Nurses suffering in silence: Addressing the stigma of mental health in nursing and healthcare

Perceptions of Ontological Coaching Among Nurses (OCN): A Descriptive Qualitative Study

AIM

To examine the perceptions of nurses receiving the Ontological Coaching among Nurses (OCN) intervention in Singapore.

DESIGN

Descriptive qualitative.

METHODS

Convenience sampling was used to recruit 34 nurses who received OCN intervention and three coaches who provided the intervention. Written informed consent was obtained, and semi-structured, one-on-one interviews were used to collect data, which were then transcribed verbatim. Thematic analysis was used to analyse the data.

RESULTS

Three themes with nine sub-themes were identified. The main themes were: (1) From 'Outlet to Confide': Ontological Coaching as an Enhanced Sense of Fulfilment; (2) Mindset Readiness and Openness for Successful Coaching; and (3) Future Endeavours for Sustainable Coaching Practices.

CONCLUSION

The findings show that nurses benefitted on personal and professional fronts from receiving coaching. Further evaluations are required to see the potential of using coaching intervention for novice nurses.

IMPLICATIONS AND IMPACT

As frontline key players in our healthcare system, nurses face a unique set of challenges that impact their psychological well-being. The impact is even more significant for early-to mid-career nurses, leading to poorer quality of life and high turnover rates. This paper highlighted the importance of resources made available to novice and mid-career nurses through coaching. The perceptions of nurses who received coaching intervention serve as a foundation for future studies examining the relevance of ontological coaching in the nursing profession. The nurses' recommendations reported in this paper include building awareness of coaching and incorporating flexibility into coaching programmes to help enhance their readiness to receive and engage with coaching for a more fulfilling coaching experience. Incorporating these recommendations can help inform future coaching-related interventional studies.

REPORTING METHOD

This study adhered to COREQ guidelines.

PATIENT AND PUBLIC CONTRIBUTION

None.

Exploring the interplay of mental health knowledge, stigma, and social distance among clinical nurses: a study in Liaoning, China

Background

Stigma related to mental health conditions has a negative impact on both the nursing staff and their patients. Most of the current research on stigma explores the impact of single factors on stigma and does not explore the relationship between knowledge, social distance and stigma among clinical nurses.

Methods

A convenience sampling method was used to conduct a questionnaire survey among 628 nurses from five hospitals in Liaoning Province in March 2021 and June 2021 using a combination of online and offline methods. To study the negative attitudes toward patients with mental illness among clinical nurses and to analyze the relationship between mental ill health stigma, social distancing, and mental health knowledge among nurses. The questionnaire includes Sociodemographic data, Scale for Assessing the Stigma of Mental Illness in Nursing (score range: 20~100, the higher the score, the less stigma attached to mental ill health), Mental Illness Social Distance Scale (score range: 6~30, the higher the score, the greater the social distance) and Mental Health and Mental Health Knowledge Questionnaire (score range: 0~25, the higher the score, the higher the knowledge level).

Results

The nurses' mental ill health stigma score was 58.96 ± 9.38 points, the mean scores of psychiatric and general nurses were 58.86 ± 9.33 and 59.41 ± 9.58 points, respectively. Willingness to become a psychiatric nurse is a factor influencing the stigma of mental illness. The stigma of mental ill health, social distance and mental health knowledge of nurses are positively correlated (P<0.01). The mediation analysis demonstrated that mental health stigma significantly mediated the relationship between mental health knowledge and social distance (a= 0.599, P<0.001; b= -0.194, P<0.001). After accounting for stigma, the direct effect of mental health knowledge on social distance was no longer significant (c'=-0.007, P=0.078), highlighting the central role of stigma in this relationship.

Conclusions

Nurses mental ill health stigma is moderate and is the main mediating effect between mental health knowledge and social distancing. The pivotal role of mental health knowledge in shaping nurses' attitudes and behaviors pertaining to social distancing in the context of mental illness. By combating stigma and enhancing mental health literacy among healthcare practitioners, we can foster environments that promote inclusive and compassionate care practices, thereby ameliorating patient outcomes and redressing disparities in mental health treatment.

Misaligned Supports: Differences in Reported Health Care Worker Well-being Supports Provided and Needed During the COVID-19 Pandemic

PURPOSE

To describe the well-being supports provided to health care workers (HCWs) during the COVID-19 pandemic in health centers and hospitals.

DESIGN

Cross-sectional qualitative interviews before and after implementation of a peer-based support intervention.

SETTING

Purposively sampled hospitals and health centers across the US.

PARTICIPANTS

28 site leaders and 56 HCWs sampled from 16 hospitals and 12 health centers.

METHOD

Site leaders and HCWs were asked to describe supports available to HCWs during the COVID-19 pandemic. Thematic and content coding and analysis of interview responses were conducted using Dedoose.

RESULTS

Both site leaders and HCWs identified a range of support resources available. Communication resources were the most frequently cited in both groups. Health care workers reported bi-directional communication, while one-way communication was emphasized by site leaders. Hospitals highlighted counseling support, particularly Employee Assistance Programs (EAP), while health centers prioritized community support. Wellness activities were more prevalent in hospital settings, while health centers offered specific workplace-provided training for HCWs. Health care workers encountered barriers when accessing support, including limited time, fear of stigma, and disruptions to their existing support networks attributable to the pandemic.

