Stressors, self-reported overall health, potential protective factors and the workplace well-being of nurses during the COVID-19 pandemic in Switzerland: a longitudinal mixed-methods study protocol

Changes in self-reported physical and mental health, behaviour and economic status among adults by known seropositivity and sociodemographic factors before and after the COVID-19 pandemic outbreak in Ischgl, Austria

Introduction

In early March 2020, a SARS-CoV-2 outbreak occurred in the ski resort of Ischgl, in Austria. After an initial seroprevalence study in April 2020, a follow-up study in November 2020 showed persistence of high levels of seropositivity. The impacts of SARS-CoV-2 infections and non-pharmaceutical interventions required to reduce transmission were wide-ranging, including worsened mental and physical health and economic damage.

Methods

We analysed data from the Ischgl follow-up study. Of the 1,259 adults that participated in the Ischgl-1 study (Ischgl-1), 801 were followed-up. Seropositivity was defined using presence of binding and neutralizing antibodies at Ischgl-1. At follow-up, 7 months later (Ischgl-2), participants reported changes to self-rated mental and physical health, physical activity, alcohol consumption, smoking and economic status. Changes were compared by serological status, using multivariable logistic and multinomial regression models, where appropriate, and adjusting for factors including age, sex, and morbidity.

Results

1 in 2 participants reported experiencing a moderate or severe impact of the pandemic. One fifth of participants reported a worsening in their mental health from November 2019 to November 2020; women and participants aged ≥35 to <70 years were disproportionately affected. Seropositivity was associated with a decline in physical health but no decline in mental health or behaviour changes. Very few participants reported any changes in behaviours. The overriding impact the population of Ischgl was economic-50% of participants reported a worsening of their professional and/or financial situation. Declines in self-reported mental health were associated with the overall experience of the pandemic and economic factors.

Conclusion

The population of Ischgl demonstrated a high level of resilience to the pandemic as measured by health. However, certain segments of the population were disproportionately affected, particularly with regard to mental health and economic wellbeing. Future pandemic preparedness must consider how pandemic mitigation strategies can be responsive to context and the wider impacts on mental health and social and economic wellbeing while minimising mortality and safeguarding health systems.

Quality of life and professional wellbeing of Portuguese nurses during the COVID-19 pandemic: a longitudinal study

BACKGROUND

Several studies have indicated that the COVID-19 pandemic has had an impact on nurses' psychological and physical quality of life (QoL), as well as on their professional well-being. The literature also indicates that perceived stress, resilience, social support, the psychosocial work environment and professional identification may be determinants of these variables. However, no studies have examined how these determinants may influence nurses' psychological and physical QoL or professional well-being throughout the COVID-19 pandemic. Thus, this study aimed to investigate the influence the influence of perceived stress, resilience, perceived social support, the psychosocial work environment and professional identification on Portuguese nurses' professional well-being and physical and psychological QoL throughout the COVID-19 pandemic.

METHODS

For this longitudinal study, data were collected through self-administered questionnaires focused on QoL, professional well-being, and sociodemographic characteristics. The data collection spanned three distinct time points, from November 2021 to June 2023. Data Analysis was conducted by utilizing random-intercept linear regression models.

RESULTS

A total of 555 responses were analyzed at all of the measurement points (340 responses at T0, 122 at T1, and 93 at T2), and compared to those at T0, physical and psychological QoL increased at T2. Perceived stress and support from colleagues diminished at T2 compared to T0. During the COVID-19 pandemic, participants who reported low perceived stress, high resilience, high social support from supervisors, high social support from colleagues, and/or high job satisfaction tended to report greater professional well-being and physical and psychological QoL.

CONCLUSIONS

Throughout the COVID-19 pandemic, perceived stress consistently negatively influenced nurses' professional well-being and physical and psychological QoL; moreover, resilience and job satisfaction were consistently significant positive determinants of all outcomes. These insights highlight the need for targeted interventions to reduce stress, enhance resilience, and foster job satisfaction among nurses, thus ultimately improving their QoL, professional well-being and effectiveness in health care delivery, particularly during high-stress periods such as pandemics. Future research should explore how these stressors and protective factors influence nurses' QoL and professional well-being.

