Psychological pathway to emotional exhaustion among nurses and midwives who provide perinatal bereavement care in China: a path analysis.

BACKGROUND: A lack of confidence in perinatal bereavement care (PBC) and the psychological trauma experienced by nurses and midwives during bereavement care leads to their strong need for sufficient organisational support. The current study intended to test a hypothesised model of the specific impact paths among organisational support, confidence in PBC, secondary traumatic stress, and emotional exhaustion among nurses and midwives. METHODS: A descriptive, cross-sectional survey was conducted in sixteen maternity hospitals in Zhejiang Province, China, from August to October 2021. The sample (n = 779) consisted of obstetric nurses and midwives. A path analysis was used to test the relationships among study variables and assess model fit. RESULTS: Organisational support directly and positively predicted confidence in PBC and demonstrated a direct, negative, and significant association with secondary traumatic stress and emotional exhaustion. Confidence in PBC had a positive direct effect on secondary traumatic stress and a positive indirect effect on emotional exhaustion via secondary traumatic stress. Secondary traumatic stress exhibited a significant, direct effect on emotional exhaustion. CONCLUSIONS: This study shows that nurses' and midwives' confidence in PBC and mental health were leadingly influenced by organisational support in perinatal bereavement practice. It is worth noting that higher confidence in PBC may lead to more serious psychological trauma symptoms in nurses and midwives. Secondary traumatic stress plays an essential role in contributing to emotional exhaustion. The findings suggest that support from organisations and self-care interventions were required to improve confidence in PBC and reduce negative psychological outcomes among those providing PBC. The development of objective measures for assessing competence in PBC and organizational support are essential.

Exploring the Experiences of Compassion Fatigue Amongst Peer Support Workers in Homelessness Services.

Peer support workers have lived experiences of the challenges their clients face. While research has shown peer work can benefit recovery, the negative consequences have not been clearly addressed. This study aimed to explore the experiences of compassion fatigue amongst peer support workers in homelessness services, and the coping strategies used. An explorative qualitative design was adopted. Six peer support workers, in homelessness services, were recruited via snowball sampling. Data was collected using semi-structured interviews and analysed using thematic analysis. Five themes were identified: relentless nature of working in homelessness services, change, making meaning of past experiences, organisational support, and personal coping strategies. There were two novel findings: (1) multiple clients recounting traumatic experiences, and (2) being unfairly blamed for lack of progress, exacerbating compassion fatigue. The findings of this study furthers limited research on compassion fatigue and can be used to develop protocols and practices for organisations that utilise peer support.

The relationship between nurses' perceived organisational, supervisor and coworker support, psychological well-being and job performance.

OBJECTIVE: To examine the relationship involving nurses' perception of organisational, supervisor and co-worker support, psychological well-being and job performance. METHODS: The cross-sectional, correlational study was conducted from June 2016 to January 2017 after approval from the ethics review committee of Istanbul Medipol University, Istanbul, Turkiye, and comprised nurses working in public or private sector and being in their current employment for at least one year. Data was obtained using Organisational Support, Co-Worker Support, Supervisor Support, Psychological Well-Being and Job Performance scales. Data was analyzed using SPSS 26. RESULTS: Of the 1056 nurses, 896(84.8%) were women and 160(15.2%) were men. The overall mean age was 30.69±7.53 years (range: 17-59 years) and mean professional experience was 9.31±7.66 years (range: 1-36 years). CONCLUSIONS: Organisational, supervisor and co-worker support increased psychological wellbeing. Supervisor and co-worker support had a positive effect on job performance, but organisational support did not. Psychological wellbeing also increased job performance. Psychological well-being had a mediating role in the effect of organisational, supervisor and co-worker support on job performance. There was a positive relationship between perceived support, psychological wellbeing and job performance of nurses.

Effects of role overload, work engagement and perceived organisational support on nurses' job performance during the COVID-19 pandemic.

