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Li C, Shi H, Zhang Y, Zhao Y, Li T, Zhou L, Guan Q, Zhu X. Association between perceived overqualification, work engagement, job satisfaction among nurses: a cross-sectional study. BMJ Open 2024; 14:e081672. [PMID: 39079931 PMCID: PMC11293402 DOI: 10.1136/bmjopen-2023-081672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 07/10/2024] [Indexed: 08/03/2024] Open
Abstract
OBJECTIVES This cross-sectional correlational study aimed to understand nurses' perceived overqualification and work engagement, explore their effects on job satisfaction and provide a theoretical basis for hospital management policies in a public comprehensive tertiary hospital in China. DESIGN Cross-sectional correlational study. SETTING The study was conducted in a public comprehensive tertiary hospital in China. The specific location is not disclosed. PARTICIPANTS 584 nurses participated in the study, with a completion rate of 97.3%. The average age of participants was 34.8±6.7 years, with 96.4% being women. 67.8% held a bachelor's degree or higher, and 71.6% had over 5 years of work experience. PRIMARY AND SECONDARY OUTCOME MEASURES The Scale of Perceived Overqualification was used to assess nurses' perceptions of their qualifications, demonstrating a high level of reliability with a Cronbach's alpha coefficient of 0.832. Utrecht Work Engagement Scale was used to assess nurses' work engagement, showing internal consistency coefficients (Cronbach's alpha) of 0.683 for the vigour dimension, 0.693 for the dedication dimension and 0.834 for the absorption dimension. Minnesota Satisfaction Questionnaire was used to evaluate nurses' job satisfaction, with internal consistency coefficients (Cronbach's alpha) of 0.765 for the intrinsic satisfaction scale and 0.734 for the extrinsic satisfaction scale. The primary outcome measures included perceived overqualification, work engagement and job satisfaction. RESULTS The average scores for perceived overqualification, work engagement and job satisfaction were 26.38±3.44, 65.36±14.92 and 74.29±15.04, respectively. Perceived overqualification showed negative correlations with work engagement (r=-0.562, p<0.05) and job satisfaction (r=-0.674, p<0.05). However, work engagement was positively correlated with job satisfaction (r=0.519, p<0.05). Path analysis indicated that perceived overqualification had both a direct (β=-0.06, p<0.001) and an indirect effect (β=-0.35, p=0.015) on job satisfaction, with work engagement partially mediating this relationship. CONCLUSION The perception of overqualification among nurses shows a significant correlation with both their work engagement and job satisfaction. This finding suggests that hospital administrators should pay attention to nurses' perceptions of their qualifications and take measures to enhance their job satisfaction. Furthermore, work engagement acts as a mediator between the perception of overqualification and job satisfaction, emphasising the importance of increasing work engagement. Overall, hospitals can improve nurses' work engagement and job satisfaction by providing career development opportunities, establishing feedback mechanisms and fostering work-life balance. Comprehensive management measures focusing on nurses' career development opportunities and levels of work engagement are necessary. Future research could expand the sample size, employ more diverse research designs and integrate qualitative research methods to further explore the factors influencing nurses' job satisfaction and happiness.
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Affiliation(s)
- Cuixian Li
- Department of Dermatology, First Affiliated Hospital of Dali University, Dali City, Yunnan, China
| | - Hongbo Shi
- Department of General Surgery, First Affiliated Hospital of Dali University, Dali City, Yunnan, China
| | - Yunhong Zhang
- First Affiliated Hospital of Dali University, Dali city, Yunnan, China
| | - Yuan Zhao
- Faculty of Public Health Management, Dali University, Dali city, Yunnan, China
| | - Ting Li
- Faculty of Nursing in Dali University, Dali city, Yunnan, China
| | - Lu Zhou
- Faculty of Nursing in Dali University, Dali city, Yunnan, China
| | - Qin Guan
- Faculty of Nursing in Dali University, Dali city, Yunnan, China
| | - Xiaoling Zhu
- Department of Nursing, First Affiliated Hospital of Dali University, Dali city, Yunnan, China
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Ingstad K, Haugan G. Balancing act: exploring work-life balance among nursing home staff working long shifts. BMC Nurs 2024; 23:499. [PMID: 39039590 PMCID: PMC11264412 DOI: 10.1186/s12912-024-02165-8] [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] [Received: 02/29/2024] [Accepted: 07/10/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Nursing home staff often face challenges in achieving a satisfactory work-life balance, particularly because of the nature of shift work. While long shifts offer extended periods off work, their impact on the delicate balance between work and leisure remains understudied in the context of nursing homes. This study investigated the experiences of nursing home staff in Norway working long shifts lasting 12-14 h and their perceptions of the balance between family life and work. METHODS Eighteen nursing home staff members were interviewed following a semi-structured qualitative approach. The participants worked in three types of long shifts and provided insights into their experiences, addressing issues such as work hours, shift patterns, and work-family balance. RESULTS The study revealed four main categories: (1) impact of long shifts on family life-the highs and lows; (2) maximizing time off with long shifts; (3) reducing job stress with long shifts; and (4) full-time work leads to predictable hours and stable income. The participants emphasised the distinct separation between work and leisure during long shifts, acknowledging limited social life during working periods but appreciating extended periods off. Family life posed challenges, especially with young children, but the participants found benefits in the longer periods of family time during days off. Longer rest periods and reduced commuting time were perceived as advantages of long shifts, contributing to better sleep, reduced stress and overall well-being. Long shifts also allowed for more predictable working hours and income, supporting a stable work-life balance. CONCLUSION Balancing work and family life involves more than just the number of hours spent at work; it also encompasses the quality of those hours both at work and at home. Our findings underscore the complex interplay between work and family life for nursing home staff working long shifts. While challenges exist, benefits such as extended time off, improved sleep, reduced stress, and predictable working hours contribute positively to their work-life balance. Long shifts in nursing homes offer a unique perspective on achieving work-life balance, revealing both the challenges and advantages inherent in such schedules. Understanding the experiences of nursing home staff in this context can inform future innovations in shift scheduling, promoting a more balanced and sustainable work environment for healthcare professionals. For some healthcare staff, extended shifts can lead to a better work-life balance.
