Fatigue as a Cause of Professional Dissatisfaction Among Chinese Nurses in Intensive Care Unit During COVID-19 Pandemic.

Aim: To clarify the mediating role of burnout and the moderating role of turnover intention in the association between fatigue and job satisfaction among Chinese nurses in intensive care units (ICU) during the COVID-19 pandemic. Methods: A cross-sectional survey of fifteen provinces in China was conducted, using an online questionnaire, from December 2020 to January 2021, during the COVID-19 pandemic. A total of 374 ICU nurses (effective response rate: 71.37%) provided sufficient responses. Sociodemographic factors, job demographic factors, fatigue, burnout, job satisfaction, and turnover intention were assessed using questionnaires. General linear modeling (GLM), hierarchical linear regression (HLR) analysis, and generalized additive modeling (GAM) were performed to examine all the considered research hypotheses. Results: Fatigue was found to be negatively and significantly associated with job satisfaction. Moreover, burnout played a partial mediating role and turnover intention played a moderating role in the relationship between fatigue and job satisfaction. Conclusion: Over time, a state of physical and mental exhaustion and work weariness among Chinese ICU nurses potentially results in job burnout and consequently promotes the level of job dissatisfaction. The results also found that turnover intention played a moderating role in the relationship between burnout and job satisfaction. Specific policies could be considered to eliminate nurses' fatigue and negative attitudes during times of public health emergencies.

Moderating Role of Peer Pressure and Positive Learning Environment Between Career Calling and Academic Procrastination in Chinese Medical Students During Controlled COVID-19 Pandemic: A Cross-Sectional Study.

Purpose: The COVID-19 pandemic sets specific circumstances that may accelerate academic procrastination behavior of medical students. Career calling is a protective factor that fights against academic procrastination and may further improve medical students' mental health and academic achievement. This study aims to determine the status of Chinese medical students' academic procrastination during controlled COVID-19 pandemic. Moreover, the study investigates the relationships and mechanisms among career calling, peer pressure, a positive learning environment, and academic procrastination. Patients and Methods: Data were collected from several Chinese medical universities through an anonymous cross-sectional survey of 3614 respondents (effective response rate = 60.0%). Using online questionnaires to collect the data and IBM SPSS Statistics 22.0 for statistical analysis. Results: The average score of academic procrastination of Chinese medical students was 2.62±0.86. This study proved the usage of peer pressure and positive learning environment as moderating roles of relationship between career calling and academic procrastination. Career calling was negatively correlated with academic procrastination (r = -0.232, p < 0.01), while it was positively correlated with peer pressure (r = 0.390, p < 0.01) and a positive learning environment (r = 0.339, p < 0.01). Moreover, academic procrastination was negatively correlated with peer pressure (r = -0.279, p < 0.01) and a positive learning environment (r = -0.242, p < 0.01). Peer pressure was positively correlated with a positive learning environment (r = 0.637, p < 0.01). Conclusion: The findings emphasize the importance of constructive peer pressure and a positive learning environment that discourages academic procrastination. Educators should highlight medical career calling education by offering related courses to fight against academic procrastination.

Current Status of Intergroup Threats Perceived by Chinese Physicians and Its Association with Organizational Psychology, Behavior, and Well-Being during the COVID-19 Pandemic: A Cross-Sectional Survey.

