Resilience and burnout in healthcare students and inpatient psychiatric nurses: A between-groups study of two populations

A hybrid approach for analyzing and assessing resilience engineering in healthcare

BackgroundToday, researchers try to recognize and improve the weaknesses of complex systems using resilience engineering (RE) principles.ObjectiveThis descriptive-analytical epidemiological study aims to evaluate the resilience performance of the hospital staff based on the principles of RE to enhance personnel performance.MethodA questionnaire containing 27 questions in four areas (anticipation, monitoring, response, and learning) was designed based on Hellangel's model and field surveys to collect data from nurses and managers of various wards of five hospitals. The face validity and reliability of the questionnaire were confirmed by 16 professors and some individuals from the statistical sample.A hybrid approach utilizing entropy, TOPSIS, and DEA was employed in the Excel environment to process the collected data.ResultsThe results of the entropy method indicated that the responding and monitoring indicators, with values of 0.29 and 0.23, respectively, had the greatest impact on the resilience performance of the studied units. The outcomes of TOPSIS revealed that hospital D possesses the highest level of resilience. According to the DEA method, the first, second, and fifth efficient units were associated with hospital B.ConclusionBy evaluating the cornerstone of resilience, this study's findings empower nurses and managers to mitigate the impacts of stress, emotional exhaustion, and burnout, fostering work interactions and improving their performance in the face of workplace challenges. The main limitation of the study was the spread of COVID-19, which impeded the training of personnel in the field of RE and its indicators, as well as the distribution, collection, and completion of questionnaires, along with challenging access to personnel.

Burnout in occupational therapy and physiotherapy students: a systematic review of the risk and protective factors

BACKGROUND AND PURPOSE

Studies consistently suggest that work as an occupational therapist or physiotherapist is associated with burnout, yet no review has been conducted on the risk and protective factors of burnout in physiotherapy and occupational therapy students (collectively termed allied health students). This systematic review identified and synthesized the risk and protective factors associated with burnout in allied health students.

METHODS

Eight databases, Google Scholar, and Connected Papers were searched in November 2024 systematically for mixed-method or quantitative studies containing primary data on the risk and protective factors of burnout. Titles, abstracts, and full-text articles were reviewed by two authors independently against the selection criteria. Risk of bias was evaluated in included studies, and the level of evidence was classified using National Health and Medical Research Council guidelines. Risk and protective factors were collated and summarized as modifiable or non-modifiable.

RESULTS

Eleven studies (10 physiotherapy, 1 occupational therapy) with 2,444 participants were included. The risk of bias was variable, and the level of evidence was satisfactory. Fifteen risk and protective factors were identified. Protective factors including higher grit and resilience, more physical activity and self-care, and more time spent supported by family, peers, faculty, and academic advisors, were consistently related to lower burnout. The relationships of other variables with burnout were unclear.

CONCLUSION

The factors identified in this study can be targeted in wellbeing, preventative, and intervention recommendations and strategies for students. Examples include increasing family and faculty support, and physical activity, to protect against burnout.

Occurrence of Stress and Burnout Among Nurses Employed in a Psychiatric Hospital and a Somatic Hospital-A Comparative Analysis (Nursing Workload KEGA č. 011KU-4/2024)

Work-related stress has been linked to various negative outcomes among healthcare professionals. For nurses, stress can arise from numerous sources, including their interactions with patients. It is often perceived that nurses working in psychiatric hospitals experience greater stress and occupational burnout compared to nurses working in somatic hospitals. However, there is limited research addressing this specific issue. To bridge this gap, a study was conducted to compare the stress levels of nurses working in a psychiatric hospital and a somatic hospital within the same city. Background/Objectives: The aim of this paper was to report on the prevalence of stress and burnout among surveyed nurses employed in a somatic hospital and in a psychiatric hospital. Methods: The study group consisted of a total of 379 nurses-189 employed at a somatic hospital and 190 employed at a psychiatric hospital. The primary test used for statistical analyses was the nonparametric Mann-Whitney U test for assessing differences. Additionally, correlations between ordinal or quantitative variables were analyzed using Spearman's rho coefficient. Results: Among respondents working at a somatic hospital, the average levels of occupational burnout, emotional exhaustion, depersonalization, and sense of personal accomplishment were moderate. Similar results were observed among respondents employed at a psychiatric hospital. Conclusions: The workplace does not significantly differentiate professional burnout or coping strategies among the nurses surveyed. Among nurses working in hospitals for somatic patients, levels of depersonalization, turning to religion, and seeking support increase with age and seniority. In contrast, psychiatric nurses show higher levels of emotional exhaustion and overall MBI burnout as they age.

