The effects of psychological first aid training on disaster preparedness perception and self-efficacy

Evaluation of a training program using the SBAR communication tool for caregivers managing acute respiratory distress in lung cancer patients: A pilot randomized controlled trial protocol

Background

Family-based caregivers are increasingly important in the management of non-hospitalized lung cancer patients. However, lack of training can negatively impact care including diagnostic errors that can lead to delays in providing appropriate medical treatment. Acute respiratory failure (ARF) is common symptom of lung cancer and requires urgent intervention as well as adequate communication with healthcare professionals (HCPs) to enable appropriate decision-making and improve patient outcomes. Standardized tools such as the Situation, Background, Assessment, Recommendation (SBAR) tool and its French adaptation SAED, standing for Situation, Antécédent, Évaluation et Demande, are designed to facilitate communication among (HCPs).Additionally, digital interventions, such as serious games, are increasingly used to train HCPs though its use for caregivers has not been studied. This pilot study aims to assess an innovative serious game training using the SAED tool combined with standard instructions on self-efficacy for family-based caregivers of lung cancer patients when facing a simulated situation of ARF. The study also aims to examine caregivers' emotional state, quality of life, satisfaction and knowledge about the SBAR tool.

Methods

A monocentric, randomized, controlled, open-label, superiority, parallel-arm trial will be conducted for 18 months with 3 mid-study assessments (NCT05839353). Family caregivers of lung cancer patients will be recruited at the University Hospital Center of Saint Pierre, Reunion Island, France. Participants will be randomized (1:1) into two groups: the experimental group receiving training using the SBAR/SAED tool and standard instructions for managing respiratory distress/dyspnea, and the control group, receiving standard instructions only. The primary outcome will be to determine perceived self-efficacy as measured by the Generalized Self-Efficacy Scale.

Discussion

This study will present a preliminary assessment of training family caregivers in using the SBAR/SAED tool in simulated episodes of ARF in lung cancer patients. Our findings may provide valuable insights into effective training methods for caregivers in critical home care situations and could be widely used for lung cancer management.

Disaster preparedness perceptions and psychological first-aid competencies of psychiatric nurses

AIM

This study aimed to determine the disaster preparedness perceptions and psychological first-aid competencies of psychiatric nurses.

BACKGROUND

Nurses must recognize the risks before a disaster occurs and have an action plan for providing effective physical and psychological care to patients and other affected individuals during and after the disaster. It is especially important for psychiatric nurses caring for a high-risk group, such as psychiatric patients, to be prepared for disasters and be able to support patients by recognizing the psychological reactions that may occur after a disaster and managing their care accordingly.

METHODS

For this cross-sectional and correlational study, data on 122 nurses were collected using a personal information form, the preparedness perception scale of disaster in nurses, and the psychological first-aid application self-efficacy scale.

RESULTS

The mean score for the participants' perception of overall disaster preparedness was 76.70 ± 8.30, the mean score for the preparation stage was 27.02 ± 2.82, the mean score for the intervention stage was 30.40 ± 5.15, the mean score for the post-disaster stage was 19.27 ± 2.88, and the mean score for psychological first-aid application self-efficacy was 140.28 ± 19.17.

CONCLUSION

The findings showed that psychiatric nurses were above the medium level in terms of disaster preparedness perceptions and psychological first-aid application self-efficacy.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

It is important for nurses caring for high-risk groups, such as psychiatric patients, to be aware of disaster preparedness, to recognize psychological reactions that may be observed after a disaster, and to be aware of psychological first-aid practices that can be used to intervene in a disaster.

Disaster response self-efficacy of nursing students: Perceived level and associated factors

OBJECTIVES

The study aimed to assess the level of disaster response self-efficacy (DRSE) among nursing students in Bangladesh and examine the factors influencing their level of DRSE.

METHODS

A cross-sectional study design was used for this research. A self-administered descriptive structured questionnaire was used to collect survey data from 573 students of nursing colleges in four districts: Chattogram, Dhaka, Khulna, and Rajshahi. The Bengali version of the DRSE Scale was adopted and used to measure the outcome variable.

