Emotional Labor in Pediatric Palliative Care: A Scoping Review

Background: Caring for children in palliative care especially impacts healthcare professionals' personal and professional lives. Their emotional experience and needs are frequently forgotten. Healthcare professionals face emotional demands when caring for children with palliative needs and their parents. Objective: This scoping review aims to identify and map the scientific production about the emotional labor of healthcare professionals in pediatric palliative care. Methods: This scoping review was conducted according to the JBI recommendations and the PRISMA Extension for Scoping Reviews. We searched 16 electronic databases in August 2023 and updated the search on 17 February 2025. Articles were screened according to eligibility criteria, and a content analysis allowed for a summary of key findings. Results: Eleven publications were selected. Most studies were conducted in the United States of America and with nurses as the professionals involved. Many publications were qualitative studies and developed in a neonatal intensive care context. Using content analysis, five themes were identified: (1) emotional experience of healthcare professionals, (2) relational context involved, (3) managing professional and personal boundaries, (4) intrapersonal strategies of emotional labor, and (5) social and organizational strategies of emotional labor. Conclusions: The importance of implementing emotional labor strategies is highlighted, especially intrapersonal, social, and organizational strategies. Education, training, and reflection are needed within a workplace culture that recognizes emotional experiences and supports the emotional management of healthcare professionals. Emotional labor in pediatric palliative care should be recognized. Further research in this area is needed.

Latent class analysis of death coping ability among palliative care nurses and its association with their emotional labor

OBJECTIVE

Death coping ability is a critical professional skill for palliative care nurses. This study aimed to identify subgroups of death coping ability among Chinese palliative care nurses based on their assessments using the Death Coping Ability Scale, and to analyze the relationship between these subgroups and their emotional labor.

METHOD

Convenient sampling was employed to survey 868 palliative care nurses from medical institutions in Beijing, Jiangsu Province, Anhui Province, and Hunan Province. Data was collected using a general information questionnaire, the Chinese version of the Death Coping Ability Scale, and the Emotional Labor Scale. Latent profile analysis was conducted to categorize the nurses' death coping abilities, and differences in emotional labor among these categories were compared.

RESULTS

The death coping ability of palliative care nurses was categorized into three groups: "low death coping ability group" (11.5%), "medium death coping ability group" (52.0%), and "high death coping ability group" (36.5%). Factors influencing these categories included specialization in palliative care, opportunities for interaction with the bereaved, participation in grief counseling training, and personal bereavement experiences, all statistically significant (p < 0.05). Notably, there were significant differences in emotional labor scores among the three groups (F = 33.006, p < 0.001).

CONCLUSIONS

The death coping ability of palliative care nurses can be classified into three distinct categories, each associated with different levels of emotional labor. Nursing managers should recognize these differences and implement targeted, personalized interventions to enhance the death coping abilities of palliative care nurses.

Emotional labor and coping strategies of gynecological nurses in recurrent pregnancy loss care: a qualitative phenomenological study

BACKGROUND

Recurrent pregnancy loss (RPL) is marked by multiple pregnancy losses, placing intense emotional and clinical demands on gynecological nurses who often serve as both medical and emotional support for affected patients. While prior research on emotional labor in healthcare underscores the toll of caring for bereaved individuals, few studies have examined the unique, cyclical nature of grief inherent in RPL care.

METHODS

A qualitative, phenomenological design was employed to explore the experiences of 12 gynecological nurses working in early pregnancy units. Semi-structured interviews investigated nurses' perceptions of emotional labor, the coping strategies they utilized, and the influence of organizational factors on their well-being. Thematic analysis guided by Braun and Clarke's framework illuminated emerging patterns, with member checking and peer debriefing ensuring analytical rigor.

RESULTS

Four key themes emerged. First, The Emotional Burden of Recurrent Loss highlighted nurses' cumulative grief and sense of "compounding sorrow" as they supported patients through multiple losses. Second, Balancing Empathy and Professional Boundaries underscored the tension between offering genuine compassion and guarding personal emotional reserves. Third, Coping Strategies and Resilience-Building revealed a multilayered approach comprising reflective practices, peer debriefing, and self-care. Finally, Organizational Support and Gaps emphasized how institutional resources, staffing levels, and specialized training significantly shaped nurses' capacity to sustain empathetic care.

CONCLUSION

Nurses caring for RPL patients experience heightened emotional labor due to repetitive, distressing encounters with loss. While individual and peer-based coping mechanisms foster resilience, organizational support-such as formal debriefing sessions and RPL-focused training-amplifies nurses' well-being and ensures sustainable, high-quality care. These findings underscore the need for targeted interventions that address both the individual and systemic dimensions of emotional labor in RPL settings.

"It's a Thing": What Nurse Elders Believe Novice Nurses Need to Know About Managing Emotional Labour

BACKGROUND

Emotional labour (EL) can take a significant toll on nurses' mental health and well-being and has serious implications for the retention of nurses in the workforce. Nurse educators have struggled to prepare novices to manage EL or find serviceable resources with which to do so within the body of nursing literature, which is dominated by essentially unhelpful narratives and is absent of the practical, real-world wisdom of elder nurses.

PURPOSE

This exploratory research study illuminated elder nurses' experiential knowledge and beliefs of what is important for novices to learn about EL.

METHODS

Conventional Content Analysis (CCA) of qualitative survey data from 688 nurses with 20+ years of experience.

RESULTS

CCA generated descriptive categories and sub-categories: What the elders themselves learned as student nurses, and their advice to novices in the individual realm, ("It's a Thing," healthy disengagement, supporting mental and physical well-being, reframing self-reproach), team realm (peer support, mentors), and institutional realm (structural barriers to mentors' support of novices, building novices' capacities for self-advocacy, resources to support health and well-being).

CONCLUSIONS

The elders' data confronted and reframed legacy individuated narratives in the literature by supporting and contextualizing nurses' emotional work. Elders advised novices that EL is a reality requiring concrete strategies to manage it throughout their practices. Elders extended their focus for management of EL beyond the individual to include peer support, mentorship, and the structural conditions in which nurses perform their EL, highlighting the need to empower nurses by building their capacity for self-advocacy of their workers' rights.

