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Burnout

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Building Trust To Extinguish Burnout: A Qualitative Study Of Hospital, State, And Federal Policies That Impact Pediatric Nurse Burnout In Connecticut, Cecelia Angelica Morello May 2024

Building Trust To Extinguish Burnout: A Qualitative Study Of Hospital, State, And Federal Policies That Impact Pediatric Nurse Burnout In Connecticut, Cecelia Angelica Morello

Senior Theses and Projects

This thesis explores how federal and state governments, as well as individual hospitals, respond or fail to respond to pediatric nurse burnout. The problem of nurse burnout is not new, and can cause nurses to make mistakes on shift, experience increased anxiety and depression, and increase risk of patient death or injury. Solutions to burnout in healthcare workers have been organized at the hospital, state, and federal government level. However, this thesis examines a lack of research on pediatric nurse burnout more specifically. After reviewing the national landscape of hospital-based solutions, short-term policy solutions, and long-term policy solutions, I examine …


Going, Going, Gone: The Influence Of Job And Home Demands And Resources On Emergency Department Nurse Turnover, Jordan Gail Smith May 2024

Going, Going, Gone: The Influence Of Job And Home Demands And Resources On Emergency Department Nurse Turnover, Jordan Gail Smith

All Dissertations

Nurse turnover, which challenged healthcare organizations even before the pandemic, reached alarming rates across hospitals worldwide during COVID-19. Due to the unprecedented and stressful nature of the pandemic, recent investigations have focused primarily on exploring job demands and nurse turnover intentions. While job demands are critical to understanding turnover, this narrow scope ignores the possible influence of other factors such as job resources and demands and resources external to the work domain. This study utilized archival qualitative data from a longitudinal survey of Emergency Department clinicians to analyze research questions and hypotheses. The first aim of this study was to …


Examining The Association Between Emotional Intelligence, Meaning In Life, Stress, And Burnout Among Preâ??Medical Students In The United States, Nayla Paulina Paulina Bejarano Chacon Aug 2023

Examining The Association Between Emotional Intelligence, Meaning In Life, Stress, And Burnout Among Preâ??Medical Students In The United States, Nayla Paulina Paulina Bejarano Chacon

Open Access Theses & Dissertations

Background and significance: The Association of American Medical Colleges (AAMC) has estimated that by 2034 there will be a physician shortage of around 124,000 physicians. With burnout being one of the main drivers, it is crucial to assess it. Burnout is characterized by high levels of emotional exhaustion and cynicism and low levels of academic efficacy.There has been substantial research on burnout among healthcare providers across different levels of training; however, few studies have examined burnout among undergraduate students who wish to pursue a graduate degree in healthcare. Given the shortage of healthcare providers in the United States, it is …


Using Drama Therapy To Foster Peer Support Among Nurse Leaders, Chyela Rowe May 2023

Using Drama Therapy To Foster Peer Support Among Nurse Leaders, Chyela Rowe

Expressive Therapies Dissertations

This study explored the use of drama therapy to support the social-emotional experiences of nurse leaders at a mid-sized regional hospital system in the Southeastern United States. Nurse leaders have experienced profound changes to their work environments in recent years and burnout has been at an all-time high among healthcare workers globally. Organizational supports for nurses and nurse leaders are both inadequate to meet the needs and under-resourced. The research questions explored 1) whether the drama therapy peer support initiative improved outcomes and 2) whether there was a significant relationship between measures, and 3) what nurse leaders described as facilitators …


Exploring The Relationship Between Nurse Supervisor’S Servant Leadership Behavior And Nursing Employee’S Self-Assessment Of Engagement And Burnout In Nigeria, Michael Otuwurunne May 2023

Exploring The Relationship Between Nurse Supervisor’S Servant Leadership Behavior And Nursing Employee’S Self-Assessment Of Engagement And Burnout In Nigeria, Michael Otuwurunne

Seton Hall University Dissertations and Theses (ETDs)

Burnout is a problem among workers in Nigeria, especially among nurses (Ozumba, & Alabere, 2019). This study examined whether there was a significant relationship between the employee perception of the servant leadership behaviors of the nurse supervisor and the employee’s self-rating of burnout: exhaustion and disengagement, and servant leadership behaviors of the nurse supervisor, and engagement: vigor, dedication, and absorption. Exhaustion refers to an intensive physical, affective, and cognitive strain while disengagement refers to the distancing of oneself from one’s work, and experiencing negative attitudes toward the work object, work content, or one’s work in general (Demerouti et al., 2001). …


