Roles of nurses and National Nurses Associations in combating COVID-19: Taiwan experience

The biosafety incident response competence scale for clinical nursing staff: a development and validation study

AIMS

This study was designed to develop a biosafety incident response competence scale and evaluate its validity and reliability among clinical nurses.

DESIGN

This study employed a sequential approach, comprising four phases: (1) the establishment of a multidimensional conceptual model, (2) the preliminary selection of the items, (3) further exploration and psychometric testing of the items, (4) the application of the scale among clinical nurses.

METHODS

The biosafety incident response competence conceptual model was developed through literature review and the Delphi method. A total of 1,712 clinical nurses participated in the preliminary items selection, while 1,027 clinical nurses were involved in the further psychometric testing from July 2023 to August 2023. The item analysis, exploratory factor analysis and confirmatory factor analysis were conducted to evaluate the construct validity. Reliability was measured using Cronbach's alpha, split-half reliability, and test-retest reliability, while validity analysis included content validity, structural validity, convergent validity, and discriminant validity. From September to November 2023, we conducted a survey using the established scale with a total of 4338 valid questionnaires collected. T-test and variance analysis was employed to determine potential variations in biosafety incident response competence based on participants characteristics.

RESULTS

The final scale is composed of 4 factors and 29 items, including monitoring and warning abilities, nursing disposal abilities, biosafety knowledge preparedness, and infection protection abilities. The explanatory variance of the 4 factors was 75.100%. The Cronbach's alpha, split-half reliability and test-retest reliability were 0.974, 0.945 and 0.840 respectively. The Scale-level content validity index was 0.866. The Average Variance Extracted of the 4 factors was larger than 0.5, the Construct Reliability was larger than 0.7, and the Heterotrait-Monotrait ratio were less than 0.9. There were significant differences in the scores of response competence among nurses of different ages, working years, titles, positions, departments, marital status and participation in biosafety training (all P < 0.05).

CONCLUSIONS

The biosafety incident response competence scale for nurses exhibits satisfactory reliability and validity, making it a valuable tool for assessing clinical nurses' abilities in responding to biosafety incidents.

Changes in the diagnosis of depression among nursing professionals during the COVID-19 pandemic: A longitudinal study

AIMS

To identify changes in mental health status among nursing professionals in a Brazilian municipality during the COVID-19 pandemic.

DESIGN

An observational and longitudinal study.

METHODS

Using the Patient Health Questionnaire-9, the presence of depressive symptoms was evaluated among 690 nursing professionals in the city of Pelotas, Brazil, at two moments: June/July 2020 and June/July 2021.

RESULTS

13.0% incidence of depressive symptoms was identified; as well as 12.2% remission; 24.1% persistence and 50.7% absence. Among the factors associated with the worst prognoses we can mention female gender, greater workload, feeling of overload, illness of family members or friends due to COVID-19 and use of psychotropic drugs CONCLUSIONS: There was significant mobility in the diagnosis of depression among the professionals studied during the period analysed, with incidence of new cases of significant depression and greater than the number of remissions. In addition to sociodemographic aspects, traumatic experiences and exposure to continuous overload were associated with persistence and incidence of new cases.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

With the advent of the COVID-19 pandemic, several studies have shown an increase in depressive symptoms among nursing professionals; however, understanding the long-term effects of this scenario is still a challenge.

IMPACT

What problem did the study address? This study investigates changes in the mental health status of nursing professionals working at different care levels, taking the prevalence of screening for depression as a proxy, during a period of a year during the COVID-19 pandemic. What were the main findings? Between both data collection moments, 2020 e 2021, there was a significant percentage of professionals with persistent depression, in addition to a significant proportion of incident cases that slightly exceeded the number of remissions and the factors associated with the worst prognoses were sociodemographic aspects such as gender and emotional stressors like illness of family members or close friends due to COVID-19, in addition to those related to the organisation and support provided by the services, such as workload and feeling of overload. Where and on whom will the research have an impact? This study will impact the nursing professionals and in role of the health services in order to establishing actions that contribute to minimising the deleterious effects of the pandemic on the mental health of their Nursing teams.

REPORTING METHOD

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were adopted in this study.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Work-related psychosocial challenges and coping strategies among nursing workforce during the COVID-19 pandemic: a scoping review

BACKGROUND

Nurses and midwives have been stretched by the COVID-19 pandemic amidst the heroic roles they have played during the peak of the COVID-19 pandemic. Nurses stood tall among their peers in the healthcare industry saving lives. The pandemic has had a toll on nurses physically, psychologically, and socio-economically. The numerous deaths have traumatized nurses coupled with the fear of possible infection. Nurses have seen their colleagues and loved ones lose their lives to the pandemic, nevertheless, they still render care to patients no matter the circumstances. Due to that, it is imperative to ascertain the extent to which nurses who are much needed in healthcare delivery have been affected by this pandemic. This scoping review used Arksey and O'Malley's review methodology to investigate the nature of work-related psychosocial challenges nurses encountered during the peak of the pandemic, noting the major contributors to the challenges and the coping strategies used to address them.

