Job-related stress, emotional labor, and depressive symptoms among Korean nurses

The Relationship Between Work-Related Stress and Depression: A Scoping Review

Objectives

Work-related stress is highly prevalent. Recent systematic reviews concluded on a significant association between common work-related stress measures and depression. Our scoping review aims to explore whether work-related psychosocial stress is generally associated with depression or depressiveness, the extent and methodology of the primary research undertaken on this topic and to elucidate inconsistencies or gaps in knowledge.

Methods

We searched for literature in Pubmed, PsycInfo and Web of Science including full reports in seven languages published between 1999 and 2022 and applied the PRISMA statement for scoping reviews criteria.

Results

Of 463 primarily identified articles, 125 were retained after abstract and full-text screening. The majority report significant associations between work-related stress and depression. Cross-sectional studies are most prevalent. Sufficient evidence exists only for job strain and effort-reward imbalance. Most studies are from Asia, North America and Europe. The health sector is the most studied. Several research gaps such as the lack of interventional studies were identified.

Conclusion

The consistency of most studies on the significant association between work-related stress and depression is remarkable. More studies are needed to improve evidence and to close research gaps.

Perception and needs: a qualitative study on sense of job security among nurses in central and western China

AIMS

To explore nurses' perceptions of sense of job security and their needs to improve it.

DESIGN

A descriptive qualitative study employed an in-depth, in-person interview from February to April in 2021. The data analysis software NVivo V.11.0 was used to assist with the data organisation, and content analysis methods were conducted to explore key concepts.

SETTING

Three tertiary hospitals in central and western China were selected by convenience sampling method.

PARTICIPANTS

A total of 20 nurses participated in this study.

RESULTS

Four categories and 13 subcategories were extracted. The four main categories included: (1) enrich connotation of sense of job security; 2) challenges to sense of job security; (3) consequences of a sense of insecurity; and (4) the need to improve nurses' sense of job security.

CONCLUSIONS

Nurses expressed a multidimensional perception of a sense of security about the nursing profession, and they highlighted the importance of communication skills training and supervisors' humanistic care and support. It is necessary to improve the training system for nurses' ability improvement, a harmonious work environment, policies and psychological health support to enhance their sense of job security.

Longitudinal mediation effect of hassles between neuroticism and dimensions of the tripartite model in college students

This study addresses a gap in the literature by exploring the longitudinal effects of hassles in mediating the relationship between neuroticism and the tripartite model of depression and anxiety. The research investigates these associations in a large sample of university students, utilising baseline and 6-month follow-up data. Initial assessments involved participants completing measures for neuroticism, depression and anxiety symptoms, and the occurrence of stress, followed by monthly assessments of stress, anxiety symptom and mood symptoms over a 6-month period. Our results illuminate the mediating role of daily hassles in the relationship between neuroticism and various dimensions of anxiety and depression, including general distress, specific depression, and anxiety symptoms. These findings underscore the significant impact of neuroticism and hassles on a broad spectrum of mood symptoms, offering valuable insights for both research and clinical practice. Discussions around the implications of these findings are provided in the our paper, where we also outline potential directions for future research and clinical applications.

Anxiety Symptoms and Associated Psychological and Job-Related Factors Among Hospital Nurses

OBJECTIVE

Recently, burnout and mental health issues regarding nurses are reported increasingly. This study aimed to investigate the prevalence of anxiety symptoms among hospital nurses and determine their association with psychological and job-related factors.

METHODS

Data on demographics, job-related characteristics, burnout, Type A behavior patterns, self-esteem, and happiness were collected from 515 nurses working at a university hospital in Korea. Anxiety symptoms were assessed using the anxiety subscale of the Hospital Anxiety and Depression Scale, with scores of 8 or higher indicating the presence of anxiety symptoms. Demographic, job-related, and psychological factors were compared according to the presence of anxiety. Logistic regression was conducted to identify factors associated with anxiety symptoms.

RESULTS

Two hundred and four (39.6%) participants had anxiety symptoms. Self-esteem and happiness were associated with a lower risk of anxiety symptoms, whereas burnout was associated with a higher risk of anxiety symptoms. Furthermore, being female, having a career of less than five years, and requiring counseling due to stress were associated with a higher risk of anxiety symptoms. Being younger, female, or a basic nurse; having a career of less than five years; partaking in shift work; experiencing job dissatisfaction; requiring counseling due to stress; being exposed to higher levels of burnout; and having lower levels of self-esteem and happiness were all found to be significantly correlated with anxiety symptoms.

CONCLUSION

These findings suggest that promoting self-esteem and happiness while reducing burnout may be beneficial in preventing and managing anxiety symptoms among hospital nurses.

Occupational stress changes and new-onset depression among male Korean manufacturing workers

Background

Studies on the association between occupational stress and depression have been frequently reported. However, the cross-sectional designs of studies limited insight into causal associations. In this study, we investigated the longitudinal association between occupational stress and new-onset depression among employees in a single manufacturing plant.

Methods

The annual health checkup data of employees at a manufacturing plant in Korea were collected. A total of 1,837 male employees without depression who completed a health checkup during two consecutive years were included. Occupational stress was measured using a short form of the Korea Occupational Stress Scale (KOSS-SF), and depression was assessed using a Patient Health Questionnaire-2. The association between occupational stress change over the two years and newly developed depression was investigated using two logistic regression models.

Results

Across all sub-factors of KOSS-SF, employees who reported increased occupational stress had a higher risk of new-onset depression. Newly developed depression was significantly associated with job demand (odds ratio [OR]: 4.34; 95% confidence interval [CI]: 2.37-7.96), job insecurity (OR: 3.21; 95% CI: 1.89-5.48), occupational climate (OR: 3.18; 95% CI: 1.91-5.31), lack of reward (OR: 2.28; 95% CI: 1.26-4.12), interpersonal conflict (OR: 2.14; 95% CI: 1.18-3.86), insufficient job control (OR: 1.93; 95% CI: 1.05-3.56), and the organizational system (OR: 1.84; 95% CI: 1.01-3.36).

Conclusions

For every sub-factor of the KOSS-SF, occupational stress increase and persistent high stress were associated with the risk of developing new-onset depression. Among the seven sub-factors, job demand had the most significant effect. Our results show that occupational stress should be managed to promote employee mental healthcare.

