Job-related stress, emotional labor, and depressive symptoms among Korean nurses

Anger Suppression and Rumination Sequentially Mediates the Effect of Emotional Labor in Korean Nurses

The degree of emotional labor in nurses has been associated with negative physical and psychological health indices. The purpose of this study was to examine the relationship between emotional labor and depressive and anxiety symptoms in nurses. Specifically, the study addressed the question of whether anger suppression and anger rumination sequentially mediated the relationship. A total of 99 nurses was recruited from a university hospital in Korea. The questionnaires included instruments assessing emotional labor, anger suppression, anger rumination, as well as depressive and anxiety symptoms. Consistent with our hypothesis, there was a significant indirect effect of anger suppression and anger rumination on the relationship between emotional labor and depressive symptoms, as well as on the relationship between emotional labor and anxiety symptoms. The nurses’ degree of emotional labor, anger suppression, and anger rumination was associated with psychological adjustment. Thus, the impact of nurses’ negative affect needs to be adequately addressed, as inadequate resolution of anger may increase their vulnerability to experience depressive and anxiety symptoms. These findings may contribute to developing a strategy for enhancing nurses’ psychological health.

Combined exposure of emotional labor and job insecurity on depressive symptoms among female call-center workers: A cross-sectional study

Call-center workers work under unfavorable psychosocial working conditions, including, emotional labor and job insecurity, which might be linked to depressive symptoms.The purpose of this study was to explore the link between emotional labor and depressive symptoms and to investigate the influence of combined exposure to emotional labor and job insecurity on depressive symptoms.A health survey was conducted among female call-center workers in Geumcheon-gu (a district in Seoul), South Korea, in November 2012. The short form of the Korean occupational stress scale was used to measure occupational stressors. A questionnaire with 8 items was employed to assess emotional labor. Depressive symptoms were estimated using the Korean Version of the Centre for Epidemiologic Studies Depression Scale (CES-D). The association of emotional labor and occupational stressors with depressive symptoms was assessed using multilevel mixed-effects logistic regression.Overall, 699 female call-center workers were enrolled into this study. The odds ratios of experiencing depressive symptoms in workers exposed to emotional labor and job insecurity were 5.45 (95% confidence interval [CI]: 3.38-8.80) and 2.37 (95% CI: 0.86-6.50), respectively. When workers were simultaneously exposed to excessive emotional labor and high job insecurity levels, the odds ratio of experiencing depressive symptoms was 10.13 (95% CI: 3.51-29.23). The Relative Excess Risk due to the Interaction (RERI) of job insecurity and emotional labor was 3.30 (95% CI: -5.50 to 12.11); however, this was not statistically significant (P = .46).Although a causal relationship could not be established due to the cross-sectional study design, the combined effect of emotional labor and job insecurity might have a serious influence on behavioral health among call-center female workers.

The role of customer service manual on workplace emotional burden in nationwide cross sectional study

BACKGROUND

We aim to discuss the overall effect of customer service manual (CSM) on service industry workers using Korean Working Condition Survey.

METHODS

Out of 50,007 total survey participants, 11,946 customer service workers were included in the current study (5613 men, 6333 women). Answers to survey questions were used to define the use of CSM, emotional burden, emotional dissonance, engaging angry customers and other covariates. Emotional burden included either depressive event or stress level. Odds ratio (OR) with 95% confidence interval (95% CI) of experiencing emotional burden was calculated by logistic regression model. Interaction effect between CSM and engaging angry customer on emotional burden was also estimated.

RESULTS

Out of 11,946 subjects, total of 3279 (27.4%) have experienced emotional burden. OR (95% CI) of experiencing emotional burden was 1.40 (1.19-1.64) in men and 1.25 (1.09-1.44) in women. There was gender difference in interaction effect between the use of CSM and engaging angry customers. In men, OR (95% CI) was 3.16 (1.38-7.23) with additive effect when always engaging angry customers with CSM compared to rarely engaging without CSM, while in women OR (95% CI) was 8.85 (3.96-19.75) with synergistic effect. Moreover, the risk of depressive event increased only in women with OR (95% CI) 2.22 (1.42-3.48).

CONCLUSIONS

Our current study highlighted association between emotional burden and CSM in both men and women service workers. Furthermore, women were affected more severely by CSM. The results from current study suggest that CSM should be changed appropriately to benefit workers.

Stress, anxiety and depression in clinical nurses in Vietnam: a cross-sectional survey and cluster analysis

Background

Hospital nurses are exposed to various work-related factors that may be associated with increased risk of developing different mental disorders. Empirical evidence on the prevalence and correlates of individual mental health problems such as stress, anxiety and depression is widely reported, while a combined pattern of these conditions is unknown. This study aims to examine the co-occurrence of stress, anxiety and depression among clinical nurses, and to explore socio-demographic characteristics of, and working conditions experienced by, nurses that may be associated with these three mental health conditions.

Methods

A cross-sectional study was implemented in one tertiary hospital in Hanoi city, Vietnam, from May to September 2015. A self-reported questionnaire including a short version of the Depression, Anxiety and Stress scale 21 items and questions on demographic and work-related characteristics was delivered to 787 registered nurses. 600 completed questionnaires was used in the final analysis (76.2% response rate). The two-step clustering analysis was performed to identify sub groups. Chi square test and post hoc ANOVA analysis with Bonferroni correction were used to examine differences in psychological status, demographic characteristics and working conditions among the clusters (two-tailed p < 0.05).

