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Väisänen V, Ruotsalainen S, Hietapakka L, Sulander J, Sinervo T. The role of workday characteristics on perceived stress and time pressure among nurses in Finnish long-term care - a cross-sectional study. BMC Health Serv Res 2024; 24:878. [PMID: 39095796 PMCID: PMC11295524 DOI: 10.1186/s12913-024-11294-4] [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: 11/20/2023] [Accepted: 07/09/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Aging populations and nursing workforce issues are causing challenges for long-term care globally, and therefore, improving the work-related wellbeing and retention of nurses is crucial. As such, gaining a further understanding of the factors that affect work strain in long-term care is important. Previously, the effect of job demands on the wellbeing of nurses has been researched principally by subjective instruments. In this study, we examined the relationship between indirectly measured workday characteristics and perceived stress and time pressure among nurses working in Finnish long-term care (assisted living facilities with 24-hour assistance). METHODS A total of 503 nurses from 44 assisted living facilities across Finland completed time measurement surveys and wellbeing questionnaires. The data were linked with client characteristics from the Resident Assessment Instrument register. The relationships between the measured number of care events during the workday, clients' care needs, and the amount of breaktime and perceived stress and time pressure were analyzed using multivariate logistic regression. RESULTS Nurses who had more care events and clients with greater care needs were at higher odds of having high stress. More care events and reduced breaktime were associated with high time pressure. Disruptions during the workday were strongly associated with both high stress and time pressure. Last, nurses who were under high stress and time pressure worked more often in teams with lower team autonomy. CONCLUSIONS Our findings on indirectly measured job demands indicate that dividing the workload equally among nurses through better work division can help reduce the stress and time pressure of nurses in long-term care. In addition, ensuring sufficient breaktime and preventing unnecessary disruptions is important. To help recruit and retain the care workforce, fair management of work that accounts for varying client care needs and workload is needed. In addition, legislative and governance tools, such as staffing level regulation, and further consideration of job demands might aid in reducing the job strain of nurses. PATIENT OR PUBLIC CONTRIBUTION Patients or nurses were not involved in the design of the study, analysis, or interpretation of the results, or in the preparation of the manuscript.
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Affiliation(s)
- Visa Väisänen
- Finnish Institute for Health and Welfare, Welfare State Research and Reform unit, Health and Social Service System Research team, Mannerheimintie 166, Helsinki, 00330, Finland.
- Faculty of Social Sciences and Business Studies, Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland.
| | - Salla Ruotsalainen
- Finnish Institute for Health and Welfare, Welfare State Research and Reform unit, Health and Social Service System Research team, Mannerheimintie 166, Helsinki, 00330, Finland
| | - Laura Hietapakka
- Finnish Institute for Health and Welfare, Welfare State Research and Reform unit, Health and Social Service System Research team, Mannerheimintie 166, Helsinki, 00330, Finland
| | - Juhani Sulander
- Finnish Institute for Health and Welfare, Welfare State Research and Reform unit, Health and Social Service System Research team, Mannerheimintie 166, Helsinki, 00330, Finland
| | - Timo Sinervo
- Finnish Institute for Health and Welfare, Welfare State Research and Reform unit, Health and Social Service System Research team, Mannerheimintie 166, Helsinki, 00330, Finland
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Wong KW, Wu X, Dong Y. Interventions to reduce burnout and improve the mental health of nurses during the COVID-19 pandemic: A systematic review of randomised controlled trials with meta-analysis. Int J Ment Health Nurs 2024; 33:324-343. [PMID: 37985559 DOI: 10.1111/inm.13251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 10/24/2023] [Accepted: 10/28/2023] [Indexed: 11/22/2023]
Abstract
This systematic review aims to investigate and determine the effectiveness of interventions on improving mental health (anxiety, depression, stress or mental well-being) and/or reducing burnout of nurses working in hospitals during the COVID-19 pandemic. A search was conducted on studies from conception to December 2022 in databases: PubMed, Embase, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, Scopus and Web of Science and in ProQuest Thesis & Dissertations Global Database, Google Scholar and ClinicalTrials.gov. A total of 17 randomised controlled trials that evaluated different interventions were included. The outcomes were anxiety (n = 11), depression (n = 5), stress (n = 13) mental well-being (n = 7) and burnout (n = 7). Not all interventions led to positive outcomes. Grading of Recommendations Assessment, Development and Evaluation (GRADE) appraisal and risk of bias assessment using the Cochrane tool for randomised controlled trials (RoB 2.0) revealed poor quality of currently available literature, with low to very low certainty. Meta-analysis showed high heterogeneity among the five different outcomes, with subgroup analysis showing greater success in interventions conducted on nurses involved in the care of COVID-19 patients. More well-designed trials are necessary to reinforce current evidence to improve the mental health of nurses, to not only protect their quality of life but also to ensure the quality of patient care.
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Affiliation(s)
- Kang Wei Wong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
| | - Xinyao Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
| | - Yanhong Dong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
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3
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Chang HE. Relationships among meal time, break time and workplace characteristics of nurses who work day, evening and night shifts: a cross-sectional study. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2024; 30:312-318. [PMID: 38124390 DOI: 10.1080/10803548.2023.2298116] [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] [Indexed: 12/23/2023]
Abstract
Objectives. This study aimed to examine the relationships among shift-working nurses' meal time, break time and workplace characteristics. Methods. The cross-sectional study analyzed 351 questionnaires from 117 nurses who worked three shifts, drawn from eight nursing units in two tertiary hospitals located in South Korea. Meal time and break time during work were investigated through a questionnaire that participants completed immediately after the end of each shift. Regression analysis was conducted to investigate the associations between nurses' work characteristics and meal time and break time. Results. Meal time and break time were less than 30 min on all shifts and significantly longer on the night shift than on the other shifts. As patients' average length of stay increased, meal time increased on day and night shifts, while break time decreased on evening shifts. Overall, a higher nursing staff-to-patient ratio was associated with shorter meal and break times. Conclusions. It was found that nurses were not able to take proper time for meals and breaks while working. A realistic and specific strategy should be prepared to address this issue, with appropriate consideration of the specific characteristics of nurse staffing, patients' conditions and shifts.
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Affiliation(s)
- Hyoung Eun Chang
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Republic of Korea
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Shin SH, Lee EH. Development and validation of a quality of healthy work environment instrument for shift nurses. BMC Nurs 2024; 23:37. [PMID: 38212736 PMCID: PMC10785413 DOI: 10.1186/s12912-023-01672-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/17/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND As the importance of a healthy work environment for nurses' good practice and patient safety has been recognized, there is a need to assess nurses' perceptions of the quality of a healthy work environment. METHODS A conceptual framework and construct components were extracted through a literature review and in-depth interviews with shift nurses. The initial items of the instrument were developed according to the conceptual attributes, and the items were selected through content validity by ten experts. Two hundred and forty-seven shift nurses participated in this study through face-to-face surveys to test the reliability and validity of the instrument. The evaluation was used for item and confirmatory factor analyses to assess the criterion-related validity and internal consistency of the instrument. Test-retest reliability was analyzed using data from thirty-two nurses. RESULTS The final instrument consisted of 23 items with five components identified through confirmatory factor analysis. Criterion-related validity was established using the K-PES-NWI (r = .54). Cronbach's alpha for the total items was 0.85, and test-retest reliability was 0.73. CONCLUSION The quality of the healthy work environment instrument developed in this study was considered reliable and valid. The instrument developed in this study can be used to measure the quality of a healthy work environment as perceived by shift nurses and to identify preventive measures needed to improve the quality of the work environment.
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Affiliation(s)
- Sun-Hwa Shin
- College of Nursing, Sahmyook University, 815, Hwarang-ro, Nowon-gu, 01795, Seoul, Republic of Korea
| | - Eun-Hye Lee
- College of Nursing, Sahmyook University, 815, Hwarang-ro, Nowon-gu, 01795, Seoul, Republic of Korea.
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Coelho J, Lucas G, Micoulaud-Franchi JA, Philip P, Boyer L, Fond G. Poor sleep is associated with work environment among 10,087 French healthcare workers: Results from a nationwide survey. Psychiatry Res 2023; 328:115448. [PMID: 37713924 DOI: 10.1016/j.psychres.2023.115448] [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: 03/31/2023] [Revised: 08/26/2023] [Accepted: 08/27/2023] [Indexed: 09/17/2023]
Abstract
Poor sleep is a prevalent issue among healthcare workers and can have detrimental effects on their health. Various individual and professional factors, including the work environment, may contribute to poor sleep. However, only a limited number of studies have examined the simultaneous influence of these factors. Hence, we conducted a nationwide survey among graduated healthcare workers in both public and private healthcare facilities in France. The aim was to analyze the association between poor sleep, assessed using the Pittsburgh Sleep Quality Index (>5), and the work environment, evaluated using the Job Content Questionnaire. The study encompassed 10,087 healthcare workers, among whom 6,540 (64.8%) reported experiencing poor sleep. Nurses, health executives, nursing assistants, and other allied healthcare professionals were more likely to experience poor sleep compared to physicians. Through multivariate regression analysis, we identified several aspects of the work environment associated with an increased likelihood of poor sleep. These factors included high speed and quantity of work, high complexity and intensity, high fragmentation and unpredictability, limited decision-making latitude, underutilization of skills, lack of emotional support from colleagues, and sustained workplace bullying. These findings highlight the significance of considering the work environment in addressing sleep issues among healthcare professionals.
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Affiliation(s)
- Julien Coelho
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux France
| | - Guillaume Lucas
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France
| | - Jean-Arthur Micoulaud-Franchi
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux France
| | - Pierre Philip
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux France
| | - Laurent Boyer
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France; Fondation FondaMental, Créteil, France
| | - Guillaume Fond
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France; Fondation FondaMental, Créteil, France.
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Sagherian K, McNeely C, Cho H, Steege LM. Nurses' Rest Breaks and Fatigue: The Roles of Psychological Detachment and Workload. West J Nurs Res 2023; 45:885-893. [PMID: 37621023 DOI: 10.1177/01939459231189787] [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] [Indexed: 08/26/2023]
Abstract
BACKGROUND Rest breaks have been shown to reduce acute fatigue, yet not all nurses who take rest breaks report lower fatigue. Psychological detachment-letting go of work-related thoughts-during rest breaks and workload may be key factors in explaining this phenomenon. OBJECTIVE To examine the mediating role of psychological detachment during rest breaks and determine how workload moderated that pathway to lower acute fatigue among hospital nurses. METHODS In this cross-sectional study, data were collected from 1861 12-hour shift nurses who answered an online survey between July and September 2021. The survey included measures of occupational fatigue, psychological detachment from work, workload, and questions on breaks, work, health, and demographics. Structural equation modeling was used in Mplus 8.9 software to estimate the direct and indirect effects of rest breaks on acute fatigue at 3 levels of workload. RESULTS Nurses, on average, reported high acute fatigue, rarely experienced psychological detachment during rest breaks, and reported heavy workloads. Around 60% were able to sit down for a break on their last shift but with patient-care responsibilities. The relationship between taking a rest break and acute fatigue was fully mediated by psychological detachment from work. However, this relationship only held in the context of manageable workloads. CONCLUSION Our findings showed that within-shift recovery is possible when nurses can psychologically detach from work during rest breaks. However, this within-shift recovery mechanism was disrupted for nurses with heavy workloads.
