Highlights
- •Work-family balance reduces job stress.
- •There was a high correlation of job stressors with development of burnout.
- •Burnout mediates the relationship between job stress and work engagement.
- •Executive nurse leaders can consider developing policies focused on clinician wellness.
Abstract
Background
Minimal research exists on how engagement, burnout, work-family balance, and job stressors
impact advanced practice nurses and physician assistants, collectively referred to
advanced practice providers (APPs).
Purpose
To investigate the interrelationships among burnout, job stressors, work-family balance,
and engagement with APPs.
Methods
An online questionnaire was distributed to APPs working in four healthcare systems.
A total of 1,216 APPs completed the survey. A hypothesized model was tested using
structural equation modeling.
Findings
There was a high correlation of job stressors with development of burnout. A significant
negative effect between job stress and work engagement was supported; however, indirect
effects of stress through job burnout had a stronger impact on work engagement. Higher
levels of work-family balance contributed to a lower level of stress experienced by
providers.
Discussion
Organizational leaders desiring to improve employee engagement and reduce burnout
need to focus on the significance of work-family balance to job stressors.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Nursing OutlookAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Interventions to alleviate burnout symptoms and support return to work among employees with burnout: Systematic review and meta-analysis.Burnout Research. 2017; 4: 1-11https://doi.org/10.1016/j.burn.2017.02.001
- Nurses' reports on hospital care in five countries.Health Affairs. 2001; 20: 43-53https://doi.org/10.1377/hlthaff.20.3.43
- Assessing the progress on the Institute of Medicine the future of nursing. (Committee for assessing progress on implementing the recommendation of the Institute of Medicine report: The future of nursing: leading change, advancing health).National Academies Press, Washington, D.C.2015
- Structural equation modeling in practice: A review and recommended two-step approach.Psychological Bulletin. 1988; 103: 411-423https://doi.org/10.1037/0033-2909.103.3.411
- Job resources buffer the impact of job demands on burnout.Journal of Occupational Health Psychology. 2005; 10: 170-180https://doi.org/10.1037/1076-8998.10.2.170
- Toward a dual-process model of work-home interference.Work and Occupations. 2004; 31: 345-366https://doi.org/10.1177/0730888404266349
- Burnout and depressive symptoms are not primarily linked to perceived organizational problems.Psychology, Health & Medicine. 2018; 23: 1094-1105https://doi.org/10.1080/13548506.2018.1476725
- Nurse practitioners’ role perception, stress, satisfaction, and intent to stay at a Midwestern academic medical center.Journal of the American Association of Nurse Practitioners. 2016; 28: 269-276https://doi.org/10.1002/2327-6924.12278
- Nursing specialty and burnout.Psychology, Health & Medicine. 2007; 12: 148-154https://doi.org/10.1080/13548500600568290
- The struggle with employee engagement: Measures and construct clarification using five samples.Journal of Applied Psychology. 2016; 101: 1201-1227https://doi.org/10.1037/apl0000124
- Is work-family balance more than conflict and enrichment?.Human Relations. 2009; 62: 1459-1486https://doi.org/10.1177/0018726709336500
- Practice pattern and professional issues of nurse practitioners in mechanical circulatory support programs in the United States: A survey report.Progress in Transplantation. 2012; 22: 229-236https://doi.org/10.7182/pit2012503
- Job burnout and employee engagement: A meta-analytic examination of construct proliferation.Journal of Management. 2012; 38: 1550-1581https://doi.org/10.1177/0149206311415252
- The Job Demands–Resources model: Challenges for future research.Journal of Industrial Psychology. 2011; 37: 1-9https://doi.org/10.4102/sajip.v37i2.974
