Louise Tourigny

Burnout and depression among nurses in Japan and China: the moderating effects of job satisfaction and absence

This study focuses on the relationships between emotional exhaustion and other dimensions of burnout as well as depression among nurses in Japan and China. Attitudinal and behavioral moderators as coping mechanisms are suggested to mitigate the effect of emotional exhaustion on depersonalization, diminished personal accomplishment and depression. More specifically, we analyze the alleviating effect of absence and the moderating effect of job satisfaction as a compensatory coping mechanism. Data were collected from 239 nurses in Japan and 550 nurses in mainland China. The study used existing measures with appropriate translations. The instruments exhibited satisfactory psychometric properties for both samples. Descriptive statistics, correlation, and hierarchical moderated regression using both two-way and three-way interactions were employed to analyze the data. Job satisfaction and absence were found to moderate the relationship between emotional exhaustion and depression simultaneously among both Japanese and Chinese nurses. Job satisfaction and absence simultaneously moderated the effect of emotional exhaustion on diminished personal accomplishment among Japanese nurses only. The theoretical role of job satisfaction and absence in alleviating the detrimental effects of emotional exhaustion, and their practical significance for healthcare in general, and for the management of nurses in Japan and China in particular are discussed.

Emotional exhaustion and job performance: the mediating role of organizational commitment

We analyze the impact of emotional exhaustion (EE) on turnover intention, task performance and organizational citizenship behavior (OCB) among hospital nurses in China. The differential mediating effects of affective organizational commitment on the associations between EE and turnover intention, task performance and OCB were examined. Data were collected from both nurses and their supervising physicians using a questionnaire survey in Mandarin. The results revealed full mediation effect for turnover intention and for OCB directed at the organization. There was a significant indirect effect for OCB directed at individuals and no mediation effect for task performance.

Job Burnout among Airline Employees in Japan A Study of the Buffering Effects of Absence and Supervisory Support

The present study focuses on the cultural meaning and effectiveness of coping strategies on the process of burnout among Japanese employees in the airline industry. The role of self-applied and other-applied strategies for coping with burnout is investigated. Voluntary absence and supervisory support were chosen as the self- and other-applied coping mechanisms because of their theoretical and contextual relevance. The study was guided by the restorative model of absence. A sequential model of burnout with emotional exhaustion leading to both depersonalization and diminished personal accomplishment was used to study the moderating effects of coping mechanisms. Data were collected from 90 airline service employees working in Tokyo, Japan. Existing instruments of measurement with appropriate translations were used. Absence was found to moderate the relationship between emotional exhaustion and diminished personal accomplishment, while supervisory support was found to moderate the relationship between emotional exhaustion and depersonalization. The theoretical implications of differential moderating effects in a burnout episode as well as its practical implications for the Japanese workplace are discussed.

Explaining executive integrity: governance, charisma, personality and agency

The recent significant occurrences of dysfunctional, and perhaps unethical, decision making and actions by a number of highly successful corporate executives suggest that there are systematic explanations for the questionable managerial behaviors that go beyond simple attributions of individual character flaws. This paper draws from four management research streams to identify some enabling conditions that constitute plausible mechanisms that may have exacerbated the present situation. Research traditions include the literature pertaining to the primacy of the rights of shareholders in equity capital financed corporate organizations, the literature describing the mechanisms whereby charisma is socially constructed and institutionalized, the literature attributing the gravitation toward positions of power on the part of individuals with predispositions to act in an unethical manner and the literature describing conditions which limit the ability of principals to fully specify the provisions of contracts with agents who are in positions of control of corporate organizations.

Stress episode in aviation: the case of China

Purpose – The purpose of this paper is to investigate the impact of role stressors on job stress among airline employees in mainland China. More specifically, the aggravating effects of shift work and the mitigating effects of decision latitude are explored to facilitate strategies of intervention aimed at reducing job stress.Design/methodology/approach – Data are collected using a field survey in Mandarin from 485 airline employees, including pilots, flight attendants, and service employees in five major cities in mainland China.Findings – The findings demonstrate that role overload and role conflict have significant positive effects on job stress. Furthermore, both shift work and its interference with non‐work activities significantly elevated the impact of role overload on job stress. Findings also reveal that decision latitude mitigated the detrimental effect of role overload on job stress for employees working on fixed shift, but not for employees working on rotating shift.Research limitations/implic...

