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Webb K, Penz K. Strategies to Reduce the Impact of Trauma in Psychiatric Nurses: An Integrative Review of the Literature. Issues Ment Health Nurs 2024; 45:173-185. [PMID: 38232041 DOI: 10.1080/01612840.2023.2278784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
BACKGROUND Psychiatric nurses are at a higher risk for exposure to violence and aggression, leading to potential burnout, moral injury, post-traumatic stress, and turnover. There is little evidence of a preferred strategy to support nurses and decrease the impact of traumatic experiences on psychiatric nurses. The aim of this integrative review was to explore potential strategies to decrease the impact of traumatic experiences among nurses in psychiatric settings. METHODS Following a systematic search of PsycINFO/Ovid, CINAHL, and MEDLINE/Pubmed, Joanna Briggs Institute quality appraisal tools were used to analyze quality of the articles. Thirteen articles met the inclusion/exclusion criteria for this study. Data were analyzed and synthesized into three key themes and seven sub-themes. RESULTS Three themes were noted to be common to the included texts. 1. Interpersonal Supports (Formal Support, Peer/Supervisor Support, and Informal Family/Social Support). 2. Organizational Supports (Perception of Job Safety/Satisfaction, Promoting Personal Resilience, Supporting Team Resilience, and Organizational Commitment to Resilience). 3. Protection of Personal Resources. CONCLUSIONS Many common suggestions for decreasing the impact of exposure to violence and trauma were noted across the thirteen articles, however, there is little evidence of a preferred strategy, how strategies are developed and employed or the efficacy of any particular strategy. Further investigation is needed to identify and evaluate supportive interventions, their feasibility and efficacy.
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Affiliation(s)
- Kayla Webb
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Kelly Penz
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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2
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Bui MV, McInnes E, Ennis G, Foster K. Mental health nurses' experience of resilience during COVID-19: A qualitative inquiry. Int J Ment Health Nurs 2023; 32:1735-1744. [PMID: 37605316 DOI: 10.1111/inm.13213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/06/2023] [Accepted: 08/08/2023] [Indexed: 08/23/2023]
Abstract
The COVID-19 pandemic created unprecedented demands and additional stress for nurses in mental health settings. There is no prior evidence on nurses' experience of building and maintaining resilience in the context of work during COVID-19. The aim of this study was to explore the experience and impacts of the COVID-19 pandemic on the resilience of nurses in mental health settings. Data from semi-structured interviews with 20 nurses from an Australian mental health service were analysed using reflexive thematic analysis. Four main themes were generated: experiencing significant disruptions; making sense of shared chaos; having professional commitment; and growing through the challenges. Nurses' practice and teamwork were disrupted by COVID-19 related changes to care models and infection prevention policies. They successfully adjusted by having awareness of self and others' emotions, using mental and emotional self-regulatory strategies, engaging in self-care, using 'bricolage' to create different ways to provide care, and having mutually supportive relationships. Nurses connected to their sense of purpose and professional commitment to fuel their therapeutic work and sustain care delivery. They experienced personal and professional growth with an increased understanding of their strengths and resilience. In the post-pandemic period, although the challenges presented by the pandemic have lessened, there are ongoing negative impacts on nurses' wellbeing. To maintain and strengthen their wellbeing and practice, the findings indicate the importance of professional development in emotional regulation skills, and strategies to strengthen self-care and build collegial relationships in teams. Resilience education can be implemented to support nurses' resilient practice skills.
