From job stress to intention to leave among hospital nurses: A structural equation modelling approach

Perceived social media addiction explained through perceived organizational support, burnout subscales, and the number of years on the job

The study assessed the relationship between perceived organizational support, burnout subscales, sex, the number of years on the job, and perceived social media addiction among nurses using an SEM model with cross-sectional data. Both perceived organizational support and burnout are important since they impact the workplace environment. At the same time, excessive social media use poses a significant challenge in many workplaces, as it often leads to missed deadlines and decreased productivity. This is the first study to examine perceived social media addiction within the workplace context. Emotional exhaustion was found to be positively related to the perception of addiction and was found to predict depersonalization and personal accomplishment assessment, supporting the fact that emotional exhaustion is the core dimension of burnout. The number of years on the job was significantly related to perceived social media addiction. The more nurses felt emotionally exhausted, the more likely they were to feel addicted to social media. The less valued the nurses felt, the more likely they were to feel emotionally exhausted, which then predicted perceived social media addiction. Lastly, sex was found to predict perceived social media addiction. The results of the current study can help guide hospitals in planning and strategizing to decrease burnout levels and increase perceived organizational support, thus supporting better patient care.

Planned Changes to Nurse Leadership, Staffing and Skill-Mix: Impact on the Working Environment, Job Satisfaction and Intention to Leave

INTRODUCTION

Job satisfaction and intention to leave have been consistently linked to the working environment. However, there are few studies of interventions for improving the environment or staff outcomes.

AIM

To determine the impact of implementing a framework for safe nurse staffing on the environment and staff outcomes. This involved an assessment of required nursing hours per patient day, supernumerary nurse in charge and minimum 80:20 skill-mix, with intentional changes in staffing if required.

DESIGN

A pre-post observational design.

METHODS

This was a prospective observational study in six medical and/or surgical wards across three acute hospitals in Ireland. The outcomes were measured pre- and post-implementation, and included the environment, using the Practice Environment Scale of the Nursing Work Index; and job satisfaction and intention to leave using a dichotomised 4-point scale.

OUTCOMES

Changes in staffing levels, adjustments to skill-mix and the supervisory role of the ward leader were seen following the implementation. A multilevel model found significant increases over time on three of the five Nursing Work Index subscales: Staffing and Resource Adequacy, Collegial Nurse-Physician Relations, and Nurse Participation in Hospital Affairs. Job satisfaction increased and intention to leave decreased, although the differences were not statistically significant. Increased job satisfaction was significantly associated with Staffing and Resource Adequacy, Collegial Nurse Physician Relations and Nurse Manager, Leadership and Support. A decreased odds of intention to leave was associated with increased job satisfaction.

CONCLUSION

There were significant improvements in the environment following the implementation of the Framework. Three of the practice environment subscales were significantly associated with job satisfaction, while job satisfaction is a predictor of intention to stay. This study indicates that intentional changes to staffing can result in improvements to working environments which may in turn have an impact on job satisfaction and furthermore, on intention to stay.

IMPACT

This study investigated intentional changes to nurse staffing in medical and surgical wards, examining the impact pre- and post-implementation. This study underlined that when staffing is based on a systematic approach, based on a Framework for Safe Nurse Staffing, a subsequent improvement can be seen in staff's perceptions of the work environment, along with improvements in staff outcomes. This research will impact on staff working in acute settings as a means of determining staffing and improving outcomes using a Framework for Safe Nurse Staffing.

REPORTING METHOD

STROBE checklist.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Intention to Leave the Profession in Nursing: A Hybrid Concept Analysis

Introduction

Leaving the profession is a major challenge in all organizations throughout the world. Intention to leave the profession (ILP) is what individuals perceive about leaving the profession. Nurses' perceptions of ILP are context-based and hence, studies in different contexts are needed to further explore ILP. The aim of this study was to analyze the concept of ILP, determine its attributes, antecedents, consequences, and provide a clear definition for it.

Methods

This concept analysis was done using the hybrid model. In the theoretical phase, Magiran, Iran Medex, SID, Science Direct, Web of Science, PubMed, ProQuest, Scopus, and CINAHL databases were searched to retrieve ILP-related studies published in 2000-2023. In the fieldwork phase, semi-structured interviews were held with twenty nurses and nursing managers and the data were analyzed through conventional content analysis. In the final analysis phase, the results of the two former phases were compared and integrated.

Results

ILP can be defined as "a voluntary and gradual process occurred due to professional disinterest, negative professional attitude, and unmanaged organizational stress and is associated with reduced job motivation, fatigue, and thoughts about leaving the profession which eventually leads to decision about staying in or leaving the organization".

Conclusion

ILP is affected by many different personal, interpersonal, occupational, professional, organizational, environmental, and social antecedents and is associated with different patient, nurse, care-related, and organizational consequences. Nursing authorities and managers need to employ strategies to manage ILP antecedents and thereby, reduce nurses' ILP.

The impact of self-reported burnout and work-related quality of life on nurses' intention to leave the profession during the COVID-19 pandemic: A cross-sectional study

The challenges of maintaining an effective and sustainable healthcare workforce include the recruitment and retention of skilled nurses. COVID-19 exacerbated these challenges, but they persist beyond the pandemic. We explored the impact of work-related quality of life and burnout on reported intentions to leave a variety of healthcare professions including nursing. We collected data at five time-points from November 2020 to February 2023 via an online survey. The validated measures used included the Copenhagen Burnout Inventory and Work-Related Quality of Life (WRQoL) scale; with subscales for Job-Career Satisfaction, General Wellbeing, Control at work, Stress at work, Working conditions, and Home-work interface. Our findings showed that 47.6% of nursing respondents (n = 1780) had considered changing their profession throughout the study period, with the 30-39-year age group most likely to express intentions to leave. Regression analysis reveale that for WRQoL, lower general wellbeing and job-career satisfaction scores predicted intentions to leave when controlling for demographic variables (p < 0.001). When burnout was added to the regression model, both work-related and client-related burnout were predictive of intentions to leave (p < 0.001). These findings highlighted that significant numbers of nurses considered leaving their profession during and shortly after the pandemic and the need for interventions to improve nurses' wellbeing and reduce burnout to improve their retention.

Impacts of Job Demands on Turnover Intention Among Registered Nurses in Hong Kong Public Hospitals: Exploring the Mediating Role of Burnout and Moderating Effect of Pay Level Satisfaction

Background: High turnover rates and burnout are prevalent issues among registered nurses in public hospitals in Hong Kong. Pay level satisfaction is one of the crucial factors influencing organisational and professional turnover intention. Understanding whether pay level satisfaction can mitigate the negative impact of burnout on turnover intention can provide insights into the role of financial rewards in employee retention. Objective: This study aims to evaluate the relationship between job demands and turnover intention among registered nurses in Hong Kong public hospitals. Additionally, it seeks to examine the mediating role of burnout and explore the potential moderating effect of pay level satisfaction on the relationship between burnout and turnover intention. Methods: The study was a cross-sectional online survey of public hospital staff in Hong Kong. A total of 502 registered nurses who had worked at their employing facility for at least 6 months participated in this cross-sectional survey. Study variables included work overload, job stress, work-family conflict, family-work conflict, conflict with other nurses, burnout, pay level satisfaction and turnover intention. The collected data were analysed using bivariate Pearson correlation analysis and mediated moderation analysis with the PROCESS macro in SPSS 28.0. Results: Burnout mediated the relationship between job demands, including work overload, job stress, work-family conflict, family-work conflict and conflicts with nurses, and organisational and professional turnover intention. Pay level satisfaction did not exert a moderating influence on the relationship between job demands and turnover intention through burnout mediating this relationship. Conclusions: The importance of addressing job stress and burnout to mitigate turnover intention and promote nurse retention is underscored. Contrary to expectations, pay level satisfaction did not buffer the negative impact of job demands on turnover intentions via burnout. This suggests that compensation alone may not be sufficient to offset the detrimental effects of high job demands and burnout on nurses' intention to leave their jobs or the profession. Further research is warranted to explore potential moderators that may influence the relationship between job demands and turnover intention.