On the Retention of Younger Nurses

Objective: In Trinidad and Tobago, younger hospital-based registered nurses are at risk of leaving the hospital and the country altogether. Therefore, there is a need to investigate the factors that contribute to turnover intention among younger nurses. The literature on newcomer adjustment has been predominantly used to study the integration and adjustment of younger nurses. However, we focus here on occupational mental health and job attitudes as antecedents of turnover intention across age groups referring to younger, mid-age and older nurses. The aim is to compare across age groups in order to determine whether younger nurses differ in terms of antecedents of turnover intention. The objective is to identify the reasons as to why younger nurses decide to quit the hospital. Methods: We used a sample of 252 hospital nurses from Trinidad and Tobago. We did a cross-sectional study design and collected survey data using existing instruments. The occupational mental health concepts included role stressors, job stress, burnout, and depression. The job attitudes included organizational commitment, job satisfaction and turnover intention. We divided the sample in three groups: younger nurses, mid-age nurses and older nurses. The analytical strategy includes ANOVA with Post Hoc Bonferroni and stepwise regression. Results: Younger nurses are more at risk of leaving the hospital. We provide detailed statistical findings revealing that high stress levels and feelings of inadequacy for the job are the most important predictors of turnover intention among younger nurses. We further demonstrate that stress, burnout and depression symptoms are significantly higher and that job satisfaction and organizational commitment are significantly lower among younger nurses. We do discuss findings obtained for the two other age groups as well. Conclusion: We highlight the need for training and development programs that do go beyond providing knowledge and skill development by considering the occupational mental health of nurses.

