A cross-sectional study exploring the relationship between burnout, absenteeism, and job performance among American nurses

An Exploratory Model of How Ethical Indicators Predict Health Professional Burnout

The objectives of this study were to characterize burnout in five different health professions (i.e., pharmacists, nurses, occupational therapists, psychologists, and mental health counselors) as well as to determine if moral distress, ethical stress, and/or ethical climate were predictive of burnout and job satisfaction. Cross-sectional survey data were collected in the USA using validated measures from a sample of 291 in early 2022 (COVID-19 Omicron wave). The average age of participants was 51 years (s.d. = 12.59) and most identified as female (78%), White/Caucasian (82%), married/in a domestic partnership (72%), without dependents (57%), and had > 20 years of experience (53%). Results demonstrated that two of the three dimensions of burnout (i.e., emotional exhaustion and depersonalization) reached clinically significant levels among nurses, occupational therapists, and pharmacists, but not among psychologists or mental health counselors. In testing an exploratory structural equation model, moral distress, ethics stress, and ethical climate contributed significantly to the burnout and job satisfaction of all professionals (CFI = 0.905; SRMR = 0.056; Gamma hat scaled = 0.931). These findings support a theoretical framework for explaining associations between ethical indicators and burnout and job satisfaction. Future research should explore if professions with less burnout experience differences in the organizational environment, autonomy, and independence of clinical work, and/or professional identity. Exploration into professional socialization, such as strategies learned as part of training and development, may be warranted to identify factors that buffer or mitigate burnout risk.

The Prevalence and Associated Factors of Job Burnout Among Medical Workers at COVID-19 Vaccination Sites: A Cross-Sectional Study

Background: During the pandemic period of the COVID-19, temporary centralized vaccination sites were set up in each administrative district in Nanjing to efficiently manage the vaccination campaign. Medical workers at COVID-19 vaccination sites are exposed to burnout syndrome due to repetitive and overload vaccination work. The purpose of our study was to investigate the prevalence of burnout among these medical workers and to explore its associated factors. Methods: A cross-sectional study was conducted at COVID-19 vaccination sites in May 2021 in Nanjing, China. The online questionnaire included demographic, job and COVID-19-related characteristics, Chinese Maslach Burnout Inventory, and Social Support Rating Scale. The hierarchical multiple regression model was used to identify the risk factors for job burnout of medical workers. Results: Of the 425 respondents, 189 had job burnout. The overall prevalence of burnout symptoms among medical workers at COVID-19 vaccination sites was 44.5% with a breakdown in severity as follows: 122 (28.7%) mild, 53 (12.5%) moderate, and 14 (3.3%) severe cases. Hierarchical multiple linear regression analysis indicated that education level, job titles, self-reported increased work intensity, self-assessment risk of contracting COVID-19 during work, and social support were significantly related to job burnout (p < 0.05), which explained 28.2% of the variance of job burnout score (F = 14.879, p < 0.01). Conclusion: The burnout symptoms were relatively common among medical workers at COVID-19 vaccination sites. More attention should be paid to medical workers with master degree or higher, junior job titles, increased work intensity, high risk of contracting COVID-19 during work, and low level of social support. Interventions that aim to reduce workload and increase social support can be effective approaches to prevent job burnout among medical workers during controlled COVID-19 period.

Virtual reality for stress management and burnout reduction in nursing: A systematic review protocol

BACKGROUND

Burnout is a pervasive issue in the nursing profession, with detrimental consequences for nurses' well-being, patient care, and healthcare systems. Virtual reality (VR) is a promising tool for delivering immersive and engaging interventions to manage stress and reduce burnout. This systematic review aims to synthesize the evidence on the effectiveness of VR interventions for stress and burnout in nursing, characterize the specific intervention approaches, and guide future research and practice.

METHODS

We will search for published and unpublished studies in PubMed, Web of Science, Embase, CINAHL, MEDLINE, The Cochrane Library, PsycINFO, and Scopus from database inception to the present. Randomized controlled trials, quasi-experimental studies, and pre-post studies examining VR interventions for stress and/or burnout in licensed nurses will be included. Two reviewers will independently screen studies, extract data, and assess risk of bias using the Cochrane Risk of Bias 2 tool for randomized trials and the ROBINS-I tool for non-randomized studies. If appropriate, meta-analysis will be performed to estimate pooled effects on stress and burnout outcomes. Subgroup and sensitivity analyses will explore the influence of intervention characteristics and study quality. Narrative synthesis will be conducted if quantitative synthesis is not possible. The review protocol follows the PRISMA-P guidelines and is registered in PROSPERO.

DISCUSSION

This systematic review will provide a comprehensive synthesis of the evidence on VR interventions for stress and burnout management in nurses. By critically appraising the research and identifying the most promising approaches, the review will guide the development and implementation of evidence-based VR programs to support nurses' well-being and address the urgent problem of burnout. The findings will also identify gaps in the literature and directions for future research to optimize the design and delivery of VR interventions for this high-need population. Systematic review registration: PROSPERO CRD42024604179.

Association Between Nurses' Comfort and Confidence in Pain Management and Compassion Satisfaction and Fatigue

PURPOSE

A current challenge that may exacerbate symptoms of compassion fatigue and compromise the ability to experience compassion satisfaction among nurses is pain management. This study examined the associations between nurses' comfort with administering pain management, confidence in providers' prescribing patterns and reported compassion satisfaction and compassion fatigue (measured as burnout and secondary traumatic stress).

DESIGN

This exploratory study used a survey design to gather primary data from nurses via a convenience sampling method.

METHODS

A survey was created and disseminated electronically to registered nurses from September to November 2019. The survey asked about nurses' comfort administering pain medications, confidence in providers' prescribing patterns, and the Professional Quality of Life Scale (ProQOL).

RESULTS

While nurses reported comfort treating patients with pain and managing pain, they were less confident that providers opioid prescribing patterns. Confidence in provider prescribing was positively correlated with compassion satisfaction and negatively correlated with burnout.

CONCLUSIONS

Organizations should focus on continuing education of pain management, creating a culture of evidence-based pain management, and promoting effective communication.

Dynamics of Absences Due to Respiratory Infections, Including COVID-19, Among Medical Staff in a Regional Pediatric Hospital

Background: Respiratory infections pose a significant public health challenge, particularly among healthcare workers (HCWs). The COVID-19 pandemic exacerbated absenteeism due to respiratory illnesses, affecting healthcare workforce stability. Identifying factors influencing absenteeism is crucial for workforce resilience and effective care. Methods: This retrospective longitudinal study analyzed HCW absenteeism due to respiratory diseases from 2017 to 2023 at the "Sf. Maria" Children's Emergency Hospital in Iași, Romania. Data from 3827 HCWs were examined, including demographic and occupational variables (age, gender, job role) and disease types. Statistical analyses (chi-square tests, ANOVA, and regression models) were conducted using SPSS to assess absenteeism trends and associated risk factors. Results: Sick leave peaked in 2020 (8322 days) and remained high in 2021 (8134 days), gradually decreasing in 2022-2023 but not returning to pre-pandemic levels (~5000 days/year). Nurses accounted for most leave days, while male staff and HCWs aged 41-50 were most affected. Seasonal variations showed higher absenteeism in transitional months and lower rates in summer. COVID-19 was the leading cause of absenteeism during the pandemic, with quarantine measures further increasing sick leave duration. Conclusions: Pediatric hospitals must strengthen infection control measures to protect HCWs and sustain care continuity. Preventive actions such as immunization, staff training, and health monitoring are critical in reducing absenteeism, maintaining a resilient workforce, and ensuring quality care during health crises.

Nurses' Performance as a Mediator Between Nurses' Fatigue and Patient Safety Culture: A Structural Equation Model Analysis

AIM

To determine the relationships among nurses' fatigue, nurses' performance and patient safety culture.

DESIGN

Cross-sectional study.

METHODS

A multicentre study was conducted with 308 nurses working in 14 medical and surgical wards from four teaching hospitals in Iran. The sampling method was stratified with a proportional allocation. Data were collected via a demographic form, the Occupational Fatigue/Exhaustion Recovery (OFER-15), the Nurse Performance Instrument (NPI) and the Hospital Survey on Patient Safety Culture (HSOPSC). The data were analysed via structural equation modelling (SEM).

RESULTS

Nurse fatigue was significantly inversely related to performance and patient safety culture (p < 0.001). Path analysis revealed that each unit of reducing nurses' fatigue improved patients' safety culture by 0.286 units and that each unit of improved nurse performance improved patients' safety culture by 0.360 units. Additionally, each one-unit increase in a nurse's fatigue could decrease his or her performance by 0.860 units. SEM analysis confirmed the mediating effect of nurses' performance on the relationship between their level of fatigue and patient safety culture.

PRACTICE IMPLICATIONS

The proposed model can assist nursing managers and healthcare policymakers in developing practical strategies to mitigate and reduce nurses' fatigue and, consequently, improve nurses' performance and patient safety.

PATIENT OR PUBLIC CONTRIBUTION

All participants contributed to this research by completing self-reported scales.

