Emotional labor and burnout among nurses in Iran: core self-evaluations as mediator and moderator.

BACKGROUND: This study investigated the mediating and moderating impact of core self-evaluations in the path from emotional labor to burnout. Our hypothesized associations are based on Hobfoll (Rev Gen Psychol 6:307-24, 2002) conservation of resources theory. METHOD: Three hundred nurses from four hospitals in Abadan, Iran, were invited to participate in our study. Of the 300, 255 completed all sections and questions in our survey for an 85% response rate. The posited direct and indirect effects were evaluated with structural equation modeling and the interaction effects were evaluated with hierarchical moderated regression and simple regression slope plots. RESULT: Deep acting has indirect effects on burnout through core self-evaluations. Though unrelated to surface acting, core self-evaluations moderate its impact: under low core self-evaluations, surface acting is strongly related to emotional exhaustion and inversely related to personal accomplishment, whereas, under high core self-evaluations, surface acting is unrelated to these burnout dimensions. CONCLUSION: Our findings reveal the dual functions of CSE as a psychological resource and buffer to offset the interpersonal demands of patient care. Limitations, directions for future research, and practical implications are discussed.

Preventing Job Burnout: Could Workplace Support Protect Maternal and Child Health Professionals Who Are Doing Public Health Equity Work?

PURPOSE: To assess the potential of workplace support to protect public health equity workers against job burnout and to identify key workplace support components. DESCRIPTION: This mixed-methods, explanatory sequential study analyzed survey and interview data collected between August 2020 and June 2021. Participants included governmental and non-governmental public health employees whose programs largely focus on Maternal and Child Health populations and who reported that their jobs involved working to reduce health inequities ("equity work"). Regression analysis tested the effect of emotional labor on job burnout, and whether workplace support modified that effect. Qualitative analysis of interview transcripts explored possible components of needed workplace support. ASSESSMENT: Emotional labor was positively associated with job burnout (p < .001), and there was a significant negative interaction between emotional labor and workplace support, meaning workplace support appeared to reduce the effect of emotional labor on burnout (p = .036). Qualitative analysis identified four support components: peer-to-peer mentoring connections, workplace accommodations, engaged and empathetic supervision, and mental health resources. CONCLUSION: Workplace support is associated with reduced job burnout for public health equity workers, especially those whose jobs involve high levels of emotional labor. Few public health employers are providing needed emotional supports for their equity workers, but certain supports appear to be helpful in reducing job burnout.

The effect of work readiness on work well-being for newly graduated nurses: The mediating role of emotional labor and psychological capital.

OBJECTIVE: To investigate the relationship between work readiness and work well-being for newly graduated nurses and the mediating role of emotional labor and psychological capital in this relationship. METHODS: A cross-sectional survey was conducted in mainland China. A total of 478 newly graduated nurses completed the Work Readiness Scale, Emotional Labour Scale, Psychological Capital Questionnaire, and Work Well-being Scale. Descriptive statistical methods, Pearson correlation analysis, and a structural equation model were used to analyze the available data. RESULTS: Newly graduated nurses' work readiness was significantly positively correlated with work well-being (r = 0.21, p < 0.01), deep acting (r = 0.11, p < 0.05), and psychological capital (r = 0.18, p < 0.01). Emotional labor and psychological capital partially mediated the relationship between work readiness and work well-being. Additionally, emotional labor and psychological capital had a chain-mediating effect on the association. CONCLUSIONS AND CLINICAL RELEVANCE: Work readiness not only affects newly graduated nurses' work well-being directly but also indirectly through emotional labor and psychological capital. These results provide theoretical support and guidance for the study and improvement of newly graduated nurses' work well-being and emphasize the importance of intervention measures to improve work readiness and psychological capital and the adoption of deep-acting emotional-labor strategies.

Secondary traumatic stress among pediatric nurses: Relationship to peer-organizational support and emotional labor strategies.