Occupational mental health among nurses: A global perspective

I recent years, there has been increasing evidence that stress and burnout in nurses affects their health and quality of life. The objective is to present three studies with applications for moderating the detrimental effects of stress and promoting health in nurses. Study 1 examined the role of stressgenerating factors and relief factors on experienced stress in nurses in a pediatric oncology institute. The subjects responded to questionnaires assessing sources of stress, sources of relief, perceived stress, quality of life, burnout and compassion fatigue. The results showed that stress and relief were independent factors affecting burnout, and that relief had a greater impact. The major sources of stress were family and daily issues, and of relief people and bodily activities. Study 2 examined the impact of stress vulnerability on quality of life. 100 nurses responded to questionnaires assessing stress vulnerability, perceived stress, and quality of life. The results showed that stress vulnerability correlated significantly with perceived stress and quality of life. Study 3 examined the impact of attitudes relevant for physical health. The responses to the questionnaire of the cognitive orientation of physical health by 52 nurses showed that attitudes on themes such as sharing experiences, expressing emotions, controlling perfectionism and cooperating with others contribute to mental and physical well-being. The major conclusions are that the mental and physical quality of life of nurses could be improved by promoting relief-generating activities, moderating stress vulnerability and enhancing specific attitudes that contribute positively to one’s well-being.T presentation will focus on acute kidney injury (AKI), and why our role as critical care nurses can impact outcome. AKI characteristics, its incidence and causes in sepsis, ischemia/reperfusion and nephrotoxin exposure will be reviewed. The impact of AKI on recovery and mortality as well as discussion of the use of new biomarkers which will replace BUN and Creatinine will be described. Critical care nursing assessment of the potential for AKI will include use of the most simple, accurate and useful biomarker we currently use today: urine output. Research on the usefulness of accurate urine output measurement on outcomes will also be reviewed and why we can make an impact on patient outcomes.Background: In Northern India, skewed sex ratios, female feticide and higher child mortality rates for girls have become serious concern. The female child mortality as a result of son preference have increased during the last several decades .Since families cannot know the sex of the fetus due to Indian government policies, they now ‘neglect’ girl child to ensure there are few survivors. Survival chances of second and third daughters are plunging neglecting healthcare and nutrition has become tool for death as ‘good riddance’.Introduction: When older patients are in need of care the desire for help is often related to practical duties, but they also express a preference for support with the emotional difficulties that d ...S activities performed in nursing programs can provide many learning opportunities for nursing students. Simulation gives the students a hands-on approach to perform skills learned throughout their nursing education. Real life simulated activities, allow students to put their knowledge into practice, while recognizing areas of weakness that need improvement. During the activities, students perform learned skills, medication administration, and professional communication. The environment to perform these activities is a safe learning environment to allow students to make and recognize mistakes prior to entering the career field. Faculty encourages students and assists in improving areas of weakness demonstrated by the students. The simulation activities begin with a pre-assignment to prepare for the lab, a hands-on approach to perform skills learned, followed by a debriefing session. The debriefing session consists of the student discussing a verbal self-evaluation regarding their performance, followed by a discussion with faculty. During the discussion, areas of weakness are identified and ways to improve are discussed. Students needing to improve are scheduled one-on-one time with lab personnel to improve on identified weakness area. By implementing simulation activities in the nursing program, students are more prepared to enter the workforce. In addition to hands-on, simulation labs are also utilized to enhance learning from the didactic setting. Simulation labs are scheduled according to the lecture schedule in order to enhance an understanding of the content delivered. By scheduling according to content, students can begin to connect theory and practice by learning in the classroom and demonstrating in the lab.‘First line healthcare’ is offered via telephone in many Western countries. The overall aim of this thesis is to describe Telephone Nursing (TN) from three viewpoints: telenurses, parents calling f ...A comparison of critical thinking skills of baccalaureate nursing students in north east, central and western China was conducted to measure and compare the critical thinking abilities of nursing students based on the California Critical Thinking Disposition Inventory (EETDI). A convenient sampling method was used in each area with 300 participants totally. The baccalaureate nursing student’s critical thinking scores in the three areas were compared for disposition. The findings indicated that in the total as well as the majority of sub-scale areas of critical thinking held by the nursing students of these three areas showed an ambivalence disposition towards critical thinking (mean=277.75 S.D=23.18). The ANOVA indicated that there were statistically significant differences among these three area on the total score as well as six sub-score P<0.01~0.001 with students in the central area holding the highest score (mean=288.94, S.D=21.18). The Tukey’s HSD indicated that the total mean score was statistically higher for students in central area than those for students in north eastern and in western areas (P<0.001). There was also a significance difference between students in the eastern and western area (P<0.01).T diversity and increasing number of elder migrants within the German and Austrian population is challenging the health care systems: How can they be included in an adequate (culturally sensitive) way? The ongoing academic discussions and the different approaches in practice to this question reveal how differently elder migrants and their needs are perceived within the German and Austrian society. In the talk, the author will introduce the different perceptions of a culturally sensitive elderly care upon the predominant paradigms that may vary locally the intercultural opening in German cities and a diversity management approach in Vienna (Austria), and upon the estimations and assessments of the importance