Negotiating Safety: Facilitation of Return to Work for Individuals Employed in High-Risk Occupations

PURPOSE

Return-to-work (RTW) after absence due to a mental illness is a largely understudied area, especially in industries already struggling with retention like those posing unique and high risks for public or personal safety (i.e., pilots, police officers, and health professionals), otherwise known as safety-sensitive sectors. The goal of this paper is to examine how RTW coordinators work with individuals who took a leave of absence for mental illness in safety-sensitive occupations and navigate the RTW process.

METHODS

Qualitative methodology was utilized to explore the experiences of 47 RTW coordinators who had worked with individuals employed in safety-sensitive industries. The participants were recruited across Canada using convenience sampling to participate in semi-structured interviews. The interviews were transcribed, anonymized, uploaded to NVIVO 11, and coded using inductive thematic analysis.

RESULTS

Our analysis shows that despite the presumed rigidity of occupational health and safety standards for safety-sensitive positions, the notion of "safety" becomes ambiguous in navigating RTW processes, and concerns about safety are often interpreted as the potential risk workers may pose to themselves, other individuals, or the workplace image. Institutional constraints of safety-sensitive jobs shape the ability of RTW coordinators to advocate on behalf of the workers, ultimately placing the workers at a disadvantage by prioritizing safety concerns for organizations over employees' needs.

CONCLUSION

It is important to consider how to protect workers in safety-sensitive occupations during the RTW process after absence due to a mental illness to ensure effective integration to the workplace.

Obesity Among Healthcare Workers in Al Ahsa, Saudi Arabia: Prevalence, Predictors, and Workplace Health Implications

Background/Objectives: Obesity is an emerging public health problem in the world, and health professionals are most likely to be exposed to several occupational determinants thereof. These include long working hours, shift work, high job stress, irregular food intake, poor opportunities for healthy eating, and physical inactivity at work. Healthcare workers' stressful jobs typically lead to poor eating habits and less opportunity for physical exercise, contributing to obesity risk. The primary objective of this study is to determine the prevalence of obesity among healthcare employees and identify unique predictors that contribute to obesity in this population. Material and Methods: Data were collected between 2021 and 2023 from 557 participants through anthropometric measurement and a structured questionnaire using a stratified random sampling technique. Results: The study found that 18.6% of participants were classified as obese or morbidly obese (12.9% and 5.7%, respectively), while 33.8% were overweight. The strong predictors of obesity included older age (>30 years, AOR = 2.404, p < 0.001) and working in nursing services (AOR = 1.999, p = 0.003). Furthermore, 34.3% of respondents had no physical activity, 71.5% slept less than 8 h per day, and 58.5% consumed fast food one to two times per week. A significant association of obesity was found with gender (p < 0.001), females being at higher risk, and type of department (p = 0.002), nursing staff being at higher risk. However, the predictable factors for obesity did not include nationality, family size, hours of TV watching, and fast-food consumption. Conclusions: These findings highlight a significant burden of obesity among healthcare employees, underscoring the need for workplace interventions. The strategy to address obesity among this highly vulnerable population should be directed toward enhancing physical activities, improving eating habits, and managing occupational stress, particularly for older workers and nursing staff.

Person-centered workplace culture: insights from an inpatient department for older adults with chronic illnesses

Introduction

An aging population and the increasing prevalence of chronic conditions challenge healthcare systems in developed countries. In response, there is a growing emphasis on person-centered care, as advocated by the World Health Organization and integrated into national health strategies in countries such as the UK and Sweden. However, transitioning to person-centered care is a complex, long-term process shaped by organizational culture and care environments. These contextual factors play crucial roles in the development and sustainability of person-centered practice, significantly transforming the experiences of both older adults and staff.

Objective

To describe how workplace culture within an inpatient hospital department shapes person-centered care practices for older adults with chronic illnesses.

Methods

A qualitative, descriptive, exploratory-observational study was performed. Data were collected through participant observation guided by the Workplace Culture Critical Analysis Tool®. In a deductive thematic content analysis, data patterns of meaning were identified. The themes were generated underpinned by the Person-Centered Practice Framework dimensions of prerequisites, the practice environment, and person-centered processes and their respective constructs.

Results

Themes related to all person-centered practice dimensions were identified. Task demands during shifts create tension between routine-oriented work and the holistic, individualized approach required for person-centeredness. The absence of systematic multiprofessional team meetings further exacerbates this issue, limiting collaborative decision-making and personalized care planning. The contrasts in some subthemes may be related to discrepancies in the care provided by different professionals.

Conclusion

This study highlights the tension between routine-driven care and individualized approaches. Addressing identified challenges, such as formalizing multiprofessional meetings and enhancing reflective practices, is crucial for advancing person-centered care in this setting.

Identifying Contextual Workplace Stressors in a Division of Plastic and Reconstructive Surgery

Background

Healthcare professionals in plastic and reconstructive surgery (PRS) face unique stressors that contribute to burnout, increasing the risk of errors and compromising patient care. Despite this, there is limited research on PRS burnout in the United States. This study aimed to measure burnout rates and identify high-impact improvement targets within a PRS division at a US academic medical center.

Methods

A sequential mixed-methods study was conducted, involving systems analysis and contextual design methods. All surgeons (n = 5) and nonsurgeons (n = 9) were invited to participate (total n = 14). Burnout rates were measured, and workplace stressors were identified using surveys, focus groups, and contextual inquiries. High-impact, low-effort improvement targets were determined through impact-effort matrices.

Results

Survey data from 13 respondents revealed an 85% burnout rate. Three focus groups and 14 contextual inquiries were conducted. After 13 participants validated and prioritized 2 affinity diagrams and provided 24 high-priority stressors, 8 respondents completed 2 surveys that yielded 6 high-impact/low-effort targets for organizational improvement efforts.

Conclusions

This study highlights the high prevalence of burnout in PRS and identifies specific improvement targets for both surgeons and nonsurgeons. Findings suggest strategies such as improving respect and recognition for surgeons and streamlining clinic flow for nonsurgeons. Implementing these targeted improvements can enhance the well-being of healthcare professionals and ultimately improve patient care. The study's methods can be replicated by other healthcare organizations to identify and address burnout-related issues effectively.

Sickness presenteeism, job burnout, social support and health-related productivity loss among nurses in the Chinese nurses' health cohort study (TARGET): A cross-sectional survey

BACKGROUND

Sickness presenteeism has potential negative impacts on job burnout and health-related productivity loss among clinical nurses, whereas social support has been identified as a potential mitigating factor for such impacts. However, there is limited evidence regarding the relationships and mechanisms between sickness presenteeism, job burnout, social support, and health-related productivity loss.

OBJECTIVE

To explore the role of job burnout and social support in the association between sickness presenteeism and health-related productivity loss among female nurses.

DESIGN

A cross-sectional study.

SETTING(S)

105 hospitals conveniently selected from 36 cities in 15 provinces in China.

PARTICIPANTS

50,653 registered female nurses.

METHODS

This study utilizes the cross-sectional data from the baseline survey of the Chinese nurses' health cohort study (Towards A Revolution in GETting nurses' health ticked, TARGET), conducted from December 2020 to February 2024. Variables were measured using the Sickness Presenteeism Questionnaire, Stanford Presenteeism Scale, Maslach Burnout Inventory, and Perceived Social Support Scale. Data analyses were performed using independent sample t-tests, Pearson correlation analysis, one-way analysis of variance, multivariate linear regression analysis, and the Process 4.0 macro plug-in method.

RESULTS

A total of 42,843 valid questionnaires were collected with an 85% response rate. The incidence of sickness presenteeism among female nurses was 62 %. Sickness presenteeism was positively correlated with job burnout and health-related productivity loss, and job burnout was also positively correlated with health-related productivity loss. Conversely, social support was negatively associated with sickness presenteeism, job burnout and health-related productivity loss. The findings showed that the association between sickness presenteeism and health-related productivity loss was partially mediated by job burnout. Moreover, the direct and indirect effects within the mediation model were moderated by social support. When levels of social support were high, the impact of sickness presenteeism on job burnout and health-related productivity loss was weaker, as was the impact of job burnout on health-related productivity loss.

CONCLUSIONS

Hospital administrators and nurses themselves can mitigate the adverse effects of sickness presenteeism on health-related productivity loss by alleviating job burnout and increasing levels of social support. By addressing these significant challenges, they can more effectively manage the consequences of sickness presenteeism and job burnout among nurses.

REGISTRATION

The protocol of TARGET was registered in the China Clinical Trial Registry (ChiCTR2100043202).

TWEETABLE ABSTRACT

The study analyses TARGET data to explore the mechanisms between sickness presenteeism and health-related productivity loss.

Faculty perceptions of wellness at an academic medical center

BACKGROUND

Despite national recommendations and decades of literature highlighting the importance of faculty wellness, gaps at academic medical centers remain. Multilevel wellness initiatives are necessary to create change and optimally support academic faculty.

OBJECTIVE

The purpose of this study is to examine faculty perceptions of factors contributing to lack of wellness and proposed solutions in the context of current resources at our academic medical center in the Mid-Atlantic region of the United States.