[Nurses' health during the COVID-19 pandemic in Switzerland: A longitudinal study with mixed methods design]

Nurses' health during the COVID-19 pandemic in Switzerland: A longitudinal study with mixed methods design Abstract: Background: The COVID19 pandemic has had a significant impact on healthcare systems worldwide. Nurses have played a crucial role in responding to the crisis, often at the expense of their own health and wellbeing. Aim: The aim of the study was to investigate the physical and mental health status as well as the resources of certified nurses during the pandemic, in German-speaking Switzerland. Methods: In a longitudinal study with a mixed methods design, data were collected among nurses from acute hospitals between 2021 and 2022 using a questionnaire survey and focus group interviews. The data were analysed using multiple regression analysis, knowledge mapping and the Neuman system model. Results: The results show improvements in health, quality of life and job satisfaction, and a decrease in stress; whereby influencing extrapersonal factors are, among others, reorganisations within hospitals with the active involvement of nurses. On the interpersonal level, support from managers or colleagues proved helpful. At the intrapersonal level, the recognition of the nurses' competencies was deemed particularly important, to help them to remain healthy during the pandemic. Conclusions: Increased recognition, participation, training and career opportunities as well as flexible working models need to be implemented in the long term to ensure a sustainable improvement of the health and well-being of nurses.

Protective Factors of Nurses' Mental Health and Professional Wellbeing During the COVID-19 Pandemic: A Multicenter Longitudinal Study

Objective

Using a salutogenic approach, this study aimed to identify similarities in the protective factors of nurses' psychological Quality of Life (QoL) and professional wellbeing (PWB) in four countries and to assess their variability over time during the COVID-19 pandemic.

Methods

This multicentric study used a longitudinal design with three measurements points: Autumn 2021, spring 2022, and autumn 2022. The study consisted in a self-administered online questionnaire addressed to nurses working in hospitals. Across all measurement times, 3,310 observations were collected in France, 603 in Switzerland, 458 in Portugal, and 278 in Canada. The outcomes were psychological QoL and PWB, and several potential protective factors were used as determinants.

Results

Analyses revealed few changes over time in the outcomes. Across all countries, psychological QoL was associated positively with resilience and perceived social support, whereas PWB was associated positively with the ability to provide quality work and support from colleagues and superiors.

Conclusion

The findings of this study highlighted the potential of several factors protective of nurses' psychological QoL and PWB. These should be fostered through policies and measures to support nurses.

Nurses Response to the Physical and Psycho-Social Care Needs of Patients with COVID-19: A Mixed-Methods Study

The COVID-19 pandemic heavily impacted nursing care. This study aimed to understand which nursing interventions were instrumental in responding to COVID-19 patients' needs by exploring the experiences of patients and nurses. In this mixed-method study with an explanatory sequential design, we involved nurses caring for COVID-19 patients in intensive and sub-intensive care units and patients. In the first phase, we collected data through a survey that assessed patients' needs from the perspective of nurses and patients, as well as patient satisfaction. In the second phase, qualitative data were collected through interviews with patients and nurses. In the third phase, we extracted quantitative data from patients' records. Our sample included 100 nurses, 59 patients, 15 patient records, and 31 interviews (15 patients, 16 nurses). The results from the first phase showed patients and nurses agreed on the most important difficulties: "breathing", "sleep/rest", and "communication". Nursing care was rated positively by 90% of the patients. In the second phase, four themes were identified through the patients' interviews: "my problems", "my emotions", "helpful factors", and "nursing care". Five themes were identified through the nurses' interviews: "the context", "nurses' experiences and emotions", "facilitators and barriers to patient care", "nursing care", and "the professional role". From the third phase, the analysis of the clinical documentation, it was not possible to understand the nursing care model used by the nurses. In conclusion, nurses adopted a reactive-adaptive approach, based on experience/knowledge, pursuing generalized objectives, and adapting their response to the clinical evolution. In difficult contexts, nursing care requires a constant competent technical-relational presence at the patient's bedside.

