Depressive symptoms among Chinese nurses: prevalence and the associated factors

The effectiveness of mindfulness for the management of anxiety in the nursing staff: Systematic review and meta-analysis

A systematic review with meta-analysis following Joanna Briggs Institute recommendations. It aimed to determine the effectiveness of mindfulness for the management of anxiety symptoms in the nursing staff and stress as a secondary outcome. The databases searched were MEDLINE, Embase, LILACS, CINAHL, Web of Science, Scopus and Psycinfo. Search was conducted in October 2022. Independent reviewers used standardized methods to research, track, and code the included studies. Data meta-analysis was performed using random effects models. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used as an approach to assess the quality and certainty of evidence in research studies. The review examined the effectiveness of mindfulness on nursing staff in 13 studies. The meta-analysis revealed a statistically significant decrease in anxiety and stress after treatment, with an average reduction of 0.36 in anxiety and 0.48 in stress. The results emphasizes the possibility of mindfulness being an effective intervention to the management of anxiety and stress in nursing staff. However, the studies analyzed presented limitations in the design and sampling in the development of the intervention, which impact the conclusive statements about the effectiveness of mindfulness and the generalization of the results. The implications to the nursing field involve adopting evidence-based research and practices to improve the well-being and quality of life of nursing professionals, as well as strengthening the evidence base surrounding mindfulness interventions in nursing practice. This may lead to changes in healthcare policies, care practices, and recognition of the importance of nurses' well-being for effective healthcare delivery.

Workplace violence and depressive symptoms: the mediating role of fear of future workplace violence and burnout among Chinese nurses

BACKGROUND

The mechanisms underlying the relationship between workplace violence (WPV) and depressive symptoms in nurses have been less studied. This study aims to examine the mediating role of fear of future workplace violence (FFWV) and burnout in the association between WPV and depressive symptoms.

METHODS

We conducted a cross-sectional web survey at 12 tertiary hospitals in Shandong province, China, in 2020. The Center for Epidemiologic Studies Depression Scale (CESD-10), the Chinese version of the Maslach Burnout Inventory-General Survey and the Fear of Future Violence at Work Scale were used to collect data. Descriptive statistics, independent sample t-test, one-way analysis of variance, Pearson's correlation coefficient, and ordinary least squares regression with bootstrap resampling were used to analyze the data.

RESULTS

The prevalence of depressive symptoms was 45.9% among nurses. The regression model showed that FFWV and burnout mediated the relationship between WPV and depressive symptoms. The total effects of WPV on depressive symptoms (3.109, 95% bootstrap CI:2.324 - 3.713) could be decomposed into direct (2.250, 95% bootstrap CI:1.583 - 2.917) and indirect effects (0.769, 95% bootstrap CI:0.543 - 1.012). Indirect effects mediated by FFWV and burnout were 0.203 (95% bootstrap CI:0.090 - 0.348) and 0.443 (95% bootstrap CI:0.262 - 0.642), respectively. Furthermore, serial multiple mediation analyses indicated that the indirect effect mediated by FFWV and burnout in a sequential manner was 0.123 (95% bootstrap CI:0.070 - 0.189).

CONCLUSION

The prevalence of depressive symptoms among Chinese nurses was high. The WPV was an important risk factor for depressive symptoms and its negative effect was mediated by FFWV and burnout. The importance of decreasing WPV exposure and level of FFWV and burnout was emphasized to prevent depressive symptoms among nurses. The findings implied that hospital managers and health policy makers should not only develop targeted interventions to reduce exposure to WPV in daily work among all nurses, but also provide psychological support to nurses with WPV experience to reduce FFWV and burnout.

The relationship of stress coping styles on substance use, depressive symptoms, and personality traits of nurses in higher education institution

AIM

This study examined the collective characteristics of nurses and their stress coping style.

METHODS

We conducted a cluster analysis of the stress coping strategies of 841 nurses belonging to Dokkyo Medical University Hospital, as measured by the Brief COPE (Coping Orientation to Problems Experienced). We also conducted multivariate analyses of each cluster's sociodemographic characteristics, personality traits, depressive symptoms, work attitudes, sense of fairness, and turnover intention.

RESULTS

The results of cluster analysis using the standardized z scores of the Brief COPE demonstrated that the study participants were classified into three clusters. The "emotional-response type" tended to favor the use of emotional support, venting, and self-blame. The "reality-escape type" tended to prefer alcohol and substance use, behavioral resignation, use of instrumental support, and lack of acceptance. The "problem-solving type" tended to prefer planning, positive reframing, and acceptance and to dislike "alcohol and substance use" and behavioral disengagement. A multinomial logistic regression analysis revealed that compared to the problem-solving type, the emotional-response type had a lower job title, a higher "neuroticism" score on the TIPI-J, and a higher K6 score. However, compared to the problem-solving type, the reality-escape type was younger, consumed more alcohol and substances, and had a higher K6 score.

CONCLUSIONS

Stress coping styles were found to be associated with substance use, depressive symptoms, and personality traits among nurses in higher education institutions. Thus, the results suggest that nurses who choose maladaptive stress coping styles require mental support and early identification of depressive symptoms and alcohol problems.

Association between occupational stress and subclinical depression in Chinese primary healthcare workers

Background

Wellbeing of healthcare workers is crucial for the effective functioning of primary health systems. This study aimed to examine the association between occupational stress and subclinical depression among primary healthcare workers, and to establish the foundation for future preventive strategies.

Methods

A cross-sectional study was conducted in Tai'an City, Shandong Province, China. Data were collected from 832 medical staff in primary health institutions using a structured self-administered questionnaire. The participants completed the Challenge and Hindrance-Related Self-Reported Stress (C-HSS) Scale and Patient Health Questionnaire-9. Multivariable logistic regression analysis was conducted to explore the relationship between occupational stress and subclinical depression among primary healthcare workers.

Results

The prevalence of subclinical depression among primary healthcare workers was 11.66%. Participants with subclinical depression have a significant higher level of occupational stress (including challenge-stress and hindrance-stress). Regression analysis result indicated that higher level of occupational stress was significantly associated with more severe subclinical depression, and the risk of subclinical depression remained after adjusting other covariates (OR = 4.57, 95%CI, 3.14-6.63). The association between challenge-stress and subclinical depression was not statistically significant when controlling for hindrance-stress. Subgroup analysis showed that male healthcare workers who perceived higher level of challenge stress were more likely to develop subclinical depression than female healthcare workers.

Conclusion

The level of subclinical depression among Chinese primary healthcare workers was high, and occupational stress especially hindrance stress may contribute to subclinical depression. Findings were also robust in subgroup analysis after adjusting for other covariates. These findings emphasize the importance of occupational stress psychosocial interventions to decrease the risk of developing depression among the primary healthcare workers.

Social Network Characteristics and Depressive Symptoms of Italian Public Health Medical Residents: The Public Health Residents' Anonymous Survey in Italy (PHRASI)

Despite the high impact of the COVID-19 pandemic on social interactions and healthcare workers' (HWs') mental health, few studies have investigated the association between social network characteristics and HWs' mental health, particularly during the pandemic. Therefore, we aimed to assess the associations between public health residents' (PHRs') social network characteristics and depression. We used data from the Public Health Residents' Anonymous Survey in Italy (PHRASI), a nationwide cross-sectional study. Social network characteristics were self-reported. Depressive symptoms were assessed using the nine-item Patient Health Questionnaire. Linear and logistic models adjusted for age, sex, physical activity, and alcohol were used. A moderation analysis by sex was also performed. A total of 379 PHRs participated in the survey (58% females, median age of 30 years). More peer-to-peer (odds ratio OR = 0.62 (0.47-0.83)) and supervisor support (OR = 0.49 (0.36-0.68)), more social participation ((OR) = 0.36 95% CI (0.25-0.50)), and having a partner (OR = 0.49 (0.25-0.96)) were significantly associated with a lower risk of clinically relevant depressive symptoms. Work-to-private-life interference was significantly associated with a higher risk of clinically relevant depressive symptoms (OR = 1.77 (1.28-2.45)). Promoting a supportive work environment and social participation as well as reducing work-to-private life interference can contribute to reducing the high burden among PHRs.

