Ethical climate, moral resilience, and ethical competence of head nurses.

BACKGROUND: The ethical competence of head nurses plays a pivotal role in nursing ethics. Ethical climate is a prerequisite for ethical competence, and moral resilience can positively influence an individual's ethical competence. However, few studies have focused on the relationship between ethical climate, moral resilience, and ethical competence among them. OBJECTIVES: To investigate the relationship between ethical climate, moral resilience, and ethical competence, and examine the mediating role of moral resilience between ethical climate and ethical competence among head nurses. DESIGN: A quantitative, cross-sectional study. METHODS: A total of 309 Chinese head nurses completed an online survey, including ethical climate questionnaire, Rushton moral resilience scale, and ethical competence questionnaire. Inferential statistical analysis includes Pearson's correlation and a structural equation model. ETHICAL CONSIDERATIONS: This study received ethical approval from the Institutional Review Board of Xiangya Nursing School of Central South University (No. E2023146). RESULTS: Head nurses' ethical climate score positively impacted ethical competence (r = 0.208, p < .001), and ethical climate could affect ethical competence through the mediating role of moral resilience. CONCLUSION: This study emphasized the value of ethical climate in moral resilience of head nurses, ultimately leading to an enhancement in their ethical competence.

The mediating role of coping styles between nurses' workplace bullying and professional quality of life.

AIMS: This study aimed to explore the relationship between workplace bullying among nurses and their professional quality of life, as well as the mediating role of coping styles between the two factors. BACKGROUND: In China, the overall status of nurses' professional quality of life is not optimistic, and the problems of low compassion satisfaction and high compassion fatigue persist. Workplace bullying, which is a serious global issue, can negatively impact the mental health and professional quality of nurses. However, it has still not attracted enough attention from managers. METHODS: The study used a cross-sectional research design and surveyed 297 clinical nurses from two tertiary grade A hospitals in Wuhan, China. Data were collected through an online questionnaire survey from March to May 2022. The data were analyzed using descriptive statistical methods, including Pearson correlation analysis and structural equation modeling. RESULTS: The score for nurses' workplace bullying was 38.72 ± 12.30. The scores for the three dimensions of professional quality of life were 27.56 ± 4.79 for compassion satisfaction, 30.51 ± 4.33 for burnout, and 28.47 ± 4.65 for secondary trauma stress. The scores for positive coping style and negative coping style were 34.59 ± 5.72 and 20.34 ± 5.08 points, respectively. Workplace bullying had a direct negative effect on compassion satisfaction, as well as positive direct effects on burnout and secondary traumatic stress. Coping styles played a mediating effect between workplace bullying and the pairwise relationships of compassion satisfaction, burnout, and secondary trauma stress. CONCLUSION: Workplace bullying hurts nurses' professional quality of life while coping styles plays an mediating role between workplace bullying and professional quality of life. Nursing managers can improve nurses' professional quality of life by reducing workplace bullying and enhancing positive coping style. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers can employ management wisdom and techniques to mitigate the presence and detrimental effects of workplace bullying. This, in turn, promotes a positive work environment and enhances the professional quality of life for nurses.

Social support, empathy and compassion fatigue among clinical nurses: structural equation modeling.

BACKGROUND: Clinical nurses are at high risk for compassion fatigue. Empathy is a prerequisite for compassion fatigue, and social support is an important variable in the process of reducing individual stress. However, the role of social support in the relationship between empathy and compassion fatigue remains unclear. This study explored whether social support mediates the relationship between empathy and compassion fatigue among clinical nurses. METHODS: A total of 992 clinical nurses were recruited through convenience sampling for a cross-sectional study in Central China. They completed the General Information Questionnaire, Perceived Social Support Scale, Professional Quality of Life Scale, and Jefferson Scale of Empathy. SPSS was used to conduct descriptive statistical analyses. Pearson's or Spearman's correlation analyses and AMOS were employed to build a structural equation model (SEM) to verify the mediating effect of social support on the relationship between empathy and compassion fatigue. RESULTS: The results indicated that the standardized direct effect of empathy on compassion fatigue was 0.127, and the standardized indirect effect of empathy on compassion fatigue through social support was 0.136. The mediation effect ratio between empathy and compassion fatigue was 51.7%. CONCLUSIONS: Our findings show that social support mediates the relationship between empathy and compassion fatigue among clinical nurses. This finding suggests that increasing nurses' social support can decrease the prevalence of compassion fatigue. Nursing managers should provide training related to flexibly adjusting empathy and educating nurses to establish effective social networks with family, friends, and colleagues to prevent compassion fatigue.

