The relationship between resilience and intent to stay among Chinese nurses to support Wuhan in managing COVID-19: The serial mediation effect of post-traumatic growth and perceived professional benefits

Personal and Workplace Characteristics as Predictors of Intent-To-Stay Among Registered Nurses: An Exploratory Quantitative Multicentre Study

AIM

This study aims to describe and examine the factors associated with registered nurses' intent-to-stay and subsequently identify predictors of nurses' intent-to-stay.

DESIGN

A quantitative, cross-sectional correlational design was used.

METHODS

A convenience sample of 270 registered nurses completed the questionnaire and was included in this study. Descriptive statistics were used to present the sociodemographic characteristics and scores of outcome measures. Pearson's correlation coefficient and multiple linear regression with backward selection were conducted to examine how nurses' characteristics and workplace factors influence nurses' intent-to-stay.

RESULTS

The mean age of the participants was 29.2 years. The mean scores for the outcomes were intent-to-stay (mean = 2.96), resilience (mean = 3.34), occupational self-efficacy (mean = 4.34), sleep quality (mean = 9.73) and workplace environment scores (mean = 3.15). The correlation analysis showed that resilience, occupational self-efficacy, self-realisation and workload were positively correlated to intent-to-stay while sleep quality was negatively correlated to intent-to-stay. Multiple linear regression analysis found occupational self-efficacy, sleep quality, workload, nervousness, nurses' designation and specialisation status to be significant factors associated with intent-to-stay.

CONCLUSION

Intent-to-stay is a complex and multidimensional construct influenced by a variety of personal and workplace factors. Hospital administrators should endeavour to develop measures to improve occupational self-efficacy, workload, nervousness and push for specialisation training to bolster nurses' intent-to-stay.

IMPACT

Against an everchanging healthcare landscape following the COVID-19 pandemic, the findings of this study contribute to a deeper understanding of the factors of registered nurses' intent-to-stay. The findings of this study alluded to the importance of professional development and workload as factors that can influence registered nurses' intent-to-stay. Hospital administrators can prioritise workforce retention policies by introducing strategies such as opportunities for upskilling, flexible working hours and streamlining work processes to promote nurses' intent-to-stay.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Factors Affecting Retention Intention Among Married Nurses With Preschool-Aged Children: A Cross-Sectional Study

This cross-sectional study examined the effects of parenting stress, resilience, and social support on the retention intentions of married nurses with preschool-aged children in South Korea. Data from 150 nurses were collected through an online survey. The findings indicate that age, household income, job satisfaction, the presence of caregiver cohabitants, and resilience significantly influence retention intentions, explaining 30.7% of the variance. The results underscore the urgent need for healthcare organizations to develop and implement customized support programs targeting midcareer married nurses with young children, emphasizing resilience building, job satisfaction, and financial support.

Nurse retention in peri- and post-COVID-19 work environments: a scoping review of factors, strategies and interventions

OBJECTIVES

The COVID-19 pandemic highlighted the deterioration of nurses' working conditions and a growing global nursing shortage. Little is known about the factors, strategies and interventions that could improve nurse retention in the peri- and post-COVID-19 period. An improved understanding of strategies that support and retain nurses will provide a foundation for developing informed approaches to sustaining the nursing workforce. The aim of this scoping review is to investigate and describe the (1) factors associated with nurse retention, (2) strategies to support nurse retention and (3) interventions that have been tested to support nurse retention, during and after the COVID-19 pandemic.

DESIGN

Scoping review.

DATA SOURCES

This scoping review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. MEDLINE, Embase, CINAHL and Scopus databases were searched on 17 April 2024. The search was limited to a publication date of '2019 to present'.

ELIGIBILITY CRITERIA

Qualitative, quantitative, mixed-methods and grey literature studies of nurses (Registered Nurse (RN), Licenced Practical Nurse (LPN), Registered Practical Nurse (RPN), Publlic Health Nurse (PHN), including factors, strategies and/or interventions to support nurse retention in the peri- and post-COVID-19 period in English (or translated into English), were included. Systematic reviews, scoping reviews and meta-syntheses were excluded, but their reference lists were hand-screened for suitable studies.

DATA EXTRACTION AND SYNTHESIS

The following data items were extracted: title, journal, authors, year of publication, country of publication, setting, population (n=), factors that mitigate intent to leave (or other retention measure), strategies to address nurse retention, interventions that address nurse retention, tools that measure retention/turnover intention, retention rates and/or scores. Data were evaluated for quality and synthesised qualitatively to map the current available evidence.

RESULTS

Our search identified 130 studies for inclusion in the analysis. The majority measured some aspect of nurse retention. A number of factors were identified as impacting nurse retention including nurse demographics, safe staffing and work environments, psychological well-being and COVID-19-specific impacts. Nurse retention strategies included ensuring safe flexible staffing and quality work environments, enhancing organisational mental health and wellness supports, improved leadership and communication, more professional development and mentorship opportunities, and better compensation and incentives. Only nine interventions that address nurse retention were identified.

CONCLUSIONS

Given the importance of nurse retention for a variety of key outcomes, it is imperative that nursing leadership, healthcare organisations and governments work to develop and test interventions that address nurse retention.

Relationship between competency inventory, perceived career benefits, and professional identity among pediatric nurses

OBJECTIVE

To investigate the relationship between competency inventory, perceived career benefits, and professional identity among pediatric nurses.

METHODS

A convenience sampling method was used to select 444 pediatric nurses from 10 tertiary hospitals in Hebei Province between June 2023 and August 2023 as the research subjects. The survey was conducted on September 15, 2023, during the morning meetings (nurses who were not on duty that day were surveyed when they returned to work). The China Competency Inventory for Registered Nurses (CIRN), Nurses' Perceived Career Benefits Questionnaire (NPCBQ), and the Professional Identity Scale for Nurses (PISN) were used to assess the competency inventory, perceived career benefits, and professional identity of pediatric nurses, respectively. Bivariate Pearson correlation analysis was used to analyze the relationship between these variables. Additionally, mediation effect analysis and structural equation modeling were used to test the mediating effect of professional identity between competency inventory and perceived career benefits of pediatric nurses.

