The Wounded Healer: A Phenomenological Study on Hospital Nurses Who Contracted COVID-19

A concept analysis of psychological trauma in labour and delivery nurses

AIM

To facilitate an understanding of the risk for psychological trauma in labour and delivery nurses.

DESIGN

Concept analysis.

METHODS

The Walker and Avant method of concept analysis was applied to 56 articles. The characteristics, antecedents, and consequences of psychological trauma in labour and delivery nurses were identified.

DATA SOURCES

Peer-reviewed articles in English from CINAHL, PubMed and Google Scholar were reviewed on July 2023.

RESULTS

The characteristics of psychological trauma in labour and delivery nurses are overwhelming distress, intrusive symptoms, avoidance and numbing behaviours, hypervigilance or hyperarousal, emotional dysregulation, cognitive distortions, and interpersonal challenges. The antecedents are exposure to one or more of the following nurse-specific traumas: natural or person-made disasters, historical role limitations, second victim situations, secondary trauma, system-mediated or over-medicalized care, insufficient resources, or workplace incivility. The consequences are disruptions in mental health, diminished physical health, alterations in relationships, and variable work performance.

CONCLUSION

Labour and delivery nurses experience unique causes of psychological trauma due to their practice environment and patient population. The consequences of labour and delivery nurses' psychological trauma extend beyond individual health and impact the quality of patient care and organizational capacity.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Furthermore, research is needed to inform education, support and policy measures to mitigate harm effectively. WHAT PROBLEM DID THE STUDY ADDRESS?: Nurse-specific trauma theory has not been applied to the unique labour and delivery environment with a high incidence of patient trauma. WHAT WERE THE MAIN FINDINGS?: Multiple causes of trauma in the perinatal context have created a pervasive yet largely preventable issue. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: This research will impact labour and delivery nurses, their leadership, and their patients.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Cardiovascular nurses and organizational well-being: a systematic review

AIMS

This systematic review assesses the organizational well-being of nurses working in cardiovascular settings and identifies environmental variables influencing it.

METHODS AND RESULTS

The Joanna Briggs Institute's methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines have been followed. The search was conducted, from the database inception up to and including 1 December 2022, on Medline (via PubMed), Cumulative Index of Nursing and Allied Health, Cochrane Library, and Scopus. Critical appraisal and data extraction were conducted using standardized tools. Six articles of high quality were included. These mostly concerned cross-sectional studies, conducted in heterogeneous contexts, which highlight the peculiarity of the cardiovascular nursing setting. Three thematic areas were identified: stressors of cardiovascular settings; outcomes of stressors on nurses; and coping strategies used by cardiovascular nurses to deal with such stress factors. Identified stress factors included a lack of autonomy, conflicts between professional and family roles, high workloads, and stressful relationships with patients and caregivers. These organizational variables could generate nurses' burnout, depression, irritability, and/or sleep disorders. In trying to cope with such stressors, cardiovascular nurses used different strategies for compensating, avoiding, escaping, or ignoring the problem, or, in other cases, became somewhat aggressive.

CONCLUSION

Considering the limited data, cardiovascular nursing coping strategies should be further investigated, so that effective pathways for preventing or limiting stress factors can be identified and applied by the organizations. Monitoring and intervening on stress factors in this care setting could improve cardiovascular nurses' organizational well-being and accordingly patients' outcomes.

REGISTRATION

PROSPERO: CRD42022355669.

Stress begets stress: The moderating role of childhood adversity in the relationship between job stress and sleep quality among nurses

BACKGROUND

Nurses exhibit considerable variations in sleep quality and experience high job stress levels. Distal factors, such as childhood adversity, and proximal factors, both influence sleep quality. We investigated the moderating role of childhood adversity with job stress and sleep quality, and whether this aligns with the stress-sensitization or stress-amplification models.

METHODS

The impact of job stressors' total score and its dimensions on sleep quality was analyzed using traditional linear regression models and the extreme gradient boosting machine learning algorithm. The hierarchical regression examined the moderating role of childhood adversity in the relationship between job stress and sleep quality. An interactive tool was used to visualize the results.

RESULTS

Among the dimensions of job stress, "time allocation and workload" strongly correlated with sleep quality, followed by "nursing profession and work problems," "patient care issues," "management and interpersonal problems," and "working environment and equipment problems." The moderating role of childhood adversity in the relationship between different dimensions of job stressors (except working environment and equipment problems) and sleep quality aligns with the stress-sensitization model.

LIMITATIONS

This study was susceptible to recall bias and objective sleep data were unavailable. Cross-sectional study design was used, thus limiting causal inferences. Finally, the moderating effect of childhood adversity on subsequent stress among nurses remains unclear.

CONCLUSION

Childhood adversity and job stress were integrated into a stress-sensitization model, providing a nuanced and specific examination of sleep quality. Healthcare policymakers should focus on job stress and childhood adversity, improve nurses' sleep quality, and ultimately benefit patient care and outcomes.

Experiences and perspectives of nurses infected with COVID-19: A qualitative systematic review and meta-synthesis

This qualitative systematic review aims to comprehensively understand the experiences and perspectives of nurses infected with COVID-19, addressing a significant gap in the current literature. Following the JBI meta-synthesis approach, a rigorous search was conducted across nine electronic databases and references until January 16, 2023. Seventeen eligible studies underwent quality assessment using the JBI critical checklist. Data were synthesized using standardized tools, and the ConQual tool evaluated confidence in the findings. Seven key findings emerged, providing valuable insights into emotional experiences, adaptation to COVID-19 challenges, influence of support systems, coping strategies, posttraumatic growth perceptions, and effects on professional identity and career advancement. The findings highlight emotional toll, adaptive strategies, and professional implications for nurses. Moreover, they emphasize the importance of support systems, coping mechanisms, and posttraumatic growth in promoting nurses' well-being and resilience. These insights have practical implications for targeted interventions and support mechanisms to enhance infected nurses' well-being and improve healthcare outcomes.

