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Yi L, Cai J, Shuai T, Jiménez-Herrera MF, Gu L, Tian X. Mediating effect of moral sensitivity and professional identity between moral courage and compassion fatigue among nursing interns: a cross-sectional study. BMC Nurs 2024; 23:551. [PMID: 39135157 PMCID: PMC11320776 DOI: 10.1186/s12912-024-02173-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 07/12/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Compassion fatigue in nursing interns contributes to career indecision and worsens the nursing shortage. While work environment and psychological factors are well-studied, the ethical dimension remains unexplored. Understanding these mechanisms, particularly the role of moral courage, is essential for designing interventions to combat compassion fatigue and address the workforce crisis. This study investigates the influence of moral courage on compassion fatigue among Chinese nursing interns, focusing on the mediating roles of moral sensitivity and professional identity. METHODS A quantitative, cross-sectional study was conducted in accordance with the STROBE guidelines. We used the convenience sampling method to recruit 467 nursing interns from four public junior colleges in Hunan Province, China in February, 2024. Data were collected using Compassion Fatigue Short Scale, Moral Courage Scale, Revised Moral Sensitivity Questionnaire, and Professional Identity Scale. Data analyses were conducted using SPSS 22.0 and Amos 21.0. RESULTS The modified model exhibited a good fit (χ2/df = 3.437, AGFI = 0.928, IFI = 0.984, TLI = 0.976, CFI = 0.984, NFI = 0.977, RMSEA = 0.072). Moral sensitivity positively influenced both moral courage and professional identity, while professional identity negatively impacted compassion fatigue. Importantly, the effect of moral courage on compassion fatigue was entirely mediated by moral sensitivity and professional identity (β = -0.114, P = 0.001). CONCLUSION This study suggests that moral courage in nursing interns mitigates compassion fatigue through the combined mediating effects of moral sensitivity and professional identity. Ethics education programs fostering moral courage, moral sensitivity, and professional values in nursing students could be crucial in alleviating compassion fatigue.
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Affiliation(s)
- Lijuan Yi
- Department of Nursing, Hunan Traditional Chinese Medical College, Zhuzhou, 412000, China
- Nursing Department, Universitat Rovira i Virgili, Tarragona, Spain
| | - Jian Cai
- School of Nursing, Yongzhou Vocational Technical College, Yongzhou, 425000, China
| | - Ting Shuai
- Second Clinical Division, Peking University School and Hospital of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
| | | | - Lei Gu
- School of sports & arts, Hunan University of Chinese medicine, Changsha, 410000, China
| | - Xu Tian
- Chongqing Center for Evidence-based Traditional Chinese Medicine, Division of Science & Technology and Foreign Affairs the First Affiliated Hospital of Chongqing University of Chinese Medicine, No. 6 of 7th Brach of Panxi Road, Jiangbei District, Chongqing, 400020, China.
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Xiong Q, Luo F, Chen Y, Duan Y, Huang J, Liu H, Jin P, Li R. Factors influencing fatigue, mental workload and burnout among Chinese health care workers during public emergencies: an online cross-sectional study. BMC Nurs 2024; 23:428. [PMID: 38918772 PMCID: PMC11197284 DOI: 10.1186/s12912-024-02070-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVES The purpose of this study was to investigate fatigue, mental workload, and burnout among health care workers (HCWs) and explore the possible underlying factors. MATERIALS AND METHODS An online cross-sectional survey design was used to collect data from HCWs in Chongqing, China. The online survey included the Fatigue Severity Scale, NASA Task Load Index, and Chinese version of the Maslach Burnout Inventory-General Survey to assess fatigue, mental workload, and burnout, respectively, and was conducted from February 1 to March 1, 2023. RESULTS In this study, the incidence of fatigue and burnout among HCWs was 76.40% and 89.14%, respectively, and the incidence of moderate to intolerable mental workloads was 90.26%. Work-family conflict, current symptoms, number of days of COVID-19 positivity, mental workload, burnout and reduced personal accomplishment were significantly associated with fatigue. Mental workload was affected by fatigue and reduced personal accomplishment. Furthermore, burnout was influenced by marital status and fatigue. Moreover, there was a correlation among mental workload, fatigue, and burnout. CONCLUSIONS Fatigue, mental workload and burnout had a high incidence and were influenced by multiple factors during COVID-19 public emergencies in China.
