Metaphorical perceptions of surgical nurses regarding care for earthquake victims

BACKGROUND

The physical, psychological, and social effects of the earthquake affect a person's functionality directly. It challenges individuals because it is often traumatizing, intense fear is experienced, and it is unpredictable, uncontrollable, and destructive. Nurses are one of the professional groups that have important duties in social disasters, and they are constantly exposed to the details of the traumatic situation, sometimes physically and sometimes by listening. To understand the severity of the trauma caused by this exposure, it is important to understand the emotions and thoughts that nurses feel while caring for earthquake victims.

AIMS

This study was planned to reveal the perceptions of nurses, who were themselves earthquake victims, regarding caring for earthquake victims through metaphors.

METHODS

This study was conducted as a phenomenological study with a qualitative research approach, in a province affected by the earthquake, with 85 surgical clinic nurses who were also earthquake victims and cared for earthquake victims.

RESULTS

The metaphors produced were examined together with their reasons and grouped under 3 categories (positive, negative, both positive and negative).

CONCLUSIONS

As a result, when the metaphors used by earthquake victims are evaluated, the effects of nurses being earthquake victims themselves can be seen in the metaphors. It is revealed through metaphors that nurses' earthquake-related traumas are triggered while caring for earthquake victims.

Experiences and psychosocial challenges of volunteer nurses in Turkey devastating earthquake zones: Lessons to be learnt for prevention of health system problems in disasters: A qualitative study

OBJECTIVE

This research aimed to investigate the experiences and psychosocial challenges encountered by volunteer nurses who provided care in the zones affected by the devastating earthquake that struck Turkey in 2023.

METHODS

This qualitative study involved semistructured, in-depth interviews with 15 volunteer nurses who were actively working in earthquake-affected regions. The study was conducted between June 2023 and July 2023. Participants were selected from diverse provinces (Hatay, Gaziantep, Adıyaman, Kahramanmaraş, and Malatya) affected by the earthquake, ensuring maximum variability. Individual online interviews were conducted using Google Meet, with data collection continuing until saturation was achieved. The study adhered to the COREQ checklist for reporting qualitative research.

RESULTS

Three main themes and eight subthemes were developed: (1) Management and Coordination (failure to meet basic needs, bureaucracy, duty, and authority issues, problems with supplies and equipment); (2) Professional Experiences (working conditions, education, perspective on the profession); and Psychosocial Problems and (3) Coping Methods (psychological problems, methods of coping with problems).

CONCLUSIONS

The study showed that volunteer nurses encountered management and organizational obstacles, were profoundly impacted by the disaster's psychosocial aspects, and often struggled with inadequacies in handling psychological challenges. Despite these challenges, the nurses reported a sense of competence in delivering care services. The insights derived from this study hold valuable lessons for future disaster response strategies. For this reason, it is recommended to plan the necessary training and initiatives to professionally strengthen the field of disaster nursing.

An Exploration of Resilience and Positive Affect among Undergraduate Nursing Students: A Longitudinal Observational Study

BACKGROUND

The purpose of this study is to analyze the variation in resilience and emotional state scores in nursing students throughout the four years of training for the nursing degree.

METHODS

This is a longitudinal observational study of a paired and prospective cohort of 176 nursing students who enrolled in the first year of a bachelor's degree in 2019. The study followed up with the students in 2022 and examined several sociodemographic factors, including sex, marital status, date of birth, living arrangements and occupation. Additionally, the study investigated changes in negative affect, positive affect, and resilience.

RESULTS

A total of 176 students participated in the study. The study found that resilience increased from 68.24 ± 10.59 to 70.87 ± 9.06 (p < 0.001), positive affect increased from 28.16 ± 4.59 to 33.08 ± 8.00 (p < 0.001), and the negative affect score decreased from 25.27 ± 5.12 to 21.81 ± 7.85 (p < 0.001). The study also found that married individuals experienced an increase in negative affect (p = 0.03) compared to singles or those in open relationships. Furthermore, the change in resilience was greater in men than in women (p = 0.01).

CONCLUSIONS

Throughout their four-year training, nursing students experience an increase in resilience and positive affect, as well as a decrease in negative affect.

Understanding the Role of Empathy and Gender on EMS Clinician Occupational Stress and Mental Health Outcomes

BACKGROUND

Emergency Medical Service (EMS) clinicians experience high levels of occupational stress due to long hours, short staffing, and patient deaths, among other factors. While gender has been partially examined, little is known regarding the role of empathy on occupational stress and mental health (MH) outcomes among EMS clinicians. Therefore, the current study examines the moderating role of empathy and, separately, gender on associations between occupational stress and mental health.

METHODS

A cross-sectional examination of EMS clinician occupational and personal wellbeing was conducted via an anonymous, electronic survey. Information on clinician demographics, and validated measures of occupational stress, burnout, and MH outcomes were collected. Empathy was assessed using the Toronto Empathy Scale (TEQ). Descriptive/bivariate statistics were conducted for variables of interest. Separate multivariable regression models evaluated associations between occupational stress and mental health outcomes. Empathy and gender were examined as potential moderators using interactions.

RESULTS

A total of 568 EMS clinicians completed the survey. High levels of mental health difficulties were reported (34.0% anxiety, 29.2% depression, 48.6% burnout). Increased occupational stress was associated with increased anxiety (OR =1.08, 95% CI 1.05-1.10), depression (OR = 1.09, 95% CI 1.06-1.10), and burnout (OR = 1.10, 95% CI 1.07-1.12). No moderation analyses were significant. Greater resilience was associated with lower depression, anxiety, and burnout.

CONCLUSION

EMS clinicians, much like other first responders, experience considerable occupational stress, of which is associated with mental health difficulties and burnout. Findings underscore the need for intervention programs aimed at reducing the impact of occupational stress and the promotion of resilience. Continuing to understand the full scope of EMS mental health, including the role of resilience, is imperative, particularly in light of future public emergencies.

Disaster preparedness perception, pyschological resiliences and empathy levels of nurses after 2023 Great Turkiye earthquake: Are nurses prepared for disasters: A risk management study

OBJECTIVE

The purpose of the study is to determine the disaster preparedness perceptions, psychological resilences and empathy levels of nurses after 2023 Great Turkiye Earthquake.

METHOD

This descriptive study was conducted in 2023 using with E-Anket. This study was carried out with voluntary participation of 464 nurses living in different geographical regions of Turkiye. The data of the study were obtained utilizing Nurses' Disasters Prepardeness Perception Scale (NDPPS), Pyschological Resileince Scale (PRS) and Empathy Scale (ES).

RESULTS

In this study, the disaster preparedness perception of the nurses was found to be at medium level. More than half of the nurses (65.1%) reported that they did not received any disaster training before. A meaningful was found between the nurses' disaster preparedness perceptions and their empathy levels and psychological resilence.

CONCLUSIONS

As in many countries, it is possible to state that also in Turkiye, the training of nurses for disasters are inadequate and that the studies on this subject are limited. This study will provide a theoretical platform to develop nurses' awareness of disaster preparedness and pyschological resilience and empathic approach programs to increase disaster resilience, and to conduct future research on disaster nursing.

The impact of emotionally challenging situations on medical students' professional identity formation

In their interactions with patients and health care professionals during work-based learning, medical students are known to experience emotionally challenging situations that can evoke negative feelings. Students have to manage these emotions. Students learn and develop their professional identity formation through interactions with patients and members of the healthcare teams. Earlier studies have highlighted the issues involved with processing emotionally challenging situations, although studies concerning learning and professional identity formation in response to these experiences are rare. In this study, we explored medical students' experiences of emotionally challenging situations in work-based learning, and the impact these experiences had on forming medical students' professional identities. We conducted an analysis of narrative data (n = 85), using a constructivist grounded theory approach. The narratives were made up of medical students' reflective essays at the end of their education (tenth term). The analysis showed that students' main concern when facing emotionally challenging situations during their work-based education was the struggle to achieve and maintain a professional approach. They reported different strategies for managing their feelings and how these strategies led to diverse consequences. In the process, students also described arriving at insights into their own personal needs and shortcomings. We consider this development of self-awareness and resulting self-knowledge to be an important part of the continuously ongoing socialization process of forming a professional identity. Thus, experiencing emotionally challenging situations can be considered a unique and invaluable opportunity, as well as a catalyst for students' development. We believe that highlighting the impact of emotions in medical education can constitute an important contribution to knowledge about the process of professional identity formation. This knowledge can enable faculty to provide students with more effective and sufficient support, facilitating their journey in becoming physicians.