METHODS

We performed a scoping review and searched for articles from five databases including PUBMED, CINAHL, SCOPUS, Google Scholar, and Grey literature from December 2019 to December 2021. A total of 7,334 articles were retrieved for the study but 45 met the inclusion criteria.

RESULTS

Work-related psychosocial challenges identified included stress, burnout (emotional exhaustion and depersonalization), Post-Traumatic Stress Disorder, depression, sleeplessness, and anxiety. Factors that accounted for the challenges were inadequate personal protective equipment (PPEs), discomfort using the PPEs, extreme workload, and fatigue. Nurses experienced job insecurity, business closure, and separation from family and loved ones, and these contributed to their challenges. Strategies used to deal with the challenges centred on emotion-focused and problem-focused coping.

CONCLUSIONS

The study recommends regular counselling and support for all nurses working at the frontline to help them better cope with the devastating effects of the pandemic so that they could build resilience towards future pandemics.

A Qualitative Study on Frontline Nurses' Experiences and Challenges in Providing Care for COVID-19 Patients in the Volta Region of Ghana: Implications for Nursing Management and Nursing Workforce Retention

Since the outbreak of COVID-19, studies related to the COVID-19 pandemic have been published widely. However, there are limited qualitative studies in Ghana that explored and shed light on frontline nurses' experiences and challenges in caring for patients diagnosed with COVID-19. This study aimed to explore frontline nurses' experiences and challenges of providing care for COVID-19 patients in the Volta Region of Ghana. This study adopted a descriptive qualitative research design to collect data. We conducted the study among frontline nurses who provided nursing care for COVID-19 patients in the Treatment Centre for COVID-19 cases in the Volta Region of Ghana. A purposive sampling method was used to select fifteen (15) participants for this study. We collected data through individual in-depth interviews facilitated by a semi-structured interview guide. The content analysis approach was used to analyse the data. The results showed: frontline nurses received inadequate information and training during the initial stages of the pandemic; stress and burnout because of inadequate staffing; logistical challenges; stigmatisation by family members and friends; frontline nurses displeased with the decision to exclude other nurses as frontline workers; participants made some recommendations towards supporting frontline nurses for effective management of patients during pandemics. This study revealed an in-depth understanding of the experiences of frontline nurses who provided nursing care to COVID-19 patients during the pandemic. Our study concludes that the frontline nurses experienced both physical and psychological problems while caring for COVID-19 patients at the treatment centre. Some challenges frontline nurses encountered were inadequate information on COVID-19 prevention and management in the early stages of the pandemic, logistical inadequacies, and stigmatisation in providing care for COVID-19 patients during the pandemic, all of which affected the quality of nursing care, work productivity, and efficiency. Therefore, nurse managers need to provide support to frontline nurses providing care for patients with COVID-19.

Healthcare professionals' families' perception of life during COVID-19 in Iran: a qualitative study

BACKGROUND

The families of healthcare professionals are one of the most vulnerable groups whose lives have been severely damaged by the COVID-19 pandemic. So far, the experiences and perceptions of these individuals have not been explored. The present study aims to investigate the experiences and perceptions of the family members of the healthcare professionals during COVID-19.

METHODS

The present study is a qualitative research with a phenomenological design. The participants were 25 family members of healthcare professionals which were selected from the medical centres in Iran via purposeful sampling from August 2021 to October 2021. The sampling was kept on until the data became saturated. To collect data, individual semi-structured interviews were conducted online. The Colaizzi approach was used to analyse the data collected.

RESULTS

The findings of the study emerged as two main themes: psychological tension with five categories (indescribable fear and worry, longing to see their loved ones, patient stone, bitter farewell, fear of the future) and dignity with four categories (acclamation, appreciation, feeling proud, spiritual growth).

CONCLUSION

During the COVID-19 pandemic, the family members of healthcare professionals have experienced dignity combined with the degrees of psychological tension which were beyond the experiences of the majority of people in the society, but similar to the psychological tension experienced by the families of COVID-19 victims. The families of healthcare workers are continuously anxious about the safety of their loved ones who are responsible to obtain the treatment of COVID-19 patients, which potentially jeopardizes their physical and psychological well-being. Therefore, the appreciation and support of people in the community of the family members of healthcare professionals have increased their tolerance. Healthcare providers can successfully promote the health of healthcare professionals' families by providing comprehensive assistance to healthcare personnel and their families.

