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Meta-analysis of effort–reward imbalance prevalence among physicians. Int Arch Occup Environ Health 2022; 95:559-571. [DOI: 10.1007/s00420-021-01784-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 07/02/2021] [Indexed: 11/05/2022]
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Huang H, Xia Y, Zeng X, Lü A. Prevalence of depression and depressive symptoms among intensive care nurses: A meta-analysis. Nurs Crit Care 2022; 27:739-746. [PMID: 34989060 DOI: 10.1111/nicc.12734] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 11/07/2021] [Accepted: 11/08/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Nurses in intensive care units (ICUs) experience more stressful workplace conditions, making them more vulnerable to high levels of depression compared with those working in other healthcare settings. OBJECTIVES This meta-analysis aimed to estimate the pooled prevalence of depression in ICU nurses. METHODS A systematic search was conducted in Medline, EMBASE, CINHO, and Web of Science databases. Studies that reported depression among ICU nurses measured by a validated tool were synthesized using a random-effects model. Differences in prevalence of depression by study-level characteristics were estimated using sub-group analysis. Heterogeneity was investigated using standard Chi-squared tests and the I2 statistic. RESULTS Data were extracted from 19 cross-sectional studies (2003-2020) from 11 countries involving 7196 ICU nurses. The overall pooled prevalence of depression or depressive symptoms among ICU nurses was 24.99% (95% CI, 17.9%-32.7%) with high between-study heterogeneity (χ2 = 812, τ2 = 0.03, I2 = 98%, P < .01). CONCLUSION Depression appears to be common among ICU nurses. Considering its negative impact on the quality of life of staff, patient care, and the overall critical care work environment, effective interventions should be designed and implemented to improve psychological health in this population. RELEVANCE TO CLINICAL PRACTICE Findings of this review indicate that regular screening for depressive symptoms might be helpful, and access to professional help and supportive care should be provided if necessary.
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Affiliation(s)
- Huan Huang
- Department of Intensive Medicine, Changsha First Hospital, Changsha, China
| | - You Xia
- Nursing Department, Changsha First Hospital, Changsha, China
| | - Xiaoyan Zeng
- Department of Intensive Medicine, Changsha First Hospital, Changsha, China
| | - Ailian Lü
- Department of Intensive Medicine, Changsha First Hospital, Changsha, China
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Portugal LCL, Gama CMF, Gonçalves RM, Mendlowicz MV, Erthal FS, Mocaiber I, Tsirlis K, Volchan E, David IA, Pereira MG, de Oliveira L. Vulnerability and Protective Factors for PTSD and Depression Symptoms Among Healthcare Workers During COVID-19: A Machine Learning Approach. Front Psychiatry 2021; 12:752870. [PMID: 35095589 PMCID: PMC8790177 DOI: 10.3389/fpsyt.2021.752870] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/08/2021] [Indexed: 01/06/2023] Open
Abstract
Background: Healthcare workers are at high risk for developing mental health problems during the COVID-19 pandemic. There is an urgent need to identify vulnerability and protective factors related to the severity of psychiatric symptoms among healthcare workers to implement targeted prevention and intervention programs to reduce the mental health burden worldwide during COVID-19. Objective: The present study aimed to apply a machine learning approach to predict depression and PTSD symptoms based on psychometric questions that assessed: (1) the level of stress due to being isolated from one's family; (2) professional recognition before and during the pandemic; and (3) altruistic acceptance of risk during the COVID-19 pandemic among healthcare workers. Methods: A total of 437 healthcare workers who experienced some level of isolation at the time of the pandemic participated in the study. Data were collected using a web survey conducted between June 12, 2020, and September 19, 2020. We trained two regression models to predict PTSD and depression symptoms. Pattern regression analyses consisted of a linear epsilon-insensitive support vector machine (ε-SVM). Predicted and actual clinical scores were compared using Pearson's correlation coefficient (r), the coefficient of determination (r2), and the normalized mean squared error (NMSE) to evaluate the model performance. A permutation test was applied to estimate significance levels. Results: Results were significant using two different cross-validation strategies to significantly decode both PTSD and depression symptoms. For all of the models, the stress due to social isolation and professional recognition were the variables with the greatest contributions to the predictive function. Interestingly, professional recognition had a negative predictive value, indicating an inverse relationship with PTSD and depression symptoms. Conclusions: Our findings emphasize the protective role of professional recognition and the vulnerability role of the level of stress due to social isolation in the severity of posttraumatic stress and depression symptoms. The insights gleaned from the current study will advance efforts in terms of intervention programs and public health messaging.
