The nurse work environment in Spanish nurses following an economic recession: From 2009 to 2014.
cross-sectional studies
job satisfaction
nursing and administration research
nursing staff
professional burnout
workplace
Journal
Journal of nursing management
ISSN: 1365-2834
Titre abrégé: J Nurs Manag
Pays: England
ID NLM: 9306050
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
19
12
2018
revised:
24
04
2019
accepted:
27
05
2019
pubmed:
31
5
2019
medline:
24
3
2020
entrez:
31
5
2019
Statut:
ppublish
Résumé
To detect possible changes in perception of the nurse work environment, job satisfaction and burnout between the years 2009 and 2014 among nurses working in the Spanish National Health System. The global economic crisis has had a great impact on nurses in the Spanish National Health Service: tougher working conditions, lower pay and a reduction in social benefits. It is not known whether these changes affect the nurses' work environment, job satisfaction and burnout. Comparative, cross-sectional study performed in seven hospitals in the Spanish National Health System between 2009 and 2014, through 1,454 surveys of nurses working in internal medicine, surgery and intensive care. Nurses participating in the second period (2012-2014) were more satisfied with their current job (p = 0.001), perceived their work environment to be more favourable (p < 0.001) and had lower levels of burnout (p < 0.01). Professional factors as 'autonomy at work,' 'opportunities for advancement,' 'professional status' and 'nursing foundations for quality care,' as well as 'collegial nurse-physician relations' and 'nurse participation in hospital affairs' were the most important variables associated with these topics. Professional factors may influence these changes more than labour conditions and remuneration aspects. In times of economic recession, encouraging interpersonal relationships, autonomy and participation in decision-making may improve the work environment, satisfaction and burnout of nurses.
Sections du résumé
AIM
OBJECTIVE
To detect possible changes in perception of the nurse work environment, job satisfaction and burnout between the years 2009 and 2014 among nurses working in the Spanish National Health System.
BACKGROUND
BACKGROUND
The global economic crisis has had a great impact on nurses in the Spanish National Health Service: tougher working conditions, lower pay and a reduction in social benefits. It is not known whether these changes affect the nurses' work environment, job satisfaction and burnout.
METHOD
METHODS
Comparative, cross-sectional study performed in seven hospitals in the Spanish National Health System between 2009 and 2014, through 1,454 surveys of nurses working in internal medicine, surgery and intensive care.
RESULTS
RESULTS
Nurses participating in the second period (2012-2014) were more satisfied with their current job (p = 0.001), perceived their work environment to be more favourable (p < 0.001) and had lower levels of burnout (p < 0.01). Professional factors as 'autonomy at work,' 'opportunities for advancement,' 'professional status' and 'nursing foundations for quality care,' as well as 'collegial nurse-physician relations' and 'nurse participation in hospital affairs' were the most important variables associated with these topics.
CONCLUSIONS
CONCLUSIONS
Professional factors may influence these changes more than labour conditions and remuneration aspects.
IMPLICATIONS FOR NURSING MANAGEMENT
CONCLUSIONS
In times of economic recession, encouraging interpersonal relationships, autonomy and participation in decision-making may improve the work environment, satisfaction and burnout of nurses.
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Pagination
1294-1303Informations de copyright
© 2019 John Wiley & Sons Ltd.
Références
Agencia EFE (2014). ¿Cuánto cobra un enfermero? ABC.Es, 09. Retrieved from http://www.abc.es/economia/20141209/abci-cuanto-cobra-enfermera-201412051850.html.
