Relationships among work stress, job satisfaction, mental health, and healthy lifestyle behaviors in new graduate nurses attending the nurse athlete program: a call to action for nursing leaders

Examining factors affecting self-care-self-regulation among registered nurses using path analysis

BACKGROUND

Practicing self-care is a requisite for nurses as they face the extreme physical, mental, and emotional challenges presented by the pandemic era. This study aimed to examine factors that contribute to self-care-self-regulation (SCSR) and investigate the mediation effect of psychological and physical health in the relationship between work stress and SCSR among registered nurses in the United States.

MATERIALS AND METHODS

This cross-sectional study was conducted on the data collected from 386 registered nurses who completed an online survey over a 3-week period during the COVID-19 pandemic (April 19 to May 6, 2020). The survey assessed demographic and work-related characteristics, work stress, depressive mood, self-rated health, and SCSR. The model was tested with depressive mood as the first mediator and self-rated health as the second mediator. The potential serial mediation effect was analyzed using PROCESS macros adjusting for covariates.

RESULTS

The sequential indirect effect of work stress on SCSR through depressive mood and self-rated health in series was significant, while its direct effect was not.

CONCLUSION

The findings of the path analysis demonstrate that psychological and physical health status is important to promote self-care behaviors when nurses experience high work stress.

Investigating the relationship between spiritual well-being, resilience, and depression: a cross-sectional study of the elderly

BACKGROUND

Mental health of the elderly is one of the health problems in most societies. This study aimed to investigate the relationship between spiritual well-being (SWB), resilience, and depression among the elderly.

METHODS

This descriptive-correlational study was conducted on 384 elderly selected by convenience-sampling method. Abbreviated Mental Test (AMT), SWB, Connor-Davidson Resilience Scale (CD-RISC), and Geriatric Depression Scale (GDS) were used to collect the data. Pearson correlation coefficient, analysis of variance and independent t-test were used to analyze the data. A path analysis was also run to test the direct and indirect effects of SWB and resilience on the depression variable.

RESULTS

The results showed a statistically significant positive correlation between SWB and resilience (r = 0.458, P < 0.001), a statistically significant negative correlation between SWB and depression (r = -0.471, P < 0.001) and between resilience and depression (r = -0.371, P < 0.001). Path analysis showed that SWB and resilience directly affected depression while SWB indirectly affected depression.

CONCLUSIONS

The results indicated there was an inverse relationship between SWB and resilience with depression. Religious programs and appropriate educational programs can help improve SWB and promote resilience in the elderly, which will reduce their depression symptoms.

General well-being of intensive care nurses: A prototype analysis

BACKGROUND

Prototype analyses of well-being have identified central characteristics and prototypicality for New Zealand teachers, lawyers, adolescents, and work well-being of nurses. What has not yet been explored is the broad construct of well-being in intensive care nurses.

AIMS

To identify intensive care nurses' conceptions of general well-being and investigate whether their general well-being is prototypically organized.

DESIGN

Prototype analysis.

METHODS

Three linked studies conceptualize well-being in this prototype analysis. In study 1, nurses reported features of well-being. Study 2 investigated the organization of these features. Study 3 sought confirmation of prototypical organization.

RESULTS

Sixty-five New Zealand nurses participated. For study 1 (n = 23), the most frequently reported elements of well-being included physical health (n = 26), work-life balance (n = 20), and personal relationships (n = 18). For study 2 (n = 25), the highest rated elements included mental and emotional health, [general] health, work-life balance, and love. Work-life balance, physical health, and personal relationships were in the top five most frequently reported and were rated in the top 12 most central. Overall, ratings of centrality and the number of times reported were positively correlated (r = 0.33, P < .005). For study 3 (n = 17), confirmatory analyses did not reach statistical significance (P = .15).

CONCLUSIONS

Physical health, work-life balance, and personal relationships are key characteristics of well-being for intensive care nurses. Mental, emotional, and general health and work-life balance were considered most important for well-being.

RELEVANCE TO CLINICAL PRACTICE

Physical health, work-life balance, and personal relationships are key characteristics of well-being for intensive care nurses. These characteristics of the broad construct of well-being are helpful in both defining and identifying conceptual models of well-being that may be used to inform the development and measurement of well-being programmes.

Qualitative Findings for Supporting Newly Graduated Nurse and Teacher Sleep During Their First Year

BACKGROUND

New graduate role transition for nurses and teachers is stressful. Poor adaptation may manifest as insomnia, which has implications for the new professionals, their employers, and the public served. This study examines factors that impact new graduate sleep, with the aim of identifying perceived helps and hindrances to sleep-during-transition.

METHODS

Targeted content analysis of transcripts from a larger longitudinal mixed methods study comparing new graduate sleep during their first year of practice. Study participants (N = 21) answered questions in the final interview regarding the most positive and negative impact(s) on sleep during the transition year. Transcripts were analyzed and compared based on the new graduate sleep typology (i.e., Got Better, Got Worse, Stayed Varied) which emerged from the parent study.

FINDINGS

Most participants, regardless of sleep type, identified a person/group as most positively impacting sleep. They identified work thoughts, stress/anxiety, people, work hours/sleep schedules, and environmental factors as negatively impacting sleep. Work thoughts and stress/anxiety were mentioned together and most frequently by participants in all three sleep types.

CONCLUSION/APPLICATIONS TO PRACTICE

This study provided insight into new graduate nurse and teacher sleep during transition. Support persons and/or groups may be essential regardless of sleep type. Thought management/stress mitigation strategies and good sleep hygiene may also improve the sleep experiences of these new professionals. Occupational health nurses can support sleep-during-transition among new nurses and teachers by acting as sleep advocates. They may also identify a need for medical intervention and/or sleep specialists and should promote fatigue risk mitigating policies.

