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Huang H, Su Y, Liao L, Li R, Wang L. Perceived organizational support, self-efficacy and cognitive reappraisal on resilience in emergency nurses who sustained workplace violence: A mediation analysis. J Adv Nurs 2024; 80:2379-2391. [PMID: 38050872 DOI: 10.1111/jan.16006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 11/13/2023] [Accepted: 11/19/2023] [Indexed: 12/07/2023]
Abstract
AIMS The aims of this study were as follows: (a) to examine the relationship between perceived organizational support and resilience; (b) to investigate the potential mediating role of general self-efficacy and cognitive reappraisal among emergency nurses who have experienced workplace violence; and (c) to explore the application of Kumpfer's resilience framework to emergency department nurses. DESIGN A cross-sectional study. METHODS From February 17, 2021, to March 8, 2021, 825 emergency nurses working in the emergency departments of tertiary hospitals in Shanghai, China, completed an online survey. Data on resilience, organizational support, cognitive reappraisal and general self-efficacy were collected through questionnaires. The Spearman analysis was employed to investigate the relationship between variables, while the mediation analysis was conducted using AMOS 23.0 statistical software. RESULTS The findings of a study involving 825 emergency nurses who reported experiencing workplace violence reveal a positive correlation between perceived organizational support and resilience. Additionally, it has been observed that the relationship between these two factors is mediated by both cognitive reappraisal and general self-efficacy. Furthermore, the mediating effect of cognitive reappraisal is more significant in this relationship. CONCLUSION Kumpfer's resilience framework is found to apply to emergency nurses. Perceived organizational support, an environmental factor, affects resilience directly and positively. In addition, cognitive reappraisal and general self-efficacy, which are individual factors, mediate this influence path. These findings suggest an interaction between environmental and individual factors in determining the resilience of emergency nurses. IMPACT These findings have implications for developing resilience intervention strategies for emergency nurses exposed to occupational violence. Enhancing personal attributes such as general self-efficacy and cognitive reappraisal is as significant as strengthening external organizational support environments for enhancing nurses' resilience. PATIENT OR PUBLIC CONTRIBUTION Emergency nurses participated in the pilot test of our questionnaire survey and gave their opinions on the questionnaire design. SUMMARY STATEMENT What is already known about the topic? In emergency rooms, workplace violence is prevalent, and it seriously endangers nurses' physical and mental health. Enhancing resilience can improve nurses' ability to self-regulate after experiencing violence. However, the drivers and mechanisms of resilience among emergency nurses who have experienced workplace violence remain unidentified. What this paper adds? This study confirms the applicability of Kumpfer's resilience framework to emergency nurses who have experienced workplace violence. Nurses' self-efficacy and cognitive reappraisal mediate the relationship between perceived organizational support and resilience after exposure to workplace violence. The resilience process for emergency nurses involves the interaction of individual and environmental factors. Implications for practice/policy. Managers and researchers should consider the interaction between individual and environmental factors when developing resilience intervention strategies for emergency nurses who have suffered workplace violence. It is essential to support emergency nurses from the dyadic dimensions of the environment and the individual. A supportive organizational environment and individual positive adjustment strategies are equally important in promoting resilience among nurses.
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Affiliation(s)
- Hanjun Huang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Ya Su
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Liwen Liao
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Rui Li
- Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
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Vallone F, Zurlo MC. Stress, interpersonal and inter-role conflicts, and psychological health conditions among nurses: vicious and virtuous circles within and beyond the wards. BMC Psychol 2024; 12:197. [PMID: 38600606 PMCID: PMC11007966 DOI: 10.1186/s40359-024-01676-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/20/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND The increasing costs of nurses' occupational-stress, conflicts, and violence within healthcare services have raised international interest. Yet, research/interventions should consider that perceived stress and conflicts- but also potential resources- within the wards can crossover the healthcare settings, impacting nurses' private lives and viceversa, potentially creating vicious circles exacerbating stress, conflicts/violence or, conversely, virtuous circles of psychological/relational wellbeing. Based on the Demands-Resources-and-Individual-Effects (DRIVE) Nurses Model, and responding to the need to go in-depth into this complex dynamic, this study aims to explore potential vicious circles featured by the negative effects of the interplay (main/mediating effects) between perceived stressors in nursing linked to interpersonal conflicts (Conflicts-with-Physicians, Peers, Supervisors, Patients/their families), work-family inter-role conflicts (Work-Family/Family-Work-Conflicts), and work-related stress (Effort-Reward-Imbalance) on nurses' psychological/relational health (Anxiety, Depression, Somatization, Interpersonal-Sensitivity, Hostility). The potential moderating role of work-resources (Job-Control, Social-Support, Job-Satisfaction) in breaking vicious circles/promoting virtuous circles was also explored. METHOD The STROBE Checklist was used to report this cross-sectional multi-centre study. Overall, 265 nurses completed self-report questionnaires. Main/mediating/moderating hypotheses were tested by using Correlational-Analyses and Hayes-PROCESS-tool. RESULTS Data confirmed the hypothesized detrimental vicious circles (main/mediating effects), impairing nurses' psychological health conditions at individual level (Anxiety, Depression, Somatization), but also at relational level (Hostility and Interpersonal-Sensitivity). The moderating role of all work resources was fully supported. CONCLUSION Findings could be used to implement interventions/practices to effectively prevent the maintenance/exacerbation of vicious circles and promote psychological/relational wellbeing in healthcare settings and beyond.
