Cognitive appraisals and coping strategies of registered nurses in the emergency department combating COVID-19: A scoping review

A descriptive analysis of nurses' self-reported mental health symptoms during the COVID-19 pandemic: An international study

AIM

To describe the self-reported mental health of nurses from 35 countries who worked during the COVID-19 pandemic.

BACKGROUND

There is little occupationally specific data about nurses' mental health worldwide. Studies have documented the impact on nurses' mental health of the COVID-19 pandemic, but few have baseline referents.

METHODS

A descriptive, cross-sectional design structured the study. Data reflect a convenience sample of 9,387 participants who completed the opt-in survey between July 31, 2022, and October 31, 2023. Descriptive statistics were run to analyze the following variables associated with mental health: Self-reports of mental health symptoms, burnout, personal losses during the pandemic, access to mental health services, and self-care practices used to cope with pandemic-related stressors. Reporting of this study was steered by the STROBE guideline for quantitative studies.

RESULTS

Anxiety or depression occurred at rates ranging from 23%-61%, with country-specific trends in reporting observed. Approximately 18% of the sample reported experiencing some symptoms of burnout. The majority of nurses' employers did not provide mental health support in the workplace. Most reported more frequently engaging with self-care practices compared with before the pandemic. Notably, 20% of nurses suffered the loss of a family member, 35% lost a friend, and 34% a coworker due to COVID-19. Nearly half (48%) reported experiencing public aggression due to their identity as a nurse.

CONCLUSIONS

The data obtained establish a basis for understanding the specific mental health needs of the nursing workforce globally, highlighting key areas for service development.

IMPLICATIONS FOR NURSING POLICY

Healthcare organizations and governmental bodies need to develop targeted mental health support programs that are readily accessible to nurses to foster a resilient nursing workforce.

Workforce research priorities for emergency nurses in Australia

BACKGROUND

The current nursing shortage is a critical issue facing healthcare systems. Workforce research priorities foremergency nurses are limited.This study aimed to identify, collate, and prioritise areas of workforce research for emergency nursing in Australia.

METHODS

This priority-setting study was conducted with ED nurses from September 2022 to August 2023 and comprised: i) an initial survey, ii) face-to-face group discussions, and iii) a prioritisation survey.

RESULTS

A total of 318 ED nurses responded to the initial survey. Staffing (n = 245), workload (n = 112), access block (n = 63) and burnout (n = 54) were nominated as workforce concerns. Responses were grouped into three overarching categories: person, department, and organisation. These categories informed the face-to-face group discussions. A total of 30 ED nurses participated in one of three face-to-face group discussions. Sub-themes, including resilience, workload, and well-being emerged. From the prioritisation survey completed by 163 ED nurses, the highest-ranked workforce research priorities pertained to turnover and retention.

CONCLUSIONS

The research priorities identified reflect important and contemporary workforce issues for emergency nurses. Efforts to progress research in these priority workforce areas should be encouraged and supported.

Determinants maintaining healthcare personnel's motivation during COVID-19 pandemic in Uganda

BACKGROUND

Maintaining the physical and psychological well-being of healthcare workers (HCWs) is crucial for health system resilience. In sub-Saharan Africa, particularly Uganda, HCWs faced significant challenges during the coronavirus disease 2019 (COVID-19) pandemic, compounded by pre-existing resource constraints. This study investigated challenges faced by HCWs at a designated COVID-19 hospital ('the Hospital') and explored determinants of maintaining healthcare personnel's motivation during the COVID-19 pandemic in Uganda.

METHODS

A facility-based cross-sectional study was conducted at the Hospital from May to July 2023, with 120 HCWs categorised by profession. Data were collected using a structured questionnaire. Descriptive and logistic regression analyses were performed to identify motivation-related factors. The questionnaire assessed sociodemographic data, COVID-19 knowledge, medical history, support received, and pandemic-related challenges. Psychological impact was measured using a four-point Likert scale.

RESULTS

Among respondents, 61.7% worked during the first lockdown and 93.3% during the second. COVID-19 knowledge was high, with over 70% answering questions correctly, although vaccine effectiveness had a slightly lower accuracy rate. The study revealed that 32.5% of HCWs tested positive for COVID-19 and 25% displayed vaccine hesitancy. Key challenges included fear of infection, transportation disruptions, income reduction, and social isolation. Notably, 92.5% reported significant anxiety related to infection. Factors positively associated with remaining motivated were age (≤ 30 versus > 30 years; adjusted odds ratio [AOR]: 10.34, 95% CI; 1.92-55.74), profession (co-medical/non-medical staff versus medical doctors/medical officers; AOR: 11.66, 95% CI: 1.03-132.22), receiving mentoring/tutoring (AOR: 18.87, 95% CI: 2.55-139.72), and information from supervisors/management (AOR: 12.5, 95% CI: 2.60-60.42). In contrast, psychological impact was negatively affected by isolation from family and friends (AOR: 0.61, 95% CI: 0.41-0.92).