Aiken, L. H., Cimiotti, J., Sloane, D., Smith, H., Flynn, L., & Neff, D. (2011). Effects of nurse staffing and nurse education on patient deaths in hospitals with different nurse work environments. Medical Care, 49(12), 1047-1053. https://doi.org/10.1097/MLR.0b013e3182330b6e
Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., Busse, R., Clarke, H., … Shamian, J. (2001). Nurses’ reports on hospital care in five countries. Health Affairs, 20(3), 43-53. https://doi.org/10.1377/hlthaff.20.3.43
Aiken, L., Sermeus, W., Van den Heede, K., Sloane, D. M., Busse, R., McKee, M., … Kutney-Lee, A. (2012). Patient safety, satisfaction, and quality of hospital care: Cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. British Medical Journal Open, 1717(March), 1-14. https://doi.org/10.1136/bmj.e1717
Aiken, L. H., Sloane, D. M., Clarke, S., Poghosyan, L., Cho, E., You, L., … Aungsuroch, Y. (2011). Importance of work environments on hospital outcomes in nine countries. International Journal for Quality in Health Care, 23(4), 357-364. https://doi.org/10.1093/intqhc/mzr022
Akman, O., Ozturk, C., Bektas, M., Ayar, D., & Armstrong, M. A. (2016). Job satisfaction and burnout among paediatric nurses. Journal of Nursing Management, 24(7), 923-933. https://doi.org/10.1111/jonm.12399
Ang, S. Y., Dhaliwal, S. S., Ayre, T. C., Uthaman, T., Fong, K. Y., Tien, C. E., … Della, P. (2016). Demographics and personality factors associated with burnout among nurses in a Singapore tertiary hospital. BioMed Research International, 2016, 1-12. https://doi.org/10.1155/2016/6960184
Atefi, N., Lim Abdullah, K., Wong, L. P., & Mazlom, R. (2015). Factors influencing job satisfaction among registered nurses: A questionnaire survey in Mashhad Iran. Journal of Nursing Management, 23(4), 448-458. https://doi.org/10.1111/jonm.12151
BOE (2012a). Boletin oficial de la rioja. Retrieved from http://www.larioja.org/bor/es/boletines-nuevo?tipo=2&fecha=2012%2F01%2F16&referencia=902440-1-HTML-443912-X.
BOE (2012b). Boletin oficial de castilla la mancha. Retrieved from http://www.cortesclm.es/index.php/publicaciones.
Bruyneel, L., Heede, K. V. D., Diya, L., Aiken, L., & Sermeus, W. (2009). Predictive validity of the international hospital outcomes study questionnaire: An RN4CAST pilot study. Journal of Nursing Scholarship, 41(2), 202-210. https://doi.org/10.1111/j.1547-5069.2009.01272.x
Bullich-Marín, I., Miralles Basseda, R., Torres Egea, P., Planas-Campmany, C., & Juvé-Udina, M. E. (2016). Evaluación del ambiente de trabajo de las enfermeras en las unidades sociosanitarias de atención intermedia de Cataluña. Revista Española De Geriatría Y Gerontología, 51(6), 342-348. https://doi.org/10.1016/J.REGG.2015.10.009
Cañadas-De la Fuente, G. A., Vargas, C., San Luis, C., García, I., Cañadas, G. R., & De la Fuente, E. I. (2015). Risk factors and prevalence of burnout syndrome in the nursing profession. International Journal of Nursing Studies, 52(1), 240-249. https://doi.org/10.1016/j.ijnurstu.2014.07.001
Clark, A. E., & Oswald, A. J. (1996). Satisfaction and comparison income. Journal of Public Economics, 61(3), 359-381. https://doi.org/10.1016/0047-2727(95)01564-7
Estryn-Béhar, M., Van derHeijden, B. I., Ogińska, H., Camerino, D., LeNézet, O., Conway, P. M., & … Hasselhorn, H. M.; NEXT Study Group (2007). The impact of social work environment, teamwork characteristics, burnout, and personal factors upon intent to leave among European nurses. Medical Care, 45(10), 939-950. https://doi.org/10.1097/MLR.0b013e31806728d8
Fernández Larraguibel, B., & Paravic Klijn, T. (2003). Nivel de satisfacción laboral en enfermeras de hospitales públicos y privados de la provincia de concepción Chile. Ciencia Y Enfermería, 9(2), 57-66. https://doi.org/10.4067/S0717-95532003000200006