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Affiliation(s)
- Liana C L Portugal
- Neurophysiology Laboratory, Department of Physiological Sciences, Roberto Alcantara Gomes Biology Institute, Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, Brazil.,Laboratory of Neurophysiology of Behavior, Department of Physiology and Pharmacology, Biomedical Institute, Federal Fluminense University, Rio de Janeiro, Brazil
| | - Camila Monteiro Fabricio Gama
- Laboratory of Neurophysiology of Behavior, Department of Physiology and Pharmacology, Biomedical Institute, Federal Fluminense University, Rio de Janeiro, Brazil
| | - Raquel Menezes Gonçalves
- Laboratory of Neurophysiology of Behavior, Department of Physiology and Pharmacology, Biomedical Institute, Federal Fluminense University, Rio de Janeiro, Brazil
| | - Mauro Vitor Mendlowicz
- Department of Psychiatry and Mental Health, Fluminense Federal University, Rio de Janeiro, Brazil
| | - Fátima Smith Erthal
- Laboratory of Neurobiology, Institute of Biophysics Carlos Chagas Filho, Rio de Janeiro, Brazil
| | - Izabela Mocaiber
- Laboratory of Cognitive Psychophysiology, Department of Natural Sciences, Institute of Humanities and Health, Federal Fluminense University, Rio de Janeiro, Brazil
| | - Konstantinos Tsirlis
- Centre for Medical Image Computing, University College London, London, United Kingdom
| | - Eliane Volchan
- Laboratory of Neurobiology, Institute of Biophysics Carlos Chagas Filho, Rio de Janeiro, Brazil
| | - Isabel Antunes David
- Laboratory of Neurophysiology of Behavior, Department of Physiology and Pharmacology, Biomedical Institute, Federal Fluminense University, Rio de Janeiro, Brazil
| | - Mirtes Garcia Pereira
- Laboratory of Neurophysiology of Behavior, Department of Physiology and Pharmacology, Biomedical Institute, Federal Fluminense University, Rio de Janeiro, Brazil
| | - Leticia de Oliveira
- Laboratory of Neurophysiology of Behavior, Department of Physiology and Pharmacology, Biomedical Institute, Federal Fluminense University, Rio de Janeiro, Brazil
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Zhang H, Ye Z, Tang L, Zou P, Du C, Shao J, Wang X, Chen D, Qiao G, Mu SY. Anxiety symptoms and burnout among Chinese medical staff of intensive care unit: the moderating effect of social support. BMC Psychiatry 2020; 20:197. [PMID: 32357865 PMCID: PMC7195710 DOI: 10.1186/s12888-020-02603-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 04/15/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Social support can be a critical resource to help medical staff cope with stressful events; however, the moderating effect of social support on the relationship between burnout and anxiety symptoms has not yet been explored. METHODS The final sample was comprised of 514 intensive care unit physicians and nurses in this cross-sectional study. Questionnaires were used to collect data. A moderated model was used to test the effect of social support. RESULTS The moderating effect of social support was found to be significant (b = - 0.06, p = 0.04, 95%CI [- 0.12, - 0.01]). The Johnson-Neyman technique indicated that when social support scores were above 4.26 among intensive care unit medical staff, burnout was not related to anxiety symptoms. CONCLUSIONS This is the first study to test the moderating effect of social support on the relationship between burnout and anxiety symptoms among intensive care unit staff.
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Affiliation(s)
- Hui Zhang
- grid.13402.340000 0004 1759 700XZhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, 310016 Zhejiang China
| | - ZhiHong Ye
- Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, 310016, Zhejiang, China.
