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van Diepen C, Lood Q, Gustavsson K, Axelsson M, Bertilsson M, Hensing G, Fors A. Person-centred care and the work-related health and job satisfaction of health and social care professionals: protocol for a prospective longitudinal cohort study combined with qualitative studies (the PCC@Work project). BMC Health Serv Res 2024; 24:683. [PMID: 38816736 DOI: 10.1186/s12913-024-11148-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/24/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND The interplay of ethical stress, heavy workloads, and job dissatisfaction poses challenges to both the recruitment and retention of health and social care professionals. Person-centred care, rooted in ethical principles, involves collaborative care, and is expected to improve care and job satisfaction. However, prior research on the impact of person-centred care practices on professionals' work-related health and job satisfaction has yielded mixed results, and most studies emanate from residential care. Understanding how person-centred care practices influence health and social care professionals across different care settings thus requires further exploration through rigorous methodology. The overall aim of PCC@Work is to follow, describe, assess, and explore the impact of person-centred care practices in hospital wards, primary care centres and municipal care on health and social care professionals' work-related health and job satisfaction. METHODS PCC@Work is designed as a prospective, longitudinal cohort study combined with qualitative studies. A web-based questionnaire will be distributed on five occasions within two years to health and social care professionals in the three care settings. In addition, focus groups and interviews will be conducted with a selection of health and social care professionals to explore their experiences of work-related health and job satisfaction in relation to person-centred practices. DISCUSSION PCC@Work will highlight some of the knowledge gaps on the impact of person-centred care practices regarding work-related health and job satisfaction of health and social care professionals. The uniqueness of the project lies in the multi-method design, combining a prospective longitudinal cohort study with qualitative studies, and the involvement of various professions and settings. This means we will be able to provide a comprehensive and representative understanding of person-centred care practices as a critical component for effective change in the working conditions of health and social care.
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Affiliation(s)
- Cornelia van Diepen
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands.
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
| | - Qarin Lood
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Ageing and Health - AgeCap, University of Gothenburg, Gothenburg, Sweden
| | - Kristoffer Gustavsson
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
| | - Malin Axelsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Monica Bertilsson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gunnel Hensing
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Andreas Fors
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
- Research, Education, Development and Innovation, Region Västra Götaland, Primary Health Care, Gothenburg, Sweden
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Gogoi M, Qureshi I, Chaloner J, Al-Oraibi A, Reilly H, Wobi F, Agbonmwandolor JO, Ekezie W, Hassan O, Lal Z, Kapilashrami A, Nellums L, Pareek M. Discrimination, disadvantage and disempowerment during COVID-19: a qualitative intrasectional analysis of the lived experiences of an ethnically diverse healthcare workforce in the United Kingdom. Int J Equity Health 2024; 23:105. [PMID: 38783292 PMCID: PMC11118759 DOI: 10.1186/s12939-024-02198-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Healthcare workers (HCWs) in the United Kingdom (UK) have faced many challenges during the COVID-19 pandemic, some of these arising out of their social positions. Existing literature explicating these challenges (e.g., lack of appropriate PPE, redeployment, understaffing) have highlighted inequities in how these have been experienced by HCWs based on ethnicity, gender or, job role. In this paper, we move a step ahead and examine how the intersection of these social positions have impacted HCWs' experiences of challenges during the pandemic. METHODS We collected qualitative data, using interviews and focus groups, from 164 HCWs from different ethnicities, gender, job roles, migration statuses, and regions in the United Kingdom (UK) between December 2020 and July 2021. Interviews and focus groups were conducted online or by telephone, and recorded with participants' permission. Recordings were transcribed and a hybrid thematic analytical approach integrating inductive data-driven codes with deductive ones informed by an intersectional framework was adopted to analyse the transcripts. RESULTS Thematic analysis of transcripts identified disempowerment, disadvantage and, discrimination as the three main themes around which HCWs' experiences of challenges were centred, based on their intersecting identities (e.g., ethnicity gender, and/or migration status). Our analysis also acknowledges that disadvantages faced by HCWs were linked to systemic and structural factors at the micro, meso and macro ecosystemic levels. This merging of analysis which is grounded in intersectionality and considers the ecosystemic levels has been termed as 'intrasectionalism'. DISCUSSION Our research demonstrates how an intrasectional lens can help better understand how different forms of mutually reinforcing inequities exist at all levels within the healthcare workforce and how these impact HCWs from certain backgrounds who face greater disadvantage, discrimination and disempowerment, particularly during times of crisis like the COVID-19 pandemic.
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Affiliation(s)
- Mayuri Gogoi
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Development Centre for Population Health, University of Leicester, Leicester, UK
| | - Irtiza Qureshi
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Development Centre for Population Health, University of Leicester, Leicester, UK
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
- The Nottingham Centre for Public Health and Epidemiology, University of Nottingham, Nottingham, UK
| | - Jonathan Chaloner
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Development Centre for Population Health, University of Leicester, Leicester, UK
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Amani Al-Oraibi
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Development Centre for Population Health, University of Leicester, Leicester, UK
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Holly Reilly
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Development Centre for Population Health, University of Leicester, Leicester, UK
| | - Fatimah Wobi
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Joy Oghogho Agbonmwandolor
- David Evans Medical Research Centre, Nottingham University Hospital NHS Trust, City Hospital, Nottingham, UK
| | - Winifred Ekezie
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Centre for Ethnic Health Research, University of Leicester, Leicester, UK
| | - Osama Hassan
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Zainab Lal
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Development Centre for Population Health, University of Leicester, Leicester, UK
| | - Anuj Kapilashrami
- School of Health and Social Care, University of Essex, Colchester, UK
- Centre for Global Health & Intersectional Equity Research, University of Essex, Colchester, UK
| | - Laura Nellums
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
- College of Population Health, Health Sciences Centre, University of New Mexico, Albuquerque, NM, USA
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, Leicester, UK.
- Development Centre for Population Health, University of Leicester, Leicester, UK.
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.
- NIHR Leicester BRC, Leicester, UK.
- NIHR ARC East Midlands, Leicester, UK.
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Nagarajan R, Ramachandran P, Dilipkumar R, Kaur P. Global estimate of burnout among the public health workforce: a systematic review and meta-analysis. HUMAN RESOURCES FOR HEALTH 2024; 22:30. [PMID: 38773482 PMCID: PMC11110232 DOI: 10.1186/s12960-024-00917-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 05/16/2024] [Indexed: 05/23/2024]
Abstract
INTRODUCTION Burnout is an occupational phenomenon resulting from chronic workplace stress. We conducted this review to estimate the pooled global prevalence of burnout among the public health workforce. METHODS We conducted this review as per the PRISMA 2020 guidelines. We included only cross-sectional studies reporting outcome estimates among the study population. We included articles published before December 2023. We used a search strategy to systematically select the articles from PubMed, Embase, and Google Scholar. We assessed the quality of the studies using an adapted version of NIH's study tool assessment for cross-sectional and observational cohort studies. We estimated the pooled proportion using the random-effects model. RESULTS We included eight studies in our review, covering a sample size of 215,787. The pooled proportion of burnout was 39% (95% CI: 25-53%; p-value: < 0.001). We also identified high heterogeneity among the included studies in our review (I2: 99.67%; p-value: < 0.001). Seven out of the eight studies were of good quality. The pooled proportion of the studies conducted during the COVID-19 pandemic was 42% (95% CI: 17-66%), whereas for the studies conducted during the non-pandemic period, it was 35% (95% CI: 10-60%). CONCLUSION In our review, more than one-third of public health workers suffer from burnout, which adversely affects individuals' mental and physical health. Burnout among the public health workforce requires attention to improve the well-being of this group. Multisite studies using standardized definitions are needed for appropriate comparisons and a better understanding of variations in burnout in various subgroups based on sociodemographic characteristics and type of work responsibilities. We must design and implement workplace interventions to cope with burnout and increase well-being. LIMITATIONS Due to the limited research on burnout among public health workers, we could not perform a subgroup analysis on various factors that could have contributed to burnout.
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Alsadaan N, Ramadan OME, Alqahtani M. From incivility to outcomes: tracing the effects of nursing incivility on nurse well-being, patient engagement, and health outcomes. BMC Nurs 2024; 23:325. [PMID: 38741096 DOI: 10.1186/s12912-024-01996-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/07/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Nursing incivility, defined as disrespectful behaviour toward nurses, is increasingly recognized as a pressing issue that affects nurses' well-being and quality of care. However, research on the pathways linking incivility to outcomes is limited, especially in Saudi hospitals. METHODS This cross-sectional study examined relationships between perceived nursing incivility, nurse stress, patient engagement, and health outcomes in four Saudi hospitals. Using validated scales, 289 nurses and 512 patients completed surveys on exposure to incivility, stress levels, activation, and medication adherence. The outcomes included readmissions at 30 days and satisfaction. RESULTS More than two-thirds of nurses reported experiencing moderate to severe workplace incivility. Correlation and regression analyzes revealed that nursing incivility was positively associated with nursing stress. An inverse relationship was found between stress and patient participation. Serial mediation analysis illuminated a detrimental cascade, incivility contributing to increased nurse stress, subsequently diminishing patient engagement, ultimately worsening care quality. Conclusions The findings present robust evidence that nursing incivility has adverse ripple effects, directly impacting nurse well-being while indirectly affecting patient outcomes through reduced care involvement. Practical implications advocate for systemic interventions focused on constructive nursing cultures and patient empowerment to improve both healthcare provider conditions and quality of care. This study provides compelling information to inform policies and strategies to mitigate workplace mistreatment and encourage participation among nurses and patients to improve health outcomes.
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Affiliation(s)
- Nourah Alsadaan
- College of Nursing, Jouf University, Sakaka, 72388, Saudi Arabia.
| | | | - Mohammed Alqahtani
- Department of Nursing, College of Applied Medical Sciences, King Faisal University, Alahsa, Saudi Arabia
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Khedr RI, Mohamed OI, Sobh ZK. Medicolegal analysis of physical violence toward physicians in Egypt. Sci Rep 2024; 14:10911. [PMID: 38740880 DOI: 10.1038/s41598-024-60857-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
This study analyzed physical violence against physicians in Egypt from a medicolegal perspective. 88%, 42%, and 13.2% of participants were exposed to verbal, physical, and sexual violence. Concerning the tools of violence, 75.2% of attackers used their bodies. Blunt objects (29.5%), sharp instruments (7.6%), and firearm weapons (1.9%) were used. The commonest manners of attacks were pushing/pulling (44.8%), throwing objects (38.1%), and fists (30.5%). Stabbing (4.8%) and slashing (2.9%) with sharp instruments were also reported. Traumas were mainly directed towards upper limbs (43.8%), trunks (40%), and heads (28.6%). Considering immediate effects, simple injuries were reported that included contusions (22.9%), abrasions (16.2%), and cut wounds (1.9%). Serious injuries included firearm injuries (4.8%), internal organs injuries (3.8%), fractures (2.9%), and burns (1.9%). Most (90.5%) of injuries healed completely, whereas 7.6% and 1.9% left scars and residual infirmities, respectively. Only 14.3% of physicians proceeded to legal action. The current study reflects high aggression, which is disproportionate to legal actions taken by physicians. This medicolegal analysis could guide protective measures for healthcare providers in Egypt. In addition, a narrative review of studies from 15 countries pointed to violence against physicians as a worldwide problem that deserves future medicolegal analyses.
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Affiliation(s)
- Rasha Ismail Khedr
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Omneya Ibrahim Mohamed
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Zahraa Khalifa Sobh
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
- Faculty of Medicine, Alexandria University, Champollion Street, Alexandria, 5372006, Egypt.
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Maple JL, Whiteside M, Smallwood N, Putland M, Baldwin P, Bismark M, Harrex W, Johnson D, Karimi L, Willis K. Culture, conditions and care support mental health of healthcare workers during crises. Occup Med (Lond) 2024; 74:211-217. [PMID: 38319824 DOI: 10.1093/occmed/kqae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has presented immense challenges to health systems worldwide and significantly impacted the mental health of frontline healthcare workers. AIMS This study drew on the experiences of frontline healthcare workers to examine organizational strategies needed to support the mental health and well-being of healthcare workers during times of crisis. METHODS Semi-structured focus groups or individual interviews were conducted with healthcare workers to examine their perspectives on organizational strategies for enhancing staff mental health and well-being during crises. Data were analysed thematically. Following this, evidence for the identified strategies was reviewed to assess alignment with participant views and recommendations. RESULTS Thirty-two healthcare workers from diverse disciplines (10 allied health, 11 nursing, 11 medical) participated in the study. Data analysis identified three broad themes contributing to supporting mental health and well-being. These themes can be encapsulated as the 'Three Cs'-culture (building an organizational culture that prioritizes mental health); conditions (implementing proactive organizational strategies during crises) and care (ensuring fit-for-purpose strategies to support mental health and well-being). CONCLUSIONS Study findings underscore the necessity of an integrated and systemic organizational approach to address mental health and well-being in the healthcare workplace. This approach must be long term with the components of the 'Three Cs', particularly cultural change and conditions, viewed as a part of a suite of strategies to ensure crisis preparedness. It is imperative that organizations collaborate with their staff, providing support and fostering a safe and inclusive work environment that ultimately benefits patients, their care and staff well-being.
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Affiliation(s)
- J L Maple
- Institute for Health and Sport, Victoria University, Footscray, Victoria 3011, Australia
| | - M Whiteside
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria 3000, Australia
| | - N Smallwood
- Department of Respiratory Medicine, The Alfred Hospital, Prahran, Victoria 3004, Australia
- Department of Allergy, Immunology and Respiratory Medicine, Central Clinical School, The Alfred Hospital, Monash University, Melbourne, Victoria 3004, Australia
| | - M Putland
- Department of Emergency Medicine, Royal Melbourne Hospital, Parkville, Victoria 3050, Australia
- Department of Critical Care, Faculty of Medicine, University of Melbourne, Parkville, Victoria 3010, Australia
| | - P Baldwin
- Black Dog Institute, Randwick, New South Wales 2031, Australia
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - M Bismark
- Centre for Health Policy, University of Melbourne, Parkville, Victoria 3010, Australia
| | - W Harrex
- Australasian Faculty of Occupational and Medicine, Royal Australasian College of Physicians, Sydney, New South Wales 2000, Australia
| | - D Johnson
- Department of General Medicine, Royal Melbourne Hospital, Parkville, Victoria 3050, Australia
| | - L Karimi
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria 3083, Australia
| | - K Willis
- Institute of Health and Sport, Victoria University, Footscray, Victoria 3011, Australia
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Mirza M, Goerke L, Anderson A, Wilsdon T. Assessing the Cost-Effectiveness of Next-Generation Sequencing as a Biomarker Testing Approach in Oncology and Policy Implications: A Literature Review. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024:S1098-3015(24)02357-X. [PMID: 38729563 DOI: 10.1016/j.jval.2024.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/21/2024] [Accepted: 04/22/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE A key hurdle in broader next-generation sequencing (NGS) biomarker testing access in oncology is the ongoing debate on NGS's cost-effectiveness. We conducted a systematic review of existing evidence of the costs of NGS as a biomarker testing strategy in oncology and developed policy suggestions. METHODS We searched multiple databases for studies reporting cost comparisons and cost-effectiveness of NGS across oncology indications and geographies between 2017 and 2022, inclusive. Inclusion criteria were established based on indication and type of cost-effectiveness analysis provided. We validated analyses and policy recommendations with 5 payer/policy maker interviews in the United States, Europe, and United Kingdom. RESULTS Of the 634 identified studies, 29 met inclusion criteria, spanning 12 countries and 6 indications. Cost comparisons of NGS were evaluated using 3 methodologies: (1) comparison of direct testing costs, (2) comparison of holistic testing costs, and (3) comparison of long-term patient outcomes and costs. Targeted panel testing (2-52 genes) was considered cost-effective when 4+ genes were assessed, and larger panels (hundreds of genes) were generally not cost-effective. Holistic analysis demonstrated that NGS reduces turnaround time, healthcare staff requirements, number of hospital visits, and hospital costs. Finally, studies evaluating NGS testing including the cost of targeted therapies generally found the incremental cost-effectiveness ratio to be above common thresholds but highlighted valuable patient benefits. CONCLUSIONS Current literature supports NGS's cost-effectiveness as an oncology biomarker testing strategy under specific conditions. These findings underscore the need to develop policies to support holistic assessment of NGS to ensure appropriate reimbursement and access.
