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Yi-Chuan Chen
School of Nursing, College of Medicine, National Taiwan University (NTU), No. 1, Ren-Ai Rd. Sec. 1, Taipei 10051, Taiwan;(Y.-C.C.);(Y.-J.L.)

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Journal article
Published: 19 January 2020 in International Journal of Environmental Research and Public Health
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Although nurses work in stressful environments, stressors in such environments have yet to be clearly assessed. This study aimed to develop a Nurses’ Occupational Stressor Scale (NOSS) with high reliability and validity. Candidate questions for the NOSS were generated by expert consensus following focus group feedback, and were used to survey in 2013. A shorter version was then developed after examination for validity and reproducibility in 2014. The accuracy of the short version of the NOSS for predicting nurses’ stress levels was evaluated based on receiver operating characteristic curves to compare existing instruments for measuring stress outcomes, namely personal burnout, client-related burnout, job dissatisfaction, and intention to leave. Examination for validity and reproducibility yielded a shorter version of NOSS with only 21 items was considered sufficient for measuring stressors in nurses’ work environments. Nine subscales were included: (1) work demands, (2) work–family conflict, (3) insufficient support from coworkers or caregivers, (4) workplace violence and bullying, (5) organizational issues, (6) occupational hazards, (7) difficulty taking leave, (8) powerlessness, and (9) unmet basic physiological needs. The 21-item NOSS proved to have high concurrent and construct validity. The correlation coefficients of the subscales for test-retest reliability ranged from 0.71 to 0.83. The internal consistency (Cronbach’s α) coefficients ranged from 0.35 to 0.77. The NOSS exhibited accurate prediction of personal burnout, client-related burnout, job dissatisfaction, and intention to leave.

ACS Style

Yi-Chuan Chen; Yue Leon Guo; Li-Chan Lin; Yu-Ju Lee; Pei-Yi Hu; Jiune-Jye Ho; Judith Shu-Chu Shiao. Development of the Nurses’ Occupational Stressor Scale. International Journal of Environmental Research and Public Health 2020, 17, 649 .

AMA Style

Yi-Chuan Chen, Yue Leon Guo, Li-Chan Lin, Yu-Ju Lee, Pei-Yi Hu, Jiune-Jye Ho, Judith Shu-Chu Shiao. Development of the Nurses’ Occupational Stressor Scale. International Journal of Environmental Research and Public Health. 2020; 17 (2):649.

Chicago/Turabian Style

Yi-Chuan Chen; Yue Leon Guo; Li-Chan Lin; Yu-Ju Lee; Pei-Yi Hu; Jiune-Jye Ho; Judith Shu-Chu Shiao. 2020. "Development of the Nurses’ Occupational Stressor Scale." International Journal of Environmental Research and Public Health 17, no. 2: 649.

Journal article
Published: 07 December 2019 in International Journal of Environmental Research and Public Health
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Background: High occupational stress has been associated with altered eating behaviors and obesity. Occupational stress is reported to be high in Asian countries. Furthermore, many Asian countries are increasingly consuming Western-type foods (e.g., incorporating drinks with meals) which collectively may also be contributing to obesity. Therefore, the aim of this study was to examine (a) associations between sugar-sweetened beverage (SSB) consumption as meal replacement and obesity and (b) associations between workload and substituting meals with SSB in nurses. Methods: A representative sample of 854 hospital-based nurses completed a structured questionnaire about SSB consumption, workload, and body mass index (BMI). Log binomial regression models were employed to test associations between SSBs and obesity rates and associations between workload and SSBs. Results: Most participants (57.6%) consumed SSBs as meal replacements during work. This was related to high workloads during shifts. Substituting SSBs for meals was significantly associated with increased likelihood of obesity (aPRR = 1.4, 95% CI (1.1, 1.7)). Workload was positively associated with SSB intake as meal substitutes (aPRR = 1.4, 95% CI (1.2, 1.6)). Conclusions: Our findings show that SSBs are used as meal substitutes and is due to the workload demands. Sugar-sweetened beverage consumption is also positively associated with the increased likelihood of obesity. Interventions that modify workloads and decrease SSB consumption may improve workers’ eating behaviors and health.

ACS Style

Ting-Ti Lin; Yue Leon Guo; Christopher Gordon; Elizabeth Cayanan; Yi-Chuan Chen; Chung-Mei Ouyang; Judith Shu-Chu Shiao. Association Between Sugar-Sweetened Beverage Consumption as Meal Substitutes, Workload, and Obesity in Nurses: A Cross-Sectional Study. International Journal of Environmental Research and Public Health 2019, 16, 4984 .

AMA Style

Ting-Ti Lin, Yue Leon Guo, Christopher Gordon, Elizabeth Cayanan, Yi-Chuan Chen, Chung-Mei Ouyang, Judith Shu-Chu Shiao. Association Between Sugar-Sweetened Beverage Consumption as Meal Substitutes, Workload, and Obesity in Nurses: A Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2019; 16 (24):4984.

Chicago/Turabian Style

Ting-Ti Lin; Yue Leon Guo; Christopher Gordon; Elizabeth Cayanan; Yi-Chuan Chen; Chung-Mei Ouyang; Judith Shu-Chu Shiao. 2019. "Association Between Sugar-Sweetened Beverage Consumption as Meal Substitutes, Workload, and Obesity in Nurses: A Cross-Sectional Study." International Journal of Environmental Research and Public Health 16, no. 24: 4984.