METHODS

The Georgetown University Medical Center Faculty Development Committee created a Wellness Task Force in response to a charge by leadership. The 11-member Task Force included faculty members from different disciplines: psychiatry, neurology, family medicine, pediatrics, nursing and oncology. Data collection occurred September 2021 to January 2022. Interviews and focus groups elicited faculty input on 1) factors that contribute to and detract from wellness and 2) strategies to enhance wellness within our academic medical center.

RESULTS

Faculty described individual and organizational factors contributing to lack of wellness: challenges with balance; lack of connection, autonomy, resources and feeling valued; communication; culture; attention to diversity, equity, and inclusion; leadership; and workload. Proposed solutions included a comprehensive, centralized and consistent plan; culture change; incentives; increased autonomy, feelings of value, and resources.

CONCLUSIONS

Wellness as a budgetary priority and strategic initiative remains a critical goal for academic medical centers. Faculty perceptions of factors contributing to lack of wellness and proposed solutions underscore and add to national recommendations.

Work engagement, resilience and turnover intentions among nurses: a mediation analysis

INTRODUCTION

Healthcare organizations experience difficult challenges as a result of nursing staff turnover. This is because it not only interrupts continuity of service but also its financial implications.

AIM

The purpose of the study was to find out the effects of work engagement on nurses' intentions to leave their jobs while considering resilience as a mediating factor.

METHODS

The study used a descriptive-analytical design using a survey questionnaire on nurses working in different healthcare settings. The Utrecht Work Engagement Scale, the Brief Resilience Scale, and the Turnover Intention Scale were among the validated scales that were employed. The hypothesized relations were tested using descriptive and mediation analyses at a significance of <0.05.

RESULTS

Though the turnover intention (n = 3.83 ± 1.42) and the level of work engagement (n = 4.03 ± 1.32) among nurses were high, their level of resilience of nurses was average (n = 2.48, SD: 0.63). Resilience had a negative association with turnover intention (β =  - 0.5699, p < .0001), and there was also a significant negative association between work engagement and turnover intentions among nurses with resilience mediating the relationship (β = -0.0367, p < .05).

CONCLUSION

Disengaged nurses are more likely to leave their jobs. Moreover, resilience acts as a mechanism through which work engagement influences turnover intentions. The study emphasizes the need to encourage work engagement among nurses to lessen intentions to leave the profession. Among factors that can improve work engagement and resilience to reduce turnover include conducting regular engagement assessments, fostering positive workplace cultures, employing flexible scheduling practices, and offering resources for personal and professional development.

The relationship between professional autonomy and job performance among Iranian ICU nurses: the mediating effect of job satisfaction and organizational commitment

BACKGROUND

Although previous studies have linked professional autonomy to nurses' job performance, research lacks how job satisfaction and organizational commitment mediate this relationship. Addressing this gap is essential for improving nursing practice outcomes. This study aims to determine the mediating effect of job satisfaction and organizational commitment in this relationship among Iranian nurses.

METHODS

This descriptive-correlational study was conducted in Urmia teaching hospitals from October 2022 to June 2023. Four hundred twenty nurses were recruited using quota sampling. Eligible participants were selected non-randomly from predetermined numbers at four hospitals, and recruitment continued until the required sample size was achieved. Data were collected using demographic questionnaires, the Varjus Professional Autonomy Scale, the Porter Organizational Commitment Questionnaire, the Minnesota Satisfaction Questionnaire, and the Paterson Job Performance Questionnaire. Data were analyzed using SPSS ver. 23 and SmartPLS ver. 3.

RESULTS

Professional autonomy had a positive, direct, and strong effect on nurses' job performance (β = 0.708, t-value = 9.867, p < 0.001). Professional autonomy had a positive, direct, strong impact on job satisfaction (β = 0.854, t-value = 39.736, p < 0.001) and a positive, minor, and direct effect on organizational commitment (β = 0.199, t-value = 3.150, p = 0.000). Professional autonomy positively affects job performance through job satisfaction (β = 0.4016, 95% CI: 0.3280, 0.4736) and organizational commitment (β = 0.7582, 95% CI: 0.6088, 0.9086).

CONCLUSIONS

Healthcare managers should promote nurses' autonomy and job satisfaction to enhance their performance. They can improve working conditions by offering competitive salaries, simplifying promotion processes, and involving nurses in decisions related to patient care. Additionally, essential steps to consider are supporting nursing autonomy, organizing educational classes, and implementing strategies such as stress reduction programs, reducing workloads, addressing nursing shortages, and decreasing working hours.

Effects of Emotional Eating Behaviour and Burnout Levels of Nurses on Job Performance: A Cross-Sectional Descriptive Study

This study was conducted to determine the effects of nurses' emotional eating behaviour and burnout levels on job performance. The population of this descriptive and cross-sectional study covered 750 nurses working in İstanbul Haseki Training and Research Hospital, and the sample included 255 nurses. The data were collected between 15.08.2023 and 15.11.2023 using the 'Personal Information Form', 'Maslach Burnout Inventory', 'Emotional Eater Questionnaire', and 'Job Performance Scale'. The mean scores of the Maslach Burnout Inventory and Emotional Eater Questionnaire of the participant nurses who had been working for 1-5 years, who were dissatisfied with their work and who worked in intensive care were found significantly higher. A positive relationship was found between the Job Performance Scale, the Maslach Burnout Inventory and the Emotional Eater Questionnaire. Based on the obtained data, it was concluded that nurses experience burnout and exhibit emotional eating behaviour. Therefore, it is recommended to support nurses in managing burnout and stress, plan training sessions, and, if necessary, provide psychiatric support. Processes in the work environment can negatively affect nurses emotionally and physically, which is reflected in job performance and patient care. Burnout affects not only job performance but also emotional eating.

Emotional intelligence training among the healthcare workforce: a systematic review and meta-analysis

Background

The healthcare sector is acknowledged as a complex and challenging field. Increasingly, research highlights the importance of healthcare workers' internal social and emotional skills in managing their well-being and enhancing their capacity to provide patient care and support to colleagues. Emotional Intelligence (EI) has been identified as a key factor in improving the health and performance of healthcare workers, leading to the implementation of numerous programs aimed at enhancing EI.

Objective

This meta-analysis aims to evaluate the effectiveness of EI training interventions among healthcare workers, focusing on various intervention designs and their impact on EI improvement.

Methods

The review encompassed 17 longitudinal studies, each implementing EI training interventions for healthcare workers aged 18 and over. The studies employed a variety of research designs.

Results

All studies demonstrated an increase in EI following the intervention. However, methodological limitations within these studies might have led to an overestimation of the actual effects of the interventions.

Conclusion

While the reviewed studies indicate a positive trend in EI enhancement post-intervention, the potential overestimation of effects due to methodological flaws necessitates caution. The findings underline the need for future research to explore the optimal duration and delivery methods for EI training in healthcare settings.

Systematic review registration

The systematic review and meta-analysis have been pre-registered with PROSPERO [CRD42023393760]. Further details can be accessed at: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023393760.

Work stress and burnout among active correctional officers in Puerto Rico: A cross-sectional study

INTRODUCTION

Correctional officers (COs) are exposed to emotional and physical harm by the nature of their work. Operational stress can lead to burnout and influence absences and COs work performance.

OBJECTIVES

This study aimed to evaluate the association between work-related stress and burnout adjusted by potential confounding variables (age, sex, correctional facility, type of correctional facility, distance to work, and absenteeism).

METHODS

The sample of this cross-sectional study was made up of 799 prison officials. The self-administered questionnaire consisted of four instruments: demographic data, Health and Job Performance Questionnaire, Police Operational Stress Questionnaire, and Maslach Burnout Inventory. The questionnaires were completed online and in person.

RESULTS

A high proportion of COs reported high operational stress and burnout levels. Fatigue was the highest mean value from all stressors, with 5.89. COs reported high levels of emotional exhaustion and depersonalization. They also reported low levels of personal accomplishment. Furthermore, COs with high stress levels are approximately eight times more likely to experience burnout.

CONCLUSION

These findings suggest that COs in Puerto Rico exposed to stress are more vulnerable to present burnout. The findings suggest that evidence-based interventions and programs should be implemented to help prevent and reduce operational stress and burnout among COs.

Clinician Wellbeing and Mental Health Assessment Across Two Acute Care Hospitals During the COVID-19 Pandemic

OBJECTIVE

The purposes of this study were to determine whether positive work environments affect clinician wellbeing and mental health, and to identify participants' priority interventions to improve clinician wellbeing. This study was designed to determine the potential benefit of modifying the aforementioned factors for clinicians and hospitals to impact positive patient outcomes.

BACKGROUND

The SARS-CoV-2 virus pandemic has become one of the leading causes of death in the United States and worldwide, and has exacerbated widespread burnout among health care professionals. This has resulted in negative collateral implications for the stability of the clinician workforce. A Clinician Wellbeing study (CWS) was launched in two Magnet®-designated hospitals in the southeast. The CWS was part of a multi-site collaborative research project led by the Center for Health Outcomes and Policy Research (CHOPR) at the University of Pennsylvania School of Nursing.

