Association of goal orientation with work engagement and burnout in emergency nurses

The Importance of Autonomy and Performance Goals in Perceived Workload Among Behavioral Health Providers

OBJECTIVE

The authors sought to assess workplace characteristics associated with perceived reasonable workload among behavioral health care providers in the Veterans Health Administration.

METHODS

The authors evaluated perceived reasonable workload and workplace characteristics from the 2019 All Employee Survey (AES; N=14,824) and 2019 Mental Health Provider Survey (MHPS; N=10,490) and facility-level staffing ratios from Mental Health Onboard Clinical Dashboard data. Nine AES and 15 MHPS workplace predictors of perceived reasonable workload, 11 AES and six MHPS demographic predictors, and facility-level staffing ratios were included in mixed-effects logistic regression models.

RESULTS

In total, 8,874 (59.9%) AES respondents and 5,915 (56.4%) MHPS respondents reported having a reasonable workload. The characteristics most strongly associated with perceived reasonable workload were having attainable performance goals (average marginal effect [AME]=0.10) in the AES and ability to schedule patients as frequently as indicated (AME=0.09) in the MHPS. Other AES characteristics significantly associated with reasonable workload included having appropriate resources, support for personal life, skill building, performance recognition, concerns being addressed, and no supervisor favoritism. MHPS characteristics included not having collateral duties that reduce care time, staffing levels not affecting care, support staff taking over some responsibilities, having spirit of teamwork, primary care-mental health integration, participation in performance discussions, well-coordinated mental health care, effective veteran programs, working at the top of licensure, and feeling involved in improving access. Facility-level staffing ratios were not significantly associated with perceived reasonable workload.

CONCLUSIONS

Leadership may consider focusing resources on initiatives that support behavioral health providers' autonomy to schedule patients as clinically indicated and develop attainable performance goals.

Updating Factors Influencing Nurse Work Engagement in the Hospital Settings: A Systematic Review

Background

Understanding the factors influencing work engagement among nurses is crucial for ensuring high-quality care and positive patient outcomes. Despite numerous factors associated with nurse work engagement, many were explored before the pandemic, potentially overlooking aspects relevant to the current context.

Aim

To explore and update factors related to nurse work engagement in the new normal era.

Design

Systematic review.

Data Sources

The search was restricted to articles published from 2019 to 2024 in CINAHL, PubMed, Scopus, ScienceDirect, Web of Science, and ProQuest, with full English text. The search was conducted from September 13th to 15th, 2023. Quantitative research articles that examined factors related to work engagement were included.

Review Methods

Data extraction, quality appraisal, and data analysis were performed in all included studies. Manual content analysis method was used to classify and group the factors.

Results

Sixty-one research articles were included in the final review. Five key groups of factors were generated from content analysis, including 1) individual-related factors, 2) organizational-related factors, 3) job and role-related factors, 4) work-life balance, and 5) work environment.

Conclusion

Understanding and addressing these multifaceted factors holistically is essential to develop strategies to sustain optimal engagement levels among nursing staff and improve overall patient care outcomes. Further studies are needed to confirm the findings.

Work Engagement among Acute Care Nurses: A Qualitative Study

Aims

To understand how Omani nurses conceptualize work engagement, explore factors influencing engagement, and identify strategies to improve work engagement.

Design

A qualitative study design.

Methods

Semistructured interviews were conducted with twenty-one Omani nurses from four acute-care hospitals. Interview transcripts were examined using directed content analysis.

Results

Participants defined work engagement as a positive state where nurses are engaged physically, emotionally, and mentally with work. Mentally engaged nurses' minds are occupied with patients even when they are off duty. Organizational factors affecting work engagement were leadership, teamwork, autonomy, pay, and job demand. Individual factors affecting engagement included considering nursing a rewarding profession. A social factor was family commitments. Strategies suggested to improve engagement included improved pay and monetary incentives, working system flexibility, open-door policy, performance feedback, recognition, and resources.

Conclusion

Mentally engaged nurses are attached to work even when they are off duty. Nurses' gait and facial expressions can indicate high or low work engagement. Nurses with family obligations felt drained of energy, affecting their vigor and enthusiasm at work. Implications. Management skills and practices impact work engagement. Nurse's feedback can be used to improve practice and design interventions that promote nurses' engagement.