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Affiliation(s)
- Myriam Mirza
- Charles River Associates, Palais Leopold, Munich, Germany.
| | - Lutz Goerke
- Charles River Associates, Palais Leopold, Munich, Germany
| | | | - Tim Wilsdon
- Charles River Associates, London, England, UK
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Drennan J, Murphy A, McCarthy VJC, Ball J, Duffield C, Crouch R, Kelly G, Loughnane C, Murphy A, Hegarty J, Brady N, Scott A, Griffiths P. The association between nurse staffing and quality of care in emergency departments: A systematic review. Int J Nurs Stud 2024; 153:104706. [PMID: 38447488 DOI: 10.1016/j.ijnurstu.2024.104706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 01/12/2024] [Accepted: 01/26/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND The relationship between nurse staffing, skill-mix and quality of care has been well-established in medical and surgical settings, however, there is relatively limited evidence of this relationship in emergency departments. Those that have been published identified that lower nurse staffing levels in emergency departments are generally associated with worse outcomes with the conclusion that the evidence in emergency settings was, at best, weak. METHODS We searched thirteen electronic databases for potentially eligible papers published in English up to December 2023. Studies were included if they reported on patient outcomes associated with nurse staffing within emergency departments. Observational, cross-sectional, prospective, retrospective, interrupted time-series designs, difference-in-difference, randomised control trials or quasi-experimental studies and controlled before and after studies study designs were considered for inclusion. Team members independently screened titles and abstracts. Data was synthesised using a narrative approach. RESULTS We identified 16 papers for inclusion; the majority of the studies (n = 10/16) were observational. The evidence reviewed identified that poorer staffing levels within emergency departments are associated with increased patient wait times, a higher proportion of patients who leave without being seen and an increased length of stay. Lower levels of nurse staffing are also associated with an increase in time to medications and therapeutic interventions, and increased risk of cardiac arrest within the emergency department. CONCLUSION Overall, there remains limited high-quality empirical evidence addressing the association between emergency department nurse staffing and patient outcomes. However, it is evident that lower levels of nurse staffing are associated with adverse events that can result in delays to the provision of care and serious outcomes for patients. There is a need for longitudinal studies coupled with research that considers the relationship with skill-mix, other staffing grades and patient outcomes as well as a wider range of geographical settings. TWEETABLE ABSTRACT Lower levels of nurse staffing in emergency departments are associated with delays in patients receiving treatments and poor quality care including an increase in leaving without being seen, delay in accessing treatments and medications and cardiac arrest.
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Affiliation(s)
- Jonathan Drennan
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland.
| | - Ashling Murphy
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Vera J C McCarthy
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Jane Ball
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Christine Duffield
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia; University of Technology Sydney, Sydney, New South Wales, Australia
| | - Robert Crouch
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Gearoid Kelly
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Croia Loughnane
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Aileen Murphy
- Department of Economics, Cork University Business School, University College Cork, Cork, Ireland
| | - Josephine Hegarty
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Noeleen Brady
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | | | - Peter Griffiths
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
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Birks M, Harrison H, Zhao L, Wright H, Tie YC, Rathnayaka N. Nursing students' experience of bullying and/or harassment during clinical placement. NURSE EDUCATION TODAY 2024; 136:106151. [PMID: 38479329 DOI: 10.1016/j.nedt.2024.106151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 02/12/2024] [Accepted: 02/29/2024] [Indexed: 03/24/2024]
Abstract
PROBLEM OR BACKGROUND Bullying is a recognised problem in nursing. Nursing students are particularly vulnerable. Bullying and harassment of nursing students can be detrimental to both students and recipients of care. AIM This study aims to identify the incidence and nature of bullying and/or harassment experienced by nursing students in Sri Lanka. METHODS A cross-sectional survey consisting of eight demographic questions and 15 items specific to the experience of bullying and harassment was administered to nursing students online. FINDINGS A total of 656 students from 26 nursing education institutions in Sri Lanka participated. The majority were female with a mean age of 24.4 years. More than a quarter of respondents reported that they had experienced bullying and/or harassment while on clinical placement, with a further 16.7 % being unsure. Most bullying or harassment (55 %) occurred in hospitals with 29 % experienced in community settings. Registered nurses, including nurse managers and clinical facilitators were the most common perpetrators. Verbal abuse was the most frequent type of behaviour reported. DISCUSSION These findings support existing literature that indicates that bullying of nursing students is an international phenomenon. The context of this study provides clues as to how culture may influence the problem. There is a need to better understand bullying and harassment in the environments in which it occurs, in order to identify strategies that can bridge cultures and settings. CONCLUSION The incidence of bullying and harassment of nursing students in Sri Lanka is concerning. Further research is needed to identify and evaluate targeted strategies to help prevent negative outcomes in all nursing contexts.
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Affiliation(s)
- Melanie Birks
- Nursing and Midwifery, College of Healthcare Sciences, James Cook University, Douglas 4811, Queensland, Australia.
| | - Helena Harrison
- Nursing and Midwifery, College of Healthcare Sciences, James Cook University, Douglas 4811, Queensland, Australia
| | - Lin Zhao
- Discipline of Nursing, School of Health & Biomedical Sciences, RMIT University, Bundoora 3083, Victoria, Australia
| | - Helen Wright
- Nursing and Midwifery, College of Healthcare Sciences, James Cook University, Douglas 4811, Queensland, Australia
| | - Ylona Chun Tie
- Nursing and Midwifery, College of Healthcare Sciences, James Cook University, Douglas 4811, Queensland, Australia
| | - Nadun Rathnayaka
- Academic Department, International Institute of Health Sciences Multiveristy, Welisara 71722, Columbo, Sri Lanka
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Ülgüt R, Tomsic I, Chaberny IF, von Lengerke T. Human resource management to assist infection prevention and control professionals: A scoping review. J Hosp Infect 2024:S0195-6701(24)00126-9. [PMID: 38679391 DOI: 10.1016/j.jhin.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/09/2024] [Accepted: 04/11/2024] [Indexed: 05/01/2024]
Abstract
Infection prevention and control (IPC) professionals are key intermediaries between hospital managers and frontline staff. During the novel coronavirus disease pandemic, IPC professionals faced new challenges. Unfortunately, research on human resource management (HRM) to support IPC during and between pandemics is lacking. Therefore, this scoping review aimed to elucidate the existing knowledge on HRM measures in this context and thus contribute to the pandemic preparedness of healthcare facilities. It was conducted as part of the "PREparedness and PAndemic REsponse in Germany (PREPARED)"-project within the Network University Medicine (NUM). Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. PubMed was searched without time restriction until 2023 (filter: English, German). Two reviewers assessed titles/abstracts and full texts, respectively. A total of 9 publications were included, 8 of which were published in the US. All publications reported survey data (quantitative: 6). Measures targeting personnel development and the qualification of IPC personnel were reported in 6 studies, i.e., almost two-thirds of the studies, of which 5 focused on the tasks of IPC professionals. In contrast, management of personnel costs and remuneration systems were reported less frequently (three studies), and only regarding issues around retention, compensation and dismissal. In conclusion, research gaps include trials on implementation and effectiveness of HRM for IPC. Given increasing shortage of IPC professionals, HRM measures during and between pandemics become more important for establishing agile pandemic preparedness.
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Affiliation(s)
- Rojda Ülgüt
- Hannover Medical School, Centre for Public Health and Healthcare, Department of Medical Psychology, Hannover, Germany
| | - Ivonne Tomsic
- Hannover Medical School, Centre for Public Health and Healthcare, Department of Medical Psychology, Hannover, Germany
| | - Iris F Chaberny
- Leipzig University Hospital, Interdisciplinary Centre for Infectious Medicine, Institute of Hygiene, Hospital Epidemiology and Environmental Medicine, Leipzig, Germany
| | - Thomas von Lengerke
- Hannover Medical School, Centre for Public Health and Healthcare, Department of Medical Psychology, Hannover, Germany.
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Rangel T, Timmerman R, Bock D, Keller M, Long J. Spiritual Support Staff Influence Stress Among Hospital-Based Health Care Personnel: A Cross-Sectional Study. West J Nurs Res 2024:1939459241247802. [PMID: 38655675 DOI: 10.1177/01939459241247802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
BACKGROUND Stress negatively affects well-being, relating to poor physical, emotional, and occupational outcomes for health care personnel. Health care professionals faced extreme stressors in the context of the COVID-19 pandemic, making occupational stress relief a top priority for hospital administrators. Many health systems employ specially trained spiritual support staff as one strategy to alleviate work-related stressors. It is unclear whether health care personnels' perceptions of the availability of spiritual care staff influence self-reported stress. OBJECTIVE The purpose of this study was to explore relationships between perceived stress and perceptions of availability of spiritual support among acute care health care personnel. METHODS This study analyzed cross-sectional, survey-based data collected between February and April 2022 from 1352 interdisciplinary health care staff working in a large, nonprofit Catholic health system in the Western United States. Bivariate tests and multivariate linear regression models were conducted to test for factors influencing perceived stress. RESULTS Results support that high stress was prevalent in the sample. Perceived availability of spiritual support staff in the hospital and seeking coworker and professional support for work-related stress all independently influence stress in this population when controlling for confounders. CONCLUSIONS Stress of health care personnel may be influenced by the perceived availability of specially trained spiritual support staff. Hospital administrators should advocate for spiritual support staff availability in all health care settings as one strategy to mitigate occupational stress that health care professionals may experience through providing high-stakes patient care. Further research is warranted to uncover targeted spirituality-related strategies to reduce stress and preserve well-being of health care personnel.
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Affiliation(s)
| | | | - Dawn Bock
- Santa Rosa Memorial Center, Santa Rosa, CA, USA
| | | | - JoAnn Long
- Lubbock Christian University, Lubbock, TX, USA
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Walsh R, Telner D, Butt DA, Krueger P, Fleming K, MacDonald S, Pyakurel A, Greiver M, Jaakkimainen L. Factors associated with plans for early retirement among Ontario family physicians during the COVID-19 pandemic: a cross-sectional study. BMC PRIMARY CARE 2024; 25:118. [PMID: 38637731 PMCID: PMC11025226 DOI: 10.1186/s12875-024-02374-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 04/09/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Higher numbers of family physicians (FPs) stopped practicing or retired during the COVID-19 pandemic, worsening the family doctor shortage in Canada. Our study objective was to determine which factors were associated with FPs' plans to retire earlier during the COVID-19 pandemic. METHODS We administered two cross-sectional online surveys to Ontario FPs asking whether they were "planning to retire earlier" as a result of the pandemic during the first and third COVID-19 pandemic waves (Apr-Jun 2020 and Mar-Jul 2021). We used logistic regression to determine which factors were associated with early retirement planning, adjusting for age. RESULTS The age-adjusted proportion of FP respondents planning to retire earlier was 8.2% (of 393) in the first-wave and 20.5% (of 454) in the third-wave. Planning for earlier retirement during the third-wave was associated with age over 50 years (50-59 years odds ratio (OR) 5.37 (95% confidence interval (CI):2.33-12.31), 60 years and above OR 4.18 (95% CI: 1.90-10.23)), having difficulty handling increased non-clinical responsibilities (OR 2.95 (95% CI: 1.79-4.94)), feeling unsupported to work virtually (OR 1.96 (95% CI: 1.19-3.23)) or in-person (OR 2.70 (95% CI: 1.67-4.55)), feeling unable to provide good care (OR 1.82 (95% CI: 1.10-3.03)), feeling work was not valued (OR 1.92 (95% CI: 1.15-3.23)), feeling frightened of dealing with COVID-19 (OR 2.01 (95% CI: 1.19-3.38)), caring for an elderly relative (OR 2.36 (95% CI: 1.69-3.97)), having difficulty obtaining personal protective equipment (OR 2.00 (95% CI: 1.16-3.43)) or difficulty implementing infection control practices in clinic (OR 2.10 (95% CI: 1.12-3.89)). CONCLUSIONS Over 20% of Ontario FP respondents were considering retiring earlier by the third-wave of the COVID-19 pandemic. Supporting FPs in their clinical and non-clinical roles, such that they feel able to provide good care and that their work is valued, reducing non-clinical (e.g., administrative) responsibilities, dealing with pandemic-related fears, and supporting infection control practices and personal protective equipment acquisition in clinic, particularly in those aged 50 years or older may help increase family physician retention during future pandemics.
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Affiliation(s)
- Rachel Walsh
- Department of Family and Community Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
| | - Deanna Telner
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, Michael Garron Hospital, Toronto, ON, Canada
| | - Debra A Butt
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, Scarborough Health Network, Scarborough, ON, Canada
| | - Paul Krueger
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Karen Fleming
- Department of Family and Community Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Aakriti Pyakurel
- Department of Family and Community Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Michelle Greiver
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, North York General Hospital, Toronto, ON, Canada
| | - Liisa Jaakkimainen
- Department of Family and Community Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
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Glette MK, Kringeland T, Samal L, Bates DW, Wiig S. A qualitative study of leaders' experiences of handling challenges and changes induced by the COVID-19 pandemic in rural nursing homes and homecare services. BMC Health Serv Res 2024; 24:442. [PMID: 38594669 PMCID: PMC11005178 DOI: 10.1186/s12913-024-10935-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/31/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic had a major impact on healthcare services globally. In care settings such as small rural nursing homes and homes care services leaders were forced to confront, and adapt to, both new and ongoing challenges to protect their employees and patients and maintain their organization's operation. The aim of this study was to assess how healthcare leaders, working in rural primary healthcare services, led nursing homes and homecare services during the COVID-19 pandemic. Moreover, the study sought to explore how adaptations to changes and challenges induced by the pandemic were handled by leaders in rural nursing homes and homecare services. METHODS The study employed a qualitative explorative design with individual interviews. Nine leaders at different levels, working in small, rural nursing homes and homecare services in western Norway were included. RESULTS Three main themes emerged from the thematic analysis: "Navigating the role of a leader during the pandemic," "The aftermath - management of COVID-19 in rural primary healthcare services", and "The benefits and drawbacks of being small and rural during the pandemic." CONCLUSIONS Leaders in rural nursing homes and homecare services handled a multitude of immediate challenges and used a variety of adaptive strategies during the COVID-19 pandemic. While handling their own uncertainty and rapidly changing roles, they also coped with organizational challenges and adopted strategies to maintain good working conditions for their employees, as well as maintain sound healthcare management. The study results establish the intricate nature of resilient leadership, encompassing individual resilience, personality, governance, resource availability, and the capability to adjust to organizational and employee requirements, and how the rural context may affect these aspects.
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Affiliation(s)
- Malin Knutsen Glette
- SHARE - Center for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Haugesund, Norway.
| | - Tone Kringeland
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Haugesund, Norway
| | - Lipika Samal
- Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - David W Bates
- Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Siri Wiig
- SHARE - Center for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Bolsewicz KT, White J, Murray P, Vidler M, Durrheim DN. "COVID-19 - A Perfect Storm": A Qualitative Exploration of Residential Care Facility Managers Perspectives on the Psychosocial Impacts of COVID-19. J Appl Gerontol 2024:7334648241238920. [PMID: 38587987 DOI: 10.1177/07334648241238920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Abstract
Growing evidence highlights the negative impact of managing the COVID-19 pandemic on the wellbeing of the healthcare workforce, including in the aged care sector. We undertook a qualitative study during the pandemic's third year to explore the psychosocial impacts on nine managers of residential care facilities (RCFs) across metropolitan and rural New South Wales, the largest state in Australia. Four themes were identified: (1) Increased pressure on maintaining aged care services, (2) Increased responsibility on RCF managers, (3) Psychosocial impacts due to accumulating pressures, and (4) Experience of beneficial supports. COVID-19 compounded pre-pandemic sector challenges and added new stressors. While resilient and resourceful, RCF managers experienced workplace stress and burnout, which may affect quality of resident care and impact on staff retention. There is a need for more investment to effectively support staff, and research to identify optimal psychosocial and management supports.
