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Zhang Y, Lei S, Yang F. Incidence of effort-reward imbalance among nurses: a systematic review and meta-analysis. Front Psychol 2024; 15:1425445. [PMID: 39027048 PMCID: PMC11255848 DOI: 10.3389/fpsyg.2024.1425445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 06/24/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction To systematically evaluate the incidence of effort-reward imbalance among nurses. Method PubMed, Web of Science, Embase, CNKI, WanFang Data, and VIP databases were searched to collect studies on the incidence of effort-reward imbalance among nurses. The search timeframe was from database construction to December 2023. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. The meta-analysis was performed using Stata 17.1 software. Results A total of 60 studies, including 79,644 participants, were included. The prevalence of effort-reward imbalance among nurses was 52.3% (95% CI: 44.9-59.7%). In terms of time, the incidence of effort-reward imbalance among nurses before 2010 (26.6, 95%CI: 6.8-46.4%) and in 2010-2015 (42.4, 95%CI: 32.1-52.8%), 2016-2020 (60.2, 95%CI: 49.6-70.7%), and 2021-2023 (65.0, 95%CI: 51.5-78.4%) continued to increase. Geographically, Asia (57.4, 95%CI: 51.8-63.1%) nurses had a relatively higher prevalence of effort-reward imbalance. In terms of department, the incidence of effort-reward imbalance among nurses was relatively higher in operating rooms (71.8, 95%CI: 64.5-79.0%), ICU (64.6, 95%CI: 27.7-100.0%), emergency (68.7, 95%CI: 62.9-74.5%), and pediatrics (65.8, 95%CI: 32.2-99.3%). Discussion The prevalence of nurse effort-reward imbalance is high, and there are differences in its prevalence across time, geography, department. Hospital administrators should actively take measures to effectively prevent and reduce the effort-reward imbalance for nurses, especially for nurses in Asia, operating rooms, emergency pediatrics and ICU departments. Systematic review registration PROSPERO (CRD42023452428).
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Affiliation(s)
- Yujie Zhang
- School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China
| | - Shanyan Lei
- The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Fang Yang
- School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China
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Martins Irvine A, Moloney W, Jacobs S, Anderson NE. Support mechanisms that enable emergency nurses to cope with aggression and violence: Perspectives from New Zealand nurses. Australas Emerg Care 2024; 27:97-101. [PMID: 37743125 DOI: 10.1016/j.auec.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Although efforts to reduce aggression and violence in emergency departments are important, it is also critical to minimise harm and support staff where this occurs. This research describes support mechanisms emergency nurses value when they experience occupational aggression and violence. METHODS A mixed-methods design including thematic analysis of six interviews and descriptive analysis of fifty-one surveys, with experienced emergency nurse participants and respondents from a single large urban emergency department. RESULTS Four key themes summarised coping with aggression and violence: Minimising exacerbating factors (mental health, lack of understanding of zero tolerance in practice, and wait times); Support before violence (use of huddles and having experienced nurses on each shift); Support during violence (education including restraint, self-defence, de-escalation and legalities); and Support after violence (debriefing, incident reporting and a sense of 'toughness') CONCLUSION: Emergency nurses need preparation and support to competently manage complex mental health presentations, understand legal rights, communicate effectively with patients, families and colleagues and access event debriefing. Security staff are valued team members but also need adequate resourcing and preparation.
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Affiliation(s)
- Alice Martins Irvine
- School of Nursing, University of Auckland, Auckland, New Zealand; Waikato Emergency Department, Te Whatu Ora Waikato, Hamilton, New Zealand
| | | | - Stephen Jacobs
- School of Nursing, University of Auckland, Auckland, New Zealand
| | - Natalie Elizabeth Anderson
- School of Nursing, University of Auckland, Auckland, New Zealand; Auckland Emergency Department, Te Whatu Ora Te Toka Tumai, Auckland, New Zealand.
