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

Stress, interpersonal and inter-role conflicts, and psychological health conditions among nurses: vicious and virtuous circles within and beyond the wards

BACKGROUND

The increasing costs of nurses' occupational-stress, conflicts, and violence within healthcare services have raised international interest. Yet, research/interventions should consider that perceived stress and conflicts- but also potential resources- within the wards can crossover the healthcare settings, impacting nurses' private lives and viceversa, potentially creating vicious circles exacerbating stress, conflicts/violence or, conversely, virtuous circles of psychological/relational wellbeing. Based on the Demands-Resources-and-Individual-Effects (DRIVE) Nurses Model, and responding to the need to go in-depth into this complex dynamic, this study aims to explore potential vicious circles featured by the negative effects of the interplay (main/mediating effects) between perceived stressors in nursing linked to interpersonal conflicts (Conflicts-with-Physicians, Peers, Supervisors, Patients/their families), work-family inter-role conflicts (Work-Family/Family-Work-Conflicts), and work-related stress (Effort-Reward-Imbalance) on nurses' psychological/relational health (Anxiety, Depression, Somatization, Interpersonal-Sensitivity, Hostility). The potential moderating role of work-resources (Job-Control, Social-Support, Job-Satisfaction) in breaking vicious circles/promoting virtuous circles was also explored.

METHOD

The STROBE Checklist was used to report this cross-sectional multi-centre study. Overall, 265 nurses completed self-report questionnaires. Main/mediating/moderating hypotheses were tested by using Correlational-Analyses and Hayes-PROCESS-tool.

RESULTS

Data confirmed the hypothesized detrimental vicious circles (main/mediating effects), impairing nurses' psychological health conditions at individual level (Anxiety, Depression, Somatization), but also at relational level (Hostility and Interpersonal-Sensitivity). The moderating role of all work resources was fully supported.

CONCLUSION

Findings could be used to implement interventions/practices to effectively prevent the maintenance/exacerbation of vicious circles and promote psychological/relational wellbeing in healthcare settings and beyond.

Impact of Workplace Bullying on Quiet Quitting in Nurses: The Mediating Effect of Coping Strategies

Workplace bullying is common among nurses and negatively affects several work-related variables, such as job burnout and job satisfaction. However, no study until now has examined the impact of workplace bullying on quiet quitting among nurses. Thus, our aim was to examine the direct effect of workplace bullying on quiet quitting and to investigate the mediating effect of coping strategies on the relationship between workplace bullying and quiet quitting in nurses. We conducted a cross-sectional study with a convenience sample of 650 nurses in Greece. We collected our data in February 2024. We used the Negative Acts Questionnaire-Revised, the Quiet Quitting Scale, and the Brief COPE to measure workplace bullying, quiet quitting, and coping strategies, respectively. We found that workplace bullying and negative coping strategies were positive predictors of quiet quitting, while positive coping strategies were negative predictors of quiet quitting. Our mediation analysis showed that positive and negative coping strategies partially mediated the relationship between workplace bullying and quiet quitting. In particular, positive coping strategies caused competitive mediation, while negative coping strategies caused complimentary mediation. Nurses' managers and policy makers should improve working conditions by reducing workplace bullying and strengthening positive coping strategies among nurses.

Relationship between workplace violence, job satisfaction, and burnout among healthcare workers in mobile cabin hospitals in China: Effects of perceived stress and work environment

Background

Although workplace violence is prevalent in the healthcare system, the relationship between workplace violence, job satisfaction, and burnout among healthcare workers (HCWs) in mobile cabin hospitals in China during the COVID-19 pandemic has not yet been investigated. This study analyzes the mediating effects of perceived stress and work environment in the relationship between workplace violence, job satisfaction, and burnout.

Methods

A cross-sectional study was conducted in December 2022 on 1,199 frontline HCWs working in mobile cabin hospitals in Chongqing, China, during the COVID-19 pandemic. Multiple linear regression and mediation analysis were performed.

Results

A positive correlation was observed between workplace violence and burnout (r = 0.420, P < 0.01) and perceived stress (r = 0.524, P < 0.01), and a negative correlation was observed with job satisfaction (r = -0.254, P < 0.01). The perceived stress was positively correlated with burnout (r = 0.528, P < 0.01) and negatively with job satisfaction (r = -0.397, P < 0.01). Job satisfaction was negatively correlated with burnout (r = -0.300, P < 0.01). Perceived stress plays a significant mediating role between workplace violence and job burnout and between workplace violence and job satisfaction. The work environment has a significant moderating effect between workplace violence and job burnout and between workplace violence and job satisfaction.

Conclusion

To reduce burnout among HCWs, hospital administrators should focus on reducing the incidence of workplace violence and perceived stress from work and on improving the work environment and job satisfaction.