METHOD

A cross-sectional observational study design was implemented. Data were collected through anonymous surveys of 708 registered nurses (RNs) and advanced practice providers (APPs) working in two Magnet hospitals in the southeastern United States. Each participant completed 8 surveys.

RESULTS

Clinicians' self-reported level of burnout was higher for both RNs and APPs at Emory University Hospital than Emory Saint Joseph's Hospital including intent to leave and dissatisfaction with their jobs. RNs and APPs self-reported their overall health to be good or excellent and they reported sleep quality as fair. Both groups in both hospitals indicated that they experienced anxiety, depression, and stress. The APPs reported a higher percent that their work did not leave enough time for personal and family life. Data also indicated that the primary work environment concern was related to inadequate nurse staffing.

CONCLUSIONS

The data illuminated opportunities for the two hospitals to employ continuous improvement interventions to positively transform the work environment.

Comparison of embryologist stress, somatization, and burnout reported by embryologists working in UK HFEA-licensed ART/IVF clinics and USA ART/IVF clinics

STUDY QUESTION

What is the prevalence of occupational stress, somatization, and burnout reported by UK and US, embryologists and the impact of work conditions on these well-being outcomes?

SUMMARY ANSWER

Surveyed UK and US embryologists reported moderate perceived stress, low somatic symptom severity, high levels of burnout, and overall stressful work conditions, but with differences that could be due to country-specific occupational and employment characteristics.

WHAT IS KNOWN ALREADY?

Spanish, UK, US, and international surveys have identified high levels of occupational stress, somatization, burnout, and occupational health issues among embryologists. These issues have been attributed to embryologists' occupational challenges and work conditions.

STUDY DESIGN, SIZE, DURATION

A cross-sectional web-based survey was sent to 253 embryologists working in UK ART/IVF clinics and 487 embryologists working in US ART/IVF clinics.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Participants self-reported their stress levels, somatization, burnout, and work conditions. Proportions across the Perceived Stress Scale (PSS), Patient Health Questionnaire (PHQ-15), Maslach Burnout Inventory-General Survey (MBI-GS), a single-item work unit grade (A-F), and customized occupational and sociodemographic questionnaires were calculated using descriptive statistics. Welch's t-test was utilized to compare PSS and PHQ-15 scores between groups. Risk ratios were calculated using log-binomial regression for all models except for levels of anxiety related to performing cryostorage tasks, for which Poisson models were used.

MAIN RESULTS AND THE ROLE OF CHANCE

In total, 50.6% (128) of the embryologists in the UK and 50.1% (244) in the US completed the survey. Both groups self-reported moderate PSS and low PHQ-15 scores, although fewer UK embryologists scored high on the MBI cynicism dimension than their US colleagues (43% UK vs 60% US embryologists, P < 0.05). The UK and US embryologists did not differ on the MBI exhaustion dimension with both scoring high for exhaustion (59% UK vs 62% US). Although 81% and 80% of UK and US embryologists, respectively, reported working overtime, more embryologists in the UK reported being adequately compensated. Increasing levels of anxiety-related to cryostorage showed a dose-dependent increased risk of burnout on at least two MBI-GS dimensions only in the UK group, and, a dose-dependent likelihood of higher PSS and PHQ-15 scores in both groups.

LIMITATIONS, REASONS FOR CAUTION

Since the two groups were surveyed 9 months apart and were self-reporting, the study is limited by the differences in responsibilities, scheduling, and workload specific to the time of year.

WIDER IMPLICATIONS OF THE FINDINGS

Work-related health issues and occupational challenges shared by UK and US embryologists could be addressed by organizational enhancements and technology. Lower levels of stress and burnout among UK embryologists might be due to the HFEA-provided structure/certainty.

STUDY FUNDING/COMPETING INTEREST(S)

This study was supported without any external funding by TMRW Life Sciences Inc., which is developing and commercializing an automated platform for embryology. M.G.C. and M.S.L. are full-time employees and stockholders/shareholders with TMRW Life Sciences, and A.M. of Novavax, Inc. was an employee of TMRW Life Sciences. G.P. is a consultant for TMRW Life Sciences. The remaining authors declare no conflict of interest.

TRIAL REGISTRATION NUMBER

NCT05326802; NCT05708963.

Burnout and psychological distress among Hispanic nurses across Illinois and New York hospitals: Implications for structural and person-centered solutions

BACKGROUND

Despite high levels of burnout and psychological distress among nurses, few studies have evaluated these outcomes among Hispanic nurses.

PURPOSE

To evaluate the differences in job-related and psychological well-being outcomes for Hispanic and non-Hispanic White nurses and the association of nurse work environments.

METHODS

Cross-sectional analysis of the 2021 RN4CAST-New York-Illinois nurse survey. Multilevel logistic regression models examined the association between nurse ethnicity and job-related outcomes and psychological well-being.

DISCUSSION

Our sample included 798 (10.7%) Hispanic and 6,642 (89.3%) non-Hispanic White nurses in 249 hospitals. In unadjusted models, Hispanic ethnicity was associated with higher odds of burnout (odds ratio (OR) 1.21, 95% confidence interval (CI): 1.03-1.42), which diminished when considering the work environment (OR 1.16, 95% CI: 1.01-1.35) and nurse characteristics (i.e., age) (OR 1.01, 95% CI: 0.83-1.21).

CONCLUSION

Equity-driven solutions to support the well-being of Hispanic nurses should consider a focus on the needs of young Hispanic nurses and include increased support in work environments.

Trauma-Informed Professional Development: An Intervention Mapping Study

BACKGROUND AND SIGNIFICANCE

Nurses are disproportionately affected by mental and physical health problems that are a result of exposure to traumatic events in the workplace.

PURPOSE

The purpose of this study was to use intervention mapping strategies to construct interventions to address traumatic stress in nurses through trauma-informed professional development (TIPD) in a rehabilitation hospital.

DESIGN

This study used a community-based participatory research design with an intervention mapping approach. Logic models were created through input from theory, evidence from the literature, and feedback from 12 focus groups with leaders, nursing professional development practitioners, and direct-care nurses.

FINDINGS

Major themes in the logic models included safety, empowerment, peer support, and awareness. These findings were used to create specific TIPD interventions to be used with nurses in a rehabilitation hospital.

Burnout and Attention Failure in STEM: The Role of Self-Control and the Buffer of Mindfulness

Drawing on self-regulatory strength models of self-control, this research examined the relationship between burnout and attentional processes for STEM (science, technology, engineering, and mathematics) students. Using data from participants in STEM, burnout was found to be associated with higher levels of off-task thinking, also known as mind-wandering. Further, self-control acted as a mediator in the relationship between burnout and mind-wandering such that higher levels of burnout predicted poor self-control that subsequently increased the mind's tendency to wander. Additionally, mindfulness buffered the relationship between burnout and mind-wandering such that burnout had the most detrimental impact on attention for those students who were low in mindfulness. Using the Johnson-Neyman approach, results reveal the upper limits for the moderating impact of mindfulness. Results and implications for science and practice are discussed with a special grounding for students in the STEM context.

Getting Ours? "Girlbossing" and the Ethics of Nurse Reimbursement Models

Introduction

This article politicizes a reimbursement model proposed by some professional nursing associations that aim to better align the price of nursing labor (nurses' pay) to the value of nursing and make nurses' contributions more visible.

Methods

Using the concept of "missing care," the critique reveals how professionalization directs attention to individual-level interactions between care seekers and practitioners while obscuring from view the harm inflicted by social institutions and structures constitutive of a capitalist political economy and the related carceral state.

Results

Direct reimbursement models render practitioners complicit in the harms perpetrated and perpetuated by the health care industrial complex while professionalization processes are deployed to reduce cognitive dissonance (and moral injury) produced by combining harm with nursing's normative principles.

Discussion

We describe and trace the complementary capitalist imperatives of extraction-based profit maximization and efficiency through the health care industrial complex to demonstrate how formative those imperatives are of the health care system, care-seekers' outcomes, nurses' experiences, nonconsensual modes of data collection, and surveillance.

Conclusion

The naturalization of racial capitalism and the precarity and violence it entails foreclose the creation of ethical alternatives that prioritize well-being instead of the pursuit of profit that could bring the provision of and payment for care closer to the normative principles held by practitioners.

Safeguarding nurses' mental health: The critical role of psychosocial safety climate in mitigating relational stressors and exhaustion

Burnout among nurses is a pervasive concern in healthcare, with profound implications for patient care and nurse well-being. While research has highlighted the detrimental effects of burnout on many aspects of nursing, including patient safety and quality of care, the underlying mechanisms driving burnout warrant further investigation. In this cross-sectional study, we surveyed 196 nurses from diverse Italian hospitals using an online questionnaire via Qualtrics. Our findings revealed significant negative correlations between psychological safety climate and both relational stressors and emotional exhaustion. Conversely, relational stressors positively correlated with emotional exhaustion, and a significant negative indirect effect of psychological safety climate was found for emotional exhaustion through relational stressors, emphasizing the pivotal role of psychological safety climate in mitigating nurse burnout. Our study underscores the potential effectiveness of interventions targeting psychological safety climate and relational stressors in alleviating emotional exhaustion and burnout among nurses. Theoretical implications underscore the importance of deepening the role of psychological safety climate in mitigating emotional exhaustion, while practical implications emphasize the need for fostering a positive psychological safety climate and implementing targeted interventions to support nurses' well-being.

