Implications of a theoretical framework on stress and burnout for the development of graduate nursing education curricula

This study had two purposes: (a) to develop a theoretical framework integrating and synthesizing findings of prior research regarding stress and burnout among critical care nurses (CCRNs), and (b) to validate the theoretical framework with an empirical study to assure a theory/research based teaching-learning process for graduate courses preparing nursing clinical specialists and administrators.^ The methods used to test the theoretical framework included: (a) adopting instruments with reported validity, (b) conducting a pilot study, (c) revising instruments using results of the pilot study and following concurrence of a panel of experts, and (d) establishing correlations within predetermined parameters. The reliability of the tool was determined through the use of Cronbach's Alpha Coefficient with a resulting range from.68 to.88 for all measures.^ The findings supported all the research hypotheses. Correlations were established at r =.23 for statistically significant alphas at the.01 level and r =.16 for alphas.05. The conclusions indicated three areas of strong correlation among the theoretical variables: (a) work environment stressor antecedents and specific stressor events were correlated significantly with subjective work stress and burnout; (b) subjective work stress (perceived work related stress) was a function of the work environment stressor antecedents and specific stressor events, and (c) emotional exhaustion, the first phase of burnout, was confirmed to be related to stressor antecedents and specific stressor events. This dimension was found to be a function of the work environment stressor antecedents, modified by the individual characteristics of work and non-work related social support, non-work daily stress, and the number of hours worked per week. The implications of the study for nursing graduate curricula, nursing practice and nursing education were discussed. Recommendations for further research were enumerated. ^

Exploring calling work orientation: Construct clarity and organizational implications

Employees maintain a personal view toward their work, which can be referred to as their work orientation. Some employees view their work as their life's purpose (i.e., calling work orientation) and they tend to be 1) prosocially motivated, 2) derive meaning from work, and 3) feel that their purpose is from beyond the self. The purpose of the current dissertation was to differentiate calling work orientation from other similar workplace constructs, to investigate the most common covariates of calling work orientation, and to empirically test two possible moderators of the relationship between calling work orientation and work-related outcomes of job satisfaction, job performance, and work engagement. Two independent samples were collected for the purpose of testing hypotheses: data were collected from 520 working students and from 520 non-student employees. Participants from the student sample were recruited at Florida International University, and participants from the employee sample were recruited via the Amazon Mechanical Turk website. Participants from the student sample answered demographic questions and responded to self-report measures of job satisfaction, job performance, work engagement, spirituality, meaningful work, prosocial motivation, and work orientation. The procedure was similar for the employee sample, but their survey also included measures of counterproductive work behaviors, organizational citizenship behaviors, conscientiousness, and numerical ability. Additionally, employees were asked whether they would be willing to have a direct supervisor, peer, co-worker, client, or subordinate rate their job performance. Hierarchical regression findings suggest calling work orientation was predictive of overall job performance above and beyond two common predictors of performance, conscientiousness and numerical ability. The results for the covariate analyses provided evidence that prosocial motivation, meaningful work, and spirituality do play a significant role in the development of an employees' work orientation. Perceived career opportunities moderated the relationship between calling work orientation and job performance for the employee sample. Core self-evaluations moderated the relationship between calling work orientation and job performance, and core self-evaluations moderated the relationship between calling work orientation and work engagement. Collectively, findings from the current study highlight the benefits of examining work orientation in the prediction of workplace outcomes.

Exploring Calling Work Orientation: Construct Clarity and Organizational Implications

Employees maintain a personal view toward their work, which can be referred to as their work orientation. Some employees view their work as their life’s purpose (i.e., calling work orientation) and they tend to be 1) prosocially motivated, 2) derive meaning from work, and 3) feel that their purpose is from beyond the self. The purpose of the current dissertation was to differentiate calling work orientation from other similar workplace constructs, to investigate the most common covariates of calling work orientation, and to empirically test two possible moderators of the relationship between calling work orientation and work-related outcomes of job satisfaction, job performance, and work engagement. Two independent samples were collected for the purpose of testing hypotheses: data were collected from 520 working students and from 520 non-student employees. Participants from the student sample were recruited at Florida International University, and participants from the employee sample were recruited via the Amazon Mechanical Turk website. Participants from the student sample answered demographic questions and responded to self-report measures of job satisfaction, job performance, work engagement, spirituality, meaningful work, prosocial motivation, and work orientation. The procedure was similar for the employee sample, but their survey also included measures of counterproductive work behaviors, organizational citizenship behaviors, conscientiousness, and numerical ability. Additionally, employees were asked whether they would be willing to have a direct supervisor, peer, co-worker, client, or subordinate rate their job performance. Hierarchical regression findings suggest calling work orientation was predictive of overall job performance above and beyond two common predictors of performance, conscientiousness and numerical ability. The results for the covariate analyses provided evidence that prosocial motivation, meaningful work, and spirituality do play a significant role in the development of an employees’ work orientation. Perceived career opportunities moderated the relationship between calling work orientation and job performance for the employee sample. Core self-evaluations moderated the relationship between calling work orientation and job performance, and core self-evaluations moderated the relationship between calling work orientation and work engagement. Collectively, findings from the current study highlight the benefits of examining work orientation in the prediction of workplace outcomes.