A comparison of emotional wellbeing and burnout of primary care professionals in 2014 and 2021

Background

Due to the pandemic that started in February-March 2020 and after many years of economic restrictions suffered by our health system, the levels of stress, exhaustion and suffering among health workers has increased.

Objective

Our study aims to perform a comparative analysis of the degree of burnout and emotional wellbeing among health professionals between 2014 and 2021.

Methods

This is a comparative descriptive study of two cohorts of primary care professionals of the Lleida health region (SPAIN). We have one cohort from 2014 and another from 2021 with the same selection criteria. Burnout was assessed using the Maslach Burnout Inventory (MBI-HSS) test. Gender, age, professional category and work environment were also evaluated.

Results

We obtained a response rate in 2014 of 52.7% (n = 267) and of 41.4% (n = 217) in 2021 with similar sociodemographic characteristics. There are significant differences (p < 0.001) in the three categories of burnout. The high scores for emotional exhaustion and depersonalization have increased, rising between 2014 and 2021 from 23.2 to 60.8% and from 12.4 to 42.4%, respectively. However, there is also a significant increase in high personal accomplishment, rising from 9.0% in 2014 to 26.7%. We have also detected differences depending on age and professional role.

Conclusion

This study shows worsening burnout levels of primary care professionals in our region, specifically emotional exhaustion and depersonalization. However, it also shows that during the pandemic, personal accomplishment was reinforced.

How emergency nurses cope and motivate themselves to sustain their caring work: An integrative literature review

AIMS AND OBJECTIVES

The aim of this integrative review was to assess how emergency nurses cope and motivate themselves to sustain their caring work.

BACKGROUND

The need to enhance sustainability of the workforce creates a demand to consolidate contemporary evidence related to emergency nurses' motivations, how they cope and sustain themselves for caring work.

DESIGN AND METHODS

The integrative literature review informed by Whittemore and Knafl involved searching four databases, which yielded 977 published research papers (2008-2021). A total of 33 studies met the inclusion and quality assessment criteria. The PRISMA checklist for review was followed.

RESULTS

No studies addressing all three areas (motivations, coping and caring sustainability) together were identified. Integration of evidence from quantitative and qualitative research was achieved in three categories: (1) emergency nurses' motivations to sustain their work, (2) emergency nurses' coping strategies and (3) sustaining care as emergency nurses.

CONCLUSION

To sustain themselves in caring work, emergency nurses need to be intrinsically and extrinsically motivated and know how to cope effectively with stressors and work demands. There is need for research examining the relationships between these aspects of emergency nursing work.

RELEVANCE TO CLINICAL PRACTICE

To ensure the sustainability of emergency nurses' work and careers understanding of the factors that influence and sustain their motivations and coping strategies is important for nurses and their clinical leaders and managers.

Facilitators, barriers and opportunities in workplace wellbeing: A national survey of emergency department staff

INTRODUCTION

Emergency department (ED) staff face daily exposure to the illness, injury, intoxication, violence and distress of others. Rates of clinician burnout are high and associated with poor patient outcomes. This study sought to measure the prevalence of burnout in ED personnel as well as determine the important facilitators of and barriers to workplace wellbeing.

METHOD

An anonymous online survey including six open-ended questions on workplace wellbeing was completed by 1372 volunteer participants employed as nurses, doctors, allied health or nonclinical roles at 22 EDs in Aotearoa, New Zealand in 2020. Responses to the questions were analysed using a general inductive approach.

RESULTS

The three key themes that characterise what matters most to participants' workplace wellbeing are: (1) Supportive team culture (2) Delivering excellent patient-centred care and (3) Professional development opportunities. Opportunities to improve wellbeing also focused on enhancements in these three areas.

CONCLUSION

In order to optimise workplace wellbeing, emergency departments staff value adequate resourcing for high-quality patient care, supportive and cohesive teams and professional development opportunities. Initiatives in these areas may facilitate staff wellbeing as well as improving safety and quality of patient care.

