Stress, interpersonal and inter-role conflicts, and psychological health conditions among nurses: vicious and virtuous circles within and beyond the wards.

BACKGROUND: The increasing costs of nurses' occupational-stress, conflicts, and violence within healthcare services have raised international interest. Yet, research/interventions should consider that perceived stress and conflicts- but also potential resources- within the wards can crossover the healthcare settings, impacting nurses' private lives and viceversa, potentially creating vicious circles exacerbating stress, conflicts/violence or, conversely, virtuous circles of psychological/relational wellbeing. Based on the Demands-Resources-and-Individual-Effects (DRIVE) Nurses Model, and responding to the need to go in-depth into this complex dynamic, this study aims to explore potential vicious circles featured by the negative effects of the interplay (main/mediating effects) between perceived stressors in nursing linked to interpersonal conflicts (Conflicts-with-Physicians, Peers, Supervisors, Patients/their families), work-family inter-role conflicts (Work-Family/Family-Work-Conflicts), and work-related stress (Effort-Reward-Imbalance) on nurses' psychological/relational health (Anxiety, Depression, Somatization, Interpersonal-Sensitivity, Hostility). The potential moderating role of work-resources (Job-Control, Social-Support, Job-Satisfaction) in breaking vicious circles/promoting virtuous circles was also explored. METHOD: The STROBE Checklist was used to report this cross-sectional multi-centre study. Overall, 265 nurses completed self-report questionnaires. Main/mediating/moderating hypotheses were tested by using Correlational-Analyses and Hayes-PROCESS-tool. RESULTS: Data confirmed the hypothesized detrimental vicious circles (main/mediating effects), impairing nurses' psychological health conditions at individual level (Anxiety, Depression, Somatization), but also at relational level (Hostility and Interpersonal-Sensitivity). The moderating role of all work resources was fully supported. CONCLUSION: Findings could be used to implement interventions/practices to effectively prevent the maintenance/exacerbation of vicious circles and promote psychological/relational wellbeing in healthcare settings and beyond.

A Model Proposal for Developing a Solution and Determining the Administrative Problems of Hospitals in Turkey: The BUY Model.

Background and Purpose: This study was conducted in line with the request of the senior management of a hospital. The objective of the current research is to identify managerial problems through the relationship between health employees' perceptions of organizational justice, trust in the manager and the organization, and job satisfaction; develop a solution proposal over the relationships between these variables and motivation variables; and present a model proposal (BUY Model) as a result. Methods: The study sample is comprised of 673 employees. The study data were collected online using a questionnaire consisting of five scales. The data were analyzed by descriptive statistical methods, correlation analysis, and regression analysis. Results: The findings obtained from the study showed that the participants' perceptions of organizational justice, trust in the manager and the organization, job satisfaction and motivation were generally at a moderate level. The study also determined that trust in the manager and the organization had a partial mediation effect on the effect of organizational justice on job satisfaction and the variables of trust in the organization, organizational justice, and trust in the manager, respectively, and especially, the job satisfaction variable also affected motivation. Conclusion: The BUY model was developed to identify problems related to the management of healthcare human resources and solve these problems. Considering the importance of the concepts of job satisfaction and motivation in terms of employee performance, health service quality, and patient satisfaction, it is thought that the developed model will benefit managers of health institutions in increasing the job satisfaction and motivation levels of health employees.

Comparative analysis of village doctors' relative deprivation: based on two cross-sectional surveys.

BACKGROUND: Village doctors are the main health service providers in China's rural areas. Compared with other rural groups, they will have a sense of relative deprivation, which has an impact on their practice mentality and job stability. This study aims to analyze the changes and causes of relative deprivation among village doctors, so as to improve the stability of them. METHODS: The data were collected from two surveys conducted in Shandong Province in 2015 and 2021. In 2015, 322 village doctors were surveyed and 307 questionnaires were collected, with a recovery rate of 95.3%. In 2021, 394 village doctors were surveyed and 366 questionnaires were collected, with a recovery rate of 92.9%. Descriptive and univariate analysis were used to compare the changes before and after the survey. RESULTS: The scores of vertical deprivation of village doctors increased from 2.77 ± 0.81 in 2015 to 3.04 ± 0.83 in 2021, with a statistically significant difference (P < 0.001). The reference group selected by village doctors changed from village teachers to ordinary villagers. Compared to village teachers, the horizontal deprivation score of village doctors increased from 3.47 ± 0.87 to 3.97 ± 0.77, with a statistically significant difference (P < 0.001). Compared to villagers, only the professional reputation deprivation score increased, from 2.38 ± 0.93 to 2.68 ± 0.76, with a statistically significant difference (P < 0.05). CONCLUSIONS: As time goes by, village doctors fail to reach the expected level in terms of economic income, social status, professional reputation and living standards, resulting in a sense of relative deprivation. This may have a negative impact on village doctors' work motivation and behavior, and will fail to guarantee the sustainability of the team. We should pay attention to this unbalanced mentality of village doctors.