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Affiliation(s)
- Minh Viet Bui
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Elizabeth McInnes
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia
- Nursing Research Institute - St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne and Australian Catholic University, Fitzroy, Victoria, Australia
| | - Gary Ennis
- Northern Health, Epping, Victoria, Australia
| | - Kim Foster
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia
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3
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Foster K, Evans A, Alexander L. Grace under pressure: Mental health nurses' stories of resilience in practice. Int J Ment Health Nurs 2023; 32:866-874. [PMID: 36807430 DOI: 10.1111/inm.13130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/30/2023] [Accepted: 02/06/2023] [Indexed: 02/23/2023]
Abstract
Mental health nurses experience both organizational and practice-related stressors in their work. Resilience is an interactive process of positive adaptation following stress and adversity. There is limited evidence on how personal resilience is applied to mental health nursing practice. The aim of this interpretive narrative study was to explore mental health nurses' stories of resilience in their practice for the purpose of gaining an understanding of resilience resources they draw on when dealing with challenging workplace situations. A storytelling approach was used in semistructured phone interviews with 12 mental health nurses who measured high on resilience (Workplace Resilience Inventory) and caring behaviours (Caring Behaviours Inventory). Within and across case narrative analysis produced stories of resilient practice within four themes: proactively managing the professional self; sustaining oneself through supportive relationships; engaging actively in practice, learning and self-care; and seeking positive solutions and outcomes. Nurses displayed poise in stressful situations and grace under pressure in demanding and emotionally challenging interactions, holding dignity and respect for self and others, with the aim of achieving positive outcomes for both. Resilient practice is the responsibility of organizations as well as individuals. To develop practice and support staff retention, we recommend organizations use tailored professional development to cultivate a growth mindset in new and experienced staff, develop organizational strategies to build positive team cultures, and prioritize strategies to reduce workplace stressors and strengthen staff psychological safety and well-being. The use of narrative techniques in reflective practice and clinical supervision may help build nurses' resilience and practice.
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Affiliation(s)
- Kim Foster
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Alicia Evans
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Louise Alexander
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia
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4
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Wang N, Chen H, Zhang M, Wang Y, Xue Z, Hao X, Liu Y. Validation of the Chinese version of the resilience scale for the oldest-old. Front Psychol 2023; 14:1055301. [PMID: 36874822 PMCID: PMC9982108 DOI: 10.3389/fpsyg.2023.1055301] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/30/2023] [Indexed: 02/19/2023] Open
Abstract
Background Resilience is one of the most important variables associated with adaptive ability. The resilience scale for the oldest-old age (RSO) has been designed to measure the resilience among the oldest-old people. Originally developed in Japan, this scale has not been used in China. The objective of this study was to translate the RSO into Chinese and investigate its validity and reliability among the community's oldest-old adults aged ≥80 years. Methods A total of 473 oldest-old people who came from communities were recruited by convenience sampling for the assessment of construct validity using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). In addition, internal consistency reliability, test-retest reliability, face validity, and content validity were used to evaluate the psychometric characteristics of RSO. Results The RSO demonstrated good face validity and content validity. The content validity index of the Chinese version of the RSO was 0.890. Moreover, one factor was extracted by exploratory factor analysis, which accounted for 61.26% of the variance. The RSO had high internal consistency with a Cronbach's alpha = 0.927. The test-retest reliability was 0.785. The item-total correlations ranged from 0.752 to 0.832. Conclusion The results of the study indicate that the Chinese version of the RSO questionnaire has good reliability and validity and can be recommended for use by health and social service agencies as a method for assessing the resilience of the oldest-old in the community.
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Affiliation(s)
- Ning Wang
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Hongyu Chen
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Minyi Zhang
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yuanyuan Wang
- Department of Nursing, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Zhihan Xue
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xixi Hao
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yan Liu
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang, China
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5
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Delgado C, Evans A, Roche M, Foster K. Mental health nurses' resilience in the context of emotional labour: An interpretive qualitative study. Int J Ment Health Nurs 2022; 31:1260-1275. [PMID: 35794727 PMCID: PMC9539887 DOI: 10.1111/inm.13037] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2022] [Indexed: 12/27/2022]
Abstract
Strengthening mental health nurses' (MHNs) resilience may help mitigate the negative effects of the emotional labour (EL) of their work. There is no prior evidence on MHNs' experiences of resilience in the context of EL. This interpretive qualitative study sought to explore how MHNs build and maintain their resilience in the face of high levels of EL. Semi-structured interviews were conducted with 11 MHNs. Reflexive thematic analysis was used to analyse the data. Four main themes were constructed. The first three; Being attuned to self and others, Having a positive mindset grounded in purpose, and Maintaining psychological equilibrium through proactive self-care, describe how MHNs build and maintain their resilience. The fourth theme, Running on emotionally empty, describes what impedes MHNs' resilience. MHNs engaged in internal self-regulatory processes to manage their mental and emotional state. They maintained intra- and inter-personal boundaries and proactively used self-care strategies to maintain their well-being. Through this, they were able to replenish and sustain the energy required to maintain a state of equilibrium between themselves, their interpersonal practice, and their working environment, and to positively adapt to EL. However, lack of organizational support and high workplace demands can negatively impact MHNs' equilibrium and adaptive ability. There is a need for organizations to proactively work to reduce workplace stressors, and support MHNs' professional well-being and practice. Education and support strategies focused on strengthening MHNs' resilience, well-being, and mental health practice capabilities, including the provision of clinical supervision, and clear role expectations within MHNs' scope of practice are recommended.