Glycemic control: Risk factors, quality of life, workforce participation, and mortality among US adults with type 2 diabetes

Despite research showing the benefits of glycemic control, it remains suboptimal among adults with diabetes in the United States. Possible reasons include unaddressed risk factors as well as lack of awareness of its immediate and long term consequences. The objectives of this study were to, using cross-sectional data, (1) ascertain the association between suboptimal (Hemoglobin A1c (HbA1c) .7%), borderline (HbA1c 7-8.9%), and poor (HbA1c .9%) glycemic control and potentially new risk factors (e.g. work characteristics), and (2) assess whether aspects of poor health and well-being such as poor health related quality of life (HRQOL), unemployment, and missed-work are associated with glycemic control; and (3) using prospective data, assess the relationship between mortality risk and glycemic control in US adults with type 2 diabetes. Data from the 1988-1994 and 1999-2004 National Health and Nutrition Examination Surveys were used. HbA1c values were used to create dichotomous glycemic control indicators. Binary logistic regression models were used to assess relationships between risk factors, employment status and glycemic control. Multinomial logistic regression analyses were conducted to assess relationships between glycemic control and HRQOL variables. Zero-inflated Poisson regression models were used to assess relationships between missed work days and glycemic control. Cox-proportional hazard models were used to assess effects of glycemic control on mortality risk. Using STATA software, analyses were weighted to account for complex survey design and non-response. Multivariable models adjusted for socio-demographics, body mass index, among other variables. Results revealed that being a farm worker and working over 40 hours/week were risk factors for suboptimal glycemic control. Having greater days of poor mental was associated with suboptimal, borderline, and poor glycemic control. Having greater days of inactivity was associated with poor glycemic control while having greater days of poor physical health was associated with borderline glycemic control. There were no statistically significant relationships between glycemic control, self-reported general health, employment, and missed work. Finally, having an HbA1c value less than 6.5% was protective against mortality. The findings suggest that work-related factors are important in a person’s ability to reach optimal diabetes management levels. Poor glycemic control appears to have significant detrimental effects on HRQOL.^

Glycemic Control: Risk Factors, Quality of Life, Workforce Participation, and Mortality Among US Adults with Type 2 Diabetes

Despite research showing the benefits of glycemic control, it remains suboptimal among adults with diabetes in the United States. Possible reasons include unaddressed risk factors as well as lack of awareness of its immediate and long term consequences. The objectives of this study were to, using cross-sectional data, 1) ascertain the association between suboptimal (Hemoglobin A1c (HbA1c) ≥7%), borderline (HbA1c 7-8.9%), and poor (HbA1c ≥9%) glycemic control and potentially new risk factors (e.g. work characteristics), and 2) assess whether aspects of poor health and well-being such as poor health related quality of life (HRQOL), unemployment, and missed-work are associated with glycemic control; and 3) using prospective data, assess the relationship between mortality risk and glycemic control in US adults with type 2 diabetes. Data from the 1988-1994 and 1999-2004 National Health and Nutrition Examination Surveys were used. HbA1c values were used to create dichotomous glycemic control indicators. Binary logistic regression models were used to assess relationships between risk factors, employment status and glycemic control. Multinomial logistic regression analyses were conducted to assess relationships between glycemic control and HRQOL variables. Zero-inflated Poisson regression models were used to assess relationships between missed work days and glycemic control. Cox-proportional hazard models were used to assess effects of glycemic control on mortality risk. Using STATA software, analyses were weighted to account for complex survey design and non-response. Multivariable models adjusted for socio-demographics, body mass index, among other variables. Results revealed that being a farm worker and working over 40 hours/week were risk factors for suboptimal glycemic control. Having greater days of poor mental was associated with suboptimal, borderline, and poor glycemic control. Having greater days of inactivity was associated with poor glycemic control while having greater days of poor physical health was associated with borderline glycemic control. There were no statistically significant relationships between glycemic control, self-reported general health, employment, and missed work. Finally, having an HbA1c value less than 6.5% was protective against mortality. The findings suggest that work-related factors are important in a person’s ability to reach optimal diabetes management levels. Poor glycemic control appears to have significant detrimental effects on HRQOL.