RESULTS

The scores of CIRN, NPCBQ, and PISN of 444 pediatric nurses were at a moderate level. The correlation results showed that the competency inventory of pediatric nurses was positively correlated with perceived career benefits and their professional identity. Perceived career benefits were positively correlated with professional identity (r = 0.236, 0.326, 0.444, P < 0.001). The mediation effect analysis indicated that professional identity accounted for 29.08% of the total effect in the relationship between competency inventory and perceived career benefits (the contribution rate of the mediating effect to the total effect: ab/c × 100% = 29.08%). Linear regression analysis showed that competency inventory and perceived career benefit are important factors influencing professional identity.

CONCLUSION

Professional identity plays a mediating role between pediatric nurses' competency inventory and perceived career benefit. In clinical practice, enhancing nurses' perceived career benefit may improve their professional identity and competency inventory.

Futile care in COVID-19: how ICU nurses' resilience impacts turnover intention? A cross-sectional descriptive study

BACKGROUND

Futile care is a set of actions without creating a reasonable chance of benefiting critically ill patients. In the COVID-19 pandemic, there is a need to discuss futile care perception. This may cause unbearable pressure for nurses in terms of resilience and turnover intention.This study was designed to determine the ICU nurses' perception of futile care in COVID-19 patients and its relationship with resilience and turnover intention.

METHODS

This cross-sectional descriptive study was conducted on 251 nurses working in COVID-19 ICUs, in 2021 who were recruited with the quota sampling method. The data collection tools included questionnaires for demographic information, futile care, resilience assessment, and turnover intention. Collected data were analyzed using SPSS v26 software.

RESULTS

A high mean level (64.78 ± 9.98) of futile care perception was found in the studied nurses, and their mean levels of turnover intention (36.4 ± 5.1) and resilience (65.5 ± 14.1) were evaluated at a moderate level. A significant and inverse relationship was observed between futile care perception and resilience (P = 0.047, rs = -0.077). There was a significant and positive relationship between futile care perception and turnover intention (P = 0.026, rs = 0.151). The resilience and turnover intention variables were correlated inversely and significantly (rs = -0.158, P = 0.014).

CONCLUSION

The adoption of appropriate strategies by managers can direct the nursing care path from futile to useful care. Given the significant relationship between resilience and turnover intention, it is recommended to teach strategies in the teaching program of nurses to enhance their resilience.

Status quo and influencing factors of posttraumatic growth of nurses exposed to nurse-to-nurse horizontal violence: a cross-sectional multicenter study

BACKGROUND

Post-Traumatic Growth (PTG) relieves physical and psychological stress symptoms in nurses who exposed to nurse-to-nurse horizontal violence (HV), has great intervention potential to reverse the negative effects of HV events. Therefore, in-depth exploration of the overall characteristics of PTG in HV-exposed nurses and its influencing factors are of great practical significance to provide them with precise psychological adaptive interventions.

OBJECTIVE

This study aims to describe the current state of PTG of HV-exposed nurses and its influencing factors.

METHODS

The staged cluster sampling method used to recruit nurses. Nurses completed the Chinese version of the nurse-to-nurse Negative Acts Questionnaire (NAQ-R), the Posttraumatic Growth Inventory-Short Form (PTGI-SF), Colquitt's Organizational Justice Measure (OJM), Inclusive Leadership Scale (ILS), 10-item Connor-Davidson Resilience Scale (CD-RISC-10), Dysexecutive Questionnaire (DEX) and provided their sociodemographic characteristics. Data were collected between February, 2023 ~ March, 2024, and were analyzed using correlation analysis, t-test, ANOVA, and multivariate linear stepwise regression analyses.

RESULTS

The prevalence of HV within eight tertiary hospitals in Shandong Province amounted to 45.03%. On average, nurses scored 18.30 ± 14.33 in PTGI-SF. There were significant differences in PTGI-SF score according to departments (F = 2.589, p < 0.01), and educational background (F = 4.587, p < 0.01). The results of correlation analysis showed that there was a significant correlation between score in CD-RISC-10 (r = 0.120, p < 0.01), DEX (r=-0.069, p < 0.05), and PTGI-SF. The results of multivariate linear stepwise regression showed that resilience, dysexecutive, educational background, and type of department might be the influencing factors of PTG in HV-exposed nurses (R2 = 0.045).

CONCLUSIONS

Exposure to HV posed a moderate risk for nurses, while PTG levels among HV-exposed nurses were low to moderate. Overall, the current study suggests that educational background, department type, resilience, and dysexecutive were the main factors influencing PTG in HV-exposed nurses. The study found that resilience had a positive effect on PTG, while dysexecutive had a slight negative effect. Consolidation of resilience and alleviation of dysexecutive, while dialectically looking at educational background and department type, is necessary to improve PTG in HV-exposed nurses.

How do some nurses achieve post-traumatic growth in stressful situations? Analysis of the role of hope, meaning of life, and resilience with the mediating role of coping self-efficacy

Background

This study aimed to investigate the relationship between hope, the meaning of life, resilience, and post-traumatic growth (PTG), with coping self-efficacy as a mediating factor among nurses working in COVID-19 care departments.

Methods

This was a quantitative cross-sectional study involving 263 nurses from three university hospitals in Zanjan, Iran, in 2022. Data were collected using Connor and Davidson's Resilience Questionnaire, Schneider's Hope scale, Steger's Meaning in Life questionnaire, Tedeschi and Calhoun's PTG inventory, and Chesney's coping self-efficacy scale. Data were analyzed using SPSS-26 and LISREL-10.2 software.

Results

Path analysis was used to analyze the causal model, which demonstrated a good fit with the data., the results showed. The results revealed direct and significant effects of resilience (ƿ<0.05, β = 0.14), hope (ƿ<0.05), β = 0.16), the meaning of life (ƿ<0.05, β = 0.13), and coping self-efficacy (ƿ<0.05, β = 0.20) on PTG among nurses. Additionally, the mediation of coping self-efficacy in the relationship between resilience, hope, meaning of life, and PTG in nurses was confirmed through the analysis of multiple mediators.

