Psychology
2011. Vol.2, No.4, 323-330
Copyright © 2011 SciRes. DOI:10.4236/psych.2011.24051
Nurse’s Roles and the Mediating Effects of Stress on Job
Performance in Low and Developing Economies
Joshua Chiroma Gandi1, Wukatda Wokji Beben2, Yohanna Gyarazama2
1Department of General and Applied Psychology, University of Jos, Jos, Nigeria;
2School of Nursing, Ministry of Health, Jos, Nigeria.
Email: jcgandi2000@yahoo.com, gandij@unijos.edu.ng
Received March 16th, 2011; revised May 13th, 2011; accepted June 1st, 2011.
The role of nursing is observed to have been associated with multiple and conflicting demands. This study was
designed to examine nurse’s roles and the mediating effects of stress on job performance in low and developing
economies. Participants were hospital-based Nurses (n = 373) measured with “Maslach Burnout Inventory-
General Survey, Job Autonomy Questionnaire, Questionnaire on Organizational Stress-Doetinchem and Job
Diagnostic Survey”. The role of work-home interference (WHI) and home-work interference (HWI) with respect
to work characteristics, burnout, and gender were analyzed, using SPSS 15.01 version. No gender differences in
burnout levels; WHI and HWI were found to mediate the relationship between work characteristics and burnout.
Lack of significant gender difference regarding burnout might be due to the fact that men and women in Nigeria
have similar working conditions. High workload and home roles seem contributory to high levels of exhaustion.
Evidence indicate the need to lower the pace of work and number of patients per Nurse, to decrease workload
thereby reducing emotional exhaustion. There is sufficient evidence to believe that work stress is a factor among
health care personnel. To derive a better understanding of stress and burnout in the workplace, studies need to
move beyond the tendency of using descriptive designs. Such studies would aid understanding the effect of
stress and burnout on patient safety (outcomes).
Keywords: Gender, Home-Work Interference (HWI), Job Performance, Nurse’s Roles, Nursing, Work-Home
Interference (WHI), Stress
Background to the Study
In terms of broad behavioural construct, the general taxonomy
of job performance includes “assessment of performance,
analysis of job, and method of job elements” (Dokotri, 2006). A
model of job performance which takes into account the multi-
faceted nature of job and separates the various elements sub-
sumed under that rubric makes fundamental distinctions. Thus,
distinctions between: aspects of work evaluation that are under
the control of the worker (behaviours involved in job perform-
ance itself), aspects not under the control of the worker (the
consequence or effectiveness of job performance), aspects that
deals with relative costs (productivity), and aspects that showed
the value placed on each by the organization (utility). The
workers’ behaviour, job effectiveness, productivity, and utility
have inherent consequences. Hence, factors capable of inducing
stress might include catastrophes, major life changes, and daily
hassles, among others (Wai, 2009). Work-related stress can
impact on an organization based on the context (the organiza-
tional culture and function) and content (the work environment
and equipment). This study was premised on the concepts: ‘job
performance, nursing roles, stress’ as the variables of interest.
Conceptual Framework
Nurse’s Roles
The word “role” is a term borrowed by social scientists from
drama. In its theatrical context, role refers to a person pretending
to be someone else for the purposes of entertainment. This im-
plies certain deception and that is not the way the word “role” is
used in the phrase the “nurse’s role”. It is acceptable to say that
“role” is the term applied to human behaviour, based on the fact
that human being behave in certain relatively predictable pat-
terns (Wai, 2009). Role is a descriptive word for relatively pre-
dictable behavioural patterns. Wai (2009) inferred that the
nursing role, then, refers to all behaviours that are considered
appropriate for a nurse. Going down memory lane, the nurse’s
role could be described in terms of the historical images of the
nurse. Kato (1994) identifies three historically traditional images
that still influence the nursing profession:
The Folk Image: The folk image of the nurse as “mother”
arises from the original use of the word “nurse” to mean suckling
the young. This meaning quickly broadened to that of caring for
the sick and the aged. Such care was provided by simple meth-
ods passed on from one person to another. The folk image, which
is still held in some quarters today, is an emotional view of the
nurse as “mother: gentle, kind, always available, nurturing life
by natural means, wise but not learned.