The Responsiveness of Mental Health Service Professionals to Two Years of Pandemic Emergency in Italy

This multicenter cross-sectional study explored the responsiveness of Mental Health Services (MHS) to two years of COVID-19 emergency in Italy. Specifically, the study explored the ability of staff to: acknowledge users' capabilities and value teamwork; reinvent the service and maintain/introduce good practices; and, acknowledge the positive aspects of the pandemic experience. These aspects were investigated in relation to socio-demographic and professional variables. Professionals from 17 MHS of 15 Italian Regions completed an online questionnaire on the MHS transformation during COVID-19. Data were collected at the end of the national health emergency (March 1-April 30, 2022). Most of the 1077 participants said they: paid more attention to users' physical health; revised treatment plans; mediated between user needs and safe work procedures; revalued the importance of gestures and habits; discovered unexpected personal resources in users; and, found positive aspects in the COVID-19 experience. The multivariate analyses showed significant differences in staff opinions related to gender, workplace, professional role, and geographic area of the MHS, covarying with staff work experience. Compared to male staff, female staff perceived MHS as more flexible and capable to maintain best practices, and female staff acknowledged more capabilities to the users. Compared to central and northern Italy staff, southern Italy staff gave more values to teamwork, perceived MHS as more capable to maintain best practices and acknowledged higher positive transformations. These findings may be useful for planning community-oriented MHS in the post-pandemic period, taking into account both the experience gained by staff and the MHS process of adaptation.

Psychometric Properties of the Greek Version of the Connor-Davidson Resilience Scale (CD-RISC-10) in a Sample of Nurses

Resilience has been defined as one's ability to maintain a mental health state and overall well-being when undergoing grave stress or facing significant adversity. Numerous resilience-investigating research tools have been developed over the years, with the Connor-Davidson Resilience Scale (CD-RISC), a self-rated tool presenting valuable psychometric properties, remaining one of the most prominent. We aimed to translate and validate the brief CD-RISC-10 in a convenience sample of 584 nurses in Greece's secondary and tertiary health care system. We conducted a confirmatory factor analysis and known-groups validity test and estimated the reliability of the CD-RISC-10. Our confirmatory factor analysis revealed that the scale had a unifactorial structure since all the model fit indices were very good. Moreover, the reliability of the CD-RISC-10 was very good since the acquired Cronbach's alpha and McDonald's omega were 0.924 and 0.925, respectively. Therefore, the Greek version of the CD-RISC-10 confirmed the factor structure of the original scale and had very good validity and reliability.

Perceived Stress Mediating the Association Between Mindfulness and Resilience Among Registered Nurses

Purpose

Resilience continues to be an important concept in the nursing profession due to its significant role in personal healthcare, patients' healthcare, and leadership. The present study examined the mediating role of perceived stress in the association between mindfulness and resilience among registered nurses in order to understand their importance among those in the Taiwanese nursing profession.

Materials and Methods

Between October and November 2021, a total of 816 registered nurses participated in a cross-sectional survey including psychometric measures assessing perceived stress (Chinese Perceived Stress Scale-10), mindfulness (Chinese Mindful Attention Awareness Scale), and resilience (Chinese Questionnaire of Resilience).

Results

Results indicated that perceived stress mediated the association between mindfulness and resilience (standardized coefficient = 0.251, p<0.001), although there was no significant association between mindfulness and resilience (standardized coefficient = 0.042, p=0.16). This suggests that perceived stress may function as both distress and eustress because mindfulness was not directly associated with resilience but indirectly via perceived stress.

Conclusion

Nurses and their administrators should focus on different ways of coping with stress so that they become more resilient in facing other stressors. Future studies may be conducted to examine the mediating role of perceived stress in the association between other coping strategies and resilience among registered nurses.

Factors contributing to healthcare professionals' adaptive capacity with hospital standardization: a scoping review

BACKGROUND

Certain factors contribute to healthcare professionals' adaptive capacities towards risks, challenges, and changes such as attitudes, stress, motivation, cognitive capacity, group norms, and teamwork. However, there is limited evidence as to factors that contribute to healthcare professionals' adaptive capacity towards hospital standardization. This scoping review aimed to identify and map the factors contributing to healthcare professionals' adaptive capacity with hospital standardization.

METHODS

Scoping review methodology was used. We searched six academic databases to September 2021 for peer-reviewed articles in English. We also reviewed grey literature sources and the reference lists of included studies. Quantitative and qualitative studies were included if they focused on factors influencing how healthcare professionals adapted towards hospital standardization such as guidelines, procedures, and strategies linked to clinical practice. Two researchers conducted a three-stage screening process and extracted data on study characteristics, hospital standardization practices and factors contributing to healthcare professionals' adaptive capacity. Study quality was not assessed.

RESULTS

A total of 57 studies were included. Factors contributing to healthcare professionals' adaptive capacity were identified in numerous standardization practices ranging from hand hygiene and personal protective equipment to clinical guidelines or protocols on for example asthma, pneumonia, antimicrobial prophylaxis, or cancer. The factors were grouped in eight categories: (1) psychological and emotional, (2) cognitive, (3) motivational, (4) knowledge and experience, (5) professional role, (6) risk management, (7) patient and family, and (8) work relationships. This combination of individual and group/social factors decided whether healthcare professionals complied with or adapted hospital standardization efforts. Contextual factors were identified related to guideline system, cultural norms, leadership support, physical environment, time, and workload.

CONCLUSION

The literature on healthcare professionals' adaptive capacity towards hospital standardization is varied and reflect different reasons for compliance or non-compliance to rules, guidelines, and protocols. The knowledge of individual and group/social factors and the role of contextual factors should be used by hospitals to improve standardization practices through educational efforts, individualised training and motivational support. The influence of patient and family factors on healthcare professionals' adaptive capacity should be investigated.

TRIAL REGISTRATION

Open Science Framework ( https://osf.io/ev7az ) https://doi.org/10.17605/OSF.IO/EV7AZ .

A narrative review of the physiology and health effects of burnout associated with veterinarian-pertinent occupational stressors

Chronic workplace stress and burnout are serious problems in veterinary medicine. Although not classified as a medical condition, burnout can affect sleep patterns and contributes to chronic low grade systemic inflammation, autonomic imbalance, hormonal imbalances and immunodeficiencies, thereby increasing the risks of physical and psychological ill health in affected individuals. Cultural misconceptions in the profession often lead to perceptions of burnout as a personal failure, ideas that healthcare professionals are somehow at lower risk for suffering, and beliefs that affected individuals can or should somehow heal themselves. However, these concepts are antiquated, harmful and incorrect, preventing the design of appropriate solutions for this serious and growing challenge to the veterinary profession. Veterinarians must first correctly identify the nature of the problem and understand its causes and impacts before rational solutions can be implemented. In this first part of two companion reviews, burnout will be defined, pathophysiology discussed, and healthcare and veterinary-relevant occupational stressors that lead to burnout identified.

Cultivating support during COVID-19 through clinical supervision: A discussion article

AIM

This article aims to discuss how clinical supervision is an important approach in supporting frontline nurses and students during and post COVID-19 through the lens of the nursing metaparadigms.

DESIGN

Discussion article.

