Exploring Mental Health, Physical Health, and Affective Commitment in Acute Care Oncology Nurses in Ontario
Abstract
With reports of a steady increase in cancer risk as the present population ages (Canadian Cancer Society’s Advisory Committee on Cancer Statistics, 2017; Statistics Canada, 2017), and little knowledge of a definitive cure, ensuring cancer sufferers and their families are adequately supported is increasingly essential. Oncology nurses must therefore be the focus of current and future research, as their front-line presence in the lives of those afflicted, is quite substantial. Further, oncology nurses report the most physical symptoms and second highest levels of emotional distress among cancer care health professionals (Jones, Wells, Gao, Cassidy, & Davie, 2013; Kash et al., 2000).
In this study, a model integrating Avolio, Gardner, Walumbwa, Luthans, and May’s (2004a) authentic leadership theory; Milliman, Czaplewski, and Ferguson’s (2003) conception of workplace spirituality; and a learning-centered version of Kanter’s (1977) organizational empowerment theory, was tested in a sample of N=274 acute care oncology nurses in Ontario, Canada. Specifically, links between authentic leadership, workplace spirituality, structural empowerment (with a focus on learning at work), and nursing stress; and the subsequent mental health, physical health, and affective commitment of oncology nurses were examined. The moderating influence of individual spirituality on the workplace spirituality-nursing stress relationship was also explored.
A predictive, non-experimental, cross-sectional design was used following Dillman’s (2000) Method for survey-based studies. The initial model demonstrated poor fit, though adding structural empowerment-workplace spirituality and physical health-mental health paths; correlating two error terms associated with nursing stress; and removing one indicator associated with workplace spirituality resulted in improved fit: X2(164, N=274)=384.254, pX2/df=2.3. All hypothesized direct relationships were significant, except for the authentic leadership-nursing stress, and structural empowerment-nursing stress paths. The indirect effect of authentic leadership on nursing stress via workplace spirituality was also supported, though the indirect effect via structural empowerment was not. The moderation hypothesis was also unsupported.
The study results offer a unique way for authentic leaders to impact the work environment of acute care oncology nurses; with a structurally empowering learning environment and workplace spirituality identified as pathways to impact nursing stress, and foster health and commitment in this priority group.