The Mental Health Epidemic In Veterinary Medicine: An Analysis Of Burnout In The Veterinary Field, Hannah Eckstein Apr 2023

The Mental Health Epidemic In Veterinary Medicine: An Analysis Of Burnout In The Veterinary Field, Hannah Eckstein

Undergraduate Theses

The Mayo Clinic describes burnout as a specific type of stress that involves a state of physical or emotional exhaustion. This exhaustion can lead to a lowered sense of accomplishment and negative personal identity. Despite burnout not being an actual diagnosis, many researchers believe there are several mental health components that contribute to burnout, such as depression and anxiety. Several factors are known to contribute to specifically work-related burnout, including lack of control, work-life imbalance, lack of social support, and extremes of the activity. All of the above factors relate to the veterinary field. In one study, 6.8% of male …


The Effects Of Secondary Traumatic Stress And Resilience On The Indicators Of Compassion Fatigue Among Occupational Therapists, Gayla Ann Aguilar Jan 2023

The Effects Of Secondary Traumatic Stress And Resilience On The Indicators Of Compassion Fatigue Among Occupational Therapists, Gayla Ann Aguilar

Walden Dissertations and Doctoral Studies

AbstractCompassion fatigue (CF) has been described as the “cost of caring” for traumatized individuals, which may lead to missed workdays, diminished work satisfaction, increased turnover, and decreased client care. CF has long been studied in other caring professionals, but occupational therapy practitioners (OTPs) have been largely overlooked. The purpose of this quantitative correlation study was to determine the relationship between secondary traumatic stress (STS) and resilience (RES) on burnout (BO) and compassion satisfaction (CS; i.e., indicators of CF) in OTPs. In this study, the moderation effect that RES has on STS and BO as related to CF in 68 completed …


The Effects Of Secondary Traumatic Stress And Resilience On The Indicators Of Compassion Fatigue Among Occupational Therapists, Gayla Ann Aguilar Jan 2023

The Effects Of Secondary Traumatic Stress And Resilience On The Indicators Of Compassion Fatigue Among Occupational Therapists, Gayla Ann Aguilar

Walden Dissertations and Doctoral Studies

AbstractCompassion fatigue (CF) has been described as the “cost of caring” for traumatized individuals, which may lead to missed workdays, diminished work satisfaction, increased turnover, and decreased client care. CF has long been studied in other caring professionals, but occupational therapy practitioners (OTPs) have been largely overlooked. The purpose of this quantitative correlation study was to determine the relationship between secondary traumatic stress (STS) and resilience (RES) on burnout (BO) and compassion satisfaction (CS; i.e., indicators of CF) in OTPs. In this study, the moderation effect that RES has on STS and BO as related to CF in 68 completed …


Occupational Burnout Factors Among Correctional Mental Health Providers, Morgan Gruhot Jan 2023

Occupational Burnout Factors Among Correctional Mental Health Providers, Morgan Gruhot

Walden Dissertations and Doctoral Studies

Burnout rates of correctional employees are higher than employees in the general public. The purpose of this study was to identify how occupational factors impact burnout rates among correctional mental health workers. Grounded in the job-demands theoretical model, this study compared burnout rates among mental health staff within county jails and state prisons. Burnout was measured using the Maslach Burnout Inventory and Occupational factors were measured using the Areas of Work life Survey and Pandemic Experience and Perception Survey. Data was analyzed using IBM SSPS software to address multiple a priori directional research questions. Research questions considered how occupational factors …


Occupational Burnout Factors Among Correctional Mental Health Providers, Morgan Gruhot Jan 2023

Occupational Burnout Factors Among Correctional Mental Health Providers, Morgan Gruhot

Walden Dissertations and Doctoral Studies

Burnout rates of correctional employees are higher than employees in the general public. The purpose of this study was to identify how occupational factors impact burnout rates among correctional mental health workers. Grounded in the job-demands theoretical model, this study compared burnout rates among mental health staff within county jails and state prisons. Burnout was measured using the Maslach Burnout Inventory and Occupational factors were measured using the Areas of Work life Survey and Pandemic Experience and Perception Survey. Data was analyzed using IBM SSPS software to address multiple a priori directional research questions. Research questions considered how occupational factors …


