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

Background: The burnout levels of nurses, who have an important place in the delivery of health services, are increasing day by day. As the burnout levels of nurses increase, there may be undesirable situations such as compassion fatigue specific to them, their patients and their institutions. Purpose: The aim of this study is to determine the effect of compassion fatigue seen in nurses on burnout and the mediating role of empathy in this effect. Methods: The research was conducted on nurses working in three public hospitals operating in Sakarya, Turkey, between 2 January and 16 April 2019. Since the research was conducted in more than one hospital, the minimum number of participants was determined for each hospital using the stratified sampling method in the first stage. In the second stage, the participants were selected by convenience sampling method. Descriptive statistics, linear regression and process macro regression analysis were used to analyse the data. Results: The results showed the effect of nurses' compassion fatigue on burnout and empathy (ß = 0.673). In addition, empathy has a mediating role in the effect of compassion fatigue on burnout (ß = 0.251). Conclusions/implications for practice: Reducing the burnout levels of nurses, who have a very important place in the delivery of health services, is important for both themselves and patients. It is recommended that the results of this study, which may contribute to the development of the awareness of nurse managers, should be made with the ability to understand the symptoms of compassion fatigue and burnout, teaching coping methods and providing support by experts when necessary.

A survey of health information seeking by cancer patients indicates some problems over medical explanations and terminology.

BACKGROUND: Cancer patients may experience stress because of insufficient information about their illness, health condition, or treatment, but some may fear what the information reveals. OBJECTIVE: This study aims to determine health information-seeking behaviour, the attitudes of cancer patients, the barriers they face in seeking health information and their sociodemographic and disease characteristics. METHODS: A survey was conducted with 84 cancer patients in Turkey. Descriptive statistics were performed to determine the characteristics of information seeking and barriers found. RESULTS: Cancer patients are likely to seek health information, often confident about finding resources easily. The main problems are as follows: (1) insufficient information from health care providers; (2) understanding medical terminology; and (3) lack of help from health care providers to explain information retrieved. DISCUSSION: The information-seeking behaviour of cancer patients in this sample in Turkey resembles studies elsewhere, with (overall) evidence of monitoring behaviour (wanting to find out more about the disease, treatment and effects on lived experience). CONCLUSIONS: The cancer patients in this survey were generally willing and confident in their information seeking to find out more about the disease, treatment and effects on lifestyle. The main barriers were medical terminology, insufficient explanations and information from healthcare providers.

The influences of corporate policies for COVID-19 on work stress and anxiety among healthcare employees.

BACKGROUND: During the coronavirus disease (COVID-19) pandemic, if it is considered that educated manpower is the most valuable resource of countries, it can be thought that various policies should be developed both at the macro- and micro-levels to minimize the loss of healthcare employees. OBJECTIVE: This study aims to determine the effects of the corporate policies for COVID-19 on the work stress and anxiety of healthcare employees. METHOD: The sample of the study consists of 136 of 265 healthcare employees in Sakarya Provincial Health Directorate Emergency Health Services in Turkey. The average age of the participants was 34.43 years, and the average duration of professional experience was 12.12 years. Approximately 61% of the participants are male and 51% have a bachelor's degree or higher level. A questionnaire form was used in the study as the data collection tool consisting of socio-demographic characteristics, institutional policies on COVID-19, work stress, and the Status Anxiety Scale. Process Macro Model 4, descriptive statistics and correlation analysis were used for the data analysis. RESULTS: According to the results of the study, the corporate policies for COVID-19 perception of participants were above average (3.30±0.82) while work stress (2.99±0.88) and anxiety (2.65±0.56) were below average. The corporate policies for COVID-19 perception of participants reduced their work stress (ß= - 0.430) and anxiety (ß= - 0.361). Additionally, anxiety played a mediating role in the effect of the corporate policies for COVID-19 perception on work stress, and it further raised the impact of corporate policies for COVID-19 perception on the work stress reduction (ß= - 0.169). CONCLUSIONS: During the COVID-19 pandemic, health managers should determine and control the anxiety and stress levels of the health employees on their staff and take a number of steps to reduce their anxiety and stress.

