【Study Design, Method】 We carried out a cross-sectional survey by providing anonymous self-administered questionnaires to 1,225 female nurses working in general hospitals of 200 or more beds in Prefecture A. The contents of the survey (scale) were attributes, work engagement (WE) (The Japanese version of the Utrecht Work Engagement Scale), coping characteristics (Brief Scales for Coping Profile (BSCP)), work demand and work resources (the new Brief Job Stress Questionnaire), spillover (Japanese version of the Survey Work–Home Interaction – NijmeGen, the SWING (SWING-J)) and mental health (The Center for Epidemiologic Studies Depression Scale (CES-D)). A lower CES-D score indicates better mental health.As an ethical consideration, after receiving approval from the University of Occupational and Environmental Health Ethics Committee (Approval No. H28-156), we provided a written explanation about the purpose of the study and its methods and the voluntary nature of the participant participation and requested for a response to the questionnaire, and confirmed their consent to participate when the forms were submitted. We carried out the analysis by first grouping the participants into two groups according to whether or not they have multiple roles at work and at home, namely a multiple role group (N = 262) and a no multiple role group (N = 350), followed by a formulation of Mann-Whitney U-Test comparisons between the two groups in terms of participant attributes and scores for each scale. Next, using the entire analysis population, we carried out a single regression analysis with mental health (CES-D) as the objective variable and each variable as the corresponding explanatory variable. After this, the significantly correlated variables were used as the explanatory variable to carry out stepwise multiple regression analysis.
【Result】 We recovered responses from 650 people (recovery rate: 53.1%), and the number of effective responses came from 620 people (effective response rate: 50.6%). The total CES-D score across the entire analysis population was 12 (9.8) points (median, (inter-quartile range)), whereas the score for the multiple role group, at 11 (9) points was significantly lower than that of the no multiple role group, at 14 (11) points. When each variable was compared between the two groups, the age, years of experience, willingness to use “proactive problem-solving” as a coping characteristic, work to family negative spillover (WFNS), work to family positive spillover (WFPS), and family to work positive spillover (FWPS) as an indicator of spillover and WE scores were higher with the multiple role group than the no multiple role group, whereas the number of night-time shifts per month, work demands, and “change of pace” and “avoidance and suppression” as coping characteristics was lower in the multiple role group than the no multiple role group. As a result of stepwise regression analysis that used the total CES-D points as an objective variable, the adjustment in the final model was R2=0.434 and the total CES-D score had a negative relationship with “change of pace” and “change in viewpoint” as coping characteristics, work resources, WE and multiple roles, while having a positive relationship with “Avoidance and suppression” as a coping characteristic, WFNS, and FWNS as spillover.
【Discussion】 The analysis population had lower mental health levels than healthy women of the same age group1, and nurses with multiple roles were shown to have better mental health than nurses without. Furthermore, the fact that deterioration of the mental health of female nurses is related to work resources and WE corresponded with the JD-R model (Job-Demand Resource model)2, 3 and also with previous research in terms of the fact that it is related to “change of pace”, “change in viewpoint”, and “avoidance and suppression” as coping characteristics and WFNS as spillover4-7. In addition, this study shows anew that there is a relationship between mental health and family to work negative spillover (FWNS). The study also shows that negative influences from both work and home deteriorate the mental health of female nurses. In addition, while the multiple role group had a higher WFNS than the no multiple role group, they tended to have higher WE, a regulatory factor raising the mental health level, and cope with stress more effectively. Therefore, while having multiple roles makes a nurse vulnerable to transferring negative influences from work to family, it could also serve as a source of strength to improve mental health.
【Conclusion】 Although the mental health level of working female nurses was low, we have shown that having multiple roles may be a source of strength for nurses to maintain and improve their mental health levels. For this reason, to assist female nurses in maintaining a healthy mental state while working, we believe that it is important not only to enhance the work resources but also to provide support for nurses in order to gain satisfaction in their family and home life.
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