Title
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Nurse practice environment, workload, burnout, job outcomes, and quality of care in psychiatric hospitals : a structural equation model approach
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Author
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Abstract
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AIM: To study the relationships between nurse practice environment, workload, burnout, job outcomes and nurse-reported quality of care in psychiatric hospital staff. BACKGROUND: Nurses' practice environments in general hospitals have been extensively investigated. Potential variations across practice settings, for instance in psychiatric hospitals, have been much less studied. DESIGN: A cross-sectional design with a survey. METHOD: A structural equation model previously tested in acute hospitals was evaluated using survey data from a sample of 357 registered nurses, licensed practical nurses, and non-registered caregivers from two psychiatric hospitals in Belgium between December 2010-April 2011. The model included paths between practice environment dimensions and outcome variables, with burnout in a mediating position. A workload measure was also tested as a potential mediator between the practice environment and outcome variables. RESULTS: An improved model, slightly modified from the one validated earlier in samples of acute care nurses, was confirmed. This model explained 50% and 38% of the variance in job outcomes and nurse-reported quality of care respectively. In addition, workload was found to play a mediating role in accounting for job outcomes and significantly improved a model that ultimately explained 60% of the variance in these variables. CONCLUSION: In psychiatric hospitals as in general hospitals, nurse-physician relationship and other organizational dimensions such as nursing and hospital management were closely associated with perceptions of workload and with burnout and job satisfaction, turnover intentions, and nurse-reported quality of care. Mechanisms linking key variables and differences across settings in these relationships merit attention by managers and researchers. |
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Language
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English
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Source (journal)
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Journal of advanced nursing. - Oxford
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Publication
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Oxford
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2013
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ISSN
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0309-2402
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DOI
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10.1111/JAN.12010
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Volume/pages
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69
:7
(2013)
, p. 1515-1524
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ISI
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000319829000007
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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