Mattering perception, work engagement and its relation to burnout amongst nurses during coronavirus outbreak

Abstract Aim To assess the mattering perception, feelings of burnout and work engagement amongst nurses during coronavirus outbreak. Design Cross‐sectional research design. Methods It conducted at Zagazig fever hospital and chest hospital on 280 nurses. A self‐administered questionnaire containing four parts; characteristics, mattering at Work Scale, Burnout scale and Engagement scale. Results The present study reported that more than half of studied nurses had moderate mattering level and more than one‐quarter of them had low mattering. More than two‐fifth of studied nurses had moderate level and slight less than one‐third of them had low engagement. More than two‐fifth of studied nurses had moderate level of burnout, whilst slight less than one‐third of them had high burnout, and one‐quarter of them had low burnout.

Opportunities at work include a decrease in social relevance and a diminished ability to set in the workplace, an increase in physiological distress and cardiovascular problems, and a higher frequency of psychological illnesses such as sadness and pressure.
Stress and its complex psychosocial risks can also affect other parts of the job, such as job performance, inspiration and work dedication. In the same context, legitimate management of psychosocial risks helps to prevent accidents and non-participation, increase efficiency and promote prosperity in the work environment (Buerhaus et al., 2020, andthe World Health Organization, 2020).
According to much literature, emissions due to healthcare worker relationships in units of work are most prominent in the interaction between caregivers and interested subjects (Guixia & Hui, 2020). Burnout begins with a few symptoms, which increase over time without any intervention. These symptoms are manifested by depersonalization, emotional fatigue and poor nurse performance (Martinelli et al., 2020). They occur in improper work, design, management, organization and poor social work environments and cause physical, psychological and social consequences such as work-related stress, depression and excretion. (Giménez-Espert et al., 2020).
According to the burnout of nurses, it also affected nurse performance. Some of the burnout nurses are nurses treating emergency patients (Asih & Trisni, 2015). Emergency nurses are nurses with the ability to give nursing care in the emergency room to gradually or suddenly resolve a patient's problems (Hardiyono et al., 2020).
Mattering perception refers to the psychosocial composition that defines material perception and the feeling that people are important in the world and makes a difference in the lives of others.
Nurses have greater awareness of the problem than have high selfesteem. Increases workplace satisfaction, reduces emissions and improves psychological and overall health. He also points out a positive link between problems and psychological health and participation in the workplace. Negative results are displayed when people feel that they are not important (Efendi et al., 2019;Tong, 2018).
A positive perception of work experience and work environment can have a positive effect on engagement and professional efforts in tasks that cause low stress levels. On the other hand, negative perception of high pressure can lead to resource depletion, that is, fatigue (Permarupan et al., 2020). Previous studies have shown that predictors of burnout include age, gender, marital status, income, education level, years of service, occupation, movement patterns, number of patients assigned to nurses and placement (Alenezi et al.,

2019).
Work engagement: It presents three measurements. (i) Commitment characterized by a sense of significance, motivation, challenges, excitement and self-esteem; (ii) vitality, high levels of energy and mental patience in the workplace, passion and difficulty in investing energy in work. It features confidence to overcome.
And (iii) absorption is characterized by experiencing the problem of immersing yourself in your work and abandoning it too deeply and too early (Giménez-Espert et al., 2020).
According to Hanafi & Reny Yuniasanti (2012), nurses are also often faced with the demands of their own professional code of ethics with those around them trying to save their lives and lives.
Besides, we still have to face different kinds of problems, both in our patients and our colleagues. This makes it very easy for nurses to feel much stressed, as these situations can burden them over time.
Excessive stress generally adversely affects the individual in coping with the environment, resulting in poor performance, indirect effects on the organization in which the individual works (Hanafi & Reny Yuniasanti, 2012).
Nurses are the main staff of medical institutions. Nurses' interventions in the workplace directly improve the quality of care given to patients and reinforce patient problems in the organization

