Effects of Day and Night Shifts on Stress, Anxiety, Quality of Life, and Oxidative Stress Parameters in Nurses

Psychometric evaluation of the Chinese version of the Nursing Student Contributions to Clinical Settings scale and analysis of factors influencing nurses' perceptions of nursing students' contributions: a cross-sectional study

BACKGROUND

Most medical organizations accept many nursing students each year who gain clinical practice skills under the supervision of clinical nurses. However, there are no assessment tools to measure the contributions nursing students make to the clinical setting during clinical practicum. This study aimed to translate the 'Nursing Student Contributions to Clinical Settings' scale into Chinese and test its reliability and validity from the perspective of Chinese clinical nurses. And to explore whether nurses' personal and professional characteristics are related to nurses' perception of nursing students' contributions to the clinical settings.

METHODS

The original scale was translated into Chinese following the Brislin translation model. A convenience sample of 935 clinical nurses was selected from January to March 2024 for the survey. The content validity of the scale was assessed by expert consultation and content validity index. Exploratory factor analysis and confirmatory factor analysis were performed to assess the construct validity of the scale. The reliability of the scale was measured using internal consistency, split-half reliability, and test-retest reliability. The measurement quality of the scales was assessed according to the COnsensus-based Standards for the selection of health Measurement INstruments. One-way analysis of variance was used to identify variables related to students' contributions.

RESULTS

The content validity index of the scale was 0.983. Exploratory factor analysis supported a one-factor structure, and the cumulative variance contribution was 71.177%. Confirmatory factor analysis showed that the model fit indicators were all within the acceptable range. The McDonald's Omega coefficient and Cronbach's alpha coefficient for the scale were 0.983. Nurses perceive that nursing students' contribution to the clinical settings is influenced by nurses' personal characteristics, professional characteristics, and the hospital environment.

CONCLUSION

The Chinese version of the Nursing Student Contributions to Clinical Settings scale has good reliability and validity and can effectively and reliably measure the contributions of Chinese nursing students to clinical settings.

Shifting Rhythms: A Systematic Review Exploring the Multifaceted Effects of Shift Work and Circadian Disruption on Employee Cardiovascular Health

Shift work has long been studied as a contributing risk factor for cardiovascular disease. This study aims to provide a comprehensive summary of data regarding shiftwork and its impact on the cardiovascular system from the last decade. It explores the association of shift schedules with multiple aspects of cardiovascular disease and the physiological processes that lead up to it. It also identifies gaps in current knowledge regarding the topic. Two hundred and sixty-eight articles were gathered from PubMed, Google Scholar, and Science Direct using relevant medical subject headings (MeSH) strategy and advanced search using keywords including 'Shift work,' 'Night shift,' 'Occupational health,' 'Circadian rhythm,' 'Cardiovascular disease,' 'Cardiovascular health.' The search was conducted in April and completed in May 2023. Systemic reviews, meta-analysis, cohort and cross-sectional studies from the last 10 years were included, and assessment of multiple systematic reviews (AMSTAR), Newcastle Ottawa, and Joanna Briggs Institute (JBI) tools were used, respectively, for quality assessment. A total of 14 articles were included in our review, including five systematic reviews and meta-analyses, six prospective cohort studies, and three cross-sectional studies. Each study reported a significant association between shift work with some aspect of cardiovascular disease. An increase in the risk of myocardial infarction, coronary heart disease, hypertension, atherosclerosis, and metabolic syndrome is reported. Circadian disruption, unhealthy diet, and emotional and physiological stress contribute to these effects. Oxidative damage and inflammatory biomarkers appear to play a role in this process, but more research is warranted for a deeper understanding of these changes. Despite an abundance of evidence pointing towards the short-term and long-term harm to shift workers' cardiovascular health, there is limited research regarding the policies that are needed to better monitor cardiovascular damage in employees. The focus needs to shift toward prevention-based policies and their efficacy in workplace settings.

Related Factors of Health-Related Quality of Life in Female Nurses with In-Service Training Program

Aim

This study aimed to investigate the related factors of the health-related quality of life among female nurses in in-service training programs.