METHODS

Discourse of the literature considering the importance of working collaboratively with healthcare and educational organisations in operationalising clinical supervision.

RESULTS

The evidence base supporting clinical supervision as an effective support strategy for nurses exists, however, its implementation and practice has become sporadic. A resurgence is required to support student's and nurse's during this pandemic. It is timely for nurse educators to creatively engage with clinical partners in supporting clinical supervision to enhance both nurses and students pandemic practice experiences. Clinical supervision is proposed as one strategy to support and guide both nurses and students to develop, strengthen and challenge the effectiveness of their care during COVID-19.

Pshychological Resilience and Percieved Stress Level in Nurses: Experience of Nurses in Turkey

OBJECTIVE

To determine the effect of psychological resilience levels of nurses on perceived stress levels in this study.

METHODS

The research was carried out with 153 nurses. Socio-demographic Questionnaire, The Brief Resilience Scale, and Perceived Stress Scale were used as data collection tools.

RESULTS

The nurses' total Brief Resilience Scale score average was 17.72 ± 4.48, and the total Perceived Stress Scale score average was 31.74 ± 7.18. There was a negative and moderately significant relationship between the resilience and stress level of the nurses. During the pandemic process, the level of stress that nurses perceive increases as their psychological resilience decreases.

CONCLUSION

Psychological resilience and coping with stress are traits that can be improved. It is important to establish strategies to increase the resilience of nurses and improve their ability to cope effectively with stress.

Students stress patterns in a Kenyan socio-cultural and economic context: toward a public health intervention

This study aimed at determining the prevalence of stress, different types of stress, their severity and their determinants in Kenyan university, college and high school students. The following tools were administered to 9741 students: (1) Researcher-designed socio-demographic tool, (2) Psychiatric Diagnostic Screening Questionnaire (PDSQ) for psychiatric disorders, (3) WERC Stress Screen for stress, (4) Washington Early Recognition Center Affectivity and Psychosis (WERCAP) screen for psychosis and affectivity, (5) Wealth Index Questionnaire for economic indicators. Descriptive analysis for the prevalence of different types of stress and inferential analysis for stress and independent variables were done. Significant variables (p < 0.05) were fitted into generalized linear model to determine independent predictors. The mean age of the respondents was 21.4 years (range 16-43). Money issues were the commonest stressors while alcohol and drug use were the least. The independent predictors of stress were females, college students and use of gas stove. In conclusion, up to 30% of the students suffer from mild to severe stress. The students experience a wide range of stressors. The most important stressors include money and finances, family related problems and concerns about their future. Our findings suggest a public health approach to create stress awareness in students.

The Impacts of Working With Victims of Sexual Violence: A Rapid Evidence Assessment

AIM

Supporting clients who have experienced trauma can lead to trauma symptoms in those working with them; workers in the sexual violence field are at heightened risks of these. This article collated and critically appraised papers, published from 2017 onward, in the area of people assisting victims of sexual violence. It explores the impacts and effects the work has on them, their coping and self-care mechanisms, and organizational support offered to them.

DESIGN

A question-based rapid evidence assessment with a triangulated weight of evidence approach was used. Academic and nonacademic databases were searched. Twenty-five papers were included for analysis based on the inclusion/exclusion criteria.

RESULTS

Most studies were of medium to high methodological quality. Negative impacts included trauma symptoms, disrupted social relationships, behavioral changes, and emotional and psychological distress. Ability to manage negative impacts was influenced by overall organizational support, availability of training, supervision and guidance, workloads and caseload characteristics, individual characteristics, and their coping and self-care mechanisms. Positive impacts included empowering feelings, improved relationships, compassion satisfaction, and posttraumatic growth.

CONCLUSIONS

Impacts are significant. Support at work and in personal life increases staff's ability to cope and find meaning in their role. Implications for research and practice are discussed.

Socioeconomic determinants of demand for dental cosmetic treatments

Introduction

The demand for cosmetic dentistry is a growing trend globally. Increased media coverage, availability of free online information, and the improved economic status of the general population have led to an increase in the patient's aesthetic expectations. Since no study has measured the relationship between the economic status of people and the choice of cosmetic dentistry in Iran and due to the growing demand for it, this study was designed.

Method

In this descriptive epidemiological study, we visited three completely different areas in terms of Socioeconomic status (SES) in Tehran. A checklist was used to record the gender, job, age, education level, maternal status, and source of payment for cosmetic dentistry treatment.

Result

The majority of the volunteers for dental cosmetic restoration were 23-26 years. Of 498 cosmetic restoration volunteers, 50 were men and 448 were women. As for the education level, most of the participants had a high school diploma. The cost of cosmetic restoration of 351 patients (70%) was paid by the parents or the spouse, and 147 patients paid the cost from their income. Our study showed that 7% of visits to dental clinics were only for cosmetic treatment demands in Tehran in 2021.

Conclusion

Type of job, education level, and marital status had no significant relationship with the choice of cosmetic treatment while age had a significant relationship with the choice of cosmetic dental restoration treatment. In addition, the choice of cosmetic dental treatment was completely related to gender, and women were the main users of it.

An Adlerian-Based Narrative Inquiry of Temporal Awareness, Resilience, and Patient-Centeredness Among Emergency Physicians-The Gyroscope Model

INTRODUCTION

Although extensive research examined time perceptions among patients in the emergency department (ED), studies on temporal awareness among emergency physicians is scant. Salutogenics is the theoretical anchor.

METHODS

The sample comprised ten emergency resident physicians from an Israeli public tertiary hospital. Narrative interviews were conducted. To determine the theme of the study, Adlerian narrative analysis was performed. To identify categories, semantic and content analyses were performed.

RESULTS

Adlerian narrative analysis highlighted temporal awareness as a strong theme across interviews. Semantic and content analyses identified categories within temporal awareness. Analyses revealed a movement among three subcategories: A clinical task in which physicians rapidly shift along seven distinct times, temporal awareness shaping their work experience, and temporal awareness as inhibiting or enabling relationships with patients. Data-analyses identified two groups of physicians, one group driven by the need to control the time to avoid errors, experiencing anxiety and poor wellbeing, and the other, shifting from clinical tasks to patient-centeredness while removing the time factor from their considerations and experiencing resilience through manageability and meaningfulness. We introduce the "gyroscope model" for physicians to illustrate these findings and propose recommendations for practice.

DISCUSSION

Understanding the complexity of the temporal continuum and the influence of shifting from the clinical task to relationships with patients may contribute to resilience of resident physician in the ED and to their self-efficacy, enriching their professional skills and capacity to cope and grow while facing the complexity of the ED.

An empirical evaluation of The Resilience Shield model

Background

Resilience refers to the process through which individuals deal with the adversity they experience. Previous research has shown there are multiple factors that contribute to individuals’ resilience, leading to increasing interest in the development of multidimensional resilience models. Once such recently proposed model is The Resilience Shield, which clusters groups of protective factors into different shield layers. The stronger these layers, the better the protection against adversity (Pronk et al. in The Resilience Shield, Pan Macmillan Australia, 2021). While this model was based in part on existing literature, no empirical evaluation has occurred to date. The aim of this study was therefore to evaluate the model fit for each of the modifiable shield layers and the overall model, and to examine whether each of the constructs included contributes to observed resilience scores.

Methods

Participants completed a series of questionnaires via The Resilience Shield website assessing constructs relevant to each resilience shield layer. Data from 3337 participants was analysed using Structural Equation Modelling and regression analyses.

Results

The results showed acceptable fit of the measurement model for the Social, Mind, and Professional Layers, but poor fit for the Body Layer. There was also good fit for the overall model. In addition, all but one of the constructs included in The Resilience Shield survey explained independent variance in either dispositional resilience scores, or dispositional vulnerability scores.

Conclusion

These results broadly support the multidimensional structure proposed by The Resilience Shield model and suggest that (at least in the population in which it was tested) this may be an acceptable model to index individuals’ performance on a range of indicators that contribute to resilience.