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Affiliation(s)
- Kari Ingstad
- Faculty of Nursing and Health Science, Nord University, Pb. 93, Levanger, 7601, Norway.
| | - Gørill Haugan
- Faculty of Nursing and Health Science, Nord University, Pb. 93, Levanger, 7601, Norway
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Taylor C, Maben J, Jagosh J, Carrieri D, Briscoe S, Klepacz N, Mattick K. Care Under Pressure 2: a realist synthesis of causes and interventions to mitigate psychological ill health in nurses, midwives and paramedics. BMJ Qual Saf 2024; 33:523-538. [PMID: 38575309 PMCID: PMC11287552 DOI: 10.1136/bmjqs-2023-016468] [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: 06/23/2023] [Accepted: 02/18/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Nurses, midwives and paramedics comprise over half of the clinical workforce in the UK National Health Service and have some of the highest prevalence of psychological ill health. This study explored why psychological ill health is a growing problem and how we might change this. METHODS A realist synthesis involved iterative searches within MEDLINE, CINAHL and HMIC, and supplementary handsearching and expert solicitation. We used reverse chronological quota screening and appraisal journalling to analyse each source and refine our initial programme theory. A stakeholder group comprising nurses, midwives, paramedics, patient and public representatives, educators, managers and policy makers contributed throughout. RESULTS Following initial theory development from 8 key reports, 159 sources were included. We identified 26 context-mechanism-outcome configurations, with 16 explaining the causes of psychological ill health and 10 explaining why interventions have not worked to mitigate psychological ill health. These were synthesised to five key findings: (1) it is difficult to promote staff psychological wellness where there is a blame culture; (2) the needs of the system often over-ride staff psychological well-being at work; (3) there are unintended personal costs of upholding and implementing values at work; (4) interventions are fragmented, individual-focused and insufficiently recognise cumulative chronic stressors; and (5) it is challenging to design, identify and implement interventions. CONCLUSIONS Our final programme theory argues the need for healthcare organisations to rebalance the working environment to enable healthcare professionals to recover and thrive. This requires high standards for patient care to be balanced with high standards for staff psychological well-being; professional accountability to be balanced with having a listening, learning culture; reactive responsive interventions to be balanced by having proactive preventative interventions; and the individual focus balanced by an organisational focus. PROSPERO REGISTRATION NUMBER CRD42020172420.
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Affiliation(s)
- Cath Taylor
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Jill Maben
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Justin Jagosh
- School of Health Sciences, University of Surrey, Guildford, UK
| | | | - Simon Briscoe
- Exeter Medical School, University of Exeter, Exeter, UK
| | - Naomi Klepacz
- School of Health Sciences, University of Surrey, Guildford, UK
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Karen Mattick
- Exeter Medical School, University of Exeter, Exeter, UK
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Dent J, Smeeton N, Whiting L, Watson T. The importance of recovery and staffing on midwives' emotional wellbeing: A UK national survey. Midwifery 2024; 132:103961. [PMID: 38479151 DOI: 10.1016/j.midw.2024.103961] [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: 08/21/2023] [Revised: 02/22/2024] [Accepted: 02/25/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND There is currently a gap in the evidence on how working practices, such as the ability to take rest breaks, finish on time or intershift recovery influence outcomes. AIM The aim of this study was to explore the association of individual characteristics, work-related factors and working practices on emotional wellbeing outcomes of UK midwives. METHODS An online cross-sectional survey collated data between September and October 2020. Outcomes explored were work-related stress, burnout, being pleased with their standard of care, job satisfaction and thoughts about leaving midwifery. Univariate analysis identified the explanatory variables to be investigated using multivariable logistic regression. FINDINGS A total of 2347 midwives from the four UK nations completed the survey. No standard approach in monitoring safe staffing or in-shift or intershift recovery was found. There were high levels of work-related stress, burnout and thoughts about leaving midwifery, and low levels of job satisfaction, with just half of midwives reporting they were satisfied with the standard of care they could provide. Multivariable regression revealed that working practices variables, generally related to impeded recovery or compounded by staffing issues, had a significant association with poorer emotional wellbeing outcomes. CONCLUSION This research has demonstrated an association between impeded recovery, including a lack of formal methods to monitor this, and poorer emotional wellbeing outcomes, and that staffing levels are highly influential in determining outcomes. There is a need to re-evaluate current approaches to job design and how midwives are expected to work.
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Affiliation(s)
- Jackie Dent
- School of Health and Social Work, University of Hertfordshire, England, UK.
| | - Nigel Smeeton
- Centre for Research in Public Health and Community Care, University of Hertfordshire, England, UK
| | - Lisa Whiting
- School of Health and Social Work, University of Hertfordshire, England, UK
| | - Tim Watson
- School of Health and Social Work, University of Hertfordshire, England, UK
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Kc S, Gooden TE, Aryal D, Koirala K, Luitel S, Haniffa R, Beane A. The burden of anxiety, depression, and stress, along with the prevalence of symptoms of PTSD, and perceptions of the drivers of psychological harms, as perceived by doctors and nurses working in ICUs in Nepal during the COVID-19 pandemic; a mixed method evaluation. BMC Health Serv Res 2024; 24:450. [PMID: 38600462 PMCID: PMC11007980 DOI: 10.1186/s12913-024-10724-7] [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: 09/05/2023] [Accepted: 02/14/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic resulted in significant physical and psychological impacts for survivors, and for the healthcare professionals caring for patients. Nurses and doctors in critical care faced longer working hours, increased burden of patients, and limited resources, all in the context of personal social isolation and uncertainties regarding cross-infection. We evaluated the burden of anxiety, depression, stress, post-traumatic stress disorder (PTSD), and alcohol dependence among doctors and nurses working in intensive care units (ICUs) in Nepal and explored the individual and social drivers for these impacts. METHODS We conducted a mixed-methods study in Nepal, using an online survey to assess psychological well-being and semi-structured interviews to explore perceptions as to the drivers of anxiety, stress, and depression. Participants were recruited from existing national critical care professional organisations in Nepal and using a snowball technique. The online survey comprised of validated assessment tools for anxiety, depression, stress, PTSD, and alcohol dependence; all tools were analysed using published guidelines. Interviews were analysed using rapid appraisal techniques, and themes regarding the drivers for psychological distress were explored. RESULTS 134 respondents (113 nurses, 21 doctors) completed the online survey. Twenty-eight (21%) participants experienced moderate to severe symptoms of depression; 67 (50%) experienced moderate or severe symptoms of anxiety; 114 (85%) had scores indicative of moderate to high levels of stress; 46 out of 100 reported symptoms of PTSD. Compared to doctors, nurses experienced more severe symptoms of depression, anxiety, and PTSD, whereas doctors experienced higher levels of stress than nurses. Most (95%) participants had scores indicative of low risk of alcohol dependence. Twenty participants were followed up in interviews. Social stigmatism, physical and emotional safety, enforced role change and the absence of organisational support were perceived drivers for poor psychological well-being. CONCLUSION Nurses and doctors working in ICU during the COVID-19 pandemic sustained psychological impacts, manifesting as stress, anxiety, and for some, symptoms of PTSD. Nurses were more vulnerable. Individual characteristics and professional inequalities in healthcare may be potential modifiable factors for policy makers seeking to mitigate risks for healthcare providers.
