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. 2024 Feb 1;24(1):90.
doi: 10.1186/s12888-024-05534-4.

Psychological pathway to emotional exhaustion among nurses and midwives who provide perinatal bereavement care in China: a path analysis

Jialu Qian #  1   2 , Gaoyan Wu #  3 , Cecilia Jevitt  2 , Shiwen Sun  4 , Man Wang  1 , Xiangyu Sun  1 , Xiaoyan Yu  5
Affiliations

Psychological pathway to emotional exhaustion among nurses and midwives who provide perinatal bereavement care in China: a path analysis

Jialu Qian et al. BMC Psychiatry. .

Abstract

Background: A lack of confidence in perinatal bereavement care (PBC) and the psychological trauma experienced by nurses and midwives during bereavement care leads to their strong need for sufficient organisational support. The current study intended to test a hypothesised model of the specific impact paths among organisational support, confidence in PBC, secondary traumatic stress, and emotional exhaustion among nurses and midwives.

Methods: A descriptive, cross-sectional survey was conducted in sixteen maternity hospitals in Zhejiang Province, China, from August to October 2021. The sample (n = 779) consisted of obstetric nurses and midwives. A path analysis was used to test the relationships among study variables and assess model fit.

Results: Organisational support directly and positively predicted confidence in PBC and demonstrated a direct, negative, and significant association with secondary traumatic stress and emotional exhaustion. Confidence in PBC had a positive direct effect on secondary traumatic stress and a positive indirect effect on emotional exhaustion via secondary traumatic stress. Secondary traumatic stress exhibited a significant, direct effect on emotional exhaustion.

Conclusions: This study shows that nurses' and midwives' confidence in PBC and mental health were leadingly influenced by organisational support in perinatal bereavement practice. It is worth noting that higher confidence in PBC may lead to more serious psychological trauma symptoms in nurses and midwives. Secondary traumatic stress plays an essential role in contributing to emotional exhaustion. The findings suggest that support from organisations and self-care interventions were required to improve confidence in PBC and reduce negative psychological outcomes among those providing PBC. The development of objective measures for assessing competence in PBC and organizational support are essential.

Keywords: Burnout; Cross-sectional; Organisational support; Path analysis; Perinatal bereavement care; Secondary traumatic stress.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The hypothesized model
Fig. 2
Fig. 2
Final model for the whole sample (N = 779), with standardized beta weights and significant level
See this image and copyright information in PMC

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