The relationship between frontline nurses' psychosocial status, satisfaction with life and resilience during the prevalence of COVID-19 disease

Testing the Effectiveness of a Mindfulness- and Acceptance-Based Smartphone App for Nurses Traumatized by the COVID-19 Pandemic: A Pilot Study

A significant proportion of frontline nurses developed post-traumatic stress disorder (PTSD) symptoms as a result of working during the COVID-19 pandemic. This study aimed to determine the efficacy of a mindfulness- and acceptance-based smartphone app intervention among nurses traumatized by the COVID-19 pandemic. This was a two-arm, randomized controlled trial. We randomly assigned 60 frontline nurses working in various clinical settings in the United States during the pandemic to either the intervention group (i.e. participants used the mindfulness app for 6 wk) or the wait-list control group. We assessed the app's efficacy through outcome measures of PTSD symptom severity, experiential avoidance, rumination, mindfulness, and resilience, measured at pre-, mid-, and post-intervention periods and a 1-month follow-up. Intervention satisfaction and perceived usability of the app were assessed within the intervention group. There was strong evidence of within-between interaction for PTSD, experiential avoidance, and rumination, implying significant improvement of these outcomes for the intervention group as compared to the control group. We only found a within-group interaction effect for mindfulness, indicating significant improvement of mindfulness within the intervention group only. Participants in the intervention group reported high satisfaction levels and perceived usability with the app. Findings highlight that mindfulness- and acceptance-based smartphone apps can improve PTSD symptoms of nurses traumatized by the pandemic. Healthcare organizations should provide nurses with accessible interventions (e.g. mindfulness apps) to treat and prevent secondary behavioral consequences of the pandemic, such as PTSD.

Psycho-emotional impact of the COVID-19 pandemic on nursing professionals in Ecuador: a cross-sectional study

AIM AND OBJECTIVES

To analyse the levels of anxiety, depression, post-traumatic stress, and burnout among nursing professionals working in the Imbabura region of Ecuador during the COVID-19 pandemic and identify the contributing socio-occupational factors.

BACKGROUND

The high demand for care of COVID-19 patients led to increased work pressure on nurses, owing to increased demands for care and shortages of medical supplies and protective equipment.

DESIGN

A cross-sectional study was conducted from September to December 2022 using a self-administered questionnaire addressed to nursing professionals who cared for COVID-19 patients.

METHODS

The questionnaire included socio-demographic characteristics, the Spanish adaptation of Hospital Anxiety and Depression Scale (HADS-Spanish), Impact of Event Scale-Revised (IES-R) for the evaluation of post-traumatic stress disorder (PTSD), and the Spanish adaptation of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS-Spanish) for burnout assessment. Univariate and multivariate analyses were performed.

RESULTS

Of the 782 participants, 88.6% had a high level of burnout (MBI-HSS-Spanish scale score > 27). Female nurses, nurses with eight-hour work shifts, and older professionals exhibited high levels of anxiety and depression. Prolonged working hours in COVID-19 patient care services were found to be a risk factor for burnout and post-traumatic stress.

CONCLUSIONS

Participating nurses presented with a high level of chronic work stress and exhibited signs of anxiety and depression during the period under consideration. Providing nurses with psychological support measures and performing liaison consultations will alleviate the psychological burden on nurses.

RELEVANCE TO CLINICAL PRACTICE

The study has shown that accounting for the environments where the emotional impact is greatest and how to reduce it would not only reduce anxiety, depression, and burnout in nurses but also improve the quality of care, not only in pandemic.

PATIENT OR PUBLIC CONTRIBUTION

Nurses contributed to the conduct of the study by participating in the data collection via questionaries.

The prevalence and risk factors of PTSD symptoms among nurses during the COVID-19 pandemic-A systematic review and meta-analysis

Since the first reported outbreak in China, the Coronavirus disease 2019 (COVID-19) has raised serious concerns globally. The COVID-19 pandemic has caused a severe psychological impact on healthcare workers (HCWs), and especially nurses, who are the most numerous and exposed frontline group. This systematic review and meta-analysis aims to summarise extant literature on the effects of the COVID-19 pandemic on the psychological health of nurses, particularly concerning the prevalence and risk factors for post-traumatic stress disorder (PTSD). A systematic search was conducted on PubMed, Embase and PsycInfo from March 2020 to July 2023. Articles were included/excluded on predetermined eligibility criteria. A random-effect meta-analysis was performed using proportions to determine the pooled prevalence for PTSD among nurses. Subgroup analyses were also performed, and heterogeneity across studies was analysed using meta-regression. Relatively high prevalence rates of PTSD were reported among nurse populations during the COVID-19 pandemic in twenty-six different countries, globally. Risk factors associated with PTSD include having prior mental health co-morbidities, being a female, having high exposure/contact with COVID-19 patients, having insufficient protective conditions and having intensive workloads. The overall pooled prevalence was 29.1% (95% C.I. = 23.5%, 35.5%) using a random-effects model in 55 studies. The regression test of funnel plot asymmetry indicated a significant level of publication bias among studies. The COVID-19 pandemic is associated with significant levels of PTSD among frontline nurses globally. A high level of heterogeneity was observed across studies. Psychological, social and administrative interventions should be implemented to mitigate heavy psychological distress in nurses.

