Caring for the caregiver during COVID-19 outbreak: Does inclusive leadership improve psychological safety and curb psychological distress? A cross-sectional study

The effect of inclusive leadership on turnover intention of intensive care unit nurses: the mediating role of organization-based self-esteem and interactional justice

BACKGROUND

Intensive Care Unit nurses are related to the medical quality and life outcome of critically ill patients. In the context of nurse shortage, it is of great significance to reduce the turnover intention of Intensive Care Unit nurses. Inclusive Leadership, organizational-based self-esteem and Interactional Justice are important factors affecting the turnover intention of Intensive Care Unit nurses. However, for the special group of Intensive Care Unit nurses, there are few studies that explore the associations between these factors. This study explores the effect of inclusive leadership on the turnover intention of Intensive Care Unit nurses and the potential mediation through organizational-based self-esteem and interactional justice.

METHOD

A cross-sectional study design was used to investigate 460 Intensive Care Unit nurses in 4 general hospitals in northern China. The scales used in this study include the inclusive leadership scale, the organization-based self-esteem scale, the interactional justice scale and the turnover intention scale. SPSS 27.0 was used for descriptive analysis and Pearson correlation analysis. AMOS 25.0 was used to construct structural equation model and Bootstrap test.

RESULTS

The results showed that the turnover intention of Intensive Care Unit nurses was higher (2.05 ± 0.67). Inclusive leadership had a negative predictive effect on turnover intention (β=-0.27, P < 0.001), and organizational-based self-esteem and interactional justice played a chain mediating role in the relationship between them (β=-0.051, P < 0.05).

CONCLUSIONS

Inclusive leadership is significantly related to the turnover intention of Intensive Care Unit nurses, and organizational-based self-esteem and interactional justice play a chain mediating role between the two. When medical institutions and nursing managers intervene to reduce the turnover intention of Intensive Care Unit nurses, they should not only focus on inclusive leadership but also consider the impact of organizational-based self-esteem and interactional justice on turnover intention, in order to develop effective talent retention strategies.

An exploration of the emotional response among nurses in Bermuda, during the Covid-19 pandemic

OBJECTIVES

This paper utilizes an ontological approach to conduct a qualitative literature review in order to investigate the emotional impact of the Covid-19 pandemic on nurses internationally. After identifying common themes in the literature review, primary research is conducted to investigate the emotional impact of the Covid-19 pandemic on nurses working in Bermuda´s only acute healthcare facility.

METHODS

The literature review used the FRAMEWORK approach (Richie and Spencer, 1994, as cited in Hackett et al. (2018) to select a total of 16 papers for review, each of them qualitative primary research, aside from one paper reviewing international literature. Within the second part of this paper, investigating the experience of nurses in Bermuda, a grounded theory approach was utilised to collect primary data. Convenience sampling was used to recruit subjects to participate in one-on-one semi-structured interviews. Data saturation was achieved after 9 interviews. The FRAMEWORK method was utilised to analyse the interview transcripts, and identify, organise and collate themes.

RESULTS

The literature review highlights that nurses have strong emotional responses to caring for patients during the Covid-19 pandemic. Specific responses include: higher stress levels at work due to higher, more challenging workload, and a reliance on clinical leaders to assuage this stress. Stigma experienced outside of work lead to feelings of anxiety and isolation. Despite this, there was a common theme that nurses felt a satisfaction within their role to ´play their part´ in the pandemic. The primary research conducted in Bermuda demonstrates that there was an initial fear of Covid-19, receding as the pandemic developed. Much anxiety was due to a perceived lack of knowledge about the disease, lack of a coherent strategy, and inadequate equipment to protect staff, and properly care for patients. An increased level of cooperation amongst staff, and mutual support amongst nurses was noted, as was social stigma leading to feelings of isolation and anxiety. Social interactions and holistic activities were identified as primary resources to alleviate stress and uncertainty.

CONCLUSIONS

Nurses in Bermuda elicited many of the same emotional responses as their international colleagues, as a result of caring for patients during the pandemic. These manifested as a result of higher, more challenging workload, and uncertainty about preparedness plan and quickly changing situations within the working environment. The results from this study can help formulate changes in policy to ensure smoother transitions to pandemic preparedness in the future.

Fostering Psychological Safety and Supporting Mental Health Among Cardiovascular Health Care Workers: A Science Advisory From the American Heart Association

The psychological safety of health care workers is an important but often overlooked aspect of the rising rates of burnout and workforce shortages. In addition, mental health conditions are prevalent among health care workers, but the associated stigma is a significant barrier to accessing adequate care. More efforts are therefore needed to foster health care work environments that are safe and supportive of self-care. The purpose of this brief document is to promote a culture of psychological safety in health care organizations. We review ways in which organizations can create a psychologically safe workplace, the benefits of a psychologically safe workplace, and strategies to promote mental health and reduce suicide risk.

Psychological Safety: Creating a Transformative Culture in a Faculty Group Peer-Mentoring Intervention

We investigated psychological safety (PS) in a randomized controlled study of a group peer mentoring intervention. Forty mid-career academic medicine research faculty participated in the year-long C-Change Mentoring & Leadership Institute, completing a survey after the first session and post-intervention. Qualitative data included ethnographic observations, interviews, and participant writings. A codebook thematic analysis used PS as one sensitizing concept. PS mean scores increased from 5.6 at baseline to 6.1 (range 1-7) post-intervention (t=3.03, p=.005, mean difference=0.48, 95% CI=0.33, 0.81). In qualitative analysis, PS resulted from intervention structure, storytelling/listening curriculum, and skilled facilitation, fostering norms that enabled sharing, repaired trust, and nurtured belonging. PS enabled faculty to be authentic, vulnerable, and responsive, and to develop social bonds within a peer community.

Preventive behaviors of respiratory infections in staff of hospital in Kazeroon, Fars, Iran: An application of protection motivation theory

BACKGROUND

One of the most crucial and essential methods for the prevention and management of respiratory infections is for healthcare professionals to take precautions for their own safety. Using Protection Motivation Theory (PMT), the current study looked into effective elements influencing the staff at Kazeroon's Valiasr Hospital's preventive actions against respiratory diseases.

METHODS

One hundred ninety-two male and 108 female employees of the Valiasr Hospital in Kazeroon, Iran, participated in this cross-sectional study, in May 2022. Census data were used as the sample technique. A questionnaire based on the PMT and a questionnaire collecting demographic data served as the data collection method. The study's content validity was confirmed by 10 health education experts, and its reliability was assessed using internal consistency techniques, resulting in a Cronbach's alpha coefficient of 0.87.The statistical program SPSS 24 was used to examine the data using the independent t test, logistic regression, and Pearson correlation.

RESULTS

The average age was 34.11 ± 8.91 for men and 32.77 ± 6.09 for women. The majority of participants were married (73.3%), had university education (76.7%), and earned a monthly income between 10 and 15 million Tomans (75%). Notably, 97.7% of participants had received the COVID-19 vaccine, and 77.7% had undergone training related to respiratory infections. The most common preventive practices included avoiding touching the eyes, noses, or mouths, wearing appropriate protective gear, and maintaining a safe distance of 1-2 m from others. Analysis of PMT constructs showed that participants had a generally positive perception toward preventive behaviors. Perceived vulnerability (P = 0.02), perceived cost (P = 0.03), and motivation (P = 0.001) were the three analyzed components that had the greatest impact on respiratory infection preventative behavior. Logistic regression revealed that perceived susceptibility, cost, and motivation significantly predicted the prevention of respiratory infections, with a predictive power of 45%. These findings highlight the importance of understanding the factors influencing preventive behaviors among hospital staff, from respiratory infections like COVID-19.

