Mediating effects of self-efficacy, coping, burnout, and social support between job stress and mental health among young Chinese nurses

J Adv Nurs. 2020 Jan;76(1):163-173. doi: 10.1111/jan.14208. Epub 2019 Oct 13.

Abstract

Aims: To examine the mediating effects of self-efficacy, coping, burnout, and social support in the link between job stress and depression and anxiety among young Chinese nurses.

Design: A cross-sectional survey was used.

Methods: Full-time young nurses (N = 1,029) who worked in nine tertiary grade A hospitals in Chengdu China were recruited from December 2016-March 2017. Structural equation modelling was applied to analyse the mediating effects.

Results: Job stress had a direct positive effect on anxiety (β = 0.054) and it also exerted indirect positive effects on depression (β = 0.337) and anxiety (β = 0.325) through mediating factors. Emotional exhaustion and social support were the main mediating variables, accounting for 72.0% of the variation in anxiety and nearly 43.4% in depression.

Conclusion: Emotional exhaustion and social support may have significant mediating effects in the link between job stress and depression and anxiety. Strategies including deceasing emotional exhaustion, enhancing social support in work environment, and reducing job stressors would be useful to prevent depression and anxiety among young nurses.

Impact: What problems did the study address? Depression and anxiety have great impact on professional performance of nurses and even patient safety. Factors such as coping, burnout, etc., may have different mediating effects in the paths from job stress to depression and anxiety. What were the main findings? Job stress had direct and indirect positive effects on anxiety and it only had indirect positive effect on depression. Emotional exhaustion and social support were the main mediating variables in the link between job stress and depression and anxiety. Where and on whom will the research have impact? Nursing managers should be more cognizant of the impact of job stress on the development of depression and anxiety. The significant mediating effect of emotional exhaustion and social support in the link between job stress and depression and anxiety should be emphasized by nursing administrators and effective targeted measures need to be adopted.

目的: 研究自我效能、应对、倦怠以及社会支持在中国年轻护士工作压力、抑郁与焦虑之间的中介作用。 设计: 使用横断面研究。 方法: 自2016年12月至2017年3月,我们招募了在中国成都市九家三级甲等医院工作的专职年轻护士(N = 1029),并采用结构方程模型分析中介作用。 结果: 工作压力对焦虑有直接的积极影响(β= 0.054),并且通过中介因素对抑郁(β= 0.337)和焦虑(β= 0.325)也有间接的积极影响。情绪疲劳和社会支持是主要的中介变量,其占焦虑变量的72.0%,占抑郁变量近43.4%。 结论: 情绪疲惫和社会支持可能对工作压力、抑郁以及焦虑之间的联系产生显著的中介作用。减少情绪疲惫,增加工作环境中的社会支持并减少工作压力等策略有助于预防年轻护士出现抑郁和焦虑。 影响: 此项研究解决了什么问题? 抑郁和焦虑会对护士的专业表现甚至患者安全产生重大影响。应对、倦怠等因素在工作压力与抑郁、焦虑之间能够产生不同的中介作用。 研究主要发现是什么? 工作压力对焦虑有直接和间接的积极影响,而多抑郁只有间接的积极影响。 情绪疲惫和社会支持是工作压力与抑郁和焦虑之间的主要中介变量。 研究将对谁以及在何处产生影响? 护理管理人员应更了解工作压力对产生抑郁和焦虑的影响。 护理管理人员应重视情绪和社会支持在工作压力与抑郁和焦虑之间的重要中介作用,并应采取有效的针对性措施。.

Keywords: burnout; job stress; mental health; social support; young nurses.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Anxiety / psychology
  • Burnout, Professional*
  • China
  • Depression / psychology
  • Female
  • Humans
  • Male
  • Mental Health*
  • Nursing Staff / psychology*
  • Self Efficacy*
  • Social Support*
  • Young Adult