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Ugwu LE, Idemudia ES, Onyedibe MCC. Decoding the impact of night/day shiftwork on well-being among healthcare workers. Sci Rep 2024; 14:10246. [PMID: 38702344 PMCID: PMC11068736 DOI: 10.1038/s41598-024-60882-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 04/29/2024] [Indexed: 05/06/2024] Open
Abstract
This study delved into the complex effects of work schedules on the well-being of healthcare professionals, spotlighting Nigeria's medical landscape. A diverse cohort of 387 participants, spanning doctors, nurses, pharmacists, and laboratory technicians or scientists, formed the research base, with the majority being women (67.7%), with a mean age of 34.67 years. Professionals self-reported their predominant schedules to gauge work patterns, classifying them as day or night shifts. The World Health Organization Quality of Life Brief Version (WHOQOL-BREF) tool assessed the quality of life across the physical, psychological, social relationship, and environmental domains. Psychological distress was measured using the Depression, Anxiety, and Stress Scales (DASS), and perceived social support was evaluated via the Multidimensional Scale of Perceived Social Support (MSPSS). A cross-sectional design was adopted, and the study employed moderated mediation analysis using SmartPLS 4.0. The results underscored the significant ramifications of night shifts on environmental and physical well-being. Psychological health and social relationships were better among day shift than night shift workers. There was a pronounced correlation between night shifts and heightened levels of anxiety, stress, and depression. The mediating role of psychological distress and the moderating influence of social support in these relationships were evident. This study offers invaluable insights into the role of work schedules in shaping the well-being of healthcare professionals, emphasising the protective role of social support and the unique challenges faced by migrant health workers.
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Affiliation(s)
- Lawrence Ejike Ugwu
- Faculty of Humanities, North-West University South Africa, Potchefstroom, South Africa.
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Eva GF, Amo-Setién F, César LC, Concepción SS, Roberto MM, Jesús MM, Carmen OM. Effectiveness of intervention programs aimed at improving the nursing work environment: A systematic review. Int Nurs Rev 2024; 71:148-159. [PMID: 36646079 DOI: 10.1111/inr.12826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 11/29/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND The nursing work environment can be compromised due to workload, stress and many other issues. A good nursing work environment is needed to for the health and wellbeing of nurses and therefore measures are developed to improve nursing work environment. AIM To determine whether measures designed to improve the work environment for nursing professionals are effective. METHODOLOGY Online research in the Medline, Scopus, Web of Science, ERIC, CINHAL, PsycINFO, and American Doctoral Dissertations databases, along with manual search, was carried out. Primary experimental studies made up of intervention and control groups were included, with pre-/post-measure evaluation in the nursing team, based on the effects of the interventions. Risk of bias was calculated using the Cochrane tool. RESULTS A total of 1997 studies were examined; 19 clinical trials met the inclusion criteria. A total of 1427 nurses participated in the selected studies. The fields of application of the interventions were personal and environmental. Out of the fields targeting individuals, three methodologies were identified: cognitive-behavioral techniques, stress management, channeling anxiety and physical well-being; and those aimed at environmental fields: aromatization and organization. The most evaluated characteristic was teamwork, and the most analyzed symptom was stress. Most of the interventions concluded with at least one significant improvement. CONCLUSIONS Interventions aimed at enhancing the work environment are effective ways of increasing job satisfaction. The heterogeneity of the data did not allow us to determine which intervention is the most effective. The combination, type, and duration are variables that affect efficacy. IMPLICATION FOR NURSING AND NURSING POLICY This systematic review provides resources for improving the work environment that affects nursing staff, other professionals, and patients. Encouraging a healthy atmosphere leads to excellence in care and improved safety.
