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Liu X, He F, Tian T, Zhang J, Ji Y, Zhong Y. Self-compassion and work engagement among clinical nurses: the mediating role of moral resilience. Front Public Health 2025; 13:1507539. [PMID: 39902394 PMCID: PMC11788411 DOI: 10.3389/fpubh.2025.1507539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Accepted: 01/03/2025] [Indexed: 02/05/2025] Open
Abstract
Background As the workload of clinical nursing continues to increase, the mental health of nurses has emerged as a critical area of concern. Self-compassion, moral resilience, and work engagement are essential components in enhancing the mental health of clinical nurses. Although it is well-established that self-compassion significantly contributes to improved work engagement, there remains a notable lack of research investigating the specific mechanisms through which self-compassion influences work engagement, particularly from the perspective of moral resilience. This study aimed to address this gap by examining the relationships among self-compassion, moral resilience, and work engagement in clinical nurses, while also validating the mediating role of moral resilience in the relationship between self-compassion and work engagement. Methods This study utilized a convenience sampling method to conduct a cross-sectional online survey involving 844 clinical nurses from four tertiary A hospitals in Xi'an, China, between January and March 2024. Participants completed self-report questionnaires that included the Self-Compassion Scale, the Rushton Moral Resilience Scale, and the Utrecht Work Engagement Scale. The data analysis involved descriptive statistics, the Mann-Whitney U test, the Kruskal-Wallis H rank-sum test, Spearman correlation analysis, and the SPSS PROCESS macro. Results A significant positive correlation was observed between clinical nurses' self-compassion and moral resilience (r = 0.700, p < 0.01). Additionally, a significant positive correlation was identified between self-compassion and work engagement (r = 0.455, p < 0.01). Furthermore, there was a significant positive correlation between moral resilience and work engagement (r = 0.510, p < 0.01). Mediation analysis indicated that moral resilience partially mediates the relationship between clinical nurses' self-compassion and work engagement. The overall effect of self-compassion on work engagement (β = 0.493) consists of both a direct effect (β = 0.251) and an indirect effect mediated by moral resilience (β = 0.242). Notably, the mediating effect accounts for 49.09% of the total effect. Conclusion Clinical nurses' moral resilience plays a mediating role in the relationship between self-compassion and work engagement. Nursing managers should prioritize fostering and enhancing the self-compassion and moral resilience of clinical nurses to effectively elevate their levels of work engagement. These targeted interventions can ultimately improve not only the mental health and professional well-being of nurses but also the overall quality of care delivered in medical institutions.
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Affiliation(s)
| | | | | | | | | | - Yuexia Zhong
- Outpatient Department, The Second Affiliated Hospital of Air Force Military Medical University, Xi’an, China
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Moreno-Martínez M, Sánchez-Martínez I. The Associated Factors of Work Engagement, Work Overload, Work Satisfaction, and Emotional Exhaustion and Their Effect on Healthcare Workers: A Cross-Sectional Study. Healthcare (Basel) 2025; 13:162. [PMID: 39857189 PMCID: PMC11765034 DOI: 10.3390/healthcare13020162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2024] [Revised: 01/10/2025] [Accepted: 01/13/2025] [Indexed: 01/27/2025] Open
Abstract
Background: In today's fast-paced work environment, work engagement is crucial for both organizational success and individual well-being. Objective: Our aim is this study was to analyze the associated factors of work engagement, work overload, work satisfaction, and emotional exhaustion and describe their effect on nurses and physicians in the Central Catalonia Health Region during 2023. Methods: A multicenter cross-sectional study was conducted using an online questionnaire at the Territorial Management of Central Catalonia (Spain). The questionnaire was accessible from 28 November 2022 to 12 March 2023. The analysis was performed using the SPSS software. CHERRIES (Checklist for Reporting Results of Internet E-Surveys) guidelines were followed for communicating research results. Results: A total of 321 professionals answered the questionnaire, 60.7% of whom were nursing professionals and 39.3% of whom were medical professionals. Work overload, work satisfaction, and emotional exhaustion were associated with work engagement. Being a physician, permanent contracts, irregular work shifts, overtime, and salary were related to work overload and emotional exhaustion. Being a woman, salary, academic level, and irregular work shifts were related to work satisfaction. There was a gender inequality in work engagement among nursing professionals to the detriment of men. In terms of class inequality, there was a difference between occupational groups with respect to work overload and emotional exhaustion among women. Conclusions: Organizational practices need to be improved to promote greater engagement and work satisfaction, as well as to reduce emotional overload and exhaustion. This may include regulating unpaid overtime and promoting more stable working hours.