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Affiliation(s)
- Federica Vallone
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | - Maria Clelia Zurlo
- Dynamic Psychology Laboratory, University of Naples Federico II, Via Rodinò 22, Naples, Italy.
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Galanis P, Moisoglou I, Papathanasiou IV, Malliarou M, Katsiroumpa A, Vraka I, Siskou O, Konstantakopoulou O, Kaitelidou D. Association between Organizational Support and Turnover Intention in Nurses: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2024; 12:291. [PMID: 38338176 PMCID: PMC10855592 DOI: 10.3390/healthcare12030291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 01/10/2024] [Accepted: 01/18/2024] [Indexed: 02/12/2024] Open
Abstract
Although recent studies suggest a negative relationship between organizational support and turnover intention among nurses, there has been no systematic review on this issue. The aim of this systematic review and meta-analysis was to synthesize and evaluate the association between organizational support and turnover intention in nurses. The review protocol was registered with PROSPERO (CRD42023447109). A total of eight studies with 5754 nurses were included. All studies were cross-sectional and were conducted after 2010. Quality was moderate in five studies and good in three studies. We found a moderate negative correlation between organizational support and turnover intention since the pooled correlation coefficient was -0.32 (95% confidence interval: -0.42 to -0.21). All studies found a negative correlation between organizational support and turnover intention ranging from -0.10 to -0.51. A leave-one-out sensitivity analysis showed that our results were stable when each study was excluded. Egger's test and funnel plot suggested the absence of publication bias in the eight studies. Subgroup analysis showed that the negative correlation between organizational support and turnover intention was stronger in studies in China and Australia than those in Europe. Organizational support has a moderate negative correlation with turnover intention in nurses. However, data regarding the impact of organizational support on turnover intention are limited. Moreover, our study had several limitations, and thus, we cannot generalize our results. Therefore, further studies should be conducted to assess the independent effect of organizational support on turnover intention in a more valid way. In any case, nursing managers should draw attention to organizational support by developing effective clinical practice guidelines for nurses so as to reduce turnover intention.
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Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.G.); (A.K.)
| | - Ioannis Moisoglou
- Faculty of Nursing, University of Thessaly, 41500 Larisa, Greece; (I.M.); (M.M.)
| | | | - Maria Malliarou
- Faculty of Nursing, University of Thessaly, 41500 Larisa, Greece; (I.M.); (M.M.)
| | - Aglaia Katsiroumpa
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.G.); (A.K.)
| | - Irene Vraka
- Department of Radiology, P. & A. Kyriakou Children’s Hospital, 11527 Athens, Greece;
| | - Olga Siskou
- Department of Tourism Studies, University of Piraeus, 18534 Piraeus, Greece;
| | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (O.K.); (D.K.)
| | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (O.K.); (D.K.)