Conclusion

The study revealed that the combination of resilience, hope, and the meaning of life, mediated by coping self-efficacy, has significant predictive power for PTG in nurses.

Factors affecting nurses retention during the COVID-19 pandemic: a systematic review

BACKGROUND

The global nursing shortage was a well-known issue before the Covid-19 pandemic, but the Covid-19 pandemic has exacerbated the current nursing workforce shortage and reduced nursing retention. This systematic review aimed to explore factors affecting retention of nurses.

METHODS

The PubMed, Web of Science, Scopus and Proquest databases were searched for relevant primary studies published on nurses retention during Covid-19 pandemic. Finally, Google Scholar was searched for retrieving more related documents that may not be indexed in other searched databases. Inclusion criteria were research articles and gray literature related to nursing retention in Covid-19 pandemic, articles published in English, access to the full-texts, and without time limitation. Both qualitative and quantitative studies focusing on factors affecting the nurses retention were included. The Joanna Briggs Institute checklists were used for assessing quality of quantitative and qualitative studies. Qualitative and thematic content analysis methods based on Braun and Clark's model were used to analyze the data.

RESULTS

Eighteen studies were identified through a systematic search of the literature. The results showed that seven factors include personal, interpersonal, organizational, social media, educational, emotional, and protective factors are the factors affect the nurses retention.

CONCLUSION

The findings of this study showed that retention of nurse is complex and multi-factorial issue that factors from micro to macro-level affect it. Managers and health policy-makers based on the results obtained from this study can plan appropriate measures to increase the retention of nurses.

Analysis of the current situation and influencing factors of night shift nurses' sense of occupational benefit

The purpose of this study was to investigate the current status and influencing factors of night shift nurses' sense of occupational benefit, and to explore the influence of psychological resilience on the sense of occupational benefit. 2022 from August to October, a cross-sectional survey was conducted on 719 night shift nurses using a general information questionnaire, psychological resilience scale, and sense of occupational benefit scale. A total of 719 valid questionnaires were collected. The score of night shift nurses' sense of occupational benefit was (137.40 ± 21.10) and psychological resilience score was (65.63 ± 17.75). Age (β = 3.359, P < .05) was significantly correlated with sense of occupational benefit. Education (β = 3.586, P < .05) was significantly correlated with the sense of occupational benefit, and whether or not they had participated in outbreak prevention and control (β = -2.321, P < .05) was significantly correlated with the sense of occupational benefit. Similarly, psychological resilience (β = 0.859, P < .05) was significantly associated with the sense of occupational benefit. Night shift nurses' sense of occupational benefit was moderate to high, and interventions should be taken to enhance the sense of occupational benefit based on nurses' age, education, whether they have participated in epidemic prevention and control, and psychological resilience.

Effect of Psychological Resilience on Posttraumatic Growth Among Midwives: The Mediating Roles of Perceived Stress and Positive Coping Strategies

AIM

To explore the relationship between midwives' psychological resilience and posttraumatic growth, and the mediating role of perceived stress and positive coping strategies.

DESIGN

A multicentre cross-sectional survey was used.

REVIEW METHODS

Data were conducted among 339 midwives from 24 Grade III A hospitals in Sichuan Province from April to July 2023, using the Chinese version of the Connor Davidson Resilience Scale, Chinese version Perceived Stress Scale, Simplified Coping Style Questionnaire, Chinese-Posttraumatic Growth Inventory and General Demographic Data Questionnaire. A descriptive statistical approach, Pearson's correlation analysis and the Mplus 8.3 were used to analyse the available data.

RESULTS

There was a significant correlation between psychological resilience, perceived stress, positive coping strategies and PTG. Psychological resilience could have a direct positive impact on PTG of midwives, but it could also indirectly affect PTG of midwives through three pathways: the mediating effect of perceived stress, the mediating effect of positive coping strategies and the chain mediating effect of perceived stress and positive coping strategies.

CONCLUSION

Results suggest that nursing managers should help to improve the psychological resilience of midwives and to reduce individual stress perception, enhance coping abilities and achieve positive growth.

IMPACT

Prior to data collection, we obtained approval from the nursing department of each hospital. Midwives who met the inclusion and exclusion criteria gave informed consent and invited to participate in this study.

REPORTING METHOD

This study was guided by STROBE.

PATIENT OR PUBLIC CONTRIBUTION

During the data collection phase, 349 midwives took the time to carefully answer the questionnaire items related to this study.

Psychological resilience and intention to stay among nurses: the mediating role of perceived organizational support

Background

This study aims to analyze the relationship between psychological resilience, perceived organizational support, and intention to stay among nurses. Additionally, it explores the mediating role of perceived organizational support in the relationship between psychological resilience and nurses' intention to stay.

Methods

A cross-sectional survey was conducted between August and September 2023, involving 1,402 nurses from five Grade 3A hospitals in Guangdong. The survey utilized several instruments, including the General Information Questionnaire (GIQ), the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC), the Chinese version of the Perceived Organizational Support Scale (POSS), and the Chinese version of the Intention to Stay Scale (ITSS). The obtained data were analyzed using descriptive statistics and Pearson's correlation coefficient, while the mediating effect of perceived organizational support was assessed using the PROCESS macro mediation model in SPSS.

Results

The overall mean score for psychological resilience among nurses in the five Grade 3A hospitals in Guangdong was 60.54 ± 19.17, the overall mean score for perceived organizational support was 45.77 ± 11.49, and the mean score for intention to stay was 20.82 ± 4.65. The results of the statistical analysis revealed positive correlations between psychological resilience and intention to stay (r = 0.388, p < 0.01), between perceived organizational support and psychological resilience (r = 0.570, p < 0.01), and between perceived organizational support and intention to stay (r = 0.550, p < 0.01). Additionally, perceived organizational support was found to mediate the relationship between psychological resilience and intention to stay, with a mediation effect value of 0.067, accounting for 71.28% of the total effect.