The Correlation Between Transformational Leadership And Mental Health Clinician Burnout, Rebekah E. Shutter Nov 2022

The Correlation Between Transformational Leadership And Mental Health Clinician Burnout, Rebekah E. Shutter

Electronic Theses and Dissertations

Mental health clinicians working in a hospital setting are at a high risk of experiencing burnout due to the stressful demands of their caseloads, compassion fatigue, limited resources, and unsupportive leadership. While there is ample research regarding the cause and effect of burnout on clinicians there is a gap in the literature when it comes to the impact leadership has on mental heath clinician burnout. The purpose of this quantitative, correlational study is to determine if and to what extent there is a correlation between Transformational Leadership and mental health clinician burnout. Participants for this study consisted of 200 mental …


Perceived Sources Of Stress Related To Burnout Amongst Emergency Department Staff Due To The Covid-19 Pandemic: A Literature Review, Sydney Craig May 2022

Perceived Sources Of Stress Related To Burnout Amongst Emergency Department Staff Due To The Covid-19 Pandemic: A Literature Review, Sydney Craig

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Emergency departments (ED) are usually considered high stress environments. The effects of the COVID-19 pandemic and the accompanying challenges such as frequent exposure to the novel virus, lack of personal protective equipment (PPE), being over worked and underpaid, and the uncertainty surrounding the overall trajectory of the COVID-19 pandemic have resulted in an increased level of burnout for ED staff, especially nurses. This study involves a meta-analysis of current literature surrounding ED burnout including incidence rate and causes during the COVID-19 pandemic. Because studies indicate upwards of three fourths of ED staff reporting increased stress and burnout, finding ways to …


Challenges To Career As A Source Of Meaning And Satisfaction Among Certified Athletic Trainers In The United States Of America, Nicole Marie Glasgow Jan 2022

Challenges To Career As A Source Of Meaning And Satisfaction Among Certified Athletic Trainers In The United States Of America, Nicole Marie Glasgow

Dissertations and Theses

There is a high prevalence of burnout in the athletic training profession. Similar to what has been found in other healthcare professions, burnout is correlated with lack of job satisfaction, high turnover, and decreased productivity. In phase one of this study, the purpose was to investigate whether there was a relationship between perceived career meaning and burnout among certified athletic trainers. In phase two, the purpose of the study was to explore the lived experiences of meaningfulness and purposefulness by certified athletic trainers. The overall objective of the research was to generate an understanding of factors associated with burnout in …


The Experience Of Providing Direct Care To Children Victims Of Boko Haram Insurgencies In Nigeria, Felicia Etuke Jan 2022

The Experience Of Providing Direct Care To Children Victims Of Boko Haram Insurgencies In Nigeria, Felicia Etuke

Walden Dissertations and Doctoral Studies

The insurgency of terrorism leaves lasting economic, social, academics, spiritual, religious, and psychological effects, but often children’s psychological welfare is neglected in the aftermath of terrorist attacks. Boko Haram’s presence in Nigeria has left many children orphaned, displaced, and impoverished. Thus, there is a need to highlight the importance of the role that care providers play in securing the psychological health of the child victims of Boko Haram insurgency. This qualitative, phenomenological study explored the experiences of care providers to the child victims of Boko Haram insurgency in Nigeria. Compassion fatigue theory was used as a theoretical framework for the …


Stress, Resiliency, And Burnout Among Leaders In The Counseling Profession, Adriana Bovee Jan 2022

Stress, Resiliency, And Burnout Among Leaders In The Counseling Profession, Adriana Bovee

Walden Dissertations and Doctoral Studies

Leaders in the counseling profession face many demands. The purpose of this quantitative regression analysis study was to determine if there was a predictive relationship between the independent variables of stress and resiliency and dependent variables of burnout, emotional exhaustion, depersonalization, and personal accomplishment among leaders in the counseling profession. Transformational leadership theory and resilience theory were applied as the theoretical framework of this study. A cross-sectional data collection method was used, and data were collected through anonymous online surveys from a purposive sample of 75 counseling leaders. Data analyses methods included descriptive statistics and multiple linear regressions. Results indicated …


