Stress, depression, and intention to leave among nurses in different medical units: implications for healthcare management/nursing practice

Psychological distress among nurses: Exploring the role of support in the work-place in Morocco

AIM

This study aimed to assess the psychological distress, specifically anxiety and depression, among nurses employed at University Hospital Center of Rabat in Morocco and tested the associations between support in the workplace and nurses' psychological well-being.

METHODS

A cross-sectional observational study was conducted at University Hospital Center of Rabat in Morocco, based on a prospective data collection employing an ad-hoc self-report questionnaire. 223 nurses were enrolled with a minimum of 1 year of practice in any care unit. Socio-demographic and professional characteristics of each participant were included. A validated tool was utilized to measure the support from superiors and colleagues in the workplace, while the Hospital Anxiety and Depression Scale (HADS) was employed to evaluate anxiety and depression. Univariate and multivariate analyses were conducted to explore the relationships between different independent and dependent variables.

RESULTS

Significant socio-demographic and professional factors associated with increased anxiety included female gender, age over 41 years old, Baccalaureate level of education, intention to leave the hospital, and less support from superiors. Regarding the levels of depression, the Baccalaureate level of education was significantly associated with higher levels of depressive symptoms (β 2.444; CI [1.203, 3.686]).

CONCLUSIONS

Our findings suggested that ensuring support from superiors was crucial for safeguarding the psychological well-being of nurses. Therefore, hospital managers should prioritize addressing the workplace support for professionals, and the organizational enhancement.

Between Clicks and Care: Investigating Social Media Addiction and Work Engagement Among Nurses in Saudi Arabia

Background/Objectives: The aim of this study was to investigate the relationship between social media networking addiction (SMNA) and work engagement (WE) among nurses at a government hospital in Jeddah, Saudi Arabia, as well as to assess the overall levels of SMNA and WE within this population. Methods: A quantitative, correlational, cross-sectional design was employed with an online survey instrument, involving 283 nurses from the government hospital. The data were analyzed using SPSS software version 26. Results: Nurses exhibited low levels of SMNA and average levels of WE. A negative relationship was identified between SMNA and WE. Conclusions: The findings indicate that SMNA influences various dimensions of WE differently. A significant negative relationship was observed between SMNA and the dimensions of vigor, absorption, and overall WE. However, SMNA did not significantly impact the dedication dimension, which emerged as the highest-scoring aspect among nursing professionals. Therefore, this study recommends raising awareness among nurses regarding the detrimental impact that excessive social media usage can have on their professional responsibilities and mental health, the implementation of clear social media usage guidelines, regular assessment of the trends in social media usage among nurses and the introduction of educational programs to raise awareness and promote responsible usage.

Determining the impact of mobile-based self-care applications on reducing anxiety in healthcare providers: a systematic review

BACKGROUND

Healthcare providers (HCP) face various stressful conditions in hospitals that result in the development of anxiety disorders. However, due to heavy workloads, they often miss the opportunity for self-care. Any effort to diminish this problem improves the quality of Healthcare providers and enhances patient safety. various applications have been developed to empower Healthcare providers and reduce their anxiety, but these applications do not meet all their individual and professional needs. The objective of this study was to investigate the impact of mobile-based self-care applications on reducing anxiety in healthcare providers.

METHODS

In this study, keywords such as anxiety, self-care, healthcare providers, and mobile health were used to search PubMed, Scopus, and Web of Science for papers published in the recent ten years (2014-2024). We used the PRISMA diagram to report the results. Ten out of 2515 retrieved articles that addressed the effect of mobile-based self-care applications on Healthcare providers' anxiety were included for analysis. Data were extracted using a data collection form designed based on the research objective. We used this form to collect data including the author's name, publication year, country, study type, intervention duration, study objectives, platform used, Modules presented in technologies, Methods of reducing anxiety, questionnaire details, and Effectiveness assessment. Data collected from the studies were analyzed by SPSS-21 using frequency and percentage.

RESULTS

Based on the results, studies were conducted in nine different countries, and the intervention duration and strategies for reducing anxiety using self-care applications ranged from two weeks to four months. The impact of mobile health applications, their content, and intervention strategies on reducing anxiety were positive. The anxiety-reduction strategies were varied among applications. Anxiety reduction strategies in this study included mindfulness, cognitive-behavioral therapy, physical activities, breathing exercises, dietary regimes, and nature exploration through virtual reality. Cognitive-behavioral therapy and mindfulness constituted the most frequently applied reduction techniques across the studies to reduce anxiety in Healthcare providers.Furthermore, the findings revealed the effectiveness of interventions in reducing other mental disorders such as anxiety, stress, depression, drug abuse, and psychotropic drug use of Healthcare providers.

CONCLUSION

The use of mobile health applications with practical strategies is effective in reducing anxiety and can also reduce other anxiety disorders in Healthcare professional.

Students' and Instructors' Perspectives on Learning and Professional Development in the Context of Interprofessional Simulation

Phenomenon: Simulation-enhanced interprofessional education is a potentially valuable pedagogical approach in health professional education. Simulation-enhanced interprofessional education merits more empirical exploration particularly in terms of experiences from different perspectives. Approach: The study aims to provide a multi-perspective in-depth understanding of students' engagement in a simulation-based interprofessional learning environment. Ninety students and thirteen facilitators participated. We analyzed data from examination sheets of medical and nursing students in a simulation-enhanced interprofessional education course and from a facilitator survey, using manifest inductive content analysis. The analysis was informed by actor network theory and Schön's reflection on action model. Findings: Students reflected on their performance in relation to (1) personal attributes, such as systemization skills; (2) other team members, such as communication skills; and (3) the surrounding environment, such as efficient employment of resources. They also reflected on the consequences of their actions and future professional growth. We observed group differences in conceptualizations of performance and knowledge enactment. Facilitators' and students' perceptions of performance were mostly aligned. Leadership enactment in the learning environment was problematic for students as well as facilitators. Insights: Students' engagement in the learning environment helped them develop a prototype of their professional identity and explore potential domains or tools for further learning and professional growth. Features of the learning environment fostered teamwork skills and allowed students to learn from each other, thus improving performance. Our findings have several implications for education, and professional practice, including the need for meticulous planning of learning environments and the importance of more intensive pedagogical efforts for soon-to-be health professionals regarding workplace dynamics and potential conflicts. It is also important to consider that an interactive learning environment can invoke reflection on action not only among students but also among facilitators and that this can contribute to the development of clinical praxis.

Differential Relationships Between Work-Life Interface Constructs and Intention to Stay in or Leave the Profession: Evidence From Midwives in Canada

This paper investigates how positive and negative work-personal life interface constructs are differentially associated with intentions to stay in or leave the profession. The findings help map work-personal life interface constructs on the typology of determinants of intention to stay and intention to leave (disengagers, retainers, criticals, and neutrals). The ordered logistic regression (ologit) modelling of cross-sectional data from a representative sample (n = 601) of midwives in Canada shows that work interference with personal life is a disengager, which has a stronger association with intention to leave than with intention to stay in the profession. Among the work-personal life interface constructs, work enhancement of personal life seems to be the most critical determinant, showing the most substantive association with both intention to stay and intention to leave. This finding suggests that interventions to increase midwives' intention to stay and decrease their intention to leave should focus on amplifying the enhancing effects of working on midwives' personal lives. Interventions that aim to reduce work interference with personal life might be more effective in decreasing intention to leave the profession than increasing intention to stay.

