1
|
Yang S, Hao Q, Sun H, Yang Y, Liu J, Li C, Fu Y, Yao C, Luo G. Prevalence and correlates of severe anxiety among front-line nurses during and after the COVID-19 pandemic: a large-scale multi-center study. BMC Nurs 2025; 24:54. [PMID: 39819465 PMCID: PMC11736933 DOI: 10.1186/s12912-025-02718-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Accepted: 01/13/2025] [Indexed: 01/19/2025] Open
Abstract
BACKGROUND Nurses have been at the forefront of the battle against the COVID-19 pandemic, facing extended work hours and heightened stress, predisposing them to psychological distress. This study aims to investigate the prevalence and correlates of severe anxiety among frontline nurses in China during and after the COVID-19 pandemic. METHODS A large-scale multi-center survey was conducted from November to December 2022 and from April to July 2023. Data were collected using online surveys, covering demographic characteristics, job-related factors, anxiety, depression, and sleep disorders. Statistical analyses, including chi-square tests, t-tests, and logistic regression, were performed to assess the incidence and factors influencing severe anxiety. RESULTS The study included 816 nurses during the pandemic and 763 nurses after the pandemic. The prevalence of severe anxiety during the pandemic (52.3%) was significantly higher than after the pandemic (8.0%). Factors such as nursing title, night shift frequency, educational level, exercise frequency, COVID-19 infection status, economic pressure, and work pressure showed significant differences between the two periods. Binary logistic regression revealed associations between severe anxiety and factors such as night shift frequency, COVID-19 infection status, nursing title, depression, and sleep disorders. Receiver Operating Characteristic analysis demonstrated good predictive value for severe anxiety. CONCLUSION The study underscores the importance of understanding and addressing severe anxiety among frontline nurses during and after the COVID-19 pandemic. Future research should delve into long-term psychological effects and implement effective intervention measures to support nurses' mental health.
Collapse
Affiliation(s)
- Shutong Yang
- Laboratory of Biological Psychiatry, Tianjin Anding Hospital, Institute of Mental Health, Center for Psychiatry of Tianjin University, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Qingling Hao
- Laboratory of Biological Psychiatry, Tianjin Anding Hospital, Institute of Mental Health, Center for Psychiatry of Tianjin University, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
- University College Dublin, Belfield, Dublin 4, D04 V1W8, Ireland
| | - Hongyu Sun
- Laboratory of Biological Psychiatry, Tianjin Anding Hospital, Institute of Mental Health, Center for Psychiatry of Tianjin University, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Yuan Yang
- Laboratory of Biological Psychiatry, Tianjin Anding Hospital, Institute of Mental Health, Center for Psychiatry of Tianjin University, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Jiao Liu
- Laboratory of Biological Psychiatry, Tianjin Anding Hospital, Institute of Mental Health, Center for Psychiatry of Tianjin University, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Cui Li
- Department of Civil Engineering, Nanjing Technical Vocational College, 58 Huangshan Rd, Nanjing, 210019, China
| | - Yunsheng Fu
- King's College London, Strand, London, WC2R 2LS, UK
| | - Cong Yao
- Laboratory of Biological Psychiatry, Tianjin Anding Hospital, Institute of Mental Health, Center for Psychiatry of Tianjin University, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Guoshuai Luo
- Laboratory of Biological Psychiatry, Tianjin Anding Hospital, Institute of Mental Health, Center for Psychiatry of Tianjin University, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China.
| |
Collapse
|
2
|
Bifarin O, Collier-Sewell F, Smith G, Moriarty J, Shephard H, Andrews L, Pearson S, Kasperska M. Standards of proficiency for registered nurses-To what end? A critical analysis of contemporary mental health nursing within the United Kingdom context. Nurs Inq 2024; 31:e12630. [PMID: 38436620 DOI: 10.1111/nin.12630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 02/17/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024]
Abstract
Against the backdrop of cultural and political ideals, this article highlights both the significance of mental health nursing in meeting population needs and the regulatory barriers that may be impeding its ability to adequately do so. Specifically, we consider how ambiguous notions of 'proficiency' in nurse education-prescribed by the regulator-impact the development of future mental health nurses and their mental health nursing identity. A key tension in mental health practice is the ethical-legal challenges posed by sanctioned powers to restrict patients' freedom at the same time as the desire (and obligation) to promote patients' self-determined recovery. The genericism of the UK's Future Nurse Standards do little to prepare mental health nurses to navigate the tensions that ensue. This has consequences for nurses and patients alike, as both risk experiencing the distress and dissonance that attends giving or receiving poor care. We argue that more needs to be done to enable mental health nurses to define and articulate the nuances of the profession as part of becoming critical, thoughtful and confident practitioners. Educators can contribute to this mission by aligning curriculum, pedagogy and assessment to create meaningful opportunities for mental health nursing students to engage with the complexities of mental health nursing practice. Without this, the credibility of the profession will continue to be questioned; its future uncertain.
