The relationship between organizational support, professional quality of life, decent work, and professional well-being among nurses: a cross-sectional study.

BACKGROUND: Nurses often face challenges such as inadequate welfare protection, injustice, and workplace adversity including violence, bullying, and sexual harassment. In this context, providing sufficient support to nurses is crucial for the promotion of their professional well-being. This study examines the direct and indirect effects of perceived organizational support on nurses' well-being, particularly highlighting the mediating roles of professional quality of life and the perception of decent work. METHODS: A cross-sectional survey design was employed in this study. Convenience sampling was used to survey 792 nurses from five tertiary A-grade hospitals in Shanxi Province in January 2024. Data collection tools included a custom demographic survey, the Perceived Organizational Support Scale, Professional Quality of Life Scale, Decent Work Perception Scale, and Nurse Occupational Well-being Questionnaire. Descriptive statistics, correlation analysis, and mediation effect analyses were performed. RESULTS: The findings demonstrate that perceived organizational support has a direct impact on nurses' occupational well-being (ß = 0.323, p < 0.001). Additionally, professional quality of life and the perception of decent work play chain mediating roles between perceived organizational support and nurses' well-being (ß = 0.019, BootLLCI = 0.010, BootULCI = 0.030). CONCLUSIONS: This study highlighted the importance of organizational support in enhancing nurses' well-being. Professional quality of life and decent work were key mediators. Healthcare institutions should prioritize support measures to improve nurses' well-being. Future research should explore additional mediators and mechanisms to develop effective strategies for nursing policymakers and administrators.

Exploring key job demands and resources in Norwegian child mental health services: a cross-sectional study of associations with and relationship between compassion satisfaction, burnout, secondary traumatic stress and turnover intention.

Background: Burnout, secondary traumatic stress, and high turnover rates among child mental health clinicians are a challenge, not only for the individual therapist and the organization but also for the successful implementation of evidence-based practices. However, little is known about which and how job-and implementation-related factors are associated with burnout, secondary traumatic stress, and turnover intention as well as compassion satisfaction among child therapists. In the present study, we aimed to explore these factors and related mechanisms by integrating the "professional quality of life" and the "job demands-resources" models of occupational health. Methods: We measured the perceived professional quality of life and turnover intention among a national sample of 256 therapists working in Norwegian Child and Adolescence Mental Health Clinics (n = 44) that implemented Trauma-Focused Cognitive Behavior Therapy (TF-CBT). Seventeen Job-and implementation-related resources and demands were also measured using the General Nordic Questionnaire for Psychological and Social Factors at Work and the Implementation Component Questionnaire. Path analysis was used to test whether burnout and compassion satisfaction mediate the relationship between job demands and resources on one hand, and secondary traumatic stress and turnover intention on the other hand. Results and discussion: Results revealed that two job resources, i.e., positive challenges at work and mastery of work, were significant predictors of all professional outcomes. The proposed model was only partly supported. That is, while burnout did mediate the relationship between some job demands (i.e., work-family interference and role conflict) and job resources (i.e., human resource primacy, positive challenges, and mastery of work) with secondary traumatic stress and turnover intention, compassion satisfaction did not mediate the relationship between job resources and turnover intention. Moreover, in addition to their indirect effects via burnout, role conflict and organizational climate (human resource primacy) also directly affected turnover intention. These findings propose that interventions that reduce burnout should be prioritized to improve the professional quality of life and turnover intention among child therapists. Theoretically, it seems that compassion satisfaction and work engagement act differently.

The Mindful Helping and Self-Care Model: Mindful Self-Care and Quality of Life Among a Racially Balanced Sample of Helping Professionals.