Conclusion

Psychological resilience of nursing staff directly impacts their intention to stay and indirectly influences their caring behaviors, with perceived organizational support serving as a key mediator in both relationships. Therefore, nursing managers should implement targeted interventions to enhance nurses' psychological resilience and perceived organizational support. Strengthening these factors can significantly increase nurses' intention to stay in their jobs, improve the quality of care, and contribute to building a strong and stable nursing workforce.

Perceived structural empowerment, resilience, and intent to stay among midwives and registered nurses in Saudi Arabia: a convergent parallel mixed methods study

BACKGROUND

Retaining midwives and registered nurses in the Obstetrics and Gynecology department/unit (OB/GYN) is not just a matter of organizational effectiveness and financial wellness. It's a crucial aspect of ensuring quality healthcare delivery. This study aimed to discuss the degree to which midwives and nurses in OB/GYN departments are structurally empowered, resilient, and committed to remaining at the organizations and to examine whether nurses' and midwives'sense of structural empowerment and resilience is a good predictor of their decision to stay with the organization.

METHODS

This study employed a unique convergent parallel mixed methods approach. The research was conducted in two distinct phases. The first phase involved a cross-sectional quantitative survey with a convenience sample of 200 midwives and nurses in OB/GYN departments. The second phase was a qualitative study utilizing semi-structured, open-ended interviews. Eighteen nurses and midwives, specifically chosen as the target population, were invited to participate in individual interviews. The data collection took place at three major hospitals in Saudi Arabia, starting in January 2023 and concluding in February 2023.

RESULTS

The study results revealed that structural empowerment and resilience were statistically significant predictors of the intent to stay in the organization (F = 35.216, p < 0.001), with 26.3% variation, the structural empowerment is higher predictor (β = 0.486, p < 0.000) to intent to stay if compared to resilience (β = 0.215, p < 0.008). Five major themes emerged from the narratives of the nurses and midwives: the nurturing of the physical and physiological, the development of the psychological, the managing finances, the restructuring of the organization, and the enrichment of the professional and occupational.

CONCLUSION

The study's findings have significant implications for healthcare organizations. They highlight the importance of cultivating a culture of empowerment and resilience, which can serve as a powerful tool to encourage registered nurses and midwives to remain in their organizations. This insight empowers healthcare administrators, human resource managers, and obstetrics and gynecology professionals to take proactive steps toward improving retention rates.

The prevalence and factors of posttraumatic growth among nurses based on the PTGI: A systematic review and meta-analysis

BACKGROUND

The urgency and risk of clinical nursing may cause nurses to experience traumatic stress, but it may also lead to posttraumatic growth. However, no study has comprehensively analyzed the prevalence of posttraumatic growth among nurses using a unified outcome measure and a validated assessment tool.

AIM

This study aims to systematically assess the prevalence and factors of posttraumatic growth among nurses based on the Posttraumatic Growth Inventory (PTGI).

METHODS

Ten databases, including The Cochrane Library, PubMed, Web of Science, CINAHL, Springerlink, Embase, Chinese Biomedical (CBM), China National Knowledge Infrastructure (CNKI), WanFang, and VIP databases, were searched as of December 31, 2022. The prevalence of posttraumatic growth was pooled using Stata 17.0 software. The PRISMA guideline was used to report the systematic review and meta-analysis. PROSPERO registration number: CRD42022365620.

RESULTS

A total of 30 studies were included in this systematic review and meta-analysis, consisting of 14,022 nurses worldwide from four countries. In our study, the pooled mean score of posttraumatic growth among nurses was 66.34 (95% CI: 61.25-71.43). From 2015 to 2022, nurses' posttraumatic growth levels gradually increased. In addition, Turkey nurses have the lowest posttraumatic growth levelnurses who experienced workplace violence have a lower posttraumatic growth level compared with other nurses; while nurses aged over 30 and male have higher posttraumatic growth levels.

CONCLUSIONS

While several studies on the prevalence of posttraumatic growth among nurses have been published, the reported data are quite different. Our systematic review and meta-analysis found that nurses' posttraumatic growth level was "moderate," and nurses' posttraumatic growth may vary based on publication year, country, traumatic event, age, and gender.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Our findings may provide a theoretical basis for hospital administrators and policy makers to scientifically manage human resources, comprehensively evaluate nurses' mental health, and promote nurses' posttraumatic growth in different traumatic events, which is conducive to the formulation and implementation of relevant policy guidelines.

A theoretical framework for Acute Care Nurse Stress Appraisal: Application of the transactional model of stress and coping

AIM

To develop a framework for understanding the stress appraisal process among acute care nurses during the COVID-19 pandemic.

DESIGN

A secondary analysis of open-ended responses from a cross-sectional survey of 3030 frontline, acute care nurses in New Jersey and the effect of burnout during the COVID-19 pandemic.

METHODS

Lazarus and Folkman's transactional model of stress and coping guided the study. Thematic analysis was used to analyse 1607 open-ended responses.

RESULTS

Nine themes emerged during the secondary appraisal of stress. Five themes contributed to distress and burnout including (1) high patient acuity with scarce resources, (2) constantly changing policies with inconsistent messaging, (3) insufficient PPE, (4) unprepared pandemic planning and (5) feeling undervalued. Four themes led to eustress and contributed to post-traumatic growth including (1) team nursing to ensure sufficient resource allocation, (2) open channels of communication, (3) sense- of-duty and (4) personal strength from new possibilities.

CONCLUSION

The COVID-19 pandemic was a traumatic event for patients and the nursing workforce. Internal and external demands placed on acute care nurses increased burnout, however, a subset of nurses with adequate support experienced personal growth.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Beyond mental health interventions for acute care nurses, organizational interventions such as reevaluation of emergency action plans to optimize resource allocation, and work environment strategies such as improved communication and decision-making transparency are necessary.

IMPACT

To better understand how frontline acute care nurses experienced stress during COVID-19, a data-informed framework was developed that included a primary and secondary appraisal of stress. Themes contributing to distress and burnout were identified, and themes leading to eustress and post-traumatic growth were also identified. These findings can assist nurse leaders in optimizing strategies to reduce burnout and promote post-traumatic growth in the post-COVID years.