BACKGROUND: Even though the cost of caring is acknowledged in multiple helping professions, research into secondary traumatic stress in pediatric nursing remains limited. This study aimed to determine the prevalence of secondary traumatic stress among pediatric nurses and examine its correlation with demographics, perceived organizational support, peer support, and emotional labor strategies. DESIGN AND METHODS: A total of 186 nurses working in a pediatric hospital completed questionnaires addressing secondary traumatic stress, perceived organizational support, peer support, and emotional labor strategies. Through correlational and mediation analyses, we explored the relationships between the study variables. RESULTS: Approximately 77.8% of the pediatric nurses surveyed exhibited moderate to severe secondary traumatic stress. Notably, the level of secondary traumatic stress did not correlate with demographic variables. Increased peer support was significantly associated with a heightened use of all emotional labor strategies (surface acting, deep acting, and natural expression) and with elevated levels of secondary traumatic stress. However, surface acting was the sole mediator of this relationship. Conversely, greater perceived organizational support correlated with decreased levels of surface acting and secondary traumatic stress, with surface acting serving as the mediator. CONCLUSIONS: Pediatric nurses are greatly impacted by secondary traumatic stress. Enhancing organizational support and carefully assessing peer support can reduce this, by decreasing nurses' need to suppress or feign genuine emotions. PRACTICE IMPLICATIONS: To enhance nurses' psychological well-being, healthcare institutions should raise awareness of secondary traumatization and foster a supportive organizational environment that prioritizes effective team emotional support and evaluates collegial emotional labor.

Affective economies in crowdfunding for cancer.

Cancer patients and survivors in the United States are increasingly likely to use online crowdfunding as a means of offsetting the expenses associated with their medical care. This practice of making an online appeal for support to a broad public audience constitutes an inadvertent form of informal emotional labor for its practitioners-labor in which striking the right affective notes in one's appeal is believed to be critical to fundraising outcomes. Drawing on ethnographic interviews, we suggest that crowdfunding produces an array of complex, often contradictory sentiments and narrative incentives for cancer patients and survivors-ultimately transforming the experience of serious illness.

Emotional labor, fatigue, and presenteeism in Chinese nurses: the role of organizational identification.

BACKGROUND: Presenteeism has become a significant issue related to health. However, the effect of fatigue and organizational identification on the relationship between emotional labor and presenteeism among Chinese nurses remains unclear. This study aims to explore the correlation of Chinese nurses' emotional labor, fatigue and organizational identification with presenteeism, and to analyze the mediating effect of fatigue and the moderating effect of organizational identification on the relationship between emotional labor and presenteeism. METHODS: A cross-sectional study was performed from June to October 2022 in Changchun City, Jilin Province, China. In total, 1,630 nurses were asked to complete a range of self-administered questionnaires, including the Emotional Labor Scale, the Fatigue Scale, the Organizational Identification Scale and the Stanford Presenteeism Scale. Besides, the PROCESS macro and multiple linear regression were used for moderated mediation analysis. RESULTS: Emotional labor (r = 0.108, P < 0.001) and fatigue (r = 0.475, P < 0.001) were positively correlated with presenteeism, while organizational identification (r = -0.261, P < 0.001) was negatively correlated with presenteeism. The effect of emotional labor on presenteeism was partially mediated by fatigue (Effect = 0.014, 95% CI = [0.007, 0.021]). Additionally, the relationship between emotional labor and fatigue was moderated by organizational identification (P = 0.018 for the interaction term). CONCLUSIONS: Fatigue and organizational identification have mediating and moderating effects on the relationship between emotional labor and presenteeism, respectively. Targeted support measures should be taken to improve the presenteeism of nurses. Nursing managers can relieve the psychological pressure and fatigue of nurses by establishing emotional release channels, and improve the presenteeism of nurses through enhancing organizational identification.

The effect of perceived organizational justice on workplace deviant behavior of new nurses: the role of emotional labor and psychological capital.

