The Mediating Role of Self-Endangering Cognitions between Nurses’ Altruistic Job Motives and Self-Esteem and Exhaustion: A Longitudinal Study

Abstract

Background: Employees in long-term care suffer under high work strain. More research is needed on individual resources and coping strategies.

Objective: To expand the perspective of the job demand-resources model by including personal characteristics and the construct of self-endangering as a mediator between personal resources and nurses’ emotional exhaustion. 

Design: Longitudinal study with two measurement points.

Settings(s): Long-term care institutions in Germany.

Participants: The final analysis sample consisted of nw1 = 416 and nw12 = 50.

Methods: A longitudinal questionnaire survey was conducted between July 2020 – March 2021 among nurses. Data were analysed by a multiverse analytic strategy using regression analysis with measurement repetition and cross-lagged-panel design for waves one and two.

Results: A highly altruistic job motivation leads to more self-endangering cognitions and to more self-endangering behavior tendencies. Mixed model analysis and cross-sectional path analysis confirmed mediation effects from altruism over self-endangering to exhaustion. 

Conclusion: Our findings are at odds with some research findings about altruism in nursing, such that too much altruism can lead to harmful self-endangering. We also introduce a new instrument to capture self-endangering in nursing care. Future research should investigate various facets of self-endangering in nursing. We assume that leadership behavior could have influence on self-endangering. New health policy structures are needed to improve working conditions in nursing and thus prevent self-endangering.

Note:
Funding Information: This research was partially supported by funds from the joint project “Healthy Ageing in Long-Term Geriatric Care” (gesaPflege) of an association of several public long term-care organizations in Germany. The publication of this article was funded by Chemnitz University of Technology.

Conflict of Interests: We have no known conflict of interest to disclose.

Informed Consent Statement: The policy conforms to European and German data protection regulations and was deposited online for participants. Before starting the survey, participants had to give their consent and confirm that they were at least 18 years old.

Keywords: Long-term care, self-esteem, nurses' self-endangering behavior, altruism, coping strategies, burnout