Impact Factor 2.089
2017 JCR, Clarivate Analytics 2018

The world's most-cited Multidisciplinary Psychology journal

Original Research ARTICLE

Front. Psychol., 18 December 2018 |

Analysis of the Mediating Role of Self-Efficacy and Self-Esteem on the Effect of Workload on Burnout’s Influence on Nurses’ Plans to Work Longer

  • 1University of Almería, Almería, Spain
  • 2Universidad Autónoma de Chile, Santiago, Chile

At the present time, we know that there is a positive relationship between self-efficacy and self-esteem in which positive beliefs about one’s own efficacy increase one’s sense of self-worth as stressful situations of a heavy workload are coped with successfully, and this, in turn, affects the nurses’ plans to work longer. Analyze the mediating role of self-efficacy and self-esteem in the effect of workload, measured as the number of users attended to during a workday, on burnout in nursing professionals. A sample of 1307 nurses aged 22 to 60 years who were administered the Brief Burnout Questionnaire, the General Self-Efficacy Scale, and the Rosenberg Self-Esteem Scale, and workload, measured as the number of users attended to during the workday. The results show that professionals with high levels of self-efficacy also scored higher on global self-esteem. Burnout correlated negatively with both variables (self-efficacy and self-esteem). Three clusters were found with the variables (self-efficacy, self-esteem, and workload) showing significant differences in burnout scores among clusters. Self-efficacy and self-esteem function as buffers of the negative effects of workload on burnout. Organizations should design interventions for promoting the personal resources of their workers through training activities and organizational resources (e.g., redesigning job positions) to promote satisfaction and wellbeing of employees, making their stay at work greater.


The World Health Organization [WHO] considers burnout, which has also been analyzed in education (Martos et al., 2018; Vizoso-Gómez and Arias-Gundín, 2018), an occupational illness of special relevance (World Health Organization [WHO], 2016). This syndrome is characterized by gradual physical and mental exhaustion of individuals, feelings of detachment and of negative attitudes toward their job, and perception of diminished professional efficacy (Maslach et al., 2001).

Even though workers in different occupational sectors may suffer from this syndrome, there is a stronger risk for healthcare professionals, because permanent contact with the suffering and illnesses of others makes their work setting particularly emotionally and psychologically stressful (Adriaenssens et al., 2015; Hunsaker et al., 2015; Banerjee et al., 2016). We can’t forget that this syndrome is also present in other sectors, such as in Alzheimer’s Patient Family Caregivers with no Specialized Training (Pérez-Fuentes et al., 2017). Therefore, the importance of its study stems from the negative consequences it has for the health of workers and the organization. For example, it has been demonstrated that burnout is related to a diversity of physical illnesses (musculoskeletal, cardiovascular, gastrointestinal, respiratory infections, etc.) (Jaworek et al., 2010; Kim et al., 2011) and psychological problems (mood, depression and anxiety disorders, etc.) (Bianchi et al., 2015; Maslach and Leiter, 2016), negatively affecting job performance and leading to absenteeism (Schaufeli et al., 2009; Bakker and Demerouti, 2014).

One of the theoretical models of reference in research on wellbeing and job stress is the Job Demands-Resources Model (JD-R), developed by Demerouti et al. (2001), to provide an understanding of burnout and other psychological processes that take place in organizations. Among other matters, this model identifies the job demands that are the best predictors of burnout though a process of deterioration of an employee’s health, which can trigger psychosocial distress, absenteeism and lack of worker commitment to the organization (LePine et al., 2005; Bakker et al., 2014; Bakker and Demeoruti, 2017). The job demands which have received the most attention in the literature are related to tasks and functions in job positions, especially workload (Garcia-Izquierdo and Rios-Risquez, 2012; Cooper et al., 2016; Kandelman et al., 2017; Purohit and Vasava, 2017). Workload may be understood from its quantitative perspective, referring to the perception of an excess volume of work with regard to the time available for it, and its qualitative dimension, which alludes to the quality and complexity of work to be done (French et al., 1982). Kalisch and Lee (2014), for example, found that workload, referring to the number of patients attended to in a workday, was related to dissatisfaction of nursing professionals. Meanwhile, Van Bogaert et al. (2017) found that factors related to daily work routines influenced the perception of workload of nursing employees, especially, the large number of patients and severity of illnesses. Nevertheless, these authors suggested that the negative perception of workload is not exclusively determined by the volume of work, but also by the feelings of frustration generated by not being able to attend adequately to the needs of patients or offer them quality service.