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Affiliation(s)
- Marina Moreno-Martínez
- Research and Innovation Unit, Primary and Community Care Management of Central Catalonia, 08242 Manresa, Spain
- Intelligence for Primary Care Research Group, Foundation University Institute for Research in Primary Care of Health Jordi Gol i Gurina, 08242 Manresa, Spain
- Faculty of Health Sciences, University of Manresa, 08242 Manresa, Spain
- Faculty of Health Sciences, International University of Valencia, 46002 Valencia, Spain
| | - Iván Sánchez-Martínez
- Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O) Research Group, Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research, University of Vic—Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), 08500 Vic, Spain
- Navarcles Primary Care Center, Primary and Community Care Management of Central Catalonia, Catalan Institute of Health, 08270 Navarcles, Spain
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Sawalma AN, Malak MZ, Asfour BY, Khader IA. The association between psychological reactions, resilience, and work engagement among Palestinian critical care nurses in West Bank. Int Nurs Rev 2024; 71:1088-1099. [PMID: 38661531 DOI: 10.1111/inr.12975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 04/03/2024] [Indexed: 04/26/2024]
Abstract
AIM This study aimed to assess the association between psychological reactions (e.g., stress, anxiety, and depression), resilience, and work engagement among Palestinian critical care nurses in the West Bank and examine the correlation of psychological reactions and resilience with work engagement. BACKGROUND Work engagement is associated with psychological reactions and resilience, particularly among critical care nurses. There is a lack of studies on work engagement and these factors in Palestine. METHODS A cross-sectional, descriptive correlational design was adopted. A convenience sample consisting of 273 critical care nurses from private and governmental hospitals was recruited to participate. Depression, Anxiety, Stress Scale-21 (DASS-21), Connor-Davidson Resilience Scale-25 (CDRS-25), Utrecht Work Engagement Scale-9 (UWES-9), and demographic data were used to collect data during the period from March 20 to May 20, 2023. RESULTS Findings demonstrated that 53.9% of the nurses reported mild-to-moderate levels of depression, 49.8% reported moderate-to-severe levels of anxiety, and 49.1% reported moderate-to-severe levels of stress. Additionally, 57.5% and 52.7% of them had low resilience and work engagement, respectively. Moreover, work engagement negatively correlated with depression (r = -0.796, P < 0.01), anxiety (r = -0.654, P < 0.01), and stress (r = -0.796, P < 0.01), while positively correlated with resilience (r = 0.42, P < 0.01) and gender (r = 0.121, P < 0.05). Depression, anxiety, stress, resilience, and gender were the main predictors of work engagement. DISCUSSION The majority of the nurses suffered from depression, anxiety, and stress. Additionally, more than half of the participants had low resilience and work engagement. Moreover, increased depression, anxiety, and stress were correlated with decreased work engagement, while high resilience and gender as being female positively correlated with high work engagement. CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY Policymakers and hospital administrators should develop interventions to improve critical care nurses' resilience and minimize psychological reactions, which have a significant influence on work engagement. Future studies should be conducted to examine the effectiveness of these interventions.