The Religious Image: The care of the sick has always been
seen as a Christian duty in Western civilization. Thus, the
Church viewed caring for the sick as important for the salvation
of the soul of the care-giver. Over the centuries, this religious
image reinforced the characteristics of the folk image, since it
suggested that nursing should be done for love and required no
formal learning. Other notions were the beliefs that a nurse
should be celibate, cloistered, unworldly and strictly disciplined.
J. C. GANDI ET AL.
324
The Servant Image: This image arose during the 16th to the
19th centuries, been the dark ages in nursing history. During this
time, illness was seen as a punishment for sin and the care, if any,
given to the sick was far from charitable. Any nursing that was
available generally was given by ill-paid, ignorant and, some-
times, immoral women.
Nurses Preparation for Roles: Roles, however, have to be
learned by the instrumentality of socialization which occurs in
intentional learning and or incidental learning. A nurse is so-
cialized intentionally through the formalized education and
experiences received during training programmes. Incidental
learning or socialization occurs through more casual interactions
within the health care system and other relevant outfits. Nursing
is synonymous with caring which encompasses empathy for and
connection with people. Despite the expanded roles (practitioner,
clinician, clinical specialist and others), the professional nurse is
at times in situations that pose ethical and or moral conflict.
Stress: Throughout its history as a psychological construct,
stress has proven to be relatively complicated and has inspired
confusion. Conceptualized, at a point, according to mechanical
principles of load (external force) or the area upon which that
force is exerted, stress “signals danger” and “prepares” us to take
defensive action. For instance, the fear of things that pose real-
istic threats motivates us to deal with them or avoid them.
Moderate stress fuels creativity and motivates us to achieve. But
excessive stress leads to less cooperation, more aggression, and
even hinders performance on difficult tasks. Psychologists view
stress in three ways, including as: 1) a stimulus, 2) a response,
and 3) an ongoing interaction between the organism and its
environment.
Factors capable of inducing stress have been described in
terms of catastrophes (calamities or disasters), major life
changes (bereavement, poverty, loss of possession, illness/dis-
ability) and daily hassles (academic pursuits, work-related issues,
relational problems or unfriendly environment). Work-related
stress can impact in many ways, including the context (organ-
isational culture and function) and the content (work environ-
ment and equipment). The commonly accepted definition reads
“stress is a condition or feeling experienced when a person per-
cieves that demands exceed the personal and social resources the
individual is able to mobilize” (Lazarus, 1984). Thus, stress is
what we experience when we feel that we are not in control.
Work stress refers to the harmful physical and emotional re-
sponses that occur when job requirements do not match the
worker’s capabilities, resources, and needs (Murphy & Sauter,
1999).
Statement of Problem
Until now, not much research has been conducted on nurse’s
roles in relation to work characteristics and family responsibility
on the employees’ performance in low income and developing
countries like Nigeria. Considering that individuals in develop-
ing economies experience continuous and prolong stress (such as
those related to political instability, civil unrest, and resource
mis-management among others), it is particularly useful to see
how these citizens (especially caring professionals like Nurses)
cope in terms of work and stress. Moreso, Wai (2009) observed
that Nursing Profession has not been openly appreciated in
Nigeria despite her positive impacts on the lives of Nigerians
and the public at large.
Significance of the Study
This study would be of importance to health care providers,
researchers, health agencies, regulatory bodies and service-
users (the patients). It would serve as the means through which
capacity of the caring professionals could be built for more
effective job performance. The outcome is a veritable tool that
could serve as a wake-up call to enhance capacity building for
effective caring services. It would provide more impetus for the
quality improvement and evidence-based goal achievement
being pursued. Regulatory bodies would be more informed
when formulating policies or determining the necessary con-
ditions for professional practice. Healthcare agencies (public or
private), who are proprietors of health service outfits, would
benefit from the study results as empirical evidence (as claim)
that could enhance their management decisions and supervisory
roles.