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Affiliation(s)
- Knar Sagherian
- College of Nursing, The University of Tennessee Knoxville, Knoxville, TN, USA
| | - Clea McNeely
- College of Nursing, The University of Tennessee Knoxville, Knoxville, TN, USA
| | - Hyeonmi Cho
- College of Nursing, Chung-Ang University, Seoul, South Korea
| | - Linsey M Steege
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
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Lorusso L, Ossmann M, Orozco T, Lawson L. On the Restorative Break: Understanding the Role of Break Room Design on Nurse Engagement and Satisfaction. Workplace Health Saf 2023; 71:329-336. [PMID: 37002663 DOI: 10.1177/21650799231157087] [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] [Indexed: 07/20/2023]
Abstract
BACKGROUND Healthcare organizations need to attract and retain qualified nurses, and break areas may influence nurse engagement with breaks, but this has not been studied in situ. The goal of this study was to understand nurse perception of breaks and ways building design and culture impact the frequency, duration, and location of nurse breaks. METHODS This was Part 1 of a two-part study. Mixed-method approaches included on-site behavior mapping, focus groups, online survey, and break room usage rates analysis. FINDINGS In this study, nurses did not take restorative breaks but focused on quick "bio" breaks in rooms nearest the central nurse station. When nurses left care floors, they preferred the cafeteria and outdoor eating spaces. CONCLUSION Nurses' proclivity to minimize restorative breaks remains a major organizational concern. Future studies should investigate leadership activities impacting nurses' perception of shifts and break-taking behavior. APPLICATION TO PRACTICE By optimizing the break setting and changing the cultural perspective of breaks, occupational health services and healthcare management can support nurses' engagement in restorative activities.
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Vieten L, Wöhrmann AM, Wendsche J, Michel A. Employees' work breaks and their physical and mental health: Results from a representative German survey. APPLIED ERGONOMICS 2023; 110:103998. [PMID: 36933419 DOI: 10.1016/j.apergo.2023.103998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 02/06/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to investigate the prevalence of three characteristics of work break organization, namely skipping work breaks, interruptions of work breaks, and meal break duration, and their relationships with physical and mental health. We used data from the BAuA-Working Time Survey 2017, a representative workforce survey in Germany, and restricted the sample to 5979 full-time employees. Logistic regression analyses were conducted with in total five health complaints as dependent variables: back pain and low back pain, pain in the neck and shoulder region, general tiredness, faintness, or fatigue, physical exhaustion, and emotional exhaustion. Many employees often skipped their work breaks (29%) and experienced break interruptions (16%). Frequent skipping of work breaks was significantly positively, that is detrimentally, related to all five health complaints and frequent interruptions of work breaks also, except for neck and shoulder pain. Meal break duration was significantly negatively, that is beneficially, related to physical exhaustion.
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Affiliation(s)
- Laura Vieten
- Federal Institute for Occupational Safety and Health (BAuA), Friedrich-Henkel-Weg 1-25, D-44149, Dortmund, Germany; Heidelberg University, Institute of Psychology, Hauptstraße 47-51, D-69117, Heidelberg, Germany.
| | - Anne M Wöhrmann
- Federal Institute for Occupational Safety and Health (BAuA), Friedrich-Henkel-Weg 1-25, D-44149, Dortmund, Germany.
| | - Johannes Wendsche
- Federal Institute for Occupational Safety and Health (BAuA), Fabricestraße 8, D-01099, Dresden, Germany.
| | - Alexandra Michel
- Federal Institute for Occupational Safety and Health (BAuA), Friedrich-Henkel-Weg 1-25, D-44149, Dortmund, Germany; Heidelberg University, Institute of Psychology, Hauptstraße 47-51, D-69117, Heidelberg, Germany.
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Iddrisu M, Poku CA, Mensah E, Attafuah PYA, Dzansi G, Adjorlolo S. Work-related psychosocial challenges and coping strategies among nursing workforce during the COVID-19 pandemic: a scoping review. BMC Nurs 2023; 22:210. [PMID: 37337228 DOI: 10.1186/s12912-023-01368-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 06/02/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Nurses and midwives have been stretched by the COVID-19 pandemic amidst the heroic roles they have played during the peak of the COVID-19 pandemic. Nurses stood tall among their peers in the healthcare industry saving lives. The pandemic has had a toll on nurses physically, psychologically, and socio-economically. The numerous deaths have traumatized nurses coupled with the fear of possible infection. Nurses have seen their colleagues and loved ones lose their lives to the pandemic, nevertheless, they still render care to patients no matter the circumstances. Due to that, it is imperative to ascertain the extent to which nurses who are much needed in healthcare delivery have been affected by this pandemic. This scoping review used Arksey and O'Malley's review methodology to investigate the nature of work-related psychosocial challenges nurses encountered during the peak of the pandemic, noting the major contributors to the challenges and the coping strategies used to address them. METHODS We performed a scoping review and searched for articles from five databases including PUBMED, CINAHL, SCOPUS, Google Scholar, and Grey literature from December 2019 to December 2021. A total of 7,334 articles were retrieved for the study but 45 met the inclusion criteria. RESULTS Work-related psychosocial challenges identified included stress, burnout (emotional exhaustion and depersonalization), Post-Traumatic Stress Disorder, depression, sleeplessness, and anxiety. Factors that accounted for the challenges were inadequate personal protective equipment (PPEs), discomfort using the PPEs, extreme workload, and fatigue. Nurses experienced job insecurity, business closure, and separation from family and loved ones, and these contributed to their challenges. Strategies used to deal with the challenges centred on emotion-focused and problem-focused coping. CONCLUSIONS The study recommends regular counselling and support for all nurses working at the frontline to help them better cope with the devastating effects of the pandemic so that they could build resilience towards future pandemics.
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Affiliation(s)
- Merri Iddrisu
- School of Nursing and Midwifery, University of Ghana, Accra, Ghana
| | - Collins Atta Poku
- School of Nursing and Midwifery, University of Ghana, Accra, Ghana.
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Eva Mensah
- School of Nursing and Midwifery, University of Ghana, Accra, Ghana
| | | | - Gladys Dzansi
- School of Nursing and Midwifery, University of Ghana, Accra, Ghana
| | - Samuel Adjorlolo
- School of Nursing and Midwifery, University of Ghana, Accra, Ghana
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Zhang X, Li M, Dong W, Lv X, Li L, Yang X, Cao Y. Prevalence and influencing factors of lower urinary tract symptoms in female nurses: a cross-sectional study based on TARGET. Front Public Health 2023; 11:1201184. [PMID: 37404267 PMCID: PMC10315681 DOI: 10.3389/fpubh.2023.1201184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/25/2023] [Indexed: 07/06/2023] Open
Abstract
Background Even though occupational women have a high incidence of lower urinary tract symptoms (LUTS), which seriously affect their daily work life, few large scale sample studies have provided empirical evidence to support this phenomenon among female nurses in China. Consequently, this article investigated female nurses who was presupposed to have a high prevalence of LUTS, which adversely exposes their health and patient safety to these risks. Additionally, it is considered important to explore the factors associated with LUTS in female nurses for patient care safety and nurse bladder health practice. Objectives The purpose of this study was to assess the incidence of LUTS and symptoms-related risk factors among female nurses, to provide evidence for the prevention and control of LUTS. Methods An online survey recruiting 23,066 participants was carried out in a multicenter cross-sectional study in 42 hospitals from December 2020 to November 2022. Stepwise multivariate logistic regression analysis and nomogram were used to identify the factors associated with lower urinary tract symptoms. Besides, SPSS version 26.0, R version 4.2.2, and GraphPad Prism Version 8.3 software packages were used for statistical analysis. Results Based on the completion rate of the questionnaire which was 84.1% (n = 19,393), it was found that among 19,393 female nurses, the prevalence of LUTS was 67.71% and this rate was influenced by age, Body Mass Index (BMI), marital status, years of working, menstrual status, mode of delivery, history of breastfeeding, history of miscarriage, history of alcohol and coffee or tea consumption (p < 0.05). Interestingly, we also find that in addition to the above mentioned factors, anxiety, depression, and perceived stress were also related to LUTS in female nurses (p < 0.05). Conclusion Given the high prevalence of LUTS among female nurses and their potential influencing factors, female nurses should focus on their reproductive health and develop good lifestyle habits. Thus, nursing managers should provide a warm and harmonious work environment and sensitize female nurses to increase their awareness about the importance of drinking clean water and urinating during work in a hygienic environment.
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Affiliation(s)
- Xinyue Zhang
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Mengli Li
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Wenshuo Dong
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Xiaoyan Lv
- Department of Nursing, Qilu Hospital of Shandong University, Shandong, Jinan, China
- Nursing Theory and Practice Innovation Research Center, Shandong University, Jinan, Shandong, China
| | - Li Li
- Department of Nursing, Qilu Hospital of Shandong University, Shandong, Jinan, China
- Nursing Theory and Practice Innovation Research Center, Shandong University, Jinan, Shandong, China
| | - Xiaorong Yang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Yingjuan Cao
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
- Department of Nursing, Qilu Hospital of Shandong University, Shandong, Jinan, China
- Nursing Theory and Practice Innovation Research Center, Shandong University, Jinan, Shandong, China
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Sagherian K, Cho H, Steege LM. The State of Rest Break Practices Among 12-Hour Shift Hospital Nurses in the United States. J Nurs Adm 2023; 53:277-283. [PMID: 37098868 DOI: 10.1097/nna.0000000000001283] [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: 04/27/2023]
Abstract
OBJECTIVE This cross-sectional study aimed to explore the characteristics, content, and context of rest breaks taken by hospital nurses. BACKGROUND Nurses often miss, skip, or take interrupted breaks. To improve the quality of breaks and promote within-shift recovery, it is important to understand current rest break practices including break activities and contextual challenges around them. METHODS Survey data from 806 nurses were collected between October and November 2021. RESULTS Most nurses did not take regular breaks. Rest breaks were often interrupted, spent being worried about work, and rarely resulted in a relaxed state. Common break activities were having a meal or a snack, and browsing the Internet. Regardless of workload, nurses considered patient acuity, staffing, and unfinished nursing tasks when deciding to take breaks. CONCLUSION Rest break practices are of poor quality. Nurses mainly consider workload-related factors when taking breaks, which warrants the attention of nursing administration.
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Affiliation(s)
- Knar Sagherian
- Author Affiliations: Assistant Professor (Dr Sagherian), College of Nursing, The University of Tennessee Knoxville; Part-time Lecturer (Dr Cho), College of Nursing, Chung-Ang University, Seoul, South Korea; and Professor (Dr Steege), School of Nursing, University of Wisconsin-Madison
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Cropley M, Weidenstedt L, Leick B, Sütterlin S. Working from home during lockdown: the association between rest breaks and well-being. ERGONOMICS 2023; 66:443-453. [PMID: 35762878 DOI: 10.1080/00140139.2022.2095038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
One of the challenges with working from home (WFH) is the question of its effect on health and well-being. The impact of home working on health has so far not been studied extensively. We address this gap by investigating the association between internal recovery, operationalised as rest break frequency (low, medium, and high) during the working day, on self-reported musculoskeletal pain, and post-work recovery symptoms in WFH knowledge workers (n = 382). The analysis showed that failing to take frequent breaks was associated with a dose-response increased risk of reporting headaches. For post-work recovery symptoms, failing to take rest breaks throughout the day was associated with an increased risk of reporting psychological fatigue, physical fatigue, and sleep problems, and a decreased risk of psychologically detaching from work and experiencing adequate rest. Our findings emphasise the importance of remote workers taking recovery breaks from work demands in the maintenance of health and well-being.Practitioner Summary: For the foreseeable future, many knowledge workers will be obliged to work from home for at least, some days of the week. It is therefore important for workers to learn to regulate their behaviour, and workers need to be educated about the value of taking regular rest breaks throughout the working day.Abbreviations: ICT: Information and communications technology; MSDs: musculoskeletal disorders; MSPs: Musculoskeletal pain symptoms; OR: Odds ratio; WFH: Working from home; WRRQ: Work-Related Rumination Questionnaire Questionnaire.
