Self-assessed quality of sleep, occupational health, working environment, illness experience and job satisfaction of female nurses working different combination of shifts

AIM: The aim of this study was to describe and compare the self-assessed quality of sleep, occupational health, working environment, illness experience and job satisfaction among female nurses working different combinations of shifts. BACKGROUND: Evidence from several studies indicates that there is an association between the disruption of the circadian cycle caused by shift work and adverse health effects. METHODS: A cross-sectional design was used with a sample of 348 nurses drawn from the registry of the Icelandic Nurses' Association, representing 17% of the workforce of Icelandic nurses. A self-administered questionnaire, measuring occupational health, quality of sleep, the illness experience, job satisfaction and working environment was used. Data were analysed according to type of shift (days only, rotating days/evenings, rotating days/evenings/nights) by use of analysis of variance and chi-square. RESULTS: No difference was found between participants based on type of shift with regard to the illness experience, job satisfaction and quality of sleep. Nurses working rotating day/evening/night shifts reported a longer working day, more stressful environmental risk factors, more strenuous work and that they were less able to control their work-pace. In general, the nurses reported low severity of symptoms; however, nurses working rotating days/evenings shifts experienced more severe gastrointestinal and musculoskeletal symptoms when compared with others. This was explained by the short rest period provided for between evening and morning shifts. CONCLUSIONS: In general Icelandic nurses are satisfied with their work and their shift assignment does not seem to pathologically disrupt their circadian cycle. Nevertheless, nursing directors are advised to look more closely at the organization of nurses' work during night shifts, as well as the rest period for nurses changing from evening to day shifts.     

Effort–reward imbalance and burnout among German nurses in medical compared with psychiatric hospital settings

The aim of this study was to investigate whether nurses' efforts and rewards, as well as the effort–reward imbalance (ERI) and burnout, differ between subjects working in psychiatric vs. medical hospitals and between nurses under education and examined nurses respectively. Furthermore, the relationship between ERI and burnout was evaluated. Nursing is associated with high levels of emotional strain and heavy workloads. Burnout and a negative ERI can result in high absenteeism and turnover and have been identified as reasons why nurses leave their profession. In the last decade, working conditions of the nursing profession have changed in Germany, but somatic and psychiatric hospitals developed in different ways. This development may lead to different profiles. A sample of 389 nurses (78.8% female) in four German hospitals was investigated. A total of 147 nurses worked in psychiatric hospitals and 236 nurses worked in medical (somatic) hospitals. Fifty participants were still under education. The Effort–Reward Imbalance Inventory measures effort, reward and overcommitment at job and provides an imbalance score between effort and reward. The Maslach Burnout Inventory with the subscales, emotional exhaustion, lack of accomplishment and depersonalization, was also used. Nurses working in medical hospitals reported more burnout and had higher ERI scores. Subjects under education were comparable to examined nurses in terms of burnout but had lower ERI scores. Multiple regression analyses showed all ERI scales to be significant predictors for emotional exhaustion, while age, field of work and educational status further predict effort or ERI respectively. At present, the working situation of nurses in different settings appears to be characterized by a perceived imbalance of effort and reward and is associated with a high risk of developing burnout symptoms.     

The professional nursing practice environment and nurse-reported job outcomes in two European countries: a survey of nurses in Finland and the Netherlands

The working environment of nurses is receiving international interest, because there is a growing consensus that identifying opportunities for improving working conditions in hospitals is essential to maintain adequate staffing, high-quality care, nurses' job satisfaction and hence their retention. Thus, the aim of this study was to investigate the relationship between nurse work environment characteristics and nurse-reported job outcomes in hospital settings in Finland and the Netherlands and to compare these results. A comparative cross-sectional nurse survey was conducted. Data were collected from the two countries randomly sampling the countries' National Nurses Association' membership databases. In this paper, the results from Registered Nurses working in hospital settings are used. In total, 869 hospital nurses participated: 535 from Finland and 334 from the Netherlands with the response rate of 44.9 and 33.4%, respectively. Fifty-five items from the Nursing Work Index-Revised were used as a main tool for the practice environment. Exploratory factor analysis was used to identify a set of internally consistent subscales. Further, logistic regression analysis and T-tests were used. Three practice environment characteristics were identified: adequacy of resources, supportiveness of management and assurance of care quality via collaborative relationships. Favourable evaluations of the adequacy of resources and supportiveness of management were positively correlated with nurse-assessed quality of care and job-related positive feelings and negatively correlated with intentions to leave a unit, organization or the entire profession. In neither of the participating countries were adverse incidents affecting nurses related to nurses' evaluations of their current professional practice environment. Compared with Finland, in the Netherlands, RN appears to evaluate the majority of work environment characteristics more positively; nevertheless, to some extent, the results were uniform as adequacy of resources and supportiveness of management were main predictors for nurse-reported job outcomes considered.     