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Affiliation(s)
| | - Francisco Amo-Setién
- Faculty of Nursing, Nursing Department, IDIVAL Nursing group, University of Cantabria, Cantabria, Spain
| | | | | | - Martín-Melón Roberto
- Library assistant, Biosciences Library, University of Cantabria, Cantabria, Spain
| | - Molina-Mula Jesús
- Nursing and Physiotherapy Department, University of Illes Balears, Palma, Spain
| | - Ortego-Maté Carmen
- Nursing Department, IDIVAL Nursing group, University of Cantabria, Cantabria, Spain
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Montero-Tejero DJ, Jiménez-Picón N, Gómez-Salgado J, Vidal-Tejero E, Fagundo-Rivera J. Factors Influencing Occupational Stress Perceived by Emergency Nurses During Prehospital Care: A Systematic Review. Psychol Res Behav Manag 2024; 17:501-528. [PMID: 38374938 PMCID: PMC10874882 DOI: 10.2147/prbm.s455224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 01/29/2024] [Indexed: 02/21/2024] Open
Abstract
Objective To assess personal and work-related factors influencing the stress levels of nurses during prehospital care. Specifically, to identify associations between the level of perceived stress, the degree of professional experience, and the level of knowledge. Secondly, to examine the relationship between stress levels and violence in the work environment. And third, to investigate the main protective factors against work-related stress during prehospital care. Methods Systematic review in PubMed, WOS, Enfispo, Cochrane, and LILACS databases following the PRISMA methodology (last search 08/Aug/2023). Following the PECO framework, studies on occupational stress factors in ambulance emergency nurses were investigated. Studies in English or Spanish, from 2013 to 2023, and only research articles were admitted, thus excluding reviews, dissertations, and grey literature. Possible bias and level evidence were assessed using critical appraisal tools and GRADE. This protocol was registered in PROSPERO with code CRD42023446080. Results Fourteen articles were selected, and n=855 prehospital nurses were identified. One study was a clinical trial, and the others were observational and qualitative. The level of evidence was very low (n=7), low (n=6), and moderate (n=1); any study was excluded due to methodological bias. Five categories of stressors were extracted: the management of the health service (ie, workload organisation, and resources), patient care (mainly paediatric care), interpersonal stressors (relationship with peers), environmental factors (exposure to injuries), and personal factors (training, experience, and coping strategies). Violence at work is frequent for prehospital nurses, implying both verbal and physical aggressions. Support from peers was associated with positive results against stress. Conclusion Managing workload and improving resources in the work environment are essential to reduce fatigue and allow emotional processes to be addressed. Providing workers with coping skills also imposes on them the responsibility to cope with stress. Collective awareness is the main element in reducing the incidence of stress.
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Affiliation(s)
- Diego José Montero-Tejero
- Department of Emergency, Hospital Universitario Lucus Augusti, Galician Health Service, Lugo, Galicia, Spain
| | - Nerea Jiménez-Picón
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Andalusia, Spain
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Andalusia, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | - Elena Vidal-Tejero
- Department of Cardiology, Hospital Universitario Virgen Del Rocío, Andalusian Health Service, Sevilla, Andalusia, Spain
| | - Javier Fagundo-Rivera
- Centro Universitario de Enfermería Cruz Roja, University of Seville, Sevilla, Andalusia, Spain
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Fricke J, Siddique SM, Douma C, Ladak A, Burchill CN, Greysen R, Mull NK. Workplace Violence in Healthcare Settings: A Scoping Review of Guidelines and Systematic Reviews. TRAUMA, VIOLENCE & ABUSE 2023; 24:3363-3383. [PMID: 36341578 DOI: 10.1177/15248380221126476] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Workplace violence in healthcare settings is alarmingly common and represents significant financial and human cost. The aim of this scoping review was to identify and summarize evidence on strategies to prevent and/or manage workplace violence in healthcare settings. Searches were limited to evidence-based clinical practice guidelines and systematic reviews published between 2015 and 2021. Multiple databases were searched and screened. Quality of the included guidelines and reviews was also assessed. Three guidelines and 33 systematic reviews were included. Both the Occupational Safety and Health Administration 2015 and Registered Nurses' Association of Ontario 2019 guidelines provided useful recommendations for building a comprehensive prevention program. Evidence-based risk assessment, prevention and management, and education and training are all central components. Regular reassessment and adjustment is required. Included reviews (n = 33) were grouped into five main categories: violence toward nurses (n = 10); violence toward healthcare workers in general (n = 8); violence in the emergency department (n = 5); violence related to mental health (n = 5); and measurement related to workplace violence (n = 5). Multicomponent interventions were often more effective than those applied in isolation. We found consistent support for certain strategies including education and training, post-incident debriefing, multidisciplinary rapid response teams, and environmental modifications; however, the strength of evidence and certainty of conclusions were limited across reviews. This scoping review found that strong leadership that cultivates and enforces a culture of inclusivity, support, and respect is a prerequisite for a successful workplace violence prevention program. Rigorous comparative effectiveness research testing interventions are needed.