CONCLUSION

According to the findings, the personnel at Kazeroon's Valiasr Hospital wore gloves, goggles, and other appropriate personal protective equipment. The individuals' decision to wear personal protection equipment was also impacted by perceived susceptibility, cost, and motivation.

Leading matters! Linking compassion and mindfulness in organizations through servant leadership

Regardless of where they are, humans are inherently human. In this study, we explore the relationship between compassion, mindfulness, and servant leadership contributing to an overall feeling of safety. Adopting a humanistic approach to human resource management, we examine how compassion and mindfulness intersect under the lens of the Conservation of Resources (COR) theory. Our investigation focuses on understanding how servant leadership facilitates the cultivation of mindfulness through compassion. Using structural equation modeling (SEM), we analyze data gathered from 360 workers across diverse occupational sectors. Our findings provide empirical support for the hypothesis that compassion, manifested as a response to suffering, enhances mindfulness levels in the workplace. Specifically, we observe that organizations promoting servant leadership principles are conducive to higher levels of mindfulness among employees. Practically, our study underscores the importance of designing work contexts that prioritize compassion and servant leadership. By doing so, organizations can foster a positive work environment that promotes mindfulness and enhances workplace safety. Our research contributes to the management literature by offering empirical evidence on the role of servant leadership in cultivating compassion and mindfulness, thereby advancing the discourse on workplace safety and organizational well-being.

Managing the COVID-19 Pandemic: Experience of Managers in Healthcare: A Narrative Inquiry

The pandemic represented a challenge for hospital managers at different levels, required to reorganise services without compromising care. This study aimed to analyse the experiences of hospital managers during the COVID-19 pandemic. A narrative inquiry was conducted in a multisite acute hospital. Data were collected through narratives and open-ended questions. Direct and non-direct-care managers were invited to participate. Data were analyzed considering Clandinin & Connelly's (2000) framework and Braun & Clarke, (2006). Thirty-six narratives and open-ended question responses were analysed. Participants were nurses (n = 20), doctors, technicians, administrative and hospitality service managers. Themes were grouped into three narrative dimensions: (1) personal-"the emergency engulfed us", (2) practical/professional-"managing the pandemic", (3) social-"the strength of the team and people". Different narrative threads were identified between direct-care and non direct-care managers. Problems faced, factors helpful for management and suggestions for improvement were also reported. The pandemic had an important impact on managers and their roles, in terms of the need for clear concise information, staff support, and adequate professional and technical resources. A sense of unity and belonging facilitated management.

Supporting Reassigned Hospital Staff During the COVID-19 Pandemic in the Montreal Region: What Does it say About Leadership Styles?

Globally, the COVID-19 pandemic took a high toll on health human resources, especially in contexts where these resources were already fragile. In Quebec, to make up for the shortage of health human resources, and to contain the COVID-19 outbreaks in long-term care facilities, many hospital staff (including a majority of nurses) were sent to those facilities, with varying degrees of support. Building on the body of evidence linking leadership style and resilience, we conducted a qualitative comparative analysis of two hospitals in the Montreal Metropolitan Area, Quebec. We explored respondents' experience of psychosocial support tools provided to hospital staff reassigned to COVID-affected facilities. Data from 27 in-depth interviews with high- and mid-level managers, and front-line workers, was analyzed through the lens of leadership styles. Our findings highlighted how the design and implementation of support tools revealed major differences across the two hospitals' leadership styles (i.e., one hospital expressing leader-centered styles vs. the other expressing follower-centered leadership styles). The expression of these leadership styles was largely shaped by recent policies, notably a major political reform of 2015, which enforced more centralized decision-making. Our study offered additional empirical evidence that leadership styles fostering the recovery of health human resources may be a key indicator of successful response to crises.

COVID-19 safety leadership, perceived severity, and emotional exhaustion: Does safety culture matter?

INTRODUCTION

Emotional exhaustion is a major health-related issue that employees face, especially during crises such as pandemics. This study seeks to understand how safety leadership applied to the COVID-19 pandemic relates to emotional exhaustion, and to examine its mechanisms (i.e., perceived severity) along with its boundary condition (i.e., safety culture).

METHOD

A time lag study was conducted to collect data from 229 employees working in the service industry in Morocco. Data were analyzed through the Partial Least Squares Structural Equation Modeling (PLS-SEM) technique using SmartPLS 4.

RESULTS

The results demonstrate that safety leadership is negatively related to emotional exhaustion. Additionally, they suggest that the relationship between COVID-19 safety leadership and perceived severity depends on the level of the moderating variable (i.e., safety culture). Specifically, the relationship is positive when safety culture is low, but is negative when safety culture is high.

PRACTICAL APPLICATIONS

The results of this study are important as they extend our knowledge of the nature of safety leadership and emotional exhaustion, and offer managers practical implications that can help to optimize safety leadership practices.

Identifying the Key Elements of Psychologically Safe Workplaces in Healthcare Settings

BACKGROUND

Psychological safety is a key concern in the workplace as organisations continue to see increases in psychological injuries that have significant ramifications on individuals and workplaces. The COVID-19 pandemic has exacerbated this issue in healthcare workforces facing extraordinary pressures. This preliminary study aims to enhance our understanding of the factors that healthcare workers value in relation to psychological safety in their respective healthcare settings.

METHODS

To achieve the research objective, qualitative self-reflection examples were conducted with 12 participants from various health professional backgrounds across public, private, and aged-care settings. The data obtained were thematically analysed using NVivo software (V 12), enabling the identification of key elements associated with psychologically safe workplaces.

RESULTS

The results revealed several significant elements that contribute to psychologically safe workplaces in healthcare settings. These elements include effective communication, organisational culture, leadership practices, performance feedback mechanisms, respect among colleagues, staff development opportunities, teamwork, and trust. The findings underscore the critical importance of these foundational elements in fostering psychological safety within healthcare.

CONCLUSION

This study contributes to the existing body of knowledge by specifically identifying the key elements that healthcare workers value in terms of psychological safety. By exploring a wide range of healthcare professionals' perspectives, this research offers valuable insights into the unique challenges faced by healthcare workforces and the necessary conditions for fostering psychological safety. The implications of these findings are discussed in relation to the lessons they provide for healthcare employers, highlighting the potential for improving workplace wellbeing and performance.

Factors determining safety culture in hospitals: a scoping review

OBJECTIVE

To evaluate and synthesise the factors determining patient safety culture in hospitals.

METHODS

The scoping review protocol was based on the criteria of the Joanna Briggs Institute. Eligibility criteria were as follows: (1) empirical study published in a peer-reviewed journal; (2) used methods or tools to assess, study or measure safety culture or climate; (3) data collected in the hospital setting and (4) studies published in English. Relevant literature was located using PubMed, CINAHL, Web of Science and PsycINFO databases. Quantitative and qualitative analyses were performed using RStudio and the R interface for multidimensional analysis of texts and questionnaires (IRaMuTeQ).

RESULTS

A total of 248 primary studies were included. The most used instruments for assessing safety culture were the Hospital Survey on Patient Safety Culture (n=104) and the Safety Attitudes Questionnaire (n=63). The Maslach Burnout Inventory (n=13) and Culture Assessment Scales based on patient perception (n=9) were used in association with cultural instruments. Sixty-six articles were included in the qualitative analysis. In word cloud and similarity analyses, the words 'communication' and 'leadership' were most prominent. Regarding the descending hierarchical classification analysis, the content was categorised into two main classes, one of which was subdivided into five subclasses: class 1a: job satisfaction and leadership (15.56%), class 1b: error response (22.22%), class 1c: psychological and empowerment nurses (20.00%), class 1d: trust culture (22.22%) and class 2: innovation worker (20.00%).