The Social Ecology of Burnout: A framework for research on nurse practitioner burnout

BACKGROUND

The U.S. health system is burdened by rising costs, workforce shortages, and unremitting burnout. Well-being interventions have emerged in response, yet data suggest that the work environment is the problem. Nurse practitioner (NP) burnout is associated with structural and relational factors in the work environment, practice autonomy, and hierarchical leadership.

PURPOSE

We explore the unique social, cultural, and political environment in which NPs work through the lens of social ecology and present the Social Ecology of Burnout (SEB) framework.

METHODS

We review current burnout frameworks in the context of the NP practice environment and discuss the SEB, specifically exploring psychological safety and its influence on burnout.

FINDINGS

Psychological safety, work environment, and policy are presented within the SEB and solutions which empower NPs are considered.

DISCUSSION

Our framework can serve as a guide for future nursing research, practice, and policy.

Does the job performance of academics' influence burnout and psychological counselling? A comparative analysis amongst high-, average-, low-, and non-performers

BACKGROUND

Extensive research has been conducted treating burnout as an independent variable and performance as a dependent variable to proffer possible solutions to burnout and job performance among academics. Despite this, the burnout crises persist and are exacerbated by the ongoing global proliferation of higher education. Acknowledging this, the current study explored whether performance may contribute to the emergence of burnout.

METHODS

The study's sample population comprised 689 academics from Jiangsu province, China. Key Performance Indicator (KPI) results served to measure performance. Psychological counselling and Burnout were calculated using mental health results garnered from the universities. Data was collected on respondents' demographic characteristics and work situations. The mean scores were 0.517 (SD = 0.5) for gender and 1.586 (SD = 1.103) for age. The relationship among performance, job burnout, and psychological counselling was analysed via a cross-sectional survey deploying grouped regression.

RESULTS

Academics' job performance was found to regulate their burnout (β = -0.058, P < 0.01). Higher performance of academics was significantly associated with lower job burnout and psychological counselling. Furthermore, psychological counselling significantly moderated job burnout (β = -0.012, P < 0.05) among academics without regulating their job performance.

CONCLUSION

The paper supplements the discourse on job burnout and academic performance by suggesting a pre-counselling measure as a strategy to address the crises of burnout. The paper argued that the continued competence of employees should prevent burnout in Higher education and ensure better job performance.

Exploring nurses' experiences: Abandoning the profession and migrating for improved opportunities

AIM

This study explores nurses' experiences in migration for employment and professional abandonment in Barcelona (Spain).

METHODS

Employing a mixed-design approach comprising 1) a qualitative descriptive phenomenological study, followed by 2) a subsequent cross-sectional study, 20 and 225 nurses participated in each study, respectively. Qualitative data, gathered through 4 focus group discussions, underwent inductive thematic analysis, following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines, while quantitative data were descriptively analyzed.

FINDINGS

Three qualitative themes emerged: 1) Migration motives, such as improved job opportunities, permanent contracts, continuous training, and professional recognition; 2) Reasons for leaving or contemplating leaving the profession, including excessive workload, lack of recognition, limited development, and exhaustion; 3) Nurses' needs, encompassing more staffing, improved remuneration, permanent contracts, flexible schedules, greater autonomy, and career growth. The cross-sectional study revealed a 13.5 % professional abandonment rate at some point across all demographics and seniority levels. Migration trends varied by professional experience, with younger nurses seeking better conditions and opportunities elsewhere.

CONCLUSIONS

Multifactorial causes underlie job migration and professional abandonment, necessitating comprehensive interventions to improve nurses' working and professional conditions.

The association between population health management tools and clinician burnout in the United States VA primary care patient-centered medical home

BACKGROUND

Technological burden and medical complexity are significant drivers of clinician burnout. Electronic health record(EHR)-based population health management tools can be used to identify high-risk patient populations and implement prophylactic health practices. Their impact on clinician burnout, however, is not well understood. Our objective was to assess the relationship between ratings of EHR-based population health management tools and clinician burnout.

METHODS

We conducted cross-sectional analyses of 2018 national Veterans Health Administration(VA) primary care personnel survey, administered as an online survey to all VA primary care personnel (n = 4257, response rate = 17.7%), using bivariate and multivariate logistic regressions. Our analytical sample included providers (medical doctors, nurse practitioners, physicians' assistants) and nurses (registered nurses, licensed practical nurses). The outcomes included two items measuring high burnout. Primary predictors included importance ratings of 10 population health management tools (eg. VA risk prediction algorithm, recent hospitalizations and emergency department visits, etc.).

RESULTS

High ratings of 9 tools were associated with lower odds of high burnout, independent of covariates including VA tenure, team role, gender, ethnicity, staffing, and training. For example, clinicians who rated the risk prediction algorithm as important were less likely to report high burnout levels than those who did not use or did not know about the tool (OR 0.73; CI 0.61-0.87), and they were less likely to report frequent burnout (once per week or more) (OR 0.71; CI 0.60-0.84).

CONCLUSIONS

Burned-out clinicians may not consider the EHR-based tools important and may not be using them to perform care management. Tools that create additional technological burden may need adaptation to become more accessible, more intuitive, and less burdensome to use. Finding ways to improve the use of tools that streamline the work of population health management and/or result in less workload due to patients with poorly managed chronic conditions may alleviate burnout. More research is needed to understand the causal directional of the association between burnout and ratings of population health management tools.

Vicarious Trauma and Health Outcomes in Forensic Mental Health Nurses

BACKGROUND

Nurses working in forensic mental health settings are at risk of vicarious trauma because of their exposure to traumatized patients and distressing material such as the aversive details of patient crimes.

AIM

The aim of this study was to determine the incidence of vicarious trauma and explore its impact on health and absence from work.

METHODS

A cross-sectional descriptive correlational study was undertaken. All 205 forensic mental health nurses working in a high-security inpatient facility were invited to participate. An online survey included the Vicarious Trauma Scale and the SF-36v2 to measure mental and physical health. Absence from work was also explored.

RESULTS

Sixty-seven respondents completed the survey. Almost half of respondents had a moderate level of vicarious trauma, and only over one-quarter experienced high levels. Higher levels of vicarious trauma were associated with poorer mental health ( r = -0.59, p < 0.000) and absence from work ( r = 0.27, p < 0.010).

CONCLUSIONS

Forensic mental health nurses are at a greater risk of vicarious trauma than nurses working in mainstream mental health services, given their exposure to aversive details of patients' violent crimes. Adverse mental health consequences of vicarious trauma, and other forms of workplace trauma experienced by forensic mental health nurses, are likely to include trauma-related symptoms, depression, and anxiety. Forensic mental health nurses experiencing vicarious trauma may use sick leave as time away from work to care for their own mental health or a coping mechanism for workplace-induced psychological distress.

The relationship between servant leadership and nurses' in-role performance: The sequential mediating effects of job autonomy and emotional exhaustion

AIMS

Drawing on the conservation of resources theory, this study examines the underlying process through which servant leadership is associated with nurses' in-role performance. Specifically, we test the indirect effect of servant leadership on in-role performance via a sequential mediating mechanism of job autonomy and emotional exhaustion.

DESIGN

A time-lagged design was implemented using data gathered from two-wave online surveys (1 week apart) of registered nurses from Jiangsu Province, China.

METHODS

Between September 2022 and February 2023, we used Wenjuanxing and Credma, which are two powerful and user-friendly data collection platforms, to distribute online surveys to potential participants. We received a total of 220 usable responses and employed the PROCESS Model 4 and Model 6 to assess our proposed hypotheses.

RESULTS

Our proposed model was supported. Servant leadership has a positive indirect effect on nurses' in-role performance through job autonomy and emotional exhaustion. Job autonomy has a negative effect on emotional exhaustion. Additionally, job autonomy mediates the negative relationship between servant leadership and emotional exhaustion.

CONCLUSION

The present research extends existing nursing studies by unravelling the complex mechanisms underlying the relationship between servant leadership and nurses' in-role performance. Our study also identifies the underlying mechanism of how servant leadership mitigates emotional exhaustion by supporting nurses' job autonomy.

IMPACT

The sequential mediation results provide us with a more fine-grained understanding of the relationship between servant leadership and nurses' in-role performance. It further promotes job autonomy and decreases emotional exhaustion, which supports the UN Sustainable Development Goal #3 (Good Health and Well-being).

PATIENT OR PUBLIC CONTRIBUTION

This study addresses the UN Sustainable Development Goal #3: 'To ensure healthy lives and promote well-being for all at all ages' and the healthcare providers will benefit from our study. Therefore, the study contributes to a more sustainable organization and society.

