A structural equation model analysis of the effects of emotional labor and job stress on depression among nurses with long working hours: Focusing on the mediating effects of resilience and social support

The Relationship Between Work-Related Stress and Depression: A Scoping Review

Objectives

Work-related stress is highly prevalent. Recent systematic reviews concluded on a significant association between common work-related stress measures and depression. Our scoping review aims to explore whether work-related psychosocial stress is generally associated with depression or depressiveness, the extent and methodology of the primary research undertaken on this topic and to elucidate inconsistencies or gaps in knowledge.

Methods

We searched for literature in Pubmed, PsycInfo and Web of Science including full reports in seven languages published between 1999 and 2022 and applied the PRISMA statement for scoping reviews criteria.

Results

Of 463 primarily identified articles, 125 were retained after abstract and full-text screening. The majority report significant associations between work-related stress and depression. Cross-sectional studies are most prevalent. Sufficient evidence exists only for job strain and effort-reward imbalance. Most studies are from Asia, North America and Europe. The health sector is the most studied. Several research gaps such as the lack of interventional studies were identified.

Conclusion

The consistency of most studies on the significant association between work-related stress and depression is remarkable. More studies are needed to improve evidence and to close research gaps.

Does perceived supervisor support reduce turnover intention? The mediating effects of work engagement among healthcare professionals

BACKGROUND: The study’s value is based on a complete understanding of the employee polychronicity–employee intention to leave the relationship in the health care sector. OBJECTIVE: This study examines (1) the role of job engagement in alleviating the relationship between employee polychronicity and intention to leave, and (2) the moderating impact of perceived supervisor support as a relationship. METHOD: This study employed a cross-cultural research design and collected data from nurses working in public sector hospitals. Through job engagement and perceived supervisor support (PSS), the effect of nurses’ polychronicity on turnover intention was examined using the PLS-SEM approach. RESULTS: The findings of this study demonstrate that employee polychronicity has an impact on employee turnover. Employee engagement appears to operate as a mediator in the association between employee polychronicity and intention to leave and a moderating effect of PSS. CONCLUSION: By emphasizing employee engagement as a mediator and moderating role, the perceived supervisor supports the association between polychronicity and intention to leave of nurses. This study offered a crisp perspective on the complexities of the links between polychronicity, engagement, perceived organizational support, and employees’ intention to leave.

The role of resilience in the work-life interface: A systematic review

BACKGROUND: In an increasingly competitive marketplace, workers struggle to find a good balance between work and personal life. Difficulties in fulfilling the demands arising from these different domains may undermine employees’ well-being and job-related outcomes, thereby, impairing organizational productivity. OBJECTIVE: Does resilience play a relevant role in relation to work-life interface? And, if so, how is resilience related to its three facets (i.e., work-life conflict, enrichment, and balance)? To answer these questions, the current paper systematically reviews studies analysing the role of resilience in the work-life interface. METHODS: A key terms literature search was performed using multiple electronic databases (i.e., Scopus, PsycINFO, Web of Science, PubMed) without setting any publication date limitation. The review process followed the international PRISMA statement guidelines. A quality assessment was conducted using the Mixed Methods Appraisal Tool. RESULTS: A total of 26 eligible papers published between 2009 and 2020 were included. Among these, 6 employed a qualitative design, while 20 studies adopted a quantitative design mostly examining resilience as antecedent. Data were predominantly collected in the healthcare sector. Resilience was mainly analysed in relation to work-life conflict. The most commonly used theoretical framework was Conservation of Resources theory. CONCLUSIONS: Overall, resilience was negatively associated with work-life conflict and positively related to both work-life balance and enrichment. A positive work-life balance can promote resilience, but resilience can also help workers to balance work and life. Additionally, resilience can protect from the negative effects of both work-life imbalance and work-life conflict on workers’ health and job-related outcomes.

Building social support: The impact of workgroup characteristics, the COVID-19 pandemic and informal interactions

BACKGROUND:

Social support from colleagues is a key resource for employees and organizations, with beneficial effects on performance, employee well-being and resilience. Although the importance of social support is well-known, the factors that help to build and maintain social support are not equally well understood.