Characteristics and Influencing Factors of Post-Traumatic Growth: A Cross-Sectional Study of Psychiatric Nurses Suffering from Workplace Violence in Guangdong China

Background

Workplace violence (WPV) had become an important issue that endangered the occupational safety of psychiatric nurses. A growing number of studies showed positive post-traumatic growth (PTG) resulting from coping with trauma.

Objective

To investigate the characteristics of PTG in psychiatric nurses who experienced violence in the workplace and analyze its influencing factors.

Methods

A total of 1202 psychiatric nurses participated in the study. From October 2022 to December 2022, this cross-sectional study collected data on psychiatric nurses from five tertiary hospitals in Guangdong Province, China. Twenty-item Chinese version post-traumatic growth inventory (PTGI), Jefferson Scale of Empathy Health Professional (JSE-HP), Confidence in Coping with Patient Aggression Instrument (CCPAI), Post-traumatic Stress Disorder Checklist-Civilian Version (PCL-C), and Connor-Davidson Resilience Scale (CD-RISC) measured PTG level, empathy, the confidence in coping with WPV, post-traumatic stress disorder, and resilience, respectively. Bivariate analysis and multiple linear regression explored potential influencing factors of PTG. This study complies with the EQUATOR (STROBE) checklist.

Results

The sample was composed of a total of 1202 psychiatric nurses suffering from WPV. The average score of PTGI in psychiatric nurses was above average (65.75 points; SD = 20.20). Linear regression analyses showed from single-child family (β=0.052,95% CI=0.342,5.409, P<0.05), education background (β=0.108,95% CI=1.833,5.097, P<0.001), the confidence in coping with patient aggression (β=0.106,95% CI=1.385,4.317, P<0.001), empathy (β=0.057,95% CI=0.312,4.374, P<0.05), and resilience (β=0.484,95% CI=7.737,9.575, P<0.001) were associated with PTG level.

Conclusion

Psychiatric nurses who were non-single child, had received higher education, had confidence in coping with patient aggression, had good resilience and strong empathy were prone to PTG after experiencing WPV. The study findings could help hospitals and nursing managers identify vulnerable individuals and take early intervention measures against such populations.

Did the COVID-19 pandemic affect levels of burnout, anxiety and depression among doctors and nurses in Bangladesh? A cross-sectional survey study

INTRODUCTION

COVID-19 has caused severe disruption to clinical services in Bangladesh but the extent of this, and the impact on healthcare professionals is unclear. We aimed to assess the perceived levels of anxiety, depression and burnout among doctors and nurses during COVID-19 pandemic.

METHODS

We undertook an online survey using RedCap, directed at doctors and nurses across four institutions in Bangladesh (The Sheikh Russel Gastro Liver Institute & Hospital (SRNGIH), Dhaka Medical College Hospital (DMCH), Mugda Medical College Hospital (MMCH) and M Abdur Rahim Medical College (MARMC) Hospital). We collected information on demographics, awareness of well-being services, COVID-19-related workload, as well as anxiety, depression and burnout using two validated questionnaires: the Hospital Anxiety and Depression Scale (HADS) and the Maslach Burnout Inventory (MBI).

RESULTS

Of the 3000 participants approached, we received responses from 2705 (90.2%). There was a statistically significant difference in anxiety, depression and burnout scores across institutions (p<0.01). Anxiety, depression and burnout scores were statistically worse in COVID-19 active staff compared with those not working on COVID-19 activities (p<0.01 for HADS anxiety and depression and MBI emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA)). Over half of the participants exhibited some level of anxiety (SRNGIH: 52.2%; DMCH: 53.9%; MMCH: 61.3%; MARMC: 68%) with a high proportion experiencing depression (SRNGIH: 39.5%; DMCH: 38.7%; MMCH: 53.7%; MARMC: 41.1%). Although mean burnout scores were within the normal range for each institution, a high proportion of staff (almost 20% in some instances) were shown to be classified as experiencing burnout by their EE, DP and PA scores.

CONCLUSION

We identified a high prevalence of perceived anxiety, depression and burnout among doctors and nurses during the COVID-19 pandemic. This was worse in staff engaged in COVID-19-related activities. These findings could help healthcare organisations to plan for future similar events.