Cytokine associated with severity of depressive symptoms in female nurses in Korea

Background

Depression has been associated with the risk of developing physical illnesses and diseases. Inflammatory hypotheses of immunoactive and dysregulated cytokine production have been proposed to describe this association; however, data pertaining to the high prevalence of depression among nurses are limited.

Objective

This study aimed to use a comprehensive immune-profiling approach to determine whether an abnormal profile of circulating cytokines could be identified in nurses with self-reported depression and whether this profile is associated with the severity of depression.

Methods

We investigated a cohort of 157 female nurses in Korea. The self-report Patient Health Questionnaire was used to measure the depression levels of nurses. In addition, peripheral blood samples were collected and used to measure the cytokine profile using the Luminex multiplexing system. Generalized gamma regression analyses were conducted to evaluate the association between cytokine and depressive symptoms.

Results

Regarding severity of depressive symptoms, 28.0% of nurses had moderately severe depression while 9.6% had severe depression. Moderately-severe depressive symptoms in nurses were associated with elevated levels of interleukin-6 (B = 0.460, p = 0.003), interleukin-8 (B = 0.273, p = 0.001), and interleukin-18 (B = 0.236, p = 0.023), whereas interferon-gamma levels (B = -0.585, p = 0.003) showed the opposite profile. Participants with severe depressive symptoms presented decreased interferon-gamma levels (B = -1.254, p < 0.001).

Conclusion

This study demonstrated that proinflammatory cytokines were associated with depression among nurses. This calls for early detection and intervention, considering the mechanisms linking depression to physical illness and disease.

Factors Influencing Frontline Screening Nurses' Depression as a Long-Term Impact of COVID-19

Frontline screening nurses experienced exhaustion and depressive symptoms as a long-term impact of COVID-19. This study aimed to explore fatigue, depression, and empowerment among frontline screening nurses and examine the factors influencing depression. This was a descriptive cross-sectional study. The study included 140 frontline screening nurses in South Korea recruited from February to March 2021. The measures included a fatigue scale, the Text of Items Measuring Empowerment (TIME), and the Center for Epidemiological Studies Depression Scale (CES-D). The STROBE checklist was used for reporting aspects of the cross-sectional design. Frontline screening nurses showed high fatigue scores (M = 3.47, SD = 0.55), and 55.7% (n = 78) of them were depressed and had low empowerment scores (M = 3.53, SD = 0.69). Empowerment and fatigue were predictors of depression. Increased empowerment and decreased fatigue were important in decreasing depression. Therefore, efforts to provide sufficient staffing, screening for depression, and listening to nurses' voices are necessary.

The Effect of Emotional Labor on the Physical and Mental Health of Health Professionals: Emotional Exhaustion Has a Mediating Effect

(1) Background: Workers who perform emotional labor for an extended period are prone to emotional exhaustion; in particular, when the work exceeds the range of one's emotional resources, it will produce job burnout. This study investigated the effects of emotional labor and emotional exhaustion on the physical and mental health of health professionals. (2) Methods: This study was cross-sectional and the sampling criteria were health professionals from August 2020 to July 2021, including rehabilitators, nutritionists, clinical psychologists, radiologists, respiratory therapists, pharmacists, medical examiners and audiologists. A questionnaire was used to collect data on participants' emotional labor, emotional exhaustion, physical health and mental health. A total of 120 valid questionnaires were obtained. (3) Results: Significant positive correlations were found between emotional labor and emotional exhaustion, physical and mental health and anxiety. A hierarchical regression analysis found that the effect of emotional labor on physical and mental health increased the predictive power to 59.7% through emotional exhaustion, and emotional exhaustion had a mediating effect on the relationship between emotional labor and physical and mental health. (4) Conclusions: This study provides a reference for managers of medical institutions to care for employees' work stress and physical and mental health, which will help institutions build a friendly and healthy workplace.

Response to NIOSH Request for Information on Interventions to Prevent Work-Related Stress and Support Health Worker Mental Health

The root causes of health care worker strain and depression include excessive job demands, extended work schedules, little decision-making opportunity, assault, bullying, and fear of injury. Potential links between working conditions and opioid overuse have also been discussed, beginning with psychological job strain or with physical pain leading to medication use. Promising solutions have been identified and many would be cost-effective, as enhanced working conditions could improve workers' mental health, job satisfaction, retention, and patient outcomes. Considering the number of health care workers leaving work during the global COVID-19 pandemic, it is urgent to address preventable root causes. In 2021, the US Congress called for educating health workers and first responders on the primary prevention of mental health conditions and substance use disorders. The CDC issued a Request for Information; this submission summarized research from CPH-NEW, a NIOSH Center of Excellence in Total Worker Health®, supplemented by a selective literature review.

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.

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.

Prevalence of depressive symptoms in nurses compared to the general population based on Propensity Score Matching: A nationwide cross-sectional study in China

BACKGROUND

Depressive symptoms have a series of negative effects and are considered especially severe among nurses, whereas there is a lack of quantitative studies comparing the risk of depressive symptoms between nurses and the general population.

METHODS

We respectively conducted a nationwide cross-sectional online survey among 17,582 Chinese nurses from July to August 2018, and 101,120 Chinese community residents from January to February 2019. The questionnaire covered social-demographic characteristics and depressive symptoms for both, work-related factors and life-related factors for nurses. Propensity Score Matching was performed to match nurses and residents by gender, age, educational level, marital status, and habitual residence.

RESULTS

Before Propensity Score Matching, the risk of depressive symptoms in nurses was higher than residents (OR, 2.16; 95% CI, 2.07-2.26). After matching, there were 15,256 nurses and residents respectively, and the risk in nurses was higher (OR, 2.14; 95% CI, 2.02-2.27). Logistic regression showed that longer years of service (OR, 1.54; 95% CI, 1.30-1.83), higher night shift frequency (OR, 1.48; 95% CI, 1.35-1.64), perceived shortage of nurses (OR, 1.98; 95% CI, 1.84-2.13), suffered verbal violence (OR, 2.43; 95% CI, 2.21-2.66) and physical violence (OR, 1.80; 95% CI, 1.64-1.98) were risk factors for depressive symptoms in nurses.