Purpose and Objectives
Purpose of the Study
The main purpose of this study was to investigate nurse’s
roles and the mediating effects of stress on job performance
among in low and developing economies of the world.
Objectives of the Study
The research aims at achieving the following objectives:
1) To assess the effects of stress among male and female
Nurses in Nigeria
2) To determine direct relationships (if any) between work
characteristics, gender and Burnout
3) To investigate the role of work-home and home-work in-
terferences on job performance.
Study Hypotheses
The study hypothesized that:
(H1) stress and burnout prevalence among Nurses in the low
income and developing economies is high due to high work-
load;
(H2) women score higher on emotional exhaustion, while
men score higher on depersonalization;
(H3) job demands are primarily related to emotional exhaust-
tion, while job resources are primarily related to depersonalize-
tion and personal accomplishment;
(H4) both WHI and HWI are higher for women than men;
(H5) both WHI and HWI mediate the relationship between
work characteristics and burnout outcomes; and this media-
tional effect is stronger for women.
Methodological Approach and Justification
Study Setting & Population
The study was conducted in Bauchi State, under the State
Chapter of the National Association of Nigerian Nurses &
J. C. GANDI ET AL. 325
Midwives (NANNM). Situated in the northeast zone, Bauchi
State is one of the 36 states of the Federal Republic of Nigeria.
The state, which housed a good number of hospitals/health
centers, have three Senatorial Districts and 16 Local Govern-
ment Areas. These hospitals/health centers are variously pro-
prietored by Federal Government, State Government, Local
Governments, Companies/Corporate Organizations, and private
enterprenures. During the period of this study, Bauchi State
population stood at 4.1 million people. There were then 3698
Nurses, including those under the services of Federal Govern-
ment, State Government, Local Governments, Companies/
Corporate Organizations, and private hospitals/clinics. These
Nurses consisted of male and female as well as Christians and
Muslims.
Participants and Sampling Techniques
From the 3698 Nurses, 373 study participants were selected
by stratified random sampling. The stratification technique
included geographical location (senatorial zones) of the hospi-
tals/health centers and sex (or gender) of the Nurses. Among
the 373 participants, 113 were randomly sampled from Bauchi
North senatorial zone, 100 from Bauchi central senatorial zone
and 160 from Bauchi South senatorial zone. Overall, the par-
ticipants included 99 male muslims, 85 male christians, 83
female muslims and 98 female christians. The sampling tech-
nique made use of formal identifying information, not the
physical Nurses. Access to the staff inventory, containing
demographic and personal data of prospective participants, at
each participating hospital/health center’s personnel office have
reasonably facilitated the whole sampling exercise.
Design
This research was an exploratory (survey-type) design.
“Nurse’s roles” and the mediating “effects of stress” was con-
sidered the independent variables while “job performance”
considered as the dependent variable.
Instruments and Measures
1) Maslach Burnout Inventory-General Survey (Maslach &
Leiter, 1997): Burnout was measured using the Maslach Burn-
out Inventory-General Survey (Maslach & Leiter, 1997) which
contained 22 items and three scales. Emotional exhaustion was
measured by ten items (α = .89), depersonalization by five
items (α = .68) and reduced personal accomplishment by seven
items (α = .75). Previous research shows that the reliability of
depersonalization score is usually low. Responses were made
on a six-point scale (0 = never, 6 = every day).
2) Job Autonomy Questionnaire (De Jonge, Landeweerd, &
Nijhuis, 1993): Workload was measured by an eight item scale
(α = .87) based on the Job Autonomy Questionnaire (De Jonge,
Landeweerd, & Nijhuis, 1993). The participants indicated their
agreement with each item on a four-point scale (1 = never, 4 =
very often). Job control was measured by 4 items (α = .72) of
the Inventory of feelings of motivation and demotivation. Re-
sponses were made on a four point scale (1 = not at all, 4 = very
much). Work-home and home-work interference were assessed
via two scales consisting of 13 items. Work-home interference
was measured by seven items (α = .90). Home-work interfere-
ence was assessed by six items (α = .84). The respondents an-
swered via five point scale (1 = never, 5 = always).