Moral Injury and its Correlates among Iranian Nurses in the Second Year of the COVID-19 Pandemic: A Multicenter Cross-Sectional Study

The COVID-19 pandemic has been associated with various health-related issues among nurses, including mental health problems such as moral injury. This study aimed to evaluate the relationship between moral injury, general health, post-traumatic stress disorder (PTSD), and type of hospital among Iranian nurses working in different clinical settings during the COVID-19 outbreak. This cross-sectional study employed convenience sampling to recruit 334 nurses working in various clinical settings, including teaching and referral hospitals, in Kerman, Southeastern Iran from October 2021 to February 2022. The study used three measures, including the General Health Questionnaire (GHQ-12), the Impact of Event Scale-Revised (IES-R), and The Moral Injury Symptom Scale-Healthcare Professionals version (MISS-HP). Data analysis was conducted using SPSS25. The results indicated that moral injury was highly prevalent among Iranian nurses, with 47% of the participants reporting experiencing it. A total, 26.9% of the participants reported experiencing mental health disorders and 57.2% of the participants reported experiencing this disorder. Significant correlations were found between moral injury, general health, and PTSD. Specifically, moral injury levels were higher among female nurses with a history of mental disorders and those designated to treat all kinds of cases, compared to other participants. The results suggest that Iranian nurses are at a high risk of experiencing moral injury during the COVID-19 pandemic. Policymakers and health authorities should establish related health educational programs, provide counseling services to promote general health, and pay particular attention to moral injury and PTSD. Additionally, nurse educators should integrate materials related to moral injury into the nursing curriculum.

The relationship between depressive symptoms and sleep quality in medical staff after their infection with COVID-19

Background

Healthcare workers (HCWs) play a crucial role in managing infectious diseases like COVID-19. However, the demanding working conditions during the pandemic have led to an increased risk of depression and sleep disorders among these dedicated professionals. Therefore, this study aimed to examine the relationship between depressive symptoms and sleep quality in medical staff who had contracted COVID-19.

Methods

This descriptive study involved a sample of 203 HCWs who had contracted COVID-19. These HCWs were employed at a hospital affiliated with Kerman University of Medical Sciences in 2020. The data for this study were collected using a demographic information form, the Pittsburgh Sleep Quality Index (PSQI), and the Beck Depression Inventory (BDI). Statistical analysis was conducted using SPSS22, with a significance level set at less than 0.05.

Results

The study found that the mean score for depressive symptoms among the participants was 11.67 ± 2.68, while the mean score for sleep quality was 5.47 ± 3.02. It was observed that 18.2% of the participants experienced moderate depression, 10.3% had severe depression, and 59.6% had poor sleep quality. Furthermore, a significant and positive correlation was identified between sleep quality and depression (r = 0.54; p = 0.001). Multiple regression models indicated that the harmful pattern and sleep quality together could predict 34% of the variance in depression. Additionally, the use of sedatives and depression were found to predict 33% of the variance in sleep quality.

Conclusion

The findings of our study indicated a high prevalence of depressive symptoms and insomnia among medical staff who had contracted COVID-19. These results provide valuable insights for health managers, highlighting the need for implementing interventions in epidemic environments to reduce the vulnerability of HCWs.

Global prevalence of low resilience among the general population and health professionals during the COVID-19 pandemic: A meta-analysis

Objective

To estimate the global prevalence of low resilience among the general population and health professionals during the COVID-19 pandemic.

Methods

Embase, Ovid-MEDLINE, PubMed, Scopus, Web of Science, CINAHL, WHO COVID-19 databases, and grey literature were searched for studies from January 1, 2020, to August 22, 2022. Hoy's assessment tool was used to assess for risk of bias. Meta-analysis and moderator analysis was performed using the Generalized Linear Mixed Model with a corresponding 95 % confidence interval (95 % CI) adopting the random-effect model in R software. Between-study heterogeneity was measured using I² and τ² statistics.

Results

Overall, 44 studies involving 51,119 participants were identified. The pooled prevalence of low resilience was 27.0 % (95 % CI: 21.0 %–33.0 %) with prevalence among the general population being 35.0 % (95 % CI: 28.0 %–42.0 %) followed by 23.0 % (95 % CI: 16.0 %–30.9 %) for health professionals. The 3-month trend analysis of the prevalence of low resilience beginning January 2020 to June 2021 revealed upward then downward patterns among overall populations. The prevalence of low resilience was higher in females, studied during the delta variant dominant period, frontline health professionals, and undergraduate degree education.

