The role of self-endangering cognitions between long-term care nurses' altruistic job motives and exhaustion.

Background: Due to demographic change and staff shortages nurses suffer under high work strain. As a consequence, caregivers' absenteeism due to mental stress, in particular burnout, is high. To explain the development of nurses' burnout more research is needed on nurses' individual resources and coping strategies. Self-endangering is a potentially harmful coping strategy.

Objective: To expand the perspective of the Job Demand-Resources Model by including caregivers' intraindividual resources and the coping construct of self-endangering as a mediator between personal resources and nurses' emotional exhaustion.

Methods: A longitudinal questionnaire survey was conducted between July 2020-March 2021 among nurses in long-term care in Germany. The final analysis sample consisted of  = 416 and = 50. Data were analysed by a multiverse analytic strategy using regression analysis with measurement repetition and cross-lagged-panel design for waves one and two. Variables used for regression analysis and cross-lagged-panel were: Independent variables: An altruistic job motivation, team identification and self-esteem, dependent variables: Exhaustion and disengagement, and mediators: Self-endangering cognitions and behavior tendencies.

Results: A highly altruistic job motivation leads to more self-endangering cognitions and to more self-endangering behavior tendencies. Mixed model analysis and cross-sectional path analysis confirmed mediation effects from altruism over self-endangering to exhaustion.

Conclusion: Our findings are at odds with some research findings about altruism in nursing, such that too much altruism can lead to harmful self-endangering. We also introduce a new instrument to capture self-endangering in nursing care. Future research should investigate various facets of self-endangering in nursing. We assume that leadership behavior could have influence on self-endangering. New health policy structures are needed to improve working conditions in nursing and thus prevent self-endangering.