Patient mistreatment, emotional exhaustion and work-family conflict among nurses: a moderated mediation model of social sharing of negative work events and perceived organizational support.

BACKGROUND: Nursing literature suggested that patient mistreatment has significant impacts on nurses' emotions and job burnout. Yet, further research is needed to understand the underlying mechanism and the spillover effect on nurses' families. Leveraging the goal progress theory, this study aimed to examine the association between patient mistreatment, nurses' emotional exhaustion, and work-family conflict, as well as the mediating role of social sharing of negative work events and the moderating role of perceived organizational support. METHODS: During the COVID-19 pandemic in China, a cross-sectional study was conducted with a sample of 1627 nurses from the Hematology Specialist Alliance of Chongqing from October to November 2022. Questionnaires were administered to measure patient mistreatment, perceived organizational support, social sharing of negative work events, emotional exhaustion, and work-family conflict. Hierarchical linear regression and conditional processes were used for statistical analyses. RESULTS: Patient mistreatment was positively associated with emotional exhaustion (ß = 0.354, p < 0.001) and work-family conflict (ß = 0.314, p < 0.001). Social sharing of negative work events played a partial mediating role in the relationship between patient mistreatment and emotional exhaustion (effect = 0.067, SE = 0.013), and work-family conflict (effect = 0.077, SE = 0.014). Moderated mediation analysis found that the mediation effect was stronger when the perceived organizational support was high. CONCLUSION: Our findings reveal the amplifying effect of social sharing of negative work events on nurses' emotional exhaustion and work-family conflict. Perceived organizational support strengthens the positive effect of patient mistreatment on the social sharing of negative work events, thus resulting in increased emotional exhaustion and work-family conflict. We also discuss practical implications, limitations, and directions for future research.

Burnout and resilience among physical therapy students: a cross-sectional study.

BACKGROUND: This study aimed to examine the prevalence of burnout, determine burnout-related factors, investigate resilience levels, and assess the relationship between burnout and resilience among physical therapy (PT) students at King Saud University (KSU) in Saudi Arabia. MATERIAL AND METHODS: This cross-sectional study involved 153 PT students studying at KSU between January and March 2023. The participants completed an online questionnaire, a Maslach Burnout Inventory, and a Brief Resilience Scale. RESULTS: Low-to-moderate levels of Emotional Exhaustion (EE) were observed in 85% of the participants and high Depersonalization (DP) levels were reported by 34.2%. Female participants reported higher levels of EE and DP, whereas males had a greater prevalence of low Personal Achievement (PA) levels. Approximately 6.5% of the study participants reported high burnout levels (a combination of high DP, high EE, and low PA). Academic stress, followed by sleeping difficulties and changes in the academic year structure, were the most important factors contributing to higher levels of burnout (75.2%, 56.9%, and 43.8%, respectively). Most study participants around (66.0%) reported normal resilience levels. A significant correlation was detected between resilience and 2 domains of burnout (DP and PA), with the correlation being negative and weak for DP and positive and moderate for PA. CONCLUSIONS: Overall, low-to-moderate levels of burnout were observed among the PT students who took part. Related factors that contributed to burnout were academic stress, sleeping difficulties, and academic year structure. A normal level of resilience was found to be significantly related to DP and PA but not to EE on the burnout subscales. Higher levels of resilience can be considered to play a protective role against burnout among PT students. Med Pr Work Health Saf. 2024;75(4):343-354.

The effect of toxic leadership on workplace deviance: the mediating effect of emotional exhaustion, and the moderating effect of organizational cynicism.