Nurses' turnover intention, hope and career identity: the mediating role of job satisfaction.

BACKGROUND: A high turnover rate has become a critical issue in the field of nursing and how to tackle the problem of nursing turnover has received increased attention worldwide. Hope, career identity, job satisfaction may be useful for reducing turnover. The aim of this study is to explore the relationships among career identity, hope, job satisfaction, and the turnover intention of nurses, and to test the mediating role of job satisfaction on the associations of hope and career identity with turnover intention. METHODS: A descriptive cross-sectional design was used. A total of 500 nurses were recruited from five comprehensive tertiary hospitals using convenience sampling. The questionnaire included items about sociodemographic information as well as the Adult Dispositional Hope Scale, Nursing Career Identity Scale, Job Satisfaction Index Scale, and Nurse Turnover Intention Scale. Pearson's correlation, multiple linear regression, and structural equation modeling were used to analyze the data. We describe the study in accordance with the STROBE statement. RESULTS: Hope (r = - 0.227, p < 0.001) and career identity (r = - 0.342, p < 0.001) were negatively correlated with turnover intention. Job satisfaction played a completely mediating role on the associations of hope and career identity with turnover intention (ß1 = - 0.09, ß2 = - 0.33). CONCLUSIONS: Job satisfaction mediated the associations of career identity and hope with turnover intention. Thus, effective measures can be taken to enhance nurses' hope and career identity in order to improve their job satisfaction and thereby reduce their turnover intention. Providing nurses with more support, helping them find a spiritual foundation, and holding mindful activities that stimulate positive emotions are helpful. In addition, colleges should pay more attention to instilling nursing students with career identity and nursing values.

Mediating role of psychological resilience in the relationship between self-efficacy and professional identity among nurses.

To explore the mediating role of resilience in the relationship between general self-efficacy and professional identity of nurses during the COVID-19 pandemic. A cross-sectional design was employed. A total of 982 nurses from four Grade III, class A hospitals in Shandong Province were investigated using general information questionnaire, nurses' professional identity rating scale, general self-efficacy scale (GSES), and Connor-Davidson flexibility scale (CD-RISC). SPSS22.0 and Amos21.0 were used for data analysis and structural equation modeling. p % counseling The nurses had a score of （27.038±5.933） for general self-efficacy score, 38.290±6.234 for psychological resilience, and （114.99±16.209） for professional identity. A positive correlation between general self-efficacy, professional identity, and psychological resilience (<0.01) was found. The SEM analysis shows that psychological resilience plays a mediating role between general self-efficacy and professional identity. The ratio of the effect is 75.155. During the COVID-19 pandemic, the levels of general self-efficacy and professional identity of nurses was medium, while psychological resilience was high. Nurses' general self-efficacy can affect their professional identity through psychological resilience. During the pandemic, the psychological status of nurses should not be ignored. Nursing managers should fully utilize of group and cognitive therapy based on mindfulness to improve nurses' psychological resilience and general self-efficacy, and to promote nurses' professional identity, so as to ensure the lower turnover rate.

Influence of resilience on depression among nurses in clean operating departments: The mediating effect of life satisfaction.

