors were inconsistent across countries. Outcomes were categorized into health status, capability, affective and behavioural responses to work, and organizational performance with generally consistent results. Model validation studies showed the non-linear or non-direct associations between stress and outcomes.

Psychosocial Factors Associated With Resilience Among Iranian Nurses During COVID-19 Outbreak

Background: In the face of COVID-19, healthcare workers need to cope with the ongoing stressors at play and keep psychological distress at a minimum level. This study examined the psychosocial and demographic factors associated with nurse's resilience in the hospitals of Ahvaz that is one of the top cities infected with COVID-19 in Iran.

Methods: The present cross-sectional study was conducted on 387 Iranian nurses in Ahvaz city. For data collection purposes, three online questionnaires (including Copenhagen Psychosocial, Demographic, and Connor–Davidson Resilience Scale) were distributed among the participants.

Results: The mean resilience score was equal to 61.8 ± 14.8 for 387 nurses. Resilience had a statistically significant negative correlation with quantitative demand (r = −0.273, P < 0.008), work pace (r = −0.262, P < 0.011), emotional demand (r = −0.226, P < 0.030), stress (r = −0.458, P < 0.000), and burnout (r = −0.287, P < 0.005). Multiple linear regression analysis indicated that stress, job satisfaction, burnout and age were the main predictors of nurses' resilience during the (COVID-19) pandemic (R² = 0.45).

Conclusions: We identified psychosocial and demographic predictive factors that may contribute to greater resilience among nurses during the COVID-19 outbreak. The findings of this study can be used to implement psychosocial interventions to amplify the resilience of medical staff during the COVID-19 outbreak.

The Role of Medical Specialization on Posttraumatic Symptoms in Pediatric Nurses

PURPOSE

Comparison of medical specialization of repeated exposure to secondary trauma and Post-Traumatic Stress Disorder (PTSD) symptoms in pediatric nurses was examined.

DESIGN AND METHODS

The PTSD Checklist-Civilian Version (PCL-C) was administered to 182 nurses over their first year on the job at a pediatric hospital (three time-points: baseline, 3 month follow-up, and 1 year follow-up). Demographic characteristics (age groups, gender, education, and race) and previous healthcare experience on whether nurses met criteria for no, partial, or full PTSD across all three time-points was examined. Differences in unit assignment on total PTSD symptoms and symptoms of each criterion of PTSD (re-experiencing, avoidance, and arousal) were also examined.

RESULTS

No significant differences of both demographic characteristics and previous healthcare experience were found on these PTSD categories. However, both ICU and Hematology/Oncology units were more at risk for developing partial and full PTSD, respectively compared to other units. Nurses in the rehabilitation units had significantly higher re-experiencing, avoidance, and arousal symptoms than those assigned to medical/surgical and intensive care units.

CONCLUSIONS

Results demonstrate a need for hospitals to assess why nurses from certain units are reporting more PTSD symptoms and screen for PTSD symptoms and other mental health concerns throughout their career.

PRACTICE IMPLICATIONS

Being aware of which units may be more at-risk should inform unit-specific prevention and intervention programs to decrease negative outcomes, including burnout, compassion fatigue, and job dissatisfaction.

Individual and environmental determinants of burnout among nurses

Objective

Burnout is a significant problem affecting the nursing workforce and is associated with significant personal suffering and high rates of nurse turnover. Efforts to further understand the variables that explain burnout are needed. The aim of this cross-sectional study was to examine both environmental and individual factors that may explain burnout among nurses.

Method

We recruited 1848 Australian nurses to complete several online questionnaires measuring the practice environment (Practice Environment Scale of the Nursing Work Index), burnout (Professional Quality of Life Scale), trait negative affect ( Spielberger State-Trait Anxiety Inventory form Y2) and resilience (Connor Davidson Resilience Scale). Correlational analysis as well as hierarchical regression was used to determine the relative importance of variables in explaining burnout scores.

Results

All of the practice environment scales were significantly related to burnout in the negative direction, and these relationships were above .3 for all except the relationship scale ( r = –.256) and the participation in hospital affairs scale ( r = –.285). Overall, the regression model accounted for 62% of the variance in nurse burnout scores. Trait negative affect, resilience and two aspects of practice environment (Manager sub-scale and Staffing sub-scale) all explained significant variance in burnout scores. The largest contribution came from the two individual variables (resilience and trait negative affect) that together explained 55% of the variance in burnout scores.