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Affiliation(s)
- Julie Fricke
- University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Shazia Mehmood Siddique
- University of Pennsylvania Health System, Philadelphia, PA, USA
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- University of Pennsylvania, Philadelphia, PA, USA
| | - Caryn Douma
- University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Alicia Ladak
- University of Pennsylvania Health System, Philadelphia, PA, USA
| | | | - Ryan Greysen
- University of Pennsylvania Health System, Philadelphia, PA, USA
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- University of Pennsylvania, Philadelphia, PA, USA
| | - Nikhil K Mull
- University of Pennsylvania Health System, Philadelphia, PA, USA
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Xie W, Liu M, Okoli CTC, Zeng L, Huang S, Ye X, Liu F, Wang J. Construction and evaluation of a predictive model for compassion fatigue among emergency department nurses: A cross-sectional study. Int J Nurs Stud 2023; 148:104613. [PMID: 37839306 DOI: 10.1016/j.ijnurstu.2023.104613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Compassion fatigue is a syndrome resulting from long-term work-related traumatic event stress exposure of medical staff. The emergency department is considered to be a high-risk, high-intensity and high-stress work environment, with a high prevalence of trauma and violence. Nurses in the emergency department are more prone to compassion fatigue than nurses in other departments. Compassion fatigue not only affects the physical and mental health, and job satisfaction of emergency department nurses, but also causes serious consequences for patients, such as poor patient outcome, medical errors, and increased patient mortality during hospitalization. OBJECTIVES Our study aims to develop and evaluate a predictive model for compassion fatigue among emergency department nurses. DESIGN A cross-sectional study. DATA SOURCES The emergency department nurses (N = 1014) were recruited from 21 tertiary hospitals (from Chengdu, Chongqing, Guiyang, Guangzhou and Shanghai) in central, southwestern, southern, and eastern China from July 25, 2022 to October 30, 2022. METHODS Univariate and multiple logistic regression analyses were used to determine the potential predictive factors associated with compassion fatigue in emergency department nurses. A nomogram was built based on the predictive factors and internally evaluated using a bootstrap resampling method (1000 bootstrap resamples). The performance of the predictive model was evaluated by measuring the Hosmer-Lemeshow goodness of fit test and calibration curve. RESULTS The prevalence of compassion fatigue among emergency department nurses was 75.9 %. The multiple logistic regression analysis revealed that the independent predictive factors for compassion fatigue among emergency department nurses were working position, job satisfaction, diet habit, sleep hours per day, occupational stress, physical harassment and the level of workplace violence, all of which were identified to create the nomogram. The Hosmer-Lemeshow goodness of fit test indicated that the predictive model was well calibrated (χ2 = 11.520, P = 0.174). The bootstrap-corrected concordance index of nomogram was 0.821 (95 % CI: 0.791-0.851). The calibration curve of the nomogram showed good consistency between the predicted and actual probabilities. CONCLUSIONS A predictive model of compassion fatigue among emergency department nurses has been developed, based on the general demographic, work-related and lifestyle characteristics, occupational stress, and workplace violence, with satisfactory predictive ability. This model can identify emergency department nurses who are at high risk of compassion fatigue. Our study provides an empirical basis for early detection, early diagnosis and early intervention of emergency department nurses at high risk of compassion fatigue.
