Relationships among social support, empathy, resilience and work engagement in haemodialysis nurses

Personal and work-related factors associated with nurse resilience: An updated systematic review using meta-analysis and narrative synthesis

BACKGROUND

Nursing shortages and increased workforce turnover have significantly increased nurses' workloads, thus increasing the risk of burnout and stress, particularly during the COVID-19 pandemic. A systematic review published in 2019 suggested that resilience could act as a buffer to adversity; however, the factors associated with resilience during and after this global pandemic have not been identified.

OBJECTIVES

To identify personal and work-related factors associated with nurse resilience, including the period during and after the COVID-19 pandemic.

DESIGN

Systematic review.

DATA SOURCES

The search was conducted between January and February 2024 in the following databases: CINAHL Plus, MEDLINE (Ovid), PsycINFO, EMBASE, and Scopus, using the key terms 'resilience', 'hardiness', 'work', 'employ', 'occupation', 'job', and 'nursing'.

REVIEW METHODS

Quantitative studies with English full text, published between 2018 and 2024, were selected if they assessed resilience and its associated factors among nurses providing direct patient care. Two authors independently completed the data selection process. Studies with quality assessment grades of 3 or above were included for final analysis. A meta-analysis was utilised for the mean resilience levels from studies using the same measures of resilience, and a narrative synthesis was performed for the demographic and work-related factors.

RESULTS

Fifty-nine cross-sectional studies with a quality assessment score of 3 or above were included. Forty-seven studies were included in a meta-analysis, which reported an estimated mean resilience level of 20.69 using a random-effects model (95 % CI [18.53, 22.85], z = 18.79, p < 0.0001, I2 = 95.1 %). Twenty studies with the Connor Davidson Resilience Scale (CD-RISC)-25 and five with the CD-RISC-10 were meta-analysed for the mean resilience levels of 62.85 (95 % CI: [55.60, 70.10], z = 16.97, p < 0.0001, I2 = 31.70 %) and 26.34 (95 % CI: [20.85, 31.83], p < 0.0001, I2 = 0 %), respectively. A low mean resilience level was identified. Sixteen demographic factors were identified as associated with resilience. Twenty job demand factors negatively associated with resilience were determined and categorised into exhaustion, psychological factors, and work challenges. Thirty-two job resource factors positively related to resilience were identified and classified into the following categories: psychological factors, leadership, work performance, well-being and quality of life, and social and organisational support.

CONCLUSIONS

Understanding the job demand and resource factors can help organisations minimise the risks and develop institutional strategies to protect nurses from the negative impact of COVID-19 or future pandemics on nurses' well-being.

Factors related to resilience and attitudes towards care of the dying among critical care nurses

BACKGROUND

Many critical care nurses provide care to patients who are injured or ill and are at the end-of-life. Therefore, they are at high risk for developing negative emotional responses due to exposure to patient suffering and death.

AIM

To determine the association between attitudes towards care of the dying, resilience, and Sense of Coherence.

STUDY DESIGN

A cross-sectional descriptive approach was used. Head nurses at 74 hospitals in Japan were sent a letter about the study; 29 head nurses agreed to send information to the critical care nurses in their hospital. Demographic factors, attitudes towards care of the dying, resilience, and Sense of Coherence were collected using Google Forms. Structural equation modelling was used to analyze the associations among the variables.

RESULTS

A total of 229 nurses completed the survey. The average years of clinical experience were 10.5 ± 8.4 years. Factors directly related to positive attitudes towards care of the dying were higher resilience, more years of clinical nursing experience, and having a Master's degree. Sense of Coherence was the strongest predictor of resilience. Other predictors for higher resilience included confidence in nursing skills, social support, and religious beliefs towards death. The main predictor for higher Sense of Coherence was workplace satisfaction.

CONCLUSION

Nurses with higher resilience had more positive attitudes about care of the dying. Individual factors, such as a Sense of Coherence, confidence in caring for patients, and religious beliefs were the most important factors related to resilience.

RELEVANCE TO CLINICAL PRACTICE

It is necessary to support newer nurses especially those with lower educational attainment, to increase workplace satisfaction, Sense of Coherence and resilience. It is necessary to develop educational programs focused on care of dying patients and to evaluate their effect so that critical care nurses have a positive response to caring for dying patients.

The impact of nurses' adversity quotient on their work stress: the mediating role of professional identity

PURPOSE

To explore the influence of nurses' adversity quotient on their work stress and to further explore whether professional identity can mediate in this process.

METHODS

From July to September 2023, an online questionnaire survey was conducted among nurses in six public tertiary hospitals in Suzhou and Wuxi, China, including demographic information, Adversity Response Profile (ARP), The Professional Identity Scale for Nurses (PIS) and Stress Overload Scale (SOS). Analyzed the collected data using correlation, multiple linear regression, and structural equation modeling.

RESULTS

1,578 nurses completed the questionnaires, resulting in 1,468 valid questionnaires. The average score of Stress Overload Scale of the surveyed nurses was 65.26 ± 17.93 points (Total score of Stress Overload Scale: 110). The correlation analysis showed a significant positive relationship between nurses' adversity quotient and their professional identity (r = 0.59, P < 0.01); professional identity and work stress were negatively correlated (r=-0.44, P < 0.01); and adversity quotient was also negatively correlated with work stress (r=-0.31, P < 0.01). The structural equation model indicated that professional identity might mediate between stress and adversity quotient.

CONCLUSION

Clinical nurses suffer from heavy work stress, and nurses' adversity quotient could change their work stress level by affecting their professional identity. Strategies and measures to improve professional identity is expected to buffer the impact of adversity quotient on nurses' work stress.

Associations Among Emotional Intelligence, Resilience, and Humanistic Caring Ability in Nursing Postgraduates: A Response Surface Analysis and Moderated Mediation Model

Purpose: This study aimed to explore the associations among the type of master program in nursing, emotional intelligence (EI), resilience, and humanistic caring ability (HCA), thereby providing a reference for cultivating HCA in Chinese nursing postgraduates.

Design and Methods: A multicenter cross‐sectional study was conducted from February 22 to March 23, 2022, in four universities with Schools of Nursing across Eastern and Central China, recruiting a total of 189 nursing postgraduates. The questionnaire included the following instruments: the sociodemographic information questionnaire, the Wong and Law Emotional Intelligence Scale (WLEIS), the 10‐item Connor–Davidson Resilience Scale (CD‐RISC‐10), and the Caring Ability Inventory (CAI). Correlation, response surface, and moderated mediation analyses were conducted to explore the associations among the variables of interest.

Findings: The results of correlation analysis and response surface analysis revealed significant positive associations of EI and resilience with HCA. The results of moderated mediation analysis indicated that resilience partially mediated the association of EI with HCA in nursing postgraduate students. The interaction effect between the type of master program and EI was significant in the association of EI with resilience.

Practice Implications: The findings of this research offered crucial insights for nursing educators on the associations among EI, resilience, and HCA and may provide important evidence for future interventional studies on promoting HCA in Chinese nursing postgraduates.

Trial Registration: Chinese Clinical Trial Registry identifier: ChiCTR2000038693

Leisure crafting and work engagement among Chinese ICU nurses: The multiple mediation effect of recovery experience and humanistic care ability

AIMS

Based on the conservation of resources theory, this study explored the intermediary role of intensive care unit (ICU) nurses' recovery experience and humanistic care ability between leisure crafting and work engagement.

BACKGROUND

As the ICU is an important life-saving department, the level of work engagement of nurses directly affect the quality of life and health outcomes of patients. Actively seeking countermeasures to improve the work engagement level of ICU nurses is of great significance to enhancing the nursing quality of the ICU. According to the theory of resource conservation, the resources owned by individuals are limited and must be replenished promptly and effectively to maintain relatively stable physical, mental, and working states. Therefore, determining ways for ICU nurses to supplement the consumed resources effectively and efficiently in a limited time to maintain a high level of work engagement is the main concern of this study.

METHODS

In this cross-sectional study from January 2023 to March 2023, 478 ICU nurses were recruited by convenience sampling. The survey tools included the Leisure Crafting Scale, the Utrecht Work Engagement Scale-9, the Caring Ability Inventory, and the Recovery Experience Questionnaire. Descriptive data and Pearson correlation coefficients were analyzed via SPSS 26.0 (IBM Corp.). PROCESS v4.0 (by Andrew F. Hayes) Macro Model 6 was applied to analyze the serial multiple mediator models. We used the STROBE checklist to report the results.

RESULTS

First, the results showed that leisure crafting, humanistic care ability, and recovery experience were positively correlated with work engagement. Second, recovery experience and humanistic care ability played a partially mediating role between leisure crafting and work engagement, respectively. Third, recovery experience and humanistic care ability also had a serial mediation effect between leisure crafting and work engagement.