Global burden of sleep disturbances among older adults and the disparities by geographical regions and pandemic periods

Sleep disturbances are highly prevalent during the COVID-19 pandemic, especially among older adults. We aimed to evaluate sleep heath during COVID-19 pandemic and assess the differences among geographical regions and pandemic periods. We searched three databases (PubMed, Embase, Web of Science) to find articles up to March 12, 2023. We included observational studies that reported the prevalence of sleep disturbances among adults aged 60 years or older in any setting. Two researchers independently reviewed the literature and retrieved the data. We used Der Simonian-Laird random effects meta-analyses to pool the data, followed by subgroup analysis, sensitivity analysis, and meta-regression. A total of 64 studies with 181,224 older adults during the pandemic were included. The prevalence of poor sleep quality, short sleep duration, long sleep duration, and insomnia symptoms were 47.12% (95% CI: 25.97%, 68.27%), 40.81% (95% CI: 18.49%, 63.12%), 31.61% (95% CI: 24.83%, 38.38%), and 21.15% (95% CI: 15.30%, 27.00%), respectively. The prevalence of sleep problems reported by self-constructed items was 26.97% (95% CI: 20.73%, 33.22%). When compared to America (64.13%), Europe (20.23%) and the Western Pacific (21.31%) showed a lower prevalence of sleep problems (all P < 0.0001). The prevalence of worsened sleep problems was 27.88% (95% CI: 11.94%, 43.82%). Compared to 2020 (15.14%), it increased to 47.42% in 2021 (P < 0.05). Eight studies on sleep disturbances among 672 older COVID-19 patients were included. The prevalence of sleep problems and insomnia symptoms among older COVID-19 patients were 41.58% (95% CI: 21.97%, 61.20%) and 41.56% (95% CI: 28.11%, 58.02%), respectively. A significant burden related to poor sleep has been observed among older adults worldwide over the past three years, with variations across different regions and time periods. It is important to make more efforts in prevention and intervention to identify the risk factors, treatment, and rehabilitation of sleep disturbances for healthy aging.

A latent profile analysis of resilience and the associations with flourishing in emergency nurses exposed to workplace violence in China

Workplace violence (WPV) exposure has been particularly prevalent in emergency nurses, coupled with negative mental health outcomes. Few explored resilience after WPV exposure using the perspective of positive mental health. We aimed to identify latent profiles of resilience and examine associations with flourishing in emergency nurses with WPV exposure. A total of 1241 Chinese emergency nurses were surveyed on the frequency of WPV exposure, resilience, and flourishing. Eight hundred and twenty five participants (90.1% female, 86.6% aged 20-39) reported WPV exposure at least once in the past 3 months. Latent profile analysis identified profiles of resilience as low resilience (15.0%), moderate decision respond and interpersonal link with low rational thought and flexible adaption (18.0%), moderate resilience (31.0%), high decision respond, interpersonal link, and rational thought with moderate flexible adaption (16.0%), and high resilience (20.0%). Higher flourishing was observed in profiles of moderate resilience, high decision respond, interpersonal link, and rational thought with moderate flexible adaption, and high resilience. We differentiated profiles of resilience and the associations with flourishing in emergency nurses with WPV exposure, which informed targeted interventions for promoting positive mental health.

Prevalence and factors associated with mental illness symptoms among school students post lockdown of the COVID-19 pandemic in the United Arab Emirates: A cross-sectional national study

Limited data exists on the mental health of children in the United Arab Emirates (UAE). This study aimed to fill this gap by examining the prevalence of anxiety, depression, and risk for Post-Traumatic Stress Disorder (PTSD) among school students in post-lockdown of the COVID-19 pandemic. A sample of 3,745 school students participated, responding to standardized tests (Mood and Feeling Questionnaire-Child Self-Report, Screen for Child Anxiety Related Disorders-Child Version, and Children's Revised Impact of Event Scale-8). Findings showed that the risk for PTSD was the most prevalent (40.6%), followed by symptoms of anxiety (23.3%), and depression (17.1%). For gender differences, symptoms of the three conditions (depression, anxiety, and PTSD) were higher in female students (9.2%) compared to male peers (7.7%) (p = 0.09). Moreover, symptoms of depression and anxiety were found to be higher among late adolescents (p<0.05). Further analysis revealed that having medical problems was a positive predictor for anxiety (OR = 2.0, p<0.01) and risk for PTSD (OR = 1.3, p = 0.002); similarly, witnessing the death of a close family member due to COVID-19 (OR for depression, anxiety, and PTSD = 1.7, p<0.01) were positive predictors associated with PTDS, depression, and anxiety. The study concluded that post COVID-19 lockdown, symptoms of anxiety, depression, and risk for PTSD were found to be prevalent among school students in the UAE. Researchers put forward recommendations on the initiation of a national school mental health screening program, the provision of follow-up services for vulnerable students, and the integration of a mental health support system in the disaster preparedness plans.