Work characteristics, job satisfaction and intention to leave: a cross-sectional survey of advanced nurse practitioners

BACKGROUND

Advanced Nurse Practitioners (ANPs) are highly skilled health care professionals with the potential to play a major role in improving the quality and accessibility of health care services. However, there is emerging evidence of disquiet among nurse practitioners who often work in suboptimal work environments. Therefore, it is important to understand the elements that contribute to ANPs' job satisfaction and retention in healthcare services.

AIM

To examine the effects of commitment to the workplace, work engagement, and influence at work on job satisfaction and intention to leave of ANPs.

METHODS

A total of 153 ANP's on the advanced practice section of the Nursing and Midwifery Board of Ireland register completed a web survey between July and August 2020. Independent variables (commitment to the workplace, work engagement, and influence at work) were measured using the Copenhagen Psychosocial Questionnaire (COPSOQ). Multivariable logistic regression models were used to investigate the association between dependent and independent variables.

RESULTS

Participants who reported higher levels of influence at work and higher levels of commitment to the workplace were also satisfied in their job (OR 1.05, 95% CI 1.01-1.09, p = 0.025), (OR 1.10, 95% CI 1.06-1.14, p < 0.001) respectively. Additionally, ANPs with higher levels of commitment to work were significantly less likely to leave their role (OR 0.94, 95% CI .92-.96, p < 0.001).

CONCLUSION

Healthcare organisations can improve job satisfaction and decrease intention to leave by creating environments in which ANPs are supported by their colleagues and supervisors, and facilitate their practice to the full extent of their capabilities.

A systematic review and meta-analysis of the effectiveness of social support on turnover intention in clinical nurses

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.

How are new nurses satisfied with their jobs? From the work value perspective of Generations Y and Z nurses

BACKGROUND

Job satisfaction has garnered significant interest across multiple disciplines as it plays a vital role in shaping human resource strategies. In the field of nursing, enhancing job satisfaction can help prevent workforce shortages. Work values and job-related characteristics are significant predictors of job satisfaction. However, the influence of factors may change as younger generations join the nursing workforce. Although research on generational commonalities and differences in work values is increasing, there is insufficient information on generational differences in the interplay between work values and job satisfaction. This study investigated the factors associated with job satisfaction of new nurses in each generational group based on a work value perspective.

METHODS

A total of 280 new nurses (151 from Generation Y and 129 from Generation Z) were selected from the Graduates Occupational Mobility Survey. Multiple linear regression analyses were performed to determine the factors associated with job satisfaction in both groups.

RESULTS

Most participants graduated with a diploma (61.1%), were paid less than the average salary of each group (60.4%), and conducted shift (72.9%) and overtime work (64.3%). Work values and job satisfaction levels were not significantly different between the two groups. Multiple linear regression analyses showed that career growth and task work values were associated with job satisfaction for Generation Z, while task, reputation, and environment work values were associated with job satisfaction for Generation Y. Among the job-related characteristics, nurses' job tenure was associated with job satisfaction in both groups; salary and overtime had varying relationships with job satisfaction between the two generations.

CONCLUSIONS

Understanding generational differences is crucial for improving the effective management of new generational nurses. Our study findings support that different work value dimensions and job-related characteristics were associated with job satisfaction in each generation. Accordingly, it is essential to develop distinct initiatives, such as a well-structured program, to support the continued career growth of the new Generation Z nurses, thereby enhancing their job satisfaction. Furthermore, providing a conducive working environment that helps new-generation nurses overcome challenges and ensures personal lives should be considered.

Development and Psychometric Test of the Salutogenic Survey on Sustainable Working Life for Nurses: Identifying Resistance Resources against Stress

Extensive research shows nurses' work environment to be particularly stressful. This study develops, explores, and psychometrically tests a new profession-specific questionnaire identifying generalised and specific resistance resources, that make it possible to measure resources to manage work-related stress. An exploratory study design was employed. The questionnaire development was inspired by the MEASURE approach and the salutogenic theory of health. Building on the results from a literature review of nursing research and salutogenesis, supplemented by twelve interviews with hospital nurses, an item pool was generated. The first version was pilot-tested in a group of nurses who were studying to become specialist nurses. The second version of the questionnaire was psychometrically tested on a sample of registered nurses in close patient care (n = 475), analysed using confirmatory factor analysis to test seven predefined domains of the questionnaire. The analysis revealed a first order seven-domain model of 21 items: job satisfaction, professional role, work motivation, commitment, belonging in the workplace, factors and conditions for remaining in the profession, and workload. The structure of the questionnaire indicates its usefulness in clinical practice for measuring resistance resources.

What influences newly graduated registered nurses' intention to leave the nursing profession? An integrative review

BACKGROUND

Newly graduated registered nurses leaving the nursing profession in the early stages of their career have enormous financial and time implications for nursing organizations and affect the quality of nursing care.

OBJECTIVE

To identify the factors influencing newly graduated registered nurses' intention to leave the nursing profession over the past 10 years.

METHODS

The framework developed by Whittemore and Knafl was used to conduct this integrative review. An electronic search was conducted for English articles to identify research studies published between 2011-2022 using the following databases of PubMed, MEDLINE, CINAHL, PsycINFO, and Scopus. Eligible publications were critically reviewed and scored using the Critical Appraisal Skills Program Checklist and the Center for Evidence-Based Management appraisal.

RESULTS

Twenty-one studies were analyzed. The main factors affecting newly graduated registered nurses' intention to leave the nursing profession included demographic factors (age, educational level, year of experience, professional title, employment status, health status, shift, hospital location and size), supervisor and peer support, challenges in the workplace, cognitive and affective response to work, work environment (collegial nurse-physician relations, insufficient staffing level, person-work environment fit), gender stereotypes, autonomous motivation, role models, and resilience.

CONCLUSIONS

The factors affecting newly graduated registered nurses' intention to leave the nursing profession are multifaceted and should receive continuous attention from nurse managers. The findings provide more comprehensive for nurse administrators to develop intervention strategies to mitigate newly graduated registered nurses' turnover intention.

Toxic leadership behaviour of nurse managers and turnover intentions: the mediating role of job satisfaction

INTRODUCTION

Globally, hospitals are confronted with major challenges of turnover of nurses. Knowledge of the factors that account for the turnover of nurses will aid in creating strategies that will enhance nurse managers' leadership behaviour and job satisfaction to reduce turnover. The study, therefore, investigated the mediating role of job satisfaction on toxic leadership and turnover intentions of nurses.

METHODS

A multi-centre cross-sectional study was undertaken to assess 943 nurses using the Toxic-leadership Behaviour of Nurse Managers scale, Minnesota Satisfaction Questionnaire and Turnover Intention scale. Descriptive statistics was used to assess the prevalence of toxic leadership, job satisfaction and turnover and Pearson's correlation examined the relationships between the variables. Hayes' PROCESS macro approach of mediation was used to determine the effect of toxic leadership behaviour on the turnover intention on the possible influence of job satisfaction.

RESULTS

The response rate for the study was 76.0%. Mean scores for turnover intentions and toxic leadership behaviour were 3.71 and 2.42 respectively. Nurses who work with toxic managers showed a higher propensity to leave their jobs. Job satisfaction acted as a mediator between the toxic leadership practices of managers and turnover intentions. The total effect of toxic leadership behaviour on turnover intention comprised its direct effect (β = 0.238, SE = 0.017, 95% CI [0.205, 0.271]) and its indirect effect (β = -0.020, SE = 0.017).

CONCLUSIONS

Job satisfaction acted as a mediating factor for toxic leadership behaviour and nurses' turnover intentions. As part of nurse retention initiatives, avoiding toxic leadership behaviours will be the ultimate agenda. Nurse administrators should recognize the value of excellent leadership and develop a structured training programme through the use of evidence-based professional development plans for nurse managers.