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Affiliation(s)
- Wanqing Xie
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Manli Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Chizimuzo T C Okoli
- University of Kentucky College of Nursing, 517 College of Nursing Building, Lexington, KY 40536, USA.
| | - Li Zeng
- Sichuan Nursing Vocational College, No. 173 Longdu South Road, Longquanyi District, Chengdu City, Sichuan province 610100, China.
| | - Shuqi Huang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Xin Ye
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Fan Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Nursing Key Laboratory of Sichuan Province, West China School of Nursing, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Jialin Wang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, No. 1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province 611137, China.
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Quon AC, Vanderburgh W, Foley A. Emergency Nurse Consensus on Most Effective and Accessible Support Strategies During COVID-19: A Delphi Study. J Emerg Nurs 2022; 48:538-546. [PMID: 35963785 PMCID: PMC9234063 DOI: 10.1016/j.jen.2022.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/07/2022] [Accepted: 06/20/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Emergency nurses face significant risk for stress-related complications while working during the COVID-19 pandemic. However, there is limited empirical evidence on the effectiveness and accessibility of support strategies for nurses in this novel situation. Expert consensus may help fill this knowledge gap. Therefore, the study objective was to gain expert consensus from emergency nurses on the most effective and accessible strategies during the COVID-19 pandemic. METHODS This 2-round Delphi study recruited an online expert panel from emergency nurses practicing during the COVID-19 pandemic within a single Mountain West health system spanning 9 urban and rural emergency departments. Over 10 weeks in the summer of 2021, participants completed 2 sequential surveys to rate and rank employee-led and employer-led support strategies collated from a literature review. RESULTS Of 327 recruitment emails sent, 28 nurses joined the expert panel. Emergency nurses reached a consensus on preference for employee-led self-care activities, including enhancing social well-being and strengthening emotional well-being. None of the employer-led strategies reached group consensus regarding high effectiveness, accessibility, and the likelihood of participation. Additionally, emergency nurses favored in-person support strategies over other delivery methods. DISCUSSION Numerous studies have explored the impact of the COVID-19 pandemic on health care workers. Although experts and researchers seek to determine the best support strategies, this study highlights how emergency nurses wish to be supported. Employers can tailor support strategies for maximum effect by understanding health care worker perceptions and preferences.
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Ma H, Huang SQ, We B, Zhong Y. Compassion fatigue, burnout, compassion satisfaction and depression among emergency department physicians and nurses: a cross-sectional study. BMJ Open 2022; 12:e055941. [PMID: 35487521 PMCID: PMC9052053 DOI: 10.1136/bmjopen-2021-055941] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Emergency department physicians and nurses are at high risk of compassion fatigue, burnout and depression. The purpose of this study was to examine the inter-relationship between compassion fatigue, burnout, compassion satisfaction and depression in emergency department physicians and nurses. DESIGN A cross-sectional study. SETTING This study was conducted in five tertiary hospitals in five different cities across the province of Sichuan, China, in 2021. PARTICIPANTS A total of 342 emergency department physicians and nurses participated in the study. MAIN OUTCOME MEASURES Compassion fatigue, burnout, compassion satisfaction and depression scores. RESULTS Among the study participants, 100% were found to have depressive symptoms, 27.8% had low compassion satisfaction, 2.3% had high burnout and 3.8% had compassion fatigue. In the final multiple linear regression model, marital status (p=0.008; 95% CI -5.205 to -0.789), history of chronic disease (p=0.003; 95% CI -6.461 to -1.386), compassion satisfaction (p<0.001; 95% CI 0.593 to 1.274), burnout (p=0.019; 95% CI 0.084 to 0.930) and compassion fatigue (p<0.001; 95% CI -1.527 to -1.053) among emergency department physicians and nurses were considered to be significant predictors of depression. CONCLUSIONS The prevalence of depression among emergency department physicians and nurses is high in the province of Sichuan, China. Compassion fatigue, burnout and compassion satisfaction were significantly associated with depression in emergency department physicians and nurses. Hospital administrations should consider these findings to develop appropriate psychological interventions and strategies, to prevent, alleviate or treat severe depression among emergency department physicians and nurses in the province of Sichuan.