Exploring the emotional labour of paediatric oncology nurses and its impact on their well-being: An integrative review

PURPOSE

To explore emotional labour in paediatric oncology nurses along with the negative impact of emotional labour on these nurses.

METHODS

The MEDLINE, CINALH, ScienceDirect, and PubMed databases were searched for relevant evidence published from 2000 to 2023. Selected studies were evaluated for quality and synthesized into themes. The Preferred Reporting Items for Systematic reviews and Meta-Analyses literature search extension was followed.

RESULTS

Eighteen empirical studies were reviewed. Nurses acknowledged the importance of managing and displaying emotions through emotional labour to gain patients' and families' trust and provide care in a safe and comfortable environment. They described emotional labour in the forms of empathy and close relationships. The frequency and intensity of performing emotional labour vary among nurses based on different factors. Nurses reported feelings associated with burnout, compassion fatigue, secondary traumatic stress, and emotional dissonance. The three main coping behaviours were avoidance, changing practice and sharing feelings.

CONCLUSION

Although using emotional labour facilitates high-quality care, it may negatively influence nurses' well-being without implementing effective supportive interventions. A considerable number of paediatric oncology nurses intended to leave the unit. The proposed solutions are to address this issue at the organizational level by providing training and support services to enhance nurses' competence in performing this high-level skill and minimize its negative impacts.

Psycho-Emotional Aspects of Pregnant Women Diagnosed with a Rare Disease: A Systematic Review

Background: Psycho-emotional aspects as a cross-cutting theme have gained relevance and scientific interest in recent years. Pregnant women diagnosed with a rare disease constitute a vulnerable population, experiencing psycho-emotional challenges due to their specific circumstances. It is essential that this group is informed and receives the proper to manage the physical, emotional, and psychological challenges linked to their condition. Objectives: The aim of this review is to understand how the diagnosis of a rare disease affects the psycho-emotional aspects of a pregnant woman. Methods: The research question posed is how does the diagnosis of a rare disease affect the psycho-emotional aspects of a pregnant woman? This systematic review has been carried out following the PRISMA model and has been registered in PROSPERO with registration number CRD42024558523. A literature search was conducted in the databases of Scopus, PubMed, Cinahl, Scielo, and the Cochrane Library. Articles were selected on the basis of the following inclusion criteria: publication in the last twenty years and all languages. Results: In the end, 28 articles were selected. The main results highlight that there is a negative impact on the psycho-emotional level in these patients, altering aspects such as anxiety, stress, social rejection, and self-stigma. Conclusion: The role of nursing in addressing this psycho-emotional dimension as a mediator between families and other branches of the health sciences environment stands out.

The Level and Outcomes of Emotional Labor in Nurses: A Scoping Review

Aims: This scoping review aims to examine the level and outcomes of emotional labor in nurses. Background: Nursing is a highly emotional profession that requires nurses to experience a wide range of emotions and control their emotional expressions in nursing practice. Chronic emotional labor and emotional burden not only impact nurses' individual well-being and professional performance but also their job satisfaction and turnover intention. Evaluation: This scoping review was guided by a five-stage scoping review framework and the PRISMA-ScR checklist. Eight databases were searched and 41 studies were reviewed. Key Issues: The Emotional Labor Scale and the Emotional Labor Scale for Nurses were the most commonly used instruments. Significant associations were found between emotional labor and 52 outcomes, which were categorized into two main themes: nurses' personal well-being and organizational well-being. There were 19 mediators and 12 moderators between nurses' emotional labor and 26 different outcomes. Conclusions: While the level of emotional labor among nurses remains uncertain, its consequences are plentiful and intricate. Studies have shown an important relationship between nurses' emotional labor and individual and organizational well-being, which is crucial for nurse managers. There is a need to explore the positive effects of nurses' emotional labor and its impact on patients. Additionally, validation studies of the instruments used to measure nurses' emotional labor are necessary. Implications for Nursing Management: The insights gained from this scoping review provided a more comprehensive understanding of emotional labor for nurse managers. This knowledge can be utilized to design training programs on emotional management and to explore different interventions aimed at alleviating the adverse impacts of nurses' emotional labor.

Mental Health and Medical Error among Nursing Staffs at Korean Medicine Clinics: a first survey in South Korea

Objectives

Nurses face mental health issues like emotional labor, stress, and depression, increasing the risk of medical errors. This study assesses the mental health and medical errors among nurses in Korean medicine clinics in South Korea.

Methods

The cross-sectional analysis involved 83 nurses, examining relationships between emotional labor, stress, depression, cognitive failure, Hwa-byung (HB) (a syndrome of suppressed anger in Korean culture), and medical errors. It identified factors associated with HB and medical errors using multiple regression analysis, presenting their odds ratios (ORs) with 95% confidence intervals (CIs).

Results

The findings revealed a current HB prevalence of 19.28% and a 6-month medical error prevalence of 16.87% among participants. The regression analysis showed that higher levels of depression (OR = 1.368, 95% CI = 1.098 to 1.703, p = 0.005), cognitive failure (OR = 1.072, 95% CI = 1.011 to 1.136, p = 0.020), and HB trait (OR = 1.136, 95% CI = 1.005 to 1.284, p = 0.041) significantly correlated with HB presence.

Conclusion

This groundbreaking study on this previously under-researched nurse workforce highlights the critical need for comprehensive mental health care, with the objective of significantly enhancing their mental well-being and improving their overall work environment.

"You close the door, wipe your sadness and put on a smiling face": a qualitative study of the emotional labour of healthcare professionals providing palliative care in nursing homes in France

BACKGROUND

Palliative care provided to frail and dying older persons in nursing homes results in intense emotions for residents and their relatives as well as for healthcare professionals. In France, scant attention has been given to how nursing home professionals manage their emotions when providing palliative care. This study analysed the emotional demands of providing palliative care in the nursing home context, the emotional strategies used by healthcare professionals to navigate such demands, and how these demands affect their emotional wellbeing.

