Self-endangering:A qualitative study on psychological mechanisms underlying nurses’burnout in long-term care

Objectives To develop a more specific understanding of psychological mechanisms in the development of burnout in long-term care as a basis for potential new intervention strategies aiming at improving nurses’mental health.Methods Two qualitative studies with thematic analysis were conducted.In Study 1,we conducted eight group interviews with 110 nurses from May–July 2019 in the context of workshops at eight nursing homes in Germany.In Study 2,we supplemented these with semi-structured interviews with 14 executives at German nursing homes in December 2019.Results The thematic analysis in Study 1 identified three main themes:causes of challenges,employees’opportunities for change,and organisational opportunities for change.Thematic analysis in Study 2 identified three main themes:job motives,reasons for filling in for others,and employee self-care.Further,our results show that the need to stand in for colleagues,in particular,is one of the greatest challenges for geriatric caregivers.In dealing with these challenges we found that self-endangering behaviour—a diminished ability to say no when asked to fill in or to do work overtime—was an important antecedent of nurses’burnout.Further,high levels of altruistic motivation and identification with the team or organisation were associated with self-endangering behaviour in the presence of adverse working conditions.Low levels of self-worth are a further risk factor for self-endangering.Conclusions Our findings are at odds with some core tenets of classic models of job demands and burnout that construe motivation and identification as resources.Our results show the need of a holistic intervention program in nursing including individual coaching,team-based interventions and organisational development processes.Employees themselves should be sensitized to this issue and supported in the long term,and politicians should create structures that do not encourage this behaviour any further.

Hospital ethical climate associated with the professional quality of life among nurses during the early stage of COVID-19 pandemic inWuhan,China:A cross-sectional study

Objectives:To describe the professional quality of life and explore its associated factors among nurses coming from other areas of China to assist with the anti-epidemic fight inWuhan and especially examine whether the hospital ethical climate was independently associated with nurses’professional quality of life.Methods:A cross-sectional online survey was conducted from March 2020 to April 2020.The nurses working in Wuhan from the other parts of China were the target population.The Professional Quality of Life Scale version 5,the Hospital Ethical Climate Survey,and a basic information sheet were used to collect data.Descriptive statistics,t-test,ANOVA,Pearson correlation,and multiple linear regression analysis were used to analyze the data.Results:In total,236 nurses participated in this study,and 219 valid questionnaires were analyzed.The average age of the participants was 31.2±5.0 years.Most nurses were female(176/219;80.4%)and married(145/219;66.2%).In term of professional quality of life,nurses reported moderate(129/219;58.9%)to high(90/219;41.1%)levels of compassion satisfaction,low(119/219;54.3%)to moderate(100/219;45.7%)levels of burnout,and low(67/219;36.0%)to high(10/219;4.6%)levels of secondary traumatic stress.Regarding hospital ethical climate,nurses reported moderately high hospital ethical climates with an average score of 4.46.After controlling for socio-demographic characteristics,the multiple linear regression models showed that the hospital ethical climate subscale of“relationship with physicians”was independently associated with the compassion satisfaction(b=0.533,P<0.01)and burnout(b=0.237,P<0.05);the hospital ethical climate subscale of“relationship with peers”(b=0.191,P<0.01)was independently associated with the secondary traumatic stress.Conclusions:During the early stage of the pandemic,nurses demonstrated moderate to high level of compassion satisfaction,low to moderate level of burnout,and all nurses experienced secondary traumatic stress.Nurses perceived a high level of hospital ethical climate,and the perceived hospital ethical climate played an important role in promoting nurses’professional quality of life during a lifethreatening infectious disease pandemic.

An analysis of association of personality traits with job burnout among nurses working in hospital

Objective:The objective of the present study is to explore the effects of personality traits on job burnout among hospital nurses.Materials and Methods:This cross-sectional research was done during 2019-2020 at Kashan Shahid Beheshti Hospital.The data analysis procedures included descriptive statistics and the partial least squares-based structural equation modeling.The participants were 150 nursing professionals.A questionnaire indicating information on demographics,burnout(measured using the Maslach Burnout Inventory with three dimensions of depersonalization,emotional exhaustion,and personal accomplishment),and personality profile(measured employing the neuroticism extraversion openness five-factor inventory including extroversion,conscientiousness,agreeableness,neuroticism,and openness to experience dimensions)was used to gather the required data.Results:The results of the study showed that the validity and reliability of the measurement model were desirable(factor load higher than 0.5,the Cronbach’s alpha value and the composite reliability are>0.7).Structural model showed statistically drastic,negative relationship between the nurses’burnout levels and neuroticism(β=0.722)and openness to experience(β=0.437).However,the relationship was significantly positive between the nurses’burnout levels and conscientiousness(β=0.672),agreement(β=0.594),and extraversion(β=0.559)(P<0.03).Conclusions:The present study helped the recognition of burnout among nurses working in hospitals and approved the effects of personality features on the burnout experience.

A unitary caring science resilience-building model:Unifying the human caring theory and research-informed psychology and neuroscience evidence

Resilience is the psychological capability to recover from difficulties quickly.Healthcare professionals are especially vulnerable to job-related stress and burnout.Unitary Caring Science is the framework for Watson’s Human Caring Theory,providing a philosophy of practice in healthcare.With the high rates of clinician burnout and psychological issues,it will be significant to unify the human caring theory with research-informed psychological and neuroscience evidence to develop clinicians’resilience-building strategies.The purpose of this article is to introduce a Unitary Caring Science Resilience Model and explain the science behind the core strategies based on Unitary Caring Science philosophy and the psychological and neuroscience research.This model includes six strategies:Embracing loving-kindness for self and others;Nurturing interpersonal and intersubjective connections/relations;Deepening a creative use of self and sense of belonging;Balancing self-learning,self-awareness,and an evolved selfconsciousness;Valuing forgiveness and releasing negativity;Inspiring and maintaining faith-hope.The caring-theory guided resilience-building strategies are proven to alleviate the depletion of clinicians’energy and emotions.Healthcare practices are challenging but rewarding.Clinicians can be emotionally,psychologically,and physically exhausted if they always consider themselves‘giving’and‘doing’institutional tasks without a sense of purpose or fulfillment.The practice can be rewarding if it becomes more aligned with clinicians’value to serve humanity.Through the unitary caring science resilience strategies,clinicians can build resilience as an antidote to clinician burnout and depletion.