Thesis (M.S.)--University of Michigan, 1992.

Thesis (M.S.)--University of Michigan, 1994.

Nurses are confronted with numerous work-related stressors that can result in burnout. This can contribute to absenteeism and high turn-over rates in the nursing profession. A review of the literature indicated that psycho-educational interventions to increase resilience could be an effective way of addressing this problem. The study aimed to develop a positive clinical-psychology approach to increasing resilience in State employed nurses. The study used a mixed-method approach to determine the current psychological functioning of a sample of 87 nurses. Quantitative data on personality traits, character strengths and levels of resilience were obtained, using the NEO PI-R, VIA – IS, and Resilience Scale. Qualitative data on the coping responses of nurses were obtained through the thematic analysis of focus groups. These data were integrated to create a positive clinical psychology conceptualisation of resilience and to develop therapeutic guidelines for a group psycho-educational intervention. The results of the study indicated a struggling psychological profile. This was defined as the ability to deal with work-related stressors – but with the potential risk of developing symptoms of burnout. The moderate levels of resilience were attributed to elevated character strengths in the sample. The distribution of personality traits indicated that the nurses in the sample were at risk of developing burnout; and this prevented them from flourishing. These data were synthesised to create therapeutic guidelines for developing resilience aimed: (1) increasing emotional stability and invulnerability; (2) increasing agreeableness; and (3) increasing conscientiousness. These guidelines were based on the personality traits that were deemed to negatively impact the resilience of the nurses. These personality traits were correlated with several character strengths that displayed strong relationships with resilience. This indicated that resilience could be developed through the cultivation of the following character strengths: perspective; perseverance; fairness; forgiveness; leadership; love; zest; hope; curiosity; and appreciation of beauty and excellence. These character strengths were identified to facilitate the positive adaptation of the personality traits identified in the therapeutic guidelines. A group psycho-educational intervention was developed, using the positive clinical psychology conceptualisation of resilience. The literature was reviewed to identify techniques to cultivate the ten character strengths specified in the therapeutic guidelines. These techniques were adapted to create experiential learning processes for the intervention. This psycho-educational programme can be applied as a secondary and tertiary intervention. It can be used to increase resilience to prevent burnout among nurses. It can also be used to psychologically empower nurses that have existing symptoms of burnout.

A person’s career takes up a large portion of his or her life for a minimum of 8 hours per day. A large portion of their time is spent performing their duties which are often accompanied by various demands or pressure that can result in an employee experiencing stress. Over time this build-up of stress due to job demands affects their ability to perform at work. This study aimed to identify, explore and describe the factors that facilitate the resilience of healthcare professionals working at a Campus Health Service at a Higher Education Institution. An exploratory descriptive study consisting of a qualitative nature was employed. Data was obtained from semi-structured interviews. The questions that were posed to participants read as follows: (1) “Tell me about the demands placed on you in your current work situation”, (2) “How do you cope with the demands placed on you?”, (3) “What can be done to assist you to cope better at work?”, and lastly (4) “Any additional questions/comments?”. The fourth question was added by the researcher in order for participants to have the opportunity to add to what they have said previously. Data was gathered until data saturation was reached. Tesch’s model of content analysis as well as Guba’s model of trustworthiness was employed, in order to analyse the data. An independent coder was subsequently employed to ensure the trustworthiness of the data. The findings revealed that all participants found workplace demands to be stressful, in terms of physical, emotional and time-related demands placed on them. Participants identified strategies that could help them cope with their demands such as open air activities, debriefing with colleagues or making use of a wellness line, maintaining a positive attitude, support from management and colleagues, the ability to practice initiative and autonomous decision-making, and lastly, religious practices. In addition, participants made recommendations on how employers can help relieve their stress. The recommendations included developing an in-house wellness programme, providing sufficient staff of the correct categories, providing adequate facilities and equipment to improve efficiency, providing developmental opportunities, scheduling training programmes for less busy times of the year, and lastly, introducing elements of structured flexi-time for employees.