METHODS

This qualitative study used a multiple case study approach. We purposively selected nine nursing homes from three geographical provinces in France with diverse ownership statuses (public, private, associative). Individual interviews and focus group discussions were held with 93 healthcare professionals from various occupational groups employed in the participating nursing homes. Data was collected from April 2021 to September 2022 and was analysed using thematic content analysis.

RESULTS

Data revealed that providing palliative care to dying residents within the nursing home context results in intertwined rewarding and exhausting emotional experiences for healthcare professionals. Professionals have to utilize multifaceted emotional strategies to navigate these experiences, including suppressing and modifying emotions and distancing themselves emotionally from residents to protect themselves from emotional suffering. Participants noted a lack of formal space to express emotions. Unrecognized emotional labour undermines the wellbeing of healthcare professionals in nursing homes, whereas acknowledging emotions enhances satisfaction and gives enhanced meaning to their crucial role in resident care.

CONCLUSION

Acknowledging emotional labour as an inevitable component of providing palliative care in nursing homes is critical to supporting healthcare professional wellbeing, resilience, and retention, which may ultimately improve the quality of care for dying residents. Ensuring quality care and supporting the emotional wellbeing of nursing home professionals requires an organisational culture that considers emotional expression a collective strength-building resource rather than an individual responsibility, in hopes of shaping a new culture that fully acknowledges their humanity alongside their professional skills.

TRIAL REGISTRATION

ClinicalTrials.gov ID: NCT04708002; National registration: ID-RCB number: 2020-A01832-37, Registration date: 2020-12-03.

Cardiovascular nurses and organizational well-being: a systematic review

AIMS

This systematic review assesses the organizational well-being of nurses working in cardiovascular settings and identifies environmental variables influencing it.

METHODS AND RESULTS

The Joanna Briggs Institute's methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines have been followed. The search was conducted, from the database inception up to and including 1 December 2022, on Medline (via PubMed), Cumulative Index of Nursing and Allied Health, Cochrane Library, and Scopus. Critical appraisal and data extraction were conducted using standardized tools. Six articles of high quality were included. These mostly concerned cross-sectional studies, conducted in heterogeneous contexts, which highlight the peculiarity of the cardiovascular nursing setting. Three thematic areas were identified: stressors of cardiovascular settings; outcomes of stressors on nurses; and coping strategies used by cardiovascular nurses to deal with such stress factors. Identified stress factors included a lack of autonomy, conflicts between professional and family roles, high workloads, and stressful relationships with patients and caregivers. These organizational variables could generate nurses' burnout, depression, irritability, and/or sleep disorders. In trying to cope with such stressors, cardiovascular nurses used different strategies for compensating, avoiding, escaping, or ignoring the problem, or, in other cases, became somewhat aggressive.

CONCLUSION

Considering the limited data, cardiovascular nursing coping strategies should be further investigated, so that effective pathways for preventing or limiting stress factors can be identified and applied by the organizations. Monitoring and intervening on stress factors in this care setting could improve cardiovascular nurses' organizational well-being and accordingly patients' outcomes.

REGISTRATION

PROSPERO: CRD42022355669.

Competence in managing workplace violence among nursing interns: Application of latent class analysis

AIM

To identify subtypes of competence in managing workplace violence (WPV) among nursing interns and to assess between-group differences.

BACKGROUND

Nursing interns are reported to be a vulnerable population for experiencing workplace violence during their clinical placement. Although WPV could have a negative impact on nursing interns' health and attitudes towards the nursing profession, little is known about nursing interns' competence in workplace violence management or its influencing factors.

DESIGN

A cross-sectional study.

METHODS

Between March to April 2023, nursing interns at three tertiary general hospitals in Anhui Province, China, completed questionnaires including a general information questionnaire, the Management of Workplace Violence Competence Scale (MWVCS), the Utrecht Work Engagement Scale (UWES-9), the Emotional Labour Scale for Nurses (ELSN) and were classified into subtypes by latent class analysis. Subsequently, univariate analysis and multivariate logistic regression were performed to identify the influencing factors by subtypes.

RESULTS

A total of 264 questionnaires were valid and the overall mean age of the participants was 21.06 ±1.41 years. Four classes were identified: low competency group (15.5%), low cognition-low coping competency group (18.2%), low cognition-medium to high competency group (21.6%) and high competency group (44.7%). The results of multinomial logistic regression analysis showed that placement hospitals with a WPV management department, emotional control effort in profession dimension and emotional pretense by norms dimension in the Emotional Labour Scale for Nurses, pursuing further education and vigour dimension in the Utrecht Work Engagement Scale were influencing factors of the potential categories of WPV management competence.

CONCLUSIONS

Four classes were identified and there was competence variability among nursing interns. More attention should be given to nursing interns who did not receive WPV-related training in their school or placement hospital.

Effects of medical and nursing group rounds combined with emotional nursing on quality of life and emotion in patients with malignant lymphoma

To investigate the effects of medical and nursing visits in the same group combined with emotional care on the quality of life and emotions of patients with malignant lymphoma. One hundred sixty cases of malignant lymphoma patients admitted to our hospital from March 2020 to July 2022 were selected as retrospective study subjects and divided into 80 cases each in the control group and the observation group according to the different nursing methods. Among them, the control group implemented conventional emotional care, and the observation group implemented medical and nursing visits in the same group on the basis of the control group. The differences in quality of life, anxiety-related scores and sleep quality between the 2 groups of patients with malignant lymphoma before and after nursing were compared. After nursing, the mental vitality (P = .015), social interaction (P < .001), emotional restriction (P = .007), and mental status (P = .028) scores of patients in the observation group were higher than those in the control group. After nursing, the Self-Rating Anxiety Scale (P < .001) and Hamilton Anxiety Scale (P < .001) of malignant lymphoma patients in the observation group were significantly lower than those in the control group, and the sleep quality (P < .001), increased awakening (P < .001), sleep disturbance (P < .001), night terrors (P < .001) scores in the observation group were significantly lower than those in the control group. The combination of medical and nursing group checkups and emotional care can effectively improve the quality of life and sleep of patients with malignant lymphoma and reduce adverse emotions, which is beneficial to patient prognosis and clinical treatment. It has certain reference value for the care of patients with malignant lymphoma.