Past the tipping point: Understanding and addressing burnout among nursing students

Burnout is a widespread concern in healthcare, with nurses bearing a disproportionate burden among healthcare professionals. This epidemic of occupational stress has also affected nursing students, who face the external demands inherent in the profession. In this call-to-action paper, we conducted an extensive literature review exploring strategies aimed at mitigating burnout among nursing students, and offer recommendations for academic institutions, healthcare leaders, research funders, and political leaders, including both the civil service and elected leaders to support the advancement and sustainability of the nursing profession and its workforce.

The associations between resilience, self-care, and burnout among medical students

Burnout is a work-related stress syndrome with substantial consequences for patients, physicians, and medical students. Personal resilience, i.e., the ability to bounce back and thrive despite challenging circumstances, and certain practices, such as self-care, may protect individuals from burnout. However, limited information exists on the complex relationships between resilience, different self-care practices, and burnout. Understanding these associations is important for designing efficient interventions within medical schools. Therefore, the present study examined the direct and indirect associations through a cross-sectional study among 95 fourth-year medical students. Self-reported questionnaires measured resilience, self-care dimensions (stress management, spiritual growth, interpersonal relations, health responsibility), and burnout dimensions (emotional exhaustion, depersonalization, personal accomplishment). Data were analyzed via IBM-SPSS and PROCESS-macro. The main results demonstrated that self-care mediated the associations between resilience and burnout: stress management and interpersonal relations mediated the associations with emotional exhaustion, while spiritual growth mediated the association with personal accomplishment. These results highlight that medical students' resilience may encourage self-care behaviors, thus decreasing levels of the burnout dimensions of emotional exhaustion and personal accomplishment. Developing curricula that enhance students' resilience through applying self-care techniques in stressful situations may reduce the negative impact of burnout in healthcare.

Turkish nurses' psychological resilience and burnout levels during the COVID-19 pandemic: A correlational study

AIMS

To investigate the relationship between the psychological resilience and burnout of nurses caring for COVID-19 patients and to determine the factors that affect their psychological resilience and burnout.

BACKGROUND

In pandemic diseases such as COVID-19, nurses experience burnout due to long working hours, decreased quality of life and anxiety/fear about their own/families' health. Psychological resilience helps to control burnout in nurses and prevent the development of a global nurse shortage.

DESIGN

This was a descriptive, correlational study.

METHODS

The sample of this study included 201 nurses in a Training and Research Hospital. The study used the Brief Resilience Scale and the Burnout Measure Short Version. Data were collected between 4 May and 1 June 2020. Statistical analysis was made with Pearson/Spearman, independent sample t test, one-way analysis of variance (ANOVA) test.

RESULTS

Nurses reported moderate burnout and psychological resilience, with a negative and highly significant correlation between psychological resilience and burnout levels.

CONCLUSIONS

In order to increase the quality of patient care/treatment, nurse managers need to reduce nurses' burnout and increase their psychological resilience. Nurses are recommended to adopt a healthy lifestyle, organize training programmes and implement psychological resilience interventions to prevent sleep disorders. Giving nurses the tools to understand what they need to manage within their locus of control will allow them to find a new sense of resilience, preventing potential burnout.

Perceived Stress and Resilience Among Psychiatric Nurses Working in Inpatients Units

The aim of this study is to assess the levels, relationships, and predictors of resilience and perceived stress among psychiatric nurses working in inpatient units. A descriptive, cross-sectional, predictive design was employed to collect data from 140 psychiatric nurses through a self-reported questionnaire. The questionnaire consisted of sociodemographic and work-related variables, Connor-Davidson Resilience Scale (CD-RISC-25), and perceived stress scale (PSS-10). The total mean score of the perceived stress was 22.73 (SD = 3.54) indicating a moderate level. The total mean score of the resilience was 49.49 (SD = 15.31) indicating a low level. Resilience correlated positively with educational level and job satisfaction; and negatively with intention to leave psychiatric settings. Significant differences were found in resilience with educational level, intention to leave psychiatric settings, and job satisfaction. Three independent variables predicted resilience: educational level, ward/unit, and job satisfaction; and only one variable (intention to leave psychiatric settings) predicted the perceived stress.

