Safeguarding nurses' mental health: The critical role of psychosocial safety climate in mitigating relational stressors and exhaustion

Teresa Galanti; Michela Cortini; Giuseppe Filippo Giudice; Salvatore Zappalà; Ferdinando Toscano; Teresa Galanti; Michela Cortini; Giuseppe Filippo Giudice; Salvatore Zappalà; Ferdinando Toscano

doi:10.3934/publichealth.2024046

AIMS Public Health

2024, Volume 11, Issue 3: 904-916. doi: 10.3934/publichealth.2024046

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Safeguarding nurses' mental health: The critical role of psychosocial safety climate in mitigating relational stressors and exhaustion

1.
Department of Psychology, University “Gabriele d'Annunzio” of Chieti-Pescara, Chieti (CH), Italy
2.
Department of Cardiovascular Diseases, “SS. Annunziata” Hospital, Chieti (CH), Italy
3.
Department of Psychology “Renzo Canestrari”, Alma Mater Studiorum University of Bologna, Cesena (FC), Italy
4.
Department of Psychology, University of Campania “Luigi Vanvitelli”, Caserta (CE), Italy

Received: 12 April 2024 Revised: 09 June 2024 Accepted: 01 July 2024 Published: 16 July 2024

Burnout among nurses is a pervasive concern in healthcare, with profound implications for patient care and nurse well-being. While research has highlighted the detrimental effects of burnout on many aspects of nursing, including patient safety and quality of care, the underlying mechanisms driving burnout warrant further investigation. In this cross-sectional study, we surveyed 196 nurses from diverse Italian hospitals using an online questionnaire via Qualtrics. Our findings revealed significant negative correlations between psychological safety climate and both relational stressors and emotional exhaustion. Conversely, relational stressors positively correlated with emotional exhaustion, and a significant negative indirect effect of psychological safety climate was found for emotional exhaustion through relational stressors, emphasizing the pivotal role of psychological safety climate in mitigating nurse burnout. Our study underscores the potential effectiveness of interventions targeting psychological safety climate and relational stressors in alleviating emotional exhaustion and burnout among nurses. Theoretical implications underscore the importance of deepening the role of psychological safety climate in mitigating emotional exhaustion, while practical implications emphasize the need for fostering a positive psychological safety climate and implementing targeted interventions to support nurses' well-being.
- psychological safety climate,
- relational stressors,
- exhaustion,
- burnout,
- nurses,
- mental health
Citation: Teresa Galanti, Michela Cortini, Giuseppe Filippo Giudice, Salvatore Zappalà, Ferdinando Toscano. Safeguarding nurses' mental health: The critical role of psychosocial safety climate in mitigating relational stressors and exhaustion[J]. AIMS Public Health, 2024, 11(3): 904-916. doi: 10.3934/publichealth.2024046

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Abstract

Burnout among nurses is a pervasive concern in healthcare, with profound implications for patient care and nurse well-being. While research has highlighted the detrimental effects of burnout on many aspects of nursing, including patient safety and quality of care, the underlying mechanisms driving burnout warrant further investigation. In this cross-sectional study, we surveyed 196 nurses from diverse Italian hospitals using an online questionnaire via Qualtrics. Our findings revealed significant negative correlations between psychological safety climate and both relational stressors and emotional exhaustion. Conversely, relational stressors positively correlated with emotional exhaustion, and a significant negative indirect effect of psychological safety climate was found for emotional exhaustion through relational stressors, emphasizing the pivotal role of psychological safety climate in mitigating nurse burnout. Our study underscores the potential effectiveness of interventions targeting psychological safety climate and relational stressors in alleviating emotional exhaustion and burnout among nurses. Theoretical implications underscore the importance of deepening the role of psychological safety climate in mitigating emotional exhaustion, while practical implications emphasize the need for fostering a positive psychological safety climate and implementing targeted interventions to support nurses' well-being.

Acknowledgments

This study has not been funded by any agency and was conducted by the authors independently.

Author contributions

Teresa Galanti, Michela Cortini, and Ferdinando Toscano designed and supervised the study; Giuseppe Filippo Giudice and Teresa Galanti collected the data; Ferdinando Toscano and Salvatore Zappalà carried out the statistical analyses; Ferdinando Toscano and Teresa Galanti drafted the manuscript; Ferdinando Toscano, Teresa Galanti, Michela Cortini, Salvatore Zappalà, and Giuseppe Filippo Giudice reviewed and edited the manuscript. All authors read and approved the final version of the manuscript.

Conflict of interest

The authors state that there is no conflict of interest in this document.

