Surface acting,emotional exhaustion,career calling and turnover intention among student nurses: A cross-sectional study

AimThis study aims to explore the mediating role of emotional exhaustion and the moderating role of career calling in the linkage of surface acting and turnover intention among student nurses in the final clinical practicum.BackgroundTurnover rates are especially high for graduating nursing students. Surface acting is considered an important factor that affects this rate among nurses. However, little is known about the relationships between surface acting and turnover intentions among graduating nursing students in the final clinical practicum.DesignThe current research is a cross-sectional study, and the data were collected from 8 January 2022–22 January 2022.MethodsA survey was completed by 275 graduating nursing students. This survey included Chinese translations of scales measuring surface acting, emotional exhaustion, career calling and turnover intentions.ResultsBoth surface acting (r = 0.47, p < 0.001) and emotional exhaustion (r = 0.59, p < 0.001) correlated positively with turnover intentions. Both surface acting (r = −0.41, p < 0.001) and emotional exhaustion (r = −0.62, p < 0.001) correlated negatively with career calling and career calling (r = −0.72, p < 0.001) correlated negatively with turnover intentions. The association between surface acting and turnover intention was mediated by emotional exhaustion. In addition, career calling moderated the relationship between surface acting and emotional exhaustion.ConclusionsSurface acting results in higher emotional exhaustion and higher turnover intention among graduating nursing students, which was more pronounced among nursing students with a lower sense of career calling.     

How work-family conflict influences emergency department nurses' turnover intention: The mediating role of positive and negative affect

BackgroundTurnover has significant impact on nursing management and nursing safety. Nurses working in the Emergency Department are especially vulnerable to high turnover intention because of their increased risk of work-family conflict associated with the work characteristics.ObjectiveThis study aimed to investigate the effects of work-family conflict on emergency nurses' turnover intention and the role of positive and negative affect between work-family conflict and turnover intention.MethodsA cross-sectional study. Data were collected from 17582 nurses working in emergency department in China. We employed a standardized questionnaire to collect sociodemographic information and target work-family conflict, affect and turnover intention. Mediation analyses were performed for the data analyses.ResultsOn turnover intention, work-family conflict exerted both direct effect and indirect effect. The results also indicated that positive and negative affect partially mediated the effect of work-family conflict on turnover intention, and that 35.7% of this effect could be explained by mediating effects totally.ConclusionsThe findings highlight positive and negative affect concern during the process of nursing management and nursing managers should take active measures to reduce negative affect and improve positive affect in order to reduce turnover intention and maintain the stability of the emergency nursing workforce.     

儿科医师感知医患关系与离职倾向关系——基于工作满意度的中介作用

目的：了解儿科医师的感知医患关系、工作满意度、离职倾向现状,探究感知医患关系、工作满意度对离职倾向的影响,为降低离职率和稳定儿科医师队伍提供参考依据。方法：采用分层随机抽样,对武汉市不同级别公立医疗机构儿科医师发放问卷600份,有效回收率为93.17%;采用Pearson相关方法分析相关性,采用t检验、方差分析探讨不同人口学特征下离职倾向差异,采用线性回归探讨其线性关系,并运用中介模型探讨感知医患关系、工作满意度对离职倾向作用效果。结果：武汉市儿科医师的感知医患关系能够预测其工作满意度,95%置信区间为（0.632,0.888）,具有统计学意义,但无法直接预测离职倾向,95%置信区间为（-0.270,0.144）;由中介效应检验结果发现工作满意度是感知医患关系和离职倾向的完全中介,95%置信区间为（-0.475,-0.235）,具有统计学意义。结论：医患关系问题长期存在,但是不会直接导致儿科医师离职,而是会与医院的内部保障和激励机制共同发生作用,若要稳定儿科医师队伍,需要通过医院内部管理措施提高其工作满意度。     

Risk Factors of Nonfusion after Anterior Cervical Decompression and Fusion in the Early Postoperative Period: A Retrospective Study

Objective

Although high fusion rates have been reported for anterior cervical decompression and fusion (ACDF) in the medium and long term, the risk of nonfusion in the early period after ACDF remains substantial. This study investigates early risk factors for cage nonfusion in patients undergoing single- or multi-level ACDF.

Methods

This was a retrospective study. From August 2020 to December 2021, 107 patients with ACDF, including 197 segments, were enrolled, with a follow-up of 3 months. Among the 197 segments, 155 were diagnosed with nonfusion (Nonfusion group), and 42 were diagnosed with fusion (Fusion group) in the early period after ACDF. We assessed the significance of the patient-specific factors, radiographic indicators, serum factors, and clinical outcomes. The Wilcoxon rank sum test, t-tests, analysis of variance, and stepwise multivariate logistic regression were used for statistical analysis.

Results

Univariate analysis showed that smoking, insufficient improvement in the C2-7 Cobb angle (p = 0.024) and the functional spinal unit Cobb angle (p = 0.022) between preoperative and postoperative stages and lower serum calcium (fusion: 2.34 ± 0.12 mmol/L; nonfusion: 2.28 ± 0.17 mmol/L, p = 0.003) β-carboxyterminal telopeptide end of type 1 collagen (β-CTX) (fusion: 0.51 [0.38, 0.71]; nonfusion: 0.43 [0.31, 0.57], p = 0.008), and N-terminal fragment of osteocalcin (N-MID-BGP) (fusion: 18.30 [12.15, 22.60]; nonfusion: 14.45 [11.65, 18.60], p = 0.023) are risk factors for nonfusion in the early period after ACDF. Stepwise logistic regression analysis revealed that poor C2-7 Cobb angle improvement (odds ratio [OR], 1.107 [1.019–1.204], p = 0.017) and lower serum calcium (OR, 3.700 [1.138–12.032], p = 0.030) are risk factors.

Conclusions

Patients with successful fusion after ACDF had higher preoperative serum calcium and improved C2-7 Cobb angle than nonfusion patients at 3 months. These findings suggest that serum calcium could be used to identify patients at risk of nonfusion following ACDF and that correcting the C2-7 Cobb angle during surgery could potentially increase fusion in the early period after ACDF.