Relationship between resilience at work, work engagement and job satisfaction among engineers: a cross-sectional study.

BACKGROUND: Workplace challenges can negatively affect employees and the organization. Resilience improves work-related outcomes like engagement, satisfaction, and performance. Gaps exist in studying resilience at work, particularly in relation to engagement and satisfaction. Therefore, this study aims to investigate relationship between Resilience at Work, Work Engagement and Job Satisfaction among engineers in an Egyptian Oil and Gas Company. METHODS: It was a cross-sectional study. The target population was the engineers who are working in Egyptian Oil and Gas Company. The study was performed on 100 engineers. Participants were enrolled by simple random sampling technique via an online questionnaire. The study was conducted from May 2023 to the end of September 2023. The data were collected in the duration of June to August 2023. Data was obtained through a structured and personally accomplished questionnaire, which was disseminated electronically via email. The questionnaire comprises of personal information, work experience, a Resilience at Work scale consisting of 20 items, the Utrecht Work Engagement Scale with nine items to evaluate work engagement, and the 20-item Short-Form Minnesota Satisfaction Questionnaire was utilized to determine employee satisfaction. The bivariate analysis employed independent samples t-test and Mann-Whitney U test. The associations between scores were measured by Spearman rho correlation. Simple linear and multiple linear regressions were used to predict work engagement and job satisfaction. RESULTS: A statistically strong positive correlation was observed among all the aspects of work engagement, including vigor, absorption, and dedication. This study demonstrated a significant correlation between resilience and work engagement (r = 0.356, p < 0.05). There was a strong correlation between resilience and job satisfaction (r = 0.608, p < 0.05). A significant moderate correlation was determined between job satisfaction and work engagement (r = 0.396, p < 0.05). Both gender with a female coefficient of -15.517, and resilience with a coefficient of 0.235 significantly predicted work engagement. Whereas, the significant predictors of job satisfaction were resilience (ß = 0.294), and work engagement (ß = 0.283). CONCLUSIONS: Resilience greatly affects work engagement and job satisfaction. Thus, organizations need to promote resilience in employees to create a positive work environment and increase productivity.

Career flexibility for PAs: What makes switching specialties successful?

ABSTRACT: Switching specialties is common among physician associates/assistants (PAs) and important in combating burnout. Despite this, little is known about the PA experience with switching specialties. This study sought to identify factors associated with successfully switching specialties using semistructured interviews with PAs and hiring managers. Participants reported that switching specialties was initially challenging for managers and PAs because of insufficient onboarding and unrealistic expectations, but they also reported that they were generally satisfied with long-term outcomes. Our findings suggest that PAs hoping to switch specialties may want to focus on building a professional network, identifying areas where they can highlight relevant experience, and demonstrating their intent to remain in that role. Hiring managers could benefit from considering their hiring practices and tailoring onboarding expectations for new hires.

The workplace culture, mental health and wellbeing of early- and mid-career health academics: a cross-sectional analysis.