Chain mediations of perceived social support and emotional regulation efficacy between role stress and compassion fatigue: insights from the COVID-19 pandemic

Background

Nurses at the frontline faced high risks of the COVID-19 infection, undertook heavy workloads of patient care, and experienced tremendous stress that often led to compassion fatigue.

Aim

This study was to explore the role of positive psychosocial resources (i.e., perceived social support and emotional regulation efficacy) in the relationship between role stress and compassion fatigue.

Methods

A cross-sectional design was conducted in Hubei Province, China between May and September 2021. The Role Stress Questionnaire, the Perceived Social Support Scale, the Emotional Regulation Efficacy Scale, and the Professional Quality of Life Scale were used to measure key variables of interest. Nurse socio-demographic data were also collected. Structural equation modeling was used to explore the relationships, including potential mediating effect, among role stress, perceived social support, emotional regulation efficacy, and compassion fatigue.

Results

A total of 542 nurses participated in this investigation, and 500 were eventually enrolled in the analysis. The incidence of compassion fatigue among nurses was 94.2%, including 65.8% of nurses reporting at least moderate compassion fatigue. Univariate analysis showed that educational level, marital status, hospital rank, sleep time were the factors affecting compassion fatigue of the nurses. The structural equation modeling revealed that: Role stress had a direct positive effect on compassion fatigue; Perceived social support and emotional regulation efficacy partially mediated the link between role stress and compassion fatigue respectively; And there was a chain mediating role of perceived social support and emotional regulation efficacy between role stress and compassion fatigue.

Conclusion

The incidence of compassion fatigue was high during the COVID-19 pandemic among bedside nurses in China. Improving social support and enhancing the efficacy of emotion regulation may help alleviate compassion fatigue directly and/or via buffering the impact of role stress.

Measuring Nurses' Organizational Well-Being: A Systematic Review of Available Instruments

This systematic review aimed to identify and compare instruments measuring nurses' organizational well-being, summarise the dimensions measured by these instruments, the statistical analysis performed for validity evidence and identify an instrument that comprehensively investigates nurses' organizational well-being. The JBI Manual for Evidence Synthesis and the PRISMA checklist were used as guidelines. The search was conducted on Medline, CINAHL, Cochrane Library and Scopus. Critical appraisal and data extraction were drawn on the COSMIN checklist. Dimensions were conceptually synthesized by the measurement concepts' similarity. Twenty-two articles were retrieved and they included 21 instruments that measured nurses' organizational well-being. The instruments vary by dimension number (range 2-19), items (range 12-118) and concept elicitation. A plurality of methodologies has been used in instrument development and assessments of evidence for validity. Only four instruments reported a concurrent criterion validity or a measurement comparison with an already tested-for-validity instrument. Similar dimensions were leadership and support, relationships and communication, work-family balance, work demands, violence, control and autonomy, satisfaction and motivation, work environment and resources, careers, and organizational policy. This review underlines the core areas of the instruments that measure nursing organizational well-being. It allows administrators and researchers to choose the appropriate instruments for monitoring this multidimensional concept.

The evolution of research on depression during COVID-19: A visual analysis using Co-Occurrence and VOSviewer

Background

The COVID-19 pandemic has led to public health problems, including depression. There has been a significant increase in research on depression during the COVID-19 pandemic. However, little attention has been paid to the overall trend in this field based on bibliometric analyses.

Methods

Co-Occurrence (COOC) and VOSviewer bibliometric methods were utilized to analyze depression in COVID-19 literature in the core collection of the Web of Science (WOS). The overall characteristics of depression during COVID-19 were summarized by analyzing the number of published studies, keywords, institutions, and countries.

Results

A total of 9,694 English original research articles and reviews on depression during COVID-19 were included in this study. The United States, China, and the United Kingdom were the countries with the largest number of publications and had close cooperation with each other. Research institutions in each country were dominated by universities, with the University of Toronto being the most productive institution in the world. The most frequently published author was Ligang Zhang. Visualization analysis showed that influencing factors, adverse effects, and coping strategies were hotspots for research.

Conclusion

The results shed light on the burgeoning research on depression during COVID-19, particularly the relationship between depression and public health. In addition, future research on depression during COVID-19 should focus more on special groups and those at potential risk of depression in the general population, use more quantitative and qualitative studies combined with more attention to scale updates, and conduct longitudinal follow-ups of the outcomes of interventions. In conclusion, this study contributes to a more comprehensive view of the development of depression during COVID-19 and suggests a theoretical basis for future research on public health.

The impact of the COVID-19 pandemic on job satisfaction among professionally active nurses in five European countries

The COVID-19 pandemic has negatively affected the work of many medical professionals, including the group of nurses. This study aimed at assessing the impact of the COVID-19 pandemic on job satisfaction of nursing staff in five European countries. The study was conducted using the Job Satisfaction Scale (SSP) and original questions on the job satisfaction. The cross-sectional online study was conducted with a sample of 1,012 professionally active nurses working in Poland, Germany, Italy, Great Britain and Sweden, who assessed their job satisfaction before (retrospectively) and during the pandemic. The results showed a significant decrease in job satisfaction due to the need to perform it during the pandemic caused by the SARS-CoV-2 virus. In 8 out of 10 examined parameters of job satisfaction, a statistically significant decrease in job satisfaction was observed at the level of p < 0.05. Among the examined factors influencing job satisfaction, the highest decrease was recorded based on the assessment of working conditions (1,480). A high level of satisfaction with the work of nurses has a significant impact on providing better patient care as well as reducing the risk of professional burnout of nurses.