| Significance of the study
Coronavirus pandemic is a genuine well-being crisis that has influenced nations everywhere on the world. Well-being crises are a basic psychosocial hazard factor for medical caretakers. As a rule, psychosocial hazards comprise difficult issues as they sway labourers' well-being, mattering perception, work engagement and burnout.
Alongside the effect that a pandemic can have all alone, a key component is the pandemic's insight by the individuals who live with it, particularly bleeding edge labourers, the medical caretakers. Their impression of the estimates taken, the assets accessible, and the pandemic's effect on their work and lives can influence and be influenced by biopsychosocial chances and their outcomes . Accordingly, the investigation introduced here means to fill this hole in the information by offering a first way to deal with the impression of COVID-19 by nursing experts and its relationship with work commitment and burnout during the pandemic.
Finally, this results of the study could give well-being specialists data to empower them to focus on preparing and different exercises focussed on viably improving medical attendants' insight and improve work commitment and consequently the lessen burnout of their consideration conveyance. The point of this examination is to survey the medical caretakers' impression of making a difference, sensations of burnout and work commitment during the COVID-19 outbreak.

| Aim of the study
This study aimed to assess the mattering perceptions, feelings of burnout, and work engagement during the COVID-19 outbreak.

| Research questions
• What are the levels of nurses' perceptions of mattering, burnout and work engagement?
• Is there relationship between nurses' mattering, work engagement and burnout?

| Research design
A cross-sectional descriptive design was used in this study.

| Setting
The study was carried out at Zagazig fever hospital and Zagazig

| Sample
Convenient sample consisted of 280 nurses working in the above mentioned settings and providing care for patients with corona virus.
Sample Size: The estimated sample size was 280 nurses arranged as mentioned below, at confidence level 95%, and the precision rate at 0.05 by using the equation devised by Suresh and Chandrashekara (2012) as the total number of available nurses is 810.
The eligibility criteria for participants were as follows.

| Inclusion criteria
-Those who have worked as nurses in hospitals for 3 years, -Be actively working during the moment of assessment.

| Tool
Four scales were used in the current study: • Personal data sheet was constructed by the researchers. It includes information about the participants such as age, gender, marital status, Primary specialty, education level, experience and residence.
It was used to measure mattering of nurses at work dependent on the 10-item divided on two domains as Societal mattering that include 5-items as I think that society values the work, I do, I feel my work meets a societal need and interpersonal mattering as my co-worker appreciate my support and help and my co-worker value my ideas and suggestions. All items were answered using a 5-point Likert scale format ranging from disagree very much (i), disagree (ii), somewhat (iii), agree (iv), to agree very much (v).
Higher scores indicate higher perceptions of mattering at work.
Total score ranged from 10-50 score and categorized on three cut points; low 10-23, moderate if score 24-37, high if score 38-50. It was translated into Arabic by researchers. Three experts checked the content validity of these questionnaires in the field of mental health nursing, nursing administration and statistics.
• Burnout scale was adopted from İlhan and et al. (2008). It was used to measure burnout of nurses at work. It consisted of 10item, such as I am the person I always wanted to be, I have beliefs that sustain me and I am a very caring person. The tool is on a 5-point Likert scale, ranging from 1 (never) and 5 (very often) for positive items and reverse-coded with negative items. High scores indicated higher experiences of burnout. Total score ranged from 10-50 score and categorized on three cut points; low 10-23, moderate if score 24-37, high if score 38-50.
• Work Engagement scale was adopted from Mills and et al. (2012).
It was used to measure the nurses' engagement at work. It con-

| Pilot study
The pilot study was conducted with 28 nurses who represent 10% of nurses at the previously mentioned settings in order to test the applicability of the constructed tools and the clarity of the included tools.
The pilot also served to estimate the time needed for each subject to fill in the questionnaire. A group of experts in the nursing administration departments ascertained the content's validity; their opinions were elicited about the format, layout, consistency, accuracy and relevancy of the tools. Reliability testing was carried out to test the reliability in terms of Cronbach's Alpha for mattering scale = 0.799, burnout scale = 0.837 and Nursing engagement scale = 0.821.