The role of sleep quality and perceived stress on depressive symptoms among tertiary hospital nurses: a cross-sectional study

BACKGROUND

Nurses in tertiary hospitals are at high risk for depression. Understanding sleep quality and perceived stress may contribute to nurses' mental health and health-related nursing productivity. The aim of this study was to investigate the role of sleep quality and perceived stress on depressive symptoms among nurses in tertiary hospitals.

METHODS

A total of 2,780 nurses (overall response rate = 91.1%) were recruited through a cross-sectional survey in 23 tertiary hospitals in China. Questionnaires included the Self-Rating Depression Scale, the Pittsburgh Sleep Quality Index, and the Chinese Perceived Stress Scale. Variables that were significant in Chi-square tests were further entered into binary logistic stepwise regression.

RESULTS

The prevalence of depressive symptoms was 60.3% (n = 1,676), of which 97.4% (n = 1,633) were female, and 77.8% were younger than 35 years (n = 1,304). Nurses who had moderate, poor, severe sleep quality and poor perceived pressure were more likely to be depressed. Master's degree, 6-10 years of work, and physical activity were protective factors, while the opposite was the case for shift work and high dissatisfaction.

CONCLUSIONS

More than half of nurses working in tertiary care hospitals reported depressive symptoms, and lower sleep quality and higher perceived stress were more associated with this. Perceived stress is an interesting concept, which may provide a new entry point for the well-known idea that there is a relationship between poor sleep quality and depression. It is possible to reduce depressive symptoms among public hospital nurses by providing information on sleep health and stress relief.

Relationships between depression, self-efficacy, and professional values among Chinese oncology nurses: a multicenter cross-sectional study

OBJECTIVES

Many factors are related to oncology nurses' professional values. However, the evidence on the relevance of professional values among oncology nurses in China remains sparse. This study aims to investigate the relationship between depression, self-efficacy, and professional values among Chinese oncology nurses and analyze the mediating effect of self-efficacy on this association.

METHODS

It was a multicenter cross-sectional study designed with the STROBE guidelines. An anonymous online questionnaire recruited 2530 oncology nurses from 55 hospitals in six provinces of China between March and June 2021. Measures included self-designed sociodemographic and fully validated instruments. Pearson correlation analysis was employed to explore the associations between depression, self-efficacy, and professional values. Bootstrapping analysis by the PROCESS macro was used to examine the mediating effect of self-efficacy.

RESULTS

The total scores of depression, self-efficacy, and professional values of Chinese oncology nurses were 52.75 ± 12.62, 28.39 ± 6.33, and 101.55 ± 20.43, respectively. About 55.2% of Chinese oncology nurses were depressed. Chinese oncology nurses' professional values were generally intermediate. Their professional values were negatively related to depression and positively correlated with self-efficacy, while depression was negatively related to self-efficacy. Moreover, self-efficacy partially mediated the relationship between depression and professional values, accounting for 24.8% of the total effect.

CONCLUSIONS

Depression negatively predicts self-efficacy and professional values, and self-efficacy positively predicts professional values. Meanwhile, depression in Chinese oncology nurses has an indirect effect on their professional values through self-efficacy. Nursing managers and oncology nurses themselves should develop strategies aimed at relieving depression and improving self-efficacy to strengthen their positive professional values.

Educational degree differences in the association between work stress and depression among Chinese healthcare workers: Job satisfaction and sleep quality as the mediators

Background

Depressive status of medical personnel worldwide and especially in China is an important public health and social problem. There is a strong relationship between education and depression, but no studies have studied grouping healthcare workers (HCWs) with different educational degree to discuss whether there are differences in the factors that affect depression. This study aims to examine the role of job satisfaction and sleep quality in the relationship between work stress and depression among Chinese HCWs, and teste whether the mediation models are differed by the differences of educational degree.

Methods

Patient Health Questionnaire-9 (PHQ-9) scale was used to test depression. Work stress was assessed using the Challenge-blocking stress scale (CBSS). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). HCWs’ satisfaction with their current work was assessed using the Job Satisfaction Index (JSI). The representative sample of HCWs was chosen using a multi-stage stratified cluster random sampling procedure and 844 HCWs were utilized to the statistical analysis of the study.

Results

In the overall sample, sleep quality could mediate the relationship between work stress and depression in healthcare workers (p < 0.001, CMIN/DF = 3.816, GFI = 0.911, AGFI = 0.886, IFI = 0.943, TLI = 0.933, CFI = 0.942, RMSEA = 0.058, SRMR = 0.055, AIC = 1039.144), and the mediating effect accounted for 36.5%. After grouping educational qualifications, the model with sleep quality and job satisfaction as mediating variables reported a better fit in the group with low educational qualifications. The intermediary effect accounted for 50.6 and 4.43%, respectively. The highly educated group only has sleep quality as an intermediary variable in the structural model, and the mediating effect accounted for 75.4% (p < 0.001, CMIN/DF = 2.596, GFI = 0.887, AGFI = 0.857, IFI = 0.937, TLI = 0.926, CFI = 0.937, RMSEA = 0.044, SRMR = 0.056, AIC = 1481.322).

Conclusion

In the overall sample, sleep quality could mediate the relationship between work stress and depression in HCWs. Among HCWs with technical secondary school education and below, job satisfaction can mediate the positive relationship between work stress and depression, while this mediating effect is not significant among HCWs with college degree and above.

Association between social support and depressive symptoms among Chinese nurses with formal employment versus contract-based employment

BACKGROUND

Inequalities may exist in social and health status among nurses with different employment types. Few studies have investigated the relationship between social support and depressive symptoms among formally employed nurses compared with those in contract-based employment. This study aimed to examine the associations between social support and depressive symptoms among Chinese nurses with different forms of employment.

METHODS

The present cross-sectional study was performed with 1,892 nurses from 12 tertiary hospitals in Shandong Province, China. The Social Support Rating Scale and the 10-item Center for Epidemiologic Studies Depression Scale were used to measure social support and depressive symptoms, respectively. The association between social support and depressive symptoms among participants was explored using multiple linear regression analysis.

RESULTS

The prevalence of depressive symptoms was 45.7%. The mean score for total social support was 40.16 (SD = 7.47), which was lower than the norms in the general Chinese population. Formally employed participants' total social support scores were statistically significantly higher than those of contract-based employees (p ≤ 0.05). After controlling for confounding factors, the multiple linear regression analysis showed that subjective support and support utilization scores were inversely associated with depressive symptoms. Objective support scores were negatively associated with depressive symptoms only among contract-employment nurses.

CONCLUSION

Chinese nurses have a higher prevalence of depressive symptoms and lower social support than the Chinese general population. Compared with contract-employment nurses, formally employed nurses had higher social support. Inverse associations exist between social support and depressive symptoms among nurses with different types of employment. It is suggested that improving Chinese nurses' social support levels and reducing their depressive symptoms, especially for nurses employed through contracts, are critical.

Relationship between serum 25 hydroxyvitamin D (25(OH)D) levels and mental health in shift female nurses

The nurses work long hours and in various shifts, and often accompanied by depression, fatigue, and sleep disorders. Many studies have found that 25 hydroxyvitamin D (25(OH)D) is related to mental health. We aimed to investigate the relationship between depression, sleep problems, fatigue, and serum 25(OH)D levels in shift nurses. We recruited 34 day-shift, 30 evening-shift and 31 night-shift nurses. The Beck Depression Inventory II (BDI-II), Numerical Rating Scale and General Sleep Disturbance Scale to evaluate the levels of depression, sleep problems, fatigue. Blood samples (20 ml) were collected under a fasting state to determine basic biochemistry and inflammatory parameters. In central of Taiwan, approximately 96.1% of shift nurses had deficient (< 20 ng/ml) (45 females and 1 male) and inadequate (20-29 ng/ml) (39 females and 2 male) 25(OH)D levels. Approximately 84.2% of shift nurses experienced fatigue. In sleep disturbance, night-shift nurses experienced significantly more severe sleep disturbance than day-shift and evening-shift nurses. However, no significant correlation was observed between 25(OH)D levels and mental health when the 25(OH)D level was categorized. 25(OH)D deficiency, sleep disturbance, depression, and fatigue were common in shift female nurses, but it was not possible to demonstrate the impact of 25(OH)D deficiency on the mental health of shift nurses in Taiwan.

