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CopingwithjobstressforhospitalnursesduringtheCOVID19crisis.docx
O R I G I N A L A R T I C L E
Received: 29 March 2021
Revised: 24 July 2021
Accepted: 27 July 2021
DOI: 10.1111/jonm.1343
Coping with job stress for hospital nurses during the COVID19 crisis: The joint roles of micro-breaks and psychological detachment
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Hongli Wang, Professor |
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Guangyi Xu PhD |
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Cuiqi Liang MD |
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Zhen Li PhD |
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School of Business Administration, South
China University of Technology, Guangzhou,
China
Correspondence
Guangyi Xu, School of Business
Administration, South China University of Technology, Guangzhou, China.
Email: [email protected]
Funding information
Special project of philosophy and social science planning in Guangdong Province,
Grant/Award Number: GD20SQ32; Guang Dong province Natural Science Foundation of China, Grant/Award Number:
2020A151501943; General projects of Humanities and social sciences of the Ministry of Education, Grant/Award Number: Y9180140; National Natural Science foundation of China,
Grant/Award Number: 71872066
|
1 | INTRODUCTION As a serious global public health disaster, the COVID-19 pandemic had led to over 125 million confirmed cases worldwide by March 2021. After the outbreak of the COVID-19 crisis, health care professionals, like nurses, have faced unprecedented challenges, exhaustion due to heavy workloads, and the fear of becoming infected and of infecting others in this dangerous situation (Liu et al., 2020; Usher |
et al., 2020). The consequent stress and huge workload among nurses also may directly affect their work engagement (Zhang et al., 2021). Work engagement is defined as ‘a positive, fulfilling, work-related state of mind’ (Schaufeli et al., 2006, p. 702), which is significant for organisational, nurse and patient outcomes (Wang et al., 2021). Specifically, nurses with a higher level of engagement are more likely to be enthusiastic about functioning and providing patient-centred care (Dempsey & Assi, 2018). Related research also |
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confirmed that there is a positive relationship between nurses’ work engagement and patient experiences and safety (Parr et al., 2020). Therefore, more attention should be paid to how to cope with the excessive job stress experienced by hospital nurses during the COVID-19 pandemic.
Prior study has demonstrated that job stress is negatively related to the work engagement of hospital nurses (Zhang et al., 2021), but it is still unclear how to block and/or reverse this process. Given the stressful environment faced by hospital nurses, we can expect that a high workload may easily cause both physical and mental exhaustion (Maffoni et al., 2020; Zito et al., 2016). Support for the nurses to help them to persevere and overcome the unprecedented challenges of COVID-19 can come from their family, friends and the leaders of their organisations (Goh et al., 2020). This study thus attempts to find effective energy management strategies to reduce the destructiveness of job stress. Traditional energy recovery studies mainly focus on recovery activity outside the work context, ignoring the importance of micro-break activity at work (Sonnentag & Fritz, 2015). Compared with recovery activity during non-work time, micro-break activity has a more immediate effect on the recovery of work energy (Trougakos & Hideg, 2009). Indeed, taking micro-breaks can help employees to reduce the risk of distraction and thus improve their work engagement (Kühnel et al., 2017). Therefore, nurses also need to take micro-breaks during working time, especially in the high-pressure environment of the COVID-19 pandemic.
We draw on the stressor-detachment model (Sonnentag & Fritz, 2015) to theorize that detaching psychologically from work may help nurses cope with work stress. Psychological detachment refers to refraining from job-related activity and thoughts, which is considered as a core recovery experience. Sonnentag and Fritz (2015) posited that whether individuals can successfully achieve psychological detachment depends on the resources that help in dealing with stressors. We thus need to explore further the conditions for the formation of psychological detachment. Micro-breaks at work, such as informal respite activity between tasks, are key resource-providing activities that affect employees’ reactions to work stressors (Kim et al., 2018). Furthermore, Kim et al. (2017) posited that recovery experience is one of the main mechanisms to explain the positive effects of micro-break activity. Therefore, we believe that micro-break activity can provide nurses with opportunities to engage in psychological detachment. From this perspective, micro-break activity and the resulting psychological detachment could, on the one hand, temporarily separate nurses from work stressors and, on the other hand, enable the lost resources to be restored thus promoting work engagement.