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Affiliation(s)
- Cynthia Delgado
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,Sydney Local Health District Mental Health Service, Concord Centre for Mental Health, Concord, New South Wales, Australia
| | - Alicia Evans
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia
| | - Michael Roche
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia.,ACT Health, Phillip, Australian Capital Territory, Australia
| | - Kim Foster
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,Northwestern Mental Health, Melbourne Health, The Royal Melbourne Hospital, Parkville, Victoria, Australia
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6
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Cognitive Behavioral Training and Positive Psychology Training for Pregnant Women’s Psychological Health. PSYCHOLOGICAL STUDIES 2022. [DOI: 10.1007/s12646-022-00673-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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7
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Zhai X, Ren LN, Liu Y, Liu CJ, Su XG, Feng BE. Resilience Training for Nurses: A Meta-analysis. J Hosp Palliat Nurs 2021; 23:544-550. [PMID: 34313624 DOI: 10.1097/njh.0000000000000791] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Nurses frequently face stressful situations during work, which makes resilience an essential quality of their personality to cope with professional stress and to prevent burnout. Resilience can be improved by training and practice. To analyze the effect of resilience training in nurses, studies reporting the changes in resilience before and after resilience training were identified by conducting the literature search in electronic databases. Meta-analyses of standardized mean differences (SMDs) between postintervention and preintervention scores of resilience and other related variables were performed. Thirteen studies (576 nurse participants) were included. Resilience training improved the resilience scores of the participants (SMD, 0.58; 95% confidence interval [CI], 0.23-0.94; P = .001), whereas there was no improvement in the resilience scores of nurses who did not participate in resilience training (SMD, -0.13; 95% CI, -0.54 to 0.27; P = .523). The stress (SMD, -0.60; 95% CI, -0.80 to -0.40; P < .00001), anxiety (SMD, -0.50; 95% CI, -0.80 to -0.20; P = .001), depression (SMD, -0.43; 95% CI, -0.67 to -0.19; P < .0001), and burnout (SMD, -1.01; 95% CI, -1.25 to -0.76; P <˂ .0001) scores of the participants were also decreased after resilience training. In conclusion, resilience training improved the resilience scores of nurses, which was also associated with improvements in stress, depression, anxiety, and burnout scores. However, because of the variations in training contents and measuring tools, only generalized assessments could be made.
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8
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Bujold A, Pariseau-Legault P, de Montigny F. [Understanding the lived experiences of undergraduate nursing students during a mental health practicum. An interpretive phenomenological analysis]. Rech Soins Infirm 2021; 145:22-37. [PMID: 34372649 DOI: 10.3917/rsi.145.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
In a global context where populations' mental health needs are growing rapidly, recruiting the next generation of nurses to work in these care settings is particularly problematic. Because of their negative views on mental health issues, nursing students reject such a career path. According to the literature, training programs, particularly clinical immersions, are the main way of mitigating the unpopularity of mental health care among this new generation of nurses. Through an interpretive phenomenological analysis of semi-structured interviews conducted with eleven undergraduate nursing students, this research studied their learning experience during a clinical immersion in mental health care. Anchored in Parse's humanbecoming theory, this study explores the meaning that students attribute to such an experience, the experiential negotiation processes of the practicum setting, and the participants' ability to project themselves beyond the learning experience itself. These results raise various issues related to mental health nursing education, such as the importance of having a nursing role model, as well as various influencing factors related to the rejection of a career in mental health care by the next generation, such as the perception that working in these care settings involves an increased risk of aggression.