Subjective COVID-19-related work factors predict stress, burnout, and depression among healthcare workers during the COVID-19 pandemic but not objective factors

Background

Work-related stress is significantly higher among healthcare workers (HCWs) than in the general population. Elevated occupational stress has been linked to burnout syndrome and depression. Moreover, medical professionals working during infectious disease outbreaks are at especially high risk for these problems. The aim of the present study was to examine the mental health status of HCWs and possible predictors of mental health status related to the COVID-19 outbreak utilizing a complex comprehensive model.

Methods

In a countrywide cross-sectional survey among HCWs (N = 2087), work-related stress, COVID-19 -related objective work factors (displacement, frontline working) and subjective work factors (insecurity, unpredictability, workload), perceived stress, work-related stress, burnout and depression were assessed between the second and third wave of COVID-19 pandemic in Hungary.

Results

COVID-19-related objective factors did not predict directly stress, burnout, and depression, whereas feelings of insecurity and unpredictability in relation to the COVID-19 situation at work had a significant medium-sized total effect (also considering the indirect effect via stress) on burnout and depression.

Conclusions

In order to prevent subsequent mental health problems during crisis situations, such as the COVID-19 pandemic, healthcare management should create a more predictable work environment and a safer work experience for healthcare workers and provide mental health support.

Work Conditions of Italian Nurses and Their Related Risk Factors: A Cohort Investigatory Study

(1) Background: Nursing is a satisfying employment pathway, as nurses preserve lives, but it is also considered one of the most stressful care professions. Nursing is a lifesaving and highly satisfying profession, yet it is considered one of the most stressful occupations. This study aimed to assess differences in anxiety, depression and stress states among nurses according to gender, work history, shift and body mass index (BMI) characteristics. (2) Methods: An online questionnaire was addressed to all Italian nurses during May 2022, investigating anxiety, depression and stress conditions according to the Depression, Anxiety and Stress Scale-21 Items (DASS-21) and sampling characteristics, such as sex, work experience, shift and BMI values. (3) Results: A total of 408 Italian nurses answered the questionnaire. Significant differences between the following were reported: anxiety levels and work experience, since nurses employed over 6 years reported higher anxiety levels than their younger colleagues (p = 0.035); depression levels and sex (p = 0.017), as females reported higher depression levels than males; and also between depression levels and BMI levels (p = 0.003), as 5.90% of overweight and 2.50% of obese participants reported extremely severe depression. By considering stress levels according to sampling characteristics, significant differences were registered according to BMI levels (p < 0.001), as overweight subjects reported higher stress levels (7.40%) than the other subgroups. Finally, significant associations were recorded between anxiety, depression and stress conditions with sex, work experience, shift and BMI. (4) Conclusions: The data were in agreement with the current literature, indicating that nurses might take care not only of their patients but also of themselves, in both the physical and mental aspects.

The Influence of Long Working Hours, Occupational Stress, and Well-Being on Depression Among Couriers in Zhejiang, China

Objective:

This study aimed to examine the association between long working hours, occupational stress, depression, and well-being, and to explore the intermediary effect of occupational stress and well-being between working hours and depression among couriers in Zhejiang, China.

Methods:

The study used a cluster random sampling method to select 1,200 couriers from mainstream express companies in Zhejiang, China. The data were collected and analyzed using the Core Occupational Stress Scale (COSS) to measure occupational stress, the Patient Health Questionnaire-9 (PHQ-9) scale to evaluate depression, and the World Health Organization five-item Well-Being Index (WHO-5) scale to assess well-being. Structural equation modeling (SEM) was used to test the hypothesized relationship among the variables.

Results:

The phenomenon of long working hours (75.1%) was quite common among couriers in Zhejiang, China. Working hours had a direct positive effect on depression (β = 0.008, p < 0.001) and on occupational stress (β = 0.009, p < 0.001), and working hours had a negative effect on well-being (β = −0.013, p < 0.001). Occupational stress had a direct positive effect on depression (β = 0.272, p < 0.001), but well-being had no significant direct effect on depression. Working hours had an indirect effect on depression through the mediating effect of occupational stress while the mediating effect of well-being was not found.

Conclusion:

Long working hours is associated with occupational stress, well-being, and depression. Our results confirmed that working hours, occupational stress, and well-being were strong predicators of depression. Working hours had a significant indirect effect on depression via occupational stress. The result of this study showed that decreasing working hours and reducing occupational stress would be effective for couriers to prevent depression. However, more studies are needed to verify the relationship between working hours and depression.

A structural equation model of the relationship among occupational stress, coping styles, and mental health of pediatric nurses in China: a cross-sectional study

BACKGROUND

Pediatric nurses experience a wide rang of stressful events at work every day, which can trigger a lot of emotional responses. The objectives of this study were mainly to explore the potential interrelationships of occupational stress, coping styles and mental health among pediatric nurse.

METHODS

A total of 381 pediatric nurses from Chongqing, China were recruited in this cross-sectional study. We performed this study based on a questionnaire survey that contained the Chinese Perceived Stress Scale (CPSS), Simplified Coping Style Questionnaire and Symptom-Checklist 90(SCL-90).

RESULTS

The pediatric nurses reported having health risk stress(HRS) was 54.3%, and nurses with different medical professional titles, style of coping and profiles of mental health had significantly different occupational stress levels (P < 0.01). And with the application of the Spearman correlation analysis and Structural Equation Modelling were revealed a significant relationship among occupational stress, coping style and mental health. The positive coping style had a negative direct predictive effect on occupational stress (β = -0.499, P < 0.01) and mental health symptoms (β = -0.115, P < 0.01), negative coping styles had positive predictive effect on occupational stress (β = 0.185, P < 0.01) and mental health symptoms (β = 0.205, P < 0.01). Occupational stress had significant impact on mental health symptoms (β = 0.416, P < 0.01), and it was played a part of mediating effect between coping style and mental health.

CONCLUSION

These findings demonstrated significant associations between occupational stress, coping style and mental health in pediatric nurses, and this SEM model highlighted that the potential prediction effects of occupational stress and coping styles for mental health and the mediated effect of occupational stress between coping style and mental health, which we believe facilitates the understanding of these associations. This model should be useful in the formulation of strategies to improve mental health level for this population.

Occupational stressors in healthcare workers in France

OBJECTIVES

To describe psychosocial constraints and mental health of hospital workers, and to identify the psychosocial constraints significantly associated with mental health difficulties, especially in two groups: caregivers and other hospital workers.

METHOD

Data about working conditions and health status collected by the Evrest National observatory in 2018-2019 during occupational health consultation were used. Psychosocial constraints and mental health among caregivers, other hospital workers and non-hospital workers were described.

RESULTS

There were 1251 hospital workers (843 caregivers, 408 other hospital workers) and 25 129 other workers. Intensity and working time (time pressure, extra working time, missing or shortening a meal), and ethical dilemmas (not having the means to ensure high-quality work, too rapidly handling a procedure that would require more painstaking care) were significantly more reported by the caregivers than by the other hospital workers (50.8% vs 44.2%, 43.4% vs 32.5%, 47.2% vs 17.2%, 21.4% vs 16.4% and 41.5% vs 29.0% respectively). Prevalence of psychological distress was not significantly higher for caregivers (12.3%) than for other hospital workers (12.4%) but was significantly higher than for other workers (7.3%). For caregivers, factors significantly associated with psychological distress were time pressure (Odds Ratio adjusted on sociodemographic factors (OR) = 2.33 CI95% [1.35-4.04]), "difficulties to reconcile private life and work life" (OR = 2.95 [1.54-5.69]), "work not recognized in the professional setting" (OR = 1.89 [1.08-3.31]) and "fear of losing one's job" (OR = 2.98 [1.53-5.8]). For other hospital workers, they were "difficulties to reconcile private life and work life (OR = 2.76 [1.04-7.30]), "insufficient possibilities of mutual aid" (OR = 2.85 [1.24-6.53] and "not having the means to ensure high-quality work" (OR = 3.42 [1.62-7.21]).

CONCLUSION

Factors significantly associated with psychological distress were not the same for caregivers and other hospital workers, nor were they the most frequently reported. Detailed description of the constraints according to group of workers could help to develop a high-priority preventive program regarding psychosocial risk factors.