Chronic stress and turnover intention of resident physicians after experiencing COVID-19

BACKGROUND

Previous studies have explored the stress and turnover intention of healthcare workers, but as important backup talents in the healthcare system, resident physicians have received little attention from researchers, especially after experiencing COVID-19. Therefore, this study aims to evaluate the chronic stress and turnover intention of resident physicians after experiencing COVID-19.

METHODS

From June to August 2022, we conducted a questionnaire survey on resident physicians in the Children's Hospital of Hebei Province through the online platform (Wenjuanxing) to evaluate their chronic stress and turnover intention after experiencing COVID-19. For the collected data, we used frequency and percentage to make the statistical description, the Chi-square test to make a univariate analysis on the scores of chronic stress and turnover intention scale, and binary logistic regression analysis to explore the influencing factors of turnover intention.

RESULTS

Out of 143 respondents, we finally received 127 questionnaires, with a response rate of 88.81%. Among 127 respondents, 80.31% of resident physicians experienced varying degrees of chronic stress (mild: 36.22%, moderate: 35.43%, severe: 8.66%), and 74.80% of resident physicians showed varying degrees of turnover intention (mild: 23.62%, moderate: 37.79%, severe: 13.39%). Moreover, age (OR = 0.772, P = 0.042), identity (OR = 8.648, P = 0.021), and chronic stress levels (mild: OR = 6.938, P = 0.003; moderate: OR = 44.049, P < 0.003; severe: OR = 46.141, P = 0.004) can significantly affect turnover intention.

CONCLUSION

In this study, we reported a relatively high proportion of resident physicians with high chronic stress and high turnover intention after experiencing COVID-19. We suggest that the relevant departments should pay more attention to the resident physicians' group and formulate corresponding measures to solve the problems faced by the resident physicians and ensure the stability of the health human resources.

Stress Impact and Care for COVID-19: Pilot Education and Support Course Decreases Burnout Among Nursing Students

BACKGROUND

Nurses and nursing students have been at the forefront of the fight against COVID-19, often working in conditions that produce stress injuries and burnout. Early recognition and mitigation of stress and emotional trauma help prevent burnout.

AIMS

To evaluate the effectiveness of an online 8-hour stress awareness course and associated 1-hour support group in reducing stress and burnout among nursing students.

METHODS

We conducted a program evaluation for an online stress awareness pilot course offered to nursing students. The course, and associated support groups led by trained psychiatric mental health nurse practitioner students, included a common language for talking about stress, screening tools for recognizing stress injuries, and strategies for improving self-care. Students completed pre- and post-course surveys. Outcome measures included changes on course learning objectives, level of burnout, health-related locus of control, and experiences of stress and coping.

RESULTS

Nursing students (n = 360) enrolled in the course, and 224 (62%) completed pre- and post-course surveys. Sixty percent rated the course excellent or very good. Depression Anxiety and Stress Scales and Impact of Event Scale Revised scores were within established normal ranges. There was a significant increase in all nine course learning objectives (p < .001) and decreased signs of stress (p < .001). Students' level of burnout decreased by odds ratio = 0.58 (95% CI: [0.4, 0.9], p < .006).

CONCLUSIONS

Nursing leaders can use psychoeducational strategies to mitigate the impact of stress, build confidence, and support nursing students entering the workforce during these unprecedented times.

Educational degree differences in the association between work stress and depression among Chinese healthcare workers: Job satisfaction and sleep quality as the mediators

Background

Depressive status of medical personnel worldwide and especially in China is an important public health and social problem. There is a strong relationship between education and depression, but no studies have studied grouping healthcare workers (HCWs) with different educational degree to discuss whether there are differences in the factors that affect depression. This study aims to examine the role of job satisfaction and sleep quality in the relationship between work stress and depression among Chinese HCWs, and teste whether the mediation models are differed by the differences of educational degree.

Methods

Patient Health Questionnaire-9 (PHQ-9) scale was used to test depression. Work stress was assessed using the Challenge-blocking stress scale (CBSS). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). HCWs’ satisfaction with their current work was assessed using the Job Satisfaction Index (JSI). The representative sample of HCWs was chosen using a multi-stage stratified cluster random sampling procedure and 844 HCWs were utilized to the statistical analysis of the study.

Results

In the overall sample, sleep quality could mediate the relationship between work stress and depression in healthcare workers (p &lt; 0.001, CMIN/DF = 3.816, GFI = 0.911, AGFI = 0.886, IFI = 0.943, TLI = 0.933, CFI = 0.942, RMSEA = 0.058, SRMR = 0.055, AIC = 1039.144), and the mediating effect accounted for 36.5%. After grouping educational qualifications, the model with sleep quality and job satisfaction as mediating variables reported a better fit in the group with low educational qualifications. The intermediary effect accounted for 50.6 and 4.43%, respectively. The highly educated group only has sleep quality as an intermediary variable in the structural model, and the mediating effect accounted for 75.4% (p &lt; 0.001, CMIN/DF = 2.596, GFI = 0.887, AGFI = 0.857, IFI = 0.937, TLI = 0.926, CFI = 0.937, RMSEA = 0.044, SRMR = 0.056, AIC = 1481.322).

Conclusion

In the overall sample, sleep quality could mediate the relationship between work stress and depression in HCWs. Among HCWs with technical secondary school education and below, job satisfaction can mediate the positive relationship between work stress and depression, while this mediating effect is not significant among HCWs with college degree and above.

Extreme work environment and career commitment of nurses: empirical evidence from Egypt and Peru

Purpose

This paper aim to analyse the motives behind the commitment of nurses to their profession despite their intense job duties during the COVID-19 pandemic.

Design/methodology/approach

The empirical sample comprises of 35 semi-structured interviews with public sector hospital nurses in under-researched contexts of Egypt and Peru.

Findings

Three types of motives were found to play a critical role in nurses’ commitment to their profession despite the difficulties associated with extreme work conditions. These factors include cultural (religious values, governmental coercion), contextual (limited education, organisational support) and personal (good nurse identity, submissive nature) dimensions.

Originality/value

This paper is one of the pioneering works to link existing literature streams on career commitment, extreme jobs, extreme context and management under disruptions (particularly COVID-19) by analysing these aspects in the under-researched Peruvian and Egyptian contexts.

Comprehensive assessment of factors contributing to the actual turnover of newly licensed registered nurses working in acute care hospitals: a systematic review

BACKGROUND

During the COVID-19 pandemic, the demand for nursing care increased, making the retention of nurses even more important. Among staff nurses, it is reported that the turnover rate of newly licensed registered nurses is higher. However, no systematic reviews have focused on the factors that influence newly licensed registered nurses' turnover. Additionally, because newly licensed registered nurses are a major source of the supply of nurses, it is critical to retain them to meet patient needs. Therefore, this study aimed to systematically synthesize the factors contributing to the actual turnover of newly licensed registered nurses working in acute care hospitals.

METHODS

CINAHL, Cochrane Library, DBpia, EBSCO, PubMed, PsycINFO, RISS, and Web of Science were searched for studies published between January 2000 and June 2021. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

RESULTS

Ten articles from 9029 were included in this review. All studies used a longitudinal design. The annual turnover rates of newly licensed registered nurses ranged from 12 to 25%. Health status, including sleep and healthy lifestyles, were significant factors affecting turnover. Most studies focused on work environment factors, and emotional exhaustion, job satisfaction, peer support, and intent to leave, were significantly associated with newly licensed registered nurses' turnover. Small hospitals located in nonmetropolitan areas were at risk of high turnover of newly licensed registered nurses.

CONCLUSIONS

Turnover is inevitable in the process of employment, but high turnover can be prevented. Through reviewing ten articles, significant contributing factors for newly licensed registered nurses' turnover included personal factors of health status; work environment factors of physical exhaustion, emotional exhaustion, depersonalization, occupational injuries, income, intent to stay, job satisfaction, and peer support; and hospital factors of hospital size, location, and unionization. Most existing studies focus on work environment factors, which reflects the significance of fostering healthy work conditions to prevent high turnover. These findings can be used to develop strategies and policies for work environment to reduce high turnover of newly licensed registered nurses, and support high-risk groups, such as small hospitals located in nonmetropolitan areas with high levels of nurses' turnover.

