title: An attribution theory perspective on emotional labour in nurse-patient encounters: a nested cross-sectional study in paediatric settings.
abstract: OBJECTIVE
  To understand the role of patients' attributions under the attribution theory framework (locus, controllability, stability) in nurses' performance of surface or deep acting, as they unfold in interactions with different patients.
  
  
  BACKGROUND
  Regulation of emotions at work, or emotional labour, has been conceptualized in terms of two main strategies: surface acting and deep acting. Most prior research tested for between-subject variation in the search for the factors evoking these strategies in nurses, assuming them to be trait-like characteristics. Only scant research has examined how nurses modify their emotional labour strategies in different patient-nurse encounters.
  
  
  METHODS
  A nested cross-sectional design (patients within nurses).
  
  
  METHODS
  Data were collected during 2011-2012 through validated questionnaires from the nursing staff (N = 41) of two paediatric hospital wards and their randomly selected patients (N = 239). Questionnaires were administered to nurses multiple times after encounters with different patients. Analyses were conducted using mixed effects models.
  
  
  RESULTS
  In accordance with attribution theory, different combinations of locus, controllability and stability attributions were related to the choice of surface or deep acting. Nurses' perceptions of patients' controllability were associated positively with surface acting and negatively with deep acting. Interaction terms of stability and locus and of controllability and stability, were distinctively associated with deep and surface acting.
  
  
  CONCLUSIONS
  Findings innovatively introduce the attribution process as an explanatory perspective to nurses' emotional labour and highlight its situational nature, providing a potential tool for emotional labour strategy prediction. Raising nurses' awareness of how they perceive patients may increase control of the strategies employed.
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Nadya
authors.initials: N
authors.lastname: Golfenshtein
authors.forename: Anat
authors.initials: A
authors.lastname: Drach-Zahavy
mesh_terms: D003430:Cross-Sectional Studies; D006801:Humans; D008960:Models, Psychological; D009723:Nurse-Patient Relations; D009740:Nursing Staff / Q000523:psychology*; D010372:Pediatrics
keywords: attribution theory; cross-sectional survey; deep acting; emotional labour; nurse-patient relations; nurses; nursing; surface acting