Answer

Concept Analysis

Introduction

            In their study, Nabizadeh-Gharghozar et al.  (2020), aimed to analyze the concept of occupational burnout among nurses. Occupational burnout can significantly impact nurses’ mental and physical health and the quality of care that nurses provide. Nurses work in challenging conditions of close relationships with other individuals and clinical settings. Patient care is a challenging task that puts nurses under high psychological and physical pressure. Nurses may not have the authority or ability to satisfy all the expectations held by patients. A challenging and demanding healthcare environment can put nurses at a greater risk of experiencing mental and physical health disorders, including job burnout. Job burnout is a psychosocial syndrome that manifest with indifference, emotional fatigue, and reduced personal achievement (Nabizadeh-Gharghozar et al., 2020). Xiao and Cooke (2019), used a similar three phase hybrid model; although step two involved use of refined search terms and phase three involved used of citation pearl-growing method to identify more sources of reference.

Method Analysis

            The authors analyzed the concept of job burnout among nurses through use of a hybrid model that involved three phases. The first phase was a theoretical phase in which search for secondary sources of evidence was conducted in electronic journal databases. The rationale was to provide background as well as to explore various definitions of job burnout with particular focus on nursing practice. The second phase was the field work in which the investigators interviewed nurses about the various issues relating to job burnout. Thematic analysis was later conducted to help identify meaning from interviewee responses. The last phase was the analytical phase in which phase 1 and phase 2 was combined to help gain more insight into the issue to nurse job burnout (Nabizadeh-Gharghozar et al., 2020).

Analytical Process

            Hybrid model is a methodological approach for conceptualization, theory advancement, and concept development. It can be used in nursing practice to clarify uncertainties on different concepts as well as to assess concepts in their contexts. Through use of hybrid model, it was possible for the authors to integrate both deductive and inductive approaches. This approach enabled the authors to refine the concept of nurse job burnout, which is commonly in use in current literature (Nabizadeh-Gharghozar et al., 2020).

            As discussed above, the hybrid model consists of three phases including the theoretical phase, the fieldwork phase, and the final analytic phase. The key goal of the theoretical phase was to develop context for redefinition of job burnout and for the in-depth analysis. Database exploration resulted in retrieval of 91 studies; however, 57 qualitative and quantitative were finally included after exclusion of 34 based on irrelevant and similar records. Data extraction form was utilized to extract definitions, consequences, antecedents, dimensions, and contributing factors of job burnout (Nabizadeh-Gharghozar et al., 2020).

            The field work phase goal was to reinforce and polish job burnout definition from various definitions that were identified in the first phase. The World Health Organization defines job burnout as a psychological process that is caused by occupational stress, manifested by depersonalization, emotional exhaustion, and reduced functionality and motivation, while the Oxford dictionary defines job burnout as mental or physical collapse caused by stress or overworking (Nabizadeh-Gharghozar et al., 2020).

The second phase involved analysis of the empirical components of nurse job burnout. The interviewees provided first hand qualitative data for extensive and in-depth analysis of the concept of job burnout among nurses.  In this phase, qualitative data was drawn from interview outcomes. Nurses were asked to provide their experiences and perceptions during the interviewees. Diversity of nurses was observed during the selection of interviewees with consideration of differences such as ward, job experience, gender, ward, work experience, hospital affiliations, work shift, and nurses who did not had any management roles from the teaching hospitals. Data collected from twelve interviews (12 participants) was then analyzed via thematic analysis for generation of meaning. The process involved transcription of recorded interviews and identification of main ideas. These data were then organized into main categories and subcategories (Nabizadeh-Gharghozar et al., 2020).

            Phase III involved combing phase I and phase II findings. The final analytical phase provided a comprehensive definition of the concept of job burnout among nurses and to determine antecedents of job burnout as well as the consequences in Iranian context. Findings from the first and second phase provided a comprehensive definition of job burnout as a state of nurses’ physical, mental, social, as well as emotional exhaustion that comes about from insufficient sociological and managerial support that leads to diminished sense of motivation for and job interest, impacts quality of care, and leads in negative attitudes and behavior towards the self, clients, and work. The identified dimensions of job burnout included physical exhaustion, social exhaustion, emotional exhaustion, lack of personal accomplishment, and depersonalization (Nabizadeh-Gharghozar et al., 2020).

Application of the Concept in a Practice Situation

            Findings from the study can be applied in practice situations. The study points out on the need to improve and streamline practice issues such as staffing working and sleep hours, work schedules, and establishment of appropriate patient-staff ratios. Heavy workload should be distributed adequately among the staff members and recruitment of new staff members if need be. Other issues that need to be addressed include job insecurity, insufficient income, poor skills for fulfilling the patient’s needs, and inadequate preparation (Nabizadeh-Gharghozar et al., 2020). There is need for healthcare organizations to put in place valid and reliable measurement models/tools for screening of nurse burnout in periodical basis. On the other hand, enhancement of environmental, organizational as well as managerial can help prevent occurrence and manage job burnout. Some of the practical strategies for lowering nurses’ burnout is via recruitment of more competent nurses in response to issues such as staff shortages. Nurses should also be provided with recreational facilities to reduce the level of job stress by resting. Managerial strategies include budget allocation for timely payments of nurses’ salaries, regular in-service training-programs, and enhancement of physician-nurse relationships. Promoting nurses’ professional autonomy, interdisciplinary collaboration, clarification of nurses’ professional roles, and organizational and managerial support (Nabizadeh-Gharghozar et al., 2020).

Conclusion

            Three phase hybrid model concept analysis demonstrate that job burnout among nurses is a major practice issue that may lead to poor outcomes among individual nurses and the patient population. Job burnout may reduce the quality and safety of care. Job burnout can have negative effects on the nurses’ professional performance, care quality, and work attendance.