Core Self-Evaluation and Burnout among Nurses: The Mediating Role of Coping Styles

Objectives

This study aimed to determine the potential association between core self-evaluation and the burnout syndrome among Chinese nurses, and the mediating role of coping styles in this relationship.

Methods

A cross-sectional survey was conducted in Shenyang, China, from May to July, 2013. A questionnaire which consisted of the Maslach Burnout Inventory-General Survey (MBI-GS), the Core Self-Evaluation Scale (CSE), and the Simplified Coping Style Questionnaire (CSQ), was completed by a total of 1,559 nurses. Hierarchical linear regression analyses and the Sobel test were performed to determine the mediating role of coping styles on the relationship between CSE and burnout.

Results

Nurses who had higher self-evaluation characteristics, reported less emotional exhaustion and cynicism, and higher professional efficacy. Coping style had a partial mediating effect on the relationship between CSE and the burnout syndrome among nurses.

Conclusions

Core self-evaluation had effects on burnout and coping style was a mediating factor in this relationship among Chinese nurses. Therefore, the improvement of coping strategies may be helpful in the prevention of burnout among nurses, thus enhancing professional performance.     

Correlates of professional burnout in a sample of employees of cell and tissue banks in Poland

Job Demands-Resources model proposes that the development of burnout follows excessive job demands and lack of job resources. Job demands are predictive of feeling of exhaustion, and lack of job resources—disengagement from work. This pilot study investigated professional burnout and its correlates in employees of Polish cell and tissue banks, many of whom were involved in procurement and processing of tissues from deceased donors, as it was hypothesized that job burnout in this population might influence the effectiveness of cell and tissue transplantation network in our country. This study utilized the Polish version of the Oldenburg Burnout Inventory (OLBI), which measures the two dimensions of burnout (exhaustion and disengagement), and the Psychosocial Working Conditions Questionnaire (PWC), a Polish instrument used for monitoring psychosocial stress at work. The study sample consisted of 31 participants. Their average time of working in a cell and tissue bank was 13.20 years. Majority of the PWC scales and subscales scores fell in the Average range, and the OLBI results for the Disengagement and the Exhaustion scales were in the Average range. A number of correlations between the Exhaustion or Disengagement and the PWC scales and subscales were detected, majority of which fell in the Moderate range. In spite of the limited number of participants, the results of this pilot study are consistent with the burnout literature reports. Among the detected correlates of professional burnout, it is job-related support which seems to be the most important factor which may influence the efficacy of transplantation network in Poland.     

The effect of social support and the work environment upon burnout among nurses

Burnout among hospital-based nurses appears to be a serious problem affecting the delivery of health care. Findings from previous empirical research indicate that burnout among these nurses results from reactions to adversities inherent in the hospital work environment, and that burnout can lead nurses to change jobs and/or abandon the practice of nursing. This paper presents and discusses research findings on the effects of various aspects of the hospital work environment on burnout among nurses, and, in addition, evaluates the effects of social support in reducing and/or mitigating the relationship between negative aspects of the work environment and burnout. A multiple regression approach is employed to test the hypothesized model. The data were collected from a sample of nurses (n = 310) employed at Fitzsimons Army Medical Center (FAMC), Aurora, Colorado. The major determinants of burnout were found to be low job enhancement (autonomy, task orientation, clarity, innovation, and physical comfort); work pressure; and lack of supervisor support, along with the interaction term involving the combined effects of job enhancement and supervisor support. These predictors, in conjunction with demographic and job-related variables explained 53% of the variance in emotional exhaustion, a central component of the burnout syndrome.     