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Affiliation(s)
- Qian Xiong
- The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400042, China
| | - Feng Luo
- The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400042, China.
| | - Yue Chen
- The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400042, China.
| | - Yi Duan
- The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400042, China
| | - Jie Huang
- The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400042, China
| | - Hong Liu
- The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400042, China
| | - Pengjuan Jin
- The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400042, China
| | - Rong Li
- The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400042, China
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Erschens R, Skrypski I, Festl-Wietek T, Herrmann-Werner A, Adam SH, Schröpel C, Nikendei C, Zipfel S, Junne F. Insights into discrepancies in professional identities and role models in undergraduate medical education in the context of affective burden. Front Psychiatry 2024; 15:1358173. [PMID: 38757136 PMCID: PMC11097199 DOI: 10.3389/fpsyt.2024.1358173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/22/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction International evidence strongly suggests that medical students are at high risk of mental health problems. This distress, which can be mediated by a variety of individual, interpersonal and contextual factors within the curriculum, can be mitigated by effective coping strategies and interventions. Central to this discourse is the recognition that the challenges of professional identity formation can contribute significantly to medical students' distress. The focus of our study is therefore to examine discrepancies in professional identities and role models in undergraduate medical education in relation to affective burden. Methods Medical students at different stages of university education and high school graduates intending to study medicine were surveyed in a cross-sectional study. The study employed Osgood and Hofstätter's polarity profile to evaluate the self-image of participants, the image of an ideal and real physician, and their correlation with depression (PHQ-9) and anxiety (GAD-7). Results Out of the 1535 students recruited, 1169 (76.2%) participated in the study. Students rated their self-image as somewhere between a more critical real image of physicians and a more positive ideal image. Medical students at all training levels consistently rated the ideal image as remaining constant. Significant correlations were found between the professional role models of medical students and affective symptoms, particularly for the discrepancy between the ideal image of a physician and their self-image. Furthermore, 17% and nearly 15% reported significant symptoms of depression and anxiety, respectively. Discussion Our study adds to the growing body of knowledge on professional identity formation in medicine and socialisation in the medical environment. The study highlights the importance of discrepancies between self-image and ideal image in the experience of depressive and anxiety symptoms. Primary prevention-oriented approaches should incorporate these findings to promote reflective competence in relation to professional role models and strengthen the resilience of upcoming physicians in medical training.
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Affiliation(s)
- Rebecca Erschens
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
| | - Isabelle Skrypski
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
| | - Teresa Festl-Wietek
- Tübingen Institute for Medical Education, University of Tübingen, Tübingen, Germany
| | - Anne Herrmann-Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
- Tübingen Institute for Medical Education, University of Tübingen, Tübingen, Germany
| | - Sophia Helen Adam
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
| | - Carla Schröpel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
| | - Christoph Nikendei
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
- Deanery of Students’ Affairs, University’s Faculty of Medicine, Tuebingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Otto von Guericke University Magdeburg, University Hospital Magdeburg, Magdeburg, Germany
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Zhang L, Li Z, Li M, Yang Y, Hsu M, Xia L, Liu T, Liu Y, Jiang F, Liu H, Tang YL. Mental health symptoms and their associated factors among pharmacists in psychiatric hospitals during the early stage of the COVID-19 pandemic. Glob Ment Health (Camb) 2023; 10:e77. [PMID: 38161747 PMCID: PMC10755378 DOI: 10.1017/gmh.2023.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 10/28/2023] [Accepted: 11/01/2023] [Indexed: 01/03/2024] Open
Abstract
As frontline workers, pharmacists often face significant work stress, especially in psychiatric settings. A multicenter cross-sectional design was conducted in 41 psychiatric hospitals. The Depression, Anxiety and Stress Scale-21 (DASS-21) was used to measure the mental health of 636 pharmacists. We also collected demographic data and work-related variables. The prevalence of depression, anxiety and stress was 20.60%, 22.96% and 8.96%, respectively. Multivariate logistic regression showed that several common factors were associated with depression, anxiety and stress, including professional identity (odds ratio [OR] = 0.132, 0.381 and 0.352) and verbal violence (OR = 2.068, 2.615 and 2.490). Those who were satisfied with their job were less likely to develop depression (OR = 0.234) or anxiety (OR = 0.328). We found specific factors associated with mental health. Older age (OR = 1.038) and perceived negative impact (OR = 2.398) of COVID-19 on medical work were associated with anxiety, and those with frontline experience with COVID-19 patients (OR = 2.306) were more likely to experience stress. More than one-fifth of pharmacists in psychiatric hospitals experienced symptoms of depression or anxiety during the pandemic, highlighting the need for policy change to improve workplace conditions and psychological well-being for this professional group.
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Affiliation(s)
- Ling Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Zhenkuo Li
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China
- Department of Psychiatry, The Fifth People’s Hospital of Xiangtan City, Xiangtan, China
| | - Mengdie Li
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yating Yang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Michael Hsu
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, USA
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Tingfang Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Feng Jiang
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Chaohu, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yi-lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, USA
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