To sum up, this study argues that micro-break activity and psychological detachment can jointly alleviate the negative impact of job stress on work engagement, and the moderating role of the micro-break activity will be mediated by psychological detachment due to their positive relationship. Figure 1 is the mediated moderation model we propose.
FIGURE 1 Conceptual model. H, hypothesis
| THEORETICAL BACKGROUND AND HYPOTHESES DEVELOPMENT
In order to better understand how and when micro-break activity at work alleviates the relationship between job stress and work engagement, we draw on the stressor-detachment model, which has proved useful for understanding how to cope with workplace stressor (Sonnentag & Fritz, 2015). Stressor-detachment model emphasizes the important role of psychological detachment in the stressor-strain process, which is not only a direct predictor of strain and impaired well-being but may also buffer the negative impact of job stressors. In line with prior studies (e.g., Moreno-Jiménez et al., 2009; Sonnentag & Binnewies, 2013), we explore the key role of psychological detachment between job stress and work engagement. In addition, according to extended stressor-detachment model (Sonnentag & Fritz, 2015), whether individuals can achieve psychological detachment depends on the resources that help in dealing stressor to a certain extent. As shown above, micro-breaks at work are key resource-providing activities (Kim et al., 2018), which provide individuals with opportunities to engage in psychological detachment. Thus, this study assumes that the moderating role of the micro-break activity on the relationship between job stress and work engagement will be mediated by psychological detachment. Through this perspective, we are able to achieve a coherent picture of how to cope with job stress for hospital nurses during the COVID-19 crisis.
| Job stress and work engagement
The COVID-19 pandemic event has posed unprecedented challenges for hospital nurses. They are facing significant potential stress and exhaustion due to heavy workloads, which may affect their level of work engagement (Zhang et al., 2021). Given the stressful environment faced by hospital nurses, we can expect that high workload would easily cause both physical and mental exhaustion (Maffoni et al., 2020; Zito et al., 2016). The existing research also suggests that job stress can result in nurses experiencing negative emotion (Alkhawaldeh et al., 2020; McVicar, 2016) and job burnout (Liu & Aungsuroch, 2019; Takemura et al., 2020), which will reduce their work engagement and the quality of care they provide to patients (Pérez-Fuentes et al., 2019; Zhang et al., 2021). Prior study has also demonstrated that job stress is negatively related to work engagement of hospital nurses (Hetzel-Riggin et al., 2019; Zhang et al., 2021). Therefore, the purpose of this study is to examine a mediated moderation of the effects of both micro-break activity at work and psychological detachment on the relationship between job stress and work engagement among hospital nurses.
| The moderating role of micro-break activity
Micro-break activities at work refer to those short and informal respite activities, which employees voluntarily take between task episodes (Kim et al., 2017), usually lasting less than 10 min
(Bennett, 2015). Such activities require little, or even no, effort and expenditure of individual energy (Trougakos et al., 2008). Micro-break activities are generally divided into four categories: relaxation, nutrition-intake, social and cognitive activities. Relaxation activities refer to experiences that can relax body and mind; nutrition-take activities involve snacking and drinking beverages; social activities cover socializing or chatting with others for social support; and cognitive activities encompass behaviours, such as leisure reading. Microbreak activities, as a positive energy management strategy, have the dual effect of reducing energy loss and replenishing energy (Trougakos et al., 2014). These activities can provide employees with temporary rest opportunities so that their depleted physical and mental resources can be recovered in time (Zhu et al., 2019). Therefore, we believe that micro-break activity can serve as an effective compensation mechanism.
According to the stressor-detachment model, the personal and job resources possessed by individuals can govern their reactions to work stressors. That is, when individuals are equipped with sufficient resources, they can devote themselves more fully to their work without being disturbed by job stress (Schaufeli, 2012). Specifically, employees can recover from daily work demands through relaxation activities such as strolling, meditating, listening to music and stretching (Kim et al., 2017). Also, they can undertake nutrition-intake activities (drinking coffee, having snacks, etc.) to deal with physical discomfort such as hunger and thirst and to keep themselves energized for the rest of workday (Fritz et al., 2011). In addition, social micro-break activities help them to obtain emotional resource (e.g., social support and positive stimulus) by interacting with others, such as discussing non-work-related topics with colleagues, which relieve the adverse effects of job demands (Bakker &
Demerouti, 2017). Moreover, by taking cognitive micro-break activities, employees can shift their attention from activities requiring high self-control, to those such as entertainment or leisure learning, which are more relaxing (Kim et al., 2018). Thus, we expect that micro-break activities could lessen the negative effect of job stress on nurses’ work engagement.