BACKGROUND: A clean operating room is an important part of surgical and critical treatment in hospitals. The workload is substantial, the pace is rapid, and the working environment is intense; therefore, nurses who work in clean operating rooms are constantly challenged, which can lead to anxiety, depression, and other mental health issues. Life satisfaction and resilience are important factors that ensure mental health. Therefore, exploring the mediating role of life satisfaction in the influence of resilience on depression among nurses in clean operating rooms can help improve nursing services and teamwork. AIM: To explore the mediating effect of satisfaction on the influence of resilience on depression among nurses in a clean operating department. METHODS: From April to November 2022, 196 nurses from the Department of Clean Operating at Harbin Medical University Cancer Hospital participated in this study. Participants were selected using convenience sampling. Participants' gender, age, marital status, position, length of service, personal monthly income, daily working hours, employment status, and professional title were collected, and the Connor-Davidson resilience scale, satisfaction with life scale, and self-rating depression scale were used to evaluate resilience, life satisfaction, and depression. The researchers conducted professional training in advance, introduced the research methods to the participants before the investigation, and explained the study's significance and purpose. Surveys were distributed and collected on-site. Each questionnaire took 30 min to complete. RESULTS: The average scores for life satisfaction, resilience, and depression were 3.13 (± 0.28), 4.09 (± 0.78), and 56.21 (± 8.70), respectively. The correlation between resilience and depression was negative (r = -0.829, P < 0.01). Life satisfaction was positively related to resilience (r = 0.855, P < 0.01) and negatively related to depression (r = -0.778, P < 0.01). The relationship between resilience and depression was partially mediated by life satisfaction. The value of the mediating effect was -6.853 (26.68% of the total effect). CONCLUSION: Life satisfaction partially mediates the link between resilience and depression among nurses in clean operating departments.

Influence of empathy on work alienation among Chinese nurses during the COVID-19 pandemic: The mediating effect of ego depletion.

Background: Nurses' work alienation has become increasingly serious due to the increase in workload and risk during the coronavirus disease 2019 (COVID-19). However, no studies have investigated the link between empathy, ego depletion, and work alienation among Chinese nurses. The present study aimed to evaluate Chinese nurses' empathy, ego depletion, and work alienation and to examine whether nurses' ego depletion mediates the relationship between empathy and work alienation. Methods: This was a descriptive, cross-sectional study involving 353 nurses from Shaanxi. The Jefferson Scale of Empathy-Health Professionals, Self-Regulating Fatigue Scale and Work Alienation Questionnaire were used to collect data through an online survey. Structural equation modeling was conducted to analyze the mediating model. Results: Work alienation was negatively correlated with empathy (r = -0.305, p < 0.01) and positively correlated with ego depletion (r = 0.652, p < 0.01). Empathy was negatively correlated with ego depletion (r = -0.325, p < 0.01). Empathy can directly predict work alienation (ß = -0.263, p < 0.01), while ego depletion has a mediating effect between empathy and work alienation (ß = -0.309, p < 0.01), and the mediating effect accounts for 54.02% of the total effect. Conclusion: Nurses' work alienation was at a moderate-to-high level. Improving empathy can reduce work alienation through less ego depletion. Nursing managers should discover nurses' work alienation as soon as possible. Interventions to improve empathy can help replenish nurses' psychological resources, thereby reducing ego depletion and work alienation.

The Role of Subjective Wellbeing in Mediating Social Trust to the Mental Health of Health Workers.

Mental health problems of health workers are attracting increasing concerns in China and the world. A trustful relationship between health workers and patients is the foundation of quality patient care, which is currently under serious threat. This study aimed to determine the associations of social trust on subjective wellbeing and mental health of health workers. Using the survey data of 262 health workers extracted from the 2018 Chinese Family Panel Studies, a structural equation model with partial least square approach was established. The results showed that social trust was linked to both subjective wellbeing (ß = 0.251, p < 0.01) and mental health (ß = -0.210, p < 0.01). The effect of social trust on mental health was partially mediated by subjective wellbeing (51.87%). The association between social trust and subjective wellbeing was moderated by socioeconomic status: social trust has a stronger effect on subjective wellbeing in those with higher socioeconomic status. Erosion of social trust may present a serious risk to mental health and subjective wellbeing of health workers. High socioeconomic status can amplify the effect of social trust.

Core self-evaluation and innovative behavior: mediating effect of error orientation and self-efficacy of nurses.

