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Dunning A, Hartley H, Unsworth K, Simms-Ellis R, Dunn M, Grange A, Murray J, Marran J, Lawton R. Nurses' experiences and sense making of COVID-19 redeployment and the impact on well-being, performance, and turnover intentions: A longitudinal multimethod study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 7:100244. [PMID: 39391563 PMCID: PMC11465193 DOI: 10.1016/j.ijnsa.2024.100244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 09/11/2024] [Accepted: 09/20/2024] [Indexed: 10/12/2024] Open
Abstract
Background During Covid-19 nurses were redeployed to new teams and specialties at a level never previously experienced. Little is known about how nurses made sense of and coped with this situation and what we can learn from this for future redeployment approaches. Objectives We sought to understand how nurses made sense of ongoing redeployment during the COVID-19 pandemic and how this related to their psychological distress, burnout, turnover intentions, and perceived performance. Design A longitudinal multi-method design. (ISRCTN: 18,172,749). Settings Three acute National Health Service (NHS) Trusts in England, selected for diversity in geographical location and ethnicity, with different COVID-19 contexts. Participants Sixty-two nurses (90 % female; 83 % white) who experienced different types of redeployment during the pandemic, with an average of 17 year's post-registration experience (mean age 41 years). Methods We gathered both interview and survey data from 62 nurses across two or three time points in 2020-2021 and sought to find commonalities and differences in patterns of experience using Pen Portrait analysis. Results The pandemic redeployment process was life-changing for all nurses, personally and professionally. The research uncovered an intertwined pattern of identity and sensemaking as nurses coped with COVID-19 redeployment. Three sensemaking 'journeys' were evident, involving professional identity as a nurse and identification with one's organisation. Nurses in journey one: 'Organisational Identification and Professional Identity Maintained' (n = 28) had the best outcomes for wellbeing, burnout, performance, and retention. Those experiencing the 'Devaluation of Organisational Identification But Maintenance of Professional Identity' journey (n = 24) maintained their professional identity, but their organisational identification deteriorated. Journey three nurses: 'Devaluation of both Organisational Identification and Professional Identity' (n = 10) had the worst outcomes for wellbeing, burnout, performance, and retention. A salient nurse identity triggered stoicism and resilient behaviours while external cues of control, support and contextual awareness affected organisational identification. Conclusions Nurses made sense of their experiences of redeployment during Covid-19 differently which, in turn affected their outcomes. Given the stark differences in how nurses perceived their psychological distress, burnout, turnover intentions and performance across the journeys, the importance of understanding the cues (e.g. having autonomy) associated with each journey is apparent. Thus, our research provides clear guidance for managers to help them support nurses during redeployment.
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Affiliation(s)
- Alice Dunning
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, University of Sheffield, Sheffield, S1 4DA UK
| | - Hannah Hartley
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK
| | - Kerrie Unsworth
- Leeds University Business School, University of Leeds, Leeds, LS6 1AN, UK
| | - Ruth Simms-Ellis
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Michael Dunn
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, 117597, Singapore
| | - Angela Grange
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK
| | - Jenni Murray
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK
| | - Jayne Marran
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK
| | - Rebecca Lawton
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
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Kim M, Jun J, Lambert J, Duah H, Tucker SJ, O'Mathúna DP, Pignatiello G, Fitzpatrick JJ. Generational Differences in Moral Injury, Resilience, and Well-Being Among Nurses: Predictors of Intention to Leave Position and Profession. West J Nurs Res 2024:1939459241287458. [PMID: 39400242 DOI: 10.1177/01939459241287458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2024]
Abstract
BACKGROUND The COVID-19 pandemic highlighted the negative impact of moral injury on nurses' well-being. However, there is a lack of research about generational differences among nurses, particularly on newer nurses who have been identified as having a higher rate of intention to leave. OBJECTIVE This study examines generational differences among nurses on moral injury, well-being, resilience, and intention to leave their nursing position and profession. METHODS This is a secondary analysis of cross-sectional data from registered nurses in clinical practice in Ohio between July and August 2021. Data on demographics, moral injury, resilience, and well-being were collected using an online survey. Participants were categorized into 4 generational groups based on their age in 2021: Baby Boomers (57-75 years old), Generation X (42-56 years old), Generation Y (27-41 years old), and Generation Z (12-26 years old). Descriptive and inferential statistics, including logistic regression and analysis of variance, were employed for analysis. RESULTS Significant generational differences were found in years of clinical experience, moral injury, resilience, and well-being. Baby Boomers reported higher well-being and resilience and lower moral injury. Notably, the intention to leave the profession was more strongly associated with well-being and moral injury levels than with the years of experience or generational group. CONCLUSIONS The findings suggest that interventions to improve nurse retention should prioritize enhancing well-being and addressing the root causes of moral injury. Tailored strategies addressing the needs of different generations are necessary for mitigating the adverse effects of current healthcare challenges on nurse attrition.
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Affiliation(s)
- Minjin Kim
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Jin Jun
- College of Nursing, The Ohio State University, Columbus, OH, USA
| | - Joshua Lambert
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Henry Duah
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Sharon J Tucker
- Department of Nursing Practice, College of Nursing, University of Central Florida, Orlando, FL, USA
| | | | - Grant Pignatiello
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Joyce J Fitzpatrick
- Marian K. Shaughnessy Nurse Leadership Academy, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
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Kaplow R, Willis P, Steele D, Swann J, Feistritzer NR. Clinician Wellbeing and Mental Health Assessment Across Two Acute Care Hospitals During the COVID-19 Pandemic. Nurs Adm Q 2024; 48:325-335. [PMID: 39213406 DOI: 10.1097/naq.0000000000000645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
OBJECTIVE The purposes of this study were to determine whether positive work environments affect clinician wellbeing and mental health, and to identify participants' priority interventions to improve clinician wellbeing. This study was designed to determine the potential benefit of modifying the aforementioned factors for clinicians and hospitals to impact positive patient outcomes. BACKGROUND The SARS-CoV-2 virus pandemic has become one of the leading causes of death in the United States and worldwide, and has exacerbated widespread burnout among health care professionals. This has resulted in negative collateral implications for the stability of the clinician workforce. A Clinician Wellbeing study (CWS) was launched in two Magnet®-designated hospitals in the southeast. The CWS was part of a multi-site collaborative research project led by the Center for Health Outcomes and Policy Research (CHOPR) at the University of Pennsylvania School of Nursing. METHOD A cross-sectional observational study design was implemented. Data were collected through anonymous surveys of 708 registered nurses (RNs) and advanced practice providers (APPs) working in two Magnet hospitals in the southeastern United States. Each participant completed 8 surveys. RESULTS Clinicians' self-reported level of burnout was higher for both RNs and APPs at Emory University Hospital than Emory Saint Joseph's Hospital including intent to leave and dissatisfaction with their jobs. RNs and APPs self-reported their overall health to be good or excellent and they reported sleep quality as fair. Both groups in both hospitals indicated that they experienced anxiety, depression, and stress. The APPs reported a higher percent that their work did not leave enough time for personal and family life. Data also indicated that the primary work environment concern was related to inadequate nurse staffing. CONCLUSIONS The data illuminated opportunities for the two hospitals to employ continuous improvement interventions to positively transform the work environment.
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Affiliation(s)
- Roberta Kaplow
- Author Affiliations: Emory University Hospital (Dr Kaplow, Ms Willis, and Dr Feistritzer), Atlanta, Georgia; Emory Saint Joseph's Hospital (Dr Steele and Ms Swann), Atlanta, Georgia; Emory Wesley Woods Hospital (Dr Feistritzer), Atlanta, Georgia; Emory Nell Hodgson Woodruff School of Nursing (Dr Feistritzer), Atlanta, Georgia
- Emory Saint Joseph's Hospital (Dr Steele and Ms Swann), Atlanta, Georgia
- Emory Wesley Woods Hospital (Dr Feistritzer), Atlanta, Georgia
- Emory Nell Hodgson Woodruff School of Nursing (Dr Feistritzer), Atlanta, Georgia
| | - Polly Willis
- Author Affiliations: Emory University Hospital (Dr Kaplow, Ms Willis, and Dr Feistritzer), Atlanta, Georgia; Emory Saint Joseph's Hospital (Dr Steele and Ms Swann), Atlanta, Georgia; Emory Wesley Woods Hospital (Dr Feistritzer), Atlanta, Georgia; Emory Nell Hodgson Woodruff School of Nursing (Dr Feistritzer), Atlanta, Georgia
- Emory Saint Joseph's Hospital (Dr Steele and Ms Swann), Atlanta, Georgia
- Emory Wesley Woods Hospital (Dr Feistritzer), Atlanta, Georgia
- Emory Nell Hodgson Woodruff School of Nursing (Dr Feistritzer), Atlanta, Georgia
| | - Dinah Steele
- Author Affiliations: Emory University Hospital (Dr Kaplow, Ms Willis, and Dr Feistritzer), Atlanta, Georgia; Emory Saint Joseph's Hospital (Dr Steele and Ms Swann), Atlanta, Georgia; Emory Wesley Woods Hospital (Dr Feistritzer), Atlanta, Georgia; Emory Nell Hodgson Woodruff School of Nursing (Dr Feistritzer), Atlanta, Georgia
- Emory Saint Joseph's Hospital (Dr Steele and Ms Swann), Atlanta, Georgia
- Emory Wesley Woods Hospital (Dr Feistritzer), Atlanta, Georgia
- Emory Nell Hodgson Woodruff School of Nursing (Dr Feistritzer), Atlanta, Georgia
| | - Julie Swann
- Author Affiliations: Emory University Hospital (Dr Kaplow, Ms Willis, and Dr Feistritzer), Atlanta, Georgia; Emory Saint Joseph's Hospital (Dr Steele and Ms Swann), Atlanta, Georgia; Emory Wesley Woods Hospital (Dr Feistritzer), Atlanta, Georgia; Emory Nell Hodgson Woodruff School of Nursing (Dr Feistritzer), Atlanta, Georgia
- Emory Saint Joseph's Hospital (Dr Steele and Ms Swann), Atlanta, Georgia
- Emory Wesley Woods Hospital (Dr Feistritzer), Atlanta, Georgia
- Emory Nell Hodgson Woodruff School of Nursing (Dr Feistritzer), Atlanta, Georgia
| | - Nancye R Feistritzer
- Author Affiliations: Emory University Hospital (Dr Kaplow, Ms Willis, and Dr Feistritzer), Atlanta, Georgia; Emory Saint Joseph's Hospital (Dr Steele and Ms Swann), Atlanta, Georgia; Emory Wesley Woods Hospital (Dr Feistritzer), Atlanta, Georgia; Emory Nell Hodgson Woodruff School of Nursing (Dr Feistritzer), Atlanta, Georgia
- Emory Saint Joseph's Hospital (Dr Steele and Ms Swann), Atlanta, Georgia
- Emory Wesley Woods Hospital (Dr Feistritzer), Atlanta, Georgia
- Emory Nell Hodgson Woodruff School of Nursing (Dr Feistritzer), Atlanta, Georgia
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Füreder N, Herber G, Stadlmayr E. [Should I Stay or Should I go? Resilience, Intention to Quit and Job Satisfaction among Nurses in Intensive Care Units]. DAS GESUNDHEITSWESEN 2024. [PMID: 39353605 DOI: 10.1055/a-2389-8453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2024]
Abstract
AIM Addressing the global nursing shortage is crucial to both national and international public health efforts. This paper aims to highlight the importance of resilience and its impact on primary care nurses' job satisfaction and intentions to quit, especially in the face of current challenges. METHODS The study utilized a mixed methods design involving nurses in intensive care units of a university hospital in Austria. In the first phase of data collection, qualitative focus group interviews were conducted to gather insights on the current challenges and stressors faced by nursing professionals. Building on relevant literature, a quantitative survey was then administered to all nurses, using scales measuring resilience, intention to quit, and job satisfaction in order to examine the relationships between these variables. In addition, a data structuring of the resilience scale by factors was achieved with the help of confirmatory factor analysis. Subsequently, the correlations of the resilience factors with the other variables were examined by means of an additional correlation, regression and mediation analysis. RESULTS The results showed negative correlations with regard to resilience and intention to quit as well as with regard to job satisfaction and intention to quit. In contrast, job satisfaction and resilience correlated significantly positively with each other. The negative correlation between resilience and the intention to quit was confirmed, but only for the factors "goal focus" and "pride and commitment". A closer examination of the two factors and their associated items revealed a connection to both professional identity and organizational identity. CONCLUSION This study provides valuable insights for health care leaders and health care decision makers to effectively lead, develop, and thereby retain primary care nurses. The authors argue that improving resilience and strengthening organizational identity are important influencing factors in increasing job satisfaction and reducing nurses' intention to quit.
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Affiliation(s)
- Nina Füreder
- Linz Institute for Transformative Change, Johannes Kepler Universität, Linz, Austria
- Juniorprofessur für Europäisches Management, Technische Universität Chemnitz, Germany
| | - Gabriele Herber
- Personalplanung und -controlling, Kepler Universitätsklinikum GmbH, Linz, Austria
| | - Elke Stadlmayr
- Operative Intensivmedizin, Kepler Universitätsklinikum Med Campus III, Linz, Austria
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Willgerodt MA, Tanner A, McCabe E, Jameson B, Brock D. Public School Nurses in the United States: National School Nurse Workforce Study 2.0. J Sch Nurs 2024; 40:468-481. [PMID: 38751376 DOI: 10.1177/10598405241253565] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2024] Open
Abstract
The National School Nurse Workforce Study 2.0 describes the demographic characteristics and distribution patterns, school nursing models and activities, and practice environment among self-reported public school nurses in the United States. A random sample of U.S. public schools was surveyed, stratified by region, school level, and urban/rural locale. A total of 2,827 schools responded, yielding a 38.1% response rate. Using these data, we estimate 78,869 full-time equivalents of school nurses, with 65,052 registered nurses (RN) and 13,817 licensed practical/vocational nurses (LPN/LVN). Findings indicate school nurse distribution differences by region, locale, and income. The predominant model of school nursing practice was the RN only, followed by the RN and LPN model. In general, school nurse respondents felt supported by school staff and parents. Less than half of survey respondents stated they were supervised by an RN. Research, policy, and school nursing practice implications are discussed.
