Kohnen Dorothea, De Witte Hans, Schaufeli Wilmar B, Dello Simon, Bruyneel Luk, Sermeus Walter
Research Group Work, Organizational, and Personnel Psychology, KU Leuven, Leuven, Belgium; KU Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium.
Research Group Work, Organizational, and Personnel Psychology, KU Leuven, Leuven, Belgium; Optentia Research Unit, North-West University, South Africa.
Int J Nurs Stud. 2023 Dec;148:104567. doi: 10.1016/j.ijnurstu.2023.104567. Epub 2023 Jul 22.
Literature shows that the work environment is a main determinant of nurses' well-being and psychological strain; yet, the (psychological) mechanisms underlying this relationship remain understudied.
This study explored the underlying (psychological) mechanisms (why) and boundary conditions (when) by which characteristics present in the clinical work environment influence nurses' well-being. We investigated the mediating role of intrinsic motivation in the relationship of job demands and job resources with burnout vs. work engagement. In addition, we examined if job resources strengthen the relationship of job demands with intrinsic motivation and burnout.
A cross-sectional survey study.
SETTING(S): General acute care hospitals in Belgium (n = 14).
Direct care nurses (n = 1729).
Data were collected by means of online questionnaires between October 2020 and July 2021. Study variables included burnout, work engagement, intrinsic motivation and a set of different job demands (workload, role conflicts, emotional demands, red tape) and job resources (performance feedback, autonomy, skill use, opportunity for growth, and value congruence). All variables were obtained using self-report measures. The central hypotheses were tested using structural equation modeling.
Job resources appeared to be a crucial factor for nurses' health showing positive associations with work motivation (β = 0.513) and work engagement (β = 0.462) and negative associations with burnout (β = -0.216). Job demands remained an essential factor that harms psychological health and is associated with increased burnout (β = 0.489). Our results confirmed that intrinsic motivation mediated the relationship of job resources with work engagement (β = 0.170) and burnout (β = -0.135). In addition, job resources moderated the relationship of job demands with burnout (β = -0.039). Against our expectations, we found no associations between job demands and intrinsic motivation or a moderation effect of job resources on the respective relationship.
A highly demanding work environment can be a source of significant stress which may put nurses' health at severe risk. Nurses who perceive sufficient job resources such as feedback, autonomy and opportunities for growth and development, are likely to feel intrinsically motivated at work. In addition, it will foster their work engagement and prevent them from burning out, particularly when job demands are high.
The study described herein is funded under the European Union's Horizon 2020 Research and Innovation program from 2020 to 2023 (Grant Agreement 848031). The protocol of Magnet4Europe is registered in the ISRCTN registry (ISRCTN10196901).
Providing nurses with sufficient resources will not only increase their motivation and engagement at work but also reduce their feelings of burnout.
文献表明，工作环境是护士幸福感和心理压力的主要决定因素；然而，这种关系背后的（心理）机制仍未得到充分研究。
本研究探讨临床工作环境中存在的特征影响护士幸福感的潜在（心理）机制（原因）和边界条件（时间）。我们研究了内在动机在工作需求和工作资源与倦怠与工作投入关系中的中介作用。此外，我们考察了工作资源是否会加强工作需求与内在动机及倦怠之间的关系。
横断面调查研究。
比利时的综合急性护理医院（n = 14）。
直接护理护士（n = 1729）。
2020年10月至2021年7月期间通过在线问卷收集数据。研究变量包括倦怠、工作投入、内在动机以及一系列不同的工作需求（工作量、角色冲突、情感需求、繁文缛节）和工作资源（绩效反馈、自主权、技能运用、成长机会和价值观契合度）。所有变量均采用自我报告测量法获取。使用结构方程模型检验核心假设。
工作资源似乎是护士健康的关键因素，与工作动机（β = 0.513）和工作投入（β = 0.462）呈正相关，与倦怠（β = -0.216）呈负相关。工作需求仍然是损害心理健康并与倦怠增加相关的重要因素（β = 0.489）。我们的结果证实，内在动机介导了工作资源与工作投入（β = 0.170）和倦怠（β = -0.135）之间的关系。此外，工作资源调节了工作需求与倦怠之间的关系（β = -0.039）。与我们的预期相反，我们发现工作需求与内在动机之间没有关联，工作资源对各自关系也没有调节作用。
要求极高的工作环境可能是巨大压力的来源，可能使护士的健康面临严重风险。认为有足够工作资源（如反馈、自主权和成长发展机会）的护士，在工作中可能会感到内在动力。此外，这将促进他们的工作投入并防止他们倦怠，尤其是在工作需求较高时。
本文所述研究由欧盟2020 - 2023年“地平线2020”研究与创新计划资助（资助协议848031）。Magnet4Europe方案已在ISRCTN注册库（ISRCTN10196901）注册。
为护士提供足够的资源不仅会增加他们的工作动机和投入，还会减少他们的倦怠感。
