Occupational stress and turnover intention: implications for nursing management

Occupational stress and associated sources and risk factors among nurses in Gaza strip, Palestine: A cross-sectional survey

AIM

To determine the occurrence of occupational stress among Palestinian nurses, and their associated sources and risk factors.

DESIGN

A cross-sectional descriptive design.

METHODS

A total of 250 registered nurses from eight governmental hospitals, using a convenience sampling method. Data collection were conducted using the 30-items self-reported Occupational Stress Scale from December 2022 to March 2023. Descriptive statistics, independent sample t-test, one-way ANOVA, and multiple linear regression analysis were applied to analysis data. Data analysis included descriptive statistics, independent sample t-test, one-way ANOVA, and multiple linear regression analysis.

RESULTS

The prevalence of high occupational stress levels was 64.8% (Mean = 3.9 out of 5). The main sources of stress are too much responsibility and work, understaffing, lack of promotion and recognition, inadequate pay, time pressure, and management style. The results regression analysis demonstrated that male nurses with a Masters or PhD degree and those working in fixed shifts experienced higher occupational stress. Moreover, participants who worked overtime hours were more susceptible to stress.

CONCLUSIONS

The research indicates that occupational stress presents a notable challenge for nurses in the Gaza Strip, Palestine. It suggests that in order to alleviate this stress, decision-makers in healthcare policy and hospital management should prioritize the execution of strategies aimed at addressing the primary stressors and risk factors identified.

REPORTING METHOD

This study adhered to the STROBE guidelines.

PUBLIC CONTRIBUTION

A total of 250 registered nurses were taken part in this study by answering a self-administered study survey.

Why do nurses leave their jobs? Understanding person-related hostility in the healthcare sector of Pakistan

Nursing is considered indigent and oppressed because of uneven organizational hierarchies and unsatisfactory work environments. This study aimed to highlight the critical aspects of organizational culture in the nursing profession and, in general, those propagating hostile behaviours among female nursing staff that result in dissatisfaction and intention to leave the organization. A quantitative research approach was applied and a survey research strategy was used to collect the data. Convenience sampling was applied and data were collected from female nurses who were easily accessible and willing to participate in the research. A total of 707 questionnaires were collected from 14 hospitals and the data was analyzed using SmartPLS 4. Lack of administrative support and gender discrimination positively affected person-related hostility. In contrast, person-related hostility mediated the relationship between gender discrimination and lack of administrative support with the intention to leave. Direct or indirect person-related hostility factors can severely damage organizational reputation and quality and may cause the loss of employees with specific organizational knowledge and exposure. Losing an experienced employee to a newer one cannot replace the costs incurred on hiring, training, and providing knowledge to older employees. HR managers in organizations should devise strategies and policies that allow for the timely resolution of issues of nursing staff based on fair work performance.

Testing the model of judicial stress using a COVID-era survey of U.S. federal court personnel

Non-judicial court personnel, critical to a well-functioning justice system, experience overloaded dockets and the responsibility of making significant decisions, contributing to cognitive stress. Understanding and mitigating their stress is essential for maintaining judicial efficiency. We adapted Miller and Richardson's Model of Judicial Stress to assess stress in a broad sample of non-judicial court personnel (n = 122), including judges, lawyers, and administrative staff. Participants responded to surveys about their stress levels, job performance, and health; they also completed cognitive performance tasks. The findings indicated that stress negatively affected employee outcomes including cognitive performance, job performance, job satisfaction, and health outcomes. Notably, perceived job performance had declined compared to the previous year, suggesting that the pandemic was an additional significant stressor. Based on the data, the Model of Judicial Stress is also applicable to other types of courtroom personnel, underlining its relevance across various judicial roles.

Predictive factors of occupational stress among nurses during the COVID-19 pandemic: a cross-sectional study in Kashan, Iran

BACKGROUND

Considering the severe and sudden changes in the job conditions of nurses during the covid-19 pandemic, the increase in job tensions during this critical period and its consequences on the quantity and quality of nursing care, this study aims to investigate the job stress of nurses during the covid-19 pandemic and its predictors in Iran.

METHODS

This cross-sectional study was conducted on 400 nurses in 'Kashan', Iran, who were randomly selected using stratified sampling. Data were collected using two questionnaires on occupational stress and potential related factors. The data were analyzed in SPSS version 16.

RESULTS

The results showed that the occupational stress of nurses in Iran was at a medium to high level with a mean and standard deviation of 103.773 ± 15.742 (scale of 34-136). Factors such as satisfaction with physical health, quality of work life, satisfaction with the availability of facilities, sense of coherence, education level, work experience, job burnout, male gender, being native, and workplace were predictors of occupational stress and explained 23.3% of the variance in occupational stress score. The highest contribution was related to satisfaction with physical health.

CONCLUSION

Considering the consequences of occupational stress for nurses, it is crucial for health and nursing authorities to take these factors into consideration in policy-making and planning.

A cross-sectional study on turnover intention of nurses in eastern China

BACKGROUND

This study aimed to investigate the turnover intention among nurses in eastern China and explore the association between turnover intention and personal characteristics, family factors, and work-related factors.

METHODS

A total of 2504 nurses participated in a cross-sectional survey administered in 26 hospitals in Eastern China from October to November 2017. In December 2021, a survey was conducted on nurses who resigned between December 2017 and November 2021.

RESULTS

The turnover intention score of in-service nurses was 15 (12-17), and 43% of nurses had a high turnover intention, which was mainly due to the following reasons: age < 40 years, raising two or more children, monthly income of USD786.10-1572.20 or < USD786.10, occupation was assigned or selected according to parental wishes, ≤ 1 or ≥ 2-night shifts per week, contractual or third-party personnel agents, full-time nurses with part-time jobs, and high job stress. Among 102 retired nurses, 80.4% reported family reasons for leaving, 39.2% for work reasons, and 21.6% for other personal reasons.

CONCLUSION

Nurses' intention to leave their occupation is high in Eastern China. Age < 40 years old, > 1 child, low income, involuntary career selection, frequent night shifts, informal employment, part-time, and high job stress are significant factors associated with nurses' willingness to leave. Government and hospital administrators should consider ways to address these factors to retain nurses in hospitals in eastern China and improve the quality of nursing services.

Perceived Stress Among Nurses at a Tertiary Care Teaching Hospital in Saudi Arabia During the COVID-19 Pandemic

BACKGROUND

The stress level of nurses, especially frontline staff, directly impacts their physical and mental health as well as work efficiency. However, few studies have been conducted to understand the stress level of nurses related to the coronavirus disease 2019 (COVID-19) pandemic.

AIM

The aim of this study is to assess the level of perceived stress among nurses at a tertiary care teaching hospital (King Abdulaziz University Hospital, Jeddah) in Saudi Arabia during the COVID-19 pandemic.

METHODS

A cross-sectional survey-based descriptive study involved 1044 nurses working at a tertiary care/teaching hospital in Saudi Arabia. The Perceived Stress Scale (PSS) was used to assess nurses' stress levels. The study was conducted in July 2021 by selecting clinical nurses from different nursing units. Considering the current situation of social isolation, an online cross-sectional survey using Google Forms was used. Data analysis was performed using IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States).

RESULTS

Out of 1044 nursing professionals, 93 (8.9%) reported experiencing low levels of stress, 915 (87.6%) reported moderate levels of stress, and 36 (3.4%) reported high perceived stress during the COVID-19 pandemic. The study found that gender (p=0.001) and nationality (p=0.016) had significant effects on stress levels. The three major causes of stress identified by the nurses were workload, lack of resources, and fear of contracting COVID-19.

CONCLUSION

Job-related stress continues to be an issue in the nursing workforce. The effects of stress experienced by nurses impact job satisfaction and retention, which, in turn, can affect the quality of patient care. This study highlights that nurses in a tertiary care (COVID care) teaching hospital in our setting often experience stress and anxiety during the pandemic. It is worth noting that this is the first study conducted to understand the level of stress perceived by nursing staff during the COVID-19 pandemic in our current study setting. The findings indicate that a considerable number of nurses experienced moderate levels of stress during COVID-19, which can have implications for patient care. Recognizing and understanding the job-related stressors of nurses can help nurse leaders implement more effective strategies aimed at reducing nurses' stress and subsequently improving patient outcomes.