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Affiliation(s)
- Katarzyna T Bolsewicz
- Health Protection, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Jennifer White
- Health Protection, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Peter Murray
- Health Protection, Hunter New England Local Health District, Wallsend, NSW, Australia
| | - Megan Vidler
- Health Protection, Hunter New England Local Health District, Wallsend, NSW, Australia
| | - David N Durrheim
- Health Protection, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
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15
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Xu HG, Johnston ANB, Ray-Barruel G. Fast-Track Training in Emergency Department During the COVID-19 Pandemic: Evaluation of a Hybrid Education Model. Adv Emerg Nurs J 2024; 46:169-181. [PMID: 38736101 DOI: 10.1097/tme.0000000000000516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
INTRODUCTION Emergency department (ED) fast track (FT) for the ambulatory, minor injury patient cohort requires rapid patient assessment, treatment, and turnover, yet specific nursing education is limited. The study aimed to test the feasibility and staff satisfaction of an education program to expand nursing skills and knowledge of managing FT patients during the COVID-19 pandemic. METHODS This quasi-experimental study, including self-rating surveys and interviews, assessed the pre- and postimplementation of an education program for nurses working in FT in a metropolitan hospital ED in Australia. Hybrid (face-to-face and Teams) education sessions on 10 topics of staff-perceived limited knowledge were delivered over 8 months. RESULTS Participants demonstrated higher knowledge scores after the implementation of short online education sessions to cover the core facets of minor injury management. Overall staff satisfaction with the program was high. Interview discussions involved three key themes, including "benefits to staff learning," "positive impact on patient care and flow," and "preferred mode of delivery." CONCLUSIIONS Recorded education sessions on minor injury topics for nurses working in FT have proved effective, and this program has now become a core facet of ED education in our hospital.
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Affiliation(s)
- Hui Grace Xu
- Author Affiliations: Emergency Department, Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia (Dr Xu) School of Nursing and Midwifery, Queensland University of Technology, Kelvin Grove, Queensland, Australia (Dr Xu) Centre of Clinical Nursing, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia (Drs Xu and Ray-Barruel) Emergency Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia (Dr Johnston) School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia, Queensland, Australia (Dr Johnston) Herston Infectious Diseases Institute, Metro North Hospital and Health Service and University of Queensland Centre for Clinical Research, Herston, Queensland, Australia (Dr Ray-Barruel) School of Nursing and Midwifery, and Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia (Dr Ray-Barruel)
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16
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Mortier P, Vilagut G, García-Mieres H, Alayo I, Ferrer M, Amigo F, Aragonès E, Aragón-Peña A, Asúnsolo Del Barco Á, Campos M, Espuga M, González-Pinto A, Haro JM, López Fresneña N, Martínez de Salázar AD, Molina JD, Ortí-Lucas RM, Parellada M, Pelayo-Terán JM, Pérez-Gómez B, Pérez-Zapata A, Pijoan JI, Plana N, Polentinos-Castro E, Portillo-Van Diest A, Puig T, Rius C, Sanz F, Serra C, Urreta-Barallobre I, Kessler RC, Bruffaerts R, Vieta E, Pérez-Solá V, Alonso J. Health service and psychotropic medication use for mental health conditions among healthcare workers active during the Spain Covid-19 Pandemic - A prospective cohort study using web-based surveys. Psychiatry Res 2024; 334:115800. [PMID: 38387166 DOI: 10.1016/j.psychres.2024.115800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/30/2024] [Accepted: 02/11/2024] [Indexed: 02/24/2024]
Abstract
Little is known about healthcare workers' (HCW) use of healthcare services for mental disorders. This study presents data from a 16-month prospective cohort study of Spanish HCW (n = 4,809), recruited shortly after the COVID-19 pandemic onset, and assessed at four timepoints using web-based surveys. Use of health services among HCW with mental health conditions (i.e., those having a positive screen for mental disorders and/or suicidal thoughts and behaviours [STB]) was initially low (i.e., 18.2 %) but increased to 29.6 % at 16-month follow-up. Service use was positively associated with pre-pandemic mental health treatment (OR=1.99), a positive screen for major depressive disorder (OR=1.50), panic attacks (OR=1.74), suicidal thoughts and behaviours (OR=1.22), and experiencing severe role impairment (OR=1.33), and negatively associated with being female (OR = 0.69) and a higher daily number of work hours (OR=0.95). Around 30 % of HCW with mental health conditions used anxiolytics (benzodiazepines), especially medical doctors. Four out of ten HCW (39.0 %) with mental health conditions indicated a need for (additional) help, with most important barriers for service use being too ashamed, long waiting lists, and professional treatment not being available. Our findings delineate a clear mental health treatment gap among Spanish HCW.
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Affiliation(s)
- Philippe Mortier
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
| | - Gemma Vilagut
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Helena García-Mieres
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Itxaso Alayo
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Biosistemak Institute for Health Systems Research, Barakaldo, Bizkaia, Spain
| | - Montse Ferrer
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Franco Amigo
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Enric Aragonès
- Institut d'Investigació en Atenció Primària IDIAP Jordi Gol, Barcelona, Spain; Atenció Primària Camp de Tarragona, Institut Català de la Salut, Spain
| | - Andrés Aragón-Peña
- Epidemiology Unit, Regional Ministry of Health, Community of Madrid, Madrid, Spain; Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
| | - Ángel Asúnsolo Del Barco
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, Spain; Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain; Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, United States
| | - Mireia Campos
- Service of Prevention of Labor Risks, Medical Emergencies System, Generalitat de Catalunya, Spain
| | - Meritxell Espuga
- Occupational Health Service. Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ana González-Pinto
- BIOARABA, Hospital Universitario Araba-Santiago, UPV/EHU, Vitoria-Gasteiz, Spain; CIBER Salud Mental (CIBERSAM), Madrid, Spain
| | - Josep M Haro
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | | | | | - Juan D Molina
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Villaverde Mental Health Center, Clinical Management Area of Psychiatry and Mental Health, Psychiatric Service, Hospital Universitario 12 de Octubre, Madrid, Spain; Research Institute Hospital 12 de Octubre (i+12), Madrid, Spain; Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Rafael M Ortí-Lucas
- Service of Preventive Medicine and Quality of Attention, University Clinical Hospital of Valencia, Valencia, Spain
| | - Mara Parellada
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - José Maria Pelayo-Terán
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Servicio de Psiquiatría y Salud Mental. Hospital el Bierzo, Gerencia de Asistencia Sanitaria del Bierzo (GASBI). Gerencia Regional de Salud de Castilla y Leon (SACYL). Ponferrada, León, Spain; Area de Medicina Preventiva y Salud Pública. Universidad de León, León, Spain
| | - Beatriz Pérez-Gómez
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; National Center of Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | | | - José Ignasio Pijoan
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Clinical Epidemiology Unit-Hospital Universitario Cruces/ OSI EEC, Bilbao, Spain/ Biocruces-Bizkaia Health Research Institute, Spain
| | - Nieves Plana
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Elena Polentinos-Castro
- Research Unit Primary Care Management, Madrid Health Service, Madrid, Spain; Department of Medical Specialities and Public Health. King Juan Carlos University, Madrid, Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud RICAPPS-(RICORS). Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Ana Portillo-Van Diest
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Teresa Puig
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Department of Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain; CIBER Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Cristina Rius
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Ferran Sanz
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain; Research Progamme on Biomedical Informatics (GRIB), Hospital del Mar Research Institute, MELIS, Universitat Pompeu Fabra, Barcelona, Spain; Instituto Nacional de Bioinformatica - ELIXIR-ES, Barcelona, Spain
| | - Consol Serra
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain; CiSAL-Centro de Investigación en Salud Laboral, Hospital del Mar Research Institute/UPF, Barcelona, Spain
| | - Iratxe Urreta-Barallobre
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia University Hospital, Clinical Epidemiology Unit, San Sebastián, Spain; Biodonostia Health Research Institute, Clinical Epidemiology, San Sebastián, Spain
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium
| | - Eduard Vieta
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Víctor Pérez-Solá
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain
| | - Jordi Alonso
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
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Dzieciolowska S, Charest H, Roy T, Fafard J, Carazo S, Levade I, Longtin J, Parkes L, Beaulac SN, Villeneuve J, Savard P, Corbeil J, De Serres G, Longtin Y. Timing and Predictors of Loss of Infectivity Among Healthcare Workers With Mild Primary and Recurrent COVID-19: A Prospective Observational Cohort Study. Clin Infect Dis 2024; 78:613-624. [PMID: 37675577 PMCID: PMC10954326 DOI: 10.1093/cid/ciad535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/21/2023] [Accepted: 08/30/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND There is a need to understand the duration of infectivity of primary and recurrent coronavirus disease 2019 (COVID-19) and identify predictors of loss of infectivity. METHODS Prospective observational cohort study with serial viral culture, rapid antigen detection test (RADT) and reverse transcription polymerase chain reaction (RT-PCR) on nasopharyngeal specimens of healthcare workers with COVID-19. The primary outcome was viral culture positivity as indicative of infectivity. Predictors of loss of infectivity were determined using multivariate regression model. The performance of the US Centers for Disease Control and Prevention (CDC) criteria (fever resolution, symptom improvement, and negative RADT) to predict loss of infectivity was also investigated. RESULTS In total, 121 participants (91 female [79.3%]; average age, 40 years) were enrolled. Most (n = 107, 88.4%) had received ≥3 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine doses, and 20 (16.5%) had COVID-19 previously. Viral culture positivity decreased from 71.9% (87/121) on day 5 of infection to 18.2% (22/121) on day 10. Participants with recurrent COVID-19 had a lower likelihood of infectivity than those with primary COVID-19 at each follow-up (day 5 odds ratio [OR], 0.14; P < .001]; day 7 OR, 0.04; P = .003]) and were all non-infective by day 10 (P = .02). Independent predictors of infectivity included prior COVID-19 (adjusted OR [aOR] on day 5, 0.005; P = .003), an RT-PCR cycle threshold [Ct] value <23 (aOR on day 5, 22.75; P < .001) but not symptom improvement or RADT result.The CDC criteria would identify 36% (24/67) of all non-infectious individuals on day 7. However, 17% (5/29) of those meeting all the criteria had a positive viral culture. CONCLUSIONS Infectivity of recurrent COVID-19 is shorter than primary infections. Loss of infectivity algorithms could be optimized.
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Affiliation(s)
| | - Hugues Charest
- Faculté de médecine, Université de Montréal, Montréal, Canada
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Canada
- Institut National de Santé Publique du Québec, Québec City, Canada
| | - Tonya Roy
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Canada
- Institut National de Santé Publique du Québec, Québec City, Canada
| | - Judith Fafard
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Canada
- Institut National de Santé Publique du Québec, Québec City, Canada
| | - Sara Carazo
- Institut National de Santé Publique du Québec, Québec City, Canada
- Université Laval, Québec City, Canada
| | - Ines Levade
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Canada
- Institut National de Santé Publique du Québec, Québec City, Canada
| | - Jean Longtin
- CHU de Québec—Université Laval, Québec City, Canada
| | - Leighanne Parkes
- McGill University Faculty of Medicine, Montréal, Canada
- Jewish General Hospital Sir Mortimer B. Davis, Montréal, Canada
| | - Sylvie Nancy Beaulac
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Canada
- Institut National de Santé Publique du Québec, Québec City, Canada
| | | | - Patrice Savard
- Faculté de médecine, Université de Montréal, Montréal, Canada
- Centre Hospitalier de l’Université de Montréal (CHUM) and CHUM Research Center, Montréal, Canada
| | | | - Gaston De Serres
- Institut National de Santé Publique du Québec, Québec City, Canada
- Université Laval, Québec City, Canada
| | - Yves Longtin
- McGill University Faculty of Medicine, Montréal, Canada
- Jewish General Hospital Sir Mortimer B. Davis, Montréal, Canada
- Lady Davis Research Institute, Montréal, Canada
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Mincarone P, Bodini A, Tumolo MR, Sabina S, Colella R, Mannini L, Sabato E, Leo CG. Association Between Physical Activity and the Risk of Burnout in Health Care Workers: Systematic Review. JMIR Public Health Surveill 2024; 10:e49772. [PMID: 38498040 PMCID: PMC10985610 DOI: 10.2196/49772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/18/2023] [Accepted: 12/12/2023] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Burnout is a multidimensional psychological syndrome that arises from chronic workplace stress. Health care workers (HCWs), who operate in physically and emotionally exhausting work contexts, constitute a vulnerable group. This, coupled with its subsequent impact on patients and public economic resources, makes burnout a significant public health concern. Various self-care practices have been suggested to have a positive effect on burnout among HCWs. Of these, physical activity stands out for its ability to combine psychological, physiological, and biochemical mechanisms. In fact, it promotes psychological detachment from work and increases self-efficacy by inhibiting neurotransmitters and neuromodulators, increasing endorphin levels, enhancing mitochondrial function, and attenuating the hypothalamic pituitary-adrenal axis response to stress. OBJECTIVE Our objective was to conduct a systematic review of the evidence on the association between physical activity and burnout among HCWs. METHODS We considered HCWs, physical activity, and burnout, framing them as population, exposure, and outcome, respectively. We searched APA PsycArticles, MEDLINE, and Scopus until July 2022. We extracted relevant data on study design, methods to measure exposure and outcome, and statistical approaches. RESULTS Our analysis encompassed 21 independent studies. Although 10% (2/21) of the studies explicitly focused on physical activity, the remaining investigations were exploratory in nature and examined various predictors, including physical activity. The most commonly used questionnaire was the Maslach Burnout Inventory. Owing to the heterogeneity in definitions and cutoffs used, the reported prevalence of burnout varied widely, ranging from 7% to 83%. Heterogeneity was also observed in the measurement tools used to assess physical activity, with objective measures rarely used. In total, 14% (3/21) of the studies used structured questionnaires to assess different types of exercise, whereas most studies (18/21, 86%) only recorded the attainment of a benchmark or reported the frequency, intensity, or duration of exercise. The reported prevalence of physically active HCWs ranged from 44% to 87%. The analyses, through a variety of inferential approaches, indicated that physical activity is often associated with a reduced risk of burnout, particularly in the domains of emotional exhaustion and depersonalization. Furthermore, we compiled and classified a list of factors associated with burnout. CONCLUSIONS Our comprehensive overview of studies investigating the association between physical activity and burnout in HCWs revealed significant heterogeneity in definitions, measurements, and analyses adopted in the literature. To address this issue, it is crucial to adopt a clear definition of physical activity and make thoughtful choices regarding measurement tools and methodologies for data analysis. Our considerations regarding the measurement of burnout and the comprehensive list of associated factors have the potential to improve future studies aimed at informing decision-makers, thus laying the foundation for more effective management measures to address burnout.
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Affiliation(s)
- Pierpaolo Mincarone
- Research Unit of Brindisi, Institute for Research on Population and Social Policies, National Research Council, Brindisi, Italy
- MOVE-Mentis s.r.l, Cesena, Italy
| | - Antonella Bodini
- Institute for Applied Mathematics and Information Technologies "Enrico Magenes", National Research Council, Milan, Italy
| | - Maria Rosaria Tumolo
- Biological and Environmental Sciences and Technology Department, University of Salento, Lecce, Italy
| | - Saverio Sabina
- MOVE-Mentis s.r.l, Cesena, Italy
- Institute of Clinical Physiology, National Research Council, Lecce, Italy
| | - Riccardo Colella
- Institute of Clinical Physiology, National Research Council, Lecce, Italy
- Innovation Engineering Department, University of Salento, Lecce, Italy
| | - Linda Mannini
- Institute of Clinical Physiology, National Research Council, Lecce, Italy
| | - Eugenio Sabato
- Research Unit of Brindisi, Institute for Research on Population and Social Policies, National Research Council, Brindisi, Italy
- Respiratory Diseases Unit, "Antonio Perrino" P.O., Local Health Unit "ASL Brindisi", Brindisi, Italy
| | - Carlo Giacomo Leo
- MOVE-Mentis s.r.l, Cesena, Italy
- Institute of Clinical Physiology, National Research Council, Lecce, Italy
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Mutsonziwa GA, Mojab M, Katuwal M, Glew P. Influences of healthcare workers' behaviours towards infection prevention and control practices in the clinical setting: A systematic review. Nurs Open 2024; 11:e2132. [PMID: 38488425 PMCID: PMC10941556 DOI: 10.1002/nop2.2132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 02/17/2024] [Accepted: 02/21/2024] [Indexed: 03/18/2024] Open
Abstract
AIM To systematically evaluate empirical studies investigating the influences of healthcare workers' behaviours towards infection prevention and control practices in the Coronavirus clinical space, and to appraise and synthesise these findings. DESIGN A systematic review of the literature. METHODS The review used a five-step framework described by Khan et al. (Journal of the Royal Society of Medicine, 2003, 96 and 118) of Framing questions for a review; Identifying relevant work; Assessing the quality of studies; Summarising the evidence; and Interpreting the findings. Searches were conducted in CINHAL, MEDLINE, PsychINFO, Scopus, and Google Scholar databases to retrieve relevant peer-reviewed literature published in English between 2019 and 2023. Covidence and Joanna Briggs Quality appraisal tools were used for critical assessment. To improve transparent reporting, this review used a Synthesis Without Meta-analysis (SWiM) in systematic review guidelines, as informed by Campbell et al. (BMJ, 2020, 368). RESULTS Twenty studies were included in this review, identifying nine themes describing factors influencing HCWs' behaviours towards IPC practices in the coronavirus environment. The overarching influences emerged as knowledge-oriented, person-oriented, and environment-oriented. CONCLUSION Healthcare workers' responsibilities at point-of-care involve providing direct care to patients with highly transmissible infections and working in clinical settings that may be ill-designed for IPC practices, increasing the risk of transmission. Given the lack of a definitive solution to eradicate new mutant viruses and that IPC practices are the mainstay of prevention and control of transmissible, measures to improve are imperative. The identified HCWs' domains on behaviours towards IPC are critical in strategies to mitigate risks and further set an opportunity for developing an IPC model congruent with the rapid response required for HCWs during emerging or re-merging mutant virus outbreaks. This is significant, given that HCWs' preparedness with IPC practices at point-of-care is central to patient care, the workforce and community safety.