BACKGROUND: Toxic leadership is abusive, destructive, and detrimental to nurses, can decrease nurse morale, increase stress levels, diminish organizational performance, and cause employee emotional exhaustion. Emotional exhaustion, a key component of burnout, has been linked to decreased job performance and increased likelihood of engaging in deviant behaviors at work. Organizational cynicism, as a negative attitude or distrust towards the organization and its leadership, may exacerbate the relationship between toxic leadership and workplace deviance. This study aims to explore how toxic leadership, workplace deviance, emotional exhaustion, and organizational cynicism are interrelated in the nursing profession. METHOD: A multicenter descriptive, cross-sectional research design was conducted at three university hospitals affiliated with three Egyptian governorates: Zagazig, El-Fayoum, and Alexandria. Two hundred forty-three nurses completed the Personal and Job-related Data Questionnaire, Toxic Leadership Scale, Emotional Exhaustion Scale, Workplace Deviance Scale, and Organizational Cynicism Scale. Mediation analysis using SPSS PROCESS revealed that emotional exhaustion indirectly influences the relationship between toxic leadership and workplace deviance, while hierarchical multiple regression showed that organizational cynicism moderates this relationship, with linear regression confirming the predictive impact of these variables on workplace deviance. RESULTS: Toxic leadership exhibits a substantial positive influence on workplace deviance (B = 16.132, p < 0.001), as does emotional exhaustion (B = 8.760, p < 0.001) and organizational cynicism (B = 5.376, p = 0.036). Furthermore, the interaction terms of toxic leadership, organizational cynicism, and emotional exhaustion are significant (B = -3.012, p = 0.036). The negative coefficient of the interaction term implies a mitigating impact, indicating that the combined presence of high toxic leadership, high emotional exhaustion, and high organizational cynicism may counterintuitively reduce workplace deviance (t = -2.110). CONCLUSION: These results suggest that while toxic leadership, emotional exhaustion, and organizational cynicism each independently increase workplace deviance, their combined presence may unexpectedly reduce deviant behaviors. IMPLICATION FOR NURSING: These results highlight the significance of tackling toxic leadership practices and cultivating a positive organizational culture to enhance a healthier work environment and reduce instances of workplace deviance. Healthcare settings should prioritize interventions to improve leadership practices, enhance employee well-being, and cultivate a supportive organizational climate.

Emotional exhaustion weakens the relationship between social media use and knowledge sharing behavior.

PURPOSE: Knowledge sharing behavior is crucial for ensuring organizational success, fueling innovation, solving problems, and informing decision-making. While social media platforms offer powerful tools for employees to share knowledge, the intricate relationship between social media use and knowledge sharing behavior remains unclear. Few studies have examined the influencing mechanisms of emotional exhaustion on the above relationships, especially through self-determination perspective. DESIGN/METHODOLOGY/APPROACH: As knowledge is inherently private to the individual, grounded in self-determination theory, this study employed a moderated mediation analysis to explore the internal mechanisms of social media use on employee knowledge sharing behavior. The survey of 356 full-time employees was collected from a large environmental protection group in China. Hypotheses are tested using hierarchical regression analysis and bootstrap tests. FINDINGS: The results show that social media use positively affects employee knowledge sharing behavior; knowledge sharing intention partially positively mediates the influence of social media use on knowledge sharing behavior; emotional exhaustion negatively moderates the relationship between social media use and knowledge sharing intention. CONTRIBUTION OF RESEARCH: The study identifies how two styles of social media use - work-related purpose and social-related purpose - affect knowledge sharing behavior. It significantly advances the understanding of social media use on knowledge sharing behavior from self-determination perspective. PRACTICAL IMPLICATIONS: This study has several important practical implications for organizations seeking to facilitate employee knowledge sharing behavior through social media use. Organizations should improve employees' knowledge sharing intention and avoid emotional exhaustion.

Impact of burnout on depression among nurses at a private hospital in Johannesburg, South Africa.

BACKGROUND:  Burnout is a syndrome that is understood as emanating from chronic workplace stressors that have not been managed successfully. Little is known about the causes of burnout among nurses in South Africa. The study aimed to determine the prevalence of burnout and its impact on depression and assess the relationship between burnout and depression among nurses at a Johannesburg private hospital. METHODS:  Nurses at a private hospital in Johannesburg were asked about their exposure to depression and burnout using a closed-ended questionnaire as part of a quantitative, cross-sectional study design. A p-value 0.05 was considered statistically significant. The respondents were selected using the simple-random sampling method. The collected data were analysed using IBM-SPSS version 28. RESULTS:  The study involved 112 nurses, of whom 95 (84.8%) were females. Most of the nurses, that is, 56 (50.0%) were registered nurses. Emotional exhaustion (p = 0.001) and depersonalisation (p = 0.001) were significantly associated with depression. Work experience (p = 0.001) and depersonalisation (p = 0.002) had an impact on depression. CONCLUSION:  The study revealed a high prevalence of burnout among nurses at a Johannesburg private hospital. The study found that depression was significantly associated with emotional exhaustion and depersonalisation. The study also found that work experience and depersonalisation have an impact on depression.Contribution: The study's recommendations can help mitigate burnout and improve the well-being of nurses, ultimately enhancing the quality of healthcare services provided at the hospital.

