Burnout in neonatal intensive care unit nurses: relationships with moral distress, adult attachment insecurities, and proneness to guilt and shame
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Peter Barr
Abstract
Background
Informed by the person-environment transactional model of stress, the purpose of the study was to explore the relationships of environment-related moral distress and person-related anxious and avoidant adult attachment insecurities, and personality proneness to guilt and shame with burnout in neonatal intensive care unit (NICU) nurses.
Methods
This was a multicenter cross-sectional self-report questionnaire cohort study comprising 142 NICU nurses currently working on six Level 3–4 NICUs in New South Wales, Australia.
Results
Burnout was reported by 37% of NICU nurses. Moral distress, anxious and avoidant attachment, and guilt- and shame-proneness had moderate-large zero-order correlations with burnout. Overall, these predictor variables explained 40% of the variance in burnout. Moral distress (β = 0.40, P < 0.001), anxious attachment (β = 0.18, P < 0.05) and shame-proneness (β = 0.22, P < 0.01) were unique predictors of burnout. Shame-proneness partially mediated the effect of anxious attachment on burnout [indirect effect, B = 0.12, confidence interval (CI) (0.051–0.201)].
Conclusion
The management of burnout in NICU nurses requires attention not only to environment-related moral distress but also to person-related anxious and avoidant adult attachment insecurities and personality proneness to guilt and shame.
Author contributions: The author has accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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©2020 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Editorial
- Women and children first: the need for ringfencing during the COVID-19 pandemic
- Review
- The decline of amniocentesis and the increase of chorionic villus sampling in modern perinatal medicine
- Original Articles – Obstetrics
- Fetal renal artery impedance in pregnancies affected by preeclampsia
- The effect of maternal position on fetal middle cerebral artery Doppler indices and its association with adverse perinatal outcomes: a pilot study
- Interpregnancy interval and the risk for recurrence of placental mediated pregnancy complications
- Short- and long-term outcomes of preterm spontaneous twin anemia-polycythemia sequence
- How do sustained birth tears after vaginal birth affect birth tear patterns in a subsequent birth?
- Disorders of placental villous maturation in fetal death
- Atrial septal aneurysm in pregnancy: echocardiography and obstetric outcomes
- Appropriate delivery method for cardiac disease pregnancy based on noninvasive cardiac monitoring
- Original Articles – Fetus
- Success rate of five fetal cardiac views using HDlive Flow with spatiotemporal image correlation at 18–21 and 28–31 weeks of gestation
- Fetal brain development in small-for-gestational age (SGA) fetuses and normal controls
- Can fetal fractions in the cell-free DNA test predict the onset of fetal growth restriction?
- Original Articles – Newborns
- Presence of neonatal intensive care services at birth hospital and early intervention enrollment in infants ≤1500 g
- The contribution of twins conceived by in vitro fertilization to preterm birth rate: observations from a quarter of century
- Burnout in neonatal intensive care unit nurses: relationships with moral distress, adult attachment insecurities, and proneness to guilt and shame
Articles in the same Issue
- Frontmatter
- Editorial
- Women and children first: the need for ringfencing during the COVID-19 pandemic
- Review
- The decline of amniocentesis and the increase of chorionic villus sampling in modern perinatal medicine
- Original Articles – Obstetrics
- Fetal renal artery impedance in pregnancies affected by preeclampsia
- The effect of maternal position on fetal middle cerebral artery Doppler indices and its association with adverse perinatal outcomes: a pilot study
- Interpregnancy interval and the risk for recurrence of placental mediated pregnancy complications
- Short- and long-term outcomes of preterm spontaneous twin anemia-polycythemia sequence
- How do sustained birth tears after vaginal birth affect birth tear patterns in a subsequent birth?
- Disorders of placental villous maturation in fetal death
- Atrial septal aneurysm in pregnancy: echocardiography and obstetric outcomes
- Appropriate delivery method for cardiac disease pregnancy based on noninvasive cardiac monitoring
- Original Articles – Fetus
- Success rate of five fetal cardiac views using HDlive Flow with spatiotemporal image correlation at 18–21 and 28–31 weeks of gestation
- Fetal brain development in small-for-gestational age (SGA) fetuses and normal controls
- Can fetal fractions in the cell-free DNA test predict the onset of fetal growth restriction?
- Original Articles – Newborns
- Presence of neonatal intensive care services at birth hospital and early intervention enrollment in infants ≤1500 g
- The contribution of twins conceived by in vitro fertilization to preterm birth rate: observations from a quarter of century
- Burnout in neonatal intensive care unit nurses: relationships with moral distress, adult attachment insecurities, and proneness to guilt and shame