Hesitancy among Iranian nursing students regarding future career trajectory: a qualitative analysis

BACKGROUND

The shortage of skilled nurses is a major concern for health systems worldwide. This may be partly due to the hesitancy of some nurses to enter or remain in the nursing career. This shortage consequently reduces the quality of standard patient care, increases patients' length of stay in a hospital, increases medical costs, and results in patients' dissatisfaction. This study aimed to explore hesitancy among senior undergraduate nursing students to pursue a career in nursing.

METHODS

This qualitative study adopted a thematic analysis approach. The population comprised senior undergraduate nursing students at Isfahan University of Medical Sciences, Iran, who indicated that they were hesitant to pursue a career in nursing. The study sampling was performed from May 2021 till February 2022 and continued until data saturation. Twenty-four interviews were conducted with the selected students. The attributes related to hesitancy among senior undergraduate nursing students to pursue a career in nursing were extracted as themes and sub-themes.

RESULTS

Four themes were identified: academic idiosyncrasies, individual characteristics, poor nursing market regulations (sub-themes: nursing as a tough and intense career, and unfavorable employment contracts), and the peculiarities of the workplace (sub-themes: conflict within work environment, and barriers to professional nursing practice).

CONCLUSIONS

The findings of this study showed that senior undergraduate nursing students weigh their future career options from various academic, personal, professional, and work environment dimensions. The findings provide new insights for decision makers to design and implement innovative strategies to promote retention in nursing careers. We recommend to provide academic counseling for all students and applicants of nursing before they enter the nursing education. Furthermore, we suggest to improve study and work environments, and to implement incentive programs to enhance enthusiasm of nursing students for pursuing a nursing career.

The effect of two facets of physicians' environmental stress on patients' compliance with COVID-19 guidelines: moderating roles of two types of ego network

Drawing upon the Conservation of Resources Theory, this study seeks to examine the association between two dimensions of environmental stress experienced by physicians and patients' adherence to COVID-19 guidelines, within the context of a social network framework. A third-wave longitudinal study was employed to gather 439 valid data points in China. Social network analysis and structural equation model were used to test the conceptual model. The results reveal the pivotal role of physicians' environmental stress related to their work and family contexts in influencing patients' adherence to COVID-19 guidelines through the mediation of physicians' information sharing. The ego networks of physicians, encompassing both advice-seeking and friendship ties, were observed to negatively moderate the relationship between stress and resource depletion. Broadly, our study shows the importance of understanding physicians' stress caused by the working and family environments, as these factorsnot only impact the psychological well-being of physicians but also significantly affect patients' compliance with COVID-19 guidelines. In addition, the work offers a framework for understanding the impact of the ego advice-seeking network and the ego friend network.

The impact of pandemics on healthcare providers' workloads: A scoping review

AIMS

To review and synthesize available evidence exploring the impact of pandemics on direct healthcare providers' workloads in the acute care setting.

DESIGN

Scoping review.

DATA SOURCES

A review of English research articles published up to August 2022 that examined the impact of pandemics on healthcare providers' workloads was undertaken. Studies were identified by searching four electronic databases: Medline (EBSCO), CINAHL (EBSCO), Web of Science and PsychInfo (EBSCO). Fifty-five studies met the inclusion criteria.

REVIEW METHODS

The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses Scoping Review checklist.

RESULTS

Healthcare workers experience an increase in workload pressures during a pandemic. This included patients requiring more care, undertaking non-normal work activities, increase in work content including changes to documentation, increase in demand and skills required, an increase in overtime and hours of work per week and higher patient-to-nurse ratios. The review also highlighted changes to the work environment and worsened work environments, including staffing shortages.

CONCLUSION

Focused efforts from health organizations to prioritize supportive conditions, policies focused on improved work environments, staffing adequacy and fair and reasonable workloads will enhance retention of the current workforce and future planning for pandemics.

IMPACT

Understanding workload challenges faced by frontline health professionals during the pandemic can improve planning, including policies and procedures, and resource allocation for future pandemic or emergency situations. In addition, extended periods of high workloads can impact staff retention. As many countries return to life after COVID-19, it is important that healthcare organizations examine staff pressures and identify ways to support staff moving forward. This will be vital for the future sustainability of the workforce.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Latent profile analysis and influence factors study of presenteeism among ICU nurses in China

Background

Presenteeism is a significant global public health problem, and nurses are a high-prevalence group of presenteeism, affecting not only nurses' physical and mental health, work efficiency, and quality of work but even poses a serious threat to patient safety.

Objective

The categorization of presenteeism among ICU nurses is unclear. Our research aims to explore the subtypes of presenteeism among ICU nurses based on latent profile analysis, analyze the influencing factors of different subtypes, and provide a reference basis for developing targeted interventions to reduce the presenteeism rate.

Methods

From January to February 2023, 509 ICU nurses in Sichuan Province, China, were selected as respondents and surveyed using the general information questionnaire, the presenteeism scale, and the perceived social support scale. Potential categories of presenteeism among ICU nurses were explored using potential profile analysis, and factors influencing the potential types of presenteeism among ICU nurses were investigated using the chi-square test and multivariate logistic regression analysis.

Results

The best model was suggested to consist of three profiles: low presenteeism-normal coping group (18.3%), moderate presenteeism group (47.9%), and high presenteeism-work limitation group (33.8%). Multiple logistic regression results showed that secondary hospitals (OR = 0.116, p = 0.015), good physical health (OR = 0.084, p = 0.023), general physical health (OR = 0.016, p = 0.037), ICU human resource allocation = 1:2.5 to 3 (OR = 0.315, p = 0.007), and higher social support scores (OR = 0.975, p = 0.047) were more likely to be grouped into low presenteeism-normal coping group; married with no children (OR = 24.554, p = 0.005) were more likely to be grouped into moderate presenteeism group; and having experienced workplace violence in the past year (OR = 1.182, p = 0.049) were more likely to be grouped into high presenteeism-work limitation group.

Conclusion

There is group heterogeneity in the presenteeism of ICU nurses, and nursing managers should develop targeted interventions to reduce the presenteeism rate of ICU nurses according to the characteristics and influencing factors of each type of presenteeism of ICU nurses.

Retention of newly graduated registered nurses in the hospital setting: A systematic review

BACKGROUND

There is a gap in the literature on identifying and describing effective interventions for the retention of newly graduated registered nurses in hospital settings. To the best of our knowledge, no systematic review has been conducted on this issue.

AIM

To identify effective interventions that promote the retention of newly graduated registered nurses in the hospital setting and their components.

DESIGN

A systematic review was conducted according to PRISMA 2020 Statement.

METHODS

Information derived from the PubMed, CINAHL, Scopus, PsycINFO and Cochrane Library databases was reviewed, for the period January 2012-October 2022. Screening, data extraction and quality appraisal were conducted independently by two reviewers. The Joanna Briggs Institute Critical Appraisal tools were used for descriptive, quasi-experimental and cohort studies. Disagreements between the two reviewers were resolved through discussion.

RESULTS

Following the critical appraisal, nine studies were included. The evidence reveals the heterogeneity of programmes developed in the hospital context to promote the retention of newly graduated registered nurses, clarifies the three competencies to be addressed (core, cross-cutting and specific), their components (programme development framework, duration, content and support components), and shows significant improvements after their implementation.

CONCLUSIONS

This systematic review identifies that either nurse residency or individualised mentoring programmes, lasting 1 year, and multi-component, addressing core and specific competencies and including preceptor or mentor components seem to be the most comprehensive and effective in promoting the retention of new nurses in the hospital setting.

RELEVANCE TO CLINICAL PRACTICE

The knowledge provided by this review will contribute to developing and implementing more effective and context-specific strategies directed at retaining newly graduated registered nurses and subsequently enhancing patient safety and healthcare costs.

