|Year : 2018 | Volume
| Issue : 3 | Page : 302-313
The impact of psychiatric nurses’ psychological capital on their burnout and coping style
Safaa Mohamed Metwaly, Hanem Ahmed, Abd Elkhalek Ahmed
Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Zagazig University, Zagazig, Egypt
|Date of Submission||23-Sep-2018|
|Date of Acceptance||16-Oct-2018|
|Date of Web Publication||28-Dec-2018|
Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Zagazig University, Zagazig
Source of Support: None, Conflict of Interest: None
Background Nurses with a high level of psychological capital have the essential motivational and cognitive properties that can be used in any given work situation to protect them from work-related stress and burnout.
Aim This study aims to examine the impact of psychiatric nurses’ psychological capital on their burnout and coping style.
Participants and methods A descriptive correlational design was utilized in this study. This study was conducted at three psychiatric hospitals: El Azazi Hospital for mental illness, Banha Hospital for mental illness, and at the Psychiatric Department at Zagazig University Hospital. A simple, random sample composed of 139 nurses who are working at a previous mentioned setting was recruited for this study. Five tools were utilized in this study for data collection, sociodemographic data sheet, burnout scale, psychological capital questionnaire, brief coping inventory, and emotional approach coping scale.
Results The present study revealed that the level of burnout was moderate among the studied nurses, more than half of them had low level of psychological capital, about half of them had low level of problems − focused coping and near half of them had a high level of emotion-focused coping.
Conclusion On the basis of the finding of this study, it can be concluded that the burnout is a psychological problem among psychiatric nurses. Unfortunately, about one-half of the studied psychiatric nurses has moderate level of burnout and has low level of psychological capital. Also, about half of them utilize the emotion-focused coping style more frequently than problem-focused coping. When nurses have a high level of psychological capital, their level of burnout decreased.
Recommendation Intervention programs for nurses should be carried out to enhance their level of psychological capital (self-efficacy, hope, optimism, and resilience), improve their coping ability, and reduce their level of burnout are recommended.
Keywords: burnout, coping style, psychiatric nurses, psychological capital
|How to cite this article:|
Metwaly SM, Ahmed H, Ahmed AE. The impact of psychiatric nurses’ psychological capital on their burnout and coping style. Egypt Nurs J 2018;15:302-13
|How to cite this URL:|
Metwaly SM, Ahmed H, Ahmed AE. The impact of psychiatric nurses’ psychological capital on their burnout and coping style. Egypt Nurs J [serial online] 2018 [cited 2019 Jan 17];15:302-13. Available from: http://www.enj.eg.net/text.asp?2018/15/3/302/248964
| Introduction|| |
Burnout is defined as individual response to long-term exposure to emotional and interpersonal stressors at work. It has three dimensions as follows: emotional exhaustion, depersonalization, and reduced personal accomplishment. Emotional exhaustion describes feelings of intense emotional fatigue and absence of enthusiasm about work. Depersonalization reflects a conscious attempt to maintain distance between the individual and clients who he/she is caring for at work as well as the demonstration of negative attitudes and emotions toward clients at work. Reduced personal accomplishment is displayed in a decreased sense of self-worth, negative evaluation of work, lack of ability to experience pleasure, satisfaction, and a sense of accomplishment accompanied by performing the job (Ahmadi, 2016).
Burnout occurs in many occupations especially nursing, as nurses spend a significant amount of time in close contact with patients. Mental health nursing is subjected to high levels of burnout. Burnout not only affects psychiatric nurses but also organizations as well Hamaideh (2011). Burnout has many adverse effects on the physical and emotional health of health-care professionals, such as physical fatigue, cardiovascular disorders, and other organic diseases like anxiety, depression, and loss of motivation (Stathopoulou et al., 2011). Burnout may potentially affect an organization’s substructures, leading to decrease productivity in the workplace and deterioration in the quality of provided healthcare, which can have a negative impact on the health-care system in general (Kontodimopoulos et al., 2009).
Results of a previous study measuring the level of burnout among nurses working in public hospitals in different clinical settings indicated high levels of burnout among psychiatric nurses compared with nurses in other units (Sahraian et al., 2008). Burnout risk factors include exposure to aggressive behavior by clients, heavy workload, monotonous tasks, and conflicts with superiors and colleagues (Danhof-Pont et al., 2011).