| | - Leiwen Tang
- grid.13402.340000 0004 1759 700XZhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, 310016 Zhejiang China
| | - Ping Zou
- grid.260989.c0000 0000 8588 8547School of Nursing, Nipissing University, 750 Dundas Street West, Toronto, Ontario Canada
| | - Chunxue Du
- grid.459540.90000 0004 1791 4503Guizhou Provincial People’s Hospital, Guiyang, 550002 Guizhou China
| | - Jing Shao
- grid.13402.340000 0004 1759 700XZhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, 310016 Zhejiang China
| | - Xiyi Wang
- grid.13402.340000 0004 1759 700XZhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, 310016 Zhejiang China
| | - Dandan Chen
- grid.13402.340000 0004 1759 700XZhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, 310016 Zhejiang China
| | - Guojing Qiao
- grid.452244.1The Affiliated Hospital of Guizhou Medical University, Guiyang, 550001 Guizhou China
| | - Shao Yu Mu
- grid.203458.80000 0000 8653 0555Nursing College of Chongqing Medical University, Chongqing, 400016 China
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Ghawadra SF, Abdullah KL, Choo WY, Phang CK. Psychological distress and its association with job satisfaction among nurses in a teaching hospital. J Clin Nurs 2019; 28:4087-4097. [DOI: 10.1111/jocn.14993] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/14/2019] [Accepted: 06/30/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Sajed Faisal Ghawadra
- Department of Nursing Science, Faculty of Medicine University of Malaya Kuala Lumpur Malaysia
| | - Khatijah Lim Abdullah
- Department of Nursing Science, Faculty of Medicine University of Malaya Kuala Lumpur Malaysia
| | - Wan Yuen Choo
- Department of Social & Preventive Medicine, Faculty of Medicine University of Malaya Kuala Lumpur Malaysia
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Zeng HJ, Zhou GY, Yan HH, Yang XH, Jin HM. Chinese nurses are at high risk for suicide: A review of nurses suicide in China 2007-2016. Arch Psychiatr Nurs 2018; 32:896-900. [PMID: 30454635 DOI: 10.1016/j.apnu.2018.07.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 06/13/2018] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE This study summarized the cases of Chinese nurses' suicide during 2007-2016. METHODS We reviewed public reports on local media, and medical websites. RESULT A total of 46 cases of nurse suicide reported or published from 2007 to 2016. In these 46 cases, the proportion of female suicide is 98%. Most cases of suicide occurred in nurses aged 18-50 years. The most common way of suicide was jump from building. Nurse suicide occurred more often in full-service tertiary hospitals. CONCLUSION The Chinese Government and medical organization should be aware of severity of suicide, and take action to be avoided of more suicide in Chinese nurses.
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Affiliation(s)
- Hong Jun Zeng
- Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong Medical Center, 2800 Gong Wei Road, Shanghai, China
| | - Gui Ying Zhou
- Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong Medical Center, 2800 Gong Wei Road, Shanghai, China
| | - Hui Hong Yan
- Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong Medical Center, 2800 Gong Wei Road, Shanghai, China
| | - Xiu Hong Yang
- Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong Medical Center, 2800 Gong Wei Road, Shanghai, China.
| | - Hui Min Jin
- Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong Medical Center, 2800 Gong Wei Road, Shanghai, China.
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Mikkola L, Suutala E, Parviainen H. Social support in the workplace for physicians in specialization training. MEDICAL EDUCATION ONLINE 2018; 23:1435114. [PMID: 29464988 PMCID: PMC5827784 DOI: 10.1080/10872981.2018.1435114] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 01/22/2018] [Indexed: 05/30/2023]
Abstract
When becoming a specialist, learning-through-service plays a significant role. The workplace affords good opportunities for learning, but the service-learning period may also impose stress on phycisians in specialization training. In medical work, social support has proved to be a very important factor in managing stress. Social support may afford advantages also for learning and professional identity building. However, little was known about how social support is perceived by doctors in specialization training. This study aimed to understand the perceptions of physicians in specialization training regarding social support communication in their workplace during their learning-through-service period. The study was conducted qualitatively by inductively analyzing the physicians' descriptions of workplace communication. The dataset included 120 essays, 60 each from hospitals and primary healthcare centres. Physicians in specialization training explained the need of social support with the responsibilities and demands of their clinical work and the inability to control and manage their workloads. They perceived that social support works well for managing stress, but also for strengthening relational ties and one's professional identity. A leader's support was perceived as being effective, and both senior and junior colleagues were described as an important source of social support. Also co-workers, such as the individual nurse partner with whom one works, was mentioned as an important source of social support. The results of this study indicate that social support works at the relational and identity levels, which is due to the multi-functional nature of workplace communication. For example, consultation functions as situational problem-solving, but also the tone of social interaction is meaningful. Thus, strengthening one's professional identity or collegial relationships requires further attention to workplace communication. Abbreviations PiST: Physician in specialization training.