NO PATIENT OR PUBLIC CONTRIBUTION

Given the study design and focus.

Association Between Authentic Leadership in Nurse Managers and Performance and Intention to Leave Among Registered Nurses

BACKGROUND

Authentic leadership in nurse managers has been identified as a strong predictor of multiple nurse outcomes. However, its association with staff performance and nurses' intention to leave has yet to be established.

PURPOSE

This study was designed to identify the predictive effect of sociodemographic variables on nurse performance and intention to leave and to examine the relationship between authentic leadership in nurse managers and, respectively, nurse performance and intention to leave.

METHODS

A comparative and correlational design and a cross-sectional survey approach were used. A convenience sample of 166 registered nurses working in a government hospital in Jordan was recruited. Data collection was performed online using the sociodemographics questionnaire, the Authentic Leadership Questionnaire, the Turnover Intention Scale, and the Six Dimensions of Nurse's Performance Scale. Data were analyzed using descriptive statistics, independent t test, one-way analysis of variance, Pearson correlation, and multiple hierarchical linear regression.

RESULTS

The overall mean score was 2.08 (SD = 0.87) for the Authentic Leadership Questionnaire, 3.57 (SD = 1.76) for the Turnover Intention Scale, and 3.00 (SD = 0.51) for the Staff Performance Scale. Mean nursing performance differed significantly based on marital status, whereas intention to leave differed significantly based on marital status and the respondent's perception of their first-line manager. A statistically significant, positive correlation between authentic leadership and staff performance and a statistically significant, negative correlation between authentic leadership and intention to leave were found. In addition, authentic leadership was uniquely associated with staff performance (B = 0.19, p < .05) and intention to leave (B = -0.39, p < .05) in the hierarchical regression analysis after controlling for sociodemographic variables.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

Authentic leadership from nurse managers is associated with improved nurse performance and lower nurse intention to leave. Nurse managers may enhance authentic leadership attributes to better retain nurses in hospitals and improve nurse job performance.

The effect of work stress on turnover intention amongst family doctors: A conditional process analysis

OBJECTIVE

To explore describe the mechanism between work stress, job satisfaction, perceived organizational support and turnover intention amongst family doctors in China, and to provide reference for improving the brain drain of family doctors.

METHOD

Using convenience sampling, a questionnaire survey was conducted among 2358 family doctors in 13 provinces in eastern, central and western China. Pearson correlation analysis and hierarchical regression analysis were used to explore the effects of job stress, job satisfaction and perceived organizational support on family doctors' turnover intention.

RESULTS

Family doctors' work stress was positively correlated with turnover intention (β = 0.631, p＜0.001), job satisfaction played a partial mediating role in the influence path of work stress on turnover intention (β = 0.9175, p＜0.001), perceived organizational support played a moderating role in the relationship between work stress, job satisfaction, and turnover intention (β = 0.124, p＜0.05; β = -0.022, p＜0.05).

CONCLUSION

Hospital managers should take corresponding measures to reduce the work stress of family doctors, improve their job satisfaction, and provide more support and attention to family doctors to ensure the stable development of family doctors in China.

The mediating role of job satisfaction and presenteeism on the relationship between job stress and turnover intention among primary health care workers

BACKGROUND

Turnover problems among primary health care workers are a significant contributor to the shortage of health human resources. This study aims to determine the relationship between job stress and turnover intention among primary health care workers, as well as to examine the mediating effects of job satisfaction and presenteeism on this relationship.

METHODS

Stratified random sampling and quota sampling were used to select 703 primary health care workers in Jilin Province, China in January 2020. Validated scales were used to measure turnover intention, job stress, job satisfaction, and presenteeism among primary health care workers. The study utilized a partial least squares structural equation modeling (PLS-SEM) approach to test the research hypotheses.

RESULTS

The turnover intention score of primary health care workers in Jilin Province was 2.15 ± 1.03, and 19.5% of respondents reported a higher turnover intention. Significant sex and occupation differences were found, with a higher rate of turnover intention for male and doctor groups among primary health care workers. This study also revealed a positive correlation between job stress and turnover intention (β = 0.235, P < 0.001), a significant negative correlation between job satisfaction and turnover intention (β= -0.347, P < 0.001), and a significant positive correlation between presenteeism and turnover intention (β = 0.153, P < 0.001). Moreover, the study revealed a significant indirect effect of job stress on turnover intention which was mediated by job satisfaction (β = 0.183, P < 0.001) and presenteeism (β = 0.078, P < 0.001).

CONCLUSION

We confirmed the positive association between job stress and presenteeism with turnover intention, as well as the negative association between job satisfaction and turnover intention. Moreover, our study confirmed the mediating role of job satisfaction and presenteeism in the relationship between job stress and turnover intention. This study provides scientific evidence to address the turnover problem among primary health care workers.

Occupational stress and associated factors among nurses working at public hospitals of Addis Ababa, Ethiopia, 2022; A hospital based cross-sectional study

Background

By its very nature, the nursing profession involves a lot of stress. Working in this field includes interacting with individuals who are already under a great deal of stress. Workplace stress affects the quality of services provided and also causes staff burnout, departure, and absenteeism.

Objective

This study is to determine occupational stress and associated factors among nurses working at public hospitals, Addis Ababa, Ethiopia, 2022.

Materials and methods

An institutional based cross sectional study was conducted among 422 nurses working at public hospitals from March 1 to April 1/2022. Simple random sampling technique was used to select public hospitals. The calculated sample size was allocated proportionally to each hospital based on the number of nurses. Finally, systematic sampling method was used to approach the study participants. The data was collected by using a self-administered structured questionnaire (Expanded Nursing Stress Scale). The collected data was entered by Epi-data version 3.1 and analyzed by SPSS version 23. Descriptive analysis such as frequency distribution and measure of central tendency and variability (mean and standard deviation) was computed to describe variables of the study. Binary logistic regression was used to assess associations between dependent and independent variables. The degree of associations was interpreted using odds ratio (OR) and 95% confidence interval (CI) and statically significance at value of p < 0.05. The result was presented using text, tables, and graphs.

Result

The study finding showed that 198 (47.8%) of nurses were occupationally stressful. Factors significantly associated with occupational stress among nurses were having children (no: AOR = 0.46, 95% CI: 0.22, 0.96) and work shift (rotating: AOR = 2.89, 95% CI: 1.87, 4.45).

Conclusion

In this study, job stress affected over half of the nurses. The presence of children and respondents' work shifts were personal characteristics that were significantly linked to job stress. Therefore based on this result the government policy makers, different stakeholders and hospitals need to collaborate to reduce nurses job related stress.

Effects of coping on nurses' mental health during the COVID-19 pandemic: Mediating role of social support and psychological resilience

BACKGROUND

Fighting against the COVID-19 pandemic, front-line nurses were under unprecedented psychological pressure. Therefore, it is necessary to promptly evaluate the psychological status of nurses during the COVID-19 epidemic period.

AIM

To investigate nurses' mental health during the COVID-19 pandemic, and to test the mediating role of social support and psychological resilience between coping and mental health.

DESIGN

This was a descriptive, cross-sectional survey which used a structural equation model.

METHOD

In total, 711 registered nurses were included. All participants were invited to complete a socio-demographic questionnaire, the general health questionnaire, the trait coping style questionnaire, the perceived social support scale and the Conner-Davidson Resilience scale.

RESULTS

In total, 50.1% nurses had high risk of mental health. Positive coping positively affected social support and psychological resilience, while it negatively affected mental health. Negative coping negatively affected social support and psychological resilience, while it positively affected mental health. Social support positively affected psychological resilience, while it negatively affected mental health. In addition, social support mediated coping and psychological resilience, and coping and mental health. Moreover, psychological resilience negatively affected mental health, and it mediated coping and mental health.

