Emotional labor and job satisfaction among nurses: The mediating effect of nurse-patient relationship

Emotional labor is considered an important part of the role in the nursing field. Previous studies have found inconsistencies between emotional labor and job satisfaction of nurses, this is due to the relationship between them being affected by other factors. However, the current nurse-patient relationship is tense and leads to an unsafe and unstable working environment for nurses. It has yet to be confirmed whether the nurse-patient relationship can be used as a mediating variable to further explain the association that exists between emotional labor and job satisfaction. Therefore, this study tested the mediating effect of the nurse-patient relationship between emotional labor and job satisfaction among Chinese nurses. A total of 496 nurses were included in the study. Data collection was from December 2021 to March 2022 using the convenience sampling method. SPSS 26.0 and AMOS 23.0 software were used to perform structural equation modeling and analyze the relationship between variables. The results showed surface acting negatively affected nurse-patient relationships and job satisfaction, contrary to deep acting and naturally felt emotions. The parallel mediation of nurse-patient trust and patient-centered nursing in the relationship between emotional labor and job satisfaction was found to be statistically significant. Our study highlighted the important mediation of nurse-patient trust and the importance of the positive effects of emotional labor. Future studies can use these findings as a reference to develop interventions.

Gender, sexual orientation, and mental health in the kink community: an application of coping self-efficacy theory

OBJECTIVE

This paper advances understanding of the kink community by examining mental health and coping-self efficacy (CSE) variation by gender and sexual orientation.

DESIGN

Adult members of the National Coalition for Sexual Freedom (N = 332) completed an online cross-sectional health assessment.

MAIN OUTCOME MEASURES

The assessment included the Coping Self-Efficacy (CSE) Scale; Depression and Anxiety Stress Scale-21; and Alcohol Use Disorders Identification Test.

RESULTS

Transgender and non-binary persons reported consistently low coping beliefs and poor mental health. Queer sexual minority persons reported low CSE thought stopping and high anxiety. Several CSE thought stopping moderation effects on mental health were observed.

CONCLUSIONS

Findings may inform clinical implications, as bolstering coping-related beliefs and skills via cognitive-behavioral therapy may offer mental health benefit to kink practitioners.

Identifying Chinese social media users' need for affect from their online behaviors

The need for affect (NFA), which refers to the motivation to approach or avoid emotion-inducing situations, is a valuable indicator of mental health monitoring and intervention, as well as many other applications. Traditionally, NFA has been measured using self-reports, which is not applicable in today's online scenarios due to its shortcomings in fast, large-scale assessments. This study proposed an automatic and non-invasive method for recognizing NFA based on social media behavioral data. The NFA questionnaire scores of 934 participants and their social media data were acquired. Then we run machine learning algorithms to train predictive models, which can be used to automatically identify NFA degrees of online users. The results showed that Extreme Gradient Boosting (XGB) performed best among several algorithms. The Pearson correlation coefficients between predicted scores and NFA questionnaire scores achieved 0.25 (NFA avoidance), 0.31 (NFA approach) and 0.34 (NFA total), and the split-half reliabilities were 0.66-0.70. Our research demonstrated that adolescents' NFA can be identified based on their social media behaviors, and opened a novel way of non-intrusively perceiving users' NFA which can be used for mental health monitoring and other situations that require large-scale NFA measurements.

Factor Structure and Measurement Invariance of the Spanish Burnout Inventory Among Professionals Across 17 Countries and Regions

Studies on the prevalence of burnout in professionals in service organizations who work in direct contact with the clients or users of the organization have concluded that burnout is a serious health disorder that has increased due to the COVID-19 pandemic. A significant advantage of the Spanish Burnout Inventory (SBI) over other instruments is that it provides a broader conceptualization of burnout by including feelings of guilt as a dimension of burnout to explain its development. However, the measurement invariance of the SBI across countries has not been investigated. The purpose of this study was to test the measurement invariance of the SBI among professionals across 17 countries and regions in Europe, Latin America, and Asia, and in different languages. All the countries showed a good fit to the four-factor model, except the Indian sample, which was excluded from the measurement invariance study. Using the alignment method, it was possible to verify the scalar measurement invariance of the four SBI factors across 15 countries and one Spanish region (16 samples). The comparison of estimated latent means indicates that France is the country with the lowest scores on the Enthusiasm factor and the highest scores on the negative factors (Exhaustion, Indolence, and Guilt). In contrast, the Andean countries, Colombia, Peru, and Ecuador, show the highest latent means on the Enthusiasm factor and the lowest means on the negative factors. These results support the validity of the SBI in the countries and regions in Europe and Latin America included in this study.