AIMS: We aim to study the effect of role overload, work engagement and perceived organisational support on nurses' job performance, including task performance, interpersonal facilitation and job dedication. BACKGROUND: Many nurses have suffered from role overload at work during the COVID-19 pandemic. However, the investigations of the influence mechanisms and boundary conditions through and under which role overload is associated with job performance have shown inconsistent results. METHODS: A total of 595 Chinese nurses were studied from November 2020 to February 2021. Confirmatory factor analysis, maximum likelihood estimation and bootstrapping analysis were used to test the mediating process and the moderating effect. RESULTS: Work engagement partly mediated the relationships of role overload with task performance (ß = -.253, p < .001, 95% CI: [-.315, -.204]) and interpersonal facilitation (ß = -.202, p < .001, 95% CI: [-.261, -.145]); work engagement also fully mediated the relationship between role overload and job dedication (ß = -.239, p < .001, 95% CI: [-.302, -.186]). Perceived organisational support moderated the relationships of role overload with task performance, interpersonal facilitation and work dedication (ß = -.171, p < .001, ß = -.154, p < .001 and ß = -.175, p < .001, respectively). CONCLUSIONS: Work engagement is the linchpin linking role overload to distal outcomes of job performance. Perceived organisational support mitigates the ways in which role overload undermines job performance. IMPLICATIONS FOR NURSING MANAGEMENT: Hospital administrators can minimize the effects of role overload and create a more supportive organisational environment to promote the job performance of nurses.

The role of organizational support and self-efficacy on work engagement among registered nurses in Jordan: A descriptive study.

AIM: The aim of the current study was to examine the relationship between work engagement and perceived organisational support and self-efficacy among registered nurses in Jordanian hospitals. BACKGROUND: Nurses constitute the backbone of the health care system. Work engagement among nurses is critical due to its various positive outcomes: it enhances job satisfaction, job performance, organisation commitment and emotional health. According to the job demand-resource model, perceived organisational support and self-efficacy increase work engagement. METHOD: A cross-sectional, descriptive and correlational design and multistage cluster sampling were implemented. A total of 186 registered nurses were recruited. Self-administered questionnaires were used to collect data from the participants. RESULTS: Nurses showed an average level of work engagement. The dedication subscale showed the highest score among the three subscales representing work engagement. The results showed that perceived organisational support and self-efficacy were positively correlated with work engagement (p < .01). CONCLUSION: Perceived organisational support and self-efficacy correlated positively with work engagement. IMPLICATIONS FOR NURSING MANAGEMENT: An effort should be made to provide a supportive work environment by offering training programmes, sufficient job resources and positive feedback, which, in turn, improve nurses' work attitudes, self-efficacy, perception of the work environment and intention to stay in a health organisation. This study is a descriptive study and has an IRB number 766-2019.

Workplace violence and turnover intentions among nurses: The moderating roles of invulnerability and organisational Support - A cross-sectional study.

AIMS AND OBJECTIVES: To investigate whether internal and external violence are associated with turnover intentions among nurses during demanding periods of work. BACKGROUND: Workplace violence can negatively impact upon mental and physical health and turnover intentions. Research focusing on how dimensions of workplace violence, internal versus external, influence turnover intentions and the factors that mitigate these effect is lacking. METHODS: An online cross-sectional survey of multi-item measures was used to collect data from 462 Iranian nurses. We employed path modelling and analysed the data using SPSS and PROCESS macro. A STROBE checklist was used to report findings. RESULTS: Both dimensions, internal and external, of violence were positively associated with turnover intentions. Moreover, perceived invulnerability and organisational support moderates this association. When individuals perceived invulnerability and perceived organisational support are high, internal violence is no longer indirectly related to turnover intentions via job satisfaction. In a similar vein, when perceived invulnerability and perceived organisational support are low, external violence is not related to intentions to quit. When perceived invulnerability and perceived organisational support are high, however, external violence is indirectly and negatively related to intentions to quit. CONCLUSIONS: Nurses who regard themselves as invulnerable might be motivated to quit when they experience workplace violence. However, they are motivated to stay on the job when they both perceive themselves as invulnerable and the organisation as supporting. RELEVANCE TO CLINICAL PRACTICE: Organisations should reconsider their policies and approach towards workplace violence especially during periods of intensive work.

Workplace-based health research training: a qualitative study of perceived needs in a rural setting.