Focus on Polish nurses' health condition: a cross-sectional study

Background

The nursing profession carries with it many negative factors and a high risk of developing chronic diseases, including overweight and obesity. According to statistics, the health condition of this professional group is much worse than that of the average population of the same age. As the largest and most trusted professional group in the world, nurses are critical to the health of any nation. The aim of the study was to assess the Polish nurse's health condition based on real measurements of parameters important for the occurrence of metabolic diseases.

Methods

This is the cross-sectional, conducted among two age groups of Polish nurses (<50 years and ≥50 years). Study included the measurements with DXA, the assessment of glucose concentration and lipid profile, the measurement of blood pressure and socio-demographic data of the surveyed nurses.

Results

The majority of respondents above 50 years old were nurses with elevated total cholesterol (79.3%), elevated LDL cholesterol (72.8%), 42.4% of studied nurses had hypertension.

Conclusion

Individual, local and national measures to prevent and support the health of this professional group are needed.

Factors Influencing Mindfulness Among Clinical Nurses in China: An Observational Cross-Sectional Study

AIM

To evaluate factors influencing mindfulness among clinical nurses in China.

BACKGROUND

Mindfulness has positive effects on nurses' negative emotions and job burnout. However, few studies have explored the antecedent variables of mindfulness.

METHODS

A total of 358 clinical nurses in Beijing Aerospace Center Hospital completed a cross-sectional survey between July and September 2020. The study employed self-report questionnaires covering social demographics, mindfulness, anxiety, job burnout, emotion regulation, stress perception, resilience, well-being, and loneliness.

RESULTS

The mean Mindful Attention Awareness Scale score was 66.82±11.53, which is near the cut-off score between the high and medium mindfulness categories. Anxiety, stress perception, emotional exhaustion, and expressive suppression negatively affected the level of mindfulness, while mental resilience and cognitive reappraisal positively influenced the level of mindfulness (all P<0.05).

CONCLUSION

Hospital nurses have higher-than-normal levels of mindfulness. The mindfulness level of clinical nurses is related to anxiety, stress perception, resilience, cognitive reappraisal, emotional exhaustion, and expressive suppression.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing managers should consider the role and mechanism of positive psychology and develop targeted intervention measures to improve nurses' mindfulness, in order to further reduce their negative emotions, improve their sense of professional benefit, and thus ensure the quality and safety of nursing.

Depressive symptoms in helping professions: a systematic review of prevalence rates and work-related risk factors

OBJECTIVE

The aim of this study is twofold. Our first aim is to provide an overview of the prevalence rate of depression in a wide array of helping professions. Our second aim is to identify work organization conditions that seem to be associated with this depression risk.

METHODS

Four databases were searched (CINAHL, PsycInfo, PubMed, and Web of Science) yielding 87,626 records in total. We were interested in identifying depression prevalence rates and work-related variables that have been found to contribute to depression in helping professions.

RESULTS

In total, this systematic review included 17,437 workers in more than 29 countries. Depression prevalence rate varied between 2.5% and 91.30%. The two most frequently reported professions were nurses and doctors with 73.83% and 30.84% of studies including nurses and doctors in their sample. Work factors contributing to depression included: skill utilization, decision authority, psychological demands, physical demands, number of hours worked, work schedule (irregular or regular), work schedule (daytime or night time), social support from coworkers, social support from supervisor and the family, job insecurity, recognition, job promotion, and bullying.

CONCLUSION

The results of this study highlight alarmingly high rates of depression in helping professions and should serve as a reminder to pay close attention to the mental health of those workers. Investing in employees' mental health by preventing and reducing depression risk could prove to be a valuable investment from an employer's point of view, as it is likely to increase productivity and reduce absenteeism among a host of other positive outcomes.

Impact of stress and coping strategies on insomnia among Polish novice nurses who are employed in their field while continuing their education: a cross-sectional study

OBJECTIVES

To determine to what degree particular coping strategies mediate the association between stress and insomnia in novice nurses who are employed while continuing their education and how type of education moderate the relationships between workplace stress, coping strategies and insomnia.

METHODS

A descriptive cross-sectional study was performed using an online questionnaire, which was completed by 159 novice registered nurses. The questionnaire comprised four components: Athens Insomnia Scale, Perceived Stress at Work (based on Perceived Stress Scale), Brief-Coping Orientation to Problem Experienced (COPE)and metrics with sociodemographic data questions.

RESULTS

Stress was found to be a significant predictor of insomnia among novice nurses. After adjusting the coping strategy, work stress ceased to be a significant predictor of insomnia. Among the strategies, the significant predictors that increased severity insomnia were acceptance, denial and self-blame. Predictors that decreased severity insomnia were use of emotional support and venting. Furthermore, the relationship between both active coping and self-distraction strategies and insomnia was significant for part-time students.

CONCLUSIONS

Insomnia is significant phenomena among novice nurses and are exacerbated by increased stress in the workplace. Choosing appropriate coping strategies for stress that are dependent on the individuals' activities significantly reduce the severity of insomnia caused by work stress.

An Open Trial of the Effectiveness, Program Usage, and User Experience of Internet-based Cognitive Behavioural Therapy for Mixed Anxiety and Depression for Healthcare Workers on Disability Leave

OBJECTIVE

An open trial of an internet-based Cognitive Behavioural Therapy (iCBT) program for healthcare workers was conducted.

METHODS

Healthcare workers on disability leave who used the iCBT program were assessed on: self-reported depression and anxiety symptoms using the Depression Anxiety Stress Scales-21; and, program usage. Healthcare workers' experience of using iCBT was evaluated in a separate survey.

RESULTS

Of the 497 healthcare workers referred to the iCBT program, 51% logged in, 25% logged in more than once, and 12% logged in more than once and completed at least two assessments. For the latter group, self-reported depression and anxiety symptoms significantly decreased from the first assessment.

CONCLUSIONS

This iCBT program was perceived to be of benefit to healthcare workers, with program usage and effectiveness that was similar to what has been previously reported for unguided iCBT.

Psychosocial Work Environment and Teachers' Psychological Well-Being: The Moderating Role of Job Control and Social Support

Nowadays, the issue of teachers’ psychological well-being causes serious concern, especially in Malaysia. Many studies related to psychological well-being have focused on students rather than on the health and well-being of teachers. Thus, the current study investigated the determinants of psychological well-being (depression, anxiety and stress) from the psychosocial work environment (job control, job demands and social support), and examined the moderating role of job control and social support in the relationship between job demands and psychological well-being among teachers. The design of this study was quantitative research through a survey questionnaire. The sample consisted of 335 high school teachers (23.3%—male; 76.7%—female) who responded to measuring scales of job demands, job control, social support, depression, anxiety and stress, and socio-demographic profile. The data were analyzed using two statistical methods, namely descriptive and inferential statistics. The hierarchical linear regression model was used to analyze the data by assisting the statistical software, i.e., SPSS-23. The results showed that job demands, job control and social support significantly predicted teachers’ psychological well-being. Furthermore, the effect of job demands on teachers’ depression and anxiety was partially moderated by job control and social support. In conclusion, this study has successfully identified the significant predictors of teachers’ psychological well-being and the role of job control and social support as a moderating variable to teachers’ psychological well-being in Malaysia. The result provides insights and contributes to the literature of teachers’ psychological well-being determinants and involves Malaysian respondents with a collectivistic eastern culture.

Relations between Stress and Depressive Symptoms in Psychiatric Nurses: The Mediating Effects of Sleep Quality and Occupational Burnout

This study examines the parallel multiple mediators of quality of sleep and occupational burnout between perceived stress and depressive symptoms in psychiatric nurses. Nurses are more likely to experience depression, anxiety, decreased job satisfaction, and reduced organizational loyalty as a result of the stressful work environment and heavy workload. A total of 248 psychiatric ward (PW) nurses participated in this cross-sectional survey study. Structural equation modelling was used for data analysis. In the model of parallel multiple mediators for depressive symptoms, quality of sleep and occupational burnout played mediating roles, and these two mediators strengthened the effect of stress on depressive symptoms, with the final model showing a good fit. Stress, occupational burnout, and quality of sleep explained 46.0% of the variance in psychiatric nurses’ depressive symptoms. Stress had no significantly direct effect on psychiatric nurses’ depressive symptoms, but it had a completed mediation effect on their depressive symptoms through occupational burnout and quality of sleep. This study showed that reduction of occupational burnout and improvement of quality of sleep play important roles against depressive symptoms among PW nurses. Healthcare managers should provide PW nurses with a better environment for improving quality of sleep and reducing occupational burnout.