Factors that contribute to turnover and retention amongst emergency department nurses: A scoping review

BACKGROUND

Internationally, the emergency nursing workforce shortage is of critical concern.

AIM

To synthesise the evidence and assess the scope of literature regarding factors that contribute to turnover and retention amongst emergency nurses.

METHOD

A scoping review using the Joanna Briggs Institute approach was undertaken. Fivedatabases (Embase, MEDLINE, PsycINFO, CINAHL, and Business Source Complete) were searched for papers published in English between January 2011 and June 2023 where the population was nurses, context was the emergency department, and the concept was turnover or retention. A quality appraisal was performed on included studies.

RESULTS

A total of 31 articles met the inclusion criteria. Twenty-six studies focussed on turnover and five studies focussed on retention. Factors that contribute to ED nursing turnover included workplace violence, personal aspects (e.g., burnout or depression), organisational characteristics, and environmental/ job characteristics. Factors that contributed to ED nursing retention included mentoring programs, the advancement in nursing skills, and the transition to practice speciality (emergency) programs.

CONCLUSIONS

A large body of literature exists regarding ED nurses' reasons for leaving their area of practice, yet limited evidence exist on retention. Research exploring factors that promote retention of emergency nurses that leads to subsequent stability and growth in the emergency nursing workforce is needed.

Cardiovascular nurses and organizational well-being: a systematic review

AIMS

This systematic review assesses the organizational well-being of nurses working in cardiovascular settings and identifies environmental variables influencing it.

METHODS AND RESULTS

The Joanna Briggs Institute's methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines have been followed. The search was conducted, from the database inception up to and including 1 December 2022, on Medline (via PubMed), Cumulative Index of Nursing and Allied Health, Cochrane Library, and Scopus. Critical appraisal and data extraction were conducted using standardized tools. Six articles of high quality were included. These mostly concerned cross-sectional studies, conducted in heterogeneous contexts, which highlight the peculiarity of the cardiovascular nursing setting. Three thematic areas were identified: stressors of cardiovascular settings; outcomes of stressors on nurses; and coping strategies used by cardiovascular nurses to deal with such stress factors. Identified stress factors included a lack of autonomy, conflicts between professional and family roles, high workloads, and stressful relationships with patients and caregivers. These organizational variables could generate nurses' burnout, depression, irritability, and/or sleep disorders. In trying to cope with such stressors, cardiovascular nurses used different strategies for compensating, avoiding, escaping, or ignoring the problem, or, in other cases, became somewhat aggressive.

CONCLUSION

Considering the limited data, cardiovascular nursing coping strategies should be further investigated, so that effective pathways for preventing or limiting stress factors can be identified and applied by the organizations. Monitoring and intervening on stress factors in this care setting could improve cardiovascular nurses' organizational well-being and accordingly patients' outcomes.

REGISTRATION

PROSPERO: CRD42022355669.

Psychopathological Burden among Healthcare Workers during the COVID-19 Pandemic Compared to the Pre-Pandemic Period

This retrospective observational study on hospital staff requesting an "application visit" (from 2017 to 2022) at the Occupational Medicine department aimed at comparing a "pre-COVID group" (2017-2019) with a "COVID group" (2020-2022) regarding (a) sociodemographic data (i.e., age, sex, occupation, years of employment at the hospital), (b) rate and type of psychiatric diagnoses in both groups and rate of psychiatric diagnoses per subject, and (c) rate of drug/psychotherapeutic prescriptions. Two hundred and five healthcare workers (F = 73.7%; mean age = 50.7 ± 10.33) were visited. Compared with the pre-COVID group, healthcare workers evaluated during COVID-19 were significantly younger and reported fewer years of employment at the hospital. Although rates of primary psychiatric diagnoses were similar in both samples, an increased number of psychopathologies per subject and associated treatment prescriptions in the COVID group was observed. In the COVID group, 61% had one psychiatric diagnosis, and 28% had 2+ psychiatric diagnoses, compared with 83.8% and 6.7% of pre-COVID. Furthermore, 56.2%/1.9% in pre-COVID and 73%/6% in the COVID group were prescribed drugs/psychotherapy, respectively. The findings of the present study highlighted an increase in both younger workers' requests and psychiatric comorbidities during the pandemic, representing a burden on the Italian healthcare system. It is thus relevant to address the mental health challenges of healthcare workers accordingly.

Mediating effects of social support, mental health between stress overload, fatigue and turnover intention among operating theatre nurses

BACKGROUND

The high rate of nurses turnover and nursing staff shortage have been an ongoing concern issue and a challenge for global health systems. To explore the turnover intention among operating theatre nurses, and to test the hypothetical model for estimating the effects of stress overload and fatigue between social support, mental health and turnover intention.

DESIGN

a multi-center and cross-sectional online survey.

METHODS

This study was conducted from October 2020 to March 2021 comprised 1060 operating theatre nurses from 76 Chinese hospitals. The descriptive analysis, independent sample t test and one-way analysis of variance and Spearman correlation analysis were used to explore the relationships among variables by the SPSS software, and stepwise multiple linear regression analysis was utilized to identify influencing factors of turnover intention and its dimensions among operating theatre nurses. A structural equation model was analyzed by the AMOS software.

RESULTS

Social support, mental health, stress overload and fatigue were important predictors of turnover intention among operating theatre nurses. Besides, stress overload positively affected fatigue, mental health and turnover intention; fatigue negatively affected social support, however, fatigue positively affected mental health; social support negatively affected mental health and turnover intention; mental health positively affected turnover intention. Moreover, social support, mental health mediated between stress overload, fatigue and turnover intention among operating theatre nurses.

CONCLUSION

Social support, mental health mediated between stress overload, fatigue and turnover intention among operating theatre nurses.

Does workplace violence affect healthcare workers' turnover intention?

AIMS

This study aimed to explore the association between workplace violence and turnover intention among Chinese healthcare workers and explore the role of gender as a moderator in this relation.

METHODS

A cross-sectional survey recruited 692 healthcare workers from a single center in a Chinese province. The content included a questionnaire regarding workplace violence, authoritarian leadership, and turnover intention. The moderated mediation effects were analyzed using the PROCESS tool in SPSS and bootstrap method was used to extract 5000 samples to estimate the 95% confidence interval of each effect.

RESULTS

The results indicated that the effect of workplace violence on turnover intention was mediated by authoritarian leadership. In addition, gender moderated the association between authoritarian leadership and turnover intention.

CONCLUSIONS

Healthcare worker managers should establish a workplace violence intervention system and change the leadership style of direct leaders to reduce healthcare workers' turnover intention.

Nurses´ Performance: The Importance of Personal Resources for Coping with Stressors

The health crisis caused by the COVID-19 pandemic has negatively influenced the work of health staff, especially nurses. Stressors that affect nurses have been intensified and new stressors have also emerged, threatening their well-being and job performance. The main objective of this study is to analyze the role of nurses´ personal resources in the relationship between job stressors and job performance during the COVID-19. Sample is composed of 438 nurses from 39 Spanish cities. This is a cross-sectional study. The results confirm the full mediation of resilience in the relationship between stressors and job performance, and the moderation of self-efficacy in the relationship between resilience and job performance, and in the full mediation. This study highlight the role played by self-efficacy as the main personal resource in buffering the effect of stressors on nurses´ performance. Resilience only becomes crucial in individuals with low levels of self-efficacy beliefs. Managers of health institutions and hospitals are invited to invest resources in strengthening the personal resources of health staff, especially self-efficacy beliefs, and resilience to ensure that their performance remains adequate.