Prevalence and factors associated with burnout among junior medical doctors at a South African tertiary public sector hospital.

Introduction: burnout is a syndrome characterized by emotional exhaustion, depersonalization and emotional exhaustion that occurs due to exposure to stressful conditions over a long period. It can lead to poor job performance, apathy, and lack of productivity. This study looks at the prevalence of burnout in medical interns in a tertiary hospital in South Africa and the factors that may contribute to burnout. Methods: an analytical cross-sectional study was conducted. Medical interns working in Chris Hani Baragwanath Hospital in 2019 were invited to participate. The participants filled questionnaire that had demographic information, the Maslach Burnout Inventory Scale, a scale to rate the rotations that they believed contributed towards their burnout and factors they think contributed towards their burnout. Our data was analyzed using Stata. Results: out of a possible 165 potential participants, 101 medical interns enrolled. 95% of the participants reported burnout. Statistically significant factors contributing towards burnout were lack of resources and poor relations with support staff and senior staff. The medical rotation that was reported by the participants to contribute most towards their burnout was internal medicine. Conclusion: burnout in this population of medical interns is alarmingly high. Higher than reported in similar studies in South Africa and internationally.

Adaptation and Validation of School Burnout Inventory-Bangla and Its Predictive Factors Among Adolescents.

School burnout (SB) among adolescents is a growing concern, yet there has been limited research in Bangladesh. This study aims to address this gap by validating the School Burnout Inventory (SBI) in Bangla and investigating the predictive factors of SB among high-school-going adolescents in Bangladesh. The study employed a cross-sectional design, recruiting participants from various high schools across urban and rural areas. Data were collected through self-reported questionnaires, which included information related to demographics, COVID-19, school burnout, daytime sleepiness, insomnia, and depression. The SBI-Bangla demonstrated high reliability and validity. The mean score of SB was 20.26 (±7.84). Significant differences in SB levels were observed across different age groups, grades, locations, mother's education levels, smoking status, and self-reported COVID-19 infection status. Multiple linear regression identified age (B = 0.647, p = .010), location (B = -1.043, p = .034), depression (B = 0.270, p < .001), daytime sleepiness (B = 0.208, p < .001), and insomnia (B = 0.662, p < .001) as significant predictors of SB. The final model explained 12.3% of the variance in SB scores. Enhancing sleep hygiene and addressing psychological issues may help reduce academic burnout. This study provides valuable baseline data that can inform future research and policy formulation aimed at reducing adolescent SB in Bangladesh.

How the Approaches of Managing Conflict With Patients Affect Nurse Emotional Exhaustion and Life Satisfaction: A Time-Lagged Three-Wave Survey.

AIM(S): To explore whether nurses' use of different approaches to manage patient mistreatment can exert distinctive effects on their emotional exhaustion and life satisfaction, and to examine whether supervisor support can mitigate the negative effects of emotional exhaustion on nurses' life satisfaction. DESIGN: A time-lagged three-wave survey study with a 2-week time interval was conducted in 2022. METHODS: A total of 257 nurses from a Joint Commission International (JCI) accredited general hospital located in eastern China in 2022 completed three-wave surveys. Descriptive analyses, confirmatory factor analyses and mediation and moderated mediation analyses were performed. DATA SOURCES: Data were collected by using three-wave self-reported questionnaires from 257 nurses from a Joint Commission International (JCI) accredited general hospital located in eastern China in 2022. RESULTS: Nurses who managed patient mistreatment more cooperatively experienced lower levels of emotional exhaustion, whereas those who managed patient mistreatment more competitively experienced higher levels of emotional exhaustion. Emotional exhaustion was negatively related to life satisfaction. Moreover, emotional exhaustion mediated the positive and negative relationships between cooperative and competitive conflict management approaches and overall life satisfaction. Additionally, supervisor support mitigated the negative impact of emotional exhaustion on life satisfaction and the indirect effects of conflict management approaches on life satisfaction. CONCLUSION: To effectively manage the negative impact of patient mistreatment on nurses, both nurses themselves and their supervisors play an important role. Nurses who adopt a cooperative conflict management approach experience lower levels of emotional exhaustion and higher levels of life satisfaction. Supervisor support can alleviate the negative effect of emotional exhaustion on life satisfaction. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The findings provide a better understanding for nurses on how to mitigate the detrimental effects of patient mistreatment on nurses and highlight the role of both nurses themselves and their supervisors in protecting nurses' well-being. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contributed to the design or conduct of the study, analysis or interpretation of the data, or in the preparation of the manuscript.

