Mental health shame, self-compassion and sleep in UK nursing students: Complete mediation of self-compassion in sleep and mental health

Exploring the moderating role of health-promoting behaviours and self-compassion on the relationship between clinical decision-making and nurses' well-being

Background

Clinical decision-making is an essential part of the nursing role and has implications for both patient care and nurses' well-being.

Aim

This study aimed to explore the relationship between nurses' perceptions of clinical decision-making ability and moral distress across a nursing population, and the potential link to self-compassion and health-promoting behaviours.

Methods

A self-report questionnaire was distributed to a sample of nurses (N = 152) from April to September 2022. The survey explored nurses' perceptions of clinical decision-making ability, moral distress, physical activity, grazing, stress-eating, burnout and self-compassion.

Results

Perceived clinical decision-making ability was associated with moral distress experience, and both self-compassion and grazing moderated this relationship, independently.

Conclusion

Findings highlight the link between nurses' perceptions of clinical decision-making ability and moral distress experience. Both eating behaviours and self-compassion influence the relationship between these two factors and identify potential areas that may support (and hinder) nurses' well-being through clinical decision-making. These findings reinforce the importance of healthy eating habits and being self-compassionate to prevent moral distress arising as a result of clinical decision-making.

Effects of metacognitions, self-compassion, and difficulties in emotion regulation on psychological resilience in oncology nurses

PURPOSE

Providing care to individuals with cancer requires oncology nurses to have superior skills related to physical care and adaptation to the changing healthcare system, as well as witnessing and supporting the psychosocial difficulties experienced by patients and families in this process. It requires oncology nurses to be psychologically resilient. Therefore, it is crucial to determine the factors affecting the psychological resilience of oncology nurses. This study aimed to determine the effect of self-compassion, metacognitions, and difficulties in emotion regulation on psychological resilience in oncology nurses.

METHODS

This is a cross-sectional correlational study. The study was conducted with 121 oncology nurses providing active oncologic care and who volunteered to participate. The Difficulties in Emotion Regulation Scale-Short Form, the Self-Compassion Scale, and the Metacognitions Questionnaire-30 were used to collect data. Data were analyzed using descriptive statistics, Pearson correlation coefficient, and multiple linear regression analysis.

RESULTS

The regression model established to determine the effect of self-compassion, metacognitions, and difficulties in emotion regulation on psychological resilience was statistically significant (F(3,117) = 24.086 p < 0.001) and explained 36.6% of the change in resilience. Among the independent variables, only self-compassion had a significant contribution to the model (p = 0.001). According to the model, 1-unit change in self-compassion caused 0.571-unit change in psychological resilience.

CONCLUSION

Self-compassion, metacognitions, and difficulties in emotion regulation were significantly related to psychological resilience, but only self-compassion significantly affected psychological resilience.

Gender difference in emotional distress among nursing and health science college students: An online survey

This cross-sectional study investigates the self-reported emotional distress of medical, nursing, dental, pharmacy, and public health students and identifies gender-related differences through an online survey. The data of 364 students were analyzed using Pearson correlation coefficients and multiple logistic regression. Emotional distress was more prevalent among female respondents (11.7 %) than male (3.8 %) respondents. The stigma, isolation, and depression experienced by female respondents influenced their emotional distress, whereas only the depression of male respondents influenced their emotional distress. Our findings suggest that mental health professionals should consider gender-specific factors when developing interventions for the study population to minimize emotional distress.

Comparing the Mental Health of Healthcare Students: Mental Health Shame and Self-compassion in Counselling, Occupational Therapy, Nursing and Social Work Students

Poor mental health of healthcare students is a cause for concern in many universities. Though previous research has identified mental health shame and self-compassion as critical in this student group, how these variables differ across different healthcare disciplines remains to be evaluated. Healthcare students (n = 344; counselling, occupational therapy, social work and nursing) completed measures regarding these variables. MANOVA and regression analyses were performed. (1) Counselling and nursing students were more depressed than occupational therapy students; (2) nursing students were more anxious than occupational therapy and social work students; (3) occupational therapy students had more positive attitudes towards mental health than the others; and (4) nursing students worried about their own reputation associated with their family more than counselling students. Self-compassion was the strongest predictor of mental health in all groups; however, the effect sizes varied: largest in nursing and smallest in social work students. Findings will help inform effective interventions for students in each healthcare discipline.