How do organizational culture and leadership style affect nurse presenteeism and productivity?: A cross sectional study of Hong Kong acute public hospitals

BACKGROUND

Presenteeism is defined as a type of work behavior in which employees are physically present at work when ill, often with reduced performance. While organizational culture and leadership style are known to impact the organizational behavior of hospital staff, as indicated by increased burnout and decreased work engagement, their impact on nurse presenteeism and productivity has not been explored. Moreover, nursing studies often neglect the importance of using multi-level analysis, adopting aggregated unit-level scores to account for collective perceptions to evaluate culture and leadership.

OBJECTIVE

This study aims to evaluate the impact of unit-level organizational culture and leadership style on individual-level nurse presenteeism and productivity in acute care hospitals using multilevel analysis.

DESIGN

Cross-sectional study.

SETTING(S)

Three major acute care public hospitals in Hong Kong, where public hospitals provide over 90 % of inpatient services.

PARTICIPANTS

All full-time nurses (N = 4657) in the three study hospitals were invited to participate in this study. A total of 2339 nurses responded to the survey for a 65 % response rate.

METHODS

Organizational culture and leadership style are characterized using the competing values framework and a two-factor leadership style typology, respectively. Multilevel hierarchical linear modeling was applied with unit-level clustering in each hospital.

RESULTS

Hierarchical culture was the dominant culture (M = 3.64, SD = 0.74) in our nurse sample. None of the unit-level organizational culture and leadership styles were associated with nurse presenteeism, however, rational organizational culture at the unit-level was significantly associated with increased productivity (regression coefficient: 0.17, 95 % CI: 0.04-0.31).

CONCLUSIONS

This study provides hospital managers with improved understanding of the differential impact of unit-level organizational culture and leadership style on nurse presenteeism and productivity. Unit-level leadership style did not have a direct impact on nurse presenteeism and productivity in this study, while the externally focused rational organizational culture increased nurse productivity. Further research is needed to understand the impacts of modifiable work factors and nurse psychosocial emotions on presenteeism and productivity.

The Relationship Between Employee Physical Activity Intensity and Workplace Burnout: A Cross-sectional Study

OBJECTIVE

This study aimed to investigate employees' physical activity (PA) levels and workplace burnout.

METHODS

Participants, employed full-time, recruited through Prolific Academic, completed the Maslach Burnout Inventory and the International Physical Activity Questionnaire.

RESULTS

An analysis of variance revealed a significant difference in burnout emotional exhaustion ( F (2,516) = 3.55, P = 0.03) and personal accomplishment ( F (2,516) = 4.23, P = 0.02) among three levels of PA groups, but not in burnout depersonalization. The moderate PA group scored significantly lower in burnout emotional exhaustion than the low PA group ( P = 0.025). The low PA group scored significantly lower in the burnout personal accomplishment than the high PA group ( P = 0.02) and the moderate PA group ( P = 0.03).

CONCLUSIONS

Employees engaging in moderate PA showed an effective reduction in their burnout emotional exhaustion and promoted personal accomplishment.

The Relationship Between Restrictive Regulation of Midwives, Practice Environment, and Professional Burnout: A 7-State Mixed-Methods Comparison of Autonomous and Restrictive State Regulation

PURPOSE

The purpose of the study was to investigate the relationship between state regulation of the midwifery workforce, practice environment, and burnout.

BACKGROUND

Burnout threatens the US midwifery workforce, with over 40% of certified nurse-midwives meeting criteria. Burnout can lead to poorer physical and mental health and withdrawal from the workforce. Burnout in midwives has been associated with lack of control and autonomy. In the United States, midwives' autonomy is restricted through state-level regulation that limits scope of practice and professional independence.

METHODS

A mixed-methods study was conducted using an explanatory sequential approach. Quantitative and qualitative data were collected by online surveys and analyzed in a 2-stage process, followed by data integration.

RESULTS

State regulation was not found to be independently associated with burnout (n = 248; P = .250); however, mediation analysis showed a significant association between state regulation, practice environment, and burnout. Qualitative analysis mirrored the importance of practice environment and expanded on its features.

CONCLUSION

For midwives, unrestrictive practice regulation may not translate to burnout prevention without supportive practice environments.

IMPLICATIONS FOR PRACTICE AND RESEARCH

Interventions should focus on promoting job flexibility, realistic demands, and professional values. While midwives' commitment to patients and the profession can help bolster the workforce, it can also amplify negative experiences of the practice environment.

The Impact of Grit on Nurses' Job Performance: Evaluating Chained Mediation through Perceived Social Support and Self-Esteem

Background

Nurses play a critical role in the medical workforce during the COVID-19 pandemic while facing various difficulties and challenges. Grit, social support, and self-esteem are important psychosocial factors influencing job performance. However, few studies have explored the relationships among these factors in nurses.

Aim

This study aimed to examine the association between grit and nurses' job performance during the COVID-19 pandemic and to explore the potential chain mediation through perceived social support and self-esteem.

Methods

A cross-sectional survey design was employed. From January 2021 to May 2022, a total of 709 Chinese nurses in Chengdu and Kunming completed a web-based cross-sectional survey, which included standard assessments on grit, perceived social support, self-esteem, and job performance as well as Big Five personalities. The chain mediation model was tested using the PROCESS macro program in the SPSS software.

Results

There was a moderate-to-large correlation (r = 0.40, p < 0.001) between grit and job performance in Chinese nurses. Furthermore, grit was indirectly linked to job performance through the chain mediating effect of perceived social support and self-esteem (all p < 0.05). These findings persisted even when Big Five personalities were included as additional controlling variables.

Conclusions

This study reveals a stable link between grit and job performance among Chinese nurses and highlights the potential role of perceived social support and self-esteem in mediating this link. Implications for Nursing Management. Nursing managers can improve nurses' grit level and provide a supportive organizational environment conducive to enhancing self-esteem and thereby promoting their job performance.

Differential impact of COVID-19 on mental health and burnout

BACKGROUND

There may be differential impact of the COVID-19 pandemic on mental health and burnout rates of healthcare professionals (HCPs) performing different roles.

AIMS

To examine mental health and burnout rates, and possible drivers for any disparities between professional roles.

METHODS

In this cohort study, online surveys were distributed to HCPs in July-September 2020 (baseline) and re-sent 4 months later (follow-up; December 2020) assessing for probable major depressive disorder (MDD), generalized anxiety disorder (GAD), insomnia, mental well-being and burnout (emotional exhaustion and depersonalization). Separate logistic regression models (at both phases) compared the risk of outcomes between roles: healthcare assistants (HCAs), nurses and midwives (nurses), allied health professionals (AHPs) and doctors (reference group). Separate linear regression models were also developed relating the change in scores to professional role.

RESULTS

At baseline (n = 1537), nurses had a 1.9-fold and 2.5-fold increased risk of MDD and insomnia, respectively. AHPs had a 1.7-fold and 1.4-fold increased risk of MDD and emotional exhaustion, respectively. At follow-up (n = 736), the disproportionate risk between doctors and others worsened: nurses and HCAs were at 3.7-fold and 3.6-fold increased risk of insomnia, respectively. Nurses also had a significantly increased risk of MDD, GAD, poor mental well-being and burnout. Nurses also had significantly worsened anxiety, mental well-being and burnout scores over time, relative to doctors.

CONCLUSIONS

Nurses and AHPs had excess risk of adverse mental health and burnout during the pandemic, and this difference worsened over time (in nurses especially). Our findings support adoption of targeted strategies accounting for different HCP roles.

The first year of private practice - new graduate physiotherapists are highly engaged and satisfied but edging toward burnout

BACKGROUND

A greater understanding of physiotherapists' work-life during their first year of work in private practice, and whether their experiences are mediated by personal traits, may provide valuable information to support their transition and retention.

OBJECTIVES

Describe the first year of practice for graduate physiotherapists in terms of employee engagement, job satisfaction, performance, and burnout, and evaluate the relationship between these measures and personal traits (resilience, grit, mind-set).

DESIGN

One-year longitudinal mixed-methods study.

METHODS

Twenty new graduate physiotherapists completed questionnaires evaluating resilience, grit, and mind-set within 1-week of commencing employment. Engagement and job satisfaction were evaluated at 3, 6 and 12-months, and burnout evaluated at 12-months. Performance data (number of patients seen, revenue) were collected throughout the year. Individual semi-structured interviews were conducted at baseline, 3, 9 and 12-months.

RESULTS

Engagement and satisfaction were high at all time points. At 12-months, burnout was at a medium level. Resilience was positively associated with job satisfaction at 6 (ρ = 0.56, p = .019) and 12-months (ρ = 0.54, p = .027). Engagement (ρ = -0.57, p = .04) and job satisfaction (ρ = -0.56, p = .03) were negatively associated with burnout at 12-months. All participants remained passionate about their work although increasing administrative burden and patient complexity contributed to feelings of burnout.

CONCLUSIONS

Resilience was positively associated with job satisfaction suggesting those with capacity to 'bounce back' were more satisfied and engaged with their job. Although moderate levels of burnout were reported at 12-months, those with higher job satisfaction and employee engagement had lower levels of burnout. Participants proposed practical strategies to help mitigate burnout.

Association between sleep duration and burnout in healthcare professionals: a cross-sectional survey

Background

Short sleep duration in healthcare professionals is a recurring concern among researchers. On the other hand, the prevalence of burnout in this population group is experiencing exponential growth. Therefore, this study aimed to explore the association between sleep duration and burnout in healthcare professionals.