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Affiliation(s)
- Abdelrahman Nedal Sawalma
- Master in Critical Care Nursing, Faculty of Nursing, Arab American University of Palestine (AAUP), Jenin, Palestine
| | - Malakeh Z Malak
- Community Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Bara Y Asfour
- Business Administration Department, Faculty of Administration and Financial Services, Arab American University of Palestine (AAUP), Jenin, Palestine
| | - Imad Abu Khader
- Critical Care Nursing, Faculty of Nursing, Arab American University of Palestine (AAUP), Jenin, Palestine
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Penturij-Kloks M, Keijsers CJPW, Enting M, De Gans ST, Kilroy S, Scheele F, Joosen M. Work engagement of hospital workers in times of pressure: do nonclinical hospital workers react differently from their well-studied clinical colleagues? J Health Organ Manag 2024; ahead-of-print. [PMID: 39548678 DOI: 10.1108/jhom-03-2024-0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2024]
Abstract
PURPOSE While prevalence and value of nonclinical hospital workers, like quality or education professionals, increase, their work engagement is understudied. Work engagement of nonclinical and clinical hospital workers is critical considering the pressure of major challenges in healthcare. The pandemic was a natural experiment for this. DESIGN/METHODOLOGY/APPROACH We conducted an observational survey study among all nonclinical and clinical hospital workers of the Jeroen Bosch Hospital, the Netherlands. In an employee satisfaction survey, we measured work engagement under acute pressure (just after the first COVID-19 wave in July 2020) and chronic pressure (within the second COVID-19 wave in November 2020) and to what extent psychological demands and co-worker support were related to work engagement. FINDINGS For all hospital staff, "average" levels of work engagement were found under acute (response rate 53.9%, mean 3.94(0.81)) and chronic pressure (response rate 34.0%, mean 3.88(0.95)). Under acute pressure, nonclinical hospital workers scored lower on the subcategory dedication than clinical workers (mean 4.28(1.05) vs mean 4.45(0.99), p < 0.001). Under chronic pressure, no differences were found. For both nonclinical and clinical hospital workers, co-worker support was positively related to overall work engagement (beta 0.309 and 0.372). Psychological demands were positively related to work engagement for nonclinical hospital workers (beta 0.130), whereas in clinical hospital workers, psychological demands were negatively related to vigor (beta -0.082). PRACTICAL IMPLICATIONS Hospitals face times of pressure. Fostering co-worker support under pressure may be vital for hospital management. ORIGINALITY/VALUE Work engagement of nonclinical hospital workers is understudied.
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Affiliation(s)
- Monique Penturij-Kloks
- Department of Quality, Safety and Academy, Jeroen Bosch Ziekenhuis, Den Bosch, Netherlands
| | - Carolina J P W Keijsers
- Department of Academy, Jeroen Bosch Ziekenhuis, Den Bosch, Netherlands
- Department of Geriatric Medicine, Jeroen Bosch Ziekenhuis, Den Bosch, Netherlands
| | - Manon Enting
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Simon T De Gans
- Department of Academy, Jeroen Bosch Ziekenhuis, Den Bosch, Netherlands
| | - Steven Kilroy
- Trinity Business School, Trinity College, University of Dublin, Dublin, Ireland
| | - Fedde Scheele
- Faculty of Science, Athena Institute, VU Amsterdam, Amsterdam, Netherlands
| | - Margot Joosen
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
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Xu L, Lin L, Guan A, Wang Q, Lin F, Lin W, Li J. Factors associated with work engagement among specialist nurses in china: a cross-sectional study. BMC Nurs 2024; 23:356. [PMID: 38807107 PMCID: PMC11131242 DOI: 10.1186/s12912-024-02012-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 05/13/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND The positive impacts of work engagement among specialist nurses on retention, organizational commitment, and quality of care are well-documented. However, there is a lack of research on the specific differences in work engagement among specialist nurses. Therefore, the purpose of this study is to assess the level of work engagement among specialist nurses in China and identify its influencing factors. METHODS A descriptive cross-sectional study was conducted in China from April to July, 2023, with 724 nurses selected from 22 hospitals through convenience sampling involved. The survey was conducted by using self-administered general information questionnaires and work engagement scales. Questionnaire Star was employed as the online data collection tool. The collected data was analyzed by using descriptive statistics and stepwise regression analysis to draw meaningful conclusions from the study. RESULTS Among specialist nurses in Xiamen, China, who had a response rate of 97.10%, an average work engagement score is 140.35 (SD=18.17), with the highest score for the work attitude at 4.65 (SD=0.52) and the lowest score for the work recognition at 4.09 (SD=0.85). It was shown through regression analysis that factors such as career satisfaction, involvement in challenging case discussions, marital status, gender, presence of promotion advantage and title accounted for 14.5% of the total variance in the model and were significant explanatory variables that could predict work engagement. CONCLUSION It is shown that specialist nurses in Xiamen, China have a high level of work engagement. It is imperative for nursing managers to prioritize the work engagement of specialist nurses, provide the specialist nurses with ample development opportunities and room for growth, and effectively promote the overall development of specialist nurses by improving work engagement in various aspects.
