Predictors of poor mental health among nurses during COVID-19 pandemic

Discrimination and Quality of Life During the COVID-19 Pandemic: Experiences of Racial/Ethnic Minority Nursing Staff in the United States

AIM

This study aimed to investigate U.S. minority nursing staff's discrimination experiences and the association of such experiences and other critical factors with their quality of life (QoL) during the COVID-19 pandemic.

BACKGROUND

Racial/ethnic minority nursing staff are at a higher risk of developing unfavorable health outcomes associated with race-based and related discrimination.

METHODS

Minority nursing staff were recruited through a professional network. An online survey, consisting of validated measures, was used to assess perceived discrimination, fear of COVID-19, perceived risk of contracting COVID-19, resilience, social support, and QoL. We used the chi-square test, ANOVA, and path analysis to compare racial/ethnic group differences and variables associated with QoL among minority nursing staff.

RESULTS

Our sample consisted of 514 minority nursing staff (31.4% Black, 25.5% Hispanic/Latinx, 17.0% Asian, 13.5% American Indian/Alaska Native, and 12.7% Native Hawaiian/Pacific Islander). The sample reported a high prevalence of discrimination experiences (60% witnessed, 28.3% experienced). Greater exposure to witnessed discrimination, higher levels of perceived risk of contracting COVID-19, and fear of COVID-19 were associated with worse QoL, whereas higher levels of resilience and social support were associated with better QoL. Multiple group analysis revealed no significant differences in these outcomes across the racial/ethnic groups.

CONCLUSION

Our findings revealed that while discrimination, fear, and perceived risk were negatively related to minority nursing staff's QoL, resilience and social support were crucial in promoting their QoL, with no significant differences observed across racial/ethnic groups.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

The findings highlight the importance of individual-, organizational-, and policy-level awareness of vulnerability related to racial/ethnic discrimination and areas that should be addressed to promote minority nursing staff's QoL.

Course of mental distress among psychotherapists throughout two years of the COVID- 19 pandemic: individual and inter-relational resources make a difference-cross-sectional and longitudinal results of the VOICE study

BACKGROUND

The COVID-19 pandemic has posed challenges to healthcare systems worldwide. For healthcare workers (HCW), an increased prevalence of mental distress and the impact of various resources have been identified. Psychotherapists specialise in helping people cope with stressful life events. At the same time, they are susceptible to mental distress, resulting from their work. Data on symptoms of depression and the role of resources during the COVID-19 pandemic are scarce for psychotherapists. Therefore, the present study aimed to evaluate the course of self-reported depression of psychotherapists throughout the COVID-19 pandemic. Additionally, the impact of resources on depression was evaluated.

METHODS

We investigated symptoms of depression using the Patient Health Questionnaire-2 (PHQ-2) at four time points (T1-T4) during the COVID-19 pandemic in Germany. The PHQ-2 scores and resources such as sense of coherence (SOC), general optimism and social support (ESSI-D) of the psychotherapists (N = 1733) were compared with those of a comparison sample of HCW (N = 8470). The impact of resources on PHQ-2 scores was examined using cross-sectional linear modelling and longitudinal linear mixed modelling with interactions and lagged predictors.

RESULTS

At T1-T4, psychotherapists showed lower mean PHQ-2 scores than the comparison sample (p < 0.001). Among psychotherapists, the PHQ-2 scores increased (T1-T2, and T1-T4, p < 0.050). Cross-sectionally, higher SOC was associated with lower PHQ-2 scores (p < 0.001), with the protective influence weakening over time (p = 0.033). Longitudinal analyses confirmed a protective effect of sense of coherence (stable over time) and general optimism (declining over time) on PHQ-2 scores. An exploratory lagged-predictor analysis suggested that higher social support was associated with lower PHQ-2 scores, whereas higher general optimism was linked to increasing PHQ-2 scores.

CONCLUSIONS

This study revealed lower levels of depression among psychotherapists compared with the comparison sample throughout the pandemic. Concurrently, the resource levels were mostly comparable and stable, with a protective impact of the sense of coherence (stable) and optimism (decreasing) and an association of high social support with low depression throughout the pandemic. Strengthening the sense of coherence and social support should be the focus of professional and policy attention to improve the ability of psychotherapists to cope with future crises.

Dysfunctional Pandemic Grief Model Among Nursing Professionals Who Experienced Death of Patients

Dysfunctional grief was not addressed adequately during the COVID-19 pandemic. This study aimed to develop a dysfunctional pandemic grief model specific to healthcare workers who experienced patient deaths during the COVID-19 pandemic. We conducted an anonymous online survey among 568 nursing professionals who had experienced a patient's death while working at three tertiary-level hospitals. We further assessed psychological status using the Pandemic Grief Scale (PGS) for Healthcare Workers, Pandemic Grief Risk Factors (PGEF), Utrecht Grief Rumination Scale (UGRS), Grief Support HealthCare Scale (GSHCS), Patient Health Questionnaire-9 (PHQ-9), and Stress and Anxiety in Viral Epidemic-9 (SAVE-9). PGS correlated with PGRF, UGRS, GSHCS, PHQ-9, and SAVE-9 (all p < 0.01). Linear regression analysis revealed that PGRF (𝛽=0.44, p < 0.001), UGRS (𝛽=0.24, p < 0.001), GSHCS (𝛽=-0.09, p = 0.004), and PHQ-9 (𝛽=0.23, p < 0.001) expected pandemic dysfunctional grief. Mediation analysis showed that PGRF directly influenced PGS; UGRS and GSHCS positively and negatively mediated the relationship between PGRF and PGS, respectively. The dysfunctional pandemic grief model shows that it is important to address grief risk factors, manage rumination, and provide effective psychological support to healthcare workers.

Machine learning-driven identification of key risk factors for predicting depression among nurses

BACKGROUND

Since the outbreak of the coronavirus disease (COVID-19) in 2019, caused by SARS-CoV-2, the disease has become a global health threat due to its high infectivity, morbidity, and mortality rates. With China's comprehensive relaxation of pandemic control policies in 2022, the risk of infection for nursing personnel has further increased.

OBJECTIVES

This study aims to identify risk factors associated with depression among nursing staff during the full reopening of COVID-19 in China in 2022 and to construct a predictive model to assess the risk.

METHODS

From December 9, 2022, to April 6, 2023, a cross-sectional study was conducted in three hospitals in Anhui Province, including 293 nursing staff. The research subjects were divided into a depression group and a non-depression group, and SPSS 23.0 software was used to analyze the data of both groups. We developed four predictive machine learning models: logistic regression, support vector machine, extreme gradient boosting machine (XGBoost), and adaptive boosting (AdaBoost). The development and validation of these models utilized open-source Python libraries such as Scikit-learn and XGBoost. The models were trained and validated using a 10-fold cross-validation method, and the final model selection was based on the area under the receiver operating characteristic curve (AUC).

RESULTS

The AUC values for the logistic regression, SVM, Logistic, XGBoost, and AdaBoost models were 0.86, 0.88, 0.95, and 0.93, respectively, with F1 scores of 0.79, 0.83, 0.90, and 0.89, respectively. The XGBoost model demonstrated the highest predictive accuracy. However, the study's findings are limited by the small sample size and single location, and further validation is needed to confirm the model's generalizability. The extreme gradient boosting machine model, tailored for common risk factors among Chinese nursing staff, provides a powerful tool for predicting the risk of depression.

CONCLUSION

This model can assist clinical managers in accurately identifying and addressing potential risk factors during and after the full reopening of COVID-19. Since the working environment and stress factors faced by nursing staff may vary across different countries, the research findings from China can promote international exchange and cooperation in the management of mental health among nursing staff, advice future research should focus on larger, multi-center studies to validate the model's performance and explore additional risk factors.

CLINICAL TRIAL NUMBER

Not applicable, because of this article belongs to cross-sectional study.

Unmasking Distress: An Analysis of COVID-19's Mental Health Impact on Nurses in South Africa

BACKGROUND

The acute mental health challenges faced by nurses during the COVID-19 pandemic have the potential to result in long-lasting psychological impacts. Promoting the mental health of nurses is crucial not only to safeguard their wellbeing but also to ensure the delivery of optimal patient care.

OBJECTIVE

This study sought to ascertain the extended mental health impact of the COVID-19 pandemic among nurses in South Africa.