Anforderungen, Ressourcen und Arbeitsengagement Pflegender während der zweiten Welle der COVID-19-Pandemie

Demands, resources, and work engagement of nurses during the second wave of the COVID-19 pandemic - A cross-sectional study Abstract. Background: Nurses are assigned a key role in managing the COVID-19 pandemic. Of particular importance is their work engagement, depending on job demands and resources. So far, there have only been scattered and first-wave related indications of nurses' job demands, resources and work engagement in Germany during the pandemic. Aim: To systematically assess key job demands, key job resources and work engagement of nursing staff for the second wave of the COVID-19 pandemic, also differentiating between various groups of nurses. Method: The study was realized in a cross-sectional design and included nurses in direct health care settings in Germany. Data was collected with an online questionnaire using valid and reliable measures during the second wave of the pandemic. The dataset for analyses comprised 1027 cases in total. Results: Regarding demands, work overload was even higher than before the pandemic, but work-life interferences were less pronounced. Nurses' resource architecture was not fundamentally changed by the pandemic, but interpersonal relationships and autonomy were rated more positively. Domiciliary care workers assessed demands and resources more positively than nurses in nursing homes or hospitals, whereas nurses caring for COVID-19 patients evaluated demands and resources more critically. Nurses' work engagement was higher during the second pandemic wave than in the first wave, but still low overall. Conclusions: Due to the importance of work engagement for nurses' health and performance and thus the quality of care, demands and resources must be further improved. Starting points are, e. g., fostering team cohesion, strengthening autonomy, and managing workload.

Achievement Goals and Goal Progress as Drivers of Work Engagement

In two studies, we investigated the role of self-regulatory behavior in terms of achievement goals and goal progress for work engagement. Study 1 (N = 205) revealed that trait learning goals were positively related to work engagement and performance-approach and performance-avoidance goals were unrelated to work engagement. In a second study, employees were asked to either set a (state) learning, performance-approach, or performance-avoidance goal for the upcoming work week. Goal progress and work engagement were measured one week later (N = 106). Learning goals at the trait and state level were associated with higher work engagement and performance-avoidance goals were unrelated to work engagement. We found a positive relationship of goal progress with work engagement, in particular for employees who pursued learning or performance-approach goals. Our studies contribute to theory building by delineating the (combined) role of goal orientations (trait), state achievement goals, and goal progress for work engagement, as well as generating practical implications for the design of effective interventions to enhance work motivation in organizational practice.

The voice of nurses as a means to promote job engagement

Objective:

The objective of this study was to establish the factors that induce nursing professionals to present engagement with their work environment.

Method:

Qualitative study, using the communicative methodology, with nursing professionals from public and private centers in the city of Huesca. The statements were collected through communicative stories and discussion groups.

Result:

The methodology used has allowed the establishment of a set of engagement promotion measures in the studied environment. These measures are framed in the three main categories analyzed: the systemic or structural variables, the subject-oriented variables, and those that refer to the relationships between the subjects.

Conclusion:

Knowledge of the situation regarding engagement among professionals, and the issues that encourage or hinder its appearance, is essential in establishing measures that contribute to its development. The use of qualitative techniques has allowed for the discovery of situations that would have gone unnoticed. After analyzing the interviews and the discussion groups, the following were present: an important lack of recognition that the participants experience, and that contribute, in their opinion, to the appearance of burnout syndrome, and, the lack of cohesion as a collective.

THE IMPACT OF ORGANISATIONAL SUPPORT AND INDIVIDUAL ACHIEVEMENT ORIENTATION ON CREATIVE DEVIANCE

Innovation-oriented firms encourage their staff to generate ideas, but lack the resources to sponsor them all. Entrepreneurially minded employees may respond to this discrepancy with creative deviance, i.e., pursue ideas despite managerial orders to stop. We elucidate this understudied flipside of corporate entrepreneurship by theorising and testing organisational and individual antecedents to creative deviance. Strain theory leads us to hypothesise that organisational support for innovation reduces creative deviance. Based on achievement goal theory, we conjecture that mastery goals foster creative deviance. These predictors are expected to interact in their impact on creative deviance. Data from 659 employees support our hypotheses. Our study contributes to corporate entrepreneurship theory by expounding an important, but so far understudied form of innovative behaviour, extends strain theory by showing how individual traits can reinforce or mitigate the structural strain created by organisations, and advances research on achievement goals by connecting mastery achievement orientation to deviant behaviour. In terms of practical implications, our study indicates how leaders may promote compliant innovation through organisational support and how they can increase person-job fit by screening candidates’ achievement goals during recruitment.