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Affiliation(s)
- Mark Cropley
- School of Psychological Sciences, University of Surrey, Guildford, UK
| | - Linda Weidenstedt
- The Ratio Institute, Stockholm, Sweden
- Department of Sociology, Stockholm University, Stockholm, Sweden
| | - Birgit Leick
- School of Business, University of South-Eastern Norway, Kongsberg, Norway
| | - Stefan Sütterlin
- Faculty of Health, Welfare and Organisation, Østfold University College, Halden, Norway
- Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
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Groves S, Lascelles K, Hawton K. Suicide, self-harm, and suicide ideation in nurses and midwives: A systematic review of prevalence, contributory factors, and interventions. J Affect Disord 2023; 331:393-404. [PMID: 36933670 DOI: 10.1016/j.jad.2023.03.027] [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: 11/15/2022] [Revised: 03/08/2023] [Accepted: 03/11/2023] [Indexed: 03/20/2023]
Abstract
BACKGROUND Nurses have been identified as an occupational group at increased risk of suicide. This systematic review examines the prevalence of, and factors influencing, suicide and related behaviours among nurses and midwives (PROSPERO pre-registration CRD42021270297). METHODS MEDLINE, PsycINFO, and CINAHL were searched. Articles published from 1996 onwards exploring suicidal thoughts and behaviours among nurses and midwives were included. Quality of included studies was assessed. Articles were subjected to narrative synthesis informed by suicide data examined, study design, and quality. PRISMA guidelines were followed. RESULTS A total of 100 studies were eligible for inclusion in the review. Articles examining suicide exclusively among midwives were absent from the literature. Several studies confirmed that nursing professionals, especially female, are at increased risk of suicide, particularly by self-poisoning. Factors contributing to risk include psychiatric disorders, alcohol and substance misuse, physical health problems, and occupational and interpersonal difficulties. In studies of non-fatal suicidal behaviours, including during the COVID-19 pandemic, psychiatric, psychological, physical and occupational factors were contributory. There has been little investigation of interventions for prevention of suicide in nurses. LIMITATIONS Only articles published in English language were reviewed. CONCLUSIONS The findings highlight the risk of suicide in nurses. They also show a combination of factors contribute to suicide and non-fatal suicidal behaviour in nurses, with psychiatric, psychological, physical health, occupational and substance misuse (especially alcohol) problems being particularly important. The limited evidence regarding prevention measures indicates a major need to develop primary and secondary interventions for this at-risk occupational group, for example, education regarding enhancing wellbeing and safe alcohol use, alongside accessible psychological support.
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Affiliation(s)
- Samantha Groves
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford OX3 7JX, United Kingdom of Great Britain and Northern Ireland
| | - Karen Lascelles
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford OX3 7JX, United Kingdom of Great Britain and Northern Ireland
| | - Keith Hawton
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford OX3 7JX, United Kingdom of Great Britain and Northern Ireland; Centre for Suicide Research, University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, United Kingdom of Great Britain and Northern Ireland.
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14
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Benzo RM, Farag A, Whitaker KM, Xiao Q, Carr LJ. Examining the impact of 12-hour day and night shifts on nurses' fatigue: A prospective cohort study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2022; 4:100076. [PMID: 38745643 PMCID: PMC11080398 DOI: 10.1016/j.ijnsa.2022.100076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 11/26/2022] Open
Abstract
Background: Fatigue is prevalent among hospital nurses and has been linked to medical errors and decreased patient safety. However, little is known regarding the relationship between occupational physical activity, sedentary behavior, and fatigue. Objective: To assess the impact of 12-hour shifts on nurses' fatigue and its relationship to occupational physical activity and sedentary behavior. Design: Prospective-cohort study design Setting(s): Midwestern trauma one academic medical center Participants: A total of 80 registered nurses working 12-hour day and night shifts participated in this study and completed momentary measures of fatigue (texting, aim one). Only 52 participants were included in aim two analyses (included activity monitoring, aim two). Methods: Occupational patterns of momentary fatigue was measured via ecological momentary assessments. Occupational physical activity and sedentary behaviors (e.g., step count, time spent sitting, standing, and walking) were measured for 14 continuous days using the ActivPAL3 micro activity monitor. Mixed models were used to examine the effects of shift type and time within a shift on occupational fatigue. General estimation equations were used to examine the relationship between time spent sitting, standing, and walking on fatigue. Results: Regardless of shift type, nurses exhibited a significant rise in fatigue; however, the rise was greater during night shifts compared to day shifts. Walking was positively associated with fatigue during day shifts, and negatively associated with fatigue during night shifts. Conclusions: The rise in fatigue was greater among nurses working night shifts compared to day shifts, which could place them at greater risk for fatigue-related consequences. The relationship between walking and fatigue was moderated by shift-type. Tweetable abstract: Nursing fatigue rises during 12-hour shifts, but the rise is greater for those working night shifts @DrRobertoBenzo.
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Affiliation(s)
- Roberto M. Benzo
- Department of Psychology, University of Miami, Miami, Florida 33136, United States of America
- Department of Health & Human Physiology, University of Iowa, E102 Field House, Iowa City, Iowa 52242, United States of America
| | - Amany Farag
- College of Nursing, University of Iowa, 101 College of Nursing Building; 50 Newton Road, Iowa City, Iowa 52242, United States of America
| | - Kara M. Whitaker
- Department of Health & Human Physiology, University of Iowa, E102 Field House, Iowa City, Iowa 52242, United States of America
- Department of Epidemiology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Qian Xiao
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, United States of America
| | - Lucas J. Carr
- Department of Health & Human Physiology, University of Iowa, E102 Field House, Iowa City, Iowa 52242, United States of America
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15
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Effects of 90 Min Napping on Fatigue and Associated Environmental Factors among Nurses Working Long Night Shifts: A Longitudinal Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159429. [PMID: 35954787 PMCID: PMC9367999 DOI: 10.3390/ijerph19159429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/25/2022] [Accepted: 07/29/2022] [Indexed: 02/01/2023]
Abstract
For nurses working long night shifts, it is imperative that they have the ability to take naps to reduce fatigue, and that an appropriate environment is prepared where such naps can be taken. We verified the effects of 90 min napping on fatigue and the associated factors among nurses working 16-h night shifts. We investigated 196-night shifts among 49 nurses for one month. Wearable devices, data logging devices, and questionnaires were used to assess nap parameters, fatigue, and environmental factors such as the napping environment, ways of spending breaks, and working environment. Nurses who nap at least 90 min on most night shifts had more nursing experience. Multivariable logistic regression analysis showed that the environmental factors significantly associated with total nap duration (TND) ≥ 90 min were noise, time spent on electronic devices such as cellphones and tablets during breaks, and nap break duration. The night shifts with TND ≥ 90 min showed lower drowsiness after nap breaks and less fatigue at the end of night shift compared to those with TND < 90 min. Nurses and nursing managers should recognize the importance of napping and make adjustments to nap for at least 90 min during long night shifts.
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16
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Min A, Hong HC, Kim YM. Work schedule characteristics and occupational fatigue/recovery among rotating-shift nurses: A cross-sectional study. J Nurs Manag 2021; 30:463-472. [PMID: 34783087 DOI: 10.1111/jonm.13511] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/23/2021] [Accepted: 11/03/2021] [Indexed: 01/30/2023]
Abstract
AIMS To determine the effects of work schedule characteristics on occupational fatigue and recovery among rotating-shift nurses in South Korea. BACKGROUND Understanding the effects of work schedule characteristics on occupational fatigue is important to prevent adverse nurse outcomes and to ensure patient safety. METHODS This study used secondary data analysis with a cross-sectional design. Data were collected on 436 rotating-shift nurses in 2018. Nurses' occupational fatigue and recovery were measured using the Occupational Fatigue Exhaustion/Recovery Scale. We used quantile regression models. RESULTS The scores for acute and chronic fatigue and intershift recovery were 70.40, 73.39, and 29.82, respectively. Overtime hours, number of night shifts, number of consecutive days off, and breaks were significant influential factors in some quantiles of acute fatigue, chronic fatigue, and intershift recovery, while total working hours was only associated with chronic fatigue in the 25th quantile. CONCLUSIONS The quantile and linear regression models revealed different results for work schedule factors that affect occupational fatigue and intershift recovery among rotating-shift nurses. IMPLICATION FOR NURSING MANAGEMENT These findings have important implications for developing targeted strategies and policies to reduce occupational fatigue and improve intershift recovery for rotating-shift nurses with different levels of occupational fatigue and recovery.
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Affiliation(s)
- Ari Min
- Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Hye Chong Hong
- Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Young Man Kim
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, South Korea
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17
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Varol YZ, Weiher GM, Wendsche J, Lohmann-Haislah A. Difficulties detaching psychologically from work among German teachers: prevalence, risk factors and health outcomes within a cross-sectional and national representative employee survey. BMC Public Health 2021; 21:2046. [PMID: 34753459 PMCID: PMC8576900 DOI: 10.1186/s12889-021-12118-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/26/2021] [Indexed: 11/11/2022] Open
Abstract
Background Teachers often face high job demands that might elicit strong stress responses. This can increase risks of adverse strain outcomes such as mental and physical health impairment. Psychological detachment has been suggested as a recovery experience that counteracts the stressor-strain relationship. However, psychological detachment is often difficult when job demands are high. The aims of this study were, first, to gain information on the prevalence of difficulties detaching from work among German teachers, second, to identify potential person-related/individual (i.e., age, sex), occupational (e.g., tenure, leadership position), and work-related (e.g., overload, cognitive, emotional, and physical demands) risk factors and, third, to examine relationships with mental and physical health impairment and sickness absence. Methods A secondary analysis of cross-sectional data from a national and representative survey of German employees was conducted (BIBB/BAuA Employment Survey 2018). For the analyses data from two groups of teachers (primary/secondary school teachers: n = 901, other teachers: n = 641) were used and compared with prevalence estimates of employees from other occupations (n = 16,266). Results Primary/secondary school teachers (41.5%) and other teachers (30.3%) reported more difficulties detaching from work than employees from other occupations (21.3%). Emotional demands and deadline/performance pressure were the most severe risk factors in both groups of teachers. In the group of primary/secondary school teachers multitasking demands were further risk factors for difficulties to detach from work whereas support from colleagues reduced risks. In both groups of teachers detachment difficulties can be linked to an increase in psychosomatic and musculoskeletal complaints and, additionally, to a higher risk of sickness absence among primary/secondary school teachers. Conclusions Difficulties detaching from work are highly prevalent among German teachers. In order to protect them from related risks of health impairment, interventions are needed which aim at optimizing job demands and contextual resources (i.e., work-directed approaches) or at improving coping strategies (i.e., person-directed approaches).
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Affiliation(s)
- Yasemin Z Varol
- Department of Educational Psychology, Institute of Psychology, Goethe University Frankfurt, Theodor-W.-Adorno-Platz 6, D-60629, Frankfurt am Main, Germany.
| | - Gerald M Weiher
- Department of Educational Psychology, Institute of Psychology, Goethe University Frankfurt, Theodor-W.-Adorno-Platz 6, D-60629, Frankfurt am Main, Germany.
| | - Johannes Wendsche
- Department of Work and Health, Federal Institute for Occupational Safety and Health, Dresden, Germany
| | - Andrea Lohmann-Haislah
- Department of Work and Health, Federal Institute for Occupational Safety and Health, Berlin, Germany
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18
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The impact of rest breaks on subjective fatigue in physicians of the General Hospital of Vienna. Wien Klin Wochenschr 2021; 134:156-161. [PMID: 34613476 PMCID: PMC8857152 DOI: 10.1007/s00508-021-01949-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/01/2021] [Indexed: 11/18/2022]
Abstract
Aims Medical doctors are affected by high levels of occupational burnout. Work organization such as sufficient rest breaks can decrease stress and fatigue; however, rest breaks are often skipped under high workload and time pressure. The present study sought to investigate the effect of self-determined rest breaks on acute and daily levels of fatigue in physicians of the General Hospital of Vienna. Methods Rest breaks and fatigue were recorded throughout day shifts over a time span of 4 weeks with a mobile assessment device. A total of 12 physicians of a university clinic participated in the study. Data were analyzed using generalized estimating equations. Results Analyses were based on a total of 115 workdays including 93 rest breaks and 800 fatigue assessments. Physicians took an average of 0.81 rest breaks per day. Fatigue was lower in the 30 min after the break than in the hour before the break; however, the number of rest breaks did not affect the increase of fatigue during shifts. Conclusion Self-determined rest breaks were effective in reducing acute fatigue in hospital physicians during work. The failure to find an effect on the increase of work-related fatigue may be due to the infrequency of rest breaks in hospital physicians.
