Changes in Chinese nurses' mental health during 1998-2016: A cross-temporal meta-analysis

The relationship between unemployment anxiety, job satisfaction and migration attitude among the next generation of Turkish nurses: A cross-sectional study

BACKGROUND

The global nursing shortage is complex and multifaceted. Despite the policy of increasing the number of nurses, concerns about the sustainability of the nursing workforce in Turkey continue.

AIM

To evaluate the relationship between unemployment anxiety, job satisfaction, and migration attitudes among Turkish nursing candidates.

METHODS

A cross-sectional study was conducted with 1100 nursing candidates between April and June 2022. The data gathered from the "Personal Form, Job Satisfaction, and Brain Drain Attitudes Scale" were analyzed using logistic regression and decision tree analysis.

RESULTS

Of the participants, 67.1% were female, and the mean age was 22.6 ± 1.7 years. Being male (OR = 1.317, 95% Cl 0.994-1.743) having a low income (OR = 1.754, 95% Cl 1.334-2.306), feeling insecure about the future (OR = 2.340, 95% Cl 1.312-4.175), expecting a lower wage than desired (OR = 2.015, 95% Cl 1.132-3.586), and employment precariousness (OR = 1.786, 95% Cl 1.355-2.353) increase the possibility of experiencing high unemployment anxiety. On the other hand, family support for living abroad (OR = 0.579, 95% CI 0.408-0.821) and job satisfaction (OR = 0.799, 95% CI 0.692-0.921) decrease unemployment anxiety (p < 0.05). According to the results of the decision tree analysis, the host country's pull factors are the best predictors of the nursing candidates' intention to work abroad as nurses (p < 0.05).

CONCLUSION

The increasing prevalence of unemployment anxiety and migration tendencies among nursing candidates requires the evaluation of policies aimed at increasing the number of nursing graduates in Turkey.

Relationships between job burnout, ethical climate and organizational citizenship behaviour among registered nurses: A cross-sectional study

AIM

This study aimed to investigate the levels of nurses' organizational citizenship behaviour and the associations between job burnout and ethical climate with organizational citizenship behaviour.

BACKGROUND

Organizational citizenship behaviour improves adverse outcomes led by nursing shortage. However, the associations between three dimensions of job burnout and organizational citizenship behaviour are inconsistent, and little is known about whether ethical climate is related to organizational citizenship behaviour in nurses.

METHODS

In this cross-sectional study, 1157 nurses were selected using convenience sampling from April to October 2019. Self-report surveys assessed nurses' organizational citizenship behaviour, emotional exhaustion, depersonalization, personal accomplishment and perceptions of ethical climate.

RESULTS

Mean organizational citizenship behaviour was high among nurses. The regression model showed that job burnout and ethical climate explained an additional 38.6% of the variance in organizational citizenship behaviour over and above sociodemographic factors, with 44.9% of the total variance.

CONCLUSION

Nurses' organizational citizenship behaviour was at a relatively high level. Depersonalization was negatively associated with organizational citizenship behaviour while personal accomplishment and ethical climate were positively related to organizational citizenship behaviour. Therefore, nurse leaders are encouraged to take measures to help nurses reduce job burnout and create a favourable ethical climate for increasing nurses' organizational citizenship behaviour.

Assessment of mental health status among Chinese nursing staff in the intensive care unit: a network analysis

Backgrounds

Nursing is the key group to provide healthcare services, and it is easy for nursing staff to develop mental health problems.

Aims

The study aimed to evaluate prevalence of psychological symptoms in nurses working in an intensive care unit (ICU) and the inter-relationship of associations of psychological symptoms using network analysis.

Methods

This study is a cross-sectional design study. The Chinese version of the Symptom Check List-90 (SCL-90) was used to measure the psychological status of ICU nurses. The network structure of psychological symptoms was characterised, and indices of 'Expected influence' were used to identify symptoms central to the network. Network stability was examined using a case-dropping bootstrap procedure.

Results

Multiple logistic regression analysis found those who had worked more than 15 years were less likely to experience positive psychological symptoms, whereas nurses working in emergency ICU and other ICUs, nurses working in departments with over 16 beds were more likely to develop psychological symptoms. In addition, 'Anxiety', 'Mental degeneration' and 'Depression' were central symptoms in the network.