Hypothesis 1. Micro-break activity at work will moderate the relationship between job stress and work engagement. Specifically, when nurses engage in higher levels of micro-break activity, job stress will have a weaker negative relationship with work engagement.
| The role of psychological detachment
To further reveal the mechanism behind the moderating role of microbreak activity, we argue that the moderating effect of micro-break activity on the link between job stress and work engagement will be mediated by psychological detachment. As depicted in Figure 1, micro-break activity provides an opportunity for nurses to engage in psychological detachment, which also can mitigate the negative effect of job stress on work engagement. The following section will discuss why micro-break activities are beneficial to psychological detachment, and then explain why psychological detachment weakens the detrimental impact of job stress on work engagement.
The stressor-detachment model suggests that work stressors are not conductive to psychological detachment, and a high workload makes it difficult to find respite from a work mentally (Meier & Cho, 2019). Sonnentag and Fritz (2015) proposed that the impact of work stressors on psychological detachment is moderated by resources that help in dealing with the stressors. As mentioned above, micro-breaks at work are a key resource-providing activity, which can be viewed as an effective resource compensation mechanism—and that is because these respite activities allow employees to escape from exposure to job stress and to relieve negative emotion (Garland et al., 2015). That is, micro-break activity at work provides occasional opportunities for employees to engage in psychological detachment. In addition, Kim et al. (2017) posited that recovery experience is one of the main mechanisms to explain the positive effects of micro-break activity, and psychological detachment is generally considered as an important recovery experience (Sonnentag & Fritz, 2015). Indeed, micro-break activity helps employees achieve and obtain high levels of psychological detachment and relaxation experience, thereby improving their well-being (Chong et al., 2020). Thus, we hypothesize:
Hypothesis 2. Micro-break activity at work is positively associated with psychological detachment.
According to the stressor-detachment model (Sonnentag & Fritz, 2015), this enhanced psychological detachment can also alleviate the detrimental impact of job stress on work engagement. Researchers examining recovery experiences point out that psychological detachment is positively related with employees’ well-being, because temporarily disengaging from work allows individuals to ‘let go’ of their work (Boekhorst et al., 2017). Therefore, psychological detachment can be regarded as an active strategy for dealing with work stressors (Sonnentag & Fritz, 2015). We can expect that nurses who engage in high levels of psychological detachment will devote more energy to their work tasks. Specifically, detaching psychologically is beneficial for recovery of cognitive and emotional resources (Barnes et al., 2007). Individuals with sufficient resources are more willing to immerse themselves in work without being disturbed by other factors (Sonnentag & Fritz, 2007). In addition, psychological detachment frees employees from stress at work, leading to a reduction in negative emotion (Garland et al., 2015). Allen et al. (2015) found that psychological detachment can alleviate the effect of bullying, a typical workplace stressor, on nurses’ job burnout. In summary, psychological detachment provides an opportunity for nurses to evade work stressors and reduces their negative effects on work engagement.
In line with Grant and Berry (2011) and Xie et al. (2019), we present a mediated moderation model suggesting that a moderating variable (micro-break activity at work) attenuates the association between independent variable (job stress) and dependent variable (work engagement): the moderating variable (micro-break activity at work) drives the mediating variable (psychological detachment), and the mediator also has a moderating effect on relationship between job stress and work engagement. The end result of this process is that the original moderating effect of micro-break activity at work is mediated through its effect on psychological detachment. Taken together, we hypothesize:
Hypothesis 3. Psychological detachment would mediate the moderating effects of micro-break activity on the association between job stress and work engagement.
| METHODS
| Participants and procedure
We tested our hypotheses using multisource data collected from seven public hospitals located in southern China. To reduce common method bias, we conducted a two-wave survey with 1-month time lag. At Time 1, participants were asked to report job stress, microbreak activities at work, psychological detachment and demographic information. One month later (Time 2), corresponding head nurses (those who had returned the completed questionnaires at Time 1) were invited to rate their subordinates’ work engagement.