BACKGROUND: The calls for increased numbers of researchers in rural health are growing. To meet this demand, training is needed. If training is to be effective, the value placed on research, the organisational need for research training and key targets for research skill development within a rural health organisation must be understood. METHODS: This qualitative study was underpinned by a critical realist perspective that allowed exploration of the organisational, cultural and structural contexts of research training and of the ability of individuals to act within these contexts. Individual interviews with purposively selected key informants from the organisation's board, executive and facility management (n = 7) and two focus groups with a convenience sample of frontline health workers with interests in research (total n = 11) were held. Data were analysed using NVivo software and thematic analysis. RESULTS: The themes emerging from this study were the fragmentation of research activity, a need for systems that support research and collaboration for expertise. CONCLUSIONS: This study has identified an overreliance on individual activity leading to a fragmented approach to research. There is a need for supportive structures, coordination and workplace leadership to overcome a longstanding culture that views research as out of the rural scope of practice. Identifying research training targets, partnering for educational expertise and planning for long-term sustainability are necessary steps toward increasing research activity in the longer term.

COVID-19 anxiety among front-line nurses: Predictive role of organisational support, personal resilience and social support.

AIM: This study examines the relative influence of personal resilience, social support and organisational support in reducing COVID-19 anxiety in front-line nurses. BACKGROUND: Anxiety related to the COVID-19 pandemic is prevalent in the nursing workforce, potentially affecting nurses' well-being and work performance. Identifying factors that could help maintain mental health and reduce coronavirus-related anxiety among front-line nurses is imperative. Currently, no studies have been conducted examining the influence of personal resilience, social support and organisational support in reducing COVID-19 anxiety among nurses. METHODS: This cross-sectional study involved 325 registered nurses from the Philippines using four standardized scales. RESULTS: Of the 325 nurses in the study, 123 (37.8%) were found to have dysfunctional levels of anxiety. Using multiple linear regression analyses, social support (ß = -0.142, p = .011), personal resilience (ß = -0.151, p = .008) and organisational support (ß = -0.127, p = .023) predicted COVID-19 anxiety. Nurse characteristics were not associated with COVID-19 anxiety. CONCLUSIONS: Resilient nurses and those who perceived higher organisational and social support were more likely to report lower anxiety related to COVID-19. IMPLICATION FOR NURSING MANAGEMENT: COVID-19 anxiety may be addressed through organisational interventions, including increasing social support, assuring adequate organisational support, providing psychological and mental support services and providing resilience-promoting and stress management interventions.

From organisational justice to turnover intention among community nurses: A mediating model.

AIMS AND OBJECTIVES: To identify the situation of organisational justice, organisational support, work engagement and turnover intention among community nurses and clarify the relationship among them. BACKGROUND: Nurse shortage has become a worldwide issue, and the shortage of community nurses is more serious. Nurse turnover is one important factor for this situation. While previous studies about turnover intention mostly focused on hospital nurses, few involved community nurses. DESIGN: A descriptive, cross-sectional design was adopted. METHODS: Questionnaire investigation was implemented among 410 community nurses to collect data about organisational justice, organisational support, work engagement and turnover intention. Structural equation modelling was applied to test the hypothesised model. The STROBE statement for observational studies was followed. RESULTS: Results showed the average score of turnover intention was 2.50 ± 0.75. The final model indicated: (a) work engagement had a direct negative effect on turnover intention; (b) organisational support had both direct and indirect effects on turnover intention, and the indirect effect was mediated by work engagement; and (c) organisational justice had an indirect effect on turnover intention mediated by organisational support. CONCLUSION: Turnover intention could be reduced directly or indirectly by improving work engagement, organisational support and organisational justice. RELEVANCE TO CLINICAL PRACTICE: This study provides evidence for community health centre managers and policymakers to improve the level of nurses' engagement and to retain more nurses in primary healthcare service.

Organisational cultural competence needed to care for foreign patients: A focus on nursing management.

AIM: This study aimed to explore the organisational level of the cultural competence needed to care for foreign patients from the Korean clinical registered nurses' perspective. BACKGROUND: Owing to the increasing foreign resident population in Korea, health care organisations face challenges arising from cultural differences. However, there is a lack of research on the impact of these changes on nursing care and management. METHOD: Participants were 16 clinical registered nurses from six general hospitals. Data were collected through individual in-depth and focus group interviews. Transcribed data were analysed by deductive content analysis. RESULTS: Data were classified into three categories: information, resources and incentives. Information included a systematic staff training programme and clear practice guidelines. Resources included convenient and credible interpretation services and adequate tools and materials, and incentives were referred to managerial support. CONCLUSION: Korean registered nurses perceived a lack of organisational support for caring for foreign patients. System-wide support and active unit-level intervention of nursing managers are essential for successful transformation towards a culturally competent organisation. IMPLICATION FOR NURSING MANAGEMENT: Registered nurses should play leadership roles to establish a dedicated nursing team or committee to create a supportive working environment and implement a monitoring system so that their organisations move towards greater cultural competence.

