This article isprotected rights by All copyright. reserved. 10.1111/jonm.12810 doi: lead todifferences version between this andthe ofPleasec Version Record. been and throughtypesetting, proofreadingwhich may thecopyediting, process, pagination This article undergone has for and buthas accepted been not review publication fullpeer Email: P Jiangyang 136 Middle Road,Hanjiang Yangzhou,District, Jiangsu Province, China. University Yangzhou of School Associate ofall List authors runningShort title: burnout;satisfaction;job turnoverintention short informativeA title: among Articletype : Original Article MISS XIAXIN WU (Orcid ID 0000: h
Accepted:(0514 Article Relationship between burnout and intention to leave toleave intention and burnout between Relationship [email protected] )+ 8687978842 Nursing, st Prof Yu RN, ZHANG,
clinical nurses: the role of spiritual cl of spiritual therole nurses: clinical :
Spiritual Climate Spiritual plays
Spirituality; Nursing practice;
- PhD 0001
(firstauthor,author) corresponding - 5130 - 4395) a
rolein
nurse performance
Evaluation; Relationship;Evaluation;
imate
ite this articleite this as job
This article isprotected rights by All copyright. reserved. Email: Jiangyang 136 Middle Road,Hanjiang Yangzhou,District, Jiangsu Province, China. Uni Yangzhou of School Nursing, ShuangLI,Miss Master Email: Jiangyang 136 Middle Road,Hanjiang Yangzhou,District, Jiangsu Province, China. University Yangzhou of School Nursing, Jinfeng Miss E 7RX, HU6 U Health of Faculty Science, MarkHayter Prof Email: Jian 136 University Yangzhou of School Nursing, MsXiaojuan RN, WAN, MSN Email: Jiangyang 136 Middle Road,Hanjiang Yangzhou,District, Jiangsu Province, China. University Yangzhou of School XiaxinW Miss mail: AcceptedHull of niversity Article
[email protected] [email protected] [email protected] [email protected] [email protected] gyangMiddle Road,Hanjiang Yangzhou,District, Jiangsu Province, China. Nursing, H ull, UK ull,
WU, RN, WU, MSN versity. U ,MSN(coRN,
-
firstauthor)
This article isprotected rights by All copyright. reserved. HospitalAffiliated University to Yangzhou Jiangsu Northern People ofICU,Department CAO,RNChaoyu Mr [email protected] Email: Jiangyang 136 Middle Road,Hanjiang Yangzhou,District, Jiangsu Province, China. University. Yangzhou of School Nursing, Yongbin LIU,RN,PhDProf E Hanjiang Middle368 Road,Yangzhou, Province,Jiangsu China. University AffiliatedYangzhou Hospital ofNursing, Department Jiangyang 136 Middle Road,Hanjiang District University. Yangzhou of School Nursing, Yuan YUAN,Prof RN Email: Hanjiang Middle368 Road,Yangzhou, Province,Jiangsu China. University AffiliatedYangzhou Hospital ofEducation, Department Jiangyang 136 Middle Road,Hanjiang Yangzhou,District, Jiangsu Province, China. University. Yangzhou of School Nursing, Prof Acceptedmail: Article
YiRN,HU, MSN
[email protected] [email protected]
’ s Hospital, s
, Yangzhou,, Jiangsu Province, China.
This article isprotected rights by All copyright. reserved. Accepted Jiangsu of foundation province ProgramofJiangsuInnovation Province wassupportedstudy This by obtained funding from statement:Funding intellectual important contents. Hayter, Mark HU, LIUare Yuan Yi involvedYUAN, Yongbin recruiting.inpersonnel WU, Shuang LIand Jinfeng ChaoyuCAOcontributions made acquisition to of questionnaires. Xiaoju interpretationand of analysis and writing.data paper Z Yu contributions:Author Article author:Corresponding Yu ZHANG Email: Jiangyang 136 Middle Road,Hanjiang Yangzhou,District, Jiangsu Province, China. University. Yangzhou of School Nursing, PhDGONG, WeijuanProf Email: Nantong 98 WestRoad, Jian Yangzhou, h angXiaxinsubstantialand WUmade contributionshave toconceptionand design,
anWAN hasmade analysiscontribution interpretation to data.and of [email protected] [email protected] Weijuan G Weijuan
ONG andONG
P.R.China(
YuZHANG
gsu gsu Province,China.
P.R.China BK201604
areinvolved in revising
( KYCX18_2384 PostgraduateResearch& Practice 79
).
)and
manuscript Naturalscience
critically for
This article isprotected rights by All copyright. reserved. Enhancing the spiritualclimate among shortagesBoth and the high turnoverof nursesare challengingproblems worldwide. Background intentions leaveto among This studyaims to identify role the thatspiritual climate inhas reducing Aim Abstract None declared Conflict of interest We Acknowledgments ‘AffiliatedH JiangsuProvince (KYCX18_2384). T Ethic Accepted Articlehis studyissupported by Postgraduate Research Practice & Innovation Programof would like extendto deepour gratitude allto theparticipants in our research
s Approval s :
ospitalof Yangzhou University
st
clinicalnurses. Ethicalpermission the studyfor was by granted st
nursescan enhance ’ .
teamwork , organisational , burnoutand .
the This article isprotected rights by All copyright. reserved. Accepted thatspiritual climate Differentdepartments have differentspiritual climate. Conclusions influencenurses' jobburnout and turnover intention (r=−0.423,p<0.01 correlatedwith burnout(33.62±0.28) and turnoverintention (2.37±0.57). Mostclinical depa ArticleResults relationships amongstrelated factors. correlationanalysis and hierarchical regression analysis wereused to explore the cross Atotal of 207 clinical nurses Methods intention. commitmentand satisfaction job and can - sectional
highjob satisfaction single site rtmentsshowed a moderate spiritualclimate (60.24±0.82) with highjob
andr=−0.292, p<0.01, respectively) may impactnursing
study. working ata tertiaryuniversity hosp
Independent
(r=0.412,p<0.01),
burnout play -
a rolereducing in burnout and turnover samples T and turnover.