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Affiliation(s)
| | - Andrea Tanner
- National Association of School Nurses, Silver Spring, MD, USA
| | - Ellen McCabe
- Hunter College, Hunter-Bellevue School of Nursing, The City University of New York, New York, New York, USA
| | - Beth Jameson
- Seton Hall University College of Nursing, Nutley, USA
| | - Doug Brock
- School of Nursing, University of Washington, Seattle, WA, USA
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Zink M, Pischke F, Wendsche J, Melzer M. Managing the work stress of inpatient nurses during the COVID-19 pandemic: a systematic review of organizational interventions. BMC Nurs 2024; 23:691. [PMID: 39334052 PMCID: PMC11437825 DOI: 10.1186/s12912-024-02358-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 09/18/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND During the coronavirus disease 2019 (COVID-19) pandemic, inpatient nurses faced various work stressors. Little is known about organizational interventions that can mitigate the negative consequences of pandemic-related stressors. OBJECTIVE The aim was to provide a synopsis of the literature concerning the types and outcomes of organizational interventions performed during the COVID-19 pandemic that directly (re)organized the work structures of inpatient nurses to address pandemic-related work stressors or to increase nurses' ability to cope. METHODS Within this preregistered systematic literature review, we searched four databases (PubMed, PsycINFO, PsycARTICLES, CINAHL) and two preprint databases (MedRxiv, PsyArXiv) for interventional studies of organizational interventions published between 01/2020 and 03/2023 (k = 990 records). We included 12 primary studies after title-abstract and full-text screening. A synthesis of results without meta-analysis was conducted. Risk of bias was assessed with the Cochrane risk-of-bias tool for randomized trials - version 2 (RoB-2) and Risk Of Bias In Non-randomized Studies - of Interventions (ROBINS-I) tool. RESULTS All interventions were implemented in hospitals. The reasons given for implementation included pandemic-related work stressors such as a high workload, understaffing, and a lack of medical resources. To respond to the various work stressors, half of the studies took a multilevel approach combining organizational and person-oriented interventions (k = 6). Most studies (k = 8) took a secondary prevention approach, focusing on the organization of rest breaks (k = 5). With respect to outcomes, the studies examined nurse-related stress and resilience, turnover intention, job satisfaction, and other factors. Risk-of-bias analyses revealed that conclusions about the effectiveness of the interventions are limited due to confounding factors and self-selection. CONCLUSIONS The identified interventions provide a basis for future research to draw conclusions on the effectiveness of organizational interventions during pandemics. The promotion of adequate work breaks could be useful if the work stressors associated with strain and negative consequences cannot be changed directly. However, the same stressors (e.g., high workload) can hinder nurses from participating in offered interventions. This emphasizes the importance of directly addressing inpatient nurses' work stressors. REGISTRATION Prospero-ID CRD42023364807 (March 2023).
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Affiliation(s)
- Maria Zink
- Federal Institute for Occupational Safety and Health (BAuA), Dresden, Germany.
| | | | - Johannes Wendsche
- Federal Institute for Occupational Safety and Health (BAuA), Dresden, Germany
| | - Marlen Melzer
- Federal Institute for Occupational Safety and Health (BAuA), Dresden, Germany
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Hundt NE, Kim B, Plasencia M, Amspoker AB, Walder A, Yusuf Z, Nagamoto H, Tsao CGJ, Smith TL. Factors associated with successful FLOW implementation to improve mental health access: a mixed-methods study. Transl Behav Med 2024:ibae050. [PMID: 39326034 DOI: 10.1093/tbm/ibae050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2024] Open
Abstract
The FLOW program assists mental health providers in transitioning recovered and stabilized specialty mental health (SMH) patients to primary care to increase access to SMH care. In a recent cluster-randomized stepped-wedge trial, nine VA sites implemented the FLOW program with wide variation in implementation success. The goal of this study is to identify site-level factors associated with successful implementation of the FLOW program, guided by the Consolidated Framework for Implementation Research (CFIR). We used the Matrixed Multiple Case Study method, a mixed-methods approach, to compare key metrics hypothesized to impact implementation that were aligned with CFIR. Based upon the number of veterans transitioned at each site, we categorized two sites as higher implementation success, three as medium, and four as lower implementation success. Themes associated with more successful implementation included perceptions of the intervention itself (CFIR domain Innovation), having a culture of recovery-oriented care and prioritizing implementation over competing demands (CFIR domain Inner Setting), had lower mental health provider turnover, and had an internal facilitator who was well-positioned for FLOW implementation, such as having a leadership role or connections across several clinics (CFIR domain Characteristics of Individuals). Other variables, including staffing levels, leadership support, and organizational readiness to change did not have a consistent relationship to implementation success. These data may assist in identifying sites that are likely to need additional implementation support to succeed at implementing FLOW.
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Affiliation(s)
- Natalie E Hundt
- VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
- VA South Central Mental Illness Research, Education and Clinical Center, A virtual center, Houston, TX, USA
| | - Bo Kim
- Department of Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
- HSR&D Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, 2 Ave de Lafayette, Boston, MA 02111, USA
- Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Maribel Plasencia
- VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
- VA South Central Mental Illness Research, Education and Clinical Center, A virtual center, Houston, TX, USA
| | - Amber B Amspoker
- VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA
- Department of Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
| | - Annette Walder
- VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA
| | - Zenab Yusuf
- VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA
| | - Herbert Nagamoto
- VA Rocky Mountain Network, Denver, 4100 E Mississippi Ave, Denver, CO 80246, USA
- University of Colorado School of Medicine, Denver, 13001 E 17th Pl, Aurora, CO 80045, USA
| | - Christie Ga-Jing Tsao
- VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA
| | - Tracey L Smith
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
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Rafferty A, Haase K, Gagnon M, Havaei F. Understanding Nurse Retention at a Mental Health and Addictions Facility During a Dual Pandemic. Can J Nurs Res 2024:8445621241283227. [PMID: 39295287 DOI: 10.1177/08445621241283227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic exposed nurses to new and more severe workplace stressors; exposure to these workplace stressors has exacerbated nurse turnover. Nurses working in mental health and substance use (MHSU) have also experienced the unique stressor of the overdose crisis in British Columbia (BC). MHSU nurses have been at the forefront of working to manage these dual emergencies. There is limited evidence related to the compounding effect of COVID-19 and the overdose crisis on nursing turnover. Understanding the unique conditions that MHSU nurses are currently experiencing and what factors influence a nurse's intention to stay in or leave a healthcare facility is essential in developing strategies to minimize turnover and maximize retention. PURPOSE To explore the factors that affect nurse turnover while working through the dual emergencies within a MHSU facility in BC, Canada. METHODS A qualitative descriptive approach with an inductive, descriptive thematic analysis guided this quality improvement project. RESULTS Findings were grouped into two main themes: reasons for leaving and reasons for staying. Reasons for leaving included workplace safety, seeking new opportunities, lack of support, and being short-staffed. Reasons to stay encompassed connections with clients, leaders and colleagues, support from colleagues and leaders, and feeling valued, safe, and heard. CONCLUSIONS Perceived personal safety and protection from workplace violence were found to increase the likelihood of intent to leave and turnover among nurses. Further, psychosocial safety and connection among nurses and health leaders were found to decrease the likelihood of turnover.
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Affiliation(s)
| | - Kristen Haase
- School of Nursing, University of British Columbia, Canada
| | | | - Farinaz Havaei
- School of Nursing, University of British Columbia, Canada
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9
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Ghaljaei F, Najafi F. Experiences of family caregivers of nurses infected with COVID-19: a qualitative study. BMC Nurs 2024; 23:631. [PMID: 39256680 PMCID: PMC11389317 DOI: 10.1186/s12912-024-02320-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 09/03/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND Nurses, as the main healthcare workers during the COVID-19 pandemic, were at high risk of contracting the disease. Family caregivers played a vital role in the support and recovery of patients with COVID-19. The experiences of family caregivers of nurses are very important due to the nature of their job. However, little information is available in this field. To this end, the present study aimed to explore the experiences of family caregivers of nurses who recovered from COVID-19. METHODS This descriptive qualitative study was conducted in one of the hospitals in southeastern Iran in 2022. The participants were 12 family caregivers of nurses who recovered from COVID-19 and were selected through purposive sampling. The data were collected through semi-structured interviews and analyzed using conventional content analysis. The Consolidated Criteria for Reporting Qualitative research checklist was used to report the findings. RESULTS The analysis of the data revealed psychosocial consequences as main theme, three categories and nine subcategories including negative emotions and attitudes (fear of deterioration/death, fear of frequent infection, fear of transmitting infection to others, despair of recovery, Changing attitudes toward the nursing profession), caregiver burden (role conflict, economic pressure) and lack of support, ineffective interactions and isolation (Lack of support from nursing managers and colleagues, ineffective interactions and isolation). CONCLUSION Like other caregivers, family caregivers of nurses recovered from COVID-19 experienced psychosocial consequences and a heavy burden of responsibility. However, what differentiates our findings from the results reported in previous studies is the change in caregivers' attitudes toward nursing and regret for their family members being nurses. The lack of support from medical staff and managers for nurses, the condition of nurses frequently contracting COVID-19 due to the nature of their profession, and the fear of transmitting the infection to others due to contact with COVID-19 patients in the workplace expose these caregivers to additional stress and many risks. Thus, these caregivers need more attention and support in similar situations; an issue that seems to have been neglected during the COVID-19 pandemic.
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Affiliation(s)
- Fereshteh Ghaljaei
- Community Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Fereshteh Najafi
- Community Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
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10
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Qiu P, Yan L, Zhang Q, Guo S, Liu C, Liu H, Chen X. Organizational display rules in nursing: Impacts on caring behaviors and emotional exhaustion through emotional labor. Int Nurs Rev 2024; 71:571-579. [PMID: 37605252 DOI: 10.1111/inr.12876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/04/2023] [Indexed: 08/23/2023]
Abstract
AIM To examine the impact of display rules on nurses' caring behaviors and emotional exhaustion and the mediating role of emotional labor (surface/deep acting). BACKGROUND Hospitals often implement emotional display rules for nurses with the expectation of performance benefits. However, these rules may have an impact on nurses' caring behaviors and emotional exhaustion. METHODS This cross-sectional correlational study included a sample of 746 nurses from five hospitals and used the STROBE checklist. Relationships between display rules, emotional labor, caring behaviors, and emotional exhaustion were analyzed using structural equation modeling. RESULTS Display rules did not directly affect caring behaviors or emotional exhaustion. Emotional labor mediated the relationships. Display rules were associated more with surface acting. Deep acting increased caring behaviors and reduced emotional exhaustion; surface acting had the opposite effect. CONCLUSIONS Findings challenge the assumption that display rules effectively promote caring behaviors. Display rules lead to emotional labor and emotional exhaustion. Reducing display rules, emotional labor, and surface acting while supporting deep acting may alleviate emotional exhaustion. IMPLICATIONS FOR NURSING AND HEALTH POLICY Nurse managers should review the nature and implementation of emotional display rules and explore ways to reduce emotional labor, encourage deep acting, mitigate the negative impact of surface acting, and ultimately improve nursing caring behaviors.
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Affiliation(s)
- Pingping Qiu
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Liting Yan
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Qianmin Zhang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Shengbin Guo
- Nursing Department, Fujian Province Maternal and Child Health Hospital, Fuzhou, China
| | - Chenyin Liu
- Nursing Department, Fujian Province Maternal and Child Health Hospital, Fuzhou, China
| | - Huijing Liu
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Xinchen Chen
- School of Nursing, Fujian Medical University, Fuzhou, China
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Kim S, Rochette A, Ahmed S, Archambault PS, Auger C, Battaglini A, Freeman AR, Kehayia E, Kinsella EA, Larney E, Letts L, Nugus P, Raymond MH, Salbach NM, Sinnige D, Snider L, Swaine B, Tousignant-Laflamme Y, Thomas A. Creating synergies among education/research, practice, and policy environments to build capacity for the scholar role in occupational therapy and physiotherapy in the Canadian context. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024; 29:1169-1198. [PMID: 38015277 DOI: 10.1007/s10459-023-10298-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 10/22/2023] [Indexed: 11/29/2023]
Abstract
Scholarly practice (SP) is considered a key competency of occupational therapy and physiotherapy. To date, the three sectors-education/research, practice, and policy/regulation-that support SP have been working relatively independently. The goals of this project were to (a) understand how representatives of the three sectors conceptualize SP; (b) define each sector's individual and collective roles in supporting SP; (c) identify factors influencing the enactment of SP and the specific needs of how best to support SP; and (d) co-develop goals and strategies to support SP across all sectors. We used interpretive description methodology. Consistent with an integrated knowledge translation approach, partners representing the three sectors across Canada recruited individuals from each sector, developed the content and questions for three focus groups, and collected and analyzed the data. Inspired by the Consolidated Framework for Implementation Research, we developed the questions for the second focus group. We analyzed the data using an inductive thematic analysis method. Thirty-nine participants from the three sectors participated. Themes related to participants' conceptualization of SP included (a) ongoing process, (b) reflective process, (c) broad concept, and (d) collective effort. Themes describing factors influencing and supporting SP were (a) recognition, (b) appropriate conceptualization, (c) social network, (d) accessibility to resources, and (e) forces outside of practitioners' effort. Goals to support SP included (a) further recognizing SP, (b) sustaining SP competency, and (c) ensuring access to information. SP requires collaborative and integrated intersectoral support and further recognition of its importance through the collaboration of multiple stakeholders.