Conclusions

Findings suggest that health service administrators should provide nursing staff with education and support to build individual resilience. Workplaces that attend to staffing and resource issues and have managers who provide high levels of support to their staff appear to be essential strategies to help prevent nurse burnout.

Factors Associated With Intent to Leave in Registered Nurses Working in Acute Care Hospitals: A Cross-Sectional Study in Ontario, Canada

Background: The work environment factors associated with nurses' intention to leave their jobs are not well understood because most studies have used non-probabilistic sampling methods, thus restricting the generalizability of the results. This study examined the relationship between work environment factors and intent to leave among nurses working in acute care hospitals in Ontario, Canada. Methods: This study included a random sample of 1,427 registered nurses who were part of a larger cross-sectional study and who responded to a mailed survey that included measures of resource availability, interprofessional collaboration, job satisfaction, and demographics. Results: Most of the respondents were female (94.8%), with an average age of 45.6 years, and 14.5 years of nursing experience at their current workplace, which included mostly urban (94.6%) and non-teaching hospitals (61.8%). In the multivariate model, we observed that the work environment variables explained 45.5% of the variance in nurses' intent to leave scores, F(9, 1362) =125.41, p < .01, with an R² of .455 or 45.5%. Job satisfaction (p < .01), flexible interprofessional collaborative relationships (p = .030), and resource availability (p < .01) were significantly associated with nurses' intent to leave scores. Conclusion/Application to Practice: Nurses who reported greater job satisfaction, flexible interprofessional relationships, and resource availability were less likely to express an intent to leave their hospital workplaces. Employers and health policy makers may use these findings as part of a broader strategy to improve the work environment of nurses. Occupational health nurses are ideally positioned to demonstrate leadership in promoting retention efforts in the workplace by advocating for the importance of job satisfaction, flexible interprofessional relationships, and resources.

Stressors and coping of nursing students in clinical placement: A qualitative study contextualizing their resilience and burnout

The aim of this study was to explore the stressors and coping of nursing students with differing levels of resilience and burnout during clinical placement. A qualitative descriptive study was conducted with twenty-four final-year baccalaureate nursing students, who were identified in the quantitative phase of the study as having scores indicating either: a) low resilience and high burnout; or b) high resilience and low burnout. Ten focus group interviews were conducted using a semi-structured interview guide. A thematic analysis of the data identified two main themes: a) stressors arising from the students aligning their expectations with the demands of the clinical placement (i.e., practice demands in busy wards, striving for learning opportunities, and discovering the social rules), and b) coping as a process of fitting into the ward culture. Those students with high resilience and low burnout scores had self-directed goals and coped by using self-regulation strategies. Those with low resilience and high burnout adopted external orientation and self-blame strategies. As suggested by the findings, the following approaches are recommended: offering interventions to enable students to fit actively into the clinical environment; encouraging engagement in reflection to facilitate self-awareness; and encouraging flexible use of personal and external resources.

Burnout in UK care home staff and its effect on staff turnover: MARQUE English national care home longitudinal survey

BACKGROUND

staff burnout and turnover lead to care home residents receiving poorer quality care. Burnout is thought to cause turnover, but this has never been investigated. We know little about which care home staffs are burnt out.

AIMS

to explore burnout's relationship with staff turnover and prevalence and predictors of burnout.

METHOD

we calculated the relationship between Maslach Burnout Inventory scores and future staff turnover (12-month number of staff leaving/number employed). We explored staff, resident and care home predictors of burnout, measured as emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA).

RESULTS

two-thousand sixty-two care staff in 97 care home units participated. Median yearly staff turnover was 22.7%, interquartile range (IQR) 14.0-37.7%. Care staff recorded low median burnout (median EE: 14, IQR: 7-22; DP: 1, IQR: 0-5; PA 42, IQR: 36-45). We found no association between staff burnout and turnover rate. Younger staff age was associated with higher burnout (EE coefficient - 0.09; 95% confidence interval (CI): -0.13, -0.05; DP -0.02; 95% CI: -0.04, -0.01; PA 0.05; 95% CI: 0.02, 0.08). Speaking English as a second language predicted higher EE (1.59; 95% CI: 0.32, 2.85), males had higher DP (0.02; 95% CI: 0.01, 0.04) and staff working only night shifts lower PA (-2.08; 95% CI: -4.05, -1.30).