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19
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Blasche G, Wendsche J, Tschulik T, Schoberberger R, Weitensfelder L. Individual Determinants of Rest-Break Behavior in Occupational Settings. Healthcare (Basel) 2021; 9:healthcare9101330. [PMID: 34683010 PMCID: PMC8544579 DOI: 10.3390/healthcare9101330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/28/2021] [Accepted: 10/01/2021] [Indexed: 11/25/2022] Open
Abstract
Aims: Work breaks improve well-being, productivity, and health. The aim of this study was to investigate the individual determinants of rest-break behavior during work using the theory of planned behavior (TPB). Methods: The association between attitude, control, and subjective norm and rest-break intention (i.e., taking rest breaks regularly), and rest-break behavior (average number of rest breaks/workhour) was analyzed with stepwise linear regression in a cross-sectional design. The study participants included 109 clerical employees, and 215 nurses. Results: Attitude and control were positively associated with rest-break intention. Intention and control were positively associated with rest-break behavior. The effect of intention was moderated by occupation, with intention being more weakly associated with rest-break behavior in nurses who had less behavioral control. Conclusions: Job control is the major predictor of rest-break behavior, with attitudes playing a minor role, and social norm playing no role. To increase rest-break behavior, a greater extent of job control is necessary.
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Affiliation(s)
- Gerhard Blasche
- Center for Public Health, Department of Environmental Health, Medical University of Vienna, A-1090 Vienna, Austria; (T.T.); (L.W.)
- Correspondence:
| | - Johannes Wendsche
- Federal Institute for Occupational Safety and Health, D-01099 Dresden, Germany;
| | - Theresa Tschulik
- Center for Public Health, Department of Environmental Health, Medical University of Vienna, A-1090 Vienna, Austria; (T.T.); (L.W.)
| | - Rudolf Schoberberger
- Center for Public Health, Department of Social and Preventive Medicine, Medical University Vienna, A-1090 Vienna, Austria;
| | - Lisbeth Weitensfelder
- Center for Public Health, Department of Environmental Health, Medical University of Vienna, A-1090 Vienna, Austria; (T.T.); (L.W.)
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20
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Mojtahedzadeh N, Neumann FA, Rohwer E, Nienhaus A, Augustin M, Harth V, Zyriax BC, Mache S. The Health Behaviour of German Outpatient Caregivers in Relation to the COVID-19 Pandemic: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8213. [PMID: 34360505 PMCID: PMC8346166 DOI: 10.3390/ijerph18158213] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic has affected outpatient caregivers in a particular way. While the German population becomes increasingly older, the number of people in need of care has also increased. The health and, thus, the health behaviour of employees in the outpatient care become relevant to maintain working capacity and performance in the long term. The aims of the study were (1) to examine the health behaviour and (2) to explore pandemic-related perceived change of health behaviour among outpatient caregivers during the COVID-19 pandemic. In a mixed-methods study, 15 problem-centred interviews and a web-based cross-sectional survey (N = 171) were conducted with outpatient caregivers working in Northern Germany. Interviewees reported partially poorer eating behaviour, higher coffee consumption, lower physical activity, skipping breaks more often and less sleep duration and quality during the pandemic. Some quantitative findings indicate the same tendencies. A majority of participants were smokers and reported higher stress perception due to the pandemic. Preventive behaviour, such as wearing PPE or hand hygiene, was increased among interviewees compared to the pre-pandemic period. Our findings indicate that the COVID-19 pandemic could negatively affect outpatient caregivers' health behaviour, e.g., eating/drinking behaviour and physical activity. Therefore, employers in outpatient care should develop workplace health promotion measures to support their employees in conducting more health-promoting behaviours during the COVID-19 pandemic.
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Affiliation(s)
- Natascha Mojtahedzadeh
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (E.R.); (V.H.)
| | - Felix Alexander Neumann
- Midwifery Science—Health Services Research and Prevention, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany; (F.A.N.); (B.-C.Z.)
| | - Elisabeth Rohwer
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (E.R.); (V.H.)
- Midwifery Science—Health Services Research and Prevention, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany; (F.A.N.); (B.-C.Z.)
| | - Albert Nienhaus
- Department of Occupational Medicine, Hazardous Substances and Public Health, Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), 22089 Hamburg, Germany;
- Competence Center for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
| | - Matthias Augustin
- Competence Center for Health Services Research in Vascular Diseases (CVvasc), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany;
| | - Volker Harth
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (E.R.); (V.H.)
| | - Birgit-Christiane Zyriax
- Midwifery Science—Health Services Research and Prevention, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany; (F.A.N.); (B.-C.Z.)
| | - Stefanie Mache
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (E.R.); (V.H.)
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21
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Wang H, Xu G, Liang C, Li Z. Coping with job stress for hospital nurses during the COVID-19 crisis: The joint roles of micro-breaks and psychological detachment. J Nurs Manag 2021; 30:2116-2125. [PMID: 34327761 DOI: 10.1111/jonm.13431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/24/2021] [Accepted: 07/27/2021] [Indexed: 02/02/2023]
Abstract
AIM To examine a mediated moderation of the effects of micro-break activity and psychological detachment on the relationship between job stress and work engagement among hospital nurses. BACKGROUND Nursing burnout, compassion fatigue and job stress have been relatively constant issues in nursing for at least the past decade-and the pervasiveness of the COVID-19 pandemic is intensifying them, which may lead to new challenges to work engagement. METHODS We tested our model using a time-lagged design to collect data from supervisor-subordinate dyads in seven public hospitals located in southern China, and 263 nurses and 58 head nurses in this survey. Confirmatory factor analysis, Pearson's correlation and hierarchical multiple regression were carried out. RESULTS The results showed that the adverse impact of job stress on work engagement disappeared when nurses engaged in high levels of micro-break activity. Moreover, the moderating role of micro-break activity was mediated by psychological detachment. CONCLUSIONS Micro-break activity and psychological detachment play joint roles in helping nurses to cope with job stress. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers should change their negative attitude toward micro-break activity (if it exists) and help nurses find opportunities for detachment under high-pressure environment.
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Affiliation(s)
- Hongli Wang
- School of Business Administration, South China University of Technology, Guangzhou, China
| | - Guangyi Xu
- School of Business Administration, South China University of Technology, Guangzhou, China
| | - Cuiqi Liang
- School of Business Administration, South China University of Technology, Guangzhou, China
| | - Zhen Li
- School of Business Administration, South China University of Technology, Guangzhou, China
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22
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Wendsche J, Paridon H, Blasche G. Nurses' rest breaks and organizational leaving intentions. PSYCHOL HEALTH MED 2021; 27:1782-1792. [PMID: 34228559 DOI: 10.1080/13548506.2021.1950784] [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] [Indexed: 10/20/2022]
Abstract
Improving nurses' staff retention is highly needed since risks of turnover are high in this profession. Prior research uncovered job demands as important driver and job resources as protective factor for the development of nurses' organizational leaving intentions. However, research on beneficial effects of rest break design as an important job resource on nurses' leaving intentions is sparse and their interactions with present job demands have been widely neglected. Therefore, we aimed to examine if different rest break characteristics (i.e. break length, break disturbances, and social breaks) predict nurses' organizational leaving intentions while also considering job demands (i.e. quantitative, cognitive, and emotional demands, and social conflicts) and other well-known person-related and work-related turnover antecedents. We conducted a cross-sectional paper-pencil survey study with 167 nurses from Germany. We found a positive relation between rest break disturbances and organizational leaving intentions even after adjusting for person-related and work-related confounders. Rest break length and the frequency of social breaks were no significant predictors when considering all rest break characteristics in combination. Moreover, high quantitative demands and high social conflicts at work related to higher leaving intentions. Fewer rest break disturbances increased the negative relation between cognitive demands and leaving intentions. In order to reduce nurses' organizational leaving intentions and to improve staff retention, nursing management should prevent disturbances of nurses' rest breaks in addition to other work design interventions such as reducing quantitative demands and social conflicts and especially when implementing cognitive challenging tasks.
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Affiliation(s)
- Johannes Wendsche
- Division 3 Work and Health, Federal Institute for Occupational Safety and Health, Dresden, Germany
| | | | - Gerhard Blasche
- Center for Public Health, Medical University of Vienna, Vienna, Austria
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Mojtahedzadeh N, Rohwer E, Neumann FA, Nienhaus A, Augustin M, Zyriax BC, Harth V, Mache S. The Health Behaviour of German Outpatient Caregivers in Relation to Their Working Conditions: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5942. [PMID: 34205961 PMCID: PMC8198833 DOI: 10.3390/ijerph18115942] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 12/31/2022]
Abstract
Ongoing demographic change is leading to an increasingly older society and a rising proportion of people in need of care in the German population. Therefore, the professional group of outpatient caregivers is highly relevant. Their work is characterised not only by interacting with patients in a mobile setting but also by working in shifts. Health behaviour under these specific working conditions is crucial for ensuring long-term work ability and performance. Little is known about the health behaviour of German outpatient caregivers and its potential impact on their work. The aims of the study were (1) to examine health behavioural patterns (nutrition, exercise, smoking, regeneration) of outpatient caregivers, (2) to illuminate their personal health-promoting behaviours, and (3) to identify potential work-related factors influencing their health behaviour. Fifteen problem-centred interviews were conducted with outpatient caregivers working in Northern Germany in the period January-April 2020. Interviews were analysed by using qualitative content analysis. Outpatient caregivers reported improvable nutrition and hydration, with simultaneous high coffee consumption, low physical activity, poor regeneration (breaks and sleep quality), and good personal health-promoting behaviour (e.g., back-friendly habits), although the majority were smokers. Barriers to the implementation of health-promoting behaviours were a high perception of stress due to increased workload and time pressure, while aids to better health-promoting behaviour were described as being social support and personal resources. The respondents perceived their working conditions as potentially influencing their health behaviour. On the basis of their descriptions, various practice-relevant strategies were derived. The data explore a potential need for outpatient care services to develop interventions on behavioural and structural levels that can help create healthier working conditions for their employees so these caregivers can adopt better health behaviours.
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Affiliation(s)
- Natascha Mojtahedzadeh
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Centre, Hamburg-Eppendorf (UKE), Seewartenstr. 10, 20459 Hamburg, Germany; (N.M.); (E.R.); (V.H.)
| | - Elisabeth Rohwer
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Centre, Hamburg-Eppendorf (UKE), Seewartenstr. 10, 20459 Hamburg, Germany; (N.M.); (E.R.); (V.H.)
| | - Felix Alexander Neumann
- Midwifery Science—Health Services Research and Prevention, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Centre Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany; (F.A.N.); (B.-C.Z.)
| | - Albert Nienhaus
- Department of Occupational Medicine, Hazardous Substances and Public Health, Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), Pappelallee 33/35/37, 22089 Hamburg, Germany;
- Institute for Health Service Research in Dermatology and Nursing (IVDP), Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany
| | - Matthias Augustin
- Institute for Health Service Research in Dermatology and Nursing (IVDP), Competence Centre for Health Services Research in Vascular Diseases (CVvasc), University Medical Centre Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany;
| | - Birgit-Christiane Zyriax
- Midwifery Science—Health Services Research and Prevention, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Centre Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany; (F.A.N.); (B.-C.Z.)
| | - Volker Harth
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Centre, Hamburg-Eppendorf (UKE), Seewartenstr. 10, 20459 Hamburg, Germany; (N.M.); (E.R.); (V.H.)
| | - Stefanie Mache
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Centre, Hamburg-Eppendorf (UKE), Seewartenstr. 10, 20459 Hamburg, Germany; (N.M.); (E.R.); (V.H.)