( R The The f
. 2 lowandburnout turnover intention
= Spiritualclimate could
10.31%
- A good testand ANOVA, Pearson indings thisfrom study indicate
)
ital spiritual climate .
wereincludedin this
also was
indirectly This article isprotected rights by All copyright. reserved. and lackof time torelax contributeto burnout in nursing (Tennant,2001, Carod productivity,high absence and job accomplishment comprising elements the emotional of exhaustion, depersonalisation and reducedpersonal and high ratesof burnout job nurses of timesthei profession employment Nursing turnoverisa globalproblem. Among Background Keywords teamworkin clinicaldepartments. staffabout spiritualitywell aUsing spiritual climate scale provideshealthcare decision Implicationsfor
AcceptedisBurnout a well Article contributeto rsalary to employ a new one when (Kovneret al., Heinen2014, etal., 2013) :
nurses; .
I nEurope, approximately33%
compared with (Maslach1981) C., n errors - ursing recognised s pirituality;spiritual climate; -
Artaland Vázquez
in care (Adriaenssenset al., 2015, Humphries, 2014) (Wang etal., 2012) - m being. being. Interventions improveto spiritual climate benefitcan anagement:
, developedcountries phenomenonof work (Peng etal., 2013)
particularlyheavy workloads, intense pressure, shift work
turnover,and exert can a negative effecton colleagues .Burnout contributes to poor performance, job low (Trepanieral., 2012)et
- Cabrera,2013) . Heavy . workloads of st
nurses expressintentionan to leave the new17.5%nurses, leave their in firstyear of burnout; turnoverintention; satisfaction job .
.loss The of one nurse costcan up 1.3to (China,2017a) - relatedstress and is characterised as
.Many are factors known to - makerswith information clear .In China thereis can , which , contributesto also . Burnout . also impacts affectnursing care
alower ratio
This article isprotected rights by All copyright. reserved. Accepteddevelopbondswith colleagues productivity stresswork and improve organisationalcohesion feelingstowards spirituality workplacein the Spiritualclimate refersto the way organisationan fosters spirituality trust,meaning, purpose, forgiveness,belief and faith al.,2017et a person’s environment Spiritualityand improving the ‘spiritual climate’ are sugg forreducing nursing burnout Article2011) al., workingrelationships with co as such Studies into jobsatisfaction and burnout increase levelsand Nagy strategies suchas alcohol healthmental
(S., 2011)(S.,
pay intentions leave,to absenteeism, and self .
Improvingthe environmentwork has been recommended asan effective strategy role conflict value , , Timminsand Caldeira,2017) , promotion , (Doramet al., 2017) . , Spiritualityis
contributingto
s, sense s, of purpose in life andthe desire to foundthat . . Thislow satisfaction job andburnout combination beenhasshown to
prospects
(Qiaoet al., 2016) a concept that low
- anddissatisfaction workers poorsleep patterns,anxiety and the use of negative coping (Ashmos,2000, Pirkola, 2016) j ob satisfactionob .Spirituality can ,benefits,
contributeto burnout
in nursingreveal that
. canbe definedseveral in ways Elemen
a poorworking environment, workload has beensuggested as a strategy to reduce .
is alsocontributory a factorin
(Cruzal.,2018a,et Gormley,2003) provide (LW (LW Fry2011) ts of spiritualityts include strength, hope, - reported performance job (McSherryand Jamieson, 2011) estedas ways of
a senseof meaningto workers and
(Klopperet al., 2012, Graham et
make .
dissatisfactionwith issues ,work efficiency and
theirlife meaning (Shuchi,2018) . improving thework
S pirituality
highburno (Piko,2006)
. and poor ful . Sharing
.
relates
(Cruz ut .
This article isprotected rights by All copyright. reserved. tertiaryuniversity hospital questionnaires weredistributed to Cluster randomsampling sample and Data burnout, turnoverintention and satisfaction job among Across Methods climate. turnoverintention. whetherexpress nurses’burnout and Cruzal.,2018a)et manynurses hesitate to workingtheir department linkedwith nurses’performance. Milliman2018, et al., 2018, Rezapouraghdam et al., behaviourand knowledge sharing a positivehas relationship with environmentstandards in 2005and 2016 environmentan with a goodspiritual climate
Accepted Article TheAmerican Association ofCritical -
sectionalsurvey was examine usedto theinfluence of spiritual climate on job
ing
. O
I personalspiritual views could help tonurses burnoutreduce and
t ur studyisdesigned to improving
is not known whetherspiritual climateis
express
, and 207 , completed questionnaires were receivedback, which isunclear was doneduring July to Octoberin 2018. retention organisationalsustainability However,how ordiscuss
(Shuchi,2018, Isebor,2018, Khari and Sinha,2018, Lacy, registerednurses served .
At same the time,under the tensemedical environment, - CareNurses proposes that caregood accompanies
ratesby reducing
(Connoret al., 2018, Pinkerton, 2005) explore their spirituality .
The nurses
AACN
thenurses’ perception spiritual of 2018) st
feelabout t
clinicalnurses.
released guidelinesabout
. turnoverintention , leadership, employees’,
Moreover, with in
associated with reducing differentdepartments co he spiritualhe climate of -
workers A total 250 of
spiritualitybeenhas
. (GrantD, 2004,
It isunknownIt . Spiritual
in the
ity
This article isprotected rights by All copyright. reserved. Acceptedoriginalscale. Chinese version spiritualclimate scale hasone dimension of fouritems, the same with avariance total of 66.79 analysis,KMO the index is0.782 with Bartlett’stest (p<0.01),one component was extracted “department” testreliability had a t pilotand a study,we developeda Chinese version ofthe spiritual climate scale. spiritualclimate”. climate. disagree) 5to (s contains internalconsistency (Cronbach’s alpha)of the scaleclinical for registered nurses is 0.867. It ArticleSexton Spiritualclimate scale Measures yearclinical of experi accommodatethe healthcare needs of civilian Registered patients. nurses with atleast1 indicateda responserate of84%. Thespiritual climate scale was developeduse for byclinical medical bystaff Sexton and otal reliabilityCronbach'salpha (Doramet al., 2017) Percentage four questions
tomake of
0.834(p<0.01) and tronglyagree).Higher scores show the that department has a better spiritual
Throughthe translation, re s ence andworkingin clinicalsettings were involved the research.in
of agreementin each item wasas” taken percentage reporting
this aspectthis
ratedon a five .scale The %.