The Mediating Role of Sense of Coherence and Striving for Work-Life Balance on Intention to Leave From Nurses' Burnout

High turnover and understaffing are significant issues plaguing the healthcare system. Some of the leading reasons of turnover include child-bearing and -rearing, stress related to working, and health concerns. With the onset of the coronavirus (COVID-19) pandemic, this problem of turnover worsened due to increased risk of infection and escalating workload. This study aimed to clarify and validate the effect of burnout on intention to leave among full-time nursing professionals and the structural relationship with sense of coherence (SOC) and striving for work-life balance (S-WLB). Secondary analyses of data obtained from a previous study was carried out; a hypothesized model was tested for goodness of fit and a final model was developed. Burnout directly affected intention to leave (P < .001). It also affected intention to leave through SOC and S-WLB (P < .01); SOC lessened the effect of burnout on S-WLB, therefore reducing its impact on intention to leave. Effective strategies need to be developed to improve the SOC and WLB of nurses to alleviate the effects of burnout and thus reduce the likelihood of turnover. Improving their ability to grasp and deal with emergencies and ambiguous situations, as well as providing emotional and tangible support can be other ways to retain nursing professionals.

Stress load of Chinese nurses in Fangcang Shelter Hospitals during the COVID-19 pandemic: A latent profile analysis

The Omicron wave of the COVID-19 pandemic significantly affected Shanghai, China, from March to June 2022. Numbers of Fangcang Shelter Hospitals (FSHs) were conversed from stadiums and exhibition centers to tackle the pandemic. This study aimed to identify the stress load profiles of nurses working in FSHs and explore the characteristics and factors influencing stress load profiles. Totally, 609 out of 700 FSH nurses (with an effective response rate of 87%) participated in an online survey investigating their socio-demographic information, work-related stressors, and stress load. Results of the latent profile analysis identified four classes of stress load, which were labeled as the low (Class 1), mild (Class 2), moderate (Class 3), and high (Class 4) stress load class. Maternity status and self-perceived health condition were significantly different between the four stress load classes by comparisons using the Chi-square test and the Kruskal-Wallis test. The contributors to the stress load profiles were determined by the multinomial logistic regression analysis, including age, education, maternity status, self-perceived health condition, working time in FSHs, and the four dimensions of work-related stressors. Participants who were less healthy (OR = 0.045, 95% CI:0.012,0.171), worked longer time in FSHs (OR = 40.483, 95% CI: 12.103,135.410), faced with more workload (OR = 3.664, 95% CI: 1.047,12.815), and worse working environment (OR = 12.274, 95% CI: 3.029,49.729) were more likely to be classified to the high stress load class. The task arrangement and working environment for FSH nurses should be optimized, and psychological training should be conducted routinely.

The mediating role of nurse-physician collaboration in the effect of organizational commitment on turnover intention

Despite extensive research having been carried out on nurse-physician collaboration, there remains a paucity of evidence on how collaboration interacts with organizational commitment and its effect on turnover intention. This study aims to determine the mediating role of nurse-physician collaboration on the effect of organizational commitment on turnover intention. We used a cross-sectional design based on voluntary paper surveys from the inpatient clinics of six public hospitals in the north of Turkey. Data including measures of nurse-physician collaboration, organizational commitment, and turnover intention were collected from a convenience sample of the nurses (n = 212) and physicians (n = 109). Pearson's correlation analysis was used to determine the relationships between variables, and the mediating effect was analyzed with PROCESS Macro "Model 4" for IBM SPSS. Statistical significance was specified at 95% confidence intervals and two-tailed P values of <0.05 for all tests. While most of the participants were nurses (66%), 34% were physicians. For both nurses and physicians, organizational commitment and nurse-physician collaboration negatively affected the turnover intention. However, the mediating role of nurse-physician collaboration was only significant for nurses (b = -0.025). The results demonstrate the importance of harmony, joint decision-making, and responsibility-sharing between nurses and physicians concerning dedication, engagement, and job satisfaction, especially for nurses.

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

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

Work-family conflict, burnout, and related factors among nurses during the COVID-19 pandemic in the Northwest of Iran

BACKGROUND

Nurses, as the largest working group in the hospital, experience many problems, conflicts, and stressors in the workplace and family especially after the widespread distribution of coronavirus 2019 (COVID-19).

OBJECTIVE

The perceived conflict and burnout among nurses, as well as the correlation between these two variables and the associated factors, were the main subjects of this study.

METHODS

This cross-sectional study involved 256 nurses from three COVID-19 referral hospitals in northwest Iran. Participants completed demographic, work-family conflict (WFC), and burnout questionnaires. The nonparametric tests including Mann-Whitney U, Kruskal-Wallis, and Spearman correlation coefficient were applied to statistical analysis.

RESULTS

The overall score of conflict was 55.3 (12.7). The time dimension received the highest score 11.4 (2.9). In terms of intensity 27.6 (8.7) and frequency 27.6(8.8), nurses had the most burnout in the lack of personal accomplishment dimension. All aspects of WFC, emotional exhaustion, and depersonalization characteristics of burnout had statistically significant positive correlations (p < 0.01). The ward, hospital and employment status variables were associated with WFC (p < 0.05). The association between taking the crisis management course and the severity of depersonalization, and the frequency of lack of personal accomplishment was confirmed (p < 0.01). Additionally, the frequency and severity of emotional exhaustion were associated with employment status and work experiences (p < 0.05).

CONCLUSION

The findings showed that nurses had WFC and burnout rates that were above average. Regarding the negative effects of these two phenomena on health, and also nurse's clinical practices, rearranging work conditions and providing better organizational support seem necessary.

Invisible Erosion of Human Capital: The Impact of Emotional Blackmail and Emotional Intelligence on Nurses' Job Satisfaction and Turnover Intention

Emotion is a compelling factor in the retention and job satisfaction of professionals, and the impacts of emotional feelings and reactions have become an indispensable issue in the nursing workforce. Drawing on the cognitive theory of emotions, this study bridges the research gap to investigate the relationships among emotional blackmail, emotional intelligence, job satisfaction, and turnover intentions of nurses. A cross-sectional design was used to collect data from a sample of 374 full-time nurses in Northern Taiwan. Hypotheses were tested and analyzed by means of SPSS 22, structural equation modeling (SEM), and PROCESS v3.3. The results revealed the direct relationships between emotional blackmail, job satisfaction, and turnover intentions, and job satisfaction partially mediated the relationship between emotional blackmail and turnover intentions. However, there is no statistical support that emotional intelligence moderates the relationships between emotional blackmail and job satisfaction and turnover intentions. Healthcare organizations must take the initiative and form strategies that will help balance nurses' work stresses. These strategies should aim to reduce unnecessary demands from supervisors, patients, and co-workers, as well as in the socio-emotional domain.

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

AIMS

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

BACKGROUND

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

IMPLICATIONS FOR NURSING MANAGEMENT

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

Work-family conflict and the professional quality of life and their sociodemographic characteristics among nurses: a cross-sectional study in Tehran, Iran

Background

Nurses are exposed to work-family conflict (WFC) due to specific occupational conditions, such as exposure to patients and shift work, which can affect the professional quality of life (ProQoL). The aim of the present study was to determine the relationship between different levels of work-family conflicts and professional quality of life and their sociodemographic characteristics among the nurses in two hospitals in Tehran, Iran.

Methods

This cross-sectional study included 234 nurses from two hospitals. Data were collected using a three-part questionnaire, including items related to nurses’ demographic characteristics, the WFC questionnaire, and the ProQoL questionnaire.

Results

There was a significant positive correlation between conflict in terms of time and behavior with compassion satisfaction and between the three types of conflict with job burnout (p < 0.05). The results indicate that the WFC and ProQoL scores and the mean WFC were higher among women, people who had a disabled family member, and nurses who worked equal to or more than 175 hours a month. Regarding the dimensions of ProQoL, the mean compassion satisfaction was lower among people who lived with their parents, people who had a second job had a child younger than one-year-old, and a disabled family member had higher means of job burnout. Also, those who had younger children experienced less PTSD. Furthermore, the mean of WFC and burnout among single nurses was significantly lower than among married and divorced/widowed nurses. Additionally, the mean of WFC and burnout among nurses living in rental houses and nurses reporting the level of satisfying relationships with co-workers as ‘bad’ were significantly more than for other nurses.