CONCLUSION

The instruments presented elements that remained indispensable for assessing the safety culture, such as leadership commitment, open communication and learning from mistakes. There was also a tendency for research to assess patient and family engagement, psychological safety, nurses' engagement in decision-making and innovation.

The mediating roles of workplace support and ethical work environment in associations between leadership and moral distress: a longitudinal study of Canadian health care workers during the COVID-19 pandemic

Introduction

The COVID-19 pandemic has resulted in heightened moral distress among health care workers (HCWs) worldwide. Past research has shown that effective leadership may mitigate potential for the development of moral distress. However, no research to date has considered the mechanisms by which leadership might have an influence on moral distress. We sought to evaluate longitudinally whether Canadian HCWs' perceptions of workplace support and ethical work environment would mediate associations between leadership and moral distress.

Methods

A total of 239 French- and English-speaking Canadian HCWs employed during the COVID-19 pandemic were recruited to participate in a longitudinal online survey. Participants completed measures of organizational and supervisory leadership at baseline and follow-up assessments of workplace support, perceptions of an ethical work environment, and moral distress.

Results

Associations between both organizational and supervisory leadership and moral distress were fully mediated by workplace supports and perceptions of an ethical work environment.

Discussion

To ensure HCW well-being and quality of care, it is important to ensure that HCWs are provided with adequate workplace supports, including manageable work hours, social support, and recognition for efforts, as well as an ethical workplace environment.

Religious coping, care burden and psychological distress among informal caregivers of COVID-19 patients: Results of a cross-sectional survey in Pakistan

BACKGROUND

There is a complex relationship between health and religiosity. People may use religion to cope with difficulties and uncertainties in their life - such as induced by the COVID-19 pandemic.

AIMS

The purpose of this study is to investigate the relationship between religious coping, care burden and psychological distress among caregivers during COVID-19 in Pakistan.

METHOD

We conducted a cross-sectional survey in Pakistan. We used the Religious Coping Scale (RCOPE), Care Burden Scale (CB), and Depression, Anxiety and Stress Scale (DASS-21) to measure psychological stress from 303 caregivers. Data were analyzed using a hierarchical linear regression model for each of the three outcome variables, which are depression, anxiety, and stress. This analysis allows to investigate whether adding variables significantly improves a model's ability to predict the criterion variable.

RESULTS

The findings reveal that emotional care burden, physical care burden, negative religious coping, and social care burden explain a significant amount of the variance of three components of psychological distress among caregivers.

CONCLUSIONS

Health experts, psychologists, and policymakers can make better strategies to combat pandemics like COVID-19 by incorporating religious coping methods.

PTSD of Chinese nurses in the normalisation of COVID-19 pandemic prevention and control: Prevalence and correlates

Background

Though the severe prevention and control measures faced by Chinese nurses had changed during the normalisation stage of the coronavirus 2019 (COVID-19) pandemic, they still worked under great stress. Due to a lack of related evidence, we aimed to investigate the prevalence and correlates of post-traumatic stress disorder (PTSD) among Chinese nurses during the normalisation of COVID-19 pandemic prevention and control measures.

Methods

Using convenience sampling, we recruited 784 nurses in Jiangsu province, China to complete a survey via their mobile devices. We used a demographic questionnaire, the Perceived Social Support Scale, the Connor-Davidson Resilience Scale, the General Self-Efficacy Scale, and The Impact of Event Scale-Revised to collect data and applied binary logistic regression analysis to identify factors associated with PTSD.

Results

The prevalence of PTSD was 26.4%. Married nurses were less likely to experience PTSD than unmarried ones (odds ratio (OR) = 0.573; 95% confidence interval (CI) = 0.33-0.99, P = 0.046). Social support (OR = 0.96; 95% CI = 0.94-0.98, P = 0.000) and resilience (OR = 0.98; 95% CI = 0.97-0.99, P = 0.004) were significant predictors of PTSD.

Conclusions

PTSD remained prevalent among Chinese nurses as COVID-19 pandemic prevention and control measures became normalised, with an incidence rate of 26.4%. Resilience, social support, and marital status were factors associated with PTSD. Chinese hospital management must intervene to improve resilience and social support for nurses to reduce symptoms of PTSD.

The influence mechanisms of inclusive leadership on job satisfaction: Evidence from young university employees in China

BACKGROUND

Leadership style and job satisfaction are currently hot issues in the field of management psychology research, especially with regard to young employees.

OBJECTIVE

This study attempted to explain the mechanism of improving employees' job satisfaction by combining the key factors of work-family balance and psychological capital.

METHODS

We adopted the literature method, questionnaire survey method, and statistics method to conduct the research. And we conducted structural equation modeling (SEM) analysis of 540 young university employees in China using the random sampling method for sampling.

RESULTS

Based on the structural equation modeling (SEM) analysis of 540 young university employees in China, the results show that inclusive leadership has a positive impact on improving employees' job satisfaction and that work-family balance is beneficial to serving leaders in improving employees' job satisfaction. Simultaneously, psychological capital positively moderates the indirect effect of inclusive leadership on improving job satisfaction.

CONCLUSION

The final model revealed an important path from inclusive leadership to job satisfaction through work-family balance. These findings not only extend and enrich the relevant research on the relationship between inclusive leadership and job satisfaction but also shed some light on university management practice.

A structural equation modelling analysis: interprofessional team collaboration, organizational career management, and post competency of community nurses

BACKGROUND

With the advent of an ageing society and an increase in the prevalence of chronic diseases, the role of primary health care has become increasingly important and reliant on multidisciplinary collaboration. As members of this interprofessional cooperative team, community nurses play a dominant role. Thus, the post competencies of community nurses study deserve our attention. In addition, organizational career management can affect nurses in some ways. This study aims to examine the current situation and relationship among interprofessional team collaboration, organizational career management and post-competency of community nurses.

METHODS

A survey was conducted among 530 nurses in 28 community medical institutions from November 2021 to April 2022 in Chengdu, Sichuan Province, China. Descriptive analysis was used for analysis, and a structural equation model was used to hypothesize and verify the model. A total of 88.2% of respondents met the inclusion criteria and did not meet the exclusion criteria. The main reason nurses gave for not participating was that they were too busy.

RESULTS

Among the competencies on the questionnaire, ensuring quality and helping roles scored the lowest. The teaching-coaching and diagnostic functions played a mediating role. Nurses with greater seniority and those who were transferred to administrative departments had lower scores, and the difference was statistically significant (p < 0.05). In the structural equation model, CFI = 0.992 and RMSEA = 0.049, which shows that the model fit well, suggesting that organizational career management had no statistically significant effect on post competency (β = -0.006, p = 0.932) but that interprofessional team collaboration had a statistically significant effect on post competency (β = 1.146, p < 0.001) and organizational career management had a statistically significant effect on interprofessional team collaboration (β = 0.684, p < 0.001).

CONCLUSIONS

Attention should be given to the improvement of community nurses' post competency in ensuring quality and performing helping, teaching-coaching, and diagnostic roles. Moreover, researchers should focus on the decline in community nurses' abilities, particularly for those with greater seniority or in administrative roles. The structural equation model shows that interprofessional team collaboration is a complete intermediary between organizational career management and post competency.