This descriptive study was designed to further the exploration of job satisfaction among hospital-employed nurses by using an established theoretical formulation of job satisfaction called the Job Characteristics Model (Hackman & Oldham, 1976) and a standardized tool called the Job Diagnostic Survey (Hackman & Oldham, 1980) to identify and measure job design variables and job satisfaction. Specific study questions guided investigation into perceptions of job characteristics and satisfactions among nurses, the relationship between job design variables and job satisfaction, and the relationship between selected nurse characteristics and job satisfaction. The study was conducted at three geographically dispersed acute care hospitals in British Columbia. A convenience sample of 96 full-time employed registered nurses completed a Nurse Characteristics Questionnaire and a Job Diagnostic Survey. Data were analyzed and compared to normative data using descriptive statistics. Sample data were further analyzed using Pearson's correlation coefficient and the chi-square test of association. Overall, nurses perceived their jobs to be rich in terms of importance, skill variety, and human interaction; but poor in terms of autonomy and the ability to complete a whole and identifiable piece of work. Significant relationships were identified between specific job design variables and job satisfaction. Compared to other professionals, nurses were less satisfied with the autonomy and motivating potential of their job. There was little evidence to support an association between nurse characteristics and job satisfaction. / Applied Science, Faculty of / Nursing, School of / Graduate

South African nursing profession is in a crisis as professional nurses leave the country in search of lucrative work overseas. This exodus will have a catastrophic effect on the delivery of health care over the next decade. It is also clear that the shortages of staff due to the turnover problems in hospitals are also creating various other problems such as enormous pressure on existing employees, job stress and job dissatisfaction. Financial constraints to compete with international competitors, exchange rates, tax-free foreign money, the existence of many job opportunities overseas and the tendency that a person’s career is enriched with overseas experience, makes the retention of professional nurses almost uncontrollable for nursing employers in South Africa. The question was therefore asked whether employers should not rather focus their retention strategies on things they can control internally to retain their employees. An alternative approach, to build strategies around the needs and work circumstances of professional nurses, was therefore proposed. The focus of this study was to develop a predictive model with organisational culture and the selected mediating variables, namely knowledge sharing, organisational commitment, organisational citizenship and job satisfaction, as well as various demographic variables (sub-cultures, tenure, age, level of education, gender, race, home language, level of seniority, marital status, number of dependents) of turnover intentions. A General Linear Model approach was adopted to answer the research question. The relationship between organisational culture and turnover intentions was determined, followed by the independent and/or interdependent role of the demographic variables in predicting firstly, organisational culture and secondly, turnover intentions on a bivariate and a multivariate level. Thereafter, the objective was to determine the independent and/or interactive role of the independent variable (organisational culture) and the selected mediating variables (knowledge sharing, organisational commitment, organisational citizenship behaviour, job satisfaction) in explaining turnover intentions. The next objective was to determine whether knowledge sharing, organisational commitment, organisational citizenship behaviour and job satisfaction mediates the relationship between organisational culture and turnover intentions. The final objective was to determine a most parsimonious model by entering all demographic variables, the independent variable and the mediating variables simultaneously into an equation to determine which variables independently and/or interactively emerged to predict turnover intentions. The most important finding was that 49% of the variance in turnover intentions was explained by the proposed model when all the variables were simultaneously entered into the equation. Organisational commitment emerged as the only independent predictor in the final most parsimonious model of turnover intentions. This result support theoretical evidence of the importance of organisational commitment as predictor of turnover intentions. Organisational culture, in interaction with knowledge sharing and job satisfaction, emerged as predictors in the final model decreasing turnover intentions, while organisational culture in interaction with organisational citizenship behaviour increases turnover intentions of professional nurses. Organisational culture also emerged in interaction with white professional nurses, as demographic variable, decreasing turnover intentions. Organisational culture is therefore an important concept in determining turnover intentions, clearly emphasising the responsibility of nursing employers to seriously embark on internal strategies to prevent turnover amongst professional nurses. Various other demographic variables also emerged in interaction to determine turnover intentions in the final model. They are professional nurses in ICU/casualties and 50 years and older, 1-5 years in unit and an incumbent of a chief professional nurse position, 11 years and more in the current hospital and no dependents above 18, being married/co-habitating and no dependents above 18, 50 years and older and no dependents under 18 and working in ICU/Casualties and in possession of a degree. Finally, knowledge sharing, organisational commitment and job satisfaction mediated the relationship between organisational culture and turnover intentions, although only partially, while OCB’s did not mediated this relationship. Various conclusions and recommendations, theoretically, methodologically and empirically, were made as a result of this study. Further theoretical development of the concepts, especially knowledge sharing, the value of General Linear Modelling and further development of turnover models amongst professional nurses and other health professional alike, were recommended. / Prof. Gert Roodt