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24
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de Pinho LG, Sampaio F, Sequeira C, Teixeira L, Fonseca C, Lopes MJ. Portuguese Nurses' Stress, Anxiety, and Depression Reduction Strategies during the COVID-19 Outbreak. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073490. [PMID: 33801740 PMCID: PMC8037799 DOI: 10.3390/ijerph18073490] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/21/2021] [Accepted: 03/22/2021] [Indexed: 12/11/2022]
Abstract
The COVID-19 pandemic has contributed to mental health problems worldwide. Nurses are particularly prone to stress because they directly care for individuals with suspected or confirmed cases of COVID-19. The aims of this study were (a) to explore the association between the mental health promotion strategies used by nurses during the COVID-19 outbreak and their symptoms of depression, anxiety, and stress; (b) to compare the symptoms of depression, anxiety, and stress of mental health nurses to those of non-mental health nurses; and (c) to compare the frequency of use of mental health strategies of mental health nurses to those of non-mental health nurses. A cross-sectional study was conducted with a sample of 821 nurses. Univariate and multivariate regression models were developed to identify potential protective factors of depression, anxiety, and stress. The chi-square test was also used to compare the use of strategies among mental health and non-mental health nurses. Portuguese nurses demonstrated high symptoms of depressive symptoms, stress, and anxiety. Healthy eating, physical activity, rest between shifts, maintaining social contacts, verbalizing feelings/emotions, and spending less time searching for information about COVID-19 were associated with better mental health. Mental health nurses had less depression, anxiety, and stress, and used more strategies to promote mental health than other nurses. We consider it important to promote nurses’ mental health literacy by encouraging them to develop skills and strategies aimed at improving their resilience and ability to deal with difficult situations while caring for the population.
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Affiliation(s)
- Lara Guedes de Pinho
- S. João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (C.F.); (M.J.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal
- Correspondence:
| | - Francisco Sampaio
- Faculty of Health Sciences, University Fernando Pessoa, 4200-253 Porto, Portugal;
- “NursID: Innovation & Development in Nursing”, Center for Health Technology and Services Research, 4200-450 Porto, Portugal;
| | - Carlos Sequeira
- “NursID: Innovation & Development in Nursing”, Center for Health Technology and Services Research, 4200-450 Porto, Portugal;
- Nursing School of Porto, 4200-072 Porto, Portugal
| | - Laetitia Teixeira
- Abel Salazar Institute of Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal;
- “AgeingC: AgeingCluster”, Center for Health Technology and Services Research, 4200-450 Porto, Portugal
| | - César Fonseca
- S. João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (C.F.); (M.J.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal
| | - Manuel José Lopes
- S. João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (C.F.); (M.J.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal
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Min A, Kang M, Hong HC. Sickness Presenteeism in Shift and Non-Shift Nurses: Using the Fifth Korean Working Conditions Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063236. [PMID: 33800982 PMCID: PMC8004057 DOI: 10.3390/ijerph18063236] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/15/2021] [Accepted: 03/19/2021] [Indexed: 02/06/2023]
Abstract
Nurses have reported higher rates of sickness presenteeism than other workers, which is particularly problematic because this problem is linked to care quality and patient safety. This secondary data analysis study aimed to identify the prevalence of sickness presenteeism and explore related factors among shift and non-shift nurses using the Fifth Korean Working Conditions Survey. A total of 272 nurses in Korean hospitals were included. The survey included questions on working conditions, health status, and sickness presenteeism. A multivariate logistic regression was used to identify associated factors of sickness presenteeism. Overall, 21.8% of the participants reported experiencing sickness presenteeism; shift nurses experienced more sickness presenteeism than non-shift nurses. Sickness presenteeism was greater in shift nurses who did not have rest breaks during work and in nurses who experienced quick return. Additionally, the odds of sickness presenteeism were approximately four times greater in shift nurses who experienced sleep disturbance and about four times higher in shift nurses who experienced health problems. Among non-shift nurses, the odds of sickness presenteeism were about 15 times greater in those who worked ≥53 h per week. Nurse managers and administrators should prevent sickness presenteeism in hospital nurses to provide quality care and enhance productivity.
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Affiliation(s)
- Ari Min
- Department of Nursing, Chung-Ang University, Seoul 06974, Korea; (A.M.); (H.C.H.)
| | - Minkyung Kang
- College of Nursing, Keimyung University, Daegu 42601, Korea
- Correspondence: ; Tel.: +82-53-258-7657
| | - Hye Chong Hong
- Department of Nursing, Chung-Ang University, Seoul 06974, Korea; (A.M.); (H.C.H.)
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Rachmawati D, Paskarini I. Correlation between Individual Characteristics and Rest Break with Work-related Fatigue on Telecommunication Network Service Workers. THE INDONESIAN JOURNAL OF OCCUPATIONAL SAFETY AND HEALTH 2021. [DOI: 10.20473/ijosh.v10i1.2021.25-33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: Work-related fatigue on workers are usually caused by some factors such as individual characteristics (age, work period, nutritional status) and rest break. This research aims to analyze the correlation between individual characteristics and rest break with work-related fatigue on telecommunication network service workers. Method: This research used an observational analytic and a cross-sectional approach. The population and sample in this research were all 32 workers at I-OAN unit in a telecommunication network service company. The independent variables in this study were age, work period, nutritional status, and rest break, while the dependent variable was work-related fatigue. Data were obtained throughquestionnaires about individual characteristics (age, work period, nutritional status) and rest break filled by workers. The data were also obtained through the Industrial Fatique Research Committee (IFRC) questionnaires filled by workers. All of the data in this study were analyzed with the Spearman correlation test (α = 0.05). Results: The majority of I-OAN unit workers are in the age range of 25-29 years (46.9%), have 3-4 years of work period (56.2%), and have normal nutritional status (40.6%). For the rest break variable, there are16 workers (50%) who have <30 minutes rest break and also 16 workers (50%) who have ≥ 30 minutes rest break. Conclusion: There is a correlation between individual characteristics and rest break with work-related fatigue on telecommunication network service workers.Keywords: individual characteristics, rest break, work-related fatigue
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Eriksson A, Jutengren G, Dellve L. Job demands and functional resources moderating assistant and Registered Nurses' intention to leave. Nurs Open 2021; 8:870-881. [PMID: 33570298 PMCID: PMC7877160 DOI: 10.1002/nop2.694] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 10/02/2020] [Accepted: 10/30/2020] [Indexed: 11/07/2022] Open
Abstract
AIMS To investigate how job demands and resources interact with each other to predict intention to leave among assistant nurses and Registered Nurses. DESIGN Longitudinal study. METHODS Questionnaire data were collected yearly during three years (October 2012-December 2014) from Registered Nurses (RN) and assistant nurses (N = 840) employed in Swedish hospitals. Associations and interaction effects of demands and resources were assessed with correlation analyses and regression models. RESULTS Job demands predicted assistant nurses' intentions to leave, while resources predicted RNs' intention to leave. For RNs, several resources were functional in moderating the associations between demands and intention to leave: social support, vertical trust, and humanity moderated work pace and workflow moderated emotional demands. For assistant nurses, organizational clarity and interprofessional collaboration moderated emotional demands. None of the resources had a moderating effect on the associations between quantitative demands or illegitimate tasks and intention to leave.
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Affiliation(s)
- Andrea Eriksson
- School of Engineering Sciences in Chemistry, Biotechnology and HealthKTH Royal Institute of TechnologyHuddingeSweden
| | - Göran Jutengren
- Department of Work Life and Social WelfareUniversity of BoråsBoråsSweden
- Faculty of Health and WelfareØstfold University CollegeHaldenNorway
| | - Lotta Dellve
- Department of Sociology and Work ScienceGothenburg UniversityGothenburgSweden
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van Woerkom M. A quasi-experimental study into the effects of naps and therapy glasses on fatigue and well-being. J Nurs Manag 2020; 29:562-571. [PMID: 33029828 PMCID: PMC8247279 DOI: 10.1111/jonm.13172] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/21/2020] [Accepted: 09/30/2020] [Indexed: 02/02/2023]
Abstract
Aim To investigate the effects of a napping facility and therapy glasses on fatigue and well‐being at the end of the night shift. Background Night shift work has adverse effects on fatigue and well‐being. Methods A quasi‐experimental study was conducted, and data were collected on 243 night shifts of 95 nurses who had either access to a napping facility, therapy glasses, both facilities or no facilities. Multilevel analyses were conducted to predict fatigue and well‐being. Results Night shifts of nurses having access to both facilities were associated with less fatigue and more well‐being. The use of therapy glasses related negatively to fatigue and positively to well‐being. The use of the napping facility was not associated with fatigue and well‐being. However, having slept while napping and sleeping time during napping were negatively associated with fatigue and positively associated with well‐being. Conclusion Therapy glasses and sleeping in a napping facility can be effective interventions in reducing the adverse effects of night shift work. Implications for Nursing Management Therapy glasses seem an effective investment to facilitate the well‐being of nurses. To enhance sleeping during napping, it is worthwhile to let nurses get accustomed to the napping facility and customize settings to personal preferences.
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Affiliation(s)
- Marianne van Woerkom
- Department of Human Resource Studies, Tilburg University, Tilburg, The Netherlands.,Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
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van Dam K. Individual Stress Prevention through Qigong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197342. [PMID: 33050017 PMCID: PMC7579037 DOI: 10.3390/ijerph17197342] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 09/29/2020] [Accepted: 10/05/2020] [Indexed: 12/17/2022]
Abstract
Owing to work intensification and an accelerated pace of life in general, individuals in many Western countries are often overactivated and find it difficult to switch off. However, recovery from physiological and mental activation is critical to prevent stress symptoms and maintain one’s physiological and mental well-being. Extensive research evidence indicates that Qigong, a traditional Chinese movement practice for promoting health, provides an effective means to recover from work and off-work demands. The main objective of this paper is to offer a comprehensive, narrative review of the effects of Qigong and its core components. Attention is first paid to the outcomes of work and off-work demands and stress, and the role of recovery for individuals’ well-being. Then, Qigong and its components are explained, followed by the results of scientific research. Finally, limitations and implications for research and practiced are discussed.
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Affiliation(s)
- Karen van Dam
- Faculty of Psychology, Open University of the Netherlands, 6419 AT Heerlen, The Netherlands
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30
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Abstract
OBJECTIVE The purpose of this study was to explore perspectives of nurse leaders regarding strategies to mitigate the job demands of 12-hour shift work and learn their views regarding the role of breaks in offsetting the cognitive and physical demands of acute care nurses working 12-hour shifts. BACKGROUND The strain of long shifts can result in adverse outcomes for nurses, organizations, and patients. METHODS A modified, 3-round, e-Delphi solicited input from nurse leaders. First, qualitative information about support and resources to mitigate the adverse effects of 12-hour shifts was collected, and then 2 subsequent rounds used consensus identification and item ranking to develop recommendations. RESULTS Findings reinforce that job demands of 12-hour shifts can be mitigated via staffing practices, quiet break spaces, and the opportunity to work with familiar patients. CONCLUSIONS Recommendations from this work may enhance patient safety, positive organizational outcomes, and a resilient and sustainable nursing workforce.