Ethical sensitivity, burnout, and job satisfaction in emergency nurses

BACKGROUND

Rising levels of burnout and decreasing job satisfaction can inhibit healthcare professionals from providing high-quality care due to a corresponding decrease in their ethical sensitivity.

AIM

This study aimed to determine the relationship between the level of ethical sensitivity in emergency service nurses and their levels of burnout and job satisfaction.

RESEARCH DESIGN

This research employed a descriptive and cross-sectional design.

PARTICIPANTS AND RESEARCH CONTEXT

This study was conducted with a sample of 236 nurses, all of whom worked in emergency service between 24 July 2015 and 28 April 2016. Data were collected using the Moral Sensitivity Questionnaire, Maslach Burnout Inventory, and Minnesota Job Satisfaction Scale.

ETHICAL CONSIDERATIONS

This study was approved by the Institutional Ethics Review Board of Ondokuz Mayıs University.

FINDINGS

There was a weak and negative correlation (r = -0.158, p = 0.015) between Moral Sensitivity Questionnaire and Maslach Burnout Inventory scores. There was also a weak and negative correlation (r = -0.335, p < 0.001) between the Maslach Burnout Inventory and Minnesota Job Satisfaction Scale scores.

DISCUSSION AND CONCLUSION

Decreased job satisfaction and increased burnout levels among emergency service nurses might result in them indulging in improper practices, frequently facing ethical problems, and a decrease in the overall quality of service in hospitals. In order for emergency service nurses to recognize ethical problems and make the most accurate decisions, a high level of ethical sensitivity is critical. In this respect, it is suggested that continuing education after graduation and training programs should be organized.

A concept analysis of professional commitment in nursing

BACKGROUND

The concept of professional commitment is being widely studied at present. However, although it is considered an indicator for the most human part of nursing care, there is no clear definition for it, and different descriptors are being used indiscriminately to reference it.

OBJECTIVE

The aim of this study is to clarify the concept of professional commitment in nursing through the Rodgers' evolutionary concept analysis process.

DESIGN

Systematic search using English and Spanish descriptors and concept analysis. Studies published between 2009 and June 2015, front-to-back analysis of the Nursing Ethics journal and manual check of articles cited in studies related to the Nijmegen Professionalism Scale.

RESEARCH DESIGN

The procedure of concept analysis developed by Rodgers was used.

ETHICAL CONSIDERATIONS

Although the topic was not labeled as sensitive and subject to ethical approval, its realization was approved by the Ethical Committee of Clinical Research of Aragon (CEICA) approved the study on 18 March 2015 and also careful procedures have been followed according to ethics expressed in the Declaration of Helsinki.

FINDINGS AND DISCUSSION

A total of 17 published studies. A clear definition of the concept was made, and surrogate terms, concept dimension, differential factors related to the concept, sociocultural variations and consequences for nursing practice were identified.

CONCLUSION

There is a need for continuous advancement in the development of the concept, specific actions to encourage this and the improvement of evaluation methods for its study.

Occupational Burnout Syndrome in the nursing context: an integrative literature review

OBJECTIVE

To characterize the scientific production on Burnout Syndrome in the Nursingcontext, systematizing the location where the studies were carried out, the related constructs, the employed methods and their main results.

METHOD

An integrative review of the literature with a bibliometric approach of articles published in Portuguese, Spanish and English between 2005 and 2016.

RESULTS

106 articles wereincluded. Mostinvolvedprevalence, and were descriptive, quantitative studies performed in hospitals.The Southeastern and Southern regions of Brazil had the largest number of publications, and stress was the construct most related to burnout.Most of the studies used the Maslach Burnout Inventory to investigate the presence of the syndrome.

CONCLUSION

New case-control and cohort studies should be carried out.Qualitative-exploratory studies are necessary to better understand Burnout Syndrome among nursing professionals usingfocus groups or interviews, as well as comparative causal studies, with the purpose of exploring the syndrome'smanifestations.

OBJETIVO

Caracterizar a produção científica sobre a Síndrome do Esgotamento Profissionalno contexto da enfermagem, sistematizando os locais onde as pesquisas foram realizadas, os construtos relacionados, os métodos empregados e seus principais resultados.