Influence path of work-family conflict on primary care physicians' resignation intention: Data from a Chinese cross-sectional survey.

BACKGROUND: Primary care physicians and their teams are the leading force in constructing primary medical services, undertaking the critical responsibility of residents' essential health, and also related to realizing the national health goal. However, primary care physicians generally have a high turnover rate due to problems such as high work pressure, low salary levels, and limited career development. Therefore, exploring primary care physicians' resignation intentions plays a vital role in promoting the construction of primary care physicians' health service system. OBJECTIVE: This study explores the factors influencing the resignation intentions of primary care physicians, specifically examining the roles of work-family conflict, job satisfaction, professional identity, and emotional exhaustion. By understanding these dynamics, the research aims to inform strategies that can enhance the stability and effectiveness of primary care services, ultimately contributing to the improvement of public health infrastructure and achieving national health goals. This investigation will utilize structural equation modeling to analyze the interrelationships among the identified variables, thereby providing a comprehensive framework for addressing the high turnover rates among primary care physicians. METHODS: This study uses the work-family conflict, job satisfaction, professional identity, and emotional exhaustion scales. The data comes from a cross-sectional survey in Zhejiang Province, China, in 2022. Using SPSS 27 and Mplus8.3 software to analyze 1205 primary care physicians and their team members, the selected cases all answered the relevant questions of resignation intention. The potential relationship among work-family conflict, job satisfaction, professional identity, emotional exhaustion, and family doctor resignation intention was explored by constructing structural equations. RESULTS: Work-family conflict can directly and positively affect primary care physicians' resignation intention (ß = -0.546, p < 0.001). The results of the mediation model found that job satisfaction, professional identity, and emotional exhaustion were significantly related to work-family conflict, and primary care physicians' resignation intention has a significant mediating effect. It mainly includes six intermediary approaches: one is through the independent intermediary effect of job satisfaction; the second is through the independent intermediary effect of professional identity; the third is through the chain intermediary effect between Job satisfaction and professional identity; the fourth is through the intermediary effect of Job satisfaction and emotional exhaustion chain intermediary; fifth is through the chain intermediary of professional identity and emotional exhaustion; sixth is through the complex chain intermediary of job satisfaction, professional identity, and emotional exhaustion. CONCLUSION: Primary care physicians have a high score in resignation intention, which deserves continuous attention. Relevant department can help primary care physicians balance work and family roles, provide them with appropriate resources and rewards, as well as a good working environment and career development opportunities, to improve their job satisfaction and professional identity and reduce emotional exhaustion, thereby reducing the risk of resignation intention.

Exploring the Relationship between Surface Acting, Job Stress, and Emotional Exhaustion in Health Professionals: The Moderating Role of LMX.

Rapid organizational changes due to technological advancements, high-efficiency expectations, and uncertainties, particularly in healthcare, have led to a global stress epidemic among em-ployees. This has been exacerbated by the COVID-19 pandemic and evolving workplace practices. Surface acting, or the suppression and faking of emotions, significantly contributes to this stress and burnout, impacting not only individual healthcare professionals but also healthcare systems' overall effectiveness and sustainability. Providing adequate resources in high-demand work environments is, thus, essential to mitigate these negative experiences. Leader-member exchange (LMX) can play a pivotal role in understanding and addressing the needs and expectations of healthcare professionals. Drawing on Conservation of Resources (COR), Job Demands-Resources (JD-R), Social Exchange theories, and Grandey's Emotional Regulation Model, this study analyzed data from a convenience sample of 350 healthcare professionals. The results reveal that surface acting intensifies healthcare professionals' experiences of job stress and emotional exhaustion. Notably, the study empirically demonstrated that high levels of LMX in healthcare professionals' relationships with their leaders can mitigate the impact of surface acting on job stress and emotional exhaustion. These findings offer valuable insights for managers and policymakers, highlighting the importance of LMX in maintaining sustainable management practices in complex and stressful healthcare organizations.