(1) Background: Chinese physicians have encountered serious physical and verbal attacks in recent decades due to poor patient-physician relationships, leading to a broad spectrum of negative consequences. This study aims to assess the status of intergroup threats perceived by physicians and explore its association with organizational psychology, behavior, and well-being during the COVID-19 pandemic. (2) Methods: We conducted a cross-sectional online survey with physicians from November to December 2020 in three provinces: Heilongjiang Province, Henan Province, and Zhejiang Province, in China. A total of 604 physicians were recruited to complete an anonymous questionnaire. There were 423 valid questionnaires. (3) Results: We developed a 25-item intergroup threat scale with four dimensions: interest damage, performance impairment, value derogation, and unjust sentiment. Internal consistency reliability analyses showed that the four dimensions and overall scale exhibited high internal consistency (0.756-0.947). Additionally, the average scores for physicians' perceived overall intergroup threat, interest damage, performance impairment, value derogation, and unjust sentiment were 4.35 ± 0.51, 4.24 ± 0.73, 4.33 ± 0.58, 4.22 ± 0.65, and 4.53 ± 0.55, respectively. Moreover, this study shows that the intergroup threats perceived positively by physicians were associated with psychological stress (ß = 0.270, p < 0.01), emotional exhaustion (ß = 0.351, p < 0.01), turnover intention (ß = 0.268, p < 0.01), and defensive medical behavior (ß = 0.224, p < 0.01), and were negatively associated with job satisfaction (ß = -0.194, p < 0.01) and subjective well-being (ß = -0.245, p < 0.01). (4) Conclusions: The newly developed scale in this study is a reliable tool for measuring intergroup threats perceived by Chinese physicians. Physicians in China were suffering high-level intergroup threats during the anti-COVID-19 pandemic, which has a significant impact on damage to organizational psychology, behavior, and well-being. Intergroup threats perceived by physicians not only enlarged the risk of emotional exhaustion and psychological stress but also threatened organizational well-being. Moreover, greater intergroup threats were associated with a lower job satisfaction, more frequent defensive medical behavior, and a higher turnover intention for physicians. The results of this study suggest that essential intervention and governance measures should be considered to protect physicians' well-being and benefits in China, which are urgently needed.

Can resilience promote calling among Chinese nurses in intensive care units during the COVID-19 pandemic? The mediating role of thriving at work and moderating role of ethical leadership

Background Nurses working in the intensive care unit (ICU) clung tenaciously to their job during the COVID-19 pandemic in spite of enduring stressed psychological and physical effects as a result of providing nursing care for the infected patients, which indicates that they possessed a high degree of professionalism and career calling. The aim of this study was to explain the associations between resilience, thriving at work, and ethical leadership influencing the calling of ICU nurses. Methods From December 2020 to January 2021 during the COVID-19 pandemic, a cross-sectional survey of 15 provinces in China was conducted using an online questionnaire. A total of 340 ICU nurses (effective response rate: 64.89%) completed sufficient responses to be used in the study. Sociodemographic factors, job demographic factors, resilience, calling, thriving at work, and ethical leadership were assessed using the questionnaire. General linear modeling (GLM), hierarchical linear regression (HLR) analysis, and generalized additive model (GAM) were performed to examine all the considered research hypotheses. Results Resilience was positively and significantly associated with calling. Moreover, thriving at work partially mediated the relationship between resilience and calling. The indirect effect of resilience on calling was 0.204 (p < 0.0001), and the direct effect of resilience on calling through thriving at work was 0.215 (p < 0.0001). The total effect of resilience on calling was 0.419 (p < 0.0001). In addition, ethical leadership played a moderating role in the relationship between resilience and calling (β = 0.16, p < 0.05). Conclusion Greater resilience can positively predict increased calling among Chinese ICU nurses during the COVID-19 pandemic. Moreover, thriving at work is a mechanism that partly transmits the positive effects of resilience on calling. Overall, nurses possessing greater resilience tend to maintain thriving at work in the face of such adversity, further resulting in subsequently increased calling. Besides, findings suggest that there is stronger influence of resilience on calling among nurses working in an organization managed by an ethical leader. The current findings may offer two insights for nursing practitioners and policymakers in the postpandemic world. First, resilience training and intervention are necessary to foster nurses' sense of thriving at work in the nursing industry, further promoting career calling. Second, better training and effort on the development of ethical leadership for leaders in nursing practice are essential to encourage followers to engage in social learning of ethical behaviors and abiding by normatively appropriate conduct, further enacting prosocial values and expressing moral emotions.

Demographic Factors and Job Characteristics Associated With Burnout in Chinese Female Nurses During Controlled COVID-19 Period: A Cross-Sectional Study.

