Perceived organizational support, self-efficacy and cognitive reappraisal on resilience in emergency nurses who sustained workplace violence: A mediation analysis

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

BACKGROUND

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

OBJECTIVES

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

DESIGN

Systematic review.

DATA SOURCES

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

REVIEW METHODS

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

RESULTS

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

CONCLUSIONS

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

The role of professional identity, psychological resilience, and coping styles in mitigating compassion fatigue among geriatric services and management interns

OBJECTIVE

To examine the impact of professional identity, psychological resilience, and coping styles on compassion fatigue among Geriatric Services and Management interns. It further elucidates how these factors interact within the framework of Kumpfer's resilience model and Lazarus and Folkman's psychological stress and coping theory in managing compassion fatigue.

METHODS

A multicenter cross-sectional survey of 654 Geriatric Services and Management interns was designed.

RESULTS

Among the 636 valid questionnaires, the average score on the Compassion Fatigue Short Scale was 54.84. Psychological resilience and coping styles had direct effects on compassion fatigue. Professional identity influenced compassion fatigue through two mediating pathways: (a) psychological resilience (β = -0.036, P < 0.001); and (b) psychological resilience combined with coping styles (negative coping styles [β = -0.012, P < 0.001], and positive coping styles [β = -0.010, P < 0.001]).

CONCLUSION

Geriatric Services and Management interns generally exhibit moderate levels of compassion fatigue. Psychological resilience and coping styles fully mediated the relationship between professional identity and compassion fatigue. Training programs focusing on psychological resilience and coping strategies are recommended to maximize the protective effect of professional identity against compassion fatigue.

The relationship between clinical nurses' feelings of underqualification and work withdrawal behavior: the multiple mediating roles of self-disgust and self-efficacy

Purpose

The purpose of this study is to analyze the influence of three variables-feelings of underqualification, self-disgust, and self-efficacy-on work withdrawal behavior, with the aim of drawing attention to the mental health of nurses.

Methods

A total of 300 nurses were recruited in Shandong Province, China for the survey. Participants completed the General Information Questionnaire, the Perceived Inadequate Qualifications Scale, the Work Withdrawal Behavior Scale, the Self-Disgust Scale, and the General Self-Efficacy Scale. The potential relationships between these variables were explored.

Results

The work withdrawal behavior of nurses in this study is characterized as being at a lower middle level. Work withdrawal behavior was positively correlated with feelings of underqualification and self-disgust, while showing a negative correlation with self-efficacy. Self-disgust and self-efficacy indirectly influence perceived underqualification and work withdrawal behavior. Both the mediating effect and the chain mediating effect were found to be significant.

Conclusion

Self-disgust and feelings of underqualification can aggravate the work withdrawal behavior of nurses, while improving self-efficacy can help reduce this behavior. Nursing managers should create opportunities for skill development, prioritize the physical and mental health of nurses, and take steps to minimize work withdrawal behavior, thereby improving the quality of clinical nursing.

"I can't endure it" vs. "I can handle it" - experiencing work fatigue risk for nurses: a qualitative study

BACKGROUND

Work fatigue has become a significant challenge for nursing staff, yet there is a paucity of qualitative research that explores their lived experiences in this context. This study aims to examine clinical nurses' experiences with work fatigue risk and to identify the hindering and facilitating factors contributing to this issue.

METHODS

In this study with descriptive phenomenological method, semi-structured interviews with 25 nurses conducted in the meeting room of a hospital from June to August 2024. Colaizzi's seven-step analysis method was used for data analysis.

RESULTS

Three main themes with twelve subthemes were identified. The primary themes included: (1) phases of work fatigue risk experience, (2) hindering factors of work fatigue risk management, and (3) facilitating factors of work fatigue risk management. Nurses faced a combination of facilitators and inhibitors in managing work fatigue. While some nurses demonstrated a positive attitude towards their work, others showed a strong intention to leave the profession.

CONCLUSIONS

Our findings offer a nuanced understanding of the dynamic stages of nurses' work fatigue experience, highlighting both hindering and facilitating factors that influence the management of work fatigue risk. Nurses encounter multiple challenges in managing work fatigue effectively, underscoring the need for comprehensive strategies. These strategies should address structural barriers while fostering individual resilience, ultimately promoting a healthier and more sustainable work environment.

Resilience and Social Support Protect Nurses from Anxiety and Depressive Symptoms: Evidence from a Cross-Sectional Study in the Post-COVID-19 Era

Background: Nurses experience high levels of anxiety and depression since they work in a highly stressful environment. Thus, the identification of preventive factors against nurses' anxiety and depression is essential to improve their quality of life. In this context, our aim was to examine the impact of resilience and social support on nurses' anxiety and depressive symptoms. Methods: A cross-sectional online study was implemented in Greece in September 2024. We used the Brief Resilience Scale, Multidimensional Scale of Perceived Social Support, and Patient Health Questionnaire-4 to measure resilience, social support, anxiety, and depressive symptoms, respectively. Results: Our sample included 677 nurses with a mean age of 37.73 years (standard deviation: 9.38). Our multivariable linear regression models identified a negative relationship between resilience and anxiety (adjusted standardized beta coefficient =-0.38; p < 0.001) and depressive symptoms (adjusted standardized beta coefficient = -0.36; p < 0.001). Similarly, we found that significant others' support was associated with reduced anxiety (adjusted standardized beta coefficient = -0.27; p < 0.001) and depressive symptoms (adjusted standardized beta coefficient = -0.23; p < 0.001). The standardized beta coefficient indicated that resilience has a greater impact on anxiety and depressive symptoms than significant others' support. Conclusions: Our findings suggest resilience and social support have a protective function against nurses' anxiety and depressive symptoms. Managers and policymakers should adopt appropriate interventions to improve nurses' resilience and social support and, thus, to improve their mental health and quality of life.