A llthe loa morespecific Thetertiary hospital ahas 1600 CVI/av
- of pointLikert scale. Thescale ranges 1 from (strongly possesses psychometricgood properties, and the 0.833, ding g
- of translation andexpertconsultation ofth factors 0.91 during the a half . The The term ”area”was changed - ofitems fold confidence
expertconsultation
were morethan 0.5. - bedcapacity to
of 0.80 (p<0.01), re .
In In factor T hescale asthe to
The escale a good good
- This article isprotected rights by All copyright. reserved. Thehigher the score withscale, scoreof 1 Thereliability thescaleof was 0.87 0.92to Minnesota job ranging 1 from (never)to 4 (always). The reliabilityour studyfor sample 0.797. was theon correlation among item1&6; (1982)thatincludes sixdivideditems into threedimensions Turnoverintention scale 0.860. accomplishment emotionalexhaustion al scale ranging 0from (never) to 6 (everyday) Maslachburnout inventory scale
Accepted Article(M aslach C., 1981,aslach C., Peng et al., 2016) TheMaslach TheMinnesota satisfaction job scale was developedby et al Weiss Theturnover
Intentionto transfer
satisfactionscale
(8 items)(8 intention burnout inventoryburnout was developedby , –
(9 items(9 thehigher the jobsatisfaction. 5 pointsin turn(most agree points, is5 and mostdisagree is 1 point).
st . The reliabilitywas reconfirmedby us with Cronbach’s a alpha of
scale the six the items. wasIt measuredby a four : item : 2&3; ) ,
depersonalisation
isa ques . . The scale consistsof 22 items with Possibilityseeking of better a job tionnaire developedMichaelby and Spector .
A total20 of questionsuse the five
and t ranslatedinto
( 5items)
Maslach
and lackof personal ( Possibilityof quitting job
Chinese byet Peng
with - pointLikert scale
a seven (Tarcanet al., 2017) : item 4&5): 3 dimensions: - pointLikert - pointLikert
: based
.
This article isprotected rights by All copyright. reserved. degree and Results significant. exploreto the relationships among related factors. data.Independent usedWe SPSS analysisData participateand withdraw University.All participants the were informed of thestudy Thestudy was approvedby Yangzhou University Ethics Participants’ demographicsare shown in Accepted1. Article care for
Characteristics ofparticipantsCharacteristics
(70.5%)and
approximately
Pearson correlationanalysis and hierarchical regression analysis wereused
20.0 - samples T significant s oftware establishto database a and
at anyat time
8 patients per8 patients - testand ANOVA were used to test differences for between workexperience. st
duringthe research. these fac
day Table 1
shift. tors.
and theAffiliated Hospital Yangzhou of Ap . Most
Clinicalnurses - value<0.05 was considered
’s nurses in this
performstatistical analysis of aimsand theirrights workin teams studyhad to
a
(96.14%) Bachelor
This article isprotected rights by All copyright. reserved. between spiritualclimate and satisfaction job was weak Spiritualclimatewas p demographicdata and nurses’ spiritual climate scores. The resultsare shown Table in performedWe independent climate clinicalarea’had a meanscore of 3.39±0.90 climatewere 47.9% and 51.2 score (3.53±0.88and 3.53±0.817, respectively),and the percentages reporting goodspiritual diverseofspiritualset views acceptedare in this clinicalarea’received the highest mean (36.3%). 3Item ‘My spirituality a comfortablehas lowest the mean score (3.19±1.09)and a percentage reporting good spiritualclimate was score fornurses’ turnover intention was 2.37±0.57 satisfactionJob among - value <0.05 2. Accepted4. 3. Article
60.24±0.82. Item1 ‘I am encouraged to express spirituality in clinicalthis area’received ly burnout intention turnover and a Correlation scores relationship between demographicThe datanurses’ and spiritual climate of Descriptive results scale each
negativelyrelated was
45.9%
was
(Table 2) usedto determine statisticalsignificance. moderate mong st
nurseswas 69.02±0.46.Burnout scores were33.62±0.28 to - . st samples T turnoverintention (r=−0.292, p<0.001). The
%, respectively.2Item ‘My spiritual views respectedare in this
ly nurses' spiritualnurses' climate,job job satisfaction,
negativelyrelatedto job burnout (r=−0.423,p<0.001) and - testand ANOVAto test therelationship between
,
and percentage the reporting spiritualgood
home in clinicalthis area’ and item 4 ‘A moderate . Thescore for
ly
significant (r=0.412,p<0.001). nurses’ spiritualclimate positive relationship . The
3 .
A This article isprotected rights by All copyright. reserved. tendencyof nurses to leave by their jobs influencing burnout job betweenburnout job and turnover intention. Spiritual climateindirectly affects significantlyin thethird step. spiritualThus, climate a has mediating effect theon relationship was effectof spiritualclimate jobon burnout and spiritualclimate bothcould predictburnout turnoverintention and spiritual clim spiritualclimate( variable andspiritualclimate was burnoutpredict the satisfaction, spiritualclimate and turnover intention. Thehierarchical regressionwas donet statisticalsignificance. p<0.001). The resultsare shown in Furthermore,job burnout was
Accepted Article5.
independentvariable andburnoutwas
weakened satisfaction, spiritualsatisfaction, turnover and climate intention Hierarchical regressionjob analysis ofnurses’ burnout andjob
(
moderate
the the
atewere ; Table
Step two
dependentpredictvariable,turnoverintention could ;
o further Stepthree ly was
4. positivelyrelatedto turnover intention (r=0.415,
the the
the
A controlledturnoverfor, intention on burnout job
, turnoverintention was dependentvariable, turnoverintention could p
( test relationship - independentvariable
value , ,burnout was
and the regressioncoefficient decrease In s In
of tep one tep
<0.05
,the turnover intention was wa s the
(
Table 5) betwe s used s determineto
dependentvariable and
s the . . Turnoverintention
en job burnout, job en job
independent .