CONCLUSIONS

Despite challenges, most HCWs at the Hospital remained motivated. These findings emphasised the importance of technical and psychological support, such as mentoring and effective communication from upper-level supervisors, rather than financial incentives, in maintaining motivation among the HCWs. Comprehensive support systems are essential for sustaining HCWs' motivation during the pandemic, especially in resource-limited settings. Further research should address the long-term mental health effects and enhance HCWs' resilience in future health crises.

The impact of nurses' stress situation coping on somatization: a mediated moderation model

Aims

The purpose of this study is to investigate the impact of nurses' stress situation coping levels on somatization symptoms, the mediating effect of depression, and the moderating effect of perceived social support.

Background

As a core part of the global healthcare system, nurses are crucial to patient health and rehabilitation outcomes. However, due to heavy workloads, unreasonable staffing structures, and constant exposure to occupational risks in their workplaces, these factors often place nurses in a high-intensity, high-stress environment, which directly affects their physical and mental health and professional burnout. Coping with stress situations is an important means to help individuals effectively manage stress, reduce negative impacts, and maintain mental health. However, research on the impact of nurses' stress situation coping methods on somatization symptoms is limited.

Methods

This study conducted a cross-sectional survey from December 2022 to April 2023, and finally included 293 nurses working on the front line of tertiary hospitals. Data was collected through questionnaires and analyzed using SPSS 24.0 and the SPSS macro program's Models 7 and 14. This study is an observational study, strictly prepared and presented according to the STROBE checklist.

Results

The somatization symptom scores of the nurses were (27.27 ± 7.33) points, the stress situation coping scores were (59.90 ± 9.64) points, the perceived social support scores were (65.64 ± 12.90) points, and the depression scores were (4.42 ± 4.12) points. The somatization symptom scores of the nurses were positively correlated with the stress situation coping scores and depression scores, and negatively correlated with the perceived social support scores, with correlation coefficients of 0.200, 0.851, and -0.302, respectively. The stress coping level of the nurses had a direct positive impact on somatization symptoms (β = 0.081, p = 0.009), and a direct positive impact on nurse depression (β = 0.202, p = 0.001). Depression had a significant positive impact on somatization symptoms (β = 0.823, p = 0.000), and depression played a mediating role. Perceived social support had a significant negative impact on depression (β = -0.383, p = 0.000). Perceived social support had a significant moderating effect on the relationship between the stress situation coping level and depression (β = -0.121, p = 0.003).

Conclusion

In this study, the stress situation coping methods of nurses had a positive impact on somatization symptoms, had a complete mediating effect on the depression level of nurses, and perceived social support had a significant moderating effect in the pathway from the stress situation coping methods of nurses to depression-mediated somatization symptoms.

Exploring Nurses' Behavioural Intention to Adopt AI Technology: The Perspectives of Social Influence, Perceived Job Stress and Human-Machine Trust

AIM

This study examines how social influence, human-machine trust and perceived job stress affect nurses' behavioural intentions towards AI-assisted care technology adoption from a new perspective and framework. It also explores the interrelationships between different types of social influence and job stress dimensions to fill gaps in academic literature.

DESIGN

A quantitative cross-sectional study.

METHODS

Five hospitals in Taiwan that had implemented AI solutions were selected using purposive sampling. The scales, adapted from relevant literature, were translated into Chinese and modified for context. Questionnaires were distributed to nurses via snowball sampling from May 15 to June 10, 2023. A total of 283 valid questionnaires were analysed using the partial least squares structural equation modelling method.

RESULTS

Conformity, obedience and human-machine trust were positively correlated with behavioural intention, while compliance was negatively correlated. Perceived job stress did not significantly affect behavioural intention. Compliance was positively associated with all three job stress dimensions: job uncertainty, technophobia and time pressure, while obedience was correlated with job uncertainty.

CONCLUSION

Social influence and human-machine trust are critical factors in nurses' intentions to adopt AI technology. The lack of significant effects from perceived stress suggests that nurses' personal resources mitigate potential stress associated with AI implementation. The study reveals the complex dynamics regarding different types of social influence, human-machine trust and job stress in the context of AI adoption in healthcare.

IMPACT

This research extends beyond conventional technology acceptance models by incorporating perspectives on organisational internal stressors and AI-related job stress. It offers insights into the coping mechanisms during the pre-adaption AI process in nursing, highlighting the need for nuanced management approaches. The findings emphasise the importance of considering technological and psychosocial factors in successful AI implementation in healthcare settings.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

"I Just Know if I Keep Going, I'll End Up Hating Nursing." Lived Experiences of Emergency Nurses Three Years Into the Global COVID-19 Pandemic

INTRODUCTION

As the coronavirus disease 2019 pandemic continues globally, the personal and professional pressure on health care workers continues to accumulate. Literature suggests that as the pandemic evolves, nurses are experiencing increased levels of anxiety, depression, and post-traumatic stress, ultimately leading them to voice intentions to leave the profession, if they have not done so already.

METHODS

Informed by an interpretive hermeneutic phenomenological approach, this longitudinal study was designed to capture how the lived experiences of 9 emergency nurses evolved over the coronavirus disease 2019 pandemic, highlighting their feelings, attitudes, and perceptions toward working in the emergency department at this time in history. Interviews were undertaken in June 2022 and were analyzed using a thematic analysis approach.