LIMITATIONS

Convenience sampling and online survey were adopted in this cross-sectional study, which may diminish the representativeness of samples.

CONCLUSIONS

Compared with the general population, nurses have a higher risk of depressive symptoms in China. Reasonable work allocation, adequate staffing, scientific shift system and violence emergency system should be implemented.

Smoking in the workplace: A study of female call center employees in South Korea

Smoking among women is characteristically high among call center employees and is associated with various individual and work-related characteristics, which have been paid little attention so far. This study explored the differences in intrapersonal and interpersonal characteristics and environmental factors among Korean women working in call centers by smoking status, based on an ecological model. In this cross-sectional study, an anonymous online survey was conducted among a sample of female employees from three credit card-based call centers (N = 588). Differences in intrapersonal (social nicotine dependence, smoking attitudes, emotional labor), interpersonal (smoking among family or friends, social support), and environmental factors (smoking cessation education, and perceived and preferred smoking policy at work) were compared according to smoking status (smokers, ex-smokers, and never smokers). Approximately 20% (n = 115) were smokers. Smokers were younger, mostly unmarried, had lower education, and had poorer perceived health status than ex- and never smokers. The mean scores for social nicotine dependence and smoking attitude were the highest among smokers, indicating their tendency to underestimate the negative effects of smoking. They also reported the highest level of emotional labor, with about half (50.4%) and almost all (95.7%) reporting smoking behaviors in their families and friends, respectively. Smokers took a lenient stance on the smoking ban policy. The results indicated the necessity to develop tailored smoking cessation programs to motivate female call center employees to quit smoking. As call centers may have a smoking-friendly environment, comprehensive smoking prevention programs considering multilevel factors are required to support smoking cessation.

Job experience as a buffer against incivility: a daily diary study

Purpose

Incivility is pervasive in organisational settings, particularly in healthcare, and is associated with negative employee outcomes. The aim of this study was to analyse the relationships between experienced incivility, sleep quality and emotional outcomes, positioning sleep quality as a mediator. Additionally, the protective role of tenure and the unique effects of incivility from different sources were examined.

Design/methodology/approach

This study used a daily diary longitudinal design using self-report questionnaires with 92 nurses of varying tenure.

Findings

This research demonstrates that experiencing incivility negatively impacts sleep quality, which, in turn, increases surface acting and emotional exhaustion. Furthermore, the negative relationship between incivility and sleep quality is attenuated among nurses who have longer tenure.

Practical implications

These findings are helpful in developing targeted practical practices, such as incivility interventions and mentorship programs to reduce the incidence and impact of incivility.

Originality/value

This study draws upon theories of self-regulation and emotion regulation to examine how incivility diminishes self-control resources, leading to negative outcomes. This study also positions job tenure as a buffer against incivility and examines the differential impact of different sources of incivility.

Working Conditions and Long-Term Sickness Absence Due to Mental Disorders: A Prospective Record Linkage Cohort Study Among 19- to 39-Year-Old Female Municipal Employees

OBJECTIVE

We examined associations between working conditions and long-term sickness absence due to mental disorders (LTSA-MD) among younger female public sector employees from different employment sectors.

METHODS

Survey data collected in 2017 (n = 3048) among 19- to 39-year-old female employees of the City of Helsinki, Finland, were used to examine job demands, job control, physical workload, computer work, and covariates. Register data on LTSA-MD were used over 1-year follow-up. Negative binomial regression models were applied.

RESULTS

Adverse psychosocial and physical working conditions were associated with higher LTSA-MD during the follow-up. Health and social care workers had the highest number of days of LTSA-MD.

CONCLUSION

Working conditions are important factors when aiming to prevent LTSA-MD among younger employees, in the health and social care sector in particular.

Prevalence of depression and depressive symptoms among intensive care nurses: A meta-analysis

BACKGROUND

Nurses in intensive care units (ICUs) experience more stressful workplace conditions, making them more vulnerable to high levels of depression compared with those working in other healthcare settings.

OBJECTIVES

This meta-analysis aimed to estimate the pooled prevalence of depression in ICU nurses.

METHODS

A systematic search was conducted in Medline, EMBASE, CINHO, and Web of Science databases. Studies that reported depression among ICU nurses measured by a validated tool were synthesized using a random-effects model. Differences in prevalence of depression by study-level characteristics were estimated using sub-group analysis. Heterogeneity was investigated using standard Chi-squared tests and the I² statistic.

RESULTS

Data were extracted from 19 cross-sectional studies (2003-2020) from 11 countries involving 7196 ICU nurses. The overall pooled prevalence of depression or depressive symptoms among ICU nurses was 24.99% (95% CI, 17.9%-32.7%) with high between-study heterogeneity (χ²  = 812, τ²  = 0.03, I²  = 98%, P < .01).

CONCLUSION

Depression appears to be common among ICU nurses. Considering its negative impact on the quality of life of staff, patient care, and the overall critical care work environment, effective interventions should be designed and implemented to improve psychological health in this population.

RELEVANCE TO CLINICAL PRACTICE

Findings of this review indicate that regular screening for depressive symptoms might be helpful, and access to professional help and supportive care should be provided if necessary.

The Experience of Emotional Labor and Its Related Factors among Nurses in General Hospital Settings in Republic of Korea: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis aimed to investigate the status of emotional labor and its related factors among nurses in general hospital settings in Korea. A total of seven electronic databases were comprehensively searched to find relevant cross-sectional studies published up to 28 January 2021. The meta-analysis was performed using Stata version 13.1. In total, 131 studies were included. The population showed a standardized mean difference of 3.38 (95% confidence interval, 3.34 to 3.42) in emotional labor assessed by a 1–5 Likert scale. The level of emotional labor had significant negative correlations with job satisfaction, social support, organizational engagement, coworker support, resilience, and nurses’ work environment, while it had significant positive correlations with emotional labor and burnout, turnover intention, and job stress. Although the methodological quality of the included studies was generally good, 24 of the included studies (18.32%) were evaluated as lacking generalization potential or otherwise as unclear. In conclusion, nurses in general hospital settings in Korea experience mild-to-moderate levels of emotional labor. There is some evidence that the emotional labor of nurses and its detrimental effects can be buffered at both the individual and hospital levels, and future research should focus on developing targeted interventions and evaluating their effectiveness.