METHODS

Participants involved nurses working at four hospitals in the Western Cape province: Helderberg, TC Newman, Stellenbosch, and Tygerberg. A convenience sample of nurses (N = 264) from the four hospitals participated in the study. Data collection involved an online survey, which included a comprehensive battery of psychological measures, such as fear of COVID-19, perceived vulnerability to disease, anxiety, depression, post-traumatic stress disorder (PTSD), alcohol use, and worry about COVID-19 infection.

RESULTS

The mean age of participants was 34.4 (SD = 7.9), with a majority being female (82%). Age was positively correlated with hopelessness and life satisfaction but negatively associated with fear of COVID-19 and symptoms of anxiety, PTSD, alcohol use, and depression. Nurses in the private sector reported higher levels of alcohol use and PTSD than nurses in public, while married and partnered nurses reported reduced levels of anxiety compared to their unmarried counterparts. Higher education levels were associated with reduced adverse mental health outcomes.

CONCLUSION

Psychological distress among nurses was exacerbated even after the peak of the COVID-19 pandemic. Potential areas of concern are highlighted, indicating the need for targeted interventions.

Perceived Trauma Among Nurses During the COVID-19 Pandemic: A Qualitative Descriptive Study

The COVID-19 pandemic has caused disruption to healthcare services worldwide, and although the pandemic was declared over, nurses continue to experience burnout and mental health implications because of events experienced since 2020. The aim of this study was to explore the experiences of trauma among nurses during the COVID-19 pandemic, using a qualitative descriptive study design. This paper used secondary analysis of qualitative, semi-structured interviews conducted with 55 Australian nurses exploring their alcohol consumption, due to the frequent narratives of trauma and traumatic events arising during this process. Data were analysed using structural coding and reported in accordance with the Consolidated Checklist for Reporting Qualitative Data (CORE-Q guidelines). Four themes emerged during data analysis: managing the traumatic stress of the clinical environment in COVID ('it doesn't feel like it's gone away'), post-pandemic trauma ('it was like war, wasn't it?'), bonding over shared trauma ('I was not expecting the camaraderie that developed') and managing trauma after the event ('If something bad happens whilst you're on shift, you just have to pretend like it hasn't happened'). Participants in this study described lasting mental health effects from working clinically during the COVID-19 pandemic that they described as trauma. These effects have lasted since governments worldwide have announced an end to the pandemic, and although participants described bonding over these shared experiences, they continue to have a detrimental impact on workforce well-being and sustainability.

The effects of psychological flexibility and night shifts on mental health and well-being in nurses

BACKGROUND

Examining mental health among nurses in the later stages of the COVID-19 pandemic could offer valuable information for addressing these symptoms in the long term. Therefore, the current study aimed to assess the mental health and well-being of Chinese nurses, as well as investigate the impact of psychological flexibility and night shifts on this relationship.

METHOD

In cross-sectional, hospital-based, multicenter study, 422 Chinese nurses were selected by multistage stratified cluster random sampling. The mental health status, psychological flexibility, and wellbeing were assessed via 12-item General Health Questionnaire (GHQ-12), Chinese version of Personalized Psychological Flexibility Index, and Chinese version of the 5-item WHO Well-Being Index, respectively. To examine the proposed theoretical model, we conducted structural equation modeling using SPSS Amos 26 version. The age, gender, night shift, psychological flexibility, mental health, and well-being data were entered into the model. Pearson correlation and chi-square were used to explore the correlation between variables.

RESULTS

The high night shifts, being young and low psychological flexibility significantly had a direct effect on worse mental health (night shifts: ES, 95% CI: 0.619, 0.328-0.725; age: ES, 95% CI: 0.542, 0.226-0.993; psychological flexibility: ES, 95% CI: 0.675, 0.369-1.466). The low psychological flexibility and worse mental health were able to directly effect on worse wellbeing (psychological flexibility: ES, 95% CI: 0.419, 0.757-1.519; mental health: ES, 95% CI: 0.719, 1.109-2.607). In addition, psychological flexibility through the mediation of mental health also had an indirect effect on wellbeing (ES, 95% CI: 0.269, 0.957-2.165).

CONCLUSIONS

Being young, having more night shifts and having less psychological flexibility can be related to the deterioration of mental health and well-being in nurses. Therefore, it is recommended that nurses use the shift routine program with the least focus on the night shifts. Also, interventions to teach younger nurses how to face work stress and interventions to improve the psychological flexibility of all nurses are needed.

No Backstage: The Relentless Emotional Management of Acute Nursing Through the COVID-19 Pandemic

AIM(S)

To explore the impact of the COVID-19 pandemic on nurse's well-being, experiences of delivering healthcare within acute settings and their emotional management.

DESIGN

Sequential mixed methods.

METHODS

February to July 2021 an online well-being survey was disseminated to nurses working in acute settings within one Scottish health board. In-depth interviews with a purposive sample of respondents were conducted. Survey data were analysed descriptively, and interview data using Framework analysis and emotional management as the theoretical framework.

RESULTS

Well-being was poor overall. Infection control measures impeded interactions, with loss of connection between patients, families and nurses. Emotional work was extended in caring for patients and families when visits were forbidden or restricted. Disconnect between colleagues was intensely felt. On COVID and non-COVID wards, nurses were caring for patients with a significantly reduced workforce and often outside their clinical speciality. Nurses masked their own anxieties, fears, moral distress and exhaustion on the ward. Communal 'backstage' spaces, were reduced to enable more infection-control space but reduced opportunity for collegial support. Formal psychological intervention required access after shift, and/or nurses feared they could not contain their emotions afterwards.

CONCLUSION

Working during the pandemic was emotionally and physically demanding for those in COVID a.nd non-COVID wards. Unintended consequences of infection control measures significantly extended nurses' emotional management, by caring for isolated patients and families but impeding opportunities to care for each other, compounding their emotions.

IMPLICATIONS FOR THE PROFESSION

There is a need to value emotional work in nursing to better support mental well-being.

IMPACT

We advance the nursing emotional management literature by addressing the gap of exploration in challenging conditions. The importance of emotional management on nurses' mental well-being has been overlooked but focusing on this in the next crisis could improve nurse's well-being.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

REPORTING METHOD

GRAMMS.

Influence of the continuing COVID-19 epidemic on sleep quality and psychological status of healthcare workers in private institutions

BACKGROUND

On January 22, 2020, Macao reported its first case of coronavirus disease 2019 (COVID-19) infection. By August 2021, the situation had escalated into a crisis of community transmission. In response, the government launched a recruitment campaign seeking assistance and services of healthcare workers (HCWs) from the private sector throughout Macao. These participants faced concerns about their own health and that of their families, as well as the responsibility of maintaining public health and wellness. This study aims to determine whether the ongoing epidemic has caused them physical and psychological distress.

AIM

To examine the influence of COVID-19 on the sleep quality and psychological status of HCWs in private institutions in Macao during the pandemic.

METHODS

Data were collected from December 2020 to January 2022. Two consecutive surveys were conducted. The Pittsburgh Sleep Quality Index (PSQI) scale, Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) were employed as investigation tools.

RESULTS

In the first-stage survey, 32% of HCWs experienced a sleep disorder, compared to 28.45% in the second-stage survey. A total of 31.25% of HCWs in the first-stage survey and 28.03% in the second had varying degrees of anxiety. A total of 50.00% of HCWs in the first-stage survey and 50.63% in the second experienced varying degrees of depression. No difference in PSQI scores, SAS scores, or SDS scores were observed between the two surveys, indicating that the COVID-19 epidemic influenced the sleep quality and psychological status of HCWs. The negative influence persisted over both periods but did not increase remarkably for more than a year. However, a positive correlation was observed between the PSQI, SAS, and SDS scores (r = 0.428-0.775, P < 0.01), indicating that when one of these states deteriorated, the other two tended to deteriorate as well.

CONCLUSION

The sleep quality, anxiety, and depression of HCWs in private institution in Macao were affected by the COVID-19 epidemic. While these factors did not deteriorate significantly, the negative effects persisted for a year and remained noteworthy.

The role of mental health in the relationship between nursing care satisfaction with nurse-patient relational care in Chinese emergency department nursing

BACKGROUND

The relationship between a nurse and a patient is a key part of nursing that can impact how happy the patient is with the care they receive. It appears that the nurse's mental health can also affect this connection. However, there is little research on this topic. So, the aim of the present study was to determine the correlation of nurse's mental health with nurse-patient relational care and nursing care satisfaction.

METHODS

A total of 532 nurses and 532 patients from 13 Level-III hospitals of Hubei province (China) completed a China Mental Health Survey, general information questionnaire, the Nursing Care Satisfaction Scale, and Relational Care Scale.

