Determinants of work-life conflict and its role in burnout among nursing staff

Du Preez, Tilani (2017-03)

Thesis (PhD)--Stellenbosch University, 2017.

Thesis

ENGLISH SUMMARY : The occupation of nursing is a high risk, high pressure, and labour-intensive profession in the Health Care system. The Health Care system is important for the well-being of the society, therefore it is vital for nursing practitioners to provide quality care to the society. The nursing shortage in South Africa is a problem, in both the private and public health sectors. Some of the challenges that nurses may experience daily is a shortage of resources and staff, illegitimate tasks, emotional distress, poor co-worker performance and poor management. All these demanding factors may be linked to the burnout syndrome, which is especially evident in occupations that support people, like nursing. Nurses are consequently leaving SA to work overseas for better working conditions and pay. The Job Demands-Resources model was used as a model to identify the variables that contribute to work-life interference and burnout. This study considered certain job demands (role overload and emotional labour) and job resources (organisational support and work-life culture), as well as family demands (care-giving responsibilities) and a family resources (marital satisfaction), that may have an effect on the level of work-life interference and burnout among nurses. Psychological Capital was also considered as a personal resource that may have an effect on the levels of work-life interference and burnout experienced. All these variables were identified as possible factors that may explain why variance in work-life conflict exists and the impact it has on the levels of burnout among nurses. The ex post facto survey study took place in one of the largest private hospitals in South Africa, situated in Bloemfontein. Quantitative data was collected with a self-compiled and self-administrated questionnaire on all the variables that were hypothesised to have an effect on the variance in work-life conflict under the nurses. A non-probability sample of 106 nursing staff members, who were in a long-term relationship and/or married, participated in the study. The self-compiled questionnaire consisted of psychometric instruments that were selected for inclusion based on their psychometric properties. The following measurements were included: Survey Work-Home Interaction Nijmegen instrument; Job Demands-Resource Scale; Copenhagen Burnout Inventory; Psychological Capital Questionnaire; Emotional Labour Scale; ENRICH (Enriching and Nurturing Relationship Issues, Communication and Happiness) Marital Satisfaction Scale (EMS) and a work-life culture scale. An ex post facto correlational design was used to test the formulated hypotheses in this research study. Of the eight main effect hypotheses, only four hypotheses were supported, namely hypotheses 1, 2, 3 and 12, whereas hypotheses 4, 5, 9 and 10 were not supported. In the case of the moderating effects only one hypothesis was supported, namely hypothesis 13, which dealt with PsyCap as a moderator of the relationship between role overload and work-life conflict. Hypotheses 15, 16 and 17 tested the mediating effects in this study, and only two of the three mediating paths were found to be significant. Work-life conflict mediated the relationship between role overload and burnout, and also between emotional labour and burnout. The findings of this study contribute to the body of knowledge regarding the antecedents of work-life interference and how it is related to burnout among nurses, as well as to the body of knowledge regarding the healthcare system. The results indicate that nurses do experience work-life conflict and burnout, and also elucidated the fact that their job resources, job demands, and personal resources should be regarded as malleable and appropriate targets of managerial interventions.