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Affiliation(s)
- Gift A. Mutsonziwa
- School of Nursing & MidwiferyWestern Sydney UniversitySydneyNew South WalesAustralia
| | - Marwa Mojab
- Western Sydney UniversitySydneyNew South WalesAustralia
| | - Megha Katuwal
- Western Sydney UniversitySydneyNew South WalesAustralia
| | - Paul Glew
- Western Sydney UniversitySydneyNew South WalesAustralia
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20
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Halperin O, Idilbi N, Robes D, Biderman SN, Malka-Zeevi H, Green G. Predicting post-traumatic stress disorder: The complex relationship between burnout, intentions to leave and emotional support among health care professionals. Nurs Outlook 2024; 72:102134. [PMID: 38301290 DOI: 10.1016/j.outlook.2024.102134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/01/2024] [Accepted: 01/10/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Health care professionals working in delivery rooms often encounter stressful situations. Understanding their challenges and the support they receive is essential for improving their well-being and consequently patient care. PURPOSE Examining the relationship between burnout, intentions to leave, post-traumatic stress disorder (PTSD) symptoms, and complex PTSD among health care professionals, and identifying their predictors. METHODS A mixed methods design, including a survey among 196 midwives and gynecologists assessing burnout, intentions to leave, exposure to negative work experiences and PTSD, as well as 15 semi-structured interviews. DISCUSSION Most participants experienced multiple difficult events in the delivery room, reporting insufficient emotional support. Burnout and lack of emotional support were significant predictors of PTSD symptoms. Participants expressed a need for emotional support to cope with complex situations. CONCLUSION Burnout among midwives must be addressed through prevention and intervention programs. Emotional support is essential in mitigating PTSD symptoms among midwives and gynecologists, enhancing their resilience and well-being.
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Affiliation(s)
- Ofra Halperin
- Nursing Department, Max Stern Academic College of Emek-Yezreel, Emek-Yezreel, Israel.
| | - Nasra Idilbi
- Nursing Department, Max Stern Academic College of Emek-Yezreel, Emek-Yezreel, Israel; Galilee Medical Center, Nahariya, Israel
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21
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Jones CB, Kim S, McCollum M, Tran AK. New insights on a recurring theme: A secondary analysis of nurse turnover using the National Sample Survey of Registered Nurses. Nurs Outlook 2024; 72:102107. [PMID: 38160504 DOI: 10.1016/j.outlook.2023.102107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/15/2023] [Accepted: 12/10/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Registered nurse (RN) turnover is a recurring phenomenon that accelerated during COVID-19 and heightened concerns about contributing factors. PURPOSE Provide baseline RN turnover data to which pandemic and future RN workforce turnover behaviors can be compared. METHODS A cross-sectional, secondary analysis of RN turnover using U.S. National Sample Survey of Registered Nurses 2018 data. Responses from 41,428 RNs (weighted N = 3,092,991) across the United States were analyzed. Sociodemographic, professional, employment, and economic data and weighting techniques were used to model prepandemic RN turnover behaviors. DISCUSSION About 17% of the sample reported a job turnover, with 6.2% reporting internal and 10.8% reporting external turnover. The factors common across both internal and external turnover experiences included education, employment settings, and years of nursing experience. CONCLUSIONS Baseline RN turnover data can help employers and policymakers understand new and recurring nursing workforce trends and develop targeted actions to reduce nurse turnover.
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Affiliation(s)
- Cheryl B Jones
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Sinhye Kim
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC.
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22
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Barrett JW, Eastley KB, Herbland A, Owen P, Naeem S, Mortimer C, King J, Foster T, Rees N, Rosser A, Black S, Bell F, Fothergill R, Mellett-Smith A, Jackson M, McClelland G, Gowens P, Spaight R, Igbodo S, Brown M, Williams J. The COVID-19 ambulance response assessment (CARA) study: a national survey of ambulance service healthcare professionals' preparedness and response to the COVID-19 pandemic. Br Paramed J 2024; 8:10-20. [PMID: 38445107 PMCID: PMC10910287 DOI: 10.29045/14784726.2024.3.8.4.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024] Open
Abstract
Background The COVID-19 pandemic placed significant demand on the NHS, including ambulance services, but it is unclear how this affected ambulance service staff and paramedics in other clinical settings (e.g. urgent and primary care, armed services, prisons). This study aimed to measure the self-perceived preparedness and impact of the first wave of the pandemic on paramedics' psychological stress and perceived ability to deliver care. Methods Ambulance clinicians and paramedics working in other healthcare settings were invited to participate in a three-phase sequential online survey during the acceleration (April 2020), peak (May 2020) and deceleration (September/October 2020) phases of the first wave of COVID-19 in the United Kingdom. Recruitment used social media, Trust internal bulletins and the College of Paramedics' communication channels, employing a convenience sampling strategy. Data were collected using purposively developed open- and closed-ended questions and the validated general health questionnaire-12 (GHQ-12). Data were analysed using multi-level linear and logistic regression models. Results Phase 1 recruited 3717 participants, reducing to 2709 (73%) by phase 2 and 2159 (58%) by phase 3. Participants were mostly male (58%, n = 2148) and registered paramedics (n = 1992, 54%). Mean (standard deviation) GHQ-12 scores were 16.5 (5.2) during phase 1, reducing to 15.2 (6.7) by phase 3. A total of 84% of participants (n = 3112) had a GHQ-12 score ≥ 12 during the first phase, indicating psychological distress. Participants that had higher GHQ-12 scores were feeling unprepared for the pandemic, and reported a lack of confidence in using personal protective equipment and managing cardiac arrests in confirmed or suspected COVID-19 patients. Conclusions Most participants reported psychological distress, the reasons for which are multi-factorial. Ambulance managers need to be aware of the risks to staff mental health and take action to mitigate these, to support staff in the delivery of unscheduled, emergency and urgent care under these additional pressures.
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Affiliation(s)
- Jack William Barrett
- South East Coast Ambulance Service NHS Foundation Trust ORCID iD: https://orcid.org/0000-0002-0040-537X
| | | | - Anthony Herbland
- University of Hertfordshire ORCID iD: https://orcid.org/0000-0001-6182-4191
| | - Peter Owen
- South East Coast Ambulance Service NHS Foundation Trust
| | - Salman Naeem
- Barts Health NHS Trust ORCID iD: https://orcid.org/0000-0002-0153-1669
| | - Craig Mortimer
- South East Coast Ambulance Service NHS Foundation Trust ORCID iD: https://orcid.org/0000-0001-6989-2244
| | - James King
- University of Hertfordshire ORCID iD: https://orcid.org/0000-0001-9259-0957
| | - Theresa Foster
- East of England Ambulance Service NHS Trust ORCID iD: https://orcid.org/0000-0002-6395-0885
| | - Nigel Rees
- Welsh Ambulance Services NHS Trust ORCID iD: https://orcid.org/0000-0001-8799-5335
| | - Andy Rosser
- West Midlands Ambulance Service University NHS Foundation Trust ORCID iD: https://orcid.org/0000-0002-5477-4269
| | - Sarah Black
- South Western Ambulance Service NHS Foundation Trust ORCID iD: https://orcid.org/0000-0001-6678-7502
| | - Fiona Bell
- Yorkshire Ambulance Service NHS Trust ORCID iD: https://orcid.org/0000-0003-4503-1903
| | - Rachael Fothergill
- London Ambulance Service NHS Trust ORCID iD: https://orcid.org/0000-0003-1341-6200
| | - Adam Mellett-Smith
- London Ambulance Service NHS Trust ORCID iD: https://orcid.org/0000-0002-6157-8979
| | | | - Graham McClelland
- North East Ambulance Service NHS Foundation Trust ORCID iD: https://orcid.org/0000-0002-4502-5821
| | - Paul Gowens
- Scottish Ambulance Service ORCID iD: https://orcid.org/0000-0002-9311-3885
| | - Robert Spaight
- East Midlands Ambulance Service NHS Trust ORCID iD: https://orcid.org/0000-0003-4361-5876
| | - Sandra Igbodo
- North West Ambulance Service NHS Trust ORCID iD: https://orcid.org/0009-0001-8290-0912
| | - Martina Brown
- South Central Ambulance Service NHS Foundation Trust ORCID iD: https://orcid.org/0000-0003-3083-8958
| | - Julia Williams
- South East Coast Ambulance Service NHS Foundation Trust; University of Hertfordshire; College of Paramedics ORCID iD: https://orcid.org/0000-0003-0796-5465
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23
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Essien EA, Mahmood MY, Adiukwu F, Kareem YA, Hayatudeen N, Ojeahere MI, Salihu MO, Sanni KA, Omotoso AB, Pinto da Costa M. Workforce migration and brain drain - A nationwide cross-sectional survey of early career psychiatrists in Nigeria. Glob Ment Health (Camb) 2024; 11:e30. [PMID: 38572258 PMCID: PMC10988168 DOI: 10.1017/gmh.2024.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/07/2024] [Accepted: 02/14/2024] [Indexed: 04/05/2024] Open
Abstract
Background Nigeria's shortage of psychiatrists is exacerbated due to health worker migration. Aim This study explores migration experiences and tendencies among early-career psychiatrists in Nigeria. Methods We conducted a cross-sectional survey covering Nigeria's six geopolitical zones, using a 61-item online questionnaire assessing short-term mobility, long-term migration experiences and migration attitudes. Data was analysed using IBM SPSS version 29. Results Of 228 early-career psychiatrists surveyed, 9.7% had short-term mobility and 8.0% had long-term migration experiences. However, 85.8% had 'ever' considered migration, 69.2% were planning to leave 'now', and 52.9% had taken 'practical migration steps'. Over half (52.7%) said they would be working abroad in 5 years, with 25.2% indicating they would migrate within a year. The top reasons to leave were financial and academic, while personal and cultural factors were the key reasons to stay. Income dissatisfaction (OR = 2.27, 95%, CI = 1.05-4.88) predicted planning to leave 'now', while being in a relationship (OR = 3.46, 95%CI = 1.06-11.30) predicted taking 'practical migration steps'. Attractive job features were good welfare (85.4%) and high salaries (80.3%). Improvements in finances (90.8%) and work conditions (86.8%) were requested. Conclusions Systemic changes to address psychiatrists' migration from Nigeria are needed.
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Affiliation(s)
| | | | - Frances Adiukwu
- Department of Mental Health, University of Port Harcourt, Choba, Rivers State, Nigeria
| | | | - Nafisatu Hayatudeen
- Department of Clinical Services, Federal Neuropsychiatric Hospital, Kaduna, Nigeria
| | | | - Mumeen Olaitan Salihu
- Department of Behavioural Sciences, University of Ilorin Teaching Hospital, Ilorin, Nigeria
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24
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Yazbeck Karam VG, Bahous S, Awada GM, Youssef N. Faculty retention at a young medical school in crisis times and beyond: prospects, challenges and propositions from a mixed-methods study. BMJ LEADER 2024:leader-2023-000900. [PMID: 38418199 DOI: 10.1136/leader-2023-000900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/20/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Retention of faculty constitutes a significant challenge for higher education institutions, especially in times of crisis. Lebanon has been experiencing economic recession since the end of its civil war in 1990 until its complete collapse in 2019. This resulted in a massive faculty exodus, escaping the daily struggle with the sinking economy. PURPOSE The purpose of this study was to empirically investigate the factors that precipitate faculty attrition and the measures that foster long-term commitment to the institution in a time of unprecedented crisis. METHODS An online anonymous survey, using a Likert scale, gathered responses from 92 faculty members. Quantitative findings were complemented by a qualitative exploration of emergent themes in comments. A team of three certified researchers conducted the analysis. Inductive analysis identified recurring themes, with steps like intercoder reliability checks and member-checking enhancing data validity. The researchers ensured methodological rigour, subject expertise, and overall reliability and validity of the thematic analysis. RESULTS A total of 78 faculty participated in the survey (84.8%), with 79.5% reporting overall satisfaction, but a varying degree of satisfaction was noted across items. Faculty satisfaction was highest in areas such as respectful interactions (91.0%), belonging to the workplace (85.9%), communication from the Dean's office (85.9%), supportive environment and medical school leadership's commitment to retaining faculty (82.1%). Financial assistance, support for research and professional assistance were identified as important retention measures. Effective, transparent communication from leadership was highlighted as a critical factor during times of crisis. CONCLUSION This study provides strategies for faculty retention in times of crisis that include ensuring timely salary payments, supporting research and professional development, fostering a positive work environment and implementing bonding programmes. Transparent communication from leadership is vital for faculty satisfaction and retention. These findings can aid medical schools and other institutions facing faculty attrition during crises.
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Affiliation(s)
| | - Sola Bahous
- Lebanese American University, Beirut, Lebanon
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25
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Seathu Raman SS, McDonnell A, Beck M. Hospital doctor turnover and retention: a systematic review and new research pathway. J Health Organ Manag 2024; 38:45-71. [PMID: 38448230 PMCID: PMC10986676 DOI: 10.1108/jhom-04-2023-0129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 11/20/2023] [Accepted: 01/12/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE Society is critically dependent on an adequate supply of hospital doctors to ensure optimal health care. Voluntary turnover amongst hospital doctors is, however, an increasing problem for hospitals. The aim of this study was to systematically review the extant academic literature to obtain a comprehensive understanding of the current knowledge base on hospital doctor turnover and retention. In addition to this, we synthesise the most common methodological approaches used before then offering an agenda to guide future research. DESIGN/METHODOLOGY/APPROACH Adopting the PRISMA methodology, we conducted a systematic literature search of four databases, namely CINAHL, MEDLINE, PsycINFO and Web of Science. FINDINGS We identified 51 papers that empirically examined hospital doctor turnover and retention. Most of these papers were quantitative, cross-sectional studies focussed on meso-level predictors of doctor turnover. RESEARCH LIMITATIONS/IMPLICATIONS Selection criteria concentrated on doctors who worked in hospitals, which limited knowledge of one area of the healthcare environment. The review could disregard relevant articles, such as those that discuss the turnover and retention of doctors in other specialities, including general practitioners. Additionally, being limited to peer-reviewed published journals eliminates grey literature such as dissertations, reports and case studies, which may bring impactful results. PRACTICAL IMPLICATIONS Globally, hospital doctor turnover is a prevalent issue that is influenced by a variety of factors. However, a lack of focus on doctors who remain in their job hinders a comprehensive understanding of the issue. Conducting "stay interviews" with doctors could provide valuable insight into what motivates them to remain and what could be done to enhance their work conditions. In addition, hospital management and recruiters should consider aspects of job embeddedness that occur outside of the workplace, such as facilitating connections outside of work. By resolving these concerns, hospitals can retain physicians more effectively and enhance their overall retention efforts. SOCIAL IMPLICATIONS Focussing on the reasons why employees remain with an organisation can have significant social repercussions. When organisations invest in gaining an understanding of what motivates their employees to stay in the job, they are better able to establish a positive work environment that likely to promote employee well-being and job satisfaction. This can result in enhanced job performance, increased productivity and higher employee retention rates, all of which are advantageous to the organisation and its employees. ORIGINALITY/VALUE The review concludes that there has been little consideration of the retention, as opposed to the turnover, of hospital doctors. We argue that more expansive methodological approaches would be useful, with more qualitative approaches likely to be particularly useful. We also call on future researchers to consider focussing further on why doctors remain in posts when so many are leaving.