RESULTS

Age, nurse working years, and night shift last month were correlated with mental health score (r = -0.142, r = -0.150, r = 0.164, p < 0.05). Nurse's mental health was correlated with relational care score and nursing care satisfaction score (r = -0.177, r = -0.325, p < 0.05). Also, relational care score, patients age and gender were correlated with nursing care satisfaction score (r = 0.584 and r = 0.143, x2 = 11.636, p < 0.05). Descriptive information of nurses had a direct impact on nurses' mental health (direct effect = 0.612, 0.419-0.713). Nurses' mental health had a direct effect on relational care score (direct effect = 0.493, 0.298-0.428) and an indirect effect on nursing care satisfaction score (indirect effect = 0.051, 0.032-0.074). Relational care score and patient's descriptive information had also a direct effect on nursing care satisfaction score (direct effect = 0.232, 0.057-0.172 and 0.057, 0.347-0.493).

CONCLUSION

This study showed that the better the mental health of nurses, the more patients feel satisfied with nursing services.

Factors Influencing Post-Traumatic Stress Disorder in Hospital Clinical Nurses during COVID-19 in Korea: Resilience, Social Support, and Professional Pride in Nursing

During the COVID-19 pandemic, clinical nurses in hospitals in South Korea were exposed to extreme stress, and many continue to suffer from post-traumatic stress disorder (PTSD). This study explores the factors influencing PTSD among hospital clinical nurses during COVID-19. In total, 121 hospital clinical nurses participated in 2022, providing demographic information and completing surveys designed to measure PTSD, resilience, social support, professional pride in nursing (PPN), and variables related to COVID-19. We observed statistically significantly higher levels of resilience (91.48 vs. 70.00), social support (47.37 vs. 35.41), and PPN (88.36 vs. 68.06) in the low-risk PTSD group compared with the high-risk PTSD group. Resilience was associated with a reduced risk of PTSD (OR, 0.91; 95% CI = 0.84-0.98). The subfactors of control (OR = 0.60; 95% CI = 0.43-0.86) and sociability (OR = 0.68; 95% CI = 0.44-0.97) decreased PTSD risk. Among the social support subfactors, family support had an OR of 0.47 (95% CI = 0.26-0.86) for reducing PTSD risk. Programs involving family participation that enhance resilience and provide psychological support can help hospital nurses affected by the COVID-19 pandemic manage their PTSD. Our findings serve as foundational data to develop interventions on psychological well-being for nurses dealing with new infectious diseases.

Prevalence of psychological and mental health symptoms among nursing professionals during the COVID-19 pandemic in the Americas: Systematic review and meta-analysis

To assess the prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic on the American continent. A systematic review and meta-analysis of observational studies that estimated the prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic was performed through bibliographic database searches. A three-level meta-analysis model was used with the inverse variance method, tau was estimated via restricted maximum likelihood and logistic transformation, and heterogeneity was presented as tau2 and I2. Of the 7467 studies obtained, 62 were included in the meta-analysis, which involved 52 270 nursing professionals. The overall prevalence for at least one mental health symptom was 56.3% (50.4%, 62.1%; I2 = 98.6%, p < 0.001). Eight mental health symptoms were found; among them, the most prevalent were burnout (52.1%, 37.1%, 88.8%; I2 = 98.5%, p < 0.001) and fear (52.1%, 30.1%, 73.3%; I2 = 98.1%, p < 0.001). The prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic on the American continent was high, and strategies should be developed and implemented by managers and government agencies to promote the well-being, physical and mental health of nursing professionals. Studies like this one are necessary to highlight the need for efforts in the implementation of promotion and prevention actions to be developed by health organisations, managers and leaders with a view to improving the quality of life of nursing workers.

Resilience, Burnout and Mental Health in Nurses: A Latent Mediation Model

Background/Objectives: The burnout syndrome in nurses has been related to the development of mental health problems. On the contrary, resilience is related to adequately coping with stressful situations and better mental health. The objective was to analyze the relationship between resilience and mental health problems in nurses and estimate the proportion mediated by burnout in the association. Methods: In 2021, a total of 1165 Spanish nurses were selected through a stratified random sampling method. Participants anonymously filled in the Resilience Scale (RS-14), the Maslach Burnout Inventory Survey, and the General Health Questionnaire. To test the hypothesis proposed and explain the mediating effect of burnout empirically, structural equation modeling (SEM) was applied. A latent mediation model was computed. Results: Resilience was negatively related to burnout and mental health problems. The direct relationship between burnout and the latent health variable was positive. In addition, in view of the total effect of resilience on mental health problems and the magnitude of the indirect effect, we stated that the proportion of this effect mediated by burnout ranged from 0.486 to 0.870. Conclusions: This study reveals that fostering resilience in nurses directly and indirectly reduces burnout and improves their mental health. The implementation of resilience programs and supportive institutional policies is recommended to improve working conditions and the quality of patient care.

How Do Presenteeism and Family Functioning Affect the Association Between Chinese Nurses' Job Stress and Intention to Stay?

BACKGROUND

Despite a great deal of existing research on nurses' job stress and intention to stay, it is still unclear how the association between Chinese nurses' job stress and intention to stay is affected by presenteeism and family functioning.

AIMS

This study aimed to investigate the correlations of Chinese nurses' job stress, presenteeism, and family functioning with their intention to stay and clarify the mediating effect of presenteeism and the moderating effect of family functioning on the association between their job stress and intention to stay.

METHOD

A cross-sectional study of 1,008 nurses was performed in a major general hospital in Qiqihar City, Heilongjiang Province, China. The participants were invited to engage in a questionnaire survey regarding job stress, presenteeism, family functioning, and intention to stay. A moderated mediation analysis was conducted through multiple linear regression analysis and the PROCESS macro.

RESULTS

Job stress and presenteeism were negatively correlated with intention to stay, whereas family functioning was positively correlated with intention to stay. The effect of job stress on intention to stay was partially mediated by presenteeism (Effect = -0.147, 95% CI = [-0.305, -0.003]). In addition, family functioning moderated the direct effect of job stress on intention to stay (Index = -0.134, 95% CI = [-0.274, -0.001]).

CONCLUSIONS

Presenteeism and family functioning were found to play mediating and moderating roles, respectively, in the relationship between job stress and intention to stay. Relevant interventions or family-friendly programs should be developed to enhance nurses' intention to stay.

Protective strategies against occupational stress among health professionals during the COVID-19 pandemic

The purpose of this study was to investigate which protective strategies against occupational stress were developed for health professionals during the COVID-19 pandemic. This was an integrative literature review conducted in 2021. The Medical Literature Analysis and Retrieval System Online and the Latin American and Caribbean Literature in Health Sciences databases were searched using the Boolean operator AND and the controlled vocabularies "health professionals" AND "occupational stress" AND "COVID-19", both in English and Portuguese. After applying the inclusion criteria and reading the selected articles, a final sample of 24 articles was obtained. Protective strategies against occupational stress developed by institutions included psychological support, support from managers and team leaders, provision of personal protective equipment, appropriate schedules and workload, and training. As for the strategies developed by health professionals themselves, these included resilience, peer support, and self-care. Several protective strategies during the pandemic were observed, but institutions still need to develop and/or improve practices to offer better psychological conditions to health professionals in general.

Spirituality and anxiety in pastoral care workers and physicians in the first wave of the COVID-19 pandemic

Background

The COVID-19 pandemic had serious impact on the well-being of health care workers and highlighted the need for resources to help hospital staff to cope with psychologically negative consequences. The purpose of this study was to investigate the potentially protective effect of spirituality, as measured by the construct of transpersonal trust, against anxiety in physicians and in hospital pastoral care workers. In addition, transpersonal trust was compared to the effects of other potential resources, namely sense of coherence, optimism, and resilience. We also explored the relationship between transpersonal trust and anxiety and how it was moderated by sense of coherence and expected a significant effect.

Method

The sample included N = 405 participants (n = 151 pastoral care workers and n = 254 physicians) who completed an online survey during the first wave of the COVID-19 pandemic between 20th April and 05th July, 2020, that comprised established questionnaires assessing anxiety, transpersonal trust, sense of coherence, and resilience.

Results

There was no statistically significant negative relationship between transpersonal trust and anxiety in either profession or broken down by occupational group. Multiple regression analysis revealed that sense of coherence inversely predicted generalized anxiety, while transpersonal trust, resilience, and optimism did not. As hypothesized, the association between transpersonal trust and anxiety was moderated by sense of coherence. However, we could not confirm our hypothesis of a protective effect of transpersonal trust against anxiety.