Effects of Online Mental Health Classes on Mental Health and Stigma: a Controlled Before-After Study with 1-Month Follow-Up

Though the importance of mental health education has been emphasised, how learning about mental health helps the learners’ mental health remains to be evaluated. Accordingly, this study aimed to appraise the mental health effects of online mental health classes in a controlled before-after study with a 1-month follow-up. The Depression, Anxiety and Stress Scale-21 and Depression Stigma Scale were completed by 16 students in a mental health class and 12 in a non-mental health class. While there was no significant difference in depression, anxiety and stress, between groups (type of class) and within groups (assessment points), the levels of stigma were significantly lower in mental health students than non-mental health students at post-semester (p = .004). Findings illustrate temporal effectiveness of mental health classes on stigma; however, continuous education is needed to maintain the effects. Educators in mental health are recommended to design a long-term plan to support learners’ mental health.

Mental Well-Being of Czech University Students: Academic Motivation, Self-Compassion, and Self-Criticism

University students in the Czech Republic suffer from a low level of mental well-being. Research in other university student populations suggests that academic motivation, self-compassion, and self-criticism are strongly related to mental well-being. Students who are motivated to study, are kind toward themselves, and are less judgmental of themselves tend to have a high level of mental well-being. These relationships had not been evaluated in Czech students. Accordingly, this cross-sectional study aimed to evaluate the relationships between mental well-being, academic motivation (intrinsic motivation, extrinsic motivation, and amotivation), self-compassion (self-reassurance) and self-criticism (self-inadequacy and self-hate). Of 130 students approached, a convenience sampling of 119 psychology students at a university in the Czech Republic completed a survey regarding these constructs. Correlation, regression, and path analyses were conducted. Mental well-being was positively associated with intrinsic motivation and self-compassion, and negatively associated with amotivation and self-criticism. Self-compassion was identified as the strongest predictor of mental well-being. Lastly, intrinsic motivation mediated the pathway from self-compassion to mental well-being, but not the one from self-inadequacy to mental well-being, and the one from self-hate to mental well-being. Our findings can help educators to identify effective means to protect students' mental well-being. Cultivating students' self-compassion may be helpful to protect their mental well-being. University staff and educators in the Czech Republic need to consider ways to embed self-compassion training into their students' programmes or university life.

Effects of Shinrin-Yoku Retreat on Mental Health: a Pilot Study in Fukushima, Japan

Shinrin-yoku (forest bathing) is a cost-effective healing practice that has recently attracted the interest of social scientists who have attributed it, in part, to mental health benefits. Japanese university students suffer from high rates of mental health problems, and the number of suicides remains high despite the total number of suicides in Japan decreasing. Effective mental health approaches which increase mental wellbeing and self-compassion, and reduce associated deficits, such as loneliness, are sought after for Japanese students; however, healthful treatment has not been identified to date. Accordingly, this pre-post-pilot study evaluated the levels of mental wellbeing, self-compassion, and loneliness among 25 Japanese undergraduate students who participated in a three-day shinrin-yoku retreat in Fukushima. Measurements were taken prior, straight after, and two weeks post-intervention. One-way ANOVA with Tukey post hoc analysis revealed that the mean scores of self-compassion, common humanity, and mindfulness increased statistically significantly from pre-retreat to follow-up. The mean scores of mental wellbeing and loneliness did not statistically significantly change. The positive effects on self-compassion indicate that shinrin-yoku retreat should be evaluated within a larger sample and in a shorter time frame to establish optimal shinrin-yoku parameters in this arena.