The influence of personality on psychological safety, the presence of stress and chosen professional roles in the healthcare environment

Healthcare teams are expected to deliver high quality and safe clinical care, a goal facilitated by an environment of psychological safety. We hypothesised that an individual's personality would influence psychological safety, perceived stressors in the clinical environment and confer a suitability for different professional roles. Staff members were recruited from the Emergency or Critical Care Departments of one National Health Service Trust. Qualitative interviews explored participants' experiences of personality, incorporating quantitative surveys to evaluate psychological safety and perceived stressors. The 16 Primary Factor Assessment provided a quantitative measure of personality. Participants demonstrated midrange scores for most personality traits, highlighting an ability to adapt to changing environments and requirements. There was a signal that different personality traits predominated between the two professional groups, and that certain traits were significantly associated with higher psychological safety and certain perceived stressors. Personality was described as having a strong influence on teamwork, the working environment and leadership ability. Our analysis highlights that personality can influence team dynamics and the suitability of individuals for certain clinical roles. Understanding the heterogeneity of personalities of team members and their likely responses to challenge may help leaders to support staff in times of challenge and improve team cohesiveness.

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

PURPOSE

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

DESIGN

The research was descriptive and cross-sectional types.

METHODS

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

FINDINGS

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

CONCLUSION

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

Explaining Novice Nurses’ Experience of Weak Professional Confidence: A Qualitative Study

Introduction

The majority of newly graduated nurses are not prepared to work at the bedside; therefore, they may not have the appropriate self-confidence.

Objective(s)

The present qualitative study aimed to explain the novice nurses’ experience of weak professional confidence.

Design

This qualitative study was performed using a content analysis method.

Methods

Content analysis was utilized to identify themes from interview transcripts. They were included in the study by purposeful sampling. Participants were interviewed through face-to-face and unstructured interviews. All data were recorded, transcribed, and analyzed based on the Graneheim and Lundman method.

Results

Thirteen nurses participated in interviews. After data collection, all interviews were implemented and reviewed and the categories and subcategories were extracted. Three main categories containing turbulence in working life, unpleasant interactions, and lack of knowledge were extracted.

Conclusion

According to the study findings, most novice nurses experienced turbulence in their working life, unpleasant interactions, and a lack of knowledge that affected their self-confidence. Therefore, educational and support programs are suggested to improve novice nurses’ professional confidence.

Relevance to Clinical Practice

According to the results of the study, the lack of self-confidence in novice nurses reduces the quality of care. Therefore, taking into account the experiences of the participants, nursing education managers should plan in such a way as to improve the self-confidence of the graduates. In addition, novice nurses need to be supported by their managers and colleagues to develop their professional confidence to provide more effective care.

How workplace violence correlates turnover intention among Chinese health care workers in COVID-19 context: The mediating role of perceived social support and mental health

AIM

To elucidate the effects of workplace violence on turnover intention among Chinese health care workers, and to identify the potential mediators in this relationship.

BACKGROUND

Workplace violence has emerged as a crucial determinant of turnover intention for health care workers.

METHODS

A cross-sectional survey was conducted among Chinese health care workers (N = 1,063) between 13 and 20 February 2020. Mediation effects were tested using structural equation modelling with weighted least squares mean and variance adjusted (WLSMV) estimator.

RESULTS

Workplace violence had both direct and indirect effects on turnover intention among Chinese health care workers. Specifically, perceived social support, mental health and perceived social support together with mental health partially mediated the relationship between workplace violence and turnover intention.

CONCLUSIONS

Chinese health care workers experiencing violence during the COVID-19 outbreak were more likely to report turnover intention. Enhancing social support and reducing mental health problems would be beneficial in decreasing the detrimental effects of workplace violence on turnover intention.

IMPLICATIONS FOR NURSING MANAGEMENT

Ensuring health care workers' health and safety is vital in reducing turnover intention, which in turn ascertains continuity of health care delivery. Health care managers should develop targeted interventions to improve social support and prevent post-violence mental health problems.

Experiences, Perceptions, and Coping Patterns of Emergency Department Nurses with Occupational Stressors in Saudi Arabian Hospitals: Mixed-Method Study

Extended working hours, a complicated workplace environment, and engagement in numerous physical and psychological stressors have been associated with the stressful nature of the nursing profession. Only a few studies have provided some insight into workplace stress and coping strategies adopted by nurses in Saudi Arabia and neighboring countries. Therefore, this study utilized a mixed-method design to explore the numerous factors that lead to stress among emergency nurses, their experience and perception of stress, and the coping mechanisms they find useful. A survey containing four domains and 86 items was adapted, pilot tested, and validated. The quantitative phase recruited 296 nurses who returned completed questionnaires, and then 21 nurses were interviewed for the qualitative phase. In total, 89.5% (n = 265) of the participants were female, 51% (n = 151) were aged 20–29 years, 83% (n = 246) were non-Saudi nationals, 49% (n = 145) were married, and 82% (n = 245) had a bachelor’s degree. The most common causes of occupational stress were work overload, personnel shortages, and inadequate pay. The qualitative phase data revealed five primary themes, including increased workload, rising living costs despite equal compensation, and staff shortages as main stressors. In addition, the study found that praying and spending quality time with friends are the primary coping techniques among nurses. The study results contribute to a better understanding of nurses’ working conditions in the emergency department. Additionally, they may contribute to the development of policies and practice reforms to improve Saudi nurses’ well-being, health, and overall work experience.

Effects of a Mindfulness Intervention Comprising an App, Web-Based Workshops, and a Workbook on Perceived Stress Among Nurses and Nursing Trainees: Protocol for a Randomized Controlled Trial

Background

Previous research has found digitally supported mindfulness interventions to be effective when used for stress management among workers in high-stress occupations. Findings on digitally supported mindfulness interventions among nurses working in acute inpatient care settings are heterogeneous, lack long-term follow-up, and do not assess adherence and acceptability.

Objective

This study aimed to investigate the effectiveness and efficacy of a digitally supported mindfulness intervention designed to improve health- and work-related outcomes among nurses and nursing trainees working in acute inpatient care settings.

Methods

We will conduct a multicenter randomized controlled trial using a wait-list control group design. Randomization will be stratified by hospital and job status (nurse or nursing trainee). Recruitment will take place on the web and offline during the working hours of nurses and nursing trainees. The intervention group will receive a digitally supported mindfulness intervention, which will comprise an app, 2 web-based workshops, and a workbook, whereas the wait-list control group will be scheduled to receive the same intervention 14 weeks later. The 2 web-based workshops will be led by a certified mindfulness-based stress reduction trainer. Nurses will use the app and the workbook independently. Self-report web-based surveys will be conducted on the web at baseline, at 10 weeks after allocation, at 24 weeks after allocation, and at 38 weeks after allocation. Outcomes of interest will include perceived stress (primary outcome), health- and work-related variables, and variables related to adherence and acceptability of the digitally supported mindfulness intervention. We will perform intention-to-treat and per-protocol analyses.

Results

Data collection will be completed by the beginning of August 2022. Data analyses will be completed by December 2022.