CONCLUSION

The findings of the study indicated that improving nurses' active control of leisure time may have particularly positive effects on ICU nurses' work engagement through increasing recovery experience and humanistic care ability.

IMPLICATIONS FOR NURSING AND NURSING POLICY

Administrators can formulate intervention measures to improve the leisure crafting level of ICU nurses, promote work-life balance, which enhances recovery and supports engagement with patient-focused humanistic care, and have a positive impact on the work engagement of ICU nurses.

The dual roles of empathy in mediating structural empowerment and compassion fatigue among Chinese nurses

BACKGROUND

Nurses in dynamic healthcare environments face escalating challenges that impact their efficacy and well-being. These challenges arise from both the increasing complexity of medical procedures and the intense emotional demands of caregiving, often leading to compassion fatigue. A global prevalence of burnout at 30.0% was observed over the past decade. This study examines the relationship between structural empowerment, empathy (cognitive and affective), and compassion fatigue among Chinese nurses. Understanding these relationships is crucial for developing strategies to mitigate compassion fatigue. It also contributes to enhancing nurses' well-being.

METHODS

Conducted at a public hospital in Shanghai, this cross-sectional study surveyed 305 nurses, with 277 valid responses. Structural empowerment was measured using the Conditions for Work Effectiveness Questionnaire-II, empathy with the Kiersma-Chen Empathy Scale, and compassion fatigue with the Compassion Fatigue Short Scale. We performed correlation and mediation analyses to explore the direct and indirect effects of structural empowerment on compassion fatigue through empathy.

RESULTS

A significant negative direct effect of structural empowerment on compassion fatigue was evidenced by a coefficient of -0.165 (confidence interval: [-0.311, -0.013]). Further analysis revealed a negative indirect effect through cognitive empathy, indicated by an effect of -0.103 (confidence interval: [-0.220, -0.008]). Increased structural empowerment was linked to higher levels of cognitive empathy, which correlated with decreased compassion fatigue. Conversely, the mediation through affective empathy showed a positive indirect effect, indicated by an effect of 0.126 (confidence interval: [0.047, 0.229]). This suggests that higher structural empowerment was associated with increased affective empathy, leading to higher levels of compassion fatigue.

CONCLUSION

The study illuminates the dual role of empathy within the framework of structural empowerment and its impact on compassion fatigue. Cognitive empathy serves as a protective factor, reducing susceptibility to compassion fatigue, while affective empathy appears to heighten vulnerability. These findings provide direct evidence supporting the dual processing pathways of empathy. It is recommended that healthcare policies integrate organizational support with targeted empathy training, such as cognitive reappraisal, emotion regulation, and peer support, to effectively counteract compassion fatigue among nurses. However, due to the cross-sectional nature and the single-hospital setting, the findings should be interpreted cautiously.

Mediating and Suppressing Effects of Coping Styles Between Resilience and Empathy for Pain in Clinical Nurses: A Cross-Sectional Study

Purpose

This study aimed to investigate the current state of empathy for pain among clinical nurses, analyze the relationship between resilience and empathy for pain, and explore the mediating effects of coping styles.

Methods

This was a multicenter cross-sectional study conducted among 1601 clinical nurses in Guangdong Province, China. The convenience sampling method was used to collect data from Sociodemographic information, the 14-Item Resilience Scale, the Simplified Coping Style Questionnaire, and the Chinese version of the Empathy for Pain Scale from June to September 2023. To analyze the relationship between resilience, coping styles, and empathy for pain among clinical nurses with descriptive statistics, Spearman correlation analysis, and mediation analysis.

Results

The empathy for pain score among Chinese clinical nurses was 2.92 ± 0.79, with the empathy reactions dimension at 3.56 ± 0.74, and the body and mind discomfort reactions dimension at 2.70 ± 0.89. Clinical nurses' resilience was positively related to the coping styles and the empathy reactions dimension, whereas negatively associated with the body and mind discomfort reactions dimension. Coping styles were negatively related to the empathy for pain and the body and mind discomfort reactions dimension, whereas positive with the empathy reactions dimension. Coping styles partially mediated between resilience and empathy reactions dimension (β=0.127, 95% CI: 0.070~0.183), accounting for 56.19% of the total effect. There were suppressing effects of coping styles between resilience and empathy for pain (β=-0.157, 95% CI: -0.189~-0.126), the body and mind discomfort reactions dimension (β=-0.172, 95% CI: -0.203~-0.142).

Conclusion

The effects of resilience on clinical nurses' empathy for pain were partially mediated and suppressed by coping styles. During clinical pain management, nursing administrators should focus on developing clinical nurses' resilience and positive coping strategies to improve nurses' physical and mental health, optimize pain management, and foster a heightened sense of empathy for pain.

The Impact of Mindfulness-Based Stress Reduction on Workplace Well-Being and Empathy Levels Among Nurses Working in Psychiatric Wards in Iran: A Controlled Trial

Workplace stressors can negatively impact the well-being and nurse-patient empathy among nurses working in psychiatric wards. This controlled trial investigated the impact of mindfulness-based stress reduction (MBSR) on workplace well-being and empathy levels among these nurses. In this study, 80 clinical nurses from the psychiatric wards of Ibn-e-Sina psychiatric hospital, affiliated with Mashhad University of Medical Sciences, Mashhad, Iran, completed a demographics form, the Eudaimonic Workplace Well-being Scale, and the Clinical Interpersonal Reactivity Index. Subsequently, participants were allocated to either the MBSR group (n = 40) or the control group (n = 40). The MBSR group received an eight-week program consisting of weekly two-hour sessions based on the MBSR principles developed by Kabat-Zinn. The participants in both the MBSR and control groups completed the data collection tools immediately after the intervention and one month later. The mean scores of workplace well-being and its intrapersonal dimension increased significantly more in the MBSR group than in the control group over time. Similarly, empathy and its perspective-taking subscale improved significantly more in the MBSR group than in the control group over time. The MBSR intervention can be a beneficial tool to improve workplace well-being and nurse-patient empathy levels among nurses working in psychiatric wards.

Relationship between nurses' mood at work and work engagement: Work morale as a mediator

AIM

To determine the effect of nurses' mood at work (positive and negative) on work engagement and whether work morale mediates this relationship.

BACKGROUND

Nurses' work engagement is a key research area, yet limited data regarding the relationship between nurses' mood at work and work engagement are available. Therefore, how nurses' positive or negative mood at work affects their work engagement remains unclear.

METHODS

This study analyzed nurses from a medical center in Taipei City. A total of 279 completed questionnaires were returned. The data were analyzed using two-stage structural equation modeling to test the hypothesized relationships.

FINDINGS

Nurses' positive mood had a significantly positive effect on work morale, whereas their negative mood had a significantly negative effect on work morale. Additionally, work morale played a mediating role in the relationship between mood at work and work engagement.

CONCLUSION

The results revealed that nurses' moods affected their work engagement and that this relationship was affected by work morale.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Healthcare institutions and hospitals could develop a positive work environment to help nurses maintain their good mood and reduce negative affectivity. They should also provide nurses with counseling services, offer morale-boosting activities, and adopt an inspirational leadership style to maintain their work morale.

Exploring resilience among hospital workers: a Bayesian approach

Background and importance

Healthcare professionals face significant workloads, as their roles are among the most demanding and stressful. Resilience serves as a crucial factor in helping them cope with the challenges encountered in their work environment and effectively manage stress. Assessing the level of resilience among healthcare workers and identifying potential variations across different groups is essential for effective public health management, preventing burnout, and ultimately enhancing patient care.

Objective

To assess the resilience of various categories of workers operating within a tertiary care multisite hospital and understanding if there are any differences in resilience, based on their characteristics, the type of department they work in, and personality traits.

Design setting and participants

This was a cross-sectional study conducted in January 2024 at EOC, a multi-site tertiary care hospital located in Southern Switzerland. 1,197 hospital workers answered an online survey which included: (1) an ad hoc questionnaire on personal and job characteristics, well-being-related activities, satisfaction level regarding communication, collaboration, support, and training opportunities in the workplace, (2) the Connor-Davidson Resilience Scale 10-Item on resilience, and (3) the Big Five Personality Inventory 10-item on personality traits.

Outcome measures and analysis

Proportion of resilient and highly resilient individuals within the various categories of workers were analyzed with Bayesian approach and Bayesian robust regression.

Main results

Being part of the hospitality staff, working as a doctor, and having a male sex were associated to the highest scores of resilience. Surgery and emergency departments had the highest proportion of highly resilient individuals. Male sex, older age, seniority, higher hierarchical rank, engagement in physical activities, relaxation or mindfulness practices, religiosity, perception of good collaboration, communication, support, and physical activity correlated with higher resilience skills.