Conclusions

ICU nurses reported a high level of psychological symptoms, which may affect the quality of their work and worsen public health problems.

Changes of medical staffs' subjective well-being in China (2004-2020): A cross-temporal meta-analysis

Subjective well-being is a crucial index measuring the mental health of medical staffs, and it is necessary to examine the changes in subjective well-being (SWB) level of Chinese medical staffs with time. A cross-temporal meta-analysis was performed using papers that measured the SWB level of Chinese medical staffs between 2004 and 2020. Moreover, a time-lag analysis was conducted to define whether the macro-social indicators can explain the changes in SWB. A total of 47 papers were included in the final sample. The results revealed that score of SWB was significantly negatively correlated with the year. Score of SWB was significantly associated with six social indicators of economic condition (the residents' consumption level, housing prices, and old-age dependency ratio), social connectedness (the divorce rate and the urbanization level), and overall threat (the crime rate), which indicated that social change may account for the decline of Chinese medical staffs' SWB level. Our study revealed a decreasing trend of Chinese medical staffs' SWB level over time, which was associated with macro-social changes in diverse areas. In addition, combined with the corresponding macro-social indicators, a three-dimensional theoretical framework is proposed to explain the SWB for medical staffs as a group.

Psychological stress and psychological support of Chinese nurses during severe public health events

The domestic health care system has been facing a difficult task, especially in medical care, and Chinese nurses are under tremendous psychological pressure. Psychological support is a protective factor to relieve stress. This study examined the stress level and characteristics of Chinese nurses with different psychological support-seeking behaviours. Data from online questionnaires for this cross-sectional study were collected between January 2020 and February 2020 and yielded 2248 valid questionnaires for analysis with a response rate of 99.8%. General information of the respondents was also collected. The nurses' stress levels were assessed using the Perceived Stress Scale (PSS-10). T tests, chi-square tests, and linear regression were used to examine the relationships among the factors. The results of this survey showed that between January and February 2020, 26.9% of nurses received psychological counselling, and the proportion was higher among men and nurses with lower education. The PSS-10 was related to gender, age group, provincial severity, and confidence in the control of the epidemic. The results showed that psychological support can effectively improve the confidence of domestic nurses in the face of arduous work and effectively relieve the psychological pressure caused by a heavy workload.

Associations of job satisfaction and burnout with psychological distress among Chinese nurses

Nurses' mental health is related to the quality of medical care and the outcome of treatment, and has become an important issue in nursing management. However, the role of burnout in the relationship between job satisfaction and psychological distress have not been evaluated. This study aimed to examine the prevalence of psychological distress among Chinese nurses and explore the associations of job satisfaction and burnout with psychological distress. A cross-sectional survey of 866 nurses was conducted in Qiqihar City, Heilongjiang Province of China. Job satisfaction, burnout, and psychological distress were assessed via the single-item, the Maslach Burnout Inventory-Human Services Survey, and the 12-item General Health Questionnaire respectively, followed by a mediation analysis through the multiple regression analysis and a PROCESS macro method. The prevalence of psychological distress was 35.2% among the participants. After controlling the potential confounding factors, job satisfaction and burnout were found to be still associated with psychological distress (P < 0.001). Furthermore, psychological distress was negatively correlated with both job satisfaction (r = -0.312) and personal accomplishment (r = -0.422) but positively correlated with both emotional exhaustion (r = 0.491) and depersonalization (r = 0.449). Burnout may mediate the association between job satisfaction and psychological distress (B = 0.139, β = 0.440, P < 0.001 for emotional exhaustion; B = 0.226, β = 0.382, P < 0.001 for depersonalization; and B = -0.105, β = -0.368, P < 0.001 for personal accomplishment). The mental health status of Chinese nurses remains to be improved. Low job satisfaction and burnout could increase the risk of psychological distress among Chinese nurses. Moreover, job satisfaction may partially affect psychological distress among Chinese nurses through emotional exhaustion, personal accomplishment, and depersonalization.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-04006-w.

Development and validation of the Nurse's Workplace Mental Health Questionnaire

OBJECTIVES

This study aimed to develop and validate the Nurse's Workplace Mental Health Questionnaire (NWMHQ).

METHODS

The questionnaire was developed based on the two continua model of mental illness and health proposed by Keyes. The initial questionnaire was generated through literature review, two rounds of Delphi expert consultation, followed by a pilot survey. Finally, the reliability and validity of the questionnaire were validated through an online survey of 2,815 registered nurses selected from the public hospitals in 11 provinces from June to July 2020.