Conclusion

Stable mental and emotional conditions are of great importance for nurses to provide safe and quality services to their patients. The results also revealed that nurses’ compassion satisfaction and job burnout were associated with different types of conflict. The WFC of nurses is related to their ProQoL and affects their job satisfaction and burnout. Reducing conflict may improve the nurses’ satisfaction and thus improve patient care and healthcare services.

Related factors influencing Chinese psychiatric nurses' turnover: A cross-sectional study

WHAT IS KNOWN ON THE SUBJECT

Because of increasingly stressful, dangerous and unpredictable psychiatric nursing work, psychiatric nurses have experienced higher job stress than general ward nurses. Little is known about the factors that affect the turnover intention of Chinese psychiatric nurses. Understanding the influencing factors of nurses' turnover intention will help to formulate targeted measures to stabilize psychiatric nursing teams.

WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE

The results showed that 70.2% of psychiatric nurses had higher turnover intention. The strong turnover intention of Chinese psychiatric nurses is a problem that needs to be considered by managers. The results showed that having more children, between 31 and 39 years old, and having a part-time job were strongly associated with turnover intention. In addition, "job stress" was also an important factor, psychiatric nurses' turnover intention decreased as their job stress level decreased.

WHAT ARE THE IMPLICATIONS FOR PRACTICE

Nursing managers should pay attention to nurses who have more children, between 31 and 39 years old, and take on part-time jobs. Additionally, nursing managers should reduce job stress and implement targeted programmes to prevent psychiatric nurses' turnover. Experience-sharing meetings and mindfulness-based stress reduction training are also useful to improve the mental health status of psychiatric nurses with great job stress. Nursing managers should arrange human resources and shifts appropriately to give nurses with more children more time with their families. Provide more development opportunities for psychiatric nurses between 31 and 39 years old. Managers explore the reasons why nurses take on part-time jobs and take targeted interventions (such as increasing income) to reduce the behaviour that happens.

ABSTRACT

Introduction Nurses' turnover is the main cause of nursing shortages, greatly affected by nurses' intention to leave. Nurses' turnover rate is particularly high in psychiatric wards. Several factors influencing the turnover intention of psychiatric nurses have not been well identified in China, and the association between job stress and turnover intention is still limited. Aims To examine the relationship between job stress and turnover intention and identify the influencing factors of psychiatric nurses' turnover intention. Methods Data were collected from 2355 psychiatric Chinese nurses using a cross-sectional design with an online questionnaire investigation. Results Psychiatric nurses had higher turnover intention. Significant factors influencing their turnover intention were job stress, having more children, age between 31 and 39 years old, part-time jobs, education, income and patient-to-nurse ratio. Discussion Demographics and job-related factors should be considered when developing strategies to reduce the turnover intention of psychiatric nurses. Implications for practice Nursing managers should pay attention to nurses with higher job stress levels and different demographic characteristics. Effective measures should be taken to reduce psychiatric nurses' job stress and turnover intention, such as arranging reasonable shifts, implementing targeted family-friendly policies, increasing their occupational possibilities and promoting mental health.

Explanatory Models of Burnout Diagnosis Based on Personality Factors in Primary Care Nurses

Burnout in the primary care service takes place when there is a high level of interaction between nurses and patients. Explanatory models based on psychological and personality related variables provide an approximation to level changes in the three dimensions of the burnout syndrome. A categorical-response ordinal logistic regression model, based on a quantitative, crosscutting, multicentre, descriptive study with 242 primary care nurses in the Andalusian Health Service in Granada (Spain) is performed for each dimension. The three models included all the variables related to personality. The risk factor friendliness was significant at population level for the three dimensions, whilst openness was never significant. Neuroticism was significant in the models related to emotional exhaustion and depersonalization, whilst responsibility was significant for the models referred to depersonalization and personal accomplishment dimensions. Finally, extraversion was also significant in the emotional exhaustion and personal accomplishment dimensions. The analysis performed provides useful information, making more readily the diagnosis and evolution of the burnout syndrome in this collective.

The Relationship Between Occupational Stress and Turnover Intention Among Emergency Physicians: A Mediation Analysis

Background

There is evidence that occupational stress is a risk factor for turnover intentions. However, the structural relationship between occupational stress and turnover intention among emergency physicians has rarely been studied. This study aimed to examine the pathways of occupational stress on turnover intention through job satisfaction and depressive symptoms among emergency physicians in China.

Methods

A cross-sectional study was conducted in China from July 2018 to August 2018. Data were collected using a structured questionnaire that included demographic characteristics, occupational stress, job satisfaction, depressive symptoms, and turnover intention. Hierarchical linear regression was performed to explore the related factors of turnover intention. Structural equation modeling was used to examine the pathways from occupational stress to turnover intention.

Results

A total of 10,457 emergency physicians completed the questionnaire. The score of turnover intention was 11.34 (SD = 3.25), and the average item score of turnover intention was 2.84 (SD = 0.81). In structural equation modeling, the occupational stress not only had a direct effect on turnover intention (standardized direct effect = 0.311, bias-corrected 95% confidence interval [0.261, 0.361], P < 0.001), but also had an indirect effect through job satisfaction and depressive symptoms (standardized indirect effect = 0.448, bias-corrected 95% confidence interval [0.412, 0.484], P < 0.001). However, the effect of depressive symptoms on turnover intention was weak (standardized coefficient [β] = 0.08, P < 0.001).

Conclusions

Job satisfaction partially mediated the relationship between occupational stress and turnover intention. However, due to the weak effect of depressive symptoms on turnover intention, the mediating role of depressive symptoms between occupational and turnover intention had little practical value. It is recommended that hospital administrators prioritize increasing job satisfaction of emergency physicians to reduce the impact of occupational stress on their turnover intention.

A multimodal sensor dataset for continuous stress detection of nurses in a hospital

Advances in wearable technologies provide the opportunity to monitor many physiological variables continuously. Stress detection has gained increased attention in recent years, mainly because early stress detection can help individuals better manage health to minimize the negative impacts of long-term stress exposure. This paper provides a unique stress detection dataset created in a natural working environment in a hospital. This dataset is a collection of biometric data of nurses during the COVID-19 outbreak. Studying stress in a work environment is complex due to many social, cultural, and psychological factors in dealing with stressful conditions. Therefore, we captured both the physiological data and associated context pertaining to the stress events. We monitored specific physiological variables such as electrodermal activity, Heart Rate, and skin temperature of the nurse subjects. A periodic smartphone-administered survey also captured the contributing factors for the detected stress events. A database containing the signals, stress events, and survey responses is publicly available on Dryad.

Effet du télétravail sur la santé psychologique et la performance des travailleurs durant la pandémie de la COVID-19

L’objectif de cette étude est d’examiner comment le recours généralisé au télétravail durant la pandémie de la Covid-19 a pu créer un contexte de travail spécifique influençant la santé psychologique et la performance des employés. Les résultats des analyses menées sur un échantillon de 3771 télétravailleurs canadiens ont révélé que le travail à distance a engendré des demandes additionnelles telles que l’interdépendance des tâches et l’isolement professionnel. Ces demandes ont eu des effets négatifs sur la performance en télétravail en augmentant la fréquence du stress perçu. Toutefois, la présence de ressources telles que le soutien organisationnel semble jouer un rôle tampon en modérant l’effet direct de l’isolement professionnel sur la performance en télétravail.

