Feelings of Entrapment during the COVID-19 Pandemic Based on ACE Star Model: A Concept Analysis

Impact of academic center for evidence-based practice star model on door-to-needle times in patients with acute ischemic stroke

Objective

To explore the impact of the academic center for evidence-based practice (ACE) star model on the door-to-needle times (DNT) in patients with acute ischemic stroke (AIS).

Methods

Clinical data of 159 patients with AIS, treated in Sir Run Run Shaw Hospital Afffliated to Zhejiang University School of Medicine Alar Hospital from March 2022 to March 2024, were retrospectively analyzed. Seventy-eight patients received routine care (routine group), and 81 patients were treated using a combination of routine care with the ACE star model (ACE star group). Operating time, intervention effects, activities of daily living (ADL), neurologic outcomes, and incidence of adverse events of the two groups were compared.

Results

The duration of venous opening, computed tomography (CT) examination, and DNT in the ACE star group were shorter than those in the routine group (P<0.05). The DNT<45 minutes compliance rate, thrombolytic efficacy, and vascular recanalization in the ACE star group were higher than those in the Routine group (P<0.05). After the intervention, the ADL score of the ACE star group was significantly higher than that of the control group, while the NIHSS score was significantly lower than that of the control group (P<0.05). There was no significant difference in the incidence of adverse events between the two groups (P>0.05).

Conclusions

Adopting routine nursing care and intervention based on the ACE-star model for patients with AIS can shorten DNT, improve thrombolytic effect and vascular recanalization rate. ACE-star model is beneficial for restoring ADL ability and improving neurological function, without significant changes in the occurrence of adverse events.

Unveiling Hidden Trauma: A Cross-Sectional Study of Violence Exposure and Its Impacts on Entrapment, Self-Stigma and Empathic Care Among Psychiatric Nurses

BACKGROUND

Psychiatric nurses often work in high-stress environments where they are frequently exposed to various forms of violence and aggression from patients. While the immediate physical consequences of violence are usually recognised, the psychological impacts, such as feelings of entrapment, self-stigma and diminished empathy, are less understood but equally critical.

AIMS

This study aimed to fill this gap by examining how different forms of violence exposure affect entrapment, self-stigma and empathic care among psychiatric nurses, providing insights that can inform both practice and policy.

DESIGN

This study utilised a descriptive correlational research design.

METHOD

This study was conducted in two prominent psychiatric hospitals in Egypt, namely the Mental Health Hospital and Addiction in Benha City and Elmaamora for Psychiatric Medicine and Addiction in Alexandria. A convenience sample of 246 psychiatric nurses who filled out the Perception of Prevalence Aggression Scale, the Impact of Event Scale-Revised, the Empathetic Care Scale, the Scale for Assessing the Stigma of Mental Illness in Nursing and the Entrapment Scale was used for the study. Data collection spanned 3 months, from June to August 2024.

FINDINGS

The findings reveal that perceived aggression is positively correlated with the impact of events (r = 0.513, p < 0.001) and entrapment (r = 0.160, p = 0.012) and negatively correlated with empathy (r = -0.232, p < 0.001). The regression analyses show that verbal aggression, threatening verbal aggression, aggressive splitting behaviour, severe self-directed violence and suicides are significant predictors of empathy, increasing its levels (R2 = 0.509, p < 0.001). Stigma is negatively influenced by threatening verbal aggression, provocative aggressive behaviour, severe physical violence, mild violence against self and suicides but positively by passive-aggressive behaviour (R2 = 0.377, p < 0.001).

CONCLUSION

These results underscore the importance of addressing aggression in psychiatric settings to promote the well-being and professional functioning of nurses.

REPORTING METHOD

STROBE is the relevant reporting method that has been adhered to.

Psychological responses to the COVID-19 pandemic and situational impact: A network analysis in Hong Kong residents

BACKGROUND

The COVID-19 pandemic has had situational impacts and induced various psychological responses among residents. The present study aims to analyze the network structure of psychological responses to the pandemic and their relationships with situational impact, resilience, and well-being through a network approach.