This study explored the Mindful Helping and Self-Care model and validated the Mindful Self-Care Scale (MSCS) among three racially balanced samples of helping professionals (n = 1,534). The study employed a cross-sectional, self-report design. The racial representation of participants was American Indian (n = 68), Asian (n = 351), African American (n = 384), Latino (n = 325), White (n = 301), and other (n = 114). The MSCS (33 items) showed good internal structure and measurement invariance to support generalizability across the three groups studied. With parsimony for application development, the Brief-MSCS (24 items) had a stronger internal structure across the three groups. Mindful self-care and secondary traumatic stress mediated the relationship between burnout and compassion satisfaction, as the total effects were greater than the direct effects. Mindful self-care practices were associated with reduced burnout risk. Mediation analysis results supported the Mindful Helping and Self-Care model. The empirical foundation for the 33-item MSCS and 24-item Brief-MSCS is further supported in this study. Both are excellent instruments for measuring mindful self-care factors in helping professionals using a behavioral frequency approach in a weekly time context. The Brief-MSCS is a more concise measure, making it particularly useful for application development. The reliability, construct, and concurrent validity of the MSCS and Brief-MSCS were confirmed. Mind-body practice is self-care; expressions vary by racial group and are associated with overall wellness. Future research should focus on professionals and cultures outside North America.

Measuring provider well-being: initial validation of a brief engagement survey.

BACKGROUND: Measurement is one of the critical ingredients to addressing the well-being of health care professionals. However, administering an organization-wide well-being survey can be challenging due to constraints like survey fatigue, financial limitations, and other system priorities. One way to address these issues is to embed well-being items into already existing assessment tools that are administered on a regular basis, such as an employee engagement survey. The objective of this study was to assess the utility of a brief engagement survey, that included a small subset of well-being items, among health care providers working in an academic medical center. METHODS: In this cross-sectional study, health care providers, including physicians and advanced clinical practitioners, employed at an academic medical center completed a brief, digital engagement survey consisting of 11 quantitative items and 1 qualitative item administered by Dialogue™. The emphasis of this study was on the quantitative responses. Item responses were compared by sex and degree, domains were identified via exploratory factor analysis (EFA), and internal consistency of item responses was assessed via McDonald's omega. Sample burnout was compared against national burnout. RESULTS: Of the 791 respondents, 158 (20.0%) were Advanced Practice Clinicians (APCs), and 633 (80.0%) were Medical Doctors (MDs). The engagement survey, with 11 items, had a high internal consistency with an omega ranging from 0.80-0.93 and was shown, via EFA, to have three domains including communication, well-being, and engagement. Significant differences for some of the 11 items, by sex and degree, in the odds of their agreement responses were found. In this study, 31.5% reported experiencing burnout, which was significantly lower than the national average of 38.2%. CONCLUSION: Our findings indicate initial reliability, validity, and utility of a brief, digital engagement survey among health care professionals. This may be particularly useful for medical groups or health care organizations who are unable to administer their own discrete well-being survey to employees.

Teachers' contributions to the school climate and using empathy at work: implications from qualitative research in two European countries.

This research aimed to reveal the factors that, based on their experiences, teachers consider important in their contribution to a positive school climate and in their relationship with students when it comes to using empathy. Teachers from two European countries-Latvia (n = 83) and Lithuania (n = 69)-participated in the research. Data were collected through focus group-based interviews and analyzed using latent qualitative content analysis. The results revealed the teachers' shared understanding of the importance of communication and professional development. However, only Lithuanian teachers emphasized strengthening institutional values and other more collectivistic aspects; the answers of Latvian teachers were specific and suggested more of an individualistic attitude, like allocating personal responsibility to use appropriate instructional strategies. This study draws attention to contextual and cultural factors of teachers' work and actualizes their educational needs.

Using Project ECHO to Keep Professionals Well at Work: Individual and Organizational Outcomes.

OBJECTIVE: The toll of COVID-19 stress on the mental health of the workforce has been well-documented. The present study examined the use of the Project ECHO framework to provide practices and resources on stress management and emotion regulation to increase individual and organizational health and well-being. METHODS: Three independent ECHOs were designed and conducted over an 18-month period. Data was collected on the implementation of new learning and comparisons of organizational efforts toward being more secondary trauma responsive from baseline to post initiative, using cloud-based survey methods. RESULTS: Findings suggest that the use of micro-interventions at the organizational level improved over time in the areas of resilience-building and policy-making, and that individuals were actively integrating skills related to managing their stress. CONCLUSIONS: Lessons learned adapting and implementing ECHO strategies in the midst of a pandemic are offered, as well as how to cultivate wellness champions in the workforce.