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Yu F, Narayanan A, Mackay L, Ward K, King A, Smith M. Describing objectively measured intensive care nurses' physical work activity behavioural patterns during a 12-hr shift. J Clin Nurs 2020; 29:4331-4342. [PMID: 32860292 DOI: 10.1111/jocn.15470] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/01/2020] [Accepted: 08/13/2020] [Indexed: 12/01/2022]
Abstract
AIM AND OBJECTIVES To describe intensive care unit (ICU) nurses' physical work activity behavioural patterns over 12 hr using dual accelerometry, following a job demands-recovery framework. BACKGROUND Limited studies utilised accelerometry to objectively analyse nurses' physical workloads. Little is known about intensive care nurses' physical activity patterns during a 12-hr shift. DESIGN A cross-sectional study was conducted with intensive care nurses from four units in Auckland, New Zealand. METHODS Each participant wore two Axivity AX3 accelerometers to measure physical activity during a 12-hr day or night shift. An online survey captured participants' demographic information. R software (version 3.6.1) and SPSS version 26 were utilised for data analysis. The STROBE was followed. RESULTS A total of 102 nurses were included in this study. A high level of light intensity activity behaviours (standing, dynamic standing, walking) was observed throughout the day shifts, with no higher intensity behaviours identified. Activity levels were highest at the beginning of shifts and followed a consistent pattern, with an additional peak around midday for day shifts and at the end of the shift for night shifts. Observable differences were seen between day and night shifts with a greater prevalence of sitting and lying during night shifts. Standing, dynamic standing, sitting, lying and walking were significant factors in the differences of the physical work behaviours between the day shift nurses and the night shift nurses. Significant differences in dynamic standing and lying were found between ICUs. CONCLUSIONS Intensive care nurses' physical work activity involved a large amount of standing and dynamic standing during a 12-hr shift. The overall physical workload during a 12-hr day shift was significantly higher than that during a 12-hr night shift. RELEVANCE TO CLINICAL PRACTICE Results may help managers attain a better understanding of nurses' physical workloads during a 12-hr shift.
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Affiliation(s)
- Fiona Yu
- Faculty of Medical and Health Sciences, School of Nursing, University of Auckland, Auckland, New Zealand.,RN in Intensive Care Unit, Waikato Hospital, Waikato, New Zealand
| | - Anantha Narayanan
- School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - Lisa Mackay
- School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - Kim Ward
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Anna King
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Melody Smith
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Improving fatigue risk management in healthcare: A scoping review of sleep-related/ fatigue-management interventions for nurses and midwives (reprint). Int J Nurs Stud 2020; 112:103745. [PMID: 32847675 DOI: 10.1016/j.ijnurstu.2020.103745] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Nurses and midwives make up almost 50% of the global healthcare shift working workforce. Shift work interferes with sleep and causes fatigue with adverse effects for nurses' and midwives' health, as well as on patient safety and care. Where other safety-critical sectors have developed Fatigue Risk Management Systems, healthcare is behind the curve; with published literature only focussing on the evaluation of discreet sleep-related/fatigue-management interventions. Little is known, however, about which interventions have been evaluated for nurses and midwives. Our review is a critical first step to building the evidence-base for healthcare organisations seeking to address this important operational issue. OBJECTIVES We address two questions: (1) what sleep-related/fatigue-management interventions have been assessed in nurses and midwives and what is their evidence-base? and (2) what measures are used by researchers to assess intervention effectiveness? DESIGN AND DATA SOURCES The following databases were searched in November, 2018 with no limit on publication dates: MEDLINE, PsychINFO and CINAHL. REVIEW METHODS We included: (1) studies conducted in adult samples of nurses and/or midwives that had evaluated a sleep-related/fatigue-management intervention; and (2) studies that reported intervention effects on fatigue, sleep, or performance at work, and on measures of attention or cognitive performance (as they relate to the impact of shift working on patient safety/care). RESULTS The search identified 798 potentially relevant articles, out of which 32 met our inclusion criteria. There were 8619 participants across the included studies and all were nurses (88.6% female). We did not find any studies conducted in midwives nor any studies conducted in the UK, with most studies conducted in the US, Italy and Taiwan. There was heterogeneity both in terms of the interventions evaluated and the measures used to assess effectiveness. Napping could be beneficial but there was wide variation regarding nap duration and timing, and we need to understand more about barriers to implementation. Longer shifts, shift patterns including nights, and inadequate recovery time between shifts (quick returns) were associated with poorer sleep, increased sleepiness and increased levels of fatigue. Light exposure and/or light attenuation interventions showed promise but the literature was dominated by small, potentially unrepresentative samples. CONCLUSIONS The literature related to sleep-related/fatigue-management interventions for nurses and midwives is fragmented and lacks cohesion. Further empirical work is warranted with a view to developing comprehensive Fatigue Risk Management Systems to protect against fatigue in nurses, midwives, and other shift working healthcare staff.
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Karhula K, Wöhrmann AM, Brauner C, Härmä M, Kivimäki M, Michel A, Oksanen T. Working time dimensions and well-being: a cross-national study of Finnish and German health care employees. Chronobiol Int 2020; 37:1312-1324. [PMID: 32727224 DOI: 10.1080/07420528.2020.1778716] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Health care professionals often face irregular working hours and high work pace. We studied associations of the five working time dimensions duration (weekly working hours), timing (shift work and weekend work), on-call work, working time autonomy, and work tempo (deadline and performance pressure) with well-being among health care employees in Finland and Germany. We used data on working time dimensions and indicators of well-being (work-life conflict, poor perceived health, sleep difficulties, and fatigue) from a cohort of 5050 hospital employees (Working Hours in the Finnish Public Sector Study 2015, WHFPS) and 1450 employees in the health care sector in Germany responding to the German BAuA-Working Time Survey in 2015 (BAuA-WTS). Findings from logistic regression analyses showed that high work tempo was associated with increased work-life conflict (WHFPS: odds ratio [OR] = 3.64, 95%CI 3.04-4.36 and BAuA-WTS: OR = 2.29, 95%CI 1.60-3.27), sleep difficulties (OR = 1.75, 95%CI 1.43-2.15 and OR = 1.33, 95%CI 1.03-1.71) and fatigue (OR = 2.13, 95%CI 1.77-2.57 and OR = 1.64, 95%CI 1.29-2.10) in both datasets. Weekend work was associated with increased work-life conflict (OR = 1.48, 95%CI 1.27-1.72 and OR = 1.61, 95%CI 1.12-2.32); and high working time autonomy with decreased work-life conflict (control over the timing of breaks: OR = 0.65, 95%CI 0.55-0.78 and OR = 0.52, 95%CI 0.33-0.81). The associations between other working time dimensions and well-being were less consistent. These results suggest that tight deadlines, performance pressure, weekend work and lack of working time autonomy are linked to impaired well-being among health care employees.
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Affiliation(s)
- Kati Karhula
- Finnish Institute of Occupational Health, Work Ability and Working Careers, Helsinki, Finland
| | - Anne Marit Wöhrmann
- Division 1 Policy Issues and Programmes, Federal Institute for Occupational Safety and Health (BAuA), Dortmund, Germany
| | - Corinna Brauner
- Division 1 Policy Issues and Programmes, Federal Institute for Occupational Safety and Health (BAuA), Dortmund, Germany
| | - Mikko Härmä
- Finnish Institute of Occupational Health, Work Ability and Working Careers, Helsinki, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Work Ability and Working Careers, Helsinki, Finland.,Clinicum, University of Helsinki, Helsinki, Finland.,Department of Epidemiology and Public Health, University College London Medical School, London, UK
| | - Alexandra Michel
- Division 1 Policy Issues and Programmes, Federal Institute for Occupational Safety and Health (BAuA), Dortmund, Germany
| | - Tuula Oksanen
- Finnish Institute of Occupational Health, Work Ability and Working Careers, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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de Wijn AN, van der Doef MP. Patient-related stressful situations and stress-related outcomes in emergency nurses: A cross-sectional study on the role of work factors and recovery during leisure time. Int J Nurs Stud 2020; 107:103579. [PMID: 32446016 DOI: 10.1016/j.ijnurstu.2020.103579] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/21/2020] [Accepted: 03/13/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Emergency nurses are frequently exposed to patient-related stressful situations, making them susceptible to emotional exhaustion and symptoms of post-traumatic stress disorder. The current study aims to assess differential effects of patient-related stressful situations (emotionally demanding situations, aggression/conflict situations, and critical events) on stress-related outcomes in emergency nurses, and to identify moderating factors based on the Job Demands-Resources model and the Effort-Recovery model (job demands, job resources, and recovery experiences during leisure time). METHOD A cross-sectional study was carried out among nurses working in the emergency departments of 19 hospitals in the Netherlands (N = 692, response rate 73%). Data were collected by means of an online survey. Multiple hierarchical regression analyses were performed, controlling for sociodemographic variables. RESULTS The frequency of exposure to patient-related stressful situations was positively related to stress-related outcomes, with emotionally demanding situations and aggression/conflict situations mainly explaining variance in emotional exhaustion (β = 0.16, p < .01, ∆R² = 0.08, and β = 0.22, p < .01, ∆R² = 0.13), whereas critical events mainly explained variance in post-traumatic stress symptoms (β = 0.29, p < .01, ∆R² = 0.11). Moderating effects were found for within worktime recovery and recovery during leisure time. Work-time demands, autonomy and social support from the supervisor were predictive of stress-related outcomes irrespectively of exposure to patient-related stressful situations. CONCLUSION As patient-related stressful situations are difficult if not impossible to reduce in an emergency department setting, the findings suggest it would be worthwhile to stimulate within worktime recovery as well as recovery experiences during leisure time, to protect emergency nurses from emotional exhaustion and symptoms of post-traumatic stress. Furthermore, this study underscores the importance of reducing work-time demands and enhancing job resources to address stress-related outcomes in emergency nurses. Practical implications, strengths and limitations are discussed.
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Affiliation(s)
- A N de Wijn
- Institute of Psychology, Health, Medical, & Neuropsychology Unit, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands.
| | - M P van der Doef
- Institute of Psychology, Health, Medical, & Neuropsychology Unit, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
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Gander P, O'Keeffe K, Santos-Fernandez E, Huntington A, Walker L, Willis J. Development and evaluation of a matrix for assessing fatigue-related risk, derived from a national survey of nurses' work patterns. Int J Nurs Stud 2020; 112:103573. [PMID: 32334846 DOI: 10.1016/j.ijnurstu.2020.103573] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 02/19/2020] [Accepted: 03/07/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Multiple aspects of nurses' rosters interact to affect the quality of patient care they can provide and their own health, safety and wellbeing. OBJECTIVES (1) Develop and test a matrix incorporating multiple aspects of rosters and recovery sleep that are individually associated with three fatigue-related outcomes - fatigue-related clinical errors, excessive sleepiness and sleepy driving; and (2) evaluate whether the matrix also predicts nurses' ratings of the effects of rosters on aspects of life outside work. DESIGN Develop and test the matrix using data from a national survey of nurses' fatigue and work patterns in six hospital-based practice areas with high fatigue risk. METHODS Survey data included demographics, work patterns (previous 14 days), choice about shifts, and the extent to which work patterns cause problems with social life, home life, personal relationships, and other commitments (rated 1 = not at all to 5 = very much). Matrix variables were selected based on univariate associations with the fatigue-related outcomes, limits in the collective employment contract, and previous research. Each variable was categorised as lower (score 0), significant (score 1), or higher risk (score 2). Logistic multiple regression modelling tested the independent predictive power of matrix scores against models including all the (uncategorised) work pattern and recovery sleep variables with significant univariate associations with each outcome variable. Model fit was measured using Akaike and Bayesian Information Criterion statistics. RESULTS Data were included from 2358 nurses who averaged at least 30 h/week in the previous fortnight in one of the target practice areas. Final matrix variables were: total hours worked; number of shift extensions >30 min, night shifts; breaks < 9 h; breaks ≥ 24 h; nights with sleep 11pm to 7am; days waking fully rested; and roster change. After controlling for gender, ethnicity, years of nursing experience, and the extent of shift choice, the matrix score was a significant independent predictor of each of the three fatigue-related outcomes, and for all four aspects of life outside work. For all outcome variables, the model including the matrix score was a better fit to the data than the equivalent model including all the (uncategorised) work pattern variables. CONCLUSIONS A matrix that predicts the likelihood of nurses reporting fatigue-related safety outcomes can be used to compare the impact of rosters both at work and outside work. It can be used for roster design and management, and to guide nurses' choices about the shifts they work.