OBJECTIVE:

This study analyzes the impact of workgroup characteristics (i.e., workgroup composition regarding national diversity and tenure; workload) and the COVID-19 pandemic on employees’ perceptions of instrumental and emotional support, and examines the mediating role of informal interactions.

METHODS:

The study is based on responses from 382 seafarers to a cross-sectional online survey. Hypotheses were tested using OLS regression and mediation analysis using PROCESS.

RESULTS:

Workgroup composition regarding national diversity had indirect effects on social support through informal interactions around social foci (here: joint leisure activities). High workload and pressure from the COVID-19 pandemic reduced interactions around social foci, thus contributing to the erosion of perceived social support.

CONCLUSION:

The findings provide insights on the development of social support, suggesting that informal interactions provide an important mechanism for the development of social support at work. From a theoretical perspective, this highlights the value of a relational perspective on the development of social support, a perspective that is based on the insight that social support is embedded in social relationships. From a practical point of view, this indicates that organizations can proactively foster the development of social support through practices that shape workgroup characteristics and social foci.

Prevalence of burnout and associated factors among health professionals working in public health facilities of Dire Dawa city administration, Eastern Ethiopia

Background

Burnout is a common condition among health workers, characterized by emotional tiredness, depersonalization, and a sense of low personal accomplishment. Ethiopia has major health workforce management challenges, including shortages, poor motivation, retention, and performance, and research evidence is limited for health professionals' burnout status, particularly in Eastern Ethiopia. Therefore, this study is aimed at determining the prevalence of burnout and associated factors among health professionals working at governmental health facilities in Eastern Ethiopia.

Method

An institutional-based cross-sectional study was conducted among health professionals using structured self-administered validated questionnaires using the Maslach Burnout Inventory scale. Data were entered into Epi-Data version 3.1 and exported to SPSS version 22 for analysis. Multivariable logistic regression was used to determine the association between burnout and its predictors.

Results

A total of 508 health professionals were approached, out of which 501 participated (a response rate of 98.4%). The magnitude of burnout was 54.1 with a 95% confidence interval of 49.9-58.0%. Working in a hospital (AOR = 3.55, 95%CI: 2.00, 6.33), age >/= 40 (AOR = 3.98, 95%CI:1.60, 9.89) and 30-39 years (AOR = 1.90, 95%CI:1.08, 3.34), being female(AOR = 2.41, 95%CI: 1.37, 4.25), being widowed (AOR = 3.39, 95%CI: 1.13, 10.18), having intention of leaving work (AOR = 2.28, 95%CI: 1.35, 3.87), using at least one substance (AOR = 2.24, 95%CI: 1.36, 3.69), having a 6-11 years of experience (AOR = 2.17, 95%CI: 1.15, 4.06), having no job supervision (AOR = 4.65, 95%CI: 2.07, 10.43), monthly payment <10,000 Ethiopian Birr (AOR = 5.69, 95%CI: 2.30, 14.07) and between 10,000 to 15,000 Ethiopian Birr (AOR = 2.74, 95%CI: 1.22, 6.15), working in Pediatric Unit (AOR = 3.28, 95%CI: 1.24, 8.70), and profession type (Midwifery, Public health officer, Medical Laboratory professionals) were factors significantly associated with burnout.

Conclusion

Burnout affected more than half of the health professionals working in governmental health facilities in Dire Dawa. Health facility type, age, sex, marital status, intention to leave work, substance use, work experience, job supervision, monthly payment, profession type, and working unit were significantly associated predictors of burnout.