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Affiliation(s)
- Sungha Kim
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Sara Ahmed
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
- Clinical Epidemiology, Center for Outcome Research and Evaluation (CORE), McGill University Health Center Research Institute, Montréal, QC, Canada
| | - Philippe S Archambault
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Claudine Auger
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
- Institut universitaire sur la réadaptation en déficience physique de Montréal, Montréal, QC, Canada
| | - Alex Battaglini
- Directorate of University Teaching and Research, CISSS de Laval, Laval, QC, Canada
- l'École de Santé Publique de l'Université de Montréal, Montréal, QC, Canada
| | - Andrew R Freeman
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Québec, QC, Canada
- VITAM: Centre de Recherche en Santé Durable, Québec, QC, Canada
| | - Eva Kehayia
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Elizabeth Anne Kinsella
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Elinor Larney
- Association of Canadian Occupational Therapy Regulatory Organizations and College of Occupational Therapists of Ontario, Toronto, ON, Canada
| | - Lori Letts
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Peter Nugus
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Marie-Hélène Raymond
- Institut National d'Excellence en Santé et en Services Sociaux, Montréal, QC, Canada
| | - Nancy M Salbach
- Department of Physical Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- The KITE Research Institute, University Health Network, Toronto, ON, Canada
| | - Diana Sinnige
- Canadian Alliance of Physiotherapy Regulators, Toronto, ON, Canada
| | - Laurie Snider
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Bonnie Swaine
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
- Institut universitaire sur la réadaptation en déficience physique de Montréal, Montréal, QC, Canada
| | - Yannick Tousignant-Laflamme
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Aliki Thomas
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada.
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada.
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada.
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He F, Zhang C, Zhao D, Zhang C, Zeng L, Liu W, Li L, Gao F. A questionnaire on the current situation of resignation intention of nurses in intensive care units in China - A descriptive quantitative study. Nurs Open 2024; 11:e2231. [PMID: 39235127 PMCID: PMC11375734 DOI: 10.1002/nop2.2231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 05/07/2024] [Accepted: 06/12/2024] [Indexed: 09/06/2024] Open
Abstract
AIM This study analysed and summarized the correlation between various indicators of ICU nurses' personal lives, hospital work situation, social opinion, psychological assessment, and their intention to resign. DESIGN A descriptive quantitative study. METHODS This study was a multicentre questionnaire on factors influencing intensive care unit (ICU) nurses' intention to resign. This study was completed through the Critical Care E Institute (CCEI) and China Calm Therapy Research Group Academic Organization (CNCSG) by contacting ICU nurses in three hospitals in 34 provinces in China. The questionnaire was in the form of a cell phone WeChat scan code. The survey included 22 indicators, including basic information about nurses (marital and child status, personal income, etc.), hospital work (weekly working hours, night shift, hospital environment, etc.), and psychological symptoms. RESULTS A total of 1904 nurses were included in this study. Among them, 1060 (55.67%) had the intention to resign. In this study, among the 22 indicators involved, 16 factors, including hospital work hours, job title, satisfaction with current income, having children, and evaluation of the hospital, significantly impact nurses' intentions to resign (all p < 0.05). Logistic regression analysis showed that six indicators influenced nurses' choice of resignation intention (all p < 0.05), including hospital work time, professional title, income satisfaction, hospital work pride, satisfaction of nurses with the compassion and care given to them by their hospitals, and career vision score. The ROC curve showed that all six indicators were <0.70, but the model receiver operating characteristic (ROC) curve constructed for the indicators was 0.756. In China, increasing the income of ICU nurses, fostering pride in hospital work, reducing working hours, ensuring smooth promotion processes, and enhancing career prospects can all decrease their likelihood of choosing to resign. Absorbing practical nursing management and work experience from other countries will help decrease the intention to resign within this group. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Feng He
- The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Chunyan Zhang
- Department of Nursing, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Di Zhao
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Chao Zhang
- Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Liangnan Zeng
- Department of Nursing, Chengdu Fifth People's Hospital, The Fifth People's Hospital Affiliated to Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Wei Liu
- Hebei Psychological Counselor Association, Shijiazhuang, Hebei, China
| | - Laiyou Li
- Department of Nursing, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Fei Gao
- Hebei General Hospital, Shijiazhuang, Hebei, China
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de Oliveira APC, Mion ABZ, Galante ML, Donato GD, Ventura CAA. Stock, composition and distribution of the nursing workforce in Brazil: a snapshot. Rev Lat Am Enfermagem 2024; 32:e4287. [PMID: 39230131 PMCID: PMC11368065 DOI: 10.1590/1518-8345.6937.4287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 04/19/2024] [Indexed: 09/05/2024] Open
Abstract
OBJECTIVE to analyze the availability (in terms of stock and composition) and accessibility (in terms of geographical distribution) of the nursing workforce in Brazil. METHOD this is a descriptive, cross-sectional study with retrospective data collection, identified by combining databases available on institutional websites and structured according to indicators from the World Health Organization's "National Health Workforce Accounts". The study considered nursing professionals at senior level (nurses) and middle level (nursing auxiliaries and technicians). Indicators of stock, composition, distribution (by age group and gender) and the ratio of nurses to doctors were included. RESULTS there was an increase in the number of personnel between 2005 and 2010, mainly in middle and technical level professionals. There are more personnel aged between 36 and 55, with a predominance of women in all categories, despite the increase in men. There was an uneven distribution of personnel across the country's regions, with the Southeast having the largest number of professionals. The ratio of nurses to doctors is less than one in the South and Southeast. CONCLUSION despite the large number of nurses, their distribution is uneven. The growth of nursing technicians has significantly outstripped that of nurses, indicating more intensive technical training policies than those found in higher education.
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Affiliation(s)
- Ana Paula Cavalcante de Oliveira
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Ana Beatriz Zanardo Mion
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Mariana Lopes Galante
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Gabriela Di Donato
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Carla Aparecida Arena Ventura
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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D’Alessandro-Lowe AM, Brown A, Sullo E, Pichtikova M, Karram M, Mirabelli J, McCabe RE, McKinnon MC, Ritchie K. Why Are Healthcare Providers Leaving Their Jobs? A Convergent Mixed-Methods Investigation of Turnover Intention among Canadian Healthcare Providers during the COVID-19 Pandemic. NURSING REPORTS 2024; 14:2030-2060. [PMID: 39189282 PMCID: PMC11348248 DOI: 10.3390/nursrep14030152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2024] [Revised: 08/16/2024] [Accepted: 08/19/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Staffing shortages across the healthcare sector pose a threat to the continuity of the Canadian healthcare system in the post-COVID-19 pandemic era. We sought to understand factors associated with turnover intention as well as Canadian healthcare providers' (HCPs) perspectives and experiences with turnover intention as related to both organizational and professional turnover. METHOD A convergent questionnaire mixed-methods design was employed. Descriptive statistics and ordinal logistic regressions were used to analyze quantitative data and ascertain factors associated with turnover intention. Thematic analysis was used to analyze qualitative open-field textbox data and understand HCPs' perspectives and experiences with turnover intention. RESULTS Quantitative analyses revealed that 78.6% of HCPs surveyed (N = 398) reported at least a 25% turnover likelihood regarding their organization, with 67.5% reporting at least a 25% turnover likelihood regarding their profession. Whereas regression models revealed the significant impact of years worked, burnout, and organizational support on turnover likelihood for organizations, age, sex, burnout, and organizational support contributed to the likelihood of leaving a profession. Patterns of meaning drawn from participants' qualitative responses were organized according to the following four themes: (1) Content to stay, (2) Drowning and no one cares, (3) Moral stressors, and (4) Wrestling with the costs and benefits. CONCLUSIONS Many HCPs described weighing the costs and benefits of leaving their organization or profession during the COVID-19 pandemic. Although challenging working conditions, moral stressors, and burnout may play a significant role in HCPs' experiences of turnover intention, there is ample room to intervene with organizational support.
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Affiliation(s)
| | - Andrea Brown
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada (M.C.M.)
| | - Emily Sullo
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Mina Pichtikova
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada (M.C.M.)
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Mauda Karram
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada (M.C.M.)
- Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - James Mirabelli
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Randi E. McCabe
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada (M.C.M.)
- St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 4A6, Canada
| | - Margaret C. McKinnon
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada (M.C.M.)
- St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 4A6, Canada
- Homewood Research Institute, Guelph, ON N1E 6K9, Canada
| | - Kim Ritchie
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada (M.C.M.)
- Trent/Fleming School of Nursing, Trent University, Peterborough, ON K9L 0G2, Canada
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15
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Beks H, Clayden S, Wong Shee A, Manias E, Versace VL, Beauchamp A, Mc Namara KP, Alston L. Low-value health care, de-implementation, and implications for nursing research: A discussion paper. Int J Nurs Stud 2024; 156:104780. [PMID: 38744150 DOI: 10.1016/j.ijnurstu.2024.104780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 03/13/2024] [Accepted: 04/19/2024] [Indexed: 05/16/2024]
Abstract
Globally, the nursing profession constitutes the largest proportion of the health workforce; however, it is challenged by widespread workforce shortages relative to need. Strategies to promote recruitment of the nursing workforce are well-established, with a lesser focus on strategies to alleviate the burden on the existing workforce. This burden may be exacerbated by the impact of low-value health care, characterised as health care that provides little or no benefit for patients, or has the potential to cause harm. Low-value health care is a global problem, a major contributor to the waste of healthcare resources, and a key focus of health system reform. Evidence of variation in low-value health care has been identified across countries and system levels. Research on low-value health care has largely focused on the medical profession, with a paucity of research examining either low-value health care or the de-implementation of low-value health care from a nursing perspective. The objective of this paper is to provide a scholarly discussion of the literature around low-value health care and de-implementation, with the purpose of identifying implications for nursing research. With increasing pressures on the global nursing workforce, research identifying low-value health care and developing approaches to de-implement this care, is crucial.
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Affiliation(s)
- H Beks
- Deakin Rural Health, Deakin University, Australia.
| | - S Clayden
- Deakin Rural Health, Deakin University, Australia; South West Healthcare, Australia
| | - A Wong Shee
- Deakin Rural Health, Deakin University, Australia; Grampians Health, Australia
| | - E Manias
- Deakin Rural Health, Deakin University, Australia; School of Nursing and Midwifery, Monash University, Australia
| | - V L Versace
- Deakin Rural Health, Deakin University, Australia
| | - A Beauchamp
- School of Rural Health, Monash University, Australia
| | | | - L Alston
- Deakin Rural Health, Deakin University, Australia; Colac Area Health, Australia
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16
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Mayer KA, Simpson VL, Jo S, Kurt S, Bennett JA, Takagi E, Skibiski J, Han SY, Reifsnider E. Understanding Rewarding and Challenging Nursing Experiences During the Pandemic in Five Countries: Toward Strengthening the Workforce. J Transcult Nurs 2024:10436596241259210. [PMID: 39044612 DOI: 10.1177/10436596241259210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024] Open
Abstract
INTRODUCTION Nurses are now more likely to leave their current role in direct patient care than they were before the COVID-19 pandemic. Country culture and the organization of health care systems drive nurses' decisions to leave or stay in the profession. METHODS In a fall 2020 survey of nurse professional quality of life, a content analysis of responses to the open-ended question, "What has been challenging or rewarding during this pandemic experience?" was performed. Results were organized within Hofstede's Cultural Dimensions Theory. RESULTS Six hundred and fifty-six nurses across five countries responded to the question; 526 comments were analyzed. Most (53.6%) respondents were staff bedside nurses. Themes, such as Distress and Fatigue and Building and Experiencing Social Capital were found and understood to reflect cultural values and dimensions such as Uncertainty Avoidance and Power Distance. DISCUSSION Recommendations include strengthening culturally tailored leadership knowledge to inform and facilitate countries' nurse retention.
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Affiliation(s)
| | | | - Soojung Jo
- Purdue University, West Lafayette, IN, USA
| | - Sule Kurt
- KU Leuven, Belgium
- Karadeniz Technical University, Ortahisar, Türkiye
| | - Jo Anne Bennett
- National Institute of Public Health/Ministry of Health, Conakry, Guinea
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17
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Ward A, Martin S, Richards C, Ward I, Tulleners T, Hills D, Wapau H, Levett-Jones T, Best O. Enhancing primary healthcare nurses' preparedness for climate-induced extreme weather events. Nurs Outlook 2024; 72:102235. [PMID: 39004069 DOI: 10.1016/j.outlook.2024.102235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/14/2024] [Accepted: 06/22/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Climate Change is causing frequent and sever extreme weather events globally, impacting human health and well-being. Primary healthcare (PHC) nurses' are at the forefront of addressing these challenges and must be prepared. PURPOSE This scoping revieww explored literature on the preparedness of the PHC nursing workforce for extreme weather events and identify gaps in knowledge and practice. METHODS Using Arksey and O'Malley's framework, a comprehensive search was conducted across PubMed, Scopus, CINHAL, Web of Sciences, and ProQuest, on studies from 2014-2024, addressing PHC nurses' preparedness. DISCUSSION Nine studies were identified and highlighted a need for preparedness training and facility-based preparedness plans. Key themes included prioritizing regional networks, clinical leadership, service delivery, health information, health workforce, medical products and technologies, and financing. CONCLUSION Strengthening PHC nurses' resilience against extreme weather requires targeted professional development, mental health support, comprehensive planning, and collaborative efforts. Future strategies should enhance PHC nurses' capacity through training, support, and policy development.