Discussing the Effect of Students' Crisis Awareness on Emotion During the COVID-19 Pandemic From the Perspective of Trust

The effects of crises vary among individuals, societies, and nations. Governments' crisis management is quite different from that of non-governmental organizations, especially in terms of “publicity,” since it involves bureaucracy to address people's accountability concerns. The purpose of this study is to investigate the relationship between students' crisis awareness, trust, and emotions in the event of a major public health emergency. A questionnaire survey was conducted for this study. A total of 500 copies of questionnaires were distributed to the college students in Jiangxi. Among those, 437 valid copies were retrieved, with a retrieval rate of 87%. A structural equation model (SEM) was used to conduct the statistical analyses. The research results were summarized as follows: (1) At the stage of epidemic spread, people can easily fall into the negative emotion. (2) The society with a good trust relationship considers schools less responsible for critical incidents and more helpful for crisis communication. (3) Reducing the negative emotions of the public after the occurrence of critical incidents can effectively reduce the damage of critical incidents to the organization. Avoiding a loss of student confidence and increasing anger, protecting the school's reputation, having a good communication effect, and minimizing the impact of the crisis can help the students develop better trust toward the school. When a crisis occurs on campus, this can reduce the possibility of students' showing negative emotions and spreading rumors. It is considered that the findings provide guidance on how to optimize the management of public health crisis situations and improve students' mental health.

New Kids on the Block? A Bibliometric Analysis of Emerging COVID-19-Trends in Leadership Research

The COVID-19 pandemic has resulted in unprecedented challenges for society. The effects on organizations have been drastic and such tough times have demanded new organizational solutions as well as strong and new forms of organizational leadership. Leadership scholars have accelerated their research efforts in the quest to identify what is needed to lead in these uncertain times. In this paper, we adopt a bibliometric review to unravel the emerging trends in leadership research in the wake of the COVID-19 pandemic, and in doing so, identify commonalities and divergences in these themes with respect to leadership approaches and assess potential avenues for future research. The findings reveal that research on the topic has emerged along six main clusters: (1) leadership and employee health during pandemic times, (2) public leadership, (3) leadership in health care, (4) leadership and diversity, (5) educational leadership, and (6) leadership and persuasive communication. The findings reveal that across these clusters, the pandemic has sparked research on leadership approaches that deal with change and uncertainty as well as those that are less hierarchical and person centered in nature. We also notice a novel attention to context. Rather than “new kids on the block,” these trends are largely continuations of established leadership theories and approaches that see their particular importance increase in this unprecedented situation. Finally, we outline some distinct avenues for further research with regard to leadership in COVID-19 times.

Environments of professional nursing practice in the context of the COVID-19 pandemic

Background:

Although COVID-19 attracted attention to the environments of professional nursing practice, triggering a series of responses to address some of the most pressing problems, it is important to identify the size and scope of other weaknesses that have emerged.

Methods:

In an observational and cross-sectional study, using the Scale for the Evaluation of the Environment of Professional Nursing Practice, 752 nurses from a Portuguese university hospital, provided socio-demographic and professional data about the components structure, process and outcome of their professional nursing environment. Data collection took place from June 1–30, 2020, immediately after the first critical period of the COVID-19 pandemic in Portugal.

Results:

In the analysed environment of professional nursing practice, Process factors were favourable to the quality of care, while the Structure and Outcome factors had a moderately favourable effect. Structure factors related to work contexts (P < .001) and nursing functions in patient care areas with COVID-19 (P = .001). Process factors related significantly to work contexts (P < .001). A significant association was found between Outcome factors and work contexts (P < .001) and nursing functions in patient care areas with COVID-19 (P = .005).

Conclusion:

The environments of professional nursing practice in the hospital under study are moderately favourable to the quality of care. However, the need to invest in nurses’ participation, involvement and professional qualification is clear. Maintenance of a sustainable nursing workforce requires attention to be given to ensuring that practice environments are conducive to the quality of care and geared to promoting professional involvement and job satisfaction among nurses.

Mental Health of Nurses during the Fourth Wave of the COVID-19 Pandemic in Poland

In the face of the current COVID-19 pandemic crisis, healthcare professionals, including nurses who provide direct care for patients, are at particular risk of mental health problems. The aim of the study was to evaluate the prevalence of symptoms of depression, anxiety, and stress among nurses working in healthcare facilities during the COVID-19 pandemic.