- The job demands resources model of burnout.Journal of Applied Psychology. 2001; 86: 499-512https://doi.org/10.1037/0021-9010.86.3.499
- Burnout and work engagement: A thorough investigation of the independency of both constructs.Journal of Occupational Health Psychology. 2010; 15: 209-222https://doi.org/10.1037/a0019408
- Novice nurse practitioner workforce transition and turnover in primary care.Journal of the American Association of Nurse Practitioners. 2017; 29: 26-34https://doi.org/10.1002/2327-6924.12381
- Abbreviated mindfulness intervention for job satisfaction, quality of life, and compassion in primary care clinicians: A pilot study.Annals of Family Medicine. 2013; 11: 412-420https://doi.org/10.1370/afm.1511
- Non-response: Implementing a sample design.Survey Research Methods. Sage Publications, Thousand Oaks, CA2014: 42-60
- Staff burn-out.Journal of Social Issues. 1974; 30: 159-165https://doi.org/10.1111/j.1540-4560.1974.tb00706.x
- Job stressors, job involvement and employee health: A test of identity theory.Journal of Occupational and Organizational Psychology. 1995; 68: 1-11https://doi.org/10.1111/j.2044-8325.1995.tb00684.x
- Psychosocial and professional characteristics of burnout in Swiss primary care practitioners: A cross-sectional survey.Swiss Medical Weekly. 2005; 135: 101-108https://doi.org/10.4414/smw.2005.10841
- Predictors of nurse practitioner retention.Journal of the American Association of Nurse Practitioners. 2018; 30: 280-284https://doi.org/10.1097/JXX.0000000000000049
- National and regional projections of supply and demand for primary care practitioners: 2013-2025.2016 (Retrieved July 20, 2018, from:)
- The association of team-specific workload and staffing with odds of burnout among VA primary care team members.Journal of General Internal Medicine. 2017; 32: 760-766https://doi.org/10.1007/s11606-017-4011-4
- A test of the Maslach Burnout Inventory in three samples of healthcare professionals.Work & Stress. 2000; 14: 35-50https://doi.org/10.1080/026783700417212
- A meta-analytic examination of the correlates of the three dimensions of job burnout.Journal of Applied Psychology. 1996; 81: 123-133https://doi.org/10.1037/0021-9010.81.2.123
- Demand, values, and burnout: Relevance for physicians.Canadian Family Physician. 2009; 55 (e1-6. Retrieved from): 1224-1225
- Making sense of work life: A structural model of burnout.Journal of Applied Social Psychology. 2010; 40: 57-75https://doi.org/10.1111/j.1559-1816.2009.00563.x
- Predicting and preventing physician burnout: Results from the United States and the Netherlands.The American Journal of Medicine. 2001; 11: 170-175https://doi.org/10.1016/s0002-9343(01)00814-2
- The Maslach burnout inventory – Human services survey.Mind Garden, Inc., 1981 (MBI-HHS)
- Understanding the burnout experience: Recent research and its implications for psychiatry.World Psychiatry. 2016; 15: 1-9https://doi.org/10.1002/wps.20311
- Job burnout.Annual Review of Psychology. 2001; 52: 397-422https://doi.org/10.1146/annurev.psych.52.1.397
- Clarifying conditions and decision points for mediational type inferences in organizational behavior.Journal of Organizational Behavior. 2006; 27: 1031-1056https://doi.org/10.1002/job.406
- Job demands and resources as antecedent of work engagement: A longitudinal study.Journal of Vocational Behavior. 2007; 70: 149-171https://doi.org/10.1016/j.jvb.2006.09.002
- Nurses’ widespread job dissatisfaction, burnout, and frustration with health benefits signal problems for patient care.Health Affairs. 2011; 30: 202-210https://doi.org/10.1377/hlthaff.2010.0100
- Understanding nurse anesthetists’ intention to leave their job: How burnout and job satisfaction mediate the impact of personality and workplace characteristics.Health Care Management Review. 2011; 36: 155-163https://doi.org/10.1097/HMR.0b013e3181fb0f41