In addition, in a recent extension of the original JD-R model, workers’ personal resources were included to complete the structure of the Work Resources and Demands Model (Xanthopoulou et al., 2007). From this perspective, positive self-evaluations or beliefs workers have about their control over their setting can buffer the negative impact of work demands and at the same time, relate positively to engagement and job performance (Bakker and Demeoruti, 2017). Among these beliefs, self-efficacy and worth, which have been widely studied in Organizational Psychology because of their involvement in wellbeing and occupational health, are emphasized (Ventura et al., 2015; Alharbi et al., 2016; Barbaranelli et al., 2018).

Self-efficacy is a “belief” that individuals have about their capacity to control their surroundings and influences the way they behave, think and feel about future events (Bandura, 1977, 1997). In this sense, workers’ beliefs about their self-efficacy are essential to how they perceive the context in which they work, especially when they have to cope with very demanding and potentially stressful job demands (Grau et al., 2012; Ventura et al., 2015). In such cases, the employees with positive beliefs about their self-efficacy respond adaptively to job stressors, predicting positive states of spiraling gains (e.g., engagement) (Ventura et al., 2006; Lorente et al., 2014; Pérez-Fuentes et al., 2018). On the contrary, those workers who consider themselves ineffective, will attribute failures to a deficit in their competence, increasing their feeling of inefficacy (Van Wingerden et al., 2017).

Self-esteem is the global positive or negative evaluation a person has of their self-worth (Rosenberg, 1965). High levels of self-esteem have been related to wellbeing, satisfaction (Orth et al., 2012; Extremera and Rey, 2018) and effective management of stress and coping with conflictive situations (Bajaj et al., 2016; Yildirim et al., 2017).

There is also considerable attention to the study of self-esteem due to its significant repercussions in the school (Pérez-Fuentes and Gázquez, 2010; González-Cabanach et al., 2017) and at work (Bakker et al., 2014; Lin et al., 2018), and more specifically, with regard to the burnout syndrome (Molero et al., 2018a,b).

Finally, we start from the following hypothesis, that some studies have shown that there is a positive relationship between self-efficacy and self-esteem (Maggiori et al., 2016), in which positive beliefs about one’s efficacy increase the feeling of self-worth as stressful situations are coped with successfully (Caprara et al., 2010, 2013).

Our objective was to analyze the mediating role of self-efficacy and self-esteem on the effect of work load, measured as the number of users attended to in the workday, on burnout in nursing professionals.

Materials and Methods


The original sample consisted of 1601 nurses in Andalusia (Spain) randomly selected from different health centers, of whom those actively employed at the time data were acquired were selected. Cases of random answers or incomplete questionnaires were discarded. Thus the final study sample was composed of a total of 1307 participants. The mean age was 32.03 years (SD = 6.53) in a range of 22 to 60. Of the total sample, 84.5% (n = 1104) were women and 15.5% (n = 203) men, with a mean age of 32.03 (SD = 6.50) and 32.01 (SD = 6.71), respectively. As for their employment situation, 67.1% (n = 877) were working at temporary jobs and 32.9% (n = 430) had permanent contracts.


An ad hoc questionnaire was prepared for sociodemographic data (age, sex), as well as for information on workload, measured as the number of users attended to in a workday.

Cuestionario Breve de Burnout [Brief Burnout Questionnaire]

This consists of 21 items on a five-point Likert-type response scale, which evaluates background, elements and consequences of the syndrome (Moreno et al., 1997). Its purpose is an overall evaluation of burnout as well as its background and consequences, in the three blocks the questionnaire is organized in. In the study subject of this paper, the block made up of the three syndrome factors in the Maslach and Jackson model (1981) was used. Instrument reliability for the study sample, specifically, for global burnout, was α = 0.78.

General Self-Efficacy Scale

This scale consists of 10 items with a four-point Likert-type format that evaluate a person’s perception of their own competence for managing different stressful situations effectively (Baessler and Schwarcer, 1996). Sanjuán et al. (2000), analyzed the reliability of the scale, finding a Cronbach’s alpha of 0.87. In our case, the calculation of internal consistency of the scale found an alpha of 0.92.

Rosenberg Self-Esteem Scale

This was developed for evaluating self-esteem in adolescents (Rosenberg, 1965). It is made up of 10 items whose contents concentrate on feelings of respect and acceptance of oneself. The response is rated on a four-point Likert scale (from 1 = Strongly agree to 4 = Strongly disagree). Other studies have demonstrated its adequate psychometric characteristics in both a general population (Atienza et al., 2000) and in more specific populations (Vázquez et al., 2013). In our case internal consistency was α = 0.86.