MÉTODO

Revisão integrativa da literatura, com abordagem bibliométrica, em artigos na língua portuguesa, espanhola e inglesa publicados entre 2005 e 2016.

RESULTADOS

Foram selecionados 106 artigos.A maioria estudos de prevalência, descritivos, quantitativos e realizados em hospitais. Nas regiões Sudeste e Sul do Brasil encontram-se o maior número de publicações, sendo o estresse o construto mais relacionado com o esgotamento profissional. A maior parte dos estudos utilizou o Maslach Burnout Inventory como meio de averiguação da presença da síndrome.

CONCLUSÃO

Novos estudos de caso controle e coorte devem ser realizados. Pesquisas de cunho qualitativo-exploratório são necessárias para poder compreender melhor a Síndrome do Esgotamento Profissionalentre os profissionais de enfermagem com grupos focais ou entrevistas, como também pesquisas causais comparativas, com o intuito de explorar as manifestações da síndrome.

Is a Transdisciplinary Theory of Engagement in Organized Settings Possible? A Concept Analysis of the Literature on Employee Engagement, Consumer Engagement and Patient Engagement

Organizations are experiencing increased competition, disruptive innovation, and continuous changes in their social and economic context. Furthermore, the decrease of resources (economic and human) in such a demanding context make it imperative for organizations to find new models and strategies to make their service delivery more sustainable at the economic, environmental and psychological levels. In such a complex scenario the concept of engagement of the individuals involved in organized settings (either as service providers or as final receivers) is a promising lever for innovation. However, despite the number of studies on the matter, the debate on engagement is still very fragmented because the corpus of literature addressing the different areas of engagement is divided and diverse in its nature. In this paper, we discuss the results of a conceptual analysis of the literature conducted in order to investigate overlapping features and areas of divergence among three different areas of investigation and application of the engagement phenomenon in organized settings: the domains of employee engagement, consumer engagement, and patient engagement. These are deliberately selected as prototypical of the phenomenon of engagement along the "inside/outside" of organizational settings. The analysis consisted in a qualitative conceptual survey? Of the scholarly literature indexed with the key terms "employee engagement," "consumer engagement," and "patient engagement." We performed a key-word based survey? Of the literature in the Scopus database. A total of 163 articles were selected and analyzed. The analysis cast light on the following areas of conceptual overlap among employee, consumer and patient engagement: (1) engagement is different from empowerment and activation; (2) engagement is a multi-componential psychological experience; (3) engagement is a self-transformative experience; (4) engagement develops within a relational context; (5) engagement is a systemic phenomenon. These findings, although preliminary and in need of further investigation, suggest the feasibility of promoting a transdisciplinary reflection on the phenomenon of engagement in organized settings.

Burnout among nurses working in social welfare centers for the disabled

Background

In the healthcare sector, we often come across the burnout syndrome. It is an occupational syndrome which causes, physical and emotional exhaustion. More information is needed on the dangers of burnout and how often it occurs in healthcare. The purpose of this study was to investigate burnout and factors associated with the syndrome among nurses working with people that are mentally challenged.

Methods

A cross-sectional survey was conducted, among 180 nurses working in public health centers for the disabled in multiple regions of Greece. A self-administered questionnaire with questions about socio-demographic and work-related characteristics was used, as well as the Maslach Burnout Inventory (MBI) for burnout assessment. Univariate and multivariate analyzes were performed.

Results

The burnout dimensions of emotional exhaustion (Mean = 31.36) and depersonalization (Mean = 11.27) were at high levels while personal accomplishment was at low levels (Mean = 44.02). Female nurses had a higher personal accomplishment score (Mean = 44.82, p = 0.047) than men (Mean = 42.10, p = 0.047). Marital status, daily routine and relationships with supervisors were significantly related with emotional exhaustion and personal accomplishment and professional experience with higher levels of emotional exhaustion and depersonalization. Reason for professional selection was an independent predictor for depersonalization and personal accomplishment, with those that have selected the nursing profession randomly or because of the fear of unemployment having higher scores. Moderate relationships with colleagues was an independent predictor for all burnout dimensions.