Conclusions

Our study design, including long-term follow-up and the investigation of variables related to adherence and acceptability, will ensure rigorous evaluation of effectiveness and efficacy. Relative to costly in-person intervention efforts, this program may present a cost-effective and potentially highly scalable alternative. Findings regarding effectiveness, efficacy, adherence, and acceptability will inform stakeholders’ decisions regarding the implementation of similar interventions to promote the well-being of nurses and nursing trainees, which may, in turn, alleviate detrimental stress-related outcomes (eg, burnout) because of work-related demands.

Trial Registration

German Clinical Trials Register DRKS00025997; https://tinyurl.com/433cas7u

International Registered Report Identifier (IRRID)

DERR1-10.2196/37195

Evaluation of a Brief Stress Management Workshop for Incoming Nursing Students

The purpose of this study was to evaluate the effectiveness of a brief stress management workshop on nursing students' perceived stress and resilience. Students who received the stress management intervention during orientation had significantly higher resilience scores and lower stress scores 1 year later during COVID-19 than the comparison group.

Impact of Occupational Risks of Medical Staff on Willingness to Occupational Mobility in COVID-19 Pandemic

Purpose

Medical staff are a crucial resource in the battle against the COVID-19 pandemic but are vulnerable to both SARS-CoV-2 infection and negative psychological outcomes. This study evaluated medical staff’s occupational risks, professional identity, and occupational mobility intention during the pandemic.

Patients and Methods

The questionnaire was anonymous. All respondents were Chinese medical personnel.

Results

Our findings suggest that the professional risks faced by medical professionals can enhance their professional mobility willingness and weaken their professional identity. They cannot only directly enhance their professional mobility willingness but also indirectly strengthen their professional mobility willingness through professional identity. The objective support and subjective support obtained by medical professionals cannot only alleviate the negative impact of occupational risk on professional identity alone but also jointly, and in the process of their joint mitigation, the former has been internalized and absorbed, while the latter has a stronger mitigation effect. The objective support and subjective support obtained by medical professionals can neither alone nor jointly alleviate the direct and positive impact of occupational risk on the willingness of occupational mobility.

Conclusion

The occupational risks faced by medical personnel can improve their willingness to move professionally and weaken their occupational identity. Early screening of high-risk groups for turnover intention among health care workers and more psychosocial health care and physical protection are needed during the COVID-19 pandemic in China.

Workplace violence and turnover intention among the Bangladeshi female nurses after a year of pandemic: An exploratory cross-sectional study

During the COVID-19 pandemic, workplace violence was widespread against healthcare personnel. Workplace violence (WPV) against nurses exhilarates their turnover intention (TI). The objective of this study was to investigate the association between workplace violence and turnover intention and also identify other factors associated with TI among Bangladeshi female nurses. An exploratory cross-sectional study was carried out among 881 female nurses between April 26 and July 10, 2021. The TI of the female nurses was the outcome variable of this study. The primary exposure variable was WPV faced by the nurses. Workplace Violence Scale (WPVS) was used to measure the WPV, and Turnover Intention Scale-6 (TIS-6) was used to measure the TI of the nurses. Multiple linear regression model was fitted to find the adjusted association of TI with WPV and other study variables. A stratified analysis by type of job (government vs. private) was also performed. The majority of the nurses (74.46%) faced low to high levels of WPV. The overall mean score of TIS was found 16.33 (± 4.72). Multiple linear regression analysis revealed that compared to government jobholders, the mean score of TIS (15.81 vs. 17.20) was found significantly higher among the private jobholders (p < 0.001). Nurses exposed to the intermediate and high level of WPV had a significantly higher TI score (β = 4.35, 95% CI: 3.36, 5.34) than the non-exposures. The TI of private jobholders was found significantly higher (β = 2.04, 95% CI: 1.09, 3.00) than the government jobholders. Compared to diploma degree holders, significantly higher TI was observed among the B.Sc. degree holders (β = 0.86, 95% CI: 0.22, 1.55) and M.Sc. degree holders (β = 1.46, 95% CI: 0.58, 2.34). Besides, the nurses who did not get timely salaries scored higher TI (β = 1.17, 95% CI: 0.12, 2.22). Moreover, the nurses who did not receive any training against WPV scored significantly higher TI (β = 1.89, 95% CI: 1.03, 2.74). The stratified analysis by type of job also revealed significant factors of TI in government and private settings. This study found a high prevalence of WPV and a high rate of TI among Bangladeshi female nurses. Moreover, this study explored an association between WPV and TI. The study findings could help policymakers facilitate a comfortable working environment by preventing WPV and addressing the factors to reduce nurses' frequent TI.

Sociodemographic Factors and Depressive Symptoms Among Cardiac Nurses: A Cross-Sectional Study

Background: The nursing profession is predisposed toward depressed mood and depressive symptoms. The multidirectionality and intensity of stressors in the nurses' occupational environment are of great significance in this respect. The study aimed to evaluate the impact of selected sociodemographic factors on depressive symptoms among cardiac nurses.

Methods: This cross-sectional study included 336 cardiac nurses (302 women and 34 men) and was conducted between December 2019 and September 2020 in four hospital cardiac units in Wroclaw, Poland. Sociodemographic data were collected using a self-developed survey. The following standardized instruments were used for the study outcomes: Patient Health Questionnaire-9 (PHQ-9) and Beck Depression Inventory (BDI).

Results: The study among cardiac nurses showed mild depression in 11.61%, moderate depression in 5.06%, and severe depression in 2.68%. Linear regression models showed that significant (p < 0.05) predictors of the PHQ-9 score included (1) higher occupational education (bachelor's degree), graduation “only” from medical high school or “other” education; (2) work experience of 16–20 years; (3) living in a relationship; (4) living in a rural area. Linear regression models showed that significant (p < 0.05) predictors of the BDI score included (1) higher occupational education (bachelor's degree); (2) graduation “only” from medical high school or “other” education; (3) living in a relationship.

Conclusions: Depressive symptoms are a significant problem among Polish cardiac nurses. The prevalence of depressive symptoms is affected by the education level, employment form, marital status, and place of residence.

Care for Joy: Evaluation of a Humor Intervention and Its Effects on Stress, Flow Experience, Work Enjoyment, and Meaningfulness of Work

The media increasingly speak of a care crisis. Systematic support is needed to prepare nursing apprentices for the high demands of their profession and to reduce the number of nurses who finally quit. Particularly in stressful jobs like nursing, humor as a coping strategy can have a beneficial effect on perceived stress and overall work enjoyment. In this study, we used a humor intervention among nursing staff in training and evaluated its effects on humor, stress, work enjoyment, the meaningfulness of work, and flow experience. The sample consists of 104 nurses in training. The intervention group received a 3-h humor intervention, while the control group received no intervention. Positive and negative affect were measured immediately before and after the intervention. Humor was measured before the intervention (t₀) and again 6 months later (t₁); at t₁, we again measured humor and also stress, work meaningfulness, work enjoyment, and flow experience. Our analyses showed a beneficial change in positive and negative affect right after the intervention. By means of repeated measures ANOVA we could further confirm an effect of the intervention on reported humor 6 months later. Humor mediated positive effects of the humor intervention on perceived meaningfulness of work, work enjoyment, and on the frequency of flow at work. Also, we found a significant negative relationship between humor and stress measured at t₁. The results of this study confirm the effectiveness of humor interventions in promoting humor, and, through this, the meaningfulness of work, work enjoyment, and the frequency of flow experience. Implications of the use of humor interventions in the nursing profession are discussed.