Psychological capital is a person’s positive psychological state which includes four important personal resources, self-efficacy(self-confidence or trust in one’s capabilities to achieve a task), hope (ability to make positive motivational state), optimism (positive future anticipations), and resilience (persistence toward goals and when necessary redirecting pathways to goals, and positive coping and capacity to recover from failure) (Roche et al., 2014). These positive psychological features indicate that an individual’s positive consideration of situations and possibility for success is based on motivated effort and persistence (Pacheco, 2017).
The psychological capital has a significant and strong relationship with positive employee attitudes, such as job satisfaction, commitment, and psychological well-being at work (Avey et al., 2011; Ali, 2017).Strategies aimed at improving workers’ overall levels of psychological capital have the capability to decrease their stress symptoms, in addition to limited turnover rates (Russo and Stoykova, 2015). Many researchers have shown that persons high on psychological capital are better prepared to deal with stressors (Hicks and Knies, 2015; Luthans et al., 2015). Psychological capital relieves nurses’ burnout by influencing their coping style. The highest score of psychological capital among nurses indicate that they are more likely to develop positive coping styles (Ding et al., 2015).
Coping style is another issue which has an important association with burnout (Lievens and Vlerick, 2014). According to Lee et al. (2016), coping is defined as a person’s cognitive and behavioral efforts to manage internal and external demands of the person–environment transaction that is appraised as taxing or exceeding the person’s resources. Coping styles are divided into positive and negative categories. Positive coping is described by positive thoughts and clarifications under demanding situations. In difference, negative coping is distinguished by comforting coping styles and negative assessments when faced with stressful situations.
Individuals who often apply positive coping style perceive demanding situations as personal challenges. In this sense, they take constructive actions and create chances for growth (Ding et al., 2015). Moreover, they are unlikely to experience psychological distress than those who adopted negative coping (Loukzadeh, 2013). In the work location, positive coping is associated with positive emotions and behaviors which lead to a state of communicative well-being, a professional and personal development, and more personal capabilities and capitals that increase competence. Therefore, positive coping is characterized by problem-solving behavior and positive evaluation. In contrast, negative coping is notable by applying more emotion-focused coping and comforting coping style (Garrosa and Moreno-Jiménez, 2013).
Significance of the study
Burnout of the nurses not only influences their health but also affects the quality of patients care. Burnout is linked to increased occupational turnover, increased rate of absenteeism, negative job attitudes, negative emotions of nurses, loss of interest in caring for clients, and deterioration in idealism toward helping others. According to previous studies, majority of nurses have a high level of burnout. Most of these studies were carried out on nurses in general. There is a shortage of literature about burnout, psychological capital, and coping style among psychiatric nurses. Accordingly, it is important to notice variables influencing burnout among psychiatric nurses as it can help to make a positive work environment and enhance the psychological health of nurses as well as improve the healthcare of patients. This study emphasis the effect of psychological capital on burnout and coping style.
| Aim|| |
This study aims to determine the impact of psychological capital on psychiatric nurses’ burnout and coping styles.
What is the impact of psychiatric nurses’ psychological capital on their burnout and coping styles?
| Participants and methods|| |
Descriptive correlational design was utilized to accomplish the aim of this study.
This study was conducted at three psychiatric hospitals: El Azazi Hospital for Mental Illness at Abo-Hamad City and Benha Hospital for Mental Illness at Benha City and Psychiatric Department at Zagazig University Hospital at Zagazig City.
Sampling and method
Assuming that the total number of nurses on the job at the previous mentioned three hospitals is 220 nurses (Benha Hospital for mental illness 100 nurses, El Azazy Hospital for mental illness 100 nurses, and psychiatric department at Zagazig University Hospital 20 nurses). The prevalence of burnout among nurses is 74.6% (Ding et al., 2015). At a confidence level of 95% the total sample size is 126 nurses, 10% is added for non-response so that the total sample size is 139 nurses (65 nurses from Banha Hospital for mental illness, 65 from El Azazy Hospital for mental illness, and nine nurses from the Psychiatric Department at Zagazig University Hospital) calculated by Epi info 7 CBCEpi Info 7.1.30 (CDC, 2013).
Names of all nurses working at the three previous mentioned hospitals were obtained from the head nurses of each hospital. Name of each nurse in each separate hospital was written in a separate paper, then folded these papers and put them in a container. Random selection of the required number of nurses from each hospital was done by another person. This step was done for each one of the previous mentioned hospitals separately.