Frontstage nursing and backstage growth: The emotional labour of student nurses in Dutch nursing homes

The complex emotional work of nurses calls for more recognition of emotional labour and the incorporation of emotional labour in nursing education. Based on participant observation and semistructured interviews, we describe the experiences of student nurses in two nursing homes for elderly people with dementia in the Netherlands. We analyse their interactions using Goffman's dramaturgical view on the front and backstage behaviour and the distinction between surface acting and deep acting. The study reveals the complexity of emotional labour, as nurses swiftly adapt their communication styles and behavioural strategies between settings, patients, and even between moments within one interaction sequence, which shows that the theoretical binaries fail to fully capture their skills. Although student nurses take pride in their emotionally taxing work, the societal undervaluation of the nursing profession negatively impacts their self-image and ambitions. More explicit recognition of these complexities would enhance their self-appreciation. This calls for a professional 'backstage area' that allows nurses to articulate and strengthen their emotional labour skills. Educational institutions should provide this backstage for nurses-in-training to strengthen these skills as part of the professional skill set.

The relationship between emotional intelligence and organizational commitment among nurses working in governmental hospitals in Jordan

INTRODUCTION

Nurses' emotions and feelings in response to their environment and their ability to manage their emotions can significantly affect several aspects of their job. In Jordan, studies are still investigating whether emotional intelligence is significantly related to organizational commitment.

AIM

To investigate whether a significant relationship exists between emotional intelligence and organizational commitment among Jordanian nurses working in governmental hospitals in Jordan.

METHODS

The study used a descriptive cross-sectional correlational design. A convenience sampling method was used to recruit participants working in governmental hospitals. A total of 200 nurses participated in the study. A participant information sheet developed by the researcher was used to obtain the participants' socio-demographic characteristics, the Emotional Intelligence Scale (EIS) developed by Schutte and colleagues, and the Organizational Commitment Scale developed by Meyer and Allen were utilized for data collection.

RESULTS

Participants had high levels of emotional intelligence (M, SD = 122.3, 14.0) and moderate levels of organizational commitment (M, SD = 81.6, 15.7). Emotional intelligence had a significant, positive relationship with organizational commitment (r = 0.53, p < 0.01). Male nurses, widowed nurses, and nurses with higher postgraduate qualifications demonstrated significantly higher levels of emotional intelligence and organizational commitment than female nurses, single nurses, and nurses with undergraduate degrees (p < 0.05).

CONCLUSION

Participants in the current study were highly emotionally intelligent and moderately committed to their organizations. Policies supporting the implementation of interventions to improve organizational commitment and maintain a high level of emotional intelligence should be developed and promoted by nurse managers and hospital administrators, as well as decision-makers should magnet the nurses with postgraduate degrees at clinical sites.

Enhancing Care of Older Adults Through Standardizing Palliative Care Education

Nursing skill in caring for persons with serious chronic illness is increasingly in demand as the proportion of older adults in the United States increases. There is robust evidence that palliative care education among health care providers influences the reduction of death anxiety and avoidance behavior, while positively impacting self-efficacy and comfort, when caring for persons with serious illness or those nearing death. The international recognition of access to palliative care as a universal human right drives the need for education to adequately prepare nurses who have not been properly prepared for this work. The development of national competencies in palliative care education for nurses is an important step in synthesizing and disseminating available evidence in support of palliative care nursing education. These recently published competencies can lead to policy innovations at local, state, and national levels. Identifying competencies that lead to more clearly defined curricula will ultimately improve standardizing education and improve nursing practice in caring for older adults with serious chronic illness and their families. [Journal of Gerontological Nursing, 49(6), 6-12.].

Factors Determining the Mood and Emotions of Nurses Working in Pediatric Wards-A Pilot Study

BACKGROUND

Mood and emotions are important aspects of social interactions. In recent years, there has been a growing interest in the participation of these emotional states in the implementation of tasks resulting from specific professions. The aim of the study is to identify the factors that determine the mood and emotions of nurses working in pediatric wards.

METHODS

The pilot studies presented in the paper were carried out using the diagnostic survey method. The collected data were obtained from the authors' own questionnaire and the standardized measurement tool "Scale for Measuring Mood and Six Emotions" by Bogdan Wojciszke and Wiesław Baryła. The study included 121 nurses working in hospital pediatric wards. The survey questionnaire results were obtained online using Google Forms.

RESULTS

Self-assessment of the health condition of nurses is statistically significantly correlated with all emotions and mood (p < 0.05). The better the self-assessment of health, the greater the positive mood measured by the General Mood Scale (GMS) and Mood Scales (MS). The financial situation showed a statistically significant correlation with guilt (p = 0.048), sadness (p = 0.041), and negative mood (p = 0.035). Single people, regardless of gender, were characterized by a greater experience of love (H = 13.497; p < 0.001). The higher the education, the greater the experience of love (p = 0.009). For people with specialization, the presence of negative emotions such as anger (p = 0.039) and guilt (p = 0.049) turned out to be statistically significant. The better the health of children staying in the ward, the higher the negative mood of nurses (p = 0.035).

CONCLUSIONS

There was a statistically significant relationship between certain demographic factors, self-assessment of health conditions with the specificity of working in pediatric wards, and the experience of mood and different emotions by nurses working with pediatric inpatients.