Working in value-discrepant environments inhibits clinicians' ability to provide compassion and reduces well-being: A cross-sectional study.

BACKGROUND: The practice of compassion in healthcare leads to better patient and clinician outcomes. However, compassion in healthcare is increasingly lacking, and the rates of professional burnout are high. Most research to date has focused on individual-level predictors of compassion and burnout. Little is known regarding how organizational factors might impact clinicians' ability to express compassion and well-being. The main study objective was to describe the association between personal and organizational value discrepancies and compassion ability, burnout, job satisfaction, absenteeism and consideration of early retirement among healthcare professionals. METHODS: More than 1000 practising healthcare professionals (doctors, nurses and allied health professionals) were recruited in Aotearoa/New Zealand. The study was conducted via an online cross-sectional survey and was preregistered on AsPredicted (75407). The main outcome measures were compassionate ability and competence, burnout, job satisfaction and measures of absenteeism and consideration of early retirement. RESULTS: Perceived discrepancies between personal and organizational values predicted lower compassion ability (B = -0.006, 95% CI [-0.01, -0.00], p < 0.001 and f 2  = 0.05) but not competence (p = 0.24), lower job satisfaction (B = -0.20, 95% CI [-0.23, -0.17], p < 0.001 and f 2  = 0.14), higher burnout (B = 0.02, 95% CI [0.01, 0.03], p < 0.001 and f 2  = 0.06), absenteeism (B = 0.004, 95% CI [0.00, 0.01], p = 0.01 and f 2  = 0.01) and greater consideration of early retirement (B = 0.02, 95% CI [0.00, 0.03], p = 0.04 and f 2  = 0.004). CONCLUSIONS: Working in value-discrepant environments predicts a range of poorer outcomes among healthcare professionals, including hindering the ability to be compassionate. Scalable organizational and systems-level interventions that address operational processes and practices that lead to the experience of value discrepancies are recommended to improve clinician performance and well-being outcomes.

The impact of job-related stress on township teachers' professional well-being: A moderated mediation analysis.

This study aimed to explore the relationship between job-related stress and township teachers' professional well-being. Based on Job Demand-Resource Model, this study examined the mediating role of teachers' professional identity and the moderating role of perceived organizational support in this relationship. A total of 24,276 township teachers in China responded to the Teacher Stress Scale, the Teachers' Professional Identity Scale, the Teachers' Professional Well-Being Structure Questionnaire, and the Perceived Organizational Support Scale. Results showed that: (1) the professional well-being of township teachers differed significantly in terms of school type and demographic characteristics like age and gender; (2) job-related stress negatively predicted township teachers' professional well-being, with teachers' professional identity playing a mediating role; (3) the relation between job-related stress and teachers' professional identity was moderated by perceived organizational support; and (4) in the moderated mediation analysis, job-related stress positively predicted township teachers' professional well-being. These findings indicated that township teachers' professional well-being was influenced by both organizational and individual factors, which provided a theoretical basis and intervention pathways for improving township teachers' professional well-being.

"Title does not dictate behavior": Associations of formal, structural, and behavioral brokerage with school staff members' professional well-being.