护士职业倦怠与工作压力源的关系分析

目的探讨护士职业倦怠与工作压力源的关系。方法采用工作倦怠量表(MBI—GS)和中国护士工作压力源量表对105名护士进行调查与分析。结果105名护士的情绪衰竭、玩世不恭与护士工作压力源呈正相关(P0.01);成就感低落与护士工作压力源(除工作环境及仪器设备不足外)呈负相关(P0.05)。护士工作压力源评分前三位是护理工作的社会地位太低、经常倒班、工作量太大。不同科室护士的职业倦怠存在差异,急诊室及ICU的护士倦怠程度较重,外科护士的职业倦怠程度较轻。结论护士的职业倦怠与工作压力源存在相关性。     

Recruitment and retention of nurses: challenges facing hospital and community employers

Understanding nurses' perceptions of their workplaces underpins successful recruitment and retention initiatives, particularly in this time of global nursing shortage. The American Nurses Association and the American Academy of Nursing have identified "magnet characteristics"--organizational factors that support excellent practice and working conditions in hospital settings. Using selected magnet characteristics, this exploratory study examined nurses' perceptions of their work experiences in both hospital and community settings. Mail surveys were completed by community and hospital nurses (n = 1248) selected randomly from a provincial registry in Ontario, Canada. Scales measured organizational factors (organizational and immediate supervisor support, decentralized decision-making, nurse-physician relationships and work-group cohesiveness) and job-related factors (autonomy, job challenge, work demands, fair treatment, work-status congruence; satisfaction with career, salary, working conditions) of nurses' experiences in their work settings. Nurses in both sectors wanted more opportunities to participate in decision-making and recognition for their contributions to their organizations. In the hospital sector, nurses reported significantly lower levels of perceived organizational and supervisory support and autonomy, and were less satisfied with working conditions and scheduling. Nurses in the community sector were most dissatisfied with salary. No cross-sector differences were reported on nurse-physician relationships, degree of job challenge or career satisfaction. Successful recruitment and retention initiatives hinge on the ability (and willingness) of healthcare organizations to attend to the concerns expressed by nurses and create work settings that are attractive to both new recruits and nurses currently in their employ.     

A discourse on female nurse job stress and reproductive hazards

The negative effects of job stress on female reproduction have been receiving greater attention due to rapidly falling fertility rates in recent years. Nurses represent the greatest number of workers in the healthcare system. Nearly all are female and most are of reproductive age. Over half of nurses perceive nursing as a high-pressure occupation, making job stress an important issue. Long-term job stress affects mental and reproductive health. The International Nursing Association's advocacy of high quality, positive medical environments in 2007 highlighted the importance of improving workplace quality. This article reviews references and discusses job stress and its relationship to reproductive hazards for female nurses. We hope it provides valuable information and encourages government and related organizations to improve the medical working environment, recognize job stress in a timely manner, and provide health promotion strategies to reduce reproductive hazards and promote nurse health.     