Before collecting data, participants were guaranteed compliance with confidentiality and ethical information standards in data processing. The study was approved by the Bioethics Committee of the University of Almería (Spain). Questionnaires were implemented on a Web platform which enabled participants to fill them out online. For control of random or incongruent answers, a series of control questions were inserted and any such cases were discarded from the study sample.

Data Analysis

First, to explore the relationships between variables, correlation analyses were done for the continuous quantitative variables. A two-stage cluster analysis was also carried out to group participants by self-esteem as a categorical variable (low, medium and high), and other continuous quantitative variables, such as general self-efficacy and the number of users attended to per workday. Once the clusters or groups had been identified, an ANOVA was done to determine the existence of significant differences between groups with respect to burnout as the dependent variable. To determine which groups were significantly different from each other, the post hoc Scheffé comparison test was applied. The SPSS statistical software version 23.0 for Windows was used for these analyses.

Finally, a multiple mediation analysis was done with two mediator variables forming a causal chain to compare the mediating effect of the perceived Self-efficacy and Self-esteem variables. The Preacher and Hayes (2008) SPSS macro for mediation effects was used to compute the mediation model. Bootstrapping was applied with coefficients estimated from 5000 bootstraps to test the indirect effect.


Burnout in Nursing and Its Relationship With Perceived Self-Efficacy, Self-Esteem, and Workload

Table 1 presents the descriptive statistics of each of the variables of the study and bivariate correlations. The correlation coefficients found reveal that professionals with high levels of self-efficacy also showed higher scores on global self-esteem (r = 0.53; p < 0.001). Moreover, burnout correlated negatively with both variables (self-efficacy: r = -0.19; p < 0.001 and self-esteem: r = -0.28; p < 0.001).


Table 1. Burnout, perceived self-efficacy, self-esteem, and workload.

A cluster analysis was done to form the groups entering the following variables: self-esteem (low, medium, and high), perceived self-efficacy, and workload. Three groups resulted from this analysis (Figure 1), distributed as follows: 43.2% (n = 563) of the participants pertained to Cluster 1, 35.9% (n = 468) to Cluster 2, and the remaining 20.9% were in Cluster 3 (n = 272).


Figure 1. Comparison of clusters. (a)Number of users attended to in a workday.

The first group (Cluster 1) was characterized by low self-esteem and means slightly below the mean of the total sample on perceived self-efficacy (M = 29.27) and number of users attended to (M = 20).

The second group (Cluster 2) included nursing professionals with a medium level of self-esteem who scored near the mean in perceived self-efficacy (M = 31.85), and a slightly higher mean (M = 21.75) in workload than the total sample.

The third group (Cluster 3) identified professionals who had high self-esteem, medium scores in perceived self-efficacy (M = 35.04) and were above the mean of the total sample. In this group, the mean users attended to per workday was similar to the mean for the sample (M = 20.93).

After classification in groups, based on the three-cluster solution, an ANOVA was performed to find out whether there were any differences in the clusters with respect to burnout. The Scheffé test was used for post hoc comparisons.

As observed in Table 2, there were significant differences between clusters [F(2,1304) = 38.94; p < 0.001; ηp2 = 0.05] for burnout scores. Cluster 1 is where the mean score on burnout was highest (M = 57.14; SD = 7.18), followed by Cluster 2 (M = 55.09; SD = 7.49) and, finally with the lowest mean score in burnout, Cluster 3 (M = 52.43; SD = 7.16). Post hoc analyses showed that the differences found among the three groups were statistically significant.


Table 2. Differences in burnout between groups (clusters).

Multiple Mediation Model for Estimating Predictors and Paths of Indirect Effects of Perceived Self-Esteem and Self-Esteem on Burnout

Considering workload as the independent variable (X), and self-efficacy and self-esteem as mediating variables (M1: SELF-EFFICACY and M2: SELF-ESTEEM), the multiple mediation model was computed with burnout as the dependent variable (Y).

Figure 2 shows the multiple mediation model for burnout including direct, indirect and full effects.


Figure 2. Multiple mediation model of perceived self-efficacy and self-esteem on the relationship between workload and burnout. (a)Number of users attended to in a workday. The correlation is significant at 0.05; ∗∗The correlation is significant at 0.01; ∗∗∗The correlation is significant at 0.001.

In the first place, there was a statistically significant effect [a1: B = 0.02, p < 0.01] of workload (X) on perceived self-efficacy (M1). The second regression analysis took the second mediator (M2) as the result variable, and included the workload (X) and perceived self-efficacy (M1) variables in the equation. There was a significant effect of self-efficacy [d21: B = 0.43, p < 0.001] on self-esteem (M2), but the same was not true of self-esteem [a2: B = 0.00, p = 0.74].