MATERIALS AND METHODS

This was a cross-sectional observational study. A total of 333 professionally active nurses participated in the study. Data was collected in the period from 10 November to 20 November 2021. We collected sociodemographic data and used the short form of Depression Anxiety Stress Scale (DASS-21) to assess the mental health among nurses.

RESULTS

Severe and very severe symptoms of depression were found in 23.1% of nurses, whereas moderate symptoms were detected in 30.3%. High to very high levels of anxiety were observed in 46.5% of respondents, while 25.8% of nurses showed a moderate level of anxiety. Moderate and high levels of stress were found in 35.4% and 14.1% of the respondents, respectively. Contact with a patient suspected of having SARS-CoV-2 infection was a significant predictor of depressive symptoms. Gender, workplace, and contact with patients suspected of SARS-CoV-2 infection and patients with COVID-19 were significant predictors of anxiety, whereas contact with patients suspected of being infected with SARS-CoV-2 and COVID-19 patients was a significant predictor of stress.

CONCLUSIONS

High scores for depressive symptoms, anxiety, and stress among Polish nurses during the fourth wave of the COVID-19 pandemic are indicative of a direct threat to the mental health of nurses. Targeted support strategies need to be developed and implemented to prevent the deterioration of mental health in this group.

Transition of graduate nurses from student to practice during the COVID-19 pandemic: Integrative review

The COVID-19 pandemic has had dire consequences for all health care workers including nurses. Consequently, those graduate nurses who transitioned into practice during that time were not spared the pandemic's impact. The purpose of this integrative review is to identify and present the extant literature on the transition of graduate nurses from student to practice during the COVID-19 pandemic. Online data bases ranging from the Cumulative Index to the Nursing and Allied Health Literature, the Education Resources Information Centre and PsychINFO were all perused for publications between 2019 and 2021. Key search terms included COVID-19, graduate nurses, newly qualified nurses, transition. The researchers then carefully assessed the articles found and used the coder to determine the relevance of those selected articles. The Critical Appraisal Skills Programme was used to validate the quality of the research articles considered for review. The search of these data bases produced 10 articles which met the inclusion criteria. Four main themes emerged from the study, namely: Organisational challenges faced by graduate nurses during their transition into practice during the COVID-19 pandemic; Personal challenges experienced by graduate nurses in their transition into practice in the context of COVID-19 pandemic; Positive outcomes emanating from the transition of graduate nurses during the pandemic; and Factors which facilitated the transition from student to practice by graduate nurses during the pandemic. The organisational challenges findings revealed that graduate nurses experienced such problems as a shortage of resources, burnout syndrome, work overload and lack of support. Challenges related to their transition throughout the COVID-19 pandemic period included psychological effects and the theory practice gap. Positive outcomes that emerged were learning and better employment opportunities. Factors which could have better facilitated their transition encompassed the availability of equipment and training opportunities. Recommendations include increased collaborative efforts amongst stakeholders to support and mentor graduate nurses during such emergencies; and psychological interventions that could assist with coping in such dire situations as the COVID-19 pandemic.

Prevalence and factors associated with poor sleep quality among nursing professionals during the COVID-19 pandemic

ABSTRACT Objective: to identify the prevalence and factors associated with poor sleep quality among nursing professionals during the COVID-19 pandemic. Method: a cross-sectional study, conducted in June and July 2020, with 890 nursing professionals. To screen the outcome, question 3 of the Self-Reporting Questionnaire was used, assessing poor sleep quality 30 days preceding the application of the questionnaire. Associations between variables of interest were tested using Poisson regression models. Results: the prevalence of poor sleep quality was 68%. Associated factors were moderate or heavy workload, poor assessment of working conditions, suspected infection with COVID-19, more than two thirds of the workload for pandemic and the use of psychotropic drugs. Conclusion: the study pointed out a high prevalence of poor sleep quality among nursing workers with an important relationship with working conditions.

Media use, positive and negative emotions, and stress levels of adults during COVID-19 pandemic in Turkey: A cross-sectional study

AIM

This study was conducted to determine media use, positive and negative emotions, and stress levels of adults during the COVID-19 pandemic.

BACKGROUND

Using media tools in the pandemic process has impacted the mental health of individuals. As the COVID-19 outbreak is a new disease fear, anxiety and stress about this situation can cause strong emotions in adults.

METHODS

The research was carried out using a cross-sectional design. The sample consisted of 1541 adults. The Positive and Negative Emotion Scale, and the Perceived Stress Scale were used to collect the data.