Background: Innovation plays a crucial role in advancing nursing and healthcare. Despite its significance, there is a paucity of research examining the interplay among nursing innovative behavior, core self-evaluation, error orientation, and self-efficacy. This study, grounded in Bandura's social cognitive theory, seeks to not only investigate the influence of core self-evaluation on nurses' innovative behavior but also to elucidate the mediating roles of error orientation and self-efficacy within this relationship. By addressing these dynamics, the research aims to provide a comprehensive understanding of the factors shaping nurses' innovative behaviors and contribute to the broader discourse on enhancing healthcare practices. Design: A cross-sectional study using an online questionnaire. Setting: Participants were recruited from 23 hospitals in 6 provinces and 1 municipality directly under the central government in China, namely Zhejiang, Anhui, Jiangxi, Guangdong, Hebei, Henan, and Shanghai. Participants: A total of 741 nurses enrolled in the study. Methods: The participants completed the nurse innovative behavior scale, the core self-evaluation scale, the error orientation questionnaire, and the self-efficacy scale online in 2023. SPSS and AMOS were used for data analysis. The reporting followed the STROBE checklist. Results: A total of 706 valid questionnaires were collected. A positive core self-evaluation was associated with more innovative behavior, and this relation was partially mediated by error orientation and self-efficacy to avoid failure. Core self-evaluation, error orientation and self-efficacy of nurses had a positive predictive effect on innovation behavior, with the path coefficients at 0.09, 0.23, and 0.39, respectively. Conclusion: Our study complements the evidence on the mechanism of action between the core self-evaluation and innovative behavior. Our findings have important clinical implications for promoting innovative behavior in nurses.

The mediating role of resilience between perceived social support and sense of security in medical staff following the COVID-19 pandemic: A cross-sectional study.

Background: The COVID-19 pandemic not only posed a serious threat to public life and health but also had a serious impact on people's mental health, especially that of medical staff. Perceived social support is an important factor in one's sense of security. Objective: Following the COVID-19 pandemic, the goal is to explore the potential mediating role of resilience in the relationship between perceived social support and the sense of security of Chinese medical personnel. Methods: The multi-stage proportionally stratified convenience sampling method was adopted to select 4,076 medical professionals from 29 hospitals in Guangdong Province between September 2020 and October 2020. The Sense of Security Scale for Medical Staff, the Chinese version of the Connor-Davidson Resilience Scale, and the Perceived Social Support Scale were employed in this study. For statistical analysis and structural equation modeling (SEM), the SPSS 23.0 and Amos 24.0 software packages were used. Regression analysis was used to select the control variables to be included in the SEM. SEM analysis was conducted to verify the mediating effect of resilience on the relationship between perceived social support and a sense of security. Results: Pearson's correlation analysis showed that perceived social support and resilience were positively associated with a sense of security (correlation coefficients range from 0.350 to 0.607, P < 0.01), and perceived social support (correlation coefficients range from 0.398 to 0.589, P < 0.01) was positively associated with resilience. Structural equation modeling revealed that resilience played a partial mediating role in the association between perceived social support and a sense of security (60.3% of the effect of perceived social support on security was direct, and 39.7% of the effect was mediated by resilience). Conclusions: Hospital managers should make efforts to develop resilience. Interventions based on resilience should be developed to enhance the perception of social support and strengthen one's sense of security.

Relationships Between Perceived Organizational Support, Psychological Capital and Work Engagement Among Chinese Infection Control Nurses.

Background: Few studies have focused on the work engagement of infection control nurses (ICNs). The perceived organizational support (POS) and psychological capital (PsyCap) might be important factors influencing ICNs' work engagement. Moreover, PsyCap might play a mediating role in the relationship between POS and work engagement. Objective: This study aims to clarify the relationships among POS, PsyCap and work engagement of Chinese ICNs. Methods: A cross-sectional design was performed to collect data on 7382 ICNs from 20 provinces in China. Data collection was conducted by an online questionnaire, including questions about demographics, the Chinese version of the Utrecht work engagement scale (UWES), the Chinese version of the psychological capital questionnaire (PCQ) and the perceived organizational support scale for medical staff. Univariate analysis, the Spearman correlation method and the mediating effect test were conducted. Results: The work engagement was at a relatively high level, with a total score of 80.87 ± 14.95. The total scores of POS and PsyCap scale were 41.45 ± 7.37 and 89.14 ± 9.06 respectively, both of which were at the upper-middle level. Work engagement was positively associated with both POS and PsyCap (both P<0.01). Furthermore, the mediating effect of PsyCap on the relationship between POS and work engagement was 0.394, the total effect was 0.443, and the ratio of mediating effect to total effect was 88.94%. Conclusion: The findings suggest that both POS and PsyCap can directly increase the work engagement of the Chinese ICNs. Besides, POS can indirectly improve work engagement, partially through PsyCap. Therefore, enhancing POS and PsyCap could be effective in improving the work engagement of ICNs.

