Effect of compassion fatigue on emotional labor in female nurses: Moderating effect of self-compassion.

Emotional labor is common in nursing but may be affected by the mental state of nurses. This study explored the effect of compassion fatigue on emotional labor and whether self-compassion moderates this effect of compassion fatigue. METHODS: A two-stage survey design with a convenience sample. Participants were female nursing staff recruited from emergency departments, intensive care units, ward nursing units, and outpatient departments of medical centers, regional hospitals, and district hospitals in Taiwan. A total of 300 questionnaire copies in each of the first and second stages were distributed, and 272 pairs of responses were retrieved (valid response rate = 91%). The reliability and validity of the questionnaire were tested, and confirmatory factor analysis was conducted with AMOS 21. The proposed hypotheses were verified using hierarchical regression conducted with SPSS version 25.0. RESULTS: This study revealed that compassion fatigue positively predicted surface acting (ß = 0.12, p < 0.05) and negatively predicted deep acting (ß = -0.18, p < 0.01) and expression of genuine emotions (ß = -0.31, p < 0.01). In addition, self-compassion negatively moderates the relationships between compassion fatigue and surface acting (ß = -0.12, p < 0.05), and positively moderates the relationships between compassion fatigue and expression of genuine emotions (ß = 0.15, p < 0.01). CONCLUSIONS: To avoid excessive consumption of emotional resources, nurses with high compassion fatigue may employ surface acting by engaging in emotional labor without making an effort to adjust their feelings. Nurses need also be sympathized with, and such sympathy can come from hospitals, supervisors, colleagues, and, most crucially, the nurses themselves. Hospital executives should propose improvement strategies that can prevent the compassion fatigue on nurses, such as improving nurses' self-compassion.

The Effect of Job Satisfaction on Psychological Well-Being for Taiwanese Home-Care Workers, Mediated by Emotional Labor.

The objective of this study was to investigate the effect of job satisfaction on psychological well-being through emotional labor for Taiwanese home-care workers. A total of 316 home-care workers who worked in Chiayi, Taiwan, were recruited in this study. Most of the participants were Taiwanese (96.5%). The mean age of the participants was 42.05 ± 12.15 years, and the participants were predominantly female (80%). The mean work experience was 5.64 ± 5.13 years. Job satisfaction, emotional labor, and psychological well-being were measured. Partial least squares structural equation modeling was used to examine the direct and indirect effects on job satisfaction, emotional labor, and psychological well-being. The results demonstrated that the internal factors of job satisfaction had indirect effects on psychological well-being through the mediating effects of surface acting and deep acting. However, it was also observed that the external factors of job satisfaction had indirect effects on psychological well-being through the mediating effect of surface acting but not deep acting. The model explained 57.6% of the variance in psychological well-being. The internal factors of job satisfaction are more important than the external factors affecting psychological well-being through the mediating effect of deep acting. Based on our results, we recommend enhancing the deep acting of emotional labor to improve the psychological well-being of Taiwanese home-care workers.

The Psychological Impact and Influencing Factors during Different Waves of COVID-19 Pandemic on Healthcare Workers in Central Taiwan.

BACKGROUND: This study aims to explore differences of psychological impact and influencing factors that affected Taiwanese healthcare workers (HCW) during the first and second wave of COVID-19. METHODS: a cross sectional survey of first-line HCW during November 2021 to February 2022: 270 paper questionnaires were issued and the valid response rate was 86% (231). For statistical analysis, descriptive statistics, Pearson correlation, and multivariate linear regression were used. RESULTS: regardless of the wave of the pandemic, nearly 70% of HCW had anxiety, nearly 60% felt depressed, half of them suffered from insomnia, and one in three felt insufficient social support, which means a high level of loneliness. With an increased number of infected patients during the second wave, HCW felt significant changes of workload and schedule, with higher concern over risk of infection, and these factors induced higher levels of anxiety, but they manifested better satisfaction over public health policies and information provided by hospitals and governments. Changes of working schedules or duties positively relate to levels of anxiety and insomnia. The risk of infection causes anxiety, depression, and insomnia. Workplace relationships significantly relate to depression and loneliness. A negative family support causes an adverse psychological impact. CONCLUSIONS: the pandemic has a negative psychological impact on HCW. Early recognition of significant influencing factors, providing psychological support and therapy, are helpful strategies for reducing the adverse psychological effects.