Journal article
Published: 29 November 2019 in International Journal of Environmental Research and Public Health
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In healthcare settings, nurses’ workload, burnout, and job satisfaction are associated to the patient–nurse ratio. Whether this ratio also affects their intention to leave the nursing profession, along with the underlying stress pathway, remains unclear. This study aimed to investigate the effects of the patient–nurse ratio on nurses’ intention to leave and considering the mediating roles of burnout and job dissatisfaction. The study analyzed the data of two pooled cross-sectional surveys collected in 2013 and 2014. Measures were obtained by a structure questionnaire, which queried the average daily patient–nurse ratio (ADPNR), nurses’ personal burnout, client-related burnout, job dissatisfaction, intention to leave, and other demographics. ADPNRs were standardized according to hospital levels. Multiple regression models examined mediation hypotheses, and a percentile bootstrap confidence interval was applied to determine the significance of indirect effects. A total of 1409 full-time registered nurses in medical and surgical wards of 24 secondary or tertiary hospitals in Taiwan completed self-administered questionnaires. Most of the participants were female (97.2%), and the mean age was 29.9 years. The association between the standardized ADPNR and intention to leave their job was significantly mediated by personal burnout, client-related burnout, and job dissatisfaction. Higher standardized ADPNRs predicted higher levels of personal burnout, client-related burnout, and job dissatisfaction, each of which resulted in higher levels of intention to leave the current job. The results highlight that appropriate patient–nurse ratio standards may be further discussed by selecting personal burnout, client-related burnout, and job dissatisfaction as indicators.

ACS Style

Yi-Chuan Chen; Yue Leon Guo; Wei-Shan Chin; Nai-Yun Cheng; Jiune-Jye Ho; Judith Shu-Chu Shiao. Patient–Nurse Ratio is Related to Nurses’ Intention to Leave Their Job through Mediating Factors of Burnout and Job Dissatisfaction. International Journal of Environmental Research and Public Health 2019, 16, 4801 .

AMA Style

Yi-Chuan Chen, Yue Leon Guo, Wei-Shan Chin, Nai-Yun Cheng, Jiune-Jye Ho, Judith Shu-Chu Shiao. Patient–Nurse Ratio is Related to Nurses’ Intention to Leave Their Job through Mediating Factors of Burnout and Job Dissatisfaction. International Journal of Environmental Research and Public Health. 2019; 16 (23):4801.

Chicago/Turabian Style

Yi-Chuan Chen; Yue Leon Guo; Wei-Shan Chin; Nai-Yun Cheng; Jiune-Jye Ho; Judith Shu-Chu Shiao. 2019. "Patient–Nurse Ratio is Related to Nurses’ Intention to Leave Their Job through Mediating Factors of Burnout and Job Dissatisfaction." International Journal of Environmental Research and Public Health 16, no. 23: 4801.

Original article
Published: 24 October 2018 in Journal of Nursing Scholarship
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Purpose Nurses are exposed to a poor psychological work environment; this may cause poor mental health, which is a risk factor for suicidal ideation. We investigated the association between psychological work environment and suicidal ideation among hospital nurses in Taiwan. Design We conducted a cross‐sectional survey in Taiwan female nurses using stratified sampling by region (north, central, south, and east) to select representative centers for this study. Methods A self‐report questionnaire including items on demographic data, the psychological work environment, and suicidal ideation was sent to nurses working in hospitals. Multiple logistic regression and population attributable risk analyses were performed to assess the effect of the psychological work environment on suicidal ideation. Findings A total of 2,734 eligible questionnaires (76.8%) were returned. The prevalence of suicidal ideation was 18.3%, and higher risk was found to be associated with the educational level of junior college or below, higher personal burnout, higher client‐related burnout, and always feeling stressed at work. Estimation of population attributable risk showed that higher personal burnout, client‐related burnout, and always feeling stressed at work were the most crucial factors among nurses, accounting for 19.4%, 8.6%, and 10.5% of suicidal ideation, respectively. Conclusions A considerable proportion of nurses developed suicidal ideation. A poor psychological work environment was a relevant factor for suicidal ideation. Clinical Evidence This study provides relevant knowledge for nursing management levels in preventing the development of suicidal ideation among nurses. Not only for nurses’ mental health, but for patient safety and care quality, further studies in improving nurses’ psychological work environment are warranted.

ACS Style

Wei‐Shan Chin; Yi-Chuan Chen; Jiune‐Jye Ho; Nai‐Yun Cheng Ms; Hsueh‐Ching Wu; Judith S. C. Shiao. Psychological Work Environment and Suicidal Ideation Among Nurses in Taiwan. Journal of Nursing Scholarship 2018, 51, 106 -113.

AMA Style

Wei‐Shan Chin, Yi-Chuan Chen, Jiune‐Jye Ho, Nai‐Yun Cheng Ms, Hsueh‐Ching Wu, Judith S. C. Shiao. Psychological Work Environment and Suicidal Ideation Among Nurses in Taiwan. Journal of Nursing Scholarship. 2018; 51 (1):106-113.

Chicago/Turabian Style

Wei‐Shan Chin; Yi-Chuan Chen; Jiune‐Jye Ho; Nai‐Yun Cheng Ms; Hsueh‐Ching Wu; Judith S. C. Shiao. 2018. "Psychological Work Environment and Suicidal Ideation Among Nurses in Taiwan." Journal of Nursing Scholarship 51, no. 1: 106-113.