Systematic Review nursing burnout 

hello, I need help to complete Systemic revive project, it about …. Strategies for Managing Burnout among Nurses during Infectious Diseases Pandemic: A systematic Review

I want to look at the…. Strategies for Managing Burnout among Nurses during Infectious Diseases Pandemic and Factors affecting nursing burnout during Infectious Diseases Pandemic

You task is

· Firs find whatever number of minimum articles about the Factors affecting nursing burnout during Infectious Diseases Pandemic

· find whatever number of minimum 6 articles of Strategies for Managing Burnout among Nurses during Infectious Diseases Pandemic

· After that please have look at the attachment and create table Method, sample and findings of identified articles.

The review questions will be as follows:

1. Do existing studies identify the strategies for managing burnout among nurses during different infectious diseases pandemic?

Objectives and research questions:

This study will aim to identify the

· Factors affecting nursing burnout during Infectious Diseases Pandemic

· strategies nurse and their leaders use to reduce the occurrence of burnout and its effects.

Search Strategies:

A comprehensive range of search strategies will be used to identify relevant published studies in the following databases: PubMed, Web of Science, and Scopus. A hand search of references using developed search strings from the keywords Burnout, infectious diseases, Strategies, Nurses, Management, and Interventions using combinations of keywords such as strategies for managing burnout or work related stress. Specific inclusion and exclusion criteria explained below will be used to select articles, studies will be first selected on the basis of the title, and later the abstract will determine if there is need to access the full article or not. A log of all the hits and the studies that will be included and excluded will be created along with the justification for inclusionor exclusion as this will be useful when reporting the results

nclusion Criteria:

This review will include the studies conducted between 2010 and 2020 which meet the following criteria:

• Aligned to the study targeted population and variables of interested such as socio-demographic data, types of burnout among nurses, interventions of management strategies and associated outcomes as well as the study design, sources of bias, and effect sizes or related statistical measures of association.

• Adopted an experimental methodology also studies using either quasi-experimental or randomized trials will be included.

• Published in English.

Exclusion Criteria

This review will exclude the studies that:

• Include observational studies as conference papers as well as case-control studies.

• Studies focusing on other healthcare providers apart from nurses.

• Involved insufficient details

Int. J. Environ. Res. Public Health 2013, 10, 2214-2240; doi:10.3390/ijerph10062214

International Journal of

Environmental Research and

Public Health
ISSN 1660-4601

www.mdpi.com/journal/ijerph

Review

Burnout in Relation to Specific Contributing Factors and Health

Outcomes among Nurses: A Systematic Review

Natasha Khamisa
1,2,

*, Karl Peltzer
3,4,5

and Brian Oldenburg
2,6

1
School of Health Sciences, Department of Public Health, Monash South Africa, 144 Peter Road,

Roodepoort, Johannesburg 1725, South Africa
2
Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Melbourne 3800,

Australia; E-Mail: [email protected]
3
Human Science Research Council, 134 Pretorius Street, Pretoria 0002, South Africa;

E-Mail: [email protected]
4
University of Limpopo, University Street, Turfloop, Sovenga, Polokwane 0727, South Africa

5
ASEAN Institute for Health Development, Mahidol University, Salaya 73170, Thailand

6
Monash Alfred Hospital Campus, Level 3 Burnet Tower, 89 Commercial Road, Melbourne 3004,

Australia

* Author to whom correspondence should be addressed; E-Mail: [email protected];

Tel.: +27-11-950-4450.

Received: 1 March 2013; in revised form: 16 May 2013 / Accepted: 24 May 2013 /

Published: 31 May 2013

Abstract: Nurses have been found to experience higher levels of stress-related burnout

compared to other health care professionals. Despite studies showing that both job

satisfaction and burnout are effects of exposure to stressful working environments, leading

to poor health among nurses, little is known about the causal nature and direction of these

relationships. The aim of this systematic review is to identify published research that has

formally investigated relationships between these variables. Six databases (including

CINAHL, COCHRANE, EMBASE, MEDLINE, PROQUEST and PsyINFO) were

searched for combinations of keywords, a manual search was conducted and an

independent reviewer was asked to cross validate all the electronically identified articles.