3) Questionnaire on Organizational Stress-Doetinchem (VOS-
D): Social support was measured by three 5-item scales de-
ducted from the Questionnaire on Organizational Stress-Doe-
tinchem (VOS-D), each assessing the social support received
from supervisor/colleague, partner and family/friends. The
scores on three subscales were averaged to yield a sum score.
Reliability of the scale was good (α = .82). Items were rated on
four point scales (1 = never, 4 = always).
4) Job Diagnostic Survey (Hackman & Oldham, 1980):
Work content was assessed via five items based on the Job
Diagnostic Survey (Hackman & Oldham, 1980. The scale (α
= .82) was based on a four point answering options (1 = never,
4 = very often).
Data Collection
Methods
Field Assistants: Research field assistants (n = 12) were re-
cruited and given appropriate orientation on effective admini-
stration and retrieval of questionnaires.
Procedure: Data collection procedure commenced after ob-
serving the appropriate tenets and protocols that defined ethical
consideration. The following sequence of activities then took
turns:
Appropriate administration of instruments (questionnaires)
to the participants
Reetrieval/collection of all completed instruments (ques-
tionnaires).
Collation of the retrieved questionnaires for onward analy-
ses.
Ethical Issues and Approval
Institutional approvals were sought from and granted by
Education Standards and Research Committee of the National
Association of Nigeria Nurses & Midwives (Bauchi State
Chapter). All participants individually signed an informed con-
sent for participation and were duly debriefed after the exercise.
Data Analysis
In order to determine gender differences in the level of
burnout, “independent samples” t-tests were performed. The
cut-off points for different levels of burnout were obtained from
the Utrechtse Burnout Schaal (UBOS) manual (Schaufeli &
Dierendonk, 2000). The relationship between work characteris-
tics and burnout was analyzed by means of linear hierarchical
regression analyses. Because of high multicollinearity of WHI
and HWI, separate analyses were carried out for these variables.
The mediating role of WHI and HWI was assessed using the
recommended method of analyses in line with Mackinnon,
Lockwood & Hoffman (2002); by checking whether paths from
predictor to intervening variable and from intervening variable
to outcome variable are both significant. If so, then the inter-
vening variable is a mediator of the relationship. This method
has most power and most accurate Type 1 error rates as com-
pared to other mediation tests (Mackinnon, Lockwood, & Hoff-
man, 2002). All the analyses were performed using SPSS 15.01
version.
J. C. GANDI ET AL.
326
Results/Findings
Preliminary Analyses and Burnout Prevalence among
Nurses
Emotional exhaustion experienced by Nigerian Nurses was
medium to high and depersonalization was medium. At the
same time, they felt they were doing their job very well, having
on average high levels of personal accomplishment. Thus, the
first hypothesis was confirmed partially (see Table 1). The
second hypothesis regarding gender differences and burnout
was not confirmed, since no significant gender differences were
detected. The trend was however, that females experienced
more emotional exhaustion, higher depersonalization and
higher personal accomplishment than men.
Direct Relationships between Work Characteristics,
Gender and Burnout
The predicted stronger relationship between job demands
than job resources on emotional exhaustion (H3) was confirmed
only for women. For men, job resources and job demands play
an equally important role in determining levels of emotional
exhaustion (see Table 2). The predicted stronger relationship
between job resources than job demands on depersonalization
(H3) was confirmed only for men. For women both job de-
mands and job resources equally contribute to depersonaliza-
tion. For men, variance accounted for by job characteristics is
higher than for women, suggesting that other variables play a
more important role in predicting depersonalization in women.