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Affiliation(s)
| | - Anthony McDonnell
- Cork University Business School,
University College Cork, Cork, Ireland
| | - Matthias Beck
- Cork University Business School,
University College Cork, Cork, Ireland
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26
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Berger S, Grzonka P, Frei AI, Hunziker S, Baumann SM, Amacher SA, Gebhard CE, Sutter R. Violence against healthcare professionals in intensive care units: a systematic review and meta-analysis of frequency, risk factors, interventions, and preventive measures. Crit Care 2024; 28:61. [PMID: 38409034 PMCID: PMC10898135 DOI: 10.1186/s13054-024-04844-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/19/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND To assess the frequency, risk factors, consequences, and prevention of violence against healthcare workers in intensive care units. METHODS PubMed, Scopus, Google Scholar, EMBASE, Cochrane, and Web of Science were searched for studies on violence against healthcare workers in adult intensive care units. Risk factors, patient characteristics, and implications for healthcare workers were collected. Study quality, bias, and level of evidence were assessed using established tools. RESULTS Seventy-five studies with 139,533 healthcare workers from 32 countries were included. The overall median frequency of violence was 51% (IQR 37-75%). Up to 97% of healthcare workers experienced verbal violence, and up to 82% were victims of physical violence. Meta-analysis of frequency revealed an average frequency of 31% (95% CI 22-41%) for physical violence, 57% for verbal violence (95% CI 48-66%), and 12% for sexual violence (95% CI 4-23%). Heterogeneity was high according to the I2 statistics. Patients were the most common perpetrators (median 56%), followed by visitors (median 22%). Twenty-two studies reported increased risk ratios of up to 2.3 or odds ratios of up to 22.9 for healthcare workers in the ICU compared to other healthcare workers. Risk factors for experiencing violence included young age, less work experience, and being a nurse. Patients who exhibited violent behavior were often male, older, and physically impaired by drugs. Violence was underreported in up to 80% of cases and associated with higher burnout rates, increased anxiety, and higher turnover intentions. Overall the level of evidence was low. CONCLUSIONS Workplace violence is frequent and underreported in intensive care units, with potential serious consequences for healthcare workers, calling for heightened awareness, screening, and preventive measures. The potential risk factors for violence should be further investigated. SYSTEMATIC REVIEW REGISTRATION The protocol for this review was registered with Prospero on January 15, 2023 (ID CRD42023388449).
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Affiliation(s)
- Sebastian Berger
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
| | - Pascale Grzonka
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Anja I Frei
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Sabina Hunziker
- Medical Faculty, University of Basel, Basel, Switzerland
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Sira M Baumann
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Simon A Amacher
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Caroline E Gebhard
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Raoul Sutter
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
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27
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Ripoll J, Chela-Alvarez X, Briones-Vozmediano E, Fiol de-Roque MA, Zamanillo-Campos R, Ricci-Cabello I, Llobera J, Calafat-Villalonga C, Serrano-Ripoll MJ. Impact of COVID-19 on mental health of health care workers in Spain: a mix-methods study. BMC Public Health 2024; 24:463. [PMID: 38355471 PMCID: PMC10865523 DOI: 10.1186/s12889-024-17979-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/04/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Spain's lockdown measures couldn't prevent the severe impact of the COVID-19 first wave, leading to high infections, deaths, and strain on healthcare workers (HCWs). This study aimed to explore the mental health impact on HCWs in the Balearic Islands during the initial months of the pandemic, the influencing factors, and the experiences of those in a COVID-19 environment. METHODS Using a mixed-methods approach, the study encompassed quantitative and qualitative elements. Cross-sectional survey data from April to June 2020 comprised HCWs who were emailed invitations. The survey covered demographics, work, clinical and COVID-19 variables, along with psychological distress and PTSD symptoms, using validated measures. Additionally, semi-structured interviews with HCWs offered qualitative insights. RESULTS Three hundred thirty-six HCWs averaging 46.8 years, mainly women (79.2%), primarily nurses in primary care with over 10 years of experience. Anxiety symptoms were reported by 28.8%, 65.1% noted worsened sleep quality, and 27.7% increased psychoactive drug usage. Psychological distress affected 55.2%, while 27.9% exhibited PTSD symptoms. Gender, age, experience, COVID-19 patient contact, and workload correlated with distress, PTSD symptoms, sleep quality, and psychoactive drug usage. Interviews uncovered discomfort sources, such as fear of infection and lack of control, leading to coping strategies like information avoidance and seeking support. LIMITATIONS Static cross-sectional design, non-probabilistic sample, and telephone interviews affecting non-verbal cues, with interviews conducted during early pandemic lockdown. CONCLUSIONS HCWs faced significant psychological distress during the pandemic's first wave, underscoring the necessity for robust support and resources to counteract its impact on mental health.
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Affiliation(s)
- J Ripoll
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - X Chela-Alvarez
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain.
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain.
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain.
| | - E Briones-Vozmediano
- Departamento de Enfermería y Fisioterapia Grupo de estudios en sociedad, salud, educación y cultura (GESEC), Universidad de Lleida.Grup de Recerca en Cures en Salut (GRECS), Institut de Recerca Biomèdica (IRB) de Lleida, Lleida, 25001, Spain
| | - M A Fiol de-Roque
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - R Zamanillo-Campos
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
| | - I Ricci-Cabello
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - J Llobera
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - C Calafat-Villalonga
- Department of Psychology, University of the Balearic Islands, Palma, 07122, Spain
| | - M J Serrano-Ripoll
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
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Nazarov A, Forchuk CA, Houle SA, Hansen KT, Plouffe RA, Liu JJW, Dempster KS, Le T, Kocha I, Hosseiny F, Heesters A, Richardson JD. Exposure to moral stressors and associated outcomes in healthcare workers: prevalence, correlates, and impact on job attrition. Eur J Psychotraumatol 2024; 15:2306102. [PMID: 38334695 PMCID: PMC10860421 DOI: 10.1080/20008066.2024.2306102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/14/2023] [Indexed: 02/10/2024] Open
Abstract
Introduction: Healthcare workers (HCWs) often experience morally challenging situations in their workplaces that may contribute to job turnover and compromised well-being. This study aimed to characterize the nature and frequency of moral stressors experienced by HCWs during the COVID-19 pandemic, examine their influence on psychosocial-spiritual factors, and capture the impact of such factors and related moral stressors on HCWs' self-reported job attrition intentions.Methods: A sample of 1204 Canadian HCWs were included in the analysis through a web-based survey platform whereby work-related factors (e.g. years spent working as HCW, providing care to COVID-19 patients), moral distress (captured by MMD-HP), moral injury (captured by MIOS), mental health symptomatology, and job turnover due to moral distress were assessed.Results: Moral stressors with the highest reported frequency and distress ratings included patient care requirements that exceeded the capacity HCWs felt safe/comfortable managing, reported lack of resource availability, and belief that administration was not addressing issues that compromised patient care. Participants who considered leaving their jobs (44%; N = 517) demonstrated greater moral distress and injury scores. Logistic regression highlighted burnout (AOR = 1.59; p < .001), moral distress (AOR = 1.83; p < .001), and moral injury due to trust violation (AOR = 1.30; p = .022) as significant predictors of the intention to leave one's job.Conclusion: While it is impossible to fully eliminate moral stressors from healthcare, especially during exceptional and critical scenarios like a global pandemic, it is crucial to recognize the detrimental impacts on HCWs. This underscores the urgent need for additional research to identify protective factors that can mitigate the impact of these stressors.
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Affiliation(s)
- Anthony Nazarov
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
| | - Callista A. Forchuk
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
| | - Stephanie A. Houle
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Research Directorate, Veteran Affairs Canada, Charlottetown, Canada
| | - Kevin T. Hansen
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Rachel A. Plouffe
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Jenny J. W. Liu
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Kylie S. Dempster
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
| | - Tri Le
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
| | - Ilyana Kocha
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
| | | | - Ann Heesters
- Department of Clinical and Organizational Ethics, University Health Network, Toronto, Canada
- The Institute for Education Research, University Health Network, Toronto, Canada
- Joint Centre for Bioethics, University of Toronto, Toronto, Canada
- The Michener Institute, University Health Network, Toronto, Canada
- The Wilson Centre, University Health Network, Toronto, Canada
| | - J. Don Richardson
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
- St. Joseph’s Operational Stress Injury Clinic, St. Joseph’s Health Care London, London, Canada
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Peutere L, Pentti J, Ropponen A, Kivimäki M, Härmä M, Krutova O, Ervasti J, Koskinen A, Virtanen M. Association of nurse understaffing and limited nursing work experience with in-hospital mortality among patients: A longitudinal register-based study. Int J Nurs Stud 2024; 150:104628. [PMID: 37992652 DOI: 10.1016/j.ijnurstu.2023.104628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 10/20/2023] [Accepted: 10/21/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Although nurse understaffing and limited nursing work experience may affect hospital patients' risk of mortality, relatively little longitudinal patient-level evidence on these associations is available. Hospital administrative data could provide important information about the level of staffing, nurses' work experience and patient mortality over time. OBJECTIVE To examine whether daily exposure to nurse understaffing and limited nursing work experience is associated with patient mortality, using patient-level data with different exposure time windows and accounting for several patient-related characteristics. METHODS This longitudinal register-based study combined administrative data on patients (clinical database Auria) and employees (Titania® shift-scheduling) from one hospital district in Finland in 2013-2019, covering a total of 254,446 hospital stays in 40 units. We quantified nurse understaffing as the number of days with low nursing hours in relation to target hours (<90 % of the annual unit median), and limited work experience as the number of days with a low proportion of nurses with >3 years of in-hospital experience, and those aged over 25 (<90 % of the annual unit median). We used two survival model designs to analyze the associations between nurse understaffing and limited nursing work experience and the in-hospital mortality of the patients: we considered these exposures during the first days in hospital and as a cumulative proportion of days with suboptimal staffing during the first 30 days. RESULTS In total, 1.5 % (N = 3937) of the hospital stays ended in death. A 20 % increase in the proportion of days with nurse understaffing was associated with an increased, 1.05-fold mortality risk at the patient level (95 % confidence interval, 1.01-1.10). The cumulative proportion of days with limited nursing work experience, or the combination of nurse understaffing and limited work experience were not associated with increased risk of death among all patients. However, both indicators of limited nursing work experience were associated with an increased mortality risk among patients with comorbidities (HR 1.05, 95 % CI 1.02-1.08 and HR 1.05, 95 % CI 1.00-1.10, respectively). CONCLUSIONS Nurse understaffing was associated with a slight, but a potentially critical increase in patient in-hospital mortality. Limited nursing work experience was associated with increased in-hospital mortality in a subgroup of patients with comorbidities. Increased use of administrative data on planned and realized working hours could be a routine tool for reducing avoidable in-hospital mortality.
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Affiliation(s)
- Laura Peutere
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland; Finnish Institute of Occupational Health, Helsinki, Finland.
| | - Jaana Pentti
- Department of Public Health, University of Turku, Turku, Finland
| | - Annina Ropponen
- Finnish Institute of Occupational Health, Helsinki, Finland; Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland; Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Mikko Härmä
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Oxana Krutova
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Aki Koskinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland; Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Sheppard-Law S, Lamb A, Zeng L, Axisa C, Causby B, Matiuk S, Levett-Jones T. The measured impact of the COVID-19 pandemic on nursing students' wellbeing, clinical placement and learning experiences: a cross sectional study. Contemp Nurse 2024; 60:7-20. [PMID: 38193929 DOI: 10.1080/10376178.2023.2300414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 12/23/2023] [Indexed: 01/10/2024]
Abstract
Background: The epidemiological patterns of COVID-19 varied across Australia and differed from most other countries. Few studies describe the impact that the pandemic had on nursing student wellbeing, education and career.Aim: This study aimed to investigate how the COVID-19 pandemic impacted on nursing students' well-being, clinical placement and learning.Design: Cross-sectional survey.Setting: Sydney, Australia.Participants: Second- and third-year nursing students.Methods: Second- and third-year nursing degree students were asked to participate in an ethically approved study during March to May 2021. The de-identified on-line survey consisted of 63 closed end question and one open ended question. On completion, the dataset was exported from Redcap and imported into SPSS for analysis. Open ended text data were analysed by two researchers.Results: Of the 105 participating nursing students, a third (n = 26/83, 31%) thought about changing their degree to a non-nursing degree. The acknowledged risk of caring for a COVID-19 patient incrementally increased stress (β-coefficient = 0.6, p value = 0.009, 95% CI 0.2-0.9). Conversely students who intended to complete their degree were less likely to report stress. Students who had prior nursing experience were three times more likely to report an increased generalised anxiety level (OR 3.8, p-value = 0.02, 95% CI 1.2-12.2), yet they were less likely to experience personal accomplishment burnout compared to other students. Nursing students who contemplated a change of degree to a non-nursing degree were 15.7 times more likely to experience emotional exhaustion and were 3.5 times more likely to be report a risk of depersonalisation (p = 0.03, 95% CI, 1.3-11.5).Conclusion: The COVID-19 pandemic compromised nursing student well-being, and theoretical and practical learning. Findings have implications for healthcare and academic staff who teach nursing students. Implementation of student-centred evidence-based strategies to manage stress, burnout and anxiety, and to sustain a healthy student cohort is essential to retain the future nursing workforce.
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Affiliation(s)
- Suzanne Sheppard-Law
- Faculty of Health, School of Nursing and Midwifery, University of Technology Sydney, Level 7, Building 10, Jones St Broadway, Sydney, NSW, Australia
| | - Aimee Lamb
- Western Sydney University, Building 3, Level 4, Liverpool, NSW, Australia
| | - Ling Zeng
- Faculty of Health, School of Nursing and Midwifery, University of Technology Sydney, Level 7, Building 10, Jones St Broadway, Sydney, NSW, Australia
| | - Carmen Axisa
- Faculty of Health, School of Nursing and Midwifery, University of Technology Sydney, Level 7, Building 10, Jones St Broadway, Sydney, NSW, Australia
| | - Belinda Causby
- Faculty of Health, School of Nursing and Midwifery, University of Technology Sydney, Level 7, Building 10, Jones St Broadway, Sydney, NSW, Australia
- Clinical Nurse Specialist, Intensive Care Unit, St Vincent's Hospital, 390 Victoria St, Darlinghurst, 2010 NSW, Australia
| | - Sonia Matiuk
- Faculty of Health, School of Nursing and Midwifery, University of Technology Sydney, Level 7, Building 10, Jones St Broadway, Sydney, NSW, Australia
| | - Tracy Levett-Jones
- Faculty of Health, School of Nursing and Midwifery, University of Technology Sydney, Level 7, Building 10, Jones St Broadway, Sydney, NSW, Australia
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Morales-García WC, Vallejos M, Sairitupa-Sanchez LZ, Morales-García SB, Rivera-Lozada O, Morales-García M. Depression, professional self-efficacy, and job performance as predictors of life satisfaction: the mediating role of work engagement in nurses. Front Public Health 2024; 12:1268336. [PMID: 38362215 PMCID: PMC10867221 DOI: 10.3389/fpubh.2024.1268336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/02/2024] [Indexed: 02/17/2024] Open
Abstract
Background The life satisfaction and job performance of nursing professionals are affected by a multitude of factors, including work engagement, self-efficacy, and depression. The Job Demands-Resources (JD-R) model provides a theoretical framework to explore these relationships. Objective Our study aimed to analyze the primary goal of this research, which is to examine the mediating role of work engagement in the relationship between depression, professional self-efficacy, job performance, and their impact on life satisfaction in nurses, using the JD-R theory as a guide. Methods This cross-sectional study involved 579 participants aged between 21 to 57 years (M = 39, SD = 9.95). Mediation analysis was used to examine the influence of depression, self-efficacy, and job performance on work engagement, and in turn, its effect on life satisfaction. Results Findings indicated that work engagement plays a crucial mediating role between depression, self-efficacy, job performance, and life satisfaction. Interventions to increase work engagement could assist nurses in better managing depression and improving their performance and life satisfaction. Conclusions Our study highlights the need for workplace policies and strategies that foster work engagement and self-efficacy among nurses while effectively managing job demands to prevent depression. Moreover, these findings underscore the importance of the JD-R theory to understand and improve nurses' job satisfaction and performance, and suggest areas for future research, including exploring other potential factors and applying these findings across different contexts and cultures.
