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      Nurses' perceptions of quality of work life in private hospitals in Enugu, Nigeria: A qualitative study

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          Abstract

          Despite being essential for retaining nurses, not much is known about nurses' quality of work life (QWL) in private hospitals in sub-Saharan Africa, including Nigeria. We explored nurses' perceptions of QWL, factors influencing it, how it affects motivation, and strategies for its improvement. The study was conducted in seven private hospitals in Enugu, Nigeria. The design was qualitative, using focus group discussion (n = 7) with registered nurses (n = 66) purposively selected using maximum variation sampling and the inclusion criteria. Data were analyzed using verbatim transcription and thematic analysis. The nurses understood QWL from work-family life, work design, work context and work world perspectives. Opportunities for skill acquisition, resource availability, helpfulness from colleagues, and a hygienic work environment improved the QWL and motivation of nurses. Work-family life factors including caring obligations, night shifts, long hours, burnout, and inappropriate leave policies; work design factors including declining autonomy, inadequate staffing, and a high workload; work context factors consisting of a lack of participatory decision-making, blaming nurses for gaps, restrictive training policy, limited training opportunity, and insecurity; and work world factors related to poor remuneration, poor community view of nursing and ease of job termination undermined QWL and demotivated nurses. Strategies identified by the nurses to improve QWL included improving staffing, vacation, care coordination, supportive supervision, teamwork, promotion, participatory decision-making, training opportunities, timely hand-over of shifts, job recognition, and compensation. The quality of nursing work life in private hospitals in Enugu needs improvement. Quality improvement programs addressing the barriers to nurses' QWL are warranted.

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          Burnout in nursing: a theoretical review

          Chiara Dall’Ora, Jane Ball, Maria Reinius … (2020)
          Background Workforce studies often identify burnout as a nursing ‘outcome’. Yet, burnout itself—what constitutes it, what factors contribute to its development, and what the wider consequences are for individuals, organisations, or their patients—is rarely made explicit. We aimed to provide a comprehensive summary of research that examines theorised relationships between burnout and other variables, in order to determine what is known (and not known) about the causes and consequences of burnout in nursing, and how this relates to theories of burnout. Methods We searched MEDLINE, CINAHL, and PsycINFO. We included quantitative primary empirical studies (published in English) which examined associations between burnout and work-related factors in the nursing workforce. Results Ninety-one papers were identified. The majority (n = 87) were cross-sectional studies; 39 studies used all three subscales of the Maslach Burnout Inventory (MBI) Scale to measure burnout. As hypothesised by Maslach, we identified high workload, value incongruence, low control over the job, low decision latitude, poor social climate/social support, and low rewards as predictors of burnout. Maslach suggested that turnover, sickness absence, and general health were effects of burnout; however, we identified relationships only with general health and sickness absence. Other factors that were classified as predictors of burnout in the nursing literature were low/inadequate nurse staffing levels, ≥ 12-h shifts, low schedule flexibility, time pressure, high job and psychological demands, low task variety, role conflict, low autonomy, negative nurse-physician relationship, poor supervisor/leader support, poor leadership, negative team relationship, and job insecurity. Among the outcomes of burnout, we found reduced job performance, poor quality of care, poor patient safety, adverse events, patient negative experience, medication errors, infections, patient falls, and intention to leave. Conclusions The patterns identified by these studies consistently show that adverse job characteristics—high workload, low staffing levels, long shifts, and low control—are associated with burnout in nursing. The potential consequences for staff and patients are severe. The literature on burnout in nursing partly supports Maslach’s theory, but some areas are insufficiently tested, in particular, the association between burnout and turnover, and relationships were found for some MBI dimensions only.
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            Challenges Faced by Healthcare Professionals During the COVID-19 Pandemic: A Qualitative Inquiry From Bangladesh

