Influence of empathy on work alienation among Chinese nurses during the COVID-19 pandemic: The mediating effect of ego depletion.

Background: Nurses' work alienation has become increasingly serious due to the increase in workload and risk during the coronavirus disease 2019 (COVID-19). However, no studies have investigated the link between empathy, ego depletion, and work alienation among Chinese nurses. The present study aimed to evaluate Chinese nurses' empathy, ego depletion, and work alienation and to examine whether nurses' ego depletion mediates the relationship between empathy and work alienation. Methods: This was a descriptive, cross-sectional study involving 353 nurses from Shaanxi. The Jefferson Scale of Empathy-Health Professionals, Self-Regulating Fatigue Scale and Work Alienation Questionnaire were used to collect data through an online survey. Structural equation modeling was conducted to analyze the mediating model. Results: Work alienation was negatively correlated with empathy (r = -0.305, p < 0.01) and positively correlated with ego depletion (r = 0.652, p < 0.01). Empathy was negatively correlated with ego depletion (r = -0.325, p < 0.01). Empathy can directly predict work alienation (ß = -0.263, p < 0.01), while ego depletion has a mediating effect between empathy and work alienation (ß = -0.309, p < 0.01), and the mediating effect accounts for 54.02% of the total effect. Conclusion: Nurses' work alienation was at a moderate-to-high level. Improving empathy can reduce work alienation through less ego depletion. Nursing managers should discover nurses' work alienation as soon as possible. Interventions to improve empathy can help replenish nurses' psychological resources, thereby reducing ego depletion and work alienation.

Predictors of organizational commitment among Chinese nurses during the COVID-19 pandemic.

AIM: To investigate organizational commitment among Chinese nurses and analyze factors influencing organizational commitment during COVID-19. BACKGROUND: Organizational commitment is the most important link between nurses and the organization because it is effective in work retention and the motivation of nurses, especially when addressing the COVID-19 crisis. However, there has been no empirical study conducted to predict organizational commitment in the field of nursing by combining work values with professional practice environments. METHODS: A cross-sectional predictive study was done with 362 nurses recruited from two tertiary hospitals in China. The Organizational Commitment Questionnaire, the Work Values Scale, and the Practice Environment Scale of the Nursing Work Index were used to collect data. Two factors related to the organizational commitment of nurses were investigated by using binary logistic regression analyses. RESULTS: Increased work values and a professional practice environment were associated with an increased likelihood of higher organizational commitment. DISCUSSION: The COVID-19 crisis became the utmost challenge to global healthcare systems and professional organizational commitment. Nurses' organizational commitment was directly influenced by the professional practice environment and work values, especially intrinsic work values, in which the spirit of collectivism was consequential. CONCLUSION AND IMPLICATIONS FOR THE FIELD OF NURSING AND HEALTH POLICY: Study results provide information for global hospital administrators to promote these organizational commitment predictive factors, including work values and a professional practice environment in nursing practice. This helped foster a stronger organizational commitment among nurses to reduce nurse resource flow during COVID-19.

Factors Associated With Post-traumatic Stress Disorder Among Nurses During COVID-19.

OBJECTIVE: To investigate post-traumatic stress disorder (PTSD), perceived professional benefits and post-traumatic growth (PTG) status among Chinese nurses in the context of the COVID-19 pandemic and to compare the differences between nurses working inside and outside Hubei. METHODS: From February 18 to February 25, 2020, the authors constructed the questionnaire using the Questionnaire Star platform, and convenience sampling was used to distribute the questionnaire via WeChat. Nurses who worked at the hospital during the COVID-19 pandemic were the research subjects. RESULTS: A total of 3,419 questionnaires were received, of which 2,860 nurses were working outside Hubei Province and 559 nurses were working inside Hubei Province. Both groups were exposed to COVID-19. The results indicated that gender, job title, department, average monthly income, the number of night shifts per month, hospital classification, specialization, and previous experience with assisting during disasters were statistically significant. The t-test results showed that the difference in perceived professional benefits scores between the two groups was not statistically significant, and the differences in PTG scores and PTSD scores between the two groups were statistically significant. The chi-square test indicated that the difference in PTSD prevalence between nurses working outside and inside Hubei Province was statistically significant and that the PTSD prevalence of nurses working outside Hubei Province was higher than that of nurses working inside Hubei Province. One-way ANOVA and independent sample t-test results showed that age, job title, job assignment, length of service, average monthly income, number of night shifts per month, number of children, and the Nurses' Perceived Professional Benefits Scale (NPPBS) and post-traumatic growth inventory (PTGI) scores influenced the prevalence of PTSD. Logistic regression showed that the occurrence of PTSD was associated with average monthly income, length of service, number of children, and the PTGI and NPPBS scores. CONCLUSION: During the COVID-19 pandemic, nurses working outside Hubei Province reported greater PTSD than those working inside Hubei Province. The occurrence of PTSD was related to average monthly income, length of service, number of children, and the PTGI and NPPBS scores.

The relationship between resilience and intent to stay among Chinese nurses to support Wuhan in managing COVID-19: The serial mediation effect of post-traumatic growth and perceived professional benefits.