The Influence of Compassion Fatigue on Job Performance and Organizational Citizenship Behaviors: The Moderating Effect of Person-Job Fit.

PURPOSE: This study investigated the influence of compassion fatigue on job performance and organizational citizenship behavior. Moreover, this study analyzed whether person-job fit effectively moderates the negative impacts of compassion fatigue. DESIGN: A longitudinal, two-stage questionnaire was used to collect data. METHODS: This study adopted a convenience sampling whose participants consisted of 263 nursing staff from medical centers, regional hospitals, district hospitals, and clinics in Taiwan. Descriptive, correlational, and hierarchical regression analyses were used to investigate the relationships between variables. FINDINGS: The study results indicated that compassion fatigue exerts a significant negative influence on job performance and organizational citizenship behavior, whereas person-job fit effectively moderates the negative relationships between compassion fatigue and job performance and organizational citizenship behavior. CONCLUSIONS: Hospital administrations could pay more attention to the negative influence of compassion fatigue on the job performance and organizational citizenship behavior of nursing staff. Enhancing person-job fit can mitigate the negative impacts of compassion fatigue. CLINICAL RELEVANCE: Apart from seeking reasons for compassion fatigue and proposing effective solutions, hospitals also could adopt appropriate practices to constantly monitor and manage the person-job fit of nursing staff, thereby assisting the nursing staff in adapting to current nursing job requirements.

Impact of Providing Compassion on Job Performance and Mental Health: The Moderating Effect of Interpersonal Relationship Quality.

PURPOSE: To examine the relationships of providing compassion at work with job performance and mental health, as well as to identify the role of interpersonal relationship quality in moderating these relationships. DESIGN AND METHODS: This study adopted a two-stage survey completed by 235 registered nurses employed by hospitals in Taiwan. All hypotheses were tested using hierarchical regression analyses. FINDINGS: The results show that providing compassion is an effective predictor of job performance and mental health, whereas interpersonal relationship quality can moderate the relationships of providing compassion with job performance and mental health. CONCLUSIONS: When nurses are frequently willing to listen, understand, and help their suffering colleagues, the enhancement engendered by providing compassion can improve the provider's job performance and mental health. Creating high-quality relationships in the workplace can strengthen the positive benefits of providing compassion. CLINICAL RELEVANCE: Motivating employees to spontaneously exhibit compassion is crucial to an organization. Hospitals can establish value systems, belief systems, and cultural systems that support a compassionate response to suffering. In addition, nurses can internalize altruistic belief systems into their own personal value systems through a long process of socialization in the workplace.

Mediating positive moods: the impact of experiencing compassion at work.

AIM: The aim of this study was to examine the mediating effects of positive moods underlying the relationship between experiencing compassion at work and both job performance and organisational citizenship behaviour (OCB). BACKGROUND: Employees who have experienced compassion might have more positive moods while at work; such moods have been connected to a host of important organisational outcomes such as better job performance and OCB. METHODS: This study adopted a two-stage survey whose participants consisted of 269 registered nurses employed by hospitals in Taiwan. All hypotheses were tested using hierarchical regression analyses. RESULTS: The results showed that positive moods mediate completely the relationship between experiencing compassion at work and both job performance and OCB. CONCLUSION: When nurses frequently feel that their hospital, supervisors or co-workers are willing to listen to them, the strength that arises from this compassion can effectively increase job performance and OCB though the positive moods process. IMPLICATIONS FOR NURSING MANAGEMENT: It is importance to cultivate a compassionate and caring culture throughout hospitals' hierarchies, especially from the top down. Nurses will have more opportunities to experience it, witness it, or participate in it when they work within a compassionate and caring organisational culture.

