Exploring the relationships among professional quality of life, personal quality of life and resignation in the nursing profession

Transforming outcome expectations into retention among hospital nurses: A cross-sectional study

AIM

To examine the main effects and interaction effects of outcome expectations (e.g., anticipated satisfactory salary and benefits), nurse identity (a sense of membership in the nursing profession), and information-access efficiency of the electronic medical record system (how the system enables nurses to quickly retrieve the needed information) on nurses' retention.

DESIGN

This study uses a cross-sectional survey and adopts proportionate random sampling to recruit a representative sample of nurses of a medical centre in Taiwan.

METHODS

This study successfully obtained completed questionnaires from 430 nurses during December 2021 to January 2022. Data are analysed by using hierarchical regressions.

RESULTS

Positive outcome expectations and identification as a member in the nursing profession are associated with retention. Information-access efficiency strengthens the link between outcome expectations and retention, while nurse identity weakens this link.

CONCLUSION

Outcome expectations can help retain nurses, particularly those who perceive high levels of information-access efficiency and possess weak nurse identity. That is, outcome expectations have a complementary role with nurse identity in retaining nurses.

IMPLICATIONS FOR THE PROFESSION

Nurse managers should devise means to build positive outcome expectations for nurses. In addition, either strengthening nurses' identification with the nursing profession or improving the information-access efficiency of the electronic medical system may also help retain nurses.

IMPACT

This study examined how to transform outcome expectation to nurse retention, offering nurse managers to devise new means to retain nurses.

REPORTING METHOD

STROBE statement was chosen as EQUATOR checklist.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Nurses quietly quit their job more often than other healthcare workers: An alarming issue for healthcare services

AIM

To assess the level of quiet quitting among healthcare workers (HCWs) and identify possible differences between nurses, physicians, and other HCWs. We investigated the impact of sociodemographic variables, job burnout, and job satisfaction on quiet quitting levels.

BACKGROUND

The quiet-quitting phenomenon is not new but has been frequently discussed during the COVID-19 pandemic. Interestingly, the level of quiet quitting among HCWs has not been measured yet.

METHODS

We conducted a cross-sectional study with a convenience sample. We measured sociodemographic variables, job burnout, job satisfaction, and quiet quitting. We adhered to STROBE guidelines for cross-sectional studies.

FINDINGS

Among our sample, 67.4% of nurses were quiet quitters, while the prevalence of quiet quitting for physicians and other HCWs was 53.8% and 40.3%, respectively. Multivariable linear regression analysis identified that the levels of quiet quitting were higher among nurses than physicians and other HCWs. Moreover, greater job burnout contributed more to quiet quitting, while less satisfaction implied more quiet quitting. HCWs who work in shifts and those working in the private sector experienced higher levels of quiet quitting.

DISCUSSION

More than half of our HCWs were described as quit quitters. Levels of quiet quitting were higher among nurses. Job burnout and job dissatisfaction were associated with higher levels of quiet quitting.

IMPLICATIONS FOR NURSING PRACTICE AND NURSING POLICY

Measurement of quiet quitting and identification of risk factors are essential to prevent or reduce quiet quitting levels among HCWs. Our study provides information on this field helping managers and organizations to identify quiet quitters within HCWs. Policymakers and managers should develop and implement interventions both at an organizational level and at an individual level.

Professional engagement: Connecting self-efficacy to actual turnover among hospital nurses

AIMS

To examine how nurses' self-efficacy impacts professional engagement (professional opportunities exploration and workplace improvement participation), nurses' turnover intention and further on actual turnover.

BACKGROUND

The problem of nursing shortage has become a common global issue. Nurses' self-efficacy could reduce nurses' turnover intention. However, whether professional engagement could connect nurses' self-efficacy and their actual turnover remains unknown.

DESIGN

This study adopts a three-wave follow-up design.

METHODS

This study uses proportionate random sampling to survey nurses in a large medical centre in Taiwan. Totally, 417 participants were enrolled from December 2021 to January 2022 (first wave) and followed up from February 2022 to March 2022 (second wave). The data of nurses' actual turnover (or not) were traced in May 2022 (third wave). STROBE statement was chosen as the EQUATOR checklist.