Conclusion

This cross-sectional study found that physicians and hospitality staff within our multi-site Swiss hospital are more resilient compared to other categories of hospital workers, and among departments, those working in surgery and Emergency Medicine. Enhancing our comprehension of resilience is crucial for more precise management of healthcare systems and the development of employment policies aimed at sustaining the capacity of healthcare systems to serve patients effectively, while also mitigating shortages of healthcare professionals.

Therapeutic Relational Communication and Resilience among Nursing Professionals in a Pandemic Situation

Therapeutic relational communication has become a fundamental human resource in the nursing profession. The positive relationship between nurse-patient communication and resilience has been shown in several studies. However, these aspects can be affected in adverse circumstances. The purpose of this study was to identify the relationship between nurse-patient therapeutic relational communication and the resilience of nursing professionals in adverse circumstances. A cross-sectional study with a sample of 201 nursing professionals was conducted. This study found high levels of both therapeutic relational communication between nurses and patients as well as resilience among nurses. The sociodemographic variables of age and years of experience in the profession positively correlated with the data obtained through the measurement instruments. The co-relational analysis revealed a positive correlation between nurse-patient therapeutic relational communication and nurse resilience, and the regression analysis showed that levels of successful therapeutic communication skills were minimally explained by resilience. Nursing professionals who participated in this study demonstrated adequate levels of therapeutic relational communication with their patients as well as adequate levels of resilience required to cope with the challenges of the COVID-19 pandemic in their daily nursing practice. This study was not registered.

The humanistic care ability of nurses in 27 provinces in China: a multi-center cross-sectional study

Background

Currently, studies found that the humanistic care ability of nurses is at low level in China, resulting in patients' concerns and dissatisfaction regarding the lack of empathy among nurses. We aimed to explore the factors that influence nurses' humanistic care ability, providing a new perspective on improving patient satisfaction and promote high quality medical services.

Methods

A multi-center cross-sectional study recruited nurses from tertiary and secondary hospitals in China between July 2022 and August 2022. Data concerning self-developed questions on nurses' socio-demographic data and Caring Ability Inventory (CAI) were collected through the Questionnaire Star Platform, using a multi-stage sampling method.

Results

The total score for the level of caring ability among the 15,653 surveyed Chinese nurses was 192.16 ± 24.94. Various factors significantly influence the level of humanistic care ability, including professional title, department, degree of passion for the job, job satisfaction, emphasis on self-care, participation in humanistic care training, support from family for the job, relationships with colleagues, satisfaction with salary, and previous experience working in pilot wards emphasizing humanistic care (p < 0.01).

Conclusion

At present, nurses exhibit a comparatively modest proficiency in humanistic care ability. Numerous factors contribute to this situation. Nursing administrators ought to enhance the scope of humanistic care practices, conduct consistent professional training sessions, advocate for the implementation of model wards emphasizing humanistic care, foster a supportive organizational culture conducive to nurses, and underscore the significance of both nurturing nurses and promoting self-care among them.

The mediating role of work-related perceptions in the relationship between empathy and self-perceived clinical performance of residents in China: A multi-center cross-sectional study

OBJECTIVE

This study aimed to describe the association between empathy and residents' clinical performance and investigate whether work-related perception mediates this relationship.

METHODS

A multi-center cross-sectional study was conducted, including 1160 residents from 10 cities in Liaoning Province between March and October 2020. The participants completed various self-reported questionnaires regarding demographic characteristics, work-related perceptions, self-perceived clinical performance, and empathy. The relationships among empathy, work-related perception, and self-perceived clinical performance were examined using a structural equation model (SEM).

RESULTS

Of the 1160 residents, 961 (82.8 %) completed the questionnaires. The SEM path analysis showed that the direct effect of empathy on self-perceived clinical performance was significant and positive (β = 0.34, P < 0.001). There existed significant effects of empathy on work-related perception (β = 0.26, P < 0.001) and work-related perception on performance (β = 0.31, P < 0.001). The path coefficients of empathy concerning self-perceived clinical performance decreased significantly (β = 0.26, P < 0.001) when work-related perception was modeled as a mediator. The bias-corrected and accelerated bootstrap test revealed that work-related perception significantly mediated the relationship between empathy and self-perceived clinical performance (a*b = 0.08, BCa 95 % CI: 0.05-0.13). However, the correlation between the sub-scales of empathy and the items of self-perceived clinical performance was not substantial, even if most of them were statistically significant. The final SEM produced a good fit to the sample data, with CMIN/DF = 2.07 (P < 0.001), CFI = 0.99, GFI = 0.99, AGFI = 0.98, TLI = 0.98, NFI = 0.97, RMSEA (90 % CI) = 0.033 (0.017, 0.049), and SRMR = 0.024.

CONCLUSION

Empathy might significantly affect self-perceived clinical performance both directly and indirectly through the mediating role of work-related perception.

PRACTICE IMPLICATIONS

Efforts to improve clinical performance among residents might benefit from interventions for cultivating empathy and practices for improving work-related perceptions of residents.

Factors influencing work engagement among male nurses: A structural equation model

AIM

To investigate the male nurses' engagement in nursing work and the influencing factors.

DESIGN

A cross-sectional study.

METHODS

A cross-sectional survey was conducted in 13 hospitals in China to collect data from 328 male nurses from August to October 2021. A structural equation model design was tested with validated measurement instruments.

RESULTS

The work engagement of male nurses in China was at a medium level. There was a high correlation of the male nurses' work engagement with career identity (r = 0.764, p < 0.01), career success (r = 0.735, p < 0.01) and social support (r = 0.477, p < 0.01). The linear multivariate regression analysis showed that career satisfaction (β = 0.393), career identity (β = 0.392) and subjective support (β = 0.116) entered regression equation of male nurses' work engagement (all p < 0.05). The structural equation model results showed that career identity and social support were the influencing factors of the male nurses' work engagement and the model explained variation of 66.4% variables.

CONCLUSION

To know the male nurses' work engagement and influencing factors in China has certain enlightening significance for male nurses themselves and nursing manager. On the one hand, it is necessary to enhance the male nurses' career recognition to nursing work. On the other hand, the society should provide more aid and support to the male nurses. Therefore, the male nurses could devote more into nursing work and promote the nursing development.

Psychological resilience and work engagement of Chinese nurses: a chain mediating model of career identity and quality of work life

Aim

To investigate how nurses' psychological resilience affects their work engagement and the resulting pathways, namely, the intermediary effect of career identity and quality of work life.

Background

Psychological resilience is the ability to adapt to new circumstances and overcome difficulties. Work engagement is a positive, perfect emotional and cognitive state in the work process, which has a positive effect on nurses' physical and mental health and career development. The importance of psychological resilience in nursing is growing in popularity. However, few studies have explored the relationship between psychological resilience and nurses' work engagement.

Design

This is a cross-sectional study.

Methods

From March to April 2023, 356 nurses in the First Affiliated Hospital of Jinzhou Medical University in China received valid questionnaires. The study was surveyed using the Connor-Davidson, Resilience Scale, the Nursing Career Identity Scale, the Work-Related Quality of Life Scale, and the 15-item Utrecht Work Engagement Scale. Process version 3.5 plug-in SPSS 25 was used to test the mediating effect.

Results

(1) Psychological resilience was significantly and positively correlated with career identity, quality of work life, and work engagement (r = 0.702-0.803, p < 0.001). (2) Career identity and quality of work life partially mediated the relationship between psychological resilience and work engagement, with effect sizes of 0.2382 and 0.0958, respectively. (3) There was a chain mediation model between psychological resilience and work engagement that had a value of 0.1219.

Conclusion

Career identity and quality of work life played a chain-mediating role between psychological resilience and work engagement. Thus, in order to enhance the work engagement of clinical nurses, it is necessary for nursing managers to take measures to enhance not only psychological resilience but also their career identity and the quality of work life.

Social support, empathy and compassion fatigue among clinical nurses: structural equation modeling

BACKGROUND

Clinical nurses are at high risk for compassion fatigue. Empathy is a prerequisite for compassion fatigue, and social support is an important variable in the process of reducing individual stress. However, the role of social support in the relationship between empathy and compassion fatigue remains unclear. This study explored whether social support mediates the relationship between empathy and compassion fatigue among clinical nurses.

METHODS

A total of 992 clinical nurses were recruited through convenience sampling for a cross-sectional study in Central China. They completed the General Information Questionnaire, Perceived Social Support Scale, Professional Quality of Life Scale, and Jefferson Scale of Empathy. SPSS was used to conduct descriptive statistical analyses. Pearson's or Spearman's correlation analyses and AMOS were employed to build a structural equation model (SEM) to verify the mediating effect of social support on the relationship between empathy and compassion fatigue.