In the third regression analysis, the effect of the independent variable and the two mediators was estimated taking burnout (Y) as the result variable. In all cases, significant effects were observed: workload [c’: B = 0.05, p < 0.001], perceived self-efficacy [b1: B = -0.12, p < 0.05], and self-esteem [b2: B = -0.50, p < 0.001]. The total effect of workload on burnout was significant [c: B = 0.06 p < 0.001].

Finally, the indirect effects were analyzed by bootstrapping, finding data supporting a significant level for Path 1 [ind1: X → M1 → Y; B = -0.002, SE = 0.001, 95% CI (-0.007, -0.000)] and Path 2 [ind2: X → M1 → M2 → Y; B = -0.004, SE = 0.001, 95% CI (-0.008, -0.001)]. However, the data did not support significance for Path 3 [ind3: X → M2 → Y; B = -0.000, SE = 0.002, 95% CI (-0.007, 0.004)].


Nursing professionals care for a large volume of patients during their workday, sometimes with an imbalance between time available to attend to their needs adequately and the workload. This workload significantly influences the health, wellbeing of the employees and the plans for working longer, generating negative feelings and job dissatisfaction because they are unable to provide quality service (Cooper et al., 2016; Van Bogaert et al., 2017). According to the Job Demands and Resources Model, workload is a powerful stressor, in addition to a predictor of burnout, through a process of worsening health (Xanthopoulou et al., 2007; Bakker et al., 2014). However, our results showed that self-efficacy and self-esteem work as buffers of the negative effects of workload on burnout. In fact, authors such as Bakker et al. (2014) and Bakker and Demerouti (2017) have shown the outstanding role of personal resources for their capacity to attenuate the negative impact of job stressors and their relationship with various positive results in the sphere of organization (e.g., engagement and job performance).

It has also been found that beliefs about self-efficacy influence self-esteem itself, increasing one’s perception of self-worth as stressful situations are overcome successfully. Bandura’s Cognitive Social Theory (1977) showed that positive beliefs in self-efficacy increase motivation to begin and maintain behavior for reaching desired goals, so successful experiences increase positive self-evaluations of self-worth and this affect the plans to work longer. Furthermore, longitudinal studies have demonstrated that there is a reciprocal relationship between self-efficacy and self-esteem over time (Caprara et al., 2010, 2013).

The mediation models show that a chain relationship may be established, in which the number of users attended to in a workday present opportunities to evaluate the degree to which professionals perceive the efficacy with which they perform their tasks, with the consequent repercussion on their self-esteem. Thus, job demands are considered challenge stressors which promote personal growth of the workers, generating positive emotions (LePine et al., 2005; Van Bogaert et al., 2017). In this light, nursing professionals consider the effort required to care for a large volume of patients to be related positively to the probability of performing the task satisfactorily, and covering this demand is also associated with positive consequences, such as the plans to work longer.

In addition to this, the results show that self-efficacy and self-esteem interact with each other, and can attenuate the negative effect of workload on burnout. Thus nursing professionals with high levels of beliefs of self-efficacy cope with the workload with effort and perseverance, contributing to maintaining optimum levels of self-esteem, and thereby, increasing their engagement with their work (Lorente et al., 2014; Ventura et al., 2015; Bajaj et al., 2016).

The evidence derived from this study transforms into relevant practical implications. For example, the important effects which personal resources such as self-efficacy or self-esteem have on job demands, wellbeing of nursing professionals and occupational health should be emphasized (Molero et al., 2018a). This is why organizations should design interventions oriented toward fostering personal resources of workers through training activities and organizational resources (e.g., redesigning job positions) to promote the satisfaction and wellbeing of their employees.

Nonetheless, the results should be considered under some limitations. The first is the method used to collect the data, which could be biased by the variance of the single method, and should therefore incorporate other qualitative methods (e.g., interviews). Second, the sample is made up of a majority of women, with the difficulty associated with generalizing the results to the entire group. Finally, with this study design, it is not possible to find out whether the data on burnout remain constant over time, and determination of the influence of time or change variables on the relationships between the variables is impeded.

As future lines of research, we suggest including other job demands (e.g., work shifts and role stress) and other psychological variables (e.g., emotional intelligence and social skills), the expectations of time to work, and variables related to work resources such as autonomy and leadership style, to complete the job resources and demands model and offer better understanding of the phenomenon. It would likewise be of interest to perform multi-level studies on burnout by the area where the nursing professionals work, so organizational preventive measures can be implemented.