Social responsibility and subjective well-being of volunteers for COVID-19: The mediating role of job involvement

Aim

Our study aimed to investigate the effect of social responsibility on the subjective well-being of volunteers for COVID-19 and to examine the mediating role of job involvement in this relationship.

Background

Nowadays, more and more people join volunteer service activities. As we all know, volunteer work contributes to society without any return. Volunteers often have a strong sense of social responsibility and reap subjective well-being in their dedication. Although research shows that social responsibility will drive them to participate in volunteer work actively, it is less clear whether job involvement will impact their subjective well-being.

Methods

The data were collected in the precaution zone in Shanghai, China, from April to May 2022. A sample of 302 volunteers for COVID-19 completed the social responsibility scale, subjective well-being scale and job involvement scale in the form of an electronic questionnaire on their mobile phones. A structural equation model was adopted to verify the research hypotheses.

Results

Social responsibility was significantly and positively related to volunteers’ subjective well-being and job involvement (p < 0.05). Job involvement fully mediates the relationship between volunteers’ social responsibility and subjective well-being.

Conclusion

Social responsibility is critical to predicting volunteers’ subjective well-being. Job involvement plays an intervening mechanism in explaining how social responsibility promotes volunteers’ subjective well-being.

Relationship between working conditions and psychological distress experienced by junior doctors in the UK during the COVID-19 pandemic: a cross-sectional survey study

OBJECTIVES

This paper explored the self-reported prevalence of depression, anxiety and stress among junior doctors during the COVID-19 pandemic. It also reports the association between working conditions and psychological distress experienced by junior doctors.

DESIGN

A cross-sectional online survey study was conducted, using the 21-item Depression, Anxiety and Stress Scale and Health and Safety Executive scale to measure psychological well-being and working cultures of junior doctors.

SETTING

The National Health Service in the UK.

PARTICIPANTS

A sample of 456 UK junior doctors was recruited online during the COVID-19 pandemic from March 2020 to January 2021.

RESULTS

Junior doctors reported poor mental health, with over 40% scoring extremely severely depressed (45.2%), anxious (63.2%) and stressed (40.2%). Both gender and ethnicity were found to have a significant influence on levels of anxiety. Hierarchical multiple linear regression analysis outlined the specific working conditions which significantly predicted depression (increased demands (β=0.101), relationships (β=0.27), unsupportive manager (β=-0.111)), anxiety (relationships (β=0.31), change (β=0.18), demands (β=0.179)) and stress (relationships (β=0.18), demands (β=0.28), role (β=0.11)).

CONCLUSIONS

The findings illustrate the importance of working conditions for junior doctors' mental health, as they were significant predictors for depression, anxiety and stress. Therefore, if the mental health of junior doctors is to be improved, it is important that changes or interventions specifically target the working environment rather than factors within the individual clinician.

Workplace violence and risk factors for PTSD among psychiatric nurses: Systematic review and directions for future research and practice

WHAT IS KNOWN ON THE SUBJECT?: Trauma among psychiatric nurses and other healthcare workers is related to workplace violence, but other risk factors may also contribute, including those occurring before, during or after workplace violence. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: Most previously identified PTSD risk factors were not tested or supported in research with psychiatric nurses, although there is promising evidence for risk factors including severe or injurious assault, cumulative exposure, burnout, and other worker characteristics. We identify directions for research needed to improve knowledge, including collecting data before nurses experience workplace violence, defining workplace risk factors consistently and conducting and reporting qualitative analysis. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Provide training in risk assessment and violence prevention to psychiatric nurses. Offer mental health support to those exposed to violence, especially with cumulative exposure. ABSTRACT: Introduction Psychiatric nurses are at risk of workplace violence and post-traumatic stress disorder (PTSD). There is limited understanding of pre-trauma and post-trauma risk factors. Aim Our aim was to review factors associated with workplace PTSD in psychiatric nurses. Method We searched quantitative and qualitative studies from 1980 to 2019 in 23 databases plus abstracts for studies on psychiatric hospital nursing staff, potentially traumatic workplace events, workplace factors and PTSD. Following duplicate abstract (n = 10,064) and full-text (n = 199) screening, data were extracted in duplicate from 19 studies. Using best-fit framework synthesis, we identified workplace violence, pre-trauma and post-trauma risk factors. Results Six variables yielded evidence in at least two empirical studies scoring at least 6/8 on a quality measure, or one such study plus more than one other study ("promising": severe/injurious assault, cumulative exposure, burnout, poor mental health, low compassion satisfaction, neuroticism). Four were supported by at least one better quality study or at least two others ("suggestive": gender, poor training, any physical aggression exposure, compassion fatigue). Discussion Pre-trauma measures, consistent definitions of workplace exposures and thorough reporting of quantitative results are needed to improve research. Implications for Practice Violence prevention and mental health care for exposed nurses appear the most promising targets for PTSD prevention. Therefore, it is particularly important to understand workplace violence and mental health among nurses working in psychiatric hospitals.