The Relationship Between Pharmacist Resilience, Burnout, and Job Performance

Background: Resilience aids healthcare professionals in navigating through and bouncing back from stressful situations in the workplace. Resilience can increase job satisfaction, work motivation, and professional commitment while decreasing burnout, and ultimately job turnover. More resilient employees experience lower instances of burnout and greater life satisfaction. Objective: The primary study objective is to determine the relationship that pharmacist resilience has on burnout and job performance. Methods: Licensed pharmacists in Florida were sent a Qualtrics survey (Qualtrics, Provo, UT) via email, which included demographics data, and valid and reliable assessment tools for resilience, burnout, and job performance. Linear regressions were used to test if resilience significantly predicted each of the output variables: burnout and job performance. Results: Survey responses were received from 942 pharmacists. The regressions showed that resilience significantly predicted both burnout (β1 = -.701, P < .001) and job performance (β1 = .35, P < .001). As resilience increased, the levels of burnout decreased, and job performance increased. Resilience explained 29% of the variance in burnout, and 11% of the variance in job performance. Conclusion: The results of this study suggest that resilience significantly predicts both pharmacist work-related burnout and job performance. The more resilient the pharmacist, the lower the chances of work-related burnout and the higher the likelihood of better job performance. Organizations should pursue opportunities to educate healthcare workers on methods to increase resilience and to bring attention to the importance of this topic.

The Lived Experience of Play and How It Relates to Psychological Wellbeing: An Interpretive Phenomenological Analysis (IPA) Study Amongst Undergraduate Students from Medicine, Nursing, and Allied Health Professions' Programmes in the United Kingdom

Current literature acknowledges that undergraduate students undertaking programmes in medicine, nursing, and allied health professions experience occupational stress which presents as a detriment to mental health, psychological wellbeing (PWB), and burnout. Strategies to improve the wellbeing of students have been slow to embed and have had limited impact, indeed the issue of declining wellbeing amongst this group is escalating. Studies from the business literature suggest that organisations that foster a playful environment reap benefits in terms of employee wellbeing. This interpretive phenomenological analysis (IPA) study explored the lived experiences of play amongst undergraduate students from medicine, nursing, and allied health professions' programmes in the clinical practice setting. The resultant findings offer some unique empirical insights into the types of play that the students engaged in, ranging from informal banter with peers and patients to artful, sophisticated, cocreated play. The study also revealed insights about the factors which facilitate play, notably the "big personalities" on the ward. The factors which limited play are related to the tension between being a health professional and the enactment of play as well as hierarchical factors. Crucially, the study found that the practice of play induced key hedonic and eudaimonic PWB benefits to the students, ranging from positive affect to improved relationships, a sense of meaning, and a positive learning environment, offering original empirical insights. These findings have not been observed previously and shine a conceptual light on a previously unknown phenomenon.

Professional Quality of Life, Job Satisfaction, and Intention to Leave among Psychiatric Nurses: A Cross-Sectional Study

Psychiatric nurses are challenged with high levels of stress, which, in turn, lower their professional quality of life (ProQoL) and job satisfaction and increase their intention to leave jobs in psychiatric settings. An adequate level of ProQoL improves patient care provision. The purpose of this study is to assess the levels, relationships, and predictors of the professional quality of life of Jordanian psychiatric nurses and their job satisfaction and intention to leave their job. A descriptive cross-sectional design was used to collect data using the Professional Quality of Life Scale-5 from a convenience sample. Data were collected from 144 psychiatric nurses working in the largest psychiatric hospitals run by Ministry of Health, military, and university-affiliated hospitals. The results showed that the mean scores for compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) were 35.21, 27.0, and 26.36, respectively. The mean scores for intention to leave and job satisfaction were 2.33 and 3.7, respectively. The income level, educational level, intention to leave, and job satisfaction significantly differed in the CS dimension. Nurses' age, intention to leave, and job satisfaction significantly differed in BO. Nurses' age, years of experience, frequent C-shifts worked, and work affiliation were different in STS. Burnout, STS, and educational level predicted CS. CS, STS, job satisfaction, and level of education predicted BO. BO, CS, and frequently working night C-shifts predicted STS. Due to the presence of nurses reporting low levels of ProQoL, job satisfaction, and intension to leave, more studies are needed to assess the factors that affect ProQoL among psychiatric nurses and to evaluate interventional programs that improve the quality of life of psychiatric nurses. This is important in retaining nurses and increasing their job satisfaction. There is a need for interventions that enhance ProQoL. Also, longitudinal studies that measure ProQoL overtime are recommended. This study was not registered.

Strategies to Reduce the Impact of Trauma in Psychiatric Nurses: An Integrative Review of the Literature

BACKGROUND

Psychiatric nurses are at a higher risk for exposure to violence and aggression, leading to potential burnout, moral injury, post-traumatic stress, and turnover. There is little evidence of a preferred strategy to support nurses and decrease the impact of traumatic experiences on psychiatric nurses. The aim of this integrative review was to explore potential strategies to decrease the impact of traumatic experiences among nurses in psychiatric settings.