Conclusion

Our results point to the significant role of sense of coherence as a protective factor against anxiety and highlight the complexity of the relationship among spirituality, transpersonal trust, and anxiety.

Stability and shifts in the combined positive and negative mental health of clergy: A longitudinal latent class and latent transition analysis study of united methodist pastors before and after the onset of COVID-19

COVID-19 and its associated restrictions presented unprecedented challenges for those in the helping professions. In this study, we seek to understand how the mental health of those who belong to one specific helping profession - clergy - changed in the context of COVID-19. Using longitudinal data of a sample of United Methodist pastors from the North Carolina Clergy Health Initiative, we conduct both cross-sectional and person-centered analyses to investigate how the overall mental health of this occupational group changed, as well as how different subgroups of clergy fared within the context of the pandemic, depending on their well-being prior to the onset of COVID-19. We found that the mental health of pastors suffered within the context of the pandemic, but that individual changes in mental health differed based on what the combined positive and negative mental health patterns of clergy were prior to the pandemic, for which we used latent class analysis to identify as Flourishing, Distressed, Languishing, or Burdened but Fulfilled. Of these subgroups, having Flourishing pre-pandemic status was protective of mental health following the onset of COVID-19, whereas the other three subgroups' mental health statuses worsened. This study is the one of the first longitudinal studies of helping professionals which has tracked changes in mental health before and after the onset of COVID-19. Our findings demonstrate the utility of considering positive and negative mental health indicators together, and they point to certain groups that can be targeted with well-being resources during future periods of acute or abnormal stress.

Impacts for health and care workers of Covid-19 and other public health emergencies of international concern: living systematic review, meta-analysis and policy recommendations

BACKGROUND

Health and care workers (HCW) faced the double burden of the SARS-CoV-2 pandemic: as members of a society affected by a public health emergency and as HWC who experienced fear of becoming infected and of infecting others, stigma, violence, increased workloads, changes in scope of practice, among others. To understand the short and long-term impacts in terms of the COVID-19 pandemic and other public health emergencies of international concern (PHEICs) on HCW and relevant interventions to address them, we designed and conducted a living systematic review (LSR).

METHODS

We reviewed literature retrieved from MEDLINE-PubMed, Embase, SCOPUS, LILACS, the World Health Organization COVID-19 database, the ClinicalTrials.org and the ILO database, published from January 2000 until December 2021. We included quantitative observational studies, experimental studies, quasi-experimental, mixed methods or qualitative studies; addressing mental, physical health and well-being and quality of life. The review targeted HCW; and interventions and exposures, implemented during the COVID-19 pandemic or other PHEICs. To assess the risk of bias of included studies, we used the Johanna Briggs Institute (JBI) Critical Appraisal Tools. Data were qualitatively synthetized using meta-aggregation and meta-analysis was performed to estimate pooled prevalence of some of the outcomes.

RESULTS

The 1013 studies included in the review were mainly quantitative research, cross-sectional, with medium risk of bias/quality, addressing at least one of the following: mental health issue, violence, physical health and well-being, and quality of life. Additionally, interventions to address short- and long-term impact of PHEICs on HCW included in the review, although scarce, were mainly behavioral and individual oriented, aimed at improving mental health through the development of individual interventions. A lack of interventions addressing organizational or systemic bottlenecks was noted.

DISCUSSION

PHEICs impacted the mental and physical health of HCW with the greatest toll on mental health. The impact PHEICs are intricate and complex. The review revealed the consequences for health and care service delivery, with increased unplanned absenteeism, service disruption and occupation turnover that subvert the capacity to answer to the PHEICs, specifically challenging the resilience of health systems.

Work-Related Health Conditions Among American Nurses: A Scoping Review

Background

Working in the nursing profession is hazardous, and nurses report poor health. Risk factors associated with poor health outcomes have been documented. However, the extent of literature exploring the prevalence of health conditions among American nurses that may be attributable to their work has not been examined.

Method

A scoping review following the Joanna Briggs Institute recommendations was conducted of peer-reviewed quantitative studies to answer the question: What are health conditions experienced by American nurses that may be attributable to their work as nurses?

Results

Thirty articles met the inclusion criteria. Due to the methods used in many articles, studies of the prevalence of health conditions among the nursing population were lacking. Health conditions studied broke into six categories: (a) work-related injuries and hazards; (b) unhealthy lifestyles; (c) mental health conditions; (d) burnout; (e) fatigue, sleep, and migraines; and (f) reproductive health. The role of work in the health conditions studied varied from an immediate impact on health (e.g., a needlestick or injury) to a cumulative impact (e.g., scheduling or workplace demands). Within the work demands, the physical environment; physical, emotional, and cognitive demands of work; and shiftwork were all frequently identified as antecedents that could be further explored and addressed to improve nurse health.

Conclusions

Healthcare systems should seek to address the hazards and exposures that may be linked to health conditions in the nursing workforce. Understanding and mitigating the impact of the pandemic and nursing work on the workforce's health is crucial to the solvency of the workforce. Occupational health practitioners should assess for workplace hazards and exposures.

The Relationship Between Nurses' Psychological Well-Being and Their Work Productivity Loss: A Descriptive Correlational Study

Introduction

Nurses play a vital role in ensuring effective patient care delivery and organizational productivity. Hence, it becomes imperative to prioritize their psychological well-being and explore how its impairment may be associated with their productivity loss.

Aims

The study aims to investigate the relationship between nurses' psychological well-being and their work productivity loss by examining how nurses self-reported their own psychological well-being and work productivity loss.

Methods

A descriptive correlational design was conducted at an Egyptian university hospital. A convenience sample of 400 nurses completed two tools: (a) Outcome Questionnaire-45 was used to assess the psychological well-being of nurses and (b) the Work Productivity and Activity Impairment - General Health Questionnaire was used to measure nurses' work productivity.

Results

Among the 400 surveyed nurses, 66.7% reported overall poor psychological well-being. Regarding work productivity loss, 22.8% of nurses missed an average of 974.81 work hours due to absenteeism, and 62.0% lost an average of 10,630 work hours due to presenteeism. Additionally, 75.5% experienced impaired daily living activities. Approximately 13.4% of total working hours were missed due to health problems or psychological distress. Regression analysis revealed that poor psychological well-being significantly predicts work productivity loss, accounting for 2.0% of absenteeism, 11.0% of presenteeism, 17.0% of daily activity impairment, and 9.0% of overall productivity loss, with the model being significant (p < 0.01).

Conclusion

Nurses often experience poor psychological well-being and distress that hinder their daily activities and cause work productivity loss. Therefore, hospital management should prioritize improving nurses' physical and mental health and bolstering their self-efficacy and resilience to minimize the effects of symptom distress on productivity. Investing in nurses' well-being through managerial caring, organizational support, and fostering a supportive work environment are vital strategies for promoting quality patient care and enhancing their work productivity.

Predictors of anxiety and depression in operating room nurses during the COVID-19 pandemic: A multi-center cross-sectional study

BACKGROUND

Operating room nurses (ORNs) who directly deal with the treatment and care of COVID-19 patients during the pandemic are at risk in terms of psychological stress and other mental health problems.

OBJECTIVE

The aim of the study was to compare the anxiety and depression levels of ORNs working in different countries in the COVID-19 outbreak, and to determine the predictors and the difference between countries.

METHODS

This was a descriptive and cross-sectional study. Data were collected online using a google form between February 2021-February 2022. The universe of the research is nurses who are members of national Perioperative Nurses Association (USA, Türkiye, Australia, England, India, Israel) and 1127 ORNs participated the study. In multivariate analysis, independent predictors of anxiety and depression status were examined by binary logistic regression analysis.

RESULTS

The rate of anxiety is 5.46 times higher in nurses in the USA, 5.07 times higher among nurses in Australia, and 4.49 times higher for nurses in England. It was determined that the rate of depression in ORNs working in Türkiye was 5.97 times higher. It was found that the rate of depression is 1.59 times higher in ORNs living away from the family after care of COVID-19 patient.

CONCLUSION

Despite some differences between countries in terms of health system, patient potential, economic and the opportunities offered, generally high levels of anxiety and/or depression indicate that all ORNs need urgent support. Identifying risk factors will help recognize anxiety and depression in ORNs and take measures to protect their mental health during the pandemic.