RESULTS

The nursing students exhibited a moderate level of disaster response self-efficacy (Mean = 3.63; SD = 0.73), as well as moderate levels of knowledge (Mean = 3.87; SD = 0.71), skills (Mean = 4.24; SD = 0.91), and preparedness (Mean = 4.31; SD = 0.76) in disaster management. Significant positive correlations were found between respondents' disaster knowledge (r = 0.447, p < 0.01), skills (r = 0.516, p < 0.01), and preparedness (r = 0.701, p < 0.01) with disaster response self-efficacy. Gender, age, having children in the household, post-basic BSc in nursing students, and disaster knowledge were significantly associated with nursing students' DRSE. Female respondents had a 0.27-unit lower DRSE (β = -0.270 (95 % CI: -0.389, -0.115), p < 0.001) than male respondents. Besides, the respondents per unit increase in disaster knowledge occurred a 0.438-unit increase in DRSE (β = 0.438 (95 % CI: 0.367, 0.510), p < 0.001). However, no statistically significant associations were found between the respondents' disaster experience and disaster-related training with their DRSE scores.

CONCLUSION

Improving disaster management knowledge by including disaster management-related courses and organizing more training, drills, seminars, and workshops may improve their DRSE.

Assessing the role of sustainability competencies in enhancing psychological first aid effectiveness for disaster responders in Fiji

Background

Psychological first aid (PFA) is essential for mental health and wellbeing after traumatic events. Integrating competency-based outcomes is crucial with the increasing demand for effective psychological first-aid interventions. This study examines the correlation between sustainability competencies and PFA principles within Fiji's disaster responder's context.

Method

The research was guided by a theoretical framework based on a comprehensive review of sustainability competencies and PFA principles. A cross-sectional survey assessed the importance of sustainability competencies in disaster responders to deliver PFA effectively. The survey used a stratified random sampling method to get diverse PFA-trained participants (66%) and non-PFA trained (34%), aiming to understand how these competencies can impact PFA success in various disaster situations. The survey, encompassing various domains of disaster response and a diverse range of respondents age, gender, and years of experience, employed the Likert scale to assess the importance of competencies such as integrated problem-solving, strategic, systems thinking, self-awareness, normative, collaboration, anticipatory, and critical thinking.

Results

The study involved 49 PFA-trained participants (55% female, 45% male) and 15 non-PFA-trained participants (53% female, 46% male), excluding 10 responses from the latter group due to ambiguous answers to critical questions. The correlation between age, experience, and the valuation of professional competencies among disaster responders indicates that disaster responders, with extensive experience and PFA training, rated competencies as "important," reflecting a perspective shaped by long-term career development and practical experiences. Equally, younger and early career responders emphasize competencies as "very important," indicating an initial recognition of their significance. The appraisal patterns across different age groups, especially among those with PFA training, suggest a tendency to moderate assessments of competency importance with increasing experience. Statistical analysis, including mean, median, standard deviation, and variance, provided a detailed understanding of the data, underscoring competencies like self-awareness in both data sets and integrated problem-solving and collaboration within PFA-trained responders as the key for effective PFA interventions.

Conclusion

The study underlines the critical need to integrate sustainability competencies into the PFA curriculum in Fiji's unique sociocultural context. This interplay between age, experience, and competency assessment stresses the diverse factors influencing perceptions in the disaster response field beyond experience alone. The results show that sustainability competencies are the ultimate to the effectiveness of PFA measurement and interventions. The research lays the foundation for future studies to develop validated tools for assessing sustainable competencies in different cultural contexts, thereby improving the effectiveness of PFA in disaster management. Integrating these competencies into PFA training could significantly strengthen PFA intervention and competency-based evaluation.

Effectiveness of a Health Belief Model-Based Education Program on Self-Efficacy and Preparedness for Infectious Disasters in Rural Populations

BACKGROUND

Health education programs can enhance self-efficacy and disaster preparedness. However, research incorporating the Health Belief Model (HBM) in education for infectious disasters is lacking.

AIMS

Examine the effectiveness of an HBM-based education program on self-reported self-efficacy and self-reported preparedness for infectious disasters in rural populations.