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Affiliation(s)
- Huan Ma
- Department of Nursing, Sichuan Vocational College of Health and Rehabilitation, Zigong, Sichuan, China
| | - Shuang Quan Huang
- Department of Emergency, The People's Hospital of Neijiang Dongxing District, Neijiang, Sichuan, China
| | - Bo We
- Department of Emergency, The People's Hospital of Neijiang Dongxing District, Neijiang, Sichuan, China
| | - Ying Zhong
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
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Lee MMD, Gensimore MM, Maduro RS, Morgan MK, Zimbro KS. The Impact of Burnout on Emergency Nurses' Intent to Leave: A Cross-Sectional Survey. J Emerg Nurs 2021; 47:892-901. [PMID: 34417028 DOI: 10.1016/j.jen.2021.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/19/2021] [Accepted: 07/12/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Emergency nurses work in one of the busiest and most stressful departments in a hospital and, as such, may experience burnout more often than nurses working in other nursing units. This study examined the relationship among orientation, burnout (emotional exhaustion, depersonalization, and low sense of personal accomplishment), and intent to leave. METHODS A cross-sectional survey design was used. Emergency nurses who were members of the Emergency Nurses Association were invited to participate in an anonymous survey. The Maslach Burnout Inventory tool was used to explore emotional exhaustion, depersonalization, and sense of personal accomplishment. Emergency nurses' intent to leave was assessed with the Turnover Intention Scale. A logistic regression analysis was used to investigate the odds of intent to leave for those who scored at or above versus below the median on each burnout subscale. RESULTS The findings revealed that a formal orientation enhanced emergency nurses' sense of personal accomplishment and was associated with lower intent to leave. The odds of intent to leave were almost 9 times greater for participants with 5 or more years of experience, approximately 13 times greater for those with above-median emotional exhaustion, and more than 6 times lower for those with above-median sense of personal accomplishment. DISCUSSION Emotional exhaustion and low sense of personal accomplishment were key factors influencing emergency nurses' intent to leave. Emergency nurse leaders may find that a formal orientation program enhances sense of personal accomplishment and decreases intent to leave. Creating work environments to help emergency nurses find joy in their work may be critical to work-life balance and staff retention.
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Xu HG, Eley R, Kynoch K, Tuckett A. Effects of mobile mindfulness on emergency department work stress: A randomised controlled trial. Emerg Med Australas 2021; 34:176-185. [PMID: 34378320 DOI: 10.1111/1742-6723.13836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/13/2021] [Accepted: 07/13/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE High-occupational stress among ED staff has a detrimental impact on both staff wellness and patient care. The objective of the study is to determine whether 4 weeks of smartphone app-guided mindfulness practice reduces stress levels of ED staff. METHODS This two-arm randomised controlled trial was conducted in two Australian EDs in 2019-2020. Eligible participants were randomly assigned (1:1) to either an App group or a Wait to Treat group to practice daily 10 min app-guided mindfulness for 4 weeks. Online surveys were collected for both groups at three time periods: before (T1), immediately after (T2) and 3 months after cessation (T3). Then the Wait to Treat group received the same intervention, followed by surveys immediately after the intervention (T4) and 3 months later (T5). Primary outcome was measured using the Perceived Stress Scale. Secondary outcomes were measured using the Maslach Burnout Inventory (three subscales: emotional exhaustion, depersonalisation and personal accomplishment), Mindfulness Attention Awareness Scale and Warwick-Edinburgh Mental Well-being Scale. Both intention-to-treat and per-protocol analysis were performed. Repeated measurement data were analysed by the linear mixed model. RESULTS Of 148 enrolled participants 98 completed all the surveys, but only half (48%) reported continuous use of the app. Based on the results of the intention-to-treat analysis, there was a statistically significant improvement of perceived stress levels (F = 15.70, P < 0.001), all three components of burnout (emotional exhaustion [F = 14.22, P < 0.001], depersonalisation [F = 3.62, P = 0.030], personal accomplishment [F = 7.51, P < 0.001]), mindfulness (F = 8.83, P < 0.001) and wellbeing levels (F = 10.71, P < 0.001) from pre-intervention to 3 months later with small effect sizes. CONCLUSION Results of the present study demonstrate that brief mindfulness training via innovative digital technology had a small positive effect in improving emergency staff stress, burnout, mindfulness and wellbeing.