Caring for COVID-19 patients: Nurses' perceptions of the most critical issues and their impact on their well-being and performance

AIMS

(1) Exploring nurses' perceptions of issues that impacted the quality of patient care and their own performance on COVID-19 wards; (2) examining nurses' perceptions of how these issues impacted their psychological state and level of performance; and (3) presenting recommendations for improving healthcare policies.

BACKGROUND

Nurses played a critical role in caring for hospitalized COVID-19 patients and managing the disease.

METHODS

Semistructured interviews were conducted with 50 nurses (32 females), aged 31-58 years, 6-37 years' tenure, from eight hospitals across Israel. Prior to working in COVID-19 wards, they worked in internal medicine, emergency rooms, or intensive care units. Based on the COREQ checklist, these interviews were recorded and transcribed, and categorized into themes and subthemes.

FINDINGS

The findings indicate that the unpreparedness of healthcare systems for the pandemic outbreak rendered nurses paying a high price at the personal and professional levels, which in turn may have impacted the levels of care that they provided.

CONCLUSION

The rich, qualitative data source revealed important interactions between clinical, personal, social, and familial factors in determining distress levels and performance impairment. A nuanced understanding of the link between these stressors is key to developing and implementing policies that could mitigate deficiencies in the management of epidemics and pandemics in the future.

IMPLICATIONS FOR NURSING AND HEALTH POLICIES

Changes should be made to government directives and healthcare policies, with an emphasis on increasing the nursing workforce, providing emotional support, ensuring availability of equipment and beds, optimizing work practices, developing transparent means of communication within teams, and clearly defining the areas of responsibility of nurses-in times of routine and crises.

Mental health and work-related factors in healthcare workers in a pandemic - meta-analysis

Due to the SARS-CoV-2 pandemic, healthcare workers worldwide faced major challenges in the form of psychological stress. The aim of this systematic literature review and meta-analysis is to identify mental health consequences and associated work-related factors in healthcare workers during a pandemic and to quantify the influence of associated work-related factors on mental health consequences. A systematic literature search according to PRISMA was conducted on 5 August 2021 using the databases PubMed Central and APA PsychInfo. The included studies investigated the mental health consequences and associated work-related factors in healthcare workers in a pandemic. In addition, we performed a risk of bias analysis to assess the study quality of the included studies using the JBI checklists. Random-effect models and pooled effect estimators were used for the meta-analysis. The Chi2 and I2 statistics were used to identify the statistical heterogeneity. Additional sensitivity analysis was performed. From a total of 3,910 publications, 43 studies met the inclusion criteria. These studies provided 15 stress consequences and 20 stress factors. The most frequently reported stress factors were 'contact with COVID-19 patients', 'no education or training in handling infectious diseases' and 'insufficient protective equipment'. Anxiety, stress, and depression were the most common outcomes identified. Analyses showed an increase in anxiety scores among HCWs who cared for COVID-19 patients, as well as a rise in depressive symptoms due to inadequate or no personal protective equipment. In this review, various pandemic-associated stress factors and stress consequences of healthcare workers were observed. With the results, criteria for effective measures and interventions can be developed to minimize the risk of stress consequences.

An Exploratory Study of Psychological Distress, Professional Quality of Life, Effort-Reward Imbalance, and Turnover Intention of Hospital Nurses during the COVID-19 Pandemic

This exploratory study aimed to identify factors that may influence nurses' turnover intentions during the COVID-19 pandemic. The data were collected during January 2023 from 250 nurses and analyzed using descriptive statistics, t-test, ANOVA, Scheffe, Pearson's correlation, and multiple regression analysis. Among the sociodemographic and clinical characteristics, nursing care and working with personal protective equipment significantly impacted the turnover intention. Among the independent variables, compassion satisfaction, burnout, effort-reward ratio, and psychological distress were significant, with an explanatory power of 43.3%. Among the subjects, 86.4% (216 people) showed a moderate or high burnout level because of the COVID-19 pandemic, and burnout seemed to have a significant impact on turnover intention. Therefore, to lower the turnover intention of nurses, burnout should be prevented, and managers should create an environment where nurses can receive a balanced reward for their efforts.

Mental Illnesses and Quality of Sleep Among Nurses Working at a Tertiary Hospital in Riyadh During the COVID-19 Pandemic

Objectives This study primarily aimed to estimate the prevalence of mental illnesses (depression, anxiety, and stress) along with the poor quality of sleep, with a secondary focus on determining whether there was an association between mental health and quality of sleep among nurses working at King Khalid University Hospital, Riyadh, Saudi Arabia, during the COVID-19 pandemic. Methods A cross-sectional study was conducted from June to December 2021 during the COVID-19 pandemic on 309 nurses from different departments at King Khalid University Hospital. Depression, anxiety, and stress were measured by the Depression, Anxiety, and Stress Scale - 21 Items (DASS-21), and sleep quality was measured by the Pittsburg Sleep Quality Index (PSQI) via an online survey. Results The prevalence of depression, anxiety, and stress was 30.4%, 43.7%, and 16.5%, respectively, while 61.5% showed poor sleep quality. The association between poor quality of sleep and the other outcome variables of mental health (depression, anxiety, and stress) was highly significant (p<0.0001). Conclusion Nurses have reported an increased prevalence of depression, anxiety, stress, and poor quality of sleep during the COVID-19 pandemic, making them particularly vulnerable to mental illnesses and sleep difficulties in the event of future pandemics. There is a clear link between mental health issues and poor quality of sleep, necessitating the provision of psychological support for nurses. Enhancing sleep quality is recommended as a way to decrease the prevalence of mental health concerns.

A cross-sectional study on coping strategies of frontline healthcare workers amid the COVID-19 pandemic in a developing country

Objectives

Frontline healthcare workers encountered a heightened susceptibility to negative psychological symptoms and behavioral shifts in light of the coronavirus disease 2019 pandemic. This study determined the coping strategies adopted by frontline healthcare workers in Ghana as well as assessed any differences based on demographics, job title, and ranking in four coronavirus disease 2019-designated centers in the Greater Accra region of Ghana.

Methods

Using a hospital-based, mixed-method approach, the study was conducted between May 2021 and September 2021. A total of 94 frontline healthcare workers were randomly sampled and given a self-administered questionnaire, while 13 healthcare workers took in-depth interviews. Data from the survey were analyzed using both IBM SPSS and IBM AMOS and the interview data were transcribed verbatim and coded using thematic analysis.

Results

The study revealed that coronavirus disease 2019 has affected the psycho-social life of frontline healthcare workers mainly in the form of depression, anxiety, and stress. The three main coping strategies adopted by frontline healthcare workers include personal preventative measures (most dominant), seeking external expert support, and obtaining institutional support. While healthcare workers within the age group 30-39 years were found most compliant with the adoption of personal preventive measures and those below 30 years were found least compliant.

Conclusion

This study concludes that frontline healthcare workers have been affected by a considerable level of anxiety, stress, and depression during the coronavirus disease 2019 pandemic. The study recommends a robust psychological support system at various levels of health care and an Employee Assistance Program with access to a 24-h hotline counseling service for frontline healthcare workers, continuous personal protective equipment provision, regular evidence-based updates on the management of coronavirus disease 2019 patients, and increased commitment from the government in addressing the medical needs of infected frontline healthcare workers.

Compassion Fatigue Influences the Mental Health and Turnover Intention of Nurses in the COVID-19 Pandemic

Background

Compassion fatigue is a true phenomenon experienced by overworked and exhausted nurses.

Objective

This study assessed frontline nurses' compassion fatigue, stress, mental health, and turnover intention during the second year of the COVID-19 outbreak.

Methods

Using a cross-sectional design, an online survey was administered in the first quarter of 2021 to 259 hospital nurses in the Central Philippines using standardized scales to gather the necessary data.

Results

Nurses were found to have moderate levels of compassion fatigue and turnover intention, high stress, and good mental health. Results revealed that compassion fatigue was associated with poor mental health (r = -5.05, p = 0.01), higher stress levels (r = 0.54, p = <0.001), and turnover intention (r = 0.27, p = <0.001).

Conclusion

Pandemic-related compassion fatigue in nurses increases their stress, worsens their mental health, and heightens their intentions to leave their jobs. Organizations should address compassion fatigue through a supportive work climate.

Perceptions, maltreatment and religion as predictors of the psycho-emotional impact on nurses during the COVID-19 pandemic

OBJECTIVES

to analyze the relationship between perceptions, abuse and religion with the psycho-emotional impact on nurses during the COVID-19 pandemic.