Tools of data collection
Five tools were utilized in this study for data collection. They were as following.
Tool I: sociodemographic characteristics of the studied nurses include variables such as age, sex, educational level, years of experience, marital state, residence, and income.
Tool 2 burnout scale: this scale was developed by Maslach and Jackson (1986). It consists of 22 items who were divided into three subscales describing their feelings associated with work. These subscales are emotional exhaustion (nine items assessing the feeling of diminished emotional resources by an individual’s work), depersonalization (five items assessing individual’s feelings of callousness or indifference toward those receiving care), and personal accomplishment (eight items assessing feelings of accomplishment and competency in working with people).
Burnout was measured using a seven-point Likert scale ranging from (0) means never to (6) means almost every day. High scores of emotional exhaustion and depersonalization subscales correspond with a low score on the personal accomplishment subscale indicate a high level of burnout. Moderate scores of the three subscales reveal a moderate level of burnout. Low scores on the emotional exhaustion and depersonalization subscales accompanied by high score on the personal accomplishment subscale indicate a low level of burnout. The cut-off points for burnout subscales can be described as follows: the emotional exhaustion subscale is considered low when the score is less than or equal to 16, moderate 17–26, and high greater than or equal to 27; depersonalization subscale, cut-off points are low (≤8), moderate (9–13), and high (≥14). In relation to personal accomplishment subscale, the cut-off points are low (≥37), moderate (36–31), and high (≤30).
Tool 3: psychological capital questionnaire: it was developed by Luthans et al. (2007) to assess the degree of psychological capital. It consists of 24 items divided into four domains of psychological capital namely self-efficacy, optimism, hope, and resiliency. Each subscale consists of six items.
Respondents rate each statement of the scale using a five-point Likert scale ranging from 1 means strongly disagree to 5 means strongly agree.
Cut-off level of psychological capital scale:
- 1 to less than 60% low.
- 60–90% moderate.
- Greatert than 90% high.
Tool 4: the brief cope inventory: this scale was developed by Carver et al. (1989) to measure problem-focused coping. It consists of 28 items assessing coping in several domains.
This scale was rated using a four-point Likert scale ranging from 1 means usually did not do this at all to 4 which means usually did this a lot. The level of problem-focused coping is considered high when the total score is greater than 91, moderate when the total score is 70–91, and low when the total score is less than 70.
Tool 5: emotional approach coping scale: this tool was adopted from Stanton et al. (1994) to measure emotion-focused coping. It consists of eight items.
This scale was rated using a four-point Likert scale ranging from 1 means usually did not do this at all to 4 which means usually did this a lot. The level of emotion-focused coping is considered high when the total score is greater than 26) moderate when the total score is 20–26, and low when the total score is less than 20.
Cut-off level of brief coping and emotional coping:
- Low level less than 50%.
- Moderate 50–75%.
- High level greater than 75%.
Content validity and reliability
Tools were translated into Arabic language using the translation and back-translation technique to ensure their original validity. Content validity of the tools was assessed by asking seven experts from the academic staff at the Faculty of Nursing, Zagazig University (psychiatric and mental health nursing and psychiatric medicine) who revised the tools for clarity, applicability, relevance, comprehensiveness, understanding, and ease for implementation. Their recommendation and suggestion were taken into consideration. Reliability of the tools was assessed by Cronbach’s α test in SPSS V.20 (SPSS Inc., Chicago, Illinois, USA). They show a good level of reliability as follows: burnout scale (α=0.73), psychological capital scale (α=0.82), brief coping scale (α=0.81), and emotional coping scale (α=0.75).
Before starting the actual study, a pilot study was conducted on 10% (14 nurses) of the total sample to evaluate the clarity and relevance of the tools, in addition to estimate the needed time for data collection. The researcher asked the participants to fill in the questionnaire and to note any questions that were confusing or hard to answer. The necessary modifications were done, namely rephrasing and utilizing simpler semantic for the statements. These nurses were excluded from the main study sample.
The researchers talked to the head nurses of the selected hospitals individually during regular working hours explaining to them the aim of the study and to gain their cooperation. The questionnaires were provided to nurses who agree to participate in the study after obtaining their informed consent for participation in the study and being informed about its aim. The average time to complete the questionnaire ranged from 30 to 45 min. Data collection lasted for 3 months from the beginning of October to the end of December 2017.