Limitations

Study outcomes showed high heterogeneity; however, sub-group and meta-regression analyses were conducted to identify potential moderating factors.

Conclusions

Globally, 1 out of 4 people among the general population and health professionals experienced low resilience due to COVID-19 adversity. The prevalence of low resilience was twice as much among the general population compared to health professionals. These findings provide information for policymakers and clinicians in the development and implementation of resilience-enhancing programs.

Nurses' clinical competency and its correlates: before and during the COVID-19 outbreak

BACKGROUND

Clinical competency is the ability to integrate knowledge, skills, attitudes and values into a clinical situation and it is very important in nursing education, clinical settings, nursing management, and crises. This study aimed to investigate nurses' professional competence and its correlates before and during the COVID-19 pandemic.

METHODS

We conducted this cross-sectional study before and during the COVID-19 outbreak and recruited all nurses working in hospitals affiliated to Rafsanjan University of Medical Sciences, southern Iran, so we included 260 and 246 nurses in the study before and during the COVID-19 epidemic, respectively. Competency Inventory for Registered Nurses (CIRN) was used to collect data. After inputting the data into SPSS24, we analysed them using descriptive statistics, chi-square and multivariate logistic tests. A significant level of 0.05 was considered.

RESULTS

The mean clinical competency scores of nurses were 156.97 ± 31.40 and 161.97 ± 31.36 before and during the COVID-19 epidemic, respectively. The total clinical competency score before the COVID-19 epidemic was not significantly different from that during the COVID-19 epidemic. Interpersonal relationships (p = 0.03) and desire for research/critical thinking (p = 0.01) were significantly lower before the COVID-19 outbreak than during the COVID-19 outbreak. Only shift type had an association with clinical competency before the COVID-19 outbreak, while work experience had an association with clinical competency during the COVID-19 epidemic.

CONCLUSION

The clinical competency among nurses was moderate before and during the COVID-19 epidemic. Paying attention to the clinical competence of nurses can improve the care conditions of patients, and nursing managers should improve the clinical competence of nurses in different situations and crises. Therefore, we suggest further studies identifying factors improving the professional competency among nurses.

Prevalence and associated factors of depressive and anxiety symptoms among healthcare workers in the post-pandemic era of COVID-19 at a tertiary hospital in Shenzhen, China: A cross-sectional study

Background

Healthcare workers were at high risk of psychological problems during the COVID-19 pandemic, but it remains not well-investigated in the post-pandemic era of COVID-19, with regular epidemic prevention and control embedded in burdened healthcare work. This study aimed to investigate the prevalence and potential risk factors of the symptoms of depression and anxiety among healthcare workers at a tertiary hospital in Shenzhen.

Method

Our cross-sectional study was conducted among 21- to 64-year-old healthcare workers in December 2021 at a tertiary hospital in Shenzhen, using a simple random sampling strategy. A wide range of socio-demographic characteristics, individual information, and psychological condition of the subjects were extracted. Healthcare workers' psychological conditions were tested with the Center for Epidemiologic Studies Depression (CESD-10), General Anxiety Disorder (GAD-7), Insomnia Severity Index (ISI), Work-Family Conflict Scale (WFCS), 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and 17-item of Maslach's Burnout Inventory-Human Services Survey (MBI-HSS-17). Data were collected based on these questionnaires. Descriptive statistics were used to assess the difference between healthcare workers with depressive and anxiety symptoms among different groups. Hierarchical logistic regression analyses were conducted to investigate the association between focused variables and mental health outcomes.

Results

A total of 245 healthcare workers were enrolled. The proportion of depressive symptoms, anxiety symptoms and their co-occurrence were 34.7, 59.6, and 33.1%, respectively. Logistic regression showed that for the three outcomes, no history of receiving psychological help and self-rated good or higher health were protective factors, whereas more severe insomnia and job burnout were risk factors. Junior or lower job title and higher psychological resilience were related to a lower prevalence of depressive symptoms, while relatively longer working hours and larger work-family conflict were positively associated with the anxiety symptoms. Psychological resilience was inversely associated with the co-occurrence of depressive and anxiety symptoms.

Conclusions

Our study revealed a high proportion of psychological problems and proved that several similar factors which were significant during the pandemic were also associated with the symptoms of depression and anxiety among healthcare workers in the post-pandemic era of COVID-19. These results provide scientific evidence for psychological interventions for healthcare workers.

Report on fraying resilience among the Ontario Registered Practical Nurse Workforce in long-term care homes during COVID-19

AIM

Registered Practical Nurses (RPNs) are frontline healthcare providers in Ontario long-term care (LTC) homes. Throughout COVID-19, RPNs working in LTC homes experienced prolonged lockdowns, challenging working conditions, and inadequate resource allocation. This study aimed to describe the personal and professional resilience of RPNs working in LTC during the COVID-19 pandemic.