We randomly selected 350 nurses from a list of hospital nurses provided by the human-resource department. In the first survey (Time 1), we sent questionnaires to 350 nurses with the assistance of the human-resource department. Three hundred and eight nurses completed questionnaires were returned via envelope, generating 88% response rate. Each nurse was also requested to provide the name of his/her immediate supervisor. One month later (Time 2), the second survey was carried out. We sent questionnaires to the 65 head nurses mentioned to obtain their views on their subordinates’ work engagement through an identity number that were assigned to each subordinate-supervisor dyad. Fifty-eight head nurses completed the questionnaires (response rate = 89.23%), and 263 nurses were evaluated by his/her supervisor. On average, one head nurse rated 4.53 subordinates. Of these nurses (N = 263), 8.74% were male, 1.52% under 20 years old, 14.45% between 21 and 23 years old, 19.39% were between 24 and 26 years old, 18.63% were between 27 and 29 years old, 11.79% were between 30 and 32 years old and 34.22% were 33 and above. With regard to education, 15.21% of these nurses completed high school, 32.32% completed their study in junior college, 47.91% completed an undergraduate degree and 4.56% were at the postgraduate level or above. In terms of tenure, 4.94% of them were employed for less than a year, 9.89% for 1 to 2 years, 12.16% for 3 to 4 years, 18.63% for 5 to 7 years, and 54.37% had a tenure of at least 7 years.
| Measures
Apart from the demographic information, all the variables were measured by five-point Likert-type scales [ranging from 1 (strongly disagree) to 5 (strongly agree)].
| Job stress
The four-item scale developed by Crank et al. (1995) was used to measure job stress. Example item is ‘When I’m at work I often feel tense or uptight’. The Cronbach’s alpha of reliability was 0.895.
| Micro-break activity at work
This variable was measured with the nine-item scale developed by Kim et al. (2017), of which relaxation activities cover 2 items including ‘Stretching, walking around the office, relaxing briefly’; nutritionintake activities cover 2 items including ‘Drinking coffee, black tea, green tea, or other caffeinated beverages’; social activities cover 3 items including ‘Chatting with co-workers on non-work-related topics’; cognitive activities cover 2 items including ‘Surfing the web for non-work purposes (e.g. microblog, WeChat)’. The Cronbach’s alpha of reliability was 0.845.
| Psychological detachment
We used four-item scale developed by Sonnentag and Fritz (2007) to measure psychological detachment. Sample item is “I get a break from the demands of work”. The Cronbach’s alpha of reliability was 0.916.
| Work engagement
The nine-item scale developed by Schaufeli et al. (2006) was used to measure work engagement which has three dimensions: vigour, dedication and absorption. Examples items are ‘At her/his work, she/he feels vigorous’, ‘she/he is enthusiastic about the job’ and ‘she/he is immersed in work’. The Cronbach’s alpha of reliability was 0.890.
| Control variables
Research on work engagement has suggested that demographic variables exert certain effects (Schaufeli, 2012; Schaufeli et al., 2006). The control variables in this study include: (i) gender (1 = ‘male’, 2 = ‘female’), (ii) age (1 = ‘20 years old or below’, 2 = ‘within 21– 23 years old’, 3 = ‘within 24–26 years old’, 4 = ‘within 27–29 years old’, 5 = ‘within 30–32 years old’ and 6 = ‘33 years old or above’), (iii) education (1 = ‘high school or below’, 2 = ‘junior college’, 3 = ‘university’ and 4 = ‘graduate school or above’), and (iv) tenure (1 = ‘1 year or below’, 2 = ‘between 1 and 2 years’, 3 = ‘between 3 and 4 years’, 3 = ‘between 5 and 7 years’ and 5 = ‘7 years or above’).
| Ethical consideration
This study was approved by the ethics committee of South China University of Technology. The purpose of the study and the principles of anonymous, voluntary participation were explained on the first page of the questionnaires. And to ensure anonymous participation, an information sheet about the names of units and hospitals was designed instead of a written, informed consent.