The Effect of Emotional Labor on Presenteeism of Chinese Nurses in Tertiary-Level Hospitals: The Mediating Role of Job Burnout

Background: Employees who are physically present but work insufficiently because of illness are deemed as having presenteeism. In the health care setting, the issue has taken on greater importance because of the impairment of the physical and mental health of nurses and the nursing safety of the patients. According to the Job Demand-Resource Model, burnout may link emotional labor with presenteeism. Thus, this study analyzed the role of burnout as a mediating factor between the three types of emotional labor strategies and presenteeism among nurses in tertiary-level hospitals. Methods: A cross-sectional study of 1,038 nurses from six Chinese hospitals was conducted. The questionnaires, including the 14-item emotional labor strategies scale, 22-item Maslach Burnout Inventory scale, 6-item Stanford Presenteeism Scale, and items about demographic characteristics and work-related factors, were used to collect data. A multivariable linear regression was used to predict work-related factors and investigate the correlation of emotional labor, burnout, and presenteeism. The structural equation model was implemented to test the mediating effects of job burnout. Results: The results of the study showed that the average presenteeism score of the participants was 14.18 (4.33), which is higher than in Spanish, Portuguese, and Brazilian nurses. Presenteeism was explained by 22.8% of the variance in the final model in multivariable linear regression (P < 0.01). Presenteeism was found to be positively correlated with surface acting, emotionally expressed demands, deep acting, emotional exhaustion, depersonalization, and low personal accomplishment (P < 0.01). Notably, presenteeism was negatively correlated with deep acting (P < 0.01). In addition, burnout partially mediated the correlation between emotionally expressed demands, deep acting, and presenteeism with a mediatory effect of 24 and 63.31% of the total effect. Burnout completely mediated the association between surface acting and presenteeism, a mediating effect of 86.44% of the total effect. Conclusions: The results of this study suggested that different emotional labor strategies affect presenteeism, either directly or indirectly. Nursing managers should intervene to reduce presenteeism by improving the ability of the nurses to manage emotions, thereby alleviating burnout.

Sociodemographic Factors and Depressive Symptoms Among Cardiac Nurses: A Cross-Sectional Study

Background: The nursing profession is predisposed toward depressed mood and depressive symptoms. The multidirectionality and intensity of stressors in the nurses' occupational environment are of great significance in this respect. The study aimed to evaluate the impact of selected sociodemographic factors on depressive symptoms among cardiac nurses.

Methods: This cross-sectional study included 336 cardiac nurses (302 women and 34 men) and was conducted between December 2019 and September 2020 in four hospital cardiac units in Wroclaw, Poland. Sociodemographic data were collected using a self-developed survey. The following standardized instruments were used for the study outcomes: Patient Health Questionnaire-9 (PHQ-9) and Beck Depression Inventory (BDI).

Results: The study among cardiac nurses showed mild depression in 11.61%, moderate depression in 5.06%, and severe depression in 2.68%. Linear regression models showed that significant (p < 0.05) predictors of the PHQ-9 score included (1) higher occupational education (bachelor's degree), graduation “only” from medical high school or “other” education; (2) work experience of 16–20 years; (3) living in a relationship; (4) living in a rural area. Linear regression models showed that significant (p < 0.05) predictors of the BDI score included (1) higher occupational education (bachelor's degree); (2) graduation “only” from medical high school or “other” education; (3) living in a relationship.

Conclusions: Depressive symptoms are a significant problem among Polish cardiac nurses. The prevalence of depressive symptoms is affected by the education level, employment form, marital status, and place of residence.

The nurses' occupational stress components and outcomes, findings from an integrative review

AIM

To identify, evaluate and summarize the components, factors and outcomes of nurses' occupational stress published between 2009-2019.

DESIGN

Integrative literature review.

METHODS

A literature search was conducted on PubMed, CINAHL and PsycINFO databases for articles published in English, between 2009-2019.

RESULTS

The review included 132 studies. Most studies were conducted in the Confucian Asia and Anglo countries, but a growing number of studies were done in other countries. Almost all studies used a quantitative design, and changes in the use of scales indicated an increasing attention to career-related components. Factors were categorized into sociodemographic, work environment and personal resources. Sociodemographic factors were inconsistent across countries. Outcomes were categorized into health status, capability, affective and behavioural responses to work, and organizational performance with generally consistent results. Model validation studies showed the non-linear or non-direct associations between stress and outcomes.

Relationship Between Emotional Labor and Perceived Health Status Among Service and Sales Workers: Findings From the Korea National Health and Nutrition Examination Survey 2007 to 2009

OBJECTIVES

This study examined the relationship between emotional labor and general health status in a nationally representative sample of South Korean service and sales workers.

METHODS

Data were obtained from the 2007 to 2009 Korea National Health and Nutrition Examination Survey. A total of 1907 subjects were included in the analysis. Multiple logistic regression was performed to determine the relationship between emotional labor and perceived health status (PHS).

RESULTS

The adjusted odds ratio (95% confidence interval) of poor PHS was 1.869 (1.464 to 2.391) among high emotional labor group, compared with the low emotional labor group as the reference. Perceived stress accounted for 35.57% of the variance in the relationship between high emotional labor and poor PHS.

CONCLUSIONS

Emotional labor was associated with increased risk of poor PHS.

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.

Influence of anxiety and resilience on depression among hospital nurses: A comparison of nurses working with confirmed and suspected patients in the COVID-19 and non-COVID-19 units

AIMS AND OBJECTIVES

This study aimed to compare anxiety, resilience, and depression between COVID-19 unit (confirmed patients and suspected patients) and non-COVID-19 unit nurses and assess their effects on depression.

BACKGROUND

Nurses working during the global pandemic are known to be physically and psychologically exhausted, and experience severe anxiety and depression. However, there is a lack of studies comparing anxiety and depression between COVID-19 and non-COVID-19 unit nurses.

DESIGN

Descriptive research study.

METHODS

This study was conducted on 64 nurses who directly worked for more than a month in a COVID-19 unit of a general hospital with nationally designated negative-pressure isolation beds and 64 nurses working in a non-COVID-19 unit. Data were collected through questionnaires and were analysed using SPSS 25.0. Reporting of this research adheres to the STROBE guidelines.