Emotional Labor of Nurses and Phlebotomists in a New Source Plasma Collection Site During the COVID-19 Pandemic

As uses of plasma-derived medical products increase globally, so does the demand to collect plasma from donors. There is evidence that positive interactions with center staff motivate plasma donors to return. This paper reports on a focused ethnography investigating experiences of nurses and phlebotomists in one of Canadian Blood Services' first source plasma collection center during the COVID-19 pandemic. Participants found the transition from whole blood collection to source plasma amid a global pandemic challenging, but they adapted by coming together as a team, and then worked to put the donor experience first. Their experience resonates with scholarship on emotional labor. As blood services worldwide attempt to increase source plasma collection, there is a need to understand care work that nurses and phlebotomists perform on the front-line. This study offers insight into how blood services can support staff in plasma operations by recognizing emotional labor.

Emotional labor as emotional regulation: Italian adaptation and longitudinal validation of the scale among undergraduate nursing students

AIM

The aim of the present study is to perform a longitudinal Italian validation of the scale and to adapt it to the nursing education contest.

BACKGROUND

Research on emotional labor has shown that the roles played by surface acting and deep acting are still uncertain. To overcome this gap, scholars suggest observing emotional labor through the lens of the emotional regulation theory. Andela and her colleagues developed a fine grained instrument, which differentiates attentional deployment, cognitive re-evaluation and expressive suppression, emotional amplification and emotional dissonance.

DESIGN

To fulfill our aim, a longitudinal study was performed in an Italian University.

METHOD

The adapted scale was administered to 168 nursing students across the three years of attendance in the course.

RESULTS

Our results confirm the five-factor structure, and the instrument shows good psychometrical properties.

CONCLUSION

Having shown satisfactory psychometric properties, this scale can be considered a useful instrument to assess those emotional elements of clinical practice, which are important for the assurance of education quality to the under graduated nursing students.

Role of affective commitment in the relationship between emotional labor and life satisfaction in nurses

PURPOSE

This study investigated relationships between hospice nurses' emotional labor, life satisfaction, and affective commitment (moderator). We started with the assumption that displaying real emotions rather than faking them may increase life satisfaction.

DESIGN AND METHODS

The study utilized a cross-sectional survey data analysis. A total of 322 nurses participated in the study. Hayes' process examined the moderation relationship predicting emotional labor and life satisfaction.

FINDINGS

The results showed that emotional labor partially affected life satisfaction. However, those effects varied at different levels of affective commitment and interestingly diminished at a high level.

PRACTICE IMPLICATIONS

Nurse leaders should understand and transform the surface emotional setting of nurses to more profound acting emotions and then to natural emotional responses, which otherwise can generate emotional conflict causing unsatisfactory life.

Why emotions need to labor—Influencing factors and dilemmas in the emotional labor of Chinese English teachers teaching online

During the COVID-19, online teaching has become a popular way of teaching in the world. Previous research on English language teachers’ emotional labor has not focused on the changes brought about by online teaching. Unlike the traditional physical teaching space, the emotional labor of English teachers teaching online changes with the daily use of online technological conditions. Therefore, this paper aims to investigate the factors influencing teachers’ emotional labor in online teaching and the emotional labor dilemmas. We took interviews with a group of English teachers in China (T1, T2, … T20) and found that their online teaching emotions were influenced by three main factors: the degree of adaptation to online teaching technology, the invisibility of the online teaching space, and the peripheral environment of the space in which the teachers were located. In addition, this study observed the online classrooms of the interviewees and found that the first two influences are at a priority level for Chinese English teachers, while whether the third factor can bring positive or negative emotions is often influenced by the nature of the emotions brought by the first two factors. In order to find a balance between norms and emotions, English teachers are often accompanied by emotional labor in their work. However, they face many dilemmas of choice and behavior during the emotional labor of teaching online: emotional rule dilemma, emotional expression dilemma and professional identity dilemma. The emergence of these dilemmas is directly related to the influencing factors. In conclusion, this article uses normative and emotional labor theories to explore how norms affect Chinese English teachers’ emotions when teaching online as a response to the question of why emotions need to be labored. Ultimately, this study offers some useful suggestions for language teachers’ emotional labor dilemmas.

Correlation Analysis between Emotion Control and Professional Self-Efficacy of Singing Artists Based on Multidimensional Environment

The tertiary industry occupies a large area in China's economic system, and it plays an important function in the growth of China's economic development. It is of positive significance to study the relationship between emotional labor and occupational self-efficacy of singing artists in the tertiary industry. This paper mainly studies the correlation between the emotional labor of singing artists and their professional self-efficacy and analyzes the strength of the correlation. This paper selects 150 singing art personnel in the singing art association in city A to conduct a questionnaire survey and conducts data processing on the questionnaire. This paper explores the influencing factors of emotional labor and four dimensions of occupational self-efficacy. This paper firstly analyzes the differences of the influencing factors of emotional labor and then tests the interaction of the different factors selected. It then conducts a significant test on the four dimensions of professional self-efficacy and finally studies the correlation between the two based on the previous analysis results. This paper concludes that there is a highly significant relationship between the emotional labor and professional ego efficacy of singing artists. And the correlation coefficient and determination coefficient are 0.293 and 0.087, respectively. It shows that 8.7% of the total variance in occupational self-efficacy variables can be explained by emotional labor. There was no significant correlation between surface acting and occupational self-efficacy. Deep acting has the greatest correlation with the physical and mental efficacy dimension of occupational self-efficacy, with a correlation coefficient of 0.391. There were significant correlations between natural performance and the four dimensions of occupational self-efficacy. The highest value is interpersonal efficacy, which is 0.337. The research conclusions of this paper have certain reference value for exploring the relationship between emotional labor and professional self-efficacy of singing artists.