Well-Being and Professional Efficacy Among Health Care Professionals: The Role of Resilience Through the Mediation of Ethical Vision of Patient Care and the Moderation of Managerial Support

Drawing on the Conservation of Resources theory, this study analyzes whether resilience could be related to healthcare providers' wellbeing and professional self-efficacy, both directly and indirectly, as mediated by ethical vision of patient care and moderated by managerial support in dealing with ethical issues. Overall, 315 Italian healthcare professionals employed in neuro-rehabilitation medicine or palliative care specialties participated in this multi-centered cross-sectional study. The following variables were investigated: resilience (Connor-Davidson Resilience Scale), wellbeing (Maugeri Stress Index-Reduced), professional self-efficacy (Maslach Burnout Inventory-General Survey), ethical vision of patient care and managerial support in dealing with ethical issues (Italian version of the Hospital Ethical Climate Survey). Overall, resilience was positively associated with healthcare providers' wellbeing and professional self-efficacy, directly and indirectly, as mediated by ethical vision of patient care. Highly resilient healthcare professionals who perceived the presence of a positive ethical vision of patient care in their workplace were more likely to experience greater wellbeing when managerial support in dealing with ethical issues was high (vs. low). Thus, these findings provide suggestions for tailored interventions sustaining healthcare professionals along their daily activity characterized by high-demanding and challenging situations.

'My Work Matters': A Qualitative Exploration of Why Staff Love Working in Acute Mental Health

Research findings and media coverage of staff experiences of working in mental health settings tend to focus on the negative aspects of the work such as burnout and stress. These negative aspects affect job satisfaction. Job satisfaction can be understood through the lense of Self-Determination theory, which emphasises the importance of autonomy, competence and relatedness (connection) in job satisfaction. This article reports on staff views on positive aspects of working in acute mental health care, drawing on qualitative interview data collected for a larger study of the social and architectural environment of mental health inpatient facilities in New Zealand. Forty-two inpatient mental health staff participated in semi-structured interviews about their experiences of working in such facilities, sharing the positive aspects of working in this setting, including 'what they liked most'. Responses were thematically analysed using the Framework Method to identify and organise key themes that were refined iteratively, checking for agreement between researchers. Four key themes were identified: work that matters; the people; the physical and social environment and the extrinsic rewards/personal benefits. The results provide an alternative framing of working in acute mental health settings compared, with commonly reported research findings and media coverage focusing on staff burnout and stress in these settings. Despite the much-documented challenges of working in this often poorly resourced and stigmatized area of health, most participants spoke warmly and enthusiastically about what they did, with frequent use of the word 'love' in relation to their work. This was largely because they found the work and social relationships rewarding and they were able to make an important contribution to the wellbeing of mental health service users.

Effects of vigor at work and weekly physical activity on job stress and mental health

This study explores the role of personal resources, specifically vigor at work (a positive affect generated by the ongoing interactions in the workplace) and weekly physical activity (PA), in the stress-mental health relationship, given the positive relationships found between PA and levels of vigor experienced on health. Thus, we hypothesized that vigor at work would mediate the relationship between job stress and workers' mental health, whereas weekly PA would moderate the relationship between stress and vigor at work. Five hundred and twenty-seven workers completed self-report scales for stress, weekly PA, vigor at work, and mental health. The results showed that vigor at work was related to better mental health, whereas stress was related to high psychological problems and low vigor at work. The interaction between stress and weekly PA on vigor was significant, indicating a counterproductive effect of weekly PA. Specifically, the negative relationship between stress and vigor at work was greater when doing weekly PA. In this vein, high levels of weekly PA would not have a favorable impact when workers experience high levels of stress, consuming part of vigor at work and reducing the positive effect of vigor at work on mental health by coping with stress.

Workplace violence, bullying, burnout, job satisfaction and their correlation with depression among Bangladeshi nurses: A cross-sectional survey during the COVID-19 pandemic

Background

Depression is one of the most serious yet understudied issues among Bangladeshi nurses, bringing health dangers to this workforce. This study aimed to investigate how workplace violence (WPV), bullying, burnout, and job satisfaction are correlated with depression and identify the factors associated with depression among Bangladeshi nurses.

Methods

For this cross-sectional study, data were collected between February 26, 2021, and July 10, 2021 from the Bangladeshi registered nurses. The Workplace Violence Scale (WPVS), the Short Negative Acts Questionnaire [S-NAQ], the Burnout Measure-Short version (BMS), the Short Index of Job Satisfaction (SIJS-5), and the Patient Health Questionnaire (PHQ-9) were used to measure WPV, bullying, burnout, job satisfaction, and depression, respectively. Inferential statistics include Pearson’s correlation test, t-test, one-way ANOVA test, multiple linear regression, and multiple hierarchal regression analyses were performed.

Results

The study investigated 1,264 nurses (70.02% female) with an average age of 28.41 years (SD = 5.54). Depression was positively correlated with WPV, bullying, and burnout and negatively correlated with job satisfaction (p <0.001). According to the multiple linear regression model, depression was significantly lower among nurses with diploma degrees (β = -1.323, 95% CI = -2.149 to -0.497) and bachelor’s degrees (β = -1.327, 95% CI = -2.131 to– 0.523) compared to the nurses with master’s degree. The nurses who worked extended hours (>48 hours) had a significantly higher depression score (β = 1.490, 95% CI = 0.511 to 2.470) than those who worked ≤ 36 hours. Depression was found to be significantly higher among those who did not receive a timely salary (β = 2.136, 95% CI = 1.138 to 3.134), rewards for good works (β = 1.862, 95% CI = 1.117 to 2.607), and who had no training on WPV (β = 0.895, 95% CI = 0.092 to 1.698).