RESULTS

Anxiety and depression were significantly higher in nurses working with patients suspected to have COVID-19 rather than nurses working with confirmed COVID-19 patients and non-COVID-19 patients. Resilience was significantly lower in suspected patient unit nurses than in COVID-19 unit nurses. Anxiety was the major factor predicting depression in both COVID-19 unit (confirmed patients and suspected patients) and non-COVID-19 unit nurses with 76.6%, 80.7%, and 63.6% explanatory power, respectively.

CONCLUSIONS

Among nurses working in COVID-19 units, suspected patients unit nurses had higher depression than confirmed patients unit nurses due to an unsafe facility environment, insufficient personal protective equipment, and unknown conditions of the patients. Thus, interventions which have a high impact on depression need to be provided to relieve anxiety.

RELEVANCE TO CLINICAL PRACTICE

The nursing organisation must provide comprehensive support including coordinated shifts, internal motivation, incentives, up-to-date information, and clear infection prevention guidelines to relieve anxiety caused by exhaustive workload, uncertainty of infectious diseases, and lack of human and material resources.

The prevalence of upper quadrants work-related musculoskeletal disorders and their predictors among registered nurses

BACKGROUND

Work-related musculoskeletal disorders (WMSDs) represent a significant health challenge facing nurses. However, very few studies investigated the prevalence of WMSDs among nurses and their predictors comprehensively using a valid and reliable set of standardized outcome measures.

OBJECTIVE

This study aimed to investigate the prevalence WMSDs of upper quadrants and their predictors among registered nurses in Jordanian hospitals.

METHODS

A cross-sectional study recruited 597 registered nurses from different hospitals in Jordan. A self-administered survey distributed in targeted hospitals wards. Outcome measures included Nordic Musculoskeletal Questionnaire (NMQ), Depression Anxiety Stress Scale (DASS), Pittsburgh Sleep Quality Index (PSQI), International Physical Activity Questionnaire (IPAQ), sociodemographic data, and manual handling and work habits. Prevalence of musculoskeletal complaints was reported using descriptive analysis. Logistic regression analyses were used to identify predictors of WMSDs at each upper quadrant body site.

RESULTS

Twelve-month WMSDs prevalence was the highest at the neck (61.1%), followed by the upper back (47.2%), shoulders (46.7%), wrist and hands (27.3%), and finally at the elbow (13.9%). Being a female, poor sleep quality, high physical activity level, poor ergonomics, increased workload, and mental stress were significant predictors of increased upper quadrant WMSDs among nurses.

CONCLUSIONS

Upper quadrant WMSDs among nurses in Jordan are highly prevalent. Identified significant predictors of these WMSDs should be given full consideration by clinicians and health policymakers. Future studies are needed to reveal the progressive nature of upper quadrant WMSDs and strategies to modify their risk factors.

Emotional Labor and Depressive Symptoms Among Healthcare Workers: The Role of Sleep

BACKGROUND

Depression is the second leading cause of disability worldwide. Health care workers report a higher prevalence of depressive symptoms than the general population. Emotional labor has contributed to poor health and work outcomes. However, the mechanism for the potential association between emotional labor and depressive symptoms has not been well studied. This study examines the relationship between emotional labor and depressive symptoms and whether sleep plays a role in explaining this relationship.

METHODS

In 2018, health care workers (n = 1,060) from five public sector facilities in the northeast United States participated in this cross-sectional survey. The survey included questions on participants' surface-acting emotional labor (masking one's feelings at work), depressive symptoms, sleep duration and disturbances, and socio-demographic characteristics. Multivariable linear and Poisson regression modeling were used to examine associations among variables.

FINDINGS

There was a significant association between emotional labor and depressive symptoms (β = 0.82, p < .001). Sleep disturbances, but not short sleep duration, partially mediated this association. Neither sleep variable moderated this association.

CONCLUSIONS/APPLICATION TO PRACTICE

Depressive symptoms were prevalent among health care workers and were associated with emotional masking. Sleep disturbances play an important intermediate role in translating emotional labor to depressive symptoms in these workers. Effective workplace programs are needed to reduce health care workers' emotional labor to improve their mental health. Sleep promotion should also be emphasized to mitigate the negative effect of emotional labor and promote mental wellbeing.

Sleep quality and its predictors among hospital-based nurses: a cross-sectional study

PURPOSE

Sleep disorders are common among nurses and may have negative effects on their performance and well-being. This study aimed to investigate the level of sleep quality and its possible associated factors among hospital-based nurses in Jordan.

METHODS

A cross-sectional design targeting Jordanian hospital-based nurses. In addition to demographics and work habits, the outcome measures included Pittsburgh Sleep Quality Index (PSQI), Nordic Musculoskeletal Questionnaire (NMQ), and Depression Anxiety Stress Scale (DASS). Data were analyzed descriptively and by a multiple variable linear regression analysis to identify predictors of sleep quality.

RESULTS

In total, 597 nurses with a mean age of 32.1 (± 5.7) years participated in this study and 47% were men. PSQI mean score was 7.8 (± 3.7) and 68% of the participants showed sleep quality deficits. Stress (β = 0.15 [95%CI 0.13 to 0.19, P < 0.001), depression (β = 0.05 [95%CI 0.009 to 0.08], P = 0.015), the number of joints with 12 months musculoskeletal pain (β = 0.25 [95%CI 0.15 to 0.36], P < 0.001) positively predicted decreased sleep quality. Manual handling training (β = - 0.48 [95%CI -0.96 to 0.003], P = 0.048) and years of experience (β = - 0.05 [95%CI -0.09 to 0.002], P = 0.039) negatively predicted decreased sleep quality.

CONCLUSIONS

Nurses reported poor levels of sleep quality, high levels of mental health symptoms, and musculoskeletal pain complaints. Sleep quality among nurses and its predictors should be carefully considered by administrations of healthcare services.