METHODS

Following a systematic search of PsycINFO/Ovid, CINAHL, and MEDLINE/Pubmed, Joanna Briggs Institute quality appraisal tools were used to analyze quality of the articles. Thirteen articles met the inclusion/exclusion criteria for this study. Data were analyzed and synthesized into three key themes and seven sub-themes.

RESULTS

Three themes were noted to be common to the included texts. 1. Interpersonal Supports (Formal Support, Peer/Supervisor Support, and Informal Family/Social Support). 2. Organizational Supports (Perception of Job Safety/Satisfaction, Promoting Personal Resilience, Supporting Team Resilience, and Organizational Commitment to Resilience). 3. Protection of Personal Resources.

CONCLUSIONS

Many common suggestions for decreasing the impact of exposure to violence and trauma were noted across the thirteen articles, however, there is little evidence of a preferred strategy, how strategies are developed and employed or the efficacy of any particular strategy. Further investigation is needed to identify and evaluate supportive interventions, their feasibility and efficacy.

Compassionate Care: A Qualitative Exploration of Nurses' Inner Resources in the Face of Burnout

There is a universal shortage of nurses, with a current needs-based shortage of 5.9 million. This is not solely a recruitment issue but one of retention, triggered by high levels of work-induced stress, burnout, and reports of low job satisfaction resulting in poor care delivery. Some of the health repercussions on nurses include anxiety, insomnia, depression, migraines, irritability, absenteeism, and sometimes alcoholism and drug abuse. To tackle some of these costly issues, a qualitative exploration into how inner resources is used by nurses to cope with stress at different points of their careers is proposed. Through the lens of grounded theory, semi-structured interviews will be carried out with two distinct sets of participants: (1) Student nurses registered at the University of the Illes Baleares between 2022-2025. (2) Experienced nurses on the Balearic nursing register. Interviews will be coded and then analysed using Atlas.ti. Expected results will inform curriculum improvements that will benefit the well-being of (student) nurses, from the outset of their training, pre-empting potential psycho-social risks before they arise in the workplace. This is vital as it addresses nurses' mental health as well as chronic issues of retention and absenteeism.

Trauma-Informed Pedagogy: Instructional Strategies to Support Student Success

Over the past several years, the ongoing coronavirus disease 2019 pandemic has contributed to challenging working and life conditions. As a result, the midwifery and health care workforce has faced significant shortages due to burnout. Increased societal awareness of historical trauma and systemic racism embedded within US culture has also led to increased anxiety and signs of trauma among midwifery and health profession students. Now more than ever, innovative teaching strategies are needed to support students, reduce the risks of burnout, and increase diversity in the workforce. One strategy is to adopt a trauma-informed pedagogy within midwifery education. Trauma-informed pedagogy is founded on core assumptions of trauma-informed care and thus supports student success by recognizing that the student cannot be separated from their own life experiences. Faculty and preceptors can develop empathetic, flexible supports that communicate care and concern regarding students' personal and social situations, and emotions. Empathetic behavior from teachers also increases student learning motivation, making it easier for students to actively engage in learning thereby reducing their distress. The purpose of this State of the Science review, therefore, was to describe the literature surrounding trauma-informed pedagogy and to offer concrete educational strategies that faculty members and educational programs can employ to increase the success of a diverse student body. This can be accomplished through flexibility in curriculum design and outcome measurement to ensure attainment of end of program learning outcomes. Institutional and administrative support are essential to develop a faculty who realize the benefit and value of trauma-informed pedagogy underpinning student success.

Exploring the Impact of the COVID-19 Pandemic on Academic Burnout Among Nursing College Students in China: A Web-Based Survey

BACKGROUND The COVID-19 pandemic has brought changes and challenges to nursing students. However, little is known about the prevalence of academic burnout among nursing students in this challenging circumstance. This study aimed to assess nursing student academic burnout and its influencing factors. MATERIAL AND METHODS We conducted a sample survey of a 4-year undergraduate nursing university in Wuhu, Anhui Province, China. The social-demographic information questionnaire, Academic Burnout Scale, Connor-Davidson Resilience Scale, Impact of Event Scale-6, Patient Health Questionnaire-2, and Professional Identity Scale were used. Stepwise multiple linear regression was used to clarify the relationship among sociodemographic characteristics, resilience, and academic burnout. RESULTS Of all the study participants, 51.30% had a certain degree of academic burnout. Academic year, satisfaction with specialty, satisfaction with online learning, professional identity, and psychological resilience were negatively correlated with academic burnout among nursing students. Depression was positively correlated with academic burnout. CONCLUSIONS Nursing students had a high degree of academic burnout. Academic year, satisfaction with specialty, satisfaction with online learning, professional identity, and psychological resilience were protective factors that reduced nursing students' academic burnout.

