Illegitimate tasks and nurses’ work engagement: The role of ego depletion

Main Article Content

Chenyan Dong
Li Zhang
Cite this article:  Dong, C., & Zhang, L. (2022). Illegitimate tasks and nurses’ work engagement: The role of ego depletion. Social Behavior and Personality: An international journal, 50(8), e11761.


Abstract
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References
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Acknowledgments
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This study explored whether ego depletion mediated the relationship between illegitimate tasks and nurses’ work engagement. We recruited 760 Chinese nurses at three tertiary hospitals and a general hospital to complete a survey on illegitimate tasks, ego depletion, and work engagement. The results show that illegitimate tasks were negatively related to work engagement and that ego depletion partially mediated this relationship. These results provide a theoretical reference to improve nurses’ work engagement through avoiding illegitimate tasks.

According to data released by the National Health Commission, the total number of registered nurses in China was 4.7 million at the end of 2020 (National Health Commission of the People’s Republic of China, 2020). Nurses are important staff members in the medical and healthcare system. They not only assist doctors by completing auxiliary health work, but also take care of patients and communicate with the patients’ families. Multiple job demands require nurses to be engaged in their work (Li et al., 2019). In particular, during the COVID-19 epidemic, nursing has become more complex and stressful (Ojo et al., 2021). Nurses’ degree of work engagement has a direct impact on nursing quality and medical service levels (Hisel, 2020). Improving nurses’ work engagement is crucial to improving the outcome of clinical treatment and patient satisfaction.

Work engagement is defined as a positive, fulfilling work-related mental state characterized by vigor (a high level of mental energy), dedication (physical and mental involvement), and absorption in work (Schaufeli & De Witte, 2017). Studies have shown that the higher the degree of nurses’ work engagement, the better is the quality of patient care (De Simone et al., 2018; Van Bogaert et al., 2017). Moreover, work engagement has been found to be related to nurses’ higher job satisfaction (Orgambídez-Ramos & de Almeida, 2017), lower job burnout (Havens et al., 2018), and lower turnover intention (De Simone et al., 2018). A recent survey conducted with nurses showed that their work engagement has been at a medium level during the COVID-19 pandemic (Allande-Cussó et al., 2021). Therefore, it is necessary to explore the factors that affect nurses’ work engagement to improve their level of engagement and satisfaction. In this study we examined illegitimate tasks as a type of work stress and assessed its relationship with work engagement.

Illegitimate Tasks and Work Engagement

Work stress, such as a heavy workload, has been identified as a powerful predictor of nurses’ work engagement (Cruz et al., 2022). Researchers have identified the performing of illegitimate tasks as a cause of stress, and have found that doing these tasks has detrimental effects on nurses’ work behaviors and well-being (Anskär et al., 2019; Kilponen et al., 2021). Illegitimate tasks are defined as those that do not meet employees’ expectations of their work role, and can be divided into two types: unreasonable tasks and unnecessary tasks (Semmer et al., 2015). Performing illegitimate tasks has become a common stressor among healthcare professionals (Anskär et al., 2019). According to Kilponen et al. (2021), healthcare workers, including nurses, face many unreasonable tasks, such as tasks outside their occupational role, conflicting or unclear demands, tasks with insufficient resources, and tasks with difficult consequences. They also face many unnecessary tasks, including impractical or outdated working habits, tasks related to dysfunctional technology, unnecessary procedures, and tasks related to bureaucratic demands.

According to the model of work engagement (Bakker, 2011), both job and personal resources predict work engagement. On the one hand, superiors’ support and reasonable arrangements are important job resources (Aggarwal et al., 2020). In general, employees consider illegitimate tasks as unreasonable arrangements and feel that they do not get enough material and psychological support from their leaders (Zhou et al., 2020). Thus, illegitimate tasks reduce the job resources of nurses. On the other hand, personal resources refers to positive self-evaluation and sense of control over the environment (Bakker, 2011). Semmer et al. (2015) found that being assigned illegitimate tasks conveys negative social messages to employees that organizations or leaders do not respect them. This information not only threatens an individual’s positive self-evaluation, but also reduces perceived control of the environment. Therefore, illegitimate tasks can reduce nurses’ personal resources. Overall, illegitimate tasks reduce both nurses’ job and personal resources, thus reducing their work engagement. Kilponen et al. (2021) found that illegitimate tasks are negatively associated with work engagement. Therefore, we proposed the following hypothesis:
Hypothesis 1: Performing illegitimate tasks will be negatively correlated with work engagement among Chinese nurses.