Conclusions

Controlling burnout, bullying, and workplace violence, as well as improving the work environment for nurses and increasing job satisfaction, are the essential indicators of reducing depression. This can be accomplished with integrative support from hospital executives, policymakers, and government officials.

A Correlational Study Exploring Nurse Work Anxiety and Animal-Assisted Therapy

OBJECTIVE

The aim of this study was to perform a correlational study to explore nurse work anxiety.

BACKGROUND

Nurses experience work anxiety with chronic stressful situations, high-acuity assignments, and rigorous patient care standards. The purpose of this study was to determine whether animal-assisted therapy during active worked hours would reduce nurse work-related anxiety.

METHODS

Animal-assisted therapy interventions were performed for both day and night shifts. Beck's Anxiety Inventory (BAI) tool was used pre and post intervention. Each nurse interacted with the therapy dog for at least 10 minutes.

RESULTS

Pet-assisted therapy as an intervention for nurses during work reduced work-related anxiety (t = 5.878, P < 0.05). A Pearson's correlational study displayed a strong positive correlation between the animal-assisted therapy and reduction in BAI scores (r = 0.7717, R2 = 0.5955).

CONCLUSION

This prospective study has shown that nurse work anxiety significantly decreased during worked hours of active bedside care when the nurses actively engaged with a therapy dog.

"Stranger in a mask" midwives' experiences of providing perinatal bereavement care to parents during the COVID-19 pandemic in Ireland: A qualitative descriptive study

OBJECTIVE

To explore the experiences and perceptions of midwives providing perinatal bereavement care during the COVID-19 pandemic and to identify the barriers and facilitators to providing compassionate bereavement care.

DESIGN

A qualitative descriptive design was utilized to address the research question. Following ethical approval, in depth, semi structured interviews were undertaken to explore midwives' experiences of providing care to parents following perinatal bereavement. Narrative data was analyzed using thematic analysis.

SETTING

A standalone regional maternity hospital located in a large metropolitan center in the Republic of Ireland.

PARTICIPANTS

A purposeful sample of eleven midwives, who cared for bereaved parents during the COVID-19 pandemic volunteered to participate in the study.

FINDINGS

Two main themes were identified, each with associated subthemes (1) Challenges of providing compassionate bereavement care during a pandemic (2) Psychological effect and coping strategies utilised by midwives during a pandemic.

CONCLUSION

The COVID-19 pandemic brought unprecedented challenges when providing perinatal bereavement care. The mandatory infection prevention and control measures significantly disrupted human communication and connections. Participants in the study utilized techniques to optimize care while adhering to COVID-19 guidelines, and simultaneously putting their own fear and anxieties aside.

The Impact of COVID-19: Nurses Occupational Stress and Strategies to Manage It

OBJECTIVE

The aim of this study was to explore the occupational stress perception of nurses and how they manage it during the COVID-19 pandemic.

BACKGROUND

The management of occupational stress is a key factor in promoting nurses' well-being.

METHODS

A descriptive cross-sectional study was conducted.

RESULTS

The top occupational stressors from the nurses' perspectives (N = 236) as measured by using an updated version of the Nursing Stress Scale (NSS) included wearing a face mask at all times in the hospital, unpredictable staffing and scheduling, not enough staff to adequately cover the unit, feeling helpless in the case a patient fails to improve, and being assigned to a COVID-19 patient. The mean stress score was 31.87. The updated NSS Cronbach's α was 0.92, and the interclass interclass correlation coefficient was 0.914.

CONCLUSION

Nurse administrators are in a strategic position to develop interventions (eg, open door policy, meetings, and employee assistance programs) to assist nurses in effectively managing stress.

Workplace Health Promotion and COVID-19 Support Measures in Outpatient Care Services in Germany: A Quantitative Study

Working conditions in the care sector, especially under the increased strain during COVID-19, make it difficult for outpatient caregivers to adhere to health-promoting behaviours. Research on workplace health promotion (WHP) and COVID-19 support measures in outpatient care services is limited. The aim of this pilot study was to characterise the current situation of WHP and COVID-19 support measures in outpatient care services and to explore how to offer WHP support measures targeted for a specific group. A web-based cross-sectional survey was conducted with outpatient caregivers (N = 171) in northern Germany. The results showed that 60.2% of the study participants were offered WHP support measures, with significantly higher work engagement when WHP support measures were available (Z = 4279.50, p < 0.01) and that 77.2% received specific support from their employer during the COVID-19 pandemic. Although spending a break in a break room was significantly associated with longer breaks as compared with being in a car (Z = 39.10, padj. = 0.01), a break room was neither available in all outpatient care services, nor did it appear to be feasible. Overall, WHP in outpatient care services is insufficiently covered. In order to be able to offer WHP support measures that are targeted to outpatient caregivers, cooperation among local care services, feasibility, and digital measures should be examined.

The relationship between spiritual health, health-promoting behaviors, depression and resilience: A longitudinal study of new nurses

AIM

To determine if levels of spiritual health, health-promoting behaviors, depressive symptoms and resilience change over time and determine if any variables have an impact on resilience among new nurses.

BACKGROUND

Nurses provide patients with medical care and emotional support in high-stress environments. Resilience is a characteristic that allows one to adjust to these adverse situations. Resilience can help new nurses withstand the emotional stress of the workplace and improve nurse retention.