What influences new graduate nurses' core competencies transformation to clinical in China? A cross-sectional study

BACKGROUND

The core competencies of new graduate nurses (NGNs) have significant health outcomes in the clinical environment. However, these nurses experience a theory-practice gap, which creates a barrier in the transition process when they first enter the clinical workplace.

OBJECTIVE

To understand the general overview of the transition of the core competencies of NGNs to clinical practice in China and the influencing factors.

DESIGN AND SETTING

A cross-sectional study design consisting of a multi-stratified grounded random sample from 31 hospitals in seven regions nationwide.

PARTICIPANTS

2400 NGNs were recruited by email.

METHODS

The Competencies Inventory for Registered Nurse (CIRN) was applied to evaluate NGNs' core competencies.

RESULTS

NGNs performed best on leadership and worst on critical thinking or research aptitude. Core competencies were predicted by depressive symptoms, worked for two-three years, having a nurse-in-charge title, professional values, department, happiness, etc. Besides, the preceptor program also has significant to core competencies.

CONCLUSION

The average level of Chinese NGNs' core competencies was at a moderate level, which wasn't well optimized. It is recommended to adopt appropriate interventions to support NGNs. With an increase in work years and the accumulation of more work experience, the corresponding core competencies of NGNs will also improve. Preceptor institutions, limiting first-degree recruitment, and early ICU or operating room department rotations can be carried out by nursing educators to improve core competencies.

A meta-analysis on predictors of turnover intention of hospital nurses in South Korea (2000-2020)

Aims

To identify the predictors of Registered Nurses’ turnover intention and analyse the effect sizes.

Design

A systematic review and meta‐analysis of previous research, conducted to comprehensively identify the predictors of turnover intention.

Methods

In total, 417 studies from 1 January 2000 to 30 April 2020 that investigated predictors of turnover intention of South Korean nurses were reviewed. The data were analysed using the R statistical package. Network graphs were used to analyse the relationships among turnover predictors, and meta‐analysis was performed to determine the effect sizes of the correlations.

Results

This review analysed common predictors identified in previous studies. Burnout (0.541), emotional exhaustion (0.511), job stress (0.390) and career plateau (0.386) showed positive effect sizes, while organizational commitment (−0.540), person−organizational fit (−0.521), career commitment (−0.508), work engagement (−0.503), job satisfaction (−0.491) and job embeddedness (−0.483) showed negative effect sizes.

Workplace Interventions in Response to COVID-19: an Occupational Health Psychology Perspective

The outbreak of COVID-19 has imposed significant threats to individuals' physical health and has substantially changed the socioeconomic order and the nature of our work and life all over the world. To guide organizations to design effective workplace interventions to mitigate the negative impacts of COVID-19, we take the occupational health psychology (OHP) perspective to propose a framework that highlights important areas for organizations to intervene in order to better protect workers' physical health and safety and to promote workers' psychological well-being. Specifically, we integrate the prevention-based public health model with the Total Worker Health (TWH) and OHP-based approaches to propose a comprehensive set of primary, secondary, and tertiary interventions that target different groups of employees with varied exposure risks to the new coronavirus. We believe these proposed interventions can contribute positively to the development of healthy and safe work. Implications of these proposed interventions for workers, organizations, and policy makers are also discussed.

Does an alignment of employment policies and individual preferences affect intention to stay in the profession? Evidence from Canadian Midwives

BACKGROUND

This study examines whether alignment of actual and preferred employment policies, including compensation method, employment status, and work schedule, affect midwives' intention to stay in the profession. The study further investigates the moderating effect of financial-rewards satisfaction and compares midwives' policy preferences in urban/rural practices.

METHODS

Cross-sectional survey data from 549 midwives across Canada were analysed through descriptive statistics, bivariate correlations, and hierarchical linear regressions. Further regression analysis separated data for urban/rural practicing midwives.

RESULTS

Three-quarters of the respondents are paid through a billable-course-of-care, while only one-third prefer this model. Another one-third prefer a combination of salary and billable-course-of-care. More than three-quarters of the respondents are independent contractors, but half prefer other forms of employee status. Lastly, half prefer a part-time work schedule, while others prefer full-time. Alignment of actual and preferred employment policies significantly explains midwives' intention to stay in the profession. Intentions to stay in the profession for urban midwives is significantly affected by the alignment of actual and preferred compensation methods, but not for rural ones. Both urban and rural midwives report similar preferences for employment status and work schedule policies. Furthermore, satisfaction with financial rewards is significantly associated with their intention to stay.

CONCLUSION

Policymakers can positively influence midwives' intention to stay in the profession by facilitating alignment of their actual and preferred employment policies.

The Psychological Impact of COVID-19 Outbreak on Nurses Working in the Northwest of Amhara Regional State Referral Hospitals, Northwest Ethiopia

Introduction

The psychosocial consequences of the coronavirus pandemic are serious for health professionals including nurses because of a higher level of exposure. Nurses often face huge psychological pressure as a result of workload, long hours, and working in a high-risk environment. This study aimed to assess the prevalence and associated factors of anxiety, depression, and stress among nurses working in northwest Amhara referral hospitals.

Methods

Institution-based cross-sectional study was conducted from 25th September to 20th October 2020. A total of 302 nurses were selected using a simple random sampling technique. A structured pretested self-administered questionnaire was used to collect data. The data were entered into EpiData version 3 and analyzed using SPSS version 21. A binary logistic regression model was used to compute bivariable and multivariable analyses.

Results

The prevalence of anxiety, depression, and stress among nurses was 69.6%, 55.3%, and 20.5%, respectively. Unavailability of a guideline, fear of infecting family, and having chronic diseases increase the risk of developing anxiety. Nurses who did not have a guideline, received negative feedback from families, had a history of mental disorders, and chronic diseases have a higher odds of depression. Working in the night shift, lack of training, fear of infecting family, negative feedback from families, presence of confirmed/suspected cases in the family, and having chronic diseases increase the risk of developing stress.

Conclusion

More than two-thirds, more than half, and nearly one-fifth of the nurses had anxiety, depression, and stress, respectively. It is better to create awareness for the community, avail a guideline, train nurses, and give special attention to nurses with chronic disease and a history of mental disorders to minimize the psychological impact of the COVID-19 pandemic on nurses and protect their mental health. The government shall develop and implement national programs for occupational health and safety, prevent violence in the workplace, improve psychological well-being, and protect from physical and biological hazards to take care of the mental health of healthcare professionals during this pandemic.

Cognitive Behavioral Therapy for Occupational Stress among the Intensive Care Unit Nurses

Background and Aims:

Nurses working in the intensive care units (ICU) are faced with numerous stressors that can pose a serious threat to their self-efficacy and affect the quality of care. The aim of this study was to evaluate the effectiveness of Cognitive Behavioral Therapy (CBT) on the ICU nurses’ occupational stress.

Methods:

This interventional study was conducted in a hospital in southeast of Iran. The participants included 120 nurses, who were randomly assigned into the control (n = 60) and intervention (n = 60) groups. In the pre-test, the occupational stress was assessed using Osipow questionnaire. Later, the intervention group attended the CBT course conducted in six 90 minute sessions. One month after the intervention, the post-test data were collected from both groups.