The effect of the fatalistic perception on the perceptions of occupational health and safety practices: The case of a hospital.

BACKGROUND: Many factors threaten occupational health and safety, such as technology and production systems used by businesses as well as employee qualifications. This research addresses the issue of how these factors have become a threat to occupational health and safety. OBJECTIVE: This study aims to determine whether healthcare professionals' fatalistic perceptions affect their perceptions of occupational health and safety practices. METHOD: The population of the study consists of 538 nurses and other auxiliary healthcare professionals working in a private hospital in Istanbul. The study initially intended to reach the whole population without establishing a sample, but 221 (41.1%) employees were reached due to reasons such as the shift system, employees' unwillingness to participate, and personnel on leave. The study employed a survey form consisting of three parts as data collection tool. The first part of the survey includes demographic information, the second part is a Fatalism Scale and the last part is the Occupational Health and Safety (OHS) Practices Scale. Descriptive statistical analyses and SEM analysis were used for data analysis. The analyses were performed within the 95% confidence interval. RESULTS: A negative relationship was found between fatalism and occupational health and safety practices. In addition, employees' fatalistic perceptions negatively affect their occupational health and safety practices. CONCLUSION: Fatalistic perception plays an important role in occupational health and safety practices. For this reason, employees can be shown through trainings that occupational accidents are not fate and can be prevented by certain measures they can take.

Does Cyberchondria Mediate the Effect of COVID-19 Fear on the Stress?

To determine the effect of COVID-19 fear on the stress of the individuals, and to investigate the mediating role of cyberchondria on this effect. The population of the present study consisted of the individuals 18 years of age or older who were resident in the Bursa province of Turkey. The research enrolled 425 individuals who agreed to complete the questionnaire. The questionnaire, which consists of four sections including, (1) sociodemographic characteristics; (2) fear of COVID-19 scale; (3) short cyberchondria scale; and (4) perceived stress scale, was used to collect data in the study. Descriptive statistical methods and path analysis were used for data analysis. Fear of COVID-19 has a significant effect on perceived stress/distress which is mediated by cyberchondria. However, fear of COVID-19 does not have a significant effect on perceived insufficient self-efficacy. Similarly, cyberchondria does not have a mediating role in this effect. Reliable and accurate information resources should be presented about COVID-19; the individuals should adopt behaviors that would improve their health; and getting professional help should be encouraged for those with psychological problems. Otherwise, fear of COVID-19 causes perceived stress/distress to the individuals.

Moderating effect of psychological well-being on the effect of workplace safety climate on job stress.

Objectives. The main purpose of this study is to reveal the moderating effect of psychological well-being on the effect of workplace safety climate on job stress. Methods. The cross-sectional study design included the survey method. A total of 291 healthcare professionals returned the survey forms, among which 75.9% were women, and the mean age of the sample was 32.83 ± 6.03 years. Most of the participants (66.6%) had a bachelor's degree or higher. We analyzed the data using a structural equation modeling framework to test both direct and mediating effects. Hayes' Model 4 was used to identify the mediating role of psychological well-being on the effect of workplace safety climate on job stress. Results. According to the analysis results, the created model is significant, and psychological well-being plays a mediating role on the effect of workplace safety climate on job stress, reinforcing the negative effect of workplace safety climate on job stress. Conclusion. First, the safety environment perceived by employees reduces their stress. Second, psychological well-being plays a mediating role in relation to the effect of safety climate on job stress. This role contributes to the reduction of stress through the improvement of the safety climate.

Turkish Adaptation of the Frommelt Attitude Toward Care of the Dying Scale.