CONCLUSIONS

we found no association between care homes staff burnout level and staff turnover rates. It is a myth that burnout levels are high. Interventions for burnout could focus on at-risk groups. Future studies could consider turnover at an individual level.

Work Engagement and Resiliency Impact the Relationship Between Nursing Stress and Burnout

Nursing is a stressful occupation, and consequently, nurses are at risk for work-related burnout. This is highly problematic, as numerous negative consequences are associated with burnout. Most notably, burnout may result in nurses leaving the profession, thereby exacerbating the nursing shortage. The purpose of the present study was to advance the understanding of burnout in the nursing profession. Specifically, three types of work engagement (i.e., vigor, dedication, and absorption) and resiliency were hypothesized to mediate the relationship between work-related stress and burnout. Nurses and nursing students were recruited through a college and a state nursing association, and participants (N = 76) completed a series of online surveys. Mediation models were assessed using multiple regression analyses and the bootstrapping method of testing indirect effects. Results indicated that vigor, dedication, absorption, and resiliency partially mediated the relationship between work-related stress and burnout, although the exact pattern of results varied depending on the specific type of burnout (Emotional Exhaustion, Depersonalization, and Reduced Personal Accomplishment). These results could be useful in helping to prevent burnout in the nursing profession and should be taken into consideration when designing employee training and support programs.

Burnout, compassion fatigue and psychological capital: Findings from a survey of nurses delivering palliative care

BACKGROUND

Ageing populations worldwide and a concomitant increase in chronic conditions translates into an increased demand for the delivery of palliative and end of life care by nurses. This increasing demand for palliative care provision may produce stressors resulting in negative outcomes such as burnout and compassion fatigue.

AIM

The purpose of this study was to explore burnout and compassion fatigue, as well as potential protective factors, among nurses in New Zealand.

METHODS

An online survey was conducted with 256 registered nurses (between January 2016 and February 2017) recruited through nursing organisations and a large tertiary level hospital. Data analysis consisted of descriptive statistics, multivariate analysis of variance, Pearson correlations, and hierarchical multiple regression.

RESULTS

Psychological empowerment and the commitment and challenge components of psychological hardiness significantly predicted lower scores for the burnout while previous palliative care education and challenge predicted lower scores for the secondary traumatic stress component of compassion fatigue. Significant predictors of compassion satisfaction included previous palliative care education, psychological empowerment and both the commitment and challenge components of psychological hardiness.

CONCLUSION

Nurses draw upon unique combinations of "psychological capital" to deal with caring for patients with life-limiting illnesses. Any interventions to increase nurse palliative care education uptake must be tailored to develop and support these internal resources.

Improving Teamwork and Resiliency of Burn Center Nurses Through a Standardized Staff Development Program

For many acute care nursing units, such as the Burn Progressive Care Unit (BPCU) at the U.S. Army Burn center, staff stress and burnout is always a concern for leaders. Job stress not only contributes to nursing turnover, but can have a negative impact on patient care. The purpose of this project was to develop a training platform for nursing staff education and teambuilding with the intent of improving nurse satisfaction, increasing resiliency, building unit cohesion, enhancing morale, and increasing staff awareness of unit performance. All nursing staff were given an 8-hour training day, half of which was focused on education and the other half on teambuilding and resiliency. At the end of the staff development day (SDD), participants were encouraged to complete an evaluation; all activities were scored on a 10-point scale, with 10 representing the most informative. In total, 46 of 48 staff (96%) participated in the first two SDDs. During the first iteration (Spring 2015), participants scored all activities very high, with a total average score of 9.15 ± 0.26 (n = 246). In the Fall of 2015, the SDD program was again rated well, with an average score of 9.36 ± 0.13 (n = 276). The SDD program has been successful in supporting teamwork and resiliency among BPCU staff. Staff feedback supported success in meeting the objectives of building unit cohesion and increasing satisfaction and morale.

Stress Resiliency Practices in Neonatal Nurses

BACKGROUND

Multiple environmental changes were experienced in a large level III neonatal intensive care unit (NICU) causing a perception of work-related stress leading to high nurse turnover, decreased engagement, and decreased satisfaction.