RESULTS

Self-efficacy was positively linked to outcome expectation, which is positively linked to professional opportunities exploration. Self-efficacy was positively linked to career interest and workplace improvement participation. Professional engagement was negatively linked to nurses' intention to leave the target hospital, which was positively linked to actual turnover.

CONCLUSION

This study uniquely finds that professional engagement is the key to the mechanism underlying the influence of nurse' self-efficacy on their actual turnover.

IMPACT

Our findings impact nursing management that professional engagement is as well important as nurses' self-efficacy, with an aim to maintain the professional nursing workforce.

PATIENT OR PUBLIC CONTRIBUTION

Nurses complete the questionnaires, return them to the investigators and permit investigators to check their personnel data.

The Prevalence and Predictors of Compassion Satisfaction, Burnout and Secondary Traumatic Stress in Registered Nurses in an Eastern Canadian Province: A Cross-Sectional Study

BACKGROUND

The quality of Registered Nurses' worklife is impacting nurses' mental health, and the standard of care received by clients. Contributing factors to nurses' stress are the trauma of continuous caring for those in great suffering, and adverse working conditions.

OBJECTIVES

i) to explore the prevalence of work-related stress in a provincial sample of Registered Nurses; ii) to compare the levels of compassion satisfaction, burnout and secondary traumatic stress reported by nurses in hospital, community, non-direct care settings, and, iii) to identify factors that predict levels of nursing work stress.

METHODS

A descriptive, predictive study with a self-report survey containing demographic questions and the Professional Quality of Life Scale was emailed to over 3,300 Registered Nurses. The scale measured the prevalence of three worklife indicators, compassion satisfaction, burnout and secondary traumatic stress. Multiple linear regression identified factors that predicted the levels of the three indicators. A subgroup analysis explored the quality of worklife based on three practice environments.

FINDINGS

Nurses (n  =  661) reported moderate compassion satisfaction, burnout, and secondary traumatic stress. The strongest predictor, satisfaction with one's current job, predicted high compassion satisfaction and lower burnout and secondary stress. The subgroup analysis identified hospital nurses as having the most work-related stress and the lowest level of compassion satisfaction.

CONCLUSION

Innovative, collaborative action can transform nurses' practice environments. Organizational support is essential to bring about needed improvements.

Investigating compassion fatigue and predictive factors in paediatric surgery nurses

BACKGROUND

Nurses provide care to meet the complex needs of patients in the increasing workload in the health system and are at risk of compassion fatigue. The concept of compassion fatigue has begun drawing attention in the last decade, as it negatively affects nurses' physical and mental health, job performance and satisfaction, and therefore patient care quality.

OBJECTIVES

This study was to examine compassion fatigue and predictive factors in paediatric surgery nurses.

PARTICIPANTS AND RESEARCH CONTEXT

The study was cross-sectional, predictive and quantitative. It was conducted with the 135 paediatric surgery nurses. The data were sent to the email addresses of the members via Google Survey. Research data were collected with the Nurse Information Form, Compassion Fatigue Scale, Life Satisfaction Scale and Multidimensional Perceived Social Support Scale.

ETHICAL CONSIDERATIONS

After obtaining the approval of the University's ethics committee, the study was carried out after obtaining participants' informed written and verbal consent.

RESULTS

There was a difference between the level of compassion fatigue according to the paediatric surgery unit that worked the longest and the thought of changing their profession. Burn unit nurses and nurses who were considering changing professions have higher compassion fatigue scores. When the predictors of compassion fatigue were examined, the thought of changing the nursing profession and life satisfaction were significant predictors of compassion fatigue. The thought of changing the nursing profession and life satisfaction explained 22% of compassion fatigue. The same variables and the longest working period of the paediatric surgery unit were the estimators of the level of occupational burnout; explaining 29% of occupational burnout.

CONCLUSIONS

Compassion fatigue, life satisfaction and perceived social support of paediatric surgery nurses are moderate. Compassion fatigue is affected by working time, the thought of changing the profession, life satisfaction and perceived social support.