BACKGROUND: New nurses are prone to workplace deviant behavior in the constrained hospital environment, which will not only directly affect the safety of patients, but also reduce the work efficiency of nurses and bring negative results to the hospital. The purpose of this study was to investigate the relationship between perceived organizational justice, emotional labor, psychological capital, and workplace deviant behavior of new nurses. METHODS: A cross-sectional study was used in this study. A survey was conducted in 5 hospitals in Henan Province, Chain from February to April 2023. The sample size was 546. The questionnaire included general information, perceived organizational justice scale, emotional labor scale, psychological capital scale, and workplace deviant behavior scale. SPSS 26.0 and PROCESS Macro were used for data analysis. PROCESS Model 4 and Model 14 were used to verify the model. RESULTS: This study displays that perceived organizational justice was negatively correlated with emotional labor and workplace deviant behavior, and emotional labor was positively correlated with workplace deviant behavior. Meanwhile, emotional labor plays a partial mediating role between perceived organizational justice and workplace deviant behavior, accounting for 32.7% of the total effect. Moreover, the path of emotional labor on workplace deviant behavior is moderated by psychological capital. CONCLUSION: This study further understood the workplace deviant behavior of new nurses, and provided a new perspective for solving this problem. Nurse managers can reduce workplace deviant behavior by enhancing the perceived organizational justice and psychological capital of new nurses and improving emotional labor.

Moderating effect of family structure on the relationship between early clinical exposure and emotional labor of nursing students: a cross-sectional study.

BACKGROUND: Emotional labor is an essential component of nursing practice and is important for Generation Z nursing students born from the mid-1990s to early 2010s. They will become the backbone of the nursing workforce but present more emotional regulation problems. Studies on emotional labor are limited to clinical nurses and influencing factors at the individual level. The impacts of external systems on emotional labor of nursing students have not been explored. This study aimed to quantify the relationship between early clinical exposure and emotional labor and test the moderating effect of family structure on the relationship. METHODS: The cross-sectional study recruited 467 nursing students using convenience sampling from seven colleges and universities in mainland China. An e-survey created on WJX.CN was used to collect data in January 2023. Emotional labor (surface acting and deep acting) was measured with the Emotional Labor scale. Early clinical exposure (exposure or not and times of exposure) and family structure (nuclear family, extended family, and single-parent family) were assessed with self-reported questions. Descriptive statistics and the linear mixed-effects modeling were used to do the analyses. RESULTS: The mean scores of surface acting and deep acting were 26.66 ± 5.66 and 13.90 ± 2.40, respectively. A significant difference in scores of surface acting was not observed for exposure or not, whereas such a significant difference was found for times of exposure. Nursing students from extended families demonstrated significantly lower scores on surface acting while exposed to clinical practice compared with those from nuclear families. Family structure moderated the relationship between times of exposure and surface acting of nursing students when exposed to clinical practice for one time, but the significance disappeared when the times of exposure increased. No significant findings of early clinical exposure on deep acting were observed. CONCLUSIONS: Early clinical exposure influenced emotional labor, and students from extended families were more likely to get benefits from early clinical exposure. Studies are needed to help students from nuclear families get comparable benefits on emotional labor as those from extended families, and improve deep acting by early clinical exposure.

Emotional Labor and the Problem of Exploitation in Roboticized Care Practices: Enriching the Framework of Care Centred Value Sensitive Design.

Care ethics has been advanced as a suitable framework for evaluating the ethical significance of assistive robotics. One of the most prominent care ethical contributions to the ethical assessment of assistive robots comes through the work of Aimee Van Wynsberghe, who has developed the Care-Centred Value-Sensitive Design framework (CCVSD) in order to incorporate care values into the design of assistive robots. Building upon the care ethics work of Joan Tronto, CCVSD has been able to highlight a number of ways in which care practices can undergo significant ethical transformations upon the introduction of assistive robots. In this paper, we too build upon the work of Tronto in an effort to enrich the CCVSD framework. Combining insights from Tronto's work with the sociological concept of emotional labor, we argue that CCVSD remains underdeveloped with respect to the impact robots may have on the emotional labor required by paid care workers. Emotional labor consists of the managing of emotions and of emotional bonding, both of which signify a demanding yet potentially fulfilling dimension of paid care work. Because of the conditions in which care labor is performed nowadays, emotional labor is also susceptible to exploitation. While CCVSD can acknowledge some manifestations of unrecognized emotional labor in care delivery, it remains limited in capturing the structural conditions that fuel this vulnerability to exploitation. We propose that the idea of privileged irresponsibility, coined by Tronto, helps to understand how the exploitation of emotional labor can be prone to happen in roboticized care practices.

Emotional labor among Turkish nurses: A cross-sectional study.