Examining a proposed job retention model for adult workers with mental retardation in supported employment

This quantitative study investigated the predictive relationships and interaction between factors such as work-related social behaviors (WRSB), self-determination (SD), person-job congruency (PJC), job performance (JP), job satisfaction (JS), and job retention (JR). A convenience sample of 100 working adults with MR were selected from supported employment agencies. Data were collected using a survey test battery of standardized instruments. The hypotheses were analyzed using three multiple regression analyses to identify significant relationships. Beta weights and hierarchical regression analysis determined the percentage of the predictor variables contribution to the total variance of the criterion variables, JR, JP, and JS. ^ The findings highlight the importance of self-determination skills in predicting job retention, satisfaction, and performance for employees with MR. Consistent with the literature and hypothesized model, there was a predictive relationship between SD, JS and JR. Furthermore, SD and PJC were predictors of JP. SD and JR were predictors of JS. Interestingly, the results indicated no significant relationship between JR and JP, or between JP and JS, or between PJC and JS. This suggests that there is a limited fit between the hypothesized model and the study's findings. However, the theoretical contribution made by this study is that self-determination is a particularly relevant predictor of important work outcomes including JR, JP, and JS. This finding is consistent with Deci's (1992) Self-Determination Theory and Wehmeyer's (1996) argument that SD skills in individuals with disabilities have important consequences for the success in transitioning from school to adult and work life. This study provides job retention strategies that offer rehabilitation and HR professionals a useful structure for understanding and implementing job retention interventions for people with MR. ^ The study concluded that workers with mental retardation who had more self-determination skills were employed longer, more satisfied, and better performers on the job. Also, individuals whose jobs were matched to their interests and abilities (person-job congruency) were better at self-determination skills. ^

Human resource development professionals' perceptions about the Academy of Human Resource Development Standards on Ethics and Integrity

Professional standards of ethics proclaim the core values of a profession, describe expected professional duties and responsibilities, and provide a framework for ethical practice and ethical decision-making. The purpose of this mixed, quantitative and qualitative, survey study was to examine HRD professionals' perceptions about the AHRD Standards on Ethics and Integrity, how HRD professionals used the Standards for research and decision-making, and the extent to which the Standards provided guidance for ethical decision-making. Through an on-line survey instrument, 182 members of AHRD were surveyed. The open-ended questions were analyzed using thematic analysis to expand on, inform, and support the quantitative findings. The close-ended questions were analyzed with frequency distributions, descriptive statistics, cross tabulations, and Spearman rank correlations. The results showed a significant relationship between (a) years of AHRD membership and level of familiarity with the Standards, (b) years of AHRD membership and use of the Standards for research, and (c) level of familiarity with the Standards and use of the Standards for research. There were no significant differences among scholars, scholar practitioners, practitioners, and students regarding their perceptions about the Standards. The results showed that the Standards were not well known or widely used. Nevertheless, the results indicated overall positive perceptions about the Standards. Seventy percent agreed that the Standards provided an appropriate set of ethical principles and reflected respondents' own standards of conduct. Seventy-eight percent believed that the Standards were important for defining HRD as a profession and 54% believed they were important for developing a sense of belonging to the HRD profession. Fifty-one percent believed the Standards should be enforceable and 61% agreed members should sign the membership application form showing willingness to adhere to the Standards. Seventy-seven percent based work-related ethical decisions on personal beliefs of right and wrong and 56% on established professional values and rules of right and wrong. The findings imply that if the professional standards of ethics are to influence the profession, they should be widely publicized and discussed among members, they should have some binding power, and their use should be encouraged.

Assessing the influence of organizational personality, applicants' need motivation, expectancy beliefs, and person-organization fit on applicant attraction

This research explored the thesis that organizational personality is related to applicants’ attraction to an organization through a process which involves need motivation, expectancy beliefs, and applicants’ perceptions of person-organization fit. Organizational personality may be defined as a collection of trait-like characteristics that individuals use to describe organizational practices, policies, values, and culture. Specifically, this research investigated the hypothesis that organizational personality information is useful to applicants because it helps individuals to determine their perceptions of fit. A sample of students (N = 198) and working adults (N = 198) participated in an online experiment. Findings indicated that individuals’ beliefs about the instrumentality of desirable work related outcomes are essential to determining their perceptions of fit and organizational attraction. Additionally, organizational personality perceptions interacted with need motivation to affect perceptions of fit and organizational attraction. For instance, perceptions of fit mediated the influence of the interaction between need for achievement and perceptions of innovativeness on organizational attraction. The interaction of need motivation and perceptions of organizational personality helped individuals to better determine their perceptions of fit and subsequent attraction toward organizations.^