RESULTS

The results indicated that the standardized direct effect of empathy on compassion fatigue was 0.127, and the standardized indirect effect of empathy on compassion fatigue through social support was 0.136. The mediation effect ratio between empathy and compassion fatigue was 51.7%.

CONCLUSIONS

Our findings show that social support mediates the relationship between empathy and compassion fatigue among clinical nurses. This finding suggests that increasing nurses' social support can decrease the prevalence of compassion fatigue. Nursing managers should provide training related to flexibly adjusting empathy and educating nurses to establish effective social networks with family, friends, and colleagues to prevent compassion fatigue.

Empathic nurses with sufficient job resources are work-engaged professionals who deliver more individualized care

AIMS

This study examined whether nurse work engagement mediated the associations of job resources (collegial support and autonomy) and a personal resource (empathy) with individualized care delivery, in both hospital and long-term care settings. We also explored potential setting-specific differences in how strongly the resources were associated with work engagement and individualized care delivery among nurses.

DESIGN

We conducted a cross-sectional study in three hospitals and two long-term care facilities.

METHODS

In total, 454 nurses completed a web-based survey including validated measures on resources (collegial support, autonomy, empathy), work engagement and individualized care delivery. Data were analysed using mediation and moderated mediation analyses.

RESULTS

In both settings, all resources were indirectly associated with individualized care delivery via work engagement. Empathy was also directly associated with individualized care delivery, and a stronger association was found in the long-term care setting than in the hospital setting.

CONCLUSION

The present study showed work engagement to mediate the associations of job resources and empathy with individualized care delivery in both hospital and long-term care settings. Individualized care delivery was furthermore directly facilitated by high levels of empathy, especially among nurses working in long-term care settings.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Patients may benefit from better individualized care delivery by empathic nurses who are more work-engaged in the face of sufficient job resources in their practice environment.

IMPACT

Nurses are better able to deliver individualized care when provided with sufficient job resources (collegial support and autonomy) that support their being work-engaged professionals. Furthermore, empathic nurses also reported being able to better support patient individuality. These findings can be translated to policies of hospitals and long-term care facilities, to optimize job resources and enhance empathy and thus facilitate the support of patient individuality by nurses.

REPORTING METHOD

This study adhered to the STROBE guidelines.

PATIENT OR PUBLIC CONTRIBUTION

Nurses were involved in the design and data collection of the study.

Work engagement among health professionals in public health facilities of Bench-Sheko zone, southwest Ethiopia

BACKGROUND

The level of health professional work engagement affects retention, burnout, job satisfaction, patient satisfaction, and outcomes; however, there is a paucity of evidence that benefit health professional work engagement. Therefore, this study aimed to assess work engagement and associated factors among health professionals at public health facilities in the Bench-Sheko zone in southwest Ethiopia.

METHODS

Facility-based cross-sectional study was conducted among 605 health professionals from 29 March to 29 April 2021. A simple random sampling technique was used to select the participants. Data were collected using a self-administered questionnaire. Linear regression was fitted and those variables with p-value < 0.2 in simple linear regression were entered into multiple linear regression analysis. Unstandardized β-coefficient with 95% CI and p-value < 0.05 were used as the cut of points to determine the factors associated with work engagement.

RESULTS

Mean score percentage of work engagement was 71.8%. Health center staff (β = 0.31; 95% CI: 0.22, 0.40), married professionals (β = 0.10; 95% CI: 0.005, 0.17), co-worker support (β = 0.06; 95% CI: 0.004, 0.11), role clarity (β = 0.14; 95% CI: 0.07, 0.21), reward (β = 0.10; 95% CI: 0.05, 0.15), resilience (β = 0.14 95%; CI: 0.07, 0.21), self-efficacy (β = 0.24; 95% CI: 0.16, 0.31) and optimism (β = 0.20; 95% CI: 0.15, 0.26) were positively associated with work engagement. On the contrary, cognitive demand (β= -0.06; 95% CI: -0.11, -0.01) was negatively associated with work engagement.

CONCLUSION

In this study, health professionals had a moderate level of work engagement. Health facilities shall improve their culture of co-worker support, role clarity, reward, resilience, self-efficacy, and optimism to enhance work engagement. Future researchers shall be done further studies to evaluate the relationship between cognitive demand and work engagement among health professionals.

Associations among leadership, resources, and nurses' work engagement: findings from the fifth korean Working Conditions Survey

BACKGROUND

Nurses' work engagement has received extensive attention due to its positive impacts on individual and organizational outcomes, including patient safety and quality care in healthcare organizations. Although nurse managers' leadership and a variety of resources have been identified as important factors of nurses' work engagement, these relationships have not been well understood in Korean nursing contexts. The purpose of this study was to examine the associations among nurse managers' leadership, resources, and work engagement among Korean nurses after controlling for nurses' demographic and work-related characteristics.

METHODS

This is a cross-sectional study using data from the fifth Korean Working Conditions Survey. Using a sample of 477 registered nurses, we employed hierarchical linear regression analyses. Nurse managers' leadership, job resources (organizational justice and support from peers), professional resources (employee involvement), and personal resources (meaning of work) were examined as potential predictors of nurses' work engagement.

RESULTS

We found that nurse managers' leadership (β = 0.26, 95% confidence interval [CI] = 0.17-0.41) was the strongest predictor of nurses' work engagement, followed by meaning of work (β = 0.20, 95% CI = 0.07-0.18), organizational justice (β = 0.19, 95% CI = 0.10-0.32), and support from peers (β = 0.14, 95% CI = 0.04-0.23). Employee involvement was not a statistically significant predictor of nurses' work engagement (β = -0.07, 95% CI = -0.11-0.01).

CONCLUSIONS

Our findings suggest that comprehensive approaches are required to promote nurses' work engagement. Considering that nurse managers' leadership was the strongest predictor of nurses' work engagement, nurse managers should demonstrate supportive leadership behaviors such as acknowledging and praising their unit nurses' work performance. Furthermore, both individual- and organizational-level strategies are necessary for nurses to be engaged at work.

Mediating role of resilience between learning engagement and professional identity among nursing interns under COVID-19: A cross-sectional study

AIM

The aim of the study was to explore the mediating effect of resilience between learning engagement and professional identity of nursing interns.

DESIGN

A descriptive, cross-sectional study design.

METHODS

An online questionnaire survey was conducted among nursing interns in Fujian Medical University from February 2022 to April 2022 by convenience sampling. The scores of learning engagement, resilience and professional identity were evaluated. The PROCESS Marco in SPSS was used to analyse the mediating effect.

RESULTS

A total of 222 senior nursing students participated in the questionnaire survey. Both learning engagement (r = 0.491, p < 0.01) and resilience (r = 0.537, p < 0.01) correlated positively with PI. Resilience is also positively related to PI (r = 0.693, p < 0.01). Also resilience played a partial mediating role in the relationship between learning engagement and professional identity (a*b = b = 0.2451, 95% CI: 0.1543, 0.3581), and its effect accounted for 53.3%.

Haemodialysis nurses' occupational health and work-related musculoskeletal hand pain after work: A cluster analysis

AIM

To identify clusters based on haemodialysis nurses' self-rated work ability, work engagement and self-reported work hours and to compare the identified clusters regarding hand pain after work.

DESIGN

Cross-sectional survey.

METHODS

Data based on the Work Ability Index, Utrecht Work Engagement Scale and hand pain severity after work were collected through a web-based survey among 503 haemodialysis nurses working in Sweden and Denmark. A two-step cluster analysis was used to identify homogenous groups of cases within the dataset, followed by comparative analyses of the clusters.

RESULTS

Four distinct clusters were identified, illustrating differing profiles of haemodialysis nurses' work ability, work engagement and working hours. Nurses who worked part-time and reported moderate work ability and average work engagement had significantly higher ratings of hand pain after work.

CONCLUSIONS

Haemodialysis nurses are a heterogeneous group as regards work ability, work engagement and self-reported work hours. The four distinct clusters of nurses indicate a need for customized interventions for retaining each subgroup at work.

Building Work Engagement in Organizations: A Longitudinal Study Combining Social Exchange and Social Identity Theories

Starting from the insights of social identity theory and social exchange theory, the present study aimed to understand how social support and organizational identification relate to work engagement. Moreover, it sought to verify if social support and organizational identification interact with each other to explain work engagement three months later. A longitudinal study was conducted on a sample of 150 employees, in which organizational identification, social support, and work engagement were measured through a questionnaire. The results show that when employees can count on their supervisors' and colleagues' support, they will be more engaged in their work. In addition, when an employee strongly identifies with their organization, the employee's evaluation of the social support received from colleagues and supervisors becomes less critical in determining their work engagement. These results confirm our hypotheses and extend the findings of previous research on withdrawal behaviors. From a practical point of view, it seems important for organizations to invest in increasing identification, as well as in building a high-quality social exchange relationship, especially when levels of organizational identification are low or decreasing.