The Influence of Social Support on the Relationship between Emotional Demands and Health of Hospital Nurses: A Cross-Sectional Study

Social support reduces the negative results of emotional labor. A more detailed analysis should be performed to facilitate adequate social support for nurses. Therefore, this study was conducted to examine the relationships among nurses’ emotional demands, social support, and health. A cross-sectional survey was conducted at two tertiary hospitals in South Korea. A sample of 117 nurses from eight units participated. Between-group differences in the main variables were analyzed using the t-test or Mann–Whitney test, and analysis of variance or the Kruskal–Wallis test. Nurses were classified into eight groups according to emotional demands and type of social support, and the effects of social support were analyzed based on mean scores. Greater social support from colleagues was associated with better health on all measures. However, greater social support from supervisors was associated with a higher incidence of burnout, stress, and sleeping troubles. Nurses’ high emotional demands must be managed actively by hospitals to maintain and promote their health. Providing appropriate social support with consideration of the nurse’s unit experience would help decrease the effects of emotional demands. Enhancing social support from nursing colleagues is a powerful way to manage the negative effects of nurses’ emotional demands.

Collegial surface acting emotional labour, burnout and intention to leave in novice and pre-retirement nurses in the United Kingdom: A cross-sectional study

Aim

To investigate the relationship between surface and deep acting in nurses' patient-focused and collegial emotional labour, with emotional exhaustion, depersonalization and personal accomplishment and intention to leave.

Design

A cross-sectional descriptive study using the Emotional Labour Scale, the Maslach Burnout Inventory and intention to leave Yes/No questions with 118 Registered Nurses to measure patient-focused and collegial emotional labour, burnout and intention to leave.

Results

Surface acting in patient-focused and collegial emotional labour was found to have positive associations with burnout and intention to leave their current job. Only surface acting in patient-focused emotional labour was positively associated with intention to leave the organization and/or the profession. The novice nurses carried out more deep acting collegial emotional labour than the pre-retirement nurses.

Conclusions

Collegial emotional labour is significant to nurses' intention to leave their current job but not their intention to leave the organization and/or the profession.

Is ionizing radiation a risk factor for anxiety in employees?

OBJECTIVE

Workers describe many physical and mental symptoms when working in radiation areas. This study aimed to assess these symptoms in radiation workers using the Beck Anxiety Inventory (BAI).

METHODS

A total of 42 radiation workers (22 males and 20 females, mean age 34±7 years) and 47 control subjects (22 males and 27 females, mean age 31± 8 years) who work in non-radiation areas in the hospital were included in the study. All participants anonymously filled out the Beck Anxiety Inventory (BAI) questionnaire.

RESULTS

The demographic data of workers were not significantly different between groups. In the BAI, the dizzy or lightheaded (p =0.01), terrified (p= 0.01), unsteady (p=0.02), heart-pounding and racing (p=0.02) items were significantly higher in the radiation-exposed group compared to the control group. |The BAI score was also significantly higher in the radiation-exposed group (11.1±6.8 vs. 8.7±3.8, p =0.04).

CONCLUSION

These results suggest the possibility that radiation may play a role in the psychometric properties of workers. The effects of radiation on the health of employees need to be further investigated and understood.

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.

A “gestalt” framework of emotions and organizing: integrating innate, constructed, and discursive ontologies

An ongoing debate exists regarding the ontology of emotions; that is, whether emotions are innate biological artifacts, social/discursive constructions, or—although less common in emotion research—both. Growing neuroscientific research provides strong evidence for the third perspective. Yet, this work foregrounds the individual’s experience, overlooking the role and context of organizing. In this article, we developed a new perspective of emotions and organizing. Our “gestalt” framework unites innate, socially constructed, and discursive ontologies to explain how emotions exist as innate yet latent organizational potentialities, become salient through social interaction, and are embedded in organizations through discourse. Together, these aspects comprise the gestalt emotion experience—where the whole is something more than its parts. The gestalt view offers organizational actors and scholars practical wisdom for navigating and analyzing emotions in organizations.

Surface-acting emotional labor predicts depressive symptoms among health care workers over a 2-year prospective study

OBJECTIVE

Surface-acting emotional labor (SaEL) is the requirement to hide or suppress felt emotions to achieve acceptable job performance. It is a common feature of jobs featuring interactions with the public, such as customers or patients. Resulting emotional inauthenticity is associated with psychological strain, but there have been few prospective studies of mental health outcomes.

METHODS

A self-administered questionnaire was distributed in 24 skilled nursing facilities at baseline and 23 facilities 2 years later. Permanent full-time and part-time employees in all jobs were eligible to participate. Respondents in these analyses provided survey information on the frequency of SaEL at baseline and depressive symptoms on both occasions. Those without depression at baseline were deemed at risk. Multivariable logistic regression modeling estimated adjusted odds ratios (aOR) for SaEL, other job features, and demographic characteristics.

RESULTS

A total of 939 eligible participants had no depression at baseline; 15% developed depressive symptoms. About two-thirds were direct care providers, including 38% nursing and medical assistants. Adjusted for potential confounders, workers with intermediate and high SaEL had a higher risk (aORs around 2). Symptom onset was also predicted by high work-family conflict, younger age and low decision latitude at work.

CONCLUSIONS

In this prospective study of long-term care workers, those who reported experiencing high SaEL at the time of the baseline survey were at higher risk of developing depressive symptoms 2 years later. Both exposure and outcome could have suffered some misclassification. Future studies should examine a broader range of strategies for coping with emotional labor demands.

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.

Longitudinal associations between occupational stress and depressive symptoms

Background

Most of the studies that have examined the association between the sub-factors of occupational stress and depressive symptoms have used cross-sectional data. However, our study has longitudinally measured the occupational stress and depressive symptoms of Korean workers of a semiconductor manufacturing company across six years to intending to investigate the associations between the sub-factors of occupational stress and depressive symptoms using longitudinal data.

Methods

Data collected from the workers of a semiconductor manufacturing company. Out of 1,013 recruited workers, 405 (40.0%) completed the survey questionnaires at 3 and 6-year follow-ups. Occupational stress was measured using a shorter version of the Korean Occupational Stress Scale (KOSS), whereas depressive symptoms were assessed using the Korean version of the Center for Epidemiological Studies-Depressive Symptoms Scale (CES-D). The data of male and female participants independently analyzed. Longitudinal associations were analyzed using panel data analysis with fixed effects.