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Affiliation(s)
- Aletha Ward
- First Nations Research Alliance, University of Southern Queensland, Ipswich, Queensland, Australia.
| | - Sophia Martin
- First Nations Research Alliance, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Catelyn Richards
- First Nations Research Alliance, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Isabella Ward
- First Nations Research Alliance, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Tracey Tulleners
- First Nations Research Alliance, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Danny Hills
- Australian Primary Health Care Nurses Association, Melbourne, Victoria, Australia
| | - Hylda Wapau
- Torres Strait Islander Nurses Indigenous Cooperation, Thursday Island, Queensland, Australia
| | - Tracy Levett-Jones
- School of Nursing and Midwifery, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Odette Best
- First Nations Research Alliance, University of Southern Queensland, Ipswich, Queensland, Australia
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18
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Németh Z, Deák P, Szűcs R, Makai A, Hock M. Validation of the Hungarian version of the 6-item turnover intention scale among elderly care workers. Sci Rep 2024; 14:15593. [PMID: 38971853 PMCID: PMC11227566 DOI: 10.1038/s41598-024-66671-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 07/03/2024] [Indexed: 07/08/2024] Open
Abstract
This research examines the psychometric characteristics and reliability of the 6-item turnover intention scale (TIS-6) by Bothma and Roodt (SA J Hum Resour Manag 11:a507, 2013) on a Hungarian sample. The internal validity of the TIS-6 was assessed using data from 269 Hungarian elderly care institution workers. Confirmatory factor analysis was performed to analyse the structural validity. Convergent and discriminant validity were examined with questions on job characteristics and using the Maslach Burnout Inventory and Effort-Reward Imbalance Scale. IBM SPSS 28.0 software was used for the statistical analysis, and the results were considered significant at p < 0.05. The internal consistency of the questionnaire's scale proved to be acceptable (α = 0.826). Convergent validity was confirmed by the relationships between the components of the questionnaire and burnout (rs = 0.512; p < 0.001; rs = 0.419; p < 0.001) and workplace stress (rs = 0.565; p < 0.001; rs = 0.310; p < 0.001). There were significant differences between the TIS-6 scores among the groups with different degrees of burnout (p < 0.001), which indicated adequate discriminant validity of the questionnaire. The structural validity of the questionnaire was acceptable, and the scale questions fit well. The Hungarian version of the TIS-6 scale is a valid and reliable tool for assessing turnover intention among elderly care institution workers in Hungary.
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Affiliation(s)
- Zsanett Németh
- Doctoral School of Health Sciences, University of Pécs, Pécs, 7621, Hungary.
| | - Petra Deák
- Toldy Ferenc Hospital and Clinic, Cegléd, 2700, Hungary
| | - Réka Szűcs
- Doctoral School of Health Sciences, University of Pécs, Pécs, 7621, Hungary
| | - Alexandra Makai
- Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, University of Pécs, Pécs, 7621, Hungary
| | - Márta Hock
- Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, University of Pécs, Pécs, 7621, Hungary
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Chen Y, Zhou X, Bai X, Liu B, Chen F, Chang L, Liu H. A systematic review and meta-analysis of the effectiveness of social support on turnover intention in clinical nurses. Front Public Health 2024; 12:1393024. [PMID: 38903567 PMCID: PMC11187297 DOI: 10.3389/fpubh.2024.1393024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/17/2024] [Indexed: 06/22/2024] Open
Abstract
Background Nurse turnover has become a salient issue in healthcare system worldwide and seriously compromises patient outcomes. Social support is considered an effective contributor to alleviate nurse turnover intention (TI). However, the degree of correlation between social support and nurse TI remains elusive. Aims This study aims to evaluate the strength of the effectiveness of social support on TI among nurses as well as its potential moderators. Design This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Methods To obtained qualified studies, two researchers searched Embase, PubMed, Web of science, CINAHL, CNKI, WanFang, and Chinese Medical Journal Full Text Database from inception to January 6, 2024. Meta-analysis, publication bias, and sensitivity analysis were carried out on the included studies using CMA 3.0 software, and the moderating effect was verified through meta-analysis of variance (ANOVA). Results A total of 38 studies were obtained, involving 63,989 clinical nurses. The comprehensive effect size of the random effect model showed a significant medium negative correlation between social support and TI among nurses (p < 0.001). The sample size and TI measurement tools significantly moderated the correlation between social support and TI (p < 0.050). However, nurse department, gender, data collection time, and social support measurement tools did not moderate the correlation between the two variables. Conclusion Social support is negatively associated with TI in nurses. Nursing administrators and the medical community should fully recognize the importance of social support for nurses and take corresponding measures to enhance it, thereby reducing TI and ensuring the stability of the nursing team.
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Affiliation(s)
- Yan Chen
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xiang Zhou
- School of Sociology and Political Science, Shanghai University, Shanghai, China
| | - Xue Bai
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Beibei Liu
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Fengzhi Chen
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Lixia Chang
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Hongli Liu
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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20
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Kunjavara J, Ali Alomari AM, Mannethodi K, Hassan N, Singh K, Joy GV, Al Lenjawi B. Middle East Nurses Turnover Intention and its Correlates Amid the COVID-19 Pandemic: A Systematic Review. Hosp Top 2024:1-9. [PMID: 38836418 DOI: 10.1080/00185868.2024.2359551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
Global nursing scarcity was more evident during COVID-19. This study investigated the rates and contributing factors of turnover intention in the middle east through meta-analysis. Medline EMCARE, Cochrane, CINAHL, EMBASE, Ovid, Psych Info, PubMed, Science Direct, Scopus, and Web of Science databases searched, Protocol PROSPERO Registration Number was CRD42022337686. The turnover intention rate was 42.3% [CI: 40%, 44.6%]. Working environment, stress, deployment to COVID, fear of infection, long working hours, shift duties, and lack of social support were the major contributing factors.
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Affiliation(s)
- Jibin Kunjavara
- Nursing and Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Nesiya Hassan
- Nursing and Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
| | - Kalpana Singh
- Nursing and Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
| | - George V Joy
- Nursing and Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
| | - Badriya Al Lenjawi
- Nursing and Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
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Aydogdu ALF. Work engagement among nurses in the context of the COVID-19 pandemic: A systematic review. Nurs Ethics 2024:9697330241257570. [PMID: 38835110 DOI: 10.1177/09697330241257570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
BACKGROUND Despite nurses receiving education on how to respond during crises, the stress and demands arising from unprecedented situations, such as the COVID-19 pandemic, may affect their work engagement. AIM To appraise and synthesize studies examining work engagement among nurses in the context of the COVID-19 pandemic. METHODS It is a systematic review in which three databases were searched. Critical appraisal tools and PRISMA guidelines were used. Content analysis was performed. ETHICAL CONSIDERATIONS Ethical approval was not required for this systematic review. FINDINGS A total of 21 studies were included. The results were classified into three categories: (1) levels and meanings of work engagement, (2) the relationship of work engagement with various factors, and (3) measures to enhance work engagement. CONCLUSION The review revealed that nurses' work engagement varied from moderate to high. Factors such as education level and work schedule flexibility influenced their engagement. Positive associations were found between work engagement and job satisfaction, intention to stay, and organizational support, while stress and workload showed negative relationships. The crucial role of health policymakers, hospital administrators, and nurse managers in acting ethically, creating favorable working conditions and fostering nurses' work engagement was emphasized.
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Drury A, Boland V, Dowling M. Patient-Reported Outcome and Experience Measures in Advanced Nursing Practice: What Are Key Considerations for Implementation and Optimized Use? Semin Oncol Nurs 2024; 40:151632. [PMID: 38658204 DOI: 10.1016/j.soncn.2024.151632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 03/10/2024] [Accepted: 03/17/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE To discuss the opportunities and challenges of implementing patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) within advanced practice nursing services in cancer care. METHODS This discussion paper has been informed by an environmental scan of evidence from systematic reviews and primary studies evaluating the use and implementation of PROMs and PREMs. Literature from the contexts of cancer and chronic disease, including nursing and multidisciplinary supportive care literature, has been included. RESULTS Advanced practice nurses are well-positioned to evaluate and respond to PROMs and PREMs data; several studies have highlighted improved patient outcomes concerning quality of life, symptom distress, and functional status within nurse-led services. Nevertheless, the implementation of PROMs and PREMs in cancer care and nurse-led services is variable. Previous studies have highlighted implementation challenges, which can hinder comparability and generalizability of PROMs and PREMs instruments. Advanced practice nurses should consider these challenges, including ways to use standardized PROM instruments. Electronic PROMs, while efficient, may exclude individuals at risk of inequity. Complex, lengthy, and frequent administration of PROMs may also overburden people living with or after cancer, with people affected by cancer expressing preference for flexible use in some studies. Therefore, the involvement of people affected by cancer in planning for PROMs/PREMs implementation may overcome this challenge. Finally, organizational considerations in implementation should address financial investments, including initial costs for technology and training and consideration of the operationalization of PROMs within existing infrastructure for the seamless utilization of PROMs data. CONCLUSION Despite the potential of advanced practice nursing services to enhance patient-reported outcomes and experiences, variability in the implementation of PROMs and PREMs poses challenges. Use of validated measures, electronic or paper-based instruments, and the preferences of people affected by cancer for the use of PROMs and PREMs must be carefully considered in consultation with end users for successful implementation. IMPLICATIONS FOR PRACTICE In planning for the implementation of PROMs and PREMs within nurse-led services, implementation risks may be mitigated through establishing clear guidelines for their use, investment in the development of the required infrastructure, user education, and rigorous implementation processes, including patient involvement in PROMs/PREMs selection.
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Affiliation(s)
- Amanda Drury
- Associate Professor in General Nursing, School of Nursing, Psychotherapy and Community Health, Dublin City University, Glasnevin, Dublin, Ireland.
| | - Vanessa Boland
- Assistant Professor in General Nursing, School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland
| | - Maura Dowling
- Associate Professor, School of Nursing and Midwifery, University of Galway, Ireland
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Lin Z, Wu W, Zhang H, He Z, Han M, Li J. Patterns of occupational commitment among nurses: a latent profile analysis. Front Psychol 2024; 15:1331425. [PMID: 38873500 PMCID: PMC11169784 DOI: 10.3389/fpsyg.2024.1331425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 05/20/2024] [Indexed: 06/15/2024] Open
Abstract
Background Occupational commitment (OC) is a multidimensional construct that predicts turnover intentions. The interindividual variability of nurses' OC merits further exploration. Therefore, this study aims to examine patterns of OC and its relationship with psychological empowerment and job crafting in nurses. Methods A sample of 1,061 nurses was recruited from February 2022 to April 2022 by using a stratified four-stage cluster sampling procedure. A self-report survey included the Psychological Empowerment Scale, Job Crafting Scale, and Occupational Commitment Scale. Latent profile analysis (LPA) was used to examine the patterns of OC. Associations of the latent class membership with individual characteristics, psychological empowerment and job crafting were examined using multinomial logistic regression. Results Three patterns of OC were identified: (1) "Low OC group" (n = 224, 21.1%); (2) "Moderate OC group" (n = 665, 62.7%); (3) "High OC group" (n = 172, 16.2%). Nurses with higher education, fewer years of service, working in medicine, lower psychological empowerment and lower job crafting had a higher likelihood of belonging to Class 1 (Low OC group). In contrast, nurses working in emergency and with higher psychological empowerment and job crafting were more likely to belong to Class 3 (High OC group). Conclusion The findings revealed the heterogeneity of occupational commitment among nurses in China and could guide the identification and early intervention of nurses with low level of occupational commitment.
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Affiliation(s)
- Zihan Lin
- Department of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an, China
| | - Wenbin Wu
- Department of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an, China
| | - Huifang Zhang
- The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Zhiqiang He
- Department of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an, China
| | - Mengyu Han
- Department of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an, China
| | - Jin Li
- Department of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an, China
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Arnetz JE, Baker N, Arble E, Arnetz BB. Workplace violence, work-related exhaustion, and workplace cognitive failure among nurses: A cross-sectional study. J Adv Nurs 2024. [PMID: 38712618 DOI: 10.1111/jan.16217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/28/2024] [Accepted: 04/24/2024] [Indexed: 05/08/2024]
Abstract
AIM To examine the relationships between nurses' exposure to workplace violence and self-reports of workplace cognitive failure. DESIGN A cross-sectional study. METHODS An online questionnaire was administered in April 2023 to nurses in Michigan, US. Structural equation modelling was used to examine effects of physical and non-physical workplace violence (occupational stressors) and work efficiency and competence development (occupational protective factors) on workplace cognitive failure. RESULTS Physical violence was a significant predictor of the action subscale of cognitive failure. There were no direct effects of non-physical violence, workplace efficiency, or competence development on any of the workplace cognitive failure dimensions. Both types of violence and efficiency had significant indirect effects on workplace cognitive failure via work-related exhaustion. Work-related exhaustion predicted significantly higher scores for workplace cognitive failure. CONCLUSION Workplace violence and work efficiency exhibited primarily indirect effects on workplace cognitive failure among nurses via work-related exhaustion. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Nurses experiencing workplace violence may be at increased risk for workplace cognitive failure, especially if they are also experiencing work-related exhaustion. Workplaces that nurses perceive as more efficient can help to mitigate the effects of violence on nurses' cognitive failure. IMPACT This study addressed the possible effects of workplace violence as well as work efficiency and competence development on nurses' cognitive failure at work. Analyses revealed primarily indirect effects of workplace violence, and indirect protective effects of work efficiency, on nurses' cognitive failure via work-related exhaustion. This research has implications for healthcare organizations and suggests that efforts made by healthcare workplaces to prevent violence and work-related exhaustion, and to enhance work efficiency, may help to mitigate workplace cognitive failure among nurses. REPORTING METHOD We have followed the STROBE checklist in reporting this study. PATIENT OR PUBLIC CONTRIBUTION No Patient or public contribution.