Nurse turnover: A longitudinal survival analysis of the Korea Nurses' Health Study

AIMS

To identify factors influencing turnover among Korean female nurses from a longitudinal perspective.

DESIGN

A national cohort study called the Korea Nurses' Health Study (2013-2020) was used.

METHODS

A national sample of female nurses from module 1 (N = 20,613, 2013-2014), module 5 (N = 11,527, 2016-2017), module 7 (N = 8,658, 2018-2019) and module 8 (N = 10,253, 2019-2020) was used. Based on a nurse turnover model, individual, health-related, social work environment and work organizational factors were considered explainable variables for nurse turnover. Kaplan-Meier survival analysis and multivariate Cox regression analysis were used to identify the factors influencing female nurse turnover in South Korea.

RESULTS

Female nurses who had less education, were unmarried, were pregnant, and had higher stress levels and an increased probability of experiencing turnover as they aged. Those who perceived moderate health rather than good/very good health, had depressive symptoms, had a higher salary, were charge nurses/unit managers/supervisors or advanced practice nurses, were advanced practice nurses rather than registered nurses, worked shifts, worked in special care units or outpatient wards/administration as opposed to general wards, and worked in larger hospitals had a decreased probability of experiencing turnover as they aged. A two-way interaction analysis revealed that those who had depressive symptoms and increased perceived stress were more likely to experience turnover as they aged.

CONCLUSION

Multiple factors influenced female nurse turnover, including individual, health-related, social work environment and work organizational factors. A multidimensional approach is needed to reduce nurse turnover.

IMPACT

Various factors predict nurse turnover as nurses age, implying that a multifaceted approach is needed to manage nurse turnover. The influence of depressive symptoms on turnover should be evaluated by considering the perceived stress level. Nursing managers and policy makers could use our results to develop programs/policies to reduce nurse turnover.

Depression, Anxiety, Stress and Workplace Stressors among Nurses in Tertiary Health Care Settings

Background:

Chronic job stress adversely impacts both mental health of nurses and patient care. There is paucity of data regarding workplace stressors and negative emotions among nurses.

Aims:

To assess depression, anxiety and stress among nurses and analyse their association with workplace stressors.

Settings and Design:

A hospital based cross-sectional study was conducted in two tertiary care hospitals.

Methods and Material:

Four hundred and thirty one nurses completed nurses rated depression, Anxiety and Stress instrument (DASS-21) and a questionnaire probing perceived workplace stressors on a 4 point Likert scale . The stressors across subgroups of workareas were compared.

Satistical Analysis:

Association between stress, anxiety or depression and workplace stressors were analysed using binary logistic regression.

Results:

50.8% of nurses had stress; 74% had anxiety; 70.8% had depression. 79.1% had at least one of them. Stressed, anxious or depressed nurses were more concerned about lack of job satisfaction and conflicts with supervisors. Work-place stressors varied with work areas: private hospital, no job satisfaction, conflicts with doctors and patients; government hospital, acquiring infectious diseases; ICUs, inadequate salary; non-ICUs, odour and sounds in workplace and conflicts with patients.

Conclusions:

Prevalence of depression, anxiety and stress was high. Workplace stressors varied across different working areas. Interventions need are to be tailored accordingly.

Strength use and nurses' depressive symptoms: The mediating role of basic psychological needs satisfaction

AIMS

This study aimed to reveal the role of satisfying basic psychological needs in the relationship between strength use and depressive symptoms in nurses.

BACKGROUND

There is a high prevalence of depressive symptoms among nurses. Previous studies on different groups have reported that strength use is beneficial for alleviating individuals' depressive symptoms.

METHOD

A total of 475 participating Chinese nurses completed questionnaires. Hypotheses were tested using the PROCESS macro.

RESULTS

Strength use was positively correlated with basic psychological needs satisfaction overall and negatively correlated with depressive symptoms. Furthermore, autonomy and relatedness satisfaction acted as mediating mechanisms through which strength use influenced depressive symptoms.

CONCLUSIONS

Autonomy and relatedness satisfaction can mediate the influence of strength use on depressive symptoms in nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

Focus should be placed on improving nurses' strength use level to reduce their depressive symptoms. Hospital managers should create an organisational environment conducive to meeting nurses' basic psychological needs and thereby reduce their depressive symptoms.

Sleep Reactivity and Depressive Symptoms Among Chinese Female Student Nurses: A Longitudinal Mediation Analysis

Previous cross-sectional studies have documented that sleep reactivity was associated with depressive symptoms, but the potential mechanisms underlying this relationship were understudied. Therefore, the present study with a longitudinal prospective design was to reveal the mediating roles of sleep disturbance and emotion regulation difficulties (ERD) between sleep reactivity and depressive symptoms. This study included 725 student nurses who were followed up periodically for 9 months, with an interval of three months. All participants completed questionnaires regarding sleep reactivity, sleep disturbance, ERD, and depressive symptoms. Adjusted analyses suggested that the direct effect of sleep reactivity on depressive symptoms was non-significant. The bootstrap procedure revealed two significant indirect effects: from sleep reactivity to depressive symptoms with sleep disturbance as a mediator and from sleep reactivity to depressive symptoms with sleep disturbance and ERD as sequential mediators. Therefore, sleep reactivity might be considered as an indicator of shiftwork adaptability in the evaluation of recruitment. Psychological interventions aimed at developing healthy sleep habits and emotion regulation skills may be helpful in decreasing the risk of depression.

Psychological Distress Amongst Medical Laboratory Professionals Involved in COVID-19-Related Duties: A Nationally Stratified Cross-Sectional Survey, Ghana

To assess the prevalence and factors associated with psychological distress (PD) and Medical Laboratory Professionals (MLPs) involvement in COVID-19-related duties. This study adopted an online cross-sectional, nationally stratified survey among 473 MLPs using Google Form with a designated link; Depression, anxiety, and stress scale-21 (DASS-21) was used to measure depression, anxiety, and stress (secondary outcome). We employed generalized Negative Binomial (NBR) and Poisson regression analytical approach to our study outcomes. All analyses were performed using Stata 16, and P-value≤.05 deemed significant. The overall DASS-21 score ranged from asymptomatic psychological distress to severe symptomatic PD. The prevalence of depression, anxiety, and stress were 9.1 [95%CI=6.8-12.0], 17.8 [95%CI=14.6-21.5], and 7.5 [95%CI=5.4-10.1], respectively. The result evinced a high and significant association; the univariate NBR predicted a significant increase of PD score by 12% and 18% among participants who were involved in one and two or more COVID-19-related duties, respectively, (β[95%CI] = .12 [.05-.18] and .18 [.10-.26], respectively). A binary outcome predicted approximately 2-folds of overall psychological distress among participants involved in two or more COVID-19-related duties compared with non-involvement (adjusted Prevalence Ratio [95%CI]= 2.34 [1.12-4.85]). For depression, anxiety, and stress symptoms, both univariate and multivariate data analyses evinced a higher disadvantage among MLP involved in COVID-19-related duties. We observed a high tendency of experiencing significant psychological distress amongst MLP involved in COVID-19-related duties. Experience of psychological distress increased with deeper involvement in COVID-19-related activities. Psychological support should be extended to MLPs to limit the effect of these negative emotions on their cognitive and social behavior as well as job performance.

Psychological symptoms in Chinese nurses may be associated with predisposition to chronic disease: a cross-sectional study of suboptimal health status

BACKGROUND

Suboptimal health status (SHS) is a reversible state between ideal health and illness and it can be effectively reversed by risk prediction, disease prevention, and personalized medicine under the global background of predictive, preventive, and personalized medicine (PPPM) concepts. More and more Chinese nurses have been troubled by psychological symptoms (PS). The correlation between PS and SHS is unclear in nurses. The purpose of current study is to investigate the prevalence of SHS and PS in Chinese nurses and the relationship between SHS and PS along with predisposing factors as well as to discuss the feasibility of improving health status and preventing diseases according to PPPM concepts in Chinese nurses.

METHODS

A cross-sectional study was conducted with the cluster sampling method among 9793 registered nurses in Foshan city, China. SHS was evaluated with the Suboptimal Health Status Questionnaire-25 (SHSQ-25). Meanwhile, the PS of depression and anxiety were evaluated with Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) self-assessment questionnaires. The relationship between PS and SHS in Chinese nurses was subsequently analyzed.

