By employing models of stress and burnout that combine psychosocial variables and working conditions, researchers can account for significant amounts of variance in outcomes related to burnout. These findings highlight the importance of vigor and perceived organizational support in predicting nurses' symptoms of burnout. For healthcare administrators, this means that a likely strategy for assuaging the negative outcomes of stress should address nurses' psychosocial concerns and the working conditions that they face during novel times of crisis.
The present study tests a psychosocial model of factors predicting emotional exhaustion and state anger in 333 nurses who worked during the severe acute respiratory syndrome (SARS) outbreak. Predictors included working conditions, feedback, risk of contracting SARS, and perceived organizational support. Results of path analysis revealed that working conditions contributed significantly to an increase in perceived SARS threat, which led to increased emotional exhaustion and state anger. Positive feedback was directly and positively related to organizational support. Higher levels of organizational support predicted lower perceived SARS threat, emotional exhaustion, and state anger. Implications for health-care providers are discussed.
The concept of the nurse-patient covenant was explored using a multiple-method research design. Analysis of the literature (167 references) was the basis for 2 focus group interviews (12 nurses) and 8 semistructured patient interviews. Attributes, antecedents, and consequences were identified through an analysis of findings across all data sources. The nurse-patient covenant in cancer care is defined as an enduring relationship, embodying caring benevolence and contextually negotiated reciprocity. It is preceded by the demonstration of nursing competence as a manifestation of nursing tradition and leads to patients' trusting and entrusting nurses, the emergence of personhood and professionhood, and benefits and obligations.
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