References

[1]	Lele ECB, Ndongo JM, Ashu-akoh AV, et al. (2023) Burnout syndrome among healthcare professionals in the Fako division, Cameroon: Impact of physical activity and sleep quality. AIMS Public Health 10: 814-827. https://doi.org/10.3934/publichealth.2023054
[2]	Toscano F, Tommasi F, Giusino D (2022) Burnout in intensive care nurses during the COVID-19 pandemic: A scoping review on its prevalence and risk and protective factors. Int J Environ Res Public Health 19: 12914. https://doi.org/10.3390/ijerph191912914
[3]	Ershad Sarabi R, Javanmard R, Mangolian Shahrbabaki P (2020) Study of burnout syndrome, job satisfaction and related factors among health care workers in rural areas of Southeastern Iran. AIMS Public Health 7: 158-168. https://doi.org/10.3934/publichealth.2020014
[4]	Edú-valsania S, Laguía A, Moriano JA (2022) Burnout: A review of theory and measurement. Int J Environ Res Public Health 19: 1780. https://doi.org/10.3390/ijerph19031780
[5]	Maslach C, Jackson SE (1981) The measurement of experienced burnout. J Organ Behav 2: 99-113. https://doi.org/10.1002/job.4030020205
[6]	Maslach C., Leiter M.P. (2016) George FinkBurnout. Stress Concepts, Cogn Emot Behav. New York: Academic Press 351-357. https://doi.org/10.1016/B978-0-12-800951-2.00044-3
[7]	Salanova M, Llorens S, García-Renedo M, et al. (2005) Toward a four-dimensional model of burnout: A multigroup factor-analytic study including depersonalization and cynicism. Educ Psychol Meas 65: 901-913. https://doi.org/10.1177/0013164405275662
[8]	Te Brake H, Smits N, Wicherts JM, et al. (2008) Burnout development among dentists: A longitudinal study. Eur J Oral Sci 116: 545-551. https://doi.org/10.1111/j.1600-0722.2008.00584.x
[9]	Alarcon GM (2011) A meta-analysis of burnout with job demands, resources, and attitudes. J Vocat Behav 79: 549-562. https://doi.org/10.1016/j.jvb.2011.03.007
[10]	Jun J, Ojemeni MM, Kalamani R, et al. (2021) Relationship between nurse burnout, patient and organizational outcomes: Systematic review. Int J Nurs Stud 119: 103933. https://doi.org/10.1016/j.ijnurstu.2021.103933
[11]	Day G, Robert G, Rafferty AM (2020) Gratitude in health care: A meta-narrative review. Qual Health Res 30: 2303-2315. https://doi.org/10.1177/1049732320951145
[12]	Cortini M, Converso D, Galanti T, et al. (2019) Gratitude at work works! A mix-method study on different dimensions of gratitude, job satisfaction, and job performance. Sustain 11: 3902. https://doi.org/10.3390/su11143902
[13]	Lim MC, Jeffree MS, Saupin SS, et al. (2022) Workplace violence in healthcare settings: The risk factors, implications and collaborative preventive measures. Ann Med Surg 78: 103727. https://doi.org/10.1016/j.amsu.2022.103727
[14]	Nashwan AJ, Mathew RG, Anil R, et al. (2023) The safety, health, and well-being of healthcare workers during COVID-19: A scoping review. AIMS Public Health 10: 593-609. https://doi.org/10.3934/publichealth.2023042
[15]	Lanza ML, Schmidt S, Mcmillan F, et al. (2011) Support our staff-a unique program to help deal with patient assault. erspect Psychiatr Care 47: 131-137. https://doi.org/10.1111/j.1744-6163.2010.00282.x
[16]	Kvas A, Seljak J (2014) Unreported workplace violence in nursing. Int Nurs Rev 61: 344-351. https://doi.org/10.1111/inr.12106
[17]	Van Bogaert P, Clarke S, Willems R, et al. (2013) Nurse practice environment, workload, burnout, job outcomes, and quality of care in psychiatric hospitals: A structural equation model approach. J Adv Nurs 69: 1515-1524. https://doi.org/10.1111/jan.12010
[18]	Diehl E, Rieger S, Letzel S, et al. (2021) The relationship between workload and burnout among nurses: The buffering role of personal, social and organisational resources. PLoS One 16: 1-17. https://doi.org/10.1371/journal.pone.0245798
[19]	Dall'ora C, Ejebu OZ, Ball J, et al. (2023) Shift work characteristics and burnout among nurses: Cross-sectional survey. Occup Med (Chic Ill) 73: 199-204. https://doi.org/10.1093/occmed/kqad046
[20]	Dollard MF, Tuckey MR, Dormann C (2012) Psychosocial safety climate moderates the job demand-resource interaction in predicting workgroup distress. Accid Anal Prev 45: 694-704. https://doi.org/10.1016/j.aap.2011.09.042
[21]	Baltes BB, Zhdanova LS, Parker CP (2009) Psychological climate: A comparison of organizational and individual level referents. Hum Relations 62: 669-700. https://doi.org/10.1177/0018726709103454
[22]	Nahrgang JD, Morgeson FP, Hofmann DA (2011) Safety at work: A meta-analytic investigation of the link between job demands, job resources, burnout, engagement, and safety outcomes. J Appl Psychol 96: 71-94. https://doi.org/10.1037/a0021484