Friese, C. R., Lake, E. T., Aiken, L. H., Silber, J. H., & Sochalski, J. (2008). Hospital nurse practice environments and outcomes for surgical oncology patients. Health Services Research, 43(4), 1145-1163. https://doi.org/10.1055/s-0029-1237430.Imprinting
Fuentelsaz-Gallego, C., Moreno-Casbas, M. T., & González-María, E. (2013). Validation of the Spanish version of the questionnaire practice environment scale of the nursing work index. International Journal of Nursing Studies, 50(2), 274-280. https://doi.org/10.1016/j.ijnurstu.2012.08.001
Fuentelsaz-Gallego, C., Moreno-Casbas, T., Gómez-García, T., & González-María, E. (2013). Entorno laboral, satisfacción y burnout de las enfermeras de unidades de cuidados críticos y unidades de hospitalización. Proyecto RN4CAST-España. Enfermeria Intensiva, 24(3), 104-112. https://doi.org/10.1016/j.enfi.2013.06.001
Fuentelsaz-Gallego, C., Moreno-Casbas, T., López-Zorraquino, D., Gómez-García, T., & González-María, E.; RN4CAST consortium (2012). Percepción del entorno laboral de las enfermeras españolas en los hospitales del Sistema Nacional de Salud. Proyecto RN4CAST-España. Enfermeria. Clinica, 22(5), 261-268. https://doi.org/10.1016/j.enfcli.2012.09.001
Gaceta médica (2014). Edicion catalana. Año XII-507. 7 al 13 de abril de 2014. (n.d.). Retrieved from http://www.gacetamedica.com/noticias-medicina/especiales.aspx?val=pdf?idcat=794&tipo=8. April 8, 2016.
Gaki, E., Kontodimopoulos, N., & Niakas, D. (2013). Investigating demographic, work-related and job satisfaction variables as predictors of motivation in Greek nurses. Journal of Nursing Management, 21(3), 483-490. https://doi.org/10.1111/j.1365-2834.2012.01413.x
Gil-Monte, P. R. (2005). Factorial validity of the Maslach burnout inventory (MBI-HSS) among Spanish professionals. Revista De Saúde Pública, 39(1), 1-8. https://doi.org/10.1590/S0034-89102005000100001
Hinno, S., Partanen, P., & Vehviläinen-Julkunen, K. (2012). The professional nursing practice environment and nurse-reported job outcomes in two European countries: A survey of nurses in Finland and the Netherlands. Scandinavian Journal of Caring Sciences, 26(1), 133-143. https://doi.org/10.1111/j.1471-6712.2011.00920.x
ICN (2008). International Council of Nurses, International Pharmaceutical Federation, International Hospital Federation, World Confederation for Physical Therapy, World Dental Federation, & World Medical Association. Positive Practice Environments for health care professionals, 2011, 6. Retrieved from http://www.whpa.org/PPE_Fact_Health_Pro.pdf.
Kanai-Pak, M., Aiken, L. H., Sloane, D. M., & Poghosyan, L. (2008). Poor work environments and nurse inexperience are associated with burnout, job dissatisfaction and quality deficits in Japanese hospitals. Journal of Clinical Nursing, 17(24), 3324-3329. https://doi.org/10.1111/j.1365-2702.2008.02639.x
Kane, R. L., Shamliyan, T., Mueller, C., Duval, S., & Wilt, T. J. (2007). Nurse staffing and quality of patient care. Evidence Report/Technology Assessment, 151, 1-115. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17764206.
Khamisa, N., Oldenburg, B., Peltzer, K., & Ilic, D. (2015). Work related stress, burnout, job satisfaction and general health of nurses. International Journal of Environmental Research and Public Health, 12(1), 652-666. https://doi.org/10.3390/ijerph120100652
Khamlub, S., Harun-Or-Rashid, M., Sarker, M. A. B., Hirosawa, T., Outavong, P., & Sakamoto, J. (2013). Job satisfaction of health-care workers at health centers in Vientiane capital and Bolikhamsai province, Lao PDR. Nagoya Journal of Medical Science, 75(3-4), 233-241. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24640179.