Increasing Couriers' Job Satisfaction through Social-Sustainability Practices: Perceived Fairness and Psychological-Safety Perspectives

Due to the spike in online-retail demand during the pandemic, couriers confront increased workload and safety concerns, posing significant social-sustainability challenges for courier companies. This study explores the impact of social-sustainability practices on couriers' job satisfaction in the context of the COVID-19 pandemic. We designed the research model from the theoretical lens of Maslow's hierarchy of needs, equity, and psychological-safety theories. We collected the views of 428 couriers from the Chinese market, where there is a developed e-commerce industry. The structural-equation-model analysis results found that social-sustainability practices such as working environment, working conditions, health and safety, education, and training positively affected the job satisfaction of couriers during the pandemic through the mediators (psychological safety and perceived fairness). These findings provide empirical recommendations for improving employees' job satisfaction in courier companies during COVID-19 and addressing the social-sustainability issues of courier companies.

Factors that influence the impact of Chronic Non-Cancer Pain on daily life: A partial least squares modelling approach

BACKGROUND

Chronic Non-Cancer Pain is pain of more than three months' duration and is not associated with an oncological condition. There is ample literature that recognises that Chronic Non-Cancer Pain impacts numerous areas of the life of the person who suffers from it. This impact is difficult to determine and quantify because Chronic Pain is a subjective experience.

OBJECTIVE

The objective of this study was to test a recursive model of hypothesised factors that comprise the concept of Chronic Non-Cancer Pain Impact on daily life using Partial Least Squares-Structural Equation Modelling.

DESIGN

A cross-sectional study was carried out. The sample size was calculated using G*Power V.3.1.9.4 with five parameters (two-tailed, large effect size (f² = 0.35), power of 0.95, statistical significance of 95% (α = 0.05) and 36 predictors). The minimum number of subjects was considered to be 137.

METHODS

A recursive model was built based on data from a sample of 395 people over 18 years of age with Chronic Non-Cancer Pain. Data collection was conducted between January and March 2020 at Pain Units and Primary Healthcare Centres belonging to the Spanish Public Health System in the province of Seville (Spain). Analyses were based on Partial Least Squares-Structural Equation Modelling. The internal consistency, convergent validity and discriminant validity of the internal measurement model were assessed. For the external measurement model, global model adjustment and structural validity were assessed. The predictive capacity of the final model was also evaluated. All analyses were performed using SmartPLS version 3.3.2 in consistent mode.

RESULTS

Findings showed an adequate validity of the proposed model, which comprised nine factors: pain catastrophising, hopelessness due to pain, support network, proactivity, treatment compliance, self-care, mobility, resilience, and sleep. The internal validity of the model (Cronbach's alpha and rho_A > 0.70; Average Variance Extracted>0.50; standardised outer loadings>0.60; Heterotrait-Monotrait-Ratio < 0.85), goodness of fit (Standardised Root Mean Square Residuals<0.08; Geodesic and Euclidean distance p-value<0.05) and predictive power with out-of-sample values (Stone-Geisser test>0.5) were adequate. The hypothesised structure of the instrument has also been confirmed (path coefficients>0.3; R² > 0.1; f² > 0.2).

CONCLUSIONS

The results have shown an adequate internal consistency, convergent validity and discriminant validity of the model. Likewise, the model has shown an adequate goodness of fit, and the validity of its structure and the hypothesis have been confirmed. However, more research is needed in this regard as the possible interaction between the different factors evaluated in the model with the confounding or moderating variables that may exist.

Mental health status and its associated factors among female nurses in the normalization of COVID-19 epidemic prevention and control in China

Objective

To investigate mental health status and its associated factors among female nurses in the normalization of COVID-19 epidemic prevention and control in China.

Methods

Random cluster sampling was applied to recruit 740 female nurses in China. The respondents completed the survey with mobile devices. Demographic questionnaire, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Insomnia Severity Index, and The Impact of Event Scale-Revised were used to assess demographic Information, anxiety, depression, insomnia and PTSD symptoms, respectively. The associated factors of mental health status were identified by binary logistic regression analysis.

Results

The prevalence of anxiety and depression was 7.9 and 17.8%, respectively. Insomnia was an associated factor of anxiety (OR = 6.237, 95%CI = 6.055-23.761, P < 0.001) and depression (OR = 9.651, 95%CI = 5.699-22.370, P < 0.001), while PTSD was an associated factor of anxiety (OR = 11.995, 95%CI = 2.946-13.205, P < 0.001) and depression (OR = 11.291, 95%CI = 6.056-15.380, P < 0.001), Being married was a protective factor of depression (OR = 0.811, 95%CI = 1.309-6.039, P < 0.01).

Conclusion

Female nurses showed problems in mental health. Insomnia, PTSD and marital status were associated with mental health. The hospital management should pay more attention to the unmarried groups, and strive to improve the sleep quality of female nurses and reduce their stress caused by traumatic events.

Effects of Inclusive Leadership on Quality of Care: The Mediating Role of Psychological Safety Climate and Perceived Workgroup Inclusion

Purpose: The aim of the study is to investigate the multilevel effects of the inclusiveness of workgroup leaders on quality of care by intervening through a “psychological safety climate” at the group level and “perceived workgroup inclusion” at the individual level within professionally diverse workgroups of healthcare professionals. Material and Methods: Data are collected from 305 healthcare professionals nested in 61 workgroups and 305 patients treated by the same workgroups working in public-sector hospitals in Pakistan. Hypothesized relationships are tested through multilevel analyses using Mplus 7. Results: The results of the study show that inclusive leadership can enhance the quality of care delivered by multiprofessional workgroups of healthcare professionals through perceived workgroup inclusion. Further, the psychological safety climate does not mediate the relationship between inclusive leadership and quality of care individually, but it transmits the effects of inclusive leadership through perceived workgroup inclusion on quality of care. Conclusion: The results of the study suggest that the inclusiveness of workgroup leaders, the psychological safety climate, and perceived workgroup inclusion can create safe and inclusive interpersonal mechanisms that play a key role in transmitting the positive effects of inclusive leadership on quality of care.

Facing the Post-Pandemic Challenges: The Role of Leadership Effectiveness in Shaping the Affective Well-Being of Healthcare Providers Working in a Hybrid Work Mode

The COVID-19 pandemic has brought new challenges to the medical industry, including hybrid work, in which specialists can perform some of their duties remotely, in addition to physical contact with patients and their teams. Hybrid work provides opportunities, but also generates difficulties (e.g., accurate long-distance diagnosis); therefore, there is a need to ensure the well-being of healthcare workers, especially in the context of leadership strategies. As there is little research on leadership practices in remote and hybrid medical worker management, this study analyses the relationship between certain behavioural strategies and competencies of leaders and the affective well-being of hybrid employees. The research was conducted among a group of employees (N = 135) from seven countries who provide healthcare in a hybrid model. The correlations between the variables showed the statistical significance of all leadership strategies introduced into the model and focused on building involvement (employee empowerment and team orientation), creating a shared vision, defining clear goals and strategies, promoting adaptability (change management, promotion of organisational learning and patient focus), managing consistency through shared values, agreement and effective coordination, as well as competencies such as communicativeness, credibility, self-development and digital readiness. Despite the significance of all the relationships, the linear regression showed that the variability of affective well-being was explained mainly by the adaptability leadership strategy. The results of the study expand the knowledge on the competencies of healthcare leaders, and shed new light on the management of medical employees performing remote and hybrid work. Because such research into well-being has not been published to date, the analysis begins an important discussion on redefining leadership in the healthcare sector, taking into account the digital transformation.

Does transformational leadership and psychological empowerment improve nurses' innovative behaviour during COVID-19 outbreak? A cross-sectional study

AIMS

To investigate the relationships between transformational leadership, psychological empowerment and innovative behaviour among nurses in China.