Mediation of Self-Compassion on Pathways from Stress to Psychopathologies among Japanese Workers

As awareness of mental health increases worldwide, how to improve mental health has begun to be discussed in many countries. Stress is known to cause diverse physical and mental health problems, including psychopathologies. On the other hand, our previous studies identified that self-compassion, kindness and understanding towards oneself are key components for good mental health in many populations, including Japanese workers. The government reports that Japanese workers suffer from high rates of mental health problems. However, the mechanism of how self-compassion helps their mental health remains to be evaluated. Accordingly, this study aimed to elucidate how self-compassion intervenes in pathways from stress to psychopathologies, namely depression and anxiety. One hundred and sixty-five Japanese workers completed an online survey regarding self-compassion, depression, anxiety and stress. Correlation and path analyses were conducted. These four variables were significantly inter-related. While self-compassion mediated the pathway from stress to depression, it did not mediate the pathway from stress to anxiety. These exploratory insights assist in understanding the mechanism of how self-compassion improves mental health and inform effective methods to implement self-compassion interventions to the Japanese workforce.

Comparison of Academic Motivation between Business and Healthcare Students in Online Learning: A Concurrent Nested Mixed-Method Study

While the demand for online education and the diversity of online students have been increasing worldwide, how online students motivate themselves to continuously engage in learning remains to be appraised. Research in the face-to-face contexts reports that academic motivation is central to student success and wellbeing, and the type of motivation can differ by subject. In particular, the motivation of business students and healthcare students can differ considerably. This study aimed to understand the motivation of online students, and compare them between business and healthcare students using a concurrent nested mixed-method design with correlation and thematic analyses. A survey regarding motivation, learning enjoyment, and study willingness was responded to by 120 online students (61 business and 59 healthcare). Business students were associated with extrinsic motivation, whereas healthcare students were associated with intrinsic motivation. While students in both groups enjoyed the pursuit of knowledge, healthcare students valued the process and accomplishment, whereas business students regarded education as steppingstones in their careers. Findings can help educators develop effective motivational support for these student groups.

Mental Health of Czech University Psychology Students: Negative Mental Health Attitudes, Mental Health Shame and Self-Compassion

High rates of mental health problems are a growing concern in Czech higher education, negatively impacting students’ performance and wellbeing. Despite the serious nature of poor mental health, students often do not seek help because of negative attitudes and shame over mental health problems. Recent mental health research reports self-compassion is strongly associated with better mental health and reduced shame. However, relationships between those constructs remain to be evaluated among Czech students. This study aims to appraise the relationships between mental health problems, negative mental health attitudes, mental health shame, and self-compassion in this population. An opportunity sample of 119 psychology students from a Czech university completed questionnaires regarding these constructs. Correlation, regression, and path analyses were conducted. Mental health problems were positively associated with negative mental health attitudes and shame, and negatively associated with self-compassion. Self-compassion negatively predicted mental health problems, while negative attitudes and shame did not. Last, self-compassion fully mediated the negative attitudes-mental health problems relationship, and partially mediated the shame-mental health problems relationship. Findings suggest self-compassion is essential for mental health in Czech students and associated with negative mental health attitudes and mental health shame. Czech universities can benefit from incorporating self-compassion training into their curricula to protect students’ mental health.

Qualitative Investigation into the Mental Health of Healthcare Workers in Japan during the COVID-19 Pandemic

The COVID-19 pandemic has negatively impacted the mental health of healthcare workers in many countries including Japan. While many survey-based findings have reported the serious state of their wellbeing among healthcare workers, the first-hand experience of the mental health and coping in this population remains to be evaluated. Accordingly, this study aimed to appraise them using constructionist thematic analysis on semi-structured interviews attended by a purposive and snowball sample of 24 healthcare workers in Japan conducted in December 2020-January 2021. Four themes were identified: (1) increased stress and loneliness, (2) reduced coping strategies, (3) communication and acknowledgement as a mental health resource, and (4) understanding of self-care. Participants noted that the characteristics of Japanese work culture such as long hours, collectivism and hatarakigai (i.e., meaning in work) to explain these themes. These findings suggest that robust support at an organizational and individual level, capturing intrinsic values, are particularly important for this key workforce to cope with increased stress and loneliness, leading to better patient care.