METHOD

The study was conducted from 2017 to 2019 with a convenience sample of nursing students (N = 195). Data were collected at four timepoints with self-report questionnaires on spiritual health, health-promoting behaviors, resilience and the Beck Depression Inventory-II from 2017 to 2019. Three timepoints were collected during the fourth year of the student stage: fall semester (T1), spring semester (T2) and just prior to graduation (T3); the fourth timepoint was the novice stage (T4), after at least 3 months as a registered nurse. General estimating equations determined predictors of resilience.

RESULTS

A total of 124 new nurses completed all questionnaires (63% response rate). Although mean scores fluctuated slightly during the student stage, the scores at T4 were significantly worse for spiritual health (Wald χ² = 30.23, p < .001), health-promoting behaviors (Wald χ² = 34.89, p < .001), depressive symptoms (Wald χ² = 46.75, p < .001) and resilience (Wald χ² = 21.54, p < .001). Spiritual health, health-promoting behaviors were positively correlated with resilience (p < .001); depressive symptoms were negatively correlated (p < .001). Controlling for the effect of time, resilience of novice nurses was positively associated with nursing school practicum grade, spiritual health and health-promoting behaviors (β = 10.30, p < .001; β = 12.14, p < .001; and β = 14.62, p < .001, respectively) and negatively associated with depressive symptoms (β = - 0.53, p < .001).

CONCLUSIONS

Scores for all variables were similar over the three timepoints of the student stage. However, the significant changes at T4 compared with the student stage suggest the novice stage of nursing was challenging. Increasing resilience could reduce the challenges of transitioning to a hospital environment. Nursing educators and administrators could increase nursing students' resilience by restructuring the educational curricula. This could include helping nurses increase their spirituality and health-related behaviors and providing psychological support to reduce depressive symptoms. Increasing levels of resilience could reduce nurses' emotional stress and improve retention of new nurses.

Psychosocial Well-Being: An Exploratory Cross-Sectional Evaluation of Loneliness, Anxiety, Depression, Self-Compassion, and Professional Quality of Life in Oncology Nurses

BACKGROUND

In addition to heavy workloads, oncology nurses are confronted with emotionally demanding caregiving moments with little training or institutional support for coping and emotional well-being.

OBJECTIVES

The aim of this study was to explore the associations and potential predictors among self-compassion, loneliness, anxiety, depression, and professional quality of life in oncology nurses.

METHODS

Participants were recruited throughout central Texas. Descriptive statistics, bivariate correlations, and multivariate regression analyses were conducted on survey data.

FINDINGS

Burnout and compassion satisfaction were strongly related to loneliness, self-compassion, and depression. Compassion fatigue was most highly related to anxiety and depression. Loneliness made the strongest unique contribution to burnout and compassion satisfaction, and depression was the only statistically significant predictor of compassion fatigue.

Barriers to healthy eating among nurses working in hospitals: A meta-synthesis

AIM

To explore the barriers to healthy eating among nurses working in hospitals.

DESIGN

Meta-synthesis.

DATA SOURCES

Published and unpublished papers were identified through electronic searches on PubMed, CINAHL, PsycINFO, Embase, Scopus, COCHRANE Library, Food Science and Technology Abstract, ProQuest Dissertations and Theses and OpenGrey from inception until 6 September 2020. English-language primary qualitative or mixed-method studies on barriers to healthy eating among hospital nurses were included. Mixed-method studies were eligible if their qualitative data were distinguishable. Studies on nursing assistants, enrolled nurses, nursing students, and patient-care assistants were excluded, as well as studies without full-texts, correlational studies, quantitative surveys, exploratory studies, conference abstracts and reviews.

METHODS

The studies were appraised using Critical Appraisal Skills Programme checklist. Qualitative data were extracted using Joanna Briggs Institute Qualitative Data Extraction Tool. Data synthesis followed two stages, meta-summary and meta-synthesis, proposed by Sandelowski & Barroso.

RESULTS

Twelve studies published from 2008 to 2020 involving 618 hospital nurses were included. The meta-summary generated 10 themes, which were meta-synthesized into three interrelated themes: personal barriers (e.g. nonchalance towards unhealthy eating), interprofessional and patient-related barriers (e.g. sharing unhealthy food), and organizational barriers (e.g. overwhelming work demands).

CONCLUSION

Insufficient self-control and self-confidence, nonchalance and negligence towards healthy eating and cultural beliefs that oppose the practice of healthy eating (personal barriers), exposure of unhealthy food practices in wards (interprofessional and patient-related barriers) and hospital cafeterias, overwhelming work exigencies and institutional constraints (organizational barriers) hindered nurses to achieve wholesome healthy eating.

IMPACT

Many hospital nurses' encountered challenges in healthy eating, thereby potentially jeopardizing their health and work performance. The findings emphasized the need of a joint effort by hospital nurses, families and colleagues, and hospital institutions to overcome the barriers to healthy eating faced by the hospital nurses.

New graduate nurse wellbeing, work wellbeing and mental health: A quantitative systematic review

BACKGROUND

The contribution of work to positive mental health is increasingly apparent. Transition into the workplace causes a range of stressors for new graduate nurses who experience both psychological wellbeing and illbeing in their first year of practice.

OBJECTIVE

To determine published prevalence, predictors, barriers and enablers of new graduate registered nurse wellbeing, work wellbeing and mental health.

DESIGN

Systematic review of quantitative research.

DATA SOURCES

Databases included Cumulative Index of Nursing and Allied Health Literature, Excerpta Medica database, Medical Literature Analysis and Retrieval System Online and Psychological Information. Quantitative and mixed-methods studies were considered for inclusion if published in English from 2009 to 2019 reporting primary data analysis including new graduate nurses' wellbeing, work wellbeing and mental health.