护士职业压力与职业倦怠的相关性研究

目的:了解护士职业压力、职业倦怠现状;探讨两者之间的关系。方法:方便抽样,抽取哈尔滨市5所三级医院的468名护士进行问卷调查。采用护士一般情况调查表、护士工作压力源量表、职业倦怠量表进行调查。结果:护士职业倦怠程度为中等,去人格化属于中度倦怠,情感衰竭、低成就感程度达到了高度倦怠;职业压力得分为87.56±20.43,以工作量及时间分配维度压力最高,病人护理维度压力最低。情感耗竭与除工作环境及资源之外的职业压力维度呈显著正相关;去人格化与职业压力各维度均呈显著正相关;低成就感与职业压力中护理专业及工作、病人护理呈显著负相关(P0.05)。护士职业压力各维度对其职业倦怠的3个维度均有较好的预测作用,尤其对护士情感耗竭的解释程度达25.5%。结论:护士职业倦怠现象不容忽视,护理管理者有针对性的对护士进行管理,鼓励护士加强自身修养、学会自我疏导,适当授权等是降低护士职业倦怠的正性激励措施。     

The Mediating Role of Coping Style in the Relationship between Psychological Capital and Burnout among Chinese Nurses

Background

Burnout is recognized as an occupational hazard, and nursing has a high risk of burnout. This study aims to explore the relationship between psychological capital (PsyCap) and burnout among Chinese nurses and the mediating role of coping style in this relationship.

Methods

A total of 1,496 nurses (effective response rate: 80.11%) from two large general hospitals in Daqing City of China were selected as participants. Data were collected via the Chinese Maslach Burnout Inventory (CMBI), the psychological capital questionnaire (PCQ-24), the Chinese Trait Coping Style Questionnaire (TCSQ) and demographic and caregiver-patient relationship. Hierarchical linear regression analyses were performed to explore the mediating role of positive coping and negative coping, and we used the Bootstrap method to confirm the mediating effect.

Results

Self-efficacy, hope, resilience and optimism of nurses were all negatively related with emotional exhaustion, depersonalization and reduced personal accomplishment among Chinese nurses. Positive coping partially mediated the relationship between hope/optimism and emotional exhaustion and between self-efficacy/optimism and reduced personal accomplishment. Negative coping fully mediated the relationship between self-efficacy and emotional exhaustion, and in the regression model self-efficacy was positively correlated with emotional exhaustion. And negative coping also partially mediated the relationship between hope/optimism and emotional exhaustion and between optimism and depersonalization.

Conclusion

PsyCap had effects on burnout and coping style was a mediator in this relationship among Chinese nurses. Nurses who had a strong sense of self-efficacy adopted more negative coping style, which in turn would lead to higher levels of emotional exhaustion. These findings shed light on the influence of negative coping on burnout, and positive coping was a positive resource for fighting against nurses’ burnout. Hence, in order to avoid negative coping style, improve skill of coping and enhance PsyCap of nurses, active interventions should be developed in the future.     

The Impact of Psychological Capital on Job Burnout of Chinese Nurses: The Mediator Role of Organizational Commitment

Background

Nursing has a high risk of job burnout, but only a few studies have explored its influencing factors from an organizational perspective.

Objective

The present study explores the impact of psychological capital on job burnout by investigating the mediating effect of organizational commitment on this relationship.

Methods

A total of 473 female nurses from four large general hospitals in Xi’an City of China were selected as participants. Data were collected via the Psychological Capital Questionnaire, the Maslach Burnout Inventory-General Survey, and the Organizational Commitment Scale.

Results

Both psychological capital and organizational commitment were significantly correlated to job burnout. Structural equation modelling indicated that organizational commitment partially mediated the relationship between psychological capital and job burnout.

Conclusion

The final model revealed a significant path from psychological capital to job burnout through organizational commitment. These findings extended prior reports and shed some light on the influence of psychological capital on job burnout.     

Psychosocial Work Environment and Musculoskeletal Symptoms among 21-Year-Old Workers: A Population-Based Investigation (2011-2013)

Background

The current labour market is becoming more flexible and informal, with job insecurity selectively affecting young workers. However, the role of these increasing adverse psychosocial working conditions on health outcomes remains little known among newly employed workers.