Predicted stronger relationship between job resources than job
demands on personal accomplishment (H3) was confirmed for
both men and women. However, for men, work characteristics
accounted for greater portion of variance (19%) than for
women (8%). This implies that for women other variables than
work characteristics are more important in accounting for levels
of personal accomplishment.
Role of Work-Home and Home-Work Interference
The fourth hypothesis about higher levels of WHI/HWI
among women could not be confirmed. No statistically signifi-
cant gender differences regarding overall levels of WHI/HWI
were found. Mean levels of WHI were higher than HWI levels
for both genders. Subanalyses (not shown) revealed that 20.7%
of men and 30.8% of women experienced WHI at least occa-
sionally, while the same analyses for HWI revealed the preva-
lence of 5.2% for men and 5.1% for women.
The results regarding mediating effects of WHI and HWI
between work characteristics and burnout outcomes are pre-
sented in Figure 2. For men, WHI mediates the relationship
between work characteristics and emotional exhaustion. Strong-
est positive association of work home interference was with job
demands and negative association with job control. No mediat-
ing role was found regarding depersonalization and personal
accomplishment. For women, WHI mediates the relationship
between work characteristics and emotional exhaustion and
depersonalization. Strongest positive association found was
between job demands and WHI, and strongest negative associa-
tion was between job control and WHI. No mediating role of
WHI between work characteristics and personal accomplish-
ment was found.
In both male and female Nurses, HWI mediates the relation-
ship between work characteristics and all three burnout vari-
ables. For men, lack of social support is most strongly related to
HWI, which in turn has the strongest association with emo-
tional exhaustion. The same pattern is found among female
Nurses, but the strength of the relationship is weake Thus, the
Table 1.
Descriptive Characteristics and Correlations between variables for males (N = 56 to 58) in the top right corner and females (N = 308 to 315) in the
bottom left corner.
Variables Mean SD Mean SD t-test1 2 3 4 5 6 7 8 9 10
Age 47.43 10.16 47.38 8.48 .03 1 .01 .22**.03 .04 .02.14** .11* .01 .05
Emotional
exhaustion 2.25 1.33 2.51 1.30 1.42 .011 .44**.12.60** .23** .21** .27** .56**.33**
Depersona
lization .63 .65 .75 .92 .75 .22**.44**1 .24** 27** .07 .19** .18** .29**.34**
Personal
accomplishment 5.10 1.06 5.18 .81 .63.03 .12*.24**1 .04.19** .31** .18** .05 .21**
Job
demands 2.83 .58 2.93 .60 .17 .04.60**.27**.041 .14** .08 .13** .56**.29**
Job control 2.89 .76 2.74 .66 1.54 .02 .23** .07.19** .141 .34** .30* .23** .17**
Job content 2.89 .73 2.92 .58 .34.14** .21** .19** .31**.08.34** 1 .32** .15*.19**
Lack of
social support 1.66 .37 1.75 .40 1.55.11**.27**.18** .18**.13* .30** .32** 1 .27* .34**
Work on home
interference 2.42 .85 2.58 .80 1.35 .01.56**.30**.05.56** .23** .15** .27** 1 .59**
Home on work
interference 1.65 .58 1.68 .61 .44 .05.33**.34** .21** .29** .17** .19** .34** .59**1
Note: ** p < 0.01 level (2-tailed); *p < 0.05 level (2-tailed) missing values were handled by pairwise deletion.
J. C. GANDI ET AL. 327
Table 2.
Means, standard deviations, and correlations between the model variables.
Males (N = 184)
Variable M SD 1 2 3 4 5 6 7 8 9 10
1. WHI 2.15 0.81
2. HWI 1.46 0.63 .31
3. Quantitative job demands 2.52 0.82 .39 .12
4. Emotional job Demands 1.71 0.71 .29 .17 .46
5. Mental job Demands 2.97 0.82 .22 .14 .63 .48
6. Quantitative home demands 2.26 0.78 .21 .27 .32 .30 .39
7. Emotional home Demands 1.66 0.65 .23 .42 .31 .35 .40 .49
8. Mental home Demands 1.89 0.76 .16 .30 .30 .27 .41 .69 .55
9. Exhaustion 2.78 1.11 .40 .34 .55 .60 .50 .39 .40 .34
10. Cynicism 2.49 1.19 .22 .33 .22 .30 .23 .31 .30 .28 .64
Note: All correlations are significant at the p < .01 level.