Method

In this cross-sectional study, purpose and snowball sampling methods were employed. Three-hundres thirty eligible individuals enrolled to participate in this study at the four universities in Taiwan. Data were collected from March 2019 to February 2020, and the instruments were the Chinese health questionnaire-12 for measuring self-perceive general health, the Resilience Scale for measuring resilience, the Chinese version of the Maslach Burnout Inventory-Human Service Survey for measuring burnout, and the World Health Organization Quality of Lfe Questionnaire for measuring health-related quality of life.

Results

Three hundred nineteen female nurses participated in this study. Participants self-perceived a moderate level of general health, burnout, and health-related quality of life, but good resilience. The scores of health-related quality of life were significantly different on chronic disease status and regular exercise (t=2.813, p = .005) as well as the significant correlation between health-related quality of life and age (r = -0.160, p =.004), years working as a nurse (r = -.204, p < .001), self-perceived general health (r = -.544, p < .001), burnout (r = -.649, p < .001), and resilience (r = .325, p < .001). However, only years of working as nurse, self-perceived general health, resilience, and burnout were shown to predict healthrelated quality of life, explaining 53.5% of the total variance (adjusted R2=.438, p < .001), with burnout having the highest β value (β=-.453, p=<.001).

Conclusion

The related factors of quality of life in female nurses with in-service training program were work year, self-perceived general health, resilience, and burnout. Managers and educators should cooperate to implement strategies that support female nurses, improve resilience, alleviate burnout, and ultimately increase the health-related quality of life of female nurses those in Registered Nurses-Bachelor of Science in Nursing programs.

Oxidative Stress in Depression: The Link with the Stress Response, Neuroinflammation, Serotonin, Neurogenesis and Synaptic Plasticity

Depression is a prevalent, complex, and highly debilitating disease. The full comprehension of this disease is still a global challenge. Indeed, relapse, recurrency, and therapeutic resistance are serious challenges in the fight against depression. Nevertheless, abnormal functioning of the stress response, inflammatory processes, neurotransmission, neurogenesis, and synaptic plasticity are known to underlie the pathophysiology of this mental disorder. The role of oxidative stress in disease and, particularly, in depression is widely recognized, being important for both its onset and development. Indeed, excessive generation of reactive oxygen species and lack of efficient antioxidant response trigger processes such as inflammation, neurodegeneration, and neuronal death. Keeping in mind the importance of a detailed study about cellular and molecular mechanisms that are present in depression, this review focuses on the link between oxidative stress and the stress response, neuroinflammation, serotonergic pathways, neurogenesis, and synaptic plasticity's imbalances present in depression. The study of these mechanisms is important to lead to a new era of treatment and knowledge about this highly complex disease.

Which Shiftwork Pattern Is the Strongest Predictor for Poor Sleep Quality in Nurses?

Shiftwork is related to an increased risk of several diseases, including gastric ulcers, myocardial infarction, and diabetes. Several shiftwork patterns are related to poor sleep quality, such as a quick returns or extended shifts. This study aimed to find the shiftwork patterns strongly associated with poor sleep quality amongst nurses. A cross-sectional analytical study was conducted among nurses working for at least one month. The sub-groups were the good sleep quality group (n = 150) and the poor sleep quality group (n = 472). Eligible participants were asked to complete a self-reported questionnaire comprising personal characteristics, job characteristics, shiftwork characteristics, and sleep quality. Factors associated with poor sleep quality were determined using logistic regression analysis. Two factors associated with poor sleep quality remained in the final model: viz., depression and backward rotational shift. The only independent factor for poor sleep quality was a backward rotational shift with an adjusted odds ratio (95% CI) of 1.946 (1.344, 2.871). In conclusion, compared with other shift patterns, backward shiftwork was the most significant factor associated with poor sleep quality and should be avoided.

The Quality of Life and the Bio-Molecular Profile in Working Environment: A Systematic Review

Working life is characterised by various requirements and degrees of control in meeting these demands. The imbalance of these elements with workers’ resources can result in work-related stress involving the repeated activation of stress response systems. Modifications in the bio-molecular profile may represent a biological signature of individuals’ life experiences and provide evidence on pathways through which such stressors can result in health outcomes. The aim of our systematic review is to characterize the quality of life (QOL) and the bio-molecular profile in the working population, to highlight if the alteration observed might be related to the working conditions. The article query was performed on PubMed, Embase, and Cochrane CENTRAL and results have been presented according to three molecular pathways involved in the stress response: oxidative stress, inflammation, and neuroendocrine activation. The epidemiological sample has been sub-grouped into “clinical” and “non-clinical” populations according to the presence of a diagnosis of psychological disorders. Besides some critical issues, the review highlights the importance of developing a valid array of biological indicators, measurable in non-invasive matrices, sensitive to both derangements from physiological conditions and stress reduction, useful for identifying those groups at higher risk of health outcomes and, eventually, promoting workers’ wellbeing.