Investigation of the relationship between working conditions and career barriers of nurses

BACKGROUND: Nurses are the largest part of a country’s healthcare workforce and need to improve themselves professionally and plan careers. If we know the career barriers, it will guide the solution suggestions on this issue. OBJECTIVE: To investigate the relationship between working conditions and career barriers experienced by nurses. METHODS: This study was conducted using the descriptive type research design involving 379 nurses working in a province of Turkey between May and June 2020. Data were collected using the Sociodemographic Characteristics Form and the Career Barriers in Nursing Scale. RESULTS: Of the participants scores, 37.21±12.1 were in the “organizational culture and policies” subscale, 17.46±6.0 in the “personal preferences and perceptions” subscale, 10.97±4.5 in the “negative thoughts about the profession” subscale, 8.37±3.0 in the “stereotypical biases” subscale, and 16.20±5.2 in the “multiple roles” subscale. The average total score of career barriers in nursing was 90.23±27.1. CONCLUSION: A significant but weak negative correlation was found between the total average of the Career Barriers in Nursing Scale score and age (r = –0.121; p = 0.019), graduation date (r = –0.025; p = 0.120), and working time (r = –0.019; p = 0.115). No significant correlation was found between working time in the current institution, average working time per week, and total of the Career Barriers in Nursing Scale score.

Occupational Stress and the Quality of Life of Nurses in Infectious Disease Departments in China: The Mediating Role of Psychological Resilience

Aim

We aim to explore the impact of occupational stress on the quality of life of nurses in infectious disease departments and to explore the mediating role of psychological resilience on this impact.

Background

Sudden public health events and the prevalence of infectious diseases give nurses in infectious disease departments a heavy task load and high occupational stress, which can affect their quality of life, and which is closely related to the quality of clinical care they provide. There are few existing studies on occupational stress, psychological resilience, and the quality of life of nurses in infectious disease departments.

Methods

We collected data from infectious-disease-specialized hospitals or infectious disease departments of general hospitals in China. In total 1,536 nurses completed questionnaires: the Effort-Reward Imbalance Questionnaire, the Connor-Davidson Resilience Scale, and the World Health Organization Quality of Life Brief Scale. We use a structural equation model to test the mediating role of the psychological resilience in the relationship between occupational stress and quality of life.

Results

Among 1,536 participants, 88.2% experienced an effort-reward imbalance. The average scores for psychological resilience and quality of life were 56.06 (SD = 14.19) and 51.80 (SD = 8.23), respectively. Our results show that occupational stress is negatively correlated with psychological resilience (r = -0.28, p < 0.01) and quality of life (r = -0.44, p < 0.01). In addition, we find that psychological resilience is positively correlated with quality of life (r = 0.55, p < 0.01) and that the indirect effect of occupational stress on quality of life through psychological resilience is significant (β = -0.036, 95% CI: 0.027 to 0.426), indicating at least a partial mediating role of psychological resilience.

Conclusion

A high proportion of nurses in infectious disease departments felt that their jobs' effort-reward imbalance was high. These nurses' scores for psychological resilience were in the middle level among Chinese people generally, but their quality of life was lower than the Chinese norm. We conclude that occupational stress has an important impact on their quality of life, and psychological resilience plays a partial mediating role on this impact.

Implications for Nursing Management

Hospital managers can benefit from paying attention to the occupational stress of nurses and helping to improve the quality of life of nurses by alleviating this occupational stress and improving psychological resilience.

Longitudinal survey on the Psychological Impact of the COVID-19 Pandemic in Healthcare Workers (PsyCOVer) in France: study protocol

INTRODUCTION

In the pandemic, healthcare professionals face even higher levels of stress. It is therefore a priority to estimate the impact of the pandemic on mental health and to propose targeted strategies to improve resilience. The aims of the study were to (1) assess the mental health of healthcare professionals working with patients with COVID-19 and identify social determinants that may increase the risk of negative outcomes; and (2) test the effectiveness of an intervention to improve the resilience of healthcare professionals in France.

METHODS AND ANALYSIS

To evaluate the first objective, a national longitudinal study will be carried out among healthcare professionals working with patients with COVID-19. Participants will be recruited via an internet link that will be widely disseminated on social media, mailing lists, medical boards and French medical journals. Primary outcomes are mental health distress/symptoms and resilience. Secondary outcomes are burnout, social and occupational supports and substance use. To meet the second objective, an interventional study will be conducted. The main outcome is the effectiveness of the PsySTART-Responder and the Anticipate.Plan.Deter program. Qualitative analyses will be conducted to understand the strategies used to cope with the pandemic.