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Affiliation(s)
- Judith E Arnetz
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA
| | - Nathan Baker
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Eamonn Arble
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Bengt B Arnetz
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA
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25
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Türkmen Keskin S, Özduyan Kiliç M. Investigation of the relationship between nurses' perception of toxic leadership and their organizational trust levels and turnover intentions. J Adv Nurs 2024; 80:1859-1867. [PMID: 37962144 DOI: 10.1111/jan.15951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 07/24/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023]
Abstract
AIM This study aimed to investigate the relationship between nurses' perception of toxic leadership and their organizational trust levels and turnover intentions. DESIGN This cross-sectional study was conducted using an online survey of 168 nurses working in public and university hospitals. METHODS Data were collected between April and November 2022 with the Toxic Leadership Scale, Organizational Trust Scale and Turnover Intention Scale. Descriptive statistics, correlations, and regression analyses were used to analyse these data. RESULTS It was determined that almost half of the nurses (46.4%) were exposed to negative behaviours from their managers within the last year. Nurses' perception of toxic leadership, organizational trust level and turnover intention were moderate. It was found that nurses' perceptions of toxic leadership had a negative effect on organizational trust level (R2 = .691; β = -0.832; p < .05) and a positive significant effect on turnover intention (R2 = .267; β = 0.521; p < .05). CONCLUSIONS This study revealed that toxic leadership behaviours in health organizations should be struggled with to increase nurses' organizational trust and reduce their turnover. In this context, an organizational culture in which toxic behaviours are not tolerated should be established in health organizations. IMPACT What problem did the study address? In the literature, mostly positive leadership behaviours of nurse managers are emphasized and little is known about their negative behaviours such as toxic leadership. What were the main findings? It was determined that nurses who perceived more toxic behaviour from their managers had less trust in their organizations and higher turnover intention. On whom will the research have an impact? To provide a positive working environment and reduce turnover, it is necessary to create an organizational culture in which the toxic behaviours of nurse managers are not tolerated. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Brown JA, Capper T, Hegney D, Donovan H, Williamson M, Calleja P, Solomons T, Wilson S. Individual and environmental factors that influence longevity of newcomers to nursing and midwifery: a scoping review. JBI Evid Synth 2024; 22:753-789. [PMID: 37661721 DOI: 10.11124/jbies-22-00367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
OBJECTIVE The objective of this review was to identify the literature and map the individual and environmental factors that influence registered nurses' and midwives' decision to stay or leave their professions within the first 3 years of practice. INTRODUCTION Nursing and midwifery workforce sustainability is an international concern. One aspect is the retention of new registered nurses and midwives in their first years of practice. Several factors are thought to influence the decisions of new registered nurses and midwives to leave or stay in their professions. This review sought to identify and map those factors to enable further research for workforce sustainability development strategies. INCLUSION CRITERIA The study cohort included registered nurses and midwives in their first 3 years of practice, which we called newcomers . Nurses who were required to work under the supervision of registered nurses and midwives (ie, enrolled nurses, licensed practical nurses, and licensed vocational nurses) were excluded. Papers were included only if they explored individual or environmental factors influencing nurses' decision to stay in or leave the professions of nursing or midwifery. Studies could be from any country or care environment, and participants were newcomers providing direct clinical care. Newcomers employed in other health roles, such as education, research, administration, or non-nursing/midwifery roles, were excluded. All research designs and peer-reviewed papers were included; policy documents were excluded. The date of inclusion was from the earliest publication on this topic, which was 1974, to the date of the search. METHODS The JBI methodology for scoping reviews was followed, and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidance. The search strategy aimed to locate published and unpublished primary studies, reviews, and text and opinion papers. The initial search of relevant databases was conducted in January 2020 and updated in January 2022. Reference lists of included articles were also screened. Following data extraction, descriptive qualitative content analysis was undertaken. RESULTS Twelve articles from 11 studies were included in this review. They were published between 2005 and 2020, and originated from 5 countries. Two studies were observational, 3 were cross-sectional, 5 were longitudinal studies, 1 was a pre- and post-program evaluation, and 1 was a scoping review. All studies focused on registered nurses; no publications on registered midwives met the inclusion criteria. Individual factors we identified that impact newcomers' intention to stay in or leave the profession included physical and psychological health, professional identity, professional commitment, and development. Environmental factors included workplace culture, engagement, and management. CONCLUSIONS Professional self-image, identity, and a sense of pride in the profession are important components of newcomer retention. Strategies that positively support transition to practice and create realistic expectations were highlighted. Managers play an important role in registered nurse retention, as they can influence many of the newcomers' experiences. It is concerning that no studies about newcomer midwives were found. Many studies explored turnover or intention to leave the job/employer rather than the profession. These are important considerations for future research.
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Affiliation(s)
| | - Tanya Capper
- School of Nursing, Midwifery and Social Sciences, CQ University Australia, Brisbane, QLD, Australia
| | - Desley Hegney
- Adelaide Nursing School, The University of Adelaide, Adelaide, SA, Australia
| | - Helen Donovan
- Faculty of Health, School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
| | - Moira Williamson
- School of Nursing, Midwifery and Social Sciences, CQ University Australia, Brisbane, QLD, Australia
| | - Pauline Calleja
- School of Nursing, Midwifery and Social Sciences, CQ University Australia, Brisbane, QLD, Australia
| | - Terena Solomons
- The Western Australian Group for Evidence-Informed Healthcare Practice: A JBI Centre of Excellence, Curtin University, Perth, WA, Australia
| | - Sally Wilson
- The Western Australian Group for Evidence-Informed Healthcare Practice: A JBI Centre of Excellence, Curtin University, Perth, WA, Australia
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Alghtany S, Madhuvu A, Fooladi E, Crawford K. Assessment of academic burnout and professional self-concept in undergraduate nursing students: A cross-sectional study. J Prof Nurs 2024; 52:7-14. [PMID: 38777528 DOI: 10.1016/j.profnurs.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Nursing turnover and shortage are an increasing phenomenon throughout the world; thus, it is critical to determine the factors that contribute to them. Nursing students' retention plans and turnover intentions are significantly influenced by academic burnout and professional self-concept. The COVID-19 pandemic could aggravate the study-associated stresses leading to burnout and jeopardize the nursing student's professional socialisation which is a key factor in their professional self-concept formation, it is important to investigate their relationship. PURPOSE To examine the relationship between professional self-concept and academic burnout among undergraduate Bachelor of Nursing students and identify predictors related to academic burnout. METHOD This cross-sectional study was conducted from May to June 2021. The participants were undergraduate Bachelor of Nursing students from two campuses of a large university in Victoria, Australia. Out of 1630 students, 198 participated in the study. The students were invited to complete an online survey through the university's online learning platform or flyers. Descriptive statistics, Pearson correlation, and Bootstrapping approaches were used to analyse the data. RESULTS The analysis found a significant positive correlation between the nursing students' total professional self-concept and academic burnout professional efficacy (r = 0.48; p < 0.01). A significant negative correlation was also detected between the total professional self-concept and academic burnout cynicism (r = - 0.21; p < 0.01). Moreover, the total nurse professional self-concept was a significant predictor of both academic burnout subscales cynicism and professional efficacy (p < 0.01). CONCLUSIONS Positive nursing professional self-concept may alleviate student's academic burnout, and it might contribute to the promotion of their professional efficacy.
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Affiliation(s)
- Safea Alghtany
- Monash Nursing and Midwifery, Monash University, Melbourne, VIC 3800, Australia.
| | - Auxillia Madhuvu
- Monash Nursing and Midwifery, Monash University, Melbourne, VIC 3800, Australia.
| | - Ensieh Fooladi
- Monash Nursing and Midwifery, Monash University, Melbourne, VIC 3800, Australia.
| | - Kimberley Crawford
- Monash Nursing and Midwifery, Monash University, Melbourne, VIC 3800, Australia.
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Ang WHD, Rusli KDB, Lau Y, Lau ST, Chew HSJ. Nursing students' readiness towards the 'new normal' in clinical practice: a distributed cognition qualitative perspective. BMC Nurs 2024; 23:258. [PMID: 38649891 PMCID: PMC11034143 DOI: 10.1186/s12912-024-01819-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 02/22/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Clinical practicums are a core component of baccalaureate nursing education. Following the coronavirus pandemic, there have been extensive changes in the workforce environment that may potentially affect nursing students' experience and readiness for clinical practicums. METHODS A qualitative study was conducted to explore final-year nursing students' experiences and readiness for their final clinical practicum before becoming a registered nurse. A purposive sample of 24 final-year baccalaureate nursing students was included in this study. Individual semi-structured interviews were conducted face-to-face via Zoom. The data was analysed using an inductive thematic analysis approach. RESULTS Three themes depicting students' experiences and clinical readiness were elucidated. The themes included: (1) Experiencing multiple concerns, (2) requiring a network of support, and (3) easing the transition to professional practice. Students considered the final clinical practicum as challenging and demanding which evoked numerous concerns. CONCLUSIONS Considering the stress that final-year nursing students experience, it will be important to devise strategies ranging from personal, relational, and environmental protective factors to enable their successful transition and completion of clinical practice.
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Grants
- H-569-00-000002 Department Research Funding, Alice Lee Centre for Nursing Studies, National University of Singapore
- H-569-00-000002 Department Research Funding, Alice Lee Centre for Nursing Studies, National University of Singapore
- H-569-00-000002 Department Research Funding, Alice Lee Centre for Nursing Studies, National University of Singapore
- H-569-00-000002 Department Research Funding, Alice Lee Centre for Nursing Studies, National University of Singapore
- H-569-00-000002 Department Research Funding, Alice Lee Centre for Nursing Studies, National University of Singapore
- H-569-00-0005 Research Fellow Start Up Grant, Alice Lee Centre for Nursing Studies, National University of Singapore
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Affiliation(s)
- Wei How Darryl Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Khairul Dzakirin Bin Rusli
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ying Lau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, 6-8/F, Esther Lee Building, Shatin, New Territories, Hong Kong, China.
| | - Siew Tiang Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Yang H, Yang L, Chen L, Liu J, Cui S, Zhang L. Exploring work readiness: A qualitative descriptive study of self-perceptions among new graduate nurses. Heliyon 2024; 10:e28507. [PMID: 38689979 PMCID: PMC11059559 DOI: 10.1016/j.heliyon.2024.e28507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 05/02/2024] Open
Abstract
Background Reduced work readiness is associated with elevated turnover rates, necessitating efforts to enhance the positive work readiness of newly graduated nurses to alleviate the shortage in the nursing workforce. Research into the work readiness of recent nursing graduates in China is still in its infancy. Most studies employ quantitative research methods, and further exploration of the self-perception of work readiness among new nurses in China is required. Objectives This study aimed to investigate genuine experiences and self-perceptions of work readiness among new graduate nurses. Design A qualitative descriptive study. Methods Sixteen new nurses from a provincial tertiary hospital in China were included in this study, which adhered to the consolidated criteria for reporting qualitative research (COREQ) checklist for reporting. The data collection process involved conducting semi-structured interviews from September to October 2021. Inductive content analysis was employed to analyze the interview data. Results The study identified four themes encompassing new nurses' real-life experiences and self-perceptions of work readiness: psychological stress, emotional conflict, empathy fatigue, and ethical dilemmas. Psychological stress comprised three subthemes: knowledge and skill deficits, communication barriers, and fear. Empathy fatigue was primarily characterized by psychological and physical symptoms. Ethical dilemmas involved conflicts over differences in values and between clinical reality and standardized nursing practice. Conclusion Drawing from the self-perceptions of work readiness among new nurses found in this study, nursing administrators and educators must enhance the existing transition support program for new nurses. Additionally, the establishment of individualized training programs is recommended to further improve the work readiness of new nurses.