Individuals in brokerage positions are vital when further developing complex organizations with multiple subgroups only loosely coupled to each other. Network theorists have conceptualized an individual's brokerage as the degree to which a person occupies a bridging position between disconnected others. Research outside the school context has indicated for quite some time that an individual's social capital in the form of brokerage is positively associated with professional development-not only on a collective but also on an individual level. Schools are without any doubt complex organizations with multiple loosely connected stakeholders involved when further developing their educational practice. Thus, it is not surprising that in recent years, the concept of brokerage has gained interest in research on school improvement as well. Up to now, in school improvement research brokerage has been operationalized in different ways: as individuals' formal entitlement to act as intermediaries (formal brokerage), their position within a social network (structural brokerage), or their behavior when linking disconnected groups of staff members (behavioral brokerage). As these perspectives have often been examined separately, this study, as a first step, aimed to simultaneously assess school staff members' formal, structural, and behavioral brokerage, and examine their degree of interrelatedness. In a second step, associations of brokerage with professional well-being were analyzed. Even though there is evidence for the positive impact of brokerage on professional development, only little is known about its associations with professional well-being. In a third step, interaction effects were examined when formal brokerage is congruent or incongruent with other facets of brokerage. Based on a sample of 1,316 school staff members at 51 primary schools in the German-speaking part of Switzerland, we conducted both bivariate correlational and multiple-group structural equation modeling analyses. The findings revealed that formal, structural, and behavioral brokerage are interrelated facets. However, formal entitlement did not determine either structural position or behavior. Moreover, brokerage within schools was only partially related to professional well-being. In the discussion section, the study's key contributions and practical implications are presented in detail.

Contributors to and consequences of burnout among clinical genetic counselors in the United States.

Prior research has found that many genetic counselors (GCs) experience burnout. Studies of other clinicians have demonstrated that burnout can have significant detrimental consequences for clinicians, patients, and the healthcare system. We sought to explore the prevalence of, contributors to, and consequences of burnout among GCs. We performed a secondary data analysis of baseline data from Me-GC, a randomized controlled trial of meditation for GCs. We applied a systems model of burnout proposed by the National Academy of Medicine (NAM), which depicts burnout arising from a combination of contributors that include both work system and individual mediating factors, and then leading to consequences. Validated self-report scales were used to measure burnout and most contributors and consequences. Female and white GCs were over-represented in our sample. Over half (57.2%) of the 397 participants had Professional Fulfillment Index scores indicative of burnout. Multiple potential contributors were associated with burnout, consistent with its known multifactorial nature. Among work system factors, higher levels of burnout were associated with insufficient administrative support, lack of autonomy, and not feeling valued by non-GC colleagues. Individual mediating factors associated with greater burnout included higher levels of anxiety, depression, and stress. Participants with lower levels of burnout reported greater mindfulness, resilience, and use of professional self-care behaviors. Among variables categorized as consequences, higher levels of burnout were associated with lower levels of empathy, counseling alliance, and positive unconditional regard, as well as higher reactive distress, and a greater desire to reduce the amount of time spent on clinical care. Given the prevalence and potential consequences of burnout observed here, it is imperative that the field take steps to mitigate burnout risk.

'Grounding a PIE in the sky': Laying empirical foundations for a psychologically informed environment (PIE) to enhance well-being and practice in a homeless organisation.

While psychologically informed environments (PIEs) are gaining in prominence in efforts to improve well-being and practice in the homeless sector, their empirical foundations remain tenuous. We present a unique scoping needs analysis of staff and client well-being, staff attitudes and the social-therapeutic climate in a UK-based homeless prevention organisation (prior to PIE implementation). Our aims were: (a) to apply a robust framework to pinpoint need and target forthcoming PIE initiatives and (b) to establish a validated needs baseline that informs and measures efficacy of PIE for its future development. Four established personal and practice well-being measures were administered to 134 (predominantly 'frontline') staff and 50 clients. Staff completed the: Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), Professional Quality of Life Scale (measuring compassion satisfaction [CS], burnout [BO] and secondary traumatic stress [STS]), Attitudes related to Trauma-informed Care Scale (ARTIC-10; measuring practice attitudes towards trauma-informed values) and the Essen Climate Evaluation Schema (EssenCES; measuring perceptions of client cohesion, safety and practitioner relationships in housing projects). Clients completed the WEMWBS and EssenCES. Vulnerability to STS was evident in nearly two-thirds of frontline staff and it was a statistically significant predictor of BO. It was not, however, associated with lesser levels of CS. We discuss this complex dynamic in relation to highlighted strategic recommendations for the PIE framework, and the identified potential challenges in implementing trauma-informed and reflective practice in the organisation. We conclude with a critique of the value and the lessons learnt from our efforts to integrate stronger empirical substance into the PIE approach.

