Quality Of Work-Life Among Advanced Practice Nurses Who Care For Patients With Heart Failure: The Effect Of Resilience During The Covid-19 Pandemic

INTRODUCTION: Heart failure (HF) prevalence continues to rise while therapeutic options expand in complexity. Advanced Practice Registered Nurses (APRNs; Nurse Practitioners & Clinical Nurse Specialists) manage high burden, complex care of patients with HF. During the COVID-19 pandemic, clinician burnout, stress and job dissatisfaction have likely impacted quality of life (WR-QoL). No studies describe burnout and resilience in APRNs who provide care to individuals with HF. AIMS: Among APRNs who work with patients with HF, three aims include: 1) Describe the level of burnout and WR-QoL; 2) Determine the relationship between burnout and QOWL variables; 3) Examine whether resilience moderates the association between WR-QoL and burnout. METHODS: This descriptive correlational study employed an online survey in October, 2020 to APRNs who were members of the American Association of Heart Failure Nurses and the HFSA. Inclusion criteria: APRN's who practiced in cardiology clinics, advanced HF clinics, inpatient cardiology units, or HF home care programs, at least 8 hours weekly. Exclusion criteria: Exclusively pediatric, administrative, educational, or research-focused APRNs. Outcomes measured: Burnout (Copenhagen Burnout Inventory), WR-QoL (Work-Related QoL Scale), and Resilience (Brief Resilience Scale). Institutional review board approval and written consents were obtained. RESULTS: Participant (N=101) mean age was 50 (±10) years, 93% identified as female, 96% White, and 70% were master's prepared. Mean weekly worked hours were more than 42 and the majority of APRNs (n=75) represented community and academic health centers. APRNs reported high levels of personal (M= 51.7, norm-referenced mean: 35.9) and work-related burnout (M=50.1, norm-referenced mean: 33.0) with significant correlations between high levels of burnout and low WR-QoL (r range: -.74 — -.39 -, p<.001). APRNs who reported medium or high resilience showed negative relationships between burnout and general well-being (r = -.64, -.76, respectively, p<.001), while the low resilience group showed no relationship. Additionally, APRNs who reported no/low or work-related burnout showed a positive relationship between resilience and general well-being (r = .57, p<.001), while the moderate and severe burnout groups did not. CONCLUSION: We found that the positive effect of resilience on general well-being decreased as work-related burnout went up, indicating the moderating role of work-related burnout. The unanticipated finding that the negative burnout-QOWL relationship was stronger with higher resilience requires more exploration. It is especially critical now, given the emphasis on supporting clinician well-being and preventing burnout, for us to better understand the role of resilience and burnout in well-being.