(10.31%)
When the
the d
This article isprotected rights by All copyright. reserved. Acceptedthat found thatmany nurses (96%)worked in teamsregularly. Previous r scores,which maysignificantlybe positively relatedto teamwork satisfactionstaff teamworkin emergencydepartments and clinical wards highest the mean scores. area’and item 4 ‘Adiverse set of spiritual views acceptedare in staff careon outcomes importance ofspirituality workiin the This finding receivedlowest the mean score etDoram al., 2017) Article than the feeling satisfiedwith work their communication climate intentionand significantly relatedto higher job satisfaction in ourstudy. A goodspiritual turnoverintentions. Spiritual climatepartially mediated ef the The offindings studythis Discussion
(Thompsonet al., 2011) b Thepercentage reporting spiritualgood climate and mean score uilding
hasbeen found by others to be findingsof previous studies
could indicateour that decision apositive
(Doramal., 2017)et (Groveral., 2017,et Henkin et al., 2016) and less focused . . Item1 ‘I am encouraged expressto spirituality in this clinicalarea’ organisationalculture and
indicated thatspiritual climate may Research by .Item 3 ‘My spirituality a comfortablehas home this in clinical
when allowed expressto their spirituality , which , .
onthe morale andworksatisfaction of their ng environment.ng in America andthe Middle East Consequently,nurses
Grover wassame as the that of Cruz related to - makers et aland Henkin etalboth indicatethat good
developinggood higherwork efficacy and better did notembrace, or were unaware Nursemanagers maybe more focused benefitsboth .
The item The may fectof job burnout on turnover reducenursing burnout and
thisclinical area’received . be
In In theresearch hospitalwe
teamworkin departments
3&4 more likely reportto
esearch also indicates (Cruzet al., 2018b, ofitems (Cruzal.,2018a)et patientsoutcome and
. received high
werelower
of .
the the
This article isprotected rights by All copyright. reserved. AcceptedKelly’sstudieswork on environment medicaldepartment, nurses also expressedhigh levelsburnout of similar to Colville’sand fatigue burnoutwith healthcare high Tawfik’s studyin neonatalICUand Meyer’s stud associatedwith physicaland mental exhaustion andturnover tendency. a week. that entire the medicalward with 40 in charge inpatients public hospitals increased by 4.0% institutionsincreased by 3.2%compared with thatin Articlemedicalservice reportin January2019, the number ofpatients in medical and health numberof patients had thelowest score(51.32), different views. This Withinhome a improveefficacy work and patients’ safety and reduce clinicalerrors enhancecan workplace spirituality theywork In additionIn tothe (Tawfiket al., 2017, Meyer al.,20 et
Nurseswith multiple roles busyface nursing jobs and high work
of8 scenario
– ed areas - 10 like
54.6h week,per which ismore than patientsduring theirday shift but at
work environment in medicinemay be regarding coulda be futureintervention target in nursing management. teamwork mentionedabove, - associatedinfections, low compassion and compassion followedby nurse’s – 50 patients50 (Pirkola,2016) (Colvilleal., 2017, et Kelly and 2017)Todd, ,clinical nurses wouldrelaxed feel to express their
scores onthe spiritual climate scale one reason for this
paediatrics, surgeryand ICU 15) . our. In research, mostof the nurses reported .In studyour the critical care department and (China,2018) yin paediatric, clinicalnurses have high .
Co a significantdifference was amongfound the operatingwith co
night,a single nurse takescharge of the lastyear,and the numberof
normalofficial working time of40 h finding .
We also We foundn that . - Accordingto the national intensityworktasks (Hwang andAhn,2015) . . The increased - workers Accordingto .
Medical
. could
ursesa
ward
also
s re
.
This article isprotected rights by All copyright. reserved. 2014) al., especially findingsof Li turnoverintention was positivelyrelatedto job burnout, which waswith consistent the intentionshowed significant intentions of nurses to quit their jobs.Correlations i coming with highturnover in our study to Dall et work (Giorgiet al., 2018) nurses feelit easy to experience burnout,and poor sleep quality experience levels high of burnout and Gu registeredlow emotionalexhaustion 2001) often the mostcommon dimension burnout of m depersonalisation theon dimensions ofemotional exhaustion, lack personal of accomplishment and
Accepted Articleeta Thejob burnout scorewas high,and it was similar to thatobtained by High turnoverintention and burnout alsoWe found that - - related fatigueand burnout associatedwith health problemsand . analysis
We foundthatnurses We with highburnout in studyour also score ,
who thatfound nurses are likely to resignor have intention an to resignwhen they . on The Chinese The
(LeiL, 2016) patients’safety of Burnout of level Medicalin Areanurses subjects spiritualclimate (WANGShao . When
domain the the g overnment .
nurses
nurse turnoverintention was highand similar to . .
Patient safety
Those with highburnout and emotional exhaustion scores -
min,2012) (Hanet al., 2014) (Dinget al., 2015, LH, Gu 2009)
work for isattempting .
(Molina
can
the mental 12 .
is Mdina have
h shifts, theyare more likely expeto a - Praena, 2018)Praena, al global
to a (Dall'Ora etal., 2016) . - Praena Lowsatisfaction job harmfulinfluence on improve the well
issue
- being ofbeing personnel et al
(Guerra et al.,2018, et Welp . thatemotional exhaustion is Emotional .
affects theirperformance (2018) workingconditions .During night the shift, d highly . Scores . forturnover found infound a is also the same nursingcare,
exhaustion Wang Shao Wang thestudy of (Maslach C.,
in ndicated that the the also rience previous
for isalso - min Ding
This article isprotected rights by All copyright. reserved. and workpressure would also be communicationwith nursesincrease can interventionsare important fornursing managers. serious, burnoutbecomes stronger before.than decrease the innursing work qualityand increase the work in pressure, the offeeling job criticisedthe nurses fornursing errors,there climateas well as nurses’ workinghigh stress. The headnurses misunderstood and communicationislimited, nurses’ advice isignored,contributing thus to a low spiritual giveneffectits of 36.8%. the spiritualWhen burnoutand turnoverintention. Burnout predictcan the occurrence of turnoverintention, burnoutand turnoverintention. Spiritual climate asworks intermediaryan factorbetween job spiritualhealth burnou amongsthealth care professionals (McCormacket al., 2018) psychologyintervention conditionsof nurses and othermeasures nurses shift nurse
AcceptedAs Article Ourregression analysis
thespiritual climate worksas a mediating factor forburnout and turnover, reasonable s
t byestablishing an (Hallal.,2016)et and , improving , the salaryand treatmentof front
nurses mayeve asa strategy s tos improve asense of . .Hall al et specialnursing position allowance, Further they when planning forimproving patient safety showedthat n leavecurrent their job. decreased
isassociated with .(2016)
suggest Consequently,the
their (China the
describeshow a
climatea in department ispoor and bynurses’causing jobsatisfaction to drop. With
with the spiritual climate
job satisfaction
that well , 2017b)
Providingcare, respectand - organisations being couldbeing help
help poor - linenurses, improving wo the .