The Relationship Between Types Of Workplace Trauma Exposure, Burnout, And Ptsd In Mental Health Workers, Armando Dominguez Jan 2022

The Relationship Between Types Of Workplace Trauma Exposure, Burnout, And Ptsd In Mental Health Workers, Armando Dominguez

Walden Dissertations and Doctoral Studies

Work-related traumatic exposure has been studied but has not been concisely defined in the widest range of research studying trauma exposure. Specifically, it is not known from previous research whether direct, indirect, and vicarious trauma exposure predict burnout and PTSD in acute care mental health care workers. The emotional processing theory was used as theoretical foundation informing this study as the habituation of response to stress and trauma has been shown to occur incidentally and cumulatively; the theory supports the concept of dichotomous and continuous type of trauma exposure over time. The purpose of this study was to use a …


Stress Among Ncaa Division Ii Head Coaches, Dee Gerlach Dec 2021

Stress Among Ncaa Division Ii Head Coaches, Dee Gerlach

Graduate Theses and Dissertations

The purpose of this quantitative study was to identify factors that create stress among head coaches at the National Association Athletic Association Division II level. Data was collected through a demographic questionnaire and the Coaching Issues Survey (CIS), a tool used to measure specific factors that may create stress among coaches. The factors of the CIS include four subscales: Athlete-Concerns, Time-Role, Program-Success, and Win-Loss. Participants (N=416) consisted of head coaches representing the following sports: baseball, men’s basketball, women’s basketball, men’s golf, women’s golf, men’s and women’s golf, softball, women’s tennis, and men’s and women’s tennis. The independent variables for this …


The Impact Of Mindfulness-Based Stress Reduction Techniques On Nurse Burnout In An Icu, Heather L. Vincent Jul 2021

The Impact Of Mindfulness-Based Stress Reduction Techniques On Nurse Burnout In An Icu, Heather L. Vincent

Student Scholarly Projects

Practice Problem: Burnout among nurses has been linked to turnover, negative patient safety and quality outcomes, and higher costs for institutions.

PICOT: The PICOT question that guided this project was, in ICU nurses (P), what was the impact of the use of MBSR techniques (I), versus the current state in which no MBSR techniques are practiced (C), on self-reported BO (O), over the course of eight weeks (T).

Evidence: A total of 14 studies were identified in the literature that directly support the implementation of this project. Themes from the literature show that mindfulness-based stress reduction techniques such as meditation, …


Burnout, Self-Efficacy, And Coping Strategies Among College Faculty, Jordan M. Ball Apr 2021

Burnout, Self-Efficacy, And Coping Strategies Among College Faculty, Jordan M. Ball

Psychology Theses & Dissertations

Due to the changing college environment, university faculty are faced with a serious burden to support their university. University faculty are expected to satisfy numerous job demands, and these demands in turn lead to burnout, a chronic response to job stressors. Burnout is an essential component of occupational research as it relates to other negative outcomes, such as turnover and decreased performance. Because of this, it behooves both faculty and universities to employ methods that decrease burnout. Research concerning other populations indicates that certain personal resources can decrease burnout. Therefore, the current study seeks to determine if coping strategies and …


Using Art To Mitigate Burnout For Those Working In Direct Care, Jessica E. Goodchild May 2020

Using Art To Mitigate Burnout For Those Working In Direct Care, Jessica E. Goodchild

Expressive Therapies Capstone Theses

Through a critical review of the existing literature, this capstone thesis seeks to investigate the potential benefits and drawbacks to the integration of guided artistic practices within the workplace. The literature reviewed focused on both qualitative and quantitative studies of burnout and explored the professional benefits that art making can provide in mitigating burnout for those within a western culture working in the field of mental health and social services, particularly in the capacity of a direct care worker (DCW). Through the review of the literature a case can be made for the benefits of using visual art to engage …


The Watson Room: Mitigating Compassion Fatigue In Oncology Nurses, Patricia A. Viscardi May 2020

The Watson Room: Mitigating Compassion Fatigue In Oncology Nurses, Patricia A. Viscardi

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Aim: The aim of this project was to plan, develop, and implement “The Watson Room” or “Quiet Room” in an inpatient oncology nursing population and evaluate changes in Professional Quality of Life (ProQOL).