Factors affecting high secure forensic mental health nursing workforce sustainability: Perspectives from frontline nurses and stakeholders

WHAT IS KNOWN ON THE SUBJECT?: There are insufficient nurses to meet current demand for mental health care. This is an international concern. Within England, the impact of staff shortages on the quality of patient care in forensic high secure settings has been highlighted by the national regulatory body for hospitals. Forensic hospital nursing is a distinct specialism within mental health. Forensic nurses must negotiate the therapeutic, ethical and practical challenges of caring for high-risk patients in a locked environment. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: There has been no previous study to ask frontline high secure forensic nurses, union representatives, senior nurses and workforce leads about what factors may be affecting recruitment and retention in their setting. As well as the specialized and challenging nature of the work, participants identified that workforce sustainability was affected by unequal working terms and conditions, the hospital locations and wider national factors, such as changes to how nurse training was funded. They also identified that some strategies that were employed to address workforce shortages, such as day-to-day movement of staff within the hospital and incentive packages for new recruits could be demotivating for established staff. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Forensic high secure nursing workforce strategies should include training, development and career pathways that are specific to the specialism and extend beyond preceptorship for newly qualified staff. There should be clear and equitable employment terms and conditions with remuneration packages that are consistent within and between organizations. Hospital managers should address the effect that movement of staff between wards may have on nurses' morale, therapeutic relationships and safety culture. ABSTRACT: Introduction There has been no previous study of stakeholders' views on recruitment and retention concerns in high secure forensic settings. Aim To identify factors affecting recruitment and retention in high secure hospitals, from the perspectives of stakeholders with experience in forensic mental health nursing. Method Framework analysis of data from fifteen interviews and three focus groups with frontline nurses, nurse leaders, recruitment leads and union representatives from three high secure hospitals in England. Results Six themes emerged from the data: (a) the unique nature of high secure nursing; (b) the impact of short staffing; (c) wider factors affecting the high secure nursing workforce; (d) the location; (e) staff being on different terms and conditions of work; (f) recruitment strategies. Discussion Multiple factors are likely to simultaneously affect high secure hospital recruitment and retention. Findings on the unique nature of high secure work reflect previous qualitative research. The themes of location, working terms and condition and recruitment strategies have not been previously identified in forensic nursing research. Implications for practice Employers should ensure that employment terms and conditions are equitable and consistent. Furthermore, hospital managers should address the effect that movement of staff between wards may have on morale and therapeutic relationships.

Forensic Mental Health Nurses' Perceptions of Clinical Supervision: A Qualitative Descriptive Study

Mental health nursing in the forensic services is perceived as stressful as there is often a tension between therapeutic and custodial processes. Clinical supervision has been discussed as a support strategy for nurses. The aim of this paper is to explore forensic mental health nurses understanding of clinical supervision and their perception of its utility within their practice. A qualitative descriptive method was used and 10 mental health nurses were interviewed with the aid of an interview guide. Qualitative data was analysed using a thematic approach culminating in the emergence of three themes.Participants talked about the tension between caring and custodial roles within the forensic services which was stressful and created difficulties in the maintenance of a therapeutic relationship. Clinical supervision was seen as a necessary support to assist nurses working in the forensic services. The findings support the premise that there is a tension between therapeutic and custodial practices. Acknowledgement of the complexities of working within the forensic services and the provision of clinical supervision within a confidential, non-judgemental relationship may assist nurses in the provision of care and the maintenance of therapeutic relationships.

An integrative review of nursing staff experiences in high secure forensic mental health settings: Implications for recruitment and retention strategies

AIMS

To identify the experiences of nursing in high secure forensic mental health settings that may affect staff recruitment and retention.

BACKGROUND

Recruitment and retention of Registered Nurses is a vital international concern in the field of mental health. The high secure forensic setting presents unique challenges for the nurse. Studies of nurse's experiences in this setting have not previously been reviewed in the context of workforce sustainability pressures.

DESIGN

An integrative review (Whittemore and Knapfl, 2005).