CONCLUSION

While there are resources for HCWs, the available supports may not align with their needs and barriers to access may limit the effectiveness of these supports. Continued engagement between leaders and HCWs could help better align resources with needs.

New graduate nurses' perspectives on well-being and transitioning into the workforce

BACKGROUND

The COVID-19 pandemic profoundly impacted nurses' well-being and the transition of new nurses into the workplace. The National Academy of Medicine and American Nurses Foundation has announced the need to prioritize well-being research.

PURPOSE

To explore new nurses' perspectives related to factors that influenced their well-being and transition to practice.

METHODS

New graduate nurses (1-2years post graduation) in Hawaii were invited to participate in a qualitative study, September 2023.

DISCUSSION

Participants (N = 25) were predominantly female (84%), Asian (80%), and had 1year of experience (76%). Participants described the effect of the pandemic on their well-being, individual factors they needed to develop, external factors that were barriers or facilitators, and considerations for future interventions to support well-being and transition to practice.

CONCLUSION

The findings highlighted components of interventions needed in the academic and professional setting to support new nurses' successful and sustained transition to the workplace.

Neurodiversity & nursing: Reflection of a final year general nursing student

Autism Spectrum Disorder is neurodevelopmental disorder, the manifestations of which and levels of support individuals may require vary greatly. Although there is a plethora of information regarding supporting autistic individuals in higher education and the workplace, there is a paucity of information regarding both autistic nurses and nursing students. This paper presents an overview of autism spectrum disorder, the particular features of which are relevant in nursing professions and in the context of higher education; and highlights issues surrounding disclosure and implementing reasonable accommodations. It concludes with a reflection of the author's experience as an autistic nursing student.

COVID-19 related negative emotions and emotional suppression are associated with greater risk perceptions among emergency nurses: A cross-sectional study

Background

As the COVID-19 pandemic began, frontline nurses experienced many emotions as they faced risks relevant to both patients (e.g., making errors resulting in patient harm) and themselves (e.g., becoming infected with COVID-19). Although emotions are often neglected in the patient safety literature, research in affective science suggests that emotions may significantly impact nurses' perceptions of risk, which can have downstream consequences. Further, the use of chronic emotion regulation strategies that are known to differ in adaptability and effectiveness (i.e., emotional suppression, reappraisal) can impact risk perceptions.

Objective

To investigate the relationship between nurses' emotional experiences in response to the pandemic and their estimates of how likely they would be to experience adverse outcomes related to both patients and themselves within the next six months. Additionally, we investigated the extent to which the use of suppression and reappraisal processes to manage emotions are associated with these risk perceptions.

Design

Cross-sectional survey.

Setting

Online survey distributed via email to emergency nurses at eight hospitals in the northeastern United States during fall 2020.

Participants

132 emergency nurses (M age = 37.05; 81.1% Female; 89.4% White).

Methods

Nurses reported the extent to which they experienced a variety of positive (e.g., hope, optimism) and negative (e.g., fear, sadness) emotions in response to the COVID-19 pandemic, and reported their perceptions of risk to both patients and themselves. Nurses also completed the Emotion Regulation Questionnaire, a measure of chronic tendencies to engage in emotional suppression and reappraisal. Immediately prior to providing data for this study, nurses completed an unrelated decision-making study.

Results

Nurses' negative emotions in response to COVID-19 were associated with greater perceptions of both patient safety risks (b = 0.31, p < .001) and personal risks (b = 0.34, p < .001). The relationships between positive emotions and risk perceptions were not statistically significant (all p values > 0.66). Greater chronic tendencies to suppress emotions uniquely predicted greater perceptions of patient safety risks (b = 2.91, p = .036) and personal risks (b = 2.87, p = .040) among nurses; however, no statistically significant relationships with reappraisal emerged (all p values > 0.16).

Conclusions

Understanding factors that influence perceptions of risk are important, given that these perceptions can motivate behaviours that may adversely impact patient safety. Such an understanding is essential to inform the development of interventions to mitigate threats to patient safety that emerge from nurses' negative emotional experiences and their use of different emotion regulation strategies.

Tweetable abstract

Covid-related negative emotions and emotional suppression are associated with greater patient and personal risk perceptions among emergency nurses @lindamisbell @Nathan_Huff_1.

Understanding the mediated relationship between moral distress, depression, and suicide risk in undergraduate nursing students

BACKGROUND

Nursing students are at higher risk for depression, suicide, and other mental health concerns as compared to the general college student population. Moral distress and other ethical issues may be a significant source of psychological harm within nursing student experiences and warrants further attention.

PURPOSE

The purpose of this study was to understand the mediating effect of depression on the relationship between moral distress and suicide risk among undergraduate nursing students.

METHODS

This cross-sectional analysis was derived from a larger sequential mixed methods study. The first phase was an online survey completed by a national sample of N = 679 nursing students in the United States.

FINDINGS

The relationship between moral distress and suicide risk was fully mediated by depression and statistically significant at the alpha = 0.05 level.

CONCLUSION

All three psychological variables (depression, moral distress, suicide risk) impact nursing students and require innovative solutions within nursing and educational programs.