Objective

To estimate the associations between psychosocial work environment and musculoskeletal outcomes (widespread pain syndrome features and regional pain) in a population-based sample of young workers.

Methods

Cross-sectional data from workers aged 21 years were collected during the third wave of the EPITeen cohort study (2011-2013; n=650). The Job Content Questionnaire was used to characterize the psychosocial work environment according to the demand-control-support model. Data on pain and non-pain dimensions of the widespread pain syndrome (Fibromyalgia Survey Questionnaire) as well as on regional musculoskeletal pain (Nordic Musculoskeletal Questionnaire) were also collected. Crude and adjusted odds ratios (OR) with 95% confidence intervals (95% CI) were computed using logistic regression and all estimates were adjusted for sex, education and occupational biomechanical demands.

Results

Job insecurity was significantly associated to the non-pain dimension of the widespread pain syndrome (adjusted OR [95% CI]=1.51 [1.08, 2.12]). Young workers with strain jobs were significantly more likely to report high levels of non-pain symptoms when compared with those with no-strain jobs and this effect was even stronger when social support was added to the main exposure: workers with strain jobs and low social support had twice the odds of reporting high levels of non-pain features than those with high strain but high social support jobs (adjusted OR=1.86, 95% CI: 1.04, 3.31). These significant associations were not observed when widespread pain or multisite regional pain were the outcomes.

Conclusion

In the beginning of professional life, high strain jobs were associated to non-pain complaints, especially when the work environment provided also low social support.     

Comparative effects of water immersion pretreatment on three different acute pancreatitis models in rats.

Cells respond to stress by upregulating the synthesis of cytoprotective heat shock proteins (HSPs) and antioxidant enzymes. The aim of this study was to compare the effects of cold (CWI) or hot water immersion (HWI) stress on three different acute pancreatitis models (cholecystokinin octapeptide (CCK), sodium taurocholate (TC), and L-arginine (Arg)). We examined the levels of pancreatic HSP60, HSP72, and antioxidants after the water immersion stress. Male Wistar rats were injected with CCK, TC, or Arg at the peak level of pancreatic HSP synthesis, as determined by Western blot analysis. HWI significantly elevated HSP72 expression and CWI significantly increased HSP60 expression in the pancreas. Water immersion stress decreased the levels of pancreatic antioxidants. CWI and-HWI pretreatment ameliorated most of the examined laboratory and morphological parameters of CCK-induced pancreatitis. CWI pretreatment decreased pancreatic edema and the serum amylase level; however, the morphological damage was more severe in TC-induced acute pancreatitis. Overall, CWI and HWI pretreatment only decreased the serum cytokine concentrations in Arg-induced pancreatitis. CWI and HWI resulted in differential induction of pancreatic HSP60 and HSP72 and the depletion of antioxidants. The findings suggest the possible roles of HSP60 and (or) HSP72 (but not that of the antioxidant enzymes) in the protection against CCK- and TC-induced acute pancreatitis. Unexpectedly, CWI pretreatment was detrimental to the morphological parameters of TC-induced pancreatitis. It was demonstrated that CWI and HWI pretreatment only influenced cytokine synthesis in Arg-induced pancreatitis.     

Burnout phenomenon and its occupational risk factors among Japanese hospital nurses.

To identify and evaluate recent working conditions and job content of hospital nurses in Japan, as well as the prevalence of the burnout phenomenon and the occupational risk factors responsible for it, a questionnaire survey was carried out. The subjects consisted of 898 nurses and 255 municipal service workers as the control group. Working conditions and workload burdens were more severe among nurses than among the municipal workers. The burnout phenomenon among the nurses was characterized by emotional exhaustion as well as depersonalization. Moreover, the rate ratio and multivariate analyses indicated that a great variety of occupational factors, not only interpersonal relationships, but the general working conditions and specific physical or mental workloads influenced the burnout phenomenon as well. Therefore, in examining measures dealing with the burnout phenomenon among nurses, it is considered important to evaluate the occupational factors systematically and comprehensively.     