Resilience and mental health nursing: An integrative review of updated evidence

Mental health nursing work is challenging, and workplace stress can have negative impacts on nurses' well-being and practice. Resilience is a dynamic process of positive adaptation and recovery from adversity. The aims of this integrative review were to examine and update understandings and perspectives on resilience in mental health nursing research, and to explore and synthesize the state of empirical knowledge on mental health nurse resilience. This is an update of evidence from a previous review published in 2019. Using integrative review methodology, 15 articles were identified from a systematic search (July 2018-June 2022). Data were extracted, analysed with constant comparison method, synthesized narratively and then compared with the findings from the original review. As an update of evidence, mental health nurse resilience was moderate to high across studies, was positively associated with psychological well-being, post-traumatic growth, compassion satisfaction and negatively associated with burnout, mental distress and emotional labour. Lack of support and resources from organizations could negatively impact nurses' ability to maintain resilience and manage workplace challenges through internal self-regulatory processes. A resilience programme improved mental health nurses' awareness of personal resilience levels, self-confidence, capacity to develop coping skills and professional relationships. Some studies continue to lack contemporary conceptualizations of resilience, and methodological quality varied from high to low. Further qualitative and interventional research is needed to investigate the role of resilience in mental health nursing practice, personal well-being, workforce sustainability and the ongoing impacts of the COVID-19 pandemic.

Students are at risk? Elucidating the impact of health risks of COVID-19 on emotional exhaustion and academic performance: role of mindfulness and online interaction quality

Although previous online learning studies have looked at how student outcomes are influenced in different settings, this study is unique in that it looks at the role of COVID-19 as a particular stressor. This study discussed how students' perceptions of health risks of COVID-19 (PHRC) influenced their academic performance through emotional exhaustion. This study also looked at how mindfulness and online interaction quality (OIQ) affected PHRC's direct effects on exhaustion, as well as PHRC's indirect effects on academic performance via exhaustion. The data for the current study were collected from 336 students in three waves who were studying online during COVID-19. The results through structural equation modeling (SEM) revealed that PHRC influenced academic performance. The results further revealed that mindfulness and OIQ attenuated the direct effects of PHRC on emotional exhaustion as well as indirect effects on academic performance through emotional exhaustion. This study provides some novel implications for practice and research.

The mediating and moderating role of psychological resilience between occupational stress and mental health of psychiatric nurses: a multicenter cross-sectional study

BACKGROUND

The particular occupational stress of psychiatric nurses has a negative impact on their mental health. There is evidence that psychological resilience can promote mental health; however, the relationship between resilience in occupational stress and mental health of psychiatric nurses is unclear, and mental health was assessed from a psychopathological perspective, neglecting the role of positive psychology. Therefore, this study was based on a dual-factor model of mental health, describing mental health in terms of both positive well-being and psychiatric symptoms. We aimed to investigate the level of psychiatric nurses' mental health and whether resilience plays a mediating or moderating role between occupational stress and mental health in psychiatry nurses.

METHODS

A cross sectional survey of 450 psychiatric nurses in five hospitals in Jiangsu Province was conducted using a convenience sampling method, of which 413 were valid questionnaires with an effective rate of 91.8%. The evaluation included the Chinese Nurses' Stress Scale, the Connor-Davidson Resilience Scale, the Warwick-Edinburgh Mental Well-being Scale, and the General Health Questionnaire. Descriptive and Spearman correlation analyses were performed using SPSS25.0 while mediating and moderating effects were performed using SmartPLS3.0.

RESULTS

Based on a dual-factor model of mental health, this study found that psychiatric nurses had a low general state of mental health, with 54.5% positive mental health, 7% vulnerable, 21.8% symptomatic but content, and 16.7% completely troubled. In addition, we found that resilience plays a mediating role in stress and mental health [β = -0.230, 95% CI of (-0.310, -0.150)] and does not play a moderating role [β = -0.018, 95%CI (-0.091, 0.055)].

CONCLUSIONS

Psychiatric nurses are in a poor state of mental health, and psychological resilience partly mediates occupational stress and mental health. This study suggests that attention should be paid to both positive and negative aspects of psychiatric nurses' mental health, and strategies should be developed to reduce occupational stress and develop psychological resilience.