Nurses are the closest healthcare providers to patients and emotional labor is the most invisible part of nursing work. However, the management of emotions to promote organizational goals and to ensure patient satisfaction may have both positive and negative impacts on nurses' working life. The purpose of this cross-sectional, descriptive study was to examine the emotional labor behaviors of nurses and their opinions on emotional labor. Two hundred nineteen nurses working at public hospitals in Ankara between September and December 2018 participated to this study. Data were collected using the sociodemographic characteristics form and "The Scale of Emotional Labor Behavior for Nurses." Nurses had higher scores on the deep and sincere emotional acting subdimensions of the emotional labor scale than the surface acting subdimension. Findings suggest that nurses act deeply and intimately, instead of surface acting. Most of the nurses expressed that nurses were emotionally affected when caring for patients; however, nurses had to control their feelings toward patients and behave professionally to meet the expectations of their managers, which may lead to an implicit emotional dissonance. Based on the results of this study, we suggest to support nurses emotionally and to incorporate the topic of emotional labor into educational programs.

The relationship between emotional labor level and moral distress.

BACKGROUND: The coronavirus disease (COVID-19) pandemic has implications for health professionals. AIM: The aim of this study was to explain the relationship between emotional labor levels and moral distress in health professionals during the COVID-19 pandemic using the Structural Equation Modeling (SEM) technique. RESEARCH DESIGN: A descriptive and cross-sectional study was adopted. PARTICIPANTS AND RESEARCH CONTEXT: Data were collected between 7 February and 7 March 2021. 302 health professionals who were not on leave (annual leave, sick leave, prenatal and postnatal leave, etc.) at the time of the research and who volunteered to participate in the research were included. Research data were collected using a "Personal Information Form," the "Emotional Labor Scale" and the "Moral Distress Thermometer." ETHICAL CONSIDERATIONS: The Ethics Committee approved the study (dated 07.01.2021 and numbered 2021/1-3). The participants were informed of the study aim and written consent was obtained before completing the survey. FINDINGS: In the present study, the mediator role of emotional labor in the effect of providing service to a patient with COVID-19 and having had COVID-19 on moral distress was examined in health professionals and it was found that there was a correlation between providing service to a patient with COVID-19 and moral distress regardless of whether or not emotional labor had a role in this relationship. CONCLUSION: In this study, the relationship between the level of emotional labor and moral distress in health professionals during the COVID-19 pandemic was evaluated with a structural equation model.

Organizational display rules in nursing: Impacts on caring behaviors and emotional exhaustion through emotional labor.

AIM: To examine the impact of display rules on nurses' caring behaviors and emotional exhaustion and the mediating role of emotional labor (surface/deep acting). BACKGROUND: Hospitals often implement emotional display rules for nurses with the expectation of performance benefits. However, these rules may have an impact on nurses' caring behaviors and emotional exhaustion. METHODS: This cross-sectional correlational study included a sample of 746 nurses from five hospitals and used the STROBE checklist. Relationships between display rules, emotional labor, caring behaviors, and emotional exhaustion were analyzed using structural equation modeling. RESULTS: Display rules did not directly affect caring behaviors or emotional exhaustion. Emotional labor mediated the relationships. Display rules were associated more with surface acting. Deep acting increased caring behaviors and reduced emotional exhaustion; surface acting had the opposite effect. CONCLUSIONS: Findings challenge the assumption that display rules effectively promote caring behaviors. Display rules lead to emotional labor and emotional exhaustion. Reducing display rules, emotional labor, and surface acting while supporting deep acting may alleviate emotional exhaustion. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nurse managers should review the nature and implementation of emotional display rules and explore ways to reduce emotional labor, encourage deep acting, mitigate the negative impact of surface acting, and ultimately improve nursing caring behaviors.

The dualistic model of passion and the service quality of five-star hotel employees during the COVID-19 pandemic.

Given the generally stressful job demands of the hospitality industry during the COVID-19 pandemic, understanding the work passion and emotions of hotel employees is particularly important. Based on the conservation of resources theory and the job demands-resources model, this study develops a multiple mediation model to investigate how frontline hotel employees with different types of work passion choose emotional labor strategies under the effects of the COVID-19 pandemic and the impact of different choices on their service quality. A two-stage survey using data from 206 frontline employees of five-star hotels in China explored how work passion influences emotional labor and thereby affects emotional expression as well as service quality. The results showed emotional labor partially mediates the relationship between work passion and emotional expression, which in turn mediates the relationship between emotional labor and service quality during the COVID-19 pandemic. The theoretical and practical implications of this study are discussed.