Collapse
Affiliation(s)
- Oladayo Bifarin
- School of Nursing and Advanced Practice, Liverpool John Moores University, Liverpool, UK
- Research & Innovation, Mersey Care NHS FT, Liverpool, UK
| | - Freya Collier-Sewell
- Centre for Culture, Media and Society, Sheffield Hallam University, Sheffield, UK
| | - Grahame Smith
- School of Nursing and Advanced Practice, Liverpool John Moores University, Liverpool, UK
| | - Jo Moriarty
- NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London, London, UK
| | | | - Lauren Andrews
- School of Nursing and Advanced Practice, Liverpool John Moores University, Liverpool, UK
| | - Sam Pearson
- School of Nursing and Advanced Practice, Liverpool John Moores University, Liverpool, UK
| | - Mari Kasperska
- School of Nursing and Advanced Practice, Liverpool John Moores University, Liverpool, UK
| |
Collapse
|
3
|
Warrender D, Connell C, Jones E, Monteux S, Colwell L, Laker C, Cromar-Hayes M. Mental health deserves better: Resisting the dilution of specialist pre-registration mental health nurse education in the United Kingdom. Int J Ment Health Nurs 2024; 33:202-212. [PMID: 37788130 DOI: 10.1111/inm.13236] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/29/2023] [Accepted: 09/19/2023] [Indexed: 10/05/2023]
Abstract
This article aims to draw attention to increasing genericism in nurse education in the United Kingdom, which sees less specialist mental health education for mental health nursing students and offers opposition to such direction. In 2018, the Nursing and Midwifery Council produced the 'Future Nurse' standards which directed changes to pre-registration nurse education. This led to dissatisfaction from many mental health nurses, specifically regarding reduced mental health content for students studying mental health nursing. Concerns have been raised through public forum and evolved into a grassroots national movement 'Mental Health Deserves Better' (#MHDeservesBetter). This is a position paper which presents the perspective of many mental health nurse academics working at universities within the United Kingdom. Mental health nurse academics collaborated to develop ideas and articulate arguments and perspectives which present a strong position on the requirement for specialist pre-registration mental health nurse education. The key themes explored are; a conflict of ideologies in nursing, no parity of esteem, physical health care needs to be contextualized, the unique nature of mental health nursing, ethical tensions and values conflict, implications for practice, necessary improvements overlooked and the dangers of honesty and academic 'freedom'. The paper concludes by asserting a strong position on the need for a change of direction away from genericism and calls on mental health nurses to rise from the ashes to advocate for a quality education necessary to ensure quality care delivery. The quality of mental health care provided by mental health nurses has many influences, yet the foundation offered through pre-registration education is one of the most valuable. If the education of mental health nurses does not attend to the distinct and unique role of the mental health nurse, standards of mental health care may diminish without assertive action from mental health nurses and allies.
Collapse
Affiliation(s)
- Dan Warrender
- Mental Health Nursing, Robert Gordon University, Aberdeen, Scotland, UK
| | - Chris Connell
- Mental Health Nursing, University of Central Lancashire, Preston, UK
| | - Emma Jones
- Mental Health Nursing, University of Central Lancashire, Preston, UK
| | | | - Lucy Colwell
- Mental Health Nursing, University of Brighton, Brighton, UK
| | - Caroline Laker
- Mental Health Nursing, City University of London, London, UK
| | | |
Collapse
|
4
|
Painter JM, Bond C. What are nurse practice assessors' priorities when assessing student mental health nurses? A qualitative content analysis. Nurse Educ Pract 2023; 72:103776. [PMID: 37690422 DOI: 10.1016/j.nepr.2023.103776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/22/2023] [Accepted: 09/01/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND UK healthcare policy has observed over a decade of changes that has focussed on healthcare staffs' professional values as a marker for safe, high-quality care In 2018 the regulatory body for nursing and midwifery introduced several new proficiencies, with an emphasis on physical health assessment. However, a global debate has since surfaced regarding the generification of nurse education, which has been thought to have eroded field specific skills in mental health nursing. AIM To explore the priorities of practice assessors, articulated within the open comments written within online practice assessment documents. METHODS A qualitative study was conducted, with data collected from comments made within online practice assessment documents relating to the ongoing assessment of student mental health nurses at one UK University. 26 individual sets of assessor comments were collected. An inductive content analysis was used to explore the nature of qualitative feedback provided to student mental health nurses, generated by mental health practice assessors. The COREQ checklist was used for the reporting of the study. RESULTS Findings demonstrated that practice assessors were prioritising two core areas or broad-based skills categories: 'transactional' and 'transformational' competencies. Transactional competencies related to the practical application of specific tasks. Transformational competencies were commented on more frequently and placed emphasis on the students' personal attributes and characteristics, and how these contribute to 'good' mental health nursing practice. CONCLUSION Mental health nurses prioritise assessing student nurses in relation to their personal attributes, work ethic, and values that are congruent with humanist perceptions of mental health nursing.
Collapse
Affiliation(s)
- Joanna M Painter
- Department of Nursing and Midwifery, College of Health Wellbeing & Life Sciences, Sheffield Hallam University, Collegiate Crescent, Sheffield, UK; Rotherham, Doncaster and South Humber NHS Trust, UK
| | - Carmel Bond
- Department of Nursing and Midwifery, College of Health Wellbeing & Life Sciences, Sheffield Hallam University, Collegiate Crescent, Sheffield, UK.
| |
Collapse
|