REPORTING METHOD

No patient or public contribution.

The prevalence of post traumatic and associated factors among nurses during COVID_19 pandemics: a systematic review and meta-analysis

BACKGROUND

Despite the negative outcomes, exposure to a crisis may cause people to experience positive changes. This study aims to analyze the prevalence of post-traumatic growth (PTG) and its relevant factors among nurses during the COVID-19 pandemic.

METHOD

The research protocol was registered with PROSPERO (CRD42022329671), and PRISMA steps were taken in this study. PubMed, Scopus and ProQuest were explored on 1/9/2022 to create the research database. According to the inclusion criterion, all studies analyzing the prevalence of post-traumatic growth through the PTG Inventory were considered eligible. They were all qualitatively assessed through the modified version of the Quality Assessment Checklist for prevalence studies.

RESULTS

A total of 15 papers met the inclusion criterion (n = 22756). According to the research results, the prevalence of PTG was randomly calculated ES [95% Conf. Interval = 0.15 [0.12-0.17]), and heterogeneity was reported I2 = 98.52% (P = 0.000). The results also indicated that the mean score of PTGI decreased in nurses as their work experience and mean age increased. However, the effect was not statistically significant for the mean age (P = 0.06). According to the results, the PTGI score decreased in nurses with more work experience, a finding which was statistically significant (P = 0.04).

CONCLUSION

This meta-analysis determined a 15% prevalence rate of PTG in nurses. Psychological interventions should be developed and applied to older nurses with more work experience in order to mitigate the harm caused by the pandemic and its consequent crises.

The levels and related factors of posttraumatic growth among nurses: A systematic review and meta-analysis

WHAT IS KNOWN ON THE SUBJECT?: Nurses often encounter traumatic events in their clinical practice. Trauma can have both negative effects, such as post-traumatic stress disorder and positive effects, such as growth and positive emotions. Posttraumatic growth is beneficial for nurses, as it contributes to positive mental health outcomes and increases life satisfaction. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Our study confirms that nurses commonly experience posttraumatic growth after being exposed to traumatic events, and the level of growth is moderate. We have identified individual, work-related, and social and organizational factors that may influence the occurrence of posttraumatic growth among nurses. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Our findings provide valuable insights for interventions aimed at promoting posttraumatic growth among nurses. It is crucial to consider individual factors, work-related factors, and social and organizational factors when designing these interventions. By addressing these factors, healthcare professionals can support nurses in coping with trauma and facilitate their posttraumatic growth.

ABSTRACT

INTRODUCTION: While the negative effects of trauma on nurses have been well-documented, it is equally important to focus on ways to promote posttraumatic growth (PTG) among nurses.

AIM

This study aims to explore the levels and related factors of PTG among nurses.

METHOD

A comprehensive search was conducted across nine databases up to 26 December 2022. The pooled mean score for PTG was calculated and presented with a 95% confidence interval. Subgroup and meta-regression analyses were performed to identify potential moderators of PTG among nurses.

RESULTS

A total of 55 studies, involving 35,621 nurses from 11 countries and regions, were included in this review. The pooled scores of the PTG indicated that nurses experienced a moderate level of PTG (55.69, 95% CI: 50.67-60.72).

DISCUSSION

Nurses commonly experience PTG following exposure to traumatic events, with a moderate level of PTG. Our systematic review highlights the potential determinants of PTG among nurses, including individual, work-related, and social and organizational factors.

IMPLICATIONS FOR PRACTICE

Targeting these factors in interventions can provide nurses with the necessary resources and support to effectively cope with stress and trauma, and potentially facilitate PTG.

The Relationship Between Resilience and the Intention to Leave Among Staff Nurses at Governmental Hospitals in the Al-Baha Region of Saudi Arabia

Background Nurses with high intent to leave can cause substantial problems for healthcare organizations, such as staffing shortages and higher expenses due to hiring and onboarding new nurses. In light of the increasing demands placed on nurses in understaffed and overloaded healthcare systems, nurses frequently face various pressures and difficulties in their field of work, including high workloads, irregular hours, complicated patients, and infectious disease exposure; resilience is critical for handling stress and hardship at work. Nurses will thus retain their jobs for longer. This study aimed to determine the relationship between resilience and the intention to leave among staff nurses. Methods This study utilized a quantitative, cross-sectional correlation design. It comprised three Saudi Ministry of Health-affiliated facilities in the Al-Baha region (King Fahad Hospital, Prince Mashari Hospital, and Mikhwah General Hospital). The study sample comprised nurses employed in critical areas and inpatient and outpatient hospital departments using convenience sampling and inclusion and exclusion criteria. An online questionnaire involving three sections was given out. The first part collected sociodemographic data, the second part included the Connor-Davidson Resilience Scale 25 (CD-RISC-25), and the third included the Anticipated Turnover Scale (ATS). Results This study found a moderate degree of intention to leave and resilience. Most participants in the survey held a bachelor's degree (75.8%), and around 87.1% of the sample consisted of women. About half of the sample (57.2%) were married; 67.6% of the participants were not Saudi nationals; and regarding the number of children, the majority (53.8%) were childless. Overall, 318 nurses working in acute and outpatient departments and critical regions participated. According to the study, 73.3% of the participants reported a moderate intention to quit, whereas 50.9% had moderate resilience. Similarly, a significant negative relationship was found between nurses' intention to leave and resilience. Conclusions In the current study, resilience has a statistically significant negative relationship with the nurses' intention to leave. Hospital management must consider the amount of work and the excessive work schedule to reduce nurses' intentions to leave. One way to do this is by assigning tasks to employees, minimizing their workload through flexible work schedules and shorter duty hours, and fostering teamwork among coworkers by ensuring clear communication and cooperation. Interventions like orientation programs for new nurses, regular meetings, seminars, and training sessions can improve nurse resilience.