Psychological Resilience and Career Success of Female Nurses in Central China: The Mediating Role of Craftsmanship.

Background: Nurses' career success is an important factor affecting the quality of nursing services and the stability of the nursing workforce, and enhancing nurses' career success level is of key significance to the development of the nursing discipline. As psychological resilience and craftsmanship are important spiritual traits in the process of nurses' career development, it is important to understand the mechanism of their effects on nurses' career success level. Objective: To explore the current situation of craftsmanship, psychological resilience and career success levels of female nurses in central China, and to verify the mediating role of craftsmanship between psychological resilience and female career success using structural equation model. Methods: A cross-sectional study was conducted among 2359 female nurses from three hospitals in central China through an online questionnaire, including craftsmanship, psychological resilience and career success scale. The data were analyzed by Z-test and Spearman rank correlation with SPSS 23.0 statistical software, and the mechanism of the effect of craftsmanship and psychological resilience on career success was completed by AMOS 23.0 statistical software. Results: The scores of career success, psychological resilience, and craftsmanship of female nurses in central China were 68.00 (61.00, 75.00), 74.00 (64.00, 84.00), and 83.00 (79.00, 95.25). Spearman rank correlation analysis showed that Chinese female nurses' career success was positively correlated with craftsmanship (r = 0.511, P < 0.01) and psychological resilience (r = 0.595, P < 0.01). Craftsmanship played a mediating role between psychological resilience and career success, accounting for 39.3% of the total effect ratio. Conclusion: The scores of career success and psychological resilience of female nurses in central China are at a moderate level, and craftsmanship plays a mediating role between psychological resilience and career success. It is suggested that nursing managers should pay attention to the importance of career success to nurses' self-development and nursing team stability, and improve their sense of career success by effectively improving nurses' psychological resilience and craftsmanship.

An Exploratory Study on the Mediating Effect of Clinical Competence in the Relationship Between Grit and Field Adaptation in Newly Graduated Nurses.

Introduction: Even under difficult situations, individuals with psychological resources such as positive psychological capital and resilience are less likely to consider turnover. Grit is a psychological factor that predicts success at work in other industries, but little is known about its impact on newly graduated nurses. Objectives: The study's purpose is to investigate newly graduated nurses' grit, clinical competence, and field adaptation as well as the mediating effect of clinical competence in the relationship between grit and field adaptation. Methods: A total of 102 nurses from university hospitals located in W city took part in this investigation. Data were collected using a self-questionnaire and were analyzed using descriptive statistics, Pearson's correlation coefficient, multiple regression, and mediation analysis with the SPSS/26.0 program. Results: Grit was remarkably related to clinical competence (r = .53, p < .001) and field adaptation (r = .30, p = .003). Clinical competence was significantly related to field adaptation (r = .24 p = .02). However, the role of clinical competence as a mediating factor in the relationship between grit and field adaptation was not found to be significant (ß = .11, p = .32). Conclusion: Grit boosted clinical competence and had a direct effect on field adaptation. In order for newly graduated nurses to retain a consistent level of enthusiasm in their work, it is necessary to develop a program or strategies to improve their grit.

Psychological Capital Mediates the Association between Job Stress and Burnout of among Korean Psychiatric Nurses.

This study examined the mediating effect of psychological capital in the relationship between job stress and burnout of psychiatric nurses. The participants were 108 psychiatric nurses working in three psychiatric hospitals located in South Korea. Data were collected from 10 August to 15 September 2018 using self-report questionnaires. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient, and multiple linear regression by IBM SPSS 24.0 program. In addition, a bootstrapping test using the SPSS PROCESS macro was conducted to test the statistical significance of the mediating effect. There was significant correlation between job stress, psychological capital, and burnout. Psychological capital showed partial mediating effects in the relationship between job stress and burnout. Job stress explained 29.7% of the variance in burnout, and the model including job stress and psychological capital explained 49.6% of the variance in burnout. The bootstrapping showed that psychological capital was a significant sub-parameter and decreased job stress and burnout (LLCI = -0.1442, ULCI = -0.3548). These findings suggest that psychiatric nurses' burnout can be reduced by implementing various health care programs designed to increase psychological capital.