Professionalism, Resilience and Reflective Thinking: How Do These Influence Occupational Therapy Student Fieldwork Outcomes?

The relationship between entry-level, undergraduate occupational therapy students' fieldwork performance and measures of professionalism, reflective thinking and resilience was examined. A group of 135 undergraduates (86% female) completed a self-report questionnaire containing the standardized instruments measuring professionalism, resilience and reflective thinking. The Australian Student Practice Evaluation Form-Revised (SPEF-R) measured fieldwork performance. Linear regression analyses identified Staying Healthy and Relationships with Others as significant predictors of students' fieldwork performance in Professional Behaviors, Self-Management and Information Gathering. The findings highlight the importance of interpersonal skills and engagement in healthy lifestyles in key fieldwork performance areas.

The Buddy System: An Intervention to Reduce Distress and Compassion Fatigue and Promote Resilience on a Palliative Care Team During the COVID-19 Pandemic

The SARS-CoV-2 pandemic (COVID-19) dramatically increased the number of stressors on healthcare workers, including palliative care practitioners. Restrictions and increased demands on time made it difficult for the UMass Memorial Health palliative care team to utilize preexisting wellness strategies. In response to team members' stress reactions, a buddy system intervention was conceived and implemented to restore a sense of connection and self-efficacy (Phase 1). Our objective with this quality improvement project was to assess the feasibility and effectiveness of the buddy system and evaluate staff attitudes toward this intervention. After four months, feedback from team members informed redesign to a more structured buddy system (Phase 2). A mixed-methods design of this project included a qualitative online survey along with quantitative data collection with the Professional Quality of Life Scale V (ProQOL V) and the Brief Resilience Scale (BRS) during Phase 1. Phase 2 was also evaluated quantitatively with ProQOL V and BRS. Semi-structured interviews were conducted at the end of this project to enhance qualitative data on staff attitudes and beliefs. Of the 12 study participants, 10 completed all phases of the study. Participants reported the buddy system was a useful, easy-to-implement intervention for mitigating personal distress and compassion fatigue (CF) by providing a strong sense of support and connection to team members.

Interventions to foster resilience in nursing staff: A systematic review and meta-analyses of pre-pandemic evidence

BACKGROUND

Given the chronic work-related stressors experienced by nursing staff in today's healthcare systems, international evidence suggests an elevated risk of developing stress-related mental symptoms. Therefore, identifying effective methods to foster resilience (i.e., maintenance or fast recovery of mental health despite stressor exposure) seems crucial. To date, little is known about the efficacy of these interventions in nurses.

OBJECTIVE

This systematic review aimed at summarizing the evidence on the pre-pandemic efficacy of psychological interventions to foster resilience, to improve mental symptoms and well-being as well as to promote resilience factors in nurses. Based on training programs with evidence for positive effects on resilience and mental health in meta-analyses, we aimed at identifying important and helpful intervention techniques.

DESIGN

Systematic review and meta-analyses based on a Cochrane review on pre-pandemic resilience interventions in healthcare professionals.

DATA SOURCES

MEDLINE, Embase, CENTRAL and 11 other databases were searched until June 2020 to identify eligible randomized controlled trials. Trial registers, reference lists and contact with authors were additional sources.

REVIEW METHODS

Two reviewers independently assessed study eligibility and extracted data. The Cochrane risk of bias assessment tool was used to evaluate the risk of bias of included studies. We conducted random-effects pairwise meta-analyses for five primary outcomes, including resilience. The intervention contents and techniques were narratively synthesized.

RESULTS

Of 39,794 records retrieved, 24 studies were included in the review (N = 1879 randomized participants), 17 in meta-analyses (n = 1020 participants). At post-intervention, we found very-low certainty evidence of moderate effects in favor of resilience training for resilience (standardized mean difference [SMD] 0.39; 95% CI [confidence interval] 0.12-0.66) and well-being (SMD 0.44; 95% CI 0.15-0.72), while there was no evidence of effects on symptoms of anxiety, depression and stress. The improvement of well-being was sustained in the short-term (≤3 months), with additional delayed benefits for anxiety and stress. There was no evidence of effects at later follow-ups, with the caveat of only three available studies. Among nine programs with evidence of positive moderate effect sizes, intervention contents included mindfulness and relaxation, psychoeducation, emotion regulation, cognitive strategies, problem-solving and the strengthening of internal and external resources.

CONCLUSIONS

Given the chronic stressor exposure in nursing staff, our findings may guide both the design and implementation of nurse-directed resilience interventions. To improve the certainty of evidence, more rigorous high-quality research using improved study designs (e.g., larger sample sizes, longer follow-up periods) is urgently needed.

REGISTRATION

PROSPERO 2017 CRD42017082827.

Healthcare Workers' Resilience Toolkit for Disaster Management and Climate Change Adaptation

Climate change has been recognised as a multiplier of risk factors affecting public health. Disruptions caused by natural disasters and other climate-driven impacts are placing increasing demands on healthcare systems. These, in turn, impact the wellness and performance of healthcare workers (HCWs) and hinder the accessibility, functionality and safety of healthcare systems. This study explored factors influencing HCWs' disaster management capabilities with the aim of improving their resilience and adaptive capacity in the face of climate change. In-depth, semi-structured interviews were conducted with thirteen HCWs who dealt with disasters within two hospitals in Queensland, Australia. Analysis of the results identified two significant themes, HCWs' disaster education and HCWs' wellness and needs. The latter comprised five subthemes: HCWs' fear and vulnerability, doubts and uncertainty, competing priorities, resilience and adaptation, and needs assessment. This study developed an 'HCWs Resilience Toolkit', which encourages mindfulness amongst leaders, managers and policymakers about supporting four priority HCWs' needs: 'Wellness', 'Education', 'Resources' and 'Communication'. The authors focused on the 'Education' component to detail recommended training for each of the pre-disaster, mid-disaster and post-disaster phases. The authors conclude the significance of the toolkit, which provides a timely contribution to the healthcare sector amidst ongoing adversity.

Compassion Satisfaction, Occupational Stress, Burnout Syndrome, and Resilience Among Experienced Audiologists

OBJECTIVE

The aim of the research was to provide insight into compassion satisfaction (CS), resilience, burnout syndrome (BOS), and overall occupational stress levels of experienced audiologists.

DESIGN

This study was based on a four-part online questionnaire consisting of the Audiology Occupational Stress Questionnaire, the Professional Quality of Life Scale (Version 5), the Connor-Davidson Resilience Scale-10, and demographic questions.

STUDY SAMPLE

Fifty-nine audiologists with more than 5 years of experience completed the survey. Clinicians were from New Zealand, Australia, South Africa, the United States, Hong Kong, Israel, Singapore, and the United Kingdom.

RESULTS

The findings illustrate that no audiologists experienced high BOS or low CS scores. Positive correlations existed between resilience and CS and between BOS and overall occupational stress. Negative correlations were found between resilience and BOS, BOS and CS, CS and overall occupational stress, and resilience and overall occupational stress. Resilience (p = .015), CS (p < .001), and overall occupational stress (p < .001) were identified as being significant predictors of BOS. The top five occupational stressors for audiologists were reported as being staff shortages, administration duties, paperwork and patient reports, patient or family expectations to fix a client's hearing, and the amount time available with each patient. The differences in occupational stress experienced by private versus public audiologists were minimal, always being below 1 Likert point.

CONCLUSIONS

Although audiologists do not report high levels of BOS, they report stress in their workplace. As stress was a significant predictor of BOS, audiologists could benefit from interventions aimed at reducing workplace stress.

Assessment of resilience levels among Sri Lankan nurses: Is there room for improvement?

BACKGROUND

Developing resilience at work is an effective primary preventive measure for occupational stress. The study aimed to adopt a tool and measure current resilience levels and determine the association of work-related characteristics on resilience among Sri Lankan nurses.