| RESULTS
| Confirmatory factor analysis
SPSS 23.0 and Mplus 7.4 were used for statistical analysis in this study. We conducted confirmatory factor analysis (CFA) to distinguish statistically these four key variables in our model (see Table 1). A CFA of this four-factor base model yielded fit indexes within an acceptable range [χ2/292 = 2.20; comparative fit index (CFI) = 0.91; Tucker– Lewis index (TLI) = 0.90; root mean square error of approximation (RMSEA) = 0.07; standardized root mean residual (SRMR) = 0.07], indicating that these constructs are distinct empirically.
| Descriptive statistics and correlations
|
TABLE 1 Confirmatory factor analysis (CFA) of measurement models
Note: The four-factor model includes job stress (JS), micro-break activity (MBA), psychological detachment (PD) and work engagement (WE). For the threefactor model, MBA and PD are combined into one factor; for the two-factor model, MBA, PD and WE are combined into one factor; and for the one-factor model, MBA, PD, WE and JS are combined into one factor. Abbreviations: CFI, comparative fit index; RMSEA, root mean square error of approximation; SRMR, standardized root mean residual; TLI, Tucker–Lewis index. TABLE 2 Descriptive statistics and correlations
Note: N = 263, Cronbach’s alpha coefficient is shown in bold on the diagonal. Abbreviations: JS, job stress; MBA, micro-break activity; PD, psychological detachment; WE, work engagement. **p < .01. *p < .05. |
Mean values, standard deviations and correlations among the variables are presented in Table 2. As expected, job stress is negatively correlated with work engagement (r =.12, p < .05), micro-break activity at work is positively correlated with psychological detachment (r = .24, p < .01), and psychological detachment is positively related to work engagement (r = .30, p < .01). These results provide initial support for the hypotheses of this study.
| Hypotheses testing
To test Hypothesis 1, the control variables were first entered in Model 1 (see Table 3), and then the main effect of job stress (Model 2) followed by the two-way interaction of job stress and micro-break activity (Model 3). As shown in Model 2, job stress is negatively related to work engagement (β=.09, p < .05). The results from Model 3 suggest that the interaction term for job stress and microbreak activity is positive and significant (β= .21, p < .01).
We further plotted the moderating effect of micro-break activity based on values plus and minus one standard deviation from the mean in Figure 2. As it shows, job stress is positively associated with work engagement at higher levels of micro-break activity, while negatively related to work engagement at lower levels of micro-break activity. Hence, Hypothesis 1 is supported.
To test Hypothesis 2, the control variables were first entered and then the main effect of micro-break activity in Model 7. The results
TABLE 3 Regression analyses
from Model 7 show that micro-break activity is positively related to psychological detachment (β= .40, p < .01), supporting Hypothesis 2.
The results from Model 4 (in Table 2) show that the interaction between job stress and psychological detachment is positively related to work engagement (β= .08, p < .05). The simple slopes analysis (Figure 3) shows that the effect of job stress on work engagement is negative and significant when psychological detachment is one standard deviation below the mean and is nonsignificant when psychological detachment is one standard deviation above the mean.
As is indicated in Model 5, the regression coefficient of the interaction between job stress and micro-break activity is significant (β= .16, p < .05), whereas the regression coefficient of the interaction between job stress and psychological detachment is not significant, suggesting that the moderating effect of micro-break activity on the job stress–work engagement relationship is not fully mediated by psychological detachment.
|
Variable |
WE M1 |
M2 |
M3 |
M4 |
PD M5 |
M6 |
M7 |
|
Gender |
0.11 |
0.11 |
0.12 |
0.15 |
0.14 |
0.04 |
0.07 |
|
Age |
0.20** |
0.20** |
0.21** |
0.18** |
0.16** |
0.13 |
0.19* |
|
Education |
0.01 |
0.01 |
0.00 |
0.06 |
0.04 |
0.20* |
0.18* |
|
Tenure |
0.19* |
0.18* |
0.17* |
0.16* |
0.13* |
0.09 |
0.19 |
|
JS |
|
0.09* |
0.09 |
0.10* |
0.09* |
|
|
|
MBA |
|
|
0.04 |
|
0.13 |
|
0.40** |
|
JS MBA |
|
|
0.21** |
|
0.16* |
|
|
|
PD |
|
|
|
0.24** |
0.26** |
|
|
|
JS PD |
|
|
|
0.08* |
0.05 |
|
|
|
R2 |
0.05 |
0.06 |
0.09 |
0.16 |
0.18 |
0.03 |
0.11 |
|
4R2 |
|
0.01 |
0.04 |
0.11 |
0.13 |
|
0.06 |
|
F |
3.03* |
3.25** |
3.45** |
7.03** |
6.36** |
1.94 |
6.01** |
Note: N = 263.