Of the eighty five articles that were identified from these databases, twenty one articles

were excluded based on exclusion criteria; hence, a total of seventy articles were included

in the study sample. The majority of identified studies exploring two and three way

relationships (n = 63) were conducted in developed countries. Existing research includes

OPEN ACCESS

Int. J. Environ. Res. Public Health 2013, 10 2215

predominantly cross-sectional studies (n = 68) with only a few longitudinal studies (n = 2);

hence, the evidence base for causality is still very limited. Despite minimal availability of

research concerning the small number of studies to investigate the relationships between

work-related stress, burnout, job satisfaction and the general health of nurses, this review

has identified some contradictory evidence for the role of job satisfaction. This emphasizes

the need for further research towards understanding causality.

Keywords: work related stress; burnout; job satisfaction; general health; staff nurses;

relationship

1. Introduction

Burnout is typically characterised by emotional exhaustion (depletion of emotional resources and

diminution of energy), depersonalization (negative attitudes and feelings as well as insensitivity and a

lack of compassion towards service recipients) and a lack of personal accomplishment (negative

evaluation of one’s work related to feelings of reduced competence) [1,2]. These three characteristics

emphasise the connection between burnout and working with people [3].

Burnout is usually thought of as an individual’s response to prolonged work related stress, which in

turn, impacts on job satisfaction and thereafter, can often affect productivity, performance, turnover

and wellbeing among health care professionals and other kinds of workers [3]. Health care

professionals in general are thought to have a high vulnerability to burnout as a result of experiencing

high levels of emotional strain, owing to stressful working environments exacerbated by sick and

dying patients to whom they provide care [4]. Nurses in particular however, have been found to

experience higher levels of burnout compared to other health care professionals [5,6], owing to the

nature of their work [7,8].

High levels of burnout among nurses have often been attributed to prolonged direct personal contact

of an emotional nature with a large number of patients [4,9,10]. This, amongst other factors such as

prolonged exposure to work related stress as well as low levels of job satisfaction, have also been

recognised as factors contributing to high levels of burnout among nurses [11,12]. Burnout in nurses

has been shown to lead to emotional exhaustion as well as a loss of compassion for others

(depersonalization) and a sense of low personal accomplishment. These experiences can have very

significant implications for the health and wellbeing of nurses [13–15].

Research has confirmed that prolonged exposure to work related stress is associated with burnout [9],

through active interactions between an individual and their working environment. During such

interaction, environmental demands exceeding individual resources may be perceived as stressful and

result in negative outcomes such as low job satisfaction, burnout and illness [16,17]. In nursing, these

demands also include role ambiguity, role conflict, responsibility for others’ lives, work overload, poor

relationships at work, inadequate salaries, lack of opportunities for advancement, a lack of personnel,

patient care, lack of support, staff issues and overtime [10,18,19].

Limited research has identified studies confirming two and three way relationships between work

related stress and job satisfaction [20], work related stress, job satisfaction and burnout [21], as well as

Int. J. Environ. Res. Public Health 2013, 10 2216

work environment and burnout [22] specifically among nurses. However, despite studies showing that

both job satisfaction and burnout are effects of exposure to stressful working environments, leading to

health consequences [23], the nature and direction of these relationships remains ambiguous (Figure 1).

Figure 1. A model illustrating relationships between contributing factors and health

outcomes of burnout among nurses.

For the purpose of this review, general health outcomes are specifically defined as being symptoms

related to anxiety, depression, somatic symptoms and/or social dysfunction [24].

Although it is already known that nurses experience higher levels of burnout compared to other

health care professionals [5,6] and that lack of job satisfaction and burnout result from the effects of

exposure to stressful working environments, leading to poor health among nurses [23], little is known

about the causal nature and direction of these relationships. Therefore, this systematic review aims to

identify those published studies that explore such relationships between work related stress, burnout,

job satisfaction and general health, specifically among nurses, while at the same time, also identifying

important evidence gaps in the published literature. This can provide a strong foundation for further

research in this field as a precursor to conducting controlled evaluations of appropriate intervention

strategies.