Qualitative Investigation into Therapists' Experiences of Online Therapy: Implications for Working Clients

Online therapy has increasingly been utilised during the COVID-19 pandemic by many, including working populations. However, few qualitative studies have explored how online therapy is experienced in practice and discussed its implications for those working clients. Semi-structured interviews attended by nine integrative psychotherapists practising in California, the United States, were conducted. Thematic analysis of the transcripts identified three themes: (i) ‘Positive experiences of online therapy’, (ii) ‘Challenges experienced by therapists and clients in online therapy’, and (iii) ‘Preparation and training for online therapy’. Online therapy was assessed as being helpful, particularly in terms of mitigating against previous geographical and temporal barriers to uptake. However, due to technological disruptions and potential blurring of professional boundaries, online therapy may detract from the emotional salience of therapy, negatively impacting the therapeutic relationship and containment. Considering these positive experiences, participants expected that the demand for online therapy would continue to increase. Particularly in the occupational context, online therapy can offer interventions without fostering shame regarding mental health. The findings provide preliminary qualitative evidence that online therapy can be a useful adjunct to traditional forms of face-to-face therapy. However, therapists require more explicit training in implementing online therapy. Results are discussed in particular regarding the utility of this therapy for working clients.

Motivation of UK graduate students in education: self-compassion moderates pathway from extrinsic motivation to intrinsic motivation

Academic motivation is recognised as a key factor for academic success and wellbeing. Highly motivated students actively engage with academic activities and maintain good wellbeing. Despite the importance of motivation in education, its relationship with engagement and wellbeing remains to be evaluated. Accordingly, this study explored the relationships between motivation, engagement, self-criticism and self-compassion among UK education postgraduate students. Of 120 postgraduate students approached, 109 completed three self-report scales regarding those constructs. Correlation, regression and moderation analyses were performed. Intrinsic and extrinsic motivation were positively associated with engagement, whereas amotivation was negatively associated with it. Engagement positively predicted intrinsic motivation. Self-criticism and self-compassion moderated the pathway from extrinsic motivation to intrinsic motivation: higher self-criticism weakened the pathway, while higher self-compassion strengthened it. Findings suggest the importance of engagement in relation to cultivating intrinsic motivation of education students. Moreover, enhancing self-compassion and reducing self-criticism can help transfer extrinsic to intrinsic motivation.

Burnout in Professional Psychotherapists: Relationships with Self-Compassion, Work-Life Balance, and Telepressure

Though negative impacts of COVID-19 on occupational mental health have been reported, the mental health of psychotherapists has not been evaluated in depth. As this occupational group treats ever-increasing mental health problems, it is essential to appraise key factors for their mental health. Accordingly, this study aimed to explore burnout of professional psychotherapists. A total of 110 participants completed self-report measures regarding burnout, self-compassion, work–life balance and telepressure. Correlation, regression and moderation analyses were conducted. Both of the burnout components—emotional exhaustion and depersonalisation—were positively associated with weekly working hours and telepressure, and negatively associated with age, self-compassion and work–life balance. Weekly working hours and work–life balance were significant predictors of emotional exhaustion and depersonalisation. Lastly, self-compassion partially mediated the relationship between work–life balance and emotional exhaustion but did not mediate the relationship between work–life balance and depersonalisation. The findings suggest that maintaining high work–life balance is particularly important for the mental health of psychotherapists, protecting them from burnout. Moreover, self-compassion needs to be cultivated to mitigate emotional exhaustion. Mental health care for this occupational group needs to be implemented to achieve sustainable mental health care for workers and the public.