Work motivation and factors associated with it among health professionals in Debre Markos Comprehensive Specialized Hospital

Motivation is the level of a person's willingness to put forth and maintain an effort in support of organizational goals. However, motivation towards task execution is affected by the organization and individual goals. For instance, low morale among the staff can damage the quality of service delivery. Hence, this study was intended to assess the working motivation status and factors associated with it among health professionals at Debre Markos Comprehensive Specialized Hospital. A hospital-based cross-sectional study was employed. Stratified sampling techniques were used to extract sample from each job category proportionally. To make the distribution fair, all health workers were grouped according to their job title and selected by using the lottery method from each group. A standardized, self-administered questionnaire was used to collect data. Data was checked, coded, and entered into EpiData 3.1 and exported for analysis into SPSS 25. Variable in the multivariable logistic regression model with a p value of < 0.05 at 95% CI were taken as significantly associated to motivation status. A total of 319 people were involved, with a 100% response rate. 20.4% of health professionals were motivated at Debre Markos Comprehensive Specialized Hospital. Job satisfaction (AOR 6.46, 95% CI 1.72, 24.35), the presence of adequate medical supplies (AOR 5.01, 95% CI 1.23, 25.37), work place security (AOR 6.78, 95% CI 1.498, 30.72), and the presence of training opportunities in health facilities (AOR 2.23, 95% CI 1.01, 4.96) were significant factors associated with motivation status. The proportion of motivated health professionals was very low compared to previous studies in Ethiopia. The presence of security at work, adequate medical equipment, drugs, and supplies, job satisfaction, and the presence of training opportunities were predominant motivational factors. The hospital administration needs to give priority and work to safeguard security, ensure adequate medical supplies, and offer training to improve their satisfaction and motivation.

The impact of COVID-19 on nurses' job satisfaction: a systematic review and meta-analysis

Background

The global healthcare landscape was profoundly impacted by the COVID-19 pandemic placing nurses squarely at the heart of this emergency. This review aimed to identify the factors correlated with nurses' job satisfaction, the impact of their job satisfaction on both themselves and their patients, and to explore strategies that might have counteracted their job dissatisfaction during the COVID-19 pandemic.

Methods

The Joanna Briggs Institute (JBI) methodology for systematic reviews of prevalence and incidence was used in this review. The electronic databases of CINAHL, MEDLINE, SCOPUS, PsycINFO and Academic Search Complete were searched between January 2020 to February 2023.

Results

The literature review identified 23 studies from 20 countries on nurses' job satisfaction during the COVID-19 pandemic. A pooled prevalence of 69.6% of nurses were satisfied with personal, environmental, and psychological factors influencing their job satisfaction. Job satisfaction improved psychological wellbeing and quality of life, while dissatisfaction was linked to turnover and mental health issues.

Conclusion

This systematic review elucidates key factors impacting nurses' job satisfaction during the COVID-19 pandemic, its effects on healthcare provision, and the potential countermeasures for job dissatisfaction. Core influences include working conditions, staff relationships, and career opportunities. High job satisfaction correlates with improved patient care, reduced burnout, and greater staff retention.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023405947, the review title has been registered in PROSPERO and the registration number is CRD42023405947.

Having Children and Being Married Are Predictors of Burnout and Obesity Among Working Men: Effects of Latent Profile Analysis

Emergency call-takers and dispatchers' (ECDs) work makes them vulnerable to occupational burnout and health problems. The aim of this research was to apply a Person-Oriented approach in order to examine the relationships between burnout risk factors (having children), personal resources (being married), and health consequences (overweight and obesity) among men working in these positions. The burnout syndrome was assessed among 228 Polish ECDs using The Link Burnout Questionnaire and the method of latent profile analysis (LPA). All ECDs were characterized by high levels of occupational burnout exhibited in 3 out of its 4 dimensions. The LPA allowed us to differentiate 4 patterns of burnout, taking into account socio-demographic variables, the length of employment as ECD and body weight. The need to balance the demands of professional work with having children and marital roles played an important role in predicting the level of professional burnout. There was a relationship between the dimensions of occupational burnout and age, being married, and having children. Being married was associated with a greater intensity of emotional exhaustion, and the level of exhaustion was higher if the employee had children in their care. Health consequences in the form of overweight and obesity can be associated with levels of emotional exhaustion and professional effectiveness. The application of the Person-Oriented approach presents hidden correlations between burnout predictors and health consequences.

Exploring the aftermath: Work demands, workplace violence, and job satisfaction among nurses in a public hospital in the post-COVID-19 era

Background

Despite the shift from the COVID-19 pandemic to an endemic phase, many individuals, including nurses, may still be facing psychosocial challenges after enduring three years of the pandemic. Although the anticipation that psychosocial issues, such as work demand and workplace violence, have diminished and nurses' job satisfaction has improved, there is a scarcity of studies in Indonesia investigating this matter.

Objective

This study aimed to 1) explore the current state of nurses' work demands, workplace violence, and job satisfaction and 2) examine the relationships between work demands, workplace violence, and respondents' characteristics with nurses' job satisfaction.

Methods

The study employed a cross-sectional survey design involving 247 nurses from a regional general hospital in Jakarta, Indonesia. Simple random sampling was used to select the participants, and the Copenhagen Psychosocial Questionnaire (COPSOQ) III was used for data collection. Data were analyzed using multiple linear regression.