The review questions are as follows:

 Do existing studies identify the causal nature and direction of relationships between work

related stress, burnout, job satisfaction and general health of nurses?

 Do existing studies focus mostly on two and three way relationships between work related

stress, burnout, job satisfaction and general health of nurses?

2. Methods

2.1. Search Strategies

A comprehensive range of search strategies as per the CRD guidelines on EQUATOR were used to

identify relevant published studies. Firstly, all of the major public health, psychology and nursing

Stressors Burnout

Job

Satisfaction

General

Health

Work Related

Stress

Int. J. Environ. Res. Public Health 2013, 10 2217

databases were searched for combinations of keywords such as work related stress, burnout, job

satisfaction, general health, relationship and nurses. These databases consisted of CINAHL Plus,

COCHRANE Library, EMBASE, MEDLINE, PROQUEST and PsycINFO. The second strategy

involved a manual search of various journals including the ISRN Nursing, Journal of Nursing

Management and Journal of Clinical Nursing using the same combinations of keywords mentioned

above. Specific inclusion and exclusion criteria explained below were used to select articles. A third

strategy involving an independent reviewer was also used to cross validate all the electronically

identified articles. The citation for each identified article was saved using a reference program known

as End Note and the full text version was saved in specific folders.

2.2. Inclusion Criteria

This review included studies conducted between 1990 and 2012 that: (a) were published in the

English language; (b) published only in academic and scholarly journals; (c) were openly accessible

and available in full text; (d) were based on empirical studies; (e) measured the relationship between at

least two of the variables (work related stress, burnout, job satisfaction and general health); (f) focused

on studies specifically consisting of nurses as the sample; and (g) focused on nurses working in various

settings (public hospitals, private hospitals, clinics, retirement homes, hospices, mental institutions,

prison institutions in urban and rural areas).

2.3. Exclusion Criteria

This review excluded studies that: (a) involved insufficient details (such as significance of results/

p-values) of the identified relationships between work related stress, burnout, job satisfaction and

general health; (b) included samples consisting of health professionals in general (doctors, nurses,

radiologists, anesthesiologists, social workers); (c) measured different health outcomes beyond the

scope of the review (cardiovascular heart disease, diabetes and hypertension). It is believed that

exclusion based on the above criteria, allowed for the selection of articles with sufficient information

about the method, sample and findings of studies. Selected articles included in this review were

analyzed according to their findings and reported in terms of the relationships between work related

stress, burnout, job satisfaction and general health of nurses.

3. Results

Using the first strategy, a total of eighty five articles meeting the inclusion criteria were

electronically identified from six databases. However, following application of the exclusion criteria,

twenty one of the eighty five articles were excluded leaving sixty four relevant articles. Four additional

articles were identified manually and two by an independent reviewer resulting in a total of 70 articles.

This is illustrated below (Figure 2).

Int. J. Environ. Res. Public Health 2013, 10 2218

Figure 2. A flow chart describing selection of articles using inclusion and exclusion criteria.

Of the 70 identified articles, 64 articles were identified electronically, four articles were identified

manually and two articles were identified by an independent reviewer. Of these 70 identified articles,

majority were from developed countries (26 European studies, 25 North American studies, 12 Asian

studies, four Australian studies, one South African study, one Nigerian study and one East African

study).

3.1. Work Related Stress and Burnout

Ten articles confirming the relationship between work related stress and burnout were identified.

Work environment related stressors such as working place, poor peer relationships, poor nurse patient

relationships, lack of professional recognition or reward [25–27], feedback clarity and supervisor

leadership style [28] were related to one or more burnout dimensions. Work content related stressors

such as nursing role, patient care, job demands [25,26,29], job complexity [28], work overload,

working overtime [30–32], stigma and discrimination while caring for HIV positive patients [29], role

conflict, role insufficiency, role ambiguity were also related to burnout [27,30,33]. Nurses who

reported inadequate communication with doctors about patients as well as fear of not completing tasks

also reported high burnout [34]. A manual search yielded one relevant article, which revealed that

burnout (including all three dimensions) is most frequently associated with recurrent night duty among

nurses [35].