DESIGN

An open cross-sectional online survey containing the Connor-Davidson Resilience Scale, Resilience at Work Scale®, and Resilience at Work Team Scale®.

METHODS

The survey was distributed by the RPN Association of Ontario (WeRPN) to approximately 5000 registered members working in Ontario LTC homes.

RESULTS

A total of 434 respondents participated in the survey (completion rate = 88.0%). Study respondents scored low on measures of resilience and reported extreme levels of job (54.5%) and personal (37.8%) stress. Resources to support self-care and work-life balance, build capacity for team-based care practice(s) are needed.

Professional quality of life and psychopathological symptoms among first-line healthcare workers facing COVID-19 pandemic: an exploratory study in an Italian southern hospital

Background

The COVID-19 pandemic has significantly affected the mental health of healthcare workers, who have taken on the major problems triggered by the emergency. The mental consequences concern high levels of insomnia, anxiety, depression and burnout, which inevitably affect their professional quality of life too.

Objective

The aim of this study was to analyze the relationship between psychopathological symptoms (tested with the Depression Anxiety Stress Scale, DASS-21) and professional quality of life (measured with the Professional Quality of Life Scale, ProQol) in a hospital of southern Italy.

Methods

204 healthcare workers were recruited by non-probabilistic sampling and divided by age, gender, work roles (physicians, nurses and intermediate care technicians) and clinical departments (Cardio-medicine, Infectious Diseases, Emergency Medicine, First Aid, Obstetrics and Pneumology).

Results

The results showed higher levels of Secondary Traumatic Stress, Depression, Anxiety and Stress in women than in men. Physicians and nurses experienced lower levels of Compassion Satisfaction but higher Burnout than intermediate care technicians; likewise, nurses were more anxious than physicians. The Emergency Medicine had higher scores in Compassion Satisfaction than Infectious Disease, Pneumology, Obstetrics and Cardio-Medicine.

Conclusion

In light of what has been said so far, it appears essential to intervene on the first mild signs of Burnout and Secondary Traumatic Stress, because they precede the onset of Depression, Stress and Anxiety in healthcare workers.

The impact of emotional intelligence on life satisfaction among Chinese nurses: A chain mediating model

Introduction

Nurses' life satisfaction exerts a positive impact on their professional careers, and it seriously affects their physical and mental health. Low life satisfaction has become a key factor in the global shortage of nurses. Emotional intelligence may protect nurses from negative emotions that can affect the care they provide, as well as their life satisfaction. In this study, we aims to explore the impact of emotional intelligence on life satisfaction, and even verify the chain mediating effect of self-efficacy and resilience on this relationship among Chineses nurses.

Method

The Emotional Intelligence Scale, the General Self, Efficacy Scale, the Connor-Davidson Resilience Scale, and the Satisfaction with Life Scale were used to survey 709 nurses in southwest China. To analyze mediating effects, SPSS 26.0 and Process V3.3 were used for statistical processing.

Result

Emotional intelligence positively predicted life satisfaction. Meanwhile, it was also found that emotional intelligence and life satisfaction were continuously mediated by self-efficacy and resilience, and the indirect effect value was 0.033, accounting for 17.37%.

Conclusion

This study reveals how emotional intelligence affects nurses' life satisfaction. The results of this study have certain implications for nurses to better balance their career and life. Nursing managers should provide nurses with a favorable working environment from the perspective of positive psychology, improve their sense of self-efficacy and resilience, ultimately improve their life satisfaction.

Sociodemographic Aspects and Healthy Behaviors Associated With Perceived Life Satisfaction in Health Professionals

BACKGROUND

Life satisfaction is a determining factor for the improvement of mental and physical health. Health care workers are a vulnerable population to suffer alterations in the factors that affect life satisfaction. Determining the influence of these factors on quality of life is important for their proper management.

OBJECTIVE

To examine sociodemographic factors and healthy behaviors influencing life satisfaction in Peruvian professionals.

METHODS

A cross-sectional study was conducted with 506 health care workers, who had a mean age of 40.34 years (SD = 10.39). A sociodemographic questionnaire, sleep quality, physical activity, eating habits, and life satisfaction were used. A regression model was fitted with the life satisfaction variable as the dependent variable.

RESULTS

In multivariable analysis, age (β = -.938, P < .01) and perception of poor health status (β = -4.743, P < .001) were found to be associated with lower life satisfaction. On the other hand, higher university education level (β = 1.667, P < .001), absence of smoking (β = 3.202, P < .01), absence of depressive symptoms (β = 3.390, P < .001), interest in daily activities (β = 3.503, P < .05), good sleep quality (β = 1.027, P < .01), a high frequency of physical activity (β = 1.056, P < .01), and healthy eating are variables associated with higher life satisfaction.