Relationship between Spiritual Care Competence, Perceived Professional Benefit, and Retention Intention among Intern Nursing Students: A Correlational Study

Aims

We aimed to investigate nursing students' spiritual care competence, perceived professional benefit, and retention intention and to analyze the relationship among these variables.

Background

Nurse shortages are a global issue, and intern nursing students' willingness to remain in the nursing profession is important. Spiritual care can reduce patients' depression and improve their quality of life. Implementing spiritual care can help individuals have satisfying experiences. Perceived professional benefit is a positive emotional experience that is important in retention intention. However, the relationship among spiritual care competence, perceived professional benefit, and retention intention remains unclear.

Methods

In this cross-sectional and correlational study, convenience sampling was used to recruit 266 intern nursing students in 10 hospitals throughout China. An online questionnaire was used to assess their sociodemographic characteristics, spiritual care competence, perceived professional benefit, and retention intention. Statistical analyses included the t-test, analysis of variance, Pearson's correlation analysis, and bootstrap analysis.

Results

Intern nursing students' mean scores were 103.35 ± 19.00 for spiritual care competence, 72.88 ± 10.40 for perceived professional benefit, and 19.58 ± 3.37 for retention intention. Spiritual care competence was positively correlated with perceived professional benefit (r = 0.545; p < 0.01) and retention intention (r = 0.149; p < 0.05). Perceived professional benefit was also positively correlated with retention intention (r = 0.320; p < 0.01). Bootstrap analysis showed that perceived professional benefit completely mediates the relationship between spiritual care competence and retention intention.

Conclusions

We found that nursing interns had a moderate level of retention intention, and perceived professional benefit was the mediating variable between spiritual care competence and retention intention. Implications. Our study results suggest that nursing administrators and educators should improve nursing interns' spiritual care competence and perceived professional benefit to enhance their willingness to remain in the nursing profession and alleviate nurse shortages.

The mediating effect of personality on mental workload and perceived professional benefits of nurses in East China

BACKGROUND

Nursing work is a work with high-stress load, and nurses with different personality may have different subjective feelings about their workload. Therefore, it is particularly necessary to comprehend the perceived professional benefits of nurses engaged in nursing work under high-pressure background, especially during the epidemic period. This study explored the relationship between mental workload, personality, and perceived professional benefits of nurses, and offer advices for the intervention of nurses with different personality to improve their perceived professional benefits.

MATERIALS AND METHODS

In this study, we used a cross-sectional study with a convenient sampling. 473 in-service nurses in Class A tertiary hospitals of Zhejiang Province were recruited by using the NASA Mission Load Index scale of nurses, the brief version of China's Big Five Personality Questionnaire, and the Nurses' perceived professional benefits questionnaire from July 2020 to March 2021. Sample size is 54.91%, and the response rate is 100%. Cronbach's alpha method was used to evaluate the reliability of the instruments. Descriptive statistical analysis was used to describe the socio-demographic data of the subject, and scores for research variables. The Mann-Whitney U-test, and Kruskal-Wallis H rank-sum test were used to compare the scores of perceived professional benefits with different demographic characteristics. Correlation analysis results were presented as the Spearman correlation coefficient. The plug-in v2.16.3 provided by SPSS software was used for linear regression analysis, and the deviation-corrected percentile Bootstrap method was used to examine the mediating role of personality (neuroticism, conscientiousness, agreeableness, openness and extroversion).

RESULTS

Age, length of service in nursing, and record of formal schooling can affect nurses' perceived professional benefits. Mental workload, and perceived professional benefits were all above the median value. The mental workload was negatively correlated with perceived professional benefits (r= -0.129, P < 0.01), positively correlated with neuroticism (r = 0.242, P < 0.01), negatively correlated with agreeableness, openness, extroversion (r=-0.229~-0.221, P < 0.01), and negatively correlated with conscientiousness, but the differences were not significant. Nurses' perceived professional benefits were negatively correlated neuroticism (r=-0.109, P < 0.05), but positively associated with conscientiousness, agreeableness, openness, and extroversion (r = 0.098 ~ 0.326, P < 0.05). The mental workload can directly affect the perceived professional benefits in the direct effects, and can also affect the it through the mediating effect of agreeableness, extroversion, neuroticism, and openness.

CONCLUSIONS

Age, length of service in nursing, and record of formal schooling could affect nurses' perceived professional benefits, and personality played a partial mediating role in the influence of mental workload on the perceived professional benefits. The results of this study can provide strategies for nurses' human resource management. According to different demographic factors, and personality, various measures should be taken to guide nurses to evaluate the mental workload correctly, reduce their emotional pressure, increase job resources, and improve their perceived professional benefits.

Latent profile analysis of nurses' perceived professional benefits in China: a cross-sectional study

OBJECTIVE

To identify profiles of nurses' perceived professional benefits as well as their predictors.

DESIGN

Cross-sectional study.

SETTING

The study was carried out online in China.

METHODS

From 6 July to 27 July 2022, a total of 1309 registered nurses participated in the survey by convenient sampling. We collected the Nurses' Perceived Professional Benefits Questionnaire and demographic data. Using latent profile analysis (LPA), subgroups of nurses' perceived professional benefits were identified. Moreover, univariate and multinomial logistic regression analyses were conducted to find the factors that were linked with the profiles.

RESULTS

The survey was validly completed by 1309 nurses, with a 92.9% effective return rate. The findings of the LPA demonstrated three unique profiles: low-perceived professional benefits (11.8%), moderate-perceived professional benefits (57.1%) and high-perceived professional benefits (31.1%). There was a correlation between marital status, the number of night shifts per month and leadership role.

CONCLUSIONS

According to our research, registered nurses have three unique professional benefit profiles. In order to sustain the nursing workforce, despite the fact that nurses get a high level of professional benefits, interventions are necessary to increase nurses' perception of their professional value.

Perceived professional benefits and their associated factors among Chinese registered nurses caring for women diagnosed with gynecological cancer

PROPOSE

Registered nurses (RNs) are considered to be a major source of professional supportive care for women diagnosed with gynecological cancer (GC). This study described the level of perceived professional benefits and explored association between perceived professional benefits, sense of coherence (SOC), and coping strategies in Chinese RNs caring for women diagnosed with GC.