Factors related to intensive care unit Nurses' work engagement: A web-based survey

A questionnaire survey on the personal and work factors related to work engagement among intensive care unit nurses concerning their recovery experiences and the nursing practice environment was conducted using a web-based tool. Two individual factors (demographics and experience on recovery from job stress) and four work factors (work employment type, nursing method, COVID-19 nursing experience, and nursing practice environment) were surveyed. Data from 244 participants were obtained, and survey items were analyzed using a multiple regression analysis with work engagement as the dependent variable. The results show that 3-5 years of nursing experience is significantly associated with lower work engagement. Conversely, certifications for higher-level and specialized nursing, mastery experience such as learning new things, 1-9 days/month of COVID-19 nursing experience, and suitable nursing practice environment were significantly associated with higher work engagement. These factors are considered important for improving the work engagement of intensive care unit nurses.

Association between proactive personality and professional identity of nursing undergraduates: The mediating role of resilience and irrational belief

AIM

To examine the relationship between proactive personality and professional identity of undergraduate nursing students, including the role of psychological resilience and irrational belief as mediators.

BACKGROUND

Personality has been shown to play a crucial role in determining professional identity. However, the influence of proactive personality on professional identity in the nursing field is poorly understood and requires further investigation.

DESIGN

We conducted a cross-sectional study in China. Between July and December of 2021, 860 nursing undergraduates participated in an online questionnaire survey.

METHODS

Four main variables (proactive personality, psychological resilience, irrational belief and professional identity) and two covariates (willingness to choose nursing profession and family attitude towards nursing) were assessed. The assessment tools chosen are both valid and reliable. To test the proposed multi-mediation model, linear regression analysis by Hayes's SPSS macro-PROCESS was used.

RESULTS

The results revealed that PP, PR and PI were positively connected with one another, but negatively with IB. PP positively predicted PI through direct and indirect paths, after controlling for two covariates. The percentage of indirect path (78.72%) outweighed the direct path (21.28%). The indirect effect of PR (72.51%) was higher than that of PR and IB (6.21%). PI was also positively predicted by students' "Yes" willingness and families' "supportive" attitude towards nursing.

CONCLUSION

This study stated that nursing educators should take nursing students' PP seriously, which would allow for activities to be taken to improve their PR and decrease their IB, hence continuously enhancing their PI. In addition, respecting students' professional aspirations and improving family support may also be valuable ways to boost their PI.

Association between hopelessness and job burnout among Chinese nurses during the COVID-19 epidemic: The mediating role of career calling and the moderating role of social isolation

Background

The COVID-19 pandemic has led to an increased workload and work pressure on nurses owing to the unpredictable changes during this challenging situation. Herein, we explored the relationship between hopelessness and job burnout in nurses working in China against the backdrop of the COVID-19 outbreak.

Method

This was a cross-sectional study involving 1216 nurses in two hospitals in Anhui Province. The data was collected using an online survey. The mediation and moderation model was constructed, and the data was analyzed using SPSS PROCESS macro software.

Results

Our results showed that the nurses had an average job burnout score of 1.75 ± 0.85. Further analysis revealed a negative correlation between hopelessness and career calling (r = -0.551, P < 0.01) and a positive correlation between hopelessness and job burnout (r = 0.133, P < 0.01). Additionally, a negative correlation was demonstrated between career calling and job burnout (r = -0.138, P < 0.01). Moreover, career calling strongly mediated (by 40.9%) the relationship between hopelessness and job burnout in the nurses. Finally, social isolation in the nurses was a moderating factor for the association between hopelessness and job burnout (β = 0.028, t = 2.851, P < 0.01).

Conclusion

Burnout severity in nurses increased during the COVID-19 pandemic. Career calling mediated the relationship between hopelessness and burnout, with greater burnout levels in nurses who experienced social isolation. Therefore, we suggest that job burnout in nurses can be improved by mitigating the effects of hopelessness and social isolation through psychological interventions and enhancing their sense of career calling through education to strengthen their professional identity.

Role of patient safety attitudes between career identity and turnover intentions of new nurses in China: A cross-sectional study

Background

Patient safety is a key priority for healthcare systems, which is not only about the safety and quality development of health care but also about the safety of patients' lives. However, there has been little research exploring the relationship between new nurses' willingness to leave, patient safety culture, and professional identity. This study was to explore patient safety for new nurses, examine the relationship between professional identity, patient safety culture, and turnover intentions of newly recruited nurses in China, and validate the mediating role of patient safety culture.