Effects of External Employment Opportunities, Nursing Professionalism, and Nursing Work Environments on Korean Hospital Nurses' Intent to Stay or Leave

This study aims to explore Korean Hospital nurses' intent to stay or leave their working environment, and to identify the difference between the intent to stay and the intent to leave by identifying the relationship between external employment opportunities, professionalism, and work environment. Data were collected via an online survey and analyzed using stepwise multiple regression analysis. As a result of the analysis, the intent to stay among Korean hospital nurses was influenced by the work environment, external employment opportunities, education level, and marital status, whereas the intent to leave was influenced by the nursing work environment, marital status, and total clinical experience. As a result, the reflected variables differed. Thus, it can be concluded that hospital nurses' intent to either stay or leave are not concepts that simply contradict each other in the same context but are, in fact, influenced differently by various factors. Nevertheless, it can also be concluded that nursing managers should make efforts to improve the nursing work environment to lower nurses' intent to leave and increase their intent to stay by improving only the nursing work environment.

Abusive supervision and employee well-being of nursing staff: Mediating role of occupational stress

AIM

The study examined whether occupational stress mediated the relationship between abusive supervision and well-being of nursing staff.

DESIGN

A cross-sectional questionnaire survey was administered.

METHODS

Data were collected at three-time points between July 2020 and January 2021. A total of 313 valid responses were obtained from nurses working in a general hospital in Taiwan. The data were analysed using descriptive statistics, Pearson's correlation analysis and the bootstrap method.

RESULTS

Abusive supervision was positively associated with occupational stress (β = 0.288, SE = 0.069, 95% CI [0.152, 0.423]) and negatively associated with employee well-being, including psychological (β = -0.350, SE = 0.084, 95% CI [-0.515, -0.186]), physical (β = -0.301, SE = 0.080, 95% CI [-0.459, -0.143]) and social well-being (β = -0.422, SE = 0.121, 95% CI [-0.661, -0.183]). Occupational stress was negatively related to employee well-being. A mediation analysis with bootstrapping revealed that occupational stress mediated the relationship between abusive supervision and employee well-being, which included psychological (95% bootstrap CI [-0.183, -0.046]), physical (95% bootstrap CI [-0.212, -0.062]) and social well-being (95% bootstrap CI [-0.178, -0.040]).

CONCLUSION

Abusive supervision influences employee well-being. Occupational stress mediates the relationship between abusive supervision and employee well-being. To improve employee well-being, hospital administrators should develop policies for effectively managing nursing supervisors' abusive behaviour and subordinates' stress management.

IMPACT

Abusive supervision increased the occupational stress of employees and influenced their well-being. Thus, educational courses should be implemented to train supervisors to practice positive leadership and treat employees fairly. Promoting stress management among nursing staff may lead to the prompt reporting of abusive events and improved employee well-being.

NO PATIENT OR PUBLIC CONTRIBUTION

This study investigated the relationship between the abusive supervision and employee well-being of nursing employees. No patient or public contribution is involved in this study.

Factors associated with changes in nurses' emotional distress during the COVID-19 pandemic

PURPOSE

The purpose of this study was twofold: to assess if nurses experienced changes in emotional distress (stress, depression, and anxiety) as the number of patients infected with coronavirus disease 2019 (COVID-19) increased and if there were any sociodemographic, psychosocial, and work environmental influence on the change.

METHODS

Using a repeated cross-sectional study design, we collected survey data among 198 South Dakota (SD) nurses. Data were collected in two waves, during the first 12 months of the COVID-19 pandemic in the United States (July and December 2020). Participants completed two online surveys: (a) The Depression, Anxiety, and Stress Scale (DASS-21); and (b) Change Fatigue Scale. Predictive factors were divided into three groups: sociodemographic, psychosocial, and work environment variables. Multiple linear regression models were run to estimate the factors associated with the change in DASS-21 subscale score.

RESULTS

Total DASS-21 score and scores for all subscales significantly increased from Survey 1 to Survey 2. Significant positive associations were found between change fatigue and workplace barriers with change in depression, anxiety, and stress scores. A linear relationship was identified between self-worry about COVID-19 risk and depression and stress and being male and young were associated with changes in depression.

CONCLUSIONS

Increase in emotional distress of nurses as the pandemic progresses is consistent with other studies. It is vital for healthcare organizations to recognize the factors associated with the changes in emotional distress and their role in decreasing the stress levels of nurses.

Evaluation of physical and psychological status of health care workers infected with COVID-19 during a hospital outbreak in Japan

PURPOSE

COVID-19 causes physical and psychological impacts on health care workers (HCWs), especially when it occurs during an outbreak. As there are few reports on outcomes of HCWs infected with COVID-19 during a hospital outbreak, we investigated the physical and psychological impacts on HCWs infected with COVID-19 during an outbreak in our hospital.

METHODS

During the outbreak in our hospital, 231 people were infected with COVID-19 including patients, HCWs and their families. Among them, 83 HCWs were enrolled in this study. Current quality of life (QOL) was assessed with the EuroQol-visual analogue scales (EQ-VAS), and motivation to keep on working was evaluated by a 10-point analogue scale. Physiological recovery rates including return to work (RTW) period were also analyzed.

RESULTS

One nurse quit work due to anxiety regarding re-infection with COVID-19. The median period to RTW from the diagnosis was 14.0 (12.0-17.0) days. Motivation to keep on working was slightly reduced, and the EQ-VAS was 75.0 (65.0-83.6). There were no significant differences in QOL and motivation between male and female HCWs, nurses and other HCWs, treatment and non-treatment group, and supplemental and non-supplemental oxygen group. The most frequent persistent symptoms at 1,3 and 6 months after infection were anosmia followed by fatigue.

CONCLUSION

Although QOL and motivation to keep on working were slightly reduced, only one HCW quit work. No severe persistent symptoms were observed, and the RTW period was relatively short.

The Race to Retain Healthcare Workers: A Systematic Review on Factors that Impact Retention of Nurses and Physicians in Hospitals

The shortage of healthcare workers is a growing problem across the globe. Nurses and physicians, in particular, are vulnerable as a result of the COVID-19 pandemic. Understanding why they might leave is imperative for improving retention. This systematic review explores both the prevalence of nurses and physicians who are intent on leaving their position at hospitals in European countries and the main determinants influencing job retention among nurses and physicians of their respective position in a hospital setting in both European and non-European countries. A comprehensive search was fulfilled within 3 electronic databases on June 3rd 2021. In total 345 articles met the inclusion criteria. The determinants were categorized into 6 themes: personal characteristics, job demands, employment services, working conditions, work relationships, and organizational culture. The main determinants for job retention were job satisfaction, career development and work-life balance. European and non-European countries showed similarities and differences in determinants influencing retention. Identifying these factors supports the development of multifactorial interventions, which can aid the formulation of medical strategies and help to maximize retention.

Ability of Emotional Regulation and Control as a Stress Predictor in Healthcare Professionals

Emotional Regulation and Control implies a person’s ability to respond to stressful demands and emotional experiences in a socially acceptable and adaptive way. The aim of this cross-sectional study was to examine the contribution of the ability of emotional regulation and control in the prediction of workplace stress in healthcare professionals. The study included 203 healthcare professionals employed at a hospital in the Republic of Croatia. Data were collected using two validated questionnaires: Questionnaire on Workplace Stressors for Hospital Professionals and Emotional Regulation and Control Questionnaire (ERC). Most respondents (64%) experienced stress in Workplace Organization and Financial Issues factor, while 52.7% experienced stress in Public Criticism factor. The respondents assessed their ability of emotional regulation and control to be low (mean = 55; range = 20−100). The level of experienced stress was significantly higher if the ability of emotional regulation and control was low (Spearman’s Rho = 0.308; p < 0.001). The multivariate regression model (11.2% explained variances; p = 0.001) indicated a greater possibility of severe stress in respondents who have stronger Memory of Emotionally Saturated Content (odds ratio = 1.18; 95% CI = 1.07−1.30). The results of this study signify the need to establish effective institutional support aimed at objectifying stress and strengthening emotional intelligence and empathy in healthcare professionals.