There are reports of poor working conditions for early and mid-career academics (EMCAs) in universities, however, empirical data using validated tools are scarce. We conducted an online, cross-sectional survey using validated tools to assess workplace satisfaction, exposure to workplace abuse, and mental health. Participants included employees of medical and health faculties of two of the largest Australian universities, surveyed between October 2020 and January 2021.Overall, 284 participants responded. Many reported job insecurity: half (50.7%) working on contracts with less than one remaining year. Workloads were considerable, with 89.5% of participants working overtime and 54.8% reporting burnout. Workplace abuse in the forms of bullying (46.6%), sexual harassment (25.3%), sexism (49.8%) and racism (22.5%) were commonly reported. Clinically significant symptoms of depression (28.0%), anxiety (21.7%) and suicidal ideation or self-harm (13.6%) were reported; with a higher prevalence among those working more overtime, and those exposed to workplace abuse. Priorities include providing a stable and safe workplace, increasing accountability and transparency in addressing workplace abuse, and supporting professional development.In summary, EMCAs in our study were commonly exposed to precarious employment conditions and workplace abuse. Our findings provide empirical evidence on where universities and funding bodies should direct resources and change organisational risk factors, to improve workplace culture.

Life satisfaction and job and personal resources among public workers with non-standard work schedules.

BACKGROUND: While the link between non-standard work schedules and poor health outcomes is established, few studies have examined how resources both in and outside of work can support the well-being of workers with non-standard work schedules. METHODS: Using a cross-sectional survey, we assessed the association between one facet of well-being, life satisfaction, and job and personal resources. In 2019, an electronic survey was administered to two unionized, public service populations who work non-standard work schedules: transportation maintainers and correctional supervisors. We assessed life satisfaction with a 10-item scale; a broad set of job resources (reward satisfaction, supervisor support, co-worker support, schedule satisfaction, and working hours fit); and a broad set of personal resources (health status, sleep, physical activity, and finances). We used log-binomial regression models to estimate prevalence ratios and 95% confidence intervals among statistically significant univariate predictors. RESULTS: Of the 316 workers surveyed, the majority were male (86%), White (68%), and reported positive life satisfaction (56%). In multivariate models, the prevalence of positive life satisfaction was higher in workers reporting reward satisfaction (PR:1.35, 95% CI: 1.11, 1.65; p = 0.003), good work schedule fit (PR:1.43, 95% CI: 1.12, 1.83; p = 0.004), good health (PR:2.92, 95% CI: 1.70, 4.99; p < 0.0001), and good finances (PR:1.32, 95% CI: 1.01, 1.72; p = 0.04). CONCLUSION: Employers should consider increasing work recognition, as well as improving schedule fit, financial well-being, and overall good health in support of worker life satisfaction and ultimately well-being.

A pilot study on psychosocial factors and perceptions of organizational health among a sample of U.S. waste workers.

Solid waste workers encounter a number of occupational hazards that are likely to induce stress. Thus, there are likely to be psychosocial factors that also contribute to their overall perceptions of organizational health. However, attitudes regarding the aforementioned among solid waste workers' have not been assessed. This descriptive, cross-sectional pilot study operationalized the INPUTS Survey to determine workers' perceptions of organizational health and other psychosocial factors of work. Percentage and mean responses to each INPUTS domain are presented in accordance with their survey manual. Pearson's chi-squared tests were run on count data; Fisher's exact tests were run for count data with fewer than five samples. ANOVAs were run on the continuous items. Due to a relatively low sample size (N = 68), two-sided p values < 0.1 were considered statistically significant. Most solid waste worker participants reported high decision authority, that they perceived their management to prioritize workplace health and safety, and had high job satisfaction. However, perceptions of support for health outside of the realm of occupational safety and health was lower. Addressing traditional occupational health hazards continues to take precedence in this industry, with less of a focus on how the social determinants of health may impact workplace health.

A new perspective on balancing life domains: work-nonwork balance crafting.

BACKGROUND: Self-initiated and proactive changes in working conditions through crafting are essential for shaping work and improving work-related well-being. Recently, the research stream of job crafting has been extended to other life domains. The present paper aims to study a novel crafting concept-work-nonwork balance crafting-investigating the role of its antecedents and identifying relevant outcomes. Work-nonwork balance crafting is defined as individuals' unofficial techniques and activities to shape their work-nonwork balance, here considering their life domain boundary preferences. METHODS: In the study, 1,060 employees in three European countries (Austria, Germany and Switzerland) were surveyed in a longitudinal three-wave study with three-month intervals. We explored the influences of job/home demands and resources as antecedents of work-nonwork balance crafting. Important constructs for employee health and well-being (i.e., work engagement, work-related burnout, mental well-being and detachment from work) were investigated as outcomes. RESULTS: The findings suggest that resources and demands in the context of work or home are key antecedents of work-nonwork balance crafting. Work-nonwork balance crafting was also predictive for important employee health and well-being outcomes over three months, mainly in a positive and health-promoting way. CONCLUSION: This study provides insights into the antecedents of proactive efforts to balance the complex interplay of life domains. By studying work-nonwork balance crafting, we provide a new perspective on crafting beyond job crafting, which may help maintain or improve employees' mental health and well-being.