Analysis of Factors Affecting Psychological Resilience of Emergency Room Nurses Under Public Health Emergencies

Resilience is essential for frontline health workers to cope with the unfavorable situations, especially under public health emergencies. Emergency room (ER) nurses are a special cohort of health professionals that may present moderate level of resilience. This study aimed to identify factors that are correlated with resilience in this special cohort to provide directions for intervention and management. ER nurses that have encountered a public health emergency within 3 months were recruited using purposive sampling and snowball technique for the study. Questionnaires, including Connor-Davidson Resilience Scale (CD-RISC), Zung Self-Rating Depression Scale (SDS), and Maslach Burnout Inventory-Human Services Survey (MBI-HSS) were established, followed by an in-depth interview to identify different clusters of themes. Thirteen ER nurses were recruited, and the average CD-RISC score was 66 ± 21. Resilience was negatively correlated with SDS index, and positively correlated with personal accomplishment. Five clusters of themes were identified from in-depth interviews, including physical tolerability, psychological tolerability, tenacity of internal drive, institutional implementation, and external adjustment. This study identified factors associated with resilience in ER nurses under public health emergencies, providing useful information for future directions for intervention.

A Longitudinal Study of the Impact of Personal and Professional Resources on Nurses' Work Engagement: A Comparison of Early-Career and Mid-Later-Career Nurses

To predict and ensure a healthy and high-performing nursing workforce, it is necessary to identify the antecedents that promote work engagement, especially among early-career nurses. To date no study has focused on this. This longitudinal survey, administered to 1204 nurses working in seven general hospitals with 200 or more beds in four prefectures in Japan at two different times in 2019, aims to examine the causal relationship between the personal and professional resources for nurses to work vigorously (PPR-N) and work engagement among nurses in the early stages of their careers, considering time as a key mediating factor. The analysis of structural equation modeling using the cross-lagged effect model supported that PPR-N had significant and positive effects on work engagement after 3 months among early-career nurses with less than 10 years of nursing experience. The PPR-N is a reliable antecedent of work engagement, which is typical of early-career nurses. These results may be provided guidance for managers in overseeing the work environment to ensure a thriving sustainable nursing workforce.

SBAR Method for Improving Well-Being in the Internal Medicine Unit: Quasi-Experimental Research

SBAR (Situation, Background, Assessment, Recommendation) is a tool for standardizing and improving interprofessional communication. This study aims to explore the impact of SBAR in healthcare professionals' wellbeing, through concepts such as job satisfaction, engagement, resilience, and job performance, in the internal medicine unit of a university hospital in the province of León (Spain). This is an observational, descriptive, longitudinal case study with a pre- and post-intervention approach. Questionnaires were distributed to a group of doctors, nurses, and healthcare assistants before and after the implementation of the SBAR tool in the ward. The use of SBAR was monitored to ensure staff compliance. Data statistical analysis was performed using the SPSS program. Resilience levels increased significantly post-intervention. Job satisfaction and engagement levels remained neutral, slightly decreasing post-intervention. Besides' being a useful tool to improve communication, SBAR was effective in improving resilience among staff. Several aspects related to hospital management may have had an impact on job satisfaction and engagement results.

Psychological resilience and related influencing factors in patients diagnosed with major depressive disorder in remission: A cross-sectional study

WHAT IS KNOWN ON THE SUBJECT?: Recurrence is common in patients diagnosed with major depressive disorder (MDD). Psychological resilience has been shown to be a protective factor against recurrence of depression. It has important clinical nursing significance to analyse the influencing factors of psychological resilience in major depressive disorder in remission (MDDR) patients. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: There are few previous studies on the influencing factors of psychological resilience in patients diagnosed with MDDR. We found the education levels, personal monthly income, social support, well-being and self-efficacy were influencing factors of psychological resilience in patients diagnosed with MDDR. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: According to the factors affecting the psychological resilience of patients diagnosed with MDDR, targeted clinical nursing is helpful to prevent the recurrence of depression. Nurses should strengthen the nursing of patients with <12 years of education, and patients with personal monthly income less than 5000 RMB. In addition, nurses should cultivate patients' awareness of social support and identity, cultivate their ability to strive for social support, cultivate interpersonal skills and positive emotional experience to improve subjective well-being and carry out self-efficacy training to improve psychological resilience by enhancing patients' internal protective factors.

ABSTRACT

AIM: Psychological resilience is closely related to recurrence of depression. There are few previous studies on the influencing factors of psychological resilience in patients diagnosed with major depressive disorder in remission (MDDR). Here, we investigated the current status of resilience in patients diagnosed with MDDR and its influencing factors.

METHODS

A descriptive cross-sectional study was conducted from June 2019 to April 2021. One hundred and forty-two patients diagnosed with MDDR were recruited from the Department of Psychiatry and Psychology of the General Hospital of Northern Theater Command. Demographic information, social support, well-being, self-efficacy and psychological resilience were collected using self-reported questionnaires.

RESULTS

The psychological resilience of MDDR patients was lower than that of the healthy Chinese adults in China. Multiple logistic regression analysis showed that education, personal monthly income, social support, well-being and self-efficacy were associated with psychological resilience. Receiver operating characteristic (ROC) curve analysis further confirmed that social support, well-being and self-efficacy were associated with psychological resilience.

CONCLUSION

The psychological resilience of MDDR patients was lower than that of the general population in China. The education levels, personal monthly income, social support, well-being and self-efficacy were influencing factors of psychological resilience.

IMPLICATIONS FOR PRACTICE

According to the factors affecting the psychological resilience of patients diagnosed with MDDR, targeted clinical nursing is helpful to prevent the recurrence of depression.

The mediating effect of psychological resilience on empathy and professional identity of Chinese nursing students: A structural equation model analysis

BACKGROUND

Previous studies have shown that empathy has a positive impact on the professional identity of nursing students. And developing psychological resilience can improve the professional identity of nursing students. However, studies investigating the mechanism of the relationship between empathy and psychological resilience on professional identity remain few.

PURPOSE

Among Chinese nursing students, we sought to determine whether psychological resilience mediates the association between empathy and professional identity.

METHODS

A total of 495 undergraduate and postgraduate nursing students in a medical university nursing college in Hefei were investigated by demographic data questionnaire, nursing students' empathy scale, nursing students' professional identity questionnaire, and psychological resilience questionnaire. Structural equation modeling was used to analyze the mediating effect of psychological resilience between empathy and the professional identity of nursing students.

RESULTS

The total score of professional identity of nursing students was 57.07 ± 10.38. Psychological resilience (r = 0.316, P < 0.01) and professional identity (r = 0.313, P < 0.01) both had positive correlations with empathy, respectively. Additionally, there was a strong correlation between psychological resilience and professional identity (r = 0.488, P < 0.01). Empathy had an indirect effect on professional identity through psychological resilience, with a direct effect of 0.256 and an indirect effect of 0.145, and the indirect effect accounted for 36.16 % of the total effect.

CONCLUSION

Nursing educators should pay attention to the cultivation of empathy ability and psychological resilience to enhance nursing students' professional identity.

The relationship between organizational commitment and work engagement among clinical nurses in China: A cross-sectional study

AIM

This study aims to investigate the levels of organizational commitment and work engagement among clinical nurses in tertiary hospitals and explore the relationship between them.

BACKGROUND

The nursing literature supports the idea that organizational commitment plays an important role in positively influencing job performance. However, the relationship between organizational commitment and work engagement among clinical nurses remains unclear.

METHODS

This was a cross-sectional study. A convenience sample of clinical nurses (n = 621) was selected from five tertiary hospitals in Sichuan Province of China. Survey instruments included a general information questionnaire about organizational commitment and work engagement. Univariate analysis, correlation analyses and linear regression analysis were used to examine the association between organizational commitment and work engagement.

RESULTS

The mean scores for organizational commitment and work engagement were 3.85 ± 0.59 and 4.58 ± 1.46, respectively. A moderate degree of positive correlation was found between them. Gender, monthly income and retention commitment were significantly associated with work engagement, and they accounted for 39.0% of the total variance.

CONCLUSIONS

Clinical nurses had a moderate level of organizational commitment and a high level of work engagement. Organizational commitment positively influenced work engagement; that is, organizational commitment is a significant determinant of nurses' work engagement.

IMPLICATIONS FOR NURSING MANAGEMENT

Hospital organizations should focus on assessing and strengthening nurses' organizational commitment to promote increased work engagement and, ultimately, improved quality of care. This may include, but is not limited to, increasing rest time for nurses, implementing a performance appraisal system and focusing on nurses' psychological state.

Career Identity and Career Success among Chinese male nurses: The mediating role of Work Engagement

AIM

This study aimed to investigate the effect of career identity on career success among Chinese male nurses and to examine the mediating role of work engagement in this relationship.