[23]	Clarke S (2010) An integrative model of safety climate: Linking psychological climate and work attitudes to individual safety outcomes using meta-analysis. J Occup Organ Psychol 83: 553-578. https://doi.org/10.1348/096317909X452122
[24]	Abdi F, Jahangiri M, Kamalinia M, et al. (2023) Developing a model for predicting safety performance of nurses based on psychosocial safety climate and role of job demands and resources, job satisfaction, and emotional exhaustion as mediators. BMC Psychol 11: 187. https://doi.org/10.1186/s40359-023-01223-1
[25]	Vévoda J, Vévodová, Nakládalová M, et al. (2016) The relationship between psychological safety and burnout among nurses. Prac Lek 68: 40-46.
[26]	Dormann C, Zapf D (2004) Customer-related social stressors and burnout. J Occup Health Psychol 9: 61-82. https://doi.org/10.1037/1076-8998.9.1.61
[27]	Oyama Y, Fukahori H (2015) A literature review of factors related to hospital nurses' health-related quality of life. J Nurs Manag 23: 661-673. https://doi.org/10.1111/jonm.12194
[28]	Dormann C, Zapf D (2002) Social stressors at work, irritation, and depressive symptoms: Accounting for unmeasured third variables in a multi-wave study. J Occup Organ Psychol 75: 33-58. https://doi.org/10.1348/096317902167630
[29]	Adamis D, Minihan E, Hannan N, et al. (2023) Burnout in mental health services in Ireland during the COVID-19 pandemic. BJPsych Open 9: e177. https://doi.org/10.1192/bjo.2023.552
[30]	Bakker AB, Demerouti E (2017) Job demands-resources theory: Taking stock and looking forward. J Occup Health Psychol 22: 273-285. https://doi.org/10.1037/ocp0000056
[31]	Neal A, Griffin MA (2006) A study of the lagged relationships among safety climate, safety motivation, safety behavior, and accidents at the individual and group levels. J Appl Psychol 91: 946-953. https://doi.org/10.1037/0021-9010.91.4.946
[32]	Gil-Monte PR, Figueiredo-Ferraz H (2013) Psychometric properties of the ‘Spanish Burnout Inventory’ among employees working with people with intellectual disability. J Intellect Disabil Res 57: 959-968. https://doi.org/10.1111/j.1365-2788.2012.01591.x
[33]	Toscano F, Zappalà S (2024) Volunteers' satisfaction with the voluntary association: exploring the role of service climate, organizational identification, and understanding motivation. Curr Psychol 43: 15471-15483. https://doi.org/10.1007/s12144-023-05475-3
[34]	Fairchild AJ, MacKinnon DP, Taborga MP, et al. (2009) R2 effect-size measures for mediation analysis. Behav Res Methods 41: 486-498. https://doi.org/10.3758/BRM.41.2.486
[35]	Zeinhom M, Higazee A, Rayan A, et al. (2016) Relationship between job stressors and organizational support among Jordanian nurses. Am J Nurs Res 4: 51-55.
[36]	Labrague LJ, McEnroe Petitte DM, Leocadio MC, et al. (2018) Perceptions of organizational support and its impact on nurses' job outcomes. Nurs Forum 53: 339-347. https://doi.org/10.1111/nuf.12260
[37]	Robaee N, Atashzadeh-Shoorideh F, Ashktorab T, et al. (2018) Perceived organizational support and moral distress among nurses. BMC Nurs 17: 2. https://doi.org/10.1186/s12912-017-0270-y
[38]	Dyrbye LN, Shanafelt TD, Johnson PO, et al. (2019) A cross-sectional study exploring the relationship between burnout, absenteeism, and job performance among American nurses. BMC Nurs 18: 57. https://doi.org/10.1186/s12912-019-0382-7
[39]	Babapour A-R, Gahassab-Mozaffari N, Fathnezhad-Kazemi A (2022) Nurses' job stress and its impact on quality of life and caring behaviors: A cross-sectional study. BMC Nurs 21: 75. https://doi.org/10.1186/s12912-022-00852-y
[40]	Khamisa N, Oldenburg B, Peltzer K, et al. (2015) Work related stress, burnout, job satisfaction and general health of nurses. Int J Environ Res Public Health 12: 652-666. https://doi.org/10.3390/ijerph120100652
[41]	Bautista JR, Lauria PAS, Contreras MCS, et al. (2020) Specific stressors relate to nurses' job satisfaction, perceived quality of care, and turnover intention. Int J Nurs Pract 26. https://doi.org/10.1111/ijn.12774
[42]	Dollard MF, Bakker AB (2010) Psychosocial safety climate as a precursor to conducive work environments, psychological health problems, and employee engagement. J Occup Organ Psychol 83: 579-599. https://doi.org/10.1348/096317909X470690
[43]	Zappalà S, Toscano F, Polevaya M V, et al. (2021) Personal initiative, passive-avoidant leadership and support for innovation as antecedents of nurses' idea generation and idea implementation. J Nurs Scholarsh 53: 96-105. https://doi.org/10.1111/jnu.12615

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