Methods

From August 2019 to September 2021, we collected data from newly recruited nurses in 5 large tertiary public hospitals in Anhui Province, China using a questionnaire survey. Descriptive analysis, a univariate analysis, Pearson correlation analysis, and mediated regression analysis were used to estimate the current status of patient safety attitudes and the effect of safety culture on career identity and turnover intentions among newly recruited nurses.

Results

The turnover intention of 816 newly recruited nurses was 14.16 ± 3.14%. Patient safety culture was positively associated with career identity (r = 0.516, P < 0.01) and negatively associated with turnover intentions (r = -0.437, P < 0.01), while patient safety was also a partial mediator between career identity and turnover intentions.

Conclusions

The results showed that the low patient safety attitudes of new nurses in China should not be ignored. The impact of professional identity on patient safety has important practical implications for promoting a culture of safety among new nurses and reducing turnover rates.

Impact of compassion satisfaction and compassion fatigue on satisfaction with life in Serbian and Polish nurses: A cross-sectional study

AIMS AND OBJECTIVES

To evaluate demographic and occupational factors of professional life on life satisfaction among nurses in Serbia and Poland.

BACKGROUND

Compassion satisfaction and compassion fatigue, as aspects of a nurse's professional life, may affect their satisfaction with life in general. However, most studies on this topic have been conducted in Asian countries, and because there are differences in health care system performance across countries amid a global shortage of nurses, it is necessary to investigate professional quality of life in the European nursing context.

METHODS

This multicenter, comparative, and correlational study was conducted on a sample of 669 hospital nurses in Serbia and Poland. The survey data were collected between November 2019 and February 2020 using the Demographic and Occupational Questionnaire (DOQ), Professional Quality-of-Life Scale (ProQOL-5), and Satisfaction with Life Scale (SWLS). STROBE Statement guidelines for cross-sectional studies were followed.

RESULTS

Most nurses from both countries reported having moderate compassion satisfaction, moderate risk for compassion fatigue, and an average life satisfaction. The predictive factors of life satisfaction that most stand out include country of origin, financial situation, education, job satisfaction, and compassion fatigue.

DISCUSSION AND CONCLUSION

Quality of professional life is significantly affected by shift duration, age, work experience, and job satisfaction. Negative aspects of professional life are significant predictors of life satisfaction.

IMPLICATIONS FOR NURSING POLICY

The findings of this study indicate a need for implementing flexible shift patterns and enhancing interventions that will improve job satisfaction and compassion satisfaction while reducing the risk of compassion fatigue.

Relationship between Psychological Ownership of the Nursing Profession and Turnover Intention: A Correlational Survey among Taiwanese Nurses

AIMS

To examine the relationship between psychological ownership of the nursing profession and turnover intention.

BACKGROUND

There is a severe shortage of nurses worldwide. Research is needed to understand how nurses' intention to leave hospitals and the nursing profession can be alleviated.

METHODS

This study adopted a cross-sectional design and a survey method. Proportionate random sampling was used to ensure sample representativeness. This study surveyed 430 registered nurses in a medical center in Taiwan between December 2021 and January 2022. We used Turnover Scale and Self-Efficacy Scale, and developed Having a Place Scale.

RESULTS

Psychological ownership comprises three dimensions: self-efficacy, nurse identity, and "having a place" in the nursing profession. This research is the first to examine how these three dimensions of psychological ownership of the nursing profession are related to the intention to leave a hospital or the nursing profession. Self-efficacy and "having a place" are negatively related to nurses' intention to leave a hospital (r=-.23 and -.31, p<.001). Nurse identity is negatively related to nurses' intention to leave the nursing profession (r=-.38, p<.001). Intention to leave a hospital is positively related to nurses' intention to leave the profession (r=.76, p<.001).

CONCLUSION

The findings provide novel insights for retaining nurses. Nurse managers could use strategies such as including nurses in making workplace decisions and encouraging them to personalize their workspace. Implications for Nursing Management Nurse managers can enhance nurses' self-efficacy and sense of "having a place" to retain nurses in hospitals, while enhance nurse identity to retain nurses in the profession.