DATA SOURCES

A systematic search of data sources: MEDLINE (PubMed), PsycINFO, EMBASE, CINAHL, International Bibliography of the Social Sciences, Applied Social Sciences Index and Abstracts (ASSIA), Social Services Abstracts, ProQuest Social Sciences Premium collection (IBSS, PAIS, and Sociological Abstracts), and Web of Science from inception to December 2019.

REVIEW METHODS

Data extraction, quality appraisal, and convergent qualitative synthesis.

RESULTS

Fifteen papers were selected for inclusion in the review, describing 13 studies. Six studies were quantitative, all cross-sectional surveys. There were seven qualitative studies, using a variety of methodologies. Four themes were identified: engagement with the patient group, the ward social environment, impact on the nurse, and implications for practice.

CONCLUSION

When policymakers address workforce shortages in high secure forensic nursing they must take account of the unique features of the setting and patient group. Nurses must be adequately prepared and supported to function in an ethically and emotionally challenging environment.

IMPACT

This study identified factors affecting workforce pressures in the speciality of forensic mental health nursing. Findings are of interest to national nursing policymakers and workforce leads in mental health service provider organizations, seeking to promote forensic nursing as a career option and retain nursing staff.

Multidimensional Models of Perfectionism and Procrastination: Seeking Determinants of Both

Background: Perfectionism is currently conceptualized using a multidimensional model, with extensive research establishing the presence of both maladaptive and adaptive forms. However, the potential adaptability of procrastination, largely considered as a maladaptive construct, and its possible developmental connection to perfectionism remains unclear. The purpose of this study was to examine the individual differences of the multidimensional models of both perfectionism and procrastination, as well as investigating potential links between the two constructs. Methods: A convenience sample of 206 undergraduate students participated in this study. Participants completed a questionnaire consisting of 236 questions regarding the variables under investigation. Results: The adaptive model of procrastination yielded largely insignificant results and demonstrated limited links with adaptive perfectionism, while maladaptive procrastination was consistently associated with maladaptive perfectionism, lending further evidence of a unidimensional model of procrastination. Conclusions: Many previous findings regarding the multidimensional model of perfectionism were replicated, along with new contributions focusing on the dual-process model and temporal orientation.

Illness prevalence rate in Tibet, China: data from the 2018 National Health Service Survey

Background

Tibet is located in the high-altitude area of Southwest China, where the health level is influenced by specific factors such as the natural environment and living habits. However, there has been little research that has focused on Tibetan health conditions. The two-week prevalence rate is an important indicator of the health level of residents. The purpose of this study was to understand the health status of the residents and the health service needs in Tibet.

Methods

The two-week prevalence rate was calculated using data from a population of 10,493 individuals aged 15 and above that was obtained from the 2018 Sixth National Health Service Survey of Tibet. We initially analysed the types and associated factors of two-week illnesses in Tibetan. The influencing factors for the two-week prevalence rate in Tibet were determined by multivariate logistic regression analysis. Subsequently, we assessed the severity of two-week illnesses by calculating the average days of the duration of the disease, the days of being bedridden and the days of being off work.

Results

The two-week illness prevalence rate was 20.1% in Tibet. Digestive system diseases were frequent, and hypertension was the most common disease. According to the multivariate logistic regression analysis, the two-week prevalence rate was associated with gender, age, residence, marital status, and employment status. In addition, the severity of two-week illnesses differed among the residents.

Conclusion

This study identified that health service needs have increased in Tibet and that the health status of the local residents needs to be improved. Moreover, hypertension has become a major health hazard for the residents and should be considered in the utilization of health services.

The Coping Self-Efficacy Scale: Psychometric properties in an outpatient sample of active duty military personnel

Active duty military service members endure a unique constellation of stressors while deployed or at home. Yet, assessment of protective factors against these stressors among active duty service members represents an under studied area. The present study advances the assessment of protective factors through the psychometric evaluation of the Coping Self-Efficacy Scale (CSES) in a clinical sample of military service members in mental health or substance abuse treatment (n = 200). Cross-sectional data were drawn from military medical records and a supplemental self-report questionnaire. Data extracted included demographic (e.g., sex, age), military characteristics (e.g., rank, years in service), physical health and mental health (e.g., anxiety, depression), and coping self-efficacy. Findings suggest a 3-factor (i.e., problem-focused coping, thought-stopping, and getting social support) CSES structure with acceptable internal consistency. Further, there were small-to-moderate associations with physical and mental health outcomes, providing evidence of construct validity. There were few significant associations with military-related characteristics. Finally, controlling for covariates, thought-stopping beliefs explained unique variance in suicide-related behaviors. Together, findings support the use of the CSES to measure coping-related beliefs in military service members. Recommendations are offered for future research and practice with active duty service members.