"I-just-wanna-get-by" hurts teachers and their work: Linking preschool teacher identity to work withdrawals in an emerging economy.

Motivation deficit in low- and middle-income countries (LMICs) has implications for teacher well-being and education outcomes. This study, utilizing the job demand resource (JD-R) theory, explores the role of teacher identity as a motivational resource that antecedes emotional labor strategies - deep acting and surface acting. We further examined the relationship between emotional labor strategies and teacher work withdrawals - presenteeism and lateness, and the intervening role of teacher emotional exhaustion. We tested our theoretical model using 574 preschool teachers in Ghana. We found that teacher identity relates positively to deep acting but negatively to surface acting. And that deep acting relates to work withdrawals negatively whilst surface acting is associated with them positively. Deep acting diminishes work withdrawals because of its capacity to prevent emotional exhaustion, but the mediation role of emotional exhaustion in surface acting and work withdrawal links was non-significant. Our study presents preliminary evidence from an emerging economy on the central role of teacher identity (motivation component) in emotion management in an attempt to reduce emotional strain, thereby lessening negative work behaviors.

[Study on the current situation and influencing factors of job involvement for employed nurses in military hospital].

Objective: To investigate the current situation of job involvement of nurses in military hospitals in Henan Province and analyze the influencing factors, so as to provide reference for improving the level of job involvement of military nurses. Methods: In February 2022, the employed nurses of 4 military hospitals in Henan Province were investigated by convenient sampling method. A total of 663 questionnaires were collected, including 632 valid questionnaires, with an effective recovery rate of 95.32%. The self-designed questionnaire was used to investigate the basic information of nurses, the Job Involvement Scale was used to investigate the job involvement of nurses, the Emotional Labor Scale for Nurses was used to investigate nurses' emotions, and the Work-Family Conflict Scale was used to investigate the work-family conflict of nurses. Independent sample t-test and univariate analysis of variance were used to compare the job involvement of military employed nurses with different demographic characteristics, Pearson correlation analysis was used to explore the correlation between emotional labor, work-family conflict and job involvement, and hierarchical regression analysis was used to explore the impact of relevant variables on the job involvement of military employed nurses. Results: The total average score of job involvement of military employed nurses was (3.68±1.13), and the scores of vitality, dedication and focus were (3.64±1.15), (3.74±1.25) and (3.67±1.21) respectively. The total score of emotional labor of nurses was 33-80 (62.95±8.12), with an average score of (3.93±0.51). The total score of work-family conflict was 18-94 (55.16±13.53), with an average score of (3.06±0.75). Professional emotional regulation, patient-centered emotional inhibition and standardized emotional play were positively related to the job involvement (r=0.46, 0.41, 0.22, P<0.01). Time-based conflict, stress-based conflict and behavior-based conflict had negative correlation with the job involvement (r=-0.12, -0.23, -0.20, P<0.01). In hierarchical regression analysis, after controlling demographic variables, emotional labor and work-family conflict accounted for 17.2% and 4.2% of the variation of job involvement. Conclusion: The job involvement of military employed nurses tends to be at a moderate level. Emotional labor and work-family conflict can significantly affect their job involvement.

Exploring the Challenge of Teachers' Emotional Labor in Early Childhood Settings.

One challenging aspect of working in early childhood education settings is engagement in emotional labor. Research suggests that emotional labor is associated with emotional exhaustion and burnout in early childhood teachers, but there is limited research available on this issue. Research focusing on early childhood contexts in the United States is especially limited. This paper explores the concept of emotional labor by early childhood teachers and reviews some of the research on teachers' experience of emotional labor in the classroom. Implications of the current research are discussed and suggestions for future research are provided. Possible solutions to the challenges of emotional labor are presented, focusing on mindfulness strategies.

Preschool Teachers' Emotional Acting and School-Based Interactions.