The Effect of Emotional Labor on the Physical and Mental Health of Health Professionals: Emotional Exhaustion Has a Mediating Effect

(1) Background: Workers who perform emotional labor for an extended period are prone to emotional exhaustion; in particular, when the work exceeds the range of one's emotional resources, it will produce job burnout. This study investigated the effects of emotional labor and emotional exhaustion on the physical and mental health of health professionals. (2) Methods: This study was cross-sectional and the sampling criteria were health professionals from August 2020 to July 2021, including rehabilitators, nutritionists, clinical psychologists, radiologists, respiratory therapists, pharmacists, medical examiners and audiologists. A questionnaire was used to collect data on participants' emotional labor, emotional exhaustion, physical health and mental health. A total of 120 valid questionnaires were obtained. (3) Results: Significant positive correlations were found between emotional labor and emotional exhaustion, physical and mental health and anxiety. A hierarchical regression analysis found that the effect of emotional labor on physical and mental health increased the predictive power to 59.7% through emotional exhaustion, and emotional exhaustion had a mediating effect on the relationship between emotional labor and physical and mental health. (4) Conclusions: This study provides a reference for managers of medical institutions to care for employees' work stress and physical and mental health, which will help institutions build a friendly and healthy workplace.

Stressors, coping strategies and intention to leave the nursing profession: A cross-sectional nationwide study in China

AIMS

This study aims to investigate the association between stressors, coping strategies and intention to leave the nursing profession among nurses.

BACKGROUND

Job stressors and coping strategies are believed to affect turnover intention among nurses, but no large-scale study has been conducted on these associations in China yet.

METHOD

A cross-sectional secondary analysis was conducted among 51,406 nurses from 1858 hospitals. Univariable and multivariable logistic regression analyses were carried out, and odds ratios were reported.

RESULTS

Overall, 49.58% nurses had an intention to leave the profession. It is found that stress from health condition, family, occupational injuries, nurse-patient tension, high job demands, strict leaders and colleague relationships were significantly associated with higher intention to leave. Coping strategies such as talking to family and friends, talking to leaders, doing outdoor activities, engaging in hobbies and attending on-the-job training were significantly associated with lower intention, but social gathering, psychological counselling and suffering in silence had an opposite effect.

CONCLUSIONS

Our study provides new insights into the association between stressors, coping strategies and turnover intention among nurses in China.

IMPLICATIONS FOR NURSING MANAGEMENT

Evidence from this study indicates that policies promoting a safe and supportive work environment should be developed to help nurses cope with stress.

Impact of emotional intelligence on work performance: The mediating role of occupational stress among nurses

INTRODUCTION

An occupational stress was reported as an inhibitor of optimal performance among nurses. Emotional intelligence (EI) has emerged as a successful behavioral buffer against occupational stress and as a facilitator for better performance. This study aimed to investigate the potential relationship between nurses' EI and their work performance; and to examine the mediating role of occupational stress.

DESIGN

A predictive correlational design was adopted.

METHOD

Self-reported questionnaires were administered to 391 full-time bedside nurses recruited from one of the big hospitals in Saudi Arabia, between April and June 2021. Data were coded and analyzed using IBM SPSS version 25.0. Simple and multiple linear regression analyses were used to test the hypotheses. The significance level for all tests was set at p ≤ 0.05. Bonferroni correction method was used to control the family-wise error rate.

RESULTS

The findings revealed an affirmative association between nurses' EI and work performance (β = 0.69, p < 0.001; r²  = 0.483). Additionally, an inverse association was established between nurses' EI and their perception of occupational stress (β = -0.54, p < 0.001; r²  = 0.286), and between nurses' perception of occupational stress and work performance (β = -0.52; p < 0.001; r²  = 0.226). Additionally, our results showed that occupational stress played a mediating role in the relationship between nurses' EI and work performance.

CONCLUSION

This study presented a novel framework that includes two factors affecting work performance among nurses in Saudi Arabia. Our results suggest that EI is vital for effective work performance among nurses. Additionally, EI was found to be a useful coping strategy against occupational stress.

CLINICAL RELEVANCE

EI has been described as a valuable asset for better performance and effective group cohesiveness among nurses. Optimal nurses᾽ performance leads to meeting patients᾽ needs and organizational goals.

Work Stressors and Intention to Leave the Current Workplace and Profession: The Mediating Role of Negative Affect at Work

The first aim of this study was to determine whether organisational constraints, interpersonal conflicts at work, workload and negative affect at work have a positive relationship with intention to leave a current job or profession. The second aim was to investigate whether negative affect at work mediates the relationship between work stressors and intention to leave a current job or profession. The study was a quantitative cross-sectional design in nature. Data were collected between March and April 2022. The sample consisted of 306 midwives working in the Polish public health service. The theoretical model was tested using structural equation modelling. The results confirmed positive direct relationships between workload and negative affect with intention to leave the current workplace and intention to leave the midwifery profession in general. The relationships between organisational constraints and interpersonal conflicts at work and intention to leave a job or profession were found to be completely mediated by negative affect at work. Our study revealed that workload is the strongest direct predictor of intention to leave the current job or profession. Organisational constraints and interpersonal conflicts at work lead to an intention to leave a job or profession by inducing negative affect at work. Interpersonal conflicts at work are the strongest predictor of negative affect at work.

A Parallel Mediation Analysis on the Effects of Pandemic Accentuated Occupational Stress on Hospitality Industry Staff Turnover Intentions in COVID-19 Context

The purpose of this research was to analyze how different effects of the COVID pandemic, expressed through pandemic accentuated occupational stress, perceived job insecurity, occupational safety and health perception and perceived organizational effectiveness, may impact turnover intentions of the personnel in the hospitality industry. Our research team designed an online questionnaire which was analyzed with network analysis to depict the relationship between factors, and, then, a confirmatory factor analysis was employed to confirm the distribution of the items to the envisaged five factors. Based on a sample of 324 randomized Romanian hospitality industry staff, the results of our cross-sectional study revealed that occupational safety and health perception, perceived organizational effectiveness and perceived job insecurity in the pandemic accentuated occupational stress to indirectly and significantly impact hospitality industry staff turnover intentions (TI). The results indicated that, while the total effect of PAOS on TI was significant, the direct effect was still significant, while all three mediators remained significant predictors. Overall, mediators partially mediated the relationship between PAOS and TI, indicating that employees with low scores on occupational safety and health perception (OSHP), and perceived organizational effectiveness (POE) and high scores on perceived job insecurity (PJI) were more likely to have higher levels of TI turnover intentions.

The moderating role of social support on workplace violence and stress among psychiatric nurses

Exposure to violent acts is considered one of the major stressful events psychiatric nurses are exposed to. Social support has been found to reduce nurses' stress and alleviate their experience of workplace violence; however, no accounts are available on whether social support moderates the relationship between workplace violence and stress. Therefore, the aim of this study was to examine the moderating role of social support on workplace violence and stress among psychiatric nurses. A cross-sectional descriptive and predictive design was utilized. A total of 195 psychiatric nurses were recruited from two governmental mental health hospitals. The results showed that psychiatric nurses were frequently exposed to violence, both verbally and physically, whether during their entire career or within the past 12 months. Verbal violence was more common among participants than physical abuse. Male nurses and nurses working mix-shift were more likely to experience violent acts. Regression analysis showed that only workplace violence and social support predicted psychiatric nurses' stress. On the other hand, social support did not moderate the relationship between workplace violence and stress. Further research is needed to investigate whether similar findings will conform with the results of this study. Meanwhile, healthcare institutions need to implement strategies to reduce or prevent nurses' exposure to workplace violence and lower their stress levels. Mobilizing and activating social support resources at work are considered other avenues to reduce stress experienced by psychiatric nurses.