The Relationship between Mindfulness and Emotional Intelligence as a Protective Factor for Healthcare Professionals: Systematic Review

Emotional intelligence is an essential trait and skill for healthcare professionals. Mindfulness meditation has proved to be effective in increasing the wellbeing of those who practice it, leading to better mental health, self-care and job satisfaction. This paper aims to identify the recent evidence on the relationship between mindfulness and emotional intelligence among healthcare professionals and students. A systematic review was conducted including the databases PubMed, Cinhal, PsycINFO and Web of Science. The main variables were emotional intelligence skills and mindfulness practice. Data were extracted according to the following outcomes: authors, year of publication, country, study design, participants, mindfulness training intervention, tools used in data collection and main results. The following inclusion criteria were applied: peer-reviewed articles; published in English or Spanish; published between 2010 and 2020; quantitative methodology; a study population of healthcare professionals or students; the relationship with the aim of the study. The Joanna Briggs Institute criteria were followed for assessing the methodological quality of the selected studies. Three researchers were involved in the review. After the selection process, 10 studies were selected out of the 197 references initially identified. These studies revealed a positive relationship between mindfulness and emotional intelligence, particularly the capacity to regulate emotions. Furthermore, mindfulness is negatively related to emotional exhaustion. Training interventions based on mindfulness have proved to be useful in promoting emotional balance, emotional awareness, emotional acceptance, emotion recognition, expressive suppression and a reduction in emotional exhaustion. This study could serve as a basis for further research on the benefits of emotional intelligence and practicing mindfulness for the bio-psycho-social welfare of healthcare professionals.

Emotional labour and cord blood collection: frontline perspectives

PURPOSE

This paper aims to examine emotional labour in the work of frontline staff (FLS) of the Canadian Blood Services' Cord Blood Bank (CBB), contributes to understandings of emotional labour by allied healthcare workers and suggests implications for healthcare managers.

DESIGN/METHODOLOGY/APPROACH

Qualitative interviews with 15 FLS were conducted and analyzed as part of a process evaluation of donor recruitment and cord blood collection in Canada.

FINDINGS

Emotional labour with donors and hospital staff emerged as a vital component of FLS' donor recruitment and cord blood collection work. Emotional labour was performed with donors to contribute to a positive birthing experience, facilitate communication and provide support. Emotional labour was performed with hospital staff to gain acceptance and build relationships, enlist support and navigate hierarchies of authority.

RESEARCH LIMITATIONS/IMPLICATIONS

The results indicate that FLS perform emotional labour with women to provide donor care and with hospital staff to facilitate organizational conditions. The findings are based on FLS' accounts of their work and would be enhanced by research that examines the perspectives of donors and hospital staff.

PRACTICAL IMPLICATIONS

Attention should be paid to organizational conditions that induce the performance of emotional labour and may add to FLS workload. Formal reciprocal arrangements between FLS and hospital staff may reduce the responsibility on FLS and enable them to focus on recruitment and collections.

ORIGINALITY/VALUE

This paper addresses a gap in the healthcare management literature by identifying the emotional labour of allied healthcare workers. It also contributes to the cord blood banking literature by providing empirically grounded analysis of frontline collection staff.

Emotional labor of nurses in the front line against the COVID-19 pandemic

OBJECTIVE

To analyze nurses' experiences in the front line of the fight against the COVID-19 pandemic regarding the performance of emotional labor (EL), aiming at its characterization and identification of support strategies and development opportunities of nurses and practices.

METHODS

Qualitative, descriptive, and exploratory study, with content analysis of eleven written narratives and reports from a focus group composed of nurses with experience in caring for patients with COVID-19 from different Hospital Centers in Lisbon, Portugal.

RESULTS

Five themes were extracted: 1) Challenges experienced by nurses in the frontline; 2) Emotions experienced by nurses in service care; 3) Emotional responses of nurses and patients: impact on care; 4) EL of nurses in the patient care process; 5) Opportunities for development in the face of the emotional challenge required of nurses in combating COVID-19.

FINAL CONSIDERATIONS

The nurses demonstrated the ability to transform this profoundly emotional experience positively.

Describing the health behaviours of future nurses: a cross-sectional study among Italian nursing students

Academic environments may influence the achievement of healthy behaviors in nursing students. However, the lifestyles among Italian nursing students have been poorly investigated. Therefore, the aim of this study was to describe the health behaviours of Italian undergraduate nursing students. A monocentric, cross-sectional, study design was performed. The study was conducted in an undergraduate nursing course in the north of Italy (University of Pavia). Data were collected through the list of freshmen in nursing in March 2018 (i.e. first years of the undergraduate program) using an online survey and a purposive sampling, where 134 nursing students were enrolled. The results highlighted that the nursing students observed a varied and balanced alimentation. The most problematic areas are referred to the physical activity and the smoking habits. Future research should frame the trajectory of the undergraduate nursing students over the overall education path, also promoting and testing strategies to address the observed issues, such as limited physical activities and smoking habits. (www.actabiomedica.it)

Improving Attitudes and Perceptions About End-of-Life Nursing on a Hospital-Based Palliative Care Unit

Nurses play an integral role in high-quality patient care. Thus, their skills in providing end-of-life care should be assessed and continually enhanced. Education intended to improve end-of-life skills must address the affective/emotional component of nursing care. Evidence demonstrates that emotional engagement and resilience among health care providers are correlated with improved quality outcomes and, conversely, that burnout and stress negatively affect patient safety. Addressing the emotional needs of health care providers is critical to improving quality throughout the health care system. An evidence-based workshop was implemented among direct care staff on a hospital-based palliative care unit, with the goal of fostering emotional engagement to improve staff perceptions and attitudes about caring for patients at or near the end of life. Although perceptions about quality of death were not affected by this intervention, there was a significant improvement in attitudes about end-of-life nursing care. Qualitative feedback also reflected appreciation for small group discussions and opportunities to debrief with peers away from the unit. This intervention reflected the value of emotional engagement in educational efforts to improve end-of-life nursing care.

Factors playing a role in the development of emotional labor behavior of clinical nurses

PURPOSE

This study aimed to investigate spirituality, sociodemographic features, and occupational features as predictors of nurses' emotional labor.

DESIGN AND METHODS

The study is descriptive cross-sectional and correlational research.