Results

The types of cognitive demands (M = 12.46, SD = 3.461), demands for hiding emotion (M = 11.66, SD = 3.554), and work pace (M = 9.87, SD = 2.847) scored an average close to or within the "sometimes/quite extensive" range on the scale. All types of workplace violence and conflicts occurred among nurses (Mean range = 1.21-2.57). Nurses perceived themselves as fairly satisfied with their job (M = 18.47, SD = 3.18). The results of the multiple linear regression indicated that nurses' job satisfaction was predominantly influenced by workplace violence (β = -0.191), followed by the type of care unit (β = -0.167) and work demands (β = -0.126). These factors collectively accounted for 9.1% of the variance in the job satisfaction variable (R2 = 0.091, p <0.005).

Conclusion

Despite the decreasing number of COVID-19 cases, nurses still experience high work demands and continue to face workplace violence. These factors, as well as the type of care unit, influence nurses' job satisfaction. Therefore, further actions need to be taken by hospital management to address these psychosocial conditions. It is recommended that future research explore the role of nurse managers in managing the psychosocial factors associated with these three factors.

The COVID-19 burnout scale: development and initial validation

BACKGROUND

Research on the pandemic-related burnout has focused on work-related burnout especially among healthcare workers, but not in the general population.

AIM

To develop a valid and reliable instrument scale to measure pandemic-related burnout in the general population.

METHODS

We took several steps to develop the scale items and achieve content and face validity; literature review, panel of experts, calculation of content validity ratio, and cognitive interviews. We assessed structural and construct validity, and reliability of the COVID-19 burnout scale (COVID-19-BS).

RESULTS

Exploratory and confirmatory factor analysis identified three factors for the COVID-19-BS; emotional exhaustion, physical exhaustion, and exhaustion due to measures against the COVID-19. Cronbach's alpha coefficients for the three factors and the COVID-19-BS ranged from 0.860 to 0.921. Kaiser-Meyer-Olkin value was 0.945, and p-value for Bartlett test was <0.001. A significant positive correlation between the three factors and anxiety and depression indicated high concurrent validity. Cohen's kappa ranged from 0.848 to 0.957, while intraclass correlation coefficients ranged from 0.888 to 0.997.

CONCLUSIONS

Our findings indicate that the final 3-factor model with 13 items of COVID-19-BS is a brief, easy to administer, valid and reliable scale for assessing COVID-19-related burnout in the general public.

Burnout and depression: A cross sectional study among health care workers providing HIV care during the COVID-19 pandemic in Malawi

Health care workers (HCWs) in eastern Africa experience high levels of burnout and depression, and this may be exacerbated during the COVID-19 pandemic due to anxiety and increased work pressure. We assessed the prevalence of burnout, depression and associated factors among Malawian HCWs who provided HIV care during the COVID-19 pandemic. From April-May 2021, between the second and third COVID-19 waves in Malawi, we randomly selected HCWs from 32 purposively selected PEPFAR/USAID-supported health facilities for a cross-sectional survey. We screened for depression using the World Health Organization Self Report Questionnaire (positive screen: score≥8) and for burnout using the Maslach Burnout Inventory tool, (positive screen: moderate-high Emotional Exhaustion and/or moderate-high Depersonalization, and/or low-moderate Personal Accomplishment scores). Logistic regression models were used to evaluate factors associated with depression and burnout. We enrolled 435 HCWs, median age 32 years (IQR 28-38), 54% male, 34% were clinical cadres and 66% lay cadres. Of those surveyed, 28% screened positive for depression, 29% for burnout and 13% for both. In analyses that controlled for age, district, and residence (rural/urban), we found that screening positive for depression was associated with expecting to be infected with COVID-19 in the next 12 months (aOR 2.7, 95%CI 1.3-5.5), and previously having a COVID-19 infection (aOR 2.58, 95CI 1.4-5.0). Screening positive for burnout was associated with being in the clinical cadre (aOR 1.86; 95% CI: 1.2-3.0) and having a positive depression screen (aOR 3.2; 95% CI: 1.9-5.4). Reports of symptoms consistent with burnout and depression were common among Malawian HCWs providing HIV care but prevalence was not higher than in surveys before the COVID-19 pandemic. Regular screening for burnout and depression should be encouraged, given the potential for adverse HCW health outcomes and reduced work performance. Feasible interventions for burnout and depression among HCWs in our setting need to be introduced urgently.