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Affiliation(s)
- Shirish Kc
- Nepal Intensive Care Research Foundation, Kathmandu, Nepal
| | - Tiffany E Gooden
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Diptesh Aryal
- Nepal Intensive Care Research Foundation, Kathmandu, Nepal.
| | | | | | - Rashan Haniffa
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK
- Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Abi Beane
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK
- Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
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Maben J, Taylor C, Jagosh J, Carrieri D, Briscoe S, Klepacz N, Mattick K. Causes and solutions to workplace psychological ill-health for nurses, midwives and paramedics: the Care Under Pressure 2 realist review. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-171. [PMID: 38662367 DOI: 10.3310/twdu4109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Background Nurses, midwives and paramedics are the largest collective group of clinical staff in the National Health Service and have some of the highest prevalence of psychological ill-health. Existing literature tends to be profession-specific and focused on individual interventions that place responsibility for good psychological health with nurses, midwives and paramedics themselves. Aim To improve understanding of how, why and in what contexts nurses, midwives and paramedics experience work-related psychological ill-health; and determine which high-quality interventions can be implemented to minimise psychological ill-health in these professions. Methods Realist synthesis methodology consistent with realist and meta-narrative evidence syntheses: evolving standards' reporting guidelines. Data sources First round database searching in Medical Literature Analysis and Retrieval System Online Database ALL (via Ovid), cumulative index to nursing and allied health literature database (via EBSCO) and health management information consortium database (via Ovid), was undertaken between February and March 2021, followed by supplementary searching strategies (e.g. hand searching, expert solicitation of key papers). Reverse chronology screening was applied, aimed at retaining 30 relevant papers in each profession. Round two database searches (December 2021) targeted COVID-19-specific literature and literature reviews. No date limits were applied. Results We built on seven key reports and included 75 papers in the first round (26 nursing, 26 midwifery, 23 paramedic) plus 44 expert solicitation papers, 29 literature reviews and 49 COVID-19 focused articles in the second round. Through the realist synthesis we surfaced 14 key tensions in the literature and identified five key findings, supported by 26 context mechanism and outcome configurations. The key findings identified the following: (1) interventions are fragmented, individual-focused and insufficiently recognise cumulative chronic stressors; (2) it is difficult to promote staff psychological wellness where there is a blame culture; (3) the needs of the system often override staff well-being at work ('serve and sacrifice'); (4) there are unintended personal costs of upholding and implementing values at work; and (5) it is challenging to design, identify and implement interventions to work optimally for diverse staff groups with diverse and interacting stressors. Conclusions Our realist synthesis strongly suggests the need to improve the systemic working conditions and the working lives of nurses, midwives and paramedics to improve their psychological well-being. Individual, one-off psychological interventions are unlikely to succeed alone. Psychological ill-health is highly prevalent in these staff groups (and can be chronic and cumulative as well as acute) and should be anticipated and prepared for, indeed normalised and expected. Healthcare organisations need to (1) rebalance the working environment to enable healthcare professionals to recover and thrive; (2) invest in multi-level system approaches to promote staff psychological well-being; and use an organisational diagnostic framework, such as the NHS England and NHS Improvement Health and Wellbeing framework, to self-assess and implement a systems approach to staff well-being. Future work Future research should implement, refine and evaluate systemic interventional strategies. Interventions and evaluations should be co-designed with front-line staff and staff experts by experience, and tailored where possible to local, organisational and workforce needs. Limitations The literature was not equivalent in size and quality across the three professions and we did not carry out citation searches using hand searching and stakeholder/expert suggestions to augment our sample. Study registration This study is registered as PROSPERO CRD42020172420. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020172420. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR129528) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 9. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Jill Maben
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Cath Taylor
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Justin Jagosh
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Daniele Carrieri
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Simon Briscoe
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Naomi Klepacz
- School of Health Sciences, University of Surrey, Guildford, UK
- School of Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) Wessex, Southampton, UK
| | - Karen Mattick
- University of Exeter Medical School, University of Exeter, Exeter, UK
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Hatukay AL, Shochat T, Zion N, Baruch H, Cohen R, Azriel Y, Srulovici E. The relationship between quick return shift schedules and burnout among nurses: A prospective repeated measures multi-source study. Int J Nurs Stud 2024; 151:104677. [PMID: 38211364 DOI: 10.1016/j.ijnurstu.2023.104677] [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: 08/15/2023] [Revised: 11/19/2023] [Accepted: 12/17/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND In today's world, essential health care services are expected round the clock, leading to distinct shift work requirements. A notable aspect is the "quick return," where the rest interval between nursing shifts is <11 h. Preliminary research suggests a potential association between quick return schedules, diminished sleep quality, and possible nurse burnout. Yet, the motivation of nurses could potentially moderate this relationship. OBJECTIVE To examine a moderated-mediation model, whereby sleep duration and nurse's motivation act together to mediate the link between quick return schedules and nurse's burnout. DESIGN A prospective repeated measures (4-5 nursing shifts per nurse) multi-source (self-report and objective measures) study. SETTING Internal and surgical departments across one large and one medium scale teaching hospitals in Israel. PARTICIPANTS Registered nurses who provide direct patient care (n = 79) across 369 shifts. METHODS Nurses completed a questionnaire containing personal information and information regarding their shifts during the study week. They wore an accelerometer (a wrist worn device that monitors and records an individual's activity level) during a work-week to objectively determine their sleep duration, completed a motivation questionnaire at the beginning of each shift, and completed a burnout questionnaire at the end of the week. Mixed-model regression analysis was used to test a moderated-mediation model following Hayes' recommendations, whereby the joint effect of sleep duration and motivation mediates the link between quick return schedules and burnout. RESULTS The moderated-mediation model was supported. Quick return schedules were negatively statistically significantly associated with sleep duration (b = -126.54, SE = 20.85, p < 0.001); so that more frequent quick return schedules were related to shorter sleep duration. However, no direct correlation was observed between sleep duration and burnout (p = 0.171). A statistically significant interaction was observed between sleep duration and motivation (b = 0.00, SE = 0.00, p < 0.001) concerning burnout. Thus, nurses with lower motivation were prone to experiencing higher levels of burnout with shorter sleep duration compared to nurses with higher motivation. CONCLUSIONS The mediating role of sleep duration, moderated by motivation, plays a role in the connection between quick return schedules and burnout. This indicates that nurses can sustain their work motivation even within the demands of quick return schedules, consequently mitigating burnout levels. To prioritize employees' well-being, organizations should adopt shift work structures that minimize quick return schedules and extend nurses' sleep duration. Consequently, managers must employ strategies to enhance nurses' motivation when addressing scenarios that necessitate quick return schedules.