Occupational Well-Being in Beginning Early Childhood Educators of Hong Kong and the Prediction of Job-Related Factors: Variable-Centered and Person-Centered Approaches.

The occupational well-being (OWB) of early childhood educators (ECEs) play a crucial role in their job performance, the development of a child, and the operation of early childhood education sectors. OWB of ECEs has been an increasing concern in recent years and this concern might be particularly salient for beginning ECEs given the multiple adaptive changes and challenges they encounter during the transition from training to teaching. However, research on the beginning ECEs' OWB has been scarce. In this study, we employed both variable-centered and person-centered approaches to explore OWB and examined job demands and resources as predictors in 117 Hong Kong beginning ECEs (113 females, M age = 21.71 years). They first reported job demands (i.e., class size, working hours, dealing with children with special education needs) and job resources (i.e., salary and job support) at the end of the first month of the fall semester upon working as in-service teachers. They then reported on four OWB variables (i.e., job satisfaction, work engagement, job stress, and job burnout) at the beginning of the spring semester. Results of the variable-centered analysis revealed that beginning ECEs reported medium or above-medium levels on the positive OWB indicators and medium or below-medium levels on the negative OWB indicators. Regression analysis found that despite some exceptions, job demands and job resources negatively (positively) and positively (negatively) predicted positive (negative) OWB indicators, respectively. Results of person-centered analysis suggested that the complex pattern of different OWB indicators could be categorized into two OWB profiles (medium well-being vs. relatively weak well-being - emotional exhaustion). Results of regression analysis showed that beginning ECEs with higher job demands were less likely, whereas those with more job resources were more likely, to be assigned to the medium well-being profile. These results inform which leverage points could be targeted to enhance a specific OWB indicator and identify who would be in dire need to enhance their OWB at the very beginning of their teaching career.

Sustaining Workforce Well-being: A Model for Supporting System Resilience During the COVID-19 Pandemic.

Professional well-being in health care is critical to the success of academic medical centers inpatient care, educating trainees, serving communities, and pursuing research missions. The COVID-19 pandemic, caused by SARS-COV-2, has stretched health care teams and individuals in unique ways, leading to high levels of persistent stress with concern for longer term mental health implications. The pandemic is a catalyst to grow and strengthen support for those who work in health professions. Using one academic health center as a model, this paper reviews how professional well-being can be approached comprehensively at a system level while considering the needs of diverse employees during a time of increased need. This ramping up of services has the opportunity to build community and support a trajectory of post traumatic growth.

Connecting theory with practice: Time to explore social reality and rethink resilience among health professionals.

AIM: To discuss and contrast different theoretical perspectives of resilience and explore the value these bring to understanding health professional well-being. BACKGROUND: Resilience has been used to describe one characteristic of health professionals who work in challenging areas, such as intensive care units, emergency departments and oncology settings. Studies have reported on how health professionals can become more resilient in these settings-with a focus on individuals-describing the conditions needed to become more resilient. DESIGN: This is a Discussion paper. DATA SOURCES: This paper draws on the extant literature to explore theoretical perspectives of social constructionism and social constructivism. These perspectives are then linked to recent literature to support the discussion of how resilience can be understood and considered in the context of health professionals. IMPLICATIONS FOR NURSING: Resilience is typically conceptualized at an individual level. This manuscript highlights the broader structural factors which impact health practitioner well-being. The benefits of a resilient workforce are known to have an impact on the quality of patient care. CONCLUSION: This paper argues that resilience should be considered from a social approach that is sensitive to the context, including the relationships an individual has within their social environment.

Meaning in medicine groups as part of faculty development.

Health care workers engaged in work that they find personally meaningful are less likely to experience professional burnout. However, health care often involves tedious and burdensome tasks. While physicians are often asked to complete tasks that are less satisfying, creating space to focus on the meaningful parts of patient care is helpful to changing the focus of the mind. We report on the integration of Meaning in Medicine groups in a faculty development program at family medicine residency programs. These groups were created to increase faculty satisfaction, team cohesion, and engagement. Each session starts with an item for reflection - a video, article, or story - and is designed to provide a safe space for discussion of the joys in medicine. Group sizes of 8 to 15, dedicated time, and establishment of ground rules have been essential for success of these meetings.