METHODS

Translated, culturally adapted and validated Resilience at Work Scale- Sinhala version (RAW-S) was used to measure resilience levels in a sample of 855 government nurses from a health district. The mean RAW-S scores were calculated and appropriate cut off points were used to determine the prevalence of 'high', 'moderate' and 'low' resilience. Chi square test was used to determine the associations.

RESULTS

The overall mean RAW-S score was 69.6 (95% CI = 68.9-70.3) and the scores ranged from 28.5 to 90.3. Only 28.4% (95% CI = 25.4-31.6) of nurses showed 'high' level of resilience at work, while 55.6% (95% CI = 52.1-58.9) & 16.0% (95% CI = 13.7-18.7) had shown 'moderate' and 'low' levels of resilience respectively. The resilience levels differed significantly (p < 0.05) by type of ward that they work and by work experience.

CONCLUSIONS

This was the first study that examined the resilience levels in any health care worker category in Sri Lanka. The need of targeted, well-designed resilience building programme for ever burdened government sector nurses is clearly shown from the results, as more than two thirds of nurses had 'moderate' or 'low' level of resilience, which may not be good enough to combat the constant work stress they face on daily basis.

Resilience among Malaysian Community Pharmacists and General Medical Practitioners Using the 10-Item Connor-Davidson Resilience Scale (CD-RISC): The First National Survey

With the growing importance of the healthcare sector, resilience has become a fundamental personal quality that healthcare professionals need to cultivate to cope with adverse events in daily work. Distress in the workplace cannot only impact the well-being of healthcare professionals but also negatively affect the capability to care effectively for others. This study was conducted to determine the score and level of resilience among private primary healthcare professionals and their relationships with independent variables. Sets of questionnaires on resilience based on the Connor–Davidson resilience scale-10 (CD-RISC-10) were completed by 164 general practitioners (GPs) and 87 community pharmacists (CPs). Inferential analysis was used to assess the difference, correlation, association, and predictor among dependent and independent variables. The validity and reliability of the study instrument were assessed using Modern Test Theory (MTT) and Classical Test Theory (CTT). The majority of GPs and CPs possessed the lowest resilience level. There were significant differences between CD-RISC-10 with gender, age, and years of experience in GPs as well as overall. Significant associations were found between CD-RISC-10 with all independent variables, except for the highest education level in GPs and overall. This study revealed significant correlations between independent variables with CD-RISC-10 in GPs and overall. However, there were nonsignificant differences, associations, and correlations among CPs between all independent variables and CD-RISC-10. Gender was the predictor of CD-RISC-10 in GPs, while age and years of experience were the predictors of CD-RISC-10 in GPs and overall. There was no predictor of independent variables for CPs. In multinomial logistics regression, years of experience and gender were the significant predictors of CD-RISC-10 among GPs. The CD-RISC-10 instrument had good validity and reliability. Overall, healthcare professionals showed a low level of resilience. This emphasized the need to cultivate and build resilience, as it is a desirable, important element when working in harsh and unprecedented healthcare settings.

Exploring professional identity in rehabilitation professions: a scoping review

Professional identity is believed to foster self-confidence and resilience in health care professionals. While literature exists describing professional identity in medicine, the relevance of this evidence to rehabilitation professionals (occupational therapy (OT), physical therapy (PT) and speech-language pathology (S-LP)) is limited due to differences between professions in decision-making authority (patient care), professional autonomy and understanding of their scope of practice. The objective was to determine the extent, range and nature of the literature on professional identity/professional identity formation in rehabilitation professionals. Findings from the scoping review based on Arksey and O'Malley's methodological framework are presented. A search was conducted on MEDLINE (Ovid), Embase (Ovid), AMED, CINAHL, and ProQuest Dissertations and Theses from 1996 to October 2020 for empirical and conceptual studies on OT, PT, and S-LP clinicians or students. Of 4983 retrieved records, 53 papers were selected for data extraction. Data were organised into themes for professional identity/professional identity formation: conceptual descriptors (dynamic state, multiple identities); influences (person, professional education/environments, profession-at-large). Findings are consistent with the professional identity literature in medicine. However, they point to gaps for further empirical inquiry in the role of symbols and rituals in the professional identity/professional identity formation of rehabilitation professionals, profession-specific differences between OT, PT and S-LP, and influences related to the profession-at-large on the professional identity/professional identity formation of rehabilitation professionals. These findings may help to inform professional education programs and health care and professional systems in developing resources to support professional identity formation of rehabilitation professionals.

Development and psychometric evaluation of the emergency nurses' professional resilience tool

BACKGROUND

There is no specific tool for measuring the professional resilience of emergency nurses. Therefore, the present study aimed to design and psychometrically evaluate a new tool named the emergency nurses' professional resilience tool.

METHOD

This mixed-method sequential exploratory study was conducted in two phases: (1) item generation using literature review and evaluation of the results of a qualitative study and (2) psychometric evaluation of the developed scale. The face, content, and construct validity (exploratory and confirmatory factor analysis), reliability (internal consistency, relative, and absolute), and accountability were assessed in the population of Iranian nurses (N = 465) during March 2019-June 2020.

RESULTS

The tool designed for assessing the professional resilience of Iranian nurses included 37 items. The average scale content validity index (S-CVI/Ave) was equal to 0.94. The exploratory factor analysis revealed five factors, including professional competencies, emotional-cognitive characteristics, external support, in addition to behavioral and cognitive strategies, and explained 75.59% of the whole variance. Cronbach's alpha and intraclass correlation were 0.915 and 0.888, respectively. Construct validity for five factors was established with acceptable model fit indices [Chi-square/df = 1336.56/619, p < .001]; [Comparative Fit Index [CFI] = 0.96]; [Non-Normed Fit Index [NNFI] = 0.96]; [Root Mean Square Error of Approximation (RMSEA) = 0.074 and 90 Percent Confidence Interval = (0.069; 0.080)]; and [SRMR = 0.095].

CONCLUSIONS

According to the findings of the current study, the emergency nurses' professional resilience tool can be used by healthcare managers as a valid and reliable scale to evaluate the professional resilience of nurses to designate them as nurses working in emergency and disaster situations.

Heard, valued, supported? Doctors' wellbeing during transitions triggered by COVID-19

INTRODUCTION

Supporting doctors' wellbeing is crucial for medical education to help minimise negative long-term impacts on medical workforce retention and ultimately patient care. There is limited study of how doctors' transitions experiences impact wellbeing, particularly socially and culturally. Multiple Multidimensional Transitions (MMT) theory views transitions as dynamic, incorporating multiple contexts and multiple domains. Using MMT as our lens, we report a qualitative analysis of how transitions experienced by doctors during the pandemic impacted on social and cultural aspects of wellbeing.

METHODS

Longitudinal narrative inquiry was employed, using interviews and audio-diaries. Data were collected over 6 months in three phases: (i) interviews with doctors from across the career spectrum (n = 98); (ii) longitudinal audio-diaries for 2-4 months (n = 71); (iii) second interviews (n = 83). Data were analysed abductively, narrowing focus to factors important to social and cultural wellbeing.

RESULTS

Doctors described experiencing multiple interacting transitions triggered by the pandemic in multiple contexts (workplace, role, homelife and education). Patterns identifiable across the dataset allowed us to explore social and cultural wellbeing crosscutting beyond individual experience. Three critical factors contributed to social and cultural wellbeing both positively and negatively: being heard (e.g., by colleagues asking how they are); being valued (e.g., removal of rest spaces by organisations showing lack of value); and being supported (e.g., through regular briefing by education bodies).

CONCLUSIONS

This study is the first to longitudinally explore the multiple-multidimensional transitions experienced by doctors during the COVID-19 pandemic. Our data analysis helped us move beyond existing perceptions around wellbeing and articulate multiple factors that contribute to social and cultural wellbeing. It is vital that medical educators consider the learning from these experiences to help pinpoint what aspects of support might be beneficial to trainee doctors and their trainers. This study forms the basis for developing evidenced-based interventions that ensure doctors are heard, valued and supported.