Further details about the method, sample and findings of identified articles are included in Table 1

below.

Int. J. Environ. Res. Public Health 2013, 10 2219

Table 1. Method, sample and findings of identified articles.

Method Sample Findings

Quantitative

(questionnaire

distribution at

conferences and

meetings) [25]

132 nurses (132

women & 22 men)

working in different

wards and clinics

[25]

Working place/nursing role was associated with higher burnout among

practicing nurses compared to those who had a managerial function (as

head nurse, deputy, or mentor) (t = 3.2, p < 0.01) owing to limited

support with complicated treatments, less power, lower status and lack

of variation in roles [25]

Quantitative

(extensive

questionnaire

survey) [26]

1,190 registered

nurses working in 43

public hospitals [26]

Social context related stressors (lack of professional recognition,

professional uncertainty, interpersonal and family conflicts, tension in

professional work relationships as well as tensions in nurse-patient

relationships) were all significantly associated with emotional

exhaustion (β = 0.44, p ≤ 0.01), depersonalization (β = 0.26, p ≤ 0.01)

and personal accomplishment (β = −0.33, p ≤ 0.01).

Job content related stressors including patient care responsibilities, job

demands and role conflict) also had significant relationships with

emotional exhaustion (β = 0.22, p ≤ 0.01), and personal

accomplishment (β = 0.23, p ≤ 0.01) but not with depersonalization

(β = −0.04, p ≥ 0.01) [26]

Quantitative

(questionnaire

distribution and

collection in 2

weeks) [27]

336 nurses (27 male

and 309 female) at

three hospitals

specializing in

acute treatment [27]

Emotional exhaustion positively correlated with qualitative workload

(β = 0.22, p < 0.01), quantitative workload (β = 0.42, p < 0.01) and

conflict with patients (β = 0.19, p < 0.01). Depersonalization was

positively related to conflict with other nursing staff (β = 0.28, p < 0.01),

qualitative workload (β = 0.15, p < 0.05), quantitative workload

(β = 0.19, p < 0.01) and conflict with patients (β = 0.24, p < 0.01) while

being negatively related to nursing role conflict (β = −0.17, p < 0.01).

Personal accomplishment was negatively correlated with qualitative

workload (β = −0.21, p < 0.01) and quantitative workload (β = −0.19,

p < 0.01) while being positively correlated with nursing role conflict

(β = 0.25, p < 0.01) [27]

Quantitative

(questionnaire

distribution with

reminders to non

responders [28]

492 nurses from

long stay wards at 5

psychiatric hospitals

[28]

Work environment stressors such as job complexity, feedback/clarity,

the level of performance of the patient group and social leadership style

explained 16% (adjusted R²) of the variance in emotional exhaustion.

Job complexity, feedback/clarity and social leadership style explained

12% of the variance in depersonalization. 11% of the variance in

personal accomplishment was explained by feedback/clarity and job

complexity [28]

Quantitative and

Qualitative (All

nurses received

questionnaires

with 5 being

selected to

participate in a

semi-structured

interview) [29]

30 community

clinical HIV/AIDS

nurse specialists [29]

Significant correlations were found between emotional exhaustion and

grief/loss (τ = 0.58, p < 0.05), emotional exhaustion and loss

tolerance/peer relationship (τ = 0.41, p < 0.05), personal

accomplishment and social recognition/reward (τ = 0.40, p < 0.05).

A weak but significant relationship was found between emotional

exhaustion and stigma/discrimination (τ = 0.29, p < 0.05). Qualitative

findings indicated that death of a patient and stigma/grief were related

to burnout [29]

Int. J. Environ. Res. Public Health 2013, 10 2220

Table 1. Cont.