Professional quality of life in animal research personnel is linked to retention & job satisfaction: A mixed-methods cross-sectional survey on compassion fatigue in the USA.

BACKGROUND: Working with research animals can be both rewarding and challenging. The rewarding part of the work is associated with understanding the necessity for animal research to improve the health of humans and animals and the knowledge that one can provide care and compassion for the animals. Challenges with animal research include witnessing stress/pain in animals necessitated by scientific requirements, end of study euthanasia, and societal stigmatization about animal research. These challenges could be compounded with more general workplace stresses, in turn, impacting job retention and satisfaction. However, these factors have yet to be formally evaluated. Therefore, the purpose of this survey was to comprehensively evaluate professional quality of life's correlation with key workplace metrics. METHODS: Six institutions were recruited to participate in a longitudinal intervention trial on compassion fatigue resiliency. This manuscript reports key baseline metrics from this survey. A cross-sectional mixed methods survey was developed to evaluate professional quality of life, job satisfaction, retention, and factors influencing compassion fatigue resiliency. Quantitative data were analyzed via general linear models and qualitative data were analyzed by theme. RESULTS: Baseline data was collected from 198 participants. Personnel who reported higher compassion satisfaction also reported higher retention and job satisfaction. Conversely, personnel who reported higher burnout also reported lower job satisfaction. In response to open-ended questions, participants said their compassion fatigue was impacted by institutional culture (70% of participants), animal research (58%), general mental health (41%), and specific compassion fatigue support (24%). CONCLUSIONS: In conclusion, these results show that professional quality of life is related to important operational metrics of job satisfaction and retention. Furthermore, compassion fatigue is impacted by factors beyond working with research animals, including institutional culture and general mental health support. Overall, this project provides rationale and insight for institutional support of compassion fatigue resiliency.

Areas of professional life and job satisfaction of nurses.

Introduction: Job satisfaction among nurses is closely related to work environment as well as organizational and professional commitment. Satisfaction is a concept derived from Latin, where "satis" means "enough," as much as is needed to fully satisfy expectations, needs, aspirations, in such a way that there is no room for complaint. Job satisfaction, on the other hand, is formulated as a positive attitude of employees toward the duties of the job, the work environment and other employees. The aim of this paper was to demonstrate how the different areas of nurses' professional life, i.e., workload, control, rewards, community, sense of justice and values, correlate with their perceived job satisfaction. Materials and methods: A cross-sectional study was conducted in a group of 509 nurses working in a public hospital in Poland. Data were collected using a survey questionnaire, which consisted of a section containing sociodemographic data and standardized instruments: The Minnesota Satisfaction Questionnaire (MSQ) and The Areas of Worklife Survey (AWS) developed by Maslach and Leiter. Correlations were made using Spearman's rho coefficient. The calculations also used stepwise linear regression analysis after checking certain assumptions, including checking the assumption of normality of residuals and the Durbin-Watson Test. Results: The mean score for the 20 items of the MSQ questionnaire ranged from 3.05 to 3.43 on a 5-point Likert scale. Support from the interdisciplinary team, which concerned assessing the quality of the social environment in the workplace, cooperation and showing positive feelings received the highest rating among respondents (3.51 ± 0.76). The sense of fair treatment at work averaged 3.26 ± 0.58. The area of value conflict within the organization itself or between the employee's values and those of the organization, respondents rated an average of 3.26 ± 0.65. The mean score for all areas of professional work in the surveyed group was 3.09 ± 0.45. Conclusion: As satisfaction in particular areas of work life increases, so does the level of satisfaction in such aspects of work as achievement and a sense of fairness. The higher the level of satisfaction in the area of control, the more the sense of satisfaction with independence increases. The higher the satisfaction of respondents in the areas of values, workload and control, the higher the level of satisfaction with working conditions occurs.