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Affiliation(s)
- Philippa Gander
- Sleep/Wake Research Centre, Massey University, Private Box 756, Wellington 6140, New Zealand.
| | - Karyn O'Keeffe
- Sleep/Wake Research Centre, Massey University, Private Box 756, Wellington 6140, New Zealand
| | - Edgar Santos-Fernandez
- Sleep/Wake Research Centre, Massey University, Private Box 756, Wellington 6140, New Zealand
| | | | - Leonie Walker
- School of Health Sciences, Massey University, New Zealand
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36
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Inoue M, Takano M, Ueno C, Mori M, Morimatsu Y, Matsumoto Y, Kushino N, Ishitake T. Advantages of the Variable Shift System, and Effective Use of Break Time to Better Support the Work Engagement of Nurses on Extended Day Shifts. Kurume Med J 2020; 65:155-168. [PMID: 31327800 DOI: 10.2739/kurumemedj.ms654001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of this study is to clarify factors that support the work engagement of nurses, who bear the burden of extended day shifts, by focusing on the advantages of the variable shift system and workday break activities. METHODS Nurses who were working under a variable shift system were asked to complete a self-report questionnaire to examine the workload, work engagement, work stressors, stress-coping strategies, and stress-coping break time activities, as well as the advantages and disadvantages of the variable shift system. Nine break activities were classified into the following four categories: social activities, rest/relaxation, entertainment, and cognitive activities. The advantages or disadvantages of the variable shift system were scored by developing composite variables using principal component analysis. These variables were used to perform a multiple regression analysis with work engagement as the dependent variable. RESULTS The advantage score was the variable most strongly correlated with work engagement. In contrast, "Quantitative workload" was negatively correlated with work engagement. Among break activities, in the social activities category correlations were observed in "Both conversation and Email/SNS" and "Conversation only". Although in fact most nurses chose conversation as one of the break options, more than half of the nurses selected rest/relaxation as their ideal break activity. CONCLUSION Our study suggested that the variable shift system supported the work engagement of nurses who worked extended day shifts. The results also suggested that it would be useful to arrange the employee lounge environment so that employees could freely choose between "conversation" or "taking a rest" depending on the circumstances.
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Affiliation(s)
- Miyako Inoue
- Department of Environmental Medicine, Kurume University School of Medicine
| | | | | | - Mihoko Mori
- Department of Environmental Medicine, Kurume University School of Medicine
| | | | - Yuki Matsumoto
- National Institute of Mental Health, National Center of Neurology and Psychiatry
| | - Nanae Kushino
- Occupational Therapy Course, Department of Rehabilitation, Faculty of Health Sciences, Tokyo Kasei University
| | - Tatsuya Ishitake
- Department of Environmental Medicine, Kurume University School of Medicine
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Development of the Nurses' Occupational Stressor Scale. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020649. [PMID: 31963903 PMCID: PMC7014241 DOI: 10.3390/ijerph17020649] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 01/15/2020] [Accepted: 01/17/2020] [Indexed: 11/16/2022]
Abstract
Although nurses work in stressful environments, stressors in such environments have yet to be clearly assessed. This study aimed to develop a Nurses’ Occupational Stressor Scale (NOSS) with high reliability and validity. Candidate questions for the NOSS were generated by expert consensus following focus group feedback, and were used to survey in 2013. A shorter version was then developed after examination for validity and reproducibility in 2014. The accuracy of the short version of the NOSS for predicting nurses’ stress levels was evaluated based on receiver operating characteristic curves to compare existing instruments for measuring stress outcomes, namely personal burnout, client-related burnout, job dissatisfaction, and intention to leave. Examination for validity and reproducibility yielded a shorter version of NOSS with only 21 items was considered sufficient for measuring stressors in nurses’ work environments. Nine subscales were included: (1) work demands, (2) work–family conflict, (3) insufficient support from coworkers or caregivers, (4) workplace violence and bullying, (5) organizational issues, (6) occupational hazards, (7) difficulty taking leave, (8) powerlessness, and (9) unmet basic physiological needs. The 21-item NOSS proved to have high concurrent and construct validity. The correlation coefficients of the subscales for test-retest reliability ranged from 0.71 to 0.83. The internal consistency (Cronbach’s α) coefficients ranged from 0.35 to 0.77. The NOSS exhibited accurate prediction of personal burnout, client-related burnout, job dissatisfaction, and intention to leave.
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Querstret D, O'Brien K, Skene DJ, Maben J. Improving fatigue risk management in healthcare: A systematic scoping review of sleep-related/fatigue-management interventions for nurses and midwives. Int J Nurs Stud 2019; 106:103513. [PMID: 32283414 DOI: 10.1016/j.ijnurstu.2019.103513] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 12/04/2019] [Accepted: 12/24/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Nurses and midwives make up almost 50% of the global healthcare shift working workforce. Shift work interferes with sleep and causes fatigue with adverse effects for nurses' and midwives' health, as well as on patient safety and care. Where other safety-critical sectors have developed Fatigue Risk Management Systems, healthcare is behind the curve; with published literature only focussing on the evaluation of discreet sleep-related/fatigue-management interventions. Little is known, however, about which interventions have been evaluated for nurses and midwives. Our review is a critical first step to building the evidence-base for healthcare organisations seeking to address this important operational issue. OBJECTIVES We address two questions: (1) what sleep-related/fatigue-management interventions have been assessed in nurses and midwives and what is their evidence-base? and (2) what measures are used by researchers to assess intervention effectiveness? DESIGN AND DATA SOURCES The following databases were searched in November, 2018 with no limit on publication dates: MEDLINE, PsychINFO and CINAHL. REVIEW METHODS We included: (1) studies conducted in adult samples of nurses and/or midwives that had evaluated a sleep-related/fatigue-management intervention; and (2) studies that reported intervention effects on fatigue, sleep, or performance at work, and on measures of attention or cognitive performance (as they relate to the impact of shift working on patient safety/care). RESULTS The search identified 798 potentially relevant articles, out of which 32 met our inclusion criteria. There were 8619 participants across the included studies and all were nurses (88.6% female). We did not find any studies conducted in midwives nor any studies conducted in the UK, with most studies conducted in the US, Italy and Taiwan. There was heterogeneity both in terms of the interventions evaluated and the measures used to assess effectiveness. Napping could be beneficial but there was wide variation regarding nap duration and timing, and we need to understand more about barriers to implementation. Longer shifts, shift patterns including nights, and inadequate recovery time between shifts (quick returns) were associated with poorer sleep, increased sleepiness and increased levels of fatigue. Light exposure and/or light attenuation interventions showed promise but the literature was dominated by small, potentially unrepresentative samples. CONCLUSIONS The literature related to sleep-related/fatigue-management interventions for nurses and midwives is fragmented and lacks cohesion. Further empirical work is warranted with a view to developing comprehensive Fatigue Risk Management Systems to protect against fatigue in nurses, midwives, and other shift working healthcare staff.
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Affiliation(s)
- Dawn Querstret
- Faculty of Sport, Health and Applied Science, St Mary's University, London TW1 4SX, UK.
| | - Katie O'Brien
- Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7YH, UK
| | - Debra J Skene
- Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7YH, UK
| | - Jill Maben
- Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7YH, UK
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39
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Methods in Experimental Work Break Research: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203844. [PMID: 31614598 PMCID: PMC6843288 DOI: 10.3390/ijerph16203844] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/04/2019] [Accepted: 10/06/2019] [Indexed: 01/09/2023]
Abstract
The number of studies on work breaks and the importance of this subject is growing rapidly, with research showing that work breaks increase employees’ wellbeing and performance and workplace safety. However, comparing the results of work break research is difficult since the study designs and methods are heterogeneous and there is no standard theoretical model for work breaks. Based on a systematic literature search, this scoping review included a total of 93 studies on experimental work break research conducted over the last 30 years. This scoping review provides a first structured evaluation regarding the underlying theoretical framework, the variables investigated, and the measurement methods applied. Studies using a combination of measurement methods from the categories “self-report measures,” “performance measures,” and “physiological measures” are most common and to be preferred in work break research. This overview supplies important information for ergonomics researchers allowing them to design work break studies with a more structured and stronger theory-based approach. A standard theoretical model for work breaks is needed in order to further increase the comparability of studies in the field of experimental work break research in the future.
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40
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Min A, Yoon YS, Hong HC, Kim YM. Association between nurses' breaks, missed nursing care and patient safety in Korean hospitals. J Nurs Manag 2019; 28:2266-2274. [DOI: 10.1111/jonm.12831] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/04/2019] [Accepted: 07/09/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Ari Min
- Red Cross College of Nursing Chung‐Ang University Seoul Korea
| | - Yea Seul Yoon
- Department of Nursing, Graduate School Yonsei University Seoul Korea
| | - Hye Chong Hong
- Red Cross College of Nursing Chung‐Ang University Seoul Korea
| | - Young Man Kim
- Department of Nursing, Graduate School Yonsei University Seoul Korea
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41
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Pierce HM, Perry L, Gallagher R, Chiarelli P. Delaying voiding, limiting fluids, urinary symptoms, and work productivity: A survey of female nurses and midwives. J Adv Nurs 2019; 75:2579-2590. [PMID: 31236988 DOI: 10.1111/jan.14128] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/07/2019] [Accepted: 06/04/2019] [Indexed: 11/28/2022]
Abstract
AIM To examine the relationships between workplace bladder practices, urinary symptoms, and work productivity. DESIGN Cross-sectional observational survey. METHODS Surveys were distributed June-November 2016 to at least 600 female nurses and midwives at three urban hospitals in New South Wales, Australia. Nurses self-reported restricted workplace access to toilets, delaying voiding, limiting of fluid intakes and urinary symptoms at work. Logistic modelling was used to examine whether nurses' bladder practices impaired their time management, ability to concentrate or perform physical demands. RESULTS Of 353 useable surveys, one in five nurses (22.4%; N = 79) reported restricted access to toilets at work, most (77.1%; N = 272) delayed voiding and one in four (26.9%; N = 95) limited fluid intakes to delay voiding at work. Almost half the sample had urinary symptoms at work (46.7%; N = 165); delaying voiding increased the likelihood of impaired mental concentration and limiting fluid intakes increased the likelihood of impaired time management. CONCLUSION As workplace access to toilets and related bladder practices are modifiable, associated urinary symptoms and productivity loss may be preventable. IMPACT Nurses' often experience restricted accesses to amenities due to job demands and workplace environments. The impact of nurses' poor bladder practices in the workplace is not known. In this study most nurses delayed voiding and many purposefully limited fluid intakes at work. These behaviours impacted a nurse's ability to manage time and/or concentrate at work. Results have implications for nurses' personal health, the design of workplace environments, workforce management, occupational health policy, and patient care.
