Quality Of Work-Life Among Advanced Practice Nurses Who Care For Patients With Heart Failure: The Effect Of Resilience During The Covid-19 Pandemic

Abstract

IntroductionHeart failure (HF) prevalence continues to rise while therapeutic options expand in complexity. Advanced Practice Registered Nurses (APRNs; Nurse Practitioners & Clinical Nurse Specialists) manage high burden, complex care of patients with HF. During the COVID-19 pandemic, clinician burnout, stress and job dissatisfaction have likely impacted quality of life (WR-QoL). No studies describe burnout and resilience in APRNs who provide care to individuals with HF.AimsAmong APRNs who work with patients with HF, three aims include: 1) Describe the level of burnout and WR-QoL; 2) Determine the relationship between burnout and QOWL variables; 3) Examine whether resilience moderates the association between WR-QoL and burnout.MethodsThis descriptive correlational study employed an online survey in October, 2020 to APRNs who were members of the American Association of Heart Failure Nurses and the HFSA. Inclusion criteria: APRN's who practiced in cardiology clinics, advanced HF clinics, inpatient cardiology units, or HF home care programs, at least 8 hours weekly. Exclusion criteria: Exclusively pediatric, administrative, educational, or research-focused APRNs. Outcomes measured: Burnout (Copenhagen Burnout Inventory), WR-QoL (Work-Related QoL Scale), and Resilience (Brief Resilience Scale). Institutional review board approval and written consents were obtained.ResultsParticipant (N=101) mean age was 50 (±10) years, 93% identified as female, 96% White, and 70% were master's prepared. Mean weekly worked hours were more than 42 and the majority of APRNs (n=75) represented community and academic health centers. APRNs reported high levels of personal (M= 51.7, norm-referenced mean: 35.9) and work-related burnout (M=50.1, norm-referenced mean: 33.0) with significant correlations between high levels of burnout and low WR-QoL (r range: -.74 — -.39 -, p<.001). APRNs who reported medium or high resilience showed negative relationships between burnout and general well-being (r = -.64, -.76, respectively, p<.001), while the low resilience group showed no relationship. Additionally, APRNs who reported no/low or work-related burnout showed a positive relationship between resilience and general well-being (r = .57, p<.001), while the moderate and severe burnout groups did not.ConclusionWe found that the positive effect of resilience on general well-being decreased as work-related burnout went up, indicating the moderating role of work-related burnout. The unanticipated finding that the negative burnout-QOWL relationship was stronger with higher resilience requires more exploration. It is especially critical now, given the emphasis on supporting clinician well-being and preventing burnout, for us to better understand the role of resilience and burnout in well-being.