Anesthesia Medication Safety in Relation to Pharmacopeia Medication Use Best Practice Initiatives.

Improvement to anesthesia medication safety is a useful and worthwhile area of research. Anesthesia is one of the few healthcare professions to have immediate access to compounding and label high-hazard medications at the bedside. There is a need to assess the perceptions of anesthesia medication safety and this relationship with pharmacopeia's updated recommendations for anesthesia to improve medication safety and prevent adverse drug events. Certified registered nurse anesthetist (CRNA) perceptions of medication safety climate in Florida were measured utilizing a validated Likert-scale that merged the Attitudes Questionnaire themes of teamwork, climate, safety climate, job satisfaction, stress recognition, perceptions of management, and working. The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture themes utilized were organizational learning, error communication, and support for patient safety. The overall email invitations delivered 5,890, 524 participants voluntarily started, and 401 completed the questionnaire resulting in a 77% completion rate. The overall response rate was 8.896% and 6.8% overall completion rate. The findings demonstrate a correlation between themes related to supportive organizational learning, stress reduction, positive changes, and creating anesthesia medication quality improvements. CRNAs' openness in adopting new pharmacopeia best practice recommendations can improve anesthesia medication safety delivery. The survey indicated clinical noteworthiness that supports the importance of additional examination of frontline providers' perceptions regarding anesthesia medication safety, buy-in, and adoption of updated pharmacopeia recommendations.

Nurses' Well-Being: An Amazing Recipe, But What Ingredients Remain Missing?

The term "system well-being" can move forward a new vision, meaning the result coming from the addition of the well-being of persons belonging to different institutions and organizations, which are all parts of the "health care system." Beginning with this "new definition," with the aim of analyzing the multifaceted issues related to nurses' well-being, we could use the "classical nursing metaparadigm" composed of 4 concepts: "health," "nursing," "environment," and "person." We briefly describe this conceptual map and provide some focused suggestions for further reflection on topics such as physical and psychological well-being, economic gain and career opportunities, work climate, burnout, low job satisfaction, moral distress, compassion fatigue, and a joyful work environment. This view may help organizations to focus on interventions to prevent or eliminate stress, which may be more proactive and effective than interventions to manage stress. Moreover, it offers a multidimensional map to analyze the different aspects influencing the well-being issue, keeping in mind that a concrete solution can be obtained only if all the components of health care systems and society do their part. Some solutions proposed by authors and organizations to increase nurses' well-being are mindfulness based, such as meditation, yoga, acupuncture, gratitude, journaling, choirs, coaching, workload reduction, job crafting, and peer networks. Other reflections on work organization, expected professional behaviors, nurses' retention, and education should be added to the discussion on this multidimensional issue.

Effectively and Efficiently Reengineering the Nursing Work Environment by Applying a Conceptual Framework for Nurse Retention.

The nursing shortage that is upon us is the result of a confluence of factors, some simple and some complex. Legacy solutions are not working. Recovery from the current situation involves examining and reshaping the nursing work environment. Creative and innovative solutions are being developed and tested. The call for addressing the work environment is surfacing in the literature, yet methods for doing so in an orderly, progressive manner have been elusive. To solve complex problems, structure helps lead to clear thinking. This work presents a conceptual framework for nurse retention derived from concept analysis of initiatives with empirical outcomes for intent to stay, intent to leave, turnover, and retention. It layers in 2 simple theorists and presents an intuitive, understandable model to guide strategic planning and decision making. The Framework has been used for several applications, one of which is a unit-based action planning method that is systematic, cyclic, and uses data relevant to specific unit culture. Improvements occurred in retention and engagement metrics, work effectiveness scores, and cost. Nurse managers extol the process's simplicity and ease of use, and the role the Framework plays in shaping the way they think about nurse retention.

Workforce Engagement for Compassionate Advocacy, Resilience, and Empowerment (WE CARE): An Evidence-Based Wellness Program.