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Affiliation(s)
- Ania Lauz Hatukay
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel; Baruch Padeh Medical Cener, Lower Galilee, Israel
| | - Tamar Shochat
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel
| | - Natalie Zion
- The Dr. Y. Zayda School of Nursing, Bnai Zion Medical Center, Haifa, Israel
| | - Hagar Baruch
- Nursing Directorate, Rambam Health Care Campus, Haifa, Israel
| | - Ricky Cohen
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel
| | - Yarden Azriel
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel; The Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Einav Srulovici
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel.
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Dartey AF, Tackie V, Lotse CW, Lily D, Sagbo FM. Experiences of Nurses and Midwives With Indecorously Structured Duty Rosters at Selected Health Facilities in Ho, Volta Region of Ghana: A Qualitative Study. SAGE Open Nurs 2024; 10:23779608241275323. [PMID: 39185503 PMCID: PMC11342322 DOI: 10.1177/23779608241275323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 07/10/2024] [Accepted: 07/18/2024] [Indexed: 08/27/2024] Open
Abstract
Introduction Decent working time in the health sector is critical to providing quality care, and balancing health workers' well-being with the requirements of 24/7 healthcare provision. Nursing and midwifery staff, comprising the largest group in the health workforce, play a crucial role. Understanding their experiences and challenges related to duty rosters is essential for improving work conditions, job satisfaction, and ultimately, the quality of care. Objective This study aims to explore the experiences of nurses and midwives with the hospital duty roster at selected health facilities in Ho, the Volta Region of Ghana. Method A qualitative research method with a phenomenological approach was employed to capture the nuanced experiences of nurses and midwives regarding the hospital duty roster. A semistructured interview guide facilitated data collection, ensuring a comprehensive exploration of participants' experiences. Three selected health facilities in Ho, the Volta Region of Ghana, served as the study's location. The study recruited 20 participants (nurses and midwives) to reach data saturation. The collected data were transcribed verbatim and analyzed through thematic content analysis, using a deductive approach. Researchers reviewed the raw data, generating initial codes to capture new concepts of interest. Results The duty roster often demonstrated organizational flaws negatively impacting the health, well-being, and job performance of nurses and midwives, consequently affecting patient care quality. The study identified that these healthcare professionals faced significant risks of work-related stress, burnout, and mental health problems due to ineffective coping strategies toward the hospital duty roster. Findings from the study also demonstrated that nurses and midwives prefer day shift because of its short time and the availability of all groups of professionals to help manage cases as compared to a night shift. Conclusions The findings underscore factors influencing nurses' choice of shift patterns, emphasizing the need for further research to explore the extent to which nurses' preferences are considered when designing hospital duty rosters. Such insights can contribute to improving both the working conditions of healthcare professionals and the overall quality of patient care.
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Affiliation(s)
- Anita Fafa Dartey
- School of Nursing and Midwifery, University of Health and Allied Sciences, Volta Region, Ghana
| | - Vivian Tackie
- School of Nursing and Midwifery, University of Health and Allied Sciences, Volta Region, Ghana
| | - Comfort Worna Lotse
- School of Nursing and Midwifery, University of Health and Allied Sciences, Volta Region, Ghana
| | - Dodoo Lily
- School of Nursing and Midwifery, University of Health and Allied Sciences, Volta Region, Ghana
| | - Francis Mawougnon Sagbo
- School of Nursing and Midwifery, University of Health and Allied Sciences, Volta Region, Ghana
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Kida R, Takemura Y. Relationship between shift assignments, organizational justice, and turnover intention: A cross-sectional survey of Japanese shift-work nurses in hospitals. Jpn J Nurs Sci 2024; 21:e12570. [PMID: 37867134 DOI: 10.1111/jjns.12570] [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: 06/08/2023] [Revised: 08/17/2023] [Accepted: 09/24/2023] [Indexed: 10/24/2023]
Abstract
AIM Shift management and planning processes for shift-working nurses are important for their continued work. This study aimed to determine the association between shift assignments, organizational justice, and their interaction with turnover intention among shift-work nurses. METHODS This cross-sectional study used an online questionnaire administered to Japanese nurses between January and February 2020. Enquiries pertaining to their daily start and end times for each shift type, the shift assignments, organizational justice, and their turnover intention were made. To examine the association with turnover intention, logistic regression analysis was performed with shift assignments, organizational justice, and their interaction terms as independent variables. RESULTS A total of 386 nurses participated in the final analysis. Of these, 161 nurses (41.7%) had turnover intention. Unequal work assignments and procedural justice were significantly associated with turnover intention. However, the interaction between these factors was not significant. CONCLUSION The results suggest that procedural justice in the workplace and turnover intention are related, but in shift planning, even procedural justice cannot buffer unequal work from leading to turnover intention. This study provides valuable insights for nursing managers who manage the schedules of shift-working nurses.
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Affiliation(s)
- Ryohei Kida
- Department of Nursing Administration and Advanced Clinical Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yukie Takemura
- Nursing Department, The University of Tokyo Hospital, Tokyo, Japan
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Kalkanis A, Demolder S, Papadopoulos D, Testelmans D, Buyse B. Recovery from shift work. Front Neurol 2023; 14:1270043. [PMID: 38020633 PMCID: PMC10651732 DOI: 10.3389/fneur.2023.1270043] [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: 07/31/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
One fifth of today's workforce is engaged in shift work and exposed to various mental and physical health risks including shift work disorder. Efficiently recovering from shift work through physical and mental interventions allows us to mitigate negative effects on health, enables a better work-life balance and enhances our overall wellbeing. The aim of this review is to provide a state-of-the-art overview of the available literature. The role of sleep timing and naps, light therapy and psychotherapy, diet and exercise in recovery from shift work is presented here. We further review the impact of shift schedules and social support on post-shift unwinding.