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Affiliation(s)
- Lichun Xu
- Zhongshan Hospital Xiamen University, Xiamen, China.
- Xiamen Nursing Quality Control Centre, Xiamen, China.
| | - Liyu Lin
- Zhongshan Hospital Xiamen University, Xiamen, China
| | - Aixuan Guan
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | | | - Feng Lin
- Zhongshan Hospital Xiamen University, Xiamen, China
| | - Weicong Lin
- Zhongshan Hospital Xiamen University, Xiamen, China
| | - Jing Li
- Zhongshan Hospital Xiamen University, Xiamen, China
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Zhang J, Yang X, Zhang X, Liu Y, Liu M, Fang Y, Liu M, Wu M. Mediating effects of social support and presenteeism on turnover intention and post-traumatic stress disorder among Chinese nurses in the post-pandemic era: a cross-sectional study. Front Public Health 2024; 12:1323126. [PMID: 38420027 PMCID: PMC10899410 DOI: 10.3389/fpubh.2024.1323126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/30/2024] [Indexed: 03/02/2024] Open
Abstract
Background The shift in national policies for epidemic prevention and control in the post-pandemic era is undoubtedly a challenge for health care professionals. Nurses, as an important part of the health care professional population, have an even greater impact on their mental health and occupational safety. This may expose nurses to post-traumatic stress disorder (PTSD) and presenteeism, and ultimately lead to their turnover. Objective This study aimed to investigate the relationship between turnover intention and post-traumatic stress disorder among Chinese nurses during post-pandemic era, and the mediating role of social support and presenteeism. Methods In this study, a multicentre cross-sectional survey was conducted in April 2023 among nursing staff in several tertiary general hospitals in northern China, with online data collection using the Turnover intention Scale (PTSD), the Impact of Events Scale (IES), the Social Support Scale (SSS), and the Stanford presenteeism Scale (STAS) and the relationship between variables was analyzed using hierarchical multivariate regression, and Structural Equation Modeling (SEM) was used to analyze the relationship between post-traumatic stress disorder and the Turnover intention from the pathway between. Results Data were collected from 2,513 nurses who met the inclusion criteria, in which general information such as age, department, specific department, Professional title, history of alcohol consumption, form of employment, Years of working, and Average working hours per day were statistically significant with the difference in the turnover intention. The results of the study showed a 32% high turnover intention among nurses in the post-pandemic era, which was lower than the turnover intention during the pandemic. The results of hierarchical multiple regression analysis showed that post-traumatic stress disorder, social support, and presenteeism were significant predictors of turnover intention. The total effect of post-traumatic stress disorder on turnover intention to work was 0.472 [bias modified 95% confidence interval (0.415-0.483), p < 0.001]. Social support and attendance played a partially intermediate role in post-traumatic stress disorder and propensity to leave (an indirect effect of 26% of the total effect). Conclusion Turnover intention and post-traumatic stress disorder levels are high and social support plays an important role in the tendency to leave the job and post-traumatic stress disorder, healthcare institution can be achieved by strengthening social support for nurses in the post-epidemic era and preventing the occurrence of presenteeism.
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Affiliation(s)
- Jingshuo Zhang
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xin Yang
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xiaoman Zhang
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yuping Liu
- The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Mengshi Liu
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yu Fang
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Mengjie Liu
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Min Wu
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
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