The effects of cultural values on mental health among the Taiwanese people: mediating of attitudes toward emotional expression.

Empirical evidence has demonstrated that an individual's cultural values can influence his or her mental health. This study extends previous research by proposing and testing a model that examines mediating processes underlying the relationship between individuals' cultural values and their mental health. This 2-stage study used data collected from 208 (at time 1) and 159 (at time 2) full-time staff employed by private enterprises in Taiwan. The author tested hypotheses through the use of hierarchical multiple regression. The results showed that under horizontal individualism and vertical collectivism, the predictors of negative mental health (ie, somatic symptoms, anxiety and insomnia, social dysfunction and/or severe depression) were partially and almost completely achieved through the mediating effect of the negative attitudes toward emotional expression.

The influence of the internalization of emotional regulation on mental health among the Taiwanese people: the moderating effect of cultural fit.

This study used a 2-stage questionnaire survey to explore whether self-regulation by withholding negative emotions (SRWNE) affects mental health and examines further whether cultural fit can moderate the relationship between SRWNE and mental health. The 2-stage studies used data collected from 405 (time 1) and 313 (time 2) full-time staff employed by private and public enterprises in Taiwan. The author tested hypotheses through the use of hierarchical multiple regression. The results showed that controlled SRWNE through external regulation and introjected regulation is significantly associated positively with somatic symptoms, anxiety and insomnia, social dysfunction, and severe depression, whereas autonomous SRWNE through identified regulation is significantly associated negatively with anxiety and insomnia, and social dysfunction. In addition, this study also found that cultural fit may moderate the relationship between SRWNE or introjected regulation and identified regulation and the mental health indicators.

The influence of perceived stress on work-family conflict and mental health: the moderating effect of person-environment fit.

AIM: This study examines whether higher perceived stress among female hospital workers can result in more serious work-family conflict (WFC) and poorer mental health, and also identifies the role that person-environment (P-E) fit plays in moderating these relationships. BACKGROUND: Female hospital workers with higher perceived stress tend to report greater WFC and worse mental health than others with less perceived stress. A better fit between a person and her environment may lead to lower perceived stress. As a result, she may experience less WFC and better mental health. METHODS: This study adopts a longitudinal design with 273 participants, all of whom are employed by hospitals in Taiwan. All hypotheses are tested using hierarchical regression analyses. RESULTS: The results show that perceived stress is an effective predictor of WFC and mental health status, whereas the P-E fit can moderate these relationships. CONCLUSION: Hospitals should pay more attention to the negative effects of perceived high stress on the WFC levels and mental health of their female employees. The P-E fit can buffer effectively the impact of perceived stress on both WFC and mental health. IMPLICATIONS FOR NURSING MANAGEMENT: If hospitals can adopt appropriate human resource management practices as well as monitor and manage the P-E fit continuously, they can better help their employees to fit into the overall hospital environment.

Mediating toxic emotions in the workplace--the impact of abusive supervision.

AIM: This study explores whether abusive supervision can effectively predict employees' counterproductive work behaviour (CWB) and organisational citizenship behaviour (OCB) and the role of toxic emotions at work as a potential mediator of these relationships in nursing settings. BACKGROUND: Workplace bullying is widespread in nursing. Despite the growing literature on abusive supervision and employees' counterproductive work behaviour and organisational citizenship behaviour, few studies have examined the relationships between abusive supervision and these work behaviours from the viewpoint of the victimed employee's emotion process. METHODS: This study adopted a two-stage survey of 212 nurses, all of whom were employed by hospitals in Taiwan. Hypotheses were tested through the use of hierarchical multiple regression. RESULTS: The results showed that abusive supervision was positively associated with toxic emotions. Moreover, toxic emotions could effectively predict nurses' counterproductive work behaviour and organisational citizenship behaviour. Finally, it was found that toxic emotions partially mediated the negative effects of abusive supervision on both work behaviours. CONCLUSION: Toxic emotions at work are a critical mediating variable between abusive supervision and both counterproductive work behaviour and organisational citizenship behaviour. Hospital administrators can implement policies designed to manage events effectively that can spark toxic emotions in their employees. IMPLICATIONS FOR NURSING MANAGEMENT: Work empowerment may be an effective way to reduce counterproductive work behaviour and to enhance organisational citizenship behaviour among nurses when supervisors do not promote a healthy work environment for them.