Kutney-Lee, A., Stimpfel, A. W., Sloane, D. M., Cimiotti, J. P., Quinn, L. W., & Aiken, L. H. (2015). Changes in patient and nurse outcomes associated with magnet hospital recognition. Medical Care, 53(6), 550-557. https://doi.org/10.1097/MLR.0000000000000355
Kutney-Lee, A., Wu, E. S., Sloane, D. M., Aiken, L. H., & Fagin, C. M. (2013). Changes in hospital nurse work environments and nurse job outcomes: An analysis of panel data. International Journal of Nursing Studies, 50(2), 195-201. https://doi.org/10.1016/j.ijnurstu.2012.07.014.Changes
Lee, H. F., Yen, M., Fetzer, S., & Chien, T. W. (2015). Predictors of burnout among nurses in Taiwan. Community Mental Health Journal, 51(6), 733-737. https://doi.org/10.1007/s10597-014-9818-4
Legido-Quigley, H., Otero, L., la Parra, D., Alvarez-Dardet, C., Martin-Moreno, J. M., & McKee, M. (2013). Will austerity cuts dismantle the Spanish healthcare system? BMJ (Clinical Research Ed.), 346(June), f2363. https://doi.org/10.1136/bmj.f2363
Lin, F., St John, W., & McVeigh, C. (2009). Burnout among hospital nurses in China. Journal of Nursing Management, 17(3), 294-301. https://doi.org/10.1111/j.1365-2834.2008.00914.x
Liu, K., You, L. M., Chen, S. X., Hao, Y. T., Zhu, X. W., Zhang, L. F., & Aiken, L. H. (2012). The relationship between hospital work environment and nurse outcomes in Guangdong, China: A nurse questionnaire survey. Journal of Clinical Nursing, 21(9-10), 1476-1485. https://doi.org/10.1111/j.1365-2702.2011.03991.x
Lomeña, J. A., Campaña, F. M., Nuevo, G., Rosas, D., Berrocal, A., & García, F. (2004). Burnout y satisfacción laboral en Atención Primaria. Medicina de Familia (And), 5(3), 147-155.
Lu, H., While, A. E., & Louise Barriball, K. (2005). Job satisfaction among nurses: A literature review. International Journal of Nursing Studies, 42(2), 211-227. https://doi.org/10.1016/j.ijnurstu.2004.09.003
Ma, C., & Park, S. H. (2015). Hospital magnet status, unit work environment, and pressure ulcers. Journal of Nursing Scholarship: An Official Publication of Sigma Theta Tau International Honor Society of Nursing/Sigma Theta Tau, 47(6), 565-573. https://doi.org/10.1111/jnu.12173
Maslach, C., & Jackson, S. (1986). The Maslach burnout inventory: Manual, 2nd edition. Palo Alto, CA: Consulting Psychologists Press, Inc.
Maslach, C., Jackson, S., Seisdedos Cubero, N. (1997). In T. Ediciones (Eds.). MBI: Inventario “burnout” de Maslach: síndrome del “quemado” por estrés laboral asistencial: manual. Madrid: TEA Ediciones.
McHugh, M. D., Rochman, M. F., Sloane, D. M., Berg, R. A., Mancini, M. E., Nadkarni, V. M., … Aiken, L. H. (2016). Better nurse staffing and nurse work environments associated with increased survival of in-hospital cardiac arrest patients. Medical Care, 54(1), 74-80. https://doi.org/10.1097/MLR.0000000000000456
Ministerio de empleo y seguridad social. (2009). Gobierno de España. Observatorio de las Ocupaciones del Servicio Público de Empleo Estatal. Información mensual de mercado de trabajo de titulados universitarios Diciembre de 2009. Gobierno de España, Europe: Ministerio de Empleo y Seguridad Social. (pp 1-26). Retrieved from https://www.sepe.es/contenidos/observatorio/titulaciones/2009_12/titulados/ciencias_de_la_salud/ESTUDIO_TITULADOS_FI_4.pdf.