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Affiliation(s)
- Wilter C. Morales-García
- Unidad de Ciencias Empresariales, Escuela de Posgrado, Universidad Peruana Unión, Lima, Peru
- Escuela Profesional de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Peruana Unión, Lima, Peru
- Facultad de Teología, Universidad Peruana Unión, Lima, Peru
- Sociedad Científica de Investigadores Adventistas (SOCIA), Universidad Peruana Unión, Lima, Peru
| | - María Vallejos
- Business Sciences Unit, Graduate School, Universidad Peruana Unión, Lima, Peru
- Universidad Peruana Unión, Tarapoto, Peru
| | - Liset Z. Sairitupa-Sanchez
- Escuela Profesional de Psicología, Facultad de Ciencias de la Salud, Universidad Peruana Unión, Lima, Peru
| | - Sandra B. Morales-García
- Departamento Académico de Enfermería, Obstetricia y Farmacia, Facultad de farmacia y Bioquímica, Universidad Científica del Sur, Lima, Peru
| | - Oriana Rivera-Lozada
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Peru
| | - Mardel Morales-García
- Unidad de Posgrado de Ciencias de la Salud, Escuela de Posgrado, Universidad Peruana Unión, Lima, Peru
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Labrague LJ, T Kostovich C. A Global Overview of Missed Nursing Care During the COVID-19 Pandemic: A Systematic Review. West J Nurs Res 2024; 46:133-142. [PMID: 38014816 DOI: 10.1177/01939459231214598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has placed unparalleled pressure on many countries' healthcare systems, impacting the delivery of health and nursing care services. Despite the growing number of missed care studies during the pandemic, a broader perspective is essential when designing theory-driven strategies to improve nursing care delivery. This review aimed to synthesize evidence of missed nursing care during the COVID-19 pandemic in acute care settings through a systematic review and narrative synthesis. An electronic search of articles published since the emergence of the pandemic was conducted using 5 databases (Scopus, PubMed, Web of Science, CINAHL, and PsycINFO). A total of 470 articles were identified during the initial search, and 10 articles were included in the review. The sample sizes of the studies ranged from 37 to 536 nurses. Results of the content analysis were grouped into 5 categories: (1) prevalence of missed care, (2) frequency of missed care, (3) reasons for missed care, (4) nurses' and organizational variables contributing to missed care, and (5) work environment elements contributing to missed care. The review's findings revealed a shift in the nature of missed nursing care during the pandemic, with an emphasis on nursing care tasks vital for the recovery of patients with COVID-19. Despite the unique circumstances brought about by the pandemic, an inadequate nursing workforce continued to be identified as the primary reason for missed care, consistent with the pre-pandemic period.
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Affiliation(s)
- Leodoro J Labrague
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA
| | - Carol T Kostovich
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA
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DePierro JM, Chan CC, Mohamed N, Starkweather S, Ripp J, Peccoralo LA. Determinants of Staff Intent to Leave Health Care During the COVID-19 Pandemic. Am J Public Health 2024; 114:200-203. [PMID: 38354356 PMCID: PMC10916731 DOI: 10.2105/ajph.2024.307574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 02/16/2024]
Abstract
Objectives. To identify potential drivers of health care worker attrition. Methods. We conducted a survey of 1083 nonphysician health care workers in a large urban health system in New York City from September to October 2022. Results. The results of a multivariable logistic regression analysis revealed that higher odds of intending to leave health care were significantly associated with male gender, registered nurse profession, burnout, self-perceived mental health service need, and verbal abuse from patients or visitors, whereas lower odds were seen among those reporting greater emotional well-being and a better workplace culture. A relative importance analysis indicated that burnout was the strongest correlate of intention to leave (22.5% relative variance explained [RVE]), followed by subjective emotional well-being (16.7% RVE), being a registered nurse (12.3% RVE), poorer perceived workplace culture (9.5% RVE), and male gender (5.9% RVE). Conclusions. Overall, our findings suggest the need for well-coordinated interventions that address both individual- and system-level factors in an effort to improve retention. Public Health Implications. Our results indicate a need for interventions targeting workplace culture, staff burnout, and mental health service provision. (Am J Public Health. 2024;114(S2):S200-S203. https://doi.org/10.2105/AJPH.2024.307574).
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Affiliation(s)
- Jonathan M DePierro
- Jonathan M. DePierro and Sydney Starkweather are with the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. Chi C. Chan, Jonathan Ripp, and Lauren A. Peccoralo are with the Office of Well-being and Resilience, Mount Sinai Health System, New York, NY. Nihal Mohamed is with the Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Chi C Chan
- Jonathan M. DePierro and Sydney Starkweather are with the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. Chi C. Chan, Jonathan Ripp, and Lauren A. Peccoralo are with the Office of Well-being and Resilience, Mount Sinai Health System, New York, NY. Nihal Mohamed is with the Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Nihal Mohamed
- Jonathan M. DePierro and Sydney Starkweather are with the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. Chi C. Chan, Jonathan Ripp, and Lauren A. Peccoralo are with the Office of Well-being and Resilience, Mount Sinai Health System, New York, NY. Nihal Mohamed is with the Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Sydney Starkweather
- Jonathan M. DePierro and Sydney Starkweather are with the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. Chi C. Chan, Jonathan Ripp, and Lauren A. Peccoralo are with the Office of Well-being and Resilience, Mount Sinai Health System, New York, NY. Nihal Mohamed is with the Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jonathan Ripp
- Jonathan M. DePierro and Sydney Starkweather are with the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. Chi C. Chan, Jonathan Ripp, and Lauren A. Peccoralo are with the Office of Well-being and Resilience, Mount Sinai Health System, New York, NY. Nihal Mohamed is with the Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Lauren A Peccoralo
- Jonathan M. DePierro and Sydney Starkweather are with the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. Chi C. Chan, Jonathan Ripp, and Lauren A. Peccoralo are with the Office of Well-being and Resilience, Mount Sinai Health System, New York, NY. Nihal Mohamed is with the Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
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Shahrin L, Nowrin I, Afrin S, Rahaman MZ, Al Hasan MM, Saif-Ur-Rahman KM. Monitoring and evaluation practices and operational research during public health emergencies in southeast Asia region (2012-2022) - a systematic review. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 21:100340. [PMID: 38361592 PMCID: PMC10866922 DOI: 10.1016/j.lansea.2023.100340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 11/01/2023] [Accepted: 11/22/2023] [Indexed: 02/17/2024]
Abstract
This systematic review aimed to explore the monitoring and evaluation (M&E) and operational research (OR) practices during public health emergencies (PHE) in the southeast Asian region (SEAR) over the last decade. We searched electronic databases and grey literature sources for studies published between 2012 and 2022. The studies written in English were included, and a narrative synthesis was undertaken. A total of 29 studies were included in this review. Among these 25 studies documented M&E and four studies documented OR practices. The majority of the studies were from India and Bangladesh, with no evidence found from Sri Lanka, Bhutan, Myanmar, and Timor-Leste. M&E of surveillance programs were identified among which PHE due to COVID-19 was most prevalent. M&E was conducted in response to COVID-19, cholera, Nipah, Ebola, Candida auris, and hepatitis A. OR practice was minimal and reported from India and Indonesia. India conducted OR on COVID-19 and malaria, whereas Indonesia focused on COVID-19 and influenza. While most SEAR countries have mechanisms for conducting M&E, there is a noticeable limitation in OR practices. There is a compelling need to develop a standard framework for M&E. Additionally, enhancing private sector engagement is crucial for strengthening preparedness against PHE. Furthermore, there is a necessity to increase awareness about the importance of conducting M&E and OR during PHE.
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Affiliation(s)
- Lubaba Shahrin
- Clinical and Diagnostic Services, icddr,b, Dhaka, Bangladesh
- Nutrition Research Division, icddr,b, Dhaka, Bangladesh
| | - Iffat Nowrin
- Maternal and Child Health Division, icddr,b, Dhaka, Bangladesh
| | - Sadia Afrin
- Maternal and Child Health Division, icddr,b, Dhaka, Bangladesh
| | - Md Zamiur Rahaman
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | | | - KM Saif-Ur-Rahman
- College of Medicine, Nursing, and Health Sciences, University of Galway, Galway, Ireland
- Evidence Synthesis Ireland and Cochrane Ireland, University of Galway, Galway, Ireland
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Ang WHD, Lim ZQG, Lau ST, Dong J, Lau Y. Unpacking the Experiences of Health Care Professionals About the Web-Based Building Resilience At Work Program During the COVID-19 Pandemic: Framework Analysis. JMIR MEDICAL EDUCATION 2024; 10:e49551. [PMID: 38294866 PMCID: PMC10867752 DOI: 10.2196/49551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/21/2023] [Accepted: 12/28/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND The COVID-19 pandemic has resulted in a greater workload in the health care system. Therefore, health care professionals (HCPs) continue to experience high levels of stress, resulting in mental health disorders. From a preventive perspective, building resilience has been associated with reduced stress and mental health disorders and promotes HCPs' intent to stay. Despite the benefits of resilience training, few studies provided an in-depth understanding of the contextual factors, implementation, and mechanisms of impact that influences the sustainability of resilience programs. Therefore, examining target users' experiences of the resilience program is important. This will provide meaningful information to refine and improve future resilience programs. OBJECTIVE This qualitative study aims to explore HCPs' experiences of participating in the web-based Building Resilience At Work (BRAW) program. In particular, this study aims to explore the contextual and implementational factors that would influence participants' interaction and outcome from the program. METHODS A descriptive qualitative approach using individual semistructured Zoom interviews was conducted with participants of the web-based resilience program. A framework analysis was conducted, and it is guided by the process evaluation framework. RESULTS A total of 33 HCPs participated in this qualitative study. Three themes depicting participants' experiences, interactions, and impacts from the BRAW program were elucidated from the framework analysis: learning from web-based tools, interacting with the BRAW program, and promoting participants' workforce readiness. CONCLUSIONS Findings show that a web-based asynchronous and self-paced resilience program is an acceptable and feasible approach for HCPs. The program also led to encouraging findings on participants' resilience, intent to stay, and employability. However, continued refinements in the components of the web-based resilience program should be carried out to ensure the sustainability of this intervention. TRIAL REGISTRATION ClinicalTrials.gov NCT05130879; https://clinicaltrials.gov/ct2/show/NCT05130879.
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Affiliation(s)
- Wei How Darryl Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Zhi Qi Grace Lim
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Siew Tiang Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jie Dong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ying Lau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
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Meese KA, Boitet LM, Sweeney KL, Gorman CA, Nassetta LB, Patel N, Rogers DA. Don't Go: Examining the Relationships Between Meaning, Work Environment and Turnover Intention Across the Entire Healthcare Team. J Multidiscip Healthc 2024; 17:353-366. [PMID: 38284119 PMCID: PMC10821655 DOI: 10.2147/jmdh.s437816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/04/2024] [Indexed: 01/30/2024] Open
Abstract
Introduction Healthcare workers tend to have a strong sense of altruism in their work, which may be protective against turnover despite poor working conditions. Due to the increased distress noted during the pandemic, the challenges of working in healthcare and changing attitudes about work may have surpassed the protective effect of meaning and purpose in work. This study empirically examines perceived meaning in work, and specific work-related factors that contribute to employees' intent to stay and to recommend working at the organization to others as COVID-19 transitions from a pandemic to endemic phase. Methods Data from a survey of 4451 clinical and non-clinical healthcare workers were analyzed using regression and dominance analyses to identify specific predictors of turnover intention and net promoter score. Results The variables that explained the greatest contribution to variance in turnover intention from highest to lowest were burnout, trust and confidence in senior leadership, perceived organizational support, sense of belonging, and sense of recognition. The variables that explained the greatest overall contribution to variance for net promoter score from highest to lowest were perceived organizational support, trust and confidence in senior leadership, resource availability, sense of recognition, and sense of belonging. While meaning in work was associated with turnover intent, organizational and team level factors such as trust and belonging were more predictive of the outcomes. Discussion While meaning and purpose are important job resources, they are not sufficient to retain employees in the absence of trust, organizational support, belonging, recognition and access to necessary resources. Leaders must seek to foster environments that support trust, belonging and recognition in their retention efforts.
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Affiliation(s)
- Katherine A Meese
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, USA
- UAB Medicine Office of Wellness, UAB, Birmingham, AL, USA
| | - Laurence M Boitet
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, USA
- UAB Medicine Office of Wellness, UAB, Birmingham, AL, USA
| | - Katherine L Sweeney
- UAB Medicine Office of Wellness, UAB, Birmingham, AL, USA
- Department of Sociology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - C Allen Gorman
- Department of Management, Information Systems, & Quantitative Methods, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - Lauren B Nassetta
- UAB Medicine Office of Wellness, UAB, Birmingham, AL, USA
- Department of Pediatrics, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - Nisha Patel
- UAB Medicine Office of Wellness, UAB, Birmingham, AL, USA
| | - David A Rogers
- UAB Medicine Office of Wellness, UAB, Birmingham, AL, USA
- Department of Surgery, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
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Zhong Y, Ma H, Zhang CC, Jiang QY, Li J, Liao CJ, Liang YF, Shu L. Professional identity, job satisfaction, and turnover intention among Chinese novice nurses: A cross-sectional study. Medicine (Baltimore) 2024; 103:e36903. [PMID: 38241583 PMCID: PMC10798701 DOI: 10.1097/md.0000000000036903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 12/18/2023] [Indexed: 01/21/2024] Open
Abstract
The world is faced with challenges due to a growing aging population and the increasing burden of chronic disease. The acute shortage of nurses and high turnover rates, particularly among novice nurses, are of great concern in many countries. Several studies have shown that turnover intention among nurses is influenced by professional identity and job satisfaction. However, to the best of our knowledge, no studies have examined this issue in the context of novice nurses. Thus, the present study aimed to explore the relationship between professional identity, job satisfaction, and turnover intention among novice nurses in China. From March 18 to April 23, 2022, a cross-sectional survey was carried out involving 532 novice nurses recruited from four public hospitals in Sichuan Province, China. Among the sample, 526 questionnaires were retrieved, with an effective response rate of 98.87%. The mean scores for turnover intention, professional identity, and job satisfaction were 13.02 ± 3.94, 36.17 ± 7.98, and 111.02 ± 21.46, respectively. High turnover intention was observed among novice nurses, of whom 54.37% (286/526) had high or very high turnover intention. Professional identity and job satisfaction among novice nurses were moderate. In terms of demographic characteristics, "Whether living with relatives" and "Monthly income" had a statistically significant impact on the turnover intention of novice nurses (P < .05). Both professional identity (r = -0.459) and job satisfaction (r = -0.517) were significantly and moderately negatively correlated with turnover intention (P < .01). The results of the multivariate linear regression analysis revealed that variables including "Whether living with relatives," "Professional identity," "Control and responsibility for work," and "Benefits" jointly accounted for 29.9% of the variance related to turnover intention among novice nurses. "Whether living with relatives," "Professional identity," "Control and responsibility for work," and "Benefits" were highly predictive of turnover intention levels among novice nurses. Hence, potential predictors of turnover intention should be considered, and intervention research should be conducted to reduce the level of turnover intention among novice nurses.