Symptoms of Post-Traumatic Stress and Mental Health in a Sample of University Students: The Mediating Role of Resilience and Psychological Well-Being.

The COVID-19 pandemic has been one of the most stressful events in recent times across the world. The long-term effect of these experiences raises several concerns, including the development of post-traumatic stress symptomatology. However, little is known about the psychological processes that mediate this association. The aim of this study was to explore the association of emotional exhaustion and anxiety in post-traumatic stress symptomatology, and the mediating role of resilience and psychological well-being in university students. A total of 526 university students of both sexes participated in this study, and they were aged between 17 and 62 years old. Symptoms of anxiety and emotional exhaustion were significantly higher in females, in contrast, males showed on average more resilience and psychological well-being. Additionally, participants with COVID-19 infection had higher levels of emotional exhaustion, anxiety, and PTSD. The results indicated that the variables were correlated with each other (p < 0.001). A conceptual model was confirmed that describes anxiety and emotional exhaustion as predictors, post-traumatic stress symptomatology as an outcome variable, and resilience and psychological well-being as mediators. Resilience and psychological well-being can be important protective factors for adaptive responses in stressful situations. The findings obtained in this study will provide a theoretical basis for designing targeted interventions to improve psychological health, whether for crisis intervention, the process of adapting to higher education, or for recovery plans from psychological trauma.

Mind over matter: mindfulness as a buffer against workplace incivility.

This study examines the relationship between co-worker incivility, emotional exhaustion, mindfulness, and turnover intention among nurses in public and private hospitals in North Cyprus. Drawing upon the Job Demand-Resources theory, the research aims to contribute to the existing literature by investigating the mediating role of emotional exhaustion and the moderating effect of mindfulness on the relationship between co-worker incivility and turnover intention. Data were collected from 238 nurses through questionnaires, and structural equation modeling was employed for data analysis. The results indicate a positive association between co-worker incivility and emotional exhaustion, as well as between co-worker incivility and turnover intention. Emotional exhaustion was found to mediate the relationship between co-worker incivility and turnover intention. Furthermore, mindfulness was identified as a moderator, attenuating the negative impact of co-worker incivility on turnover intention. The findings underscore the importance of addressing workplace incivility and promoting mindfulness to mitigate turnover intentions among nurses. Practical implications include the implementation of interventions to foster a supportive work environment and enhance nurses' emotional wellbeing.

The Importance of Training to Manage a Church as a Predictor of Emotional Exhaustion and Ministry Satisfaction.

The study found that pastors who agreed they were trained to manage a church ranked high in ministry satisfaction and low in emotional exhaustion compared to those who disagreed to receiving such training. This work has implications for seminaries, congregations, denominational leaders and clergy themselves to ensure clergy are properly prepared and continue their career journey. This study could be used to modify curricula at seminaries and produce post seminary training and educational information.

The Relationship Between Financial Stress and Job Performance in China: The Role of Work Engagement and Emotional Exhaustion.

Purpose: Economic pressure has become an important source of stress for employees. However, the conclusions regarding the relationship between financial stress and employees' work behavior are not consistent. The present study explored the relationship between financial stress and employee job performance with a Chinese sample and further explored how and when financial stress influenced job performance. Samples and Methods: The present study investigated five distinct companies operating in diverse sectors using a convenience sampling technique. Three hundred and twenty-one employees were recruited. Financial Stress, Job Performance, Work Engagement, and Emotional Exhaustion were measured for this investigation. The mediation effect was tested using a four-step procedure. The analysis of the moderated mediation model was performed using Hayes's PROCESS macro for SPSS. Results: The results found financial stress was positively related to job performance, and work engagement mediated the positive relationship between financial stress and job performance. In addition, emotional exhaustion moderated the mediating process between financial stress, work engagement, and job performance. Specifically, the beneficial effect of financial stress on work engagement disappeared when emotional exhaustion was high. Besides, a high level of emotional exhaustion weakened the positive relationship between work engagement and job performance. Conclusion: Financial stress plays a motivating role in employees' job performance in China. Work engagement is a key factor between financial stress and job performance. Notably, the positive effect of financial stress and work engagement on job performance is contingent upon the individual's level of emotional exhaustion. These results might explain the inconsistency of the effect of financial stress in previous research. Moreover, this finding suggests that emotional factors may not only be the result of stress but can also influence its effects.