Poor well-being and burnout among the nursing workforce were heightened by the COVID-19 pandemic. The purpose of this study was to deliver, spread, and sustain an evidence-based wellness program, Workforce Engagement for Compassionate Advocacy, Resilience, and Empowerment (WE CARE), for nurse leaders, staff registered nurses (RNs), and patient care technicians (PCTs) to ameliorate or prevent burnout, promote resilience, and improve the work environment. The program included Community Resiliency Model (CRM) training provided by a certified 6-member wellness team. A baseline and 6-month follow-up survey included measures of well-being, moral distress, burnout, resilience, perceived organizational support (POS), job satisfaction, intent to leave (ITL), and work environment. A total of 4900 inpatient RNs, PCTs, and leaders of a 1207-bed academic medical center in the southeastern United States were analyzed. From baseline (n = 1533) to 6-month follow-up (n = 1457), well-being, moral distress, burnout, job satisfaction, and work environment improved; however, resilience, POS, and ITL did not. Although we have seen some improvements in well-being and mental health indicators, it is still early in the intervention period to have reached a critical mass with the training and other interventions. The mental health and work environment issues among nurses are so complex, no one-size-fits-all intervention can resolve.

How work stress influence turnover intention among Chinese local undergraduate university teachers: the mediating effect of job burnout and the moderating effect of self-efficacy.

Background: Turnover intention is one of the common disturbances that affect the career development and management of university teachers. With an aim to solve this thorny issue, the study examined the associations between turnover intention and work stress among local undergraduate university teachers in China. Methods: A questionnaire survey was carried out on 7,565 local university teachers. Initially, confirmatory factor analysis was employed to validate the reliability and validity of the scale. Subsequently, descriptive statistics and correlation analyses were conducted. Following this, a latent moderated structural equation (LMS) was used to explore the relationship among work stress, job burnout, self-efficacy, and turnover intention. Moreover, the bias-corrected Bootstrap method was applied to further examine the mediating effects, moderating effects, and moderated mediating effects in the model. Results: The hypothesized moderated mediation model was verified significant. Work stress directly and positively predicted job burnout and turnover intention, with job burnout serving a partial mediating role between work stress and turnover intention. Additionally, self-efficacy negatively moderated the direct impact of work stress on job burnout, as well as the mediating effect of job burnout. As the self-efficacy of university teachers increased, the direct effect of work stress on job burnout and the mediating effect of job burnout decreased. Conclusion: This study expanded the research on the antecedent variables of university teachers' turnover intention and revealed the individual contingency mechanism by which work stress affected turnover intention: the negative moderating effect of self-efficacy. Work stress induced university teachers' turnover intention, and this phenomenon was more obvious for faculties with low self-efficacy. Administrators of local undergraduate universities need to rationalize the allocation of teachers' job responsibilities and pay attention to the negative consequences of work stress in order to reduce turnover intentions. Particular attention should be paid to enhance teachers' self-efficacy. The findings of this study can provide in-depth recommendations for university faculty management and policy making, which can help shape a working atmosphere more conducive to teaching and research, thus enhancing the overall quality and competitiveness of faculty members within universities.

A cross-sectional study on turnover intention of nurses in eastern China.

BACKGROUND: This study aimed to investigate the turnover intention among nurses in eastern China and explore the association between turnover intention and personal characteristics, family factors, and work-related factors. METHODS: A total of 2504 nurses participated in a cross-sectional survey administered in 26 hospitals in Eastern China from October to November 2017. In December 2021, a survey was conducted on nurses who resigned between December 2017 and November 2021. RESULTS: The turnover intention score of in-service nurses was 15 (12-17), and 43% of nurses had a high turnover intention, which was mainly due to the following reasons: age < 40 years, raising two or more children, monthly income of USD786.10-1572.20 or < USD786.10, occupation was assigned or selected according to parental wishes, ≤ 1 or ≥ 2-night shifts per week, contractual or third-party personnel agents, full-time nurses with part-time jobs, and high job stress. Among 102 retired nurses, 80.4% reported family reasons for leaving, 39.2% for work reasons, and 21.6% for other personal reasons. CONCLUSION: Nurses' intention to leave their occupation is high in Eastern China. Age < 40 years old, > 1 child, low income, involuntary career selection, frequent night shifts, informal employment, part-time, and high job stress are significant factors associated with nurses' willingness to leave. Government and hospital administrators should consider ways to address these factors to retain nurses in hospitals in eastern China and improve the quality of nursing services.