REVIEW METHODS

Quantitative studies were systematically identified then screened and appraised against pre-determined inclusion criteria. Analysis was conducted by grouping according to analytical methods and results reported as a narrative synthesis.

RESULTS

Thirty-four studies were included. The quality of the evidence was variable with just a quarter of the studies being assessed as meeting the quality criteria on all nine measures. For the new graduate nurses prevalence of wellbeing, levels of resilience, optimism, and hope were found to be high. For work wellbeing, most reported higher job satisfaction by 12-months. For work illbeing, levels of burnout were moderately high, predominantly in terms of emotional exhaustion, and stress was initially high, particularly in terms of workload, but decreased over time. For the predictors, job satisfaction was positively predicted by structural empowerment and career satisfaction, and negatively predicted by co-worker incivility, supervisor incivility and emotional exhaustion. For work illbeing, stress was a positive predictor for intent to leave. Stress reductions were associated with momentary levels of high task mastery, social acceptance and role clarity.

CONCLUSIONS

For new graduate nurses, levels of emotional exhaustion, workload and stress were moderately high to high initially, decreasing over time as the graduate nurses' job satisfaction increased. Most studies focused on the nurses' intent to resign or stay and both psychological capital and work engagement positively predicted intent to stay whereas work stress positively predicted intent to resign. Resilience and group cohesion moderated the negative effects of some variables, thus may be potential enablers of work wellbeing. The standards of research reporting or design were generally sub-optimal according to quality indicators. Systematic review registration number: (CRD42020148812).

The effect of occupational stress on marital satisfaction and mental health in Iranian nurses

BACKGROUND

Work and family life are the two basic components of the individuals' life and each one affects the other.

OBJECTIVE

This study aimed to investigate the relationship between occupational stress, mental health and marital satisfaction among Iranian nurses.

METHODS

A cross-sectional study was conducted on 200 randomly selected nurses. The 35 items hospital stress scale, Enrich Marital Satisfaction questionnaire and Scl-25 mental health questionnaire were used. Descriptive statistics, Pearson correlation coefficient, independent sample t-test and analysis of variance and regression analysis were used.

RESULTS

Inverse correlations were observed between the scores of job stress and mental health (r = -0.468, p = 0.001) and marital satisfaction (r = -0.517, p = 0.001). More than 0.74% of variation in marital satisfaction is explained by the components of occupational stress.

CONCLUSION

The results revealed that occupational stress plays a decisive role in nurses' marital satisfaction and mental health. Due to the destructive effects of occupational stress on the people's mental health, interpersonal relationships and on their efficacy in their job, establishment of some counseling services for nurses to be used by them periodically or by need, can help them to manage their stress level and better management of their family life problems. Moreover, in-service courses or workshops on stress management may help nurses to possess appropriate knowledge and skills on stress management.

The Role of Psychiatry in Treating Burnout Among Nurses During the Covid-19 Pandemic

The prevalence of burnout among US registered nurses ranges from 35 to 45%. In one study, nurses had twice the rate of depression compared with other health care professionals. Owing to the Covid-19 pandemic, burnout is a major threat to the stability of the workforce on the front lines. Consultation-liaison (C/L) psychiatry can provide assistance through liaison meetings, stress management programs, and curbside consults to help reduce the risk of burnout. Narrative medicine programs, mindfulness-based stress reduction, and meditation apps are additional means to alleviate stress. Given the current challenges facing C/L psychiatry and the mental health field in general, there is an urgent need to overcome stigma and financial barriers to make treatment readily accessible.

Is there any association among depressive symptoms, job satisfaction and self-assessed empathy? A correlational study in Greek Psychiatric/Mental Health Nurses

A descriptive correlational design was applied to explore association among self-assessed depressive symptoms, job satisfaction and self-assessed empathy in 206 Greek Psychiatric-Mental Health Nursing Personnel (PMHNP). Depressive symptom intensity was associated with satisfaction from performed tasks (r = -0.157, p = 0.033), professional prestige (r = -0.255, p < 0.0001), relations with colleagues (r = -0.263, p < 0.0001) and empathy (r = -0.183, p = 0.013). In a regression model, only satisfaction from relations and workload remained significant depressive symptom predictors after controlling for important covariates. The quality of relations with colleagues and workload are important predictors of PMHNPs self-perceived mental health well-being, independently of clinicians' self-assessed empathy or overall professional satisfaction.

Impact of ethical leadership on job satisfaction: the mediating effect of work–family conflict

Purpose

The purpose of this paper is to explore the mediating effect of the work–family conflict in the relation between ethical leadership and job satisfaction.

Design/methodology/approach

A questionnaire was answered by 234 nursing professionals working in Portuguese public health institutions.

Findings

Regression analyses indicate that there is a positive relationship between ethical leadership and satisfaction and a negative relationship between ethical leadership and the nurse's work–family conflict. Furthermore, it was revealed that the work–family conflict mediated (partially) the relationship between ethical leadership and job satisfaction.

Research limitations/implications

Ethical leadership was measured by assessing the nurses' perceptions of their leaders' character. The cross-sectional data limited the possibility of establishing the causality of the study variables, where the generalization of results was not possible due to the fact that data were obtained in public health institutions alone.

Practical implications

Considering that ethics precede good relations between the manager and collaborator, it is recommended that organizations develop ethical training for their leaders, more specifically in the case of head nurses.

Originality/value

The added value of this empirical study lies in the mediated role of the work–family conflict in the analysis of the relationship between ethical leadership and job satisfaction.