Affective and Personality Characteristics in Function of Nightmare Prevalence, Nightmare Distress, and Interference Due to Nightmares.

This study analyzes the relationships among nightmare frequency, nightmare distress, and interference due to nightmares, sleep quality, psychopathology (anxiety and depression), and personality (neuroticism, psychoticism, and boundaries). The nightmare parameters were evaluated with the Nightmare Frequency Questionnaire (B. Krakow et al., 2000; see also record 2000-16731-002), the Nightmare Distress Questionnaire (K. Belicki, 1992b; see also record 1993-08389-001), and the Nightmare Effects Survey (Krakow et al., 2000). The sample was composed of 147 healthy students. The results demonstrated that the 2 measurements of distress (subjective distress associated with nightmares and, especially, deterioration of psychosocial functioning) were the dimensions that best related to the variables studied, although the relationships were modulated by nightmare frequency. The parameter of nightmare frequency was found to be useful as an indicator of certain personality characteristics rather than psychological perturbation. Having nightmares on a weekly basis was strongly associated with depressed mood. The knowledge about these relations is relevant not only theoretically but also as a practical guide. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Late chronotype and high social jetlag are associated with burnout in evening-shift workers: Assessment using the Chinese-version MCTQshift

Chronotypes are associated with shift work tolerance and sleep in shift workers, and sleep mediates the impact of shift work on mental health. However, the role of chronotype in the association between shift work and mental health has not been clarified. In this study, we aimed to examine the association between chronotype and burnout in shift workers, using the validated Munich ChronoType Questionnaire for shift workers (MCTQ^shift). A total of 288 shift workers with irregular shift frequencies were recruited and completed the Chinese-version MCTQ^shift and the Morningness–Eveningness Questionnaire (MEQ). Chronotypes were assessed by the calculation of corrected mid-sleep time (MSF_SC) from mid-sleep time on free days (MSF) based on their exact shift schedules. Another 26 evening-shift nurses were monitored with actigraphy for at least two consecutive evening shifts and the following two free days. Burnout was evaluated using the Copenhagen Burnout Inventory. We found that MSF^E_SC, MSF^E and mid-sleep time on workdays (MSW^E) had normal distributions and correlated significantly with MEQ scores (r = ? 0.47, ?0.45 and ?0.47, respectively; all p < 0.001). MSW was more closely correlated with actigraphy-derived mid-sleep time on the free day before workdays than that on workdays (r = 0.61 and 0.48, respectively, p < 0.05). Sleep duration was significantly longer on workdays among evening-shift workers who slept late on workdays than those who slept early (β = 0.59, p < 0.001). After demographic and work characteristics were adjusted for in linear regression models, late chronotype and high social jetlag were associated with burnout scores in evening-shift workers. In conclusion, the Chinese-version MCTQ^shift is a valid tool for chronotype assessment. Interventions to improve sleep in shift workers should be tailored to chronotype due to variations in sleep behavior. Late chronotype may be an inherent feature of mental health problems, because the association with burnout was significant in both day workers in previous studies and shift workers.     

Daily and yearly burnout symptoms in Israeli shift work residents

Burnout is a syndrome of physical and emotional exhaustion that develops among individuals who are open to public demands. In view of their heavy work load and sleep deprivation, we decided to evaluate the impact of long working hours on burnout and psychological status among a sample of residents during the first 2 years of their residency. Seventy-eight residents participated in the study, all residents completed self-administered questionnaires, and their sleep-wake cycle was monitored by a wrist-worn actigraph for a period of 5-7 days. The questionnaires included a short form suitable for Experience Sampling Method (ESM), and a longer background Questionnaire. The results revealed that sleep duration, Work Load and the interaction between them, explain the Negative Mood the day after the night shift. However, positive mood, and fatigue were not affected by sleep duration or workload. In general, after one year of residency, residents become more stressed, less involved in the job, and had a high level of burnout and psychosomatic symptoms. However, after the second year, the burnout symptoms were almost the same as at the beginning except for the level of stress that remained high. Sleep duration was unrelated to the burnout symptoms.     