CONCLUSION

Sociodemographic aspects such as age and the perception of poor health are associated with lower life satisfaction. On the other hand, healthy behaviors such as absence of smoking, absence of depressive symptoms, interest in daily activities, good quality of sleep, high frequency of physical activity, and a healthy diet were associated with higher life satisfaction.

Associations among resilience, hope, social support, stress, and anxiety severity in Chinese women with abnormal cervical cancer screening results

This study was to explore the resilience level and its potential correlates and further to evaluate the influence of these resilience-centred variables on anxiety severity among Chinese women with abnormal cervical cancer screening results. One hundred and seventy-five subjects completed self-administered questionnaires to collect relevant variables. The level of resilience of our sample is moderate (70.57 ± 12.14). The data identified hope (β = 0.218), social support (β = 0.247) and perceived stress (β = -0.320) as independent associates for resilience. Finally, among variables, only perceived stress is found to have a direct and positive influence on anxiety severity. Interventions on these variables can be effective for resilience promotion in this population. In addition, anxiety should be preferentially intervened in through the alleviation of perceived stress.

Life Satisfaction of Nurses during the COVID-19 Pandemic in Poland

BACKGROUND

Health care practitioners are at highest risk of COVID-19 disease. They experience an enormous overload of work and time pressures. The objective of the study was to assess nurses' life satisfaction.

METHOD

The study included professionally active nurses. The research method was an author's questionnaire and a standardized questionnaire, the Satisfaction with Life Scale (SWLS).

RESULTS

The study group included 361 working nurses. The mean raw score and the sten score of the nurses' responses to the statements on the SWLS questionnaire were 21.0 (SD ± 5.6, range = 5-35) and 5.73 (SD ± 1.94, range = 1-10), respectively. It was shown that lower life satisfaction was experienced by nurses aged 51 to 60 (raw score: p = 0.003, sten score: p = 0.005), as well as nurses with secondary and undergraduate nursing education (raw score: p = 0.061, sten score: p = 0.043). Nurses who had a higher self-evaluation of the level of knowledge about SARS-CoV-2 infection experienced greater life satisfaction (raw score: p = 0.008, sten score: p = 0.022).

CONCLUSIONS

The majority of Polish nurses surveyed during the COVID-19 pandemic had a low or medium level of life satisfaction. The low response rate to the survey was most likely due to work overloads during the pandemic. Working in a public service profession, a nurse is exposed to stressful conditions related to protecting human health. Constant difficult and stressful situations and total fatigue experienced by nursing professionals can be the cause of a lack of motivation, occupational burnout, listlessness and mental and physical disease. Further research is necessary to assess the factors positively influencing the level of life satisfaction.

Post-traumatic stress in healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis

The SARS-CoV-2 (COVID-19) pandemic has increased healthcare worker (HCW) susceptibility to mental illness. We conducted a meta-analysis to investigate the prevalence and possible factors associated with post-traumatic stress disorder (PTSD) symptoms among HCW during the COVID-19 pandemic. We searched PubMed, SCOPUS and EMBASE databases up to May 4th, 2022. We performed random effects meta-analysis and moderator analyses for the prevalence of PTSD-relevant symptoms and severe PTSD symptoms. We identified 1276 studies, reviewed 209 full-text articles, and included 119 studies (117,143 participants) with a total of 121 data points in our final analysis. 34 studies (24,541 participants) reported prevalence of severe PTSD symptoms. Approximately 25.2% of participants were physicians, 42.8% nurses, 12.4% allied health professionals, 8.9% auxiliary health professionals, and 10.8% "other". The pooled prevalence of PTSD symptoms among HCWs was 34% (95% CI, 0.30-0.39, I² >90%), and 14% for severe PTSD (95% CI, 0.11 - 0.17, I² >90%). The introduction of COVID vaccines was associated with a sharp decline in the prevalence of PTSD, and new virus variants were associated with small increases in PTSD rates. It is important that policies work towards allocating adequate resources towards protecting the well-being of healthcare workers to minimize adverse consequences of PTSD.

COVID-19-Related Self-Stigma, Post-Traumatic Stress Disorder, Insomnia, and Smartphone Addiction Among Frontline Government Workers with COVID-19 Pandemic Control Duties

Purpose

The duties related to COVID-19 control and prevention may have caused psychological stress for the individuals in charge (eg, frontline government workers) and have reportedly led to mental health issues, such as insomnia and post-traumatic stress disorder (PTSD). However, the prevalence of these COVID-19-related disorders and their associated factors remain unclear. Therefore, the purpose of the present study was to investigate the prevalence rates of insomnia, PTSD, COVID-19-related self-stigma, and smartphone addiction, along with the identification of risk factors and protective factors for Taiwan frontline government workers with COVID-19 pandemic control duties.