Linking Creative Self-Efficacy and Emotional Exhaustion: Mediation Through Cognitive Reappraisal.

Drawing from the motivational emotion regulation perspective and self-verification theory, this study demonstrates the mechanism linking creative self-efficacy and emotional exhaustion in which cognitive reappraisal serves as a mediator. Study 1 (N = 137) conducted in an experimental setting provided evidence for a causal relationship between creative self-efficacy and cognitive reappraisal. Individuals who have higher creative self-efficacy are more likely than those who have lower creative self-efficacy to engage in cognitive reappraisal because they reinterpret potentially emotion-eliciting situations in a way that reduces their emotional impact. Study 2 (N = 206), a survey study, revealed the indirect effect of creative self-efficacy on emotional exhaustion such that creative self-efficacy drives a mechanism that reduces emotional exhaustion by fostering the use of cognitive reappraisal as an emotion regulation strategy. Finally, Study 3 (N = 210) verified the mediation mechanism in the experimental setting, suggesting that creative self-efficacy can reduce momentary emotional exhaustion through the mediating effect of cognitive reappraisal. The findings provide implications for the research and practices on emotional exhaustion by highlighting the motivational process underlying emotion regulation.

Prevalence and risk of burnout among HIV service providers in South Africa and Zambia: findings from the HPTN 071 (PopART) trial.

BACKGROUND: In the high disease burden and resource-constrained contexts of sub-Saharan Africa (SSA), health workers experience a range of psychosocial stressors that leave them vulnerable to developing burnout, which can reduce service quality and negatively impact their own health and wellbeing. As universal testing and treatment (UTT) for HIV scales up across SSA, we sought to understand the implications of this human resource-intensive approach to HIV prevention to inform decision-making about health workforce staffing and support needs. METHODS: Using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), we assessed the prevalence of three domains of burnout-emotional exhaustion, depersonalization, and personal accomplishment-among three cadres of health workers delivering health services in areas receiving a UTT intervention in Zambia and South Africa. These cadres included health facility workers (n = 478), community health workers (n = 159), and a study-specific cadre of community HIV care providers (n = 529). We used linear regression to assess risk factors associated with emotional exhaustion, the only domain with sufficient variation in our sample. RESULTS: The MBI-HSS was completed by 1499/2153 eligible participants (69.6% response rate). Less than 1% of health workers met Maslach's definition for burnout. All groups of health workers reported lower levels of emotional exhaustion than found in previous studies of this type (mean score scores ranged from 10.7 to 15.4 out of 54 across health cadres). Higher emotional exhaustion was associated with higher educational attainment (ßadj = 2.24, 95% CI 0.76 to 3.72), greater years providing HIV services (ßadj = 0.20, 95% CI 0.03 to 0.36), and testing negative for HIV at last HIV test (ßadj = - 3.88 - 95% CI 5.69 to - 2.07). Working as a CHW was significantly associated with lower emotional exhaustion (ßadj = - 2.52, 95% CI - 4.69 to - 0.35). Among all health workers, irrespective of HIV status, witnessing stigmatizing behaviors towards people living with HIV among their co-workers was associated with significantly increased emotional exhaustion (ßadj = 3.38, 95% CI 1.99 to 4.76). CONCLUSIONS: The low level of burnout detected among health workers is reassuring. However, it remains important to assess how UTT may affect levels of emotional exhaustion among health workers over time, particularly in the context of emerging global pandemics, as burnout may impact the quality of HIV services they provide and their own mental health and wellbeing. Interventions to reduce HIV stigma in health facilities may protect against emotional exhaustion among health workers, as well as interventions to increase mindfulness and resilience among health workers at risk of burnout. Trial registration ClinicalTrials.gov number: NCT01900977.

Impact of state and trait emotion regulation on daily emotional exhaustion among Korean school counsellors.