A cross-sectional multisite exploration of Italian paediatric nurses' reported burnout and its relationship to perceptions of clinical safety and adverse events using the RN4CAST@IT-Ped.

AIM: To explore Italian paediatric nurses' reported burnout and its relationship to their perceptions of safety and adverse events. DESIGN: A cross-sectional study using the RN4CAST@IT-Ped database with a web-based survey design. METHODS: The RN4CAST@IT-Ped questionnaire was used to collect data in 2017. This comprised three main components: three dimensions (22 items) of the Maslach Burnout Inventory including emotional exhaustion, depersonalization and personal accomplishment. Participants also scored an overall grade of patient safety and estimated the occurrence of adverse clinical events. RESULTS: Nurses (N = 2,243) reported high levels of burnout. Most rated clinical safety as high. The risk of adverse events ranged from 1.3-12.4%. The degree of burnout appeared to influence the perception of safety and adverse events. CONCLUSION: The association between nurses' burnout and perceptions of higher rates of adverse events and reduced safety in clinical practice is an important finding. However, it is unclear whether this was influenced by a negative state of mind, and whether reduced safety and increased adverse events negatively influenced nurses' well-being, thus leading to burnout. Regardless, the association between nurses' burnout and these quality concepts needs further exploration to examine the effect, if any, on burnout and safety, and identify supportive mechanisms for nurses. IMPACT: The association between reported burnout and perception of safety and risk of adverse events in Italian paediatric nurses has been reported for the first time. Nurses reporting burnout are at greater risk of intensely negative perceptions of clinical safety and adverse events. This is an important finding as perceptions can influence practice and behaviours. Quality measures in children's clinical environments need to go beyond obvious indicators to examine nurses' well-being as this also influences quality and safety.

Being Mindful: A Long-term Investigation of an Interdisciplinary Course in Mindfulness.

BACKGROUND: Burnout and work-related stress in health-care professionals (HCPs) is a growing concern to the optimal functioning of the health-care system. Mindfulness-based interventions may be well-suited to address burnout in HCPs. OBJECTIVE: The purpose of this study was (1) to quantitatively evaluate the effect of a mindfulness-based intervention for interdisciplinary HCPs over time and at a long-term follow-up and (2) to explore perceived benefits, facilitators, and barriers to the practice of mindfulness at the long-term follow-up. DESIGN: A mixed-method, repeated measures, within-subjects design was used to investigate Mindfulness for Interdisciplinary HCPs (MIHP) at baseline, post-MIHP, and a follow-up (6 months to 1.5 years after MIHP). MIHP is an 8-week, group-based course for interdisciplinary HCPs and students, with weekly meditation training, gentle yoga, and discussions on the application of mindfulness to common stressors faced by HCPs. Main outcome measures were the Maslach Burnout Inventory-Health Services Survey and the Five Facet Mindfulness Questionnaire. A semistructured interview was used to explore participants' perceptions of sustained effects and practice in the context of HCP work at the long-term follow-up. The study protocol was registered with ClinicalTrials.gov (NCT02736292). RESULTS: Eighteen HCPs (88% female) participated in the study. Significant reductions were found after the intervention for 2 subscales of burnout: depersonalization, F(2, 17) = 5.98, P = .01, and emotional exhaustion, F(2, 17) = 2.64, P = .10. Three facets of dispositional mindfulness showed significant increases at long-term follow-up, act aware: F(2, 15) = 4.47, P = .03, nonjudge: F(2, 15) = 4.7, P = .03, and nonreactivity: F(2, 15) = 3.58, P = .05. Continued practice of skills long term was facilitated by the use of informal practice and perceived improvement in work and personal life. CONCLUSION: In sum, MIHP improved subscales of burnout and mindfulness. These findings should be further explored with a larger, controlled study. Interventions should focus on developing mindfulness practice that can be integrated into the work of HCPs.