PURPOSE

To identify a preintervention measure of perceived stress resiliency and ranking of interpretive styles in a population of neonatal, bedside registered nurses faced with a change in the physical practice environment.

METHODS

A descriptive, cross-sectional, correlational design was used to measure stress resiliency. The Stress Resiliency Profile (SRP) questionnaire was administered to a convenience sample of 48 neonatal bedside nurses. The SRP identifies 3 distinct interpretive styles as constructs of stress resiliency including deficiency focusing (negative thinking), necessitating (managing forced change), and skill recognition. Statistical analysis was used to describe associations between ages, years of experience, and resiliency.

RESULTS

Results showed skill recognition to be significantly lower than expected in participants 40 years and older. Also, participants with greater than 5 years of NICU experience revealed low to moderate levels of resiliency.

IMPLICATIONS FOR PRACTICE

Although skill is critical in nursing, it may not be the key factor in reducing the perception of work-related stress. Implementation of interventions targeting interpretative styles known to enhance resiliency may promote positive coping and quality change management.

IMPLICATIONS FOR RESEARCH

Baseline resiliency data are necessary to guide unit leaders to manage future challenges found in evolving NICU nurse practice environments. More research is warranted to determine the generalizability of study results as healthcare organizations strive to implement best practices, control costs, and deliver safe, quality care.

A Grounded theory study of the intention of nurses to leave the profession

Objective

this study explores the process of the development of an intention to leave bedside nursing.

Method

the process was studied from the perspective of 21 nurses using the grounded theory method. Data were collected using semi-structured interviews and the constant comparative method of Corbin and Strauss was used for data analysis.

Results

according to the participants, the two main categories, "social image of nursing", and "culture and structure of the bedside", were the contextual factors that influence why nurses are leaving bedside care provision. Disappointment with a perceived lack of progress or improvement in the clinical experience formed primary psychosocial concerns for the participants. Competence and a process of self-control were steps taken by the participants. These, associated with interventional conditions produced the outcomes of the loss of professional commitment and desire to leave bedside nursing. "Failure to integrate personal expectations with organizational expectations: in search of escape" was the central category of the study that linked the categories together.

Conclusion

the findings of this study provide useful information about the needs of nurses for overcoming the intention to leave bedside care. The identification of this process can help in recognizing emerging problems and providing solutions for them.

Creating positive practice environments in a primary health care setting

AIM

The aim of this study was to explore and describe the perceptions of nurse managers, nurses, and a physician in the community health centre with the most positive practice environment in a province of South Africa.

METHODS

Ten (N = 10) semistructured individual interviews were conducted with personnel of the community health centre with the most positive practice environment.

RESULTS

Personnel cited the following as the most important characteristics of a positive practice environment in a primary health care setting: support, leadership and governance, collegial nurse-physician relationships, and quality of care.

CONCLUSION

In a primary health care setting, it is important to train, appoint, and support managers who in turn will be able to train and support their personnel. Furthermore, reciprocal community involvement must be encouraged between personnel of the community health centre and stakeholders in the community to improve the health status of the community. Finally, group cohesions between all health care workers and managers at different organisational levels should be encouraged, as this enhances teamwork and a culture of teaching-learning and improves the competence of all staff.

The juxtaposition of ageing and nursing: the challenges and enablers of continuing to work in the latter stages of a nursing career

AIMS

To identify why some nurses cope well with continuing to work as they age and others struggle.

BACKGROUND

There is a need to understand better the challenges older nurses face and how they manage them.

DESIGN

Secondary analysis of existing data.

METHODS

Data collected in two separate studies were analysed. The first study (2012) was an online, anonymous survey that collected free text (qualitative) and categorical data (n = 3273, 57·6% response rate). The second (2014) was an explorative, descriptive study that collected data through focus groups and interviews (n = 46). Qualitative data from both studies were analysed using David Thomas' () general inductive approach. Research Ethics Committee approval was gained for the 2012 and 2014 studies.

RESULTS

Data were categorised in two themes: the challenges of ageing and nursing; and factors that enable nurses to continue to practice. Physical challenges, fatigue, guilt, ageism and demands to complete continuing education were considered challenges. Maintaining personal fitness, self care, flexible working and a strong belief in their ability to contribute to the profession were present in older nurses who continued to practice.