Background: Oncology Nurses are at high risk for compassion fatigue (CF), burn-out (BO), and secondary traumatic stress (STS) related to the effects of living the traumas of oncology patients and their families through their cancer journey and the innate stress in a complex and intense workplace. High levels of compassion fatigue, burn-out, and secondary traumatic stress that are poorly managed reduces the nurse’s ability to self-regulate their …


Mindfulness In Medicine: Modified Mindfulness-Based Stress Reduction (Mbsr) Program Among Future Doctors, Virtue Sankoh May 2019

Mindfulness In Medicine: Modified Mindfulness-Based Stress Reduction (Mbsr) Program Among Future Doctors, Virtue Sankoh

Dissertations, Theses, and Capstone Projects

Medical trainees are at particular risk for stress-related illness, including mental health problems such as suicidal ideation, substance abuse, and mood disorders. A vast literature on mindfulness-based stress reduction (MBSR), consisting of mindfulness education and structured meditative practices, has consistently demonstrated that MBSR and related mindfulness-based interventions improve mental and physical health, as well as one’s overall sense of well-being. Moreover, theorists and researchers have begun to suggest further that mindfulness plays a particular role in social cognition, or social-emotional learning. Medical schools have long been interested in ways to improve the “soft skills” related to interpersonal connectedness that are …


Redefining Burnout: Exploring Common Conceptualizations And The Neurophysiology Of Chronic Stress To Establish An Integrated Allostatic Model, Danny A. Guzzi Apr 2019

Redefining Burnout: Exploring Common Conceptualizations And The Neurophysiology Of Chronic Stress To Establish An Integrated Allostatic Model, Danny A. Guzzi

Dissertations

Burnout is a widely researched stress-related phenomenon associated with numerous adverse outcomes for employees and organizations. Unfortunately, burnout is not well understood and research to this point has been flawed due to a lack of consensus on the definition, dimensionality, and context of the construct. Prevalent conceptualizations of burnout have been criticized for being arbitrarily developed without solid theoretical foundation and for failing to clearly distinguish burnout from depression or other work-related conditions such as compassion fatigue, secondary traumatization, and vicarious traumatization. The current project first examines relevant literature to identify commonalities among prevalent burnout conceptualizations. Then relevant stress research …


Hardiness, Adult Attachment Style, And Burnout In Nurses, Kristy A. Negri Jan 2018

Hardiness, Adult Attachment Style, And Burnout In Nurses, Kristy A. Negri

Walden Dissertations and Doctoral Studies

The current nursing shortage is a pressing crisis that is expected to worsen over time. A key reason nurses leave nursing is burnout. The purpose of this study was to investigate personality hardiness and adult attachment style in relation to the development of burnout in licensed professional nurses. Hardiness theory and attachment theory indicated that each provided protection against burnout, but no research has been conducted to examine both factors in relation to burnout in nurses. Research Question 1 asked if there was a relationship between attachment style and total hardiness score; Research Question 2 asked if there was a …


Providing Care For Many In The Context Of Few Resources: Secondary Traumatic Stress, Burnout And Moral Distress Experienced By Healthcare Providers In Rural Uganda, Lauren Michelle Dewey Sep 2016

Providing Care For Many In The Context Of Few Resources: Secondary Traumatic Stress, Burnout And Moral Distress Experienced By Healthcare Providers In Rural Uganda, Lauren Michelle Dewey

Dissertations, Theses, and Capstone Projects

In the context of the global nursing shortage, and particularly in low-resource settings, nurses are at an increased risk for work-related stress problems like secondary traumatic stress (STS), burnout, and moral distress. These three work-related mental health consequences, sometimes associated with absenteeism and intent to leave the profession, could potentially contribute further to the shortage of nurses. This two-part study is a longitudinal examination of the work-related mental health consequences experienced by healthcare providers in rural Uganda. In Study 1, participants (n=208; 159 students and 49 experienced health workers) completed self-report, psychosocial measures at baseline and 134 of the students …


Implementation Of A Nursing Workload Tool To Reduce Nurse Burnout, Nicole K. Greives Apr 2016

Implementation Of A Nursing Workload Tool To Reduce Nurse Burnout, Nicole K. Greives