Abbreviations: JS, job stress; MBA, micro-break activity; PD, psychological detachment; WE, work engagement.
**p < .01. *p < .05.
FIGURE 2 The interactive
effects of job stress with microbreaks on work engagement FIGURE 3 The interactive effects of job stress with psychological detachment on work engagement
TABLE 4 Direct, indirect and total effect of our model
|
|
|
DE |
IE |
Total effect |
|
PZM |
PXM |
PXZ |
PZMPXM |
PXZ+ PZMPXM |
|
0.40 |
0.08 |
0.21 |
0.03 |
0.24 |
Note: DE refers to the direct effect of the interaction between job stress and micro-break activity on work engagement. IE refers to the indirect effect of psychological detachment. PZM represents the path for microbreak activity to psychological detachment. PXM represents the regression coefficient for the interaction between job stress and psychological detachment. PXZ represents the regression coefficient for the interaction between job stress and micro-break activity.
Hypothesis 3 predicted that psychological detachment would mediate the moderating effects micro-break activity on the relationship between job stress and work engagement. To further test Hypothesis 3, we applied procedures described by Grant and Wrzesniewski (2010) and Grant and Berry (2011). Specifically, we used a bootstrapping procedure to estimate the 95% bias-corrected confidence interval surrounding our estimate of the indirect effects of micro-break activity through psychological detachment. When the 95% confidence interval excludes zero, an indirect effect is significant (Edwards & Lambert, 2007). Results show that in 95% confidence intervals [0.008, 0.112], confidence interval values of the conditional indirect effect did not include zero. Therefore, Hypothesis 3 is partially supported. We used the information from Table 3 to compute estimates of the direct, indirect and total effects of our full model. These estimates were shown in Table 4. Specifically, the direct effect of the interaction between micro-break activity and job stress on work engagement is 0.21. The indirect effect of psychological detachment is 0.03, and the total effect is 0.24.
| DISCUSSION
| Theoretical implications
Our study makes several contributions to the relevant literature. First, we have expanded the research on nursing management by finding that micro-break activity at work can alleviate the detrimental impact of job stress on work engagement. Prior study found that nurses’ rest breaks often related to better physical and mental well-being, and rest break activity can relieve nurses from job demands (Wendsche, Ghadiri, et al., 2017). Well-designed rest breaks can function as a resource that buffers adverse consequences of understaffing in nursing (Wendsche, Ghadiri, et al., 2017). After the COVID-19 pandemic outbreak, hospital nurses faced remarkable job stress and huge workloads, which may lead to new challenges to work engagement (Usher et al., 2020; Zhang et al., 2021). In conditions of endless work for a long time, health care professionals cannot avail of high-quality rest breaks. Therefore, micro-break activity at work, which has the dual effects of reducing energy loss and replenishing energy (Trougakos et al., 2014), is essential for nurses. That is, micro-break activity can help nurses manage their resources and energies, so that they can actively engage in their work even in the high-pressure environment of the COVID-19 pandemic. Second, this study makes a contribution to recovery experience literature by demonstrating that psychological detachment can reduce the negative impact of job stress on work engagement. Although high workloads and overtime may not be changed easily for nurses and other health professionals, detachment experiences can help them to persevere and overcome the unprecedented challenges of COVID-19 (Fauzi et al., 2020). Psychological detachment is generally considered to be a core recovery experience (Sonnentag & Fritz, 2015). Not only does it enable nurses to avoid work stressors, thus reducing a consequent negative emotion experience (de Wijn & van der Doef, 2020), but also it is conducive to the restoration of cognitive and emotional resources, thus providing energy support for subsequent work engagement. Finally, our study contributes to the literature on stress-coping strategies by showing that psychological detachment, which appears after micro-break activity at work, may subsequently affect nurses’ responses to job stress. Although previous studies have examined how micro-break activity at work and psychological detachment may independently influence outcomes (e.g., Allen et al., 2015; Kim et al., 2018), far fewer have explored the intersection in the relation to outcomes. This study further investigates the joint effects of micro-break activity and psychological detachment on the relationship between job stress and work engagement. Our findings provide a new perspective for efforts to help nurses cope with tremendous stress during the pandemic.