The main objective of this study was to evaluate the mediating role of psychological variables on the effect of workload on burnout in nursing professionals. It revealed that workload has a significant positive relationship with burnout, while self-efficacy and self-esteem act as protective variables. It was also demonstrated that workload has an indirect effect on self-esteem, mediated by beliefs about self-efficacy, and that the joint effect of self-efficacy and self-esteem can buffer the negative effect of workload on burnout. In view of all of the above, a line of research is now starting in which the analysis of the complex relationships established between the different variables and the effects of their combination, beyond the impact of isolated variables on burnout, is prioritized.

Ethics Statement

This study was carried out in accordance with the recommendations of ‘Bioethics Committee of the University of Almería (Spain),’ with written informed consent from all subjects. All subjects gave written informed consent in accordance with the Declaration of Helsinki. The protocol was approved by the Bioethics Committee of the University of Almería (Spain).

Author Contributions

MM and MPF contributed to bibliographic review, article writing, and data analysis. All authors contributed to researchers of the project to which the article data belong.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


The present study has the collaboration of the Excma. Diputación Provincial de Almería.


Adriaenssens, J., De Gucht, V., and Maes, S. (2015). Determinants and prevalence of burnout in emergency nurses: a systematic review of 25 years of research. Int. J. Nurs. Stud. 52, 649–661. doi: 10.1016/j.ijnurstu.2014.11.004

PubMed Abstract | CrossRef Full Text | Google Scholar

Alharbi, J., Wilson, R., Woods, C., and Usher, K. (2016). The factors influencing burnout and job satisfaction among critical care nurses: a study of Saudi critical care nurses. J. Nurs. Manage. 24, 708–717. doi: 10.1111/jonm.12386

PubMed Abstract | CrossRef Full Text | Google Scholar

Atienza, F. L., Balaguer, I., and Moreno, Y. (2000). Análisis de la dimensionalidad de la escala de autoestima de Rosenberg en una muestra de adolescentes valencianos [Analysis of the dimension of the escalation of Rosenberg’s self-esteem in a sample of Valencian adolescents]. Revista de Psicología Universitas Tarraconensis 22, 29–42.

Baessler, J., and Schwarcer, R. (1996). Evaluación de la autoeficacia: adaptación española de la escala de Autoeficacia General [Evaluation of self-efficacy: spanish adaptation of the General Self-Efficacy Scale]. Ansiedad estrés 2, 1–8.

Bajaj, B., Gupta, R., and Pande, N. (2016). Self-esteem mediates the relationship between mindfulness and well-being. Pers. Individ. Differ. 94, 96–100. doi: 10.1016/j.paid.2016.01.020

CrossRef Full Text | Google Scholar

Bakker, A. B., and Demerouti, E. (2014). “Job demands-resources theory,” in Wellbeing: A Complete Reference Guide, eds C. Cooper and P. Chen (Chichester: Wiley-Blackwell), 37–64.

Google Scholar

Bakker, A. B., and Demerouti, E. (2017). Job demands–resources theory: taking stock and looking forward. J. Occup. Health Psychol. 22, 273–285. doi: 10.1037/ocp0000056

PubMed Abstract | CrossRef Full Text | Google Scholar

Bakker, A. B., Demerouti, E., and Sanz-Vergel, A. I. (2014). Burnout and work engagement: the JD–R approach. Annu. Rev. Organ. Psychol. Organ. Behav. 1, 389–411. doi: 10.1146/annurev-orgpsych-031413-091235

CrossRef Full Text | Google Scholar

Bandura, A. (1977). Self-efficacy: Towards a unifying theory of behavior change. Psychol. Rev. 84, 191–215. doi: 10.1037/0033-295X.84.2.191

CrossRef Full Text | Google Scholar

Bandura, A. (1997). Self-Efficacy: The Exercise of Control. New York, NY: Freeman.