Hann
of patientsafety and increased turnoverintention
poor and communication
(Featheret al., 2015) increasingthe pay night for playsimportantan role in ah senseof improve suggeststhat
reduce burnout (Hallal.,2016)et
well employees’ becomes - being
carryingout from . Burnout .
rking
nurse more .
This article isprotected rights by All copyright. reserved. Accepted of their and job profession. associatedwith healthcare mayalso encourage staff debateto the more spiritualelements interventions. Taking time outto cons dealstaff with at stress work throughthe provision of staff health,counselling and relaxation Ensuringthatstaff feelvalued isimportantand employers could consider howcan that help space and time for reflective discussionsamongst co techniquescould improvesense a of cohesion and sharedpurpose amongst staff. Providing climatein workingareas NurseManagers could considera number of thingsthatcould for Implications busynurses communicateto their Articlebuilds a Clinicalnurses undergo intensive nursingwork. Conclusion questionnaire mayhave Futurestudies should beconducted in othercities and healthcare centres. Theself Limitation furtherstudy can also becoping strategies managers.Encouraging and morallyrewarding the staff and piritu s
alclimate
managers where .Providing space for teambuilding and using teambuilding a certain degreeof bias.
nurses’opinions
spiritualityto iderthe overarching values and life meanings (Koiniset al., 2015)
are accepted improve N urse - wor m
theirwork mentality. anagers
kers may kers also have benefits.
providingopportunities for and . developa strong
have the opportunityto a space isprovided for
spiritual - reported
This article isprotected rights by All copyright. reserved. 2018. November to January servicehealth from The national 2018.O. R. S. T.P. C. O. F. P. A. H. N. CHINA, health national the of conference press regular of the Transcript 2017b. O. R. S. T.P. C. O. F. P. A. H. N. CHINA, F. P A. H. N. CHINA, CAROD measure. and conceptualization a Work: at Spirituality 2000. D. DUCHON, P., D. ASHMOS, stress in occupational of consequences and S. 2015.Causes MAES, & V. GUCHT, J., DE ADRIAENSSENS, References None declared Conflict of interest would We like extendto deepour gratitude allto theparticipants in our rese Acknowledgments ‘AffiliatedH JiangsuProvince (KYCX18_2384). T Approval Ethics Accepted Articlehis studyissupported by Postgraduate Research & - ARTAL, F. J. & VáZQUEZ J.& F. ARTAL, ml http://www.nhfpc.gov.cn/mohwsbwstjxxzx/s7967/201901/57dec69d2c8c4e669864b067d2a1fb2e.sht http://www.nhc.gov.cn/xcs/s3574/201705/c2270bb8b4a640ce923cef0bc9569ee1.shtml 2017. 10, May on China of Republic People's the of commission familyplanning and Talents. Planning Inquiry, Management study. longitudinal a nurses, emergency .
ospitalof Yangzhou University
. C. O. T. P. S. R. O. 2017a. Thirteenth Five Thirteenth 2017a. O. R. S. T.P. C. O. .
Chinese Nursing Management, Nursing Chinese
9 - CABRERA, C. 2013. C. 2013. CABRERA, ,
134 - 145.
Ethicalpermission the studyfor was by granted Journal of Nursing Management, Nursing of Journal ’ . Burnout Syndrome in an InternationalSetting an in Syndrome Burnout
17 , -
145 Year Plan for the Development of Health Family of Health Development the for Year Plan
Practice Innovation Programof - 149.
23 ,
346 Journal of of Journal - arch 58.
. , Springer US. Springer , .
the
This article isprotected rights by All copyright. reserved. Accepted Burnout, Wellbeing, Staff B. 2016.Healthcare D. O'CONNOR, & TSIPA,A. I., WATT, J., JOHNSON, H., L. HALL, G., GUTIERREZ GUERRA, nurs forpredicting model factor comprehensive A 2009. QP ZHANG Y, FENG XUXF, ZH, YE H., L. GU LH, explor An J.2017. MORPHET, & E. J. PORTER, E., GROVER, of Study the in Directions New Empirical Workplace: the in 2004.Spirituality L STEPHENS N., K. O. D, GRANT public Canadian 2011.Impacting S. L. MANTHA, & J. SIMPSON, K., A. WOODEND, B. L., DAVIES, R., GRAHAM, K. 200 K. D. GORMLEY, affect burnout and quality sleep Can 2018. L. LANCIA, & C. PETRUCCI, I., NOTARNICOLA, A., MATTEI, F., GIORGI, Job Their Affect to Perceive RNs That Behaviors Manager 2015.Nurse BAKAS, T. & P. EBRIGHT, A., R. FEATHER, The spirit? Got 2017. J.B. SEXTON, & J.D. SEXTON, J., PROFIT, J., BOKOVOY, W., CHADWICK, K., DORAM, ArticleH. SUI, & L. WANG, W., WANG, X., HE, X., QIU, T., ZHANG, X., YANG, Y., YANG, Y., DING, Twelve J.2016. BALL, & P. GRIFFITHS, C., DALL'ORA, care perspectives spiritual and 2017.Spirituality C. P. COLET, & K. A. ALOTAIBI, F., ALSHAMMARI, CRUZ, J.P., MORENO & M. S. ALHARBI, M., H. ALBAQAWI, N., ALQUWEZ, CRUZ, J.P., Y.2018a. H. ABUNAB, & M. L. G., VITORINO, J. ALICANTE, M., S. ALHARBI, M., H. ALBAQAWI, CRUZ, J.P., HICKEY, & L. WOOD, P., DWYER, M., MOONAN, D., DOHERTY, C., PORTER, I., S. J. ZINIEL, A., CONNOR, O. TAM, D., P. SHAUNAK, M., N. NGURU, K., CITRON, J., BRIERLEY, J.G., SMITH, G.A., COLVILLE, and Patient Safety: A Systematic Review. Review. Safety: ASystematic Patient and turnove GONZALEZ & burnout. 20 department. emergency the in teamwork experience of and Sacred. the satisfaction. job nurses' health Education, Nursing, shift of performance job the Satisfaction. Res, Serv Health spir Nurses. among Chinese Burnout and Capital Psychological between Relationship the in Style Role of Coping 22 Today, cross A Arabia: Saudi in students nursing baccalaureate among perceived spiritual Management, Nursing of Journal Ps Care, Critical of Journal American Tool. Assessment Environment Work Healthy AACN the of Validation Use and 2018.Interprofessional Medicine, Care Critical Pediatric Work and Staff Burnout With Coping 2017. L. PORRAS, ychometric assessment of the Spiritual Climate Scale Arabic version for nurses in Saudi Arabia. Arabia. Saudi in nurses for version Arabic Scale Climate Spiritual of the assessment ychometric , -
3. 92 directions. future and data benchmarking properties, psychometric scale, climate itual
-
97. 49 r: challenges for the Mexican health system. system. health Mexican the for r: challenges PLoS One, PLoS
74 Chinese journal of Nursing of journal Chinese ,
156 42 3. Factors affecting job satisfaction in nurse faculty: a meta a faculty: nurse in satisfaction affecting job 3. Factors , Sociology of Religion Religion of Sociology
698 Nursing Forum, Nursing - , BLOCK, M. A. 2018. Loss of job of Loss 2018. A. M. BLOCK,
- 174 - 162. CALDERON, E., SALGADO DE SNYDER, N., BORJA N., SNYDER, SALGADODE E., CALDERON,
- 17 708.