The aim of the research was to conduct the Turkish validity and reliability study of the Frommelt Attitude toward Care of the Dying Scale. The study used a cross-sectional research design. The sample of the study consists of 236 intensive care nurses. The data were analyzed using SPSS 22.0 and SPSS AMOS 22.0 programs. Descriptive statistical methods, reliability analysis, exploratory and confirmatory factor analyses were used in the analysis of the data. According to the findings of the exploratory factor analysis, the scale was divided into six factors as in its original. According to results of the confirmatory factor analysis showed that the goodness of fit of the scale was acceptable level. Cronbach's alpha coefficients of the Frommelt Attitude toward Care of the Dying and subdimensions were found to be between 0.606 and 0.800. These results showed that the Turkish form of scale was valid and reliable and it had the necessary conditions for using Turkish form.

Defensive Medicine Practices: Scale Development and Validation.

AIM: Defensive medicine refers to practices with low marginal benefit to patients that doctors may undertake to protect themselves from legal liability. We aimed to develop a scale to measure the practice of defensive medicine. METHOD: We identified aspects of defensive medicine previously reported in the literature and conducted and analyzed semi-structured interviews with 21 physicians in Sakarya to augment and clarify these aspects between May 15, 2018, and June 15, 2018. Informed by these results, we developed, pilot tested, refined, and fielded a 10-item survey to 1724 doctors in Turkey between April 1, 2019, and July 16, 2019. We examined the psychometric properties of the scale using exploratory (EFA) and confirmatory factor analyses (CFA). RESULTS: The 10-item scale provided measures of 2 factors: positive defensive medicine (assurance) and negative defensive medicine (avoidance), with Cronbach's alpha >0.8 for the scale and both subscales in both the EFA and CFA subsamples and excellent goodness-of-fit measures. CONCLUSIONS: We developed a highly reliable scale to measure positive and negative defensive medicine practice that may be suitable for future research on physician decision making.

The mediating role of patient satisfaction in the effect of patient visit experiences on word-of-mouth intention.

The purpose of this study is to find out whether patient experiences of examinations affect their word-of-mouth (WOM) intention and to identify the role of patient satisfaction with the physician in this effect. Data were collected via survey form (N = 1,100). Descriptive statistical methods, reliability analysis, exploratory factor analysis, confirmatory factor analysis, and structural equation modeling were used in the data analysis. According to the result of the study, patient visit experiences had a positive effect on patient satisfaction with the physician, and WOM intention and patient satisfaction with the physician played a mediating role in this effect.

The Mediating Role of Shared Decision-Making in the Effect of the Patient-Physician Relationship on Compliance With Treatment.

BACKGROUND: For a successful treatment outcome, the components of the treatment process are very important. The patient-physician relationship plays a key role in the successful therapeutic process and effective health service delivery. The patient's compliance with the treatment directly affects the success of the treatment. OBJECTIVE: This study aims to determine the effect of the patient-physician relationship on compliance with the treatment and to determine whether shared decision-making has an mediating role in this effect. PATIENT INVOLVEMENT: Most of the study participants (55%) were younger than 35 and their average age was 30. The majority of the participants have an associate degree or higher education. METHOD: The study used a 4-part survey form as the data collection tool. The sample in this study consisted of 399 participants. To analyze the obtained data, Structural Equation Modeling was used by employing the Smart PLS3 software. RESULTS: The results of the study show that the patient-physician relationship positively affects the patient's compliance with the treatment and shared decision-making. In addition, shared decision-making positively affects the patient's compliance with the treatment. The effect of the patient-physician relationship on compliance with treatment was strengthened through shared decision-making. DISCUSSION: The results of the study revealed that patient-physician relationship and shared decision-making are two important factors in patients' compliance with the treatment. Accordingly, the stronger the patient-physician relationship and the more patients participate in their treatment decisions, the higher their compliance with the treatment.

The role of the human factor in occupational safety and health performance.