Administrative and ethical consideration
The researcher obtained an official permission by submitting an official letter from the faculty of nursing to the directors of the selected hospitals to get their permission for data collection. Nurses’ voluntary participation was confirmed. Clear instructions on how to complete the questionnaire were given. Confidentiality of the collected information was confirmed that it would be used only for the purpose of scientific research.
All data were collected, tabulated, and statistically analyzed using SPSS version 20.0 for Windows. Quantitative data were expressed as the mean±SD and qualitative data were expressed as number and percentage. Analysis of variance test was used to compare between more than two groups of normally distributed variables. Spearman’s rank correlation coefficient was calculated to assess the relationship between various study variables, ‘+’ sign indicates direct correlation, and ‘−’ sign indicates inverse correlation, also values near 1 indicates strong correlation and values near 0 indicates weak correlation. A P value less than 0.05 was considered statistically significant (S) and a P value greater than or equal to 0.05 was considered statistically nonsignificant (NS).
| Results|| |
[Table 1] shows that 75% of the studied nurses were women. According to age, 64% of them were lower than 30 years old with a mean age of 31±8. Regarding educational degree, 79% of the studied nurses were diploma holders or from technical institutes with equal percent (39.5%). As regards years of experience 63% of studied nurses have a work experience of 10 years or less; 96% of studied nurses were married and 77% were living in rural areas. As regards income, 60.5% of them have sufficient income.
[Table 2] and [Figure 1] show that hope and resilience had the highest mean scores (23±4). The mean score of total psychological capital was 89±13. The level of psychological capital was low in 57.3% of the studied subjects.
|Table 2 Frequency distribution of psychological capital among the studied nurses (n=139)|
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|Figure 1 Frequency distribution level of psychological capital parameters among the studied group.|
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[Table 3] and [Figure 2] reveal that 44.6% of studied subjects were high in emotional exhaustion; however, 72.6% of them were low in depersonalization and 45.3% were low in personal accomplishment. The mean score of total burnout in the studied sample was 63±22.
|Table 3 Frequency distribution of burnout among the studied nurses (n=139)|
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|Figure 2 Frequency distribution level of burnout parameters among the studied nurses.|
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[Table 4] shows that the level of problem-focused coping was low in 49% of studied subjects, while the level of emotion-focused coping was high in 44% of them.
|Table 4 Frequency distribution of coping style among the studied nurses (n=139)|
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[Table 5] shows a positive significant correlation between burnout and education level where r=0.22 at P=0.01, but negative significant correlation between burnout score and income where r=−0.32 at P=0.0001.
|Table 5 Relations between main studied variables and demographic characteristics of the studied nurses (n=139)|
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As observed in [Table 6], there was a statistically significant positive correlation between emotional exhaustion and depersonalization. There was also statistically significant positive correlation between self-efficacy and reduced personal accomplishment. Optimism had statistically significant positive correlations with reduced personal accomplishment and self-efficacy. Regarding hope, there was a negative correlation between hope and depersonalization; however, it correlates positively with reduced personal accomplishment, self-efficacy, and optimism. Also, there were positive correlations between resilience and reduced personal accomplishment, self-efficacy, optimism, and hope; however it was negatively correlated with depersonalization. The same table also shows that there were positive correlations between problem-focused coping and self-efficacy and resilience. There was negative correlation between problem-focused coping and emotion-focused coping.
| Discussion|| |
Nursing is a highly stressful profession. Nurses are at risk of developing burnout as a consequence of an emotionally challenging profession (Carolina, 2010). Burnout among nurses leads to nurses experiencing tiredness, chronic fatigue, anger, exhaustion, irritability, frequent headaches, gastrointestinal disorders, abnormal weight loss or gain, insomnia, depression, and breathing difficulties. It is associated with increased rate of job withdrawal, absenteeism, and turnover (Matin et al., 2012; El-Demerdash et al., 2013; Ali, 2017).
In the current study nearly two-thirds of the studied nurses’ age were 30 years or less with a mean of 31±8, three quarters of them were women, and most of them were married. This is in agreement with the finding of the Elrassas et al. (2016) study of burnout syndrome among the nursing staff in Egypt, who found that the mean age of the psychiatric nurse group was 36.5±7 years, the majority of the respondents were women (84%) and married (62.6%).