of a culturally sensitive elderly care, how they varied within the last decade and among different groups of people.This study examined the validity and reliability of a Turkish version of the Modified Moral Sensitivity Questionnaire for Student Nurses (MMSQSN). After obtaining permission to adapt the MMSQSN into Turkish, the translation/back-translation method was used with expert opinions to determine content validity. Factor analysis was conducted to examine the construct validity and test–retest was performed on the questionnaire to determine reliability. Cronbach’s alpha coefficients were calculated to assess for internal consistency. Participants included 272 baccalaureate degree student nurses who took ethics lessons prior to their clinical internship. The factor analysis revealed that even though the factor structure in the original scale was the same, relevant items were categorized with similar components, and factor loads were sufficient. The correlation coefficient in the analyses of test–retest scores was .66 for the total scale (p < .05) and the Cronbach’s alpha was .73 for the total scale. The translated MMSQSN is a valid and reliable measure of ethical sensitivity in student nurses in Turkey.Due to the uncertainties of job availabilities among rural communities, poverty stricken families find it hard to supply enough food to their family members. Food insecurity refers to limited or uncertain availability of nutritionally adequate, safe foods or the inability to acquire personally acceptable foods in socially acceptable ways. The purpose of this study was to explore food insecurity among HI Sero-positive patients in rural Vhembe district of Limpopo Province. A qualitative, exploratory, descriptive and contextual design was used. A non-probability, purposive sampling method was used to select eight family members who care for HI seropositive patients at home. Permission to conduct a study was obtained from University of Venda Higher Degrees Committee, University of Venda Health, Safety Research Ethics Committee and the Provincial Department of Health. Informed consent also obtained from participants. In-depth interviews were conducted with eight family members. Data were analyzed according to Teschs open-coding method. This study revealed that debilitating nature of patient, condition, altered socio-economic status and insufficient knowledge about the importance of nutrition in human health are the determinants of food insecurity amongst HIV Seropositive patients. The study concluded that food insecurity is challenge among HI seropositive patients and thus hinders their recovery.Methodology: This is a descriptive, comparative, and correlational study. 277 male/female Haitians who were older than 18 years old and lived in rural areas were included into sample. It was a convenience sampling. The sample was collected in four different rural areas in Haiti from Jan 1 thru Jan 9th, 2014. The subjects who voluntarily walked into a free health clinic were screened with blood pressure (both systolic and diastolic blood pressure), pulse pressure, and heart rate. Descriptive analyses and t-test were used to achieve the study objectives.D is both an urgent and complex occupational health issue. Many individuals are employed at the same time as they are experiencing a major depressive episode. A large proportion of workers who experience a depression-related absence from work are women. However, little is known about the experiences of returning to work for women with depression. The goal of this study is to identify women’s experiences of returning to work after a lapse due to a depression. Grounded Theory is the method being used. At this time 31 women of the projected 40 have participated in in-depth interviews. Analysis is currently being conducted and reoccurring themes are emerging. In this presentation the focus will be on two themes. The first theme is “Battling Adversity” which includes battling depression, battling the workplace and battling the institution, all of which describe the struggle many women have experienced in returning to work. The second theme “Upholding Silence” includes concealing their depression and selective disclosure. Women speak about wearing a mask when they are in the workplace in order to conceal their depression. Many women mention triggers and use particular language while explaining their absence from work, such as burnout, stress, and fatigue. These words are thought to be helpful in concealing the depression. Women described their journey back to work and back to wellness.Five out of eight Liguria Region public health care facilities participated: San Martino Hospital (SMH), Galliera Hospital (GH), Azienda Sanitaria locale 1(ASL 1), Azienda Sanitaria locale 4(ASL 4), Azienda Sanitaria locale (ASL 5).Information about introduction to SCDs was collected through regular meetings with the staff of the Health Protection and Prevention Department or the occupational health physicians of the participating companies.Background: Acute lymphoblastic leukemia (ALL) is the highest incidence malignancy among children under the age of 15 years old. For the limited cognitive ability of the children with ALL, family caregivers especially for the children’s parents are essential partners in the delivery of complex health care services and are mainly response for taking care of children in and out of the hospital. Thus, caregivers have huge care burden and urgently need professional and available support which can be satisfied by the technique of mobile health.Clinical trial rating scale based outcome measures have been criticized of lacking relevance and meaning to end-users, particularly patients. This is concerning since inferences regarding the usefu ...W in the patient narrative has become a familiar term, used as part of the common language in the context of caring for patients. To do so encompasses sharing conversation that allows exploration of the entire patient experience as it relates to health and illness. However, the complexity of engaging in conversations about life-altering disease trajectories, potential outcomes from treatment, and end-of-life decisions is a learned practice. To stand steady with conflict, allowing for expression of grief, loss, anger, and frustration, yet remaining fully present, maintaining neutrality, and actively listening continue to be challenging concepts in practice. To do so is integral to collaborative practice and essential to effective engagement. A literature review identified key elements of intentional interactions which lead to significant opportunities to “wander more fully” in the patient narrative. Case studies used in discussion will demonstrate how patient/clinician encounters, such as end-of-life discussions; afford the interdisciplinary team members purposeful engagement with patients. Application of these principles will support clinicians in real world situations to delve more deeply into the patient experience. Such exploration lays the foundation for