METHOD

A cross-sectional survey was employed to collect data using the Nurses' Perceived Professional Benefits Questionnaire (NPPBQ), Sense of coherence scale (SOC-13), and Brief Coping Orientation to Problems Experienced (Brief COPE). The questionnaires were administered to 250 RNs in China. The correlations between NPPBQ, SOC-13, and Brief COPE were evaluated with Pearson's correlation coefficient. Multiple regression analysis was performed to assess the relative contribution of each possible factor in explaining variance in the increased NPPBQ.

RESULTS

The total score for the NPPBQ was 142.4 (range 33.0-165.0). SOC, dysfunctional coping strategies, and problem-focused coping strategies were recognized as predictors of RNs' perceived professional benefit, while, emotion-focused coping strategies were not significantly associated with RNs' perceived professional benefits.

CONCLUSIONS

The findings indicate that RNs who have high levels of SOC, dysfunctional coping strategies, and problem-focused coping strategies tend to experience more perceived professional benefit. These findings propose new perspectives for nursing managers to promote RNs' perceived professional benefit by helping RNs to find meaningfulness when caring for women diagnosed with GC, increasing RNs' communication skills to improve their relationship with patients, and training RNs to use coping strategies effectively.

Factors influencing nurses' post-traumatic growth during the COVID-19 pandemic: Bayesian network analysis

Objective

During the COVID-19 pandemic, nurses, especially if females and working in intensive care units or emergencies unit, were much more at risk than other health-workers categories to develop malaise and acute stress symptoms. This study aimed to examine the nurses' post-traumatic growth and associated influencing factors during the COVID-19 pandemic.

Methods

A cross-sectional study using an online survey was conducted at Henan Provincial People's Hospital to gather data from nurses. A set of questionnaires was used to measure the participants' professional identity, organizational support, psychological resilience and post-traumatic growth. Univariate, correlation, and multiple linear regression analyses were used to determine significant factors influencing post-traumatic growth. A theoretical framework based on the Bayesian network was constructed to understand post-traumatic growth and its associated factors comprehensively.

Results

In total, 1,512 nurses participated in the study, and a moderate-to-high level of post-traumatic growth was reported. After screening, the identified variables, including psychological counseling, average daily working hours, average daily sleep duration, professional identity, organizational support, and psychological resilience, were selected to build a Bayesian network model. The results of Bayesian network showed that professional identity and psychological resilience positively affected post-traumatic growth directly, which was particularly pronounced in low- and high-scoring groups. While organizational support positively affected post-traumatic growth indirectly.

Conclusion

Although this study identified a moderate-to-high level of nurses' post-traumatic growth, proactive measures to improve psychological resilience fostered by professional identity and organizational support should be prioritized by hospitals and nursing managers.

Nurses' sense of organizational support, Self-esteem and perceived professional benefits: A mediating model

AIM

To explore the mediating role of self-esteem in the relationship between perceived organizational support and professional benefits among Registered Nurses in China.

DESIGN

This was an online, cross-sectional study involving 1850 nurses from six hospitals in China.

METHODS

Data were collected using a 4-part questionnaire including a sociodemographic questionnaire, perceived organizational support scale, self-esteem scale and brief nurses' perceived professional benefits questionnaire from September to November 2021. Structural equation modelling (SEM) was used to explore the associations among them.

RESULTS

Perceived organizational support was positively correlated with self-esteem and perceived professional benefits among nurses, whereas self-esteem positively predicted nurses' perceived professional benefits . Self-esteem partially mediated the relationship between the two variables. The ratio of the mediating effect to the total effect was 16.7%.

Predictors of Post-Traumatic Growth in a Sample of United Kingdom Mental and Community Healthcare Workers during the COVID-19 Pandemic

Experiences of adversity can generate positive psychological effects alongside negative impacts. Little research to date has evaluated predictors of post-traumatic growth in mental or community healthcare workers during the COVID-19 pandemic. Following a survey of 854 community and mental healthcare staff in the United Kingdom in July to September 2020, multiple linear regression was used to determine the association between hypothesised risk and protective factors (personal, organisational and environmental variables) and total scores on the Post-traumatic Growth Inventory-Short Version. Positive self-reflection activities, black and minority ethnic status, developing new healthcare knowledge and skills, connecting with friends and family, feeling supported by senior management, feeling supported by the UK people, and anxiety about the personal and work-related consequences of COVID-19 each significantly independently predicted greater post-traumatic growth. Working in a clinical role and in mental healthcare or community physical healthcare predicted lower post-traumatic growth. Our research supports the value of taking an organisational growth-focused approach to occupational health during times of adversity, by supporting staff to embrace opportunities for personal growth. Valuing staff's cultural and religious identity and encouraging self-reflective activities, such as mindfulness and meditation, may help to promote post-traumatic growth.

Fostering Resilience in Nursing Through R.E.S.T

ABSTRACT

With about one-third of nurses having expressed an intention to leave the profession or change jobs in 2022, the effects of nursing job stress are evident. For nurses to continue to provide care in high stress, they must practice self-compassion and build resilience. The importance of resilience education and self-compassion for nurses and in nursing education is discussed from a Christian perspective, along with self-care strategies using the R.E.S.T. (Relationship, Exercise, Self-Compassion, Transformative Thinking) framework. Strategies for building resilience for both individuals and organizations are offered.

Factors Associated with Post-Traumatic Growth in Healthcare Professionals: A Systematic Review of the Literature

Post-traumatic growth (PTG) research is flourishing across various disciplines; however, it is only emerging in healthcare. Recently, a flurry of studies assessed PTG among healthcare professionals. However, to date, no systematic review has identified the factors that predict their experiences of PTG among healthcare professionals. The current paper aims to address this gap. Of 126 papers, 27 were selected for this systematic review. The analysis identified a range of demographic, individual (work-related and personal), interpersonal and environmental factors that contributed to healthcare professionals' experiences of PTG. Analysis of findings offers a novel perspective on individual factors by dividing them into personal and work-related factors. Results also highlight a variety of psychological interventions that can be used in healthcare to cultivate PTG. In addition, the gaps in current research, implications for further research, policy and practice that can facilitate the experience of PTG among healthcare professionals are discussed.