Conclusions

Nurses working in services for people with intellectual disabilities in Greece show increased burnout levels. Burnout can be prevented by offering more opportunities for professional advancement and education, new ways to provide supervisor support, provide incentives for nurses to initiate or participate in innovative programs. Specific training on conflict resolution, collaboration, reinforcement and stress coping techniques must be implemented.

Associations of Occupational Stressors, Perceived Organizational Support, and Psychological Capital with Work Engagement among Chinese Female Nurses

This study aimed to explore the associations of occupational stressors (extrinsic effort, reward, and overcommitment), perceived organizational support (POS), and psychological capital (PsyCap) and its components (self-efficacy, hope, resilience, and optimism) with work engagement and the mediating roles of PsyCap and its components among Chinese female nurses within the framework of the job demands-resources (JD-R) model. A cross-sectional sample (1,330) completed the Utrecht Work Engagement Scale, Effort-Reward Imbalance Scale, Survey of POS, and PsyCap Questionnaire, and effective respondents were 1,016 (76.4%). Hierarchical regression analysis and Preacher and Hayes' asymptotic and resampling strategies were used. Extrinsic effort was negatively associated with vigor, dedication, and absorption, while POS, PsyCap, and hope were positively associated with them. Reward and overcommitment were positively associated with dedication and absorption. Optimism was positively associated with vigor and dedication. Optimism mediated the associations of extrinsic effort, reward, and POS with vigor and dedication. PsyCap and hope mediated the associations of POS with vigor, dedication, and absorption. There is a low level of work engagement among Chinese female nurses. Extrinsic effort could reduce work engagement, while reward, overcommitment, POS, PsyCap, hope, and optimism could enhance work engagement. Hospital managers should develop the PsyCap of female nurses through controlling occupational stressors and establishing supportive organizational climate to enhance their work engagement.

A Pilot Study: Testing of the Psychological Conditions Scale Among Hospital Nurses

OBJECTIVE

The aim of this study was to test the reliability and validity of the Psychological Conditions Scale (PCS), a measure of drivers of engagement in hospital-based nurses.

BACKGROUND

Research suggests drivers of engagement are positive links to patient, employee, and hospital outcomes. Although this scale has been used in other occupations, it has not been tested in nursing.

METHODS

A cross-sectional, methodological study using a convenience sample of 200 nurses in a large Magnet® hospital in New Jersey.

RESULTS

Cronbach's α's ranged from .64 to .95. Principal components exploratory factor analysis with oblique rotation revealed that 13 items loaded unambiguously in 3 domains and explained 76% of the variance. Mean PCS scores ranged from 3.62 to 4.68 on a 5-point Likert scale.

CONCLUSIONS

The scale is an adequate measure of drivers of engagement in hospital-based nurses. Leadership efforts to promote the facilitators of engagement are recommended.

Psychosocial job characteristics and psychological distress / well-being: the mediating role of personal goal facilitation

OBJECTIVE

This study examined the mediating role of personal goal facilitation through work (PGFW), defined as perceptions of the extent to which one's job facilitates the attainment of one's personal goals, in the association between psychosocial job characteristics and psychological distress and job-related well-being.

MATERIAL AND METHODS

Questionnaire data from 217 nurses (84% female, with a mean age of 42.7 years, SD=7.2) were analyzed. Participants completed the following measures: the Leiden Quality of Work Questionnaire for Nurses, Workplace Goal Facilitation Inventory, Maslach Burnout Inventory-Human Services Survey, and Utrecht Work Engagement Scale (short version). A cross-sectional study design was applied. Hierarchical multiple regression analyses were conducted.

RESULTS

The results indicated that unfavorable psychosocial job characteristics (high demands, low control, and low social support) were associated with lower PGFW. Furthermore, personal goal facilitation through work explained significant additional variance (from 2 to 11%) in psychological distress (somatic complaints and emotional exhaustion) and job-related well-being (personal accomplishment, job satisfaction, and work engagement), controlling for demographic indicators and psychosocial job characteristics. Finally, the results provided support for the mediating effects of PGFW between all psychosocial job characteristics and all outcomes, except in the case of depersonalization.

CONCLUSIONS

This study suggests that hindered personal goal facilitation may be a mechanism through which psychosocial job characteristics have a negative impact on employees' well-being.