Methods

This is a cross-sectional study. Data were collected by applying a non-probabilistic convenience sampling, considering a sample of 300 healthcare professionals from the public sector in Peru. The association between variables was explored using multivariate logistic regression. Values of p < 0.05 were considered statistically significant.

Results

The results of the analysis in the crude models revealed that both men and women who slept < 7 h during workdays and days off were 8.33 (95% CI = 2.68-13.99, p = 0.004) and 17.18 (95% CI = 10.50-23.87, p < 0.001) times more likely to have burnout compared to those who reported ≥7 h, respectively. After adjusting for confounding variables, the association remained statistically significant.

Conclusion

The findings of this study underscore the critical importance of sleep duration in the incidence of burnout among healthcare professionals. In the context of the global challenges to the mental and physical health of these professionals, our results highlight the urgent need to implement strategies at the organizational and individual level. This includes promoting a better work-life balance, and effective stress management and improved sleep quality.

Compassion Satisfaction, Burnout, and Secondary Traumatic Stress Among Nursing Staff at an Academic Medical Center: A Cross-Sectional Analysis

BACKGROUND

Although several studies have recently described compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) in nurses, few to date have examined these issues across nursing specialties. Such examination is needed to inform future nursing-subspecialty tailored interventions.

AIMS

To examine (1) differences in CS, BO, and STS across nursing specialties and (2) differences associated with demographic, work-related, and behavioral factors among nurses.

METHOD

A secondary analysis of survey responses from nurses (N = 350) at an academic medical center. Demographic, behavioral, work-related, and professional quality of life variables were analyzed using hierarchical regression analyses.

RESULTS

CS, BO, and STS scores significantly varied across specialties with emergency nurses experiencing significantly elevated rates of BO and STS, and lowest rates of CS; scores were also differentially associated with demographic, work-related, behavioral, and workplace violence variables.

CONCLUSIONS

Key differences in CS, BO, and STS by nursing specialty suggests the importance of tailoring BO and STS mitigative interventions. BO and STS risk factors should be assessed in nurses (e.g., behavioral health problems and poor sleep quality) and specialty-specific interventions (e.g., reducing workplace violence exposure in emergency settings) may be considered to improve CS while reducing BO and STS among nurses.

The Relationship Between Nurses' Psychological Well-Being and Their Work Productivity Loss: A Descriptive Correlational Study

Introduction

Nurses play a vital role in ensuring effective patient care delivery and organizational productivity. Hence, it becomes imperative to prioritize their psychological well-being and explore how its impairment may be associated with their productivity loss.

Aims

The study aims to investigate the relationship between nurses' psychological well-being and their work productivity loss by examining how nurses self-reported their own psychological well-being and work productivity loss.

Methods

A descriptive correlational design was conducted at an Egyptian university hospital. A convenience sample of 400 nurses completed two tools: (a) Outcome Questionnaire-45 was used to assess the psychological well-being of nurses and (b) the Work Productivity and Activity Impairment - General Health Questionnaire was used to measure nurses' work productivity.

Results

Among the 400 surveyed nurses, 66.7% reported overall poor psychological well-being. Regarding work productivity loss, 22.8% of nurses missed an average of 974.81 work hours due to absenteeism, and 62.0% lost an average of 10,630 work hours due to presenteeism. Additionally, 75.5% experienced impaired daily living activities. Approximately 13.4% of total working hours were missed due to health problems or psychological distress. Regression analysis revealed that poor psychological well-being significantly predicts work productivity loss, accounting for 2.0% of absenteeism, 11.0% of presenteeism, 17.0% of daily activity impairment, and 9.0% of overall productivity loss, with the model being significant (p < 0.01).

Conclusion

Nurses often experience poor psychological well-being and distress that hinder their daily activities and cause work productivity loss. Therefore, hospital management should prioritize improving nurses' physical and mental health and bolstering their self-efficacy and resilience to minimize the effects of symptom distress on productivity. Investing in nurses' well-being through managerial caring, organizational support, and fostering a supportive work environment are vital strategies for promoting quality patient care and enhancing their work productivity.

Subjective Well-Being and Burnout Among the Maternal and Child Health Workforce

OBJECTIVES

This study investigates burnout and subjective well-being among the Maternal and Child Health (MCH) workforce, considering recent events such as the Dobbs decision, the maternal mortality crisis, and the COVID-19 pandemic.

METHODS

An anonymous web-based, cross-sectional survey was conducted among 313 MCH professionals in the United States. Data were collected using validated measures, including the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and the Oxford Happiness Questionnaire (OHQ) short scale. Sociodemographic characteristics and factors associated with burnout and subjective well-being were examined using univariate statistics and multivariable models.

RESULTS

Analysis revealed moderate levels of burnout among MCH professionals, particularly in emotional exhaustion. However, subjective well-being levels were relatively high. After controlling for covariates, significant associations were found between subjective well-being and burnout dimensions, as well as sociodemographic factors such as sex and race.

CONCLUSIONS

The study's findings indicate that higher subjective well-being is significantly associated with lower burnout, emotional exhaustion, and higher personal accomplishment. Variations in burnout and well-being are also influenced by sociodemographic factors such as age, sex, race, and occupation. Tailored interventions addressing the specific needs of MCH professionals are essential for building a resilient workforce. Organizational reforms and legislative measures are crucial for fostering supportive workplace environments and ensuring access to care and services amidst workforce challenges.

Examining the Impact of Burnout on Hospital Nurses Engaged in Shift Work: Insights From a Nationwide Cross-Sectional Study in Malaysia

Introduction

Shift workers follow nonstandard schedules that encompass overnight duty, rotational timetables, or permanent night work which can lead to misaligned core circadian physiology. Shift work has been associated with sleep deprivation, burnout, and metabolic syndrome among healthcare workers.

Objective

We aimed to examine if shift nurses working in Malaysian public hospitals are more predisposed to burnout and to determine the predictors of burnout in this profession.

Method

This national-level cross-sectional study was conducted among nurses in public hospitals in Malaysia between July and November 2019 using self-administered questionnaires. Maslach Burnout Inventory-Human Service Survey was used to determine burnout. Multistage stratified sampling was used to recruit nurses from 32 hospitals. A complex sampling analysis was performed.

Results

Among the 1,491 hospital nurses, more than half (70.8%) of them followed shift work schedules. Shift nurses were mostly below 40 years old (80.9%), diploma holders (87.2%), and of lower professional grades (64.2%). The prevalence of overall burnout, as well as the domains of emotional exhaustion and depersonalization, was higher among shift nurses (27.1%) as compared to their counterparts (22.4%). Nurses who performed more than six night shifts per month were 2.6 times more predisposed to burnout.

Conclusion

Shift work is integral to ensure round-the-clock nursing care for patients. However, nurses are increasingly faced with more shift duties due to heavy patient loads and staff shortages. Modified work schedules must be implemented to provide sufficient rest time for shift nurses to mitigate burnout. Additionally, proper human resource projection and distribution are imperative to prevent worsening burnout.

Factors influencing healthcare workers' performance before and after the coronavirus disease 2019 pandemic: A bibliometric analysis with supplementary comparative analysis

BACKGROUND

The performance of healthcare workers directly impacts patient safety and treatment outcomes. This was particularly evident during the coronavirus disease 2019 (COVID-19) pandemic.

OBJECTIVE

This study aimed to analyze research trends on factors influencing work performance among healthcare workers through bibliometric analysis and conduct a comparative analysis from macro and micro perspectives before and after the COVID-19 pandemic to complement the existing research.

METHODS

This study involved a bibliometric analysis of 1408 articles related to work performance in the healthcare field published between 2010 and 2023, using the Web of Science, Scopus, and PubMed databases, and 37 articles were selected to determine the factors influencing work performance.

RESULTS

By conducting a bibliometric analysis of the articles based on country, institution, journal, co-cited references, and keywords, this study identified a significant growth trend regarding the factors influencing work performance in the healthcare field, and research hotspots shifted from organizational factors like standard towards psychological factors such as burnout, anxiety, and depression following the outbreak of the COVID-19 pandemic. Subsequently, this study extracted 10 micro-level and 9 macro-level influencing factors from the selected articles for supplementary analysis. Furthermore, this study conducted a comparative analysis of the impact of these factors on work performance before and after the COVID-19 pandemic.

CONCLUSIONS

This study addressed the limitations of previous studies regarding incomplete extraction of factors influencing work performance and unclear comparisons of parameters before and after the COVID-19 pandemic. The findings provide insights and guidance for improving the performance of healthcare workers.

Protective and risk factors associated with substance use coping among healthcare workers during the COVID-19 pandemic

Background

Healthcare workers (HCWs) experienced high levels of stress and mental health consequences associated with the COVID-19 pandemic, which may have contributed to unhealthy coping behaviors, such as substance use coping (SUC). This study aimed to understand the extent of and predictors of SUC.