Mental health nurses' resilience in the context of emotional labour: An interpretive qualitative study

Strengthening mental health nurses' (MHNs) resilience may help mitigate the negative effects of the emotional labour (EL) of their work. There is no prior evidence on MHNs' experiences of resilience in the context of EL. This interpretive qualitative study sought to explore how MHNs build and maintain their resilience in the face of high levels of EL. Semi-structured interviews were conducted with 11 MHNs. Reflexive thematic analysis was used to analyse the data. Four main themes were constructed. The first three; Being attuned to self and others, Having a positive mindset grounded in purpose, and Maintaining psychological equilibrium through proactive self-care, describe how MHNs build and maintain their resilience. The fourth theme, Running on emotionally empty, describes what impedes MHNs' resilience. MHNs engaged in internal self-regulatory processes to manage their mental and emotional state. They maintained intra- and inter-personal boundaries and proactively used self-care strategies to maintain their well-being. Through this, they were able to replenish and sustain the energy required to maintain a state of equilibrium between themselves, their interpersonal practice, and their working environment, and to positively adapt to EL. However, lack of organizational support and high workplace demands can negatively impact MHNs' equilibrium and adaptive ability. There is a need for organizations to proactively work to reduce workplace stressors, and support MHNs' professional well-being and practice. Education and support strategies focused on strengthening MHNs' resilience, well-being, and mental health practice capabilities, including the provision of clinical supervision, and clear role expectations within MHNs' scope of practice are recommended.

A scoping review and evaluation of instruments used to measure resilience among post-secondary students

As mental health problems continue to increase among post-secondary populations, the need to develop effective initiatives designed to bolster students' resilience has increasingly been identified as a priority. Therefore, access to valid tools with which to measure the efficacy of these interventions is imperative. To date, a comprehensive assessment of existing instruments used to evaluate the construct of resilience among post-secondary student populations has not been conducted. The purpose of this study was to fill this gap by conducting a scoping review of literature detailing the use of resilience instruments and evaluating their quality based on suitability for use in the post-secondary setting and associated psychometric evidence. We identified a total of 78 records published between 2010 and 2022, extracting a total of 12 instruments. Using detailed criteria frameworks, each instrument was assessed in terms of suitability and quality of associated psychometric evidence for validity and reliability. The results of our study suggest that many of the instruments currently being used to assess resilience among post-secondary students may not be appropriate. The majority of the instruments included in our review were developed for use among general adult populations and not specifically designed for use in the post-secondary setting. Most instruments did not assess resilience in a comprehensive, holistic matter that addressed the ability to bounce back from adversity by drawing upon psychological, social, cultural, and environmental resources, as defined by recent research. Further, no instruments included in our review had published evidence in support of a complete psychometric analysis. The results of our evaluation suggest that the Connor-Davidson Resilience Scale (CD-RISC) is the most suitable instrument for measuring resilience among post-secondary populations due to its suitability, comprehensive assessment of the construct of resilience, and demonstrably strong psychometric properties for both the 25- and 10-item versions of the tool.

The impact of social support and stress on academic burnout among medical students in online learning: The mediating role of resilience

Background

As the COVID-19 pandemic continues, online learning and long-term isolation from social and clinical settings has exacerbated mental health problems and symptoms of academic burnout among medical students. However, few studies have discussed symptoms of academic burnout as a result of reduced social support, and increased stress among medical students during the process of online learning. To fill this gap, this study investigated the influencing factors and mechanism of academic burnout in medical students' online learning process. Both the positive inhibition effect of positive factors such as social support, and the negative aggravation effect of negative factors such as stress were explored, while the mediating and protecting role of resilience is also discussed.

Method

We collected survey data from a total of 817 medical students from a medical school in China who participated in online learning during the fall 2021 semester. An online questionnaire was sent to the students in January, 2022. Items adapted from the DASS Scale developed by Lovibond and Lovibond were used to measure medical students' stress levels. The perceived social support of medical students was assessed by the Gregory MSPSS. Resilience was evaluated by the 10-Item Connor–Davidson Resilience Scale (CD-RISC). Items from the Maslach Burnout Inventory–Student Survey (MBI-SS) were used to calculate students' academic burnout. Descriptive analysis, correlation analysis, hierarchical linear regression analysis and structural equation modeling were used to analyze the collected data.

Results

The results identified that in the context of online learning there was a positive correlation between medical students' stress and academic burnout, and their resilience played a partial mediating role. However, social support did not directly affect academic burnout, but inhibited the prevalence of academic burnout through resilience. In addition, stress was negatively related to resilience, while social support was positively related to resilience. Resilience was found to be negatively related to medical students' academic burnout in online learning.

Conclusion

The results of this study can provide a reference for the future development of appropriate educational strategies and coping measures to ameliorate the academic burnout of medical students.