From organisational support to second victim-related distress: Role of patient safety culture.

AIM: This cross-sectional correlation study aimed to explore the associations among patient safety culture, organisational support, second victim-related distress, absenteeism and turnover intentions in the registered nurses (RNs) by using structural equation modelling. BACKGROUND: Medical errors could cause RNs' second victim-related distress, which may either positively or negatively impact patient safety culture. METHOD: The Hospital Survey on Patient Safety Culture (HSOPSC) and Second Victim Experience and Support Tool (SVEST) were used to investigate 267 RNs who were involved in direct patient care and medical errors within the previous year in China. RESULTS: About half (45.3%) of nurses experienced psychological distress, and 26.6% of the nurses intended to leave. The model showed that 6 dimensions of patient safety culture have contributed to decreasing absenteeism and turnover intention via increased organisational supports and decreased second victim-related distress. CONCLUSION: The second victim-related distress may be relieved, and organisational support may be enhanced through improvements in patient safety culture. IMPLICATIONS FOR NURSING MANAGEMENT: Strategies are needed to establish an environment where cooperation/cooperative relationships between the supervisor and the staff nurse can be ensured.

Organisational and individual support for nurses' ethical competence: A cross-sectional survey.

BACKGROUND: Nurses' ethical competence has been identified as a significant factor governing high quality of care. However, nurses lack support in dealing with ethical problems, and therefore managerial support for nurses' ethical competence is needed. RESEARCH QUESTIONS: This study aimed to analyse, from the perspective of nurse and nurse leaders, the level of nurses' and nurse leaders' ethical competence, perceptions of support for nurses' ethical competence at the organisational and individual levels and background factors associated with this support. RESEARCH DESIGN: A descriptive, cross-sectional study design was employed. The Ethical Competence and Ethical Competence Support questionnaires were used to measure the main components. Descriptive statistics and multifactor analysis of variance were used for data analysis. PARTICIPANTS: The participants were 298 nurses and 193 nurse leaders working in specialised (48%/52%), primary (43%/36%) or private healthcare (5%/7%) in Finland. Ethical considerations: Ethical approval was obtained from the university ethics committee. RESULTS: Nurses estimated their own ethical competence to be at an average level, whereas nurse leaders estimated their own competence at a high level. Nurses' and nurse leaders' perceptions of provided support for nurses' ethical competence was not at a high level. The positive agreement percentage related to organisational support was 44% among nurses and 51% among nurse leaders. The positive agreement percentage related to individual support was lower, that is, 38% among nurses and 61% among nurse leaders. University education had a positive association with some items of individual support. CONCLUSION: Despite the findings that ethical competence was estimated at a high level among nurse leaders, perceptions of support for nurses' ethical competence were not at a satisfactory level. At the organisational level, nurse leaders need to inform of ethical procedures and practices in orientation; encourage multidisciplinary ethics discussions and collaboration; and support nurses at an individual level to participate in ethics education, multidisciplinary ethics discussions and in solving ethical problems.

Work-family conflict and enrichment in nurses: between job demands, perceived organisational support and work-family backlash.

AIM: This study investigated how work relationships (perceived organisational support, supervisor and co-worker work-family backlash) and job demands (workload, emotional dissonance) can interact with work-family conflict and work-family enrichment. BACKGROUND: Despite the extensive literature on the work-family interface, few studies on the nursing profession have considered the role of job demands and work relationships, focusing on both the positive and negative side of the work-family interface. METHOD: The study involved a sample of 500 nurses working in an Italian hospital. Hierarchical multiple regression analyses were used to test hypotheses. RESULTS: Analyses showed that work-family conflict has a positive relationship with job demands and supervisor backlash, and a negative relationship with perceived organisational support. Work-family enrichment was found to have a negative relationship with job demands and a positive relationship with perceived organisational support. No significant relationships were found between work-family enrichment and both backlash dimensions. CONCLUSION: The study confirmed the importance of promoting a balance between job demands and resources in order to create favourable conditions for work-family enrichment and to prevent work-family conflict. IMPLICATIONS FOR NURSING MANAGEMENT: The findings suggest that it may be advisable for health-care organisations to invest in measures at individual, team and organisational levels, specifically in training and counselling for nurses and supervisors.