Hospital nurses' perceptions of respect and organizational justice

OBJECTIVE: To test an exploratory model of the antecedents and consequences of nurses' perceptions of respect in hospitals. BACKGROUND: Although nurses in hospital settings often state that they do not receive the respect they deserve for their contribution to patient care, there is little empirical research on this phenomenon. Interactional organizational justice theory framed the analysis. METHODS: A random sample of 285 staff nurses from Ontario teaching hospitals completed measures of interactional justice, structural empowerment, perceived respect, work pressures, emotional exhaustion, and work effectiveness. RESULTS: More than half of the nurses felt that managers did not show concern or deal with them in a sensitive and truthful manner regarding decisions affecting their jobs. The strongest predictors of perceptions of respect were interactional organizational justice, followed by structural empowerment and job stress resulting from lack of recognition, poor interpersonal relationships and heavy workload. Consequences of nurses' feelings of respect included greater job satisfaction, trust in management, and lower emotional exhaustion, as well as higher nurse ratings of quality of care and perceived staffing adequacy. CONCLUSIONS: A positive organizational environment increases nurses' perceptions of respect, resulting in positive outcomes for both the nurse and the organization.     

The association of Chinese hospital work environment with nurse burnout,job satisfaction,and intention to leave

The purpose of this study was to describe nurse burnout, job satisfaction, and intention to leave and to explore the relationship of work environment to nursing outcomes in a sample of 9,698 nurses from 181 hospitals in China. Nurses reported moderate levels of emotional exhaustion and depersonalization and high levels of reduced personal accomplishment. Nearly one-fifth of the nurses reported high levels of burnout on all three dimensions. Forty-five percent of the nurses were dissatisfied with their current job; these nurses were most dissatisfied with their salary. Five percent of nurses reported an intention to leave. Nurses reporting mixed and good work environments were less likely to report high burnout, job dissatisfaction, and intention to leave compared with those in poor work environments. The results suggest that high burnout and low job satisfaction are prominent problems for Chinese nurses, and improving work environment might be an effective strategy for better nursing outcomes in Chinese hospitals.     

护士分层次使用在NICU管理中的实践

目的：通过对NICU护士进行分层次使用管理,合理利用现有的人力资源,激发护理人员的工作热情、提高护士工作满意度。方法：根据护理人员的职称、学历、工作年限、个人实际工作能力等进行综合评价,将护士优化组合分层次使用后,用Mudler／McCloskey满意度量表（MMSs）对NICU护士进行问卷调查。结果：护士的工作满意度明显提高,既稳定了护理队伍,减少了人员流失,又保证了护理质量。结论：分层次使用可提高护士的工作满意度,调动护理人员的工作积极性,提高工作效率,合理使用现有人力资源,达到人尽其才,才尽其用的目的。     

A model of burnout and life satisfaction amongst nurses

This study, among 109 German nurses, tested a theoretically derived model of burnout and overall life satisfaction. The model discriminates between two conceptually different categories of working conditions, namely job demands and job resources. It was hypothesized that: (1) job demands, such as demanding contacts with patients and time pressure, are most predictive of exhaustion; (2) job resources, such as (poor) rewards and (lack of) participation in decision making, are most predictive of disengagement from work; and (3) job demands and job resources have an indirect impact on nurses' life satisfaction, through the experience of burnout (i.e., exhaustion and disengagement). A model including each of these relationships was tested simultaneously with structural equations modelling. Results confirm the strong effects of job demands and job resources on exhaustion and disengagement respectively, and the mediating role of burnout between the working conditions and life satisfaction. These findings contribute to existing knowledge about antecedents and consequences of occupational burnout, and provide guidelines for interventions aimed at preventing or reducing burnout among nurses.     

医院护士职业压力与身心健康调查

[目的]了解医院护士职业压力与身心健康状况,提高护士的身心健康水平。[方法]采用职业压力测量问卷、工作能力指数调查表及症状自评量表(SCL-90),对某医院545名护士进行调查,分析主要的职业压力与易受职业压力影响的护士群体。[结果]护士主要职业压力源是心理负荷、工作负荷、缺乏提升与参与机会;年龄越大、职称越高,所患疾病的数目也越多;护士SCL-90总均分、躯体化、焦虑、恐怖、精神病性各项因子得分均较全国常模高;SCL-90总均分在护龄分布中呈先上升再下降趋势,以10年~20年组最高。[结论]医院护士的主要职业压力源为心理和工作负荷,身心健康相对较差的护士是年龄大、护龄长、职称较高、承受压力较大的护士群体;过大的职业压力对护士身心健康有不良作用。     