Methods

The survey was carried out with 151 participants between September and October 2021. All participants completed the Fear of COVID-19 Scale (assessing fear of COVID-19), Self-Stigma Scale (assessing self-stigma during the COVID-19 pandemic), Smartphone Application-Based Addiction Scale (assessing the risk of smartphone addiction), Insomnia Severity Index (assessing insomnia), Impacts of Event Scale-6 (assessing PTSD), and a self-designed set of questions assessing trait resilience.

Results

The results showed that the prevalence rate was 31.1% for insomnia and 33.8% for PTSD. Furthermore, service duration (adjusted odds ratio [AOR] = 0.93; 95% confidence interval [CI] = 0.86, 0.999) and trait resilience (AOR = 0.19; 95% CI = 0.08, 0.46) were protective factors and fear of COVID-19 (AOR = 1.91; 95% CI = 1.02, 3.57) was a risk factor for insomnia. Fear of COVID-19 (AOR = 2.63; 95% CI = 1.35, 5.14), self-stigma (AOR = 3.62; 95% CI = 1.19, 11.02), and smartphone addiction (AOR = 1.09, 95% CI = 1.001, 1.19) were risk factors, and trait resilience was a protective factor (AOR = 0.58; 95% CI = 0.29, 1.17) for PTSD.

Conclusion

The findings demonstrated a high prevalence of insomnia and PTSD. Risk-reducing strategies and protective factor promotion strategies are recommended to help reduce the symptoms of insomnia and PTSD among Taiwan frontline government workers.

Professional grief among nurses in Spanish public health centers after caring for COVID-19 patients

AIMS AND OBJECTIVES

The aim of the present study is to investigate the professional grief suffered by nurses in various medical units, after coping with the COVID-19 pandemic for the last 18 months.

BACKGROUND

Addressing and acknowledging the reality of professional grief is of fundamental importance to nurses' mental health, as this condition has both professional and personal consequences.

DESIGN

A qualitative, content analysis approach was taken.

METHODS

Based on 25 interviews with nursing professionals working in different health centers units were performed. The following sampling schemes were used: first, convenience sampling, then nominated sampling, and finally theoretical sampling.

RESULTS

From our analysis of the data obtained, three main themes were identified: the impact on nurses of COVID-19 outcomes; the symptoms of professional grief; and cognitive reactions. These core elements interacted with 12 subtopics, including symptoms of grief and the cognitive impact produced.

CONCLUSIONS

A large proportion of the nurses consulted in this study have suffered and suffered professional grief and report many related symptoms. In response to the present pandemic and any future occurrence, the question of professional grief needs to be addressed.

RELEVANCE TO CLINICAL PRACTICE

To help them cope better with this type of situation, nurses should receive appropriate training. Moreover, healthcare institutions should be made aware of the problem and be encouraged to offer assistance to address the impact produced on nurses by the deaths of their patients.

CLINICAL RELEVANCE

This study shows the impact of professional grief on nurses in the context of the COVID-19 pandemic. Nurses are affected personally by the deaths of patients and by alterations to their working conditions. In many cases, this grief remains unresolved and its various symptoms persist.

The relationship between spiritual health and happiness in medical students during the COVID-19 outbreak: A survey in southeastern Iran

It is necessary to study the various dimensions of health and their affecting factors during the coronavirus disease-19 (COVID-19) pandemic to identify the necessary interventions. The study aims to determine the relationship between spiritual health and happiness in medical students during the COVID-19 outbreak. In this analytical cross-sectional design study, 409 medical students were examined for the state of happiness and spiritual health and the relationship between them. Student information was collected through Web-based sampling by using standard tools from 20 April to 20 June 2020. Medical students completed the demographic questionnaire as well as Oxford Happiness Questionnaire (OHQ) and Paloutzian and Ellison spiritual health questionnaire. The results showed that while the score of spiritual health and happiness was related to factors such as marriage, interest in a field of study, and socioeconomic status, the relationship between spiritual health and happiness was significant (r = 0.72). This study showed that students' happiness scores were not optimal during the COVID-19 pandemic. Due to the strong relationship between spiritual health and happiness scores, spiritual health promotion, in conjunction with other interventions, can be used to improve happiness in this group.

Master's Prepared Clinical Nurse Leaders: 2 to 10 Years Post-Graduation

BACKGROUND

Because the Clinical Nurse Leader (CNL) role is relatively new, little is known about the success of CNL graduates. Our aim was to describe the career path of CNL graduates and to measure satisfaction 2 to 10 years after graduation.

METHODS

A cross-sectional survey design was used to assess career trajectory and self-reported satisfaction with work, life, and educational preparation in a sample of 109 CNL graduates from one university. Online data collection was used, resulting in participants from across the United States.