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Affiliation(s)
- Ying Zhong
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Huan Ma
- School of Nursing, Sichuan Vocational College of Health and Rehabilitation, Sichuan, China
| | - Cui-Cui Zhang
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Qin-Ying Jiang
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Jun Li
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Chang-Ju Liao
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Yu-Fen Liang
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Li Shu
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
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Idriss-Wheeler D, Ormel I, Assefa M, Rab F, Angelakis C, Yaya S, Sohani S. Engaging Community Health Workers (CHWs) in Africa: Lessons from the Canadian Red Cross supported programs. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002799. [PMID: 38236795 PMCID: PMC10796059 DOI: 10.1371/journal.pgph.0002799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/10/2023] [Indexed: 01/22/2024]
Abstract
Universal Health Coverage (UHC) will not be achieved if health care worker shortages, estimated to increase to 18 million by 2030, are not addressed rapidly. Community-based health systems, which pivot to effective engagement of community health workers (CHW), may have an essential role in linking communities with health care facilities and reducing unmet health services needs caused by these shortages. The Canadian Red Cross (CRC) has partnered with different National Red Cross/Red Crescent Societies and Ministries of Health in Africa in the implementation of programs where CHWs contributed to the provision of various health services. This study reports on key findings (i.e., beneficiaries reached, CHWs engaged, programs implemented, intervention outcomes) and lessons learned from CRC supported CHW programs in Africa over the last 15 years (2007-2022). Qualitative methodology was employed to conduct document analysis on 17 sets of reports from each CRC-supported community health worker project in Africa over the past 15 years. Focus was on identifying challenges, facilitators, and lessons learned. CRC supported projects have trained over 9000 CHWs, benefiting nearly 7.5 million people across Africa. Key success factors include adaptability and agility in programming and project management, and considering contextual factors (political, social, and cultural systems). Investing in essential training for CHWs, staff, and volunteers is crucial, alongside employing an evidence-based approach to inform all aspects of programming and implementation. Additionally, projects prioritizing protection, gender and inclusion (PGI) while leveraging existing community structures and partnerships important for successful implementation. Despite challenges (i.e., weak health systems, lack of political commitment, insufficient funding, inadequate training) CHWs are recognized as crucial in promoting community-based health, improving access to care, addressing disparities, and contributing to achieving (UHC). Their unique position within communities enables them to provide culturally appropriate and localized primary health care- particularly in remote, resource limited and poverty-stricken regions.
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Affiliation(s)
- Dina Idriss-Wheeler
- Faculty of Health Sciences, Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Health Intelligence Research and Development, Canadian Red Cross, Ottawa, Ontario, Canada
| | - Ilja Ormel
- Health Intelligence Research and Development, Canadian Red Cross, Ottawa, Ontario, Canada
| | - Mekdes Assefa
- Health Intelligence Research and Development, Canadian Red Cross, Ottawa, Ontario, Canada
| | - Faiza Rab
- Health Intelligence Research and Development, Canadian Red Cross, Ottawa, Ontario, Canada
| | - Christina Angelakis
- Health Intelligence Research and Development, Canadian Red Cross, Ottawa, Ontario, Canada
| | - Sanni Yaya
- Faculty of Social Sciences, School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
- The George Institute for Global Health, Imperial College London, London, United Kingdom
| | - Salim Sohani
- Health Intelligence Research and Development, Canadian Red Cross, Ottawa, Ontario, Canada
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Maruf MA, Weng YH, Chiu YW, Chiou HY. Perceptions of COVID-19 during and after the Omicron outbreak among healthcare personnel in Indonesia. Front Public Health 2024; 11:1321045. [PMID: 38259792 PMCID: PMC10800601 DOI: 10.3389/fpubh.2023.1321045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction The COVID-19 pandemic occurred in several waves with different levels of seriousness. Healthcare personnel (HCP) constituted a high-risk population for COVID-19, necessitating monitoring of their knowledge, attitudes, and practices (KAP) status and level of psychological distress. This study investigated differences in the impacts of COVID-19 during and after the Omicron outbreak among HCP in Indonesia. Methods An online structured questionnaire survey was distributed twice in selected hospitals of Indonesia: the first survey was between December 2021 and February 2022 (Omicron era) and the second between August and October 2022 (post-Omicron era). A multiple logistic regression model was used to determine the differences in KAP and psychological distress among HCP toward COVID-19 with demographic characteristics adjusted for. Results This study included 402 (Omicron era) and 584 (post-Omicron era) HCP members. Positive attitudes were more common in the Omicron era than in the post-Omicron era (p = 0.001). The availability of face shields and protective eyewear significantly decreased from 62.7 to 55.6% (p = 0.028). However, psychological distress among HCP significantly increased after the Omicron outbreak (p = 0.024). Multiple logistic regression analyses revealed a decrease of positive attitudes (OR = 0.626; 95% CI = 0.476-0.823) in the post-Omicron era. Conclusion Our data indicated a significant increase in psychological distress among HCP in the post-Omicron era. These findings suggest a need for greater focus on psychological distress among HCP in Indonesia.
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Affiliation(s)
- Mohammad Ainul Maruf
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Faculty of Public Health, Universitas Muhammadiyah Jakarta, Jakarta, Indonesia
| | - Yi-Hao Weng
- Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan
| | - Ya-Wen Chiu
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
- Research Center for Global Health and Security, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Hung-Yi Chiou
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
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Belkić K, Rustagi N. Job stressors in relation to burnout and compromised sleep among academic physicians in India. Work 2024:WOR230383. [PMID: 38189728 DOI: 10.3233/wor-230383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Burnout among physicians, especially in the academic setting, is an urgent concern, with adequate sleep one of the key focal points. OBJECTIVE To identify job stressors contributing to burnout and compromised sleep among academic physicians, using a comprehensive, theory-based instrument, the Occupational Stressor Index (OSI), whose specific form was created 'for physicians by physicians'. METHODS This parallel mixed-methods cross-sectional investigation was conducted among 109 physicians employed in a public teaching hospital, Jodhpur, India. Work conditions were evaluated by the physician-specific OSI (part I). The Copenhagen Burnout Index and Pittsburgh Sleep Quality Index (PSQI) were the outcome instruments (part II). Seventy-six physicians completed parts I and II. RESULTS The physicians were from wide-ranging specialties, and 82% of the cohort were residents. Mean total OSI scores were 87.4±8.1, with unit-change yielding adjusted odds-ratios (95% confidence-intervals) for personal (1.10 (1.02-1.18)) and work-related burnout (1.12 (1.04-1.22)), and PSQI (1.09 (1.01-1.17)). Significant multivariable associations with burnout and/or sleep indices included: working 7 days/week, lacking work-free vacation, insufficient rest breaks, interruptions, many patients in intensive-care, no separate time for non-clinical duties, pressure to publish, injury/suicide attempts of colleagues/staff, performing pointless tasks. The latter were described as administrative/clerical. Lacking genuine rest breaks was mainly patient-related, further compromised by emergency work and lacking separate time for non-clinical duties. Long workhours and exhausting schedule were cited as most difficult parts of work, while reducing workhours, improving work schedule, and hiring more staff most frequently recommended. CONCLUSION Specific working conditions potentially contributory to burnout and compromised sleep among physicians working in academic medicine are identified using a methodologically-rigorous, in-depth approach. These findings inform evidence-based interventions aimed at preserving physician mental health and work capacity.
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Affiliation(s)
- Karen Belkić
- Department of Oncology/Pathology, Karolinska Institute, Stockholm, Sweden
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
- Claremont Graduate University, School of Community and Global Health, Claremont, CA, USA
- Institute for Health Promotion and Disease Prevention Research, University of Southern California School of Medicine, Los Angeles, CA, USA
| | - Neeti Rustagi
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, India
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Hexom BJ, Quao NSA, Bandolin NS, Bonney J, Collier A, Dyal J, Lee JA, Nicholson BD, Rybarczyk MM, Rees CA, Roy CM, Bhaskar N, Kivlehan SM. Global Emergency Medicine: A Scoping Review of the Literature from 2022. Acad Emerg Med 2024; 31:71-85. [PMID: 37813813 DOI: 10.1111/acem.14816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVE The objective was to identify the highest quality global emergency medicine (GEM) research published in 2022. The top articles are compiled in a comprehensive list of all the year's GEM articles and narrative summaries are performed on those included. METHODS A systematic PubMed search was conducted to identify all GEM articles published in 2022 and included a manual supplemental screen of 11 organizational websites for gray literature (GRAY). A team of trained reviewers and editors screened all identified titles and abstracts, based on three case definition categories: disaster and humanitarian response (DHR), emergency care in resource-limited settings (ECRLS), and emergency medicine development (EMD). Articles meeting these definitions were independently scored by two reviewers using rubrics for original research (OR), review (RE) articles, and GRAY. Articles that scored in the top 5% from each category as well as the overall top 5% of articles were included for narrative summary. RESULTS The 2022 search identified 58,510 articles in the main review, of which 524 articles screened in for scoring, respectively, 30% and 18% increases from last year. After duplicates were removed, 36 articles were included for narrative summary. The GRAY search identified 7755 articles, of which 33 were scored and one was included for narrative summary. ECRLS remained the largest category (27; 73%), followed by DHR (7; 19%) and EMD (3; 8%). OR articles remained more common than RE articles (64% vs. 36%). CONCLUSIONS The waning of the COVID-19 pandemic has not affected the continued growth in GEM literature. Articles related to prehospital care, mental health and resilience among patients and health care workers, streamlining pediatric infectious disease care, and disaster preparedness were featured in this year's review. The continued lack of EMD studies despite the global growth of GEM highlights a need for more scholarly dissemination of best practices.
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Affiliation(s)
- Braden J Hexom
- Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Nana Serwaa A Quao
- Department of Emergency Medicine, Accident and Emergency Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - N Shakira Bandolin
- Department of Emergency Medicine, University of California, Davis, California, USA
| | - Joseph Bonney
- Department of Emergency Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Global Health and Infectious Disease Research Group, Kumasi Center for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | - Amanda Collier
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada
- Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jonathan Dyal
- Department of Emergency Medicine, University of Texas, Houston, Texas, USA
| | - J Austin Lee
- Department of Emergency Medicine, Brown University, Providence, Rhode Island, USA
| | - Benjamin D Nicholson
- Department of Emergency Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Megan M Rybarczyk
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Chris A Rees
- Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Charlotte M Roy
- Department of Emergency Medicine, Loma Linda University, Loma Linda, California, USA
| | | | - Sean M Kivlehan
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Humanitarian Initiative, Cambridge, Massachusetts, USA
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Greene AC, Mankarious MM, Matzelle-Zywicki M, Patel A, Reyes L, Tsai AY, Santos MC, Moore MM, Kulaylat AN. A Magnetic Resonance Imaging Protocol for the Evaluation of Pediatric Postappendectomy Abscess: A Quality Improvement Project. J Surg Res 2024; 293:587-595. [PMID: 37837813 DOI: 10.1016/j.jss.2023.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 10/16/2023]
Abstract
INTRODUCTION Computed tomography (CT) scans are often used when cross-sectional imaging is required for evaluation of postappendectomy abscess, exposing children to a source of ionizing radiation. Our aim was to decrease the use of CT scans in pediatric postappendectomy patients by 50% in 12 mo and to sustain those results for 1 y. METHODS A comprehensive magnetic resonance imaging protocol was introduced in 2018 at a tertiary children's hospital within a general health system to replace CT scans in suspected pediatric postappendectomy abscess. Diagnostic and clinical outcomes were compared preprotocol (2015-2017) and postprotocol (2018-2022) implementation using standard univariate statistics. P < 0.05 was considered significant. Quality improvement methodology was used to design and implement the protocol. RESULTS Sixty eight pediatric postappendectomy patients received cross-sectional imaging during the study period. Overall, CT scans were used exclusively (100%, n = 27) in the preimplementation period compared to 31.7% (n = 13) of cross-sectional imaging in the postimplementation period. However, in the first year of protocol implementation, CT scan use only decreased to 78% of cross-sectional studies performed. The majority of protocol deviations (54%) also occurred in this time period. With improved education and reinforcement, CT scan utilization decreased to approximately 24% of cross-sectional studies annually. Missed abscess rate, time to diagnosis, drainage procedure type, readmission, and reoperation were similar between preimplementation and postimplementation periods. CONCLUSIONS Implementation of a postappendectomy abscess magnetic resonance imaging protocol was associated with decreased CT utilization in the pediatric population, while maintaining comparable diagnostic evaluation and clinical outcomes. Adherence to quality improvement principles facilitated achieving goals and sustaining gains.
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Affiliation(s)
- Alicia C Greene
- Department of Surgery, Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Marc M Mankarious
- Department of Surgery, Penn State Hershey Medical Center, Hershey, Pennsylvania
| | | | - Akshilkumar Patel
- Department of Surgery, Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Lilia Reyes
- Division of Pediatric Emergency Medicine, Penn State Children's Hospital, Hershey, Pennsylvania
| | - Anthony Y Tsai
- Division of Pediatric Surgery, Penn State Children's Hospital, Hershey, Pennsylvania
| | - Mary C Santos
- Division of Pediatric Surgery, Penn State Children's Hospital, Hershey, Pennsylvania
| | - Michael M Moore
- Department of Radiology, Nemours Children's Hospital, Wilmington, Delaware
| | - Afif N Kulaylat
- Division of Pediatric Surgery, Penn State Children's Hospital, Hershey, Pennsylvania.
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Galanis P, Moisoglou I, Malliarou M, Papathanasiou IV, Katsiroumpa A, Vraka I, Siskou O, Konstantakopoulou O, Kaitelidou D. Quiet Quitting among Nurses Increases Their Turnover Intention: Evidence from Greece in the Post-COVID-19 Era. Healthcare (Basel) 2023; 12:79. [PMID: 38200985 PMCID: PMC10779139 DOI: 10.3390/healthcare12010079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/16/2023] [Accepted: 12/26/2023] [Indexed: 01/12/2024] Open
Abstract
As turnover intention is a strong determinant of actual turnover behavior, scholars should identify the determinants of turnover intention. In this context, the aim of this study was to assess the effect of quiet quitting on nurses' turnover intentions. Additionally, this study examined the impact of several demographic and job characteristics on turnover intention. A cross-sectional study with 629 nurses in Greece was conducted. The data were collected in September 2023. Quiet quitting was measured with the "Quiet Quitting" scale. In this study, 60.9% of nurses were considered quiet quitters, while 40.9% experienced high levels of turnover intention. Multivariable regression analysis showed that higher levels of quiet quitting increased turnover intention. Moreover, this study found that turnover intention was higher among females, shift workers, nurses in the private sector, and those who considered their workplace understaffed. Also, clinical experience was associated positively with turnover intention. Since quiet quitting affects turnover intention, organizations, policymakers, and managers should address this issue to improve nurses' intentions to stay at their jobs.
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Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.G.); (A.K.)
| | - Ioannis Moisoglou
- Faculty of Nursing, University of Thessaly, 41500 Larisa, Greece; (I.M.); (I.V.P.)
| | - Maria Malliarou
- Faculty of Nursing, University of Thessaly, 41500 Larisa, Greece; (I.M.); (I.V.P.)
| | | | - Aglaia Katsiroumpa
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.G.); (A.K.)
| | - Irene Vraka
- Department of Radiology, P. & A. Kyriakou Children’s Hospital, 11527 Athens, Greece;
| | - Olga Siskou
- Department of Tourism Studies, University of Piraeus, 18534 Piraeus, Greece;
| | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (O.K.); (D.K.)
| | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (O.K.); (D.K.)
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Abraham SAA, Amoah JO, Agyare DF, Sekimpi DK, Bosomtwe-Duker D, Druye AA, Osei Berchie G, Obiri-Yeboah D. Health service factors affecting the COVID-19 vaccination campaign in a Ghanaian metropolis: A qualitative exploratory study. BMJ Open 2023; 13:e076184. [PMID: 38128932 DOI: 10.1136/bmjopen-2023-076184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE The study sought to explore the perspectives of vaccinators on the health system factors that impacted the COVID-19 vaccination campaign. DESIGN The study employed an exploratory-descriptive qualitative design. Key-informants' interviews were conducted using semi-structured guide to gather the data. Thematic analysis following the steps of Braun and Clark was conducted using ATLAS.ti software. SETTING The study setting was the Cape Coast Metropolis where the Central Regional Health Directorate is located. The Directorate initiates and implements policy decisions across the region. It is also the only metropolis in the region that recorded about 5970 of the total COVID-19 cases recorded in Ghana. PARTICIPANTS Eleven vaccinators who had been trained for the COVID-19 vaccination and had participated in the campaign for at least 6 months were purposively sampled through the Regional Public Health Unit. RESULTS Four themes were derived from the data after analysis; 'vaccine-related issues'; 'staffing issues'; 'organising and planning the campaign' and 'surveillance and response systems'. Subthemes were generated under each major theme. Our results revealed the health service promoted the COVID-19 vaccination campaign through public education and ensured access to COVID-19 vaccines through the use of community outreaches. Also, the health service ensured adequate logistics supply for carrying out the campaign as well as ensured vaccinators were adequately equipped for adverse incidence reporting and management. Dissatisfaction among COVID-19 vaccinators attributed to low remuneration and delays in receiving allowances as well as shortfalls in efforts at securing transportation and a conducive venue for the vaccination exercise also emerged. Other challenges in the vaccination campaign were attributed to poor data entry platforms and limited access to internet facilities. CONCLUSION This study highlights the health system's strategies and challenges during the COVID-19 vaccination campaign, emphasising the need for critical interventions to prevent low vaccination rates.