FINDINGS

The results demonstrated that there was a statistically significant positive relationship between the nurses' spirituality and the subdimension of intimate behavior (r = .545) (P < .05). Regarding the nurses' in-depth behaviors, the study found that spirituality (β = .550) and the number of patients that the nurses were responsible for (β = -.154) were statistically significant predictors (P < .05). The subdimensions of superficial behavior, spirituality (β = .498), and rechoosing the profession (β = -.142) were statistically significant predictors as well (P < .05).

PRACTICE IMPLICATIONS

For the development of emotional labor in clinical nurses, administrators should be sensitive to nurses' spiritual values.

Exploring Provider Cultural Competence and Patient Mood in an Outpatient Apheresis Unit

Introduction: Health care and culture are important to patient care. Theoretical frameworks, service delivery, and self-awareness are important to the provider/patient. Provider care varies, and studies are needed to understand the current interactions between providers, patients, and culture. Methodology: This was a prospective, descriptive correlational pilot study. Providers and patients completed a baseline assessment of culture, as well as a Brief Mood Introspection Scale at each visit at the patient's standard of care visit (i.e., visit as part of clinical procedures). Results: The providers and baseline assessment of culture showed higher than average cultural awareness. All four mood subscales show no statistically significant differences in patient or providers' mood. There were no significant differences in mood when considering differences and similarities between gender, race, and ethnicity. Discussion: There was no difference in patient or provider mood in this study when based on the differences or similarities in gender, race, and ethnicity.

Outrage and the emotional labour associated with environmental activism among nurses

AIM

To investigate the emotions associated with environmental activism among nurses.

BACKGROUND

Nursing has a long history of political activism in relation to social justice issues. Some nurses are environmental activists.

DESIGN

Ethnography.

METHODS

Focus groups and individual interviews were triangulated with additional observational data. The 40 participants (USA = 23, UK = 17) were nurses actively engaged with environmental/sustainability issues. Data collection was from March-October 2017. Data were analysed using discourse analysis.

RESULTS

The trigger for nurses' environmental activism was a strong emotional response to recognizing risks to human health. Their activism results in an additional emotion burden above which they routinely experience in caring for patients. Many feel over-whelmed by the magnitude of the issues. Nurses in America feel more supported and empowered to be activists than UK nurses.

CONCLUSION

This study reveals for the first time that advocating for the environment is emotional labour, additional to the previously recognized emotional labour associated with caring for patients. Encouragement and support from others, particularly fellow nurses, helps nurse environmental activists continue to fight for the health of communities and the planet.

IMPACT

Outrage at threats to human health triggers nurses' environmental activism. Environmental activism creates an additional emotional burden above that routinely experienced in caring for patients. Nurses in America feel more supported and empowered to be activists than UK. Nurses whose practice embraces environmental activism need practical and emotional support from other nurses.

Upholding an ideal image of palliative work in the face of obstacles

OBJECTIVE:

Homecare workers play a pivotal role in palliative care, but research on their experiences is limited. The aim of this study was to describe how homecare workers in Sweden experience their work in palliative homecare.

METHOD:

This qualitative study used open-ended interviews with a purposive sample of 15 homecare workers. The data was analysed by means of qualitative content analysis.

RESULTS:

One main theme emerged from the analysis: upholding an ideal image of palliative work. This had four subthemes: doing good; doing their best work; feeling work satisfaction; and facing difficulties.

CONCLUSION:

Palliative care performed by homecare workers is demanding. Homecare workers need more practical support and would benefit from a care model that involves working with registered nurses, as a team, to provide humanistic care to dying patients and their relatives.

Caring for Children with Non-Accidental Head Injuries: A Case for a Child-Centered Approach

Child abuse remains a significant issue. Non-accidental head injury (NAHI) is a major cause of mortality in young children with survivors often having to live a life with severe developmental and neurological dysfunction. The aim of this hermeneutic phenomenological research study was to examine the lived experiences of nurses who care for children and their families admitted to hospital with a non-accidental head injury. Semi-structured interviews were conducted with six nurses who had at least five years' experience of nursing children with NAHI. Following the interpretive approach described by van Manen data was analyzed and two essential themes identified. Firstly, nursing children with NAHI is different from the care of children admitted with a similar neurological injury related to accidental injuries or medical conditions. Secondly, when nursing these children nurses adopt protective qualities, conceptualized in this study as a shield of protection. The findings of this study support the findings of other studies in regard to the emotional labor required of nurses caring for children who have been subject to child abuse and the importance for nurses of maintaining a professional demeanor. The study highlighted the tensions of sustaining a family-centered care approach when caring for a child with NAHI. It is argued that greater acknowledgment and emotional support for nurses is needed and that a child-centered approach offers a more compatible model of care than Family-Centered Care in the acute phase of caring for children with a NAHI.

Providing Personal Care to Patients: the Role of Nursing Students' Emotional Labor

Background Providing personal care may be a source of emotional difficulties and negative feelings for students interacting with patients during their first clinical placement. This study was done to describe the role of emotional strategies for first year nursing students providing personal care to patients and the relationship of these strategies to students' emotional exhaustion, self-efficacy, and turnover intention. Method A self-reported questionnaire was administrated to a convenience sample of 226 first-year undergraduate nursing students attending their first clinical placement in one Italian University hospital. Results Results suggested a positive link between students' cognitive re-evaluation of their experiences and their self-perceived self-efficacy. Attentional deployment was the strongest antecedent of emotional exhaustion. Emotional dissonance was the primary contributor to students' turnover intention. Emotional exhaustion mediated the relationship between emotional dissonance and turnover intention. Conclusion This research suggested that there are emotional coping strategies useful for protecting student nurses from emotional exhaustion and turnover intention and that these strategies are positively related to students' self-perceived self-efficacy in providing personal care.