BACKGROUND

The innovative behaviour of nurses is important to adapt to the changing medical environment. However, there is currently a limited understanding of the relationship between nurses' innovative behaviour and transformational leadership and psychological empowerment during the pandemic.

METHODS

Convenience sampling was used to conduct an investigation involving 1317 nurses from 10 hospitals in China from January 2022 to April 2022. Data analysis was performed using correlation analysis, univariate analysis and multiple regression analysis. The STROBE checklist was followed when writing this manuscript.

RESULTS

High transformational leadership and high psychological empowerment were associated with high innovative behaviour. The results of the multiple linear regression analysis showed that physical condition, whether or not you have attended academic conferences or whether or not you have participated in fund research projects, transformational leadership and psychological empowerment were the main factors on nurses' innovative behaviour, together explaining 64.5% of the total variance.

CONCLUSION

Promotion of transformational leadership and psychological empowerment is vital for nurses to promote innovation, thereby meeting the urgent demand for innovative nurses and the rapid development of nursing disciplines.

IMPLICATIONS FOR NURSING MANAGEMENT

This study highlights the importance of transformational leadership in developing nurses' innovative behaviours. Understanding the role of psychological empowerment can help nurse managers formulate relevant intervention strategies and cultivate nurses' innovative behaviour.

Workforce Experiences of a Rapidly Established SARS-CoV-2 Asymptomatic Testing Service in a Higher Education Setting: A Qualitative Study

The aim of the study was to explore workforce experiences of the rapid implementation of a SARS-CoV-2 asymptomatic testing service (ATS) in a higher education setting during the COVID-19 pandemic. The setting was a multi-campus university in the UK, which hosted a testing service for employees and students over two years. Qualitative semi-structured videoconference interviews were conducted. We contacted 58 participants and 25 were interviewed (43% response rate). Data were analysed thematically. The analysis produced four overarching themes: (1) feelings relating to their involvement in the service, (2) perceptions of teamwork, (3) perceptions of ATS leadership, (4) valuing the opportunity for career development. Agile and inclusive leadership style created psychological safety and team cohesion, which facilitated participants in the implementation of a rapid mitigation service, at pace and scale. Specific features of the ATS (shared vision, collaboration, networking, skills acquisition) instilled self-confidence, value and belonging, meaningfully impacting on professional development and career opportunities. This is the first qualitative study to explore the experiences of university employees engaged in the rapid deployment of a service as part of a pandemic outbreak and mitigation strategy within a higher education setting. Despite pressures and challenges of the task, professional growth and advancement were universal. This has implications for workforce engagement and creating workplaces across the sector that are well-prepared to respond to future pandemics and other disruptive events.

Fear of COVID-19 and secondary trauma: Moderating role of self-efficacy

COVID-19 has affected millions of people around the globe. People's mental health, especially those of nurses, has been primarily affected by the fear of this virus. More focus has been paid to vaccination and treatment of the virus, but less attestation has been given to addressing the mental health of people affected by the virus. Empirical studies show that different external factors are not easily manageable and controllable by the individual. This study preliminarily explores the connection between fear of COVID-19 and secondary traumatic stress in nurses. Further, it examines the moderating effects of occupational self-efficacy on the relationship between fear of COVID-19 and secondary traumatic stress. Data for the study was collected from the nurses of six large hospitals in Karachi, Pakistan. The final analysis was performed on 243 samples. Studies on COVID-19 suggest that increased occupational self-efficacy decreases fear and its impact. This study offers insights for managers to develop stress management programs and provide proper training and counseling sessions to the nurses to motivate them emotionally. Theoretically, this study broadens the understanding of the theory of emotions by using the pandemic as a stressor. Future studies may explore different roles of occupational self-efficacy and study its influential role in managing different kinds of emotions explained by the theory of emotions. Managers at the workplace could design different self-efficacy training for nurses to increase their self-motivation to fight different types of stress they face at the workplace.

The interplay between servant leadership, psychological safety, trust in a leader and burnout: assessing causal relationships through a three-wave longitudinal study

COVID-19 pandemic has brought unprecedented psychological challenges for frontline healthcare workers, especially nurses, causing anxiety and depression leading to burnout. The responsibility of healthcare leaders has increased manyfold to deal with such challenges. This study attempts to employ the conservation of resources theory to examine the relationship between servant leadership and nurses' burnout, with the mediating role of psychological safety and the moderating effect of trust in leader. A three-wave longitudinal design was employed for data collection from 1204 nurses from 27 hospitals in China. The partial least squares structural equation modeling technique was used for data analyses with SmartPLS version 3.2.8. The findings endorse that servant leadership at time 1 significantly reduces nurses' burnout measured at time 3 through the mediating role of psychological safety measured at time 2, and that a higher level of trust in the leader enhances the impact of servant leadership in reducing nurses' burnout.

How Does Inclusive Leadership Curb Workers’ Emotional Exhaustion? The Mediation of Caring Ethical Climate and Psychological Safety

The COVID-19 pandemic has transformed the politics, economy, and society of the world, which has dealt the most severe blow to the hospitality industry. Meanwhile, the pandemic and government control policies have brought high psychological pressure to hospitality front-line employees, resulting in emotional exhaustion. As a part of burnout syndrome, emotional exhaustion poses a threat to employees’ mental health, career sustainability, and well-being. Therefore, the purpose of this paper was to investigate the curb effectiveness of inclusive leadership on emotional exhaustion and to explore the mediation roles of ethical climate and psychological safety between them. Time-lagged data were collected from 65 teams and 358 hospitality front-line employees working in Chinese hotels in two stages with a one-month gap. This research verified that inclusive leadership has a negative impact on emotional exhaustion both indirectly through the mediation roles of ethical climate and psychological safety. And the ethical climate and psychological safety played partial mediation roles between inclusive leadership and emotional exhaustion. In theory, the findings explored the dual mediation mechanism of the inhibitory effect of inclusive leadership on emotional exhaustion. In practice, we provided the training and correct guidance to develop inclusive leadership for hotel enterprises and to resolve the emotional exhaustion of employees, which can enhance sustainability in careers.

Psychological Distress and Work-Related Quality of Life Among Oncology Nurses During the COVID-19 Pandemic: A Cross-Sectional Study

BACKGROUND

Oncology nurses are at disproportionate risk for psychological distress because they often encounter ethical challenges and deaths while providing care. Exposures to emergent suffering during the COVID-19 pandemic compound their chronic distress, which likely increased their vulnerability to psychological distress and may increase their risk for reduced work-related quality of life (WRQOL).

OBJECTIVES

This study examined the association between psychological distress and WRQOL among oncology nurses during the COVID-19 pandemic.

METHODS

A cross-sectional analysis of psychological distress and WRQOL among oncology nurses (N = 63) was conducted.

FINDINGS

The mean Depression, Anxiety and Stress Scale score was 33.4, showing low depression levels, mild anxiety, and mild stress. The mean PTSD score was 29.3, and the mean WRQOL Scale score was 78.8. Depression, anxiety, and stress were strongly correlated to PTSD, and WRQOL was negatively correlated to PTSD, depression, anxiety, and stress.

Psychological safety in elite sport settings: a psychometric study of the Sport Psychological Safety Inventory

Objectives

Effectively supporting the mental health of elite athletes and coaches requires validated tools that assess not only individual-level factors but organisational-level influences. The aim of this study was to develop a bespoke scale assessing perceived psychological safety within high-performance environments.

Methods

337 elite athletes (M=24.12 years) and 238 elite-level coaches and high-performance support staff (HPSS; M=41.9 years) identified via the Australian Institute of Sport provided data across a range of mental health and well-being domains. Exploratory factor analysis (EFA; n=169 athletes) with parallel analysis identified the Sport Psychological Safety Inventory (SPSI) factor structure. Confirmatory factor analysis (CFA) validated the identified structure in separate validation subsamples of athletes (n=168) and coaches/HPSS (n=238).