The fundamental managerial challenges in the role of a contemporary district nurse: A discussion.

This article examines some of the fundamental challenges facing the district nurse in delivery of the managerial aspects of her role in contemporary practice. It discusses the personal attributes that are essential for this role to ensure safe, effective and compassionate leadership and management. The communication skills and ethos underpinning collaborative multidiscilplinary team work and person-centred care are discussed. Issues that compromise positive and productive team working are identified, and strategies dealing with conflict and also change management are debated. These factors are interrelated with the everyday demands of caseload management, the development of educational needs to meet the demands of increased complexity in care needs, and the place of technology in modern health care. It is evidenced that sustained organisational support for this role is more important than ever, due to increasing demand and decreasing capacity. Potential solutions to these challenges are offered to assist the contemporary district nurse.

Perceived organisational support, organisational commitment and self-competence among nurses: a study in two Italian hospitals.

AIM: This study examined the contributions of perceived organisational support (POS) and organisational commitment (i.e. affective, continuance and normative) to self-competence among nurses. BACKGROUND: In high-POS environments, workers benefit from socio-emotional resources to improve their skills, while positive forms of commitment (e.g. affective commitment) create a fertile context for developing one's competencies. METHODS: A cross-sectional study was conducted among the nursing staff of two Italian urban hospitals (hospital A, n = 160; hospital B, n = 192). A structured questionnaire was administered individually to the nurses. Data analysis was conducted through multi-group analysis and supplemented by a bootstrapping approach. RESULTS: The results showed that POS was positively related to self-competence through affective commitment. In contrast, continuance and normative commitment did not mediate this relationship. CONCLUSIONS: This study shows that supporting employees through caring about their well-being as well as fostering positive forms of organisational commitment increases nurses' self-competence. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers may increase support perceptions and commitment among their staff by rewarding their contributions and caring about their well-being, as well as concentrating on training strategies that improve work-related skills.

Conflict management style, supportive work environments and the experience of work stress in emergency nurses.

AIMS: To examine the conflict management style that emergency department (ED) nurses use to resolve conflict and to determine whether their style of managing conflict and a supportive work environment affects their experience of work stress. BACKGROUND: Conflict is a common stressor that is encountered as nurses strive to achieve patient satisfaction goals while delivering quality care. How a nurse perceives support may impact work stress levels and how they deal with conflict. METHODS: A correlational design examined the relationship between supportive work environment, and conflict management style and work stress in a sample of 222 ED nurses using the expanded nurse work stress scale; the survey of perceived organisational support; and the Rahim organisational conflict inventory-II. RESULTS: Twenty seven percent of nurses reported elevated levels of work stress. A supportive work environment and avoidant conflict management style were significant predictors of work stress. CONCLUSIONS: Findings suggest that ED nurses' perception of a supportive work environment and their approach to resolving conflict may be related to their experience of work stress. IMPLICATIONS FOR NURSING MANAGEMENT: Providing opportunities for ED nurses in skills training in constructive conflict resolution may help to reduce work stress and to improve the quality of patient care.

The effect of perceived organisational support on burnout among community health nurses in China: the mediating role of professional self-concept.

AIM: To examine the mediating effect of professional self-concept on the association between perceived organisational support and burnout among community health nurses in Chengdu, China. BACKGROUND: Burnout is a common phenomenon among nurses and previous studies have focused on work environmental factors contributing to burnout. Limited studies have examined the effects of perceived organisational support and professional self-concept on burnout among community health nurses. METHODS: This was a cross-sectional study with 551 community health nurses in Chengdu, China, which included a two-stage sampling method. Structural equation modelling was used to examine the relationships among perceived organisational support, professional self-concept and burnout. RESULTS: The final sample included 456 nurses (82.7%). Perceived organisational support was a significant positive direct predictor for professional self-concept and a significant negative direct predictor for burnout. Professional self-concept was a significant negative direct contributor to burnout. Professional self-concept had a mediating effect on the relationship between perceived organisational support and burnout. CONCLUSIONS: Perceived organisational support may result in reduced burnout by facilitating the development of positive professional self-concept. IMPLICATIONS FOR NURSING MANAGEMENT: Strategies such as establishing a supportive work environment and professional competence training may be effective methods for burnout prevention and management among community health nurses.