Ego Depletion as a Mediator

In the extant research, the mediating mechanism between illegitimate tasks and work engagement is yet to be explored. We suggested that ego depletion would mediate the relationship between illegitimate tasks and work engagement of nurses. It has been found that people perform worse on a self-control task after having been already engaged in a previous task requiring self-control (Friese et al., 2019). This phenomenon is called ego depletion or mental fatigue (Sjåstad & Baumeister, 2018). According to the energy model of the self, individuals who experience ego depletion have insufficient self-control to cope with subsequent tasks (Sjåstad & Baumeister, 2018). Work engagement requires individuals to focus on work-related tasks and withstand irrelevant interference (Aggarwal et al., 2020). Therefore, ego depletion will be negatively associated with work engagement. Young et al. (2018) found that sufficient sleep can buffer employees’ ego depletion and promote people’s work engagement. In the field of nursing, researchers are concerned about the impact of ego depletion on nurses’ mental health and work behavior, but few have investigated ego-depletion factors and their impact on work engagement (Hatami et al., 2022). The prevalence of ego depletion among nurses during the COVID-19 pandemic has been assessed as between 16% and 36% (Hatami et al., 2022).

Furthermore, performing illegitimate tasks can induce ego depletion. From the perspective of cognition, performing illegitimate tasks decreases individuals’ self-esteem, resulting in negative self-evaluation and ego depletion (Friese et al., 2019). From the perspective of emotion, performance of illegitimate tasks is accompanied by anger and other negative emotions, and negative emotions lead to higher ego depletion (Shmueli & Prochaska, 2012). In conclusion, we proposed the following hypothesis:
Hypothesis 2: Ego depletion will mediate the relationship between performance of illegitimate tasks and work engagement of Chinese nurses.

Method

Participants

We obtained ethical approval for our study from the ethics review board of the first author’s university. Participants were staff nurses recruited using convenience sampling from three tertiary hospitals and a general hospital in Ningbo, China. We distributed the survey link via WeChat groups using the Wenjuanxing survey platform. The participants were 760 nurses with an average age of 31 years (SD = 7.89; range = 20–60). There were 725 women (95.4%) and 35 men (4.6%). The average number of years working in the profession was 7.87 (SD = 3.67; range = 2–27). Places of work for nurses were as follows: outpatient department = 73 (9.6%), emergency room = 20 (2.6%), operating room = 43 (5.7%), intensive care unit = 34 (4.5%), ward = 508 (66.8%), medical laboratory = 12 (1.6%), and other departments = 70 (9.2%). More than 60% had a monthly income of RMB 5,000–10,000 (USD 700–1500).

Measures

Bern Illegitimate Tasks Scale
Illegitimate tasks were assessed using the Bern Illegitimate Tasks Scale (Semmer et al., 2010), which consists of eight items. It has been translated into Chinese by Ma and Peng (2019). Each item is rated on a 5-point Likert scale ranging from 1 (never) to 5 (frequently). Unnecessary tasks are measured with four items, prompted by “Do you have work tasks to take care of, which keep you wondering…” followed by different options, such as “…if they should be done at all?” Unreasonable tasks are similarly measured with four items, prompted by “Do you have work tasks to take care of which you believe…” followed by different options, such as “…should be done by someone else?” Higher scores indicate greater severity of illegitimate tasks. Cronbach’s alpha values were .88 for unnecessary tasks, .94 for unreasonable tasks, and .93 for the total scale in this study.

The 5-Item State Self-Control Capacity Scale
Ego depletion was measured using the 5-Item State Self-Control Capacity Scale published by Lindner et al. (2018). The items (e.g., “My mind feels unfocused right now”) are rated on a 5-point Likert scale ranging from 1 (very slightly or not at all) to 5 (very much). Higher scores indicate higher levels of ego depletion. Cronbach’s alpha was .90 for this study.

The 9-Item Utrecht Work Engagement Scale
Work engagement was measured using the 9-Item Utrecht Work Engagement Scale (Schaufeli et al., 2006). Work engagement is assessed in three dimensions: three items for vigor (e.g., “At my work, I feel bursting with energy”), three items for dedication (e.g., “I am enthusiastic about my job”), and three items for absorption (e.g., “I feel happy when I am working intensely”). The items are rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Higher scores indicate higher levels of work engagement. Previous research has supported the reliability and validity of this scale among Chinese nursing students (Meng & Jin, 2017). Cronbach’s alpha values for vigor, dedication, absorption, and the total scale in this study were .84, .92, .88, and .94, respectively.