Females (N = 184)
Variable M SD 1 2 3 4 5 6 7 8 9 10
1. WHI 2.15 0.81
2. HWI 1.46 0.63 .31
3. Quantitative job demands 2.52 0.82 .39 .12
4. Emotional job Demands 1.71 0.71 .29 .17 .46
5. Mental job Demands 2.97 0.82 .22 .14 .63 .48
6. Quantitative home demands 2.26 0.78 .21 .27 .32 .30 .39
7. Emotional home Demands 1.66 0.65 .23 .42 .31 .35 .40 .49
8. Mental home Demands 1.89 0.76 .16 .30 .30 .27 .41 .49 .45
9. Exhaustion 2.78 1.11 .50 .34 .45 .45 .40 .69 .55 .46
10. Cynicism 2.49 1.19 .22 .33 .22 .30 .23 .31 .30 .28 .64
Note: All correlations are significant at the p < .01 level.
fifth hypothesis was confirmed partially. WHI and HWI are
mediating the relationship between job characteristics and some
burnout outcomes, but the relationship is stronger for men than
women.
Limitations of the Study
This study has a number of limitations. Considering that we
used a cross sectional method of data collection, no causal rela-
tionships could be established and no insight is available into
how the situation has been developing from then on.
Discussion
This study assessed nurse’s roles and the mediating effects of
stress on job performance which have not been sufficiently
explored in low and developing economies of the world. Hence,
the role of work-home and home-work interferences were also
examined with respect to work characteristics while paying
special attention to gender.
Burnout Prevalence and Gender Differences among
Nurses
The results regarding burnout and stress could be explained
in terms of JD-R model. Since the levels of job demands among
Nurses were high (see Table 1), this was reflected in exhaustion
from work. However, job resources were also high, which
buffered this negative role of job demands (Bakker, Demerouti,
& De Boer, 2003). Lack of significant gender difference re-
garding burnout might be due to the fact that men and women
J. C. GANDI ET AL.
328
Figure 1.
The concept model of relationship between work characteristics, work-home interference/home-work interference on burnout.
in Nigeria have very similar working conditions. The Nurses’
empathy for and connection with patients actually demonstrates
the five core professional values which are essential but, con-
sequently, attracts factors capable of inducing stress.
The role of nursing is associated with multiple and conflict-
ing demands, impose by the patients needs, which are sources
of initiating and promoting burnout. An explanation for this
might be in terms of high workload, having many patients (with
varying needs) per Nurse. However, family and a wider socio-
economic perspective could also play a role. High levels of
exhaustion experienced among Nigerian Nursess may be a re-
flection of accumulated tiredness from wider economic and
political worries that persons carry and that spills-over to work,
resulting in work-related exhaustion. Prevalence of personal
accomplishment might be inherent when Nurses often see cli-
ents generally recover fast, following their caring services.
Direct Relationship between “Work Characteristics
and Burnout” Outcomes
Job demands were associated with emotional exhaustion for
both genders, which is in line with the JD-R model and the
study hypothesis that predicts a strong association between
demands and exhaustion (Bakker & Geurts, 2004). However,
for men, the link between job resources and emotional exhaus-
tion was as important as between job demands and emotional
exhaustion, which contradicts the JD-R model. Depersonaliza-
tion was strongly related to job resources for men and only
weakly for women. Consequently, job demands were more
strongly associated with women than men. That is probably
because women have more elaborate systems of support than
men and so lack of emotional support regarding the work does
not have much effect on them. Thus, when social support is
lacking, men react by distancing themselves from patients,
while women have other sources of support that buffer the lack
of this type of support.