- 10 climate of a hospital in Saudi Arabia. Arabia. Saudi in hospital a of climate , 8.
132. ,
e0122128.
- 50 work nurses? A hospital cross hospital A work nurses? Can ,
18 125
65
26 27 adian Journal of Public Health, Public of Journal adian , , , e267
44 - ,
265
36. 485 363 ,
502.
- - - 283. - PLoS One, PLoS 492. e273. 371. - hour shifts: burnout or job satisfaction? satisfaction? job or burnout shifts: hour - related right to healthcare associated with employment employment with associated healthcare to right related
ation of emergency nurses' perceptions, attitudes attitudes perceptions, nurses' emergency of ation
11 BMC Health Services Research, Services Health BMC , -
Related Posttraumatic Stress in Intensive Care. Care. Intensive in Stress Posttraumatic Related e0159015. International Nursing Review, Nursing International -
sectional study. study. sectional Australasian Emergency Nursing Journal, Nursing Emergency Australasian - sectional study. study. sectional - - LACALLE, R. C. 2018b. Nurses' Nurses' 2018b. C. R. LACALLE, ABURTO, V. H., MARTINEZ H., V. ABURTO,
102
,
- 427 analysis. analysis. - 31. Journal of Advanced Advanced of Journal
2015. The Mediating Mediating 2015.The Nurse Education Education Nurse Journal of Nursing Nursing of Journal
Nurs Times, 18
65 , & PERKINS &
457. ,
559 BMC - VALLE, A. A. VALLE,
P. A. P. - es' job es' job 566.
112 -
,
This article isprotected rights by All copyright. reserved. Accepted compassion examining nurses: novice Pediatric 2015. J.I. GOLD, J.& KLARISTENFELD, A., LI, M., R. MEYER, care. spiritual and spirituality of perceptions survey nurses' of online S. 2011.An JAMIESON, & W. MCSHERRY, The J. 2018. M. CAMPBELL, & P. M. HERRING, D., O'SHEA, T.E., MACINTYRE, M., H. MCCORMACK, 2001.Job burnout. MP. LEITER S. W., C., MASLACH measure The J.C., S.1981. MASLACH performance”: unit leadership on of spiritual “Impact 2011. WALUMBWA FO NOEL, M H., S. FRYLW , analys bibliometric A China: in research 2016.Nurse M turnover J, LI G., LI L. L, LEI and Satisfaction Employee Improve to Guide AChaplain's Strategies: to Spirituality From LACY, 2018. A. R. is the what and mean rate turnover doesnurse What JUN,J.2014. & F. FATEHI, C. S., C. T., BREWER, KOVNER, of Impact The 2015. M. SARIDI, & E. STRATOU, S., ANGELAINA, V., DRANTAKI, V., GIANNOU, A., KOINIS, satisf job environment, 2012.Practice P. BESTER, & PRETORIUS,R. K., S. COETZEE, C., H. KLOPPER, & C. KHARI, Article Environment. Work Healthy the and Fatigue Compassion 2017. M. TODD, & L. KELLY, o Inquiry ANarrative Century: The 21st for Leadership Transcendental 2018. J. E. ISEBOR, hospitals. Korean in nurses among reporting error clinical and Teamwork J.2015. AHN, & J.I. HWANG, of 2014.Quality H. MCGEE, & A., MONTGOMERY, Y., MCGOWAN, C., CONRY,M. K., MORGAN, N., HUMPHRIES, J.T.2016. RATELLE, & M. L. WORDEN, J., A. HALVORSEN, L., M. T.Y.,CHRISTOPHERSON, CHON, S., HENKIN, ENSIO, M., KOZKA, MATTHEWS, A., B., ZANDER, R., SCHWENDIMANN, T., ACHTERBERG, VAN M., M. HEINEN, GEIGER & M. A. TRINKOFF, K., HAN, satisfaction. satisfaction. job and burnout, satisfaction, compassion and stress exposure between mediator fatigue as a Nursin Clinical of Journal 9 Review. ASystematic Psychologists: Applied Among of Burnout Cause(s) and 130. Corrigendum. Sciences, Nursing of Journal International Positivity. Workplace rate? General Hospital. Local of a TheirMental on Environment Job Workers Healthcare Africa. South in of care nurses critical burnout Management, Systems Flexible of Journal Global Care, Spirituality. Workplace and Research Nursing Care . review. literature narrative burnout: professional health care and Healthcare, Multidisciplinary nurse Improving Studies, of Nursing 10 in study observational sectional cross a profession: their leave to 2013. intention Nurses' L. SCHOONHOVEN, J.& BALL, T., CASBAS, MORENO S., I. SJETNE, A., 12 working nurses hospital in recovery ,
1897.