COVID-19 anxiety and quality of life among Iranian nurses

BACKGROUND

The Coronavirus Disease 2019 (COVID-19) pandemic has exposed nurses, who are a very important group involved in the care of these patients, to many stresses that may affect their quality of life. This study aimed to determine the relationship between COVID-19 anxiety and the quality of life among Iranian nurses.

METHOD

This online cross-sectional study enrolled 1,131 of Iranian nurses working at the time of the COVID-19 outbreak in treatment centers in different parts of Iran from April to May 2020. The convenience sampling strategy was used. Data were collected using a demographic questionnaire, the 36-Item Short-Form Health Survey (SF-36), and Corona Disease Anxiety Scale (CDAS). The stepwise multiple linear regression models were used to examine the relationships among self-reported anxiety concerning COVID-19 and SF-36 quality of life, its components, and subscales. Partial r was used as an estimate of effect size.

RESULT

The mean SF-36 score was 65.2 (SD=17.6). The mean score of the mental component summary (MCS) (M=56.8, SD=22.3) was lower than the mean score of the physical component summary (PCS) (M=71.6, SD=17.5). The mean score of COVID-19 anxiety was 17.8 (SD=10.5). Of the participants, 378 (33.4%; 95% CI [30.7%, 36.3%]), and 152 (13.4%; 95% CI [11.5%, 15.6%]) reported moderate and severe anxiety, respectively. According to the results of stepwise multiple linear regression model, after adjusting for possible confounding variables, the SF-36 quality of life was still significantly negatively associated with COVID-19 anxiety, with a large effect size (The partial r = -0.515, p < 0.001). The relationship between the SF-36 components and COVID-19 anxiety were also significant, and moderate to large effect sizes were observed (The partial r for (PCS; COVID-19 anxiety) = -0.404; p < 0.001, and for (MCS; COVID-19 anxiety) = -0.521; p < 0.001). In addition, significant correlation coefficients for every subscale of the SF-36 were found for COVID-19 anxiety and its two components, with small to large effect sizes (The partial correlations= -0.211 to -0.524, all ps< 0.001).

CONCLUSIONS

The results showed that higher COVID-19 anxiety in nurses decreases their quality of life. In order to increase nurses' quality of life during the COVID-19 pandemic, it is recommended to design and implement programs to reduce their COVID-19 anxiety.

(-)-Epigallocatechin-3-gallate Ameliorates Intervertebral Disc Degeneration Through Reprogramming of the Circadian Clock

The circadian clock is vital in the management of our daily physiological as well as metabolic processes. Disturbances of the clock can cause degenerative and age-related diseases. Increasing evidence has indicated that the intervertebral discs contain an internal biological clock related to degeneration. However, to date, no bioactive compounds have been found that can ameliorate intervertebral disc degeneration (IDD) by restoring the circadian clock. (-)-Epigallocatechin-3-gallate (EGCG) is a nutritious food with powerful antioxidant properties, as well as entraining biological clock to improve health. The purpose of this study was to determine whether the protective effects of EGCG on nucleus pulposus (NPCs) under oxidative stress is related to the circadian clock. First, we found that EGCG attenuated H₂O₂-induced extracellular matrix degradation in NPCs and inhibited H₂O₂-induced NPC apoptosis. Our in vivo experiments also confirmed this finding. Furthermore, EGCG attenuated H₂O₂-triggered dampening of phase shifts and daily oscillations in circadian clock gene transcription as well as protein expression levels. Intriguingly, core clock gene (Bmal1) knockdown notably blocked the protective effects of EGCG. To our knowledge, this study provides the first convincing evidence that EGCG prevents IDD in a Bmal1-dependent manner. In general, EGCG supplementation can be used as a nutritional prevention strategy for the rehabilitation of degenerative diseases related to the circadian clock.