Resilience and Parental Burnout Among Finnish Parents During the COVID-19 Pandemic: Variable and Person-Oriented Approaches

During the coronavirus disease 2019 (COVID-19) crisis, different personality characteristics may have influenced parental well-being in different ways. In the present study, we combined variable and person-oriented approaches and examined relationships between resilience, parental burnout, and perfectionism during the lockdown. We first used structural equation modeling to assess the paths between variables. We then used latent profile analysis to examine different profiles of parents based on resilience, perfectionism, and symptoms of parental burnout. Finally, we examined how these profiles differ in terms of relevant background variables. The results showed that resilience predicted parental burnout negatively even after controlling for multidimensional perfectionism. Parents' age, children's age, children's special needs, and the increase in time spent with children due to lockdown contributed independently to burning out as a parent. Three profiles were found: a resilient profile, perfectionist profile, and burned-out profile. Resilient parents were likely to be men, older, and with less financial difficulties than parents in the other two profiles, and less likely to spend increased time with their children due to lockdown than the burned-out parents. Perfectionist parents, in turn, had older children than the burned-out parents did. These results suggest that resilience may help parents overcome burnout at times of crisis.

Global prevalence of resilience in healthcare professionals: A systematic review, meta-analysis, and meta-regression

AIMS

This review aims to examine the prevalence estimate of low resilience among healthcare professionals and identify the factors affecting the prevalence.

BACKGROUND

Healthcare professionals experience high levels of stress. Understanding the healthcare professionals' resilience may provide an insight into how they perform in a highly stressed environment. Evaluation A comprehensive search of 11 databases was conducted. Studies that provided prevalence rates for low resilience among healthcare professionals working in a healthcare setting were included. Meta-analyses, sensitivity, subgroup analyses and meta-regression were conducted.

KEY ISSUES

Among 27,720 studies, 41 studies (N = 17,073) across 16 countries were included. The prevalence of low resilience was 26% (95% CI: 20-32). Subgroup analyses indicated that types of resilience measures affect resilience prevalence significantly. A higher prevalence of low resilience was observed among allied health professions during the COVID-19 pandemic in the Middle East.

CONCLUSIONS

This review indicated the prevalence of low resilience and type of resilience measurement instruments that affected the prevalence.

IMPLICATIONS FOR NURSING MANAGEMENT

This review provides a roadmap to design tailored, discipline-specific, and sustainable resilience training for nurses. Nursing managers should monitor the working hours and workload of nursing staffing in order to provide a protective working environment.

Preparedness and response to COVID-19 in a quaternary intensive care unit in Australia: perspectives and insights from frontline critical care clinicians

OBJECTIVES

This study was conducted to explore the perspectives and opinions of intensive care unit (ICU) nurses and doctors at a COVID-19-designated pandemic hospital concerning the preparedness and response to COVID-19 and to consolidate the lessons learnt for crisis/disaster management in the future.

DESIGN

A qualitative study using in-depth interviews (IDIs) and focus group discussions (FGDs). Purposeful sampling was conducted to identify participants. A semistructured guide was used to facilitate IDIs with individual participants. Two FGDs were conducted, one with the ICU doctors and another with the ICU nurses. Thematic analysis identified themes and subthemes informing about the level of preparedness, response measures, processes, and factors that were either facilitators or those that triggered challenges.

SETTING

ICU in a quaternary referral centre affiliated to a university teaching COVID-19-designated pandemic hospital, in Adelaide, South Australia.

PARTICIPANTS

The participants included eight ICU doctors and eight ICU nurses for the IDIs. Another 16 clinicians participated in FGDs.

RESULTS

The study identified six themes relevant to preparedness for, and responses to, COVID-19. The themes included: (1) staff competence and planning, (2) information transfer and communication, (3) education and skills for the safe use of personal protective equipment, (4) team dynamics and clinical practice, (5) leadership, and (6) managing end-of-life situations and expectations of caregivers.

CONCLUSION

Findings highlight that preparedness and response to the COVID-19 crisis were proportionate to the situation's gravity. More enablers than barriers were identified. However, opportunities for improvement were recognised in the domains of planning, logistics, self-sufficiency with equipment, operational and strategic oversight, communication and managing end-of-life care.

Professional identity, perceived job performance and sense of personal accomplishment among social workers in Israel: The overriding significance of the working alliance

This study examined the associations between social workers' professional identity and the quality of their work, as reflected by their perceived job performance and sense of personal accomplishment. Based on literature attesting to the contribution of the working alliance between social workers and their service-users to the attainment of interventions' goals, a model in which the working alliance mediated the associations between social workers' professional identity and the quality of their work was also tested. The study's sample consisted of 570 social workers in Israel, from a wide range of professional and organisational backgrounds. The study was cross-sectional, and data were gathered using an online questionnaire. Its results demonstrate direct effects of social workers' professional identity on the quality of their work. At the same time, social workers' working alliance with service-users acted as a mediator in the association between certain aspects of workers' professional identity and the quality of their work. These findings reassert and broaden understandings regarding the crucial role of relationships with service-users in the discussion of social work professional identity and its outcomes. The specific associations found also offer sustenance to the idea that autonomous social workers, who are committed to their profession, manage to generate stronger working alliances with their service-users; which in turn makes them better at what they do.

Career resilience and self-efficacy of Greek primary school leaders in times of socioeconomic crisis

Purpose

This paper investigates the levels of career resilience and self-efficacy of the principals of primary school units, identifies the relationship between them and determines the effect of the demographic elements of the sample on their career resilience and self-efficacy.

Design/methodology/approach

The convenient sample of this study was 165 principals from public schools across the prefecture of Central Macedonia. A total of 422 questionnaires were mailed to all principals of kindergarten and elementary schools, accompanied by a personal letter to inform them about the procedure and the purpose of the survey. A pilot survey took place to check the adequacy of and get feedback on the questionnaire. The questionnaire used in the study consisted of three parts: The Career Resilience Scale (CRS) by Kodama (2015), the Principal Self-Efficacy Scale (PSES) by Tschannen-Moran and Gareis (2004) and demographic questions.

Findings

The results of the survey showed that principals have high levels of career resilience and very high levels of self-efficacy. There are four factors that form the levels of career resilience: (a) problem-solving skills (b) social skills (c) interest in innovation and (d) optimism for the future. Demographic factors play a role in shaping career resilience as they affect two of the four factors. There are two factors that shape levels of self-efficacy: (a) self-efficiency in administration and (b) self-efficiency in moral leadership. Demographic factors play a role in shaping the factor of self-efficacy that refers to administration. Finally, there was a high positive correlation and a causal relationship between career resilience and self-efficacy.

Research limitations/implications

The convenient sample used in the present study is a limiting factor, as it may not be representative of Greek primary school principals. Also, research is based on self-evaluation questionnaires, which may show a lack of objectivity, as the answers may reflect the personal worldviews of leaders and particular needs of educational institutions (Sarid, 2021). This fact may not allow us to generalize the results.

Practical implications

The present study showed that resilience and self-efficacy have a causal relationship and that one enhances another, making their relation pivotal for a successful educational leadership. Regarding the professional development of school leaders, educational leadership training programs could be designed and offered by the Greek Ministry of Education (Dexter et al., 2020). Coaching programs and practices that help principals develop social skills, coping mechanisms, emotional capacities and confidence in one's knowledge should be widely introduced. Governments have to take the necessary initiative to ensure that, particularly in adverse contexts, education stimulate and nurture resilience and self-efficacy among citizens, by promoting appropriate lifelong learning programs and by ensuring the continuous training of employees (Renko et al., 2020).