Burnout syndrome--assessment of a stressful job among intensive care staff

The purpose of the study was to investigate the degree of burnout experienced by intensive care staff particularly, in Medical (MICU) and Surgical Intensive Care Units (SICU) General Hospital "Sveti Duh", Zagreb. A sample group of 41 emergency physicians and nurses from MICU and 30 from SICU was tested. The survey included demographic data and Maslach Burnout Inventory (MBI) scoring test identified by the three main components associated with burnout: emotional exhaustion (MBI-EE), depersonalization (MBI-DEP), and personal accomplishment (MBI-PA) were assessed using 22-item questionnaire. The degrees of burnout were stratified into low, moderate, and high range. Mean total MBI (X +/- SD) were high in both groups: higher for the MICU (65.5 +/- 6.7) than for SICU staff (55.7 +/- 3.8, p < 0.05). MICU staff showed moderate degree of MBI-EE (24.9 +/- 11.2), MBI-DEP (6.0 +/- 5.6), and as well as MBI-PA (34.4 +/- 8.8). The same parameters showed better results among SICU staff: low degree of MBI-EE (17.1 +/- 5.2), as well as low level of MBI-DEP (5.2 +/- 5.0), and moderate degree of MBI-PA (33.7 +/- 9.8). The differences between the groups was statistically significant only for the total MBI, and for MBI-EE (p < 0.05). There were no significant differences between MICU and SICU staff for MBI-DEP or MBI-PA parameters. Overall job burnout represented in a moderate degree. The presence of burnout is a serious phenomenon, because it can lead to psychosomatic complaints, work-associated withdrawal behaviour, and a lower quality of care at intensive care units. Early recognition of burnout phenomenon as a result of prolonged stress and frustration among intensive care staff, contributes to better professional behavior, organizational structure changes in the work environment and better health care quality for critically ill patients.     

Constraints to exclusive breastfeeding practice among breastfeeding mothers in Southwest Nigeria: implications for scaling up

Background

The practice of exclusive breastfeeding is still low despite the associated benefits. Improving the uptake and appropriating the benefits will require an understanding of breastfeeding as an embodied experience within a social context. This study investigates breastfeeding practices and experiences of nursing mothers and the roles of grandmothers, as well as the work-related constraints affecting nurses in providing quality support for breastfeeding mothers in Southwest Nigeria.

Methods

Using a concurrent mixed method approach, a structured questionnaire was administered to 200 breastfeeding mothers. In-depth interviews were also held with breastfeeding mothers (11), nurses (10) and a focus group discussion session with grandmothers.

Results

Breastfeeding was perceived as essential to baby's health. It strengthens the physical and spiritual bond between mothers and their children. Exclusive breastfeeding was considered essential but demanding. Only a small proportion (19%) of the nursing mothers practiced exclusive breastfeeding. The survey showed the major constraints to exclusive breastfeeding to be: the perception that babies continued to be hungry after breastfeeding (29%); maternal health problems (26%); fear of babies becoming addicted to breast milk (26%); pressure from mother-in-law (25%); pains in the breast (25%); and the need to return to work (24%). In addition, the qualitative findings showed that significant others played dual roles with consequences on breastfeeding practices. The desire to practice exclusive breastfeeding was often compromised shortly after child delivery. Poor feeding, inadequate support from husband and conflicting positions from the significant others were dominant constraints. The nurses decried the effects of their workload on providing quality supports for nursing mothers.