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Affiliation(s)
- Leena Mikkola
- Department of Language and Communication Studies, University of Jyvaskyla, Jyvaskyla, Finland
| | - Elina Suutala
- Faculty of Social Sciences/Health Sciences, University of Tampere, Tampere, Finland
| | - Heli Parviainen
- Faculty of Social Sciences/Health Sciences, University of Tampere, Tampere, Finland
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Karanikola M, Giannakopoulou M, Mpouzika M, Kaite CP, Tsiaousis GZ, Papathanassoglou EDE. Dysfunctional psychological responses among Intensive Care Unit nurses: a systematic review of the literature. Rev Esc Enferm USP 2016; 49:847-57. [PMID: 26516757 DOI: 10.1590/s0080-623420150000500020] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Accepted: 07/06/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To systematically review evidence on dysfunctional psychological responses of Intensive Care Units nurses (ICUNs), with focus on anxiety and depressive symptoms and related factors. METHOD A literature search was performed in CINAHL, PubMed and Scopus databases, from 1999 to present, along with a critical appraisal and synthesis of all relevant data. The following key words, separately and in combination, were used: "mental status" "depressive symptoms" "anxiety" "ICU nurses" "PTSD" "burnout" "compassion fatigue" "psychological distress". RESULTS Thirteen quantitative studies in English and Greek were included. The results suggested increased psychological burden in ICUNs compared to other nursing specialties, as well as to the general population. CONCLUSIONS Studies investigating psychological responses of ICUNs are limited, internationally. Future longitudinal and intervention studies will contribute to a better understanding of the phenomenon.
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Affiliation(s)
- Maria Karanikola
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | | | - Meropi Mpouzika
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Charis P Kaite
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
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Lifestyle and Depression among Hong Kong Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13010135. [PMID: 26784216 PMCID: PMC4730526 DOI: 10.3390/ijerph13010135] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 01/12/2016] [Accepted: 01/13/2016] [Indexed: 01/18/2023]
Abstract
Recent longitudinal data suggest a close association between depression and lifestyle. Little work to date has estimated the prevalence of depression in the nursing workforce in China, nor considered what lifestyle factors might be correlated with it—a gap filled by the present study. The study’s web-based cross-sectional survey solicited data from qualified nurses aged between 21 and 65 registered with the Hong Kong Nursing Council. The Depression, Anxiety and Stress Scale 21 was used to measure 850 nurses for depression, anxiety and symptoms of stress; a generalized linear regression model examined associations between lifestyle factors and depression. Mean depression symptom scores show a downward linear trend for male and female participants. Gender and age, however, did not emerge as significant predictors of depression. Three lifestyles factors (sleep, entertainment and hobbies) showed a significant association with depression. Nurses should make therapeutic lifestyle changes to improve their work-life balance and safeguard their functioning at work and personal well-being.
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10
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Cheung T, Lee PH, Yip PS. Suicidality among Hong Kong nurses: prevalence and correlates. J Adv Nurs 2015; 72:836-48. [DOI: 10.1111/jan.12869] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Teris Cheung
- School of Nursing; Hong Kong Polytechnic University; Hong Kong
| | - Paul H. Lee
- School of Nursing; Hong Kong Polytechnic University; Hong Kong
| | - Paul S.F. Yip
- Centre for Suicide Research and Prevention; the University of Hong Kong; Hong Kong
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Cheung T, Yip PSF. Depression, Anxiety and Symptoms of Stress among Hong Kong Nurses: A Cross-sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:11072-100. [PMID: 26371020 PMCID: PMC4586662 DOI: 10.3390/ijerph120911072] [Citation(s) in RCA: 165] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 08/29/2015] [Accepted: 09/01/2015] [Indexed: 01/22/2023]
Abstract
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.
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Affiliation(s)
- Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China.
- Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China.
| | - Paul S F Yip
- Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China.
