Electronic Thesis/Dissertation
 

An Exploratory Sequential Mixed Method Study of Nebraska Nurses

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The Role of Emotional Regulation on Acute Care Nurses’ Burnout Delivering Care to COVID-19 Patients

Lee & Cha, 2023

2002). The exploratory sequential mixed method study design was utilized to study the role of emotional regulation on acute care nurses from March 2020 through September 2022 in Nebraska. In the first phase of the qualitative study, the structure of the phenomenon identified was “powering through emotional experiences and emotional challenges in caring for COVID-19 patients” and 4 themes and 14 sub themes emerged. Quantitative cross-sectional study between October 1, 2020, through March 31, 2021, indicated congruence between the theme powering through (staffing shortages) and high patient-nurse ratio. High patient-nurse ratio was statistically significantly associated with emotional exhaustion (b = 7.88, SE = 1.35, p < .05) and depersonalization (b = 3.58, SE = 0.81, p < .05) after controlling for covariates. Congruence was observed between the theme showing up to work and cognitive reappraisal. Cognitive reappraisal was significantly (b = -0.25, SE = .09, p = .009) associated with emotional exhaustion and depersonalization (b = -0.17, SE = 0.05, p = .002) and with personal accomplishment (b = 0.53, SE = 0.06, p = .001) after controlling for covariates. The theme support in managing emotions corroborated with the support variable in the quantitative study although only marginally associated with emotional exhaustion. An additional finding of the study was on the moderation analysis with support as the variable. The study found that among nurses who did not receive support, cognitive reappraisal was statistically (b = -0.64, SE = .19, p < .05) associated with emotional exhaustion after controlling the covariates. For those who received support, cognitive reappraisal was not associated (b = -0.06, SE = 0.12, p < .05) with emotional exhaustion. Cognitive reappraisal was associated with personal accomplishment among the participants who reported having support (b = 0.42, SE = 0.08, p = .001) and the participants who reported a lack of support (b = 0.73, SE = 0.12, p = .001). Addressing burnout requires a targeted and combined intervention at the organization and individual levels that will be unique to each healthcare organization. Additional research is needed to understand burnout using the latent profile analysis along with the other instruments, such as the Areas of Worklife, Perceived Organizational Support, and the Process Model of Emotional Regulation Questionnaire.

Villarante et al., 2024). The core components of burnout are emotional exhaustion, negative emotions and attitudes, such as cynicism towards people and work (Golonka et al., 2017) and reduced personal accomplishment (Maslach, 2017). Emotional regulation strategies (cognitive reappraisal and expressive suppression) are often used to down-regulate negative emotions to reduce the emotional impact (Gross 1998

NASEM, 2019). Nurses’ burnout can have negative consequences on the nursing profession, healthcare organizations, patients, and the health (physical, psychological, behavioral, and emotional) of the nurse (Golonka et al., 2017

Burnout is a psychological syndrome that is multifactorial, context-dependent, and due to chronic work-related stressors affecting professional behavior and attitudes (Hert, 2020

Sullivan et al., 2022

Maslach & Leiter, 2016

NASEM, 2019

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