Mediating effects of self-efficacy, coping, burnout, and social support between job stress and mental health among young Chinese nurses

AIMS

To examine the mediating effects of self-efficacy, coping, burnout, and social support in the link between job stress and depression and anxiety among young Chinese nurses.

DESIGN

A cross-sectional survey was used.

METHODS

Full-time young nurses (N = 1,029) who worked in nine tertiary grade A hospitals in Chengdu China were recruited from December 2016-March 2017. Structural equation modelling was applied to analyse the mediating effects.

RESULTS

Job stress had a direct positive effect on anxiety (β = 0.054) and it also exerted indirect positive effects on depression (β = 0.337) and anxiety (β = 0.325) through mediating factors. Emotional exhaustion and social support were the main mediating variables, accounting for 72.0% of the variation in anxiety and nearly 43.4% in depression.

CONCLUSION

Emotional exhaustion and social support may have significant mediating effects in the link between job stress and depression and anxiety. Strategies including deceasing emotional exhaustion, enhancing social support in work environment, and reducing job stressors would be useful to prevent depression and anxiety among young nurses.

IMPACT

What problems did the study address? Depression and anxiety have great impact on professional performance of nurses and even patient safety. Factors such as coping, burnout, etc., may have different mediating effects in the paths from job stress to depression and anxiety. What were the main findings? Job stress had direct and indirect positive effects on anxiety and it only had indirect positive effect on depression. Emotional exhaustion and social support were the main mediating variables in the link between job stress and depression and anxiety. Where and on whom will the research have impact? Nursing managers should be more cognizant of the impact of job stress on the development of depression and anxiety. The significant mediating effect of emotional exhaustion and social support in the link between job stress and depression and anxiety should be emphasized by nursing administrators and effective targeted measures need to be adopted.

Systemic assessment of depressive symptoms among registered nurses: A new situation-specific theory

BACKGROUND

A mentally-healthy nursing workforce is vital to providing quality healthcare. While there has been research conducted internationally on depressive symptoms in nurses, most studies have lacked a theoretical framework.

PURPOSE

The purpose of this article is to describe the development of a situation-specific theory, the Systemic Assessment of Depressive Symptoms among Registered Nurses (SAD-RN).

METHODS

The SAD-RN was developed through theory synthesis using the Roy's Adaptation Model (RAM) as a framework. Sixty-four research articles were selected to abstract relevant concepts based on a priori RAM concepts.

FINDINGS

Using depressive symptoms as the anchor concept, related emergent concepts of SAD-RN include context, stressors, protective factors, negative health outcomes, and low patient care quality.

DISCUSSION

SAD-RN is an evidence-based comprehensive model that offers researchers a guiding theory to be used in their future research on depressive symptoms among RNs.

Predictors of new graduate nurses' health over the first 4 years of practice

AIM

To examine predictors of Canadian new graduate nurses' health outcomes over 1 year.

DESIGN

A time-lagged mail survey was conducted.

METHOD

New graduate nurses across Canada (N = 406) responded to a mail survey at two time points: November 2012-March 2013 (Time 1) and May-July 2014 (Time 2). Multiple linear regression (mental and overall health) and logistic regression (post-traumatic stress disorder risk) analyses were conducted to assess the impact of Time 1 predictors on Time 2 health outcomes.

RESULTS

Both situational and personal factors were significantly related to mental and overall health and post-traumatic stress disorder risk. Regression analysis identified that cynicism was a significant predictor of all three health outcomes, while occupational coping self-efficacy explained unique variance in mental health and work-life interference explained unique variance in post-traumatic stress disorder risk.

The Role of Service Providers’ Resilience in Buffering the Negative Impact of Customer Incivility on Service Recovery Performance

In the service sector, customer-related social stressors may weaken employees’ well-being, impairing job-related outcomes. Drawing on the Conservation of Resources theory and on the psychology of sustainability, fostering personal resources become critical to encourage service providers who can effectively manage such job demands. This study investigated how customer-related social stressors and customer orientation influence service recovery performance and whether resilience buffers the negative effects of customer incivility on service recovery performance. One hundred and fifty-seven Italian customer-contact employees completed a questionnaire analyzing customer incivility, customer-related social stressors, resilience, customer orientation, and service recovery performance. Regression analyses and SEMs were conducted. Although all customer-related social stressors indirectly and negatively influenced service recovery performance by increasing burnout symptoms, customer incivility only exerted a direct and detrimental impact on service recovery performance. Customer orientation was directly and positively associated with service recovery performance. Highly resilient employees were less affected by variations in service recovery performance across customer incivility levels. Within the psychology of sustainability framework, promoting resilient workplaces is crucial to foster healthy and sustainable work settings. Service organizations can greatly benefit from providing their employees with psychological resilience training programs, cultivating high customer-oriented attitudes through mentoring sessions, and hiring highly customer-oriented and resilient employees for customer-contact occupations.

The influence of nursing care integration services on nurses' work satisfaction and quality of nursing care

AIM

To investigate differences in work satisfaction and quality of nursing services between nurses from the nursing care integration service and general nursing units in Korea.

BACKGROUND

The nursing care integration service was recently introduced in Korea to improve patient health outcomes through the provision of high quality nursing services and to relieve the caregiving burden of patients' families.

METHODS

In this cross-sectional study, data were collected from a convenience sample of 116 and 156 nurses working in nursing care integration service and general units, respectively. The data were analysed using descriptive statistics, t tests and one-way analysis of variance.

RESULTS

Regarding work satisfaction, nursing care integration service nurses scored higher than general unit nurses on professional status, autonomy and task requirements, but the overall scores showed no significant differences. Scores on overall quality of nursing services, responsiveness and assurance were higher for nursing care integration service nurses than for general unit nurses.