Factors protecting Swiss nurses' health during the COVID-19 pandemic: a longitudinal study

BACKGROUND

The COVID-19 pandemic reached Europe in early 2020 and impacted nurses over a prolonged period, notably causing heavy work overloads. Exposure to sources of stress in such situations is inevitable, which can put nurses' health at risk. The present study took a salutogenic approach to investigating nurses' health and the principal factors protecting it found in the literature (i.e., resilience, post-traumatic growth, social support, and certain organizational factors), as well as how those elements evolved from February 2021 to September 2022.

METHODS

All nurses working at eight French-speaking Swiss hospitals who accepted to disseminate the study to their employees were invited to complete an online questionnaire at four time points (February 2021, September 2021, March 2022, and September 2022: T0, T1, T2, and T3, respectively) and respond to items measuring their health, factors protecting their health, and their perceived stress levels. Data were analyzed using random-intercept linear regression models.

RESULTS

A cumulated total of 1013 responses were collected over all measurement points (625 responses at T0; 153 at T1; 146 at T2; 89 at T3). Results revealed that nurses' health had not changed significantly between measurements. However, their perceived stress levels, feelings of being supported by their management hierarchies, and belief that they had the means to deliver a high quality of work all diminished. At every measurement point, nurses' health was negatively associated with perceived stress and positively associated with resilience, perceived social support, and the belief that they were provided with the means to deliver a high quality of work.

CONCLUSION

Despite the difficult conditions caused by the pandemic, the factors recognized as protective of nurses' health played their role. The lack of improvements in nurses' health in periods when the pandemic's effects lessened suggests that the pressure they were experiencing did not drop during these moments. This phenomenon may have been due to the need to clear backlogs in scheduled surgery and the work overloads caused by prolonged staff absences and nurses quitting the profession. Monitoring changes in nurses' health is thus crucial, as is establishing measures that promote factors protective of their health. Organizational factors influencing nurses' working conditions are also key and should not be neglected.

Workplace Wellbeing and Quality of Life Perceived by Portuguese Nurses during the COVID-19 Pandemic: The Role of Protective Factors and Stressors

During the COVID-19 pandemic, nurses were exposed to many stressors, which may have been associated with some mental health problems. However, most of the studies carried out on nurses' quality of life and workplace wellbeing during the COVID-19 pandemic took a pathogenic approach. Given that current scientific knowledge in this field presented too many gaps to properly inform preventive and therapeutic action, the aim of this study was to explore whether protective factors (resilience, perceived social support, and professional identification) and stressors (perceived stress and psychosocial risks in the workplace) influenced the quality of life and workplace wellbeing perceived by Portuguese nurses during the COVID-19 pandemic. Data for this cross-sectional study was collected through online self-administered questionnaires. Linear regression models were used to analyze the relationships between variables. Results showed that perceived stress, resilience and job satisfaction were associated with quality of life and workplace wellbeing among Portuguese nurses. The study's findings could serve to inform health policy and should draw the attention of nursing managers to the needs and difficulties reported by nurses, to the importance of providing them with emotional support, and to the relevance of promoting a good work environment.

Protective Factors and Coping Styles Associated with Quality of Life during the COVID-19 Pandemic: A Comparison of Hospital or Care Institution and Private Practice Nurses

In France, nurses work either in hospitals and care institutions or in private practice, following physicians' prescriptions and taking care of patients at their homes. During the COVID-19 pandemic, these populations of nurses were exposed to numerous sources of stress. The main objective of the present study was to identify the protective factors they mobilized to face the crisis and how these factors contributed to sustaining their quality of life (QoL). A cross-sectional study was conducted to answer these questions. Overall, 9898 French nurses participated in the study, providing demographic information and filling out QoL (WHOQOL-BREF), perceived stress (PSS-14), resilience (CD-RISC), social support (MSPSS), and coping style (BRIEF-COPE) questionnaires. The results revealed very few differences between the two groups of nurses, which is surprising given the drastically different contexts in which they practice. Social support and two coping strategies (positive reframing and acceptance) were associated with a high QoL, whereas perceived stress and four coping strategies (denial, blaming self, substance use, and behavioral disengagement) were associated with poor QoL. In the light of these results, we recommended promoting social support and coping strategies to help nurses cope during the pandemic.