METHODS

An online survey recruited 1122 residents (mean age = 32.5 years, 65.4 % female) in Hong Kong from October 2020 to October 2021. The participants completed the Mental Impact and Distress Scale: Psychological Response (MIDc-PR) and other validated measures. Gaussian graphical modeling was conducted in R to identify the central MIDc-PR symptoms and their bridge linkages with situational impact, resilience, and well-being.

RESULTS

In the MIDc-PR network, the central symptoms were 'Routine' and 'Images' for Anticipation and 'Tense' and 'Lonely' for Modulation, with 12 bridge edges between the two clusters. In the combined network, the MIDc-PR nodes showed 12 bridge edges with situational impact, particularly in the health domain. 'Concerned', 'Sleep', and 'Lonely' showed negative linkages with resilience; 'Unmotivated' and 'Trapped' showed negative linkages with well-being. The network models showed good levels of stability and did not differ significantly in network structure and global strength across gender and age groups.

LIMITATIONS

The cross-sectional study design only allowed undirected associations in the network and could not model the within-subject effects.

CONCLUSIONS

The study findings contributed to the literature by elucidating the network structure of psychological responses to the pandemic. The central and bridge symptoms have clinical implications as potential targets for future interventions.

Pandemic lockdowns: who feels coerced and why? - a study on perceived coercion, perceived pressures and procedural justice during the UK COVID-19 lockdowns

BACKGROUND

This study examined perceptions of coercion, pressures and procedural injustice and how such perceptions influenced psychological well-being in those who experienced a UK COVID-19 lockdown, with a view to preparing for the possibility of future lockdowns.

METHODS

40 individuals categorised as perceiving the lockdown(s) as either highly or lowly coercive took part in one of six asynchronous virtual focus groups (AVFGs).

RESULTS

Using thematic analysis, the following key themes were identified in participants' discussions: (1) Choice, control and freedom; (2) threats; (3) fairness; (4) circumstantial factors; and (5) psychological factors.

CONCLUSIONS

As the first qualitative study to investigate the psychological construct of perceived coercion in relation to COVID-19 lockdowns, its findings suggest that the extent to which individuals perceived pandemic-related lockdowns as coercive may have been linked to their acceptance of restrictions. Preparing for future pandemics should include consideration of perceptions of coercion and efforts to combat this, particularly in relation to differences in equity, in addition to clarity of public health messaging and public engagement.

Cognitive Flexibility's Role in Reducing Academic Stress During the COVID-19 Pandemic

Background

Cognitive flexibility (CF) in the psychological literature has been described as an individual's ability to produce several solutions and retain control in novel situations. Recently, the COVID-19 pandemic appeared to be an ideal scenario that demanded the application of adaptive thinking by students to deal with several challenges of the pandemic.

Aim

This study aimed to assess the role of CF in reducing academic stress among university students due to the sudden and strict implementation of online education during the COVID-19 pandemic.

Methods

This study employed a cross-sectional survey design and data collection was completed during the 2020-2021 academic year. The study sample comprised 328 university students from Saudi Arabia. The online survey method was used, and study tools comprises of reliable and valid psychological measures to assess CF, academic stress, the negative impact of the COVID-19 pandemic, and emotional symptoms. IBMSPSS25 was used for statistical analysis of data. Multiple regression analysis was applied to determine the role of CF in reducing academic stress after controlling for other factors such as gender, age, academic year, negative impact of COVID-19 on daily life, and unpleasant emotional experiences.

Results

CF was significantly decreased the risk of experiencing academic stress (b = ‒0.196, t = ‒3.54; p < 0.001; 95% CI = ‒3.53 to ‒0.11) after controlling for the negative impact of the COVID-19 pandemic on daily life (b = 0.119, t = 2.09; p < 0.05; 95% CI = 0.02-0.63) and emotional repercussions (b = 0.109, t = 1.91; p < 0.05; 95% CI = ‒0.01-0.15).