Method Sample Findings

Quantitative

(questionnaire

distribution and

completion at 2

time points) [30]

98 nurses attending a

post-work course

towards a licentiate

degree [30]

Amount of variance explained increased (ΔR² = 0.14, p < 0.001)

when work related stressors were entered into the burnout model.

Work overload was the only stressor that significantly predicted

emotional exhaustion (β = 0.35, p < 0.01). Experience with pain and

death significantly predicted depersonalization (β = −0.38, p < 0.001)

and role ambiguity (β = 0.32, p < 0.05) while lack of cohesion

(β = 0.24, p < 0.05) significantly predicted the lack of personal

accomplishment [30]

Quantitative

(Questionnaires

posted to

members of the

Association of

Nurses in AIDs

Care) [31]

445 nurses providing

care to people living

with HIV/AIDS [31]

Findings confirmed association between perceived workload (hours

worked and amount of work) and burnout (r = 0.24, p < 0.01).

Workload accounted for 5.6% of the variance in burnout [31]

Quantitative

(questionnaire

packages were

mailed to nurses)

[32]

574 Australian

Nursing Federation

members [32]

Generally, working overtime was positively related to higher

emotional exhaustion (r = 0.21, p < 0.05). Being pressured or

expected to work overtime (involuntarily) was related to higher

emotional exhaustion (r = 0.41, p < 0.05) and depersonalization

(r = 0.22, p < 0.05); while working unpaid overtime was also

associated with higher emotional exhaustion (r = 0.13, p < 0.05) [32]

Quantitative

(questionnaire

distribution by

nominated

coordinator at

each hospital)

[33]

495 nurses from three

provincial hospitals

[33]

Role insufficiency was significantly related to exhaustion (r = 0.38,

p < 0.05), cynicism (r = 0.39, p < 0.05) and professional efficacy

(r = 0.28, p < .05). Role ambiguity was significantly related to

exhaustion (r = 0.20, p < 0.05), cynicism (r = 0.28, p < 0.05) and

professional efficacy (r = 0.27, p < 0.05). Role boundary was

significantly related to exhaustion (r = 0.29, p < 0.05), cynicism

(r = 0.34, p < 0.05) and professional efficacy (r = 0.21, p < 0.05).

Responsibility, physical environment, and role overload are all

significantly related to exhaustion (r = 0.33, p < 0.05, r = 0.31,

p < 0.05, r = 0.42, p < 0.05 respectively) and cynicism (r = 0.28,

p < 0.05, r = 0.20, p < 0.05, r = 0.30, p < 0.05 respectively) [33]

Quantitative

(questionnaire

distribution via

the hospital’s

internal mail

system) [34]

101 registered nurses,

employed at a major

specialist oncology

metropolitan hospital

[34]

Significant correlations were found between nursing stressors (lack

of support, poor communication with doctors) and emotional

exhaustion (r = 0.48, p < 0.01) as well as depersonalization (r = 0.34,

p < 0.01), but not personal accomplishment [34]

Quantitative

(questionnaire

distribution after

receiving

consent) [35]

292 nurses working at

a state hospital [35]

Doctor/nurse conflict (OR = 3.1; 95% CI, 1.9–6.3), low doctor/nurse

ratio (OR = 6.1; 95% CI, 2.5–13.2), inadequate nursing personnel

(OR = 2.6; 95% CI, 1.5–5.1) and too frequent night duties (OR = 3.1;

95% CI, 1.7–5.6) were significant predictors of emotional exhaustion.

Doctor/nurse conflict (OR = 3.4; 95% CI, 2.2–7.6), low doctor/nurse

ratio (OR = 2.4; 95% CI, 1.4– 4.1), and too frequent night duties

(OR = 2.4; 95% CI, 1.5– 4.8) significantly predicted depersonalization.