Association of workplace bullying and burnout with nurses' suicidal ideation in Bangladesh

Suicidal ideation is a complex phenomenon influenced by several predisposing, contextual, and mediating factors that seem more common among healthcare workers, especially nurses. We investigated the association of bullying and burnout with suicidal ideation among Bangladeshi nurses and identified the associated factors. We conducted a cross-sectional study among 1264 nurses in Bangladesh between February 2021 and July 2021. We applied a modified Poisson regression model with robust error variance to determine the association of bullying and burnout with suicidal ideation. Among 1264 nurses, the female was 882 (70.02%), and the mean age was 28.41 (SD = 5.54) years. The prevalence of high levels of suicidal ideation was 13.26%. In the Poison regression model, high risk bullying (RR = 6.22, 95% CI 3.13-12.38), targeted to bullying (RR = 7.61, 95% CI 3.53-16.38), and burnout (RR = 8.95, 95% CI 2.84-28.20) were found to be significantly associated with suicidal ideation. Furthermore, we found significant interaction between workplace bullying and burnout with suicidal ideation (p < 0.05). The high prevalence of bullying, burnout, suicidal ideation, and their association indicate an unsafe workplace for the nurses. Initiatives are needed to make a favorable work environment to improve nurses' overall mental health and reduce suicide ideation.

Working time variation and mental health during the Covid-19 pandemic in China

The Covid-19 pandemic has brought about a significant shift in labor market dynamics, leading to a notable increase in labor market flexibilization. One prominent aspect of this transformation is the growing variation in working time patterns. The irregular and unpredictable nature of working time may contribute to increased stress levels, difficulty in establishing routines, and challenges in maintaining work-life boundaries. Drawing on China General Social survey 2021, this study aims to examine (1) the relationship between working time variation and mental health during the Covid-19 pandemic in China; (2) whether the relationship can be mediated by work-family conflict; (3) to what extent the relationship varies across occupations. We find that working time variation is associated with significantly worse mental health during the Covid-19 pandemic in China, and around half of the negative effect can be mediated by increased work-family conflict. Moreover, the negative association is more pronounced among non-professional occupations than professional occupations. Overall, these findings shed light on the detrimental impact of working time variation on mental health and its potential mechanism, highlighting how novel work paradigm may interact with existing labor market inequalities to shape workers' mental health.

Prediction of violence or threat of violence among employees in social work, healthcare and education: the Finnish Public Sector cohort study

OBJECTIVES

To develop a risk prediction algorithm for identifying work units with increased risk of violence in the workplace.

DESIGN

Prospective cohort study.

SETTING

Public sector employees in Finland.

PARTICIPANTS

18 540 nurses, social and youth workers, and teachers from 4276 work units who completed a survey on work characteristics, including prevalence and frequency of workplace violence/threat of violence at baseline in 2018-2019 and at follow-up in 2020-2021. Those who reported daily or weekly exposure to violence or threat of violence daily at baseline were excluded.

EXPOSURES

Mean scores of responses to 87 survey items at baseline were calculated for each work unit, and those scores were then assigned to each employee within that work unit. The scores measured sociodemographic characteristics and work characteristics of the work unit.

PRIMARY OUTCOME MEASURE

Increase in workplace violence between baseline and follow-up (0=no increase, 1=increase).

RESULTS

A total of 7% (323/4487) of the registered nurses, 15% (457/3109) of the practical nurses, 5% of the social and youth workers (162/3442) and 5% of the teachers (360/7502) reported more frequent violence/threat of violence at follow-up than at baseline. The area under the curve values estimating the prediction accuracy of the prediction models were 0.72 for social and youth workers, 0.67 for nurses, and 0.63 for teachers. The risk prediction model for registered nurses included five work unit characteristics associated with more frequent violence at follow-up. The model for practical nurses included six characteristics, the model for social and youth workers seven characteristics and the model for teachers included four characteristics statistically significantly associated with higher likelihood of increased violence.

CONCLUSIONS

The generated risk prediction models identified employees working in work units with high likelihood of future workplace violence with reasonable accuracy. These survey-based algorithms can be used to target interventions to prevent workplace violence.

Spatiotemporal Analysis of Injury Events Against Doctors in Guangdong Province by Geographic Information System

Background

Violence against doctors is a global concern. Violent injuries against doctors occur periodically in China. At least one violent injury event was witnessed by 54% of medical staff against doctors in 2020. Analyzing this phenomenon and establishing preventive measures is a common concern of the medical and criminal communities.

Methods

This study comprised 712 injury events against doctors in Guangdong Province, China, from January 2019 to October 2022. The spatial distribution and spatiotemporal changes of these events were analyzed using ArcGIS and Excel software.

Results

Considering the geographical distribution, the injury events against doctors showed a three-level concentric circle pattern where, Guangzhou and Shenzhen, adjacent cities, and distant cities were ranked as high, medium, and low-risk areas, respectively. In temporal distribution, the periods of high incidence were 9-11, 14-15, and 20 o'clock, and the incidence tended to be similar daily, with the peaks in June and July.