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Affiliation(s)
- Alexandros Kalkanis
- Department of Respiratory Diseases, Louvain University Center for Sleep and Wake Disorders (LUCS), University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Saartje Demolder
- Department of Respiratory Diseases, Louvain University Center for Sleep and Wake Disorders (LUCS), University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Dimitrios Papadopoulos
- Department of Respiratory Diseases, Louvain University Center for Sleep and Wake Disorders (LUCS), University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Dries Testelmans
- Department of Respiratory Diseases, Louvain University Center for Sleep and Wake Disorders (LUCS), University Hospitals Leuven, KU Leuven, Leuven, Belgium
- Laboratory of Respiratory Disease and Thoracic Surgery (BREATH), KU Leuven-University, Leuven, Belgium
| | - Bertien Buyse
- Department of Respiratory Diseases, Louvain University Center for Sleep and Wake Disorders (LUCS), University Hospitals Leuven, KU Leuven, Leuven, Belgium
- Laboratory of Respiratory Disease and Thoracic Surgery (BREATH), KU Leuven-University, Leuven, Belgium
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11
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Chen S, Wu H, Sun M, Wei Q, Zhang Q. Effects of shift work schedules, compensatory sleep, and work-family conflict on fatigue of shift-working nurses in Chinese intensive care units. Nurs Crit Care 2023; 28:948-956. [PMID: 37078518 DOI: 10.1111/nicc.12909] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 03/06/2023] [Accepted: 03/14/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Shift work is inevitable for nurses in intensive care units. Various studies explored nurses' fatigue in multiple hospital wards. However, few studies focused on fatigue among nurses in intensive care units. AIMS To determine the association between shift work schedules, compensatory sleep, work-family conflict, and fatigue of shift-working nurses in critical care units. STUDY DESIGN A descriptive cross-sectional multi-center study was conducted in March 2022 among intensive care nurses from five hospitals. METHODS Data were collected by online survey, including self-designed demographic questions, the Fatigue Scale-14, the Chinese adult daytime sleepiness scale, and the work-family scale. Pearson correlation was conducted for bivariate analysis. Independent-sample t-test, one-way ANOVA, and multiple linear regression analysis were performed to examine fatigue-related variables. RESULTS A total of 326 nurses responded to the survey with an effective response rate of 74.9%. The mean scores of physical fatigue and mental fatigue were 6.80 and 3.72, respectively. The bivariate analyses showed that work-family conflict was positively correlated with physical (r = 0.483, p < .001) and mental fatigue (r = 0.406, p < .001). Multiple linear regression results showed that work-family conflict, daytime sleepiness, and shift system were statistically significant factors influencing physical fatigue (F = 41.793, p < .001). Work-family conflict, sleep duration after the night shift, and daytime sleepiness were the main influencing factors of mental fatigue (F = 25.105, p < .001). CONCLUSIONS Nurses with higher work-family conflict, daytime sleepiness, and working 12-h shifts have higher levels of physical fatigue. Higher work-family conflict, shorter sleep duration after night shifts, and daytime sleepiness are associated with higher mental fatigue among intensive care nurses. RELEVANCE TO CLINICAL PRACTICE Nursing managers and nurses should consider work-family factors and compensatory sleep in their efforts to reduce fatigue. It is necessary to strengthen work-supporting strategies and compensatory sleep guidance for nurses to promote fatigue recovery.
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Affiliation(s)
- Shanshan Chen
- Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Huihui Wu
- Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Mimi Sun
- Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qing Wei
- Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qixia Zhang
- Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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12
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Tremayne P, de Bourg L. Exploring nurses' well-being and strategies to support self-care. Nurs Stand 2023; 38:e12206. [PMID: 37842764 DOI: 10.7748/ns.2023.e12206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2023] [Indexed: 10/17/2023]
Abstract
Nurses experience a range of challenges in their practice that can adversely affect their well-being, for example work-related stress and workforce issues. These challenges may have been intensified by various factors, such as the coronavirus disease 2019 (COVID-19) pandemic and shift working. This article considers the concept of well-being and explores nurses' well-being in the context of ongoing stressors and workforce issues. It also examines some of the effects of shift work on nurses' well-being and how these could be mitigated. The authors outline a range of self-care practices that nurses could engage in and consider how they may be supported in this by their line managers and healthcare organisations.
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Affiliation(s)
- Penny Tremayne
- Leicester School of Nursing and Midwifery, De Montfort University, Leicester, England
| | - Lorna de Bourg
- Leicester School of Nursing and Midwifery, De Montfort University, Leicester, England
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13
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Gehri B, Bachnick S, Schwendimann R, Simon M. Work-schedule management in psychiatric hospitals and its associations with nurses' emotional exhaustion and intention to leave: A cross-sectional multicenter study. Int J Nurs Stud 2023; 146:104583. [PMID: 37619391 DOI: 10.1016/j.ijnurstu.2023.104583] [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: 03/08/2023] [Revised: 06/16/2023] [Accepted: 07/30/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Managing nurses' work schedules in hospitals is challenging because employer needs, like shift changes at short notice and overtime, may conflict with nurses' desires for a predictable and stable schedule. Nurses should have a certain degree of control over their work schedules, and their supervisors should support their needs in scheduling. How perceived control over work schedules, perceived support from supervisors in scheduling, shift changes at short notice, and overtime affect nurses' emotional exhaustion and intentions to leave has not been studied. OBJECTIVES The aims are (1) to describe perceived control, perceived supervisor support, shift changes at short notice, and overtime among nurses in psychiatric hospitals; (2) to assess the variation of these four factors between units at psychiatric hospitals; and (3) to investigate the association between these factors with nurses' emotional exhaustion and intentions to leave. DESIGN Cross-sectional survey study. SETTING(S) Swiss psychiatric hospitals with 24-hour services. PARTICIPANTS Registered nurses (N = 994) from 114 adult-inpatient units. METHODS To describe perceived control, perceived supervisor support, shift changes at short notice, and overtime among nurses, we calculated frequencies, percentages, means, and standard deviations of their responses to the survey. To assess the variation between units, we computed intraclass correlations for the four factors. We constructed random-effects models accounting for the clustering of nurses in units for emotional exhaustion and intentions to leave separately. RESULTS Perception of work-schedule control was 3.32 (SD 1.39, range 0-5); perception of supervisor work-schedule support was 3.28 (SD 1.14, range 0-4). On average, 9 % of the nurses had to take over a shift at short notice at least three times per month, and 40 % worked at least 15 minute overtime on their most recent shift. Intraclass correlation for all four factors was higher than 0.05. Emotional exhaustion was significantly associated with supervisor support and overtime, and leaving intentions were significantly associated with perceived control, supervisor support and overtime. CONCLUSION Perceived control, perceived supervisor support, shift changes at short notice, and overtime are promising factors for interventions to prevent nurses' emotional exhaustion and allay their intentions to leave. Unit managers should provide nurses with increased predictability and influence on their work schedules. This could reduce early career endings and early retirement and counteract nurse shortages.