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9
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Lee H. Resilience to Combat the COVID-19 pandemic and beyond. Arch Psychiatr Nurs 2021; 35:A2-A3. [PMID: 33966804 PMCID: PMC9758594 DOI: 10.1016/j.apnu.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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10
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Corgan S, Ford Winkel A, Sugarman R, Young JQ. From Burnout to Wholehearted Engagement: A Qualitative Exploration of Psychiatry Residents' Experience of Stress. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:709-717. [PMID: 33410608 DOI: 10.1097/acm.0000000000003912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE Physician burnout is endemic across medical education and has numerous deleterious effects. Given the prevalence and negative effects of burnout, there is an urgent need to understand how residents experience and cope with stress and develop explanatory models that inform the development of more effective interventions. METHOD Using a qualitative, constructivist approach informed by grounded theory, the authors conducted semistructured interviews from March to April 2019, in which psychiatry residents were asked about their experiences of stress and how they coped. First- through fourth-year trainees at Zucker Hillside Hospital at Northwell Health, Glen Oaks, New York, were invited. Two authors independently and inductively coded deidentified transcripts. A constant comparative approach was used to analyze data and support construction of themes. Theoretic sufficiency was observed after 14 interviews. RESULTS The authors constructed an explanatory model for how residents cope with stress and whether they tended toward burnout or wholehearted engagement. The model included 3 themes: self-care, work relationships, and meaning making. Self-care, including time spent with others, provided connection and belonging that bolstered physicians' developing identities. Interpersonal relationships at work profoundly influenced the experience of residents. Positive peer and supervisor relationships enhanced confidence and perseverance. Negative role models and conflict engendered feelings of inadequacy. The ability to shift perspective and build meaning through examining moral values in the face of challenges was crucial for residents who reported success at coping with stress. Residents identified personal psychotherapy as an especially important strategy to facilitate meaning making. CONCLUSIONS These findings provide guidance for how residency programs may help residents cope with stress and move away from burnout toward wholehearted engagement. Strategies may include reducing barriers to self-care and to accessing help early in training, creating spaces that promote peer connection and providing training in addressing conflict, and facilitating engagement in meaning-making activities.
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Affiliation(s)
- Sondra Corgan
- S. Corgan is a fellow in child and adolescent psychiatry, Department of Psychiatry, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Abigail Ford Winkel
- A. Ford Winkel is associate professor and vice chair for education, Department of Obstetrics and Gynecology, and assistant director, Institute for Innovations in Medical Education, New York University Grossman School of Medicine, New York, New York
| | - Rebekah Sugarman
- R. Sugarman is a medical student, University of Michigan Medical School, Ann Arbor, Michigan
| | - John Q Young
- J.Q. Young is professor and vice chair for education, Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and Zucker Hillside Hospital at Northwell Health, Glen Oaks, New York; ORCID: http://orcid.org/0000-0003-2219-5657
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11
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Nunstedt H, Eriksson M, Obeid A, Hillström L, Truong A, Pennbrant S. Salutary factors and hospital work environments: a qualitative descriptive study of nurses in Sweden. BMC Nurs 2020; 19:125. [PMID: 33342433 PMCID: PMC7751112 DOI: 10.1186/s12912-020-00521-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 12/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Extensive research describes how nurses experience their work environment. The conditions are described as stressful and dissatisfying with nurses intending to leave their workplace. Knowledge about the personal perception regarding why nurses consider leaving the hospital workplace is limited. The purpose of this study was to understand why hospital nurses remain in their workplace, which facilitates their continuation in the profession. OBJECTIVE The objective was to explore and describe factors explaining why hospital nurses remain in the workplace. METHODS This was a descriptive qualitative study with a purposive sample of hospital nurses in Sweden. The salutogenic theory was the basis for the interview guide and the semi-structured questions. Individual interviews were conducted in a hospital in western Sweden. Content analysis was performed to organize the coded data according to the sense of coherence. RESULTS Data saturation was achieved with 12 interviews. Within the three themes of coherence (comprehensibility, manageability, and meaningfulness), ten subthemes were categorized from the data as follows: job satisfaction and fun at work, acknowledgement and productivity, togetherness and team security, manageable workload, variable work and challenging situations, workplace and personal space balance, collaboration and supportive leadership, valued role and good work, commitment and involvement, and pride in the professional role. CONCLUSIONS The main findings of this study have shown the critical importance of being in a meaningful, comprehensible and manageable work context that supports nurses in maintaining their professional identity.