Job Satisfaction and Associated Factors among Physicians

Job satisfaction of the employees represents the significant factor for the effective functioning of the medical facilities. The aim of this study is to examine job satisfaction of physicians and to explore its associated factors. Quantitative study method is applied in this study. Two hundred and nine physicians from the large medical facilities in Tbilisi (Georgia) are participated in the survey. The most important components of satisfaction were: relation with managers (78.5%), relations with colleagues (77%), communication with patients (73.5%), possibility of continuous medical education (74.2%), and service quality (66%). Younger physicians were more likely to be dissatisfied than older physicians. Women were less satisfied with workload rather than men, which can be related with burden of solving the family issues for them, besides the career. Majority of the inquired respondents are not satisfied with ongoing incomes and remuneration methods. Family physicians seemed to be especially dissatisfied with remuneration. Most of the interviewed physicians (76%) assessed work/life balance in range of 1-3 points. Particular dissatisfaction was stated by the doctor-specialists, referring that they do not work with normal work schedule and their work/life balance is infringed. Satisfaction level depends on multiple factors (communication with patients, intellectual stimulation, possibility of CME, relationship with colleagues and managers). The main recommendation is a need to address job satisfaction among physicians in order to improve the quality of health care. Attention to working conditions, career and professional development, and salary/incentives is critical for sustaining the continuity of quality health care in Georgia.

The Intervening Effects of Perceived Organizational Support on COVID-19 Pandemic Stress, Job Burnout and Occupational Turnover Intentions of Collegiate Sport Athlete-Facing Professionals

Already a challenging position in higher education, collegiate sport athlete-facing professionals have been exposed to excessive stress amid the COVID-19 pandemic that can result in emotional exhaustion and a mass exodus of valued employees within collegiate sport organizations. Accordingly, based on COR theory, we aimed to assess the intervening effects of perceived organizational support that can mitigate job burnout and occupational turnover intentions due to pandemic stress. A total of 427 academic support professionals in National Collegiate Athletic Association (NCAA) Division I organizations responded to an online survey measuring pandemic stress, job burnout, occupational turnover intention, and organizational support. Hypotheses were tested through a serial-mediation analysis using the PROCESS macro for SPSS Model 6. Results showed that pandemic stress had a statistically significant effect on occupational turnover through job burnout. It was also confirmed that organizational support fully mediates the relationship between pandemic stress, job burnout, and occupational turnover. Overall, our findings highlight the importance of providing adequate organizational support towards employees under a high level of stress due to the pandemic. As ASPs adapt to the “new normal,” college sport organizations can assist employees by catering the support they provide to meet changing needs, especially by leveraging technologies that have been advanced during the pandemic. Further implications of the findings on collegiate sport organization literature are offered, as are suggestions for future research.

Stress and Turnover Intentions Within Healthcare Teams: The Mediating Role of Psychological Safety, and the Moderating Effect of COVID-19 Worry and Supervisor Support

Employees at healthcare organizations are experiencing more stress than ever given the current COVID-19 pandemic. Different types of stress are affecting diverse organizational outcomes, including the employees' voluntary turnover. This is the case of cognitive stress, a type of stress that affects how individuals process information, which can influence employees' turnover intentions. In this study, we look at the mechanisms that can reduce the adverse effects of cognitive stress on turnover intentions, particularly the role of employees' perceived psychological safety (i.e., how safe they perceive the interactions with their colleagues are). We hypothesize that psychological safety mediates the relationship between cognitive stress and turnover intentions, and COVID-19 worry and supervisor support moderate the relationship between cognitive stress and psychological safety. To test our hypothesis, we invited two public health care organizations in Chile to join this study. In total, we obtained a sample of 146 employees in 21 different teams. Using a multilevel model, we found that psychological safety prevents the harmful effects of cognitive stress on employees' turnover intentions. In addition, while COVID-19 worry can worsen the relationship between cognitive stress and psychological safety, supervisor support only directly affects psychological safety. This study contributes to expanding the stress and psychological safety literature and informs practitioners in healthcare organizations about how to deal with cognitive stress in the "new normality" that the pandemic has brought.

COVID fear and work-family conflict: a moderated mediated model of religiosity, COVID stress and social distancing

Purpose

Based on the arguments of conservation of resource theory (COR), this study aims to investigate the mechanism underlying the linkage of COVID fear, work-family conflict (W-FC) and family-work conflict (F-WC) while investigating the mediating role of COVID stress and social distancing. The study also tests the moderating role of religiosity in these relationships.

Design/methodology/approach

In total, 401 survey responses from doctors and university teachers are collected through online and personally administrated questionnaires. Partial least square-based structural equation modeling technique is applied using Smart PLS software.

Findings

This study finds that COVID fear has a positive and significant impact on COVID stress and social distancing while religiosity negatively impacts COVID fear. Further, COVID stress and social distancing mediates the relationships between COVID fear and W-FC/ F-WC. However, the study found that COVID stress is a more effective mechanism as compared to social distancing in explaining the mediation process. It is also found that religiosity significantly moderates the nexus between COVID stress and both W-FC and F-WC negatively.

Practical implications

Findings imply that the teachers, as well as doctors, must be immediately be provided with the proper facilitation to maintain their work from home operations with the best of the institutional facilities. Moreover, the recruitment policy in such professions can also consider religious practices to be the indicators of problem-solving and stress management in such a challenging context.

Originality/value

This study provides timely and novel insight into the interplay between the domains of work and family during the period of stressful COVID outbreak. By distinguishing W-FC and F-WC, it provides a detailed understanding of the process during the COVID period. The groundbreaking finding in the research is with the moderation of religiosity.

Mindfulness as a well-being initiative for future nurses: a survey with undergraduate nursing students

BACKGROUND

Mindfulness can potentially positively impact well-being and resilience in undergraduate nursing students. The psychological well-being of such students undertaking clinical training is paramount to ensure optimal learning, and to equip them with skills to manage their wellbeing in future clinical practice. The aim of our study was to explore the views of undergraduate nursing students in relation to understanding and engaging with mindfulness, and how mindfulness could best be delivered within their university programme.

METHODS

An online survey was administered via a cloud-based student response system to a convenience sample of first year undergraduate nursing students completing a Bachelor of Science (BSc) Honours (Hons) degree in nursing at a University in the United Kingdom. Data were analysed using descriptive statistics and thematic analysis.

RESULTS

The survey achieved a response rate of 78% (n = 208). Seventy-nine percent of participants had heard of mindfulness and were interested in taking part in a mindfulness programme. Respondents reported that the ideal delivery of the programme would consist of weekly 45-min, in person group sessions, over a 6-week period. Respondents also indicated that a mobile application could potentially facilitate participation in the programme. Thematic analysis of open-ended comments, and free text, within the survey indicated 4 overarching themes: 1) Perceptions of what mindfulness is; 2) Previous mindfulness practice experiences; 3) Impact of mindfulness in nursing; 4) The need for a future well-being initiative for undergraduate nursing students.

CONCLUSIONS

Undergraduate nursing students perceived that a mindfulness programme has the potential to enhance well-being and future clinical practice. This student cohort are familiar with mindfulness and want more integrated within their undergraduate curriculum. Further research is required to examine the effectiveness of a tailored mindfulness intervention for this population that incorporates the use of both face-to-face and mobile delivery.

Assessment and correlation between job satisfaction and burnout among radiographers

INTRODUCTION

Previous research on job satisfaction (JS) and burnout has focused on physicians and nurses. However, limited work has evaluated radiographers' JS and burnout, factors affecting them and the correlation between them. The aim of this study is to assess the level and specific factors affecting burnout and JS among radiographers and to examine the correlation between them.

METHODS

A questionnaire consisting of socio-demographic information and two validated instruments (Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS (MP)) and JS Survey (JSS)) was distributed to radiographers. The MBI included 22 questions and JSS consisted of 36 questions. Mean scores were used to compare responses between participants according to demographic characteristics. Correlation between JS and burnout was examined using Pearson correlation test, with P < 0.05 determining statistical significance.