Results:

The means of occupational stress and its dimensions were not significant before the intervention between the intervention and control groups (P = 0.47). The means of occupational stress and its dimensions were moderately high at pretest for all nurses. In the post-test, the stress level and all its dimensions reduced from moderate-high to moderate-low (P < 0.001), except for the physical environment dimension that remained at the moderate-high level (P = 0.32).

Conclusion:

The findings showed that CBT was effective on the nursing stress. Therefore, CBT training is suggested in in-service training programs for nurses.

Psychological interventions to foster resilience in healthcare students

BACKGROUND

Resilience can be defined as maintaining or regaining mental health during or after significant adversities such as a potentially traumatising event, challenging life circumstances, a critical life transition or physical illness. Healthcare students, such as medical, nursing, psychology and social work students, are exposed to various study- and work-related stressors, the latter particularly during later phases of health professional education. They are at increased risk of developing symptoms of burnout or mental disorders. This population may benefit from resilience-promoting training programmes.

OBJECTIVES

To assess the effects of interventions to foster resilience in healthcare students, that is, students in training for health professions delivering direct medical care (e.g. medical, nursing, midwifery or paramedic students), and those in training for allied health professions, as distinct from medical care (e.g. psychology, physical therapy or social work students).

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, 11 other databases and three trial registries from 1990 to June 2019. We checked reference lists and contacted researchers in the field. We updated this search in four key databases in June 2020, but we have not yet incorporated these results.

SELECTION CRITERIA

Randomised controlled trials (RCTs) comparing any form of psychological intervention to foster resilience, hardiness or post-traumatic growth versus no intervention, waiting list, usual care, and active or attention control, in adults (18 years and older), who are healthcare students. Primary outcomes were resilience, anxiety, depression, stress or stress perception, and well-being or quality of life. Secondary outcomes were resilience factors.

DATA COLLECTION AND ANALYSIS

Two review authors independently selected studies, extracted data, assessed risks of bias, and rated the certainty of the evidence using the GRADE approach (at post-test only).

MAIN RESULTS

We included 30 RCTs, of which 24 were set in high-income countries and six in (upper- to lower-) middle-income countries. Twenty-two studies focused solely on healthcare students (1315 participants; number randomised not specified for two studies), including both students in health professions delivering direct medical care and those in allied health professions, such as psychology and physical therapy. Half of the studies were conducted in a university or school setting, including nursing/midwifery students or medical students. Eight studies investigated mixed samples (1365 participants), with healthcare students and participants outside of a health professional study field. Participants mainly included women (63.3% to 67.3% in mixed samples) from young adulthood (mean age range, if reported: 19.5 to 26.83 years; 19.35 to 38.14 years in mixed samples). Seventeen of the studies investigated group interventions of high training intensity (11 studies; > 12 hours/sessions), that were delivered face-to-face (17 studies). Of the included studies, eight compared a resilience training based on mindfulness versus unspecific comparators (e.g. wait-list). The studies were funded by different sources (e.g. universities, foundations), or a combination of various sources (four studies). Seven studies did not specify a potential funder, and three studies received no funding support. Risk of bias was high or unclear, with main flaws in performance, detection, attrition and reporting bias domains. At post-intervention, very-low certainty evidence indicated that, compared to controls, healthcare students receiving resilience training may report higher levels of resilience (standardised mean difference (SMD) 0.43, 95% confidence interval (CI) 0.07 to 0.78; 9 studies, 561 participants), lower levels of anxiety (SMD -0.45, 95% CI -0.84 to -0.06; 7 studies, 362 participants), and lower levels of stress or stress perception (SMD -0.28, 95% CI -0.48 to -0.09; 7 studies, 420 participants). Effect sizes varied between small and moderate. There was little or no evidence of any effect of resilience training on depression (SMD -0.20, 95% CI -0.52 to 0.11; 6 studies, 332 participants; very-low certainty evidence) or well-being or quality of life (SMD 0.15, 95% CI -0.14 to 0.43; 4 studies, 251 participants; very-low certainty evidence). Adverse effects were measured in four studies, but data were only reported for three of them. None of the three studies reported any adverse events occurring during the study (very-low certainty of evidence).

AUTHORS' CONCLUSIONS

For healthcare students, there is very-low certainty evidence for the effect of resilience training on resilience, anxiety, and stress or stress perception at post-intervention. The heterogeneous interventions, the paucity of short-, medium- or long-term data, and the geographical distribution restricted to high-income countries limit the generalisability of results. Conclusions should therefore be drawn cautiously. Since the findings suggest positive effects of resilience training for healthcare students with very-low certainty evidence, high-quality replications and improved study designs (e.g. a consensus on the definition of resilience, the assessment of individual stressor exposure, more attention controls, and longer follow-up periods) are clearly needed.

Transition shock and newly graduated nurses' job outcomes and select patient outcomes: A cross-sectional study

AIM

This study examined transition shock experiences in newly graduated nurses as well as its relative influence on job outcomes (job satisfaction, stress and burnout, and intent to leave their organisation) and select patient outcomes (missed care, adverse events and perceived quality of care).

BACKGROUND

Transition shock is a reality common among newly graduated nurses and has been considered an issue relevant to nursing administrators. To date, the mechanism by which transition shock perception is linked with nurse and patient outcomes remains unexplored.

METHODS

A descriptive, cross-sectional design was used. One hundred seventy-six newly graduated nurses (nurses with <1 year of work experience) were included in the study. Data were collected using seven standardized scales.

RESULTS

Hospital classification (e.g., being employed in a government-owned hospital) (β = 0.255; p = .001) predicted transition shock. Overall, newly graduated nurses reported greatest challenges with regard to their expectations of the actual work environment (mean = 2.60, standard deviation = 0.42) and in balancing their professional and personal lives (mean = 2.51, standard deviation = 0.35). Higher levels of reality shock were associated with adverse patient events (β = 0.821; p = .001).

CONCLUSION

New graduates experience great challenges in balancing their professional and personal lives. Ensuring work-life balance and work readiness in newly graduated nurses may potentially reduce the occurrence of missed nursing care and adverse events.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers can adequately support newly graduated nurses' transition through the implementation of empirically based transition programmes. By providing flexible work arrangement, reasonable workload, adequate nurse staffing, limited mandatory overtime and self-scheduling, nurse managers can effectively assist newly graduated nurses in attaining work-life balance.

The Comorbidity of Musculoskeletal Disorders and Depression: Associations with Working Conditions Among Hospital Nurses

Background: Musculoskeletal disorders (MSDs) are the leading cause of pain and disability among nurses and are frequently accompanied by depression. However, the association between the comorbidity of MSDs and depression and working conditions has not been studied, which was the aim of this study. Methods: In 2015, all nurses (n = 1,102) employed at a community hospital in the Northeast United States were invited to participate in this cross-sectional study. A survey was distributed in which participants were asked to report on MSDs, depressive symptoms, as well as subjective working conditions assessed including physical demands, psychological demands, decision authority, social support, and work-family conflict. Findings: 397 nurses responded (36%), and the prevalence of the comorbidity of MSDs and depression was 14.5%. Poisson regression (PR) models suggested that work-family conflict was associated with increased risk of the comorbidity (PR = 2.18; 95% confidence interval [CI] = 1.33-3.58), as was 8-hour night shift (PR = 2.77; 95% CI = [1.22, 6.31]) or 12-hour day shift (PR = 2.20; 95% CI = [1.07, 4.50]). Other working conditions were not directly associated with the comorbidity. Conclusions/Application to Practice: The comorbidity of MSDs and depression is prevalent among hospital nurses, and work-family conflict and working night shift or longer shifts were significantly associated with this. Effective workplace programs are needed to address nurses' working conditions to reduce their work-family conflict, thereby improving their musculoskeletal and mental health.