Sick Leave and Intention to Quit the Job among Nursing Staff in German Hospitals during the COVID-19 Pandemic

Background: Sick leave and turnover of nurses exacerbate an already existing nursing shortage during the COVID-19 pandemic in Germany and other countries. Frequency and associated factors of sick leave and intention to quit among nurses need to be examined to maintain healthcare. Methods: An online survey among nursing staff (N = 757) in German hospitals was conducted between May and July 2021. Sick leave days, intention to quit, working conditions, depression, anxiety and sleep disorder symptoms, effort-reward imbalance (ERI), COVID-19-related and sociodemographic variables were measured. Regression analyses were performed. Results: The intention to quit was present in 18.9%. One third (32.5%) reported sick leave of ≥10 and 12.3% more than 25 days in 12 months. Significant predictors for ≥10 sick leave days were infection with SARS-CoV-2, a pre-existing illness, exhaustion, trust in colleagues and fear of becoming infected. Higher ERI reward levels, perception of sufficient staff and contact with infected patients were associated with lower odds for ≥10 sick leave days. Lower reward levels, having changed work departments during the pandemic, working part-time and higher depression levels significantly predicted turnover intention. Conclusion: Alarmingly, many nurses intend to quit working in healthcare. Perceived reward seems to buffer both sick leave and turnover intention. Enhancing protection from COVID-19 and reducing workload might also prevent sick leave. Depression prevention, improved change management and support of part-time workers could contribute to reducing turnover intention among nurses.

Nurses' turnover intention, hope and career identity: the mediating role of job satisfaction

Background

A high turnover rate has become a critical issue in the field of nursing and how to tackle the problem of nursing turnover has received increased attention worldwide. Hope, career identity, job satisfaction may be useful for reducing turnover. The aim of this study is to explore the relationships among career identity, hope, job satisfaction, and the turnover intention of nurses, and to test the mediating role of job satisfaction on the associations of hope and career identity with turnover intention.

Methods

A descriptive cross-sectional design was used. A total of 500 nurses were recruited from five comprehensive tertiary hospitals using convenience sampling. The questionnaire included items about sociodemographic information as well as the Adult Dispositional Hope Scale, Nursing Career Identity Scale, Job Satisfaction Index Scale, and Nurse Turnover Intention Scale. Pearson’s correlation, multiple linear regression, and structural equation modeling were used to analyze the data. We describe the study in accordance with the STROBE statement.

Results

Hope (r = − 0.227, p < 0.001) and career identity (r = − 0.342, p < 0.001) were negatively correlated with turnover intention. Job satisfaction played a completely mediating role on the associations of hope and career identity with turnover intention (β₁ = − 0.09, β₂ = − 0.33).

Conclusions

Job satisfaction mediated the associations of career identity and hope with turnover intention. Thus, effective measures can be taken to enhance nurses’ hope and career identity in order to improve their job satisfaction and thereby reduce their turnover intention. Providing nurses with more support, helping them find a spiritual foundation, and holding mindful activities that stimulate positive emotions are helpful. In addition, colleges should pay more attention to instilling nursing students with career identity and nursing values.

A Group Intervention to Promote Resilience in Nursing Professionals: A Randomised Controlled Trial

In this study, a new group intervention program to foster resilience in nursing professionals was tested for efficacy. In total, 72 nurses were recruited and randomised to either an intervention condition or to a wait list control condition. The study had a pre-test, post-test, follow-up design. The eight-week program targeted six resilience factors: cognitive flexibility, coping, self-efficacy, self-esteem, self-care, and mindfulness. Compared to the control group, the intervention group reported a significant improvement in the primary outcome mental health (measured with the General Health Questionnaire) from pre-test (M = 20.79; SD = 9.85) to post-test (M = 15.81; SD = 7.13) with an estimated medium effect size (p = 0.03, η² = 0.08) at post-test. Further significant improvements were found for resilience and other resilience related outcomes measures. The individual stressor load of the subjects was queried retrospectively in each measurement. Stress levels had a significant influence on mental health. The intervention effect was evident even though the stress level in both groups did not change significantly between the measurements. Follow-up data suggest that the effects were sustained for up to six months after intervention. The resilience intervention reduced mental burden in nurses and also positively affected several additional psychological outcomes.

Effects of a hospital-based leisure activities programme on nurses' stress, self-perceived anxiety and depression: A mixed methods study

AIMS

To determine the effects of a hospital-based leisure activities programme on nurses' stress, self-perceived anxiety and depression.

BACKGROUND

Nursing work in clinical settings is highly stressful and may result in an increase in nurses' turnover rate, which threatens the quality of nursing care and patient safety.

METHODS

We used a mixed methods design and a three-month intervention (January to April, 2019) involving a convenience sample of 176 nurses working at a Chinese tertiary hospital. We conducted 12 semi-structured interviews and performed a content analysis. The pre- and post-intervention comparisons of nurses' stress, self-perceived anxiety and depression were performed using a paired t test.

RESULTS

The 3-month leisure activities programme significantly decreased nurses' job stress (t = 3.80, p < .01), perceived personal stress (t = 3.30, p < .01), self-perceived anxiety (t = 3.76, p < .01) and depression (t = 2.73, p < .01). The qualitative findings revealed five mechanisms linking leisure activities to subjective well-being: detachment recovery, autonomy, mastery, meaning and affiliation.

CONCLUSIONS

A hospital-based leisure activities programme had a positive effect on job stress, self-perceived anxiety and depression, thus improving nurses' well-being.

IMPLICATIONS FOR NURSING MANAGEMENT

A hospital-based leisure activities programme provides a beneficial strategy for ameliorating nurses' psychosocial issues. Interventions aimed at facilitating or increasing nurses' participation in leisure activities are greatly needed.

Faculty supportive behaviors and nursing student mental health: a pilot study

OBJECTIVES

Relationships between perceived faculty support and prevalence of depression, anxiety, and stress among undergraduate nursing students were explored.

METHODS

A mixed method design was used for this descriptive, cross-sectional pilot study. Depression, Anxiety and Stress Scale-21 (DASS-21), Perceived Faculty Support Scale (PFSS), a demographic questionnaire, and open-ended questions were used to collect data.

RESULTS

Nursing students experienced moderate depression and stress, and severe anxiety. Perceived faculty support was moderate. An inverse correlation between select perceived faculty supportive behaviors and depression, anxiety, and stress was evident. Student stressors were related to faculty actions. The theme being attentive to student stress emerged from the qualitative data.

CONCLUSIONS

Symptoms of poor mental health among undergraduate nursing students are prevalent and represent a significant public health concern among nursing students. Nurse educators must develop psychological and functional supportive behaviors to promote mental health during nursing students' transition throughout the nursing program and beyond.

Stressors and level of stress among different nursing positions and the associations with hyperlipidemia, hyperglycemia, and hypertension: a national questionnaire survey

BACKGROUND

Nurses are faced with varying job stressors depending on their positions and duties. Few previous studies have compared job stress and related chronic conditions among different nursing positions. The objectives were to compare job stressors among clinical registered nurses, nurse practitioners, and head nurses and explore the impact of job stressors and stress level on hyperlipidemia, hyperglycemia, and hypertension.

METHODS

Secondary data extracted from a survey of health-care workers conducted from May to July 2014 across 113 hospitals in Taiwan was used. This analysis included 17,152 clinical registered nurses, 1438 nurse practitioners, and 2406 head nurses. Socio-demographic characteristics, job stressors, stress levels, and hyperlipidemia, hyperglycemia, and hypertension variables were extracted.

RESULTS

Perceived stressors differed among clinical registered nurses, nurse practitioners, and head nurses, but overall stress level did not. Nurse practitioners and head nurses showed significantly higher prevalence of hyperlipidemia, hyperglycemia, and hypertension than clinical registered nurses. Higher stress levels, age, body mass index, work hours, and caring for family members were positively associated with hyperlipidemia, hyperglycemia, and hypertension. After adjustment for these variables, risk of hyperlipidemia, hyperglycemia, and hypertension did not differ across the nursing positions.

CONCLUSIONS

Although stressors vary by different nursing positions, overall stress level does not. Hyperlipidemia, hyperglycemia, and hypertension are related to stress level, age, body mass index, weekly working hours, and caring for family members. Hence, alleviating job stress and avoiding long working hours are likely to reduce the risk of hyperlipidemia, hyperglycemia, and hypertension in nurses.