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Affiliation(s)
- Hui Grace Xu
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia.,Emergency Department, Queen Elizabeth Jubilee II Hospital, Brisbane, Queensland, Australia
| | - Robert Eley
- Emergency Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Southside Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Kathryn Kynoch
- Clinical Governance Unit and the Queensland Centre for Evidence Based Nursing and Midwifery: a Joanna Briggs Institute Centre of Excellence, Mater Health, Brisbane, Queensland, Australia
| | - Anthony Tuckett
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia.,Curtin School of Nursing, Curtin University, Perth, Western Australia, Australia
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Anderson N, Pio F, Jones P, Selak V, Tan E, Beck S, Hamilton S, Rogan A, Yates K, Sagarin M, McLeay A, MacLean A, Fayerberg E, Hayward L, Chiang A, Cadzow A, Cadzow N, Moran S, Nicholls M. Facilitators, barriers and opportunities in workplace wellbeing: A national survey of emergency department staff. Int Emerg Nurs 2021; 57:101046. [PMID: 34243105 DOI: 10.1016/j.ienj.2021.101046] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/28/2021] [Accepted: 06/14/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Emergency department (ED) staff face daily exposure to the illness, injury, intoxication, violence and distress of others. Rates of clinician burnout are high and associated with poor patient outcomes. This study sought to measure the prevalence of burnout in ED personnel as well as determine the important facilitators of and barriers to workplace wellbeing. METHOD An anonymous online survey including six open-ended questions on workplace wellbeing was completed by 1372 volunteer participants employed as nurses, doctors, allied health or nonclinical roles at 22 EDs in Aotearoa, New Zealand in 2020. Responses to the questions were analysed using a general inductive approach. RESULTS The three key themes that characterise what matters most to participants' workplace wellbeing are: (1) Supportive team culture (2) Delivering excellent patient-centred care and (3) Professional development opportunities. Opportunities to improve wellbeing also focused on enhancements in these three areas. CONCLUSION In order to optimise workplace wellbeing, emergency departments staff value adequate resourcing for high-quality patient care, supportive and cohesive teams and professional development opportunities. Initiatives in these areas may facilitate staff wellbeing as well as improving safety and quality of patient care.
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Affiliation(s)
- Natalie Anderson
- Faculty of Medical & Health Sciences, University of Auckland, New Zealand; Emergency Department, Auckland City Hospital, Auckland District Health Board, New Zealand.
| | - Fofoa Pio
- Malatest International, Auckland, New Zealand
| | - Peter Jones
- Faculty of Medical & Health Sciences, University of Auckland, New Zealand; Emergency Department, Auckland City Hospital, Auckland District Health Board, New Zealand
| | - Vanessa Selak
- Faculty of Medical & Health Sciences, University of Auckland, New Zealand
| | - Eunicia Tan
- Faculty of Medical & Health Sciences, University of Auckland, New Zealand; Emergency Department, Middlemore Hospital, Counties Manukau Health, New Zealand
| | - Sierra Beck
- Division of Health Sciences, University of Otago, New Zealand; Emergency Department, Dunedin Hospital, Southern District Health Board, New Zealand
| | - Suzanne Hamilton
- Emergency Department, Christchurch Hospital, Canterbury District Health Board, New Zealand; Emergency Department, Wellington Hospital, Capital & Coast District Health Board, New Zealand
| | - Alice Rogan
- Division of Health Sciences, University of Otago, New Zealand; Emergency Department, Christchurch Hospital, Canterbury District Health Board, New Zealand
| | - Kim Yates
- Faculty of Medical & Health Sciences, University of Auckland, New Zealand; Emergency Departments, North Shore & Waitakere Hospitals, Waitematā District Health Board, New Zealand
| | - Mark Sagarin
- Emergency Department, Taranaki Base Hospital, Taranaki District Health Board, New Zealand
| | - Adam McLeay
- Emergency Department, Southland Hospital, Southern District Health Board, New Zealand
| | - Alistair MacLean
- Emergency Department, Tauranga Hospital, Bay of Plenty District Health Board, New Zealand