Conclusion

We found that the risk level of injury events against doctors was positively correlated with the medical resources level in the areas. The injury event incidence was higher during the daytime working hours. Temperature may have a strong positive effect on injury events against doctors.

Depression in healthcare workers during COVID-19 pandemic: results from Czech arm of HEROES Study

The pandemic due to COVID-19 brought new risks for depression of health care workers, which may have differently influenced men and women. We aimed to investigate (1) whether health care workers in Czechia experienced an increase in depression during the COVID-19 pandemic, (2) which factors contributed the most to this change, and (3) whether the magnitude of the associations differed by gender. We studied 2564 participants of the Czech arm of the international COVID-19 HEalth caRe wOrkErS (HEROES) Study. Online questionnaire was administered to health care workers in summer 2020 (wave 0) and spring 2021 (wave 1). Depression was defined by reaching 10 or more points on the Patient Health Questionnaire. Logistic regression investigated the association of participant´s characteristics with depression and multivariable decomposition for non-linear models assessed, to what extent the characteristic explained the change in depression occurrence. The prevalence of depression increased twice during the pandemic (11% in wave 0 and 22% in wave 1). Stress accounted for 50% of the difference, experience of death due to COVID-19 for 15% and contact with COVID-19 patients for 14%. Greater resilience and sufficient personal protective equipment were strongly associated with lower occurrence of depression. The protective association of resilience with depression was stronger in men than in women. We conclude that interventions to promote mental health of health care workers in future health crisis should aim at decreasing stress and enhancing resilience. They should be delivered especially to individuals who have contact with the affected patients and may face their death.

Mediating role of depression between workplace violence and job burnout among healthcare workers

OBJECTIVES

Health workers are at risk of workplace violence, which can seriously affects their mental health and work status. This study aims to explore the mediating role of depression between workplace violence and job burnout among healthcare workers.

METHODS

From January 10 to February 5, 2019, a questionnaire was distributed to frontline healthcare workers through the wenjuanxing platform using convenient sampling (snowball sampling). The questionnaire included the Chinese version of the Workplace Violence Scale, Maslach Burnout Inventory, and Patient Health Questionnaires (PHQ-2). Descriptive statistics, correlation analysis, and mediation model tests were conducted on the cross-sectional data collection.

RESULTS

The study included 3 684 participants, with (31.63±7.69) years old. Among them 2 079(56.43%) were experienced workplace violence, 687(18.65%) were screened positive for depression, and 2 247(60.99%) were experienced high levels of occupational burnout. Correlation analysis showed positive association between workplace violence and depression, workplace violence and occupational burnout, depression and occupational burnout (r=0.135, r=0.107, r=0.335, respectively, all P<0.001). After controlling for covariates, workplace violence had an indirect effect on occupational burnout through depression, with a standardized coefficient of 0.25 (SE=0.02, 95% CI 0.21 to 0.28), accounting for 13.87% of the total effect.

CONCLUSIONS

The study highlights the close relationship between workplace violence, depression, and occupational burnout among healthcare workers, with depression acting as a mediator between workplace violence and occupational burnout. This study suggests that it is necessary to improve the communication skills of healthcare workers, increase the installation of security systems and emergency plans, use new media platforms to convey positive energy between doctors and patients, and open channels for medical consultation and complaints. It is also necessary to provide guidance for healthcare workers' depressive emotions. Addressing depression among health care workers will help reduce the harm caused by workplace violence, protect the physical and mental health of healthcare workers, and reduce work burnout.

Workplace Bullying among Healthcare Professionals: A Quanti-Qualitative Survey in a Sample of Women Working in an Italian Healthcare Setting

The main objective of this study was to analyze, in a sample of female healthcare workers in Italy, the training needs to improve positive relationships in the healthcare organization. To better understand these needs, perceived workplace bullying and its consequences in terms of professional commitment and well-being were analyzed from a descriptive and quantitative perspective (or mixed-methods analysis). A questionnaire was completed online in a healthcare facility in northwestern Italy. The participants were 231 female employees. The quantitative data showed that, on average, the sampled population perceived a low burden of WPB. The majority of the sample expressed moderate engagement at work and moderate perception of psychological well-being. It is interesting to note that one element seemed to be overarching in the responses to the open-ended questions: communication, which emerged as a problematic element that affects the entire organization. The research data provide useful evidence for intervention in favor of an environment that helps to recognize the phenomenon and intervene in time, offering the possibility of accepting the discomfort and fatigue of healthcare workers and offering useful interventions to the individual and the team.

Prevalence and correlators of burnout among health professionals during different stages of the COVID-19 pandemic in China

Background

Persistently increased workload and stress occurred in health professionals (HPs) during the past 3 years as the COVID-19 pandemic continued. The current study seeks to explore the prevalence of and correlators of HPs' burnout during different stages of the pandemic.