Results

The prevalence of self-reported stress, anxiety and depression were 18.5%, 39.8% and 13.2%, respectively. 45.3% participants reported symptoms of at least one mental disorder, 7.3% had all three. Nurses in the first cluster (high prevalence of mental disorders), had high task demand and conflict at work with low job control and reward. The second cluster nurses (moderate percentage of mental strain) were significantly older and in marital relationship, high task demand and job control, and presence of chronic diseases. The lowest proportion of self-perceived mental disorders were observed in the cluster three who were younger and had fewer years of services, moderate task demand and low job control and better physical health in comparison with those in the other two clusters (p < 0.05).

Conclusions

Stress, anxiety and depression were prevalent among clinical nurses. Heterogeneity in demographic characteristics and working conditions were observed across clusters with different patterns of mental disorders. Institutional effort should be emphasized to support nurses in their career development to reduce psychological strains.

Electronic supplementary material

The online version of this article (10.1186/s13033-018-0257-4) contains supplementary material, which is available to authorized users.

The association between workplace violence and physicians' and nurses' job satisfaction in Macau

Background

This paper describes the association between workplace violence and job satisfaction among physicians and nurses in Macau. Convenience sampling was sourced from six health centers under the Macau Health Bureau.

Methods

This study uses a cross-sectional self-administrative survey. The study used case studies research instruments for workplace violence in the health sector by country (from the ILO, ICN, WHO, PSI), the Minnesota Satisfaction Questionnaire and Perceived Stress Scale. The data collection period spanned from August to December, 2014.

Data analysis

Multiple logistic regression examines levels of intrinsic and extrinsic satisfaction in physicians and nurses and significant correlates affecting their job satisfaction.

Results

A total of 720 (14.9% physicians) participants were recruited. 57.2% of participants reported physical and psychological workplace violence in the preceding year. The most common forms of workplace violence were verbal abuse (53.4%), physical assault (16.1%), bullying / harassment (14.2%), sexual harassment (4.6%) and racial harassment (2.6%). Nurses were at a significantly higher risk of physical assault and verbal abuse compared to physicians. Patients, patients’ relatives, and colleagues were the main perpetrators. Worry about WPV, on-call duty and shift work, experience of bullying and verbal abuse and employment sector emerged as significant correlates affecting the intrinsic and extrinsic job satisfaction of physicians and nurses. Frontline staff, aged 30 and 39, coming from an ethnic minority, and perceived stress were significant correlates affecting nurses’ job satisfaction.

Conclusions

WPV remains a significant concern in healthcare settings in Macau. Stakeholders should legally enforce a zero-tolerance policy towards WPV within healthcare workplaces. WPV is detrimental to healthcare professionals’ mental wellbeing, risking irreversible physical and psychological harm for its victims.

The Relationship between Emotional Labor and Job Stress among Hospital Workers

BACKGROUND

We divided hospital workers into two groups according to whether one was an interpersonal service worker (ISW) or was not (non-ISW). We then explored differences between these groups in job stress and emotional labor type and investigated the mediating factors influencing their relationships.

METHODS

Our participants included both ISW (n = 353) and non-ISW (n = 71) hospital workers. We administered the Korean Standard Occupational Stress Scale Short Form to measure job stress and the Emotional Labor Scale to indicate both emotional labor type and characteristics. We also administered the Beck Depression Inventory-II to indicate the mediating factors of depressive symptoms, the Beck Anxiety Inventory to indicate the mediating factors of anxiety, and the State Anger Subscale of the State-Trait Anger Expression inventory to indicate the mediating factors of anger.

RESULTS

The ISW group showed more severe job stress than the non-ISW group over a significantly longer duration, with greater intensity, and with higher level of surface acting. The ISW group showed a significant positive correlation between surface acting and job stress and no significant correlation between deep acting and job stress. Parallel mediation analysis showed that for ISWs surface acting was directly related to increased job stress, indirectly related to depression, and unrelated to anxiety and anger.

CONCLUSION

The ISW group displayed more surface acting and job stress in its emotional labor than the non-ISW group. In the ISW group, surface acting during emotional labor was positively correlated with job stress. Depression partially mediated their relationship.

Emotional Distress as a Predictor of Work-Related Musculoskeletal Disorders in Malaysian Nursing Professionals

BACKGROUND

Emotional distress is becoming a great concern and is more common in both developed and developing countries. It is associated with several disease conditions.

OBJECTIVE

To determine the prevalence of self-perceived emotional distress and its relation to work-related musculoskeletal disorders (WRMSDs) in nurses.

METHODS

A self-administered questionnaire survey was carried out on 660 female nurses working in public hospitals in the Klang Valley, Malaysia. The validated Malay version of the standardized Nordic musculoskeletal questionnaire (M-SNMQ) was used to identify the annual prevalence of WRMSDs; perceived emotional distress was assessed using the validated Malay short version, depression, anxiety, and stress (M-DASS) instrument. In addition, socio-demographic and occupational profiles of the participants were considered. Factors associated with WRMSDs were identified using logistic regression analysis.