| | - Eugene Fayerberg
- Emergency Department Whangarei Hospital, Northland District Health Board, New Zealand
| | - Luke Hayward
- Emergency Department, Hutt Hospital. Hutt Valley District Health Board, New Zealand
| | - Arthur Chiang
- Division of Health Sciences, University of Otago, New Zealand; Emergency Department, Timaru Hospital, South Canterbury District Health Board, New Zealand
| | - Alastair Cadzow
- Emergency Department, Timaru Hospital, South Canterbury District Health Board, New Zealand
| | - Natalie Cadzow
- Emergency Department, Timaru Hospital, South Canterbury District Health Board, New Zealand
| | - Suzanne Moran
- Emergency Department, Rotorua Hospital, Lakes District Health Board, New Zealand
| | - Mike Nicholls
- Faculty of Medical & Health Sciences, University of Auckland, New Zealand; Emergency Department, Auckland City Hospital, Auckland District Health Board, New Zealand
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13
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De Angelis M, Giusino D, Nielsen K, Aboagye E, Christensen M, Innstrand ST, Mazzetti G, van den Heuvel M, Sijbom RB, Pelzer V, Chiesa R, Pietrantoni L. H-WORK Project: Multilevel Interventions to Promote Mental Health in SMEs and Public Workplaces. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8035. [PMID: 33142745 PMCID: PMC7662282 DOI: 10.3390/ijerph17218035] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 12/31/2022]
Abstract
The paper describes the study design, research questions and methods of a large, international intervention project aimed at improving employee mental health and well-being in SMEs and public organisations. The study is innovative in multiple ways. First, it goes beyond the current debate on whether individual- or organisational-level interventions are most effective in improving employee health and well-being and tests the cumulative effects of multilevel interventions, that is, interventions addressing individual, group, leader and organisational levels. Second, it tailors its interventions to address the aftermaths of the Covid-19 pandemic and develop suitable multilevel interventions for dealing with new ways of working. Third, it uses realist evaluation to explore and identify the working ingredients of and the conditions required for each level of intervention, and their outcomes. Finally, an economic evaluation will assess both the cost-effectiveness analysis and the affordability of the interventions from the employer perspective. The study integrates the training transfer and the organisational process evaluation literature to develop toolkits helping end-users to promote mental health and well-being in the workplace.
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Affiliation(s)
- Marco De Angelis
- Department of Psychology, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (D.G.); (R.C.); (L.P.)
| | - Davide Giusino
- Department of Psychology, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (D.G.); (R.C.); (L.P.)
| | - Karina Nielsen
- Institute of Work Psychology, Sheffield University Management School, University of Sheffield, Sheffield S10 FL, UK;
| | - Emmanuel Aboagye
- Institute of Environmental Medicine, Karolinska Institute, 171 65 Stockholm, Sweden;
| | - Marit Christensen
- Department of Psychology, Norwegian University of Science and Technology, N-7941 Trondheim, Norway; (M.C.); (S.T.I.)
| | - Siw Tone Innstrand
- Department of Psychology, Norwegian University of Science and Technology, N-7941 Trondheim, Norway; (M.C.); (S.T.I.)
| | - Greta Mazzetti
- Department of Education Studies, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy;
| | - Machteld van den Heuvel
- Department of Work and Organizational Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands; (M.v.d.H.); (R.B.L.S.); (V.P.)
| | - Roy B.L. Sijbom
- Department of Work and Organizational Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands; (M.v.d.H.); (R.B.L.S.); (V.P.)
| | - Vince Pelzer
- Department of Work and Organizational Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands; (M.v.d.H.); (R.B.L.S.); (V.P.)
| | - Rita Chiesa
- Department of Psychology, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (D.G.); (R.C.); (L.P.)
| | - Luca Pietrantoni
- Department of Psychology, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (D.G.); (R.C.); (L.P.)
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