ETHICS AND DISSEMINATION

The study protocol was approved by the Sorbonne Université Ethical Committee (No 2020-CER-2020-27) and was declared to French Commission on Information Technology and Liberties, CNIL (N°2222413, 20-05-2021). The results of this study will provide a better understanding of mental health and social inequalities in mental health among healthcare professionals working in the pandemic; data about the effectiveness of the PsySTART-Responder and the Anticipate.Plan.Deter interventional program in France.

Role Stress and Psychological Distress Among Chinese Nurses During the COVID-19 Pandemic: A Moderated Mediation Model of Social Support and Burnout

OBJECTIVE

Nurses are at high risk of psychological distress including stress, depression, and anxiety due to low personnel density and high work demand. Despite mounting evidence showing that role stress is a risk factor for nurses' psychological distress, the mediating and moderating mechanisms underlying this relationship are less known. This study tests the mediation effect of burnout in the association between role stress and psychological distress, and whether this mediation is moderated by social support.

METHODS

A sample of 623 Chinese nurses were recruited from all hepatological surgery departments in Hunan Province and filled out an online questionnaire to collect data on socio-demographics, role stress, burnout, psychological distress, and social support. Mediation and moderation analyses were carried out in SPSS macro-PROCESS.

RESULTS

Burnout partially mediated the positive association between role stress and psychological distress. Social support moderated the indirect effect of role stress on psychological distress via burnout, with the effect being stronger for nurses with low social support than those with high social support.

CONCLUSIONS

These findings demonstrated how role stress contributed to nurses' psychological distress both directly and indirectly through burnout, and how this indirect effect was moderated by social support. The results provide important practical implications for future prevention and intervention programs to improve nurses' mental health from multiple aspects such as decreasing role stress and burnout while increasing social support.

Risk factors for digital stress in German public administrations

OBJECTIVE

As the digitization of the working world progresses, the demands on employees change. Not least, this is true for the setting of public administrations in Germany, which is currently affected by the transformation to E-Government. This study aims to identify and describe a risk cluster of digitally stressed employees in public administrations.

METHODS

An online sample of 710 employees from three public administrations in North Rhine-Westphalia were surveyed about digital stress (7 items) and several potential risk factors (19 items) derived from the current research. In the first step, a hierarchical agglomerative cluster analysis is used to detect the risk cluster. This is followed by a comparison to the group of the remaining employees regarding their risk profiles.

RESULTS

The analysis states that the digitally stressed cluster accounts for approximately ten percent of the public administration's employees of the total sample. Employees in the risk cluster are less satisfied with on-site work overall, experience less collegial support on-site, experience less collegial support in the home office, resign more often, are more likely to feel overwhelmed, are less educated, are older in age and more often have relatives in need of care.

CONCLUSION

This work was able to identify and describe a group of digitally stressed rather than left-behind employees in public administrations to bring awareness to potentially destructive factors in the digital transformation process but eventually to social inequalities. The findings offer the basis for interventions to arise and evoke potential for further research.

The Experience of Emotional Labor and Its Related Factors among Nurses in General Hospital Settings in Republic of Korea: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis aimed to investigate the status of emotional labor and its related factors among nurses in general hospital settings in Korea. A total of seven electronic databases were comprehensively searched to find relevant cross-sectional studies published up to 28 January 2021. The meta-analysis was performed using Stata version 13.1. In total, 131 studies were included. The population showed a standardized mean difference of 3.38 (95% confidence interval, 3.34 to 3.42) in emotional labor assessed by a 1–5 Likert scale. The level of emotional labor had significant negative correlations with job satisfaction, social support, organizational engagement, coworker support, resilience, and nurses’ work environment, while it had significant positive correlations with emotional labor and burnout, turnover intention, and job stress. Although the methodological quality of the included studies was generally good, 24 of the included studies (18.32%) were evaluated as lacking generalization potential or otherwise as unclear. In conclusion, nurses in general hospital settings in Korea experience mild-to-moderate levels of emotional labor. There is some evidence that the emotional labor of nurses and its detrimental effects can be buffered at both the individual and hospital levels, and future research should focus on developing targeted interventions and evaluating their effectiveness.