M.Cur. (Nursing Management) / The largest and most expensive asset of any health care institution is its human resources. Mol [1984 : 1J quite correctly says that no organization can reach its full potential when these resources are not utilized effectively. The researcher has noticed certain behavior patterns amongst the nursing staff in intensive care units. These behaviour patterns include an increase in staff turnover and absenteeism. The question that arose was whether it could be ascribed to professional burnout and whether nursing managers could be contributing to the cause thereof. Th. burnout syndrome is a slowly developing psychologically destructive process, which is in relation to the effect the work environment· has on the individual. The consequences of professional burnout has many negative effects on the nurse, ·the patient, the profession and the health care delivery system. The concept of professional burnout is described with reference from the literature and by means·of a survey the following was determined, that:- all nurses working in intensive care units in the hospital were the research was conducted, had experienced symptoms of professional burnout; the majority of these nurses perceive their work situation as severely stressful; and - nursing managers are overwhelmingly applying the autocratic leadership style. Some of the important conclusions culminating from this study are that:- all these nurses experience one or other degree of professional burnout as a result of experiences resulting from unresolved stress in the work environment; and the nursing manager possibly uses ineffective management strategies due to a lack of management training, thus contributing to professional burnout.

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Most attempts to lessen the nursing shortage have focused on external factors, such as wages and benefits. In view of the continuing shortage, however, it appears that most of these attempts have not been effective. Research studies are inconclusive as to factors influencing the nursing shortage. The majority of studies examined why nurses leave nursing; this study investigated why they stay. The purpose of the study was to determine if selected demographic variables (age, basic nursing education, time in profession, type of hospital, clinical area of practice) and/or personality factors are related to nurses' job satisfaction and intent to stay in nursing. This was a descriptive exploratory design in which the survey method was used for data collection. The sample consisted of 200 randomly selected staff nurses who met the study criteria; there were 104 usable returns. Instruments were the California Psychological Inventory (CPI), the Minnesota Satisfaction Questionnaire, and a Data Sheet designed by the investigator. Data were analyzed by descriptive statistics, chi-square analysis, t tests, and discriminant analysis. Results showed no statistical significance between demographic variables and Job Satisfaction or Intent to Stay. These CPI subscales were statistically significant: for Job Satisfaction-Responsibility, Achievement via Conformance, Psychological-mindedness, and Socialization; for Intent to Stay-Sociability, Dominance, Self-Acceptance, Capacity for Status, Femininity/Masculinity, and Socialization. Based on the CPI, some of the conclusions were that satisfied nurses take their duties more seriously, find conforming easier, are more at ease in structured settings, and are more interested in why people act than in what they do. Nurses intending to stay are less assertive, dislike competition, are less sociable, readily assume blame when things go wrong, find conforming easier, are more sensitive to criticism, and are more sympathetic. Significant predictor variables were identified for both Job Satisfaction and Intent to Stay. Implications for counseling, education, and nursing were discussed, and recommendations for further study were included. / Ed. D.

The study investigated factors influencing nursing turnover in selected private hospitals in England as the United Kingdom recruited 57 136 nurses from non-European countries from 1998 till 2003. Herzberg's Theory of Motivation was used to contextualise the research results obtained from 85 completed questionnaires. In terms of Herzberg's Theory of Motivation the intrinsic factors (motivators) that could influence nurses' turnover rates were nurses' dissatisfaction with irregular promotions, lack of recognition by doctors, and nurses' lack of autonomy. The extrinsic (hygiene) factors included dissatisfaction with their salaries, and marked dissatisfaction with organization and administration policies and nurses' inability to access information about patient care and about the management of their units. Nurses' turnover rates might be reduced if promotion policies could be consistent, doctors would value nurses' work and if nurses could be more autonomous. Enhanced communication about policies and about accessing information, as well as improved salaries,could contribute to reduced turnover rates among nurses. / Health Studies / M. A. (Public Health)