Methods

Three repeated online studies were conducted in different stages of the COVID-19 pandemic: wave 1: after the first peak of the pandemic, wave 2: the early period of the zero-COVID policy, and wave 3: the second peak of the pandemic in China. Two dimensions of burnout, emotional exhaustion (EE) and declined personal accomplishment (DPA), were assessed using Human Services Survey for Medical Personnel (MBI-HSMP), a 9-item Patient Health Questionnaire (PHQ-9), and a 7-item Generalized Anxiety Disorder (GAD-7) to assess mental health conditions. An unconditional logistic regression model was employed to discern the correlators.

Results

There was an overall prevalence of depression (34.9%), anxiety (22.5%), EE (44.6%), and DPA (36.5%) in the participants; the highest prevalence of EE and DPA was discovered in the first wave (47.4% and 36.5%, respectively), then the second wave (44.9% and 34.0%), and the third wave had the lowest prevalence of 42.3% and 32.2%. Depressive symptoms and anxiety were persistently correlated with a higher prevalence risk of both EE and DPA. Workplace violence led to a higher prevalence risk of EE (wave 1: OR = 1.37, 95% CI: 1.16-1.63), and women (wave 1: OR = 1.19, 95% CI: 1.00-1.42; wave 3: OR =1.20, 95% CI:1.01-1.44) and those living in a central area (wave 2: OR = 1.66, 95% CI: 1.20-2.31) or west area (wave 2: OR = 1.54, 95% CI: 1.26-1.87) also had a higher prevalence risk of EE. In contrast, those over 50 years of age (wave 1: OR = 0.61, 95% CI: 0.39-0.96; wave 3: OR = 0.60, 95% CI: 0.38-0.95) and who provided care to patients with COVID-19 (wave 2: OR = 0.73, 95% CI: 0.57-0.92) had a lower risk of EE. Working in the psychiatry section (wave 1: OR = 1.38, 95% CI: 1.01-1.89) and being minorities (wave 2: OR = 1.28, 95% CI: 1.04-1.58) had a higher risk of DPA, while those over 50 years of age had a lower risk of DPA (wave 3: OR = 0.56, 95% CI: 0.36-0.88).

Conclusion

This three-wave cross-sectional study revealed that the prevalence of burnout among health professionals was at a high level persistently during the different stages of the pandemic. The results suggest that functional impairment prevention resources and programs may be inadequate and, as such, continuous monitoring of these variables could provide evidence for developing optimal strategies for saving human resources in the coming post-pandemic era.

Impact of workplace bullying and burnout on job satisfaction among Bangladeshi nurses: A cross-sectional study

Background

Job satisfaction is one of the most important but least researched issues in the nursing profession in Bangladesh. This study aimed to investigate how workplace bullying and burnout are related to job satisfaction, as well as determine the factors that are associated with job satisfaction among Bangladeshi nurses.

Methods

Data were collected from Bangladeshi registered nurses between February 26, 2021, and July 10, 2021, in this cross-sectional study. Bullying, burnout, and job satisfaction were measured with the Short Negative Acts Questionnaire [S-NAQ], the Burnout Measure-Short version (BMS), and the Short Index of Job Satisfaction (SIJS-5), respectively. The correlations between age, bullying, burnout, and job satisfaction were assessed using a Pearson's correlation test. In order to investigate the adjusted association of demographic characteristics, occupational variables, bullying, and burnout with job satisfaction, multiple linear regression models were fitted.

Results

The study included 1,264 nurses (70.02% were female) with a mean age of 28.41 (±5.54) years. Job satisfaction was significantly negatively correlated with bullying and burnout (p < 0.001). According to the multiple linear regression models, the private-employed nurses had lower job satisfaction than the government-employed nurses (β = -0.901, CI: -1.640 to -0.162). Compared to the nurses in the Dhaka division, the nurses in the Chattogram division (β = 0.854, CI: 0.099 to 1.609) and other divisions (β = 0.993, CI: 0.273 to 1.713) had higher job satisfaction. Nurses without sufficient equipment to manage patients (β = -1.230, CI: -1.696 to -0.763), and nurses not paid on time (β = -1.475, CI: -2.221 to -0.729) were predicted to have significantly lower job satisfaction. Nurses' job satisfaction levels were decreased with higher levels of workplace bullying (β = -0.086, CI: -0.120 to -0.053), and burnout (β = -1.040, CI: -1.242 to -0.838).

Conclusions

Nurses' job satisfaction was correlated with workplace bullying and burnout. Moreover, insufficient professional support from the authorities predicted nurses' job satisfaction. Reducing the instances of bullying and burnout among nurses, as well as improving their working environment, are essential to increase job satisfaction. This is possible with the support of hospital management, policymakers, and government authorities.