Individual-level determinants of interprofessional team collaboration in healthcare

Interprofessional team collaboration (ITC) is pivotal for the safety and the quality of healthcare settings, being associated with higher staff and patient satisfaction. However, individual-level determinants (i.e. socio-demographic and working satisfaction) remain currently largely unexplored. This study aimed to describe the overall ITC (i.e. partnership, cooperation, coordination), identifying the individual-level determinants of each ITC domain. This study had a multicentre approach, using cross-sectional data collection. ITC was assessed using the Interprofessional Team Collaboration Scale II, Italian version (I-AITCS II). The determinants of ITC were investigated through multivariable linear regression models. The study results showed significant associations between the same ITC domains, as well as the important role of work satisfaction in determining cooperation and coordination. Physicians reported more inadequate partnership levels than other healthcare professionals. This study provides insights for future research and gives a useful description of the determinants of ITC for multi-stakeholder healthcare organizations.

Development and validation of the pressure ulcer management self-efficacy scale for nurses

BACKGROUND

Pressure ulcers (PUs) represent a current issue for healthcare delivery. Nurse self-efficacy in managing PUs could predict patients' outcome, being a proxy assessment of their overall competency to managing PUs. However, a valid and reliable scale of this task-specific self-efficacy has not yet been developed.

OBJECTIVES

To develop a valid and reliable scale to assess nurses' self-efficacy in managing PUs, that is, the pressure ulcer management self-efficacy scale for nurses (PUM-SES).

METHODS

This study had a multi-method and multi-phase design, where study reporting was supported by the STROBE checklist (File S1). Phase 1 referred to the scale development, consisting in the items' generation, mainly based on themes emerged from the literature and discussed within a panel of experts. Phase 2 focused on a three-step validation process: the first step aimed to assess face and content validity of the pool of items previously generated (initial version of the PUM-SES); the second aimed to assess psychometrics properties through exploratory factorial analysis; the third step assessed construct validity through confirmative factorial analysis, while concurrent validity was evaluated describing the relationships between PUM-SES and an established general self-efficacy measurement. Reliability was assessed through the evaluation of stability and internal consistency.

RESULTS

PUM-SES showed evidence of face and content validity, adequate construct and concurrent validity, internal consistency and stability. Specifically, PUM-SES had four domains, labelled as follows: assessment, planning, supervision and decision-making. These domains were predicted by the same second-order factor, labelled as PU management self-efficacy.

CONCLUSION

PUM-SES is a 10-item scale to measure nurses' self-efficacy in PU management. A standardised 0-100 scoring is suggested for computing each domain and the overall scale. PUM-SES might be used in clinical and educational research.

RELEVANCE TO CLINICAL PRACTICE

Optimising nurses' self-efficacy in PU management might enhance clinical assessment, determining better outcomes in patients with PUs.

Nurses' organizational communication satisfaction, emotional labor, and prosocial service behavior: A cross-sectional study

In this study, we investigated nurses' organizational communication satisfaction and emotional labor in an attempt to identify the factors that influence nurses' prosocial service behavior in Korea. A cross-sectional study was conducted on 145 nurses at two Korean tertiary hospitals in 2017. Most participants (89%) were female, and the mean age was 28.45 ± 5.50 years; data analysis was mainly based on a multiple regression. It was consequently found that nurses' organizational communication satisfaction and emotional labor positively affected their prosocial service behavior. The potential benefits of emotional labor were also explored, and these variables were determined to explain 41.1% of the variance in prosocial service behavior. These findings provide evidence that organizational communication satisfaction and emotional labor in nurses can have significant effects on their prosocial service behavior.

Italian version of the Assessment of Interprofessional Team Collaboration Scale II (I-AITCS II): a multiphase study of validity and reliability amongst healthcare providers

Objective:

To develop and validate an Italian version of the Assessment of Interprofessional Team Collaboration Scale II (I-AITCS II).

Methods:

A multiphase validation study was conducted. The first phase was the AITCS-II translation from English into Italian to develop the first version of I-AITCS II for practitioners. The second phase was the study of I-AITCS II face and content validity, and the third phase was a cross-sectional data collection to provide evidence of construct validity using the psychometrics testing and the reliability assessment through the internal consistency study.

Results:

The agreement for the forward-translation among researchers was high. The face and content validity were satisfactory. The underlying constructs of I-AITCS II were partnership, cooperation and coordination. Internal consistency was good for both scale and domains level. There were significant differences related to partnership in the comparison between settings.

Conclusions:

I-AITCS II showed evidence of validity and reliability. It will be useful to gather data to address programs aimed to enhance interprofessional team collaboration within the Italian healthcare contexts, and it could be used for cross-national researches.

Glimpses into the transition world: New graduate nurses' written reflections

BACKGROUND

This study was born out of our reflections as educators responsible for helping new graduate nurses transition into their first year of professional practice through a formal education programme. Finding ourselves wondering about many of the questions the students raised with us, we set about looking more closely at what could be gleaned from the students' experience, captured in their written work over the course of a year.

OBJECTIVES

To identify the challenges and learning experiences revealed in reflective assignments written by new graduate nurses undertaking a postgraduate course as part of their transition to registered nurse practice.

STUDY DESIGN, SETTING AND PARTICIPANTS

Data consisted of the written work of two cohorts of students who had completed a postgraduate university course as part of their transition to new graduate practice in New Zealand. Fifty four reflective essays completed by twenty seven participating students were collected and their contents analysed thematically.

RESULTS

Five key themes were identified. The students' reflections noted individual attributes - personal and professional strengths and weaknesses; professional behaviour - actions such as engaging help and support, advocating for patients' needs and safety and putting their own feelings aside; situational challenges such as communication difficulties, both systemic and interpersonal, and the pressure of competing demands. Students also identified rewards - results they experienced such as achieving the nursing outcomes they desired, and commented on reflection as a useful tool.

CONCLUSIONS

The findings shed light on the experiences of new graduates, and how they fare through this critical phase of career development. Challenges relating to the emotional labour of nursing work are particularly evident. In addition the reflective essay is shown to be a powerful tool for assisting both new graduate nurses and their lecturers to reflect on the learning opportunities inherent in current clinical practice environments.