Changes of regional cerebral oxygen saturation during spinal anesthesia.

BACKGROUND: During spinal anesthesia, hemodynamic status is routinely monitored, but this may not give an accurate assessment of cerebral oxygenation. Cerebral oximetry, facilitated by using a near-infrared spectroscope, is a way of estimating regional cerebral oxygen saturation (SrO2). We designed this prospective clinical study to determine whether the changes in mean arterial pressure (MAP) and heart rate (HR) could predict changes in SrO2 during spinal anesthesia. METHODS: The study sample available for analysis included 45 patients, ASA class I to II, who were scheduled for elective ureteroscopic surgery requiring spinal anesthesia. Spinal anesthesia was performed with 12 mg 0.5% hyperbaric bupivacaine injected intrathecally via L3-4 or L4-5 interspace. MAP, HR, oxygen saturation by pulse oximeter, and SrO2 by near-infrared spectroscope were recorded every 2 min throughout the procedure. RESULTS: SrO2 was tested by the Shapiro-Wilk test and the results departed from the multivariate normal distribution. The method of generalized estimating equations (GEE) was then used to estimate the model. The output of the GEE analysis for the time-lag model showed that there were relationships between SrO2 and two predictors (MAP and HR) with the correction of the baseline values. All the parameters were significant at a level of 5%. The effects of the decreases of MAP and HR on SrO2 lasted continuously for at least 6 min. CONCLUSIONS: Based on the time-lag pattern between two predictors (MAP and HR) and SrO2 during spinal anesthesia, we ventured to conclude that a change in MAP or HR caused a significant decrease in SrO2. Since no patient developed any neurologic complication perioperatively, further study must be performed to elucidate the clinical importance of our findings.

NF-kappaB inhibitors significantly attenuate the transcription of high affinity type-2 cationic amino acid transporter in LPS-stimulated rat kidney.

BACKGROUND: Sepsis-induced renal failure is closely related to inducible nitric oxide synthase (iNOS) upregulation and nitric oxide (NO) overproduction. Trans-membrane L-arginine transportation mediated by type-2 cationic amino acid transporter (CAT-2) isozymes, including CAT-2, CAT-2A, and CAT-2B, is one of the crucial mechanisms that regulate NO biosynthesis by iNOS. We previously had shown that endotoxemia significantly upregulated renal CAT-2 and CAT-2B but not CAT-2A expression. This study was, thus, conducted to further explore the role of nuclear factor-kappaB (NF-kappaB) in regulating the expression of CAT-2 isozymes in lipopolysaccharide (LPS)-treated rat kidney. METHODS: Adult male Sprague-Dawley rats were randomly given intra-peritoneal injections of normal saline (N/S), LPS, LPS plus NF-kappaB inhibitor pre-treatment (PDTC, dexamethasone, or salicylate), or an NF-kappaB inhibitor alone. The rats were sacrificed at 6 hours after LPS injection and enzyme expression and renal injury were examined. RESULTS: Renal iNOS, CAT-2, and CAT-2B were significantly upregulated in LPS-stimulated rat kidney. NF-kappa B inhibitors significantly attenuated this upregulation induced by LPS and resultantly attenuated renal NO biosynthesis and renal injury induced by LPS. In contrast, renal CAT-2A expression was not affected by either LPS or NF-kappaB inhibitors. CONCLUSIONS: LPS co-induces iNOS, CAT-2 and CAT-2B expression in LPS-stimulated rat kidney. Furthermore, inhibition of NF-kappaB significantly attenuates NO biosynthesis through inhibition of iNOS, CAT-2, and CAT-2B, and, in turn, significantly reduces endotoxemia-induced renal injury.