Grief Support and Coping Mechanism Mediate the Effect of Grief on Burnout Among Intensive Care Unit Nurses: A Structural Equation Modeling Analysis.

Background: Patients' death caused the intensive care unit (ICU) nurses to grieve, which led to their burnout. Intensive care unit nurses use various coping mechanisms and need support to overcome grief.

Objective: The aim of this study was to identify the mediation effects of coping mechanisms and grief support on the impact of grief on burnout.

Method: This cross-sectional study among 660 ICU nurses from 9 hospitals used 4 self-reported instruments to collect data, apart from the sociodemographic and employment-related variables. A final model was developed through structural equation modeling after establishing the construct validities of the measures through confirmatory factor analysis.

Results: The representation of ICU nurses from each hospital was greater than 50%, with the majority being female (90.8%) with a mean age of 27.27 years. Most nurses perceived the absence of grief, low burnout, and moderate to low grief support. The nurses use various coping mechanisms. Grief support significantly mediated the relationship between grief and burnout using a bootstrapping method with a mediation strength using the variance counted for (VAF) of 34.95%. The final model fit indices with acceptable values validated the direct and indirect relationships of grief, grief support, and coping mechanisms on burnout.

Discussion: The significant influence of grief support in mediating the effect of grief on burnout is an important finding. The nursing and hospital management can use this finding to provide grief support to ICU nurses, enhance the grief support resources, and promote future studies to test the model's validity and applicability to health care professionals who frequently face patients' death.