Social implications

Career resilience and self-efficacy ensures economic prosperity in times of crisis, globalization and rapid technology development and may be the best way to create strong and successful leaders. Coaching programs and practices that help principals develop social skills, coping mechanisms, emotional capacities and confidence in one's knowledge should be widely introduced. The results of the present research could prove helpful in developing strategic plans, building networks between organizations to improve communication and flow of information, through employee exchange programs.

Originality/value

This research, which combined career resilience and self-efficacy, took place for the first time in Greece. The CRS by Kodama (2015) was also used for the first time in Greek population.

Proximity to COVID-19 patients and role-specific mental health outcomes of healthcare professionals

BACKGROUND

Healthcare professionals (HCPs) experience extreme hardships and challenges during the time of COVID-19, due to their professional roles. At the same time, HCPs may experience a feeling of importance as contributing members of the community, which could enhance their well-being alongside COVID-19-work-related stressors.

AIMS

This cross-sectional study examined the relationship between HCPs' proximity to COVID-19 patients and role-specific fears of COVID-19 and sense of emotional, social and psychological well-being.

METHODS

Participants (N = 1,378) included: HCPs who treated COVID-19 patients (frontliners, n = 188), HCPs that did not work directly with COVID-19 patients (secondliners, n = 524), and a group of non-HCPs who served as the comparison group (n = 666). Participants completed the Depression and Anxiety Stress Scale-21; Fear of COVID-19 Scale; Fear of COVID-19 Familial Infection Scale; and the Mental Health Continuum Short-Form.

RESULTS

Results indicate that the comparison group reported higher levels of fear of COVID-19 compared to secondliners, while frontliners reported the highest levels of fear of infecting their families. Frontliners and secondliners HCPs reported significantly higher levels of social and psychological well-being compared to the non-HCP group.

CONCLUSIONS

This study indicates that there are role-specific mental health outcomes related to HCP's proximity to COVID-19 patients.

Associations among eHealth literacy, social support, individual resilience, and emotional status in primary care providers during the outbreak of the SARS-CoV-2 Delta variant

Objective

This study aimed to investigate eHealth literacy among primary care providers (PCPs) and explore its association with social support, individual resilience, anxiety, and depression during an outbreak of the SARS-CoV-2 Delta variant in Guangzhou, China.

Methods

A cross-sectional web-based survey was conducted in 18 community healthcare centers in Guangzhou, China. The responses of 600 PCPs were tagged as valid responses. Information pertaining to their background, eHealth literacy, anxiety, depression levels, social support, and individual resilience was also collected. Multilevel analysis was used to determine the association among the measures to account for the nested random effect of community health centers in different districts.

Results

Participants showed a moderate self-perceived level of eHealth literacy (M = 30, SD = 5.8). Participants who reported higher levels of eHealth literacy were more likely to exhibit lower levels of anxiety and depression, higher social support, and greater resilience. After adjusting for background characteristics, the results of the multilevel logistic analysis showed that eHealth literacy was significantly associated with anxiety and depression, social support, and individual resilience. Younger participants and those who were highly educated reported enhanced eHealth literacy.

Conclusions

This study presents a baseline reference for eHealth literacy among Chinese PCPs. Improving their ability to search for and use reliable web-based information was beneficial for facilitating perceived social support and raising resilience during the pandemic. Strategies to provide high-quality web-based information to PCPs to self-assess and identify psychological distress at an early stage should be encouraged.

Self-Compassion and Psychological Well-Being Among Malaysian Counselors: The Mediating Role of Resilience

This study investigated the associations between self-compassion, resilience, and psychological well-being among 408 counselors in Malaysia. Data were collected by using a web-based survey. PLS-SEM analyses revealed that self-compassion was positively related to counselors’ resilience and psychological well-being, whereas resilience was positively related to counselors’ psychological well-being. Results also showed that resilience significantly mediated the associations between self-compassion and psychological well-being among counselors. The hypothesized model explained the substantial influences of self-compassion and resilience on counselors’ psychological well-being. This study highlighted the two important human factors, i.e., self-compassion and resilience, with implications for integrating these two influential constructs in the development of counselors’ psychological well-being.

Examining the dimensionality, reliability, and invariance of the Chinese version of the Resilience Scale-14: A multicenter cross-sectional survey in Chinese junior nurses

BACKGROUND

This study aimed to present the psychometric properties (dimensionality, reliability, and invariance) of the Chinese 14-Item Resilience Scale (RS-14) within Chinese register nurses (RNs) with less than 3 years work experiences. And we aimed to compare the fit of a unidimensional model and a bifactor model.

MATERIALS AND METHODS

This multicenter cross-sectional survey was conducted from August to September in 2019. A total of 7,231 registered nurses from 90 hospitals were recruited. Data was anonymously obtained through online questionnaires. Both reliability and validity of Chinese RS-14 were assessed. The confirmatory factor analyses (CFA) were used to compare the fit of two different factor structures of the RS-14 (unidimensional model vs. a bifactor model). Moreover, multigroup CFA (MGCFA) were applied to evaluate the measurement invariance (MI) across sociodemographic parameters (gender, educational level, marital status, and et al.).

DESIGN

Cross-sectional quantitative analyses.

RESULTS

Our study confirmed that the bifactor model presented the best fit within Chinese nurses (CFI = 0.924, TLI = 0.909, RMSEA = 0.095, SRMR = 0.043), and found strong factorial invariance across gender, marital status, and status of receiving standardized training. The reliability of RS-14 was high with a Cronbach's alpha coefficient of 0.939. Moreover, RS-14 was positively correlated with the social support and was negatively correlated with workplace bullying.

CONCLUSION

This is the first study to explore the latent factor structure for the RS-14 among Chinese RNs and evaluated MI across a series of sociodemographic variables. Based on our findings, the Chinese version RS-14 is both valid and reliable.

Improving Healthcare Worker Resilience and Well-Being During COVID-19 Using a Self-Directed E-Learning Intervention

Introduction: High rates of burnout, depression, anxiety, and insomnia in healthcare workers responding to the COVID-19 pandemic have been reported globally. Methods: Responding to the crisis, the Foundation for Professional Development (FPD) developed an e-learning course to support healthcare worker well-being and resilience. A self-paced, asynchronous learning model was used as the training intervention. Each module included practical, skill-building activities. An outcome evaluation was conducted to determine if completing the course improved healthcare worker knowledge of and confidence in the learning outcomes of the course, their use of resilience-building behaviours, their resilience, and their well-being. A secondary objective was to explore if there were any associations between behaviours, resilience, and well-being. Participants completed pre- and post-course questionnaires to measure knowledge of and confidence in the learning outcomes, y, frequency of self-reported resilience-building behaviours, and levels of resilience (CD-RISC) and well-being (WHO-5). Results were analysed in STATA using paired T-tests, univariate and multivariate linear regression models. Results: Participants (n = 474; 77.6% female; 55.7% primary care) exhibited significant increases in knowledge, confidence, resilience-building behaviour, resilience, and well-being scores. Statistically significant improvements in the frequency of resilience-building behaviours led to significant improvements in resilience (0.25 points; 95% CI: 0.06, 0.43) and well-being (0.21 points; 95% CI: 0.05, 0.36). Increasing changes in well-being scores had a positive effect on change in resilience scores (β = 0.20; 95% CI: 0.11, 0.29), and vice versa (β = 0.28; 95% CI: 0.14, 0.41). Conclusion: A healthcare worker e-learning course can build knowledge and skills that may prompt changes in resilience-building behaviours and improvements in well-being and resilience scores. The findings suggest that e-learning courses may improve more than competency-based outcomes alone but further research is warranted to further explore these relationships.

