JKANA Journal of Korean Academy of Nursing Administration J Korean Acad Nurs Adm 1225-9330 2288-4955 Korean Academy of Nursing Administration 10.11111/jkana.2019.25.3.248 jkana-25-248 Original Article Mediating Effects of Burnout between Time Pressure and Safety Care Activities of Nurses YunJungim1 SonHyun-mi2 Dongeui Medical Center College of Nursing, Pusan National University Corresponding author: Son, Hyun-Mi, College of Nursing, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 50612, Korea. Tel: +82-51-510-8315, Fax: +82-51-510-8308, E-mail: hmson@pusan.ac.kr 012019 17012019 253 248257 27022019 18032019 18032019 Copyright © 2019 Korean Academy of Nursing Administration 2019 This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Purpose:

This study was done to identify the effects of nurses’ time pressure on their safety care activities through the mediation of burnout.

 Methods:

Participants, 147 nurses with at least one year of work experience in two university hospitals were enrolled in this study. Data were collected using a self-reported questionnaire from July 31, to August 31, 2017 and analyzed with t-test, ANOVA, and Pearson’s correlation coefficients. SPSS 23.0 was used for analysis. Mediating effects were examined with stepwise simple and complex regression, and statistical significance was verified with the Sobel test.

 Results:

Time pressure and burnout were significantly negatively correlated with safety care activities, and there was a positive correlation between time pressure and burnout. Regarding the mediating effects of burnout in the relationship between time pressure and safety care activity, time pressure had a significant effect on safety care activity both directly and indirectly through burnout, confirming a partial mediation effect of burnout.

 Conclusion:

Strategies for enhancing work efficiency to reduce nurses’ time pressure are needed to promote safety care activities. Furthermore, because burnout facilitated by time pressure among nurses influences their patient care activities, interventions for burnout management must also be implemented simultaneously.

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General and Work Characteristics of Participants (N=147)

Characteristics Categories n (%) M±SD
Age (year) ＜25 37 (25.2) 27.18±3.95
≥25~＜30 81 (55.1)
≥30 29 (19.7)
Marital status Single 122 (83.0)
Married 25 (17.0)
Religion Yes 45 (30.6)
No 102 (69.4)
Education level College 26 (17.7)
Bachelor or higher 121 (82.3)
Workplace Medical ward 72 (49.0)
Surgical ward 59 (40.1)
Pediatric/Maternity ward 16 (10.9)
Clinical career (year) 1~2 52 (35.4) 4.39±3.03
3~4 39 (26.5)
5~6 27 (18.4)
≥7 29 (19.7)
Current position career (year) ＜1 19 (12.9) 3.21±2.21
1~2 56 (38.1)
3~4 34 (23.1)
5~6 28 (19.0)
≥7 10 (6.8)
Work hours per day ≤8.0 30 (20.4) 9.37±0.90
＞8.0 117 (79.6)
Safety education experience Yes 122 (83.0)
No 25 (17.0)

Time Pressure, Burnout, and Safety Care Activities (N=147

Characteristics M±SD Range Min Max
Time pressure 6.04±0.92 4.00~7.00 1 7
Burnout 4.68±0.64 3.41~6.08 1 7
  Emotional burnout 5.46±1.08 2.22~7.00 1 7
  Dehumanization 5.03±1.02 2.60~7.00 1 7
  Decrease in personal achievement 3.56±0.82 1.75~7.00 1 7
Safety care activities 4.38±0.40 3.33~4.88 1 5
  Medication 4.35±0.57 2.00~5.00 1 5
  Falls 4.31±0.46 2.83~5.00 1 5
  Infection 4.58±0.46 2.75~5.00 1 5
  Fire safety 4.11±0.79 2.00~5.00 1 5
  Patient identification 4.37±0.61 2.00~5.00 1 5
  Communication 3.98±0.83 2.00~5.00 1 5
  Blood transfusion 4.58±0.47 2.25~5.00 1 5
  Patient education 4.23±0.53 2.80~5.00 1 5
  Facility inspection 4.89±0.39 2.00~5.00 1 5

Difference in Patient Safety Activities by General and Work Characteristics (N=147)

Characteristics Categories M±SD t or F p
Age (year) ＜25a 4.18±0.38 6.48 .002
≥25~＜30b 4.36±0.38 a＜b, c*
≥30c 4.60±0.26
Marital status Single 4.34±0.42 -2.48 .014
Married 4.56±0.28
Religion Yes 4.43±0.42 0.96 .337
No 4.36±0.40
Education level College 4.36±0.39 -0.29 .770
Bachelor or higher 4.38±0.41
Workplace Medical ward 4.30±0.44 2.67 .073
Surgical ward 4.44±0.37
Pediatric/Maternity ward 4.48±0.33
Clinical career (year) 1~2a 3~4b 4.22±0.41 4.50±0.37 5.35 b, d＞a* .002
5~6c ≥7d 4.38±0.36 4.50±0.40
Current position career (year) ＜1a 1~2b 3~4c 5~6d 4.42±0.44 4.25±0.41 4.47±0.39 4.37±0.37 4.11 e＞b* .004
≥7e 4.73±0.13
Work hours per day ≤8.0 4.45±0.33 1.15 .252
＞8.0 4.36±0.42
Safety education experience Yes 4.38±0.40 0.09 .929
No 4.37±0.43

*Scheffé test.

Correlation among Time Pressure, Burnout, and Safety Care Activities (N=147)

Variables Time pressure
 Burnout
r (p) r (p)
Burnout .25 (.002)
Safety care activities -.30 (＜.001) -.28 (.001)

Mediating Effects of Burnout between Time Pressure and Safety Care Activities (N=147)

Models B SE β (p) R2 Adj. R2 F (p) Z (p)
I. Time pressure → Burnout 0.17 0.06 .25 (.002) .06 .06 9.71 (.002)
II. Time pressure → Safety care activity -0.13 0.04 -.30 (＜.001) .09 .08 14.05 (＜.001)
III. Time pressure → Safety care activity Burnout → Safety care activity -0.11 -0.14 0.04 0.05 -.24 (.003) -.22 (.006) .13 .12 11.17 (＜.001) 2.07 (.039)