Cross-sectional study of workplace violence on work engagement among Chinese nurses: the mediating role of psychological resilience

OBJECTIVES

This study aimed to investigate the status of workplace violence, psychological resilience and work engagement, and explore the potential mediating role of psychological resilience in the relationship between workplace violence and work engagement among Chinese nurses.

DESIGN

A cross-sectional survey was conducted among a convenience sample of clinical registered nurses.

SETTING

A convenience sample of clinical registered nurses was recruited from affiliated hospitals of Hunan University of Chinese Medicine.

PARTICIPANTS

A total of 1725 questionnaires were received, of which 1571 were deemed valid, resulting in an effective response rate of 91.07%. The final sample consisted of 1571 clinical registered nurses with a mean age of 31.65±7.16 years.

OUTCOME MEASURES

Data were collected through an online questionnaire comprising a general information form, the Workplace Violence Scale (WVS), Connor-Davidson Resilience Scale (CD-RS) and Utrecht Work Engagement Scale (UWES). Descriptive analysis, correlation analysis, and mediation analysis were performed using IBM SPSS Statistics software.

RESULTS

This cross-sectional investigation recruited a convenience sample of 1571 clinical registered nurses, who encountered multiple types of workplace violence in the past year. Pearson correlation analysis indicated negative associations between workplace violence and work engagement (r=-0.505, p<0.01), as well as between workplace violence and psychological resilience (r=-0.523, p<0.01). Mediation analysis revealed that psychological resilience partially mediated the relationship between workplace violence and work engagement, with the mediation effect accounting for 66.67% of the total effect.

CONCLUSIONS

Nurses exposed to workplace violence demonstrated decreased work engagement, while psychological resilience acted as a protective factor to mitigate the adverse impacts of workplace violence on work engagement. These findings provide a theoretical basis for interventions that equip nurses with resilience to combat workplace violence and improve work engagement.

Relationship Between Perceived Organizational Support, Work Well-Being, and Medical Narrative Ability Among Nurses: A Cross-Sectional Multicenter Study

Aims: The purpose of this study was to investigate the relationship between nurses' perceived organizational support, work well-being, and medical narrative ability. Background: With the proposed bio-psycho-social medical model, nurses' medical narrative ability is closely related to patients' health problems and quality of life. Nurses' perceived organizational support and work well-being can improve nurses' empathy and reflection ability to a certain extent and promote patients' rehabilitation. However, the relationship between nurses' perceived organizational support, work well-being, and medical narrative ability is unclear. Methods: A total of 1831 nurses from 8 hospitals in China were surveyed using an online questionnaire that included nurses' sociodemographic, perceived organizational support, work well-being, and medical narrative ability. IBM SPSS 27.0 was used for Pearson's correlation analysis, one-way ANOVA, t-test, and mediation effect analysis using Model 4 in PROCESS (5000 resamples). Results: The total mean score of perceived organizational support (46.68 ± 11.00), work well-being (53.09 ± 10.81), and medical narrative ability (154.48 ± 22.93) among nurses was found to be moderate. The relationship between perceived organizational support, work well-being, and medical narrative ability was significant, with correlation coefficients ranging from 0.348 to 0.685 (p < 0.01). The relationship between perceived organizational support and medical narrative ability is partially mediated by work well-being. The intermediate effect accounted for 52.36% of the total effect. Conclusion: This study found that nurses' work well-being mediated the relationship between perceived organizational support and medical narrative ability. Implications for Nursing Management: This study evaluated nurses' medical narrative ability and explored the relationship between nurses' perceived organizational support, work well-being, and medical narrative ability. The results of this study can help nursing managers and educators to take appropriate measures to intervene nurses' perceived organizational support and work well-being, so as to improve nurses' medical narrative ability and optimize nursing quality.

A meta-analysis of cognitive reappraisal and personal resilience

Cognitive reappraisal, an adaptive emotion regulation strategy that involves subjectively reinterpreting stressful and adverse experiences in a more positive manner, can enhance personal resilience. Personal resilience is a constellation of attributes that facilitate successful coping and an expeditious return to adaptive functioning after exposure to stress or adversity. This meta-analysis evaluated the association between cognitive reappraisal and personal resilience. A systematic and exhaustive search identified 64 independent samples from 55 studies (N = 29,824) that examined the correlation between cognitive reappraisal and personal resilience. A random-effects model revealed a positive summary effect (r = 0.47, p < .001), indicating that higher cognitive reappraisal was associated with higher personal resilience. Six potential meta-moderators were tested: culture, age, name of the cognitive reappraisal measure, name of the personal resilience measure, study design, and publication period. After two extreme effect size outliers were omitted, tests of publication bias did not reveal any publication bias in this line of research. This quantitative synthesis offers compelling evidence showing that cognitive reappraisal skills operate as a protective strategy against stress and adversity and, therefore, enhance personal resilience. The protective benefits of cognitive reappraisal in relation to personal resilience are relatively robust, as the correlations were statistically significant for all subgroups in the meta-moderation analyses.