RESULTS

A total of 376 nurses completed the survey (response rate 83.3%). 73.1% of the nursing staffs experienced WRMSDs in at least one anatomical site 12 months prior to the study. 75% of nurses expressed emotional distress. Of these, over half also reported anxiety and stress. Multiple logistic regression analysis showed that stress and anxiety significantly increased the risk of WRMSDs by approximately twofold.

CONCLUSION

There were significant associations between emotional distress and WRMSDs. Future longitudinal studies are therefore needed to investigate and identify the sources of emotional distress (non-occupational and occupational) to be used to establish preventive strategies to reduce the risk of WRMSDs.

Emotional labor, workplace violence, and depressive symptoms in female Bank employees: a questionnaire survey using the K-ELS and K-WVS

Background

In modern society, the scale of the service industry is continuously expanding, and the number of service workers is increasing. Correspondingly, physical and mental problems related to emotional labor are becoming a major social problem. In this study, we investigated the relationship between emotional labor, workplace violence, and depressive symptoms in female bank employees, which is a typical service industry.

Methods

In this study, the Korean Emotional Labor Scale (K-ELS) and Korean Workplace Violence Scale (K-WVS) were distributed to 381 female workers in their 20s at a bank in Seoul, Korea. Data were obtained from 289 subjects (75.9%) and analyzed for 278 respondents, after excluding those with missing responses. We examined the relationship between emotional labor, workplace violence, and depressive symptoms, using multiple logistic regression analysis.

Results

Among 278 subjects, 27 workers (9.7%) had depressive symptoms. “Emotional disharmony and hurt” (OR 2.93, 95% CI = 1.17–7.36) and “Organizational surveillance and monitoring” (OR 3.18, 95% CI = 1.29–7.86) showed a significant association with depressive symptoms. For workplace violence, the “Experience of psychological and sexual violence from supervisors and coworkers” (OR 4.07, 95% CI = 1.58–10.50) showed a significant association. When the number of high-risk emotional labor-related factors was 1 or more, 13.1% showed depressive symptoms. When the number of high-risk workplace violence-related factors was 1 or more, 14.4% had statistically significant depressive symptoms.

Conclusions

A significant result was found for depressive symptoms related to Emotional disharmony, which is a sub-topic of emotional labor, and those at high risk for “Organizational surveillance and monitoring.” For workplace violence, depressive symptoms were high for the group at high risk for the “experience of psychological and sexual violence from supervisors and coworkers.” In this way, management of emotional disharmony, a sub-factor of emotional labor, is necessary, and improvements to traditional corporate culture that monitors emotional labor is necessary. Violence from colleagues and supervisors in the workplace must also be reduced.

IRB Approval No. SCHUH 2017–01-029. Registered 26 January 2017. Retrospectively registered.

Electronic supplementary material

The online version of this article (10.1186/s40557-018-0229-9) contains supplementary material, which is available to authorized users.

Predicting Factors of Depression and Anxiety in Mental Health Nurses: A Quantitative Cross-Sectional Study

INTRODUCTION

The nursing profession is characterized as one of the most stressful and emotional dementing professions. It is widely agreed that many nurses are experiencing anxiety and depression as a results of their profession.

PURPOSE

The purpose of this study was to assess the prevalence and associated factors of depression and anxiety among mental health nurses working in public psychiatric hospitals, in order to identify independent predictors of mental health disorders risk.

MATERIAL AND METHODS

A descriptive, cross-sectional study was conducted in which 110 mental health nurses who were working in public psychiatric hospitals of Greece participated. The Patient Health Questionnaire-2 (PHQ-2) and the Generalized Anxiety Disorder-2 (GAD-2) questionnaire along with a sheet with basics demographic, social, and work characteristics, including gender, age, marital status, educational level, working experience in nursing, working position and shift, were used as instrument for data collection.

RESULTS

The mean age of the nurses was 42.64 years (SD = 5.87 years) and working experience in nursing 15.73 years (SD = 5.64 years). Most participants were women 64.5%, married 59.1% and nursing assistant 53.6%, while 48.2% of them held a higher education degree. A very large percentage found to be classified as depressed (52.7%) and anxious (48.2%) and factors that found to be associated were age, marital status and educational level (for depression and anxiety) and working experience (only for depression).

CONCLUSIONS

Mental health nurses are in high risk for developing psychiatric disorders such as depression and anxiety. Being single, divorced or widowed, older, with many years of experience and a higher education degree can be predicting factors associated with depression and anxiety in mental health nurses.

Job insecurity and depression among automobile sales workers: A longitudinal study in South Korea

BACKGROUND

Job insecurity, the subjective perception of fear due to uncertainty about job continuity, could have long-term health effects. We aimed to examine the effect of job insecurity on depression among automobile sales workers in South Korea.

METHODS

We analyzed data collected in 2007 and 2014 from a longitudinal cohort of 560 sales workers from an automobile company in South Korea. Change in job insecurity was classified into four groups: secure to secure; insecure to secure; secure to insecure; and insecure to insecure.

RESULTS

After adjusting for potential confounders, workers in the insecure to insecure group had a significantly higher likelihood of depression in 2014 than workers in the secure to secure group (OR: 2.74; 95%CI: 1.41, 5.31).