Role and Function of the Clinical Tutor in Mental Health Nursing in Ireland

The clinical tutor (CT) in mental health nursing is a role aimed at supporting the learning needs of mental health nursing students undertaking a 12-month post-registration programme. This paper aims to examine the role of the clinical tutor in mental health nursing in Ireland by describing the experience of nursing students and key service stakeholders. A qualitative descriptive design was employed using focus group discussions and semi-structured interviews. Two focus groups were conducted with 14 nursing students in the final week of their one-year programme. Semi-structured interviews were undertaken with seven service stakeholders and service leaders. Participants reported positive experiences of working with the clinical tutor and valued the role in terms of educational and pastoral support. Participants suggested the role strengthened the link between theory and practice and enhanced the relationship between the higher education institute and clinical sites. However, a lack of clarity existed in terms of role description. Participants suggested the CT role enhanced the link between the university and clinical areas providing benefits to both student and service stakeholders. Implementing similar roles may benefit post-registration mental health nursing students in other jurisdictions. Further investigation on how the role operates from the perspective of those in the post may provide more clarity and enhance the development of such roles in the future.

A comprehensive evaluation of factors affecting nurse leaders' work-related well-being

PURPOSE

This study aims to describe nurse leaders' experiences of work-related well-being and its association with background variables, working conditions, work engagement, sense of coherence and burnout.

DESIGN/METHODOLOGY/APPROACH

An electronic survey design was used. Data was collected between December 2015 and May 2016 with an instrument that included demographic questions and four internationally validated scales: the Utrecht Work Engagement Scale, QPS Nordic 34+, the shortened Sense of Coherence scale and the Maslach Burnout Inventory. Data was analysed using statistical methods.

FINDINGS

A total of 155 nurse leaders completed the questionnaire, giving a 44% response rate. Most of them worked as nurse managers (89%). Participants' work-related well-being scores ranged from 8 to 10. Statistically significant relationships were found between participants' work-related well-being and their leadership skills, current position, sense of coherence and levels of burnout. In addition, there were statistically significant relationships between work-related well-being and all dimensions of working conditions.

ORIGINALITY/VALUE

This study underlines the fact that work-related well-being should not be evaluated based on a single factor. The participants' perceived work-related well-being was high, although almost half of them reported always or often experiencing stress. The results suggest that nurse leaders may have resources such as good leadership and problem-solving skills, supportive working conditions and a high sense of coherence that prevent the experienced stress from adversely affecting their work-related well-being.

An Italian Adaptation of the Burnout Assessment Tool-Core Symptoms (BAT-C) for Students

Burnout is psychological, physical, and emotional suffering that may affect students with low or inadequate resources to face stressful events at school. Although the existing instruments are used worldwide to assess school burnout risk, they show several flaws and mainly focus on the emotional facets of the syndrome. No previous studies have developed a multi-component tool to reveal students’ burnout by simultaneously analyzing cognitive, behavioral, and emotional problems. The central core of the current study is to adapt the Burnout Assessment Tool-Core symptoms (BAT-C; Schaufeli et al., 2020), comprising four subscales, exhaustion, mental distance, cognitive impairment, and emotional impairment, for a sample of Italian students. The factor structure, the reliability, and the validity of the scale are investigated. The participants are 745 middle school students (male, 52.2%; aged 9–13, M = 11.84, and SD = 1.21). Confirmatory factor analyses confirmed the best fit of the second-order model (four first-order factors and one second-order factor). Specifically, four factors were loaded onto a main high-order factor, which constitutes the BAT-C. Our findings support the Italian adaptation of the BAT-C for students’ samples as a valid instrument for measuring the core symptoms of school burnout.

Polish medical students facing the pandemic-Assessment of resilience, well-being and burnout in the COVID-19 era

INTRODUCTION

Recent reports indicate that COVID-19 pandemic has significant influence on medical professionals' mental health. Strict limitations in clinical practice and social interactions within academic community, which had to be introduced, could lead to significant psychological distress in medical students. The aim of the study was to assess resilience, well-being and burnout among Polish medical students in the COVID-19 era.

METHODS

The online survey consisting of validated questionnaires assessing resilience (Resilience Scale 14; RS-14), well-being (Medical Student Well-Being Index) and burnout (Maslach Burnout Inventory) as well as self-created survey concerning mental health problems, use of stimulants, SARS-CoV-2 infection, work in COVID-19 units, medical education and social attitude towards health care professionals in the pandemic era was distributed via Facebook and other online students' platforms. 1858 MSs from all polish medical schools agreed to fill in the survey.