Google Scholar

Banerjee, S. C., Manna, R., Coyle, N., Shen, M. J., Pehrson, C., Zaider, T., et al. (2016). Oncology nurses’ communication challenges with patients and families: a qualitative study. Nurse Educ. Pract. 16, 193–201. doi: 10.1016/j.nepr.2015.07.007

PubMed Abstract | CrossRef Full Text | Google Scholar

Barbaranelli, C., Paciello, M., Biagioli, V., Fida, R., and Tramontano, C. (2018). Positivity and behaviour: the mediating role of self-efficacy in organisational and educational settings. J. Happiness Stud. 19, 1–21. doi: 10.1007/s10902-018-9972-4

CrossRef Full Text | Google Scholar

Bianchi, R., Schonfeld, I. S., and Laurent, E. (2015). Burnout-depression overlap: a review. Clin. Psychol. Rev. 36, 28–41. doi: 10.1016/j.cpr.2015.01.004

PubMed Abstract | CrossRef Full Text | Google Scholar

Caprara, G. V., Alessandri, G., and Barbaranelli, C. (2010). Optimal functioning: the contribution of self-efficacy beliefs to positive orientation. Psychother. Psychosomat. 79, 328–330. doi: 10.1159/000319532

PubMed Abstract | CrossRef Full Text | Google Scholar

Caprara, G. V., Alessandri, G., Barbaranelli, C., and Vecchione, M. (2013). The longitudinal relations between self-esteem and affective self-regulatory efficacy. J. Res. Pers. 47, 859–870. doi: 10.1016/j.jrp.2013.08.011

CrossRef Full Text | Google Scholar

Cooper, S. L., Carleton, H. L., Chamberlain, S. A., Cummings, G. G., Bambrick, W., and Estabrooks, C. A. (2016). Burnout in the nursing home health care aide: a systematic review. Burnout Res. 3, 76–87. doi: 10.1016/j.burn.2016.06.003

PubMed Abstract | CrossRef Full Text | Google Scholar

Demerouti, E., Bakker, A. B., Nachreiner, F., and Schaufeli, W. B. (2001). The job demands resources model of burnout. J. Appl. Psychol. 86, 499–512. doi: 10.1037/0021-9010.86.3.499

CrossRef Full Text | Google Scholar

Extremera, N., and Rey, L. (2018). Core self-evaluations are associated with judgments of satisfaction with life via positive but not negative affect. Pers. Individ. Differ. 130, 112–116. doi: 10.1016/j.paid.2018.03.054

CrossRef Full Text | Google Scholar

French, J. R. P. Jr., Caplan, R. D., and Van Harrison, R. (1982). The Mechanism of Job Stress and Strain. Chichester: Wiley.

Google Scholar

Garcia-Izquierdo, M., and Rios-Risquez, M. (2012). The relationship between psychosocial job stress and burnout in emergency department: an exploratory study. Nurs. Outlook 60, 322–329. doi: 10.1016/j.outlook.2012.02.002

PubMed Abstract | CrossRef Full Text | Google Scholar

González-Cabanach, R., Souto-Gestal, A., and Fernández-Cervantes, R. (2017). Emotion regulation profiles and academic stress in physiotherapy students. Eur. J. Educ. Psychol. 10, 57–67.

Google Scholar

Grau, R., Salanova, M., and Peiró, J. M. (2012). Efectos moduladores de la autoeficacia en el estrés laboral [Modulating effects of self-efficacy in job stress]. Apuntes Psicol. 30, 311–321.

Google Scholar

Hunsaker, S., Chen, H. C., Maughan, D., and Heaston, S. (2015). Factors that influence the development of compassion fatigue, burnout, and compassion satisfaction in emergency department nurses. J. Nurs. Scholarsh. 47, 186–194. doi: 10.1111/jnu.12122

PubMed Abstract | CrossRef Full Text | Google Scholar

Jaworek, M., Marek, T., Karwowski, W., Andrzejczak, C., and Genaidy, A. M. (2010). Burnout syndrome as a mediator for the effect of work-related factors on musculoskeletal complaints among hospital nurses. Int. J. Ind. Ergon. 40, 368–375. doi: 10.1016/j.ergon.2010.01.006

CrossRef Full Text | Google Scholar

Kalisch, B., and Lee, K. H. (2014). Staffing and job satisfaction: nurses and nursing assistants. J. Nurs. Manage. 22, 465–471. doi: 10.1111/jonm.12012

PubMed Abstract | CrossRef Full Text | Google Scholar

Kandelman, N., Mazars, T., and Levy, A. (2017). Risk factors for burnout among caregivers working in nursing homes. J. Clin. Nurs. 27, e147–e153. doi: 10.1111/jocn.13891

PubMed Abstract | CrossRef Full Text | Google Scholar

Kim, H., Ji, J., and Kao, D. (2011). Burnout and physical health among social workers: a three-year longitudinal study. Social Work 56, 258–268. doi: 10.1093/sw/56.3.258

PubMed Abstract | CrossRef Full Text | Google Scholar

LePine, J. A., Podsakoff, N. P., and LePine, M. A. (2005). A meta-analytic test of the challenge stressor–hindrance stressor framework: an explanation for inconsistent relationships among stressors and performance. Acad. Manage. J. 48, 764–775. doi: 10.5465/amj.2005.18803921