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Affiliation(s)
- Håkan Nunstedt
- Department of Health Sciences, University West, Trollhättan, Sweden.
| | - Monica Eriksson
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - Ayman Obeid
- Department of Health Sciences, University West, Trollhättan, Sweden
| | | | - Anh Truong
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - Sandra Pennbrant
- Department of Health Sciences, University West, Trollhättan, Sweden
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12
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Bujold A, Pariseau-Legault P, de Montigny F. [The unpopularity of mental health/psychiatry care settings among nursing students: A systematic review]. Rech Soins Infirm 2020; 141:17-37. [PMID: 32988187 DOI: 10.3917/rsi.141.0017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
In every population and country around the world, mental health needs are great and are on the rise. Through their training and their vast field of expertise, nurses are an important lever for addressing the issue of accessibility in these care settings. While the increase in the number of new nursing graduates should have helped this issue, recent data show a sharp increase in the shortage of nurses in these care settings. This systematic review (n=40) using the CINAHL, MEDLINE, PsycArticles, and Scopus databases aims to explore why psychiatric and mental health care settings are unpopular with the next generation of nurses. Guided by Parse's theory, this review identifies three major themes : (1) nursing students' perspectives on mental health issues, (2) the influences of educational interventions on these perspectives, and (3) the factors facilitating and constraining a career in these care settings for new nursing graduates. These results enable a better understanding of what can affect the recruitment of new graduate nurses in mental health/psychiatry, while proposing various levers of intervention to specifically address this issue.
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13
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Abstract
Nurse resilience is attracting increasing attention in research and practice. Possession of a high level of resilience is cited as being crucial for nurses to succeed professionally and manage workplace stressors. There is no agreed definition of nurse resilience. A concept analysis was undertaken to examine nurse resilience using a priori selected analysis framework. This concept analysis aims to systematically analyse resilience as it relates to nurses and establish a working definition of nurse resilience. Sixty-nine papers met the search criteria for inclusion. Key attributes of nurse resilience were social support, self-efficacy, work-life balance/self-care, humour, optimism, and being realistic. Resilience enables nurses to positively adapt to stressors and adversity. It is a complex and dynamic process which varies over time and context and embodies both individual attributes and external resources. Sustaining nurse resilience requires action and engagement from both individuals and organizations.
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Affiliation(s)
- Alannah L Cooper
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
- St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
| | - Janie A Brown
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
| | - Clare S Rees
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
- School of Psychology, Curtin University, Perth, Western Australia, Australia
| | - Gavin D Leslie
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
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14
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Muir‐Cochrane E, James R. Safe and secure? The complexities of caring in hospitals. J Clin Nurs 2020; 29:3603-3604. [DOI: 10.1111/jocn.15343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 04/13/2020] [Accepted: 05/09/2020] [Indexed: 11/28/2022]
Affiliation(s)
| | - Russell James
- School of Nursing College of Health and Medicine University of Tasmania Adelaide TAS Australia
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15
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Delgado C, Roche M, Fethney J, Foster K. Workplace resilience and emotional labour of Australian mental health nurses: Results of a national survey. Int J Ment Health Nurs 2020; 29:35-46. [PMID: 31050127 DOI: 10.1111/inm.12598] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/07/2019] [Indexed: 11/26/2022]
Abstract
Emotional labour is a form of adversity faced by mental health nurses in the context of their workplace interactions. Frequent exposure to emotional adversity can negatively impact mental health nurses' biopsychosocial well-being, workplace relationships, and performance. Workplace resilience is a dynamic interactive process within and between the person and their environment that promotes positive adaptation to adverse events and restores well-being. Workplace resilience could be a protective process that helps mental health nurses positively adapt to workplace emotional adversity. This study aimed to investigate Australian mental health nurses' workplace resilience and emotional labour and explore the relationship between them. A national cross-sectional online survey comprising the Resilience at Work and Emotional Labour scales was completed by registered nurses (n = 482) working in a mental health role or setting across Australia. There was a strong negative relationship between resilience and the emotional labour strategy of surface acting. A positive association between resilience, frequency of emotional labour, and clinical supervision was also found. These findings point to a potential link between mental health nurses' skills of cognitive reframing, and emotional and behavioural regulation needed to effectively manage their emotions and remain therapeutic in interpersonal interactions. Clinical supervision may be a key strategy in supporting mental health nurses' resilience. Further investigation of workplace individuals' internal and external resources, and organizational resources, supports, and strategies that can promote and strengthen mental health nurses' well-being is needed.