Objectives. The purpose of this study is to determine the effect of managers' commitment to occupational safety and health (OSH) on employees' safety awareness and competency, employees' involvement, reporting culture and OSH performance; the effect of employees' involvement in OSH on safety awareness and competency, reporting culture and OSH performance; and the mediating role of employees' involvement in the effect of managers' commitment to OSH on OSH performance. Methods. The study population consisted of 600 people working in a private company and the sample consisted of 533 employees agreeing to participate in the survey. Data were analyzed using structural equation modeling. Results. The analysis results showed that managers' commitment to OSH had no significant effect on OSH performance but a significant positive effect on employees' safety awareness and competency, employees' involvement in OSH and reporting culture. Although managers' commitment to OSH alone had no significant effect on OSH performance, it had a significant effect on OSH performance when employees' involvement was used as a mediating variable. Conclusion. OSH should not be considered only as a technical matter. It is recommended that arrangements should be made to improve OSH considering the human factors involved in OSH.

The Impact of Patient Satisfaction on Patient Commitment and the Mediating Role of Patient Trust.

The purpose of this study is to determine the effect of patient satisfaction on patient commitment and the mediating role of patient trust in this effect. The study was conducted with 595 patients receiving healthcare services from the city center of Sakarya in Turkey. The data were collected between March 30, 2017, and May 29, 2017, via questionnaire method. The Patient Satisfaction Scale by Chang et al, the Patient Commitment Scale by Torres et al, the Patient Trust Scale by Ozawa, and an Introductory Information Form were used as the data collection tools in the study. Descriptive statistical methods, exploratory factor analysis, reliability analysis, correlation analysis, and Model 4 within the Process Macro regression analysis for SPSS developed by Hayes in order to determine the mediating role were used for the data analysis. The analyses were made at a 95% confidence interval, and the variables of patient satisfaction, patient trust, and patient commitment have a strong positive correlation. The result of this study demonstrated that patient satisfaction affects patient trust and patient commitment. Another outcome of this study is that there is a mediating effect of patient trust in the impact of patient satisfaction on patient commitment. In conclusion, these related concepts might influence the beliefs and behavior of the patient concerning the healthcare institution in question or the services that they have received.

The mediating role of work alienation in the effect of workplace loneliness on nurses' performance.

AIM: The purpose of this study was to determine the mediating role that work alienation has in the effect of loneliness at the workplace on nurses' job performance. BACKGROUND: The literature includes no research on the relationship between nurses' workplace loneliness, work alienation and job performance. The study used work alienation as a mediating variable, which adds to the originality of the study. This study was carried out to contribute to relevant field research. METHODS: The study used a cross-sectional research design and surveyed 138 nurses working in a public hospital in Turkey. The data were analysed using descriptive statistical methods, Pearson correlation analysis and the PROCESS macro Model 4 in the regression analysis. RESULTS: Workplace loneliness has a negative effect on job performance. This negative effect is magnified when work alienation is used as a mediating variable. CONCLUSION: Nurses' loneliness at the workplace and work alienation leads to a decline in their job performance. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers should take into consideration that nurses' feelings of workplace loneliness and alienation can reduce the nurses' job performance. When managers create formal and informal support networks, it can reduce nurses' negative feelings of loneliness and alienation. Thus, helping nurses to perform better at work.

The influence of patient-physician communication on physician loyalty and hospital loyalty of the patient.

OBJECTIVE: Patient-physician communication is important for an effective healthcare service and for the patient's development of loyalty to the hospital. In this regard, this study aimed to determine whether there is a relationship between the patient-physician communication, the loyalty of the patient to the physician and to the hospital. Also study aimed to determine whether there is a mediating role of the physician loyalty on the patient-physician communication effect on to the hospital loyalty. METHOD: Five hundred ten questionnaires were distributed to regular public patients of the government hospitals, clinics, and private clinic patients in Sakarya using a simple random sampling method. Data were analysed using descriptive statistics and Structural Equation Modelling (SEM). RESULTS: According to the findings, there was a significant relationship between patient-physician communication and loyalty to physician and to hospital. Patient-physician communication has a significant effect on loyalty to physician and hospital. In addition, patient loyalty has a mediating role on the patient-physician communication effect on the hospital loyalty. CONCLUSION: According to the result of the study, physician-patient communication could be used as an important tool in creating physician loyalty and hospital loyalty. This study helps physicians and health service providers to formulate strategies and tactics that will effectively develop the loyalty of patients.