SINHA, S. 2018. Organizational Spirituality and Knowledge Sharing: A Model of Multiple Mediation. Mediation. of Multiple Model A Sharing: Knowledge and Spirituality S. 2018.Organizational SINHA,
Quality Assurance, Quality
28 Policy Politics & Nursing Practic Nursing & Politics Policy
,
351 Journal of Pediatric Nursing Pediatric of Journal - 358. Leadership Quarterly, Leadership - physician teamwork through interprofessional bedside rounding. interprofessional teamwork through physician 9
, 50
14 Nurse Leader, Nurse ,
- 174 20.
27 g,
- -
, 20 BROWN, J. 2014. Factors associated with work with associated Factors J.2014. BROWN,
84. Social Science Electronic Publishing Electronic Science Social Health Psychology Research, Psychology Health 293 ment of experienced burnout. burnout. of experienced ment
9 ,
,
1757
- 201 307.
- -
16 5. 22 67.
e,
, - ,
hour shifts. shifts. hour 15
173 259 - Nursing Care of Children & Families, & Children of Care Nursing
3 , Annual Psychology, of Review Annual
, 64 -
- 176. 208 270. - 71. Management, Nursing of Journal -
212. 19
Workplace Health & Safety, & Health Workplace ,
337
- emo -
3 348. ,
Behaviour, Occupational of Journal
tional Health. Coping Strategies: The Case Strategies: Coping Health. tional 1984. European countries. countries. European
.
International Journal of Health Health of Journal International
52 is from 2000 to 2015. to 2000 from is - related fatigue and and fatigue related ,
397 AACN Advanced Critrical Advanced AACN
Frontiers in Psychology, in Frontiers 30
62
, - 20 n Effctive Leadership Leadership Effctive n
International Journal Journal International 422. 174 ,
,
Journal of of Journal 409
685 -
83. - - 14. 95.
action and and action Prevalence Prevalence
Asian Asian
2 ,
99 -
This article isprotected rights by All copyright. reserved. AcceptedWANG SHAO & B. ULRICH, S., EARLY, S., TREPANIER, patients. of needs spiritual the Assessing S. 2017. CALDEIRA, F. & TIMMINS, & T.E. MINNIER, K., H. BURNS, G.A., WOLF, L., H. LORENZ, S. M., SEREIKA, A., L. HOFFMAN, N., D. THOMPSON, 2001.Work C. TENNANT, J., P. SHAREK, P., KAN, B., J. SEXTON, S., D. TAWFIK, G.Y. TARCAN, & M. TOP, B., SCHOOLEY, N., HIKMET, M., TARCAN, Mediation. ofMultiple KnowledgeModel A and Sharing: Spirituality 2018.Organizational C. S. K. SHUCHI, single a 2011.Using M. N. S., spirituali 2018.Workplace H. ARASLI, & H. ALIPOUR, H., REZAPOURAGHDAM, Article MA, D., HAN, X., QIU, X., YANG, TANG, Q., YANG, J., Y., JIAO, L., M., WANG, CHEN, GUAN, X., L., CHEN, Z., QIAO, & P., RANTAKOKKO, H., PIRKOLA, environments. work healthy sustaining establishing and for AACN standards 2005. S. PINKERTON, care health Hungarian among health psychosocial and satisfaction job role conflict, Burnout, F. 2006. B. PIKO, core can How J.2016. ZHANG, & W. XIAO, D., MIAO, Y., TIAN, Z., ZHANG, D., LI, J., PENG, X. FENG, Y., SONG, R., XIAO, J., JIANG, ZHANG, J., X., PENG, MOLINA employee hospitality on spirituality workplace effectof The J.2018. KIM, & A. GATLING, J., MILLIMAN, - in nurses.in usage. labor contract and turnover on based benefitanalysis Nursing, of College Royal the of newspaper Nu unit on leadership perspective relational A 2011. R. RAMANUJAM, 704. Perinatology, of Journal healthcare to its relation and intensive careunit neonatal the in Burnout professionals. health department socio burnout, between Management, Systems Flexible of Journal Global Psychology, Sustainability & behavior. sustainable employees’ hospitality on perspective theoretical a cross a China: in workers healthcare HIV/AIDS J. literature. the review of Economics, survey. questionnaire a staff: Psychology, Health satisfaction. job and commitment roles organizational of The key burnout? influence job commitment. role organizational of mediator of the Chinese nurses: burnout job on capital psychological Study. 35 service delivery. and stay, to intention engagement, PRAENA, J., ET AL 2018. Levels of Burnout and Risk Factors in Medical Area Nurses: A Meta A Nurses: Area Medical Factors in Risk and Burnout of Levels 2018. J., AL ET PRAENA, , YANG, Y. & ZHAI, X. 2016. Prevalence and factors associated with occupational burnout among burnout occupational with factors associated and 2016.Prevalence X. ZHAI, Y.& YANG, , , rsing Administration,
5 -
6 MIN, W. J. 2012. Analysis of correlation between job burnout and job satressors and self job satressors and and burnout job between correlation Analysisof J. 2012. W. MIN, - International Journal of Environmental Research and Public Health, Public and Research of Journal Environmental International 65.
Journal of Qilu Nursing, Qilu of Journal
23 75 PLoS One, PLoS , ,
138, 140. , 77 -
1 related stress and depressive disorders. depressive stress and related - - 19.
86. 21 - item approach to measure facet job satisfaction. satisfaction. job facet measure to approach item ,
50
-
37 41 Journal of Nursing Management, Nursing of Journal 8 demographic and workplace factors and job satisfaction among emergency emergency among satisfaction job and factors workplace and demographic SUHONEN, M. 2016. Workplace spirituality in health care: an integrated integrated care:an health in spirituality 2016.Workplace M. SUHONEN, - , 9.
, , e84193.
315 479
International Journal of Nursing Studies, Nursing of Journal International CHERRY, B. 2012. New graduate nurse residency program: a cost a program: residency nurse graduate New 2012. B. CHERRY, - - 320. 87.