RESULTS

The Positive Emotion Scale mean scores were lower (p < 0.05) for those people whose daily media use time was more than 4 h and who followed the developments about COVID-19 through the media once a day. It was found that those with daily media use of more than 4 h/day had higher Perceived Stress Scale scores than those with lower use (p > 0.05).

CONCLUSION

This study concluded that the use of media in adults increased during the COVID-19 outbreak and that media use was associated with positive and negative emotions and stress levels. Health professionals should assess the effect of the COVID-19 outbreak on mental health in various community groups and develop interventions to prevent negative consequences of increased media use.

Work environment of hospital nurses during the COVID-19 pandemic in Brazil

AIM

To investigate the nurses' work environment in university hospitals during the COVID-19 pandemic in Brazil.

BACKGROUND

The COVID-19 pandemic brought challenging times for nurses worldwide. In Brazil, as well as in several countries, nurses are working hard in hospital settings caring for patients infected with the virus, sometimes with unfavourable work environment conditions.

METHODS

This study was a convergent embedded mixed methods research. The sample comprised 104 nurses from three Brazilian university hospitals. Data were collected in April-June 2020 from an online questionnaire with a self-reporting Likert scale survey designed to measure the nurses' perceptions of their work environment. Qualitative data in the form of written comments were also collected through an open question. Data were analysed using descriptive statistics and content analysis.

RESULTS

The quantitative results showed that the responses to 'I received training on the correct use of personal protective equipment' and 'I am afraid of being infected' items had the best and worst evaluations, respectively. The qualitative findings revealed five themes: feeling of insecurity, lack of personal protective equipment, lack of diagnostic tests, changes in the care flow and fear of the unknown.

CONCLUSION

The study has highlighted the challenges faced by hospital nurses while caring for patients with COVID-19.

IMPLICATIONS FOR NURSING AND NURSING POLICY

The gaps identified will assist the policymakers and hospital managers in developing policies to enhance the support offered to nurses and improve the care provided to patients with COVID-19 in university hospitals. The results also indicate the need for attention to the mental health of the professionals due to the increasing workload and treatment of an illness hitherto unknown.

Nurses' core emergency competencies for COVID-19 in China: A cross-sectional study

Aim

To investigate nurses’ core emergency competencies for handling the coronavirus disease‐19 (COVID‐19) and analyse the factors associated with those competencies.

Background

COVID‐19 has become a major global public health event. Nursing staff have played an important role in COVID‐19 prevention and control. Understanding their emergency competencies for handling COVID‐19, and the potential disadvantages will help governments to develop targeted training policies and improve nurses’ capacities in relation to pandemics and emergency preparedness.

Introduction

COVID‐19 is a disastrous infectious disease, but the competencies of nurses in China to handle COVID‐19 have not been well documented.

Methods

We conducted a cross‐sectional survey on nurses from 22 provinces of China in February 2020. The scores of self‐report questionnaires were used to analyse their competencies for core emergency care, and linear regression analysis was used to explore influential factors.

Results

A total of 2570 nurses participated. The study revealed that nurses had a good grasp of COVID‐19 knowledge, but the majority of nurses lacked experience in isolation ward work and emergency training. We found that age, professional title, work department, major work content, total work time, disaster rescue history, emergency training and infectious disease training were associated with core emergency competencies.

Conclusions

Chinese nurses were qualified for handling COVID‐19 but still need to strengthen the accumulation of practical experience.

Implications for nursing

Nurses should actively participate in emergencies to strengthen their operational capacity, whether in training or actual practice.

Implications for nursing/health policy

Managers should improve relevant policies to ensure that nurses have more opportunities to participate in the practical training of health emergencies and explore effective training methods to improve the ability of nurses to respond to these.

Roles of nurses and National Nurses Associations in combating COVID-19: Taiwan experience

As the COVID‐19 pandemic continues to expand worldwide, Taiwan has effectively contained the spread domestically and protected its citizens after registering its first case relatively early on 21 January 2020. Proactive preparedness and deployment by the national government, timely evidence and experience‐based judgements and decision‐making, information transparency, rapid response, and effective communication and measures have all been critical to combating COVID‐19 in Taiwan. Nurses play a pivotal role in providing direct health care as well as providing contact tracing and care for the quarantined clients and community care services. The Taiwan Nurses Association and other nurses’ associations serve a vital leadership role in advocating for nurses, raising public awareness, enhancing nursing’s professional profile, and sharing experiences via national and international platforms. The implications for nursing and health policy are that we need to well prepare for any unpredicted emerging pandemic in the future. Providing adequate personal protective equipment and safe staffing should be the highest priority for the governments and policymakers around the world to combat pandemic successfully.