Post-traumatic growth in people experiencing high post-traumatic stress during the COVID-19 pandemic: The protective role of psychological flexibility

The COVID-19 pandemic evokes high levels of post-traumatic stress (PTS) in some people as well as positive personal changes, a phenomenon known as post-traumatic growth (PTG). Experiencing an adverse event as traumatic is crucial for triggering PTG, therefore higher PTS is often associated with higher PTG. This longitudinal study examined the protective role of psychological flexibility in fostering PTG in a group of people reporting high PTS related to COVID-19 as compared to those with low PTS. We hypothesized that higher psychological flexibility will be associated with higher PTG in those with high PTS and that psychological flexibility would be unrelated to PTG in those with low PTS. Secondary data analysis was conducted on data from a larger project investigating the psychological impacts of COVID-19. Adult Italians (N = 382) completed online surveys at Time 1 (three months after the first national lockdown, July 2020) and Time 2 (three months later when the number of COVID-19 cases increased, October 2020). Based on the Impact of Event Scale-Revised cut-off score, two PTS groups were identified at Time 2: low PTS (below cut-off) and high PTS (above cut-off). As predicted, moderation analyses showed that after controlling for Time 1 PTS and PTG and confounding variables, Time 1 psychological flexibility was associated with higher Time 2 PTG in the high PTS group, whereas psychological flexibility was unrelated to PTG in the low PTS group. Four psychological flexibility sub-processes (present moment awareness, defusion, values, committed action) at Time 1 were related to higher Time 2 PTG in only the high PTS group. Findings advance understanding of the role of psychological flexibility in trauma reactions and pandemic mental health adjustment. Evidence-based approaches that target psychological flexibility, like Acceptance and Commitment Therapy, are likely to foster PTG and ultimately adjustment in people with high PTS during and after the pandemic.

Perceived professional benefits and associated factors among nurses during the COVID-19 pandemic: A cross-sectional study

AIMS

To examine the perceived professional benefits (PPB) and associated factors among nurses during the coronavirus disease 2019 (COVID-19) pandemic in China.

DESIGN

Cross-sectional study.

METHODS

Using the snowball sampling method, 492 nurses (478 females, 14 males) were recruited. Data were collected using an online survey, including participants' socio-demographic and working characteristics, psychological distress related to the COVID-19 pandemic, dealing with professional frustration, professional self-reflection and PPB from 1-30 April 2020.

RESULTS

Nurses experienced high levels of PPB. In linear regression analysis, self-perceived concerns about COVID-19, emotional shock caused by it, risk perception towards their occupations, dealing with professional frustration and professional self-reflection were positively associated with PPB among nurses. These factors explained 84% variance in PPB.

CONCLUSIONS

This study highlighted that although the nurses experienced psychological distress, they gained high PPB during the COVID-19 pandemic. Additionally, to facilitate nurses' efforts to achieve professional growth, more educational resources and opportunities for engaging in reflective practices could be provided.

The Relationship between Burnout and Intention to Leave Work among Midwives: The Long-Lasting Impacts of COVID-19

Objective. It is important to evaluate the long-term effects of the COVID-19 pandemic on the intention of midwives to leave their jobs. The study examined the relationship between burnout and the intent to leave work among midwives who worked at Ayatollah Mousavi Hospital of Zanjan, one year after the COVID-19 outbreak. Method. In a descriptive-analytical study, the intention of 88 midwives to leave their jobs was evaluated, one year after the outbreak of COVID-19 disease in 2021. The midwives were selected using convenience sampling methods. Data were collected using the Maslach burnout questionnaire and the Anticipated Turnover Scale (ATS). Data were analyzed with descriptive statistics, Chi-square test, Pearson correlation coefficient, and multiple linear regression model with the stepwise method at a 95% confidence level. Results. The mean intention to leave the job was 29.71 ± 6.75. Most of the midwives reported a moderate level of intention to leave the job (47.7%). There was a significant positive correlation between the intention to leave the job and all three components of burnout. The stepwise regression analyses indicated that emotional exhaustion (β = 0.344) and working rotational shifts (β = 0.276) were significant predictors of intent to leave the job. Conclusions. It can be concluded that the intention to leave the job of midwives was moderate. Given the relationship between emotional exhaustion and the intent to leave the job, interventions to increase the mental strength and resilience of midwives during the COVID-19 pandemic seem necessary.

Resilience, Coping Strategies and Posttraumatic Growth in the Workplace Following COVID-19: A Narrative Review on the Positive Aspects of Trauma

The COVID-19 pandemic represents a traumatic event that has profoundly changed working conditions with detrimental consequences for workers' health, in particular for the healthcare population directly involved in addressing the emergency. Nevertheless, previous research has demonstrated that traumatic experiences can also lead to positive reactions, stimulating resilience and feelings of growth. The aim of this narrative review is to investigate the positive aspects associated with the COVID-19 pandemic and the possible health prevention and promotion strategies by analyzing the available scientific evidence. In particular, we focus on the constructs of resilience, coping strategies and posttraumatic growth (PTG). A literature search was performed on the PubMed, EMBASE, Scopus, Web of Science, Google Scholar and Psycinfo databases. Forty-six articles were included in the literature synthesis. Psychological resilience is a fundamental variable for reducing and preventing the negative psychological effects of the pandemic and is associated with lower levels of depression, anxiety and burnout. At the individual and organizational level, resilience plays a crucial role in enhancing wellbeing in healthcare and non-healthcare workers. Connected to resilience, adaptive coping strategies are essential for managing the emergency and work-related stress. Several positive factors influencing resilience have been highlighted in the development of PTG. At the same time, high levels of resilience and positive coping strategies can enhance personal growth. Considering the possible long-term coexistence and consequences of COVID-19, organizational interventions should aim to improve workers' adaptive coping skills, resilience and PTG in order to promote wellbeing.