Results

EFA identified the 11-item, 3-factor SPSI. Factors assessed domains of the Mentally Healthy Environment, Mental Health Literacy and Low Self-Stigma. All scale items loaded strongly on their specific domain. CFA model fit indices validated scale structure for athletes and coaches/HPSS. Internal consistency and convergent and divergent validity were evident. Logistic regression indicated that incrementally higher Mentally Healthy Environment scores reduced the likelihood of athletes scoring in the ‘moderate’ range of general and athlete-specific distress, with a stronger endorsement of the Low Self-Stigma subscale reducing the likelihood of being identified for athlete-specific distress.

Conclusion

Psychometric properties of the SPSI support scale utility among athletes and coaches/HPSS in elite sports settings, though further psychometric efforts are needed. This brief measure may support benchmarking efforts across elite sporting contexts to improve mental health culture and broader well-being among athletes and coaches/HPSS.

Nurse experience during the COVID-19 pandemic: Implications for nurse leaders

Results of a two-question survey of nurses at one hospital identified 5 clear themes related to nurses' experiences during the pandemic and 7 areas for improvement, providing potential strategies for nurse leaders.

Leadership During a Pandemic: A Lexical Analysis

To manage pandemics, like COVID-19, leadership can enable health services to weather the storm. Yet there is limited clarity on how leadership manifested and was discussed in the literature during COVID-19. This can have considerable public health implications given the importance of leadership in the health sector. This article addresses this missed opportunity by examining the literature on leadership during a pandemic. Following a systematic search of nine academic databases in May 2021, 1,747 publications were screened. Following this, a lexical analysis of the results section was conducted, sourced from a corpus of publications across myriad journals. The results found a prevalence of references to “leader” as a sole actor, risking the perpetuation of a view that critical decisions emanate from a singular source. Moreover, “leadership” was a concept disconnected from the fray of frontline workers, patients, and teams. This suggests a strong need for more diverse vocabularies and conceptions that reflect the “messiness” of leadership as it takes shape in relation to the challenges and uncertainties of COVID-19. There is a considerable opportunity to advance scholarship on leadership via further empirical studies that help to clarify different approaches to lead teams and organizations during a pandemic.

"Did You Bring It Home with You?" A Qualitative Investigation of the Impacts of the COVID-19 Pandemic on Victorian Frontline Healthcare Workers and Their Families

Concerns regarding the physical and mental health impacts of frontline healthcare roles during the COVID-19 pandemic have been well documented, but the impacts on family functioning remain unclear. This study provides a unique contribution to the literature by considering the impacts of the COVID-19 pandemic on frontline healthcare workers and their families. Thirty-nine frontline healthcare workers from Victoria, Australia, who were parents to at least one child under 18 were interviewed. Data were analysed using reflexive thematic analysis. Five superordinate and 14 subordinate themes were identified. Themes included more family time during lockdowns, but at a cost; changes in family responsibilities and routines; managing increased demands; healthcare workers hypervigilance and fear of bringing COVID-19 home to their family members; ways in which families worked to “get through it”. While efforts have been made by many healthcare organisations to support their workers during this challenging time, the changes in family functioning observed by participants suggest that more could be done for this vulnerable cohort, particularly with respect to family support.

Working Environment, Personal Protective Equipment, Personal Life Changes, and Well-Being Perceived in Spanish Nurses during COVID-19 Pandemic: A Cross-Sectional Study

During the COVID-19 pandemic, nurses have had to face logistical problems related to critical changes in their work environment, the supply of personal protective equipment (PPE), and hard personal life decisions. This study aimed to investigate the changes in the working environment, PPE use, personal lives, and well-being as perceived by nurses in hospitals and primary care centers in Spain, during the COVID-19 pandemic. A descriptive cross-sectional survey study was conducted in April 2020, including 61 public and private hospitals, and 852 primary care centers. A total of 1296 nurses participated. The redeployment practice for organizational or vulnerability reasons was used by 26.4% of the participants. A total of 61.9% of the nurses doubled the time they used masks, and 8.3% of them could only replace the mask once a week. A total of 11.2% (n = 145) of the nurses left home to avoid infecting their family. Finally, 60.97% of the participants stated that their well-being was reduced compared to the state before the pandemic. Changes in the work environment, the use of PPE, and personal life may be related to the decrease in personal well-being perceived by the nurses.

Clinical Leader Series: A Virtual Mental Well-being Initiative for Nurse Leaders During the COVID-19 Pandemic and Beyond

OBJECTIVE

A virtual mental well-being initiative was developed for nurse leaders to provide education about mental health and to teach self-care skills.

BACKGROUND

Because of substantial demand placed on nurse leaders during the COVID-19 pandemic, organizations must address stress and burnout by providing a continuum of care to include education, support, and intervention.

METHODS

All levels of nurse leaders at a multicampus healthcare system were invited to attend. Data were collected on coping, empowerment, burnout, and quality of life. Participant responses to discussion prompts were compiled and reviewed.

RESULTS

Although the independent parallel comparison did not show significant improvements, scores on the coping, empowerment, burnout, and quality-of-life measures were maintained. Discussion prompts yielded valuable insights into nurse leader experiences and session effectiveness.

CONCLUSIONS

This type of education, as well as psychological support, will continue to be needed after the pandemic due to burnout, moral injury, and primary or secondary trauma. Findings are applicable to future crisis situations.

Does Servant Leadership Control Psychological Distress in Crisis? Moderation and Mediation Mechanism

Purpose

This study aims to investigate the impact of servant leadership on the psychological distress of healthcare staff during the Covid-19 crisis. The authors propose that work engagement mediates and mindfulness moderates the direct relationship between servant leadership and psychological distress.

Methods

Time-lagged data were collected from 277 healthcare staff working at different hospitals in Pakistan. Process Macro version 3.1 on SPSS 23 was used for statistical analysis. For model fitness, we used AMOS V 22.

Results

The results show that servant leadership is negatively related to psychological distress. Furthermore, work engagement mediates the relationship between servant leadership and psychological distress. Moreover, mindfulness is anticipated to moderate the direct relationship between servant leadership and psychological distress, drawing on the social exchange and conservation of resources theory.

Discussion

This study finds that servant leadership is vital for the mental health of healthcare staff. Thus, it extends the utility of the concept of servant leadership to the psychology and crisis management literature.

Mental Health of Healthcare Workers During the COVID-19 Pandemic

On January 16, 2020, the first case of coronavirus disease 2019 (COVID-19) in Japan was reported. In the spring of the same year, the shortage of personal protective equipment (PPE) such as surgical masks became a significant issue. In addition, the medical staff had to encounter discrimination during this period. Thus, the mental health of these staff has been greatly affected by the social situation, the media coverage of the COVID-19 epidemic, and the shortage of PPE in hospitals. Various factors make it difficult for the medical staff to seek professional help for mental well-being. Therefore, self-care plays an important role in the prevention of depression and anxiety disorders among healthcare workers. When the healthcare workers face problems in their work environment, they should coordinate with the hospital to promptly improve the system. COVID-19 resulted in new societal norms and changed our lifestyles significantly. Insomnia is a particular issue among healthcare workers. Lifestyle analysis is thus necessary if insomnia needs to be addressed. Because the opportunities for communication are reduced during the COVID-19 pandemic, conscious communication is essential. During this difficult time, the staff may not receive sufficient guidance from their superiors at work, for example for guidance received by resident doctors from their seniors. This will also provide opportunities to communicate vital information about matters such as infection control. Therefore, quality communication and accurate information should be directed toward all healthcare workers.