Ministerio de empleo y seguridad social (2014).Gobierno de España. Observatorio de las Ocupaciones del Servicio Público de Empleo Estatal. Información mensual de mercado de trabajo de titulados universitarios Diciembre de 2014. Gobierno de España, Europe: Ministerio de empleo y seguridad social. Retrieved from https://www.sepe.es/contenidos/observatorio/titulaciones/2014_12/titulados/ciencias_de_la_salud/ESTUDIO_TITULADOS_FI_4.pdf
Ministerio de Sanidad servicios sociales e Igualdad (2014). Informe anual del sistema nacional de salud 2013 situación de salud-sistema sanitario y opinión de los ciudadanos. Retrieved from www.msssi.gob.es.
Moreno-Casbas, M. T., Ruzafa-Martinez, M., Rol, M. A., Madrid, J. A., Serrano Pinto, A., González-María, E., … Network, S. Y. C. E. (2014). Sleepiness in Spanish nursing staff-influence of chronotype and care unit in circadian rhythm impairment: Research protocol. Journal of Advanced Nursing, 70(1), 211-219. https://doi.org/10.1111/jan.12200
Myhren, H., Ekeberg, O., & Stokland, O. (2013). Job satisfaction and burnout among intensive care unit nurses and physicians. Critical Care Research and Practice, 2013, 786176. https://doi.org/10.1155/2013/786176
Numminen, O., Ruoppa, E., Leino-Kilpi, H., Isoaho, H., Hupli, M., & Meretoja, R. (2016). Practice environment and its association with professional competence and work-related factors: Perception of newly graduated nurses. Journal of Nursing Management, 24(1), E1-E11. https://doi.org/10.1111/jonm.12280
National Hospital Catalogue (2007). Ministerio de Sanidad, Consumo y Bienestar Social. Available on: https://www.mscbs.gob.es/ciudadanos/prestaciones/centrosServiciosSNS/hospitales/home.htm
OECD (2015). Health at a glance 2015: OECD indicators. Paris, France: OECD Publishing. Retrieved from http://dx.doi.org/10.1787/health_glance-2015-en.
OECD (2017). Health at a glance 2017: OECD indicators. Paris, France: OECD Publishing. Retrieved from http://dx.doi.org/10.1787/health_glance-2017-en.
OECD/EU (2018). Health at a glance: Europe 2018: State of health in the EU cycle. Paris, France: OECD Publishing. Retrieved from https://doi.org/10.1787/health_glance_eur-2018-en.
Poghosyan, L., Aiken, L. H., & Sloane, D. M. (2009). Factor structure of the Maslach burnout inventory: An analysis of data from large scale cross-sectional surveys of nurses from eight countries. International Journal of Nursing Studies, 46(7), 894-902. https://doi.org/10.1016/j.ijnurstu.2009.03.004
Puialto, M., Antolín, R., & Moure, L. (2006). Prevalencia del síndrome del quemad@ y estudio de factores relacionados en l@s enfermer@s del CHUVI (complexo hospitalario universitàrio de vigo). Enfermeria Global, 8, 1-18.
Purdy, N., Spence-Laschinger, H., Finegan, J., Kerr, M., & Oliveira, F. (2010). Effects of work environments on nurse and patient outcomes. Journal of Nursing Management, 18(8), 901-913. https://doi.org/10.1111/j.1365-2834.2010.01172.x
Satse (2012a). Estudio descriptivo del clima laboral y las condiciones de trabajo de los profesionales de enfermería en España. Madrid, Spain: SATSE. Retrieved from http://www.satse.es/comunicacion/sala-de-prensa/informes/estudio-descriptivo-del-clima-laboral-y-las-condiciones-de-trabajo-de-los-profesionales-de-enfermeria-en-espana.