How preschool teachers manage and express their feelings across school-based interactions (e.g., teacher-child, teacher-family, and teacher-colleague) has implications for their professional success and the developmental and academic outcomes of their relational counterparts. This study explores how preschool teachers make sense of their emotional labor, or the deliberate expression or suppression of emotions to achieve organizational goals, in the context of three professional interactions. Qualitative findings show preschool teachers' decisions to engage in particular types of emotional acting are both informed by and a facilitator of the strength and intimacy of their relationships. Implications for research, practice and policy are reviewed. Supplementary Information: The online version contains supplementary material available at 10.1007/s10643-022-01326-1.

The Effects of Role Differentiation Among Clergy: Impact on Pastoral Burnout and Job Satisfaction.

The present study investigated the impact of differentiation of self as an emotion regulation strategy on work and family conflict, ministerial job satisfaction, and burnout for pastors. Specifically, does differentiation of self provide a psychological resource for pastors coping with the experience of burnout as emotional exhaustion, given the unique social context of the pastor's family and the role emotional labor has in causing burnout in social service professions? A unique aspect of the pastorate is the pastor's family's social context of living with the congregation. Due to this unique social context, work and family conflict were investigated as predictors of pastoral burnout. A sample of pastors (N = 164) was surveyed to investigate the impact of differentiation and job satisfaction on personal and work-related burnout. Findings suggest that differentiation of self provides a resource against the personal experience of burnout, while ministerial job satisfaction buffers pastors against work-related burnout.

A qualitative exploration of "empathic labor" in Chinese hospice nurses.

BACKGROUND: Hospice nurses may devote more emotional labor during the empathy process with patients, and this empathy can be used as a form of psychological behavior of emotional labor in the hospice care model. The aim of this study was to analyze hospice nurses' empathy characteristics in the context of emotional labor theory, and explore the impact of empathy on patient care. METHODS: We conducted semi-participant observations from three hospitals and multicenter in-depth interviews with n = 26 hospice nurses from eight cities. Interviews were transcribed, and directed content analysis was applied. RESULTS: Two categories with four sub-categories were extracted from the data analysis. Category 1 described the "empathic labor" process which covers cognitive empathy (including empathic imagination, empathic consideration, and empathic perception) and affective empathy (including natural empathy, surface empathy, and deep empathy). The second category concerns the outcome of nurses' "empathic labor" which incorporates both positive and negative effects. CONCLUSIONS: The findings indicated that hospice nurses' empathy process should be understood as emotional labor. Nursing managers should pay more attention to raising the ability of deep empathy with hospice nurses, and explore more sufficient active empowerment strategies to alleviate the negative impact of empathy on nurses and to strengthen nurses' deep empathy with terminal ill patients.

The Potential Relationship Between a Cognitive Dissonance State and Musculoskeletal Injury: A Systematic Review.

OBJECTIVE: The objective of this systematic review was to investigate the potential link between cognitive dissonance or its related constructs (emotional dissonance, emotional labor) and musculoskeletal disorders. BACKGROUND: The etiology of musculoskeletal disorders is complex, as pain arises from complex interactions among physical, social, and psychological stressors. It is possible that the psychological factor of cognitive dissonance may contribute to the etiology and/or maintenance of musculoskeletal disorders. METHOD: MEDLINE, APA PsycInfo, and CINAHL Plus databases were searched for studies investigating cognitive dissonance or its related constructs as exposure(s) of interest and outcomes related to physical health (including, but not limited to, musculoskeletal pain). Risk of bias was assessed using the Appraisal tool for Cross-Sectional Studies (AXIS) tool. RESULTS: The literature search yielded 7 studies eligible for inclusion. None of the included studies investigated cognitive dissonance directly but instead investigated dissonance-related constructs of emotional dissonance and emotional labor, in which a mismatch between required and felt emotions might elicit a psychological response consistent with the cognitive dissonance state. Moderate effect sizes between dissonance-related constructs and musculoskeletal disorders were noted (OR 1.25-2.22). CONCLUSION: There is likely a relationship between the two factors studied. However, as the included studies were cross-sectional in nature, a causal relationship between cognitive dissonance-related constructs and musculoskeletal disorders cannot be inferred. Therefore, future study proposing and validating a causal pathway between these variables is warranted. APPLICATION: Cognitive dissonance and its related constructs may serve as risk factors for musculoskeletal disorders that have not been considered previously.