CONCLUSION

While older nurses face growing physical and cognitive challenges as they age, they demonstrate strong resilience in the face of these challenges. It is recommended nurses seek support from their workplaces early to address challenges. Organisations must address ageism in the workplace and provide practical interventions such as supporting changes to work hours, shifting nurses to less physical roles and providing career planning to support resilience in older workers.

Hospital employees’ perceptions of fairness and job satisfaction at a time of transformational change

Objective This study examines the relationships between job satisfaction and organisational justice during a time of transformational change. Methods Data collection occurred immediately before a major regional hospital’s move to a greenfield site. Existing measures of job satisfaction and organisational justice were used. Data were analysed (n = 316) using descriptive, correlation and regression methods together with interactions between predictor variables. Results Correlation coefficients for satisfaction and organisational justice variables were high and significant at the P < 0.001 level. Results of a robust regression model (adjusted R2 = 0.568) showed all three components of organisational justice contributed significantly to employee job satisfaction. Interactions between the predictor variables showed that job satisfaction increased as the interactions between the predictor variables increased. Conclusions The finding that even at a time of transformational change staff perceptions of fair treatment will in the main result in high job satisfaction extends the literature in this area. In addition, it was found that increasing rewards for staff who perceive low levels of organisational justice does not increase satisfaction as much as for staff who perceive high levels of fairness. If people feel negative about their role, but feel they are well paid, they probably still have negative feelings overall. What is known about the topic? Despite much research highlighting the importance of job satisfaction and organisational justice in healthcare, no research has examined the influence of transformational change, such as a healthcare organisational relocation, on these factors. What does this paper add? The research adds to academic literature relating to job satisfaction and organisational justice. It highlights the importance of organisational justice in influencing the job satisfaction of staff. What are the implications for practitioners? Financial rewards do not necessarily motivate staff but low rewards do demotivate. Shortages of health professionals are often linked to a lack of job satisfaction, and recruitment and retention strategies are often based on salary.

Testing a theoretical model of clinical nurses' intent to stay

BACKGROUND

Published theoretical models of nurses' intent to stay (ITS) report inconsistent outcomes, and not all hypothesized models have been adequately tested. Research has focused on cognitive rather than emotional determinants of nurses' ITS.

PURPOSE

The aim of this study was to empirically verify a complex theoretical model of nurses' ITS that includes both affective and cognitive determinants and to explore the influence of relational leadership on staff nurses' ITS.

METHODOLOGY

The study was a correlational, mixed-method, nonexperimental design. A subsample of the Quality Work Environment Study survey data 2009 (n = 415 nurses) was used to test our theoretical model of clinical nurses' ITS as a structural equation model.

RESULTS

The model explained 63% of variance in ITS. Organizational commitment, empowerment, and desire to stay were the model concepts with the strongest effects on nurses' ITS. Leadership practices indirectly influenced ITS.

PRACTICE IMPLICATIONS

How nurses evaluate and respond to their work environment is both an emotional and rational process. Health care organizations need to be cognizant of the influence that nurses' feelings and views of their work setting have on their intention decisions and integrate that knowledge into the development of retention strategies. Leadership practices play an important role in staff nurses' perceptions of the workplace. Identifying the mechanisms by which leadership influences staff nurses' intentions to stay presents additional focus areas for developing retention strategies.

Mediating role of work engagement in the relationship between job resources and personal resources with turnover intention among female nurses

BACKGROUND

One of the latest models proposed with regard to work engagement is the detailed model put forward by Bakker and Demerouti (2007). The present study aims at investigating the effect of job resources and personal resources on turnover intention with the mediator role of work engagement among female nurses at Isfahan Alzahra Hospital. In the current study, job and personal resources were considered as the predictors of job turnover and work engagement was considered as the mediator variable among predictive and criterion variables.

METHOD

The data of the present study were collected from 208 female nurses who were selected by systematic random sampling. As for the analysis of the collected data, structural equations model, normal distribution method, and Bootstrap method in Macro, Preacher and Hayes, (2004) program were deployed.

FINDING

The findings showed that the personal resources affect the turnover intention both directly and indirectly (through work engagement); however, job resources are just associated with turnover intention with the mediating role of work engagement.

CONCLUSION

The results of the study have important implications for organizations' managers about improving work engagement.

