The relationship between role ambiguity, emotional exhaustion and work alienation among chinese nurses two years after COVID-19 pandemic: a cross-sectional study

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Abstract

Background

work alienation is receiving increasing attention as a psychological risk at work, and little is known about the mechanisms of role ambiguity and work alienation in nurses in the context of the COVID-19 pandemic. This article aims to examine how role ambiguity affects work alienation among Chinese nurses during the two years after COVID-19 pandemic and verify emotional exhaustion as mediators.

Methods

A cross-sectional study design was used to recruit 281 Chinese nurses. Nurses completed online questionnaires containing demographic characteristics, role ambiguity, emotional exhaustion, and work alienation, and SPSS 26.0 and AMOS 24.0 were used for data analysis and structural equation modelling.

Results

work alienation scores were (34.64 ± 10.09), work alienation was correlated with role ambiguity and emotional exhaustion ( r1 = 0.521, r2 = 0.755; p < .01), and role ambiguity was positively correlated with emotional exhaustion ( r = 0.512; p < .01). A mediating effect of emotional exhaustion between role ambiguity and work alienation held (mediating effect of 0.288, 95% CI: 0.221–0.369, accounting for 74.8% of the total effect).

Conclusion

Role ambiguity has a significant direct effect on nurses’ feelings of alienation and exacerbates alienation through emotional exhaustion. Clarifying roles at work and being less emotionally drained are effective ways to reduce nurses’ feelings of alienation.

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Effective self-regulation is an important key to successful functioning in many spheres, and failed self-regulation may be centrally conducive to substance abuse and addiction. The program of research summarized here indicates that self-regulation operates as a limited resource, akin to strength or energy, especially insofar as it becomes depleted after use-leaving the depleted self subsequently vulnerable to impulsive and undercontrolled behaviors (including increased consumption of alcohol). The self's resources, which are also used for decision-making and active responding, can be replenished by rest and positive emotions.

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Burned out cognition--cognitive functioning of burnout patients before and after a period with psychological treatment.

Michiel A. J. Kompier, Bart G Oosterholt, Joseph H. R. Maes … (2012)

Many employees with burnout report cognitive difficulties. However, the relation between burnout and cognitive functioning has hardly been empirically validated. Moreover, it is unknown whether the putative cognitive deficits in burnout are temporary or permanent. Therefore, the purpose of the study was to answer two related questions: (i) Is burnout associated with self-reported cognitive difficulties and with deficits in a specific and well-defined set of executive functions? (ii) Do these putative self-reported cognitive difficulties and deficits in executive functioning in burnout diminish after a 10-week period of cognitive behavioral therapy? Sixteen employees with burnout were compared with sixteen matched healthy employees on self-reported cognitive difficulties and tests measuring the basic executive functions, namely, updating, inhibition, and switching, on two test occasions. The interval between the test occasions was ten weeks, during which the burnout individuals received cognitive behavioral therapy. On the first test occasion, and relative to healthy individuals, individuals with burnout reported more cognitive difficulties and showed deficits in the "updating" function. No group differences were found regarding the "inhibition" and "switching" functions, although individuals with burnout generally responded slower than healthy individuals on the latter test. Even though after the ten-week treatment period individuals with burnout revealed positive changes regarding burnout symptoms, general health, and self-reported cognitive difficulties, no evidence was found for improved cognitive test performance. These findings suggest that either (i) burnout leads to permanent cognitive deficits, (ii) subjective burnout complaints reduce faster than deficits in cognitive test performance, or (iii) cognitive deficits are a cause rather than a consequence of burnout.

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Is Open Access

Primary Care Practitioners’ Barriers to and Experience of COVID-19 Epidemic Control in China: a Qualitative Study

Zhijie Xu, Yuanqu Ye, Yang Wang … (2020)

Background The coronavirus disease 2019 (COVID-19) emerged in December 2019 and posed numerous challenges to China’s health system. Almost 4 million primary care practitioners (PCPs) participated in controlling the outbreak. However, PCPs’ barriers to and experience of the epidemic control remain unknown and are essential for improving countermeasures. Objective To better understand the barriers PCPs faced in COVID-19 epidemic control and their psychological and occupational impacts, and explore potential solutions. Design This qualitative study was conducted through semi-structured, in-depth interviews from February 12, to March 10, 2020. Participants A purposive sample of frontline PCPs affiliated with either community health centers or township health centers in four provinces of China were recruited. Approach Interviews were conducted by telephone, and then recorded, transcribed, and content analyzed. Themes surrounding PCPs’ barriers to COVID-19 epidemic control, their experience, and potential solutions were iteratively identified using the constant comparative method. Key Results Of the 21 PCPs interviewed, 10 (48%) were women and 5 (24%) worked in rural areas. Barriers to epidemic control in primary care included inappropriate PCP scheduling and role ambiguity, difficult tasks and inadequate capacities, and inexperienced community workers and insufficient cooperation. Some PCPs perceived respect and a sense of accomplishment and were preoccupied with the outbreak, while others were frustrated by fatigue and psychological distress. PCPs reported potential solutions for improving countermeasures, such as improving management, optimizing workflows, providing additional support, facilitating cooperation, and strengthening the primary care system. Conclusions Due to their roles in controlling the COVID-19 epidemic, PCPs in China faced a series of barriers that affected them physically and mentally. Support for PCPs should help them to overcome these barriers and work efficiently. The current findings provide insight into the challenges and potential solutions for strengthening the preparedness and response of China’s primary care system in future disease outbreaks. Electronic supplementary material The online version of this article (10.1007/s11606-020-06107-3) contains supplementary material, which is available to authorized users.

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Author and article information

Contributors

Hong-li Zhang: 1215905769@qq.com

Chao Wu: 386024416@qq.com

Jia-ran Yan: 740435923@qq.com

Huan-min Qu: 285323392@qq.com

Hong-juan Lang: langhj@fmmu.edu.cn

Journal

Journal ID (nlm-ta): BMC Psychiatry

Journal ID (iso-abbrev): BMC Psychiatry

Title: BMC Psychiatry

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-244X

Publication date (Electronic): 18 July 2023

Publication date PMC-release: 18 July 2023

Publication date Collection: 2023

Volume: 23

Electronic Location Identifier: 516

Affiliations

[1 ]GRID grid.449637.b, ISNI 0000 0004 0646 966X, School of Nursing, , Shaanxi University of Chinese Medicine, ; Xianyang, China

[2 ]GRID grid.233520.5, ISNI 0000 0004 1761 4404, Department of Nursing, , Fourth Military Medical University, ; No.169 Changle West Road, Xi’an, 710032 Shaanxi China

[3 ]Department of Nursing, Qufu Traditional Chinese Medicine Hospital, Shandong, China

[4 ]GRID grid.460007.5, ISNI 0000 0004 1791 6584, Human Resources Department, , Tangdu Hospital, Air Force Medical University, ; Shaanxi, 710032 Xian China

Article

Publisher ID: 4923

DOI: 10.1186/s12888-023-04923-5

PMC ID: 10355025

PubMed ID: 37464335

SO-VID: 0ddfdc7b-b2e5-4cf1-b3b2-fbaf3fba814e

License:

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