The current study finding revealed that work experience was 10 years or less in less than two-third of studied nurses and a minority of them had bachelor’s degree or postgraduate education. This result goes in line with that of Yim et al. (2017) study ‘Psychological Capital and Occupational Stress among Nurses in Korea’, who found that the highest proportion of their studied sample have less than 10 years of work experience; however, contradicting with the current study findings, they found that the greatest proportion of their studied sample had a bachelor’s degree.
The present study results indicated that the highest score of psychological capital subscales was usually for resilience and hope, followed by self-efficacy and the least for optimism. This was to some extent in harmony with Liu et al. (2012) and Zhou et al. (2017) who found that among the subscales of psychological capital, resilience was the most prominent trait, followed by optimism, self-efficacy, and hope.
The findings of this study revealed that the studied nurses experience high burnout in emotional exhaustion, low burnout in depersonalization, and low burnout in a reduced sense of personal accomplishment. This result may be due to that nurses working in psychiatric wards suffer not only from nursing shortages, but also from many factors such as increased workload, conflicts with colleagues and supervisors, insufficient rewards such as low salaries and lack of job promotion, aggressive behavior either verbally or physically from the patients, stigma of working in psychiatric hospitals, scarcity of patients’ recovery, complexity of patients’ needs, difficulties related to dealing with patients who are dependent, at risk for suicide and have different words, thoughts, and behaviors. All these factors increase the risk of burnout among psychiatric nurses. Those results were consistent with those of a study done by El-Demerdash et al. (2013) who studied the relationship between burnout and organizational commitment among nurses at Tanta University Hospitals. They found that more than half of the studied nurses experience a high level of emotional exhaustion, and nearly all of them experienced a low level of personal accomplishment. Also, Hamaideh (2011) indicated that Jordanian mental health nurses experience a high level of emotional exhaustion and moderate levels of depersonalization and personal accomplishment.
In agreement with the current study result, the Ahanchian et al. (2015) study of job burnout among psychiatric nurses found that increased workload, dependence, ambiguous responsibilities and roles, and insufficient support from nurses were accompanied by burnout. As well, this was consistent with Al-Nabhani et al. (2016) who conducted a study about burnout, stress, and coping among nurses, reported that nurses are the most susceptible group among healthcare professionals to experience burnout. They explained that this might be related to numerous factors, such as increased workload, the burden of caring for many patients at the same time, doing shift work and the continuous worry about developing infection from clients. Other factors, such as hostile manners of some patients, continuous requirements of the physicians and their patients, lack of support from superiors and colleagues, and unclear work accountabilities, also play a role. Also, in a similar study conducted by Farahbod et al. (2015) showed that nurses had a high burnout in emotional exhaustion, moderate burnout in depersonalization, and low burnout in a reduced sense of personal accomplishment.
The result of this study revealed that about half of the studied nurses experience low level of problem-focused coping while less than half of them experience a high level of emotional approach coping in dealing with their problems. This finding goes in line with the result of Ramezanli et al. (2015), who found that the level of problem-focused coping strategies among 43% of the sample were poor, average in 40.2%, and satisfactory in 16.8% of them. In relation to emotion-approach coping strategies, the level of its use was poor in 33.6% of the sample, average in 25.2%, and satisfactory in 41.1% of the studied sample. This is in contrast with the finding of Abd-El Bary (2015) who found that more than one- quarter of the studied sample had high problem-focused coping and nearly all of them had low emotional coping.
The results of the current study have shown that there was a significant positive relation between burnout and higher educational level (postgraduate).This may be due to that postgraduate nurses act as supervisors in most cases and have greater responsibilities as confirming patient satisfaction with the provided care and make sure that the nursing staff are compliant with standards and instructional regulations. This finding goes in line with that of Bradley et al. (2015), who indicated that nurses with higher levels of education experienced high levels of burnout which was attributed to increased responsibilities.
In congruent with the previous results, a study on burnout and psychosocial care among Australian nurses done by Mcmillan et al. (2016) found that burnout was low among nurses who had been worked as a nurse for more than 5 years and among those nurses who have postgraduate degrees.