RESULTS

Among the 9793 participants, 6107 nurses were included in the final analysis. The prevalence of SHS in the participants was 74.21% (4532/6107) while the symptoms of depression and anxiety were 47.62% (2908/6107) and 24.59% (1502/6107) respectively. The prevalence of SHS in the participants with depression and anxiety was significantly higher than those without the symptoms of depression (83.3% vs 16.7%, P < 0.001) and anxiety (94.2% vs 5.8%, P < 0.0001). The ratio of exercise habit was significantly lower than that of non-exercise habit (68.8% vs 78.4%, P < 0.001) in SHS group.

CONCLUSIONS

There is a high prevalence of SHS and PS in Chinese nurses. PS in Chinese nurses are associated with SHS. Physical exercise is a protective factor for SHS and PS so that the exercise should be strongly recommended as a valuable preventive measure well in the agreement with PPPM philosophy. Along with SDS and SAS, SHSQ-25 should also be highly recommended and applied as a novel predictive/preventive tool for the health measures from the perspectives of PPPM in view of susceptible population and individual screening, the predisposition to chronic disease preventing, personalization of intervention, and the ideal health state restoring.

Mental health status of the general population, healthcare professionals, and university students during 2019 coronavirus disease outbreak in Jordan: A cross-sectional study

BACKGROUND

The emergence of COVID-19 global pandemic coupled with high transmission rate and mortality has created an unprecedented state of emergency worldwide. This global situation may have a negative impact on the psychological well-being of individuals which in turn impacts individuals' performance. This study aims to explore the prevalence of depression and anxiety among the GP, HCPs, and USs during COVID-19 outbreak, and to identify key population(s) who might need psychological intervention.

METHODS

A cross-sectional study using an online survey was conducted in Jordan between 22 and 28 March 2020 to explore the mental health status (depression and anxiety) of the general population, healthcare professionals, and university students during the COVID-19 outbreak. The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to assess depression and anxiety among the study participants. Logistic regression analysis was used to identify predictors of depression and anxiety.

RESULTS

The prevalence of depression and anxiety among the entire study participants was 23.8% and 13.1%, respectively. Anxiety was most prevalent across university students 21.5%, followed by healthcare professionals 11.3%, and general population 8.8%. Females among healthcare professionals and university students, divorced healthcare professionals, pulmonologists, and university students with history of chronic disease were at higher risk of developing depression. Females, divorced participants among the general population, and university students with history of chronic disease and those with high income (≥1,500 JD) were at higher risk of developing anxiety.

CONCLUSIONS

During outbreaks, individuals are put under extreme stressful condition resulting in higher risk of developing anxiety and depression particularly for students and healthcare professionals. Policymakers and mental healthcare providers are advised to provide further mental support to these vulnerable groups during this pandemic.

Sleep quality and mood symptoms in conscripted frontline nurse in Wuhan, China during COVID-19 outbreak: A cross-sectional study

The aim of this study was to investigate the prevalence of sleep problems, depression and anxiety symptoms among conscripted frontline nurses fighting coronavirus disease 2019 (COVID-19) in Wuhan.This study was a cross-sectional study conducted with 100 frontline nurses. Sleep quality, depression, and anxiety symptoms were measured using the Pittsburgh sleep quality index (PSQI), the Generalized Anxiety Disorder 7-Item Scale (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9), respectively.Mean sleep duration was 5.71 hours (SD = 1.09) and mean sleep latency was 33.49 minutes (SD = 28.87). A total of 76%, 81%, 45%, and 19% reported difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS) or early morning awakening (EMA), nightmares and using hypnotics respectively. Among 100 participants in this study, 60 (60%) had poor sleep quality, 46 (46%) suffered depression symptoms and 40 (40%) reported anxiety symptoms. Sleep quality (OR = 3.16, 95% CI: 1.17-8.52) and anxiety symptoms (OR = 8.07, 95% CI: 2.92-22.33) were significantly associated with depression symptoms. Depression symptoms (OR = 7.92, 95% CI: 2.89-21.73) were related to anxiety symptoms. Similarly, depression symptoms (OR = 3.24, 95% CI: 1.19-8.79) were associated with poor sleep quality.Sleep disturbance, depression, and anxiety symptoms are very common among frontline nurses who treating patients with COVID-19 in Wuhan, China. Comprehensive measures that involve psychosocial and personal behaviors should be implemented to improve sleep quality and prevent depression and anxiety symptoms.

Occupational Stress and Employees Complete Mental Health: A Cross-Cultural Empirical Study

Given the shortcomings of previous research on occupational stress and mental health (e.g., predominantly in Western, educated, industrialized, rich and democratic (WEIRD) societies, based on the traditional mental health model and a lack of comparative studies), this study aimed to (a) examine the relationship between occupational stress and complete mental health among employees in Cabo Verde and China, and also explored the mediation and moderation roles of burnout and optimism in accounting for the empirical link. Mental health was defined as comprised of two distinguishable factors: positive and negative mental health. The Pearson correlation test, structural equation modeling (SEM) analysis, bootstrap analysis, hierarchical moderated regression and an independent t-test were used to analyze the data. The results indicated that, in both countries, occupational stress showed a negative relation to positive mental health and lower psychopathology symptoms—and job burnout mediated the relation between occupational stress and mental health. Optimism moderated the relation between occupational stress and burnout, but not the relation between occupational stress and complete mental health. The results are interpreted in light of the comparative framework.

Recovery Experience as the Mediating Factor in the Relationship Between Sleep Disturbance and Depressive Symptoms Among Female Nurses in Chinese Public Hospitals: A Structural Equation Modeling Analysis

Purpose

Nurses are suffering from considerable work-related stress, which can result in disturbed sleep and depressive symptoms. Whereas, recovery experience can alleviate sleep disturbance and help maintain well-being in the working environment. The aim of this study was to examine whether recovery experiences play a mediating role in the relationship between sleep disturbance and depressive symptoms of female nurses in Chinese public hospitals.

Methods

From December 2017 to May 2018, the study with proportional sampling of cross-sectional design was carried out in the public tertiary hospitals from Shenyang of Liaoning Province in China. A total of 1500 female nurses who had been working for one or more years participated in this study. A structural equation model (SEM) was applied to test the assumption that recovery experiences might function as a mediator in the relationship between sleep disturbance and symptoms of depression.

Results

Sleep disturbance contributed most to the variance (32.9%) of depressive symptoms and had a significantly positive correlation with depressive symptoms (P<0.01) among nurses. Psychological detachment in recovery experience had a significantly positive correlation with sleep disturbance (P<0.01) and depressive symptoms (P<0.01). Whereas, relaxation, mastery experience, and control in recovery experience were significantly and negatively correlated with sleep disturbance (P<0.01) and depressive symptoms (P<0.01). Recovery experience served as a mediator between sleep disturbance and depressive symptoms (a * b = 0.066, BCa 95% CI: 0.045, 0.095).

Conclusion

Sleep disturbance was the predictor of depressive symptoms for female nurses. Moreover, recovery experience could combat the detrimental impacts of sleep disturbances on symptoms of depression. This study suggested that nurses might benefit from interventions on improving sleep quality to relieve depressive symptoms through mediating path of recovery experience.

Prevalence, social-demographic and cognitive correlates of depression in Chinese psychiatric medical staff

BACKGROUND

The high prevalence of depression in general population was related to its social-demographics and cognitive performance. However, no studies investigated the prevalence of depression, its social-demographic and cognitive correlates in psychiatric medical staff. Thus, the aims of this study investigated the prevalence, social-demographic and cognitive correlates of depression in Chinese psychiatric medical staff.

METHODS

186 Chinese psychiatric medical staff were enrolled in Wenzhou Kangning Hospital. Depressive symptom score was assessed by the Self-rating Depression Scale (SDS). Cognition was assessed by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).

RESULTS

The prevalence of depression was 17.74% in these medical staff. The RBANS total score in participants with depressive symptom was significantly lower than that in participants with not depressive symptom after controlling for the confounding variables. The Person correlation analysis found that the normal SDS score in these medical staff was significantly related to age, education, occupations, RBANS total score and subscale scores. Stepwise multivariate regression analysis further identified that age and RBANS total score were significantly associated with the normal SDS score in these medical staff.