CONCLUSIONS

We found that chronic job insecurity may be a risk factor for developing depression among Korean automobile sales workers. This is the first longitudinal study examining the association between job insecurity and depression in South Korea.

Human service work, gender and antidepressant use: a nationwide register-based 19-year follow-up of 752 683 women and men

OBJECTIVES

To examine antidepressant use among male and female human service professionals.

METHODS

A random sample of individuals between 25 years and 54 years of age (n=752 683; 49.2% women; mean age 39.5 years). Information about each individual's filled antidepressant prescriptions from 1995 to 2014 was provided by the Social Insurance Institution. First, antidepressant use in five broad human service categories was compared with that in all other occupations grouped together, separately for men and women. Then, each of the 15 human service professions were compared with all other occupations from the same skill/education level (excluding other human services professions). Cox models were applied and the results are presented as HRs for antidepressant use with 95% CIs.

RESULTS

The hazard of antidepressant use was higher among men working in human service versus all other occupations with the same skill/occupational level (1.22, 95% CI 1.18 to 1.27), but this was not the case for women (0.99, 95% CI 0.98 to 1.01). The risks differed between professions: male health and social care professionals (including medical doctors, nurses, practical nurses and home care assistants), social workers, childcare workers, teachers and psychologists had a higher risk of antidepressant use than men in non-human service occupations, whereas customer clerks had a lower risk.

CONCLUSIONS

Male human service professionals had a higher risk of antidepressant use than men working in non-human service occupations. Gendered sociocultural norms and values related to specific occupations as well as occupational selection may be the cause of the elevated risk.

Binge eating disorder and depressive symptoms among females of child-bearing age: the Korea Nurses' Health Study

BACKGROUND

Most studies regarding the relationship between binge eating disorder (BED) and depression have targeted obese populations. However, nurses, particularly female nurses, are one of the vocations that face these issues due to various reasons including high stress and shift work. This study investigated the prevalence of BED and the correlation between BED and severity of self-reported depressive symptoms among female nurses in South Korea.

METHODS

Participants were 7,267 female nurses, of which 502 had symptoms of BED. Using the propensity score matching (PSM) technique, 502 nurses with BED and 502 without BED were included in the analyses. Data were analyzed using descriptive statistics, Spearman's correlation, and multivariable ordinal logistic regression analysis.

RESULTS

The proportion of binge eating disorder was 6.90% among the nurses, and 81.3% of nurses displayed some levels of depressive symptoms. Multivariable ordinal logistic regression analysis revealed that age (40 years old and older), alcohol consumption (frequent drinkers), self-rated health, sleep problems, and stress were associated with self-reported depression symptoms. Overall, after adjusting for confounders, nurses with BED had 1.80 times the risk (95% CI = [1.41-2.30]; p-value < 0.001) of experiencing a greater severity of self-reported depression symptoms.

CONCLUSIONS

Korean female nurse showed a higher prevalence of both binge eating disorder and depressive symptoms, and the association between the two factors was proven in the study. Therefore, hospital management and health policy makers should be alarmed and agreed on both examining nurses on such problems and providing organized and systematic assistance.

Depressive Symptom and Related Factors: A Cross-Sectional Study of Korean Female Workers Working at Traditional Markets

Background: Depression is one of the psychiatric diseases with a high prevalence rate, globally, and reportedly more prevalent among women than among men. Especially, women workers working at traditional markets are in depressive conditions without occupational health services. The purpose of this study is to investigate factors having a significant effect on the depressive symptoms of women workers at traditional markets in South Korea. Methods: A cross-sectional study was used and subjects for the present study were 500 female workers in three selected representative traditional marketplaces in South Korea. Results: The results of hierarchical regression analysis indicated that increased BMI (β = 0.297, p = 0.017), poor nutritional status (β = 0.596, p < 0.001), street vendor status (β = 2.589, p = 0.001), job stress (β = 0.491, p < 0.001), lower back pain (β = 0.377, p = 0.011), lower self-efficacy (β = −0.368, p = 0.002) and diminished family function (β = −0.633, p = 0.001) affected workers’ depressive symptoms. The explanatory power of these variables was 38.5%. Conclusions: Based on these results, future research should focus on incorporating theses significant factors into effective interventions designed to decrease depressive symptoms in this population. Moreover, this study will increase interest in occupational health nursing, particularly in relation to vulnerable social groups, and expand the scope of practice in the field.

Psychological symptoms among hospital nurses in Taiwan: a cross sectional study

Background

A considerable number of studies have identified the risk factors attributable to job-related stress among nurses. However, studies investigating psychological symptoms among hospital nurses is still lacking, especially in Taiwan, where the average patient to nurse ratio is among the highest in the world. This study aimed to investigate the potential role of self-rated health status, self-reported diseases, and utilization of occupational health checks in psychological symptoms among Taiwanese nurses.

Methods

A cross-sectional design was conducted from September through December 2013. Data were collected through online self-administered questionnaire among 697 registered nurses in seven regional hospitals governed by the Taipei City Government.

Results

Nurses with fair or poor self-rated health, lower education, <30 years of age, and low back pain were more likely to suffer from psychological symptoms. A trend toward significance was also noticed for those aged 30–39. Importantly, low back pain was the most common disease among nurses in self-reported diseases and half of the nurses reported not utilizing the occupational health examination for the last 5 years.

