A cross-sectional study of job burnout, psychological attachment, and the career calling of Chinese doctors.

BACKGROUND: The main objectives of this study were as follows: (1) evaluate the prevalence of burnout syndrome among doctors, (2) establish associations with demographic factors in China, and (3) examine the mediating role of psychological attachment in the relationship between job burnout and career calling. METHODS: This cross-sectional survey was conducted by administering an online questionnaire in May 2016. The survey was performed across Thirty provinces. In total, A total of 3016 Chinese doctors were selected as participants, of which 2617 completed valid questionnaires (effective response rate: 86.77%). RESULTS: The overall prevalence of burnout symptoms among Chinese doctors was 85.79%. Little variance was reported for burnout symptoms according to age (Waldχ2 = 6.843, P < 0.05, OR < 1), professional title (Waldχ2 = 13.110, P < 0.05, OR > 1), and daily working hours (Waldχ2 = 7.226, P < 0.05, OR > 1). However, the burnout of Chinese doctors was found to be associated with psychological attachment (B = - 0.6433, P < 0.0001) and career calling (B = 0.3653, P < 0.0001); furthermore, psychological attachment (B = 0.2350, P < 0.001) mediated the relationship between job burnout and career calling. CONCLUSION: Burnout symptoms among Chinese doctors were prevalent and associated with age, professional title, and long working hours. Chinese doctors aged 20-30 experienced a much higher level of burnout symptoms. The longer hours doctors worked, the more likely they were at risk of burnout symptoms, especially among attending physicians. Doctors who endured high-level burnout tended to exhibit decreasing psychological attachment, which threatened their sense of career calling. Finally, this paper proposed related explanations for the function mechanisms based on both theoretical and practical perspectives.

Impact of workplace incivility in hospitals on the work ability, career expectations and job performance of Chinese nurses: a cross-sectional survey.

OBJECTIVES: The objectives of this study were to investigate new nurses' experiences of workplace incivility; verify the mediating role of work ability in the relationship between workplace incivility and job performance and examine the moderating role of career expectations in the relationship between workplace incivility and job performance. DESIGN: This cross-sectional survey was conducted in China in May 2016. SETTINGS: The research settings included 54 cities across 29 provinces of China. PARTICIPANTS: Of the 903 participants recruited, 696 new nurses (<3 years of nursing experience) agreed to complete the online questionnaire of the study. The effective response rate was 77.1%. The inclusion criteria were voluntary participation, <3 years of nursing experience and recognition as a registered nurse. The exclusion criteria were refusal to participate, >3 years of nursing experience or not recognised as a registered nurse. RESULTS: New nurses (60.7%) experienced some level of workplace incivility in the previous year, and it was more frequent among those with higher educational degrees. Work ability mediated the relationship between workplace incivility and job performance, and this relationship was moderated by career expectations. CONCLUSION: Incivility towards new nurses was relatively common in the workplace. Workplace incivility impairs job performance by weakening the work ability of new nurses. Higher career expectations may buffer workplace incivility and contribute to the maintenance of job performance by buffering the detrimental effects of workplace incivility.

Impact of workplace violence and compassionate behaviour in hospitals on stress, sleep quality and subjective health status among Chinese nurses: a cross-sectional survey.