重庆市万州区护士工作家庭冲突现状及其与结果变量关系的研究

目的 了解重庆市万州区护士工作家庭冲突的现状及其与工作压力感、压力症状、工作满意度、工作倦怠、工作绩效等结果变量的关系.方法 采用工作家庭冲突量表、工作压力感量表、压力症状量表、工作满意度量表、工作倦怠量表、工作绩效量表对重庆市万州区的1094名执业护士进行分层抽样问卷调查.结果 重庆市万州区护士面临较高的工作家庭冲突.工作家庭冲突显著影响护士的个人健康(工作压力感、压力症状、工作满意度、工作倦怠),对工作绩效没有显著影响.结论 重视护士群体的工作家庭冲突并采取平衡策略降低冲突水平,对保障护士的个人身心健康有着非常重要的意义.     

A comparative study of work characteristics and reactions between general and mental health nurses: a multi-sample analysis

AIM OF THE STUDY: The first aim of this study was to examine differences in work characteristics (autonomy, social support and workload) and work reactions (emotional exhaustion and job involvement) between general and mental health nurses. The second aim was to validate whether a specific pattern of relationships between work characteristics and reactions was the same for mental health and general nurses. BACKGROUND: Nurses are generally being considered as an above risk group regarding work stress. However, health care is a diverse sector and literature suggests important differences regarding the work of different categories of nursing, such as general and mental health nurses. In addition, little empirical evidence exists about these differences. In order to improve their work situation, more insight is needed regarding differences and similarities in the work of general and mental health nurses. The demand-control-support (DCS) model was used as a research framework. We hypothesized that autonomy, job involvement, and emotional exhaustion are higher in mental health nursing, whereas social support is expected to be lower. Next, in line with the propositions of this model and several recent studies, we hypothesized that emotional exhaustion is primarily predicted by workload and social support, whereas job involvement is primarily predicted by autonomy. In addition, we investigated whether this pattern of relationships was similar in both groups. DESIGN/METHODS: Questionnaires were distributed to nurses working in a general and a psychiatric hospital in the Netherlands. We used MANOVA and MSA (by means of LISREL) to analyse the data. RESULTS AND CONCLUSIONS: Regarding the differences in work characteristics and work reactions between mental health and general nurses, our hypotheses were confirmed, except for social support and job involvement. Autonomy and emotional exhaustion were higher among mental health nurses, whereas their job involvement proved to be significantly lower. Emotional exhaustion was primarily predicted by workload and lack of social support. Contrary to our expectations, the relationship between autonomy and job involvement was not significant in both samples. Finally, we found that the proposed pattern of relationships appeared to be invariant across the two samples.     

Influence of workplace demands on nurses' perception of patient safety

Abstract   Patient safety is an ongoing challenge in the design and delivery of health-care services. As registered nurses play an integral role in patient safety, further examination of the link between nursing work and patient safety is warranted. The present study examines the relationship between nurses' perceptions of job demands and nurses' perceptions of patient safety. Structural equation modeling is used to analyze the data collected from a survey of 430 registered nurses at two community hospitals in the USA. As hypothesized, nurses' perception of patient safety decreases as the job demands increase. The level of personal control over practice directly affects nurses' perception of the ability to assure patient well-being. Nurses who work full-time and are highly educated have a decreased perception of patient safety, as well. The significant relationship between job demands and patient safety confirms that nurses make a connection between their working conditions and the ability to deliver safe care.     

护士疲劳状况与领悟社会支持的调查分析

目的 通过对护士疲劳状况与领悟社会支持的调查,了解护士疲劳状况及所获领悟社会支持程度的现状,并对影响因素做初步的回归分析,为进一步预防护士慢性疲劳的发生提供参考.方法 采用疲劳评定量表(FAI)、疲劳量表(FS-14)和领悟社会支持量表(PSSS)对济宁市的200名女性护士进行问卷调查,收回有效问卷191份,有效回收率为95.5%,对所得结果进行统计分析.结果 护士中有疲劳者占69.11%,有疲劳的护士较无疲劳者4因子得分均显著提高;护士的躯体疲劳、脑力疲劳程度均大于一般健康人群;护士所获社会支持得分较高;对年龄、工作时间等各因素进行回归分析后显示:工作紧张程度、脑力疲劳、体力疲劳等显著加剧了疲劳严重程度.结论 护士为疲劳的高危人群,其中工作紧张程度为主要的影响因素;对护士进行社会支持与关怀,及保证充足的睡眠,增加护士人数,良好的工作环境等能有效减轻疲劳状况.     