CrossRef Full Text | Google Scholar

Lin, N., Jang, J., and Roberts, K. R. (2018). Are employees with higher organization-based self-esteem less likely to quit? A moderated mediation model. Int. J. Hosp. Manag. 73, 116–124. doi: 10.1016/j.ijhm.2018.01.021

CrossRef Full Text | Google Scholar

Lorente, L., Salanova, M., Martínez, I. M., and Vera, M. (2014). How personal resources predict work engagement and self-rated performance among construction workers: a social cognitive perspective. Int. J. Psychol. 49, 200–207. doi: 10.1002/ijop.12049

PubMed Abstract | CrossRef Full Text | Google Scholar

Maggiori, C., Johnston, C. S., and Rossier, J. (2016). Contribution of personality, job strain, and occupational self-efficacy to job satisfaction in different occupational contexts. J. Career Dev. 43, 244–259. doi: 10.1177/0894845315597474

CrossRef Full Text | Google Scholar

Martos, A., Pérez-Fuentes, M. C., Molero, M. M., Gázquez, J. J., Simón, M. M., and Barragán, A. B. (2018). Burnout y engagement en estudiantes de Ciencias de la Salud. Eur. J. Investig. Health Psychol. Educ. 8, 23–36. doi: 10.30552/ejihpe.v8i1.223

CrossRef Full Text | Google Scholar

Maslach, C., and Leiter, M. P. (2016). Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry 15, 103–111. doi: 10.1002/wps.20311

PubMed Abstract | CrossRef Full Text | Google Scholar

Maslach, C., Schaufeli, W. B., and Leiter, M. P. (2001). Job burnout. Annu. Rev. Psychol. 52, 397–422. doi: 10.1146/annurev.psych.52.1.397

CrossRef Full Text | Google Scholar

Molero, M. M., Pérez-Fuentes, M. C., Gázquez, J. J., and Barragán, A. B. (2018a). Burnout in health professionals according to their self-esteem. Social support and empathy profile. Front. Psychol. 9:424. doi: 10.3389/fpsyg.2018.00424

PubMed Abstract | CrossRef Full Text | Google Scholar

Molero, M. M., Pérez-Fuentes, M. C., Gázquez, J. J., Simón, M. M., and Martos, Á (2018b). Burnout risk and protection factors in certified nursing aides. Int. J. Environ. Res. Public Health 15:1116. doi: 10.3390/ijerph15061116

PubMed Abstract | CrossRef Full Text | Google Scholar

Moreno, B., Bustos, R., Matallana, A., and Miralles, T. (1997). La evaluación del burnout. Problemas y alternativas. El CBB como evaluación de los elementos del proceso [Evaluation of burnout. Problems and alternatives The CBB as evaluation of elements of the process]. Rev. Psicol. Trabajo Organ. 13, 185–207.

Orth, U., Robins, R. W., and Widaman, K. F. (2012). Life-span development of self-esteem and its effects on important life outcomes. J. Pers. Soc. Psychol. 102, 1271–1288. doi: 10.1037/a0025558

PubMed Abstract | CrossRef Full Text | Google Scholar

Pérez-Fuentes, M. C., and Gázquez, J. J. (2010). Variables relacionadas con la conducta violenta en la escuela según los estudiantes [Variables related to violent behavior in the school according to the students]. Int. J. Psychol. Psychol. Ther. 10, 427–437.

Google Scholar

Pérez-Fuentes, M. C., Gázquez, J. J., Ruiz, M. D., and Molero, M. M. (2017). Inventory of overburden in Alzheimer’s patient family caregivers with no specialized training. Int. J. Clin. Health Psychol. 17, 56–64. doi: 10.1016/j.ijchp.2016.09.004

PubMed Abstract | CrossRef Full Text | Google Scholar

Pérez-Fuentes, M. C., Molero, M. M., Gázquez, J. J., and Oropesa, N. F. (2018). The role of emotional intelligence in engagement in nurses. Int. J. Environ. Res. Public Health 15:1915. doi: 10.3390/ijerph15091915

PubMed Abstract | CrossRef Full Text | Google Scholar

Preacher, K. J., and Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav. Res. Methods Instr. Comput. 40, 879–891. doi: 10.3758/BRM.40.3.879

CrossRef Full Text | Google Scholar

Purohit, B., and Vasava, P. (2017). Role stress among auxiliary nurses midwives in Gujarat. India. BMC Health Serv. Res. 17:69. doi: 10.1186/s12913-017-2033-6

PubMed Abstract | CrossRef Full Text | Google Scholar

Rosenberg, M. (1965). Society and the Adolescent Self-image. Princeton, NJ: Princeton University Press. doi: 10.1515/9781400876136

CrossRef Full Text | Google Scholar

Sanjuán, P., Pérez, A. M., and Bermúdez, J. (2000). Escala de autoeficacia general: datos psicométricos de la adaptación para población española [Scale of general self-efficacy: psychometric data of adaptation for the Spanish population]. Psicothema 12, 509–513.