Time orientation in organizations: Polychronicity and multitasking

This dissertation consists of four studies examining two constructs related to time orientation in organizations: polychronicity and multitasking. The first study investigates the internal structure of polychronicity and its external correlates in a sample of undergraduate students (N = 732). Results converge to support a one-factor model and finds measures of polychronicity to be significantly related to extraversion, agreeableness, and openness to experience. The second study quantitatively reviews the existing research examining the relationship between polychronicity and the Big Five factors of personality. Results reveal a significant relationship between extraversion and openness to experience across studies. Studies three and four examine the usefulness of multitasking ability in the prediction of work related criteria using two organizational samples (N = 175 and 119, respectively). Multitasking ability demonstrated predictive validity, however the incremental validity over that of traditional predictors (i.e., cognitive ability and the Big Five factors of personality) was minimal. The relationships between multitasking ability, polychronicity, and other individual differences were also investigated. Polychronicity and multitasking ability proved to be distinct constructs demonstrating differential relationships with cognitive ability, personality, and performance. Results provided support for multitasking performance as a mediator in the relationship between multitasking ability and overall job performance. Additionally, polychronicity moderated the relationship between multitasking ability and both ratings of multitasking performance and overall job performance in Study four. Clarification of the factor structure of polychronicity and its correlates will facilitate future research in the time orientation literature. Results from two organizational samples point to work related measures of multitasking ability as a worthwhile tool for predicting the performance of job applicants.

Wellness and Obesity: Implications for Health Care Costs Among Restaurant Managers

Overeating, inadequate exercise, work-related stress, and long working hours are accepted issues among restaurant managers. The underlying question was whether such life styles affect employers' health care cost and restaurant managers' health and ability to cope with imposed business requirements. The author discusses strategies to help employers reduce health care costs, increase employee productivity, and improve job satisfaction.

Factors Affecting De Novo Urinary Retention after Holmium Laser Enucleation of the Prostate

Objective Patients can experience urinary retention (UR) after Holmium laser enucleation of the prostate (HoLEP) that requires bladder distension during the procedure. The aim of this retrospective study is to identify factors affecting the UR after HoLEP. Materials and Methods 336 patients, which underwent HoLEP for a symptomatic benign prostatic hyperplasia between July 2008 and March 2012, were included in this study. Urethral catheters were routinely removed one or two days after surgery. UR was defined as the need for an indwelling catheter placement following a failure to void after catheter removal. Demographic and clinical parameters were compared between the UR (n = 37) and the non-urinary retention (non-UR; n = 299) groups. Results The mean age of patients was 68.3 (±6.5) years and the mean operative time was 75.3 (±37.4) min. Thirty seven patients (11.0%) experienced a postoperative UR. UR patients voided catheter free an average of 1.9 (±1.7) days after UR. With regard to the causes of UR, 24 (7.1%) and 13 (3.9%) patients experienced a blood clot-related UR and a non-clot related UR respectively. Using multivariate analysis (p<0.05), we found significant differences between the UR and the non-UR groups with regard to a morcellation efficiency (OR 0.701, 95% CI 0.498–0.988) and a bleeding-related complication, such as, a reoperation for bleeding (OR 0.039, 95% CI 0.004–0.383) or a transfusion (OR 0.144, 95% CI 0.027–0.877). Age, history of diabetes, prostate volume, pre-operative post-void residual, bladder contractility index, learning curve, and operative time were not significantly associated with the UR (p>0.05). Conclusions De novo UR after HoLEP was found to be self-limited and it was not related to learning curve, patient age, diabetes, or operative time. Efficient morcellation and careful control of bleeding, which reduces clot formation, decrease the risk of UR after HoLEP.