Applied Nursing Research, Nursing Applied 18
,
55 - 57. NISBET, C. C., RIGDON, J., LEE, H. C. & PROFIT, J. 2017. C. & PROFIT, H. LEE, J., RIGDON, C., C. NISBET,
31
- ,
sectional study. study. sectional 47
19 , ZHANG, Y. & MIAO, D. 2013. The impact of of impact The 2013. D. MIAO, Y.& ZHANG, , - 53. ,
Journal of Hospitality & Tourism Management, & of Hospitality Journal 337
-
348. Journal of Psychosomatic Research, Psychosomatic of Journal
2017. An analysis of the relationship relationship the of analysis An 2017. 24
, 34
Nursing Economics, Nursing
859 BMC Public Health, BMC Public ,
40 - 868. - - level safety climate. climate. level safety Nursing Standard: official Standard: Nursing 47. ty and organization sustainability: sustainability: organization and ty
Journal of Occupat of Journal 43
- , associated infections. infections. associated
Environment Development Development Environment
311 15 ,
- 2800. 8.
self
30
16 -
, evaluations evaluations
207 ,
335. Journal of of Journal ional ional - Journal of of Journal Nursing Nursing 14.
- Analytic Analytic
51 - ef - , ficacy
697
- This article isprotected rights by All copyright. reserved. L. MEIER, A., WELP, 2012.Work L. WANG, J.& FU, Y., CHANG, Y., WANG, Accepted Article objective patient safety. safety. patient objective capital. psychological effectof mediating the nurses: L. & MANSER, T. 2014. Emotional exhaustion and workload predict clinician predict workload and exhaustion T. MANSER,2014.Emotional & L. Frontiers Psychology, in
- family conflict and burnout among Chinese female Chineseamong burnout and conflict family
5 ,
1573. BMC Public Health, Public BMC
12 ,
915.
- rated and and rated This article isprotected rights by All copyright. reserved. hours Weekly working of the in presentYears working unit patients of Number of Number Associate administrator Nursing nurse Staff assistant Nursing Current level Educational Working Age Teamwork Variable TableDemographic 1 and work
Accepted degree College degree Bachelor’s ArticleOncology ICU Paediatrics Surgery Medicine 51 41 31 22
– – – – 55 50 40 30
p u
osition chiefnurse
nit (yes
patients carefor to
)
to careforto
per per dayper shift night
- relatedcharacteristics of participants (
shift
28 29 29 69 52 3 15 69 120 199 Mean 54.6 9.35 4 8 13 45 97 52 61 146
3(0.65) (1.4%) (0.36)
(13.6%) (14%) (14%) (33.3%) (25.1%) (7.2%) (33.3%) (6.3%) (21.7%) (46.9%) (25.1%) (29.5%)
(58%) (96.14%) (70.5%) (0.35) (0.72)
(SD)/n
(%) n =207)
This article isprotected rights by All copyright. reserved. climate(36.3%) spiritual item2 climate(51.2%);c, percentage percentage reporting good climate(47.9%);b,a,item3 percentagespiritual spiritual reporting good item4 Turnover J J Climate Spiritual Variables TableDescriptive 2 resultsof eachscale Accepted Article ob burnout ob satisfaction
intention
Items/ Possibility of of Possibility s Intention Possibility accomplishmentpersonal depersonalization exhaustion emotional am encouraged to1.‘I express in this are spirituality clinical views are2.My this respected in spiritual clinical area diverseof set views 4.A spiritual in this accepted clinical are area comfortable3.My a has spirituality in home this area clinical
Dimensions
to
of
transfer
quitting eek reporting spiritual good 1 reportingclimate(45.9%);d, item percentage good
ing
job
a a better job
c
a a d
b 2.157(0.738) 2.242(0.739) 2.37(0.57) 24.46(0.509) 8.749(0.509) 26.46(0.065) 33.62(0.28) 69.02(0.46) 60.24(0.82) Mean(SD) 2.720(0.582)
3.19(1.09) 3.39(0.90) 3.53(0.817) 3.53(0.88)
This article isprotected rights by All copyright. reserved. **,p<0.01; *,p<0.05 Associate administrator Nursing nurse Staff assistant Nursing Current degree College degree Bachelor’s level Educational Oncology ICU Surgery Paediatrics Medicine Working >50 41 31 20 Age no yes Teamwork Table – – – Accepted Article
50 40 30
3 p
u
osition Analysisspiritualof climate chiefnurse
nit
60.83 59.21 60.10 61.78 59.59 70.31 64.01 62.86 (2.43) 56.47 51.32 72.92 69.17 61.68 57.97 59.09 85.42 Spiritual 66.35
(2.51) (2.01) (2.37) (2.40) (1.56) (4.04) (3.38) (2.32) (2.21) (12.67) (5.19) (2.31) (1.65) (1.24) (1.66)
(2.81) c limate
2.342 4.273 0.565 0.764 4.461 t/F
0 <0.01** P .639 .446 <0.01** .074
57.66 14.18 Lower 95% 57.66 − 57.66 3.47
CI
62.81 38.47 62.81 7.86 62.81 Upper
This article isprotected rights by All copyright. reserved. p<0.01; ** p<0.05* F R climate Spiritual Turnover intention satisfaction Job Teamwork I variable spiritualsatisfaction, turnover and climate intention 5 Table p<0.01; ** p<0.05* 4. Turnover 3. intention Job burnout 2. Spiritual climate 1. Variable satisfaction ( Table ndependent variable ndependent
2
Accepted ArticleJob satisfaction 4
Hierarchical regressionHierarchical analysisjob burnout ofnurses’ and job Correlationamong
n
=207)
67.520** 0.248 − − burnout variable: Dependent Step
0.498** 0.168**
0.412** − − - climate 1.
0.292** 0.423**
Spiritual st
spiritualclimate, job burnout, turnover intentionand job
59.405** 0.368 0.350** − − burnout Dependent one Step − 0.415** - − 2. 0.447** 0.165**
0.498** 0.423**
Job Job burnout
variable:
− - 0.415** − intention 3. climate variable: spiritual Dependent
0.411* 0.292**
Turnover 24.537** 0.296 - 0.185** 0.178** two Step 0.205**
- − − 0.412** satisfaction 4.
0.411* 0.498**
Job Job 43.620** 0.392 − 0.151** − − burnout variable: Dependent three Step
0.176** 0.381** 0.163**