Conclusions

To alleviate or prevent the psychological symptoms, psychosocial support, and awareness program on prevention of occupational injuries should be offered to nurses younger than 39 years old and having lower educational levels. Moreover, underutilization of occupational health examination among nurses deserves more attention.

Electronic supplementary material

The online version of this article (doi: 10.1186/s12905-017-0460-5) contains supplementary material, which is available to authorized users.

The associations between religion, bereavement and depression among Hong Kong nurses

Background

This paper is to examine the associations between religion, bereavement and depression among nursing professionals using a cross-sectional survey design. There is little empirical evidence in Asia suggesting that religion may either increase or lower the likelihood of nursing professionals being depressed.

Methods

We analyzed the results of a Mental Health Survey soliciting data from 850 Hong Kong nurses (aged 21–59, 178 males) regarding their mental well-being and associated factors, including participants’ socio-economic profile and recent life-events. Multiple linear regression analyses examined associations between religion, bereavement and depression.

Results

Religious faith is weakly associated with lower self-reported depression in bereavement.

Conclusions

Our findings confirm those studies suggesting that religion positively affects mental health and yet healthcare providers have yet to assimilate this insight.

Predictors of depressive symptoms among nurses of intensive care unit

Abstract Objectives: To identify the prevalence and analyze the existence of predictive factors of depressive symptomatology among nurses from intensive care unit. Methods: A quantitative, descriptive, cross-sectional study was performed with 91 intensive care nurses. Two instruments were used for data collection performed in July 2014: a sociodemographic questionnaire and the Beck Depression Inventory (version I). Fisher's exact test was used to analyze the existence of associations between depressive symptomatology and categorical variables. Results: Eleven percent of the sample presented with depressive symptomatology. Of the variables studied, none was significantly associated with depressive symptomatology (p-value ≥ 0.05). Conclusion: The prevalence of depressive symptomatology corresponded to 11%. None of the variables showed a significant association with depressive symptomatology.

Nursing Staff Members Mental's Health and Factors Associated with the Work Process: An Integrative Review

BACKGROUND

The mental health of nursing staff members influences the work process outcomes.

OBJECTIVE

Identify the work related factors that harms the nursing team's mental health.

METHODS

Databases PubMed, Scopus, CINAHL and MEDLINE, by mating between the indexed descriptors in MeSH terms "mental health" and "occupational health nursing". 783 articles were rescued to give a final sample of 18 articles. Integrative review in order to identify factors associated with the work process of the nursing staff that negatively affects mental health.

RESULTS

The main associated factors were work demands, psychological demands, violence, aggression, poor relationships with administrators, accidents involving the risk of exposure to HIV, stress and errors in the execution of labor activities. The main findings regarding the nursing staff's mental health were post-traumatic stress disorder, depression, stress, major depressive episode and generalized anxiety disorder.

CONCLUSION

Occupational nurses need to understand the complexities of mental health problems and substance use among nursing staff members to recognize, identify and care for workers at risk and offer adequate mental health care. Although the researches interests in this theme have increased, proving that all these factors contribute to the risk to mental health of nursing professionals, the protective measures and care are being neglected by managers in both private and public network . The health of nursing workers in question here is one more challenge for a profession that takes care of others in need, therefore, requires some caring with their own health.

Emotional Labor: Links to Depression and Work-Related Musculoskeletal Disorders in Call Center Workers

Little evidence links emotional labor to either psychological or physical health. This study determined whether the two types of emotional labor (i.e., surface vs. deep acting) were significantly associated with depressive symptoms and work-related musculoskeletal disorders in call center workers. A cross-sectional study was conducted with 274 workers recruited from a call center in Seoul, South Korea. In adjusted regression models, levels of surface, but not deep, acting were significantly and positively associated with depressive symptoms. Higher surface acting levels were significantly and positively associated with low back pain; higher deep acting levels were significantly and inversely associated with low back pain. Study findings could inform occupational health nurses as they delineate differentiated strategies, according to the nature of surface and deep acting, to promote psychological and physical health in call center workers.

'Mental health day' sickness absence amongst nurses and midwives: workplace, workforce, psychosocial and health characteristics

AIM

To examine the workforce, workplace, psychosocial and health characteristics of nurses and midwives in relation to their reported use of sickness absence described as 'mental health days'.

BACKGROUND

The occupational stress associated with the nursing profession is increasingly recognized and nurse/midwifery absenteeism is a significant global problem. Taking a 'mental health day' as sickness absence is a common phenomenon in Australian health care. No previous studies have empirically explored the characteristics of nurses and midwives using such sickness absence.

DESIGN

Online cross-sectional survey.

METHODS

Survey comprising validated tools and questions on workplace and health characteristics was distributed to nurses and midwives in New South Wales, Australia, between May 2014 - February 2015. Sample characteristics were reported using descriptive statistics. Factors independently predictive of 'mental health day' reportage were determined using logistic regression.

RESULTS

Fifty-four percentage of the n = 5041 nurse and midwife respondents took 'mental health days'. Those affected were significantly more likely to be at younger ages, working shifts with less time sitting at work; to report workplace abuse and plans to leave; having been admitted to hospital in previous 12 months; to be current smokers; to report mental health problems, accomplishing less due to emotional problems and current psychotropic medication use.