RESULTS

The item-content validity index (I-CVI) of the questionnaire ranged from 0.750 to 1.000 and the average scale-level content validity index (S-CVI/Ave) was 0.906. Cronbach's α coefficient was 0.948 and test-retest reliability was 0.850. The self-rating depression scale score was negatively related to the NWMHQ score (r = -0.664, P < 0.01). The exploratory factor analysis (EFA) yielded six factors (emotional status, psychological security, positive relationship, resilience, self-efficacy, and subjective well-being), consisting of 32 items. The cumulative variance contribution rate was 65.58%. Confirmatory factor analysis (CFA) showed an acceptable fit.

CONCLUSION

The NWMHQ developed in this study showed good reliability and validity. This questionnaire may help assess the mental health status of nurses and help nursing managers to develop appropriate targeted psychological interventions.

A Cross-Temporal Meta-Analysis on Marital Satisfaction of Chinese Couples

Objective

To investigate the changing trend of Chinese couples' marital satisfaction and its relationship with social changes.

Methods

A cross-temporal meta-analysis was performed on 118 original studies (n = 31,909) reporting marital satisfaction of Chinese couples from 1994 to 2020, primarily using correlation analysis and regression analysis.

Results

(1) Overall, the marital satisfaction of Chinese couples showed a downward trend over time. (2) Men's marital satisfaction displayed almost no change, while women's marital satisfaction had a more obvious downward trend. (3) Changes in macrosocial factors (per capita consumption expenditure, housing prices, old-age dependency ratio, and divorce rate) could significantly predict the downward trend of marital satisfaction, especially for women.

Conclusion

In the past 27 years, the overall marital satisfaction level of Chinese couples has shown a downward trend, and there are gendered differences, which may be related to changes in the socioeconomic and cultural environments.

Effect of a group-based acceptance and commitment therapy program on the mental health of clinical nurses during the COVID-19 sporadic outbreak period

Aim

To develop and implement of a group‐based acceptance and commitment therapy programme in helping clinical nurses with mental health problems during the sporadic COVID‐19 outbreak period.

Background

In the face of the continuing COVID‐19 pandemic, clinical nurses have a high risk of mental health issues.

Methods

A quasi‐experimental design was used. Two hundred twenty‐six nurses were recruited from four general hospitals to receive 10 sessions of acceptance and commitment therapy programme. The Symptom Checklist‐90, Perceived Stress Scale and Connor–Davidson Resilience Scale were used to assess nurses' mental health symptom, perceived stress and psychological resilience at pre‐intervention and 4‐week post‐intervention.

Results

The mean attendance sessions was 5.78. The Symptom Checklist‐90 score was significantly lower at post‐intervention than pre‐intervention (P < 0.01), and there were no significant changes of perceived stress and psychological resilience. There were significant correlations among the changed rates of mental health, perceived stress and psychological resilience (P < 0.01).

Conclusion

The acceptance and commitment therapy programme was effective in relieving mental health symptoms for clinical nurses and could protect clinical nurses' perceived stress and psychological resilience. However, a randomized controlled trial is needed to confirm the findings.

Implication for Nursing Management

To facilitate clinical nurses' psychological health in crisis situation, nursing management team should provide and allocated appropriate resources to support the healthcare providers.

Nurse admissions at a specialized mental health programme: A pre-Covid-19 retrospective review (2000-2019)

AIMS

Nursing is a stressful and emotionally demanding profession. To date, few mental health treatment interventions have been developed for them worldwide. This study aims to explore referral trends in nurses with mental disorders admitted to a pioneer specialized mental health programme in Europe from 2000 to 2019.

DESIGN

A retrospective observational study of 1297 medical e-records of nurses with mental health disorders admitted to the Galatea Care Programme in Barcelona was conducted.

METHODS

Three periods were analysed: 2000-2006, 2007-2012 and 2013-2019. Socio-demographic and clinical variables were compared. Diagnoses followed Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria.