AFRIKAANSE OPSOMMING : Die verpleegkundige beroep is bekend as ‘n hoe risiko, hoe druk, en arbeidsintensiewe professie binne die gesondheidsorgsisteem. Die gesondheidsorgsisteem is belangrik vir die welsyn van die samelewing, daarom is dit noodsaaklik vir die verpleers om gehalte sorg te verskaf aan die gemeenskap se lede. Die tekort aan verpleegsters is in Suid-Afrika 'n probleem, in beide die private-en openbare gesondheidsektore. Sommige van die uitdagings wat verpleegsters daagliks ervaar is 'n tekort aan hulpbronne en personeel, nie-legitieme take, emosionele nood, swak medewerkerprestasies en swak bestuur. Al hierdie veeleisende faktore kan gekoppel word aan die sindroom van uitbranding, wat veral sigbaar is in beroepe, soos verpleging, wat ander mense versorg. Verpleegsters verlaat gevolglik SA om oorsee te gaan werk vir beter werksomstandighede en betaling. Die model van werkseise en hulpbronne (Job Demand-Resource model) is gebruik om die veranderlikes te identifiseer wat ‘n invoed op werkslewekonflik (work-life conflict) en uitbranding (burnout) het. Die studie het op s-ekere veranderlikes gefokus soos werkeise (roloorlading en emosionele arbeid) en werkshulpbronne (organisatoriese ondersteuning en werkslewe-kultuur), sowel as famile-eise (soos familie verantwoordelikhede) en familehulpbronne (huweliksbevrediging), wat ‘n effek op die werkslewe-konflik onder die verpleegsters mag he. Sielkundige kapitaal (Psychological capital) is ook oorweeg as ‘n persoonlike hulpbron wat ‘n effek op werkslewe-konflik en uitbranding kan he. Al hierdie veranderlikes is geidentifiseer as moontlike faktore wat kan verklaar waarom daar variansie in die werkslewe-konflik bestaan en wat die impak daarvan op die vlakke van uitbranding onder verpleegsters is. ‘n Ex post facto opnamestudie is onderneem in een van die grootste private hospitale in Bloemfontein, Suid-Afrika. Die studie het gebruik gemaak van kwantitatiewe data wat deur middel van ‘n self-saamgstelde en self-geadministreerde vraelys ingesamel is, wat uit al die veranderlikes bestaan wat hipoteties 'n invloed op die variansie in die werkslewe-konflik en uitbranding onder verpleegsters kan he. ‘n Gerieflikheidsteekproef van 106 verpleers wat in ‘n langtermyn verhouding en/of getroud was, het aan die studie deelgeneem. Die self-saamgestelde vraelys het uit verskillende psigometriese instrumente bestaan wat gekies is op grond van hulle goeie psigometriese eienskappe. Die volgende instrumente is ingesluit: Survey Work-Home Interaction Nijmegen instrument; Job Demands-Resource Scale; Copenhagen Burnout Inventory; Psychological Capital Questionnaire; Emotional Labour Scale; ENRICH (Enriching and Nurturing Relationship Issues, Communication and Happiness) Marital Satisfaction Scale (EMS) en ‘n werk-lewe-kultuurvraelys. ‘n Ex post facto korrelasie-ontwerp is gebruik om die geformuleerde hipoteses in hierdie studie te toets. Van die agt hipoteses oor die hoofeffekte (main effects), is ondersteuning vir slegs vier van die hipoteses gevind, naamlik. hipoteses 1, 2, 3 en 12, daarteenoor is hipoteses 4, 5, 9 en 10 nie ondersteun nie. In die geval van die modererende (moderated) effekte is net een hipotese ondersteun, naamlik hipotese 13, wat verwys na die modererende invloed van sielkundige kapitaal op die verband tussen roloorlading en werk-lewe-konflik. Hipoteses 15,16 en 17 het die bemiddelende (mediation) effekte in hierdie studie getoets, en slegs twee van die drie bemiddelde paaie (mediating paths) is beduidend bevind, naamlik werk-lewe-konflik wat 'n bemiddelende rol in die verband tussen roloorlading en uitbranding, asook tussen emosionele arbeid en uitbranding gespeel het. Die bevindinge van hierdie studie dra by tot die kennisbasis rakende die voorspellers van werkslewe-konflik en uitbranding onder verpleers, asook die kennisbasis van die gesondheidsorgstelsel. Die resultate dui daarop dat verpleegsters werkslewe-konflik en uitbranding ervaar, en dat werkshulpbronne, werkseise, en persoonlike hulpbronne as smeebaar beskou behoort te word en as toepaslike teikens vir bestuursintervensies.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/101298
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