Stress and Turnover Intentions Within Healthcare Teams: The Mediating Role of Psychological Safety, and the Moderating Effect of COVID-19 Worry and Supervisor Support

Employees at healthcare organizations are experiencing more stress than ever given the current COVID-19 pandemic. Different types of stress are affecting diverse organizational outcomes, including the employees' voluntary turnover. This is the case of cognitive stress, a type of stress that affects how individuals process information, which can influence employees' turnover intentions. In this study, we look at the mechanisms that can reduce the adverse effects of cognitive stress on turnover intentions, particularly the role of employees' perceived psychological safety (i.e., how safe they perceive the interactions with their colleagues are). We hypothesize that psychological safety mediates the relationship between cognitive stress and turnover intentions, and COVID-19 worry and supervisor support moderate the relationship between cognitive stress and psychological safety. To test our hypothesis, we invited two public health care organizations in Chile to join this study. In total, we obtained a sample of 146 employees in 21 different teams. Using a multilevel model, we found that psychological safety prevents the harmful effects of cognitive stress on employees' turnover intentions. In addition, while COVID-19 worry can worsen the relationship between cognitive stress and psychological safety, supervisor support only directly affects psychological safety. This study contributes to expanding the stress and psychological safety literature and informs practitioners in healthcare organizations about how to deal with cognitive stress in the "new normality" that the pandemic has brought.

Multilevel analysis of resonant leadership and subordinate's work performance during COVID-19: a study of the indian software industry

This study examined the multilevel model that explains how the interaction effect of resonant leadership and gender identity influences proposed outcomes through the mediating role of psychological capital. We performed a multilevel analysis by conducting an online survey using multisource data from the 104 team/project leaders and 527 team members of nine major Indian IT companies. The results demonstrated that psychological capital positively and significantly mediated the relationship between resonant leadership and work performance. The mediation role was stronger when androgynous identity attenuated the relationship between resonant leadership and psychological capital at a higher level. The study adds a unique lens to the literature of resonant leadership and proposes outcomes by validating it through the hierarchical linear modelling principle and efficient statistical procedures. This is the first study to empirically confirm the multilevel moderation mediation process wherein psychological capital mediates the relationship between resonant leadership and work performance, subject to the leader's androgynous identity level.

[Factors Influencing Nurses' Performance of Care in COVID-19 Wards]

PURPOSE

The purpose of this study was to identify factors influencing nurses' performance of care in COVID-19 wards.

METHODS

The participants were 132 nurses who worked in COVID-19 wards at three hospitals, and were recruited from April 1 to May 31, 2021. Data were analyzed using descriptive statistics, t-test, ANOVA, and multiple regression analysis with SPSS/WIN 24.0 program.

RESULTS

Nursing performance was significantly and positively correlated with ethical sensitivity (r = .75, p < .001), nursing professionalism (r = .67, p < .001), and social support (r = .67, p < .001). Nursing professionalism was positively correlated with ethical sensitivity (r = .64, p < .001) and social support (r = .55, p < .001). Multiple regression analysis for nursing performance revealed that the most significant factor was ethical sensitivity (β = .47, p < .001). Ethical sensitivity, nursing professionalism, and social support explained 66.0% of total variance in nursing performance.

CONCLUSION

Ethical sensitiviy, nursing professionalism, and social support significantly influence nurses' performace of care in COVID-19 wards. It suggests that intervention programs should be directed at improving nurses' ethical sensitivity, bolstering social support, and enhancing nursing professionalism.

Impact of COVID-19 in nursing professionals: systematic review and meta-analysis

Abstract Nursing work is in increasing demand, becoming strenuous especially during the COVID-19 pandemic. Thus, the objective of the study was to assess the impacts of the COVID-19 pandemic on the health of nursing professionals through a systematic review of the literature with meta-analysis, including studies published in 2020 in Web of Science, PubMed and SciELO. Regarding the systematic review, we included 25 studies with a cross-sectional design, from 12 countries. The participants were mostly nurses or nursing teams. Mental impacts such as anxiety, depression, discouragement and a feeling of obligation to work were frequently reported by study participants. The meta-analyses included psychological distress variables, and no association was found between psychological distress and being a frontline healthcare professional (OR 0.94; 95% CI 0.33-2.67). The mental health of nursing professionals has been negatively impacted by the Covid-19 pandemic. The main symptoms presented were anxiety, depression and discouragement, and many nurses felt obliged to work on the front lines of the fight against the pandemic; although they suffer emotional impacts and work overload in health services.

Lived Experience of Medicine Nurses Caring for COVID-19 Patients: A Quality Improvement Perspective

BACKGROUND

The COVID-19 pandemic has overwhelmed health care systems globally. To understand how health care systems can best support frontline health care providers caring for patients in similar situations, it is necessary to gain insights into their experience.

PURPOSE

This quality improvement study explored the lived experience of Canadian frontline medicine nurses caring for COVID-19 patients during the first wave of the pandemic.

METHOD

A qualitative interpretive phenomenological approach was conducted. Forty-three eligible nurses participated in semistructured interviews and online surveys. Full transcription and thematic content analysis were performed.

RESULTS

Three overarching themes were deduced: (1) a traumatic experience, (2) living through the experience, and (3) achieving transcendence.

CONCLUSION

Several recommendations were identified. These recommendations aim to aid health care systems in emergency preparation planning and future pandemic responses while supporting frontline health care providers' resilience and well-being.

Risk perception and psychological state of healthcare workers in referral hospitals during the early phase of the COVID-19 pandemic, Uganda

Background

Safeguarding the psychological well-being of healthcare workers (HCWs) is crucial to ensuring sustainability and quality of healthcare services. During the COVID-19 pandemic, HCWs may be subject to excessive mental stress. We assessed the risk perception and immediate psychological state of HCWs early in the pandemic in referral hospitals involved in the management of COVID-19 patients in Uganda.

Methods

We conducted a cross-sectional survey in five referral hospitals from April 20–May 22, 2020. During this time, we distributed paper-based, self-administered questionnaires to all consenting HCWs on day shifts. The questionnaire included questions on socio-demographics, occupational behaviors, potential perceived risks, and psychological distress. We assessed risk perception towards COVID-19 using 27 concern statements with a four-point Likert scale. We defined psychological distress as a total score > 12 from the 12-item Goldberg’s General Health Questionnaire (GHQ-12). We used modified Poisson regression to identify factors associated with psychological distress.

Results

Among 335 HCWs who received questionnaires, 328 (98%) responded. Respondents’ mean age was 36 (range 18–59) years; 172 (52%) were male. The median duration of professional experience was eight (range 1–35) years; 208 (63%) worked more than 40 h per week; 116 (35%) were nurses, 52 (14%) doctors, 30 (9%) clinical officers, and 86 (26%) support staff. One hundred and forty-four (44%) had a GHQ-12 score > 12. The most common concerns reported included fear of infection at the workplace (81%), stigma from colleagues (79%), lack of workplace support (63%), and inadequate availability of personal protective equipment (PPE) (56%). In multivariable analysis, moderate (adjusted prevalence ratio, [aPR] = 2.2, 95% confidence interval [CI] 1.2–4.0) and high (aPR = 3.8, 95% CI 2.0–7.0) risk perception towards COVID-19 (compared with low-risk perception) were associated with psychological distress.