| Procedure
Official approval was obtained from Directorate of Health in Zagazig Governorate and the directors of Zagazig fever hospital and Zagazig chest hospital and also from head of different departments at the two hospitals to access the potential participants and the researchers approached the available sample to identify the eligible participants for the current study. The researchers started to contact nurses who met the inclusion criteria of the study. Then, the researchers interviewed all nurses who met inclusion criteria and agreed to participate in the study.
The aim of the study was explained to the selected nurses. Written consent was obtained from the study participants. The researchers began data collection by introducing themselves to the participants and explained the content of the study tools to establish initial rapport and gain cooperation between nurses and researchers. All questions related to the study tools were answered, and a detail explanation.
Data was collected over a period from March 2020-June 2020.

| Ethical considerations
Official approval for the study was obtained from the scientific research ethics committee of the Faculty of Nursing at Zagazig University (January, 2020), Directorate of Health in Zagazig Governorate and relevant hospital authorities. The study purpose was explained to chairperson of the continuing education department and nurses' supervisors to obtain their support for conducting the study and facilitate the data collection process. The participants were informed that they had the right to withdraw from the study at any time without any adverse consequences. Code numbers were generated and used to ensure patient data confidentiality. Subjects who were willing to participate were asked to sign the informed consent.

| Statistical design
Statistics was analysed using the Statistical Package for the Social Sciences (SPSS), version 22. Data were presented using descriptive statistics in the form of Frequency and percentages were used for numerical data, and mean and standard deviation. For parametric analysis, Pearson's correlation coefficient is the test statistics that measures the statistical relationship, or association, between two continuous variables (engagement, mattering and burnout variable). A linear regression model was used to assess the relationship between a scalar response and one or more explanatory variables. The level of statistical significance was set at p < .05.

| D ISCUSS I ON
After analysing the collected data, related with first research question, we demonstrated that, more than half (53.2%) of studied nurses had moderate mattering level and more than one-quarter (28.9%) of them had low mattering. Total engagement, more than two fifth (42.9%) of studied nurses had moderate level and slight less than one-third (32.1%) of them had low engagement. About to burnout, more than two fifth of studied nurses had moderate level of burnout, whilst slight less than one-third (32%) of them had high burnout and one-quarter (25%) of them had low burning out. These results may due to the period in which the data were collected and the study was conducted was a critical time because it was immediately following the first wave of COVID-19, especially since the hospitals in which the study was held were a fever hospital and another a chest hospital, meaning that they were directly related to the pandemic, so had negative effect on mattering and engagement, also increased burnout feeling. These results similar with the study by Eseadi and Diale (2020) who detected that, nurses reported having high burnout strategies are required to reduce burnout amongst nurses (Hailay et al., 2020).
As regards to the correlation between engagement and mat-  Park and Kim (2020) who demonstrated that, self-esteem, compassion satisfaction, and secondary traumatic stress were also statistically significant factors affecting burnout.

| Limitation of the study
There was no specific method for data collection from nurses during

| CON CLUS ION
Based on the findings of the present study, the study concluded that, nurses had moderate mattering perception level. Related total work engagement, nurses had moderate level. According burnout, nurses had moderate level of burning out level. Also, there was a statistically significant positive correlation between engagement and mattering perception. Whilst, there were a statistically significant negative correlation between burning out with engagement and mattering.

| Recommendations
The current study was limited to nurses working at a two central hospital, therefore, recommended that a larger sample size be used in the future studies to enhance external validity.
Future researches can emphasis on the causal associations between nurses' characteristics and mattering and engagement. Training workshop for nurses about coping mechanism for burnout feeling.
Design training programme for head nurses and directors for enhancing engagement and mattering of nurses.
Development of Psycho-educational nursing programmes should be held to help the nurses to deal with biopsychosocial risks faced them during COVID−19 (second wave of pandemic).

ACK N OWLED G EM ENTS
We would like to extend our sincere appreciation to the nursing students who participated in the study.

CO N FLI C T O F I NTE R E S T
No conflict of interest has been declared by the authors.

AUTH O R CO NTR I B UTI O N S
All authors contributed to conception and study design, data collection, analysis, interpretation, manuscript writing, reviewing and revising it. All authors read and approved the final manuscript.

DATA AVA I L A B I L I T Y S TAT E M E N T
All data are already present at the published article.