Conclusion

The current findings suggest that CF could be fostered among university students as a useful mental tool to cope with academic stress during less-structured educational and social circumstances that may impact their daily lives and emotional wellness.

The Psychoneuroimmunological Model of Moral Distress and Health in Healthcare Workers: Toward Individual and System-Level Solutions

Healthcare is presently experiencing a global workforce crisis, marked by the inability of hospitals to retain qualified healthcare workers. Indeed, poor working conditions and staff shortages have contributed to structural collapse and placed a heavy toll on healthcare workers' (HCWs) well-being, with many suffering from stress, exhaustion, demoralization, and burnout. An additional factor driving qualified HCWs away is the repeated experience of moral distress, or the inability to act according to internally held moral values and perceived ethical obligations due to internal and external constraints. Despite general awareness of this crisis, we currently lack an organized understanding of how stress leads to poor health, wellbeing, and performance in healthcare workers. To address this critical issue, we first review the literature on moral distress, stress, and health in HCWs. Second, we summarize the biobehavioral pathways linking occupational and interpersonal stressors to health in this population, focusing on neuroendocrine, immune, genetic, and epigenetic processes. Third, we propose a novel Psychoneuroimmunological Model of Moral Distress and Health in HCWs based on this literature. Finally, we discuss evidence-based individual- and system-level interventions for preventing stress and promoting resilience at work. Throughout this review, we underscore that stress levels in HCWs are a major public health concern, and that a combination of system-level and individual-level interventions are necessary to address preventable health care harm and foster resilience in this population, including new health policies, mental health initiatives, and additional translational research.

The effect of COVID-19 on employees' mental health

Long lockdowns, food shortages, and the inability to receive basic primary healthcare have aggravated the effects of pandemics. However, most studies have focused on the health problems of the infected people or the measures employed to keep the disease under control. This cross-sectional study focused primarily on the mental health issues of employees. By employing a convenient sampling method, we reached 237 respondents (135 with coronavirus history) to assess the impact of the pandemic on employees. Multivariate causal relationships were assessed with Structural Equation Modeling (SEM). The predictors included internal entrapment (INT) and difficulty identifying feelings (DIF), which are significant predictors of depression (DEPR). DIF was found to be a significant predictor of INT and EXT feelings, while FEAR was found to be a significant predictor of INT, DIF, and DEPR. Quality of life (QoL) was found to be a significant predictor of DIF and DDF, DEPR, EXT and INT, and FEAR. The results also showed that DIF mainly manifested its effect on depression through INT. The DEPR level of employees working only from home was higher than that of other employees. The depression levels of women, young employees, and those whose QoL was adversely affected by the coronavirus were higher than the rest.

COVID-19 and Quitting Jobs

Despite substantial studies on COVID-19 and the problems employees face, the association between COVID-19 and resigning jobs has not caught the interest of researchers. Millions have already resigned from their employment, and more are expected to resign. This study aims to investigate the relationship between the demographics of employees, the course of COVID-19, perceived effect of COVID-19 on life (PEoC), fear, entrapment feeling, depression, and quitting the job during the COVID-19 pandemic. A cross-sectional study was designed, and a convenient sampling method was adopted. Data were collected via an online questionnaire and analyzed by using SPSS version 26. Correlation and regression analyses were performed to reveal the relationship. Coefficients and significance values were used to interpret the results. Independent samples t-test and one-way ANOVA are used to determine the difference across the groups. The correlation between depression and work location is statistically significant. The PEoC increases fear, internal and external entrapment, and depression. Despite the statistically significant correlations between quitting jobs and the education level, internal and external entrapment, PEoC, fear, and depression for employees who have COVID-19 history, quitting the job was found to be affected only by COVID-19 history, internal entrapment feeling, and education level. This study has shown that quitting the job is associated with PEoC, depression, and internal and external entrapments. The correlation between quitting jobs and other conditions differs depending on the COVID-19 history of the employee. Furthermore, quitting the job is being affected by the coronavirus history, the internal entrapment, and education level.