Job stress and burnout among nurses: the mediational effect of spiritual well-being and hardiness

The purpose of this study was to determine the relationships among job stress, spiritual well-being, and burnout among nurses. A model of burnout based on Selye's stress theory and the Neuman Systems Model was empirically tested with the structural equation modeling (SEM) approach. A nonrandomized sample of 208 registered nurses completed four instruments--the Stress Diagnostic Survey, the JAREL Spiritual Well-Being Scale, the Personal Views Survey, and the Maslach Burnout Inventory.

Data were analyzed using EQS 5.1 for Windows Statistical Software Package and consisted of an assessment of the shape of the sample distribution, of the residuals, of the goodness of fit indices, of the iterative summary, and of the parameter estimates. The model was found to fit the observed data and the following five hypothesized relationships were supported: (a) job stress has a direct positive effect (parameter coefficient =.55) on burnout among nurses, (b) spiritual well-being has a direct negative effect (parameter coefficient = $-$.36) on burnout among nurses, (c) spiritual well-being has a direct positive effect (parameter coefficient =.40) on hardiness among nurses, (d) hardiness has a direct negative effect (parameter coefficient = $-$.27) on burnout among nurses, (e) spiritual well-being operating through hardiness has an indirect negative effect (parameter coefficient = $-$.11) on burnout. The fit indices for the model were as follows: Bentler-Bonett Normed Fit Index =.91, Bentler-Bonett Non-normed Fit Index =.92, Robust Comparative Fit Index =.95. The following conclusions were made: (1) Job stress has a moderate direct positive effect on burnout among nurses. (2) Spiritual well-being has a moderate direct effect on burnout among nurses. (3) Spiritual well-being has a moderate direct effect on hardiness. (4) Hardiness has a small direct negative effect on burnout. (5) Spiritual well-being operates indirectly through hardiness to influence burnout among nurses. (6) The conceptual framework for the study was supported.