This study findings revealed that there was significant positive relation between burnout and insufficient income among the studied nurses. This may be due to that the nurses’ salaries are always low and insufficient for their families’ requirements. They are always worried regarding the future needs of their kids and how they can afford enough money for them, which would increase their sense of emotional tension and burnout. This result is in agreement with that of Wu et al. (2014), who conducted a study on burnout among Chinese nurses, that lower levels of experience and income, inadequate nursing qualification, extensive working hours per week correlated with burnout.
There was a statistically significant positive correlation between emotional exhaustion and depersonalization. This is in contrast with the finding of Alsaqri (2014) who found that emotional exhaustion has negative correlation with depersonalization. Also, the current study result revealed that there was a significant positive correlation between self-efficacy and personal accomplishment; this is may be due to that individuals with a high level of self-efficacy are enthusiastic and have more confidence concerning their abilities in accomplishing their goals, so they exert all needed efforts to accomplish these goals. Moreover, they are able to manage and cope with the stressful event they face in their work situations. This finding comes in line with Demerouti et al. (2011), who found that individuals with higher self-efficacy are able to succeed in difficult tasks, insistent in works, and have strong confidence that their abilities will assist them to succeed. Similarly, Oles (2017) indicated that personnel who have high levels of self-efficacy are self-motivated. They are able to succeed inspite of the difficulties they face. They follow tasks, put goals and subgoals for themselves, and take the needed time to achieve these goals. A recent study carried out in Arizona, by Pacheco (2017) revealed that self-efficacy is directly related to the personal accomplishment component of burnout. In this context, Ventura et al. (2015) highlighted that employees with high levels of professional self-efficacy will realize more challenge requirements and little barriers, which will lead to less burnout and more work engagement.
The result of the present study indicated that optimism is positively correlated with personal accomplishment and self-efficacy. This may be due to that optimistic people always hold positive anticipations and remain confident about the future, even when they are dealing with stressful situations. They make decisions easily, and find better solutions in handling any problems. This would increase their self-esteem and sense of personal accomplishment. This goes in line with Herbert (2011) and Peng et al. (2013), who reported that optimistic individuals display positive emotions which would increase their psychological well-being, even when they are dealing with difficult situations. This would improve their abilities of adjustment to stressful events and increase their ability to lessen the negative emotions and moods accompanying burnout (e.g. emotional exhaustion and frustration). Recently, Rehman et al. (2017), in their study in Pakistan indicated that an individual’s optimism is significantly related to his/her trust in his/her capabilities.
The findings of the current study indicated that hope was negatively correlated with depersonalization and positively correlated with personal accomplishment, self-efficacy, and optimism. This may be experienced as the most hopeful individuals have certain work goals and identify different ways of achieving these goals. They are confident that goal achievement will support them to make their life better. Therefore, they are less likely to experience the negative effects of burnout (depersonalization). This finding goes in line with that of Oles (2017), who found that employees high in hope are those who are intrinsically motivated as hope assists them to recognize the several methods of achieving their goals and modifying them according to the situations. They are able to protect themselves from job stressors and burnout by adjusting and modifying their work goals.
The result of the present study indicated that resilience was positively correlated with personal accomplishment, self-efficacy, optimism, and hope; however, it was negatively correlated with depersonalization. This may be due to that individuals with a high level of resiliency are able to overcome frustration and failure more easily, and this adaptive ability enhances their personal development and competence, and helps them overcome emotional exhaustion and stress related to work. Thus, their feeling of personal accomplishment and level of self-efficacy would be increased. This finding is congruent with those of Taku (2014) and Rushton et al. (2015), who indicated that higher levels of resilience protect nurses from emotional exhaustion and enhance their level of personal accomplishment by this way lowering their level of burnout. In the same line, Riollib et al. (2012) found that a nurse, who is efficacious, optimistic, hopeful, and ego resilient is considered to have enough resources to prevent feeling distress, being overwhelmed, and experiences burnout. Another study done by Peng et al. (2013) found that when nurses possess high levels of endurance and adjustment ability, are hopeful about their jobs, have optimistic attitudes, their emotional, physical, and psychological depletion will be at the lower level, and they are rarely subjected to job burnout. This finding is in harmony with those of the Wang et al. (2017) very recent study in China which indicated that individuals who have higher levels of psychological capital work more efficiently to achieve success, are more self-confident and maintain the will to achieve goals or tasks, gain experience and become stronger after any hazardous situations or personal setbacks, and develop positive anticipations and qualities concerning consequences.