CONCLUSION

Specific characteristics of nurses and midwives who report taking 'mental health day' sickness absence offer healthcare administrators and managers opportunities for early identification and intervention with workplace measures and support frameworks to promote well-being, health promotion and safety.

Facing Complaining Customer and Suppressed Emotion at Worksite Related to Sleep Disturbance in Korea

This study aimed to investigate the effect of facing complaining customer and suppressed emotion at worksite on sleep disturbance among working population. We enrolled 13,066 paid workers (male = 6,839, female = 6,227, age < 65 years) in the 3rd Korean Working Condition Survey (2011). The odds ratio (OR) and 95% confidence intervals (CI) for sleep disturbance occurrence were calculated using multiple logistic regression models. Among workers in working environments where they always engage complaining customers had a significantly higher risk for sleep disturbance than rarely group (The OR [95% CI]; 5.46 [3.43-8.68] in male, 5.59 [3.30-9.46] in female workers). The OR (95% CI) for sleep disturbance was 1.78 (1.16-2.73) and 1.63 (1.02-2.63), for the male and female groups always suppressing their emotions at the workplace compared with those rarely group. Compared to those who both rarely engaged complaining customers and rarely suppressed their emotions at work, the OR (CI) for sleep disturbance was 9.66 (4.34-20.80) and 10.17 (4.46-22.07), for men and women always exposed to both factors. Sleep disturbance was affected by interactions of both emotional demands (engaging complaining customers and suppressing emotions at the workplace). The level of emotional demand, including engaging complaining customers and suppressing emotions at the workplace is significantly associated with sleep disturbance among Korean working population.

Depression in Registered Nurses: A State of the Science

Registered nurses suffer from depression at almost twice the rate of individuals in other professions. Major depression affects both employees and organizations. Depression is linked to increases in work absenteeism, short-term disability, and decreased productivity and presenteeism. Depression experienced by registered nurses may not be fully preventable, but realizing its presence and prevalence in the workplace is of vital importance. It is essential that we have a healthy, vibrant, and present registered nurse workforce to ensure that quality patient outcomes are achieved. This review of 36 articles assesses the current state of the science related to depression in registered nurses so that occupational health nurses can create pathways and work environments for better mental health for registered nurses.

Concealing Emotions at Work Is Associated with Allergic Rhinitis in Korea

Concealing emotions at work can cause considerable psychological stress. While there is extensive research on the adverse health effects of concealing emotions and the association between allergic diseases and stress, research has not yet investigated whether concealing emotions at work is associated with allergic rhinitis. Allergic rhinitis is a common disease in many industrialized countries, and its prevalence is increasing. Thus, our aim was to determine the strength of this association using data from three years (2007-2009) of the 4th Korean National Health and Nutrition Examination Survey. Participants (aged 20-64) were 8,345 individuals who were economically active and who had completed the questionnaire items on concealing emotions at work. Odds ratio (OR) and 95% confidence intervals (95% CIs) were calculated for allergic rhinitis using logistic regression models. Among all participants, 3,140 subjects (37.6%) reported concealing their emotions at work: 1,661 men and 1,479 women. The OR (95% CIs) for allergic rhinitis among those who concealed emotions at work versus those who did not was 1.318 (1.148-1.512). Stratified by sex, the OR (95% CIs) was 1.307 (1.078-1.585) among men and 1.346 (1.105-1.639) among women. Thus, individuals who concealed their emotions at work were significantly more likely to have a diagnosis of AR in comparison to those who did not. Because concealing emotions at work has adverse health effects, labor policies that aim to reduce this practice are needed.

Does High Emotional Demand with Low Job Control Relate to Suicidal Ideation among Service and Sales Workers in Korea?

We examined the relationship of high emotional demands and low job control to suicidal ideation among service and sales workers in Korea. A total of 1,995 service and sales workers participated in this study. Suicidal ideation and level of emotional demand and job control were assessed by self-reported questionnaire in 4th Korean National Health and Nutrition Examination Survey. Gender-specific odds ratio (OR) and 95% confidence intervals (95% CI) for suicidal ideation were calculated using logistic regression analysis. The results show that workers who suffered from high emotional demands (OR, 2.07; 95% CI, 1.24-3.45 in men, OR, 1.97; 95% CI, 1.42-2.75 in women) or low job control (OR, 1.96; 95% CI, 1.42-2.75 in men, OR, 1.33; 95% CI, 0.91-1.93 in women) were more likely to experience suicidal ideation after controlling for age, household income, and employment characteristics. The interaction model of emotional demands and job control revealed that workers with high emotional demands and high job control (OR, 1.93; 95% CI, 1.08-3.45 in men, OR, 1.60; 95% CI,1.06-2.42 in women) and high emotional demands and low job control (OR; 4.60, 95% CI;1.88-11.29 in men, OR; 2.78, 95% CI;1.64-4.44 in women) had a higher risk for suicidal ideation compared to those with low emotional demands and high job control after controlling for age, household income, employment characteristics, smoking, alcohol drinking and physical activity habit. These results suggest that high emotional demands in both genders and low job control in men might play a crucial role in developing suicidal ideation among sales and service workers in Korea.