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Affiliation(s)
- Heather M Pierce
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Lin Perry
- Faculty of Health, University of Technology Sydney, Sydney, Australia.,Prince of Wales Hospital, Sydney Hospital and Sydney Eye Hospital, Randwick, Australia
| | - Robyn Gallagher
- Charles Perkins Centre, Sydney School of Nursing, University of Sydney, Sydney, Australia
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42
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Cooper S, Cant R, Kelly M, Levett-Jones T, McKenna L, Seaton P, Bogossian F. An Evidence-Based Checklist for Improving Scoping Review Quality. Clin Nurs Res 2019; 30:230-240. [PMID: 31088144 DOI: 10.1177/1054773819846024] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
A scoping review aims to systematically explore and map the research available from a wide range of sources. The objective of this study was to produce a scoping review checklist to guide future scoping studies to enable rigorous review and critique of phenomena of interest. The methods used included a review of literature, expert consensus group meetings, a modified Delphi survey and, finally, verification against recent scoping study examples. Results showed that the checklist was able to identify key elements of scoping reviews. The 22-item Scoping Review Checklist (SRC), which includes two optional stakeholder consultation items, has been developed using rigorous recommended approaches. The checklist can be used to guide the conduct and critique of scoping studies.
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Affiliation(s)
- Simon Cooper
- Federation University Australia, Churchill, Victoria, Australia
| | - Robyn Cant
- Federation University Australia, Churchill, Victoria, Australia
| | | | | | - Lisa McKenna
- La Trobe University, Bundoora, Victoria, Australia
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43
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Defining organizational contributions to sustaining an ageing workforce: a bibliometric review. Eur J Ageing 2019; 16:337-361. [PMID: 31543728 DOI: 10.1007/s10433-019-00499-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
The ageing of populations worldwide has implications for workforces in developed countries, and labour shortages have increasingly become a political concern. Governments in developed countries have responded by increasing the retirement age as a strategy for overcoming the fall in labour supply. Using bibliometric techniques, we reviewed 122 articles published between 1990 and 2018 to examine the effectiveness of the strategy in addressing the labour shortages and, in particular, to identify the factors that contribute positively to maintaining worker participation within an ageing workforce at an organizational level. The results identified five organizational factors that support continued participation: health, institutions, human resource management, human capital and technology tools. Employers will increasingly need to develop "age-friendly" workplaces and practices if they are to recruit and retain older workers.
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44
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Riedl EM, Thomas J. The moderating role of work pressure on the relationships between emotional demands and tension, exhaustion, and work engagement: an experience sampling study among nurses. EUROPEAN JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2019. [DOI: 10.1080/1359432x.2019.1588251] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Elisabeth M. Riedl
- Department of Psychological Assessment and Intervention, Faculty of Philosophy and Education, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
| | - Joachim Thomas
- Department of Psychological Assessment and Intervention, Faculty of Philosophy and Education, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
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45
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Li H, Shao Y, Xing Z, Li Y, Wang S, Zhang M, Ying J, Shi Y, Sun J. Napping on night-shifts among nursing staff: A mixed-methods systematic review. J Adv Nurs 2018; 75:291-312. [DOI: 10.1111/jan.13859] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 08/05/2018] [Accepted: 09/04/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Huanhuan Li
- Basic Nursing Department; School of Nursing; Jilin University; Changchun Jilin China
| | - Yanping Shao
- Department of Obstetrics and Gynecology; The Second Hospital of Jilin University; Changchun Jilin China
| | - Zhuangjie Xing
- Basic Nursing Department; School of Nursing; Jilin University; Changchun Jilin China
| | - Yuan Li
- Basic Nursing Department; School of Nursing; Jilin University; Changchun Jilin China
| | - Shouqi Wang
- Basic Nursing Department; School of Nursing; Jilin University; Changchun Jilin China
| | - Meiling Zhang
- Basic Nursing Department; School of Nursing; Jilin University; Changchun Jilin China
| | - Jie Ying
- Basic Nursing Department; School of Nursing; Jilin University; Changchun Jilin China
| | - Ying Shi
- Basic Nursing Department; School of Nursing; Jilin University; Changchun Jilin China
| | - Jiao Sun
- Basic Nursing Department; School of Nursing; Jilin University; Changchun Jilin China
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Griffiths P, Ball J, Bloor K, Böhning D, Briggs J, Dall’Ora C, Iongh AD, Jones J, Kovacs C, Maruotti A, Meredith P, Prytherch D, Saucedo AR, Redfern O, Schmidt P, Sinden N, Smith G. Nurse staffing levels, missed vital signs and mortality in hospitals: retrospective longitudinal observational study. HEALTH SERVICES AND DELIVERY RESEARCH 2018. [DOI: 10.3310/hsdr06380] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background
Low nurse staffing levels are associated with adverse patient outcomes from hospital care, but the causal relationship is unclear. Limited capacity to observe patients has been hypothesised as a causal mechanism.
Objectives
This study determines whether or not adverse outcomes are more likely to occur after patients experience low nurse staffing levels, and whether or not missed vital signs observations mediate any relationship.
Design
Retrospective longitudinal observational study. Multilevel/hierarchical mixed-effects regression models were used to explore the association between registered nurse (RN) and health-care assistant (HCA) staffing levels and outcomes, controlling for ward and patient factors.
Setting and participants
A total of 138,133 admissions to 32 general adult wards of an acute hospital from 2012 to 2015.
Main outcomes
Death in hospital, adverse event (death, cardiac arrest or unplanned intensive care unit admission), length of stay and missed vital signs observations.
Data sources
Patient administration system, cardiac arrest database, eRoster, temporary staff bookings and the Vitalpac system (System C Healthcare Ltd, Maidstone, Kent; formerly The Learning Clinic Limited) for observations.
Results
Over the first 5 days of stay, each additional hour of RN care was associated with a 3% reduction in the hazard of death [hazard ratio (HR) 0.97, 95% confidence interval (CI) 0.94 to 1.0]. Days on which the HCA staffing level fell below the mean were associated with an increased hazard of death (HR 1.04, 95% CI 1.02 to 1.07), but the hazard of death increased as cumulative staffing exposures varied from the mean in either direction. Higher levels of temporary staffing were associated with increased mortality. Adverse events and length of stay were reduced with higher RN staffing. Overall, 16% of observations were missed. Higher RN staffing was associated with fewer missed observations in high-acuity patients (incidence rate ratio 0.98, 95% CI 0.97 to 0.99), whereas the overall rate of missed observations was related to overall care hours (RN + HCA) but not to skill mix. The relationship between low RN staffing and mortality was mediated by missed observations, but other relationships between staffing and mortality were not. Changing average skill mix and staffing levels to the levels planned by the Trust, involving an increase of 0.32 RN hours per patient day (HPPD) and a similar decrease in HCA HPPD, would be associated with reduced mortality, an increase in staffing costs of £28 per patient and a saving of £0.52 per patient per hospital stay, after accounting for the value of reduced stays.
Limitations
This was an observational study in a single site. Evidence of cause is not definitive. Variation in staffing could be influenced by variation in the assessed need for staff. Our economic analysis did not consider quality or length of life.
Conclusions
Higher RN staffing levels are associated with lower mortality, and this study provides evidence of a causal mechanism. There may be several causal pathways and the absolute rate of missed observations cannot be used to guide staffing decisions. Increases in nursing skill mix may be cost-effective for improving patient safety.
Future work
More evidence is required to validate approaches to setting staffing levels. Other aspects of missed nursing care should be explored using objective data. The implications of findings about both costs and temporary staffing need further exploration.
Trial registration
This study is registered as ISRCTN17930973.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 6, No. 38. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Peter Griffiths
- Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Wessex, Southampton, UK
| | - Jane Ball
- Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Wessex, Southampton, UK
| | - Karen Bloor
- Health Sciences, University of York, York, UK
| | - Dankmar Böhning
- Mathematical Sciences, University of Southampton, Southampton, UK
| | - Jim Briggs
- Centre for Healthcare Modelling and Informatics, University of Portsmouth, Portsmouth, UK
| | - Chiara Dall’Ora
- Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Wessex, Southampton, UK
| | - Anya De Iongh
- Independent lay researcher c/o National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, Southampton, UK
| | - Jeremy Jones
- Health Sciences, University of Southampton, Southampton, UK
| | - Caroline Kovacs
- Centre for Healthcare Modelling and Informatics, University of Portsmouth, Portsmouth, UK
| | | | - Paul Meredith
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Wessex, Southampton, UK
- Clinical Outcomes Research Group, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| | - David Prytherch
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Wessex, Southampton, UK
- Centre for Healthcare Modelling and Informatics, University of Portsmouth, Portsmouth, UK
- Clinical Outcomes Research Group, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| | - Alejandra Recio Saucedo
- Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Wessex, Southampton, UK
| | - Oliver Redfern
- Centre for Healthcare Modelling and Informatics, University of Portsmouth, Portsmouth, UK
| | - Paul Schmidt
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Wessex, Southampton, UK
- Clinical Outcomes Research Group, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| | - Nicola Sinden
- Clinical Outcomes Research Group, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| | - Gary Smith
- Health and Social Sciences, Bournemouth University, Bournemouth, UK
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47
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Hamilton D. Belonging and loss in the transition to newly qualified nursing. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2018; 27:1011. [PMID: 30235029 DOI: 10.12968/bjon.2018.27.17.1011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Duncan Hamilton, at the time of writing a final year adult nursing student at the University of Surrey, considers an unexpected sense of melancholy at the end of his course.
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Affiliation(s)
- Duncan Hamilton
- The time of writing a final year adult nursing student at the University of Surrey
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48
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Dall'Ora C, Ball J, Redfern O, Recio-Saucedo A, Maruotti A, Meredith P, Griffiths P. Are long nursing shifts on hospital wards associated with sickness absence? A longitudinal retrospective observational study. J Nurs Manag 2018; 27:19-26. [PMID: 29978584 PMCID: PMC7328726 DOI: 10.1111/jonm.12643] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2018] [Indexed: 11/27/2022]
Abstract
Objective To investigate whether working 12 hr shifts is associated with increased sickness absence among registered nurses and health care assistants. Background Previous studies reported negative impacts on nurses’ 12 hr shifts; however, these studies used cross‐sectional techniques and subjective nurse‐reported data. Methods A retrospective longitudinal study using routinely collected data across 32 general inpatient wards at an acute hospital in England. We used generalized linear mixed models to explore the association between shift patterns and the subsequent occurrence of short (<7 days) or long‐term (≥7 days) sickness absence. Results We analysed 601,282 shifts and 8,090 distinct episodes of sickness absence. When more than 75% of shifts worked in the past 7 days were 12 hr in length, the odds of both a short‐term (adjusted odds ratio = 1.28; 95% confidence index: 1.18–1.39) and long‐term sickness episode (adjusted odds ratio = 1.22; 95% confidence index: 1.08–1.37) were increased compared with working none. Conclusion Working long shifts on hospital wards is associated with a higher risk of sickness absence for registered nurses and health care assistants. Implications for Nursing Management The higher sickness absence rates associated with long shifts could result in additional costs or loss of productivity for hospitals. The routine implementation of long shifts should be avoided.
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Affiliation(s)
- Chiara Dall'Ora
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (Wessex), University of Southampton, Southampton, UK.,Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Jane Ball
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (Wessex), University of Southampton, Southampton, UK.,Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Oliver Redfern
- School of Computing, University of Portsmouth, Southampton, UK
| | - Alejandra Recio-Saucedo
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (Wessex), University of Southampton, Southampton, UK.,Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Antonello Maruotti
- Faculty of Health Sciences, University of Southampton, Southampton, UK.,Dipartimento di Scienze Economiche, Politiche e delle Lingue Moderne, Libera Università Maria Ss Assunta, Roma, Italy
| | - Paul Meredith
- Research & Innovation Department, Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Peter Griffiths
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (Wessex), University of Southampton, Southampton, UK.,Faculty of Health Sciences, University of Southampton, Southampton, UK
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