| Limitations and future directions
We have to admit that this study has several limitations. First, although the time-lagged research design has strong causal inference, micro-break activity at work and psychological detachment may fluctuate daily. Future research about micro-break activity could conduct a daily diary design, improving the robustness of research conclusions. Second, we focus on hospital nurses, so whether the conclusions drawn from this study are applicable to other occupations has not been verified. Employees in low-structured and high-autonomy environments have more opportunities to take micro-break activities. Researchers could take other occupations (e.g., white-colour workers) into account in the future. Finally, micro-break activity can stimulate recovery and emotion mechanisms at the same time (Kim et al., 2018), whereas our study only clarifies how psychological detachment works, indicating the influence of micro-break activity on recovery experience (e.g., psychological detachment and relaxing experience). Future studies could further explore the emotion mechanism of micro-break activity, investigating the role of micro-breaks in helping employees generate mental energy such as positive affect and intrinsic motivation (Chong et al., 2020; Kim et al., 2018).
| CONCLUSION
Based on the stressor-detachment model, our study explores the joint roles of micro-break activity and psychological detachment on how to cope with the job stress experienced by hospital nurses. This study suggests that micro-break activity at work, as an important moderator, can reduce the negative impact of job stress on work engagement. Additionally, psychological detachment, as a key mediating mechanism, explains how the moderating role of micro-break activity occurs.
| IMPLICATIONS FOR NURSING MANAGEMENT
Several implications can be obtained for nursing management when nurses have to deal with various work stressors (Alkhawaldeh et al., 2020), especially in the environment influenced by the COVID19 pandemic. First, although some enterprise managers may regard micro-break activity as an obstacle to complete work tasks (Kim et al., 2018), this study demonstrates that micro-break activity at work can help nurses to cope with job stress and thus enhance their work engagement. That is, when long rests cannot be provided during the COVID-19 crisis, it is necessary for nurses to take micro-breaks at work. We thus recommend that nurse managers should change a negative attitude toward micro-break activity (if it exists) and allow nurses to take short breaks when necessary. Second, our results imply that micro-break activity at work provides an opportunity for nurses to detach psychologically from work, which is an effective stress-coping strategy for hospital nurses. Well-designed rest breaks can function as a resource that buffers adverse consequences of understaffing in nursing (Wendsche, Hacker, et al., 2017). Therefore, establishing ways for nurses to detach routinely from work is important. Although high workload and overtime are common and may not be changed easily, prioritizing job tasks and goal setting strategies are essential to help nurses find opportunities for detachment even in the high-pressure environment of the COVID-19 pandemic.
ACKNOWLEDGEMENTS
We would also thank all of the nurses and nurse managers who supported the study and participated in it. This study was funded by National Natural Science foundation of China (71872066), General projects of Humanities and social sciences of the Ministry of Education (Y9180140), Guang Dong province Natural Science Foundation of China (2020A151501943) and Special project of philosophy and social science planning in Guangdong Province (GD20SQ32).
CONFLICT OF INTEREST
There is no conflict of interest among authors.
ETHICAL APPROVAL
This study was approved by the ethics committee of South China University of Technology. The questionnaires were filled in anonymously, and we promise that personal information about the participants will be kept absolutely confidential.
DATA AVAILABILITY STATEMENT
The data sets used and analysed in the current study are available from the corresponding author upon reasonable request.
ORCID
Guangyi Xu https://orcid.org/0000-0002-0925-8804
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How to cite this article: Wang, H., Xu, G., Liang, C., & Li, Z.
(2022). Coping with job stress for hospital nurses during the COVID-19 crisis: The joint roles of micro-breaks and psychological detachment. Journal of Nursing Management, 30
(7), 2116–2125. https://doi.org/10.1111/jonm.13431
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