School counsellors in South Korea face significant emotional exhaustion due to their challenging occupational environment. Previous studies have shown that cognitive reappraisal (CR) reduces emotional exhaustion, whereas expressive suppression (ES) increases it. However, these findings predominantly rely on trait questionnaires within cross-sectional approaches, overlooking the dynamic nature of emotion regulation (ER) strategy selection. Individuals may choose strategies that deviate from their general tendencies based on situational demands. There is limited empirical knowledge regarding the interaction between trait and state regulation strategies and their influence on exhaustion. Utilizing the strategy-situation fit hypothesis, this study examines the context-specific effects of ER strategies, considering both situational contexts and individual response tendencies. A multilevel analysis was performed to examine the influence of state and trait ER strategies on daily emotional exhaustion. A daily diary study was conducted for 5 days with 111 Korean school counsellors. Daily CR was associated with lower daily exhaustion and daily ES predicted higher daily exhaustion. Contrastingly, none of the trait ER strategies had an impact on daily exhaustion, but the trait level of both strategies significantly moderated the relationship between daily CR and exhaustion. The positive impact of daily CR was more pronounced in school counsellors who often utilized suppression strategies, and this impact was also evident in trait reappraisal. Re-evaluating daily emotions instead of suppressing them may assist in coping with emotional exhaustion caused by work. The effectiveness of these strategies may vary based on an individual's inclination to regulate emotions as state and trait. ER may aid in implementing preventive interventions for school counsellors experiencing emotional exhaustion.

The impact of burnout on paediatric nurses' attitudes about patient safety in the acute hospital setting: A systematic review.

BACKGROUND: Patient safety is the cornerstone of quality healthcare. Nurses have a duty to provide safe care, particularly to vulnerable populations such as paediatric patients. Demands on staff and resources are rising and burnout is becoming an increasingly prevalent occupational hazard in paediatric healthcare today. Occupational stress is a barrier to maintaining a positive patient safety culture. PURPOSE: This paper seeks to explore the impact of burnout on paediatric nurses' attitudes about patient safety. METHODS: A systematic review approach was used. Embase, Cochrane Library, Medline, CINAHL, and PsycINFO were the databases searched. All quantitative, primary, empirical studies, published in English, which investigated associations between burnout and attitudes to patient safety in the paediatric nursing workforce were included. RESULTS: Four studies were eligible for inclusion. These studies examined a total of 2769 paediatric nurses. Pooled data revealed overall moderate to high levels of burnout. All studies exposed a negative association between emotional exhaustion and safety attitude scoring (r = -0.301- -0.481). Three studies demonstrated a negative association to job satisfaction (r = -0.424- -0.474). The potential link between burnout and an increased frequency of adverse events was also highlighted. CONCLUSIONS: Burnout may negatively impact paediatric nurses' attitudes to patient safety in the acute hospital setting. Targeted interventions to tackle burnout are urgently required to protect both paediatric nurses and patients. IMPLICATIONS: Managers and policy makers must promote nurse well-being to safeguard staff and patients. Educational interventions are required to target burnout and promote patient safety. Further research is required to investigate the long-term impact of burnout.

Compassion Fatigue in Emergency Medicine: Current Perspectives.

Compassion fatigue (CF), or loss of ability to empathize or feel compassion for others for whom one cares, is a growing concern for emergency physicians (EP). EPs, by the nature of their jobs, work under unpredictable conditions at odd hours with high levels of exposure to traumatic events. They are placed under substantial psychological, physical, and cognitive pressure, with little opportunity to recover or reflect. CF occurs when this workplace stress leads to feelings of being overwhelmed, helpless, unsupported, and unable to cope. Additionally, primary traumatic stress from threats of workplace violence and secondary traumatic stress (STS) from witnessing the suffering of others increase the likelihood of developing CF. Unchecked, this progression to CF causes reduction in quality of care to patients, reduction in patient satisfaction, increased levels of EP depression and anxiety, increased levels of EP substance use, and increased attrition from the specialty. To truly improve CF, individuals and organizations should be aware of the contributors to CF: namely, emotional exhaustion, depersonalization, primary and STS, and personal achievement. EPs should maximize their resilience to CF by using cognitive behavioral techniques and mindfulness, taking care of their physical health, seeking meaning and development within their work, developing hobbies outside of work, and creating boundaries between work and home. Organizations should actively address the known drivers of physician burnout: workload and job demands, efficiency and resources, meaning in work, culture and values, control and flexibility, work community, and work-life integration. Organizations should also provide adequate safety within facilities to reduce the threat of primary trauma and should supply adequate support and destigmatization for post-traumatic symptoms for EPs suffering from STS.