Ru-Wen Liao1, Mei-Ling Yeh2, Kuan-Chia Lin3, Kwua-Yun Wang4. 1. PhD, RN, Vice Director, Department of Nursing, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation. 2. PhD, DMS, RN, Professor, School of Nursing, National Taipei University of Nursing and Health Sciences. 3. PhD, Professor, Institute of Hospital and Health Care Administration, National Yang-Ming University. 4. PhD, RN, FAAN, Director, Rui Guang Healthcare Group, and Jointly Appointed Professor, School of Nursing, National Defense Medical Center.
Abstract
BACKGROUND: Nurses may experience different levels of occupational burnout in different unit and hospital settings. However, pooling multilevel data in an analysis ignores independent, environmental, and sociocultural contexts of ecological validity. PURPOSE: This study aimed to explore a hierarchical model of occupational burnout that is associated with job-induced stress, nurse self-concept, and practice environment in nurses working in different units and hospitals. METHODS: A cross-sectional study was conducted, and 2,605 nurses were recruited from seven hospitals. The outcomes were measured using the Maslach Occupational Burnout Inventory-Human Services Survey, Nurses' Self-Concept Instrument, Nurse Stress Checklist, and Nursing Work Index-Revised. Hierarchical Linear Modeling 6.0 software was used to conduct hierarchical analysis on the study data. RESULTS: On the nurse level, job-induced stress was a significant factor affecting emotional exhaustion (β = 0.608, p < .001) and depersonalization (β = 2.439, p < .001), whereas nurse self-concept was a significant factor affecting emotional exhaustion (β = -0.250, p < .001), depersonalization (β = -1.587, p < .001), and personal accomplishment (β = 4.126, p < .001). Furthermore, emotional exhaustion and depersonalization were significantly related to level of education (β = 0.111, p < .01; β = 0.583, p < .05). No significant unit-level associations were identified between occupational burnout and the factors of job-induced stress, nurse self-concept, and practice environment (p > .05). The intragroup correlation coefficient for emotional exhaustion was 2.86 (p < .001). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The findings of this study confirm that individual nurse characteristics are strong predictors of emotional exhaustion, depersonalization, and personal accomplishment as these relate to occupational burnout. In addition, nurse self-concept was identified as the most important predictor of all three aspects. In clinical practice, self-concepts about nursing may reduce occupational burnout. Nursing managers formulating new policies should consider nursing background and offer autonomous control over practice.
BACKGROUND: Nurses may experience different levels of occupational burnout in different unit and hospital settings. However, pooling multilevel data in an analysis ignores independent, environmental, and sociocultural contexts of ecological validity. PURPOSE: This study aimed to explore a hierarchical model of occupational burnout that is associated with job-induced stress, nurse self-concept, and practice environment in nurses working in different units and hospitals. METHODS: A cross-sectional study was conducted, and 2,605 nurses were recruited from seven hospitals. The outcomes were measured using the Maslach Occupational Burnout Inventory-Human Services Survey, Nurses' Self-Concept Instrument, Nurse Stress Checklist, and Nursing Work Index-Revised. Hierarchical Linear Modeling 6.0 software was used to conduct hierarchical analysis on the study data. RESULTS: On the nurse level, job-induced stress was a significant factor affecting emotional exhaustion (β = 0.608, p < .001) and depersonalization (β = 2.439, p < .001), whereas nurse self-concept was a significant factor affecting emotional exhaustion (β = -0.250, p < .001), depersonalization (β = -1.587, p < .001), and personal accomplishment (β = 4.126, p < .001). Furthermore, emotional exhaustion and depersonalization were significantly related to level of education (β = 0.111, p < .01; β = 0.583, p < .05). No significant unit-level associations were identified between occupational burnout and the factors of job-induced stress, nurse self-concept, and practice environment (p > .05). The intragroup correlation coefficient for emotional exhaustion was 2.86 (p < .001). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The findings of this study confirm that individual nurse characteristics are strong predictors of emotional exhaustion, depersonalization, and personal accomplishment as these relate to occupational burnout. In addition, nurse self-concept was identified as the most important predictor of all three aspects. In clinical practice, self-concepts about nursing may reduce occupational burnout. Nursing managers formulating new policies should consider nursing background and offer autonomous control over practice.