            Shaharior Rahman Razu, Tasnuva Yasmin, Taimia Arif … (2021)
            Background: The coronavirus disease 2019 (COVID-19) pandemic has caused increasing challenges for healthcare professionals globally. However, there is a dearth of information about these challenges in many developing countries, including Bangladesh. This study aims to explore the challenges faced by healthcare professionals (doctors and nurses) during COVID-19 in Bangladesh. Methods: We conducted qualitative research among healthcare professionals of different hospitals and clinics in Khulna and Dhaka city of Bangladesh from May 2020 to August 2020. We conducted 15 in-depth telephone interviews using a snowball sampling technique. We used an in-depth interview guide as data were collected, audiotaped, and transcribed. The data were analyzed both manually and using QDA Miner software as we used thematic analysis for this study. Results: Seven themes emerged from the study. Participants experienced higher workload, psychological distress, shortage of quality personal protective equipment (PPE), social exclusion/stigmatization, lack of incentives, absence of coordination, and proper management during their service. These healthcare professionals faced difficulty coping with these challenges due to situational and organizational factors. They reported of faith in God and mutual support to be the keys to adapt to adversities. Adequate support to address the difficulties faced by healthcare professionals is necessary for an overall improved health outcome during the pandemic. Conclusion: The findings highlight the common challenges faced by healthcare professionals during the COVID-19 outbreak. This implies the need to support adequate safety kits, protocols, and support for both physical and mental health of the healthcare professionals.
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              Health care workers’ experiences during the COVID-19 pandemic: a scoping review

              Souaad Chemali, Almudena Mari-Saez, Charbel El Bcheraoui … (2022)
              Background COVID-19 has challenged health systems worldwide, especially the health workforce, a pillar crucial for health systems resilience. Therefore, strengthening health system resilience can be informed by analyzing health care workers’ (HCWs) experiences and needs during pandemics. This review synthesizes qualitative studies published during the first year of the COVID-19 pandemic to identify factors affecting HCWs’ experiences and their support needs during the pandemic. This review was conducted using the Joanna Briggs Institute methodology for scoping reviews. A systematic search on PubMed was applied using controlled vocabularies. Only original studies presenting primary qualitative data were included. Results 161 papers that were published from the beginning of COVID-19 pandemic up until 28th March 2021 were included in the review. Findings were presented using the socio-ecological model as an analytical framework. At the individual level, the impact of the pandemic manifested on HCWs’ well-being, daily routine, professional and personal identity. At the interpersonal level, HCWs’ personal and professional relationships were identified as crucial. At the institutional level, decision-making processes, organizational aspects and availability of support emerged as important factors affecting HCWs’ experiences. At community level, community morale, norms, and public knowledge were of importance. Finally, at policy level, governmental support and response measures shaped HCWs’ experiences. The review identified a lack of studies which investigate other HCWs than doctors and nurses, HCWs in non-hospital settings, and HCWs in low- and lower middle income countries. Discussion This review shows that the COVID-19 pandemic has challenged HCWs, with multiple contextual factors impacting their experiences and needs. To better understand HCWs’ experiences, comparative investigations are needed which analyze differences across as well as within countries, including differences at institutional, community, interpersonal and individual levels. Similarly, interventions aimed at supporting HCWs prior to, during and after pandemics need to consider HCWs’ circumstances. Conclusions Following a context-sensitive approach to empowering HCWs that accounts for the multitude of aspects which influence their experiences could contribute to building a sustainable health workforce and strengthening health systems for future pandemics. Supplementary Information The online version contains supplementary material available at 10.1186/s12960-022-00724-1.
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                Author and article information

                Journal
                Journal ID (nlm-ta): AIMS Public Health
                Journal ID (iso-abbrev): AIMS Public Health
                Journal ID (publisher-id): PublicHealth
                Title: AIMS Public Health
                Publisher: AIMS Press
                ISSN (Electronic): 2327-8994
                Publication date (Electronic): 1 November 2022
                Publication date Collection: 2022
                Volume: 9
                Issue: 4
                Pages: 718-733
                Affiliations
                [1 ] Department of Health Administration and Management, Faculty of Health Sciences and Technology, University of Nigeria Enugu Campus, Enugu, Nigeria
                [2 ] Department of Management, Faculty of Business Administration, University of Nigeria Enugu Campus, Enugu, Nigeria
                [3 ] Department of Health Systems and Policy, Sustainable Impact Resource Agency, Enugu, Nigeria
                Author notes
                * Correspondence: Email: daniel.ogbuabor@ 123456unn.edu.ng ; Tel: +2348038774436.
                Article
                Publisher ID: publichealth-09-04-050
                DOI: 10.3934/publichealth.2022050
                PMC ID: 9807407
                PubMed ID: 36636153
                SO-VID: d58e68c0-c3d4-46d5-889a-acb8d8198e12
                Copyright © © 2022 the Author(s), licensee AIMS Press
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0)

                History
                Date received : 3 August 2022
                Date revision received : 12 October 2022
                Date accepted : 19 October 2022
                Categories
                Subject: Research Article

                Keywords: quality of work life,nurses,nursing,work-family life balance,work design,work context,work relevance,work world
                Data availability:
                Keywords: quality of work life, nurses, nursing, work-family life balance, work design, work context, work relevance, work world

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