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Affiliation(s)
- Beatrice Gehri
- Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland; University Psychiatric Clinics, Basel, Switzerland
| | - Stefanie Bachnick
- HS-Gesundheit Bochum, University of Applied Sciences, Bochum, Germany
| | - René Schwendimann
- Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland; University Hospital Basel, Basel, Switzerland
| | - Michael Simon
- Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland.
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14
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Ooshige N, Matsunaka E, Ueki S, Takuma S. Pregnant nurses' experiences of working shifts: a qualitative systematic review. JBI Evid Synth 2023:02174543-990000000-00211. [PMID: 37747425 DOI: 10.11124/jbies-23-00184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
OBJECTIVE The objective of this systematic review was to synthesize the experiences of nurses who work shifts during pregnancy. INCLUSION CRITERIA This review included studies that focused on the experiences of pregnant registered nurses, regardless of their level of qualification, working shifts in any workplace, including hospitals, nursing home facilities, or clinics, in any country. Nurses not involved in direct care (eg, advanced practice nurses, administrators, educators) were excluded. METHODS The review followed the JBI methodology for qualitative systematic reviews. Published and gray literature were searched for via CINAHL (EBSCOhost), MEDLINE (EBSCOhost), PsycINFO (EBSCOhost), Igaku Chuo Zasshi (Japan Medical Abstracts Society). No language restrictions were imposed, and the date limit was set for 2013 to 2021. Two independent reviewers performed data collection, extraction, critical appraisal, and analysis. Unequivocal and credible findings were used to develop categories, which were then synthesized to provide a set of comprehensive findings, which were graded according to ConQual. RESULTS Five qualitative studies were included (2 from the USA, 2 from Japan, and 1 from Korea), from which 23 findings with narrative illustrations were extracted. Of these findings, 22 were assessed as unequivocal and 1 as credible. The studies were low-to-moderate quality based on the JBI critical appraisal checklist for qualitative research. All studies used qualitative methodologies, including phenomenology, qualitative description, and the grounded theory approach. Results were integrated into 8 categories and 3 synthesized findings. The first synthesized finding was that nurses struggle with the physical burden of pregnancy and work environments that threaten continued pregnancy. The second was that nurses achieve work-pregnancy compatibility by disclosing their pregnancy and obtaining support. The third was that development as a nurse results from continuing to work during pregnancy. CONCLUSIONS Pregnant nurses face a harsh work environment; the support they receive after disclosing their pregnancy allows them to balance work and pregnancy; and they feel that they grow as professionals by continuing to work even if they are pregnant. More research is needed to inform support systems for them. REVIEW REGISTRATION PROSPERO CRD42022309674. SUPPLEMENTAL DIGITAL CONTENT A Japanese-language version of the abstract of this review is available as Supplemental Digital Content: http://links.lww.com/SRX/A31.
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Affiliation(s)
- Narumi Ooshige
- Department of Nursing, Faculty of Nursing and Nutrition, University of Nagasaki, Nagasaki, Japan
| | - Eriko Matsunaka
- Japanese Red Cross, Kyushu International College of Nursing, Fukuoka, Japan
- The Japan Centre for Evidence Based Practice: A JBI Centre of Excellence, Osaka University, Osaka, Japan
| | - Shingo Ueki
- The Japan Centre for Evidence Based Practice: A JBI Centre of Excellence, Osaka University, Osaka, Japan
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Sayuka Takuma
- Reference Service Section, Medical Library, Kyushu University, Fukuoka, Japan
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15
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Kabunga A, Kigongo E, Udho S, Auma AG, Okalo P, Apili B, Halimah N, Nalwoga V. Chronic stress and coping mechanisms among nurses in Lango sub-region, northern Uganda. Nurs Open 2023; 10:6101-6107. [PMID: 37199048 PMCID: PMC10415976 DOI: 10.1002/nop2.1831] [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: 09/13/2022] [Revised: 02/05/2023] [Accepted: 05/05/2023] [Indexed: 05/19/2023] Open
Abstract
AIM This study aimed to assess chronic stress and coping mechanisms among nurses in Lango sub-region, northern Uganda, conducted between May and June 2022. DESIGN Institutional-based cross-sectional design conducted between May and June 2022. METHODS The study included 498 participants recruited from six health facilities. A 12-Item Short Form Survey tool was used to collect data on chronic stress, while a researcher-developed questionnaire was used to collect data on coping strategies. Descriptive statistics, binary logistic regression and multiple regression were conducted for data analysis. A p-value of 0.05 was considered statistically significant. RESULTS Out of 498 participants, 153 (30.7%) were aged between 31 and 40 years, 341 (68.5%) were female, 288 (57.8%) were married, and 266 (53.4%) had less than Diploma. Of the 498 participants, 351 (70.5%) experienced chronic stress. The protective factors against chronic stress were being married (AOR: 0.132; 95% CI: 0.043-0.408; p < 0.001), optimizing shift length (AOR: 0.056; 95% CI: 0.027-0.115; p < 0.001), religiosity/Spirituality (AOR: 2.750; 95% CI: 1.376-5.497; p = 0.004), and regular exercise and breaks (AOR: 0.405; 95% CI: 0.223-0.737; p = 0.003).
