Buckley Laura, Berta Whitney, Cleverley Kristin, Widger Kimberley
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
Hospital for Sick Children, Toronto, ON, Canada.
Front Pediatr. 2021 Dec 21;9:807245. doi: 10.3389/fped.2021.807245. eCollection 2021.
Pediatric nurses care for some of the most vulnerable patients in our healthcare system. Research on health care provider organizational behavior shows that the quality of care nurses provide is directly related to their well-being, influenced by Burnout and job stress, in the workplace. However, most of the research conducted on nursing populations neglects to separately study nurses who care for children. In a resource limited system where health care provider well-being is recognized as a priority, it is important for administrators to understand the environmental and attitudinal work factors most influential to pediatric nurse work outcomes in order to target optimization strategies. The aim of the study was to identify which work environment factors, e.g., [Incivility, Perceived Organizational Support, Quality of Work-life] make the contribution to the work outcome of Burnout (i.e., Personal Accomplishment, Emotional Exhaustion, Depersonalization) in pediatric nurses. A cross-sectional survey design was used at a large quaternary care pediatric hospital in Toronto, Canada. We administered a survey to a convenience sample of all registered nurses with >3 months experience in the Pediatric, Cardiac, and Neonatal Intensive Care Units from January 2021-March 2021. Path analysis was used to test our proposed model which was specified based on a review of the literature. 143 nurses completed the survey. Path analysis of the tested model resulted in good fit. Quality of Work-life had the largest direct effect on Work Engagement (β = 0.582, S.E. = 0.111, < 0.001). Work Engagement had the largest direct effect on Personal Accomplishment (β = 0.68, S.E. = 0.53, < 0.001). Quality of Work-life had the largest indirect effect on Personal Accomplishment (β = 0.4, S.E. = 0.65, < 0.001), Emotional Exhaustion (β = -0.33, S.E. = 0.87, < 0.001), and Depersonalization (β =-0.17, S.E. = 0.41, = 0.006), respectively. Work Engagement had the largest total effect on Personal Accomplishment (β = 0.68, S.E. = 0.64, < 0.001) and the third largest total effect on Emotional Exhaustion (β = -0.57, S.E. = 0.83, < 0.001). Quality of Work-life had the second largest total effect on Work Engagement (β = 0.58, S.E. = 0.11, < 0.001) indicating that Quality of Work-life is mediated through Work Engagement for its effect on Burnout. Our results indicate work environment and work attitude factors that can provide organizational leadership with a targeted focus to reduce pediatric critical care nurse Burnout, and thus improve provider well-being, in a resource limited system.
儿科护士照顾着我们医疗系统中一些最脆弱的患者。对医疗保健提供者组织行为的研究表明，护士提供的护理质量与他们的幸福感直接相关，而幸福感又受到工作场所倦怠和工作压力的影响。然而，大多数针对护士群体的研究都忽略了对照顾儿童的护士进行单独研究。在一个资源有限且医疗保健提供者的幸福感被视为优先事项的系统中，管理人员了解对儿科护士工作成果影响最大的环境和态度工作因素，以便制定优化策略，这一点很重要。该研究的目的是确定哪些工作环境因素，如[不文明行为、感知到的组织支持、工作生活质量]对儿科护士的倦怠工作成果（即个人成就感、情感耗竭、去个性化）有贡献。在加拿大多伦多的一家大型四级护理儿科医院采用了横断面调查设计。我们对2021年1月至2021年3月在儿科、心脏科和新生儿重症监护病房工作经验超过3个月的所有注册护士进行了便利抽样调查。路径分析用于检验我们根据文献综述指定的模型。143名护士完成了调查。对测试模型的路径分析结果显示拟合良好。工作生活质量对工作投入的直接影响最大（β = 0.582，标准误差 = 0.111，< 0.001）。工作投入对个人成就感的直接影响最大（β = 0.68，标准误差 = 0.53，< 0.001）。工作生活质量对个人成就感的间接影响最大（β = 0.4，标准误差 = 0.65，< 0.001），对情感耗竭的间接影响为（β = -0.33，标准误差 = 0.87，< 0.001），对去个性化的间接影响为（β = -0.17，标准误差 = 0.41，= 0.006）。工作投入对个人成就感的总影响最大（β = 0.68，标准误差 = 0.64，< 0.001），对情感耗竭的总影响排第三（β = -0.57，标准误差 = 0.83，< 0.001）。工作生活质量对工作投入的总影响排第二（β = 0.58，标准误差 = 0.11，< 0.001），这表明工作生活质量对倦怠的影响是通过工作投入来介导 的。我们的研究结果表明，在资源有限的系统中，工作环境和工作态度因素可以为组织领导提供有针对性的重点，以减少儿科重症护理护士的倦怠，从而提高医疗保健提供者的幸福感。