Job satisfaction in nursing: a concept analysis study

AIM

This study aims to undertake a concept analysis of job satisfaction in the nursing profession.

BACKGROUND

Around current global shortage of nurses, it is important to stabilize the nursing workforce. Nurses' job satisfaction has been found to be related to intention to leave.

INTRODUCTION

In the nursing profession, there is a lack of evidence to support the attributes of nurses' job satisfaction.

METHODS

Walker and Avant's approach of concept analysis was used.

RESULTS

The main attributes of job satisfaction from this study are (1) fulfillment of desired needs within the work settings, (2) happiness or gratifying emotional responses towards working conditions, and (3) job value or equity. These attributes are influenced by antecedent conditions like demographic, emotional, work characteristics and environmental variables. Additionally, the consequences of nurses' job satisfaction have a significant impact on both nurses and patients.

DISCUSSION

This study integrated both the content and process of motivational theories to generate the attributes of job satisfaction in nursing that overcome the limitation of the previous studies, which looked only at the definitions of nurses' job satisfaction based on content motivational theories.

CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY

The findings of this study can facilitate both nursing researchers to develop a cultural adaption instrument and policy makers to improve clinical nursing practice. This analysis provides nurse managers with a new perspective to deal with nurses' job satisfaction by taking into account all the attributes that influence it in the nursing field.

Positive resources for combating job burnout among Chinese telephone operators: Resilience and psychological empowerment

Job burnout is a major concern within the service industry. However, there is a lack of research exploring positive resources for combating burnout among telephone operators. The purpose of this study was to examine the associations between resilience, psychological empowerment, and job burnout, and the mediating role of psychological empowerment. A cross-sectional survey of 575 telephone operators was conducted in 2 call centers in Shandong Province, China. Self-report questionnaires were used to assess job burnout symptoms, resilience, and psychological empowerment. Hierarchical linear regression was performed to analyze the degree to which resilience and psychological empowerment are associated with job burnout, and the mediating role of psychological empowerment. The results showed that resilience and psychological empowerment had significant "net effects" on job burnout, which may represent positive resources for combating job burnout. Psychological empowerment may partially mediate the relationship between resilience and job burnout. Thus, interventions focused on resilience and psychological empowerment may be useful options for managers concerned about burnout.

Group cohesion and organizational commitment: protective factors for nurse residents' job satisfaction, compassion fatigue, compassion satisfaction, and burnout

Stress can have detrimental effects on nurse residents' levels of job satisfaction, compassion, fatigue, and burnout. This can lead to high turnover rates and poor quality of care among novice nurses. Therefore, it is critical to identify protective factors to prevent the onset of negative nurse outcomes (compassion fatigue, burnout, and job dissatisfaction) and to promote positive nurse outcomes (job satisfaction, compassion satisfaction). This study aimed to determine whether factors such as group cohesion and organizational commitment would be protective and moderate the association between stress exposure and posttraumatic stress symptoms and other negative nurse outcomes, thus facilitating positive outcomes. Findings showed that group cohesion was effective in moderating the negative effects of current stress exposure and posttraumatic stress symptoms on negative nurse outcomes, specifically on increased compassion fatigue and burnout, and reduced compassion satisfaction. In addition, organizational commitment was determined to promote positive nurse outcomes such as job satisfaction and compassion satisfaction. The study findings are promising, as retention of quality nurses is a significant problem for hospitals. Nurse managers and hospital administrators should be aware of the benefits of group cohesion and organizational commitment and strive to make the promotion of these factors a priority.

Relationships among structural empowerment, psychological empowerment, intent to stay and burnout in nursing field in mainland China-based on a cross-sectional questionnaire research

The aim of the study was to explore the relationship among perceived structural empowerment, psychological empowerment, burnout and intent to stay by nurses in mainland China.With the shortage of nurses in many countries, including China, intent to stay is a dominant factor to influence the quality of care. Also, burnout is identified to negatively affect the quality of care. Empowered clinical nurse practical environment is related to intent to stay and burnout. In the current literature, there is a lack of data based on empowering environment discussing the relationship between burnout and intent to stay. The study used an anonymous questionnaire, filled voluntarily by 219 nurses from different sections in a city in mainland China, 2012.Structural equation modelling (SEM) was used to test the proposed hypotheses. Based on the SEM model, structural empowerment and psychological empowerment had significant positive effects on intent to stay of nurses and negative effects on burnout. Burnout had a significant negative effect on intent to stay. The final modified models yielded χ(2)  = 58.580, P > 0.05, χ(2) /df = 1.046, root mean square error of approximation = 0.015, Tucker-Lewis Index = 0.996, comparative fit index = 0.998,which indicated good fit indices. Creating a positive empowering workplace can encourage nurses to stay long and prevent burnout. Therefore, higher level of empowering environment is required.