CONCLUSIONS

Nursing care integration service nurses scored higher than general unit nurses on some aspects of work satisfaction and quality of nursing services. Further studies with larger sample sizes will contribute to improving the quality of nursing care integration service units.

IMPLICATIONS FOR NURSING MANAGEMENT

These findings can help to establish strategies for the implementation and efficient operation of the nursing care integration service system, for the improvement of the quality of nursing services, and for successfully implementing and expanding nursing care integration service services in other countries.

Outcomes of interventions for nurse leaders' well-being at work: A quantitative systematic review

AIMS

The aim of this study was to gather, assess and synthesize current research knowledge on interventions that aimed to improve nurse leaders' well-being at work.

BACKGROUND

The research evidence on interventions for nurse leaders' well-being at work has been sporadic and there are a lack of evidence-based recommendations for effective interventions that inform practice, future studies and education.

DESIGN

A quantitative systematic review, in accordance with the Cochrane Collaboration procedures and the reporting guidance in the PRISMA statement.

METHODS

CINAHL, Cochrane, EBSCO, PubMed, PsycInfo and Scopus databases were searched from 2009 - December 2016. The final data consisted of five studies, which were assessed with the Cochrane Risk of Bias Tool. The data were summarized narratively.

RESULTS

The interventions were mainly concerned with stress management and were targeted at individuals. Four of the five interventions examined produced statistically significant outcomes on well-being at work.

CONCLUSIONS

Stress management interventions that included mental exercises were the most successful. Interventions primarily reduced the stress experienced by participants, but the evidence on the stability of these outcomes was poor because of the short follow-up periods. The certainty of evidence was low, indicating that the use of these interventions among nurse leaders might be beneficial. Further studies are needed to provide more reliable recommendations for their use. As the performance of nurse leaders influences organizations, through interpersonal relationships, it is important to pay more attention in the future to the development of organization- and person-directed interventions and their combinations. A structural empowerment approach should also be considered.

Health, workforce characteristics, quality of life and intention to leave: The 'Fit for the Future' survey of Australian nurses and midwives

AIM

To examine the quality of life of nurses and midwives in New South Wales, Australia and compare values with those of the Australian general population; to determine the influence of workforce, health and work life characteristics on quality of life and its effect on workforce intention to leave.

BACKGROUND

Few studies have examined nurses' and midwives' quality of life and little is known of its effects on workforce longevity.

DESIGN

This was a cross-sectional survey conducted in 2014-2015.

METHOD

The "Fit for the Future" electronic survey, delivered to nurses and midwives, examined demographic, work and health-related factors, which were compared with Australian general population normative values for physical and mental components of quality of life (the Short Form-12). Univariate and multivariate logistic regression models assessed associations with workforce intention to leave.

RESULT

Physical and mental component scores, calculated for 4,592 nurses and midwives, revealed significantly higher physical but lower mental component scores than the general population. Physical component scores decreased with increasing age; higher scores were seen in nurses with better health indices and behaviours. Mental well-being scores increased with increasing age; in nurses who reported job satisfaction, no work injury, sleep problems or frequent pain and non-smokers. The odds of intention to leave decreased with increasing mental well-being.

CONCLUSION

Managers and decision-makers should heed study recommendations to implement health promotion strategies for nurses and midwives, aiming to improve mental health, specifically to promote workforce retention.

Nurses and Health-Promoting Behaviors: Knowledge May Not Translate Into Self-Care

Nurses are knowledgeable regarding the importance of health-promoting activities such as healthy eating, physical activity, stress management, sleep hygiene, and maintaining healthy relationships. However, this knowledge may not translate into nurses' own self-care. Nurses may not follow recommended guidelines for physical activity and proper nutrition. Long hours, work overload, and shift work associated with nursing practice can be stressful and contribute to job dissatisfaction, burnout, and health consequences such as obesity and sleep disturbances. The purpose of this article is to provide an overview of research examining nurses' participation in health-promoting behaviors, including intrinsic and extrinsic factors that may influence nurses' participation in these activities. This article also provides recommendations for perioperative nurse leaders regarding strategies to incorporate into the nursing workplace to improve the health of the staff nurses by increasing health-promoting behaviors.

Internal service quality as a driver of employee satisfaction, commitment and performance

Purpose

The purpose of this paper is to use “positive organizational behavior” and “transformative service research” paradigms to introduce “employee well-being” as a focal construct in the process by which internal service quality (ISQ) drives employee satisfaction, commitment and performance.

Design/methodology/approach

A field-survey using a structured questionnaire is employed to test all the hypotheses with 250 employees and their 25 supervisors in a manufacturing unit in Guangdong province of the People’s Republic of China.

Findings

All the eight hypotheses are supported. ISQ has a positive effect on employee satisfaction, commitment and employee well-being, which in turn positively influence employee performance. Employee well-being also positively moderates (strengthens) the effects of employee satisfaction and commitment on employee performance.

Research limitations/implications

This paper uses data from a single factory in China and focuses on a few key constructs, which may restrict the generalizability of its findings. Moreover, no significant differences were found among the supervisor-workers units.

Practical implications

Managers in non-service industries should focus on improving ISQ and employee well-being in their organizations because both these constructs have significant direct and indirect effects on employee performance.

Originality/value

This paper extends past research on ISQ by showing that it affects employee performance via satisfaction and commitment, and that employee well-being moderates the effects of employee satisfaction and commitment on performance.

Association among components of resilience and workplace violence-related depression among emergency department nurses in Taiwan: a cross-sectional study

AIM AND OBJECTIVES

This correlation study examined the relationship among recently workplace violence, depressive tendency, social support, and resilience of victimised nurses, and we also tried to identify protective factors and potential targets for preventive interventions for these nurses.