BACKGROUND

Recently, with the development of the nursing career, male nurses take up a higher share and play a more important role in the nursing team. With its own particularity and advantages, this group's stability closely relates to the future of the nursing team. Therefore, promoting the career success of the male nurses is essential to the nursing team development.

METHODS

The data were collected in China. A sample of 557 male nurses completed measures of career identity, work engagement and career success scale. Structural equation model was adopted to verify the research hypotheses.

RESULTS

Career identity was significantly and positively related to male nurses' work engagement and career success (p< .01). And work engagement partially mediated the association between career identity and career success.

CONCLUSION

Career identity are critical to predicting and enhancing male nurses' career success. Work engagement plays an intervening mechanism explaining how career identity promotes career success among male nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing management should minimize the impact of the traditional concept, implement the gender equality and provide moderate care for male nurses to facilitate balanced development of gender by upgrading the management system. The administrators should carry out skill training based on male nurses' features and the need of the department. Given full play to their respective advantages, male nurses will make great progress in professional development and achieve greater career identity and work engagement. Meanwhile, the further exploration of better incentive mechanism also makes sense in improving career identity and work engagement by the reform of performance appraisal mechanism and salary adjustment according to their ability.

Nurse leaders' resilience and their role in supporting nurses' resilience during the COVID-19 pandemic: A scoping review

AIM

To explore nurse leaders' resilience and their role in supporting nurses' resilience during the COVID-19 pandemic.

BACKGROUND

The COVID-19 pandemic has challenged health care systems on a global level. Nurse leaders are tasked with ensuring high-quality care, even during crises, which requires active problem-solving and confidence in the future-resilience from leaders.

METHOD

A scoping review was conducted using inductive thematic analysis and the PCC (Participants, Concept, Context) framework. The PubMed, Scopus, CINAHL, and PsycINFO databases, as well additional studies and grey literature, were searched from December 2019 to June 2021.

RESULTS

The review included 12 studies. Nurse leaders' self-awareness, self-reflection, and coping strategies described their resilience during the pandemic. A relational leadership style, supportive and safe work environment, and adequate communication were found to support nurses' resilience.

CONCLUSIONS

There is scarce research concerning nurse leaders' resilience during the COVID-19 pandemic. Future research needs to address nurse leaders' personal resilience due to the link with nurses' resilience.

IMPLICATIONS FOR NURSING MANAGEMENT

A healthy work environment is essential for nurses' resilience. During crises, nurse leaders should adopt relational leadership styles and actively interact with nursing staff.

The mediating effects of adversity quotient and self-efficacy on ICU nurses' organizational climate and work engagement

AIM

This study aimed to explore the mediating effects of adversity quotient and the moderating effect of self-efficacy on the relationship between the organizational climate and the work engagement of intensive care unit nurses.

BACKGROUND

A good organizational climate can contribute to a high level of work engagement. Adversity quotient and self-efficacy are the key factors affecting nurses' work engagement, while the mechanism of these factors in the organizational climate and work engagement remains unclear. This study was conducted to contribute to the relevant field research.

METHODS

The study used a cross-sectional research design and surveyed 323 intensive care unit nurses working in a public hospital in China. The data were analyzed using descriptive statistical methods: Pearson correlation analysis and PROCESS macro Model 7 in the regression analysis.

RESULTS

Organizational climate was positively correlated with work engagement and adversity quotient. The indirect effect of organizational climate on work engagement through adversity quotient was positive. Furthermore, self-efficacy moderated the relationship between the two factors.

CONCLUSION

Cultivating organizational climate and adversity quotients is an important strategy to improve the work engagement of intensive care unit nurses, particularly for nurses with high self-efficacy.

IMPLICATIONS FOR NURSING MANAGEMENT

Administrators should make efforts to create a good organizational climate and cultivate nurses' adversity quotients and self-efficacy to decrease their intent to leave.

Impact of the COVID-19 Pandemic on the Work Engagement of UK Active Employees

The objective of this investigation was to describe the work engagement perceived by UK workers during the COVID-19 pandemic. A descriptive cross-sectional study was conducted. The sample included 1085 participants, aged 18 years and older, living in the UK during the COVID-19 pandemic, who were active workers. Data were collected using an online questionnaire and the UWES-9. They were analysed using descriptive statistics, a t-test for equality of means or ANOVA, and the Chi-squared Automatic Interaction Detection method. The mean value in the UWES-9 was 3.46 (SD = 1.11). Participants with lower satisfaction (21.8%) gave significantly low or very low UWES-9 scores in 58.5% of the cases. Greater work engagement was obtained with more resources and less conflict, risk, and stress. In cases where there had been contact with COVID-19, this was associated with slightly lower levels of work engagement. These results could motivate and guide companies to adopt risk prevention measures and protocols to return to normal working conditions after the initial crisis phase of the pandemic.

Empathy alleviates the learning burnout of medical college students through enhancing resilience

OBJECTIVE

The problem of learning burnout of medical students is becoming prominent, and empathy can play a good predictive role in learning burnout. The present study aimed to investigate the relationship between empathy and learning burnout, as well as the mediation effect of resilience in this relation.

METHODS

Five hundred and eighty-eighth college students from a key medical university in Yunnan Province was investigated using the Basic Empathy Scale, Learning Burnout Scale, and Connor-Davidson Resilience Scale. All the measures showed good reliability and validity in the present study. Data were analyzed using SPSS 23.0 and Amos 22.0.

RESULTS

Using structural equation modeling, we tested a conceptual model indicated that: (1) medical students' empathy negatively and significantly predicted learning burnout; (2) medical students' empathy positively predicts mental resilience; (3) resilience of medical students negatively predicts learning burnout; (4) resilience partially mediated the relationship between empathy and learning burnout of medical students, while also controlling for family socioeconomic status.

CONCLUSION

These findings highlight the mediating role of resilience in the effect of empathy on learning burnout of medical college students. It may contribute to a better understanding of the effect of empathy. Moreover, it can also provide constructive suggestions for protecting and improve empathy and resilience of medical college students.

Does Gender Matter? Effect of Colleagues’ Support on Work Engagement of Salespeople

Salespeople suffer from work pressure in their workplace. Hence, an important issue in sales management is how to increase salesperson confidence and motivate them to work harder. This study examines social support from management and peers on sales employees using the stimulus-organism-response (SOR) theory. A cross-sectional survey was then conducted among 140 female and male salespersons from the insurance/financial/retail industries during the pandemic period in Hong Kong. It was found that management support was important for the work engagement of salespeople. Self-confidence can be improved through consultation with managers. Female salespersons prefer sharing their concern with managers from another department, whereas male salespersons opt for managers from the same department. Peer support from sales colleagues of the same department was not preferred. Emotional support for female salespeople and cognitive support for male salespeople should be provided.

Effects of role overload, work engagement and perceived organisational support on nurses' job performance during the COVID-19 pandemic

Aims

We aim to study the effect of role overload, work engagement and perceived organisational support on nurses' job performance, including task performance, interpersonal facilitation and job dedication.

Background

Many nurses have suffered from role overload at work during the COVID‐19 pandemic. However, the investigations of the influence mechanisms and boundary conditions through and under which role overload is associated with job performance have shown inconsistent results.

Methods

A total of 595 Chinese nurses were studied from November 2020 to February 2021. Confirmatory factor analysis, maximum likelihood estimation and bootstrapping analysis were used to test the mediating process and the moderating effect.

Results

Work engagement partly mediated the relationships of role overload with task performance (β = −.253, p < .001, 95% CI: [−.315, −.204]) and interpersonal facilitation (β = −.202, p < .001, 95% CI: [−.261, −.145]); work engagement also fully mediated the relationship between role overload and job dedication (β = −.239, p < .001, 95% CI: [−.302, −.186]). Perceived organisational support moderated the relationships of role overload with task performance, interpersonal facilitation and work dedication (β = −.171, p < .001, β = −.154, p < .001 and β = −.175, p < .001, respectively).

Conclusions

Work engagement is the linchpin linking role overload to distal outcomes of job performance. Perceived organisational support mitigates the ways in which role overload undermines job performance.

Implications for Nursing Management

Hospital administrators can minimize the effects of role overload and create a more supportive organisational environment to promote the job performance of nurses.

Personal Resources and Work Engagement: A Literature Review

The level of nurse work engagement affects retention, burnout, job satisfaction, patient satisfaction, and outcomes. However, there is a paucity of evidence identifying the specific personal resources that benefit nurse work engagement and mechanisms to develop personal resources. The purpose of this review was to examine which personal resources affect work engagement, reveal strategies to improve work engagement, and uncover implications for the nursing professional development practitioner. A total of 400 articles resulted from a review of the literature, with 14 studies meeting inclusion criteria. Personal resources varied. Interventions to promote the development of personal resources are described. [J Contin Educ Nurs. 2022;53(3):115-121.].