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Affiliation(s)
- Cynthia Delgado
- School of Nursing, Midwifery& Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,Sydney Local Health District Mental Health Service, Camperdown, NSW, Australia
| | - Michael Roche
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Judith Fethney
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, Camperdown, New South Wales, Australia
| | - Kim Foster
- School of Nursing, Midwifery& Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,Northwestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
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16
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Reyes AT, Constantino RE, Cross CL, Tan RA, Bombard JN, Acupan AR. Resilience and psychological trauma among Filipino American women. Arch Psychiatr Nurs 2019; 33:177-185. [PMID: 31753225 DOI: 10.1016/j.apnu.2019.08.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 07/10/2019] [Accepted: 08/18/2019] [Indexed: 11/28/2022]
Abstract
AIMS To explore the types of traumatic exposure, prevalence of posttraumatic stress disorder (PTSD), and level of resilience in a community sample of Filipino American women (FAW), as well as to investigate the relationships between their PTSD symptoms, history of traumatic exposure, and resilience. METHOD A cross-sectional study with a total of 188 adult FAW. RESULTS We observed high levels of resilience and low levels of PTSD symptom severity. The most common form of traumatic exposure was non-interpersonal trauma occurring after the age of 18 years old. We also found a significant correlation between history of traumatic exposure and PTSD and between resilience and PTSD. Resilience was found to have a significant moderating effect on the relationship between traumatic exposure and PTSD. CONCLUSIONS The results provide preliminary evidence on the buffering and protective properties of FAW's resilience to PTSD despite traumatic exposure.
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Affiliation(s)
| | - Rose E Constantino
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Chad L Cross
- School of Medicine and School of Community Health Sciences, University of Nevada Las Vegas, Las Vegas, NV, USA
| | | | - Judzia N Bombard
- School of Nursing, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Alvin Ryan Acupan
- School of Nursing, University of Nevada Las Vegas, Las Vegas, NV, USA
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17
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Eriksson M, Kerekes N, Brink P, Pennbrant S, Nunstedt H. The level of sense of coherence among Swedish nursing staff. J Adv Nurs 2019; 75:2766-2772. [PMID: 31236952 DOI: 10.1111/jan.14137] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 04/19/2019] [Accepted: 05/14/2019] [Indexed: 11/30/2022]
Abstract
AIM To explore the level of sense of coherence among Swedish nursing staff. DESIGN An explorative quantitative study design was adopted using a short form for measuring sense of coherence. METHODS Data were collected in January 2018 from nurses working in full-time positions at two hospitals in Western Sweden. A total of 93 nurses completed the 13 item questionnaire measuring sense of coherence. Descriptive statistics were applied to obtain means and standard deviations. Spearman's rank correlation was used to describe strength of association between sense of coherence and socio-demographic categories. Between-group differences were defined using the nonparametric tests of Mann Whitney U test and Kruskal-Wallis test. RESULTS The internal consistency of the SOC-13 was low. An inter-item-correlation test indicated that two items decreased the internal consistency of the scale. The level of the three dimensions of sense of coherence varied; manageability was weakest and decreased the total sense of coherence. The meaningfulness dimension was as strongest. CONCLUSION On a national level, nurses reported weaker sense of coherence (SOC) than the general population, but stronger in an international comparison of nurses. They found their work difficult to manage, but meaningful. IMPACT On a national level, the nurses reported weaker SOC than the general population, but stronger in an international comparison of nurses. Findings from this study will have an impact on how nurses can manage work related stress in terms of sense of coherence. There will also be an impact on nurses' well-being, which in a long run benefits patients.