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Affiliation(s)
- Heng Yang
- Department of Nursing, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, No.N1, ShangCheng Avenue, 322000, China
| | - Lili Yang
- Department of Nursing, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, No.N1, ShangCheng Avenue, 322000, China
| | - Lixia Chen
- Department of Nursing, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, No.N1, ShangCheng Avenue, 322000, China
| | - Jinheng Liu
- Department of Nursing, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, No.N1, ShangCheng Avenue, 322000, China
| | - Shaomei Cui
- Department of Nursing, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, No.N1, ShangCheng Avenue, 322000, China
| | - Liyan Zhang
- Department of Nursing, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, No.N1, ShangCheng Avenue, 322000, China
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Maben J, Taylor C, Jagosh J, Carrieri D, Briscoe S, Klepacz N, Mattick K. Causes and solutions to workplace psychological ill-health for nurses, midwives and paramedics: the Care Under Pressure 2 realist review. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-171. [PMID: 38662367 DOI: 10.3310/twdu4109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Background Nurses, midwives and paramedics are the largest collective group of clinical staff in the National Health Service and have some of the highest prevalence of psychological ill-health. Existing literature tends to be profession-specific and focused on individual interventions that place responsibility for good psychological health with nurses, midwives and paramedics themselves. Aim To improve understanding of how, why and in what contexts nurses, midwives and paramedics experience work-related psychological ill-health; and determine which high-quality interventions can be implemented to minimise psychological ill-health in these professions. Methods Realist synthesis methodology consistent with realist and meta-narrative evidence syntheses: evolving standards' reporting guidelines. Data sources First round database searching in Medical Literature Analysis and Retrieval System Online Database ALL (via Ovid), cumulative index to nursing and allied health literature database (via EBSCO) and health management information consortium database (via Ovid), was undertaken between February and March 2021, followed by supplementary searching strategies (e.g. hand searching, expert solicitation of key papers). Reverse chronology screening was applied, aimed at retaining 30 relevant papers in each profession. Round two database searches (December 2021) targeted COVID-19-specific literature and literature reviews. No date limits were applied. Results We built on seven key reports and included 75 papers in the first round (26 nursing, 26 midwifery, 23 paramedic) plus 44 expert solicitation papers, 29 literature reviews and 49 COVID-19 focused articles in the second round. Through the realist synthesis we surfaced 14 key tensions in the literature and identified five key findings, supported by 26 context mechanism and outcome configurations. The key findings identified the following: (1) interventions are fragmented, individual-focused and insufficiently recognise cumulative chronic stressors; (2) it is difficult to promote staff psychological wellness where there is a blame culture; (3) the needs of the system often override staff well-being at work ('serve and sacrifice'); (4) there are unintended personal costs of upholding and implementing values at work; and (5) it is challenging to design, identify and implement interventions to work optimally for diverse staff groups with diverse and interacting stressors. Conclusions Our realist synthesis strongly suggests the need to improve the systemic working conditions and the working lives of nurses, midwives and paramedics to improve their psychological well-being. Individual, one-off psychological interventions are unlikely to succeed alone. Psychological ill-health is highly prevalent in these staff groups (and can be chronic and cumulative as well as acute) and should be anticipated and prepared for, indeed normalised and expected. Healthcare organisations need to (1) rebalance the working environment to enable healthcare professionals to recover and thrive; (2) invest in multi-level system approaches to promote staff psychological well-being; and use an organisational diagnostic framework, such as the NHS England and NHS Improvement Health and Wellbeing framework, to self-assess and implement a systems approach to staff well-being. Future work Future research should implement, refine and evaluate systemic interventional strategies. Interventions and evaluations should be co-designed with front-line staff and staff experts by experience, and tailored where possible to local, organisational and workforce needs. Limitations The literature was not equivalent in size and quality across the three professions and we did not carry out citation searches using hand searching and stakeholder/expert suggestions to augment our sample. Study registration This study is registered as PROSPERO CRD42020172420. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020172420. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR129528) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 9. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Jill Maben
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Cath Taylor
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Justin Jagosh
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Daniele Carrieri
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Simon Briscoe
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Naomi Klepacz
- School of Health Sciences, University of Surrey, Guildford, UK
- School of Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) Wessex, Southampton, UK
| | - Karen Mattick
- University of Exeter Medical School, University of Exeter, Exeter, UK
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Lee J, Kim J, Lim HA, Song Y. The mediating and moderating role of recovery experience between occupational stress and turnover intention in nurses caring for patients with COVID-19. J Clin Nurs 2024; 33:1470-1481. [PMID: 38050923 DOI: 10.1111/jocn.16937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/25/2023] [Accepted: 11/01/2023] [Indexed: 12/07/2023]
Abstract
AIM This study aimed to investigate the relationships among occupational stress, recovery experience and turnover intention among nurses caring for patients with coronavirus disease 2019 (COVID-19). BACKGROUND The high turnover intention among nurses affect patient safety quality of patient care. DESIGN The cross-sectional study design was used. This study was guided by STROBE. METHODS Convenience sampling identified 202 registered nurses working in the COVID-19 wards of three tertiary general hospitals in two cities in South Korea. The collected data were analysed using SPSS version 26.0, and the PROCESS macro in SPSS was employed to estimate path coefficients and assess the adequacy of the model. The moderating effects of recovery experience on the pathway in which occupational stress of the participants affects turnover intention were verified using model 1 of the SPSS PROCESS macro proposed by Hayes. RESULTS The recovery experience did not significantly mediate the relationship between occupational stress and turnover intention. However, it had significant moderating effect on the relationship between occupational stress and turnover intention (β = .005, 95% CI [.001, .010]). The effect of occupational stress on turnover intention was dependent on recovery experience. CONCLUSION The results revealed that occupational stress among nurses caring for patients with COVID-19 affect the turnover intention and the level of recovery experience moderates this relationship. Thus, not only during the COVID-19 pandemic but also during challenging times of various infectious disease outbreaks, hospitals can enhance the health and well-being of nurses and promote the retention of nursing staff. IMPLICATIONS FOR THE PROFESSION During the COVID-19 pandemic, nurses have been exposed to understaffing and overwhelming workloads. However, policies for nurses' welfare and benefits are still insufficient, even as the pandemic comes to an end. The results of this study indicate that sufficient rest and appropriate nursing personnel are of utmost importance to nurses. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Junghoon Lee
- Department of Nursing, Keimyung College University, Daegu, South Korea
| | - Junekyu Kim
- Department of Nursing, Kyungil University, Gyeongsan, South Korea
| | - Hong-A Lim
- Kyungpook National University College of Nursing, Research Institute of Nursing Science, Daegu, South Korea
| | - Yeoungsuk Song
- Kyungpook National University College of Nursing, Research Institute of Nursing Science, Daegu, South Korea
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Yu W, Zhang Y, Xianyu Y, Cheng D. Stressors, emotions, and social support systems among respiratory nurses during the Omicron outbreak in China: a qualitative study. BMC Nurs 2024; 23:188. [PMID: 38515080 PMCID: PMC10956170 DOI: 10.1186/s12912-024-01856-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/10/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Respiratory nurses faced tremendous challenges when the Omicron variant spread rapidly in China from late 2022 to early 2023. An in-depth understanding of respiratory nurses' experiences during challenging times can help to develop better management and support strategies. The present study was conducted to explore and describe the work experiences of nurses working in the Department of Pulmonary and Critical Care Medicine (PCCM) during the Omicron outbreak in China. METHODS This study utilized a descriptive phenomenological method. Between January 9 and 22, 2023, semistructured and individual in-depth interviews were conducted with 11 respiratory nurses at a tertiary hospital in Wuhan, Hubei Province. A purposive sampling method was used to select the participants, and the sample size was determined based on data saturation. The data analysis was carried out using Colaizzi's method. RESULTS Three themes with ten subthemes emerged: (a) multiple stressors (intense workload due to high variability in COVID patients; worry about not having enough ability and energy to care for critically ill patients; fighting for anxious clients, colleagues, and selves); (b) mixed emotions (feelings of loss and responsibility; feelings of frustration and achievement; feelings of nervousness and security); and (c) a perceived social support system (team cohesion; family support; head nurse leadership; and the impact of social media). CONCLUSION Nursing managers should be attentive to frontline nurses' needs and occupational stress during novel coronavirus disease 2019 (COVID-19) outbreaks. Management should strengthen psychological and social support systems, optimize nursing leadership styles, and proactively consider the application of artificial intelligence (AI) technologies and products in clinical care to improve the ability of nurses to effectively respond to future public health crises.
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Affiliation(s)
- Wenzhen Yu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, No. 238, Jiefang Road, 430060, Wuhan, China
| | - Ying Zhang
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, No. 238, Jiefang Road, 430060, Wuhan, China
| | - Yunyan Xianyu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, No. 238, Jiefang Road, 430060, Wuhan, China
| | - Dan Cheng
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, No. 238, Jiefang Road, 430060, Wuhan, China.
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Boudreau C, Rhéaume A. Impact of the Work Environment on Nurse Outcomes: A Mediation Analysis. West J Nurs Res 2024; 46:210-218. [PMID: 38343035 PMCID: PMC10903131 DOI: 10.1177/01939459241230369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND The nursing workforce remains in a vulnerable state post pandemic as working conditions are difficult and exacerbated by a global nursing shortage. Identifying factors leading to turnover intentions are thus critical for health care system recovery. PURPOSE The purpose of this study was to examine the impact of nurses' work environment and the pandemic on missed nursing care, scope of practice, emotional exhaustion, and intent to leave. METHODS This study was a cross-sectional, self-reporting online survey, sent to hospital-based nurses in a Canadian province (n = 419). Mediation analysis was used to examine both direct and indirect effects of work environment and COVID-19 impact on nurse outcomes (emotional exhaustion and intent to leave) through missed care and scope of practice. RESULTS The results showed that 73% of nurses were considering leaving the profession. Several direct and indirect pathways predicted emotional exhaustion and intent to leave. A better work environment was related to both decreased emotional exhaustion and intent to leave. Nurses' scope of practice partially mediated the relationship between work environment and intent to leave. On the other hand, missed care did not mediate emotional exhaustion or intent to leave. CONCLUSIONS While considering the global nursing shortage, it is imperative to implement strategies to promote nurses' well-being and their retention within the health care system.
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Affiliation(s)
| | - Ann Rhéaume
- School of Nursing, Université de Moncton, Moncton, NB, Canada
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Jones CB, Kim S, McCollum M, Tran AK. New insights on a recurring theme: A secondary analysis of nurse turnover using the National Sample Survey of Registered Nurses. Nurs Outlook 2024; 72:102107. [PMID: 38160504 DOI: 10.1016/j.outlook.2023.102107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/15/2023] [Accepted: 12/10/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Registered nurse (RN) turnover is a recurring phenomenon that accelerated during COVID-19 and heightened concerns about contributing factors. PURPOSE Provide baseline RN turnover data to which pandemic and future RN workforce turnover behaviors can be compared. METHODS A cross-sectional, secondary analysis of RN turnover using U.S. National Sample Survey of Registered Nurses 2018 data. Responses from 41,428 RNs (weighted N = 3,092,991) across the United States were analyzed. Sociodemographic, professional, employment, and economic data and weighting techniques were used to model prepandemic RN turnover behaviors. DISCUSSION About 17% of the sample reported a job turnover, with 6.2% reporting internal and 10.8% reporting external turnover. The factors common across both internal and external turnover experiences included education, employment settings, and years of nursing experience. CONCLUSIONS Baseline RN turnover data can help employers and policymakers understand new and recurring nursing workforce trends and develop targeted actions to reduce nurse turnover.
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Affiliation(s)
- Cheryl B Jones
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Sinhye Kim
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC.
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Parvin MR, Sharmi PD, Kayesh I, Rony MKK. "Patient dignity can be ensured by providing adequate health care": A phenomenological analysis on survival strategies of military nurses. Heliyon 2024; 10:e25893. [PMID: 38379966 PMCID: PMC10877287 DOI: 10.1016/j.heliyon.2024.e25893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 01/23/2024] [Accepted: 02/05/2024] [Indexed: 02/22/2024] Open
Abstract
Background The devastating COVID-19 outbreak has considerably influenced basic human healthcare needs. Due to healthcare organizational limitations, workload, and a shortage of healthcare professionals, particularly military nurses in developing countries, faced critical situations in dealing with COVID-19 patients. However, little is known about the survival strategies military nurses used while caring for coronavirus-infected patients. Aims This study aimed to investigate the survival strategies that inspired military nurses to manage COVID-19 patients in Bangladesh. Methods This study employed the phenomenology of practice framework developed by Max van Manen. Fourteen military nurses were purposefully selected to participate in this study. Semi-structured online interviews were conducted individually from January to February 2023 in three divisional (Dhaka, Chittagong, and Sylhet) COVID-19 dedicated military hospitals in Bangladesh. The study was reported using the COREQ checklist. Audio-video sessions of discussions were recorded, analyzed, and transcribed verbatim. Dataset analysis was performed using thematic analysis. Results Eight themes were developed: (i) Nurses' self-strategies; (ii) colleagues' strategies; (iii) Nurse managers' strategies; (iv) Feelings about nursing ethical values; (v) Employers' strategies; (vi) Government strategies; (vii) Family members' strategies; (viii) Strategies of social people. Conclusions The study's findings would inspire healthcare professionals to use various survival strategies when facing critical clinical situations. Additionally, this study encourages nurses to develop survival skills to avoid depression, fear, and anxiety and to learn how to deal with work-related stress situations.
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Affiliation(s)
- Mst. Rina Parvin
- Afns Major at Bangladesh Army, Combined Military Hospital, Dhaka, Bangladesh
- School of Medical Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Priyanka Das Sharmi
- Assistant Professor, International University of Business Agriculture and Technology, Dhaka, Bangladesh
| | - Ibne Kayesh
- Institute of Social Welfare and Research, University of Dhaka, Dhaka, Bangladesh
| | - Moustaq Karim Khan Rony
- Institute of Social Welfare and Research, University of Dhaka, Dhaka, Bangladesh
- Master of Public Health, Bangladesh Open University, Dhaka, Bangladesh
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Lieb M, Erim Y, Morawa E. Development and validation of a questionnaire for measuring team cohesion: the Erlangen Team Cohesion at Work Scale (ETC). BMC Psychol 2024; 12:91. [PMID: 38388465 PMCID: PMC10885512 DOI: 10.1186/s40359-024-01583-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/11/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Team cohesion is a crucial factor when it comes to job satisfaction and turnovers. However, in Germany, economic measures for team cohesion are scarce. The aim of this study was to develop and validate an economic self-report questionnaire for measuring team cohesion in a work setting in health care. METHODS The questionnaire was developed in a stepwise procedure. After item analysis, exploratory factor analysis was conducted to assess factor structure. Reliability was tested via internal consistency. To assess convergent and divergent validity, we applied the Copenhagen Psychosocial Questionnaire (COPSOQ), the Perceived Cohesion Scale (PCS), the ENRICHD Social Support Inventory (ESSI), the Effort-Reward Imbalance Scale (ERI) and the Patient Health Questionnaire (PHQ-4), respectively. RESULTS The pilot version was tested in a sample of n = 126 adult nurses. Item analysis resulted in a total of 13 items for the final version. Exploratory factor analysis indicated a two-factor structure. Internal consistency for the two subscales was good, with α = 0.88 and α = 0.84, respectively. Convergent validity with the subscales of COPSOQ and PCS was moderate to high (r =.26- r =.64). For divergent validity, correlations with the ESSI were low (r =.01- r = -.09). We further found significant correlations with depression symptoms (r=-.22- r=-.37), as well as reward (ERI) (r =.41 -r =.47) and effort (ERI) (r=-.20 - r = -.24). CONCLUSIONS We developed and validated the Erlangen Team Cohesion at Work Scale (ETC), a self-report measure for team cohesion with very good psychometric properties. Due to its economic deployment, it is suitable for measuring team cohesion in work settings, especially in health care.
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Affiliation(s)
- Marietta Lieb
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
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Galanis P, Moisoglou I, Papathanasiou IV, Malliarou M, Katsiroumpa A, Vraka I, Siskou O, Konstantakopoulou O, Kaitelidou D. Association between Organizational Support and Turnover Intention in Nurses: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2024; 12:291. [PMID: 38338176 PMCID: PMC10855592 DOI: 10.3390/healthcare12030291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 01/10/2024] [Accepted: 01/18/2024] [Indexed: 02/12/2024] Open
Abstract
Although recent studies suggest a negative relationship between organizational support and turnover intention among nurses, there has been no systematic review on this issue. The aim of this systematic review and meta-analysis was to synthesize and evaluate the association between organizational support and turnover intention in nurses. The review protocol was registered with PROSPERO (CRD42023447109). A total of eight studies with 5754 nurses were included. All studies were cross-sectional and were conducted after 2010. Quality was moderate in five studies and good in three studies. We found a moderate negative correlation between organizational support and turnover intention since the pooled correlation coefficient was -0.32 (95% confidence interval: -0.42 to -0.21). All studies found a negative correlation between organizational support and turnover intention ranging from -0.10 to -0.51. A leave-one-out sensitivity analysis showed that our results were stable when each study was excluded. Egger's test and funnel plot suggested the absence of publication bias in the eight studies. Subgroup analysis showed that the negative correlation between organizational support and turnover intention was stronger in studies in China and Australia than those in Europe. Organizational support has a moderate negative correlation with turnover intention in nurses. However, data regarding the impact of organizational support on turnover intention are limited. Moreover, our study had several limitations, and thus, we cannot generalize our results. Therefore, further studies should be conducted to assess the independent effect of organizational support on turnover intention in a more valid way. In any case, nursing managers should draw attention to organizational support by developing effective clinical practice guidelines for nurses so as to reduce turnover intention.