Resilience, Moral Distress, and Job Satisfaction Driving Engagement in Emergency Department Nurses: A Qualitative Analysis

AIM

The aim of this study was to explore how resilience, job satisfaction, and moral distress affect emergency department (ED) nurses' workplace engagement.

BACKGROUND

Stressful nursing workplace conditions increase moral distress. Lowering moral distress and improving resilience can increase workplace engagement.

METHOD

Semistructured qualitative interviews were conducted with 15 ED nurses.

RESULTS

Participants indicated that greater nursing experience, increased confidence in skills, ability to overcome emotional stressors, and more satisfaction with patient care all improved resilience and workplace engagement. Morally distressed, disengaged nurses reportedly lacked workplace autonomy and/or ability to make workplace changes or worked in hostile and/or unsafe workplaces. Engaged nurses invested more time in their job and were more willing to remain in their workplace.

CONCLUSION

Retaining older, more experienced nurses, valuing staff work, and creating a meaningful workplace foster workplace engagement.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers can support nurses' workplace engagement through interventions that build resilience, lower moral distress, and increase job satisfaction.

Organizational learning, resilience and psychological empowerment as antecedents of work engagement during COVID-19

Purpose

This paper aims to explore the relationship between organizational learning (OL) and work engagement (WE) in the Middle East region amid the COVID-19 pandemic and to test the mediating role of employee resilience (ER) and psychological empowerment (PE) on this relationship.

Design/methodology/approach

The sample size was 208 respondents working in the Middle East area during COVID-19. Hypotheses were tested using regression analysis with bootstrapping.

Findings

The findings indicate a significant positive impact of OL on WE. Moreover, both constructs – ER and WE – were identified as mediators for this relationship.

Practical implications

Practical implications within this study call for organizations to focus on promoting a learning culture in order to adapt and respond effectively to unprecedented external challenges.

Originality/value

The current study extends previous research and strengthens the antecedents of WE, namely, OL, ER and PE in the Middle East region while controlling for COVID-19 perceptions.

Quality of work life and work engagement among nurses with standardised training: The mediating role of burnout and career identity

AIM

To explore the impact of the quality of work life of nurses with standardised training on their work engagement and its impact path, that is, the intermediary role of career identity and job burnout.

BACKGROUND

Most countries currently face the serious problem of a shortage of nurses and this difficulty is likely to persist for a long time. In recent years, some hospitals in China have attempted to try out clinical standardised training for new nurses for a duration of at least two years. They need to cope with clinical work, training assessments, and low salaries. Ways to improve the work input of new nurses play a pivotal role in reducing the turnover rate of nurses.

DESIGN

The current research is a cross-sectional study.

METHODS

Valid questionnaires were received from 245 nurses from the tertiary hospitals between June and July 2021. AMOS was used to conduct a structural equation model to evaluate the mediating effect of burnout and career identity on the association between the quality of work life and work engagement. We describe the study in accordance with the STROBE statement.

RESULTS

The quality of the work life of nurses with standardised training is at a medium to high level (191.62 ± 27.18) and their work engagement is at a relatively high level (75.77 ± 19.60). Quality of work life was negatively correlated with burnout (r1 = -0.672, p < 0.001) and positively correlated with career identity (r2 = 0.810, p < 0.001) and work engagement (r2 = 0.642, p < 0.001). Moreover, a positive relationship was found between the quality of work life and work engagement (β1 =0.644), which was mediated by burnout and career identity (β2 =0.144, β3 =0.218).

CONCLUSIONS

Although the work engagement of nurses with standardised training is encouraging, that work engagement decreases with the increase in the age of nurses, still needs investigation. When nurse managers want to improve the work engagement of new nurses, they should not only pay attention to the quality of work life but take career identity and burnout into consideration.

Impact of training perception on affective commitment and the mediating role of work engagement: Evidence from hospitality sector of Pakistan

BACKGROUND: Given the importance and issues about the hospitality industry, commitment has remained a significant concern for human resource managers and researchers. This paper aims to develop the insights by assessing perceptions of training and work engagement as predictors of commitment among hospitality employees in Pakistan. OBJECTIVE: Following social exchange theory, this study investigated the relationship between five training perceptions: perceived access to training (PAT), motivation to learn (MLT), perceived benefits (PBT), perceived supervisory support (PSST), and coworker support (PCST) and the affective commitment via work engagement. METHOD: Employing survey-based data, this study analyzed 239 responses from the front-line employees in Pakistan’s hospitality industry. RESULTS: Smart-PLS results reveal that only PAT and PCST significantly predicted affective commitment out of five training perceptions. Similarly, work engagement was found to mediate the relationship between training perception and affective commitment except for MLT. The study also found that work engagement had the most substantial mediating effect between PSST and affective commitment. CONCLUSION: Organizations invest a lot of money in training and developing their employees to derive desired organizational outcomes. Therefore, it is important to consider perceptions of training while designing and delivering training. For organizational commitment, it is important that employees feel motivated to contribute to the organization and reciprocate with engagement and commitment with the organization.

Resilience in Organizations: An Integrative Multilevel Review and Editorial Introduction

The interest of organization and management researchers in the resilience concept has steadily grown in recent years. Although there is consensus about the importance of resilience in organizational contexts, many important research questions remain. For example, it is still largely unclear how resilience functions at different levels of analysis in organizations and how these various levels interact. In this special issue, we seek to advance knowledge about the complex resilience construct. For laying a foundation, in this editorial introduction we offer an integrative literature review of previous resilience research at three different levels of analysis (i.e., individual, team, and organization). Furthermore, we demonstrate what is already known about resilience as a multilevel construct and interactions among different resilience levels. Based on the results of our literature review, we identify salient research gaps and highlight some of the more promising areas for future research on resilience. Finally, we present an overview of the articles in this special issue and highlight their contributions in light of the gaps identified herein.

The Mediating Effects of Nursing Professional Commitment on the Relationship between Social Support, Resilience, and Intention to Stay among Newly Graduated Male Nurses: A Cross-Sectional Questionnaire Survey

The current shortage of nurses is an important global issue. Most male nurses leave nursing within four years of starting their nursing career. It is crucial to understand the influencing factors on newly graduated male nurses staying in nursing. Previous studies on intentions to stay as nurses were seldom based on theory and failed to consider the differences between genders. Based on the Job Demands-Resources (JD-R) model, this study tested the model that social support, resilience, and nursing professional commitment influence the intention to stay and the mediating effect of nursing professional commitment in the above relationship. This cross-sectional study adopted purposive and snowball sampling methods. Data were collected using online questionnaire, and 272 newly graduated male nurses completed it. The hypothetical model had a good fit with the data. Nursing professional commitment had a complete mediating effect between social support and intention to stay and between resilience and intention to stay. Nursing professional commitment was highly positively correlated to intention to stay. It is suggested that future research and practice should enhance male nurses’ professional commitment to increase their intention to stay. The findings can serve as reference for developing newly graduated male nurse retention programs.

Empathy, Affect and Personality as Predictors of Engagement in Nursing Professionals

BACKGROUND

It seems that personality traits affect engagement and the quality of professional life, which is mediated by the emotional and affective states of nursing personnel. Therefore, the objectives of this study were to analyze the relationships between the components of empathy, affect, personality, and engagement, find personality profiles, identify the variables with the most explanatory value, and analyze the mediating role of the variables susceptible to intervention in the relationship between personality and the components of engagement.

METHODS

A sample of 1268 nurses completed the Utrecht Work Engagement Scale, 10-item Big Five Inventory, Basic Empathy Scale, and Positive and Negative Affect Schedule.

RESULTS

Empathy, affect, and personality influence engagement factors in nurses. The vigor and absorption factors of engagement showed a positive relationship with empathy, positive affect, and all of the Big Five personality factors except neuroticism with which the relationship was negative. Personality affected the vigor, dedication, and absorption factors of engagement, and cognitive empathy mediated this relationship.

CONCLUSIONS

This study shows the need to continue investigating the factors that affect and mediate in engagement of nursing professionals.

Examining the Predictors of Resilience and Work Engagement during the COVID-19 Pandemic

Previous studies have acknowledged the importance of resilience in enabling individuals to cope and bounce back from crises and unexpected situations like the COVID-19 pandemic. Thus, this study advances conservation of resources theory by investigating the job, social, and personal resources underlying employees’ resilience, and the impact of resilience in stimulating job engagement amid the COVID-19 pandemic. The model was tested using data collected from 259 employees in Malaysia. Results of path modeling analysis revealed significant impacts of self-efficacy, facilitating conditions, and family and friends’ support on employees’ resilience. Besides, resilience was significantly associated with job engagement. Our findings suggest that management concerns for employees may not enhance employees’ resilience amid the COVID-19 pandemic. Nevertheless, management could stimulate their employees’ resilience by providing them with the flexibility to spend quality time with their loved ones and adequate support for enabling working conditions.