RESULTS

Gender and age at referral did not change over time. Self-referrals grew from 85.1% in the first period to 95.3% in the last period; inpatient admissions decreased from 24.1% to 18.2%, although this was not significant; nurses were less frequently on sick leave on admission over time (59.1% vs. 45.7%); they were more likely to have a temporary contract in the second period (9.5% vs. 4.8% and 4%) and prevalence of main diagnosis changed with a considerable decrease in affective and substance use disorders after 2006 and a progressive increase in adjustment disorders during the whole period.

CONCLUSION

Free, voluntary, highly confidential programmes for nurses with mental disorders may enhance voluntary and earlier help seeking. These findings can be considered when implementing specialized interventions for them in other settings. WHAT PROBLEM DID THE STUDY ADDRESS?: Nursing is a stressful and emotionally demanding profession. To date, few specialized mental health services have been developed for them worldwide. This study aims to explore referral trends in nurses with mental disorders admitted to a pioneer programme in Europe, the Galatea Care Programme in Barcelona, from 2000 to 2019. WHAT WERE THE MAIN FINDINGS?: The number of referrals to the programme grew especially after the first 7-year period. Admissions were more likely to be voluntary during the last period. Prevalence of substance use disorders at admission dropped steadily while prevalence of adjustment disorders progressively increased over the two decades. Nurses were also less likely to be on sick leave at admission. WHERE AND ON WHOM WILL THE RESEARCH HAVE IMPACT?: Free, voluntary, highly confidential programmes for nurses with mental disorders may enhance voluntary and earlier help seeking. These findings can be considered when implementing specialized interventions for them in other settings.

Digital biomarkers of anxiety disorder symptom changes: Personalized deep learning models using smartphone sensors accurately predict anxiety symptoms from ecological momentary assessments

Smartphones are capable of passively capturing persons' social interactions, movement patterns, physiological activation, and physical environment. Nevertheless, little research has examined whether momentary anxiety symptoms can be accurately assessed using these methodologies. In this research, we utilize smartphone sensors and personalized deep learning models to predict future anxiety symptoms among a sample reporting clinical anxiety disorder symptoms. Participants (N = 32) with generalized anxiety disorder and/or social anxiety disorder (based on self-report) installed a smartphone application and completed ecological momentary assessment symptoms assessing their anxiety and avoidance symptoms hourly for the course of one week (T = 2007 assessments). During the same period, the smartphone app collected information about physiological activation (heart rate and heart rate variability), exposure to light, social contact, and GPS location. GPS locations were coded to reveal the type of location and the weather information. Personalized deep learning models using the smartphone sensor data were capable of predicting the majority of total variation in anxiety symptoms (R² = 0.748) and predicting a large proportion of within-person variation at the hour-by-hour level (mean R² = 0.385). These results suggest that personalized deep learning models using smartphone sensor data are capable of accurately predicting future anxiety disorder symptom changes.

TRANSFORMAÇÃO DE UMA CLÍNICA CIRÚRGICA PARA ATENDIMENTO A PACIENTES COM COVID 19: RELATO DE EXPERIÊNCIA

RESUMO Objetivo: relatar o processo de transformação de uma unidade de internação cirúrgica em unidade de atendimento a pacientes infectados pelo novo coronavírus e o impacto na saúde dos profissionais de enfermagem e usuários desse serviço, na opinião de enfermeiros que vivenciaram o processo. Método: trata-se de um relato de experiência de enfermeiros de uma unidade de internação cirúrgica de um Hospital Escola Federal da região Centro-Oeste do Brasil. A experiência foi apresentada em três eixos temáticos: 1) Reestruturação interna da unidade de internação cirúrgica; 2) Capacitação, gerenciamento de pessoal e distribuição de recursos; 3) Impactos na saúde dos trabalhadores. Resultados: a clínica cirúrgica passou a contar com equipe exclusiva e fluxo de atendimento único. Pacientes pré-cirúrgicos receberam alta hospitalar sem perspectiva de retorno ao tratamento previsto. Enfermarias cirúrgicas foram adaptadas para enfermarias de isolamento, e instalações de equipamentos para a assistência ventilatória foram otimizadas. A falta de Equipamentos de Proteção Individual adequados e a sobrecarga de trabalho foram apontados como situações que aumentam o risco de infecção para os profissionais da saúde. Conclusão: o estudo retratou condições insalubres que favorecem o esgotamento físico e o sofrimento mental de profissionais da enfermagem. Sugerem-se novas pesquisas no âmbito do planejamento da saúde ocupacional que possam subsidiar o trabalho de gestores de serviços de saúde em futuros cenários de pandemia no Brasil.

