Mediating Effects of Anger Expression in the Relationship of Work Stress with Burnout among Hospital Nurses Depending on Career Experience.

objectivesThis study examined the mediating effects of anger expression in the relationship between work stress and burnout among nurses with more than or less than 3 years of career experience.

methodsA cross-sectional study was conducted with 454 nurses working at three university hospitals in South Korea. Nurses completed a survey consisting of demographic questions, the Maslach Burnout Inventory, the Work Stress Scale, and the Korean version of the Anger Expression Inventory. A multiple-group mediation analysis was performed using structural equation modeling.

resultsIn total (N = 454), work stress directly affected burnout, and all anger expressions indirectly affected the relationship of work stress with burnout. Different mediating effects of anger expression style according to career experience were shown; anger-out and anger-in in nurses with less experience (n = 184) and only anger-in in those with more experience (n = 270) partially mediated the relationship of work stress with burnout. CONCLUSIONS AND CLINICAL RELEVANCE: The indirect effect of anger-in style was higher than other anger expression styles in all nurses; suppression of anger caused by work stress can increase burnout. Anger-out played a functional role in the relationship of work stress with burnout among nurses who had less career experience. Therefore, to reduce burnout, creating a work environment with collaborative culture including authentic leadership and providing anger management programs will help to manage nurses' anger properly. For new nurses, promoting work and life balance, and creating a culturally empowering work environment to help them use anger-out expression constructively, are important to reduce burnout.