Midwives׳ experiences of workplace resilience

BACKGROUND

many UK midwives experience workplace adversity resulting from a national shortage of midwives, rise in birth rate and increased numbers of women entering pregnancy with complex care needs. Research evidence suggests that workplace pressures, and the emotional demands of the job, may increase midwives׳ experience of stress and contribute to low morale, sickness and attrition. Much less is known about midwives who demonstrate resilience in the face of adversity. Resilience has been investigated in studies of other health and social care workers, but there is a gap in knowledge regarding midwives׳ experiences.

OBJECTIVE

to explore clinical midwives׳ understanding and experience of professional resilience and to identify the personal, professional and contextual factors considered to contribute to or act as barriers to resilience.

DESIGN

an exploratory qualitative descriptive study. In Stage One, a closed online professional discussion group was conducted over a one month period. Midwives discussed workplace adversity and their resilient responses to this. In Stage Two, the data were discussed with an Expert Panel with representatives from midwifery workforce and resilience research, in order to enhance data interpretation and refine the concept modelling.

SETTING

the online discussion group was hosted by the Royal College of Midwives, UK online professional networking hub: 'Communities'.

PARTICIPANTS

11 practising midwives with 15 or more years of 'hands on clinical experience', and who self-identified as being resilient, took part in the online discussion group.

FINDINGS

thematic analysis of the data identified four themes: challenges to resilience, managing and coping, self-awareness and building resilience. The participants identified 'critical moments' in their careers when midwives were especially vulnerable to workplace adversity. Resilience was seen as a learned process which was facilitated by a range of coping strategies, including accessing support and developing self-awareness and protection of self. The participants identified the importance of a strong sense of professional identity for building resilience.

KEY CONCLUSIONS

this study provides important new insights into resilience within UK midwifery, of relevance to the wider profession. Some findings echo those of other resilience studies; however, there are new insights such as the importance of professional identity which may be relevant to other health care workers. Through understanding more about resilience, it may be possible to facilitate positive adaptation by midwives and ameliorate the effects of workplace adversity.

IMPLICATIONS FOR PRACTICE

This study indicates that resilience is a complex phenomenon, which warrants serious consideration from clinical midwives, managers, educators and researchers.

Reassessment of the psychometric characteristics and factor structure of the 'Perceived Stress Questionnaire' (PSQ): analysis in a sample of dental students

Background

The training to become a dentist can create psychological distress. The present study evaluates the structure of the ‘Perceived Stress Questionnaire’ (PSQ), its internal consistency model and interrelatedness with burnout, anxiety, depression and resilience among dental students.

Methods

The study employed a cross-sectional design. A sample of Spanish dental students (n = 314) completed the PSQ, the ‘Goldberg Anxiety and Depression Scale’ (GADS), ‘Connor-Davidson Resilience Scale’ (10-item CD-RISC) and ‘Maslach Burnout Inventory-Student Survey’ (MBI-SS). The structure was estimated using Parallel Analysis from polychoric correlations. Unweighted Least Squares was the method for factor extraction, using the Item Response Theory to evaluate the discriminative power of items. Internal consistency was assessed by squaring the correlation between the latent true variable and the observed variable. The relationships between the PSQ and the other constructs were analysed using Spearman’s coefficient.

Results

The results showed a PSQ structure through two sub-factors (‘frustration’ and ‘tenseness’) with regard to one general factor (‘perceived stress’). Items that did not satisfy discriminative capacity were rejected. The model fit were acceptable (GFI = 0.98; RSMR = 0.06; AGFI = 0.98; NFI = 0.98; RFI = 0.98). All the factors showed adequate internal consistency as measured by the congeneric model (≥0.91). High and significant associations were observed between perceived stress and burnout, anxiety, depression and resilience.