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Affiliation(s)
- Amir Kabunga
- Department of Psychiatry, Faculty of MedicineLira UniversityLiraUganda
| | - Eustes Kigongo
- Department of Environmental Health and Disease ControlLira UniversityLiraUganda
| | - Samson Udho
- Department of Nursing and Midwifery, Faculty of Nursing and MidwiferyLira UniversityLiraUganda
| | - Ann Grace Auma
- Department of Nursing and Midwifery, Faculty of Nursing and MidwiferyLira UniversityLiraUganda
| | - Ponsiano Okalo
- Department of Psychiatry, Faculty of MedicineLira UniversityLiraUganda
| | - Brenda Apili
- Department of Psychiatry, Faculty of MedicineLira UniversityLiraUganda
| | - Namata Halimah
- Department of Mental HealthMakerere UniversityKampalaUganda
| | - Viola Nalwoga
- Department of Psychiatry, Faculty of MedicineLira UniversityLiraUganda
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16
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Al-Moteri M, Alzahrani AA, Althobiti ES, Plummer V, Sahrah AZ, Alkhaldi MJ, Rajab EF, Alsalmi AR, Abdullah ME, Abduelazeez AEA, Caslangen MZM, Ismail MG, Alqurashi TA. The Road to Developing Standard Time for Efficient Nursing Care: A Time and Motion Analysis. Healthcare (Basel) 2023; 11:2216. [PMID: 37570456 PMCID: PMC10418769 DOI: 10.3390/healthcare11152216] [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: 06/26/2023] [Revised: 07/29/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023] Open
Abstract
(1) Background: The amount of time nurses spend with their patients is essential to improving the quality of patient care. Studies have shown that nurses spend a considerable amount of time on a variety of activities--which are often not taken into account while estimating nurse-to-patient care time allocation--that could potentially be eliminated, combined or delegated with greater productivity. The current study aimed to calculate standard time for each activity category by quantifying the amount of time required by nurses to complete an activity category and determine the adjustment time that can be given during work, as well as determine factors that can be altered to improve the efficiency of nursing care on inpatient general wards of a governmental hospital. (2) Method: A time and motion study was conducted over two weeks using 1-to-1 continuous observations of nurses as they performed their duties on inpatient general wards, while observers recorded each single activity, and specifically the time and movements required to complete those activities. (3) Result: There was 5100 min of observations over 10 working days. Nurses spent 69% (330 min) of time during their 8 h morning shift on direct patient care, (19.4%) ward/room activities (18%), documentation (14%), indirect patient care (12%) and professional communication (5%). Around 94 min of activities seem to be wasted and can be potentially detrimental to nurses' overall productivity and threaten patient care quality. The standard number of hours that represents the best estimate of a general ward nurse regarding the optimal speed at which the staff nurse can provide care related activities was computed and proposed. (4) Conclusions: The findings obtained from time-motion studies can help in developing more efficient and productive nursing work for more optimal care of patients.
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Affiliation(s)
- Modi Al-Moteri
- Nursing Department, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Amer A. Alzahrani
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
| | - Ensherah Saeed Althobiti
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
| | - Virginia Plummer
- Institute of Health and Wellbeing, Federation University, Berwick, VIC 3806, Australia;
| | - Afnan Z. Sahrah
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
| | - Maha Jabar Alkhaldi
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
| | - Eishah Fahad Rajab
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
| | - Amani R. Alsalmi
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
| | - Merhamah E. Abdullah
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
| | | | - Mari-zel M. Caslangen
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
| | - Mariam G. Ismail
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
| | - Talal Awadh Alqurashi
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
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17
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Cockerham M, Kang DH, Beier ME. Consecutive Shifts: A Repeated Measure Study to Evaluate Stress, Biomarkers, Social Support, and Fatigue in Medical/Surgical Nurses. Behav Sci (Basel) 2023; 13:571. [PMID: 37504018 PMCID: PMC10376272 DOI: 10.3390/bs13070571] [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] [Received: 06/05/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/29/2023] Open
Abstract
Nurses report that they are required to work during their scheduled breaks and generally experience extended work times and heavy workloads due to staffing shortages. This study aimed to examine changes in personal, work-related, and overall stress, as well as biological responses and fatigue experienced by nurses during three consecutive 12 h workdays (i.e., the typical "three-twelves" schedule). We also considered the moderating effects of social resources. This prospective study of 81 medical/surgical nurses who completed questionnaires and provided saliva samples at four designated intervals (i.e., pre-shift and post-shift on workdays 1 and 3). Fatigue reported by night shift nurses increased significantly over three consecutive workdays (p = 0.001). Day shift nurses said they encountered more social support than those on the night shift (p = 0.05). Social support moderated the relationship between work-related stress at baseline and reported fatigue on day 3.
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Affiliation(s)
- Mona Cockerham
- School of Nursing, Sam Houston State University, The Woodlands, TX 77380, USA
- Houston Methodist, Willowbrook Hospital, Houston, TX 77030, USA
| | - Duck-Hee Kang
- Cizik School of Nursing, University of Texas Health Science Center, Houston, TX 77355, USA
| | - Margaret E Beier
- Department of Psychological Sciences, Rice University, Houston, TX 77005, USA
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18
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Ervasti J, Peutere L, Virtanen M, Krutova O, Koskinen A, Härmä M, Kivimäki M, Ropponen A. Concurrent trajectories of self-rated health and working hour patterns in health care shift workers: A longitudinal analysis with 8-year follow-up. Front Public Health 2022; 10:926057. [PMID: 36148352 PMCID: PMC9485932 DOI: 10.3389/fpubh.2022.926057] [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] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/19/2022] [Indexed: 01/24/2023] Open
Abstract
Background The association between health and working hours is hypothesized to be reciprocal, but few longitudinal studies have examined changes in both health and working hour patterns over time. We examined combined trajectories of self-related health and two working hour patterns (working <35 h/week and working night shifts) and the extent to which these trajectories were predicted by employees' lifestyle and mental health. Methods Participants of this cohort study with a 8-year follow-up were 5,947 health care shift workers. We linked self-reports of health from three repeated surveys with objective pay-roll based data on working hours. Using group-based multi-trajectory analysis we identified concurrent trajectories for self-rated health and working hour patterns. We examined their associations with baseline lifestyle-related factors (smoking, at-risk alcohol use, obesity, and physical inactivity) and mental health (sleep problems and psychological distress) using multinomial regression analysis. Results Three combined trajectories of self-rated health and working <35 h/week and four combined trajectories of self-rated health and night work were identified. Unhealthy lifestyle and poor mental health were associated with trajectories of moderate and declining health. Sleep problems were linked with working <35 h/week. Younger age and good mental health were associated with a combined trajectory of good health and continued night shift work. Conclusion Trajectories of suboptimal and declining health are associated with trajectories of reducing working hours and leaving night work, and are more common in employees with unhealthy lifestyle, sleep problems, and psychological distress.