Quality of work life and working conditions among oncology nurses: A national online descriptive cross-sectional study

The aim of this study was to examine the quality of work life (QoWL) and working conditions of oncology nurses in Turkey. The study utilized a descriptive cross-sectional design. The data were collected via the introductory information form and Brooks' Quality of Nursing Work Life Survey. The study was completed with 138 nurses. The factors affecting QoWL were determined using stepwise multiple linear regression. Nurses had a moderate QoWL, and age, duration of working in nursing, the number of nurses, and the working style were significantly associated with QoWL. To improve the QoWL, the nurses' socio-demographic factors should be considered and working conditions should be improved. Furthermore, well-designed institutional policies should be developed to improve the patient-nurse ratio and provide a quality healthcare.What this paper adds?In the current study, Turkish oncology nurses had a moderate quality of work life.Age, duration of working in the nursing, the number of nurses in the unit and the working style were linked to work-related quality of life in oncology nurses.Well-designed institutional policies should be developed to improve the working conditions and to increase work-related quality of life in oncology nurses.

Influence of sleep fragmentation and fatigue on turnover of female nurses working rotating shifts

AIMS AND OBJECTIVES

To investigate whether the sleep quality and fatigue of female nurses working rotating shifts could be used to predict future turnover status.

BACKGROUND

Female nurses working rotating shifts often suffer from sleep problems and fatigue, and the turnover rates of nurses are generally higher than those of other hospital personnel.

DESIGN

A prospective study.

METHODS

We recruited a total of 198 female nurses working rotating shifts from December 2017 to March 2019. The nurses completed the Checklist Individual Strength (CIS) scale and wore an actigraph for seven consecutive days in order to collect their sleep parameters. Their turnover status was tracked until 31 May 2021 at which time 55 participants (27.8%) had resigned. The Cox proportional hazard model was used to analyse the factors influencing turnover. In addition, the study adhered to the STROBE checklist.

RESULTS

The results revealed significant differences between the nurses in the still-working group and the resigned group in terms of the sleep quality parameters sleep efficiency (SE) and wake after sleep onset (WASO) as well as CIS scores. WASO was significantly correlated with intensity of fatigue, and fatigue was common among all of the nurses working rotating shifts. As time progressed, the sleep quality parameter WASO and CIS scores could be used to predict turnover status after 2.4 years.

CONCLUSION

The results of this study indicated more sleep fragmentation and poor sleep efficiency in the resigned group. Sleep fragmentation was highly correlated with fatigue, and sleep fragmentation and fatigue could be used to predict turnover status.

RELEVANCE TO CLINICAL PRACTICE

We suggest that relevant hospital management pay more attention to the sleep conditions and fatigue of female nurses working rotating shifts when arranging personnel and schedules and offer them more understanding.

Quality of professional life of primary healthcare nurses: A systematic review

AIMS

To identify and critically appraise the available evidence on the overall quality of professional life of primary care nurses worldwide and its main influencing factors.

BACKGROUND

Quality of professional life of healthcare workers is a keystone that influences the quality of healthcare services provided by healthcare organisations. Nurses have a key role as healthcare services providers given the growing shortage of doctors in primary care.

DESIGN

A systematic review design in accordance with the PRISMA statement.

METHODS

The search was conducted through MEDLINE (PubMed), CINAHL, SCOPUS, Scientific Electronic Library Online (SciELO) and Web of Science databases. The grey literature was reviewed at OpenGrey. The search was limited to human studies published from April 2010-April 2020. No limit of original language publication was applied. Three independent reviewers analysed the methodological quality of the studies.

RESULTS

Ten studies were included from five countries. Five studies reported nurses were satisfied with their quality of professional life and the influencing factors identified were Workload, Job autonomy, Demographic variables, Management support, Recognition, Intrinsic motivation, Interpersonal relations, Compassion fatigue, Burnout, Turnover intention, and work was reported as a component of Quality of life.

CONCLUSION

Primary healthcare nurses reported a high level of quality of professional life, but the scarce studies found do not provide solid consistency to assess the overall quality of professional life. Perception of high workload was the most frequently identified factor to negatively influence the quality of professional life of nurses.

RELEVANCE TO CLINICAL PRACTICE

Quality of professional life of primary care nurses is a key issue because of nurses' important relation with patient's care and satisfaction. Healthcare organisations should strive to address primary care nurses' quality of professional life to enhance their well-being and consequently patients' safety and high-quality healthcare services.