Conclusions

The PSQ showed a hierarchical bi-factor structure among Spanish dental students. Using the questionnaire as a uni-dimensional scale may be useful in perceived stress level discrimination, while the sub-factors could help us to refine perceived stress analysis and improve therapeutic processes.

Job satisfaction in nursing: a concept analysis

TOPIC

Concept analysis and job satisfaction in nursing.

PURPOSE

In this article, Walker and Avant's concept analysis methodology is used to examine and clarify the phenomenon of job satisfaction in nursing.

SOURCES

Published literature.

CONCLUSION

A review of the published nursing literature suggests that job satisfaction is an affective reaction to a job that results from the incumbent's comparison of actual outcomes with those that are desired, expected, and deserved. In health care, specifically nursing in a hospital setting, job satisfaction can be measured and identified. Job satisfaction is compromised of three attributes: autonomy, interpersonal relationships, and patient care.

Ending disruptive behavior: staff nurse recommendations to nurse educators

The purpose of this qualitative descriptive study was to identify educational strategies that can prepare new graduates to manage disruptive behavior (DB) in the workplace. DB is any inappropriate behavior, confrontation, or conflict - ranging from verbal abuse to sexual harassment - that harms or intimidates others to the extent that quality of care or patient safety could be compromised. Individual interviews were conducted with nine staff nurses currently in practice in acute care settings in the United States. Staff nurses recommended educational strategies that focused on communication skills for professional practice. These included learning how to communicate with hostile individuals, and giving and receiving constructive criticism. Descriptions that participants provided about their work culture were an unexpected finding that has relevance for nurse educators as they prepare students for transition to practice Nurses described lack of management support and intervention for DB situations, personality clashes with coworkers, and devaluation of nursing work as affecting professional practice.

Burnout in relation to specific contributing factors and health outcomes among nurses: a systematic review

Nurses have been found to experience higher levels of stress-related burnout compared to other health care professionals. Despite studies showing that both job satisfaction and burnout are effects of exposure to stressful working environments, leading to poor health among nurses, little is known about the causal nature and direction of these relationships. The aim of this systematic review is to identify published research that has formally investigated relationships between these variables. Six databases (including CINAHL, COCHRANE, EMBASE, MEDLINE, PROQUEST and PsyINFO) were searched for combinations of keywords, a manual search was conducted and an independent reviewer was asked to cross validate all the electronically identified articles. Of the eighty five articles that were identified from these databases, twenty one articles were excluded based on exclusion criteria; hence, a total of seventy articles were included in the study sample. The majority of identified studies exploring two and three way relationships (n = 63) were conducted in developed countries. Existing research includes predominantly cross-sectional studies (n = 68) with only a few longitudinal studies (n = 2); hence, the evidence base for causality is still very limited. Despite minimal availability of research concerning the small number of studies to investigate the relationships between work-related stress, burnout, job satisfaction and the general health of nurses, this review has identified some contradictory evidence for the role of job satisfaction. This emphasizes the need for further research towards understanding causality.

Job satisfaction in mainland China: comparing critical care nurses and general ward nurses

AIM

To explore the level of nurses' job satisfaction and compare the differences between critical care nurses and general ward nurses in Mainland China.

BACKGROUND

Hospitals continue to experience high nurse turnover. Job satisfaction is a key factor to retain skilled nurses. The differences in job satisfaction among critical care nurses and general ward nurses are unknown.

DESIGN

A cross-sectional design was selected for this descriptive correlation study.

METHODS

Cross-sectional study of critical care nurses (n = 446) and general ward nurses (n = 1118) in 9 general hospitals by means of questionnaires that included the Chinese Nurses Job Satisfaction Scale and demographic scale. The data were collected from June 2010-November 2010.

RESULTS

Chinese nurses had moderate levels of job satisfaction, were satisfied with co-workers and family/work balance; and dissatisfied with pay and professional promotion. Critical care nurses were younger; less educated and had less job tenure when compared with nurses working on general wards. Critical care nurses were significantly less satisfied than general ward nurses with many aspects of their job.

CONCLUSION

Levels of nurses' job satisfaction can be improved. The lower job satisfaction of critical care nurses compared with general ward nurses should warn the healthcare administrators and managers of potentially increasing the critical care nurses turn over. Innovative and adaptable managerial interventions need to be taken to improve critical care nurse' job satisfaction and retain skilled nurse.