LIMITATIONS

The limitations included cross-sectional study design, the small sample size, and the self-rating scale of depression.

CONCLUSIONS

The prevalence of depression in Chinese psychiatric medical staff was higher in comparison with Chinese general population, but lower in comparison with Chinese medical staff. Cognitive deficits might be considered a core feather of depression that should be a valuable target for future interventions. Age influenced depressive symptom in these medical staff .

Evaluation of the correlation between job stress and sleep quality in community nurses

Chronic sleep deprivation may worsen many medical and mental health conditions, causing difficulty in the ability to function at work. Job stress may be a factor that directly correlates with the poorer sleep quality of nurses from different departments in a general hospital. However, epidemiological evaluations of sleep problems among community nurses in China are scarce, and an association between sleep problems and occupational stress has not been investigated. This study investigated the association between nurses' job stress and sleep quality in a community hospital in China. This cross-sectional study was conducted from September to November 2017 and involved 180 nurses who had worked for more than 1 year in 12 community hospitals. The Job Stress Questionnaire was administered to evaluate occupational stress. The Pittsburgh Sleep Quality Index was used to evaluate sleep disorder status. Logistic regression was performed to investigate the association between job stress and sleep disorder among these community nurses in China. For the 155 nurses who completed the study, the job stress score was 58 ± 18, and 72 nurses (46%) had a Pittsburgh Sleep Quality Index (PSQI > 7). The type of nurse contract and total job stress scores were related to sleep disturbances within the previous month. The job stress scores were negatively associated with sleep quality; in other words, the higher the job stress scores were, the worse the quality of sleep. The logistic regression analysis showed that the type of nurse contract and self-reported job stress were significant factors affecting sleep quality. Sleep disturbances in nurses were highly associated with job difficulty factor, doctor-patient relationships, psychosomatic state, environment or events, promotion or competition and total pressure scores. Sleep problems were prevalent among clinical nurses in community hospitals in China. Occupational stress negatively affects sleep quality in Chinese community nurses; the higher the stress is, the worse the sleep quality.

The Effect of Workplace Violence on Depressive Symptoms and the Mediating Role of Psychological Capital in Chinese Township General Practitioners and Nurses: A Cross-Sectional Study

OBJECTIVE

The most existing research has predominantly focused on city rather than township hospitals. This study aimed to explore depressive symptoms and its associated factors among general practitioners and nurses in Chinese township hospitals.

METHODS

This cross-sectional study was carried out in Liaoning, China in 2016. 2,000 general practitioners and nurses in Chinese township hospitals were recruited and 1,736 of them became final subjects (effective response rate: 86.8%). Data on depressive symptoms, workplace violence (WPV), psychological capital (PsyCap), and demographic factors were collected through questionnaires. Hierarchical multiple regression was used to explore the factors related to depressive symptoms. Asymptotic and resampling strategies were applied to examine the potential mediating effect of PsyCap.

RESULTS

The prevalence of depressive symptoms among the participants was 49.9%. Workplace violence was positively associated with depressive symptoms, whereas psychological capital and its components of hope, optimism and resilience were negatively associated with depressive symptoms. Psychological capital and its components of hope, optimism and resilience all played partial mediating roles between workplace violence and depressive symptoms.

CONCLUSION

Nearly half of general practitioners and nurses surveyed suffered from depressive symptoms. Reduction of workplace violence and development of psychological capital can be targeted for interventions to combat depressive symptoms.

Moderating Role of Self-Esteem Between Perceived Organizational Support and Subjective Well-Being in Chinese Nurses: A Cross-Sectional Study

Purpose

Nurses are undertaking tremendous physical and psychological pressure, which may reduce their subjective well-being (SWB). This study is aimed to identify the relationship among perceived organizational support (POS), self-esteem, and SWB, and to further explore whether self-esteem could be a moderator in the association between POS and SWB in Chinese nurses.

Materials and Methods

This study was conducted in Liaoning Province in China, in 2018. 606 valid questionnaires were collected. Demographic factors, job conditions, the Index of Well-Being, Survey of Perceived Organizational Support (SPOS), and Rosenberg's Self Esteem Scale (RSES) were included in each questionnaire. The association among POS, self-esteem, and POS × self-esteem interaction with SWB were examined by hierarchical multiple regression analysis. The interaction was visualized by using simple slope analysis.

Results

Average score of SWB in Chinese nurses was 8.27 ± 2.64. Being married was positively related to SWB, while having longer work time per week, having night shift and dissatisfied with nurse-patient relationship were correlated with lower SWB. POS and self-esteem were important factors for SWB. Self-esteem could moderate the relationship between POS and SWB. When self-esteem was higher, POS had a greater effect on SWB.

Conclusion

Subjective well-being of nurses in the study was at a low level. Self-esteem could moderate the association between POS and SWB. More interventions related to POS and self-esteem will be helpful to improve SWB among nurses.

Women's heart health: a focus on nurses' physical activity and sedentary behaviour

PURPOSE OF REVIEW

This review focuses on recent literature examining and targeting the physical activity and sedentary behaviour of nurses. The role of physical activity and sedentary behaviour in preventing and managing cardiovascular disease (CVD) in women is also discussed.

RECENT FINDINGS

Nurses (most of whom are women) represent the largest professional group within the health care workforce and many present with risk factors for CVD (e.g. physical inactivity, sedentary behaviour, overweight/obesity, hypertension, dyslipidemia, diabetes, smoking, depression, anxiety). Several studies have measured the physical activity and sedentary behaviour of nurses and found low levels of physical activity (i.e. most do not meet physical activity guidelines) and high levels of sedentary behaviour (50-60% of the day). Nurses working rotating shifts, 12-h shifts and/or working full-time or part-time (vs. casual) may be at greater risk of physical inactivity; however, the opposite has been observed for sedentary behaviour. Few interventions targeting nurses' physical activity levels have shown promise, but those that have used activity monitors with behavioural strategies; no studies, to date, have evaluated the impact of sedentary behaviour interventions in nurses.

SUMMARY

Improving the physical activity levels and reducing the sedentary behaviour of nurses is important for nurses' cardiovascular health. There is a need for interventions to address low physical activity and high sedentary behaviour among nurses.

Effects of job conditions, occupational stress, and emotional intelligence on chronic fatigue among Chinese nurses: a cross-sectional study

Purpose: Nurses are undertaking considerable emotional and physical work, which may lead to unrecoverable fatigue. This study aimed to evaluate the level of chronic fatigue and explore its associated factors among Chinese nurses in the hope of providing scientific evidence for fatigue-reduction strategies.

Methods: This cross-sectional study was carried out in Liaoning Province, China in 2018. The study recruited 700 nurses and collected 566 effective respondents. Chronic fatigue, demographic factors, job conditions, and emotional intelligence were assessed through questionnaires. Chronic fatigue was assessed with the Fatigue Scale 11, occupational stress with the Effort–Reward Imbalance Questionnaire, and emotional intelligence with the Wong and Law Emotional Intelligence Scale. Hierarchical multiple regression was used to explore factors related to chronic fatigue and to test the moderating effect of emotional intelligence on the association between occupational stress and chronic fatigue. Simple slope analysis was conducted to visualize the interaction.

Results: The mean score of chronic fatigue among the Chinese nurses was 17.14±6.16. Being married, having long weekly work time, working night shifts, and discontent with the nurse–patient relationship were positively associated with chronic fatigue. Effort:reward ratio, overcommitment, and emotional intelligence were important factors related to chronic fatigue. Emotional intelligence played a moderating role in the relationship between the effort:reward ratio and chronic fatigue. When emotional intelligence was higher, the effect of the effort:reward ratio on chronic fatigue became weaker.

Conclusion: Most nurses surveyed in China might have relatively high levels of chronic fatigue. Our results highlight the importance of interventions on these factors for the reduction of fatigue among nurses in China. Providing more opportunities and support and developing emotional intelligence are crucial strategies to reduce chronic fatigue among nurses in China.