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Affiliation(s)
- Monica Eriksson
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - Nóra Kerekes
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - Peter Brink
- Department of Health Sciences, University West, Trollhättan, Sweden.,NU Hospital Group, Trollhättan, Sweden
| | - Sandra Pennbrant
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - Håkan Nunstedt
- Department of Health Sciences, University West, Trollhättan, Sweden
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18
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Foster K, Roche M, Delgado C, Cuzzillo C, Giandinoto JA, Furness T. Resilience and mental health nursing: An integrative review of international literature. Int J Ment Health Nurs 2019; 28:71-85. [PMID: 30294937 DOI: 10.1111/inm.12548] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2018] [Indexed: 12/15/2022]
Abstract
Mental health nurses work in challenging and potentially high stress settings. Stressors can occur in the context of consumer, family, and/or staff relationships, as well as the work environment and organization. The cumulative effects of stress and professional challenges can lead to harmful impacts for mental health nurses including burnout and poorer physical and mental health. Resilience involves a process of positive adaptation to stress and adversity. The aims of this integrative review were to examine understandings and perspectives on resilience, and explore and synthesize the state of knowledge on resilience in mental health nursing. Following systematic search processes, screening, and data extraction, 12 articles were included. Constant comparative analysis and synthesis of the data resulted in two key categories: Theoretical concepts of resilience and Knowledge on mental health nurses' resilience. In mental health nursing, resilience has been variously constructed as an individual ability, collective capacity, or as an interactive person-environment process. Resilience was most often reported as low-moderate, with positive correlations with hardiness, self-esteem, life and job satisfaction, and negative correlations with depression and burnout. A resilience programme improved mental health nurses' coping self-efficacy and capacity to regulate thoughts and emotions and developed their resilient practice. Use of contemporary resilience definitions will inform more consistent investigation and progressively scaffold knowledge of this emergent construct in mental health nursing. Future research on the implementation of resilience programmes and resilience-building strategies for mental health nurses at the individual, work unit, and organizational levels is needed.
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Affiliation(s)
- Kim Foster
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Michael Roche
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,Northern Sydney Local Health District Mental Health Drug and Alcohol Services, Sydney, New South Wales, Australia
| | - Cynthia Delgado
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.,Sydney Local Health District Mental Health Services, Professor Marie Bashir Centre, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Celeste Cuzzillo
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Jo-Ann Giandinoto
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
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19
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Cleary M, Kornhaber R, Thapa DK, West S, Visentin D. The effectiveness of interventions to improve resilience among health professionals: A systematic review. NURSE EDUCATION TODAY 2018; 71:247-263. [PMID: 30342300 DOI: 10.1016/j.nedt.2018.10.002] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/19/2018] [Accepted: 10/07/2018] [Indexed: 05/13/2023]
Abstract
OBJECTIVE To assess the effectiveness of resilience interventions in improving resilience outcome among health professionals. BACKGROUND The nature of health professionals' work is physically and emotionally demanding, with trauma a common consequence with the act of providing health care. DESIGN A systematic review. DATA SOURCE A comprehensive search of the literature was conducted in February 2018 using PubMed, PsychInfo, Cumulative Index of Nursing and Allied Health Literature (CIHAHL) and Scopus. REVIEW METHODS Methodological quality was assessed and a standardized data coding form was used to extract data. RESULTS Of the 33 included studies, 15 were single-arm pre-post-design, 10 were RCTs, five used a non-randomized controlled design, and three were qualitative. Eleven studies (out of 16) showed a significant improvement in resilience scores while five (out of eight) studies reported a significant difference in resilience scores between treatment and control groups. CONCLUSION Findings suggest that resilience training may be of benefit to health professionals. However, not all interventions enhanced resilience with training volume being more effective. Not all studies reporting resilience used standard resilience instruments. The results of the current review may inform resilience programs as well as future interventional studies on resilience building.
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Affiliation(s)
- Michelle Cleary
- School of Health Sciences, College of Health and Medicine, University of Tasmania (Sydney Campus), Locked Bag 5052, Alexandria, NSW 2015, Australia.
| | - Rachel Kornhaber
- School of Health Sciences, College of Health and Medicine, University of Tasmania (Sydney Campus), Locked Bag 5052, Alexandria, NSW 2015, Australia.
| | - Deependra Kaji Thapa
- School of Health Sciences, College of Health and Medicine, University of Tasmania (Sydney Campus), Locked Bag 5052, Alexandria, NSW 2015, Australia.
| | - Sancia West
- School of Health Sciences, College of Health and Medicine, University of Tasmania (Sydney Campus), Locked Bag 5052, Alexandria, NSW 2015, Australia.
| | - Denis Visentin
- School of Health Sciences, College of Health and Medicine, University of Tasmania (Sydney Campus), Locked Bag 5052, Alexandria, NSW 2015, Australia.