OBJECTIVES: The aim of this study is to describe the current state of workplace violence (WPV) and compassionate behaviour towards nurses and to explain how they affect nurses' stress, sleep quality and subjective health status. DESIGN: A cross-sectional online survey study. SETTING: The survey was conducted across eight provinces in China. PARTICIPANTS: A total of 1024 nurses were recruited to complete an online questionnaire survey from February to May 2016 in China. RESULTS: Approximately 75.4% participants had experienced some form of violence. Most of the participants experienced WPV such as verbal violence (65.2%), made difficulties (54.5%), tarnished reputation (37.5%), mob behaviour (34.9%), intimidation behaviour (18.8%), physical violence (14.6%) and sexual harassment (5.9%). In this study, 92.4% participants experienced compassionate behaviour from their coworkers (84.9%), supervisors (67.3%), and from their patients (65.3%). The results show that the exposure to WPV behaviour significantly affected the psychological stress (ß=0.295, p<0.01), sleep quality (ß=-0.198, p<0.01) and subjective health status (ß=-0.252, p<0.01) of nurses. The exposure to compassionate behaviour significantly affected the psychological stress (ß=-0.229, p<0.01), sleep quality (ß=0.326, p<0.01) and subjective health status (ß=0.342, p<0.01) of nurses. The results of the mediation analysis showed that psychological stress is a partial mediator in the relationship between violence and sleep quality (ß=-0.458, p<0.01) and between violence and subjective health (ß=-0.425, p<0.01). Moreover, psychological stress also partially mediated the relationship between compassionate behaviour and sleep quality (ß=-0.473, p<0.01), and between compassionate behaviour and subjective health (ß=-0.405, p<0.01). CONCLUSION: In China, most nurses have experienced different forms of WPV from patients and/or their relatives, as well as experiencing various forms of compassionate behaviour from their coworkers, supervisors and/or patients. This study investigates the prevalence of the different types of WPV and compassionate behaviour. Several aspects of harm to nurses from exposure to violence is confirmed. We found that WPV can damage nurses' health outcomes, while compassionate behaviours were beneficial to their health outcomes. A harmonious nursing environment should be provided to minimise threats to nurses' health status.

Impact of workplace incivility against new nurses on job burn-out: a cross-sectional study in China.

This study had three objectives: (1) to investigate the impact of workplace incivility on job burn-out of new nursing staff, (2) to verify the partial mediating role of anxiety in the relationship between workplace incivility and job burn-out, (3) to examine the resilience moderating the relations between workplace incivility and job burn-out. DESIGN: A cross-sectional online survey was conducted in May 2016 in China. SETTING: The survey was conducted in 54 cities across 29 provinces of China. PARTICIPANTS: A total of 903 participants were invited. Ultimately, 696 new nurses (<3 service years) completed valid questionnaires. The effective response rate was 77.1%. Entry criteria: voluntary participation, having less than three service years and being a registered nurse. EXCLUSION CRITERIA: being an irregular nurse, having more than three service years and refusing to participate in this work. OUTCOME MEASURES: An anonymous questionnaire was distributed among new nurses. The relationships and mechanism among the variables were explored using descriptive statistical analysis, Pearson's correlation coefficient and multiple linear regression analysis. RESULTS: The findings showed that workplace incivility was positively correlated with anxiety (r=0.371, p<0.01) and job burn-out (r=0.238, p<0.01) of new nurses. The positive relation between anxiety (ß=0.364, p<0.01) and job burn-out (ß=0.240, p<0.01) was also significant. Moreover, anxiety partially mediated (z=7.807, p<0.01) and resilience moderated (ß=-0.564, p<0.01) the association between workplace incivility and job burn-out. CONCLUSION: Experience of workplace incivility by new nurses would likely generate anxiety in the victims. Further, the increased anxiety state could elevate their level of job burn-out. New nurses with high levels of resilience could buffer the negative influence of workplace incivility by using a positive coping style.

Prevalence of Workplace Violence Against Chinese Nurses and Its Association with Mental Health: A Cross-sectional Survey.

OBJECTIVES: The aim of this study to investigate the prevalence of workplace violence (WPV) in nurses in hospitals in China, and its influence on nurses' mental health. METHODS: A cross-sectional, anonymous survey was conducted with 886 nurses (effective response rate: 87.46%) from Heilongjiang Province of China. RESULTS: Findings revealed that 595 of the 886 participating nurses (67.2%) were exposed to different levels of WPV. Further, WPV was correlated positively with nurses' anxiety (r=0.256, P<0.01) and depression (r=0.131, P<0.01) levels. In addition, this survey demonstrated that service years (r=0.263, P<0.01) played a moderating role in the relationship between WPV and anxiety, and gender (r=0.135, P<0.01) played a moderating role in the association between WPV and depression. CONCLUSIONS: WPV is an extensive problem in the work setting of nurses and it poses a major threat to Chinese nurses. Chinese nurses encounter hospital workplace violence frequently, and WPV has a considerably negative impact on the mental health and well-being of the nurses. It is critical to establish a more secure working environment for Chinese nursing staff to minimize the health threats caused by the negative outcomes associated with WPV, such as symptoms caused by anxiety and depression. This study also confirmed that new nurses and female nurses were more likely to be affected by WPV. Thus, addressing WPV should be one of the top concerns for both the government and the society.