RESULTS

Respondents were primarily Direct Entry CNL graduates. The majority (95%) were still working full- or part-time in nursing. Most (over 90%) were satisfied or extremely satisfied with their decision to become a nurse. Life satisfaction was high: the Satisfaction with Life Scale mean score was 24.9 (SD = 5.67).

CONCLUSION

These results help describe CNL career trajectories and provide useful suggestions for education and practice. This information can help build the business case for the CNL.

The emotional impact of COVID-19 on Spanish nurses and potential strategies to reduce it

BACKGROUND

Although the emotional and psychological impact of nurses' work had been identified before the COVID-19 pandemic, the pandemic aggravated risk indicators for their mental health.

AIM

The objective of this study was to analyse the levels of anxiety, depression, post-traumatic stress and burnout of nurses in the Balearic Islands (Spain) during the pandemic to identify possible sociodemographic and related occupational factors.

DESIGN

A cross-sectional study of 892 nurses was conducted during four weeks from February to March 2021.

METHODS

Sociodemographic data related to the pandemic were collected and anxiety, depression, burnout and post-traumatic stress were measured with validated scales. A multivariate and predictive analysis was carried out with risk estimates.

FINDINGS

About 75.6% of the nurses had experience in COVID-19 units, and 49.1% had worked for more than 10 months in a COVID-19 unit. Nurses in COVID-19 units (hospital ward or ICU) were more likely to report emotional fatigue (OR 1.9, p < 0.001) and anxiety (OR 1.5, p = 0.021). In general, moderate post-traumatic stress was evident in general nurses (p = 0.027), and severe post-traumatic stress was evident in ICU nurses (p = 0.027). A 1.24-month reduction in COVID-19 patient care predicted reduced levels of emotional fatigue (5.45 points), depersonalisation (1.87 points) and post-traumatic stress (4.65 points) in nurses.

CONCLUSION

Given the occurrence of new waves of COVID-19, the need to establish preventive strategies that focus on the personal and occupational characteristics related to these indicators and to implement urgent psychological support strategies is demonstrated.

IMPACT

Given these findings, it is imperative solutions are urgently applied in order to prevent compounding risk to the health system.

Compassion Satisfaction, Compassion Fatigue and Hardiness Among Nurses: A Comparison Before and During the COVID-19 Outbreak

BACKGROUND

Nurses provide the majority of health-care services and face numerous health challenges during an epidemic. During the COVID-19 epidemic, nurses are subjected to physical, mental, and social disorders that impair their quality of life and hardiness. Therefore, it is important to be aware of the situation of nurses. The current study aimed to compare the compassion satisfaction, compassion fatigue and hardiness among nurses before and during the COVID-19 outbreak.

MATERIALS AND METHODS

This cross-sectional study included 508 clinical nurses from one public hospital in southern Iran. The subjects were recruited using census sampling methods in 2019-2020. Sampling was performed before (n = 266) and during the COVID-19 (n = 242) with a 1-year interval. Although, the study setting was the same before and during the COVID-19, questionnaires were completed by different nurses before and during the COVID-19. Demographic questionnaire, professional quality of life (ProQOL) questionnaire and Occupational Hardiness Questionnaire were used to collect data.

RESULTS

The scores of compassion satisfaction, compassion fatigue and hardiness did not differ significantly during the COVID-19 compared with before the COVID-19 (p > 0.05). Before COVID-19, hardiness and work experience predicted 11% of the variance of compassion satisfaction, whereas during COVID-19, hardiness and gender predicted 26% of the variance of compassion satisfaction. Before COVID-19, hardiness and work experience predicted 3% of the variance of compassion fatigue, whereas during COVID-19, hardiness, type of employment and gender predicted 6% of the variance of compassion fatigue.

CONCLUSION

The current study found that compassion satisfaction, compassion fatigue and hardiness did not change during the COVID-19 outbreak compared with before the COVID-19 outbreak. However, during the COVID-19, the hardiness was a significant predictor of compassion satisfaction and compassion fatigue. The study results showed that it was possible to increase the compassion satisfaction and reduce the compassion fatigue by strengthening the hardiness of nurses. However, these results need to be considered in future studies, especially in crises such as COVID-19 disease.

Helping Others Helps Me: Prosocial Behavior and Satisfaction With Life During the COVID-19 Pandemic

Prosocial behavior (PsB) and its effects have been analyzed in times of crisis and natural disasters, although never before in the face of such exceptional circumstances as those created by the COVID-19 pandemic. This research analyzes the role of PsB on satisfaction with life (SWL) in Colombia, considering the negative emotional impact of events that began in February 2020. We conduct an exploratory analysis using a sample of Colombia's general population (N = 2,574; 53.2% women) with an average age of 44.66 years (SD = 15.36). Using the Classification Tree technique, we find that engaging in one or more PsBs (e.g., donating money or sharing food) enhances SWL and decreases the impact of negative emotions such as pessimism, indecisiveness, and irritability that have emerged during the COVID-19 pandemic. These findings are significant because they confirm the importance of life satisfaction as a personal resource for coping with complex situations and provide evidence of the benefits of PsB on one's wellbeing.