TRANSFORMATION OF A SURGICAL CLINIC FOR COVID-19 PATIENTS: EXPERIENCE REPORT

ABSTRACT Objective: to report the transformation process of a surgical inpatient unit into a coronavirus patient care unit and the impact on the health of nursing professionals and users of this service, in the opinion of nurses who experienced the process. Method: this is an experience report of nurses of a surgical inpatient unit of a Federal Teaching Hospital in the Midwest region of Brazil. The experience was presented in three thematic axes: 1) Internal restructuring of the surgical hospitalization unit; 2) Training, personnel management and distribution of resources; 3) Impacts on worker health. Results: the surgical clinic started to have an exclusive team and flow of single care. Pre-surgical patients were discharged from the hospital with no prospect of returning to the planned treatment. Surgical wards were adapted to isolation wards, and equipment facilities for ventilatory care were optimized. The lack of adequate Personal Protective Equipment and work overload were identified as situations that increase the risk of infection in health professionals. Conclusion: the study demonstrated unhealthy conditions that favor the physical exhaustion and mental suffering of nursing professionals. New research in occupational health planning which supports the work of health service managers in future pandemic scenarios in Brazil is suggested.

Dynamic brain connectome and high risk of mental problem in clinical nurses

With the growing population and rapid change in the social environment, nurses in China are suffering from high rates of stress; however, the neural mechanism underlying this occupation related stress is largely unknown. In this study, mental status was determined for 81 nurses and 61 controls using the Symptom Checklist 90 (SCL-90) scale. A subgroup (n = 57) was further scanned by resting-state functional MRI with two sessions. Based on the SCL-90 scale, "somatic complaints" and "diet/sleeping" exhibited the most prominent difference between nurses and controls. This mental health change in nurses was further supported by the spatial independent component analysis on functional MRI data. First, dynamic functional connectome analysis identified two discrete connectivity configurations (States I and II). Controls had more time in the State I than II, while the nurses had more time in the State II than I. Second, nurses showed a similar static network topology as controls, but altered dynamic properties. Third, the symptom-imaging correlation analysis suggested the functional alterations in nurses as potential imaging biomarkers indicating a high risk for "diet/sleeping" problems. In summary, this study emphasized the high risk of mental deficits in nurses and explored the underlying neural mechanism using dynamic brain connectome, which provided valuable information for future psychological intervention.

A cross-temporal meta-analysis review of the personality of Chinese military personnel, 1991-2017

OBJECTIVE

The personality of military personnel is an important factor for their mental health. It has been revealed that military personnel's mental health has changed over the past decades. The objective of the present study was to examine the birth cohort changes in the personality of Chinese military personnel.

METHODS

To examine the birth cohort changes in the personality of Chinese military personnel, a cross-temporal meta-analysis of 53 studies that measured the personality of Chinese military personnel with the Eysenck Personality Questionnaire from 1991 to 2017 was conducted (61 data points, N = 55 708).

RESULTS

The results showed that during this period, the respondents' personality traits changed significantly. Specifically, their levels of neuroticism and psychoticism decreased by 0.84 and 0.62 standard deviations respectively, and the younger participants exhibited higher levels of extraversion.

CONCLUSIONS

This study found that Chinese military personnel showed decreasing neuroticism and psychoticism from 1991 to 2017 and that younger participants exhibited higher levels of extraversion. © 2020 John Wiley & Sons, Ltd.

Neighborhood Environment, Internet Use and Mental Distress among Older Adults: The Case of Shanghai, China

As the Internet evolves in urban communities, its consequences on mental distress have drawn significant research attention. We examine the relationships of mental distress with neighborhood environment and Internet use among older adults, using data from a representative sample of 2036 adults aged older than 60 years in Shanghai, China. We assess mental health with a 10-item scale from the Symptom Checklist 90 and Internet use with a 4-item scale and obtain information of neighborhood environment from an online map platform. Results from multilevel models show that both neighborhood environment and Internet use are significantly related to mental distress. Moreover, a worse neighborhood environment may strengthen the correlation between Internet use and mental distress, indicating the strong moderating role of the neighborhood environment. Thus, promoting Internet use among elderly people might result in a reduction in the prevalence of mental distress in disadvantaged neighborhoods.