RN-BS Students' Reports of Their Self-Care and Health-Promotion Practices in a Holistic Nursing Course

PURPOSE

This study explored RN-BS students' self-care and health-promotion (SCHP) practices in a semester-long holistic nursing course with emphasis on the utility of self-reflection through journal writing.

DESIGN

A qualitative single case study blended in practical action research.

METHOD

Fifteen RN-BS students enrolled in the holistic nursing course completed (a) three reflective journal entries (beginning, midterm, and conclusion); (b) two IHWA-short form surveys (beginning and conclusion); and (c) one demographic form (beginning) of the course.

FINDINGS

Three reflective journals indicated that students' understanding of their SCHP practices progressed from novice, to advanced, and finally to competent from the beginning, middle, and at the conclusion of the course. Four findings emerged in relation to reports of their SCHP practices: (a) new awareness of self, (b) application of SCHP practices knowledge, (c) role modeling, and (d) dedication to SCHP practices beyond the semester. Four findings emerged in relation to participation in the reflective journaling about reports of their SCHP practices: (a) self-discovery, (b) retrospective self-evaluation, (c) useful intervention for SCHP, and (d) beneficial learning tool in academic environment.

CONCLUSIONS

Reflective journaling enhanced students' SCHP practices and was recognized as useful instructional strategy to improve learning in the classroom.

Self-harm in nurses: prevalence and correlates

AIMS

The aim of this study was to examine the weighed prevalence of self-harm and its correlates among Hong Kong nurses.

BACKGROUND

Recent epidemiological data suggest that the weighted prevalence of past-year suicidality among Hong Kong nurses was found to be 14·9%. Deliberate self-harm was a significant correlate of suicidality. Nonetheless, there are few population-based studies exploring the prevalence of self-harm and its correlates among medical occupational groups in Asia.

DESIGN

The study uses a cross-sectional survey design.

METHOD

Data were collected in Hong Kong over a four-week period from October-November 2013. Statistical methods, including binary and multivariate logistic regression models, were used to examine the weighted prevalence of self-harm and its associated factors in nurses.

RESULTS

A total of 850 nurses participated in the study. Seventy-nine participants (9·3%) reported self-harm in the past year. Nurses aged between 25-44 were at especially high risk of self-harm. Female nurses reported self-harm more than male nurses. The most common forms of self-harm were self-cutting, striking oneself and poisoning oneself. Clinical experience, chronic illness, relationship crises with family members, a family history of self-harm, smoking, symptoms of stress and psychiatric disorder were significantly associated with nurses' self-harm. The positive correlation between psychiatric disorder and self-harm was confirmed.

CONCLUSIONS

There is a need for a raft of self-harm prevention strategies, including a continuous monitoring system in the healthcare setting detecting and managing the risks of self-harm in nurses as part of the ordinary provision for their well-being.

Job Stress and Job Satisfaction among Health-Care Workers of Endoscopy Units in Korea

Background/Aims:

The management of job-related stress among health-care workers is critical for the improvement of healthcare services; however, there is no existing research on endoscopy unit workers as a team. Korea has a unique health-care system for endoscopy unit workers. In this study, we aimed to estimate job stress and job satisfaction among health-care providers in endoscopy units in Korea.

Methods:

We performed a cross-sectional survey of health-care providers in the endoscopy units of three university-affiliated hospitals in Korea. We analyzed the job stress levels by using the Korean occupational stress scale, contributing factors, and job satisfaction.

Results:

Fifty-nine workers completed the self-administered questionnaires. The job stress scores for the endoscopy unit workers (46.39±7.81) were relatively lower compared to those of the national sample of Korean workers (51.23±8.83). Job stress differed across job positions, with nurses showing significantly higher levels of stress (48.92±7.97) compared to doctors (42.59±6.37). Job stress and job satisfaction were negatively correlated with each other (R²=0.340, p<0.001).

Conclusions:

An endoscopy unit is composed of a heterogeneous group of health-care professionals (i.e., nurses, fellows, and professors), and job stress and job satisfaction significantly differ according to job positions. Job demand, insufficient job control, and job insecurity are the most important stressors in the endoscopy unit.

Relationship Between Hiding Emotions and Health Outcomes Among South Korean Interactive Service Workers

The purpose of this study was to examine the relationships among hiding emotions, psychological well-being, and presenteeism for South Korean interactive service workers. This study is a secondary analysis of data extracted from the 2011 Korean Working Conditions Survey (KWCS), a longitudinal study conducted by the Korea Occupational Safety and Health Agency (KOSHA). For the present analysis, 15,669 workers who interacted with others at work were selected. Based on existing literature, a set of variables was chosen from the KWCS. Psychological well-being was measured using the World Health Organization (WHO)-5 Well-Being Index. The results indicated that frequently hiding feelings is related to presenteeism. Also, among workers who hide emotions at work, an inverse relationship was found between the degree to which these workers hide their feelings and their psychological well-being. Based on these results, the researchers offered practical suggestions to assist interactive service workers adjust to duties that require emotion management.