The impact of resilience on turnover intention in dialysis nurses: The mediating effects of work engagement and compassion fatigue

AIM

To describe the levels of turnover intention, and to explore the mediating effects of work engagement and compassion fatigue on the relationship between resilience and turnover intention in dialysis nurses.

METHODS

A descriptive cross-sectional study was conducted to recruit 496 dialysis nurses in 25 tertiary hospitals in Sichuan province, China. Structural equation modeling technique was used to examine the mediating roles of work engagement and compassion fatigue on the association between resilience and turnover intention.

RESULTS

The prevalence of high and exceptionally high levels of turnover intention in dialysis nurses were 56.8% (282 nurses) and 8.7% (43 nurses), respectively. Resilience was a significant and direct contributor to work engagement (standardized direct effect = 0.62, p < .001) and compassion fatigue (standardized direct effect = -0.35, p < .001), respectively. However, resilience had no direct and significant effect on turnover intention (standardized direct effect = 0.15, p > .05). Work engagement and compassion fatigue had direct and significant effects on turnover intention (standardized direct effect = -0.40, p < .001; standard direct effect = 0.31, p < .001). Resilience affected turnover intention indirectly and significantly via the whole mediating effects of work engagement and compassion fatigue (standardized indirect effect = -0.36, p < .001).

CONCLUSION

Higher resilience leads to lower turnover intention via enhancing work engagement and reducing compassion fatigue in dialysis nurses. Nursing policies should be established to promote resilience training, enhance work engagement and reduce compassion fatigue in order to alleviate turnover intention in dialysis nurses.

Work engagement and psychological distress of health professionals during the COVID-19 pandemic

AIMS

To describe the level of work engagement of active health care professionals during the COVID-19 pandemic, and its relationship with psychological distress according to the professional category.

BACKGROUND

Health care professionals working on the front line of the COVID-19 pandemic are at risk of psychological distress, and work engagement could be a positive attitude that could serve as a protective factor.

METHODS

Cross-sectional observational study of 1,459 health care professionals. Psychological distress was measured with the General Health Questionnaire and work engagement with the Utrecht Work Engagement Scale. Data were analysed with bivariate analyses and correlations.

RESULTS

Psychological distress was reported by 80.6% of health care professionals. Work engagement as high with a total mean score of 5.04 (SD = 1.14). The results showed that distressed professionals showed significantly lower levels of work engagement.

CONCLUSIONS

The present study identified psychological distress and work engagement experienced by health care professionals during the COVID-19 pandemic. Most of the variables included in the study revealed a significant relationship with psychological distress and work engagement.

IMPLICATIONS FOR NURSING MANAGEMENT

The relationship between the working conditions with psychological distress and work engagement suggests that improvements in the workplace are needed to promote protective measure for the mental health of health care professionals.

Relationships between resilience, empathy, compassion fatigue, work engagement and turnover intention in haemodialysis nurses: A cross-sectional study

AIM

To explore the relationships between resilience, empathy, compassion fatigue, work engagement and turnover intention in Chinese haemodialysis nurses.

BACKGROUND

Although several studies explored nurses' turnover intention in multiple hospital wards, fewer studies focused on turnover intention and its predictors among nurses in dialysis care.

METHODS

We conducted a cross-sectional study and adopted a two-stage sampling method to recruit 528 Chinese haemodialysis nurses. Multiple regression analysis was performed to explore the effects of resilience, empathy, compassion fatigue and work engagement on turnover intention.

RESULTS

The prevalence of high and exceptionally high levels of turnover intention was 59.1% and 9.0%. Compassion fatigue had the strongest significant effect on turnover intention (β = 0.276), followed by work engagement (β = -0.256) and resilience (β = 0.193). Haemodialysis nurses in tertiary hospitals reported significant higher levels of turnover intention than those in secondary hospitals (β = 0.127).

CONCLUSIONS

Higher levels of compassion fatigue and lower levels of resilience and work engagement can result in higher turnover intention in haemodialysis nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

Strategies such as resilience training programme, mindfulness-based intervention and establishing a positive work environment may be effective methods to improve resilience, reduce compassion fatigue, promote work engagement and decrease turnover intention.

The Relationship Among Organizational Identity, Psychological Resilience and Work Engagement of the First-Line Nurses in the Prevention and Control of COVID-19 Based on Structural Equation Model

Purpose

To explore how the organizational identity and psychological resilience affect work engagement of the front-line nurses in the prevention and control of coronavirus disease 2019 (COVID-19) and to establish the relationship model based on these factors.

Material and Methods

Convenience sampling was applied to collect questionnaire samples from 216 nurses (from 12 cities in 6 provinces). General information questionnaires, organizational identity scale (OIQ), psychological resilience scale (CD-RISC), and Utrecht Work Engagement Scale (UWES) were used as tools for data collection.

Results

Both organizational identification and psychological resilience had a positive impact on work engagement (r=0.457~0.669). The structural equation model indicated that psychological resilience had a significant partial mediating effect on the relationship between organizational identity and work engagement; the mediating effect value was 0.25, the overall effect value of work engagement was 0.73, and the mediating effect accounted for 34.2%.

Conclusion

Our results revealed that organizational identity could directly affect nursing. It can also indirectly affect nurses’ work engagement through the intermediary role of psychological resilience. In face of the COVID-19 epidemic, hospitals and nursing managers could improve the level of nurses’ job involvement by improving organizational identity, which in turn may have a positive effect on psychological resilience.

Resilience Among Professional Health Workers in Emergency Services

INTRODUCTION

Although it seems logical to assume that working in an emergency service implies having a great capacity to face extreme situations, resilience in health care workers has been shown to be related not only to individual personality characteristics but also with external factors. The objective of this study was to determine the resilience of professional health workers in emergency services and its relationships with sociodemographic and working conditions.

METHODS

This cross-sectional study included emergency physicians, nurses, and nursing assistants. Sociodemographic variables and the Resilience Scale-25 were analyzed.

RESULTS

A total of 320 professionals participated. Their mean age was 43.5 years (SD 8.9), and 81.87% were women. The mean resilience score was 133.52 (SD 7.22), which corresponds to moderately low to moderate levels. An association was found between the highest resilience scores and being a physician (χ² 8.84; P = 0.01) and a higher capacity if working in emergency mobile units (χ² 6.29; P = 0.04). Working the day shift and being a nurse (beta = -5.71; P = 0.02) were associated with lower resilience scores. Age (odds ratio 1.095; P = 0.02; 95% confidence interval 1.015, 1.184), and not having a partner decreased resilience (being divorced odds ratio 5.17; P = 0.01; 95% confidence interval 1.503, 18.235 and being single odds ratio 3.371; P = 0.01; 95% confidence interval 1.259, 9.257). However, more work experience increased the resilience levels (odds ratio 0.906; P = 0.02; 95% confidence interval 0.833, 0.983).

DISCUSSION

Resilience in professional health workers was related to personal and working conditions. The scores of emergency staff were low and should be improved with specific strategies.

The mediating role of cognitive and affective empathy in the relationship of mindfulness with engagement in nursing

BACKGROUND

The work of health professionals is characterized by a high demand for psychological and emotional resources and high levels of stress. Therefore, the promotion of commitment and job well-being through strategies such as increased mindfulness, is important among nursing workers. Although mindfulness has shown positive effects in the health field, few studies have explored the mechanisms and processes underlying these results. We investigated the mediating role of empathy (cognitive/affective) in the effect of mindfulness on the dimensions of engagement in nursing professionals.

METHODS

Sample was comprised of 1268 Spanish nurses between 22 and 62 years old, that completed the Utrecht Labor Engagement Scale and the adapted versions of Mindful Attention Awareness Scale and Basic Empathy Scale. The relationship between variables to be included in the regression analyses, bivariate correlations were carried out, and the descriptive statistics of these variables were also found. To estimate the mediation model was used, in this case for multiple mediation effects.

RESULTS

Mindfulness is found to affect the Vigor and Dedication factors of engagement through cognitive empathy. While for the Absorption factor, the affective component of empathy also exerts a mediating role, although weaker than cognitive empathy. Cognitive empathy, as an individual factor, was shown to have a mediating effect between mindfulness and the factors of engagement in healthcare workers.

CONCLUSIONS

The level of mindfulness influences engagement of nursing professionals positively, and this result is mediated mainly by cognitive empathy. Both mindfulness and empathy are modifiable individual factors, so their intervention by designing and implementing specific programs, can increase the commitment and wellbeing of professionals generating benefits to workers and to their patients.