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Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.G.); (A.K.)
| | - Ioannis Moisoglou
- Faculty of Nursing, University of Thessaly, 41500 Larisa, Greece; (I.M.); (M.M.)
| | | | - Maria Malliarou
- Faculty of Nursing, University of Thessaly, 41500 Larisa, Greece; (I.M.); (M.M.)
| | - Aglaia Katsiroumpa
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.G.); (A.K.)
| | - Irene Vraka
- Department of Radiology, P. & A. Kyriakou Children’s Hospital, 11527 Athens, Greece;
| | - Olga Siskou
- Department of Tourism Studies, University of Piraeus, 18534 Piraeus, Greece;
| | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (O.K.); (D.K.)
| | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (O.K.); (D.K.)
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Boch C, Cappaert T, Shotwell MP, Schmelzer C. Investigating the Impact of Mindfulness Meditation on Stress Reduction and Self-Compassion of Nursing Health Care Professionals in a Small Community Hospital in the Midwest: A Pilot Study. Holist Nurs Pract 2024; 38:14-23. [PMID: 37966986 DOI: 10.1097/hnp.0000000000000623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Coronavirus-19 exacerbated daily stressors for nurses due to long hours, understaffing, and potential burnout in health care personnel. There is evidence that nurses who participate in mindfulness activities may experience significant changes related to stress, anxiety, and mood; however, more quantitative research studies are needed to investigate and substantiate the impact of mindfulness-based interventions. This intervention investigated the impact of a 4-week mindfulness meditation on perceived stress and self-compassion. Thirty-two participants were enrolled at the beginning of the study and 26 completed the intervention (intervention group, n = 17; control group, n = 9). A 2-tailed Mann-Whitney U sample rank-sum test was used to explore differences between groups on the 2 outcome variables-Perceived Stress Scale (PSS) and the Self-Compassion Scale (SC). Postintervention assessments were conducted, and statistically significant differences were found between the intervention and control groups for 2 constructs. The intervention group was more likely to "feel confident handling problems" (PSS#4) versus the control group (median = 11.76, 16.78, respectively; P = .020; α = .05); and the intervention group tended to "take a more balanced view of life situations" (SC#3) than the control group (median = 12.50, 15.39, respectively; P =.047; α = .05). Other constructs from the PSS and the SC were not statistically different. In conclusion, this study found observable improvements in the raw data and statistically significant differences for the intervention group; however, more research is warranted.
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Affiliation(s)
- Cenell Boch
- Rocky Mountain University, Provo, Utah (Ms Boch); Rocky Mountain University of Health Professions, Provo, Utah (Drs Cappaert and Shotwell); and Fairfield Medical Center, Lancaster, Ohio (Ms Schmelzer)
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Usset TJ, Stratton RG, Knapp S, Schwartzman G, Yadav SK, Schaefer BJ, Harris JI, Fitchett G. Factors Associated With Healthcare Clinician Stress and Resilience: A Scoping Review. J Healthc Manag 2024; 69:12-28. [PMID: 38175533 DOI: 10.1097/jhm-d-23-00020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
GOAL Clinician stress and resilience have been the subjects of significant research and interest in the past several decades. We aimed to understand the factors that contribute to clinician stress and resilience in order to appropriately guide potential interventions. METHODS We conducted a scoping review (n = 42) of published reviews of research on clinician distress and resilience using the methodology of Peters and colleagues (2020). Our team examined these reviews using the National Academy of Medicine's framework for clinician well-being and resilience. PRINCIPAL FINDINGS We found that organizational factors, learning/practice environment, and healthcare responsibilities were three of the top four factors identified in the reviews as contributing to clinician distress. Learning/practice environment and organizational factors were two of the top four factors identified in the reviews as contributing to their resilience. PRACTICAL APPLICATIONS Clinicians continue to face numerous external challenges that complicate their work. Further research, practice, and policy changes are indicated to improve practice environments for healthcare clinicians. Healthcare leaders need to promote resources for organizational and system-level changes to improve clinician well-being.
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Affiliation(s)
- Timothy J Usset
- Division of Health Policy and Management, University of Minnesota, Minneapolis, Minnesota, and VA Maine Health Care System, Augusta, Maine
| | | | - Sarah Knapp
- Ascension St. Vincent Hospital, Indianapolis, Indiana
| | - Gabrielle Schwartzman
- The School of Medicine and Health Sciences, George Washington University, Washington, DC
| | | | | | - J Irene Harris
- VA Maine Health Care System, Augusta, Maine, and Department of Psychology, University of Maine, Orono, Maine
| | - George Fitchett
- Department of Religion, Health and Human Values, Rush University Medical Center, Chicago, Illinois
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Galanis P, Moisoglou I, Malliarou M, Papathanasiou IV, Katsiroumpa A, Vraka I, Siskou O, Konstantakopoulou O, Kaitelidou D. Quiet Quitting among Nurses Increases Their Turnover Intention: Evidence from Greece in the Post-COVID-19 Era. Healthcare (Basel) 2023; 12:79. [PMID: 38200985 PMCID: PMC10779139 DOI: 10.3390/healthcare12010079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/16/2023] [Accepted: 12/26/2023] [Indexed: 01/12/2024] Open
Abstract
As turnover intention is a strong determinant of actual turnover behavior, scholars should identify the determinants of turnover intention. In this context, the aim of this study was to assess the effect of quiet quitting on nurses' turnover intentions. Additionally, this study examined the impact of several demographic and job characteristics on turnover intention. A cross-sectional study with 629 nurses in Greece was conducted. The data were collected in September 2023. Quiet quitting was measured with the "Quiet Quitting" scale. In this study, 60.9% of nurses were considered quiet quitters, while 40.9% experienced high levels of turnover intention. Multivariable regression analysis showed that higher levels of quiet quitting increased turnover intention. Moreover, this study found that turnover intention was higher among females, shift workers, nurses in the private sector, and those who considered their workplace understaffed. Also, clinical experience was associated positively with turnover intention. Since quiet quitting affects turnover intention, organizations, policymakers, and managers should address this issue to improve nurses' intentions to stay at their jobs.
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Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.G.); (A.K.)
| | - Ioannis Moisoglou
- Faculty of Nursing, University of Thessaly, 41500 Larisa, Greece; (I.M.); (I.V.P.)
| | - Maria Malliarou
- Faculty of Nursing, University of Thessaly, 41500 Larisa, Greece; (I.M.); (I.V.P.)
| | | | - Aglaia Katsiroumpa
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.G.); (A.K.)
| | - Irene Vraka
- Department of Radiology, P. & A. Kyriakou Children’s Hospital, 11527 Athens, Greece;
| | - Olga Siskou
- Department of Tourism Studies, University of Piraeus, 18534 Piraeus, Greece;
| | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (O.K.); (D.K.)
| | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (O.K.); (D.K.)
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Havaei F, Tang X, Adhami N, Kaulius M, Boamah SA, McMillan K. Working through a pandemic: The mediating effect of nurses' health on the relationship between working conditions and turnover intent. Nurs Open 2023; 10:7650-7658. [PMID: 37786297 PMCID: PMC10643829 DOI: 10.1002/nop2.2005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 07/06/2023] [Accepted: 09/17/2023] [Indexed: 10/04/2023] Open
Abstract
AIM While research has demonstrated that nurses' health and working conditions are important predictors of turnover in COVID-19, the relationship between these factors is not well understood. Our study investigated the mechanism through which working conditions and nurses' physical and mental health could impact intent to leave the nursing profession. DESIGN Secondary data from a cross-sectional survey of 3478 nurses in British Columbia administered in May 2021 were analysed using structural equation modelling. METHODS Two models were assessed utilizing workplace conditions as the predictor, nurses' health as the mediator, and reported turnover intent (Model 1), and anticipated time to turnover (Model 2) as the outcomes. RESULTS Nurses' health partially mediated the relationship between working conditions and turnover intent, where poorer workplace conditions were directly and indirectly associated with greater likelihood of leaving the profession. Nurses' health fully mediated the relationship between working conditions and nurses' anticipated time to turnover, after controlling for age. The findings from this study underscore the importance of enhancing working conditions and improving nurses' mental health and safety on the job. PATIENT OR PUBLIC CONTRIBUTION The British Columbia Nurses' Union provided the data for this study; survey data from 3478 nurses were utilized in our study.
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Affiliation(s)
- Farinaz Havaei
- University of British ColumbiaBritish ColumbiaVancouverCanada
| | - Xuyan Tang
- University of British ColumbiaBritish ColumbiaVancouverCanada
| | - Nassim Adhami
- University of British ColumbiaBritish ColumbiaVancouverCanada
| | - Megan Kaulius
- University of British ColumbiaBritish ColumbiaVancouverCanada
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Aliafsari Mamaghani E, Sheikhnezhad L, Estebsari T. Abnormal Burnout of Nurses in Crisis; Double Pressure of Low Support and Competence. J Caring Sci 2023; 12:211-212. [PMID: 38250000 PMCID: PMC10799272 DOI: 10.34172/jcs.2023.33177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 09/25/2023] [Indexed: 01/23/2024] Open
Affiliation(s)
| | - Leila Sheikhnezhad
- Department of Community Health Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Taher Estebsari
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Hoying J, Terry A, Kelly S, Melnyk BM. A cognitive-behavioral skills building program improves mental health and enhances healthy lifestyle behaviors in nurses and other hospital employees. Worldviews Evid Based Nurs 2023; 20:542-549. [PMID: 37897217 DOI: 10.1111/wvn.12686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 09/19/2023] [Accepted: 10/02/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Mental health outcomes in nurses have historically indicated a greater prevalence of anxiety, depression, and suicide than the general population. It is vital to provide programming for healthcare workers to gain the necessary skills to reduce burnout and improve their mental and physical health. AIMS The aims of this study were to evaluate mental health outcomes and healthy lifestyle beliefs and behaviors among nurses and other hospital employees who completed MINDBODYSTRONG, a cognitive-behavioral skill building program. METHODS A pre-experimental, pre- and poststudy design was used to examine mental health and well-being outcomes among 100 hospital personnel who participated in MINDBODYSTRONG, a program designed to improve coping and resiliency and decrease stress, anxiety, and depressive symptoms. Outcomes measured included healthy lifestyle behaviors, healthy lifestyle beliefs, anxiety, depression, stress, and burnout. RESULTS One hundred hospital personnel, including 93 nurses, completed the pre- and post-survey. Among all participants, post- MINDBODYSTRONG scores for healthy lifestyle beliefs (p = .00; Cohen's d = 0.52) and healthy lifestyle behaviors (p = .00; Cohen's d = -0.74) increased significantly with medium effects, while depression (p = .00; Cohen's d = -0.51), anxiety (p = .00; Cohen's d = -0.54), stress (p = .00; Cohen's d = -0.33), and burnout (p = .00; Cohen's d = -0.37) decreased significantly with small and medium effects. The program produced even stronger positive effects on mental health outcomes for participants who started the study with higher levels of depression and anxiety. LINKING EVIDENCE TO PRACTICE Anxiety, depression, stress, and burnout decreased significantly postintervention. Participants also significantly improved their healthy lifestyle beliefs and behaviors with the MINDBODYSTRONG program. MINDBODYSTRONG is an effective program that reduces anxiety, depression, burnout, and stress and improves healthy lifestyle beliefs and behaviors in hospital-based clinicians. It is of utmost importance to provide evidence-based programs to improve mental resiliency and decrease stress, anxiety, burnout, and depressive symptoms, which will ultimately improve the safety and quality of health care.
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Affiliation(s)
| | - Ayanna Terry
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Stephanie Kelly
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
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Chang YH, Hsu CH, Tseng YC, Hsiung CA. Country-Level Factors Associated With Nurse Salaries: Empirical Evidence From Organisation for Economic Co-operation and Development Countries and Taiwan. J Nurs Res 2023; 31:e303. [PMID: 37988058 DOI: 10.1097/jnr.0000000000000585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Salary impacts nurse retention rates and thus is a factor affecting the nursing shortage both in Taiwan and around the world. Nurses in Taiwan earn a low salary compared with other health professionals and may be undervalued compared with their international counterparts. PURPOSE This study was designed to analyze the factors associated with nurse salary (NS) in Organisation for Economic Co-operation and Development (OECD) countries and to compare NS in Taiwan with those in OECD member states. METHODS Data were extracted from the OECD statistics database and official statistics for Taiwan. For the 28 OECD member countries considered in this study and Taiwan, 21 indicators characterizing healthcare systems, including demographics, socioeconomic status, health behaviors and risks, healthcare resources, health financing, healthcare utilization, health outcomes, and economic inequality, were examined for the period of 2009-2018. A random-effects model (REM) and a fixed-effects model (FEM) were used to investigate the associations between these indicators and annual NS levels. The expected annual NS for Taiwan was estimated and compared with the actual NS for Taiwan using the REM. RESULTS In the REM, higher NS in OECD countries was shown to be positively associated with gross domestic product per capita (0.49, 95% confidence interval [CI] [0.41, 0.56]), proportion of population aged 65 years and over (2.72, 95% CI [2.17, 3.26]), crude birth rate (1.02, 95% CI [0.56, 1.49]), number of computerized tomography scanners per million population (0.26, 95% CI [0.17, 0.35]), alcohol consumption per person (0.94, 95% CI [0.26, 1.61]), and prevalence of obesity (0.64, 95% CI [0.40, 0.89]) and to be in inversely associated with infant mortality rate (-3.13, 95% CI [-3.94, -2.32]), bed density (-0.99, 95% CI [-1.72, -0.25]), number of hospital discharges (-0.08, 95% CI [-0.11, -0.05]), household out-of-pocket expenditure as a percentage of health expenditure (-0.34, 95% CI [-0.56, -0.11]), and the Gini coefficient (-0.25, 95% CI [-0.50, -0.01]). The FEM results were similar to those of the REM. The predicted annual NS for Taiwan based on the REM rose from 29,390 U.S. dollars (corrected for purchasing power parity; 95% CI [22,532, 36,247]) in 2009 to 49,891 U.S. dollars (95% CI [42,344, 57,438]) in 2018. The actual annual NS in Taiwan in 2018 was approximately 12% lower than the model-predicted value. CONCLUSIONS/IMPLICATIONS FOR PRACTICE Taiwan has a lower NS compared with its OECD counterparts. These findings may help policymakers, healthcare managers, and nurse organizations develop effective strategies to improve the remuneration system for nurses in Taiwan.