METHODS

descriptive-analytical cross-sectional study. It took place between 2020 and 2021 and a total of 319 clinical nurses in Peru were interviewed using the DASS-21. Associations were assessed using Spearman's Rho and multiple regression.

RESULTS

18.5% had some degree of stress; 50.2%, anxiety and 29.1%, depression. Experience of abuse, self-perception of mental health and religion were predictors of stress, anxiety and depression. The length of work experience predicts stress and anxiety. In addition, self-perception of information and gender were predictors of depression.

CONCLUSIONS

peruvian nurses have high levels of stress, anxiety and depression, and this psycho-emotional impact was associated with perceptions, experiences of abuse and religion.

Spiritual needs during COVID 19 pandemic in the perceptions of Spanish emergency critical care health professionals

OBJECTIVES

To investigate the perceptions and attitudes of health professionals working in emergency services and critical care units in Spain about spiritual care provided during the COVID-19 pandemic.

METHODS

A qualitative investigation was carried out using in-depth interviews.

SETTING

Emergency and emergency and ICU health professionals from different regions of Spain.

FINDINGS

The sample consisted of 47 nursing and one nursing assistant. The qualitative analysis yielded four main themes that reflect the following categories: "the experience with spirituality in clinical practice"; "resources and barriers to provide spiritual care"; "the COVID pandemic and spiritual care" and "training in spiritual care". In addition, two subdeliveries were also obtained: "ethical dilemma" and "rituals of death".

CONCLUSIONS

The majority of emergency and critical care nurses believe spiritual care is important to their clinical practice, but there are still several barriers to address patients' spiritual needs. During the COVID-19 pandemic in Spain, professionals felt that spiritual beliefs have emerged as important needs of patients and the restrictions imposed by the pandemic made health professionals more exposed to ethical dilemmas and end-of-life religious issues. The general impression of health professionals is that more training and resources are needed on this topic.

IMPLICATIONS FOR CLINICAL PRACTICE

Health professionals in emergency intensive care must provide nursing care that meets the spiritual needs of their patients to improve care in crisis situations such as the one suffered by the COVID-19 pandemic. For this, emergency services professionals must work and participate in the development of measures to overcome certain barriers present in emergency services, such as lack of time, lack of training and misconceptions that make it difficult to approach emergency services these needs.

Anxiety Levels and Coping Strategies to Deal with COVID-19: A Cross-Cultural Study among the Spanish and Latin American Healthcare Populations

Given its impact, COVID-19 has engendered great challenges in terms of health, highlighting the key role of health personnel. This study aims to analyze the level of anxiety, as well as coping strategies, among the health personnel in Latin American countries and Spain. An exploratory, descriptive, quantitative, cross-sectional study was conducted with 584 participants from the healthcare population. No significant differences were observed in anxiety levels due to COVID-19 between Latin American countries and Spain. In Spain, an active and passive coping style is used, while in Latin American countries, an avoidance coping style is employed; there is a direct correlation between anxiety levels and the avoidance coping style. There exists an inverse correlation between anxiety levels and the use of an active coping style; moreover, there are no significant differences in the anxiety level of health personnel depending on whether they have cared for patients with COVID-19. Low cognitive activity, use of the avoidance method and Spanish geography were the main predictive coping styles of anxiety. Effective measures are required for preserving the mental health of health professionals during pandemics.

Occupational Risk Factors for Physical and Mental Health in Primary Healthcare Providers: A National Cross-Sectional Survey from 62 Urban Communities in China

Purpose

To understand the physical and mental health status of primary healthcare providers (PHPs) including physicians, nurses and other staff and the workplace risk factors for depression, anxiety and intention-to-leave.

Patients and Methods

In December 2021, a national cross-sectional survey was conducted from 62 urban communities in China, and all PHPs were invited to complete a standardized questionnaire. Information on demographic, health-related lifestyle, cardiovascular risk factors and physical health status, occupational stress and intention-to-leave was collected. Depression and anxiety were assessed using the Zung Self-Rating Anxiety/Depression Scale (SAS/SDS).

Results

A total of 4901 PHPs were included. 67.0% males currently drank alcohol vs 25.3% in females; 36.0% males currently smoked cigarettes vs 1.4% in females. Notably, more than half males were overweight or obese, but this proportion was 24.2% in females. The prevalence of chronic diseases, including hypertension, diabetes, dyslipidemia, non-alcoholic fatty liver disease, gout, and disease clustering were higher in males than in females. The prevalence of depression and anxiety were high, 50% had depression, of whom 15.6% had moderate/severe depression. Over 15% participants had varied levels of anxiety, and approximately 4% had moderate/severe anxiety. PHPs who aged 18-29 (OR: 1.31, 95% CI: 1.05-1.64), were males (OR: 1.34, 95% CI: 1.14-1.57), with lower professional title (comparing with staff with senior title, the ORs of the intermedium, junior and none were 1.83, 2.18 and 2.49, respectively), took charge in nursing (OR: 1.41, 95% CI: 1.20-1.65), with higher perceived stress level (OR: 1.82, 95% CI: 1.41-2.34), and suffering from severe fatigue (OR: 2.55, 95% CI: 1.99-3.27) were more likely to have depression. Likewise, PHPs who were younger, with intermedium professional title, had higher perceived pressure level, and higher fatigue levels were more likely to have anxiety.

Conclusion

The mental health of PHPs is worrisome, with a high burden of chronic diseases and occupational risk factors. Younger PHPs, nurses, and those with higher levels of work pressure and fatigue are more vulnerable to psychological problems. The high prevalence of intention-to-leave calls for strategies that relieve the workplace stress and enhance the human resource capability.

Challenge, threat, coping potential: How primary and secondary appraisals of job demands predict nurses' affective states during the COVID-19 pandemic

AIM

The COVID-19 pandemic has led to a rapid raise of work-related stress among nurses, affecting their emotional well-being. This study examined how nurses appraise job demands (i.e. time pressure, emotional demands and physical demands) during the pandemic, and how primary (i.e. challenge and threat) and secondary appraisals (i.e. coping potential) of job demands predict nurses' affective states (i.e. positive affect, anger and anxiety).

DESIGN

A cross-sectional online survey.

METHODS

419 nurses completed self-report measures of job demands and related appraisals. Data analyses comprised correlation analysis, factor analysis, hierarchical linear regression analysis and dominance analysis.

RESULTS

Emotional and physical demands correlated exclusively with threat appraisal, while time pressure correlated with challenge and threat appraisal. Time pressure, emotional demands and threat appraisals of job demands predicted negative affective states, while challenge appraisals of emotional and physical demands predicted positive affect. Coping potential was identified as the most important predictor variable of nurses' affective states.

PUBLIC CONTRIBUTION

The current study identified statistically significant risk and protective factors in view of nurses' affective states experienced during the COVID-19 pandemic.

The Effect of Personality Traits of Surgical Nurses on COVID-19 Fear, Work Stress and Psychological Resilience in the Pandemic

PURPOSE

This research was carried out to determine the effects of the personality traits of surgical nurses on covid-19 fear, work stress and psychological resilience in the pandemic.

DESIGN

The research was descriptive and cross-sectional types.

METHODS

The study was conducted between February 2021 and May 2021 at a State University Research Hospital. The research aimed to reach all surgery nurses (357) working in surgical units without selecting a sample. The sample included 325 participants. At the end of the study, the participation rate was 91.03%. Study reporting adheres to STROBE checklist.

FINDINGS

It was determined that 43.4% of the nurses participating in the study were in the age range of 26-30, 64.9% were women The correlation values between the COVID-19 Fear Scale and the Nurse Stress Scale scores were found to be significant in the positive direction. The correlation values between the Eysenck Personality Questionnaire neuroticism sub-dimension and the Nurse Stress Scale, and Fear of COVID-19 Scale scores were found to be positive.

CONCLUSION

During the pandemic, it is suggested that nurses' work stress and psychological resilience levels should be evaluated at regular intervals and that in-service trainings on coping with stress and stress management should be organized. Taking the necessary precautions and improving working conditions will have positive effects on both the health of nurses and patient care.

Mental health status and its associated factors among female nurses in the normalization of COVID-19 epidemic prevention and control in China

Objective

To investigate mental health status and its associated factors among female nurses in the normalization of COVID-19 epidemic prevention and control in China.