Drivers of working longer: Results from a large-scale and representative German employee survey

Most research on the factors driving employees to work longer than expected or preagreed has focused on behaviors of work extension and has widely neglected work intensification. Therefore, the aim of this study is to investigate whether job demands, as well as employees' job-related resources and personal resources (skill discretion, educational level), predict behavioral indicators of work extension (total working hours, overtime) and work intensification (skipping mandatory rest breaks). We use data from the sixth wave of a large cross-sectional and representative German employee survey (N = 10 148). The findings suggest that job demands and skill discretion are positively associated with the different behaviors of working longer. The relationship between work extension and skill discretion is stronger for higher-educated employees than for lower-educated employees. Our findings suggest that specific job demands and resources must be considered simultaneously to explain working longer and to differentiate between behaviors of working longer.

The effect of night shift on sleep quality and depressive symptoms among Chinese nurses

PURPOSE

Night shift is associated with adverse physical and psychological health outcomes such as poor sleep quality and depressive symptoms. We aimed to compare sleep quality as well as depressive symptoms in nurses working night shifts to those working day shifts only and explore the association between sleep quality and depressive symptoms among nurses.

PATIENTS AND METHODS

Eight hundred sixty-five nurses were enrolled in the current study. Sleep quality and depressive symptoms among nurses were evaluated by the Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depressive Disorders Rating Scale (HADS), respectively.

RESULTS

PSQI and HADS scores were both significantly higher in the nurses working night shifts (P<0.05) than in those working day shifts only. Besides, there was a positive correlation between PSQI and HADS scores. Binary logistic regression showed that night shift and poor sleep quality were independent risk factors of depressive symptoms among nurses.

CONCLUSION

Higher rates of depression among Chinese nurses working night shifts may be associated with poor sleep quality induced by night shift.

Moderating Effect of Mindfulness on the Relationships Between Perceived Stress and Mental Health Outcomes Among Chinese Intensive Care Nurses

This study aimed to explore the potential moderating effect of mindfulness and its facets on the relationships among perceived stress and mental health outcomes (burnout, depression, anxiety, and subjective well-being) among Chinese intensive care nurses. A total of 500 Chinese intensive care nurses completed self-report measures of mindfulness, burnout syndromes, perceived stress, depression, anxiety, and subjective well-being. Correlation and hierarchical multiple regressions were applied for data analysis. Mindfulness moderated the effects of perceived stress on emotional exhaustion (the core component of burnout syndrome), depression, anxiety, positive affect, and negative affect but not on the other two dimensions of burnout and life satisfaction. Further analyses indicated that the ability to act with awareness was particularly crucial in improving the effects of perceived stress on depression. These results further broaden our understanding of the relationships between perceived stress and burnout, depression, anxiety, and subjective well-being by demonstrating that mindfulness may serve as a protective factor that alleviates or eliminates the negative effects of perceived stress on depression, anxiety, burnout syndrome, and subjective well-being and may instigate further research into targeted mindfulness interventions for Chinese intensive care nurses.

The Effects of a Modified Mindfulness-Based Stress Reduction Program for Nurses: A Randomized Controlled Trial

The purpose of the study was to evaluate the effects of a modified mindfulness-based stress reduction (MBSR) program on the levels of stress, affect, and resilience among nurses in general hospitals in mainland China. In addition, the study attempted to determine the impact of the program on job satisfaction. A total of 110 nurses were randomly assigned to the intervention versus control groups. The intervention group participated in a modified 8-week MBSR program. All participants were evaluated with questionnaires at baseline, immediately after the intervention, and 3 months later. The intervention group showed decreases in stress and negative affect and increases in positive affect and resilience after the intervention. No improvement in job satisfaction was observed, but the trends of the data were in the hypothesized direction that job satisfaction would improve. The modified MBSR program is an effective approach for nurses to decrease stress and negative affect and improve positive affect and resilience. In addition, the program has the potential to improve job satisfaction.

Mental disorders among workers in the healthcare industry: 2014 national health insurance data

Background

Numerous studies have shown that healthcare professionals are exposed to psychological distress. However, since most of these studies assessed psychological distress using self-reporting questionnaires, the magnitude of the problem is largely unknown. We evaluated the risks of mood disorders, anxiety disorders, sleep disorders, and any psychiatric disorders in workers in healthcare industry using Korea National Health Insurance (NHI) claims data from 2014, which are based on actual diagnoses instead of self-evaluation.

Methods

We used Korea 2014 NHI claims data and classified employees as workers in the healthcare industry, based on companies in the NHI database that were registered with hospitals, clinics, public healthcare, and other medical services. To estimate the standardized prevalence of the selected mental health disorders, we calculated the prevalence of diseases in each age group and sex using the age distribution of the Korea population. To compare the risk of selected mental disorders among workers in the healthcare industry with those in other industries, we considered age, sex, and income quartile characteristics and conducted propensity scored matching.

Results

In the matching study, workers in healthcare industry had higher odds ratios for mood disorders (1.13, 95% CI: 1.11–1.15), anxiety disorders (1.15, 95% CI: 1.13–1.17), sleep disorders (2.21, 95% CI: 2.18–2.24), and any psychiatric disorders (1.44, 95% CI: 1.43–1.46) than the reference group did. Among workers in healthcare industry, females had higher prevalence of psychiatric disorders than males, but the odds ratios for psychiatric disorders, compared to the reference group, were higher in male workers in healthcare industry than in females.

Conclusions

The prevalence of mood disorders, anxiety disorders, sleep disorders, and all psychiatric disorders for workers in the healthcare industry was higher than that of other Korean workers. The strikingly high prevalence of sleep disorders could be related to the frequent night-shifts in these professions. The high prevalence of mental health problems among workers in healthcare industry is alarming and requires prompt action to protect the health of the “protectors.”

Effects of Individual Differences and Job Characteristics on the Psychological Health of Italian Nurses

The Demand Resources and Individual Effects Model (DRIVE Model) is a transactional model that integrates Demands- Control-Support and Effort-Reward Imbalance models emphasising the role of individual (Coping Strategies; Overcommitment) and job characteristics (Job Demands, Social Support, Decision Latitude, Skill Discretion, Effort, Rewards) in the work-related stress process. The present study aimed to test the DRIVE Model in a sample of 450 Italian nurses and to compare findings with those of a study conducted in a sample of UK nurses. A questionnaire composed of Ways of Coping Checklist-Revised (WCCL-R); Job Content Questionnaire (JCQ); ERI Test; Hospital Anxiety and Depression Scale (HADS) was used. Data supported the application of the DRIVE Model to the Italian context, showing significant associations of the individual characteristics of Problem-focused, Seek Advice and Wishful Thinking coping strategies and the job characteristics of Job Demands, Skill Discretion, Decision Latitude, and Effort with perceived levels of Anxiety and Depression. Effort represented the best predictor for psychological health conditions among Italian nurses, and Social Support significantly moderated the effects of Job Demands on perceived levels of Anxiety. The comparison study showed significant differences in the risk profiles of Italian and UK nurses. Findings were discussed in order to define focused interventions to promote nurses’ wellbeing.

Binge eating disorder and depressive symptoms among females of child-bearing age: the Korea Nurses' Health Study

BACKGROUND

Most studies regarding the relationship between binge eating disorder (BED) and depression have targeted obese populations. However, nurses, particularly female nurses, are one of the vocations that face these issues due to various reasons including high stress and shift work. This study investigated the prevalence of BED and the correlation between BED and severity of self-reported depressive symptoms among female nurses in South Korea.

METHODS

Participants were 7,267 female nurses, of which 502 had symptoms of BED. Using the propensity score matching (PSM) technique, 502 nurses with BED and 502 without BED were included in the analyses. Data were analyzed using descriptive statistics, Spearman's correlation, and multivariable ordinal logistic regression analysis.

RESULTS

The proportion of binge eating disorder was 6.90% among the nurses, and 81.3% of nurses displayed some levels of depressive symptoms. Multivariable ordinal logistic regression analysis revealed that age (40 years old and older), alcohol consumption (frequent drinkers), self-rated health, sleep problems, and stress were associated with self-reported depression symptoms. Overall, after adjusting for confounders, nurses with BED had 1.80 times the risk (95% CI = [1.41-2.30]; p-value < 0.001) of experiencing a greater severity of self-reported depression symptoms.

CONCLUSIONS

Korean female nurse showed a higher prevalence of both binge eating disorder and depressive symptoms, and the association between the two factors was proven in the study. Therefore, hospital management and health policy makers should be alarmed and agreed on both examining nurses on such problems and providing organized and systematic assistance.