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Affiliation(s)
- Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland,*Correspondence: Jenni Ervasti
| | - Laura Peutere
- Finnish Institute of Occupational Health, Helsinki, Finland,School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland,Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Oxana Krutova
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Aki Koskinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mikko Härmä
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland,Clinicum, University of Helsinki, Helsinki, Finland,Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Annina Ropponen
- Finnish Institute of Occupational Health, Helsinki, Finland,Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
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19
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20
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Li D, Li X, Zeng Y. The Moderating Effect of Community Environment on the Association Between Social Support and Chinese Older Adults' Health: An Empirical Analysis Study. Front Public Health 2022; 10:855310. [PMID: 35570963 PMCID: PMC9092342 DOI: 10.3389/fpubh.2022.855310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background The aging population conundrum and the gradual weakening of older adults' health and ability to obtain resources as they age have drawn attention to this population's health. Older adults' health relates not only to their own quality of life, but also to the development of families/society. Methods We analyzed micro data from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study Follow-up Questionnaire, using the probit model, ordinary least squares model, and other methods. Results and Conclusions Both formal and informal social support significantly impacted the physical and mental health of Chinese older adults, and the community environment moderated this relationship. To build a reasonable and effective social support system for older adults and improve their health, we suggest that stakeholders should continue to strengthen the formal and informal social support provided to older adults; they should also build a community-based care system, which will allow for the moderating role of community environment on the relationship between social support and older adults' health. Family and social support factors are important for older adults' health. We should enable the moderating role of community environment on the relationship between social support and health to be fully exerted, as well as build a community-based pension system.
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Affiliation(s)
- Dongfang Li
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Xiaolin Li
- Center for Social Security Studies of Wuhan University, Wuhan University, Wuhan, China
| | - Yi Zeng
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
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21
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Dall'Ora C, Ejebu OZ, Griffiths P. Because they're worth it? A discussion paper on the value of 12-h shifts for hospital nursing. HUMAN RESOURCES FOR HEALTH 2022; 20:36. [PMID: 35525947 PMCID: PMC9077839 DOI: 10.1186/s12960-022-00731-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/19/2022] [Indexed: 05/20/2023]
Abstract
The organisation of the 24-h day for hospital nurses in two 12-h shifts has been introduced with value propositions of reduced staffing costs, better quality of care, more efficient work organisation, and increased nurse recruitment and retention. While existing reviews consider the impact of 12-h shifts on nurses' wellbeing and performance, this discussion paper aims to specifically shed light on whether the current evidence supports the value propositions around 12-h shifts. We found little evidence of the value propositions being realised. Staffing costs are not reduced with 12-h shifts, and outcomes related to productivity and efficiency, including sickness absence and missed nursing care are negatively affected. Nurses working 12-h shifts do not perform more safely than their counterparts working shorter shifts, with evidence pointing to a likely negative effect on safe care due to increased fatigue and sleepiness. In addition, nurses working 12-h shifts may have access to fewer educational opportunities than nurses working shorter shifts. Despite some nurses preferring 12-h shifts, the literature does not indicate that this shift pattern leads to increased recruitment, with studies reporting that nurses working long shifts are more likely to express intention to leave their job. In conclusion, there is little if any support for the value propositions that were advanced when 12-h shifts were introduced. While 12-h shifts might be here to stay, it is important that the limitations, including reduced productivity and efficiency, are recognised and accepted by those in charge of implementing schedules for hospital nurses.
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Affiliation(s)
- Chiara Dall'Ora
- Innovation Centre, NIHR ARC Wessex, Southampton Science Park, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK.
- School of Health Sciences, University of Southampton, University Road, Southampton, SO17 1BJ, UK.
| | - Ourega-Zoé Ejebu
- Innovation Centre, NIHR ARC Wessex, Southampton Science Park, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK
- School of Health Sciences, University of Southampton, University Road, Southampton, SO17 1BJ, UK
| | - Peter Griffiths
- Innovation Centre, NIHR ARC Wessex, Southampton Science Park, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK
- School of Health Sciences, University of Southampton, University Road, Southampton, SO17 1BJ, UK
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22
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The Daily Basic Psychological Need Satisfaction and Work Engagement of Nurses: A ‘Shortitudinal’ Diary Study. Healthcare (Basel) 2022; 10:healthcare10050863. [PMID: 35627999 PMCID: PMC9141162 DOI: 10.3390/healthcare10050863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 04/26/2022] [Accepted: 05/03/2022] [Indexed: 11/25/2022] Open
Abstract
Nurses’ satisfaction and work engagement have been linked to patient outcomes. Nightshift nurses provide healthcare to the population and experience unique challenges in performing their healthcare tasks. Therefore, the current study aimed to investigate the daily basic needs satisfaction and work engagement of nightshift nurses in accordance with the satisfaction of three basic psychological needs as indicated by the Self-Determination Theory. A quantitative, ‘shortitudinal’ design (diary study; over a few days) with a multi-level research approach using a daily diary survey method was completed by a convenience sample of nurses working the nightshift in a public hospital (n = 33). The results revealed that the daily need for autonomy and need for relatedness did not significantly predict variance in daily work engagement. However, need for competence did significantly predict variance in daily work engagement, and general emotional load explained significant variability in daily need satisfaction of competence. Lastly, general role clarity had a negative impact on the daily variability in work engagement. This study provides healthcare organisations with explanations for variance in nursing performance and suggests possible interventions to address nursing outcomes in accordance with the three basic needs of nightshift nurses in daily activity.
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Dall'Ora C, Sainsbury J, Allen C. Student nurses' views on shift patterns: What do they prefer and why? Results from a Tweetchat. Nurs Open 2022; 9:1785-1793. [PMID: 35307974 PMCID: PMC8994946 DOI: 10.1002/nop2.1208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 02/09/2022] [Accepted: 03/08/2022] [Indexed: 11/23/2022] Open
Abstract
Aim The main aim of the study was to understand student nurses’ views around shift patterns. Design Qualitative study. Method We held a Tweetchat in May 2019, where we asked questions around the frequency of 12‐hr shifts working on placement; schedule flexibility while on placement; which shift patterns they preferred and why. Data from the Tweetchat were analysed using reflexive thematic analysis to generate themes from initial codes. Results Seventy‐three nursing students participated in the Tweetchat. The majority reported that they work 12‐hr shifts on placements, particularly when based in a hospital. We identified three themes: ‘Achieving a personal equilibrium’; ‘Meeting the needs of the care environment’; ‘Factors affecting negotiation capacity’. Data highlighted a conflict for most students, where they preferred 12‐hr shifts because of more time off for study, paid work and leisure, while acknowledging 12‐hr shifts negatively affected their fatigue, exhaustion and led them to follow a poor diet and neglect exercise and sleep.
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Affiliation(s)
- Chiara Dall'Ora
- NIHR ARC Wessex, Wessex, UK.,School of Health Sciences, University Of Southampton, Southampton, UK
| | - Jessica Sainsbury
- School of Health Sciences, University Of Southampton, Southampton, UK.,Solent NHS Trust, and seconded at the Florence Nightingale Foundation, London, UK
| | - Chris Allen
- School of Health Sciences, University Of Southampton, Southampton, UK
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