Methods

Random cluster sampling was applied to recruit 740 female nurses in China. The respondents completed the survey with mobile devices. Demographic questionnaire, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Insomnia Severity Index, and The Impact of Event Scale-Revised were used to assess demographic Information, anxiety, depression, insomnia and PTSD symptoms, respectively. The associated factors of mental health status were identified by binary logistic regression analysis.

Results

The prevalence of anxiety and depression was 7.9 and 17.8%, respectively. Insomnia was an associated factor of anxiety (OR = 6.237, 95%CI = 6.055-23.761, P < 0.001) and depression (OR = 9.651, 95%CI = 5.699-22.370, P < 0.001), while PTSD was an associated factor of anxiety (OR = 11.995, 95%CI = 2.946-13.205, P < 0.001) and depression (OR = 11.291, 95%CI = 6.056-15.380, P < 0.001), Being married was a protective factor of depression (OR = 0.811, 95%CI = 1.309-6.039, P < 0.01).

Conclusion

Female nurses showed problems in mental health. Insomnia, PTSD and marital status were associated with mental health. The hospital management should pay more attention to the unmarried groups, and strive to improve the sleep quality of female nurses and reduce their stress caused by traumatic events.

The personality of newly graduated and employed nurses: Temperament and character profiles of Swedish nurses

Background

One of the challenges of the 21st century is the high turnover rate in the nursing profession due to burnout and mental illness. From a biopsychosocial perspective, an individual's personality is an important vulnerability-resilience factor that comprises four temperament traits (i.e., a person's emotional reactions) and three character traits (i.e., self-regulation systems). Indeed, different personality profiles are associated to different coping strategies and health outcomes.

Objective

We investigated and mapped the temperament and character of Swedish newly graduated and employed nurses' in relation to the Swedish general population and an age-matched sub-sample.

Design

In this cross-sectional study, nurses self-reported their personality (Temperament and Character Inventory) at the beginning of their employment.

Setting

The data collection was conducted at a hospital in the South of Sweden.

Participants

A total of 118 newly graduated and employed nurses (Mage = 25.95±5.58) and 1,564 individuals from the Swedish general population participated in the study.

Methods

We calculated T-scores and percentiles for all seven personality dimensions using the Swedish norms (N = 1,564). The profiles were calculated by combining high/low percentiles scores in three temperament dimensions (Novelty Seeking: N/n, Harm Avoidance: H/h, and Reward Dependence: R/r) and in the three character dimensions (Self-Directedness: S/s, Cooperativeness: C/c and Self-Transcendence: T/t).

Results

Regarding T-scores, the nurses reported moderately lower Novelty Seeking (> 0.5 SD), slightly higher Harm-Avoidance (about 0.5 SD), moderately higher Persistence (> 0.5 SD) and Reward Dependence (> 0.5 SD), and extremely lower Self-Directedness (> 1 SD). The prevalence of the most common temperament profiles among the nurses (Swedish general population in brackets) were: 39.80% [10.90%] Cautious (nHR), 21.20% [10.90] Reliable (nhR), and 15.30% [16.50%] Methodical (nHr). The prevalence of the most common character profiles among the nurses were: 31.40% [4.90%] Dependent (sCt), 25.40% [14.40%] Apathetic (sct), and 19.50% [8.80%] Moody (sCT).

Conclusions

The analyses of the personality profiles showed that Low Novelty Seeking (79%), high Harm Avoidance (65%) high Reward Dependence (80%), low Self-Directedness (95%), and low Self-Transcendence (60%) were more prevalent among the newly graduated and employed nurses. This may partially explain newly graduated nurses' difficulties at work and high turnover rate. After all, a well-developed character is of special importance when working with patients with serious and terminal illness or under large global crises, such as the current pandemic. Hence, both education at universities and development at work need to be person-centered to reduce stress levels and promote positive self-regulation strategies.

Religiousness in the first year of COVID-19: A systematic review of empirical research

The COVID-19 pandemic emerged suddenly in early 2020, posing a serious health threat and creating tremendous stress and distress across the world. Religion has been shown to play important and varied roles in previous disasters and health crises, but its roles in the pandemic have yet to be outlined. We aimed to summarize the research conducted on religion and COVID-19 in the first year of the pandemic with a systematic review of studies that specifically involved individual-level religiousness and COVID-19. Searches were conducted in PubMed, Scopus, CINAHL, and PsycINFO covering a one-year period from the first published mention of the novel coronavirus (Jan. 5, 2020) through January 4, 2021. We included articles about COVID-19 that were peer-reviewed and empirical, measured and reported results on religion on an individual level, and were available in English. Our search produced 137 empirical articles that met the inclusion criteria. In the course of sorting studies by their primary focus, eight categories of empirical findings emerged: general distress and wellbeing (53 articles), COVID-19-specific stress (24 articles), beliefs in science, conspiracies, and misinformation (15 articles), COVID-19 public health behaviors (12 articles), perceived risk of COVID-19 (10 articles), perceived growth or positive changes taking place during the pandemic (nine articles), health behaviors (three articles), and consumer behavior (three articles). Findings indicated that religiousness was associated with both unique benefits and challenges and played a significant role in the pandemic. Religiousness was associated with a broad range of outcomes across geographical regions and populations during the first year of COVID-19. It was a commonly reported coping mechanism with varying levels of favorable associations with mental health and COVID-19-related behaviors.

Impact of COVID-19 on Nursing Students: Factors Associated with PTSD Risk

ABSTRACT

The COVID-19 pandemic rapidly transformed nursing education, creating multiple stressors for students. The researchers in this study examined how undergraduate and graduate nursing students at a faith-based university perceived the impact of COVID-19. A multiple linear regression model explored the effect of 17 variables on the Impact of Events Scale-Revised (IES-R) scores. Anxiety level, quality of sleep, and perceived health demonstrated a statistically significant influence on IES-R scores; 27% of students had IES-R scores above 33, indicating high risk for posttraumatic stress disorder. Strategies to help address student stress and anxiety are discussed.

La resiliencia como predictora del impacto negativo (depresión, ansiedad y estrés) del COVID-19 en médicos de atención primaria

Antecedentes

Objetivo

Método

Resultados

Conclusiones

The COVID-19 fear, anxiety, and resilience among emergency nurses

Background

Besides physical complications, COVID-19 is associated with psychological issues such as fear and anxiety. High resilience in nurses enables them to adopt positive coping mechanisms and successfully operate in the stressful environment of COVID-19 wards. The present study aimed to evaluate the correlation between COVID-19 fear and anxiety with resilience in the emergency nurses of the hospital affiliated with Kurdistan University of Medical Sciences (west of Iran) in 2021.

Materials and methods

This cross-sectional study was conducted on 295 emergency nurses of selected hospitals in Kurdistan province, Iran, in 2021. Data were collected using a demographic questionnaire, Fear of COVID-19 Scale (FCV-19S), Corona Disease Anxiety Scale (CDAS), and Connor-Davidson Resilience Scale (CD-RISC). Data analysis was performed in R software version 3.6.3.

Results

The mean scores of resilience, COVID-19 fear, and COVID-19 anxiety were 55.07 ± 19.82 (ranging from 0 to 100), 20 ± 7.37 (ranging from 7 to 35) and 36.48 ± 13.21 (ranging from 18 to 54) respectively. There was a negative and significant correlation between resilience with COVID-19 fear (r = -0.449, p = 0.001), COVID-19 anxiety (r = 0.458, p = 0.001). A significant correlation was observed between COVID-19 fear and anxiety, which indicated that if the other demographic variables remained unchanged, a one-unit increase in COVID-19 fear and anxiety decreased the mean resilience score by -0.66 (P = 0.008) and -0.34 (P = 0.015), respectively.

Conclusion

COVID-19 fear and anxiety were significantly correlated. Therefore, providing training courses for promoting resilience could reduce the fear and anxiety of nurses during the COVID-19 pandemic.

Purpose in Life and Character Strengths as Predictors of Health Sciences Students' Psychopathology During the COVID-19 Pandemic

BACKGROUND

Health sciences students experience high levels of psychopathology conditioned by psychosocial, financial, and academic factors. However, COVID-19 pandemic might even have worsened their mental health. Thus, this article aims to evaluate how the exposure to COVID-19 pandemic has affected these students' mental health and to determine the effect of purpose in life and character strengths on this psychopathology.

METHODS

A cross-sectional study of unpaired samples was carried out in Spain during the first and third waves of the pandemic in 70 medical and 52 nursing students.