Depression, Anxiety and Symptoms of Stress among Hong Kong Nurses: A Cross-sectional Study

Recent epidemiological data suggests 13.3% of Hong Kong residents suffered from Common Mental Disorders, most frequently mixed anxiety and depressive disorder. This study examines the weighted prevalence and associated risk factors of depression, anxiety and stress among Hong Kong nurses. A total of 850 nurses were invited to participate in this cross-sectional study. Participants completed the Depression, Anxiety and Stress Scale 21 and multiple logistic regression was used to determine significant relationships between variables. Chronic past-year illness and poor self-perceived mental health were significant correlates of past-week depression, anxiety and stress. It confirmed further positive correlations between depression and divorce, widowhood and separation, job dissatisfaction, disturbance with colleagues, low physical activity levels and sleep problems. Marital status; general medicine; sleep problems, and a lack of leisure significantly correlated with anxiety. Stress was significantly associated with younger age, clinical inexperience, past-year disturbance with colleagues, low physical activity, no leisure and drinking alcohol. Nurses were more depressed, anxious and stressed than the local general population, with over one-third of our respondents classified as subject to these disorders.

Relationships of job demand, job control, and social support on intention to leave and depressive symptoms in Japanese nurses

This study aims to elucidate the relationships among the factors of the demand-control-support model (DCS) on the intention to leave a hospital job and depressive symptoms. Participants included 1,063 nurses. Job demand, job control, and support from supervisors were found to be significantly related to both the intention to leave and depressive symptoms. Based on the odds ratios per 1 SD change in the DCS factors, low support from supervisors was found to be most related to the intention to leave, and low job control was found to be most related to depressive symptoms. In models that did not include "job demand" as an independent variable, 60-h working weeks were found to have a significantly higher odds ratio for depressive symptoms. Support from supervisors is more important in preventing intention to leave and depressive symptoms among nurses than is support from co-workers. Improving job control and avoiding long working hours may be important to prevent depressive symptoms.

Relationship between Long Working Hours and Suicidal Thoughts: Nationwide Data from the 4th and 5th Korean National Health and Nutrition Examination Survey

Background

Long working hours are a worldwide problem and may increase the risk of various health issues. However, the health effects of long working hours on suicidal thoughts have not been frequently studied. Our goal was to investigate the relationship between long working hours and suicidal thoughts in the rapidly developing country of Korea.

Methods

Data from 12,076 participants (7,164 men, 4,912 women) from the 4^th and 5^th Korean National Health and Nutrition Examination Surveys were used for the current analysis. Multivariate logistic regression models were used to estimate odds ratios and 95% confidence intervals for suicidal thoughts. Combined effects of long working hours and lower socioeconomic status or sleep disturbance were also estimated.

Results

Compared to groups who worked less than 52 hours per week, odds ratios (95% confidence intervals) for suicidal thoughts in groups who worked 60 hours or more per week were 1.36 (1.09–1.70) for males and 1.38 (1.11–1.72) for females, even after controlling for household income, marital status, history of hypertension or diabetes mellitus, health-related behaviors, and past two weeks’ experience of injury, intoxication, or acute or chronic diseases, as well as type of work. The combined effects of long working hours with lower socioeconomic status, or with sleep disturbance, were also significantly higher compared to participants who worked less than 52 hours per week with higher socioeconomic status, or with 6–8 hours of nighttime sleep.

Conclusion

In this study, long working hours were linked to suicidal thoughts for both genders. Additionally, the odds of those suicidal thoughts were higher for lower socioeconomic groups. To prevent adverse psychological health problems such as suicidal thoughts, a strategy regarding long working hours should be investigated.

Relationship between occupational stress and depression among psychiatric nurses in Japan

Psychiatric nursing is a stressful area of nursing practice. The purpose of this study was to examine occupational stress among psychiatric nurses in Japan. In this cross-sectional study, 238 psychiatric nurses were recruited from 7 hospitals. Data regarding the Generic Job Stress Questionnaire (GJSQ), the Center for Epidemiologic Studies for Depression Scale (CES-D), and the Health Practice Index (HPI) were obtained via self-report questionnaires. After adjusting for all the variables, CES-D scores were associated with job stress, but social support reduced the effect of stress on depression among psychiatric nurses. However, the interpretation of these results was hampered by the lack of data concerning important occupational factors, such as working position, personal income, and working hours. Further longitudinal investigation into the factors associated with depression may yield useful information for administrative and psychological interventions.

A survey of student nurses' attitudes toward help seeking for stress

BACKGROUND

Globally, stress in student nurses may have serious implications for health, absenteeism, and attrition. Despite this, there is scant research on student nurses' attitudes toward help seeking.

OBJECTIVES

To examine student nurses' attitudes toward stress and help-seeking.

DESIGN METHODS AND STATISTICAL ANALYSIS

A cross-sectional questionnaire survey design was employed to gather data from 219 student nurses at two large U.K. universities. Two-sample chi-square tests and Fisher's exact tests were used to analyze categorical associations between responses.

RESULTS

Most had experienced stress before, believed the incidence within the profession was high, and would disclose their own stress to family/friends rather than to colleagues or professional institutions. The most popular outpatient treatment choice was social support; few would choose formal advice. The most common factor influencing inpatient treatment choice was confidentiality; for many, this factor would also lead them to seek distant rather than local inpatient care. Encouragingly, most would not lose confidence in a stressed colleague.

CONCLUSIONS

Negative attitudes toward stress and help seeking may be entrenched even before training and may have a marked influence on how/whether students seek help. Nurse employers and educators should foster more supportive and accepting attitudes toward stress in order to tackle its unwanted consequences.