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Huang S, Zhai J, Lu X, Liang Y, Li Q, Lilenga HS. Prevalence of workplace violence in Chinese obstetric nurses under the new situation and its correlation with violence prevention knowledge-attitude-practice and climate perception: a cross-sectional study. BMC Nurs 2023; 22:473. [PMID: 38093351 PMCID: PMC10717719 DOI: 10.1186/s12912-023-01637-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Workplace violence severely impacts individual nurses. With the three-child opening policy of China and the impact of the COVID-19 epidemic in the recently years, obstetric nurses face the double attack of heavy workload and staffing shortage. This study aimed to evaluate the current situation of workplace violence among Chinese obstetric nurses under the new situation, assess the level of violence prevention knowledge-attitude-practice and climate perception in Chinese obstetric nurses and explore the correlation between workplace violence and the level of violence prevention knowledge-attitude-practice and climate perception. METHODS A cross-sectional survey on the workplace violence for Chinese obstetric nurses was conducted from August to February 2023. All the questionnaires came from 10 provinces and 3 autonomous regions in China. The basic characteristics of obstetric nurse's workplace violence, workplace violence prevention knowledge-attitude-practice scale and workplace violence climate perception scale were collected. RESULTS Totally, 522 Chinese obstetric nurses were included. 55.0% of obstetric nurses (287) had experienced workplace violence in the past 12 months, including verbal assault (40.4%), physical assault (34.1%), and sexual assault (31.0%). The overall level of obstetric nurses' workplace violence prevention knowledge-attitude-practice and climate perception of workplace violence was low. Multiple linear regression analysis showed that the violence prevention knowledge dimension significantly influenced obstetric nurses' workplace violence (B = -0.278, P < .001), attitude dimension (B = -0.241, P < .001), behavior dimension (B = -0.216, P < .001) and the violence climate perception's organizational management (B = -0.177, P < .001), organizational training (B = -0.175, P < .001), organizational support (B = -0.143, p < .001) and the violence handling (B = -0.165, P < .001). CONCLUSION The incidence of workplace violence among obstetric nurses in the new situation is high. However, the overall violence prevention knowledge-attitude-practice and climate perception levels are low. Therefore, nursing managers should take targeted measures according to the relevant influencing factors and the characteristics of obstetrics to improve the level of obstetric nurses' violence prevention knowledge-attitude-practice and climate perception to reduce workplace violence among obstetric nurses.
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Affiliation(s)
- Shan Huang
- School of Nursing, Southern Medical University, Guangzhou, 510515, China
| | - Jinguo Zhai
- School of Nursing, Southern Medical University, Guangzhou, 510515, China.
- School of Nursing, Southern Medical University, No.1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong Province, 510515, China.
| | - Xiaoqin Lu
- Nursing Department, Guangzhou University of Traditional Chinese Medicine Dongguan Hospital, No. 3, Dongcheng section, Songshan Lake Avenue, Dongguan City, Guangdong Province, 523000, China
| | - Yulian Liang
- Nursing Department, Guangzhou University of Traditional Chinese Medicine Dongguan Hospital, No. 3, Dongcheng section, Songshan Lake Avenue, Dongguan City, Guangdong Province, 523000, China
| | - Qiumei Li
- Department of Obstetrics and Gynecology, Songshan Lake Central Hospital, No. 1, Xianglong Road, Dongguan City, Guangdong Province, 523000, China
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Yun JY, Myung SJ, Kim KS. Associations among the workplace violence, burnout, depressive symptoms, suicidality, and turnover intention in training physicians: a network analysis of nationwide survey. Sci Rep 2023; 13:16804. [PMID: 37798353 PMCID: PMC10556140 DOI: 10.1038/s41598-023-44119-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 10/04/2023] [Indexed: 10/07/2023] Open
Abstract
Depression and anxiety are the most common mental disorders among physicians, who have a greater risk of suicide than those in other professional occupations. Relationships among a demanding workload, workplace violence, burnout, and intention to turnover have also been reported. The current study examined the principal components and propagating patterns of mental health and working environment interactions in training physicians. A total of 1981 training physicians completed online self-report questionnaires during September-October (midpoint of the training year) 2020. Regularized partial correlations in a mixed graphical model (MGM) and joint probability distributions (directed acyclic graph; DAG) were estimated for four subtypes of workplace violence (verbal abuse/physical violence perpetrated by clients/hospital staff), three burnout subdomains (Maslach Burnout Inventory), thoughts about quitting, and nine depressive symptoms, including suicidality, comprising the DSM-5 diagnostic criteria for major depressive disorder (assessed using the Patient Health Questionnaire-9). Thoughts of death/self-harm showed directional dependencies on the joint probability distributions of psychomotor agitation/retardation, concentration difficulty, self-reproach, and sadness in the DAG. In the MGM, a partial correlation with psychomotor agitation/retardation (r = 0.196) accounted for 56.5% of the variance in thoughts of death/self-harm. Partial correlations with concentration difficulties (r = 0.294), self-reproach (r = 0.257), changes in appetite (r = 0.184), and worker-on-worker physical violence (r = 0.240) in the MGM accounted for 54.4% of the variance in psychomotor agitation/retardation. Thoughts about quitting were partially correlated with and dependent upon the joint probability distributions of emotional exhaustion (r = 0.222), fatigue (r = 0.142), anhedonia (r = 0.178), and sadness (r = 0.237). In contrast, worker-on-worker (r = 0.417) and client-on-physician (r = 0.167) verbal abuse had regularized partial correlations with directional dependencies on thoughts about quitting. Organization-level interventions aiming to reduce the worker-on-worker violence and individual-level approaches of clinical screening program and psychiatric counseling clinic are required. Follow-up studies to verify the effectiveness of these interventions for training physicians are needed.