RESULTS

308 radiographers returned a completed questionnaire, 48.4% of participants were male, 48.7% had 1-6 years of experience and 61.4% examined >25 patients per day. Total emotional exhaustion, depersonalization and personal accomplishment scores were 28.7, 11.3 and 35.8 respectively. Most participants felt dissatisfied with pay (n = 221, 71.8%), opportunities for promotion (n = 202, 65.6%), fringe benefits (n = 239, 77.6%), contingent rewards (n = 231, 75.0%), operating procedures (n = 190, 61.7%) and communication (n = 162, 52.6%). Burnout was associated with work experience and caseload and JS was associated with section of work. Most of the JS domains were significantly inversely related to emotional exhaustion and depersonalisation domains. Emotional exhaustion and depersonalization drew a significant positive correlation. Emotional exhaustion and depersonalization drew a significant positive correlation.

CONCLUSION

Participating radiographers are mostly dissatisfied about their jobs and they suffer a high level of emotional exhaustion.

IMPLICATIONS FOR PRACTICE

To avoid the consequences of burnout and decreased JS on individuals and organizations, efforts should be done in alleviating the main factors affecting them.

Stress and turnover intention among healthcare workers in Saudi Arabia during the time of COVID-19: Can social support play a role?

The turnover intention of healthcare workers is a threat to the competence of health services, especially during COVID-19 time. This study aimed to investigate the association between stress and turnover intention among healthcare workers in Saudi Arabia and whether social support could affect this association. In this cross-sectional study, healthcare workers in primary healthcare centers in Saudi Arabia responded to an online questionnaire assessing their sociodemographic and occupational history, stress levels using the Perceived Stress Scale-10 (PSS-10), social support using the Multidimensional Scale of Perceived Social Support (MSPSS), and turnover intention within the next few months. Path analysis was conducted to assess the mediating effect of social support on the association between stress and turnover intention. A total of 1101 healthcare workers (242 physicians, 340 nurses, 310 paramedics, and 209 administrative workers) participated in this study. The path between stress and support had a significant standardized regression weight (-.34, p < .05). The path between support and turnover had a significant standardized regression weight (.08, p < .05). The standardized total effect of stress on turnover without the impact of support was significant (-.39, p < .05). The direct effect of stress on turnover with the presence of support was significant (-.36, p < .05). The indirect effect of stress on turnover with the presence of support was significant (-.03, p < .05). Thus, there is evidence to show that support mediates the relationship between stress and support. Stress is associated with turnover intention among healthcare workers in Saudi Arabia. Social support had a mitigating effect on the relationship between stress and turnover intention.

High involvement work practices often lead to burnout, but thanks to humble leadership

Purpose

Based on the conservation of resources theory, this study aims to investigate high involvement work practices (HIWP) as an antecedent to burnout with a mediating role of perceived work–family (WF) imbalance. Moreover, this study examines whether humble leadership moderates the relationship between HIWP and WF imbalance.

Design/methodology/approach

Using a time-lagged survey approach, data are collected from 200 employees working in the Indian services sector organizations.

Findings

The findings demonstrate that HIWP has a direct negative effect on burnout and an indirect effect via WF imbalance. Also, humble leadership moderates the relationship between HIWP and WF imbalance.

Originality/value

By studying the pessimistic view of HIWP in the Indian context, this study contributes to the scant studies available on its effect on burnout in collectivistic societies. Furthermore, humble leadership's moderating role in the relationship between HIWP and WF imbalance is unique to this study.

Emotional Labor and Depressive Symptoms Among Healthcare Workers: The Role of Sleep

BACKGROUND

Depression is the second leading cause of disability worldwide. Health care workers report a higher prevalence of depressive symptoms than the general population. Emotional labor has contributed to poor health and work outcomes. However, the mechanism for the potential association between emotional labor and depressive symptoms has not been well studied. This study examines the relationship between emotional labor and depressive symptoms and whether sleep plays a role in explaining this relationship.

METHODS

In 2018, health care workers (n = 1,060) from five public sector facilities in the northeast United States participated in this cross-sectional survey. The survey included questions on participants' surface-acting emotional labor (masking one's feelings at work), depressive symptoms, sleep duration and disturbances, and socio-demographic characteristics. Multivariable linear and Poisson regression modeling were used to examine associations among variables.

FINDINGS

There was a significant association between emotional labor and depressive symptoms (β = 0.82, p < .001). Sleep disturbances, but not short sleep duration, partially mediated this association. Neither sleep variable moderated this association.

CONCLUSIONS/APPLICATION TO PRACTICE

Depressive symptoms were prevalent among health care workers and were associated with emotional masking. Sleep disturbances play an important intermediate role in translating emotional labor to depressive symptoms in these workers. Effective workplace programs are needed to reduce health care workers' emotional labor to improve their mental health. Sleep promotion should also be emphasized to mitigate the negative effect of emotional labor and promote mental wellbeing.

The factor of affecting head nurse's delegation: A cross sectional study

Nursing delegation is one component that can improve the quality of nursing services. This study was to identify the factors associated with delegating the head nurse, as perceived by implementing nurses at the Military Hospital in Jakarta. This cross-sectional study with 227 nurses who were selected using the purposive sampling technique. The data was analyzed using the Pearson correlation test, ANOVA, and T-tests to determine the relationship between variables influencing the head nurse delegation and linear regression tests to assess the variables related most. Factors related to nurses' perceptions of head nurse delegation were age (p=0.045), education level (p=0.002), management function (p=0.020), planning function (p=0.043), workforce function (p=0.002), control function (p=0.019), leadership style (p=0.02) and communication (p=0.030). Education level emerged as the most dominant variable. This result was to provide a reference for developing standard operating procedures regarding nursing delegation based on related factors.

Occupational Stress and Burnout Among Health Care Workers in Ethiopia: A Systematic Review and Meta-analysis

OBJECTIVE

To estimate the pooled national burden of occupational stress, burnout, and contributing factors among health care workers in Ethiopia.

DATA SOURCES

Both published and unpublished observational studies conducted on the burden of occupational stress and burnout among health workers in Ethiopia were included.

STUDY SELECTION

This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered on PROSPERO (CRD42020166585). The eligibility of the studies was evaluated based on predetermined inclusion and exclusion criteria.

DATA EXTRACTION

Data extraction was conducted using major databases; PubMed, Google Scholar, Cumulative Index to Nursing and Allied Health, Scopes, Cochrane Library, the Web of Science, and African Journals Online were involved in the review. Two reviewers extracted data independently using a standardized data extraction checklist on Microsoft Excel. Any discrepancy was resolved by including the third reviewer for a possible consensus.

DATA SYNTHESIS

Fourteen studies, with a total of 4066 health care workers, were included in the meta-analysis. The pooled burdens of occupational stress and burnout were 52.9% (95% confidence interval [CI], 46.2-59.7) and 39.1% (95% CI, 23.9-52.3), respectively. Major determinants of occupational stress were being female (odds ratio [OR], 1.9; 95% CI, 1.1-3.3), being younger (OR, 1.4; 95% CI, 1.03-1.9), having a lower educational level (OR, 2.7; 95% CI, 1.05-7.2), and being satisfied with a job (OR, 0.3; 95% CI, 0.2-0.5). Being married (OR, 0.7; 95% CI, 0.5-0.9), having a lower educational level (OR, 0.5; 95% CI, 0.4-0.8), and working in shifts (OR, 0.7; 95% CI, 0.5-0.9) were significant predictors of burnout.

CONCLUSIONS

More than half and more than one-third of health care workers were affected by occupational stress and burnout, respectively, in Ethiopia, and sociodemographic and occupation-related factors were significant factors. Measures that improve job satisfaction, career development, and educational opportunities should be strengthened.

Predictors of stress and associated factors among healthcare workers in Western Ghana

Healthcare professionals are the most vulnerable to stress among all occupational groups due to the nature of their work environment. The aim of this study is to determine the level of stress and associated factors among healthcare workers in Western Ghana. The study employed a cross-sectional design with self-administered questionnaires. The results show that 69.5% of the respondents were stressed. Prevalence of stress was higher among female respondents than males. We found that 40.4 % of respondents intend to change work as a result of stress faced at their work places. Respondents aged 56≥ were more (3.16) likely to be stressed than those in the other age groups. We found a significant association between age, marital status, workload and educational background and stress levels among the respondents. The management of these healthcare institutions and their stakeholders must adopt strategies to help health workers cope with the stress they encounter.