Conclusion

Breastfeeding mothers are faced with multiple challenges as they strive to practice exclusive breastfeeding. Thus, scaling up of exclusive breastfeeding among mothers requires concerted efforts at the macro, meso and micro levels of the Nigerian society.     

三甲综合医院住院医师职业倦怠现状调查与影响因素分析

目的:探究三甲综合医院住院医师职业倦怠的发生现状及其影响因素,为预防三甲综合医院住院医师发生职业倦怠提供依据。方法:选择三甲综合医院各临床住院医师218名为研究对象,采用问卷调查住院医师性别、年龄、文化程度、职务、婚姻状况、职称、工作时间、编制及身体健康情况等基线资料及职业倦怠程度,采用logistics回归分析住院医师职业倦怠的影响因素。结果:218例三甲住院医师中119例人(54.59%)发生职业倦怠,其中轻度倦怠者60人(27.52%),中度倦怠者49人(22.48%),重度倦怠者10人(4.59%);身体健康状况一般、差(OR=1.547,5.342;P0.05)是住院医师发生职业倦怠的危险因素,职称为初级、中级、副高及以上(OR=0.893,0.827,0.736;P0.05)是住院医师发生职业倦怠的保护因素。结论:三甲住院医师职业倦怠发生的现状不容乐观,无编制、身体健康状况一般、差是住院医师发生职业倦怠的危险因素,职称为初级、中级、副高及以上是住院医师发生职业倦怠的保护因素。     

Chronobiological factors for compassion satisfaction and fatigue among ambulatory oncology caregivers

Primary caregivers for victims of chronic illness and or trauma experience both positive and negative emotional consequences. These are broadly classified as compassion satisfaction (CS) and compassion fatigue (CF). Because one of the components of CF, burnout, varies with chronotype and sleep quality, we assessed the influence of chronobiological features on the broader constructs of CS and CF. Responses from primary ambulatory care oncology staff working dayshifts were assessed for potential relationships of chronotype and sleep quality with CS and CF using the professional quality of life scale. These were analyzed further in a multivariate model that included personality and job satisfaction as cofactors. We found that sleep quality was a key contributor to CS development and CF reduction. Morningness was positively linked to CS, but the univariate association was masked in the multivariate model. Job satisfaction (contingent rewards, nature of work and operating procedures) heavily influenced CS and CF development. Agreeableness and openness showed positive correlations with CS and negative with burnout, while emotional stability was linked to reduced CF. While job satisfaction and personality predictably played roles in the development of CS and CF, sleep quality and chronotype contributed significantly to benefits and negative consequences of providing care.     

Insomnia,Excessive Sleepiness,Excessive Fatigue,Anxiety, Depression and Shift Work Disorder in Nurses Having Less than 11 Hours in-Between Shifts

Study objective

To assess if less than 11 hours off work between work shifts (quick returns) was related to insomnia, sleepiness, fatigue, anxiety, depression and shift work disorder among nurses.

Methods

A questionnaire including established instruments measuring insomnia (Bergen Insomnia Scale), sleepiness (Epworth Sleepiness Scale), fatigue (Fatigue Questionnaire), anxiety/depression (Hospital Anxiety and Depression Scale) and shift work disorder was administered. Among the 1990 Norwegian nurses who participated in the study; 264 nurses had no quick returns, 724 had 1–30 quick returns and 892 had more than 30 quick returns during the past year. 110 nurses did not report the number of quick returns during the past year. The prevalence of insomnia, excessive sleepiness, excessive fatigue, anxiety, depression and shift work disorder was calculated within the three groups of nurses. Crude and adjusted logistic regression analyses were performed to assess the relation between quick returns and such complaints.

Results

We found a significant positive association between quick returns and insomnia, excessive sleepiness, excessive fatigue and shift work disorder. Anxiety and depression were not related to working quick returns.

Conclusions

There is a health hazard associated with quick returns. Further research should aim to investigate if workplace strategies aimed at reducing the number of quick returns may reduce complaints among workers.