AIM: To explore the mediating role of post-traumatic growth and perceived professional benefits between resilience and intent to stay among Chinese nurses to support Wuhan in managing COVID-19. DESIGN: A cross-sectional questionnaire survey. METHODS: In May 2020, the study recruited a convenience sample of 200 Chinese nurses to support Wuhan in managing COVID-19. A set of self-rating questionnaires was used to measure resilience, post-traumatic growth, perceived professional benefits and intent to stay. Structural equation modelling was performed with 5,000 bootstrap samples using AMOS 23.0. RESULTS: The final model provided a good fit for the data. Resilience had the strongest direct effect on intent to stay. Perceived professional benefits partially mediated the association between resilience and intent to stay. Overall, the serial multiple mediations of post-traumatic growth and perceived professional benefits in the relationship between resilience and intent to stay was statistically significant.

Burnout in nurses during the COVID-19 pandemic in China: New challenges for public health.

During the COVID-19 pandemic, frontline nurses have faced extraordinary personal and professional challenges. These challenges have had mental health consequences, and concerning reports of burnout have emerged globally. We conducted a cross-sectional survey at a designated COVID-19 hospital in Shanghai at the peak of the pandemic, i.e. about 2 months after the onset of the outbreak from February to April 2020. Findings revealed burnout in 6.85% of nurses. Of 336 respondents, 87 (25.89%) had a high level of emotional exhaustion, 61 (18.15%) had a high level of depersonalization, and 100 (29.76%) had a low level of personal accomplishment. Burnout can be prevented by offering more support from families and supervisors, paying attention to health monitoring and personal protection, and creating a rational human resource allocation and shift management system. Specific training on infection control and self-protection, mental health guidance, and stress coping techniques must be implemented. As the current health crisis ultimately abates, moving the focus from mental health issues to public health issues, more attention and support at the national and organizational levels are needed to reduce occupational discrimination, nurse autonomy and status need to be promoted, and public health emergency teams need to be created. A positive and fair working environment is essential to effective healthcare delivery.

Prevalence and Influencing Factors on Fatigue of First-line Nurses Combating with COVID-19 in China: A Descriptive Cross-Sectional Study.

Nurses' work-related fatigue has been recognized as a threat to nurse health and patient safety. The aim of this study was to assess the prevalence of fatigue among first-line nurses combating with COVID-19 in Wuhan, China, and to analyze its influencing factors on fatigue. A multi-center, descriptive, cross-sectional design with a convenience sample was used. The statistical population consisted of the first-line nurses in 7 tertiary general hospitals from March 3, 2020 to March 10, 2020 in Wuhan of China. A total of 2667 samples from 2768 contacted participants completed the investgation, with a response rate of 96.35%. Social-demographic questionnaire, work-related questionnaire, Fatigue Scale-14, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Chinese Perceived Stress Scale were used to conduct online survey. The descriptive statistic of nurses' social-demographic characteristics was conducted, and the related variables of work, anxiety, depression, perceived stress and fatigue were analyzed by t-tests, nonparametric test and Pearson's correlation analysis. The significant factors which resulted in nurses' fatigue were further analyzed by multiple linear regression analysis. The median score for the first-line nurses' fatigue in Wuhan was 4 (2, 8). The median score of physical and mental fatigue of them was 3 (1, 6) and 1 (0, 3) respectively. According to the scoring criteria, 35.06% nurses (n=935) of all participants were in the fatigue status, their median score of fatigue was 10 (8, 11), and the median score of physical and mental fatigue of them was 7 (5, 8) and 3 (2, 4) respectively. Multiple linear regression analysis revealed the participants in the risk groups of anxiety, depression and perceived stress had higher scores on physical and mental fatigue and the statistically significant positive correlation was observed between the variables and nurses' fatigue, the frequency of exercise and nurses' fatigue had a statistically significant negative correlation, and average daily working hours had a significantly positive correlation with nurses' fatigue, and the frequency of weekly night shift had a low positive correlation with nurses' fatigue (P<0.01). There was a moderate level of fatigue among the first-line nurses fighting against COVID-19 pandemic in Wuhan, China. Government and health authorities need to formulate and take effective intervention strategies according to the relevant risk factors, and undertake preventive measures aimed at reducing health hazards due to increased work-related fatigue among first-line nurses, and to enhance their health status and provide a safe occupational environment worldwide. Promoting both medical and nursing safety while combating with the pandemic currently is warranted.

Work stress among Chinese nurses to support Wuhan in fighting against COVID-19 epidemic.

AIMS: To investigate the work stress among Chinese nurses who are supporting Wuhan in fighting against Coronavirus Disease 2019 (COVID-19) infection and to explore the relevant influencing factors. BACKGROUND: The COVID-19 epidemic has posed a major threat to public health. Nurses have always played an important role in infection prevention, infection control, isolation, containment and public health. However, available data on the work stress among these nurses are limited. METHODS: A cross-sectional survey. An online questionnaire was completed by 180 anti-epidemic nurses from Guangxi. Data collection tools, including the Chinese version of the Stress Overload Scale (SOS) and the Self-rating Anxiety Scale (SAS), were used. Descriptive single factor correlation and multiple regression analyses were used in exploring the related influencing factors. RESULTS: The SOS (39.91 ± 12.92) and SAS (32.19 ± 7.56) scores of this nurse group were positively correlated (r = 0.676, p < .05). Multiple regression analysis showed that only children, working hours per week and anxiety were the main factors affecting nurse stress (p = .000, .048, .000, respectively). CONCLUSIONS: Nurses who fight against COVID-19 were generally under pressure. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse leaders should pay attention to the work stress and the influencing factors of the nurses who are fighting against COVID-19 infection, and offer solutions to retain mental health among these nurses.