Time Orientation in Organizations: Polychronicity and Multitasking

This dissertation consists of four studies examining two constructs related to time orientation in organizations: polychronicity and multitasking. The first study investigates the internal structure of polychronicity and its external correlates in a sample of undergraduate students (N = 732). Results converge to support a one-factor model and finds measures of polychronicity to be significantly related to extraversion, agreeableness, and openness to experience. The second study quantitatively reviews the existing research examining the relationship between polychronicity and the Big Five factors of personality. Results reveal a significant relationship between extraversion and openness to experience across studies. Studies three and four examine the usefulness of multitasking ability in the prediction of work related criteria using two organizational samples (N = 175 and 119, respectively). Multitasking ability demonstrated predictive validity, however the incremental validity over that of traditional predictors (i.e., cognitive ability and the Big Five factors of personality) was minimal. The relationships between multitasking ability, polychronicity, and other individual differences were also investigated. Polychronicity and multitasking ability proved to be distinct constructs demonstrating differential relationships with cognitive ability, personality, and performance. Results provided support for multitasking performance as a mediator in the relationship between multitasking ability and overall job performance. Additionally, polychronicity moderated the relationship between multitasking ability and both ratings of multitasking performance and overall job performance in Study four. Clarification of the factor structure of polychronicity and its correlates will facilitate future research in the time orientation literature. Results from two organizational samples point to work related measures of multitasking ability as a worthwhile tool for predicting the performance of job applicants.

Longitudinal effects of family factors on alcohol use and alcohol-related problems among males from pre-adolescence to adulthood

The goal of this study was to examine the longitudinal effects of five family factors on alcohol use among adolescent males. The family factors included familism (family pride, loyalty, and cohesion), parent derogation (being put down by parents), parent/child communication, family alcohol problems and family drug problems. The study focused on the effects of the family factors reported by a sample of 451 White-non-Hispanic and African American males during early and mid-adolescence on (1) the intensity of alcohol use in mid-adolescence, and (2) the number of problems associated with alcohol use during the transition to young adulthood. The study also explored racial differences in the effects of the family factors. The data for this study were derived from a two-phase longitudinal epidemiologic cohort study of male and female adolescents enrolled in middle schools in Miami, FL. Data were collected at four points between 1990 and 2001. Linear and logistical regressions were used to analyze the effects of the family variables on the dependent variables. ^ The results of the analyses indicated that all of the family variables except family drug problems were statistically significant predictors of the level of alcohol use and alcohol-related problems. Familism had a moderate influence on both of the dependent variables at all data points, while parent derogation, parent/child communication and family alcohol problems were weak predictors. While the family factors varied by race, their impact on the dependent variables did not vary substantially. ^ This study had methodological shortcomings related to measurement and design that may have contributed to the weak influence of the variables. Future studies should explore possible mediating effects of these variables, and should employ more sensitive measures that are culturally appropriate. The results suggest that, since early family factors have long-term effects on children's substance-using behaviors, the family environment should be addressed in prevention and intervention efforts. ^

An investigation of the strategies used by organizations participating in the welfare-to-work network program and correlation of the strategies with the retention data to determine best practices for job retention among former welfare recipients

This ex post facto study (N = 209) examined the relationships between employer job strategies and job retention among organizations participating in Florida welfare-to-work network programs and associated the strategies with job retention data to determine best practices. ^ An internet-based self-report survey battery was administered to a heterogeneous sampling of organizations participating in the Florida welfare-to-work network program. Hypotheses were tested through correlational and hierarchical regression analytic procedures. The partial correlation results linked each of the job retention strategies to job retention. Wages, benefits, training and supervision, communication, job growth, work/life balance, fairness and respect were all significantly related to job retention. Hierarchical regression results indicated that the training and supervision variable was the best predictor of job retention in the regression equation. ^ The size of the organization was also a significant predictor of job retention. Large organizations reported higher job retention rates than small organizations. There was no statistical difference between the types of organizations (profit-making and non-profit) and job retention. The standardized betas ranged from to .26 to .41 in the regression equation. Twenty percent of the variance in job retention was explained by the combination of demographic and job retention strategy predictors, supporting the theoretical, empirical, and practical relevance of understanding the association between employer job strategies and job retention outcomes. Implications for adult education and human resource development theory, research, and practice are highlighted as possible strategic leverage points for creating conditions that facilitate the development of job strategies as a means for improving former welfare workers’ job retention.^

Making Non-Career Jobs Attractive to Younger Workers

As most hospitality industry managers in the U.S. are already aware, there is a growing and persistent shortage of labor available for service-sector, non-career jobs, the very jobs so vital to the industry. In most cases, recruitment efforts for these jobs are targeted toward younger workers, those under age 25. The authors explore issues regarding the attractiveness of non-career jobs in the eyes of young persons and suggest that, in addition to factors related to the job itself (pay, hours, type of work), the type of procedures used by employers to make selection decisions are equally influential. Recommendations are made concerning how hospitality employers with non-career positions to fill can maximize the chances of successfully staffing their organizations.