Effect of Psychological Capital of Volunteers on Volunteering Behavior: The Chained Mediation Role of Perceived Social Support and Volunteer Motivation

This study explored the role of perceived social support and voluntary motivation in the effect of psychological capital of volunteers on volunteering behavior. A sample of 1,165 volunteers who were registered in the China Voluntary Service Information System was investigated using a self-reported questionnaire, showing that the psychological capital, perceived social support, voluntary motivation, and volunteering behavior of the volunteers were significantly and positively related to each other. The psychological capital of the volunteers affected volunteering behavior not only directly, but also indirectly through the mediating role of voluntary motivation. Moreover, perceived social support and voluntary motivation also played a chain role in the relationship between the psychological capital and volunteering behavior of the volunteers. Therefore, increasing the psychological capital of the volunteers should promote their perceived social support and inspire voluntary motivation, in turn affecting their volunteering behavior.

The Mediating Role of Resilience in the Relationship between Perceived Stress and Mental Health

The COVID-19 pandemic has created great uncertainty around the world, and due to the pandemic, nurses have been exposed to an increase in highly stressful clinical situations. This study examines the relationships between perceived stress and emotional disorders among nurses who have provided direct patient care during the COVID-19 pandemic and explores the mediating role of resilience in these relationships. In an online cross-sectional design, we asked Spanish nurses (N = 214) to complete self-reported scales, and we performed correlation and mediation analyses between perceived stress (Perceived Stress Scale, PSS-4), resilience (Wagnild Resilience Scale, RS-14), wellbeing (World Health Organization Wellbeing Index, five items, WHO-5), anxiety (PHQ-2) and depression (GAD-2). The nurses self-reported moderate levels of perceived stress, considerable psychological distress and high resilience. We found resilience to be significantly negatively correlated with the reported levels of perceived stress, anxiety and depression (p < 0.001). The mediating analysis revealed that resilience played a protective role in the direct relationships of stress with depression, anxiety, and psychological distress. To conclude, our findings supported the hypothesis that resilience mediated the relationship between stress and mental health.

Anxiety effects on quality of life during the COVID-19 outbreak: A parallel-serial mediation model among nurses in Turkey

BACKGROUND

Nurses experience loneliness, anxiety, fear, fatigue, sleep disorders, and other physical and mental health problems due to their close contact with patients in cases of epidemic diseases. Among nurses in Turkey, we want to explore how anxiety, psychological health, and social isolation affect nurses' quality of life.

OBJECTIVES

This study aimed to investigate the effects of the COVID-19 pandemic on the quality of life (COVID-19 EQLS), State-Trait Anxiety Inventory (STAI-1 and STAI-2), psychological health, and social isolation among nurses. It also aimed to identify whether the influence of trait anxiety, psychological health, and social isolation are stronger than the direct influence of state anxiety on nurses' quality of life during the pandemic.

METHODS

A cross-sectional study design and STROBE guidelines were implemented. In this study, 638 nurses in Turkey were included using simple random sampling. The participants completed the STAI-1 and STAI-2 and COVID-19 EQLS online-form. The parallel-serial mediation model was used to examine the relationships between the determined variables.

RESULTS

Psychological health, psychological effects of social isolation, and trait anxiety fully mediated the relationship between state anxiety and quality of life of nurses. The total indirect effect of the confidence interval of bootstrapping was statistically different from zero.

CONCLUSIONS

Trait anxiety, psychological health, and social isolation were the main factors with statistically significant indirect effects on the quality of life of Turkish nurses in this study.