Impact of Role Conflict on Intention to Leave Job With the Moderating Role of Job Embeddedness in Banking Sector Employees

This study investigates why some employees intend to leave their jobs when facing conflict between family responsibilities and job routines. The present study also reveals the moderating role of on-the-job embeddedness between role conflict and intention to leave the job. Drawing on conservation of resources theory, the paper investigates the buffering effect of the three on-the-job embeddedness components (fit, links, and sacrifice). Data were collected from banking officers because most of the employees have to face role conflict between family and job responsibilities, as banking is considered among the most stressful jobs. Collected data were analyzed by applying structural equation modeling. Results indicate that the role conflict significantly influences intention to leave the job. Furthermore, the study shows that on-the-job embeddedness moderates the relationship between role conflict and intention to leave. The results suggest that organizations can reduce turnover intention during times of work and life conflict by developing employee on-the-job embeddedness. This study provides some insights to managers on why many employees leave their jobs and how to overcome this problem. Management should also offer extra and available resources in periods of greater tension to minimize early thinking regarding quitting.

The nurses' occupational stress components and outcomes, findings from an integrative review

AIM

To identify, evaluate and summarize the components, factors and outcomes of nurses' occupational stress published between 2009-2019.

DESIGN

Integrative literature review.

METHODS

A literature search was conducted on PubMed, CINAHL and PsycINFO databases for articles published in English, between 2009-2019.

RESULTS

The review included 132 studies. Most studies were conducted in the Confucian Asia and Anglo countries, but a growing number of studies were done in other countries. Almost all studies used a quantitative design, and changes in the use of scales indicated an increasing attention to career-related components. Factors were categorized into sociodemographic, work environment and personal resources. Sociodemographic factors were inconsistent across countries. Outcomes were categorized into health status, capability, affective and behavioural responses to work, and organizational performance with generally consistent results. Model validation studies showed the non-linear or non-direct associations between stress and outcomes.

A closer look to the high burden of the psychiatric disorders among health care workers (HCWs) in Egypt during COVID-19 outbreak: A meta-analysis of 3137 HCWs

Objectives

To study the prevalence of psychiatric disorders among Egyptian health care workers (HCWs) during the Coronavirus Disease 2019 (COVID-19) outbreak.

Method

We searched six databases for relevant papers. The quality of the included articles was measured by The National Institute of Health quality assessment tool. We used the fixed-effect model if there is no heterogeneity and the random model if heterogeneity exists.

Results

After the screening of 197 records, we included 10 studies. Among all psychiatric disorders, anxiety was the most commonly reported psychiatric disorder among HCWs with a prevalence of 71.8% (95% confidence interval (CI): 49.4-86.9), followed by stress, depression, and insomnia, 66.6% (95%CI: 47.6-81.3), 65.5% (95%CI: 46.9-80.3) and 57.9% (95%CI: 45.9-69.0), in order. Regarding severity according to the Depression, Anxiety and Stress Scale-21 Items, the moderate form was the most common type of severity in depression 22.5% (95%CI: 19.8-25.5) and stress 14.5% (95%CI: 8.8-22.5), while very severe form was the most common type of severity reported in anxiety comorbidity 28.2% (95%CI: 3.8-79.6).

Conclusion

The COVID-19 pandemic has an unfavorable effect on the Egyptian HCWs' psychological wellbeing. More psychological support and preventive measures should be.

Disparities in Nurse Job Dissatisfaction and Intent to Leave: Implications for Retaining a Diverse Workforce

OBJECTIVE

To determine if Black nurses are more likely to report job dissatisfaction and whether factors related to dissatisfaction influence differences in intent to leave.

BACKGROUND

Minority nurses report higher job dissatisfaction and intent to leave, yet little is known about factors associated with these differences in community settings.

METHOD

Cross-sectional analysis of 11 778 nurses working in community-based settings was conducted. Logistic regression was used to estimate the association among race, job satisfaction, and intent to leave.

RESULTS

Black nurses were more likely to report job dissatisfaction and intent to leave. Black nurses' intent to leave decreased in adjusted models that accounted for dissatisfaction with aspects of their jobs including salary, advancement opportunities, autonomy, and tuition benefits.

CONCLUSION

Nurse administrators may find opportunities to decrease intent to leave among Black nurses through focused efforts to target areas of dissatisfaction.

Influence of Striving for Work-Life Balance and Sense of Coherence on Intention to Leave Among Nurses: A 6-Month Prospective Survey

The increase in the elderly population in need of healthcare services has led to a serious shortage in the nursing workforce. To retain a large nursing workforce, a strong work–life balance among nurses is needed along with a healthy work environment. This prospective study investigates the influence of work–life balance and sense of coherence on intention to leave among hospital nurses. A questionnaire survey was conducted with 2239 nurses as a baseline. The explanatory variables included striving for work–life balance behavior, a sense of coherence in terms of personal resources, and work-, organizational-, and individual-related factors. Using a cohort of 1368 valid responses, we measured intention to leave among 975 nurses with whom we were able to follow up 6 months after the baseline survey. We then performed multiple regression analysis. The behavior striving for work–life balance was shown to influence nurses’ intention to leave. Nurses who exhibited less striving for work–life balance behavior showed higher intentions to leave. The sense of coherence was not identified as a factor affecting intention to leave. Securing a comfortable work–life balance would reduce the nurses’ desire to quit the hospital. To reduce nurse turnover, nurse managers should develop support programs that can help nurses achieve a better work–life balance.

Communication Skills and Transformational Leadership Style of First-Line Nurse Managers in Relation to Job Satisfaction of Nurses and Moderators of This Relationship

The job satisfaction of nurses is reflected in almost all organizational outputs of medical facilities. First-line nurse managers (FLNMs), who are directly related to subordinate nurses, have a great influence on this satisfaction. The aim of our paper is to examine the connection between communication skills and the transformation style of FLNMs management with the job satisfaction of nurses and to verify the influence of three moderators on the strength of this relationship. The chosen moderators-the practice of managing FLNMs, the degree of control (span of control) and psychosocial work-follow from theoretical studies. The moderating effect of the variable management practice is also significant from the point of view of Slovak legislation. The sample consisted of 132 FLNMs from five university hospitals in Slovakia. Data collection took place in the form of a questionnaire. All data were processed using the SPSS 24 software package. A series of regression analyzes were used to identify the proposed hypotheses. ANOVA analysis was used to analyze multiple dependencies. We worked at a 5% level of significance. The findings point to the strong direct effects of communication skills and the transformational leadership style of FLNMs on nurses' job satisfaction. Moderation effects are mild, but significant in the case of management and span of control practices. The lower values of both variables reinforce the positive relationships among the two predictors and the job satisfaction of nurses. The third moderator, psychosocial work factors, also have a significant moderating effect, which is negative, and the higher value of this moderator mitigates both positive direct effects.

Occupational stress, job satisfaction, and intent to leave: nurses working on front lines during COVID-19 pandemic in Zagazig City, Egypt

During epidemics, the medical working environment is highly stressful especially for the nurses. The purpose of this study was to assess occupational stress, job satisfaction, and intent to leave among nurses dealing with suspected COVID-19 patients. A comparative cross-sectional study was conducted among 210 nurses from Zagazig Fever Hospital (ZFH) which is one of COVID-19 Triage Hospitals (Group I) versus 210 nurses from Zagazig General Hospital (ZGH) (Group II) which is neither triage nor isolation hospital; dealing only with suspected COVID-19 patients in emergency at Sharkia Governorate, Egypt, from 10th to 24th of April 2020. Assessment was done through online questionnaire formed of the Expanded Nursing Stress Scale, the McCloskey/Mueller Satisfaction Scale, and questionnaire assessing specific COVID-19-associated stressors and nurses' intent to leave. Three quarters of nurses (75.2%) in ZFH had high stress level versus 60.5% in ZGH. Workload (98.6%), dealing with death and dying (96.7%), personal demands and fears (95.7%), employing strict biosecurity measures (95.2%), and stigma (90.5%) represented the highest priority stressors in ZFH, while exposure to infection risk (97.6%) was the stressor of highest priority among ZGH according to Pareto analysis. More than half of nurses (51.0%) in ZFH reported low satisfaction level versus 41.9% in ZGH. Only 4.8% of nurses in ZFH definitely had no intent to leave their present job. Type of hospital and its related workload were the most significant predictor of all the studied outcomes.