High nursing hierarchy (OR = 2.7; 95% CI, 1.5–4.8), poor wages

(OR = 2.9; 95% CI, 1.6–5.6) and too frequent night duties (OR = 2.3;

95% CI, 2.3–4.5) significantly predicted reduced personal

accomplishment [35]

Int. J. Environ. Res. Public Health 2013, 10 2221

3.2. Work Related Stress and Job Satisfaction

Sixteen articles confirming the relationship between work related stress and job satisfaction

were found. Work related stressors including pay, task requirements, well maintained up to date

resources [36–38], physical work environment [39], autonomy [40–42], peer relationships, cohesion,

feedback [40,41,43], workload, control over practice [44,45] patient outcomes and supervisor

support [36,41] recognition, independence, responsibility, authority [46], meaningfulness of work, nurse

centered communication involving humor and clarity [47], role stress [48] as well as overtime [38,41]

were related to job satisfaction. It has also been found that the interaction between workload and

autonomy best predicts job satisfaction [44]. A common conclusion was that work related stress is

significantly related to job satisfaction [49,50] and nurses who experience higher stress levels are less

satisfied with their jobs [51]. Further details about the method, sample and findings of identified articles

are included in Table 2 below.

Table 2. Method, sample and findings of identified articles.

Method Sample Findings

Qualitative (interviews,

observations and field

notes) [36]

8 nurses

selected from a

local nursing

agency [36]

Thematic analysis revealed that nurses were most satisfied with

compensation (patient outcomes, compliments, salary, incentives and

lessons learned), team spirit (working together and sharing duties),

strong support from physicians and advocacy (assisting and supporting

new nurses) [36]

Quantitative

(questionnaires were

sent out with each

nurses’ paycheck) [37]

249 nurses

employed at a

children’s

hospital [37]

In general job stress was found to be significantly associated with job

satisfaction (r = 0.64, p < 0.05). Pay (r = 0.40, p < 0.05, r = 0.43,

p < 0.05), interaction/cohesion (r = 0.44, p < 0.05, r = .41, p < 0.05) and

task requirements (r = 0.53, p < 0.05, r = 0.67, p < 0.05) were

significantly associated with both job stress and job satisfaction

respectively [37]

Quantitative

(questionnaires were

mailed to nurses) [38]

944 RN’s

working in rural

and remote

hospital settings

[38]

Workplace stressors explained 32% of the variance in job satisfaction.

Having available, well maintained and up-to-date equipment and

supplies was highly related to job satisfaction, accounting for 17% of

the total variance. Greater scheduling and shift satisfaction (no

overtime) as well as lower psychological job demands (fewer time

constraints, less excessive workloads) were strong predictors of job

satisfaction (accounting for 12% of the variance) [38]

Quantitative (survey

packets with

instructions were placed

in staff mailboxes) [39]

116 medical-

surgical nurses

working in

acute-care

settings [39]

Only one environmental factor, noise, was significantly associated with

perceived stress (r = −0.18, p = 0.05). Perceived stress was directly

related to job satisfaction (r = 0.55, p = 0.00) [39]

Quantitative (survey

distribution via the

hospital’s internal mail)

[40]

135 nurses

employed in a

170 bed hospital

[40]

Work content stressors including variety, autonomy, task identity and

feedback are all strongly correlated with job satisfaction (r = 0.35–0.50,

p < 0.001). Work environment stressors including collaboration with

medical staff and cohesion among nurses are also strongly correlated

with job satisfaction (r = 0.37–0.45, p < 0.001). Job satisfaction was

mostly predicted by variety, feedback and collaboration with medical

staff (r = 0.55, R² = 0.30) [40]

Int. J. Environ. Res. Public Health 2013, 10 2222

Table 2. Cont.

Method Sample Findings

Quantitative (E-mails

containing a $5 e-mail

gift certificate and a

web link to the survey

instrument were sent.