BACKGROUND

Workplace violence in hospitals negatively affects occupational health and safety of medical professionals, especially for emergency department nurses.

DESIGN

A cross-sectional, correlation research design was applied.

METHODS

Hierarchical regression was used to examine data which were collected from June 2013 to December 2013 from emergency departments in Taiwan. One hundred and eighty nurses were recruited from two hospitals. Structured interviews and questionnaires were applied to collect data, including the Social Support Scale, the Resilience Scale and the Center for Epidemiologic Studies Depression.

RESULTS

A total of 159 (88·33%) nurses had suffered from physical or verbal violence by patients or their family. Resilience and peer support were significantly higher in the group without depressive tendency. Components of resilience of personal strength, social competence, structure style and religious beliefs were significant factors which accounted for 46·0% of variance in depressive tendency. Three of the five components of resilience: personal strength, social competence and structured style were found to have profounder effects against depressive tendency than peer support.

CONCLUSIONS

Hospital managers should establish a safer working environment for emergency department nurses and reinforce their resilience against depression when they encounter workplace violence.

RELEVANCE TO CLINICAL PRACTICE

This study showed that three of the five components of resilience: personal strength, social competence and structured style are protective factors against depressive tendency in victimised nurses. Improving these three components with coping and problem-solving skills by healthcare manager would be effective measures for enhancing their resilience in situations of workplace violence.

Exploring Environmental Factors in Nursing Workplaces That Promote Psychological Resilience: Constructing a Unified Theoretical Model

Building nurses' resilience to complex and stressful practice environments is necessary to keep skilled nurses in the workplace and ensuring safe patient care. A unified theoretical framework titled Health Services Workplace Environmental Resilience Model (HSWERM), is presented to explain the environmental factors in the workplace that promote nurses' resilience. The framework builds on a previously-published theoretical model of individual resilience, which identified the key constructs of psychological resilience as self-efficacy, coping and mindfulness, but did not examine environmental factors in the workplace that promote nurses' resilience. This unified theoretical framework was developed using a literary synthesis drawing on data from international studies and literature reviews on the nursing workforce in hospitals. The most frequent workplace environmental factors were identified, extracted and clustered in alignment with key constructs for psychological resilience. Six major organizational concepts emerged that related to a positive resilience-building workplace and formed the foundation of the theoretical model. Three concepts related to nursing staff support (professional, practice, personal) and three related to nursing staff development (professional, practice, personal) within the workplace environment. The unified theoretical model incorporates these concepts within the workplace context, linking to the nurse, and then impacting on personal resilience and workplace outcomes, and its use has the potential to increase staff retention and quality of patient care.

Physical health, lifestyle beliefs and behaviors, and mental health of entering graduate health professional students: Evidence to support screening and early intervention

BACKGROUND AND PURPOSE

Little is known about the physical health, lifestyle beliefs and behaviors, and mental health among first-year health professional graduate students. Therefore, the purpose of this study was to describe these attributes as well as to explore the relationships among them.

METHODS

A descriptive correlational study was conducted on the baseline data from a wellness onboarding intervention study with 93 health sciences students from seven different colleges within a large public land grant university in the Midwest United States.

FINDINGS

Nearly 40% of the sample was overweight/obese, and 19% of students had elevated total cholesterol levels. Only 44% met the recommended 30 min of exercise 5 days per week. Forty-one percent reported elevated depressive symptoms and 28% had elevated anxiety. Four students reported suicidal ideation. Inverse relationships existed among depression/anxiety and healthy lifestyle beliefs/behaviors.

CONCLUSIONS

Students entering health professional schools are at high risk for depression, anxiety, and unhealthy behaviors, which could be averted through screening and early evidence-based interventions.

IMPLICATIONS FOR PRACTICE

Assessing the physical health, lifestyle behaviors, and mental health of first-year health sciences professional students is important to identify health problems and modifiable at-risk behaviors so that early interventions can be implemented to improve outcomes.

Association between depression and work stress in nursing professionals with technical education level

OBJECTIVE

to analize the relationship between depression and work stress in nursing professionals with technical education level of a teaching hospital in a city of the state of São Paulo.

METHODS

a cross-sectional study was carried out with 310 nursing technicians and nursing assistants, randomly selected. The outcome analyzed was the report of depression and its relationship with high levels of work stress, measured using the Job Stress Scale. Descriptive statistics and logistic regression were performed.

RESULTS

the prevalence of depression in this study was 20%, and it was more expressive in females, aged over 40 years, living without a partner and in smokers. The chance of depression was twice as high among professionals showing high levels of work stress, even after multiple regression adjusting.

CONCLUSION

depressive symptoms were strongly associated with high stress levels among nursing assistants and nursing technicians, evidencing a problem to be considered along with the planning of specific intervention programs for this population, as well as the need for better cases management by the supervisors.

Positive affect and age as predictors of exercise compliance

Physical exercise is linked to individuals whose affect profiles are invariably positive and it induces anti-apoptotic and anti-excitotoxic effects, buttressing blood–brain barrier intactness in both healthy individuals and those suffering from disorders accompanying overweight and obesity. In this regard, exercise offers a unique non-pharmacologic, non-invasive intervention that incorporates different regimes, whether dynamic or static, endurance, or resistance. In this brief report we present a self-reported study carried out on an adolescent and adult population (N = 280, 144 males and 136 females), which indicated that the propensity and compliance for exercise, measured as the “Archer ratio”, was predicted by a positive affect. This association is discussed from the perspective of health, well-being, affect dimensions, and age.