Is nurses’ self‐esteem interwoven with patients’ achievements? The concept of patient‐invested contingent self‐esteem

Objectives To explore the notion of patient‐invested contingent self‐esteem (Pa‐CSE) and investigate its association to nurses’ self‐reported engagement in controlling or autonomy‐supportive interactions with chronic care patients. Background Considering the high number of patients sub‐optimally managing their chronic condition, nurses might experience a drop and rise in self‐worth when patients fail and succeed, respectively, in managing their chronic condition. This dynamic has not received prior research attention. Design Multivariate analysis employing cross‐sectional data according to STROBE guidelines. Methods Self‐reports among nurses employed in chronic care (N = 394) from eight randomly selected hospitals in Belgium. Exploratory factor analysis and stepwise linear regression analyses were conducted. Results Success‐based and failure‐based orientations could be distinguished and refer to nurses' tendency to associate, respectively, patients’ successes with feelings of professional success and self‐worth and patients’ failures with feelings of professional failure, shame and inadequacy. Nurses’ self‐esteem is fairly interwoven with patients’ achievements in the management of their chronic condition. A success‐based orientation was positively related to autonomy‐supportive care in case a failure‐based orientation was low. Nurses with a simultaneous success‐based and failure‐based orientation interacted in a more controlling way. Conclusions The findings of this study suggest that basing one's self‐worth on patients' accomplishments may be a double‐edged sword. Although tying one's personal glory to the successes of one's patient is related to greater patient participation and support of autonomy, these effects only emerge if nurses' self‐worth is not interwoven with patients' failures. In fact, having both success‐ and failure‐oriented contingent self‐worth is related to a more pressuring approach. Relevance to clinical practice To prevent nurses from developing inferior professional feelings when their patients fail to manage their condition, a reflective stance towards the impact of patients’ behaviour on the nurses' professional feeling of (in)adequacy is an important step to deal with such situations.