Mediating effects of self-efficacy, coping, burnout, and social support between job stress and mental health among young Chinese nurses

AIMS

To examine the mediating effects of self-efficacy, coping, burnout, and social support in the link between job stress and depression and anxiety among young Chinese nurses.

DESIGN

A cross-sectional survey was used.

METHODS

Full-time young nurses (N = 1,029) who worked in nine tertiary grade A hospitals in Chengdu China were recruited from December 2016-March 2017. Structural equation modelling was applied to analyse the mediating effects.

RESULTS

Job stress had a direct positive effect on anxiety (β = 0.054) and it also exerted indirect positive effects on depression (β = 0.337) and anxiety (β = 0.325) through mediating factors. Emotional exhaustion and social support were the main mediating variables, accounting for 72.0% of the variation in anxiety and nearly 43.4% in depression.

CONCLUSION

Emotional exhaustion and social support may have significant mediating effects in the link between job stress and depression and anxiety. Strategies including deceasing emotional exhaustion, enhancing social support in work environment, and reducing job stressors would be useful to prevent depression and anxiety among young nurses.

IMPACT

What problems did the study address? Depression and anxiety have great impact on professional performance of nurses and even patient safety. Factors such as coping, burnout, etc., may have different mediating effects in the paths from job stress to depression and anxiety. What were the main findings? Job stress had direct and indirect positive effects on anxiety and it only had indirect positive effect on depression. Emotional exhaustion and social support were the main mediating variables in the link between job stress and depression and anxiety. Where and on whom will the research have impact? Nursing managers should be more cognizant of the impact of job stress on the development of depression and anxiety. The significant mediating effect of emotional exhaustion and social support in the link between job stress and depression and anxiety should be emphasized by nursing administrators and effective targeted measures need to be adopted.

Systemic assessment of depressive symptoms among registered nurses: A new situation-specific theory

BACKGROUND

A mentally-healthy nursing workforce is vital to providing quality healthcare. While there has been research conducted internationally on depressive symptoms in nurses, most studies have lacked a theoretical framework.

PURPOSE

The purpose of this article is to describe the development of a situation-specific theory, the Systemic Assessment of Depressive Symptoms among Registered Nurses (SAD-RN).

METHODS

The SAD-RN was developed through theory synthesis using the Roy's Adaptation Model (RAM) as a framework. Sixty-four research articles were selected to abstract relevant concepts based on a priori RAM concepts.

FINDINGS

Using depressive symptoms as the anchor concept, related emergent concepts of SAD-RN include context, stressors, protective factors, negative health outcomes, and low patient care quality.

DISCUSSION

SAD-RN is an evidence-based comprehensive model that offers researchers a guiding theory to be used in their future research on depressive symptoms among RNs.

A comparative analysis of work-family conflict among staff, managerial, and executive nurses

BACKGROUND

Nurses frequently are caught between the demands of work and family. While studies have explored this issue among staff nurses, none have compared nurse leaders to staff nurses. This study compares work-family conflict (WFC) and family-work conflict (FWC) among staff, managerial, and executive nurses.

METHODS

In this survey design, 20% of registered nurses were randomly sampled across Florida with a 9% response rate. Survey questions included personal, professional, and work environment characteristics and perceptions of WFC/FWC. Analyses of variance tested the differences between- and within-group scores for WFC/FWC for staff, managerial, and executive nurses. Ordinary Least Squares regressions tested the relationships between personal, professional and work environment measures, focusing on the three different nursing roles, and WFC/FWC scores.

FINDINGS

Nurses experienced more WFC than FWC. Staff nurses experienced significantly less WFC than nurse managers and nurse executives (analysis of variance mean difference -0.881 and -2.693, respectively). Nonwhite nurses experienced more WFC and FWC than white nurses. Longer shift length predicted greater WFC. FWC was lower with paid leave for childbirth.

DISCUSSION

Higher WFC among nurse managers and executives may discourage nurses from taking on or staying in leadership roles. Efforts must be taken to decrease WFC/FWC among nurses in these roles.

Negative Mental States and Their Association to the Cognitive Function of Nurses

Abstract. Nurses’ inherently stressful occupation leaves them at a higher risk of developing negative mental states (stress, anxiety, and depression). However, research examining the effect of negative mental states on these health professionals’ cognitive performance is sparse. Thus, the present study aimed to assess the link between negative mental states and cognitive performance in nurses ( n = 53). Negative mental state data was obtained using the Depression Anxiety Stress Scale, brain activity was measured using electroencephalography, and finally, cognitive performance was assessed using the Cognistat and the Mini-Mental State Examination. Significant negative correlations ( p < .05) were observed between anxiety and attention, and all three negative mental states and memory performance. Electroencephalographic changes indicated that increases in anxiety were significantly associated ( p < .05) with decreases in gamma reactivity at fronto-central sites. The current study suggests that higher levels of negative mental states are associated with domain-specific cognitive impairments, and variations in gamma reactivity; possibly reflecting less optimal cortical functioning.

Job insecurity, fear of litigation, and mental health among expatriate nurses

The objective was to assess whether job insecurity and fear of litigation were correlates of depression, anxiety, and stress among expatriate nurses in Saudi Arabia. The participants included 977 expatriate nurses working in Al-Qassim, Saudi Arabia who completed an online survey that assessed depression, anxiety, and stress (using DASS-21) as well as demography, lifestyle, and job characteristics. Mean age was 32 years and 60% of nurses were from India/Pakistan. Twenty-four percent of nurses reported job insecurity, and 18% reported a fear of litigation. Severe depression, anxiety, and stress were significantly higher among nurses who always felt insecure about their job (compared to never) and among those who always feared litigation (compared to never). We concluded that job insecurity and fear of litigation were significant correlates of severe depression, anxiety, and stress among expatriate nurses.

Prevalence and Risk Factors of Depression, Anxiety, and Stress in a Cohort of Australian Nurses

Nurses remain at the forefront of patient care. However, their heavy workload as a career can leave them overworked and stressed. The demanding nature of the occupation exposes nurses to a higher risk of developing negative mental states such as depression, anxiety, and stress. Hence, the current study aimed to assess the prevalence and risk factors of these mental states in a representative sample of Australian nurses. The Depression Anxiety Stress Scale was administered to 102 nurses. Information about demographic and work characteristics were obtained using lifestyle and in-house designed questionnaires. Prevalence rates of depression, anxiety, and stress were found to be 32.4%, 41.2%, and 41.2% respectively. Binominal logistic regressions for depression and stress were significant (p = 0.007, p = 0.009). Job dissatisfaction significantly predicted a higher risk of nurses developing symptoms of depression and stress respectively (p = 0.009, p = 0.011). Poor mental health among nurses may not only be detrimental to the individual but may also hinder professional performance and in turn, the quality of patient care provided. Further research in the area is required to identify support strategies and interventions that may improve the health and wellbeing of nursing professionals and hence the quality of care delivered.