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Affiliation(s)
- Je-Yeon Yun
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sun Jung Myung
- Office of Medical Education, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Kyung Sik Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
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Wang M, Wang L, Lu C. Nurses' sense of organizational support, Self-esteem and perceived professional benefits: A mediating model. Nurs Open 2023; 10:2098-2106. [PMID: 36490363 PMCID: PMC10006623 DOI: 10.1002/nop2.1457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 09/22/2022] [Accepted: 10/22/2022] [Indexed: 12/13/2022] Open
Abstract
AIM To explore the mediating role of self-esteem in the relationship between perceived organizational support and professional benefits among Registered Nurses in China. DESIGN This was an online, cross-sectional study involving 1850 nurses from six hospitals in China. METHODS Data were collected using a 4-part questionnaire including a sociodemographic questionnaire, perceived organizational support scale, self-esteem scale and brief nurses' perceived professional benefits questionnaire from September to November 2021. Structural equation modelling (SEM) was used to explore the associations among them. RESULTS Perceived organizational support was positively correlated with self-esteem and perceived professional benefits among nurses, whereas self-esteem positively predicted nurses' perceived professional benefits . Self-esteem partially mediated the relationship between the two variables. The ratio of the mediating effect to the total effect was 16.7%.
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Affiliation(s)
- Mingjing Wang
- School of Nursing, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
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Cakal H, Keshavarzi S, Ruhani A, Dakhil‐Abbasi G, Ünver H. Mental health and intentions to quit among nurses in Iran during COVID-19 Pandemic: A social identity approach. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2022; 33:CASP2666. [PMID: 36718475 PMCID: PMC9878192 DOI: 10.1002/casp.2666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 10/11/2022] [Accepted: 10/15/2022] [Indexed: 12/12/2022]
Abstract
The positive effects of social identification on mental health are well documented in the literature. However, most of this research has been conducted among small groups in WEIRD (Western Educated Industrialized Rich and Democratic Henrich, Heine, & Norenzayan, 2010, Behavioral and Brain Sciences, 33, 61) settings. Understanding how social identity as a psychological source can improve resilience and welfare among frontline healthcare workers in non-WEIRD contexts can help to alleviate the negative impact of large-scale epidemics overall, especially in resource-poor settings and contribute towards improved welfare of key healthcare workers. The present research investigates whether identifying as a nurse could influence mental health and intentions to quit directly and indirectly via positive and negative emotions among a unique sample of Iranian nurses (N = 462) during a risky period, the COVID-19 pandemic. Multiple regression results showed that identifying as a nurse was negatively associated with negative emotions which in turn were positively related to depressive symptoms. In a similar vein, identifying as a nurse was positively associated with positive emotions which, in turn, were negatively related to intentions to quit. Results also confirmed that risk perceptions related to COVID-19 positively moderated the effect of social identification on negative emotions only. That is, identification as a nurse was associated with reduced negative emotions only when perceived risk was low. We discuss the theoretical and practical implications of the findings.
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Seymour RJ, Charles SJ. Workplace violence influences nurses' turnover intentions, but only when organisational support and perceived invulnerability are considered. Evid Based Nurs 2022; 25:ebnurs-2021-103485. [PMID: 35470176 DOI: 10.1136/ebnurs-2021-103485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 06/14/2023]
Affiliation(s)
| | - Sarah Jane Charles
- Centre for Trust, Peace and Social Relations, Coventry University, Coventry, UK
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