The result of the present study indicated that all dimensions of psychological capital (self-efficacy, optimism, hope, and resilience) were positively correlated with personal accomplishment; while (hope and resilience) were negatively correlated with depersonalization. This describes the answer of the research question. This is consistent with the finding of Cheung et al. (2011) and Li et al. (2015), who revealed that psychological capital was negatively correlated with emotional exhaustion and depersonalization, and positively correlated with personal accomplishment. As well, Peng et al. (2013) stated that nurses who are optimistic, resilient, hopeful, and have high levels of self-efficacy (display high levels of psychological capital) tend to have positive work attitudes and excel at work and unlikely to depersonalize their service and feel burnout. This result goes in line with that of Pu et al. (2017) whose recent study done in China found that individuals who possess high levels of psychological capital are more likely to have more optimistic anticipations of the future, find it easier to accomplish their work accountabilities, have confidence in their abilities to cope with challenges, and in general avoid job burnout compared with individuals with low levels of psychological capital.
The result of the present study indicated that all variables of psychological capital (self-efficacy, optimism, hope, and resilience) correlated with each other. In agreement with the recent finding, Rehman et al. (2017) indicated that having high a level of self-efficacy results in an individual’s greater interest in difficult tasks and this interest will motivate him/her to exert effort to get mastery on it This deeper understanding of tasks can increase his/her optimism in going for things he/she has not attempted yet. This optimism encourages the person to raise his/her purpose and give rise to hope for positive consequences of his/her efforts that result in goal-directed point of view and a tendency to maintain confidence and maintain doing and increase the ability to become resilient to any challenges in the way. These capacities of faith, hope, optimism, and resilience may additionally help in solving problems in new job situations of an individual and improve the ability to do better than friends in stressful conditions.
The findings of this study revealed that there was a significant positive correlation between self-efficacy, resilience, and problem-focused coping. This describes the answer of the research question. This finding may be due to that an individual with high self-efficacy has confidence in his ability to solve any problem and difficult that may face him in his/her work. Moreover, persons who utilize problem-focused coping style do not consider hazards, and requirements such as possible risk, injury, or failure. Instead, they realize difficult situations as personal challenges. This result goes in line with those of Ding et al. (2015) and Garrosa and Moreno-Jiménez (2013), who found that problem-focused coping and positive consideration of difficult situations could generate positive manners and feelings, which give rise to better proficiency and personal development; as a result, their personal accomplishment would be improved. Previous research conducted by Herbert (2011) has shown that people with a high level of self-efficacy manage and cope with any threat they may face and their consequent stress more effectively than people with a low level of self-efficacy. In the same line, the Deklava et al. (2014) study and Li and He (2015) reported that nurses who had a high psychological capital were more likely to develop high problem-focused coping and low emotion-focused coping that decreased their job burnout.
Similarly, Mealer et al. (2012) found that nurses who are highly resilient were expected to utilize positive coping strategies to adjust to the stressful work environment by participating in supportive social networks, identifying with spirituality and rituals, optimism, and having a resilient role model.
The current study findings revealed that there was a significant negative correlation between emotion-focused coping and problem-focused coping. This result may be due to that problem-focused coping involves doing something to solve the problem such as finding different solutions and making a plan of action. In contrast an individual utilizing emotion-approach coping focuses on the undesirable emotional influences of stressful situations instead of finding a way to improve their causes. This is inconsistent with the finding of Abd-El Bary (2015) who found that problem-focused coping was positively correlated with emotion-focused coping among the studied sample.
| Conclusion|| |
On the basis of the finding of this study, it can be concluded that burnout is a psychological problem among psychiatric nurses. Unfortunately, about one-half of the studied psychiatric nurses has a moderate level of burnout and has a low level of psychological capital. Also, about half of them utilize emotion-focused coping styles more frequently than problem-focused coping. When nurses have a high level of psychological capital, their level of burnout decreased.
- Intervention programs are recommended for nurses to enhance their level of psychological capital (self-efficacy, hope, optimism, and resilience), improve their coping ability, and to reduce their level of burnout.
- Equal access for staff members to the attendance of in-service training, workshops, and seminars should be implemented.
- Further researches are required to determine nurses’ burnout and to investigate their needs for its prevention.
- Periodical assessment of nurses’ burnout should be done regularly for early detection and develop training programs to improve their coping abilities and decrease burnout.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2]
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]