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Affiliation(s)
| | - Chia Hui Hsu
- MS, Research Assistant, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Yu-Chun Tseng
- MS, Research Assistant, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Chao A Hsiung
- PhD, Honorary Investigator, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
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Apaydin EA, Rose DE, McClean MR, Mohr DC, Yano EM, Shekelle PG, Nelson KM, Guo R, Yoo CK, Stockdale SE. Burnout, employee engagement, and changing organizational contexts in VA primary care during the early COVID-19 pandemic. BMC Health Serv Res 2023; 23:1306. [PMID: 38012726 PMCID: PMC10683139 DOI: 10.1186/s12913-023-10270-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/02/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic involved a rapid change to the working conditions of all healthcare workers (HCW), including those in primary care. Organizational responses to the pandemic, including a shift to virtual care, changes in staffing, and reassignments to testing-related work, may have shifted more burden to these HCWs, increasing their burnout and turnover intent, despite their engagement to their organization. Our objectives were (1) to examine changes in burnout and intent to leave rates in VA primary care from 2017-2020 (before and during the pandemic), and (2) to analyze how individual protective factors and organizational context affected burnout and turnover intent among VA primary care HCWs during the early months of the pandemic. METHODS We analyzed individual- and healthcare system-level data from 19,894 primary care HCWs in 139 healthcare systems in 2020. We modeled potential relationships between individual-level burnout and turnover intent as outcomes, and individual-level employee engagement, perceptions of workload, leadership, and workgroups. At healthcare system-level, we assessed prior-year levels of burnout and turnover intent, COVID-19 burden (number of tests and deaths), and the extent of virtual care use as potential determinants. We conducted multivariable analyses using logistic regression with standard errors clustered by healthcare system controlled for individual-level demographics and healthcare system complexity. RESULTS In 2020, 37% of primary care HCWs reported burnout, and 31% reported turnover intent. Highly engaged employees were less burned out (OR = 0.57; 95% CI 0.52-0.63) and had lower turnover intent (OR = 0.62; 95% CI 0.57-0.68). Pre-pandemic healthcare system-level burnout was a major predictor of individual-level pandemic burnout (p = 0.014). Perceptions of reasonable workload, trustworthy leadership, and strong workgroups were also related to lower burnout and turnover intent (p < 0.05 for all). COVID-19 burden, virtual care use, and prior year turnover were not associated with either outcome. CONCLUSIONS Employee engagement was associated with a lower likelihood of primary care HCW burnout and turnover intent during the pandemic, suggesting it may have a protective effect during stressful times. COVID-19 burden and virtual care use were not related to either outcome. Future research should focus on understanding the relationship between engagement and burnout and improving well-being in primary care.
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Affiliation(s)
- Eric A Apaydin
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA.
- RAND Corporation, Santa Monica, CA, USA.
| | - Danielle E Rose
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
| | - Michael R McClean
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
| | - David C Mohr
- National Center for Organization Development, Veterans Health Administration, Cincinnati, OH, USA
- Department of Health Law, Policy & Management, School of Public Health, Boston University, Boston, MA, USA
| | - Elizabeth M Yano
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Paul G Shekelle
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Karin M Nelson
- Seattle-Denver Center of Innovation, VA Puget Sound Health Care System, Seattle, WA, USA
- Division of General Internal Medicine, Department of Medicine, University of Washington School of Medicine, University of Washington, Seattle, WA, USA
| | - Rong Guo
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
| | - Caroline K Yoo
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Susan E Stockdale
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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Nigam JAS, Barker RM, Cunningham TR, Swanson NG, Chosewood LC. Vital Signs: Health Worker-Perceived Working Conditions and Symptoms of Poor Mental Health - Quality of Worklife Survey, United States, 2018-2022. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2023; 72:1197-1205. [PMID: 37917563 PMCID: PMC10629752 DOI: 10.15585/mmwr.mm7244e1] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Introduction Health workers faced overwhelming demands and experienced crisis levels of burnout before the COVID-19 pandemic; the pandemic presented unique challenges that further impaired their mental health. Methods Data from the General Social Survey Quality of Worklife Module were analyzed to compare self-reported mental health symptoms among U.S. adult workers from 2018 (1,443 respondents, including 226 health workers) and 2022 (1,952, including 325 health workers). Logistic regression was used to examine associations between health workers' reported perceptions of working conditions and anxiety, depression, and burnout. Results From 2018 to 2022, health workers reported an increase of 1.2 days of poor mental health during the previous 30 days (from 3.3 days to 4.5 days); the percentage who reported feeling burnout very often (11.6% to 19.0%) increased. In 2022, health workers experienced a decrease in odds of burnout if they trusted management (odds ratio [OR] = 0.40), had supervisor help (OR = 0.26), had enough time to complete work (OR = 0.33), and felt that their workplace supported productivity (OR = 0.38), compared with those who did not. Harassment at work was associated with increased odds of anxiety (OR = 5.01), depression (OR = 3.38), and burnout (OR = 5.83). Conclusions and implications for public health practice Health workers continued to face a mental health crisis in 2022. Positive working conditions were associated with less burnout and better mental health. CDC's National Institute for Occupational Safety and Health has developed a national campaign, Impact Wellbeing, to provide employers of health workers with resources to improve the mental health of these workers.
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Lerret SM, Nuccio S, Compton A, Keegan M, Rapala K. Nurses' Experiences and Perspectives of the Telehealth Working Environment and Educational Needs. J Contin Educ Nurs 2023; 54:501-508. [PMID: 37747140 DOI: 10.3928/00220124-20230918-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
BACKGROUND The continuing evolution of health care and the nursing profession includes the exponential growth of telehealth platforms. The goal of this study was to describe nurses' experiences with and perspectives on their practice with and future need for telehealth. METHOD A cross-sectional descriptive mixed methods study was conducted with nursing graduates from a single university. Completed survey questions focused on demographics, current work status, plans for employment participation, and telehealth experience. Descriptive analysis was conducted with statistical software, with directed content analysis for narrative responses. RESULTS A total of 305 of 5,080 participants completed the survey (6% response rate). Nurses described perceived benefits and barriers to working in a telehealth environment. Nurses identified continuing education needs that could form the basis for a telehealth continuing education program to increase confidence in telehealth delivery. CONCLUSION The identified telehealth educational needs will positively influence the formation of continuing education opportunities for practicing nurses. [J Contin Educ Nurs. 2023;54(11):501-508.].
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D'Alessandro-Lowe AM, Ritchie K, Brown A, Easterbrook B, Xue Y, Pichtikova M, Altman M, Beech I, Millman H, Foster F, Hassall K, Levy Y, Streiner DL, Hosseiny F, Rodrigues S, Heber A, O'Connor C, Schielke H, Malain A, McCabe RE, Lanius RA, McKinnon MC. Canadian respiratory therapists who considered leaving their clinical position experienced elevated moral distress and adverse psychological and functional outcomes during the COVID-19 pandemic. Health Promot Chronic Dis Prev Can 2023; 43:460-471. [PMID: 37991889 PMCID: PMC10753904 DOI: 10.24095/hpcdp.43.10/11.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
INTRODUCTION Respiratory therapists (RTs) faced morally distressing situations throughout the COVID-19 pandemic, including working with limited resources and facilitating video calls for families of dying patients. Moral distress is associated with a host of adverse psychological and functional outcomes (e.g. depression, anxiety, symptoms of posttraumatic stress disorder [PTSD] and functional impairment) and consideration of position departure. The purpose of this study was to understand the impact of moral distress and its associated psychological and functional outcomes on consideration to leave a clinical position among Canadian RTs during the COVID-19 pandemic. METHODS Canadian RTs (N = 213) completed an online survey between February and June 2021. Basic demographic information (e.g. age, sex, gender) and psychometrically validated measures of moral distress, depression, anxiety, stress, PTSD, dissociation, functional impairment, resilience and adverse childhood experiences were collected. RESULTS One in four RTs reported considering leaving their position. RTs considering leaving reported elevated levels of moral distress and adverse psychological and functional outcomes compared to RTs not considering leaving. Over half (54.5%) of those considering leaving scored above the cut-off for potential diagnosis of PTSD. Previous consideration to leave a position and having left a position in the past each significantly increased the odds of currently considering leaving, along with system-related moral distress and symptoms of PTSD, but the contribution of these latter factors was small. CONCLUSIONS Canadian RTs considering leaving their position reported elevated levels of distress and adverse psychological and functional outcomes, yet these individual-level factors appear unlikely to be the primary factors underlying RTs' consideration to leave, because their effects were small. Further research is required to identify broader, organizational factors that may contribute to consideration of position departure among Canadian RTs.
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Affiliation(s)
| | - Kimberly Ritchie
- McMaster University, Hamilton, Ontario, Canada
- Homewood Research Institute, Guelph, Ontario, Canada
| | | | | | - Yuanxin Xue
- McMaster University, Hamilton, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Mina Pichtikova
- McMaster University, Hamilton, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Max Altman
- McMaster University, Hamilton, Ontario, Canada
| | - Isaac Beech
- McMaster University, Hamilton, Ontario, Canada
- Homewood Research Institute, Guelph, Ontario, Canada
| | | | - Fatima Foster
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Kelly Hassall
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Yarden Levy
- McMaster University, Hamilton, Ontario, Canada
| | - David L Streiner
- McMaster University, Hamilton, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Fardous Hosseiny
- Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada
- Institute of Mental Health Research at the Royal, University of Ottawa, Ottawa, Ontario, Canada
| | - Sara Rodrigues
- Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada
- Institute of Mental Health Research at the Royal, University of Ottawa, Ottawa, Ontario, Canada
| | - Alexandra Heber
- McMaster University, Hamilton, Ontario, Canada
- Veterans Affairs Canada, Ottawa, Ontario, Canada
| | | | | | - Ann Malain
- Homewood Health Centre, Guelph, Ontario, Canada
| | - Randi E McCabe
- McMaster University, Hamilton, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Ruth A Lanius
- Homewood Research Institute, Guelph, Ontario, Canada
- University of Western Ontario, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Margaret C McKinnon
- McMaster University, Hamilton, Ontario, Canada
- Homewood Research Institute, Guelph, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
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Sonney J, Peck JL. The Cost of Caring During COVID-19: A Clarion Call to Action to Support the Pediatric Advanced Practice Nursing Workforce. J Pediatr Health Care 2023; 37:658-672. [PMID: 37725029 DOI: 10.1016/j.pedhc.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION This study reexamined the holistic impacts of COVID-19 on the pediatric advanced practice registered nursing (APRN) workforce two years after the 2020 assessment. METHOD This cross-sectional descriptive study used a convenience sample of pediatric APRNs affiliated with the National Association of Pediatric Nurse Practitioners (NAPNAP). A modified NAPNAP survey explored numerous impacts of COVID-19 on the pediatric APRN workforce. RESULTS Study participants (n = 1,087) reported widespread pandemic impacts across personal and professional domains. Alarmingly, 87% reported professional burnout, and 80% expressed concern over their overall mental health. The impacts of the pandemic on child health are ominous, with 94% of participants reporting pediatric mental health concerns, a devastating increase from the previous study. DISCUSSION The pediatric APRN workforce is in crisis amid a national pediatric mental health emergency. Multilevel interventions are critically emergent to sustain the APRN workforce and promote the health and well-being of children and families.
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Han SJ, Lee SY, Kim SE. An Exploratory Study of Psychological Distress, Professional Quality of Life, Effort-Reward Imbalance, and Turnover Intention of Hospital Nurses during the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:2695. [PMID: 37830732 PMCID: PMC10572966 DOI: 10.3390/healthcare11192695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/02/2023] [Accepted: 10/06/2023] [Indexed: 10/14/2023] Open
Abstract
This exploratory study aimed to identify factors that may influence nurses' turnover intentions during the COVID-19 pandemic. The data were collected during January 2023 from 250 nurses and analyzed using descriptive statistics, t-test, ANOVA, Scheffe, Pearson's correlation, and multiple regression analysis. Among the sociodemographic and clinical characteristics, nursing care and working with personal protective equipment significantly impacted the turnover intention. Among the independent variables, compassion satisfaction, burnout, effort-reward ratio, and psychological distress were significant, with an explanatory power of 43.3%. Among the subjects, 86.4% (216 people) showed a moderate or high burnout level because of the COVID-19 pandemic, and burnout seemed to have a significant impact on turnover intention. Therefore, to lower the turnover intention of nurses, burnout should be prevented, and managers should create an environment where nurses can receive a balanced reward for their efforts.
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Affiliation(s)
- Suk-Jung Han
- College of Nursing, Sahmyook University, Seoul 01795, Republic of Korea
| | - Soon-Youl Lee
- Department of Nursing, Graduate School of Sahmyook University, Seoul 01795, Republic of Korea; (S.-Y.L.); (S.-E.K.)
| | - Sie-Eun Kim
- Department of Nursing, Graduate School of Sahmyook University, Seoul 01795, Republic of Korea; (S.-Y.L.); (S.-E.K.)
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