Work-Life Balance and Mental Health Needs of Health Professionals During COVID-19 Pandemic in Turkey

Health professionals constitute a group that is at a high risk of COVID-19. They have been found to experience difficulties in many issues, one of which is that they face the risk of infecting themselves and others due to interaction with high-risk patients. The present study investigates how demographical and individual factors and work addiction affected work-life balance and mental health needs of health professionals. The data of the present study were collected in the first wave of pandemic. The hypothesized structural equation model was rejected based on the fit indices. The second analysis of modified model was significant and indicated that whether health professionals live alone or with others such as family members had direct effects on work addiction, indirect effects on work-life balance, and needs for mental health. In addition, gender and working hours had direct effects on work-life balance. The highest effect on work-life balance was caused by work addiction. Moreover, work addiction had a moderate effect on mental health needs. As a result, the current study showed that work-life balance, work addiction, and the need for mental health were affected during the COVID-19 pandemic.

Reactions of Novice Interviewers Conducting Trauma Research With Marginalized Communities: A Qualitative Analysis

Trauma-focused research highlights the reactions of seasoned professionals when engaging with vulnerable clients; however, less is known about the common reactions of novices engaged in trauma research, who may lack the skills to cope and interact with traumatized participants. The purpose of this study is to (a) describe common reactions experienced by novice trauma interviewers; (b) examine whether the issues they face are similar to those of seasoned helping professionals; and (c) discuss ways in which training and supervision can increase the well-being of interviewers in trauma research. A semi-structured assessment was administered to novice interviewers who had previously conducted psychosocial and trauma assessments with diverse community participants. Participation was voluntary. The assessment elicited responses concerning secondary traumatic stress, vicarious trauma, posttraumatic growth, and self-help and resources. Audio files were transcribed; responses were compiled to explore themes and identify illustrative quotes. Eight interviewers (two males, six females) participated. Six reported no prior experience working with populations with histories of trauma. Novice interviewers described experiences of secondary traumatic stress, vicarious trauma, compassion fatigue, posttraumatic growth, and resilience. Novice interviewers described symptoms consistent with those reported by seasoned helping professionals; positive and negative symptoms often coexisted. Interviewers who completed more assessments described reactions of sadness, anger, insomnia, and changes in worldview. Interviewers who shared similar traumatic histories or environments reported more examples of countertransference. All reported similar feelings of posttraumatic growth, such as hope and optimism, for their participants and an increased appreciation of their resilience. Implications for training and supervision are discussed.

Coping, resilience, and emotional well-being in pharmacy students during the COVID-19 pandemic

Introduction

The purpose of this study was to investigate the significant contributions of coping, resilience, personal characteristics, and health behaviors on the emotional well-being of pharmacy students during the COVID-19 pandemic. COVID-19 was identified in December 2019 and declared a pandemic by the World Health Organization in March 2020. Pharmacy students may experience greater stress during this outbreak because of interruptions in classes or rotations, concerns regarding personal or family health, and social isolation from peers. These changes may result in behavior shifts, difficulty concentrating, and increased use of negative coping strategies. The extent to which these factors affect overall student well-being during a pandemic is largely unknown.

Methods

A cross-sectional study of 3 colleges of pharmacy was completed during May to July 2020 via an online, anonymous 64-item questionnaire using REDCap software. Linear regression and descriptive statistical analyses were conducted using SPSS version 26.

Results

Using the enter method, levels of coping strategies, personal resilience, and Hispanic ethnic identity explain 29% of the variance in emotional well-being scores in pharmacy students during the first months of the COVID-19 pandemic (F (2,76) = 11.785, P < .000, R² = 0.317, R^{2 adjusted} = 0.291). For this sample (N = 104), higher levels of resilience, greater use of coping strategies, and identifying as Hispanic were significant predictors of emotional well-being.

Discussion

Student mental health continues to be important, especially during crises and pandemics. Therefore, pharmacy programs should cultivate an environment that supports the emotional well-being of their students. Campus-based initiatives may be needed to encourage healthy coping behaviors and bolster students' personal resilience to better prepare them for providing front-line patient care in the future.

Resilience, Well-being, and Empathy Among Private Practice Physicians and Advanced Practice Providers in Texas: A Structural Equation Model Study

Objective

To investigate structural relationships of latent constructs such as occupational wellbeing, resilience, work meaningfulness, and psychological empowerment with affective and cognitive clinical empathy among a community of physicians and advanced practice providers.

Methods

We conducted a cross-sectional observational study. We gathered data by an anonymous self-administered multidimensional questionnaire disseminated electronically between March and May 2016. Participants were physicians and advanced practice providers belonging to the Health Texas Provider Network, a group private practice affiliated with the Baylor Scott and White Health system. We excluded allied health care staff (eg, nurses) and trainees (eg, residents, medical students). We pursued a 3-step strategy: (1) confirmatory factor analysis of a theory-driven measurement model, (2) a modified structural equation model from which pathways with nonsignificant path coefficients were deleted, and (3) multigroup analyses of the modified model.

Results

Cognitive empathy was the strongest predictor of affective empathy. We observed modest positive associations of resilience with cognitive and affective empathy and of well-being and meaning with affective but not with cognitive empathy. Resilience, meaning, and psychological empowerment were surprisingly negatively associated with well-being, suggesting diminished self-care among practitioners. Effects of psychological empowerment on empathy and well-being were mediated by resilience and meaning.

Conclusion

Cognitive empathy directly influenced affective empathy; well-being and meaningfulness exerted direct positive effects on affective but not on cognitive empathy, whereas resilience had direct positive associations with both empathy dimensions. Resilience and meaning manifested direct, negative associations with well-being, revealing clinicians’ disproportionate focus on patient care at the expense of self-care.

Medical students' engagement in the context of the SARS-CoV-2 pandemic: The influence of psychological factors on readiness to volunteer

Objective: To avert staff shortages during the first wave of the SARS-CoV-2 pandemic in spring 2020, the medical faculties of the Technical University of Munich (TUM) and the Ludwig Maximilian University of Munich (LMU) appealed to their students to volunteer for relief work. In this study, we examine the influence of psychological factors on the students' decisions to respond to this call or not. Methodology: We report on a cross-sectional study based on an online survey among medical students at the TUM and LMU. The survey consisted of a questionnaire containing items on motivation and other factors related to the decision for or against volunteering. Questions were also asked about anxieties regarding COVID-19 and the occurrence of depressive symptoms, as well as about resilience. Results: Responses from 244 participants were analysed. Students' decisions to volunteer revealed both altruistic and introjected motivations. For those students who did not volunteer, time overlaps and workload related to other activities played an important role. Between the two groups, no significant difference was detected in terms of their resilience and COVID-19-related anxieties. However, the non-volunteering students reported a significantly higher prevalence of depressive symptoms. Conclusion: Sense of duty and the desire to help were, according to the students, the most important reasons for volunteering. Depressive symptoms and lack of time made volunteering less likely. Resilience and COVID-19-related anxieties do not seem to have had any influence on the decision to volunteer or not.

Fostering an ethos of cultural humility development in nurturing inclusiveness and effective intercultural team working

AIM

To discuss the importance of fostering an ethos of cultural humility development in cultivating inclusiveness and effective intercultural team working.

BACKGROUND

Widening cultural and ethnic diversity of the health care workforce enriches the working environment and encourages a broader perspective on health care services and delivery. However, the intricacies of learning to work effectively within intercultural health care teams and adapting to new ways of working are often under estimated and thus overlooked.

EVALUATION

In adopting a framework for cultural humility development (Hughees et al., 2020, 10.1016/j.profnurs.2019.06.005), this paper proposes some practical suggestions for nurturing intrapersonal, interpersonal and system level cultural humility simultaneously.

KEY ISSUES

Fostering an ethos of cultural humility development within the workplace can support inclusiveness and better intercultural team working relationships. Nurses need support in developing awareness of their own cultural beliefs, whilst examining perceptions of cultural difference.

CONCLUSION

Examining cultural factors that influence intercultural working relationships will help in identifying structures, supports and approaches required for integration and inclusiveness.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurturing ways of supporting interpersonal, intrapersonal and systems levels cultural humility development inspires the self-awareness, openness and respect for cultural difference required. Developing culturally responsive leadership styles and prioritizing their own cultural humility development is critical.