- Improving quality and safety in the hospital: The link between organizational culture, burnout, and quality of care.British Journal of Health Psychology. 2013; 18: 656-662https://doi.org/10.1111/bjhp.12045
- Mplus user’s guide: Statistical analysis with latent variables.7 ed. Muthén & Muthén, Los Angeles, CA1998-2012
- Controlled interventions to reduce burnout in physicians: A systematic review and meta-analysis.JAMA Internal Medicine. 2017; 177: 195-205https://doi.org/10.1001/jamainternmed.2016.7674
- Common method biases in behavioral research: A critical review of the literature and recommended remedies.Journal of Applied Psychology. 2003; 88: 879-903https://doi.org/10.1037/0021-9010.88.5.879
- Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models.Behavior Research Methods. 2008; 40: 879-891https://doi.org/10.3758/BRM.40.3.879
- Job demands, job resources, and their relationship with burnout and engagement: a multi-sample study.Journal of Organizational Behavior. 2004; 25: 293-315https://doi.org/10.1002/job.248
- The measurement of work engagement with a short questionnaire.Educational and Psychological Measurement. 2006; 66: 701-716https://doi.org/10.1177/0013164405282471
- The burnout companion to research and practice: A critical analysis.Taylor & Francis, London, England1998
- Burnout: Thirty-Five years of research and practice.Career Development Inventory. 2009; 14: 204-220https://doi.org/10.1108/13620430910966406
- The construct validity of the Utrecht work engagement scale: Multisample and longitudinal evidence.Journal of Happiness Studies. 2009; 10: 459-481https://doi.org/10.1007/s10902-008-9100-y
- Burnout and satisfaction with work-life balance among US physicians relative to the general US population.Archives of Internal Medicine. 2012; 172: 1377-1385https://doi.org/10.1001/archinternmed.2012.3199
- Changes in burnout and satisfaction with work-life balance in physicians and the general U.S. working population between 2011 and 2014.Mayo Clinic Proceedings. 2015; 90: 1600-1613https://doi.org/10.1016/j.mayocp.2015.08.023
- Executive leadership and physician well-being: Nine organizational strategies to promote engagement and reduce burnout.Mayo Clinic Proceedings. 2017; 92: 129-146https://doi.org/10.1016/j.mayocp.2016.10.004
- Work hours and caseload as predictors of physician burnout: The mediating effects by perceived workload and by autonomy.Applied Psychology. 2010; 59: 539-565https://doi.org/10.1111/j.1464-0597.2009.00411.x
- Individual and organizational psychosocial predictors of hospital doctors’ work-related well-being: A multi-level and moderation perspective.Health Care Management Review. 2018; (Advance online publication)https://doi.org/10.1097/HMR.0000000000000207
- Organizational stressors, work- family interface, and the role of gender in the hospital: Experiences from Turkey.British Journal of Health Psychology. 2014; 19: 442-458https://doi.org/10.1111/bjhp.12041
- Formulation of work stress in 1960-2000: Analysis of scientific works from the perspective of historical sociology.Social Science & Medicine. 2012; 75: 784-794https://doi.org/10.1016/j.socscimed.2012.04.014
- Work-based resources as moderators of the relationship between hours and satisfaction with work-family balance.Journal of Applied Psychology. 2007; 92: 1512-1523https://doi.org/10.1037/0021-9010.92.6.1512
- Validation of single-item screening measures for provider burnout in a rural health care network.Evaluation & the Health Professions. 2016; 39: 215-225https://doi.org/10.1177/0163278715573866
- Interventions to prevent and reduce physician burnout: A systematic review and meta-analysis.The Lancet. 2016; 388: 2272-2281https://doi.org/10.1016/S0140-6736(16)31279-X
- Physician burnout: Contributors, consequences and solutions.Journal of Internal Medicine. 2018; 283: 516-529https://doi.org/10.1111/joim.12752
Article info
Publication history
Published online: September 23, 2019
Accepted:
September 18,
2019
Received in revised form:
September 4,
2019
Received:
April 4,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