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Perry L, Lamont S, Brunero S, Gallagher R, Duffield C. The mental health of nurses in acute teaching hospital settings: a cross-sectional survey. BMC Nurs 2015; 14:15. [PMID: 25904820 PMCID: PMC4405850 DOI: 10.1186/s12912-015-0068-8] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 03/17/2015] [Indexed: 12/01/2022] Open
Abstract
Background Nursing is an emotionally demanding profession and deficiencies in nurses’ mental wellbeing, characterised by low vitality and common mental disorders, have been linked to low productivity, absenteeism and presenteeism. Part of a larger study of nurses’ health, the aim of this paper was to describe the mental health status and related characteristics of nurses working in two acute metropolitan teaching hospitals. Methods A cross sectional survey design was used. The Registered and Enrolled Nurse workforce, employed on any form of contract, at two teaching hospitals in Sydney Australia were invited to participate. The survey tool was compiled of validated tools and questions. Family and medical history and health risk-related characteristics, current psycho-active medications, smoking status, alcohol intake, eating disorders, self-perceived general health, mental health and vitality, demographic, social and occupational details were collected. Results A total of 1215 surveys were distributed with a usable response rate of 382 (31.4%). Altogether 53 nurses (14%) reported a history of mental health disorders, of which n = 49 (13%) listed diagnoses of anxiety and/or depression; 22 (6%) were currently taking psychoactive medication. Symptoms that could potentially indicate a mental health issue were more common, with 248 (65.1%) reporting they had experienced symptoms sometimes or often in the last 12 month. Nurses had better mental health if they had better general health, lived with a spouse/ partner rather than alone, had fewer symptoms, sleep problems or disordered eating behaviours, were not an informal carer and did not work nights. Nurses had greater vitality if they were male, had better general health, fewer sleep problems or symptoms generally and lived with a spouse/ partner rather than alone; less vitality if they were an informal carer or had disordered eating. Conclusion Nurses and their managers should strive to create workplaces where working practices promote nurses’ health and wellbeing, or at least are configured to minimise deleterious effects; where both nurses and their managers are aware of the potential for negative effects on the mental health of the workforce; where cultures are such that this can be discussed openly without fear of stigma or denigration.
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Affiliation(s)
- Lin Perry
- Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007 Australia
| | - Scott Lamont
- Mental Health Liaison, Prince of Wales Hospital and Community Health Services, Randwick, NSW 2031 Australia
| | - Scott Brunero
- Mental Health Liaison, Prince of Wales Hospital and Community Health Services, Randwick, NSW 2031 Australia
| | - Robyn Gallagher
- Charles Perkins Centre and Sydney Nursing School, University of Sydney, Sydney, NSW 2006 Australia
| | - Christine Duffield
- Centre for Health Services Management, Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007 Australia ; Edith Cowan University, Perth, WA Australia
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Ohlander J, Weigl M, Petru R, Angerer P, Radon K. Working conditions and effort-reward imbalance of German physicians in Sweden respective Germany: a comparative study. Int Arch Occup Environ Health 2014; 88:511-9. [PMID: 25228139 DOI: 10.1007/s00420-014-0978-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 09/03/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Work stress among physicians is a growing concern in various countries and has led to migration. We compared the working conditions and the work stress between a migrated population of German physicians in Sweden and a population of physicians based in Germany. Additionally, specific risk factors for work stress were examined country wise. METHOD Using a cross-sectional design, 85 German physicians employed in Sweden were surveyed on working conditions and effort-reward imbalance and compared with corresponding data on 561 physicians working in Germany. Multiple linear regression analyses were applied on both populations separately to model the associations between working conditions and effort-reward ratio (ERR), adjusted for a priori confounders. RESULTS German physicians in Sweden had a significantly lower ERR than physicians in Germany: mean (M) = 0.47, standard deviation (SD) = 0.24 vs. M = 0.80, SD = 0.35. Physicians in Sweden worked on average 8 h less per week and reported higher work support and responsibility. Multivariate analyses showed in both populations a negative association between work support and the ERR (β = -0.148, 95% CI -0.215 to (-0.081) for physicians in Sweden and β = -0.174, 95% CI -0.240 to (-0.106) for physicians in Germany). Further significant associations with the ERR were found among physicians in Sweden for daily breaks (β = -0.002, 95% CI -0.004 to (-0.001)) and among physicians in Germany for working hours per week (β = 0.006, 95% CI 0.002-0.009). CONCLUSION Our findings show substantial differences in work stress and working conditions in favor of migrated German physicians in Sweden. To confirm our results and to explain demonstrated differences in physicians' work stress, longitudinal studies are recommended.
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Affiliation(s)
- Johan Ohlander
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig Maximilians University Munich, Ziemssenstr. 1, 80336, Munich, Germany,
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