Self-endangering: A qualitative study on psychological mechanisms underlying nurses’ burnout in long-term care

Abstract

Objectives To develop a more specific understanding of psychological mechanisms in the development of burnout in long-term care as a basis for potential new intervention strategies aiming at improving nurses’ mental health. Methods Two qualitative studies with thematic analysis were conducted. In Study 1, we conducted eight group interviews with 110 nurses from May–July 2019 in the context of workshops at eight nursing homes in Germany. In Study 2, we supplemented these with semi-structured interviews with 14 executives at German nursing homes in December 2019. Results The thematic analysis in Study 1 identified three main themes: causes of challenges, employees’ opportunities for change, and organisational opportunities for change. Thematic analysis in Study 2 identified three main themes: job motives, reasons for filling in for others, and employee self-care. Further, our results show that the need to stand in for colleagues, in particular, is one of the greatest challenges for geriatric caregivers. In dealing with these challenges we found that self-endangering behaviour—a diminished ability to say no when asked to fill in or to do work overtime—was an important antecedent of nurses’ burnout. Further, high levels of altruistic motivation and identification with the team or organisation were associated with self-endangering behaviour in the presence of adverse working conditions. Low levels of self-worth are a further risk factor for self-endangering. Conclusions Our findings are at odds with some core tenets of classic models of job demands and burnout that construe motivation and identification as resources. Our results show the need of a holistic intervention program in nursing including individual coaching, team-based interventions and organisational development processes. Employees themselves should be sensitized to this issue and supported in the long term, and politicians should create structures that do not encourage this behaviour any further.

Burnout and poor perceived health in flexible working time in Japanese employees: the role of self-endangering behavior in relation to workaholism, work engagement, and job stressors

“…Among the psychological/behavioral factors associated with flexible working time in the present study, the path analysis indicated that SEWB caused burnout and poor perceived health. This is in accord with findings by Eder & Meuer 26) that SEWB reduces workers' ability to refuse when asked to fill in or to do work overtime, and that this is an important antecedent of burnout in nurses, and findings by Baeriswyl et al 25) that sickness presenteeism (an aspect of SEWB) is associated with burnout and somatic complaints in teachers.…”

“…The concept of SEWB combines several maladaptive coping styles that have so far been studied separately, such as extension of working hours, intensification of working hours, sickness presenteeism, faking, substance abuse to recuperate, substance abuse to perform, reduction of quality, and bypassing of safety standards [22][23][24] . SEWB is a work style that is functional in achieving work goals and provides motivation and satisfaction to workers; however, this style poses a risk to workers' health and may have a negative effect on the workforce [22][23][24][25][26] . A scale to measure SEWB was originally in German, and comprises a self-administered questionnaire consisting of 21 items on five subscales: "Intensification of working hours," "Prolongation/extension of working hours," "Refraining from recovery/leisure activities," "Working despite illness," and "Use of stimulating substances" [22][23][24] .…”

Coping strategies that motivated frontline nurses while caring for the COVID‐19 patients during the pandemic: A scoping review

“…Besides, every nurse has unique self‐strategies for dealing with stressful situations (Ausar et al, 2021; Hofmeyer & Taylor, 2021) and providing appropriate nursing care (Mintz‐Binder et al, 2021). This enables nurses to avoid burnout by reducing the severity of job stress (Eder & Meyer, 2022; Shahzad et al, 2021). Additionally, it plays a significant role for nurses to develop advanced skills and to utilize their nursing knowledge and abilities at the appropriate time (Hossain & Clatty, 2021).…”

Tìm hiểu ảnh hưởng của môi trường làm việc đến kiệt sức nghề nghiệp ở điều dưỡng bệnh viện chấn thương chỉnh hình Thành phố Hồ Chí Minh: Một tiếp cận định tính

“…11,13 Tuy nhiên, một số nghiên cứu đã ghi nhận sự thiếu hỗ trợ từ đồng nghiệp, căng thẳng trong nhóm làm việc, khó khăn trong mối quan hệ với bác sĩ thúc đẩy tình trạng kiệt sức ở điều dưỡng. 11,13,15,19,20…”