The relationship between managed competition in home care nursing services and nurse outcomes.

The objective of this study was to investigate the relationship between the characteristics of home-care contracts, as indicators of employment relationships, and nurses'job satisfaction and perceived job security. A cross-sectional design was used to collect data on the study variables.The setting was 11 Community Care Access Centres and 11 nursing provider agencies in the Canadian province of Ontario. The sample included 700 nurses. A mailed survey was used to collect data from CCACs on length of contract awarded to provider agencies, potential for renewal, volume of service awarded, and profit status of the agency. Data were collected, via a mailed survey, on nurses' age, gender, work status, and years of employment in the community and at the current agency. The Nursing Job Satisfaction Scale was used to collect data on nurses'job satisfaction. Perceived job security was assessed using a single item measured on a 5-point Likert scale. Significant differences were found among provider agencies in nurses' perception of the quality of care, work enjoyment, satisfaction with time for care, and job security. Older nurses rated work enjoyment higher than younger nurses. Nurses paid on an hourly basis were more satisfied with their time for care than those paid on a per-visit basis. Nurses employed on a casual basis were less satisfied with job security than those employed on a full-time basis. Differences in nurse outcomes were observed among nursing provider agencies, but these were not related to the profit status of the agency. Further research is needed on the best practices within agencies that result in more satisfied staff.     

Which resources moderate the effects of demanding work schedules on nurses working in residential elder care? A longitudinal study

BackgroundShiftwork is a major job demand for nurses and has been related to various negative consequences. Research suggests that personal and job resources moderate the impact of work schedules on stress, health and well-being.ObjectivesThis longitudinal study examined whether the interactions of personal and job resources with work schedule demands predicted work engagement and emotional exhaustion in nursing.DesignThis longitudinal study included two waves of data collection with a one year follow-up using self-report questionnaires among 247 nurses working shifts or irregular working hours in residential care for the elderly in the Netherlands.MethodsModerated structural equation modelling was conducted to examine the interactions between personal and job resources and work schedule demands. Two work schedule demands were assessed: type of work schedule (demanding vs. less demanding) and average weekly working hours. Two personal resources, active coping and healthy lifestyle, and two job resources, work schedule control and the work schedule fit with nurses’ private life, were assessed.ResultsResults showed that the work schedule fit with nurses’ private life buffered the relationship between work schedule demands and emotional exhaustion one year later. Furthermore, the work schedule fit with nurses’ private life increased work engagement one year later when work schedule demands were high. Work schedule control strengthened the positive relationship between work schedule demands and emotional exhaustion one year later. The personal resources, active coping and healthy lifestyle were no moderators in this model.ConclusionNurses suffer less from decreasing work engagement and emotional exhaustion due to work schedule demands when their work schedules fit with their private lives. Work schedule control did not buffer, but strengthened the positive relationship between weekly working hours and emotional exhaustion one year later. Job resources appeared to be more important for nurses’ well-being than personal resources. These findings highlight the importance of the fit of a work schedule with nurse's private life, if the work schedule is demanding.     

Community health care nursing in Rajasthan. A registered nurse's perspective

This study focused on the great shortage of registered nurses (RNs) in primary health care in Rajasthan, India. It dealt especially with the nurses' own opinions about working in primary health care and their reasons for not working in it. Nurses at different levels in the health care organization were interviewed. The study was based on interviews with six RNs individually, three groups of six to eight nursing students each, and three policy-making chief nurses individually. The Minister of Health in Rajasthan also participated in the study. The study showed that the reasons for the lack of RNs in community health care were as follows: a government policy decision to place less educated nurses in the communities; the great shortage of nurses in general; the system whereby a nurse is not able to choose her/his place of work; unwillingness on the part of the nurses to work in community health care because of the great security problems; lack of support from authorities and lack of equipment. In general, community health care nursing as a work area was despised by society at large in Rajasthan.