assuring goals of care are aligned with patient’s individual goals and values. Cases also demonstrate how the use of symbols by patients can be understood to assist in dialogue related to expressions of illness or tasks of dying. When directed and focused, intentional facilitation occurs, the patient’s unique holistic needs and values are identified and goals of care can be clarified. Practice implications are presented using research and clinical applications.Persistent nausea and vomiting associated with hyperemesis gravidarum in early pregnancy remains a significant health problem that result in negative side effects on women and their pregnancy. The aim of the study: Was to evaluate the effectiveness of nurses using for P6 acupressure on nausea, vomiting and retching in women with hyperemesis gravidarum. Methods: A Randomized clinical Trial was used, the study conducted on 120 women diagnosed with hyperemesis gravidarum admitted to maternity high risk care unit Mansoura University Hospital, Egypt in a period of six months and divided randomly in P6 acupressure and conventional therapy group. Data were collected by two tools; 1 st A structured Interviewing Questionnaire Schedule and 2 nd Rhodes Index of Nausea, Vomiting and Retching (INVR). Results: It showed that there no statistically significant difference was found in baseline characteristics of nausea, vomiting and dry retching scores between the P6acupressure and conventional therapy group; while there was significant decrease in the average mean scores of nausea, vomiting and retching and the total score from base line to 4 th day. Difference between the base line improvements in conventional group is significantly better than acupressure group in different days. The rate of improvement compared in P6 acupressure to conventional was 71.9% to 100% respectively. Conclusion: The study concluded that using of P6-acupressure has an effective role in reducing nausea, vomiting and retching episodes in women with hyperemesis gravidarum.Findings: Most (86%) of the pregnant women reported that their sleep was disturbed by their child, at least once a week and (63%). The PSQI global score mean was 8.3 (SD=2.3). Ninety-three% (n=65) of the subjects met the criteria for being poor sleepers. Participants in the study reported their mean sleep duration of 7.5 hours (SD=1.7), with an average of 22.5 minutes to fall sleep (SD=15.3). Trimester and total PSQI have a positive correlation (r=0.25, P<0.05), while a negative correlation was found between working and sleep latency (r=-0.301 p<0.005).E degrees strongly impact professional development. In Japan, no studies have examined the relationship between educational degrees and nursing professionalism. The aim of this study is to examine the effect of educational degrees on nursing professionalism among Japanese nurses. Wheel of professionalism in nursing model was applied as a theoretical framework and the corresponding inventory, behavioral inventory for professionalism in nursing, was used to measure the relationship between education and level of professionalism. A total of 2,972 surveys were distributed and 1,846 respondents returned surveys from 25 hospitals in the random sample in Japan. The results revealed that nursing professionalism was related significantly to higher educational preparation (F=154.47, p<0.0001) by a one-way ANOVA, and the Tukey-Kramer multiple comparison test revealed that graduate degree was significantly associated with high scores of professionalism (p<0.0001). The correlation and regression analyses also showed a moderate to strong relationship between education preparation and nursing professionalism (r=0.20, p<0.0001; β=0.52, p<0.0001). The results confirm that higher level of educational preparation, especially graduate degree, is associated with higher nursing professionalism. Awareness of important professional factors is essential to continually maintain nursing professionalism.T health care system presents an ever increasing complexity that requires nurses to possess multiple skills including interprofessional collaboration skills, cost effectiveness, currency, informatics skills, technical skills, clinical reasoning skills and a need for life-long learning. Both the Institute of Medicine (2011) and the Carnegie Foundation for the Advancement of Teaching (2010) have called for radical transformation in the way nurses are educated. A particular challenge to nursing education is the need to bridge the gap between theory and clinical. Nursing education often clearly demarcates acquisition of theory knowledge in the classroom and clinical practice and does not effectively assist students with the application of theory knowledge to hands on patient care. This sharp separation of classroom and clinical teaching must be overcome. “Teaching for a sense of salience” dictates that nurse educators better assist students with this translation of theory to practice. This challenge in nursing education includes the need to not only improve the way students acquire theory based knowledge (signs, symptoms, pathophysiology), but to also effectively translate theory knowledge to the clinical area to provide effective hands on patient care in order to improve patient outcomes. Chronic illnesses such as diabetes mellitus are multidimensional and require nurses not only to possess theory knowledge but effective clinical skills as well. Strategies for increasing salience related to diabetes mellitus management in classroom and clinical settings includes evolving case studies, in class active learning strategies, simulation activities and strategies to promote teaching effectiveness of adjunct clinical instructors.B cancer is the most commonly diagnosed cancer among women in the United States. Breast cancer screening with mammography has proved effective in reducing breast cancer mortality. While the incidence and overall mortality in Caucasian women has steadily decreased in the past decade, incidence and mortality rates among non-Caucasian, particularly Asian/Pacific Islander women has remained unchanged. Additionally, Korean immigrant women (KIW) living in the United States have extremely low screening rates as compared with other races. There is a paucity of studies that focused on factors that influence screening rate in Korean women. The purpose of this pilot study is to identify key health beliefs that influence Korean immigrant women’s decision to participate in breast cancer screening so that the findings can contribute to increased KIW participation in breast health screening. Utilizing health belief theoretical model participants responded to two questionnaires used to measure the attitudes of KIW in their decision to have a mammogram. Certain health beliefs were significantly correlated with benefits and barriers of health screening. Focusing on improving health motivation through breast health education for this population will increase mammogram screening rate, thus increasing possibility toward improved overall health care.