Relationships Between Mental Health, Emotion Regulation, and Meaning in Life of Frontline Nurses During the COVID-19 Outbreak

BACKGROUND

The sporadic outbreak of COVID-19 and the constant mutation of the virus have put the public in panic. Frontline nurses' appropriate emotional regulation and mental health are the key to win the victory of fighting against the epidemic. The relationships between these variables directly influence the availability of human resources to combat COVID-19.

OBJECTIVE

To investigate the relationship between meaning in life, emotional regulation, and mental health of frontline nurses during the Delta virus epidemic.

METHODS

A cross-sectional survey was conducted in August 2021 among 105 nurses from the Second Xiangya Hospital, Central South University, Changsha, China, who were deployed at the COVID-19 units in Zhangjiajie People's Hospital. The Chinese Meaning in Life Questionnaire, Emotion Regulation Questionnaire, and Psychological Questionnaire for Emergent Events of Public Health were used to evaluate their meaning in life, emotion regulation, and mental health. Their correlation and the moderating effect of emotion regulation were conducted.

RESULTS

In total, 105 (100%) nurses responded. There were 14 men and 91 women and the mean age was (30.295 ± 4.653) years. The average score of meaning in life and mental health of frontline nurses was 49.971 ± 6.386 and 2.755 ± 2.580, respectively. The meaning in life of frontline nurses was positively correlated with cognitive reappraisal and negatively correlated with expressive suppression and mental health. Mental health was negatively correlated with cognitive reappraisal and positively correlated with expressive suppression. The emotional regulation of frontline nurses has a moderating effect between meaning in life and mental health.

CONCLUSION

Meaning in life and emotion regulation of frontline nurses were significantly correlated with mental health under the effects of the COVID-19 pandemic. Changing the emotion regulation of frontline nurses, strengthening cognitive reappraisal, and weakening expressive suppression could reduce the predictive effect of meaning in life on mental health.

Burnout, Anxiety, Stress, and Depression Among Iranian Nurses: Before and During the First Wave of the COVID-19 Pandemic

Background: Nurses are the major healthcare workforce in an epidemic and have the most contact with patients. Frontline nurses face many health challenges during the COVID-19 epidemic, are directly at risk when treating and caring for COVID-19 patients, and thus experience severe stress and problems in the workplace leading to physical, mental, and social disorders, as well as burnout, anxiety, stress, and depression. The purpose of this study was to compare burnout, anxiety, stress, and depression in nurses before and during the first wave of the COVID-19 pandemic. Methods: This was a cross sectional study. We assessed 266 frontline nurses before and 242 frontline nurses during the first wave of the COVID-19 pandemic with one year apart in 2019 and 2020 (two-stage sampling). The data were collected using demographic questionnaire, Maslach Burnout Questionnaire and Depression, Anxiety and Stress Scale (DASS-21) in public hospitals in Southern Iran. Results: There were no significant differences between groups in subscales of burnout (p > 0.05). Anxiety, stress and depression scores significantly increased during the first wave of the COVID-19 pandemic compared with before the COVID-19 outbreak (p < 0.05). There were significant differences between groups in level of anxiety (p < 0.001) and stress (p = 0.04). Before the COVID-19 outbreak, burnout predicted 11, 15, and 13% of the variance of anxiety, stress and depression, respectively. In addition, stress, monthly working hours and shift were variables that predicted 16% of the variance of burnout before COVID-19. Conclusion: The results of the present study showed that burnout during the first wave of the COVID-19 pandemic did not change significantly compared with before COVID-19. Anxiety, stress and depression increased significantly first wave of the COVID-19 pandemic.

The relationship between frontline nurses' psychosocial status, satisfaction with life and resilience during the prevalence of COVID-19 disease

AIM

The present study aimed to investigate the association between frontline nurse's psychosocial status, satisfaction with life and resilience during the prevalence of COVID-19 disease.

DESIGN

A cross-sectional study.

METHODS

185 frontline nurses taking care of the COVID-19 patients participated in the study from March to April 2020. The data were collected using demographic questionnaire, General Health Questionnaire (GHQ-28), Generalized Anxiety Disorder 7-item (GAD-7), Impact of Event Scale-Revised (IES-R), Satisfaction with Life Scale (SWLS) and Connor-Davidson Resilience Scale (CD-RISC).

RESULTS

The results showed that not being at risk of coronavirus infection, poor/no satisfaction with life and non-resilience were significantly associated with higher psychological disorders. The coronavirus disease has significant consequences for the mental health of nurses. The factors affecting the mental health of nurses should be considered to support nurses in crises such as coronavirus. Provision of effective psychological interventions for nurses can be one of the effective solutions.