Results

In panel data analysis with fixed effects, job insecurity (B = 0.048, p-value = 0.004) was associated with depressive symptoms among male workers. In female workers, inadequate social support (B = 0.080, p-value < 0.001), job insecurity (B = 0.039, p-value = 0.004), lack of reward (B = 0.059, p-value = 0.004) and discomfort in occupational climate (B = 0.074, p-value < 0.001) were associated with depressive symptoms among female workers.

Conclusions

Temporal changes in the sub-factors of occupational stress were associated with changes in depressive symptoms within the same period. There was a gender difference in occupational stress sub-factors related to depressive symptoms.

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.

Validation of Chinese Multidimensional Depression Assessment Scale (MDAS) in Inner Mongolia pregnant women and risk factors of antenatal depression in Inner Mongolia in the era of one-child policy

BACKGROUND

Pregnancy involves physiological changes in reproductive and endocrine systems, and social role changes that can increase the risk of mental health problems. In China, greater emphasis has been given to postpartum depression and its negative impact on infant development. This study examined depression in pregnant women in Inner Mongolia, who are under the influence of cultural values of collectivism and social factors specific to China. Chinese society adheres firmly to traditional values, while market reform, birth-control policy, together with high parental investment in childcare and rearing construct a unique and sometimes unfavorable environment for Chinese women that may influence their depression expression.

THE AIMS OF THIS STUDY ARE TWOFOLD

First, it validated the Chinese Multidimensional Depression Assessment Scale (MDAS), a holistic self-report questionnaire measuring depression severity in four domains of depression-emotional, somatic, cognitive and interpersonal in pregnant women in Inner Mongolia; second, it examined the influences of demographic characteristics (including age, education and employment), pregnancy characteristics (week of gestation, first pregnancy), self-esteem, social support, social activity, work stress, and work-family balance on depression.

METHODS

A total of 234 pregnant women, mostly in their third trimester, were recruited in an antenatal hospital in Inner Mongolia and self-reported questionnaires were completed.

RESULTS

Using Confirmatory factor analysis (CFA), MDAS gave rise to a best-fit four-factor model corresponding to each subscale when it was first developed. MDAS also reported high Cronbach's alpha (0.96) and good convergent validity. Using hierarchical multiple linear regressions with significant demographic variables controlled for, self-esteem, work-family conflict, and social support were found to be significant predictors for depression.

CONCLUSIONS

MDAS is a valid scale to be used with Chinese pregnant women, especially in more collectivistic geographical areas. Risk factors specific to the Chinese context add insights to the experience of antenatal depression in China and contribute to understanding depression in from a global mental health perspective.

Does Emotional Labor Increase the Risk of Suicidal Ideation among Firefighters?

PURPOSE

To investigate whether emotional labor is associated with suicidal ideation in Korean firefighters.

MATERIALS AND METHODS

Data were obtained from the Firefighter Research: Enhancement of Safety & Health (FRESH) Study, which was designed to investigate the effects of job characteristics on mental and physical health among Korean firefighters. A total of 18101 firefighters were chosen from a nationwide sample. The Korean Emotional Labor Scale (K-ELS) was used to evaluate exposure to emotional labor, which consisted of five sub-factors: emotional demand and regulation, overload and conflict in customer service, emotional disharmony and hurt, organizational surveillance and monitoring, and lack of a supportive and protective system in the organization.

RESULTS

Firefighters who were in the risk group were more likely to experience suicidal ideation than those in the normal group for each of the five sub-scales of emotional labor. The estimated mean values for suicidal ideation in the risk group were significantly higher than those in the normal group: 1.667 (95% CI: 1.344-2.069) for emotional demand and regulation, 1.590 (95% CI: 1.243-2.033) for overload and conflict in customer service, 2.409 (95% CI: 1.954-2.969) for emotional disharmony and hurt, 2.214 (95% CI: 1.832-2.676) for organizational surveillance and monitoring, and 1.665 (95% CI: 1.387-1.999) for lack of a supportive and protective system in the organization.

CONCLUSION

These results suggest that experience and exposure to chronic and excessive emotional labor might play a crucial role in the development of suicidal ideation among firefighters.

A systematic review on the effect of work-related stressors on mental health of young workers

PURPOSE

There is no review on the effect of work-related stressors on mental health of young workers. We systematically reviewed epidemiological evidence on this relationship.

METHODS

The review searched eight databases: Embase, PubMed, Web of Science, Cinahl, Cochrane Library, Informit, PsycINFO, and Scopus from their respective start dates until May 2017. Studies that have examined a mental health outcome in relation to a work-related stressor as exposure in young workers were included. The review was reported based on the PRISMA statement.

RESULTS

Three cross-sectional studies and six longitudinal cohort studies were included. Cross-sectional evidence showed that adverse work conditions including working overtime, job boredom, low skill variety, low autonomy, high job insecurity, and lack of reward were associated with poor mental health of young workers. Longitudinal evidence showed that high job demands, low job control, effort-reward imbalance, and low work support (men only) were associated with poor mental health. There was evidence on the contemporaneous relationship between two or more adverse work conditions and poor mental health.

CONCLUSIONS

Although more research (particularly high-quality longitudinal studies) is warranted in this area, our review indicates that work-related stressors have a negative impact on the mental health of young workers. The current review suggests that workplace interventions and policy are required to improve the quality of work for young workers.

Assessing the Association Between Emotional Labor and Presenteeism Among Nurses in Korea: Cross-sectional Study Using the 4th Korean Working Conditions Survey

Background

Presenteeism has emerged as an important health-related issue and has been studied in a variety of occupation groups. This study examines the relationship between emotional labor and presenteeism in nurses in Republic of Korea.

Methods

As a cross-sectional study, our study was conducted on 328 female nurses participating in the fourth Korean Working Conditions Survey (2015). Nurses were identified by the Korean Industry Classification Code. Multivariable logistic regression analysis was performed to explore the association between emotional labor and presenteeism.

Results

Female nurses who always or sometimes hide their emotions in the workplace were found to have a high risk for presenteeism compared with female nurses who rarely hide their emotions in the workplace {odds ratio [OR] = 2.40 [95% confidence interval (CI) 1.04–5.54]; OR = 4.12 [95% CI 1.72–9.84], respectively}. Furthermore, the risk of presenteeism was higher in nurses who sometimes engaged with complaining customers compared with nurses who rarely did so, but it lacked statistical significance.