The Role of Filial Piety in the Relationships between Work Stress, Job Satisfaction, and Turnover Intention: A Moderated Mediation Model

In China, filial piety, which usually refers to showing respect and obedience to parents, has exerted an important effect in the relationship between work stress and turnover intention. However, the mechanism behind this effect is still unclear. To address this gap in the existing literature, we developed and tested a moderated mediation model of the relationship that work stress shares with job satisfaction and turnover intention. In accordance with the dual filial piety model and the stress-moderation model, our hypothesized model predicted that the mediating effect of job satisfaction on the relationship between work stress and turnover intention would be moderated by reciprocal filial piety (RFP) and authoritarian filial piety (AFP). The analytic results of data that were obtained from 506 employees of manufacturing industries in China supported this model. Specifically, RFP and AFP, as a contextualized personality construct, positively moderated the direct relationship between work stress and turnover intention as well as the corresponding indirect effect through job satisfaction. In particular, RFP and AFP strengthened the positive effect of work stress on turnover intention. Based on these findings, recommendations to help employees fulfill their filial duties and reduce the effect of work stress on turnover intention among employees of Chinese manufacturing industries are delineated.

Impact of night shift rotations on nursing performance and patient safety: A cross-sectional study

Aim

Hospitals operate on a 24‐hr basis, with shiftwork being unavoidable for most nurses. This study aims to explore the impact of night shiftwork rotations on nurses' physiological status, work performance and patient safety concerns among nurses in public hospitals.

Design

A descriptive predictive correlational design using a self‐administered questionnaire.

Methods

Electronic and printable survey questionnaires were distrusted among nurses working in public hospitals in multiple regions of Saudi Arabia. The study recruited 1,256 nurses from different nationalities, hospital work units and work experience.

Results

A large proportion of nurses on night shiftwork encountered patient safety issues (85.7%) and physiological consequences (93.6%). Counselling sessions and programmes to support at‐risk nurses are recommended.

Salutary factors and hospital work environments: a qualitative descriptive study of nurses in Sweden

BACKGROUND

Extensive research describes how nurses experience their work environment. The conditions are described as stressful and dissatisfying with nurses intending to leave their workplace. Knowledge about the personal perception regarding why nurses consider leaving the hospital workplace is limited. The purpose of this study was to understand why hospital nurses remain in their workplace, which facilitates their continuation in the profession.

OBJECTIVE

The objective was to explore and describe factors explaining why hospital nurses remain in the workplace.

METHODS

This was a descriptive qualitative study with a purposive sample of hospital nurses in Sweden. The salutogenic theory was the basis for the interview guide and the semi-structured questions. Individual interviews were conducted in a hospital in western Sweden. Content analysis was performed to organize the coded data according to the sense of coherence.

RESULTS

Data saturation was achieved with 12 interviews. Within the three themes of coherence (comprehensibility, manageability, and meaningfulness), ten subthemes were categorized from the data as follows: job satisfaction and fun at work, acknowledgement and productivity, togetherness and team security, manageable workload, variable work and challenging situations, workplace and personal space balance, collaboration and supportive leadership, valued role and good work, commitment and involvement, and pride in the professional role.

CONCLUSIONS

The main findings of this study have shown the critical importance of being in a meaningful, comprehensible and manageable work context that supports nurses in maintaining their professional identity.

The Nursing Stress Scale-Spanish Version: An Update to Its Psychometric Properties and Validation of a Short-form Version in Acute Care Hospital Settings

Stressful working conditions are correlated with a negative impact on the well-being of nurses, job satisfaction, quality of patient care and the health of the staff. The Nursing Stress Scale (NSS) has been shown to be a valid and reliable instrument to assess occupational stressors among nurses. This study updates the psychometric properties of the “NSS-Spanish version” and validates a short-form version. A cross-sectional design was carried out for this study. A reliability analysis and a confirmatory factor analysis and an exploratory factor analysis were undertaken. Items were systematically identified for reduction using statistical and theoretical analysis. Correlation testing and criterion validity confirmed scale equivalence. A total of 2195 Registered Nurses and 1914 Licensed Practical Nurses were enrolled. The original 34-item scale obtained a good internal consistency but an unsatisfactory confirmatory and exploratory factor analysis. The short-form Nursing Stress Scale (11-items) obtained a good internal consistency for Registered Nurses (α = 0.83) and for Licensed Practical Nurses (α = 0.79). Both Nursing Stress Scales obtained a strong correlation for Registered Nurses (rho = 0.904) and for Licensed Practical Nurses (rho = 0.888). The 11-item version of the Nursing Stress Scale is a valid and reliable scale to assess stress perception among Registered Nurses and Licensed Practical Nurses. Its short-form nature improves the psychometric properties and the feasibility of the tool.

How organisational commitment influences nurses' intention to stay in nursing throughout their career

BACKGROUND

The current COVID 19 pandemic brings into sharp focus the global necessity of having sufficient numbers of nurses and the dire impacts of nursing shortages throughout health systems in many countries. In 2020 retaining skilled experienced nurses continues to be a major global challenge. The dominant and consistent concentration of workforce research to date has focused on attitudinal factors including job satisfaction and burnout and there is limited research on how organisational commitment in combination with job satisfaction and burnout may explain what keeps nurses in nursing.

OBJECTIVES

To measure how organisational commitment in combination with job satisfaction and burnout relate to the intention of Registered General Nurses' staying in nursing (ITSN).

DESIGN & METHODS

A quantitative descriptive design using a cross-sectional survey was utilised. A national postal survey of a representative sample of registered general nurses employed within the Republic of Ireland (ROI) health services was undertaken in 2010. A number of established valid and reliable instruments were used to measure attitudinal factors and their relationship with intention to stay (ITSN). Data were analysed using IBM SPSS version 24.0 and descriptive, correlational and multiple regression analysis were undertaken.

RESULTS

A total of 756 registered nurses participated in this study. The strongest predictor of intention to stay in nursing was organisational commitment (β=0.32, p=.000) while burnout and job satisfaction had a significant relationship with ITSN.

CONCLUSION

Results reveal the complex and multidimensional nature of ITSN with the majority of nurses having a strong intention to stay in nursing. Organisational commitment and low burnout represented predictors which are influential in nurses remaining in nursing throughout their career lifespan. These results remain relevant in 2020 particularly in light of the ongoing pandemic when retention and recruitment of skilled and experienced nurses to the workforce will be critical to the management of health care, considering the increased nurse vacancy rates in many countries and the evident lack of resolution of the issues raised from this study.

The Impact of Changes in Professional Autonomy and Occupational Commitment on Nurses' Intention to Leave: A Two-Wave Longitudinal Study in Japan

This study aimed to investigate changes in nurses’ attitudes toward professional autonomy and occupational commitment over time, and their effect on nurses’ intentions to leave, using a two-wave longitudinal design. Anonymous, self-report questionnaires were distributed to all nurses working at 28 hospitals in western Japan on two separate occasions (n = 1778). Multivariate analysis using a generalized estimation equation was conducted, with the intention to leave at Time 2 as the dependent variable, and the changing secular trends in all subscales of attitudes toward professional autonomy and occupational commitment as the independent variables. Age, sex, education, and intention to leave at Time 1 were control variables. Results showed that increasing changing secular trends in control over work conditions, which is a subscale of attitudes toward professional autonomy, increased intention to leave at Time 2, while increasing changing secular trends in all subscales of occupational commitment decreased intention to leave at Time 2. Nurses with a progressive attitude toward discretion of control over work conditions may have higher intentions to leave. Therefore, increasing control over their work conditions may reduce this intention. Additionally, it is necessary to continually enhance nurses’ occupational commitment by offering professional development programs.