Impact of workplace violence against nurses' thriving at work, job satisfaction and turnover intention: A cross-sectional study.

AIMS AND OBJECTIVES: To investigate the interrelationships between workplace violence, thriving at work and turnover intention among Chinese nurses and to explore the action mechanism among these variables. BACKGROUND: Workplace violence is a dangerous occupational hazard globally, and it is pervasive in the health service industry. As a corollary, workplace violence may produce many negative outcomes among nursing staff. Consequently, it hinders nurses' professional performance and reduces nursing quality. DESIGN: A cross-sectional online survey was conducted. METHODS: A total of 1,024 nurses from 26 cities in China were recruited from February-May 2016. An anonymous questionnaire was used in this survey. Participants' completed data were collected using a demographics form and a 26-item questionnaire consisting of scales addressing workplace violence, thriving at work, job satisfaction, subjective well-being and turnover intention. To evaluate multivariate relationships, some multiple linear hierarchical regression analyses were performed. RESULTS: Workplace violence significantly negatively influenced nurses' job satisfaction and thriving at work, and significantly positively influenced nurses' turnover intention. Job satisfaction significantly predicted thriving at work and turnover intention. Job satisfaction not only fully mediated the relationship between workplace violence and thriving at work, but also partially mediated the relationship between workplace violence and turnover intention. Subjective well-being moderated the relationship between workplace violence and job satisfaction and the relationship between workplace violence and nurses' turnover intention. CONCLUSIONS: Adverse effects of workplace violence were demonstrated in this study. Decreases in job satisfaction were a vital mediating factor. The moderating effect of subjective well-being was helpful in reducing the harm of workplace violence to nurses and in decreasing their turnover intention. RELEVANCE TO CLINICAL PRACTICE: Workplace violence and its negative impact on nursing work should not go unnoticed by nursing managers. Nurses' subjective well-being is critical in controlling and mitigating the adverse effects of workplace violence.

Workplace violence, psychological stress, sleep quality and subjective health in Chinese doctors: a large cross-sectional study.

BACKGROUND: Workplace violence (WPV) against healthcare workers is known as violence in healthcare settings and referring to the violent acts that are directed towards doctors, nurses or other healthcare staff at work or on duty. Moreover, WPV can cause a large number of adverse outcomes. However, there is not enough evidence to test the link between exposure to WPV against doctors, psychological stress, sleep quality and health status in China. OBJECTIVES: This study had three objectives: (1) to identify the incidence rate of WPV against doctors under a new classification, (2) to examine the association between exposure to WPV, psychological stress, sleep quality and subjective health of Chinese doctors and (3) to verify the partial mediating role of psychological stress. DESIGN: A cross-sectional online survey study. SETTING: The survey was conducted among 1740 doctors in tertiary hospitals, 733 in secondary hospital and 139 in primary hospital across 30 provinces of China. PARTICIPANTS: A total of 3016 participants were invited. Ultimately, 2617 doctors completed valid questionnaires. The effective response rate was 86.8%. RESULTS: The results demonstrated that the prevalence rate of exposure to verbal abuse was the highest (76.2%), made difficulties (58.3%), smear reputation (40.8%), mobbing behaviour (40.2%), intimidation behaviour (27.6%), physical violence (24.1%) and sexual harassment (7.8%). Exposure to WPV significantly affected the psychological stress, sleep quality and self-reported health of doctors. Moreover, psychological stress partially mediated the relationship between work-related violence and health damage. CONCLUSION: In China, most doctors have encountered various WPV from patients and their relatives. The prevalence of three new types of WPV have been investigated in our study, which have been rarely mentioned in past research. A safer work environment for Chinese healthcare workers needs to be provided to minimise health threats, which is a top priority for both government and society.