Background: To investigate the prevalence of burnout syndrome among Chinese female nurses during the controlled coronavirus disease 2019 (COVID-19) period and explore its associated socio-demographic factors and job characteristics. Methods: With the multistage, stratified sampling method, a cross-sectional online survey was conducted from September to October 2020 in China. The survey tool included revised Maslach Burnout Inventory (MBI) with 15 items, socio-demographic and job characteristics. Univariate logistic regression analysis and multivariate factor logistic regression analysis were used to identify the risk factors for burnout of female nurses. Results: During controlled COVID-19 period in China, the overall prevalence of burnout symptoms among Chinese female nurses was 60.2% with a breakdown in severity as follows: 451 (39.8 %) mild, 163 (14.4%) moderate, and 68 (6.0%) severe burnout. Little variance was reported for burnout symptoms according to job tenure (Waldχ2 = 14.828, P < 0.05,odds ratio [OR] <1), monthly salary income (Waldχ2 = 12.460, P < 0.05, OR <1), and night shift (Waldχ2 = 3.821, P < 0.05, OR > 1). Conclusion: Burnout symptoms among Chinese female nurses were prevalent and associated with job tenure, monthly salary income, and night shift. Female nurses who were with shorter job tenure, worked at night shifts, and had lower monthly salaries tended to exhibit increasing high-level burnout than their counterparts. This study serves as an implication for administrators and policy-makers to improve the work conditions of nurses for promoting overall healthcare service quality.

What motivates individual public service motivation and cooperation at the initial stage of the COVID-19 outbreak: A cross-sectional survey.

OBJECTIVES: This study assesses the status of public service motivation and explains it's the positive association with public cooperation during the initial stage of the COVID-19 crisis. Moreover, potential causes of Chinese citizens' public service motivation have been explored. METHODS: A cross-sectional survey of 30 provinces in China was conducted using an online questionnaire. The study was conducted in February 2020 during the initial stage of the COVID-19 pandemic. Socio-demographic factors, public service motivation, public satisfaction, public confidence, and public cooperation were assessed using questionnaires. Hierarchical multiple regression was used to identify clusters of interrelationships among public service motivation, public satisfaction, public confidence, and public cooperation among Chinese citizens. RESULTS: We found that participants' public satisfaction with COVID-19-related public services had a positive association with public confidence (B = 0.456, p < 0.001) and public service motivation (B = 0.177, p < 0.001). Moreover, public confidence regarding anti-COVID-19 measures had a positive influence on public service motivation (B = 0.308, p < 0.001) while mediating the relationship between public satisfaction and public service motivation. Public service motivation were positively associated with public cooperation with anti-COVID-19 measures during the initial stage of the COVID-19 pandemic. CONCLUSION: A considerably high level of public service motivation among Chinese citizens appeared during the initial stage of the COVID-19 pandemic, resulting in an increase in public cooperation. Moreover, the findings prove that a high degree of satisfaction with the government's initiatives regarding anti-COVID-19 measures encouraged greater personal public service motivation in respondents by increasing confidence in governmental responses and performance.

What Motivates Medical Students to Engage in Volunteer Behavior During the COVID-19 Outbreak? A Large Cross-Sectional Survey.

After the COVID-19 outbreak, the health status of the general population has suffered a huge threat, and the health system has also encountered great challenges. As critical members of human capital in the health sector, medical students with specialized knowledge and skills have positively fought against the epidemic by providing volunteer services that boosted the resilience of the health system. Although volunteer behavior (VB) is associated with individual internal motivation, there is sparse evidence on this relationship among medical students, especially regarding potential mechanisms. Therefore, this study had two main objectives: (1) to examine the influence of prosocial motivation (PM) of medical students on their VB; and (2) to verify the chain-mediating role of calling and vocation (CV) as well as social responsibility (SR) in the relationship between PM and VB. Study I: a total of 2454 Chinese full-time medical students were invited to complete an online survey. Data analysis was performed using descriptive statistics, Pearson's correlation coefficient, and multiple linear regression analysis. The results demonstrated that PM significantly affected VB in medical students (ß = 0.098, P < 0.001); CV as well as SR chain-mediated the relationship between PM and VB (ß = 0.084, P < 0.001). PM promoted the formation of SR by positively evoking CV of medical students, further resulting in increased VB. Study II: A 28 person qualitative interview was conducted. Qualitative data are added to reduce the limitations of online questionnaires. At the same time, we can also critically study the VB of Chinese medical students during COVID-19. The results showed that there were various reasons for medical students to volunteer in the process of fighting against COVID-19, and the experience of volunteer service and the impact on their future life were different. Lastly, the current findings suggest that fostering volunteerism among medical students requires the joint effort of the government, non-profit organizations, and medical colleges.