Conclusions

Forty-four percent of HCWs surveyed in hospitals treating COVID-19 patients during the early COVID-19 epidemic in Uganda reported psychological distress related to fear of infection, stigma, and inadequate PPE. Higher perceived personal risk towards COVID-19 was associated with increased psychological distress. To optimize patient care during the pandemic and future outbreaks, workplace management may consider identifying and addressing HCW concerns, ensuring sufficient PPE and training, and reducing infection-associated stigma.

[How are key resources and key demands associated with nurses' work engagement during the COVID-19 pandemic? A cross-sectional study]

INTRODUCTION

Nurses are assigned a key role in pandemic response, with work engagement considered to be pivotal. The job demands-resources theory assumes that work engagement depends on job resources and job demands. Key job resources and demands have already been proposed for nurses. However, there is no evidence on their importance under pandemic conditions. Hence, the aim of this study was to investigate their relevance to nurses' work engagement during the second wave of the COVID-19 pandemic.

METHODS

The study was carried out in a cross-sectional design and addressed nurses in direct health care settings in Germany. Data was collected administering a quantitative online survey using valid and reliable measures during the second wave of the pandemic. A convenience sample was obtained, including the use of social media, randomly selected health care facilities, and all universities with nursing-related programs in Germany. The dataset for analyses comprised a total of 1,027 cases. The sample included nurses of various educational levels and from different sectors. Multiple linear regression analysis after multiple imputation was used to examine the relevance of key resources and demands for work engagement.

RESULTS

Key resources and demands explained 36% of the variance in nurses' work engagement during the COVID-19 pandemic. Positive associations were found between the key resources of autonomy (β¯_SP=0.072, 95% CI [0.011; 0.133]), professional resources (β¯_SP=0.204, 95% CI [0.124; 0.285]), and interpersonal relationships (β¯_SP=0.178, 95% CI [0.117; 0.240]) and nurses' work engagement. On the demands side, lack of formal rewards negatively (β¯_SP=-0.312, 95% CI [-0.380; -0.245]) affected work engagement, whereas work overload (β¯_SP=0.063, 95% CI [0.001; 0.126]) was positively associated with work engagement.

DISCUSSION

The job demands-resources theory is suitable for explaining nurses' work engagement even in times of crisis. Taken together, key resources and demands have a significant influence on nurses' work engagement under pandemic conditions. However, not all so-called key resources and demands actually have a key status in a pandemic.

CONCLUSION

Any lack of formal rewards should be countered, professional resources should be sustainably secured, and the autonomy of nurses and their interpersonal relationships should be strengthened. Nursing management decisions should be made not only with the current pandemic but also the post-pandemic period in mind.

Curbing nurses' burnout during COVID-19: The roles of servant leadership and psychological safety

AIMS

This study examines the role of servant leadership through the mechanism of psychological safety in curbing nurses' burnout during the COVID-19 pandemic.

BACKGROUND

During the COVID-19 pandemic, studies have shown an increased level of stress and burnout among health care workers, especially nurses. This study responds to the call for research to explore the mechanisms of servant leadership in predicting nurses' burnout by employing the perspective of conservation of resources theory.

METHODS

Through a cross-sectional quantitative research design, data were collected in three waves from 443 nurses working in Pakistan's five public sector hospitals. Data were analysed by employing the partial least squares path modelling (PLS-PM) technique.

RESULTS

Servant leadership (β = -0.318; 95% CI = 0.225, 0.416) and psychological safety (β = -0.342; CI = 0.143, 0.350) have an inverse relationship with nurses' burnout and explain 63.1% variance.

CONCLUSIONS

Servant leadership significantly reduces nurses' burnout, and psychological safety mediates this relationship.

IMPLICATIONS FOR NURSING MANAGEMENT

Human resource management policies in health care must emphasize training nursing leaders in servant leadership behaviour.

Followers' unclear demands during the COVID-19 pandemic can undermine leaders' well-being: A moderated mediation model from an entrapment perspective

Although effective leaders are important for reducing employee stress during the COVID-19, limited studies have examined how follower behaviors can influence leader stress and well-being during the COVID-19. This study draws on defeat-entrapment theory to examine how followers' unclear demands during the COVID-19 consequently impact leaders' psychological states and well-being. We conducted a three-wave time-lagged investigation with a sample of 281 leaders in the United Kingdom and found that followers' unclear demands could generate feelings of entrapment in leaders, leading to decreased levels of well-being outcomes in leaders. Importantly, we found that leaders who have higher levels of leadership responsibility during the COVID-19 are likely to feel trapped by followers' unclear demands. They are also likely to face higher levels of feelings of entrapment and impaired well-being compared with leaders who have lower levels of leadership responsibility. We discuss the implications for theories and practices, as well as directions for future research.

Impact of Supportive Leadership During Covid-19 on Nurses' Well-Being: The Mediating Role of Psychological Capital

The corona virus disease (Covid-19) has significantly affected the social, physical, and psychological health of workers, specifically the nurses working in the healthcare sectors. Studies have been conducted on the impact of Covid-19 on employees' well-being, organizational structure, and job design; however, limited studies have been conducted focusing on the impact of leadership on employee's well-being during the Covid-19 pandemic. Drawing on job demands resources model and social exchange theory, we examined the impact of supportive leadership on employees' physical, social, and psychological well-being during the Covid-19 pandemic. In addition, we examined the mediating role of psychological capital in examining the relationship between supportive leadership and employees' physical, social, and psychological well-being. Based on three wave time-lagged design, the data were collected from 214 nurses' linear regression analysis and Hayes Process for mediation to test the proposed hypothesis. As hypothesized, supportive leadership predicted employees' physical, social, and psychological well-being. In addition, psychological capital mediated the relationship between supportive leadership and employees' physical, social, and psychological well-being. Implications for research, theory, and practice are discussed.

Using the Nurse Coaching Process to Support Bereaved Staff During the COVID-19 Crisis

Nurses are confronting a number of negative mental health consequences owing to high burdens of grief during COVID-19. Despite increased vaccination efforts and lower hospitalization and mortality rates, the long-term effects of mass bereavement are certain to impact nurses for years to come. The nurse coaching process is an evidence-based strategy that nurse leaders can use to assist staff in mitigating negative mental health outcomes associated with bereavement. The End-of-Life Nursing Education Consortium brought together a team of palliative nursing experts early in the pandemic to create resources to support nurses across settings and promote nurse well-being. This article shares a timely resource for health systems and nursing administration that leverages the nurse coaching process to support bereaved staff in a safe and therapeutic environment.

Organizational learning during COVID-19: A qualitative study of nurses' experiences

Aim

The aim of this study is to test the validity of the Organizational Learning in Hospitals model in the context of the COVID‐19 pandemic.

Background

Organizational learning is especially crucial in circumstances of intense, complex, enduring change, as with the COVID‐19 pandemic. Nurse managers need additional guidance for fostering organizational learning under such circumstances. The Organizational Learning in Hospitals model may be a helpful resource but requires additional validation.

Methods

Semi‐structured interviews were conducted to gather 19 nurses' first‐hand experiences of organizational learning during the COVID‐19 pandemic. Data were analysed using deductive thematic analysis.

Results

Nurses' experiences of organizational learning generally aligned with the tenets of the model. Specifically, effective organizational learning occurred when the contextual factors and mechanisms portrayed in the model converged. Model and contrary cases illustrate this phenomenon.

Conclusions

This study validates and adds context to the model. It offers practical examples of the contextual factors and mechanisms of organizational learning. Leaders can use the model to guide their efforts to foster organizational learning.

Implications for Nursing Management

This study reaffirms the importance of nurse leaders' central role in organizational learning. Nurse leaders can use the Organizational Learning in Hospitals model, and the practical examples provided, to foster organizational learning during challenging times.