Procedure

The survey was organized by trained research assistants. Before data collection began, the nurses were informed that their participation was voluntary and they could discontinue at any point without giving any reason. After obtaining informed consent from the nurses, the research assistants explained the study purpose and asked participants to respond to a series of items and questions. After completion, participants were given a water glass (USD 1.00) as a gift.

Results

The correlations between the variables involved in this study are presented in Table 1. The results show that illegitimate tasks were positively associated with ego depletion, and that work engagement was negatively related to illegitimate tasks and ego depletion.

Table 1. Means, Standard Deviations, and Correlation Coefficients of Variables

Table/Figure

Note. N = 760.
** p < .01.

Mediation Model Test

We used bootstrapping analysis to determine the intermediary effect, calculating 5,000 resamples and 95% confidence intervals (CIs). The mediating role of ego depletion between illegitimate tasks and work engagement was tested using multivariate linear regression analysis. Results in Table 2 show that illegitimate tasks were significantly associated with work engagement (Model 1), 95% CI [−0.69, −0.33]. Thus, Hypothesis 1 was supported. After introducing ego depletion into the model, both illegitimate tasks and ego depletion were significantly associated with work engagement (Model 2), 95% CI [−0.42, −0.21]; 95% CI [−0.36, −0.12], respectively. In addition, illegitimate tasks were significantly correlated with ego depletion (Model 3), 95% CI [0.47, 0.71].

Table 2. Mediating Effect of Illegitimate Tasks on Work Engagement

Table/Figure

Note. *** p < .001.

Figure 1 shows the indirect effect of illegitimate tasks on work engagement via ego depletion was significant, ab = − .14, p < .001, 95% CI [−0.29, −0.09], accounting for 25.00% of the total effect. Thus, Hypothesis 2 was also supported.

Table/Figure

Figure 1. Effect of Illegitimate Tasks on Work Engagement Through Ego Depletion
Note. The coefficients provided are standardized values.
*** p < .001.

Discussion

Theoretical Implications

As hypothesized, our results show that illegitimate tasks were negatively associated with the work engagement of Chinese nurses, which is similar to the results of a study conducted with municipal healthcare organization employees in Finland (Kilponen et al., 2021). One possible reason for this negative association is that reducing work engagement may be a self-protective strategy for nurses facing illegitimate tasks. In an appropriate environment, nurses are usually willing to perform and execute their role tasks. However, illegitimate tasks require nurses to perform extrarole behaviors (Kilponen et al., 2021). This may drain their internal resources and cause them to reduce their in-role behaviors, including enthusiasm, engagement, and immersion.

In addition, the results show that illegitimate tasks were positively associated with ego depletion. First, according to the job demands–resources model (Bakker & Demerouti, 2007), illegitimate tasks are job demands that consume employees’ physical and mental resources. Second, according to the conservation of resources theory (Hobfoll, 1989), illegitimate tasks that go beyond the scope of nurses’ role and violate their professional identity constitute a work pressure situation, which causes negative emotions of stress. The more resources nurses consume to resist stress, the more likely they are to become depleted.

As expected, we found that ego depletion was negatively related to work engagement. Work engagement requires a high level of energy and self-control. Sufficient energy and self-control are necessary for nurses to improve their work engagement (Allande-Cussó et al., 2021). Ego depletion causes individuals to consume cognitive and emotional resources, which reduces their ability to deal with stressful events and makes it difficult to be focused. When nurses’ control energy is insufficient due to early depletion, they cannot maintain a high level of work engagement with their stock of mental resources.

In conclusion, we found that ego depletion mediated the relationship between illegitimate tasks and nurses’ work engagement. According to the theory of ego depletion, individuals need to consume self-control resources to perform volitional activities (Baumeister & Vohs, 2007). Performing illegitimate tasks requires nurses to consume considerable time and energy, pay high attention, and manage themselves. These self-control behaviors lead to resource depletion, thus negatively influencing subsequent control behaviors, including work engagement.