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20
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Foster K, Shochet I, Wurfl A, Roche M, Maybery D, Shakespeare-Finch J, Furness T. On PAR: A feasibility study of the Promoting Adult Resilience programme with mental health nurses. Int J Ment Health Nurs 2018; 27:1470-1480. [PMID: 29488298 DOI: 10.1111/inm.12447] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/23/2018] [Indexed: 01/07/2023]
Abstract
Mental health settings are recognized as complex, unpredictable environments, and challenging interpersonal situations are common for nurses in acute adult mental health services. Occupational stressors include verbal aggression and physical assault and are correlated with poor physical and mental health outcomes for nurses. There is a clear need for proactive approaches that address the negative impacts of stressors on the mental health nursing workforce. Resilience interventions are a preventive approach to strengthening skills for addressing workplace stress, improving health and well-being, and preventing adverse outcomes associated with occupational stressors. The aim of this study was to evaluate the feasibility of a workplace resilience education programme for nurses in high-acuity adult mental health settings. The outcomes were measured using a single-group pretest post-test design with follow-up at 3 months postintervention. The feasibility and acceptability of the programme were identified with descriptors of mental health, well-being, resilience, facilitator fidelity checklists, and participant satisfaction questionnaires. The programme was found to be feasible for nurses working in high-acuity inpatient settings. There were significant changes to mental health, well-being, and workplace resilience. The programme was delivered with fidelity by facilitators and accepted with high levels of satisfaction by participants. The study findings indicated that nurses can benefit from resilience education that equips them with cognitive, emotion regulation, and relational skills, in conjunction with available external supports and resources, to address workplace challenges. There is a need for comprehensive organizational approaches that include individual, work unit, and organizational-level strategies to support staff well-being.
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Affiliation(s)
- Kim Foster
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia
| | - Ian Shochet
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Astrid Wurfl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Michael Roche
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,Northern Sydney Local Health District Mental Health Drug and Alcohol Services, Sydney, New South Wales, Australia
| | - Darryl Maybery
- Department of Rural Health, Monash University, Moe, Victoria, Australia
| | - Jane Shakespeare-Finch
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia
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21
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Manomenidis G, Panagopoulou E, Montgomery A. Resilience in nursing: The role of internal and external factors. J Nurs Manag 2018; 27:172-178. [DOI: 10.1111/jonm.12662] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 04/21/2018] [Accepted: 05/16/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Georgios Manomenidis
- Primary Health Care Lab, General Practice and Health Research, Department of Medical School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Efharis Panagopoulou
- Primary Health Care Lab, General Practice and Health Research, Department of Medical School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Anthony Montgomery
- Department of Educational and Social Policy; University of Macedonia; Thessaloniki Greece
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22
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Alburquerque-Sendín F, Ferrari AV, Rodrigues-de-Souza DP, Paras-Bravo P, Velarde-García JF, Palacios-Ceña D. The experience of being a psychiatric nurse in South Africa: A qualitative systematic review. Nurs Outlook 2018; 66:293-310. [PMID: 29573827 DOI: 10.1016/j.outlook.2018.01.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 01/15/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE The purpose of the study was to summarize the experiences of African psychiatric nurses in their workplace by examining the findings of existing qualitative studies. METHODS Eleven studies published in English, Portuguese, and Spanish, between 1998 and 2016, which explored psychiatric nurses' experiences in Africa, were included. FINDINGS After meta-aggregation, five key findings were identified: 1) organization and management, 2) perceptions of professional safety and insecurity, 3) relationship with the patient, 4) emotional experiences and 5) recommendations for improvement. DISCUSSION The findings in this study highlight the stressful nature of the work climate of the psychiatric nurse in South Africa. More focus on improving working conditions and providing support is necessary to increase the quality of care for psychiatric mental health patients and their nurse providers.
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Affiliation(s)
| | | | | | | | - Juan Francisco Velarde-García
- Department of Nursing, Spanish Red Cross, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Autonoma de Madrid, Madrid, Spain
| | - Domingo Palacios-Ceña
- Department of Physiotherapy, Occupational Therapy, Rehabilitation, and Physical Medicine, Universidad Rey Juan Carlos, Comunidad de Madrid, Spain
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