Reminder e-mails were

sent to non responders)

[41]

362 registered

nurses in a large

metropolitan

hospital [41]

Job satisfaction was positively and significantly correlated with

physical work environment (r = 0.26, p < 0.01). Significant positive

predictors of job satisfaction from the baseline model were autonomy

(β = 0.09, p < 0.05), supervisor support (β = 0.05, p < 0.05),

workgroup cohesion (β = 0.09, p < 0.05), working in a unit other than

the intensive care unit (β = 0.67, p < 0.05), working in a step-down

unit or general medical surgical unit (β = 0.31, p < 0.05), and number

of hours of voluntary overtime worked in a typical work week

(β = 0.05, p < 0.05). A negative significant predictor was working a

12-hour shift (β = −0.83, p < 0.05) [41]

Quantitative

(questionnaire

distribution through the

nurse manager of each

unit) [42]

431 critical care

nurses, all of whom

were RN’s working

at 16 different

hospitals [42]

Professional autonomy had a moderate positive correlation with

reported role conflict and role ambiguity (r = 0.33, p < 0.001).

A positive moderate correlation between professional autonomy and

job satisfaction was found (r = 0.33, p < 0.001) [42]

Quantitative

(anonymous

questionnaire

distribution) [43]

117 Registered

Nurses (77 Army

RNs – 40 Civilian

RNs) [43]

Work related stress was inversely correlated with job satisfaction for

both civilian (r = −0.32, p < 0.05) and army (r = −0.23, p < 0.05)

nurses. Army nurses were most stressed and least satisfied by their

working relations with colleagues (r = −0.40, p < 0.01), while civilian

nurses were most stressed and least satisfied with their physical

working environments (r = 0.32, p < 0.05) [43]

Quantitative

(participants were

invited by e-mail to

attend a one-day event

where they completed

surveys) [44]

271 public health

nurses [44]

Control-over-practice (x² = 7.22, p = 0.01; OR = 1.01, 95% CI 1.00–1.02)

and workload (x² = 15.04, p < 0.01; OR = 0.90, 95% CI 0.86–0.95)

significantly predicted job satisfaction.

The strongest association was found between workload and job

satisfaction, whereby a one-unit increase on the work overload scale

decreased the odds of job satisfaction by nearly 10%. The interaction

between autonomy and workload was a significant predictor of job

satisfaction (x² = 15.87, p < 0.01) [44]

Quantitative (voluntary

completion of

standardized

questionnaires) [45]

129 qualified nurses

[45]

Results showed that workload was the highest perceived stressor in

the nurses’ working environment (M = 1.61, SD ± 0.88). Nursing

stress was found to be negatively and significantly correlated with job

satisfaction (r = −0.22, p < 0.05). Nurse stress predictor variables

combined accounted for 17% of the variance in job satisfaction

(R² = 0.17, F (3, 123) = 8.9, p < 0.001) [45]

Quantitative

(distribution of

questionnaire packets)

[46]

140 registered

nurses from

medical-surgical,

management and

home health nursing

specialties [46]

There was a significantly positive correlation between job satisfaction

and perceived autonomy (r = 0.538, p < 0.05) [46]

Quantitative (surveys

were made available in

each unit and were also

distributed to nurses

during unit meetings

with incentives) [47]

205 nurses

employed at a at a

large women and

children’s hospital

[47]

Nurses’ perceptions of physicians’ nurse centered communication was

significantly related to job satisfaction (r = 0.23, p = 0.002).

Physicians’ nurse centered communication behaviors examined as

predictors of nurses’ reported job satisfaction revealed a significant

model (F (5, 160) = 3.86, R² = 0.11, p = 0.003, with humor and clarity

being the most significant predictors of job satisfaction). Work

environment, meaningfulness of work, and stress also significantly

predicted job satisfaction in another model (F (7, 188) = 27.40,

R² = 0.51, p = 0.001) [47]

Quantitative

(anonymous

questionnaire

distribution and

collection) [48]

532 nurses with job

rotation experience

[48]

Structural equation modeling revealed a negative relationship between

role stress and job satisfaction (γ = 0.52, p < 0.01) [48]

Int. J. Environ. Res. Public Health 2013, 10 2223

Table 2. Cont.

Method Sample Findings

Quantitative (survey

distribution by nurse

managers. Follow up

surveys were

redistributed after 2

weeks to boost