Evidence-Based Practice Project Reports

Nursing burnout and workload is a complicated issue with far-reaching effects. Nursing burnout and inappropriate nursing workload have been linked to increased risk of urinary tract infection, respiratory infections, decreased patient satisfaction, decreased quality and safety of care, and increased mortality. The purpose of the project was to decrease nursing burnout on a Medical Progressive Care Unit (MPCU) by moving patients with high workloads and medical instability to a higher level of care. Within this project, Rosabeth Kanter’s Theory of Structural Power was used for the theoretical framework, and the Stetler Model guided the implementation. The intervention consisted of a …


What Works For Successful In-Home Family Therapists Working At Community-Based Agencies, Aleyah R. Yasin Jan 2016

What Works For Successful In-Home Family Therapists Working At Community-Based Agencies, Aleyah R. Yasin

Department of Family Therapy Dissertations and Applied Clinical Projects

Resiliency is an important characteristic of successful therapists (Aponte, 1991; Aponte & Carlsen, 2009; Aponte & Winter, 2000; Clark, 2009; Hamel & Laraway, 2004; Kuiper, 2012; Protinsky & Coward, 2001; Rosenburg & Pace, 2006; Wolgien & Coady, 1997), especially those in entry-level positions that tend to involve high stress and turnover (Acker, 2004; Clark, 2009; Davis, 2013; Greenson, Guo, Barth, Harley, & Sission, 2009; Grosch & Olsen, 1994; Gupta, Peterson, Lysaght, & Zweck, 2012; Horan, 2002; Maslach & Leiter, 1997; Negash & Sahin, 2011; Rosenburg &Pace, 2006; Skovolt &Trotter Mathison, 2011). This study explored the perspectives of six therapists providing …


Relationship Among Motivation, Emotion Regulation, And Psychological Well-Being Of Sophomore And Senior Level Nursing Students, Aryene Delgado, Douglas Garner, Nicole Langhals Jan 2016

Relationship Among Motivation, Emotion Regulation, And Psychological Well-Being Of Sophomore And Senior Level Nursing Students, Aryene Delgado, Douglas Garner, Nicole Langhals

Williams Honors College, Honors Research Projects

Nursing education and professional work involve stressful circumstances that may lead to attrition, which can further contribute to the projected nursing shortage. This study examines the relationships between motivation, emotional regulation, psychological well-being and academic performance in baccalaureate sophomore and senior level nursing students at a Midwest urban university in the United States. The non-experimental, correlational study is guided by Deci and Ryan’s self-determination theory and uses an online survey data collection and convenience sampling. Measures include: motivation, emotional regulation, psychological well-being (burnout; inauthenticity), and academic performance (GPA), and will be measured using Deci and Ryan’s scale, the Emotion Regulation …


Clinician Mindfulness Practice And The Implications For Burnout Mitigation: Mindfulness As A Values Component Of Self-Care, Stephanie Wachter Jan 2016

Clinician Mindfulness Practice And The Implications For Burnout Mitigation: Mindfulness As A Values Component Of Self-Care, Stephanie Wachter

Counselor Education Theses

Over 40 years after Freudenberger (1975) introduced the term, burnout remains a critical concern among mental health clinicians. Many researchers in recent decades have focused their attention upon burnout prevention, exploring the practices of clinicians, and proposing the possible factors at-play in counselor, therapist, and social workers’ resiliency in the face of vicarious trauma, and other burnout factors. Mindfulness is a growing area of interest in this course of study, with yoga, meditation, and visualizations as some of the exercises associated with the practice and its apparent benefits. This qualitative study examined mindfulness as a component of mental health clinician …


The Effect Of Education On Compassion Fatigue As Experienced By Staff Nurses, Kathryn L. Zehr Apr 2015

The Effect Of Education On Compassion Fatigue As Experienced By Staff Nurses, Kathryn L. Zehr

Evidence-Based Practice Project Reports

Historically, nursing has been perceived as a highly rewarding profession. Yet, due to the increasing complexity of today’s healthcare, nurses are faced with greater challenges in their work environments. Registered nurses who work in tertiary care settings are exposed to disturbing patient situations including trauma, death, abuse, or chronic disease. Joinson (1992) described this experience as compassion fatigue and symptoms include headaches, short attention span, or fatigue. A review of literature has identified that nurses should be educated about risk factors and coping strategies to combat compassion fatigue. Guided by the Model for Evidence-Based Practice Change and Jean Watson’s Theory …