RESULTS

'Very low', 'low' and 'on the low end' levels of resilience were found in 26%, 19.1% and 26.9% of the study group, respectively. Students with higher resilience level presented better attitude towards online and hybrid classes. 16.8% of respondents stated that they worked, currently work or plan to work voluntarily at the pandemic frontline. In terms of burnout, these respondents presented lower exhaustion (p = 0.003) and cynicism (p = 0.02), and higher academic efficacy (p = 0.002). That group also showed greater resilience (p = 0.046). The SARS-CoV-2 infection among respondents, their relatives and friends did not influence the results. 39.1% of respondents declared the need of the psychological or psychiatric consultation in relation to pandemic challenges. 231 (26.4%) participants previously diagnosed with mental health disorders noticed worsening of their symptoms. Increased intake of alcohol, cigarettes or other stimulants was noticed by 340 (28.6%) respondents. 80.2% of respondents thought that social aversion and mistrust towards doctors increased during the pandemic and part of them claimed it affected their enthusiasm toward medical career.

CONCLUSIONS

The majority of medical students presented low levels of resilience and high burnout at the time of pandemic. Providing necessary support especially in terms of mental health and building up the resilience of this vulnerable group seems crucial to minimize harm of current pandemic and similar future challenges.

Anxiolytic and Antidepressant Use and Burnout: Optimism as a Mediator in Spanish Nurses

The aim of this study was to analyze the relationship between burnout, the use of drugs (anxiolytics and antidepressants) and optimism in nurses. At the end of 2018, a cross-sectional descriptive study was carried out with a sample of actively employed nurses recruited by snowball sampling. The sample consisted of 1432 nurses in Andalusia (Spain), aged 22–58, who were working at the time of data collection, 83.2% of whom were women. Data were collected anonymously in an ad hoc questionnaire about sociodemographic information and use of anxiolytics and/or antidepressives: the Brief Burnout Questionnaire—Revised for Nurses (CBB-R) and the Life Orientation Test—Revised (LOT-R). Descriptive, mediation and moderation analyses were performed, with significant results having a p-value less than 0.05. The results on burnout showed significant relationships with use of the drugs. In particular, personal impact, job dissatisfaction and motivational abandonment were positively related to use of certain of the anxiolytics and antidepressants presented, while the correlation with the social climate was negative. Furthermore, optimism correlated negatively with drug use. Knowing that optimism can alleviate the repercussions of the use of drugs opens up new lines of research and the possibility of developing programs aimed at promoting a positive disposition in the face of complicated events.

Influence of Digital Competence on Perceived Stress, Burnout and Well-Being Among Students Studying Online During the COVID-19 Lockdown: A 4-Country Perspective

PURPOSE

This paper aims to reveal the influence of digital competence on perceived stress, burnout and well-being among students studying online during the COVID-19 lockdown in the spring of 2020 and to compare this influence on the basis of studies conducted in four countries.

METHODS

An exploratory study was conducted in Poland, Lithuania, Turkey and India using a cross-sectional research design. A total of 1097 respondents took part in the survey. Well-being was measured by the World Health Organization (WHO) Well-being Index, stress was evaluated using a psychological stress measure (PSM-9) instrument, burnout was evaluated using the Copenhagen Burnout inventory, and digital competence was measured by the Digital Competency Profiler (DCP).

RESULTS

The results revealed that social and informational dimensions of digital competencies had a positive influence on dealing with stress or burnout and improved well-being of students studying online during the COVID-19 lockdown. Moreover, the analysis on a country level highlighted that with regard to dealing with stress and burnout, the epistemological dimension of digital competence was the most important for Lithuanians and Indians, the informational dimension for Polish students and the social dimension for Turkish students.

CONCLUSION

The findings support the importance of digital competence on perceived stress, burnout and well-being among students studying online during the COVID-19 lockdown and propose deeper research directions on this phenomenon.

Social Support Mediates the Effect of Burnout on Health in Health Care Professionals

Burnout is characterized by emotional exhaustion and caused by exposure to excessive and prolonged stress related to job conditions. Moreover, burnout is highly prevalent among health care professionals. The aim of this study is, first, to examine the mediating role of social support over the effect of burnout in health care professionals and, second, to explore potential gender differences. A convenience sample of 1,035 health professionals from Ecuador, including 608 physicians and 427 nurses (68% women, with and age M = 40 + 9 years old), was surveyed using the Maslach Burnout Inventory (MBI), Social Support Survey (MOS), and General Health Questionnaire (GHQ-28) as measures of burnout, social support, and general health, respectively. Social support was found to mediate the negative effects of burnout on health regardless of gender. Differences across the three dimensions of burnout and health are further discussed, along with their implications for designing effective burnout interventions for health care professionals in Ecuador.