The effects of perceived organisational support and span of control on the organisational commitment of novice leaders.

AIM: The purpose of this study was to examine the main and interaction effects of perceived organisational support, span of control and leadership rank on novice nurse leaders' organisational commitment. BACKGROUND: As nurse leaders' organisational commitment is eroded at times of healthcare restructuring, it is important to study factors associated with organisational commitment. METHODS: Cross-sectional data from 69 novice nurse leaders, collected via mailed surveys at two time points, were analysed using hierarchical regression. RESULTS: The findings supported our hypotheses about the positive effect of perceived organisational support, the positive effect of leadership rank and the negative effect of span of control on novice nurse leaders' organisational commitment. In addition, perceived organisational support was shown to moderate the negative effect of span of control on novice nurse leaders' organisational commitment at time 2. CONCLUSION: Organisational strategies aimed at supporting nurse leaders, and attention to span of control, are required to enhance the organisational commitment of novice nurse leaders. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse leaders with a wide span of control, in particular those with little leadership experience, need to adopt leadership strategies that maximise their effectiveness, such as organising smaller work groups or teams within their wide span of control.

A study of the determinants of work-to-family conflict among hospital nurses in Belgium.

AIMS: This study examines the relative impact of three sources of work-to-family conflict among hospital nurses: work-family policy use (childcare assistance, schedule flexibility, part-time work), job dimensions (work overload, job autonomy, overtime hours, night shifts, regularity in type of shift, weekend work, hierarchical position, variation in tasks) and organisational support (physician/co-worker support). BACKGROUND: Many studies claim that organisational support and job dimensions are more important sources of work-to-family conflict than work-family policy use, a relation that has not been fully investigated. This study attempts to fill this gap by empirically assessing the relative impact of these sources on nurses' work-to-family conflict. METHODS: Four hundred and fifty three Belgian nurses completed a web survey. The sources of work-to-family conflict were analysed using a hierarchical linear regression. RESULTS: Organisational support influences work-to-family conflict, above and beyond work-family policy use and job dimensions, while policy use has no influence. Physician and co-worker support have a unique decreasing effect, while work overload and overtime hours increase work-to-family conflict. CONCLUSIONS: Organisational support, lack of work overload and absence of overtime hours reduce work-to-family conflict, whereas work-family policy use does not. IMPLICATIONS FOR NURSING MANAGEMENT: To retain and attract nurses by reducing work-to-family conflict, hospitals should not (only) rely on work-family policies but should also invest in organisational support and adapted job dimensions.

Mapping the family incivility, dissatisfaction and organizational support after the COVID-19 outbreak.

BACKGROUND: Stress is a pivotal aspect of organizational psychology. Although an individual's attitude and behaviour at work have received greater investigation, scant attention has been given to family-related dynamics and their impact on work. OBJECTIVE: This study contributes to understanding work-family dynamics by investigating the connection between family incivility and job dissatisfaction during the pandemic. Based on the conservation of resources theory, the research explores the potential moderating role of perceived organizational support. METHODS: The investigation uses structural equation modelling (SEM) for data analysis while controlling for age, gender, and experience. Data has been collected with an adapted scale and time-lag technique in which the first wave encompassed independent variables and demographics. The second wave gathered moderator and dependent variables through a non-probability sampling of IT employees. RESULTS: Findings reveal a significant positive link between family incivility and job dissatisfaction, implying higher family incivility is linked to increased job dissatisfaction. Moreover, the study indicates that organizational support can mitigate the negative impact of family incivility on job dissatisfaction. CONCLUSION: This research underscores the pivotal role of organizational support in enhancing employee job outcomes. Hence, organizations should prioritize employee well-being, recognizing it as an integral aspect of their functioning.