Google Scholar

Schaufeli, W. B., Bakker, A. B., and Van Rhenen, W. (2009). How changes in job demands and resources predict burnout, work engagement, and sickness absenteeism. J. Organ. Behav. 30, 893–917. doi: 10.1002/job.595

CrossRef Full Text | Google Scholar

Van Bogaert, P., Peremans, L., Van Heusden, D., Verspuy, M., Kureckova, V., Van de Cruys, Z., et al. (2017). Predictors of burnout, work engagement and nurse reported job outcomes and quality of care: a mixed method study. BMC Nurs. 16:5. doi: 10.1186/s12912-016-0200-4

PubMed Abstract | CrossRef Full Text | Google Scholar

Van Wingerden, J., Derks, D., and Bakker, A. B. (2017). The impact of personal resources and job crafting interventions on work engagement and performance. Hum. Resour. Manage. 56, 51–67. doi: 10.1002/hrm.21758

CrossRef Full Text | Google Scholar

Vázquez, A. J., Vázquez-Morejón, R., and Bellido, G. (2013). Fiabilidad y validez de la Escala de Autoestima de Rosenberg (EAR) en pacientes con diagnóstico de psicosis [Reliability and validity of the Rosenberg Self-Esteem Scale (RAS) in patients diagnosed with psychosis]. Apuntes de Psicología, 31, 37–43.

Google Scholar

Ventura, M., Llorens, S., and Salanova, M. (2006). El Rol de la Autoeficacia en el Estudio del Engagement. Available at:

Google Scholar

Ventura, M., Salanova, M., and Llorens, S. (2015). Professional self-efficacy as a predictor of burnout and engagement: the role of challenge and hindrance demands. J. Psychol. 149, 277–302. doi: 10.1080/00223980.2013.876380

PubMed Abstract | CrossRef Full Text | Google Scholar

Vizoso-Gómez, C., and Arias-Gundín, O. (2018). Resiliencia, optimismo y burnout académico en estudiantes universitarios [Resilience, optimism and academic burnout in university students]. Eur. J. Educ. Psychol. 11, 47–59. doi: 10.30552/ejep.v11i1.185

CrossRef Full Text | Google Scholar

World Health Organization [WHO] (2016). ICD-10: Version 2016. Recuperado 3 de Octubre de 2018. Available at:

Xanthopoulou, D., Bakker, A. B., Demerouti, E., and Schaufeli, W. B. (2007). The role of personal resources in the job demands-resources model. Int. J. Stress Manage. 14, 121–141. doi: 10.1037/1072-5245.14.2.121

CrossRef Full Text | Google Scholar

Yildirim, N., Karaca, A., Cangur, S., Acikgoz, F., and Akkus, D. (2017). The relationship between educational stress, stress coping, self-esteem, social support, and health status among nursing students in Turkey: a structural equation modeling approach. Nurse Educ. Today 48, 33–39. doi: 10.1016/j.nedt.2016.09.014

PubMed Abstract | CrossRef Full Text | Google Scholar

Keywords: self-efficacy, self-esteem, workload, burnout – professional, psychology, mediating model

Citation: Molero MdM, Pérez-Fuentes MdC and Gázquez JJ (2018) Analysis of the Mediating Role of Self-Efficacy and Self-Esteem on the Effect of Workload on Burnout’s Influence on Nurses’ Plans to Work Longer. Front. Psychol. 9:2605. doi: 10.3389/fpsyg.2018.02605

Received: 24 October 2018; Accepted: 04 December 2018;
Published: 18 December 2018.

Edited by:

Gabriela Topa, Universidad Nacional de Educación a Distancia (UNED), Spain

Reviewed by:

Juan Luis Castejon, University of Alicante, Spain
Antonio Valle, University of A Coruña, Spain
Celestino Rodríguez, Universidad de Oviedo, Spain

Copyright © 2018 Molero, Pérez-Fuentes and Gázquez. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: María del Carmen, Pé