Experience of Workplace Incivility and Its Impact on Stress and Turnover Intention among the Nurses Working at a Hospital: Cross-Sectional Survey Approach

Background:

Incivility in the workplace drowns the mental health of the nurses and hampers the daily routine. The majority of the nurses working at hospitals were experiencing incivility. It affects the physical and psychological health of the nurses. Experience of workplace incivility and its impact on stress and turnover among nurses was discussed in this study.

Materials and Methods:

Cross-sectional survey approach was used to select 50 nurses by simple random sampling technique. Standard scales for incivility, stress, and pre-tested scale for the turnover intention was used to collect the data.

Result:

Nurses experience incivility in their workplace almost from all the sources. The majority (64%) of the staff nurses had a moderate level of stress and 30% had average intention to leave the present job. There was a positive relationship found between the experience of incivility and stress (r = 0.43, p < 0.002), stress, and turnover intention (r = 0.40, p < 0.004).

Conclusions:

Experience of incivility provokes stress among the nurses, and this may influence turnover intention.

Development and validation of challenge-hindrance demands scale for the nursing profession: A mixed-methods research study

Background

Although common work conditions cannot be clearly classified as positive or negative, previous challenge-hindrance demands scales have failed to address this issue.

Objective

The purpose of this study was to develop and validate scales that allow the assessment of perceived levels of challenge-hindrance demands in the nursing profession and that are in conformance with the nature of the construct.

Design

The study employed an exploratory sequential mixed-methods design, composed of two phases. Firstly, the qualitative method was employed to find out the common work environment that is typically linked to the job demands of nurses; new scales were generated following the results. Secondly, the quantitative method was employed to refine and assess the validity and reliability of the instruments.

Participants

The key informants for the interview were 11 registered nurses from seven private hospitals in Bangkok, Thailand. In addition, the sample of the quantitative study, consisting of 761 Thai nurses from 16 private hospitals in Bangkok was randomly divided into three parts for different analyses (i.e., exploratory factor analysis, confirmatory factor and reliability analysis, and nomological validity analysis).

Results

The findings demonstrated that the assessment of the challenge-hindrance demands consists of three parts: The amount of experience with stressors, the appraisal of challenges, and the appraisal of obstacles. The analyses led to the creation of two scales: the challenge demands scale and the hindrance demands scale, each with 14 variables and four dimensions.

Conclusions

The separation of the scales into three parts made it evident that, since job demands themselves are part of an inevitably stressful work environment, hospitals have to focus on the individual interpretation of each job demand in order to manage the burnout and engagement of nurses. In addition, the scales have potential use in studies relevant to problems encountered in the nursing profession (e.g., opting to pursue a different career).

Linking nurses' job security to job satisfaction and turnover intention during reform and privatization: A cross-sectional survey

BACKGROUND

Reforming health care systems can influence the workers. Among the aspects that could be influenced are the perception of job security, job satisfaction and turnover intention. However, nurses' perception on job security, job satisfaction and turnover intention during health care reform and privatization is a topic yet to be explored.

OBJECTIVES

To examine the link between job security, job satisfaction and turnover intention during the reform and privatization of a health care system.

DESIGN

A cross-sectional survey design was utilized in this study.

METHODS

The survey was composed of sociodemographic items, global job satisfaction item, global turnover items and job security scale. Data were analysed using SPSS, and univariate, bivariate and multivariate analyses tests were used.

RESULTS

Although job satisfaction partially mediated the association between job security and organisational turnover during health care reform, it completely mediated the association between job security and professional turnover intention.

CONCLUSIONS

Further research is needed to examine this finding.

IMPLICATION FOR NURSING MANAGEMENT

The findings of this study benefit nurse managers and leaders for their evidence-based management. Moreover, this study will help them focus on practices that satisfy the staff and improve the job security by improving the communication and work on changing the policy.

Understanding sport coaches' turnover intention and well-being: an environmental psychology approach

OBJECTIVE

The purpose of this study was to examine the role of environmental and personal factors in sport coaches' well-being and behavioral intention. To be precise, this study measured how workplace social support, work involvement, and work satisfaction are associated with sport coaches' well-being and turnover intention, adopting the framework of the environmental psychological model.

DESIGN

A total of 519 responses were collected from sport coaches in Singapore. In this study, confirmatory factor analysis and structural equation modeling analysis were conducted using EQS 6.3 software.

RESULTS

Results of structural equation modeling supported all hypothesized relationships, except the paths from work involvement to turnover intention and well-being. Additionally, this study found the indirect effects of workplace social support and work involvement on turnover intention and well-being.

CONCLUSION

This study provided an understanding of external and internal antecedents of sport coaches' future behavior and well-being, ultimately benefiting sport organizations.

Strategies first year doctor of pharmacy students use to promote well-being

INTRODUCTION

The objective of this study is to assess strategies that first-year doctor of pharmacy (PharmD) students utilize to manage stress and promote well-being throughout the program.

METHODS

Participants included students at a university in an urban Midwestern region. Students were enrolled in the second semester of their first year of a four-year PharmD program. Students were participating in a social and administrative sciences course in which they were required to write a two-page reflection before a small group discussion and lecture on their overall well-being while in pharmacy school. Open and axial coding was conducted on these reflections using a standard content analysis approach of qualitative thematic analysis.

RESULTS

A total of 49 pharmacy students reported multiple strategies to help cope with stressors of a PharmD program and improve their well-being. Four themes emerged, including: (1) availability and accessibility of institutional resources, (2) personal time management and organizational strategies, (3) personal mental and physical health strategies, and (4) activities that maintain social relationships.

CONCLUSIONS

First-year pharmacy (P1) students are actively thinking about and participating in activities to promote personal well-being, manage extreme stress, and proactively prevent the detrimental effects of burnout. P1 students were aware of the need to incorporate specific strategies into their daily routine to aid in their overall well-being and experience during pharmacy school. Colleges and schools of pharmacy can use the findings of this study to understand strategies students currently use to identify approaches for supporting student needs and any gaps in wellness resources.

Magnitude of turnover intention and associated factors among nurses working in emergency departments of governmental hospitals in Addis Ababa, Ethiopia: a cross-sectional institutional based study

Background

Turnover intention is a probability of an employee to leave the current institution within a certain period due to various factors. It is the strongest predictor of actual turnover expected to increase as the intention increases. Emergency Department (ED) nurses are especially vulnerable to high turnover because of their increased risk of developing burnout and compassion fatigue associated with the work environment. This study is aimed to assess nurses' intention to leave emergency departments and associated factors at selected governmental hospitals in Addis Ababa, Ethiopia.

Methods

Institutional based cross-sectional study was conducted on 102 nurses in three selected governmental hospitals, Addis Ababa from February 19 to March 31, 2018, using a structured pre-tested self-administered questionnaire. The logistic regression model was used and an adjusted odds ratio with a 95% confidence interval was calculated to identify associated factors.

Result

A total of 102 respondents were involved with a response rate of 91.1%. Among them, 79 (77.5%) respondents had the intention to leave the current working unit of the emergency department or hospital. Significant predictive factors of nurses' intention to leave their institutions are educational status (adjusted odds ratio (OR) =4.700, 95% confidence interval (CI) = 1.033-50.772; p < 0.048), monthly income of less than 3145 Birr (adjusted OR = 6.05, 95% CI = 1.056-34.641; p < 0.043) and professional autonomy (adjusted OR = 0.191, 95% CI = 0.040-0.908; p < 0.037).

Conclusion

More than 77% of the respondents have the intention to leave their current working place of the emergency unit. Educational status, monthly income, and autonomy were significantly associated with emergency nurses' turnover intention in three governmental hospitals. Emergency leaders and hospital managers should have made efforts to enhance nurses' decision making for patient care activities and shared decision overwork or unit related activities.