Job resources (as predicted by the JD-R model) are associ-
ated with the personal accomplishment (Bakker & Geurts, 2004;
Schaufeli & Enzmann, 1998). There is a gender difference with
regards to this component; with job resources playing a more
important role in determining levels of personal accomplish-
ment for men than women. This is in line with earlier study
(Houkes, Winnants, & Twellaar, 2008), which found different
role of job resources for men and women in relation to burnout
components.
It was found that levels of WHI are higher than levels of
HWI. It appears that the boundar from work to home duties is y
J. C. GANDI ET AL. 329
Figure 2.
Mediating role of WHI and HWI for males/females.
more permeable than the boundary from home to work. Higher
WHI might be a reflection of broader societal phenomena that
values career success more than family harmony. Since WHI
interferes with meeting family demands, it can be particularly
strenuous for women, for whom family-related self-image is
often an important part of identity.
No gender differences regarding the levels of WHI/HWI
were found. However, women in this study indicated being
more in charge of home duties than their partners. Stemming
from this, home-work interference for women would have been
expected to be higher. One possible explanation might lie in
women’s extensive web of social network that they can rely on,
which ensures that the childrearing duties do not spill-over to
work. Furthermore, the fact that women did more chores at
home might not lead to interference with work, but rather with
free time and leisure activities. However, regarding the mediat-
ing role of WHI and HWI, some gender differences were noted.
For men, the strength of relationships between predictor vari-
ables and WHI/HWI as mediators was stronger than for women.
This is surprising, considering that the sample size of males
was much smaller, which should have led to less power. This
implies that in particular for males, WHI/HWI are important
mediators of relationship between work characteristics and
burnout outcomes.
Implications for Research and Practice
Results of our study indicate obvious need to lower the pace
of work and number of patients per Nurse. This is crucially
anticipated in order to decrease workload, which should subse-
quently decrease emotional exhaustion. Decreasing work de-
mands is especially beneficial for women, since for them the
demands are linked both to exhaustion and distancing from
clients. At the same time, improving available resources such as
better social relations and more autonomy are important (espe-
cially for male Nurses) since they are linked with all three
burnout outcomes. Considering that a complex bureaucratic
healthcare system is the issue, such changes need to be incur-
porated both in a wider policy level as well as at a micro, de-
partmental level.
Roughly every third female and every fourth male Nurse in
our sample experienced WHI at least occasionally. This group
should be attended to, since WHI is directly associated in
women with levels of exhaustion and distancing, and plays an
important mediating role in males between work characteristics
and emotional exhaustion. When WHI is low, it is a protective
factor against negative work characteristics, while when it is
high, it is an important risk factor. Thus in the future, particular
attention should be paid to public health policy that would en-
hance as much as possible the healthy work-life balance.
HWI level in our sample was very low and at the moment is
not an important concern for the employees. However, it is a
predictor of burnout and its mediating role is very potent and
should not be neglected. Should the level of HWI increase, such
as due to childcare related needs or extended family caretaking
duties, persons are then particularly vulnerable to the negative
J. C. GANDI ET AL.
330
influence of job demands and lack of job resources. In this re-
spect, no gender differences were observed and both male and
female are equally vulnerable.
Gender differences in terms of contribution of job demands
and job resources to burnout subcomponents call for a gender
sensitive approach not only in research work, but also in de-
velopment of theoretical models. It might be that different
models apply for two genders. Thus in the future, it is advisable
to develop and test gender specific models that will provide
better understanding of gendered expressions of health (Ham-
marstrom, 2003).
Conclusion
Considering the perceived implications of the study findings,
there’s need for replication and further studies. It seems accept-
able to conclude that intervention studies will, in particular,
help remedy the inherent problems and or prevent them.
Acknowledgements
We thank the Bauchi State Nurses for their kind participating
willingly as study participants. We also thank Dr P. S. Wai, Dr
H. Karick and Dr A. Zamani for their selfless mentorship.
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