Methods

The sample consisted of 263 HCWs in North Central Florida. Univariable and multivariable logistic regression analyses investigated whether moral injury and other work risk factors, protective factors, and clinically relevant symptoms (i.e., work exhaustion, interpersonal disengagement, depression, anxiety, and/or PTSD) were associated with likelihood of SUC.

Results

Clinically relevant levels of interpersonal disengagement and anxiety increased the likelihood of SUC. Mediational analyses found that interpersonal disengagement and anxiety explained 54.3% of the relationship between Self Moral Injury and SUC and explained 80.4% of the relationship between professional fulfillment and SUC.

Conclusion

Healthcare supervisors should be aware that providers who are experiencing moral injury and less professional fulfillment may be experiencing significant interpersonal disengagement and anxiety, which could lead to SUC. Future studies should examine the effects of implementing targeted prevention and treatment interventions, along with longitudinal outcomes related to SUC behaviors.

The association of burnout with work absenteeism and the frequency of thoughts in leaving their job in a cohort of healthcare workers during the COVID-19 pandemic

Introduction

During the coronavirus disease 2019 pandemic, high levels of burnout were reported among healthcare workers. This study examines the association of work absenteeism and frequency of thoughts in leaving current job with burnout among a cohort of healthcare workers during the COVID-19 pandemic.

Methods

A cross-sectional survey of healthcare workers was conducted from April-May, 2022 on healthcare workers from 10 hospitals, 18 immediate care centers, and 325 outpatient practices in the Chicago area and surrounding Illinois suburbs. Logistic regression models were used to assess the association of burnout scores (Oldenburg Burnout Inventory-OLBI) and its sub-scores (exhaustion and disengagement scores) with work absenteeism and thoughts of leaving work.

Results

One-fifth and 60% of respondents (n = 1,825) reported unplanned absenteeism and thoughts of leaving their job, respectively. After adjusting for covariates, higher burnout scores, especially exhaustion scores, were associated with increased odds of unplanned absenteeism (OR = 1.04, 95% CI: 1.01-1.08). Burnout scores and both sub-scores were also positively associated with the frequency of thoughts of leaving work, e.g., each unit increase in the OLBI burnout score was associated with 1.39 (95% CI: 1.34-1.43) times higher odds of thinking about leaving work "a lot/constantly" vs. "never".

Discussion

Overall, this study cohort showed a positive association between burnout scores and unplanned work absenteeism (and frequency of thoughts in leaving job) during the COVID-19 pandemic. More research is needed to support healthcare worker well-being during times of stress and direct solutions to addressing unplanned absenteeism in the light of a pandemic.

Moral courage, burnout, professional competence, and compassion fatigue among nurses

BACKGROUND

Moral courage is the ability to defend and practice ethical and moral action when faced with a challenge, even if it means rejecting pressure to act otherwise. However, moral courage remains an unexplored concept among middle eastern nurses.

AIM

This study investigated the mediating role of moral courage in the relationship between burnout, professional competence, and compassion fatigue among Saudi Arabian nurses.

RESEARCH DESIGN

Correlational, cross-sectional design following the STROBE guidelines.

PARTICIPANTS AND RESEARCH CONTEXT

Convenience sampling was used to recruit nurses (n = 684) for four government hospitals in Saudi Arabia. Four validated self-report questionnaires (Nurses' Moral Courage Scale, Nurse Professional Competence Scale-Short Form, Maslach Burnout Inventory, and Nurses Compassion Fatigue Inventory) were used to collect data between May to September 2022. Spearman rho and structural equation modeling analyses were employed to analyze the data.

ETHICAL CONSIDERATIONS

The ethics review committee of a government university in Ha'il region, Saudi Arabia, approval this study (Protocol no.: H-2021-012; Approved: 08/022,021). Participants were fully explained the study aims, and consent was voluntarily secured.

RESULTS

The emerging model showed that burnout had a direct and positive influence on compassion fatigue, while professional competence had a direct, negative effect on compassion fatigue. Moral courage had a small and direct but negative influence on compassion fatigue. Mediation analyses also indicated that moral courage significantly mediated the indirect effects of burnout and professional competence on compassion fatigue.

CONCLUSION

Moral courage can be a crucial aspect in preserving the psychological and mental health of nurses, particularly under stressful conditions. Therefore, it is advantageous from an organizational and leadership standpoint to implement measures such as programs and interventions to foster moral courage among nurses.

The mediating role of empathy in the impact of compassion fatigue on burnout among nurses

Background

The burnout levels of nurses, who have an important place in the delivery of health services, are increasing day by day. As the burnout levels of nurses increase, there may be undesirable situations such as compassion fatigue specific to them, their patients and their institutions.

Purpose

The aim of this study is to determine the effect of compassion fatigue seen in nurses on burnout and the mediating role of empathy in this effect.

Methods

The research was conducted on nurses working in three public hospitals operating in Sakarya, Turkey, between 2 January and 16 April 2019. Since the research was conducted in more than one hospital, the minimum number of participants was determined for each hospital using the stratified sampling method in the first stage. In the second stage, the participants were selected by convenience sampling method. Descriptive statistics, linear regression and process macro regression analysis were used to analyse the data.

Results

The results showed the effect of nurses' compassion fatigue on burnout and empathy (β = 0.673). In addition, empathy has a mediating role in the effect of compassion fatigue on burnout (β = 0.251).

Conclusions/implications for practice

Reducing the burnout levels of nurses, who have a very important place in the delivery of health services, is important for both themselves and patients. It is recommended that the results of this study, which may contribute to the development of the awareness of nurse managers, should be made with the ability to understand the symptoms of compassion fatigue and burnout, teaching coping methods and providing support by experts when necessary.

Impact of COVID-19 pandemic on pediatric healthcare burnout in acute care: a longitudinal study

BACKGROUND

COVID-19 pandemic introduced significant challenges that may have exacerbated healthcare worker (HCW) burnout. To date, assessments of burnout during COVID-19 pandemic have been cross-sectional, limiting our understanding of changes in burnout. This longitudinal study assessed change across time in pediatric HCW burnout during the COVID-19 pandemic and whether demographic and psychological factors were associated with changes in burnout.

METHODS

This longitudinal study included 162 physicians, physician assistants, nurses, and medical technicians within the emergency department (ED), intensive care, perioperative, and inter-hospital transport services in a children's hospital. HCW demographics, anxiety and personality traits were reported via validated measures. HCWs completed the Maslach Burnout Inventory in April 2020 and March 2021. Data were analyzed using generalized estimating equations.

RESULTS

The percentage of HCWs reporting high emotional exhaustion and/or depersonalization burnout increased significantly across time (18.5% to 28.4%, P = 0.010). Factors associated with increased emotional exhaustion included working in the ED (P = 0.011) or perioperative department (P < 0.001), being a nurse or medical technician (P's < 0.001), not having children (P < 0.001), and low conscientiousness (P < 0.001).

CONCLUSIONS

Pediatric HCW burnout significantly increased over 11-months of the COVID-19 pandemic. Results suggest that certain demographic and psychological factors may represent potential area to target for intervention for future pandemics.

IMPACT

This longitudinal study revealed that the COVID-19 pandemic has had a significant impact on pediatric healthcare worker burnout. The percentage of healthcare workers reporting high levels of emotional exhaustion and depersonalization burnout increased significantly over 11-months of the COVID-19 pandemic. Results suggest that certain demographic and psychological factors may represent potential targets for future interventions.

An Innovative Assistant Nurse Manager Residency Program Focused on Participation, Satisfaction, Promotion, and Retention

Assistant nurse managers (ANMs) were asked what they needed to be successful, fully engaged, and equipped to perform in their roles. The ANM Residency Program was created to support development of new ANMs through resources, education, and mentoring. Evaluations were used to guide curriculum enhancements and improve course facilitation. Participation, satisfaction, promotion, and retention were measured. Similar programs may be used to support development for all levels of nurse leaders.

Factors Associated with Burnout in Medical Staff: A Look Back at the Role of the COVID-19 Pandemic

Despite the significant consequences for medical practice and public health, burnout in healthcare workers remains underestimated. Pandemic periods have increased the reactivity to stress by favoring some changes whose influence are still felt.

PURPOSE

This study aims to identify opportune factors during pandemic periods that predispose medical personnel to burnout and the differences between medical staff which worked with COVID-19 patients and those who did not work with COVID-19 patients.

MATERIAL AND METHODS

This is a prospective study on 199 subjects, medical staff and auxiliary staff from national health units, COVID-19 and non-COVID-19, who answered questions using the Google Forms platform about the level of stress related to the workplace and the changes produced there. All statistical analyses were conducted using IBM SPSS Statistics (Version 28).

RESULTS

The limited equipment and disinfectant solutions from the lack of medical resources category, the fear of contracting or transmitting the infection from the fears in relation to the COVID-19 pandemic category and the lack of personal and system-level experience in combating the infection due to the lack of information on and experience with COVID-19 were the most predisposing factors for burnout. No significant differences were recorded between those on the front line and the other healthcare representatives.

CONCLUSIONS

The results of this study identify the stressors generated in the pandemic context with prognostic value in the development of burnout among medical personnel. At the same time, our data draw attention to the cynicism or false-optimism stage of burnout, which can mask a real decline.