Satse (2012b). El sindicato de enfermería calcula que el recorte real de su salario supera el 20%. Acta Sanitaria.
Sermeus, W., Aiken, L. H., Van den Heede, K., Rafferty, A. M., Griffiths, P., Moreno-Casbas, M. T., … Zikos, D.; RN4CAST consortium, (2011). Nurse forecasting in Europe (RN4CAST): Rationale, design and methodology. BMC Nursing, 10(1), 6. https://doi.org/10.1186/1472-6955-10-6
Squires, A., Aiken, L. H., van den Heede, K., Sermeus, W., Bruyneel, L., Lindqvist, R., … Matthews, A. (2013). A systematic survey instrument translation process for multi- country, comparative health workforce studies. International Journal of Nursing Studies, 50(2), 264-273. https://doi.org/10.1016/j.ijnurstu.2012.02.015
Sutton, S. (2000). Interpreting cross-sectional data on stages of change. Psychology & Health, 15(2), 163-171. https://doi.org/10.1080/08870440008400298
Swiger, P. A., Patrician, P. A., Miltner, R. S. S., Raju, D., Breckenridge-Sproat, S., & Loan, L. A. (2017). The practice environment scale of the nursing work index: An updated review and recommendations for use. International Journal of Nursing Studies, 74, 76-84. https://doi.org/10.1016/j.ijnurstu.2017.06.003
Toh, S. G., Ang, E., & Devi, M. K. (2012). Systematic review on the relationship between the nursing shortage and job satisfaction, stress and burnout levels among nurses in oncology/haematology settings. International Journal of Evidence-Based Healthcare, 10(2), 126-141. https://doi.org/10.1111/j.1744-1609.2012.00271.x
Tourangeau, A., Hall, L. M., Doran, D., Petch, T., & Bloomberg, L. S. (2006). Measurement of nurse job satisfaction using the McClosky/Mueller satisfaction scale. Nursing Research, 55(2), 128-136. https://doi.org/10.1097/00006199-200603000-00008
Twigg, D. E., Myers, H., Duffield, C., Pugh, J. D., Gelder, L., & Roche, M. (2016). The impact of adding assistants in nursing to acute care hospital ward nurse staffing on adverse patient outcomes: An analysis of administrative health data. International Journal of Nursing Studies, 63, 189-200. https://doi.org/10.1016/j.ijnurstu.2016.09.008
Viscardi, M. K., Lin, P. S., & McHugh, M. D. (2014). Factors influencing job satisfaction of new graduate nurses participating in nurse residency programs: A systematic review. The Journal of Continuing Education in Nursing, 45(10), 439-450. https://doi.org/10.3928/00220124-20140925-15
Wang, S., & Liu, Y. (2015). Impact of professional nursing practice environment and psychological empowerment on nurses’ work engagement: Test of structural equation modelling. Journal of Nursing Management, 23(3), 287-296. https://doi.org/10.1111/jonm.12124
Warshawsky, N. E., & Havens, D. S. (2011). Global use of the practice environment scale of the nursing work index. Nursing Research, 60(1), 17-31. https://doi.org/10.1097/NNR.0b013e3181ffa79c
You, L.-M., Aiken, L. H., Sloane, D. M., Liu, K. E., He, G.-P., Hu, Y., … Sermeus, W. (2013). Hospital nursing, care quality, and patient satisfaction: Cross-sectional surveys of nurses and patients in hospitals in China and Europe. International Journal of Nursing Studies, 50(2), 154-161. https://doi.org/10.1016/j.ijnurstu.2012.05.003
Zhang, L.-F., You, L.-M., Liu, K., Zheng, J., Fang, J.-B., Lu, M.-M., … Bu, X.-Q. (2014). The association of Chinese hospital work environment with nurse burnout, job satisfaction, and intention to leave. Nursing Outlook, 62(2), 128-137. https://doi.org/10.1016/j.outlook.2013.10.010