This study provides new evidence showing that ego depletion mediated the relationship between illegitimate tasks and work engagement among staff nurses in China. Illegitimate tasks and ego depletion have been reported as significant predictors of work engagement (Kilponen et al., 2021; Kühnel et al., 2017; Young et al., 2018). The novel aspect of our study is that we examined the mediating mechanism between illegitimate tasks and work engagement with a sample of Chinese nurses. Confirming our expectations, ego depletion partially mediated this relationship. If this finding reflects a causal mechanism, then performing illegitimate tasks may lead to ego depletion, which, in turn, leads to low levels of work engagement among nurses.

Practical Implications

The results of this study have several practical implications. First, managers should focus on reducing nurses’ illegitimate tasks (Kilponen et al., 2021). Hospital human resource managers should formulate clearer job descriptions and clarify the job content as well as nurses’ rights and obligations within their areas of responsibility. Moreover, managers should refine the work content and set up corresponding posts to ensure that people and positions match. Second, nursing supervisors should attach importance to and eliminate nurses’ ego depletion. Hospital managers should optimize human resource management, arrange the number of nursing staff members reasonably, enrich the nursing team, and help the nursing staff reduce their workload and working time (Hatami et al., 2022). Interventions to eliminate nurses’ illegitimate tasks and reduce their ego depletion are effective in improving their work engagement (Cruz et al., 2022). Nursing managers should focus on and attach importance to the feelings and needs of their nursing staff when formulating hospital policies and implementing management of these policies. By eliminating nurses’ illegitimate tasks and addressing their ego depletion, work engagement and quality of patient care should be ensured.

Limitations and Future Research Directions

This study has several limitations. First, only hospital nurses in a certain area of China were selected as participants, and the sample size was small. In the future, the sample size could be expanded and nurses from different hospitals in multiple regions could be selected to obtain more reliable results. Second, in cross-sectional studies the causality between variables cannot be determined. Experimental studies could be conducted in the future to determine the causal relationships between variables. Questionnaires are the main method used for measuring illegitimate tasks. Related experimental operational tasks can be developed in the future. Thus, double randomization designs can be used to manipulate illegitimate tasks and ego depletion to test mediating effects (Highhouse & Brooks, 2021).

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Allande-Cussó, R., García-Iglesias, J. J., Ruiz-Frutos, C., Domínguez-Salas, S., Rodríguez-Domínguez, C., & Gómez-Salgado, J. (2021). Work engagement in nurses during the COVID-19 pandemic: A cross-sectional study. Healthcare, 9(3), Article 253.
https://doi.org/10.3390/healthcare9030253

Anskär, E., Lindberg, M., Falk, M., & Andersson, A. (2019). Legitimacy of work tasks, psychosocial work environment, and time utilization among primary care staff in Sweden. Scandinavian Journal of Primary Health Care, 37(4), 476–483.
https://doi.org/10.1080/02813432.2019.1684014

Bakker, A. B. (2011). An evidence-based model of work engagement. Current Directions in Psychological Science, 20(4), 265–269.
https://doi.org/10.1177/0963721411414534

Bakker, A. B., & Demerouti, E. (2007). The job demands-resources model: State of the art. Journal of Managerial Psychology, 22(3), 309–328.
https://doi.org/10.1108/02683940710733115

Baumeister, R. F., & Vohs, K. D. (2007). Self-regulation, ego depletion, and motivation. Social and Personality Psychology Compass, 1(1), 115–128.
http://doi.org/10.1111/j.1751-9004.2007.00001.x

Christian, M. S., & Ellis, A. P. J. (2011). Examining the effects of sleep deprivation on workplace deviance: A self-regulatory perspective. Academy of Management Journal, 54(5), 913–934.
http://doi.org/10.5465/amj.2010.0179

Cruz, J. P., Alquwez, N., & Balay-Odao, E. (2022). Work engagement of nurses and the influence of spiritual climate of hospitals: A cross-sectional study. Journal of Nursing Management, 30(1), 279–287.
https://doi.org/10.1111/jonm.13492

De Simone, S., Planta, A., & Cicotto, G. (2018). The role of job satisfaction, work engagement, self-efficacy and agentic capacities on nurses’ turnover intention and patient satisfaction. Applied Nursing Research, 39, 130–140.
https://doi.org/10.1016/j.apnr.2017.11.004

Friese, M., Loschelder, D. D., Gieseler, K., Frankenbach, J., & Inzlicht, M. (2019). Is ego depletion real? An analysis of arguments. Personality and Social Psychology Review, 23(2), 107–131.
https://doi.org/10.1177/1088868318762183