Conclusion

Presenteeism in nurses can cause various negative secondary effects; therefore, an alternative should be sought to mediate nurses' emotional labor to prevent presenteeism.

Impact of emotional labour and workplace violence on professional quality of life among clinical nurses

AIM

We examined Korean nurses professional quality of life, emotional labour and workplace violence to guide development of interventions to improve nurses professional quality of life.

BACKGROUND

Nurses face heavy exposure to emotional labour and workplace violence. Stress experienced by nurses reduces compassion satisfaction and increases compassion fatigue.

METHODS

Participants comprised 399 clinical nurses chosen by convenience sampling. Questionnaires measured demographic characteristics, emotional labour, workplace violence and professional quality of life.

RESULTS

Nurses professional quality of life was affected by emotional labour and workplace violence. Graduate educational level, emotional exposure and emotional supervision were associated with compassion satisfaction. Burnout was commonly associated with emotional exposure, experience and supervision of workplace violence. Secondary traumatic stress was associated with emotional exposure and experience of workplace violence.

CONCLUSIONS

We elucidated the relationship between professional quality of life, emotional labour and workplace violence. Raising professional quality of life among nurses requires regular analysis of emotional labour and provision of organizational-level interventions. Counselling programmes that address violence prevention education and comprehensive response strategies among nurses and policies that foster an organizational culture of respect and cooperation in hospitals are needed.

Compassion fatigue, emotional labor, and emotional display among hospice nurses

The purpose of this study was to investigate relationships between compassion fatigue, emotional labor, and emotional display among hospice nurses (N = 90; 94.4% women). The hospice nurses indicated the emotional labor they utilize is primarily suppressing both positive and negative affect. Compassion fatigue was positively associated with expressing negative emotions, faking negative emotions, negative display rule perceptions, and surface acting, and negatively associated with suppressing negative emotions. Interventions and policies that foster greater authenticity and support emotional regulation may help reduce compassion fatigue among hospice nurses.

Workplace Violence in Chinese Hospitals: The Effects of Healthcare Disturbance on the Psychological Well-Being of Chinese Healthcare Workers

Healthcare disturbance is a form of workplace violence against healthcare workers perpetrated by patients, their relatives, and gangs hired by them. It is a prevalent phenomenon in China, where evidence suggests that it impacts on the job satisfaction of healthcare workers. This study aims to examine the relationship between healthcare disturbance, surface acting as a response to emotional labour, and depressive symptoms in Chinese healthcare workers. The study adopted a cross-sectional design and used an online survey methodology. Data were collected from 418 doctors and nurses from one hospital in China. The results showed that frequency of healthcare disturbance was positively related to surface acting and depressive symptoms, respectively; surface acting was also positively related to depression, while deep acting showed no effect on symptoms of depression. Furthermore, surface acting in response to emotional labour mediated the relationship between healthcare disturbance and depressive symptoms. The results highlight the importance of preventing healthcare disturbance and of training healthcare staff in strategies for managing emotional demands in reducing depressive symptoms in Chinese healthcare staff.

Systemic assessment of depressive symptoms among registered nurses: A new situation-specific theory

BACKGROUND

A mentally-healthy nursing workforce is vital to providing quality healthcare. While there has been research conducted internationally on depressive symptoms in nurses, most studies have lacked a theoretical framework.

PURPOSE

The purpose of this article is to describe the development of a situation-specific theory, the Systemic Assessment of Depressive Symptoms among Registered Nurses (SAD-RN).

METHODS

The SAD-RN was developed through theory synthesis using the Roy's Adaptation Model (RAM) as a framework. Sixty-four research articles were selected to abstract relevant concepts based on a priori RAM concepts.

FINDINGS

Using depressive symptoms as the anchor concept, related emergent concepts of SAD-RN include context, stressors, protective factors, negative health outcomes, and low patient care quality.

DISCUSSION

SAD-RN is an evidence-based comprehensive model that offers researchers a guiding theory to be used in their future research on depressive symptoms among RNs.

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.

Association of cumulative job dissatisfaction with depression, anxiety and stress among expatriate nurses in Saudi Arabia

AIMS

We aimed to (a) determine the prevalence of depression, anxiety and stress among expatriate nurses in Saudi Arabia, and (b) assess how dissatisfaction with salary, workload and teamwork, individually and in combination, was associated with those conditions.

BACKGROUND

Prevalence estimates for depression, anxiety and stress among nurses are higher than those in the general population. Available data on the mental health of expatriate nurses are limited.

METHODS

Expatriate nurses (n = 977) from governmental hospitals completed an electronic survey on demography, lifestyle, job factors, depression, anxiety and stress (assessed with DASS-21 scale). Multinomial logistic regressions were used for analyses.

RESULTS

Dissatisfaction with workload and teamwork was significantly associated with both mild/moderate and severe depression in adjusted models. Dissatisfaction with workload was significantly associated with both anxiety and stress, but teamwork was not. There was a significant dose-response relationship between the number of domains of dissatisfaction and depression, anxiety and stress (p for trend was < 0.001).

CONCLUSIONS

Dissatisfaction with salary, workload and teamwork is associated with depression, anxiety and stress in expatriate nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

Hospital and nursing administrators should identify specific aspects related to workload and teamwork and offer solutions to reduce mental health distress among nurses.

Job insecurity, fear of litigation, and mental health among expatriate nurses

The objective was to assess whether job insecurity and fear of litigation were correlates of depression, anxiety, and stress among expatriate nurses in Saudi Arabia. The participants included 977 expatriate nurses working in Al-Qassim, Saudi Arabia who completed an online survey that assessed depression, anxiety, and stress (using DASS-21) as well as demography, lifestyle, and job characteristics. Mean age was 32 years and 60% of nurses were from India/Pakistan. Twenty-four percent of nurses reported job insecurity, and 18% reported a fear of litigation. Severe depression, anxiety, and stress were significantly higher among nurses who always felt insecure about their job (compared to never) and among those who always feared litigation (compared to never). We concluded that job insecurity and fear of litigation were significant correlates of severe depression, anxiety, and stress among expatriate nurses.