Occupational stress, coping strategies, and psychological-related outcomes of nurses working in psychiatric hospitals

AIMS

Psychiatric nurses experience a wide range of stressful events, evolving from the care of violent, aggressive patients, recurrent relapse, and poor prognosis of mental disorders. The aim of the study was to assess workplace stress, coping strategies, and levels of depression among psychiatric nurses.

METHODS

A descriptive correlation design was conducted on psychiatric nurses working in mental health settings Port-Said, Egypt. Data were collected from 70 nurses at a mental health hospital.

RESULTS

The results revealed that psychiatric nurses had moderate levels of work-related stress and depression, and exhibiting different coping strategies. Stress and depression are prevalent among psychiatric nurses.

CONCLUSIONS

Implementing programs aimed at teaching them how to deal with stress at work and improving their coping strategies and problem-solving skills are recommended.

Risks of treated anxiety, depression, and insomnia among nurses: A nationwide longitudinal cohort study

The high level of occupational stress and burnout among nurses can lead to insomnia, anxiety, and depression. However, the actual risks for healthcare-seeking for these stress-related mental health problems among nurses are still unclear. The aim of this study was to explore the risks and influencing factors of treated anxiety, depression, and insomnia among nurses. We used claims data obtained from the 2010 National Health Insurance Research Database (NHIRD) in Taiwan. Hospital nurses who had at least 3 coded ambulatory care claims or 1 inpatient claim with a principal diagnosis of anxiety, depression, or insomnia were identified. A cohort of 46,120 nurses and 92,240 matched controls were included. All the study subjects were followed up until the onset of any of the aforementioned outcomes, death, or the end of 2012. Results showed that the adjusted hazard ratios (HRs) for treated anxiety, depression, and insomnia among all the nurses were 0.91 (95% CI, 0.88–0.95), 0.59 (95% CI, 0.55–0.63), and 1.43 (95% CI, 1.38–1.48), respectively. Furthermore, the risks of these psychiatric problems in healthcare-seeking nurses were affected by age, gender, hospital level, and job tenure. Our findings suggest that hospital nurses have lower hazards of treated anxiety and depression than the general population, although they have a higher hazard of treated insomnia. There may be undertreatment in some subgroups of nurses with different demographic and working characteristics.

Nurses' Occupational and Medical Risks Factors of Leaving the Profession in Nursing Homes

This study aimed to evaluate the association between intention to leave work, and working conditions and health status among female care-staff in nursing homes. A multicenter cross-sectional study included female care-staff in 105 nursing homes for the elderly. We used validated questionnaires to assess occupational, psychosocial and medical data in a multicenter transverse study. Univariate analysis on chi² test was performed with stratification according to job (nurse, nursing assistant), and variables found to be significant on each dimension were included on multivariate models. 1428 nursing assistants and 342 registered nurses were included. 391 nursing assistants and 85 registered nurses intended to leave their work with the elderly. The registered nurses' intention to leave was associated with deteriorated care-team or residents relations, and with perceived elevated hardship due to the proximity of residents' death. The nursing assistants' intention to leave was associated with deteriorated management relation, with job insecurity and elevated hardship due to the residents' intellectual deterioration. Impaired physical or psychological health status also correlated with this intention. Policy to reduce voluntary turnover of care-staff in nursing homes for the elderly could be based on multifactorial management, acting on work organization and reducing psychosocial stress.

Job burnout and turnover intention among nurses in China: the mediating effects of positive emotion

Objective

The aim of this study was to explore whether positive emotion mediates the relationship between job burnout and turnover intentions among Chinese nurses.

Methods

A cross-sectional survey was conducted in the present study. Full-time registered nurses (n = 150) from Grade A hospitals in Tianjin were surveyed. Pearson correlation, hierarchical regression analyses, and the Sobel test were used in the study.

Results

The results illustrated that positive emotion mediated the relationship between burnout and nurses’ turnover intention.

Conclusions

Nursing administrators should pay more attention to the benefits of positive emotions on working motivation. It is helpful to relieve burnout in the working process so that nurses are willing to remain in their current employment.

From job stress to intention to leave among hospital nurses: A structural equation modelling approach

AIMS

The aim of this study was to examine the structural relationships linking job stress to leaving intentions through job satisfaction, depressed mood and stress adaptation among hospital nurses.

BACKGROUND

High turnover among nurses is a global concern. Structural relationships linking job stress to leaving intentions have not been thoroughly examined.

DESIGN

Two nationwide cross-sectional surveys of full-time hospital staff in 2011 and 2014.

METHODS

The study participants were 26,945 and 19,386 full-time clinical nurses in 2011 and 2014 respectively. Structural equation modelling was used to examine the interrelationships among the study variables based on the hypothesized model. We used cross-validation procedures to ensure the stability and validity of the model in the two samples.

RESULTS

There were five main paths from job stress to intention to leave the hospital. In addition to the direct path, job stress directly affected job satisfaction and depressed mood, which in turn affected intention to leave the hospital. Stress adaptation mitigated the effects of job stress on job satisfaction and depressed mood, which led to intention to leave the hospital. Intention to leave the hospital preceded intention to leave the profession. Those variables explained about 55% of the variance in intention to leave the profession in both years.

CONCLUSION

The model fit was good for both samples, suggesting validity of the model. Strategies to decrease turnover intentions among nurses could focus on creating a less stressful work environment, increasing job satisfaction and stress adaptation and decreasing depressed mood. Hospitals should cooperate in this issue to decrease nurse turnover.

Psychological symptoms among hospital nurses in Taiwan: a cross sectional study

Background

A considerable number of studies have identified the risk factors attributable to job-related stress among nurses. However, studies investigating psychological symptoms among hospital nurses is still lacking, especially in Taiwan, where the average patient to nurse ratio is among the highest in the world. This study aimed to investigate the potential role of self-rated health status, self-reported diseases, and utilization of occupational health checks in psychological symptoms among Taiwanese nurses.

Methods

A cross-sectional design was conducted from September through December 2013. Data were collected through online self-administered questionnaire among 697 registered nurses in seven regional hospitals governed by the Taipei City Government.

Results

Nurses with fair or poor self-rated health, lower education, <30 years of age, and low back pain were more likely to suffer from psychological symptoms. A trend toward significance was also noticed for those aged 30–39. Importantly, low back pain was the most common disease among nurses in self-reported diseases and half of the nurses reported not utilizing the occupational health examination for the last 5 years.

Conclusions

To alleviate or prevent the psychological symptoms, psychosocial support, and awareness program on prevention of occupational injuries should be offered to nurses younger than 39 years old and having lower educational levels. Moreover, underutilization of occupational health examination among nurses deserves more attention.

Electronic supplementary material

The online version of this article (doi: 10.1186/s12905-017-0460-5) contains supplementary material, which is available to authorized users.

Depression in Registered Nurses: A State of the Science

Registered nurses suffer from depression at almost twice the rate of individuals in other professions. Major depression affects both employees and organizations. Depression is linked to increases in work absenteeism, short-term disability, and decreased productivity and presenteeism. Depression experienced by registered nurses may not be fully preventable, but realizing its presence and prevalence in the workplace is of vital importance. It is essential that we have a healthy, vibrant, and present registered nurse workforce to ensure that quality patient outcomes are achieved. This review of 36 articles assesses the current state of the science related to depression in registered nurses so that occupational health nurses can create pathways and work environments for better mental health for registered nurses.