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Affiliation(s)
- Susanna Aba Aba Abraham
- Department of Public Health, School of Nursing and Midwifery, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - John Oti Amoah
- Centre for Gender Research, Advocacy and Documentation (CEGRAD), University of Cape Coast College of Humanities and Legal Studies, Cape Coast, Ghana
| | - Dorcas Frempomaa Agyare
- Department of Adult Health, School of Nursing and Midwifery, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | | | - Andrews Adjei Druye
- Department of Adult Health, School of Nursing and Midwifery, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Gifty Osei Berchie
- Department of Maternal and Child Health, School of Nursing and Midwifery, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Dorcas Obiri-Yeboah
- Directorate of Research, Innovation and Consultancy, University of Cape Coast, Cape Coast, Ghana
- Microbiology and Immunology Department, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Clinical Microbiology/Public Health Unit, Cape Coast Teaching Hospital, Cape Coast, Ghana
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Nelson HW, Yang BK, McSweeney-Feld MH, Jerome GJ, Barry TT. Psychological and Structural Burdens and Nursing Home Administrator Turnover Intentions During the COVID-19 Pandemic. J Appl Gerontol 2023:7334648231216641. [PMID: 38102567 DOI: 10.1177/07334648231216641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
The COVID-19 pandemic created challenges for U. S. nursing home administrators (NHA) and staff. This study explored organizational and psychological factors associated with NHA stress, dissatisfaction, and turnover intent (TI) during the third year of the pandemic. Results from a nationwide, cross-sectional survey of 1139 NHAs were merged with Centers for Medicare and Medicaid Services nursing home survey deficiency, staffing, complaint, and other operations data. A hierarchical, generalized estimating equations model with ordered logit link found that NHAs with higher COVID stress (AOR = 1.65, 95% CI = 1.22, 2.23), higher use of agency/contract staff (AOR = 1.50, 95% CI = 1.08.2.09) and higher role conflict were more likely to indicate TI. NHAs with higher job satisfaction in workload, work content, and rewards were less likely to hold TI. Industry leaders should create strategies to reduce NHA's job stress and role conflicts and provide opportunities for improving staff recruitment and retention, reducing reliance on agency staffing.
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Affiliation(s)
- H Wayne Nelson
- Department of Health Sciences, Towson University, Towson, MD, USA
| | - Bo Kyum Yang
- Department of Health Sciences, Towson University, Towson, MD, USA
| | | | - Gerald J Jerome
- Department of Kinesiology, Towson University, Towson, MD, USA
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Lauck SB, Saarijärvi M, De Sousa I, Straiton N, Borregaard B, Lewis KB. Accelerating knowledge translation to improve cardiovascular outcomes and health services: opportunities for bridging science and clinical practice. Eur J Cardiovasc Nurs 2023; 22:e125-e132. [PMID: 37578067 DOI: 10.1093/eurjcn/zvad077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 07/29/2023] [Indexed: 08/15/2023]
Abstract
Knowledge translation (KT) is the exchange between knowledge producers and users to understand, synthesize, share, and apply evidence to accelerate the benefits of research to improve health and health systems. Knowledge translation practice (activities/strategies to move evidence into practice) and KT science (study of the methodology and approaches to promote the uptake of research) benefit from the use of conceptual thinking, the meaningful inclusion of patients, and the application of intersectionality. In spite of multiple barriers, there are opportunities to develop strong partnerships and evidence to drive an impactful research agenda and increase the uptake of cardiovascular research.
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Affiliation(s)
- Sandra B Lauck
- School of Nursing, University of British Columbia, St. Paul's Hospital, Vancouver, Canada
| | - Markus Saarijärvi
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Ismália De Sousa
- School of Nursing, University of British Columbia, St. Paul's Hospital, Vancouver, Canada
| | - Nicola Straiton
- Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE), Nursing Research Institute, St Vincent's Health Network, Sydney, Australia
| | - Britt Borregaard
- Department of Cardiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Krystina B Lewis
- Faculty of Health Sciences, University of Ottawa, University of Ottawa Heart Institute, Ottawa, Canada
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Pelli J, Nordquist H. Learning Lessons for Future Preparedness: Exploring Work Well-Being-Related Leadership Challenges among Paramedics during the Early Stage of the COVID-19 Pandemic-A Qualitative Study. NURSING REPORTS 2023; 13:1721-1730. [PMID: 38133118 PMCID: PMC10745729 DOI: 10.3390/nursrep13040142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/29/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
The beginning of the COVID-19 pandemic majorly impacted the population and public services. In Finland, a state of emergency was declared to ensure the security of healthcare resources, and prehospital emergency medical service (EMS) organizations faced emergency conditions for the first time. This study explores the leadership challenges related to well-being experienced during the early phase of the pandemic. This qualitative study utilized reflective essay material written between August and November 2020 by experienced advanced-level paramedics (n = 30) who participated actively in EMS fieldwork at the beginning of the pandemic. The material (32,621 words) was analyzed with inductive content analysis. The work well-being-related leadership challenges experienced by paramedics during the early phase of the pandemic were divided into four upper categories: inadequate guidance, workplace reorganization, atmosphere mismanagement, and insufficient resources to cope. These upper categories were comprised of 17 subcategories. Several actions can be taken to enhance personnel well-being and prepare for similar challenges. Guidance and support should be clear and timely. Visible leadership should be emphasized and enhanced with modern communication. Efforts should be made to strengthen the work atmosphere to support those on the front lines of healthcare. This study was not registered on a publicly accessible registry.
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Affiliation(s)
- Jukka Pelli
- Faculty of Information Technology and Communication Sciences, Tampere University, Kalevantie 4, 33100 Tampere, Finland
| | - Hilla Nordquist
- Department of Health Care and Emergency Care, South-Eastern Finland University of Applied Sciences, Pääskysentie 1, 48220 Kotka, Finland
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Bradford N, Moore E, Taylor K, Cook O, Gent L, Beane T, Williams N, Alexander K, Pitt E, Still J, Wellard C, McErlean G, Kirk D, Monterosso L, McCarthy A, Lokmic-Tomkins Z, Balson J, Gates P. The cancer nursing workforce in Australia: a national survey exploring determinants of job satisfaction. BMC Nurs 2023; 22:461. [PMID: 38057825 DOI: 10.1186/s12912-023-01629-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 11/29/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND To maintain and improve the quality of the cancer nursing workforce, it is crucial to understand the factors that influence retention and job satisfaction. We aimed to investigate the characteristics of cancer nurses in Australia and identify predictors of job satisfaction. METHODS We analysed data from an anonymous cross-sectional survey distributed through the Cancer Nurses Society Australia membership and social media platforms from October 2021 to February 2022. The survey was compared to national nursing registration data. Data were analysed with non-parametric tests, and a stepwise, linear regression model was developed to best predict job satisfaction. RESULTS Responses were received from 930 cancer nurses. Most respondents (85%) described themselves as experienced nurses, and more than half had post-graduate qualifications. We identified individual, organizational, and systemic factors that contribute to job satisfaction and can impact in workforce shortages. The findings include strategies to address and prioritize workforce challenges. There were 89 different titles for advanced practice nursing roles. Managing high workload was a reported challenge by 88%. Intention to stay less than 10 years was reported by nearly 60%; this was significantly correlated with job satisfaction and age. Significantly higher scores for job satisfaction were associated with those who had career progression opportunities, career development opportunities, adequate peer support and a clearly defined scope of role. Conversely, job satisfaction scores decreased the more people agreed there was a lack of leadership and they had insufficient resources to provide quality care. CONCLUSION Cancer nurses are critical to the delivery of cancer care however, the workforce faces multiple challenges. This study provides an understanding of the Australian cancer nursing workforce characteristics, their roles and activities, and highlights important considerations for retaining nurses in the profession.
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Affiliation(s)
- Natalie Bradford
- Cancer and Palliative Care Outcomes Centre and School of Nursing, Queensland University of Technology, QLD, Brisbane, QLD, Australia.
- Cancer Nurses Society of Australia, Gabbadah, WA, Australia.
| | - Elizabeth Moore
- Cancer Nurses Society of Australia, Gabbadah, WA, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Karen Taylor
- Cancer Nurses Society of Australia, Gabbadah, WA, Australia
- Cancer Network WA, Perth, WA, Australia
| | - Olivia Cook
- Cancer Nurses Society of Australia, Gabbadah, WA, Australia
- McGrath Foundation - Level 1, 32 Walker St North Sydney, Sydney, NSW, Australia
- Monash Nursing and Midwifery, Monash University, Melbourne, VIC, Australia
| | - Lucy Gent
- Cancer Nurses Society of Australia, Gabbadah, WA, Australia
- Sir Charles Gairdner Osborne Park Hospitals Health Care Group, Perth, WA, Australia
- Edith Cowan University, Perth, WA, Australia
| | - Theresa Beane
- Cancer Nurses Society of Australia, Gabbadah, WA, Australia
- Hervey Bay Hospital, Queensland Health, Pialba, QLD, Australia
| | - Natalie Williams
- Cancer Nurses Society of Australia, Gabbadah, WA, Australia
- King Edward Memorial Hospital, Perth, WA, Australia
| | - Kimberly Alexander
- Cancer and Palliative Care Outcomes Centre and School of Nursing, Queensland University of Technology, QLD, Brisbane, QLD, Australia
- Cancer Nurses Society of Australia, Gabbadah, WA, Australia
| | - Erin Pitt
- Cancer and Palliative Care Outcomes Centre and School of Nursing, Queensland University of Technology, QLD, Brisbane, QLD, Australia
- Cancer Nurses Society of Australia, Gabbadah, WA, Australia
| | - Jemma Still
- Cancer Nurses Society of Australia, Gabbadah, WA, Australia
| | - Cameron Wellard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Gemma McErlean
- Cancer Nurses Society of Australia, Gabbadah, WA, Australia
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia
| | - Deborah Kirk
- Cancer Nurses Society of Australia, Gabbadah, WA, Australia
- Edith Cowan University, Perth, WA, Australia
| | - Leanne Monterosso
- Cancer Nurses Society of Australia, Gabbadah, WA, Australia
- Notre Dame University, Perth, WA, Australia
| | - Alexandra McCarthy
- Cancer Nurses Society of Australia, Gabbadah, WA, Australia
- The University of Queensland, Brisbane, QLD, Australia
| | - Zerina Lokmic-Tomkins
- Cancer Nurses Society of Australia, Gabbadah, WA, Australia
- Monash Nursing and Midwifery, Monash University, Melbourne, VIC, Australia
| | - Jessica Balson
- Cancer Nurses Society of Australia, Gabbadah, WA, Australia
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Priscilla Gates
- Cancer Nurses Society of Australia, Gabbadah, WA, Australia
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Deakin University, Melbourne, VIC, Australia
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Zhang J, Ren X, Lai F, Chen J, Shan S, Tian L. Professional commitment and related factors among nursing undergraduates: A latent profile analysis. NURSE EDUCATION TODAY 2023; 131:105958. [PMID: 37690440 DOI: 10.1016/j.nedt.2023.105958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/19/2023] [Accepted: 09/03/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE To identify different subgroups of nursing professional commitment among nursing undergraduates and to analyze the related factors of the different subgroups. METHODS A cross-sectional study using the professional commitment scale with 430 nursing undergraduates was conducted. Latent profile analysis was used to explore the nursing students' professional commitment subgroups and using multivariate logistic regression to analyze the related factors of nursing professional commitment. RESULTS The overall mean score for professional commitment in nursing was (75.07 ± 14.715). There were three different subgroups of professional commitment characteristics, namely the "high professional commitment group" (20.465 %), the "medium professional commitment group" (66.279 %), and the "low professional commitment group" (13.256 %). Dissatisfaction with clinical placement (OR = 3.556, p = 0.008) and self-enrollment (OR = 0.186, p = 0.002) were significantly related factors for low-level and medium-level nursing commitment groups. Students' origin in western China (OR = 1.869, p = 0.042) significantly influenced the medium-level specialty commitment group. CONCLUSIONS Most nursing undergraduates have been categorized in the "medium professional commitment group". Students who were dissatisfied with their clinical experience and chose the nursing profession involuntarily were the main factors for low-level and medium-level nursing professional commitment. The clinical practice environment should be further improved to enhance the clinical experience satisfaction of nursing undergraduates; at the same time, the professional value cultivation of students whose choice of nursing profession was not made by themselves should be strengthened to improve the level of professional commitment of nursing undergraduates.
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Affiliation(s)
- Jiyin Zhang
- The First Affiliated Hospital of Soochow University, Suzhou 215006, China; School of Nursing, Soochow University, Suzhou 215006, China.
| | - Xinran Ren
- The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Fengxia Lai
- The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
| | - Jing Chen
- The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
| | - Shengnan Shan
- The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
| | - Li Tian
- The First Affiliated Hospital of Soochow University, Suzhou 215006, China; School of Nursing, Soochow University, Suzhou 215006, China.
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Thanh ND, Anh PQ, Huyen Chang PT, Dung HV, Xiem CH, Chau LB. Health staff's job motivation post COVID-19 pandemic: A case study in Vietnam. SAGE Open Med 2023; 11:20503121231207699. [PMID: 38020795 PMCID: PMC10640800 DOI: 10.1177/20503121231207699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/28/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives Vietnam has witnessed a severe shortage of qualified staff in the public health sector after the COVID-19 pandemic. Our cross-sectional study aimed to identify job motivation and associated factors among experienced frontline health staff working in public health in order to have preventive measures in the event of future pandemics. Methods A cross-sectional study, from March 2022 to November 2022 at a Vietnamese public hospital, on the job motivation and the predicted factors of 381 healthcare workers who participated in the frontlines of the COVID-19 pandemic from 2020 to 2021. The survey tool, developed by Mbindyo Patrick (2009), includes three components: (i) job satisfaction, (ii) organizational commitment, and (iii) conscientiousness. The survey tool was revalidated in our study with structural equation model for the construction of job motivation model and confirmatory factor analysis for certifying the elementary three components (factors) of the tool. And the tool's reliability was evaluated by Cronbach's Alpha. Bivariate analysis and multiple logistic regression were used to identify the predicted factors with the job motivation cutoff of 4.0. Results The tool for job motivation constructs showed all specifications were good fit indices and the Cronbach's Alpha was 0.85. The job motivation of health staff decreased dramatically in all dimensions post COVID-19 pandemic, with a mean score of 3.26. Job satisfaction and organizational commitment were the most negatively impacted areas, with scores of 3.02 and 3.00, respectively. The predicted factors of low job motivation were young age (less than 30 years old), low monthly income (less than $400), high qualification, and non-managerial positions with odds ratio of 2.27, 2.5, 2.09, and 3.61, respectively. Conclusion Following the COVID-19 outbreak in Vietnam, healthcare workers who had been in the frontlines of the COVID-19 pandemic, had experienced a significant decline in their job motivation, despite their continued employment at public hospitals.
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Affiliation(s)
- Nguyen Duc Thanh
- Department of Hospital Management, Health Management Training Institute, Hanoi University of Public Health, Hanoi, Vietnam
| | - Pham Quynh Anh
- Department of Health Organization and Management, Health Management Training Institute, Hanoi University of Public Health, Hanoi, Vietnam
| | - Pham Thi Huyen Chang
- Department of Health Organization and Management, Health Management Training Institute, Hanoi University of Public Health, Hanoi, Vietnam
| | | | - Chu Huyen Xiem
- Department of Hospital Management, Health Management Training Institute, Hanoi University of Public Health, Hanoi, Vietnam
| | - Le Bao Chau
- Department of Health Organization and Management, Health Management Training Institute, Hanoi University of Public Health, Hanoi, Vietnam
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