RESULTS

Data analysis resulted in a total of 2 major themes and 8 minor themes. The 2 major themes included "exposed wounds" and "Band-Aid solutions." Levels of burnout increased during the pandemic, with most of the emergency nurse participants dropping their hours, moving roles within the profession, or leaving the profession entirely. Findings elucidate where and how concerns may arise in clinical practice and holistic well-being among emergency nurses, particularly surrounding professional boundaries and protecting work-life balance and professional identity.

DISCUSSION

As the world moves to managing coronavirus disease 2019 as a recognized common respiratory illness, providing time and space for emergency nurses to voice their concerns, design their well-being interventions, set professional boundaries, and reconnect with their professional passion may see lower attrition rates and higher levels of professional satisfaction in emergency nurses globally.

Covid-19 pandemic? Mental health implications among nurses and Proposed interventions

Background

With its abrupt and huge health and socio-economic consequences, the coronavirus disease (COVID-19) pandemic has led to a uniquely demanding, intensely stressful, and even traumatic period. Healthcare workers (HCW), especially nurses, were exposed to mental health challenges during those challenging times.

Objectives

Review the current literature on mental health problems among nurses caring for COVID-19 patients.

Methods

This is a narrative review and critical evaluation of relevant publications.

Results

Nurses experienced higher levels of stress, burnout, anxiety, depression, frustration, stigma, and depersonalization compared to other HCW. Factors that increased this symptomatology included concerns about infection or infection of family members, inadequate staff protective equipment, extended working hours, insufficient information, a reduced sense of security, and post-traumatic stress disorder. The factors that improved the psychopathology included a general positive attitude, job satisfaction, adequate information and education, harmonious group relationships, post-traumatic development, emotional intelligence, psychological counseling, mindfulness-based stress reduction, stable leadership, guidance, and moral and practical administrative support.

Conclusions

Recent studies clearly show that nurses, especially women, are the most vulnerable subgroup among HCW and are particularly prone to mental health impacts during the COVID-19 pandemic. The documented mental health vulnerability of frontline nursing staff during the COVID-19 pandemic requires preventive nursing management actions to increase resilience and to develop relevant defense mechanisms.

"Patient dignity can be ensured by providing adequate health care": A phenomenological analysis on survival strategies of military nurses

Background

The devastating COVID-19 outbreak has considerably influenced basic human healthcare needs. Due to healthcare organizational limitations, workload, and a shortage of healthcare professionals, particularly military nurses in developing countries, faced critical situations in dealing with COVID-19 patients. However, little is known about the survival strategies military nurses used while caring for coronavirus-infected patients.

Aims

This study aimed to investigate the survival strategies that inspired military nurses to manage COVID-19 patients in Bangladesh.

Methods

This study employed the phenomenology of practice framework developed by Max van Manen. Fourteen military nurses were purposefully selected to participate in this study. Semi-structured online interviews were conducted individually from January to February 2023 in three divisional (Dhaka, Chittagong, and Sylhet) COVID-19 dedicated military hospitals in Bangladesh. The study was reported using the COREQ checklist. Audio-video sessions of discussions were recorded, analyzed, and transcribed verbatim. Dataset analysis was performed using thematic analysis.

Results

Eight themes were developed: (i) Nurses' self-strategies; (ii) colleagues' strategies; (iii) Nurse managers' strategies; (iv) Feelings about nursing ethical values; (v) Employers' strategies; (vi) Government strategies; (vii) Family members' strategies; (viii) Strategies of social people.

Conclusions

The study's findings would inspire healthcare professionals to use various survival strategies when facing critical clinical situations. Additionally, this study encourages nurses to develop survival skills to avoid depression, fear, and anxiety and to learn how to deal with work-related stress situations.

Factors Effective in Lowering Professional Commitment in Nursing and Strategies to Address Them: A Scoping Review

Objectives

This study explores the factors leading to decreased professional commitment among nurses and proposes actionable solutions to mitigate the challenges posed by this phenomenon in nursing.

Methods

This research was conducted by employing the scoping review methodology. To this end, the relevant studies were obtained by two researchers independently searching over Scopus, Medline (via PubMed), Proquest, SID, Magiran, and Web of Science databases. The extracted data from the primary studies were organized into a table, including author names, publication year, study population, study objectives, study methodology, and key findings.

Results

Based on the primary research question, seven main themes contributing to the decline in professional commitment to nursing were determined as follows: professional and organizational challenges, human relations, personal wellbeing and coping, work-life balance and success, organizational culture, the nature of the nursing profession and beliefs, human emotions, values, and ethics. Also, the secondary question of the research was responded to by identifying four main themes: (1) empowering nurses, (2) nursing leadership and support, (3) safety concerns and interactions with patients, and (4) welfare facilities.

Conclusion

The findings of this study highlight the necessity of implementing nurse empowerment programs and providing financial and moral support from the organization and nursing leaders to enhance professional commitment to nursing.