RESULTS

The risk factor that most determined the appearance of anxiety was the exposure of family and friends to COVID-19 (OR = 4.01; p < 0.001), while the most protective factors were honesty (OR = -1.14; p = 0.025) and purpose in life (OR = -0.18; p < 0.001). Purpose in life also protected against the onset of depression and total psychopathology. In addition, we observed studying medicine was a protective factor against total psychopathology while being a nursing student was associated with high levels of acute stress.

CONCLUSION

Exposure of the students' family and friends to SARS-CoV-2 favored the appearance of symptoms of anxiety. Honesty had a preventing role in the onset of anxiety and a high purpose in life was protective against the appearance of anxiety, depression, and total psychopathology.

Predictive Factors of the Burnout Syndrome Occurrence in the Healthcare Workers During the COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic is probably the most critical epidemiological situation that human civilization has faced in the last few decades. In this context, of all the professional categories involved in the management of patients with COVID-19 are the most likely to develop burnout syndrome. The main objective of this study is to analyze specific predictive factors of the occurrence and development of the burnout syndrome in the healthcare workers involved in the diagnosis and treatment of patients with COVID-19. The study focused on determining factors of the occurrence, development and maintaining the specific burnout syndrome related to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic infection. The study was conducted on a sample of 959 participants, medical personnel from all the public medical entities in Romania(including 5 hospitals): 122 male and 755 female (82 participants did not declare their gender), with a mean age of 42.29 years (SD = 9.97). The sample included 219 doctors, 477 nurses, 214 auxiliary medical personnel and 49 other types of hospital workers. A cross-sectional design was used. Three predictors of the burnout syndrome were identified: Work conditions, Fear of the consequences (including death) determined by the COVID-19 and Need for emotional support. Meaning of work had a moderating role. Several moderated mediation models were tested. The indirect relationship of Work conditions with burnout via Fear of infection was statistically significant; in addition, the indirect effect of Work conditions on burnout through both fear of infection and need for support was statistically significant. The moderation analysis showed that Meaning of work buffer the relationship between Work conditions and Fear of infection. The variance explained by the model including the moderator (30%) was higher than the variance explained by Model 1 (27%), showing that adding the moderating effect of Meaning of work to the relationship of Work conditions with burnout was relevant. The results could be used to design specific interventions to reduce the occurrence of the burnout syndrome in healthcare workers, the implementation of a strategy to motivate employees by highlighting and recognizing the high significance of the work of those in the frontline of the fight against COVID-19.

The Role of Spirituality and Religiosity in Healthcare During the COVID-19 Pandemic: An Integrative Review of the Scientific Literature

The pandemic caused by the new coronavirus SARS-CoV-2 has been affecting populations globally since the end of 2019. Previous studies have indicated that spirituality in these times of crisis serves as a source of hope and well-being that helps people get through the day. This study investigated the role of spirituality and religiosity in healthcare during the COVID-19 pandemic. An integrative review of the scientific literature available on PubMed, Scopus, and Web of Science databases and a review of the gray literature in the Information System on Gray Literature in Europe (OpenGrey) were carried out. From a total of 1,338 articles searched; 25 articles were included in this review (22 quantitative observational, 2 qualitative and one randomized controlled trial). Our findings revealed the importance of including spirituality in clinical practice for both health professionals and patients. On the one hand, spirituality can be considered a good coping strategy used by healthcare professionals to promote mental health and well-being during the COVID-19 pandemic and resulting in greater patient satisfaction with the care given. On the other hand, addressing spiritual needs of individuals leads to a reduction in stress, anxiety, depression, and an increase in resilience and hope among patients.

Impact of nurses' roles and burden on burnout during the COVID-19 pandemic: multicenter cross-sectional survey

AIM

To identify groups of nurses engaging in coronavirus disease (COVID-19) care who are most in need of organizational support.

BACKGROUND

Overwhelming stress and susceptibility to burn-out have been reported in nurses during the COVID-19 pandemic.

METHODS

Nurses working at five hospitals which accepted COVID-19 patients answered the questionnaire. The Tokyo Metropolitan Distress Scale for Pandemic, Self-Diagnosis Check List for Assessment of Workers' Accumulated Fatigue, and Japanese Burnout Scale were evaluated. Multiple regression analysis was performed to examine the relationship between engaging in COVID-19 care and psychosocial/physical burden.

RESULTS

In total, 895 questionnaires were analyzed. With experience in caring for COVID-19 patients as the independent variable, nurses caring for suspected cases had significantly higher standardized Tokyo Metropolitan Distress Scale for Pandemic scores for "concerns for infection" (standardized partial regression coefficient β = 0.921, P = 0.004), Assessment of Workers' Accumulated Fatigue (β = 0.445, P = 0.022), and Japanese Burnout Scale "emotional exhaustion" (β = 0.136, P = 0.021) than those caring for confirmed cases.

CONCLUSIONS

Nurses caring for suspected COVID-19 patients have the highest psychological/physical burden and propensity for burnout.

IMPLICATIONS FOR NURSING MANAGEMENT

Extensive support systems are required for nurses caring for confirmed and suspected COVID-19 cases.

Mental Health Outcomes in Australian Healthcare and Aged-Care Workers during the Second Year of the COVID-19 Pandemic

Objective: the COVID-19 pandemic has incurred psychological risks for healthcare workers (HCWs). We established a Victorian HCW cohort (the Coronavirus in Victorian Healthcare and Aged-Care Workers (COVIC-HA) cohort study) to examine COVID-19 impacts on HCWs and assess organisational responses over time. Methods: mixed-methods cohort study, with baseline data collected via an online survey (7 May–18 July 2021) across four healthcare settings: ambulance, hospitals, primary care, and residential aged-care. Outcomes included self-reported symptoms of depression, anxiety, post-traumatic stress (PTS), wellbeing, burnout, and resilience, measured using validated tools. Work and home-related COVID-19 impacts and perceptions of workplace responses were also captured. Results: among 984 HCWs, symptoms of clinically significant depression, anxiety, and PTS were reported by 22.5%, 14.0%, and 20.4%, respectively, highest among paramedics and nurses. Emotional exhaustion reflecting moderate–severe burnout was reported by 65.1%. Concerns about contracting COVID-19 at work and transmitting COVID-19 were common, but 91.2% felt well-informed on workplace changes and 78.3% reported that support services were available. Conclusions: Australian HCWs employed during 2021 experienced adverse mental health outcomes, with prevalence differences observed according to occupation. Longitudinal evidence is needed to inform workplace strategies that support the physical and mental wellbeing of HCWs at organisational and state policy levels.

Modulating Elements of Nurse Resilience in Population Care during the COVID-19 Pandemic

COVID-19 has significantly affected the work environment of nurses. In the face of the challenges posed by stressors in clinical practice, some nurses adapt and prove to be resilient. In the face of the COVID-19 pandemic, the nature of care itself and the new ways of working are potentially very stressful. We aim to analyze the resilience of care nurses to the psychological impact of the COVID-19 pandemic. This study is a systematic review of nurse caregiver resilience to the COVID-19 pandemic in 2021. Our search was conducted in the WOS, Medline/PubMed, Cochrane, BVS/LILACS, and Cuiden databases. The inclusion criteria were: studies published in Spanish or English; carried out from March 2020 to May 2021 on nurses caring for patients with COVID-19; and investigating the factors influencing the psychological impact, resilience, strategies to develop it, and interventions to promote it during this pandemic and others, such as SARS, MERS, or ebola. The quality of the studies and the risk of bias were evaluated following ICROMS, STROBE and AMSTAR-2 criteria. Twenty-two studies were selected. Most of the studies highlighted the presence of stressors in nurses, emphasizing those of the environment, which converged in dysfunctional responses that hurt their resilience. The most persuasive factors were social and organizational support. Coping strategies developed by nurses and especially interventions by organizations were detected as instruments to foster resilience, but have not been well researched. Resilience has a key moderating role in mitigating the psychological impact of nurses in the face of the COVID-19 pandemic.

Promoting Spiritual Well-Being Among Nurses

Health care organizations are facing the fallout from inadequate nurse staffing in addition to the emotional and spiritual tolls of the COVID-19 pandemic. Organizations must strategically differentiate themselves by novel methods of recruitment and retention, including care of the nurse as a whole person. Tactical strategies can be implemented by nurse leaders to promote the spiritual well-being of the nursing workforce. These strategies include incorporating spirituality and soft skills into nursing orientation, developing and providing interventions to support spiritual well-being, and implementing methods to provide spiritual care of patients by nurses.