A Study On The Relationship Between Social Support And Occupational Well-Being Of Nurses In Hospital Of Shandong Province:the Mediating Role Of Job Stress

BackgroundNurse’s professional well-being is a positive emotional experience that arises at work and continues throughout their career.Nurses are the main bearers of China’s medical and health care,and are the main force in maintaining people’s health.Since the new medical reform in 2009,the state has repeatedly issued documents emphasising the need to optimise the professional environment of nurses and enhance their professional identity.However,nurses in China account for only 1 per cent of the total population.The total number of nurses is insufficient and their workload is heavy,and their physical and mental health and working conditions are worrying.Nurses feel that their work is stressful,their sense of professional well-being is low and there is a serious problem of staff turnover.How hospitals should protect the rights and interests of nurses,improve their working environment and motivate them to work is an issue that managers need to focus on.Therefore,it is important to understand the current situation of nurses’ work and their expectations and requirements of the profession in order to target interventions and improvements.ObjectivesTo analyse the current situation of social support,career well-being and work stress among nurses in tertiary general hospitals,and to explore the impact of social support on occupational well-being using work stress as a mediating variable.To provide an evidencebased basis for reduce the work stress and scale up the occupational well-being of nurses in tertiary general hospitals.MethodsThe information of this study included on-site survey data and interview data.The questionnaire was administered to nurses in a tertiary general hospital in Jinan,and a total of 435 valid questionnaires were collected.The questionnaires included basic personal information,social support scale,occupational well-being questionnaire and work stress scale.According to the type of data,the nurses’ basic personal information was described by frequency,percentage,mean and standard deviation;on the basis of reliability and validity tests of the scales,the differences in nurses’ social support,occupational well-being and work stress under different demographic characteristics and different job characteristics were compared and analysed by independent sample t-test or one-way ANOVA;the nurses’occupational well-being was analysed by multiple linear stepwise regression of The relationship between social support,occupational well-being and work stress was analysed by Pearson’s correlation;the mediating effect of work stress between social support and occupational well-being was analysed by Bootstrap method.A total of 20 participants participated in semi-structured interviews to understand the current situation and causes of social support,occupational well-being and work stress among nurses.The thematic framework method was used to categorise the interview data.Data collation and analysis was done mainly through Excel 2019,SPSS 23.0 and AMOS 26.0 software.Results(1)The average score of social support for nurses in tertiary general hospitals was 41.703±0.398,with objective support(10.034±0.163),subjective support(23.885±0.236)and use of support(7.784±0.093)at an intermediate level.The mean occupational well-being score of 86.26±11.63 was at a medium level.The per capita scores for the five dimensions including physical and mental health,value/competence expression,respect and recognition,financial income and work environment were 3.085±1.059,3.726±0.851,4.073±0.707,3.665±0.905 and 3.746±0.888 respectively,with physical and mental health issues prominent;the average score for nurses’ work stress was 10.802±2.182 points,which is at a high level.(2)The differences in the scores of nurses’ social support level and its dimensions by marital status,sleep quality,sleep duration,administrative position,form of employment,department and annual income level were statistically significant(p<0.05);the differences in the scores of nurses’ occupational well-being or its dimensions by marital status,sleep quality,sleep duration,administrative position,form of employment,years of practice,title,department,annual income,weekly working hours and number of weekly night shifts were statistically significant(p<0.05).The differences in well-being or their scores on each dimension were statistically significant(p<0.05);the differences in nurses’ work stress scores by marital status,sleep quality,sleep duration,annual income level and weekly working hours were statistically significant(p<0.05).(3)The variables that were statistically significant in the univariate analysis were analysed using multiple linear regression with social support and job stress as independent variables and occupational well-being as the dependent variable.The results showed that the variance inflation factors were all less than 5,and there was no serious multicollinearity among the variables.Meanwhile,a total of five variables entered into the linear regression equation,namely gender,sleep quality,sleep duration,work stress and social support,which together explained 65.5%of the variance in nurses’ occupational well-being(p<0.01).(4)There was a significant positive correlation between nurses’ social support and occupational well-being(r=0.356,p<0.01),a significant negative correlation between nurses’social support and work stress(r=-0.244,p<0.01);and a significant negative correlation between nurses’ work stress and occupational well-being(r=-0.161,p<0.01).(5)Job stress partially mediated the effect of social support on occupational well-being,with a mediating effect value of 0.096(95%CI=[0.061,0.142]),accounting for 16.35%of the total effect.(6)The results of the qualitative interviews further validated the current situation of high work pressure and low levels of professional well-being among nurses,with some nurses expressing difficulties in scheduling,further study,title promotion and autonomy in nursing,which need to be taken into account by the hospital.Conclusions and recommendationsNurses’ social support and occupational well-being are at an intermediate level,with high levels of work stress,physical and mental health,and financial income problems.Factors such as gender,marital status,department,title,income level,sleep quality and duration had an impact on nurses’ work stress,occupational well-being and social support levels.There was a positive correlation between nurses’ occupational well-being and all dimensions of social support,a negative correlation between all dimensions of social support and job stress,and a negative correlation between nurses’ job stress and all dimensions of occupational well-being.Work stress mediated the relationship between social support and occupational well-being.Based on the above findings,in order to reduce nurses’ work stress and enhance their occupational well-being,this study proposes the following recommendations:(1)Build a flexible scheduling mechanism to reduce nurses’ work stress;(2)Improve hospital infrastructure to enhance the level of social support for nurses;(3)Create a good hospital atmosphere of "respect for doctors and nurses";(4)To attach importance to nurses’ career management and build up their career confidence;(5)Smooth the mechanism for title promotion and strengthen the nursing talent pool.