Hatami, Z., Sarkhani, N., & Nikpeyma, N. (2022). Decision fatigue in nurses in the COVID-19 pandemic: A commentary. Nursing Open, 9(1), 4–5.
https://doi.org/10.1002/nop2.1069

Havens, D. S., Gittell, J. H., & Vasey, J. (2018). Impact of relational coordination on nurse job satisfaction, work engagement and burnout: Achieving the quadruple aim. The Journal of Nursing Administration, 48(3), 132–140.
https://doi.org/10.1097/NNA.0000000000000587

Highhouse, S., & Brooks, M. E. (2021). A simple solution to a complex problem: Manipulate the mediator! Industrial and Organizational Psychology, 14(4), 493–496.
https://doi.org/10.1017/iop.2021.117

Hisel, M. E. (2020). Measuring work engagement in a multigenerational nursing workforce. Journal of Nursing Management, 28(2), 294–305.
https://doi.org/10.1111/jonm.12921

Hobfoll, S. E. (1989). Conservation of resources: A new attempt at conceptualizing stress. American Psychologist, 44(3), 513–524.
http://doi.org/10.1037/0003-066X.44.3.513

Kilponen, K., Huhtala, M., Kinnunen, U., Mauno, S., & Feldt, T. (2021). Illegitimate tasks in health care: Illegitimate task types and associations with occupational well-being. Journal of Clinical Nursing, 30(13–14), 2093–2106.
https://doi.org/10.1111/jocn.15767

Kühnel, J., Zacher, H., de Bloom, J., & Bledow, R. (2017). Take a break! Benefits of sleep and short breaks for daily work engagement. European Journal of Work and Organizational Psychology, 26(4), 481–491.
https://doi.org/10.1080/1359432X.2016.1269750

Li, B., Li, Z., & Wan, Q. (2019). Effects of work practice environment, work engagement and work pressure on turnover intention among community health nurses: Mediated moderation model. Journal of Advanced Nursing, 75(12), 3485–3494.
https://doi.org/10.1111/jan.14130

Lindner, C., Nagy, G., & Retelsdorf, J. (2018). The need for self-control in achievement tests: Changes in students’ state self-control capacity and effort investment. Social Psychology of Education, 21(5), 1113–1131.
https://doi.org/10.1007/s11218-018-9455-9

Ma, J., & Peng, Y. (2019). The performance costs of illegitimate tasks: The role of job identity and flexible role orientation. Journal of Vocational Behavior, 110(Part A), 144–154.
https://doi.org/10.1016/j.jvb.2018.11.012

Meng, L., & Jin, Y. (2017). A confirmatory factor analysis of the Utrecht Work Engagement Scale for Students in a Chinese sample. Nurse Education Today, 49(3), 129–134.
https://doi.org/10.1016/j.nedt.2016.11.017

National Health Commission of the People’s Republic of China. (2020). The National Health Commission’s 2020 annual report on open government information work [In Chinese].
https://bitly.ws/qipS

Ojo, A. O., Fawehinmi, O., & Yusliza, M. Y. (2021). Examining the predictors of resilience and work engagement during the COVID-19 pandemic. Sustainability, 13(5), Article 2902.
https://doi.org/10.3390/su13052902

Orgambídez-Ramos, A., & de Almeida, H. (2017). Work engagement, social support, and job satisfaction in Portuguese nursing staff: A winning combination. Applied Nursing Research, 36, 37–41.
https://doi.org/10.1016/j.apnr.2017.05.012

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Table 1. Means, Standard Deviations, and Correlation Coefficients of Variables

Table/Figure

Note. N = 760.
** p < .01.


Table 2. Mediating Effect of Illegitimate Tasks on Work Engagement

Table/Figure

Note. *** p < .001.


Table/Figure

Figure 1. Effect of Illegitimate Tasks on Work Engagement Through Ego Depletion
Note. The coefficients provided are standardized values.
*** p < .001.


This paper is funded by 

the General Project of Soft Science Research Plans of Ningbo (202002Z1015)

&ldquo

Investigation on the Status Quo of Young Scientific and Technological Talents in Ningbo City and Research on Inclusive Supporting Countermeasures.&rdquo

Chenyan Dong, Ningbo College of Health Sciences, No. 51 Xuefu Road, Yinzhou District, Ningbo, Zhejiang Province, People’s Republic of China. Email: [email protected]

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