METHODS

In total, 109 eligible participants were allocated to two groups: participants who received HBM-based education (n = 55) or regular education (n = 54), presented at in-person meetings, with individual follow-up conducted on WhatsApp. Self-reported self-efficacy and preparedness for infectious disasters in both groups were measured at 4 and 8 weeks.

FINDINGS

Participants showed a significant interaction between groups and in time to increase in self-reported self-efficacy and self-reported preparedness to deal with infectious disasters. After 4 and 8 weeks, the groups had statistically significant differences (p≤.001) in all outcome measures.

CONCLUSION

HBM-based education was associated with increased self-reported self-efficacy and self-reported infectious disaster preparedness among the rural population. Follow-up by nurses is essential to implementing continuing health belief education programs to enhance rural populations' self-efficacy and infectious disaster preparedness.

The effect of psychological first-aid virtual education on the communication skills of nurses in disasters: a randomized controlled trial

BACKGROUND

Disasters have affected the physical and mental health of people around the world. Since nurses are frontlines in disasters, it seems necessary to prepare for this responsibility. This study investigates the effect of psychological first-aid virtual education on the communication skills of nurses in disasters such as COVID pandemic.

METHODS

In a randomized controlled trial, 55 nurses were selected by purposive sampling method from two hospitals in Isfahan and Tehran, Iran in December-November 2022 and randomly replaced in the intervention group who participated in psychological first aid virtual training and control group. The data were collected through the personal information form and Communication Skills -Test-Revised (CSTR).

RESULTS

Two groups were homogeneous in terms of communication skills (p = 0.177), the total score of communication skills was significant between the two groups after the intervention (p < 0.0001). Regarding communication skills, in the pre-intervention phase, the subscale of "the ability to receive and send messages" and "insight into the communication process" the difference before the intervention was not significant between the two groups (p > 0.05). However, it was significant between the two groups after the intervention (p < 0.05), and regarding "emotional control", "listening skills", and "communication along with assertiveness" the difference before and after the intervention was not significant between the two groups (p > 0.05).

CONCLUSION

Pre-disaster training and virtual education can increase nurses' communication skills in their ability to handle a disaster such as COVID pandemic. Virtual education of post-disaster psychological interventions is suggested.

TRIAL REGISTRATION

IRCT20220923056023N1; date: 2023-01-31.

Stress First Aid for Health-care Workers: An Indicated Mental Illness Prevention Program for Nursing Education

Spurred by a global pandemic, the incidence and prevalence of stress-related injury and illness continues to increase amid an overburdened nursing workforce that has remarkably and reliably performed on the frontlines of health care. Indicated mental illness prevention programs such as Stress First Aid for Healthcare Workers create an opportunity to target the acute and chronic expressions of stress experienced by nurses earlier through coordinated peer support with the goals of preserving life, preventing further harm, and promoting recovery. This article will describe how a Stress First Aid program was operationalized at a school of nursing at a private university.

Psychological first aid practice self-efficacy of nurses in disasters

In the present cross-sectional study, we determined the self-efficacy of nurses to apply psychological first aid (PFA) during disasters. The study sample consisted of 580 nurses working in Turkey. The data were collected online between July and November 2022 using the "Personal Information Form" and the "PFA Application Self-Efficacy Scale." The data were analyzed using descriptive statistical methods (number, percentage, mean, and standard deviation), generalized linear models, Bonferroni correction, and linear regression analysis. The mean PFA scale scores of male nurses, nurses working in intensive care units, working as service nurses, nurses who have previously received PFA training and applied PFA in disaster situations were higher. Moreover, 91.3% of nurses did not receive PFA training and 90.3% did not receive PFA service earlier, 31.0% did not apply for PFA, 18.3% did not know about PFA. The mean score of the PFA practice self-efficacy scale of nurses was 131.61 ± 19.41. There exists an urgent requirement to develop nurses' PFA application self-efficacy. It is recommended that nurses should be provided repeated PFA training and applied studies focusing on PFA interventions.

Factors influencing nurses self-efficacy two years after the COVID-19 outbreak: A cross-sectional study in Wuhan, China

This study explored the anxiety, depression, and self-efficacy of nurses in Wuhan, China 2 years after the corona virus disease 2019 outbreak. A total of 552 nurses were enrolled in the study. Four well-established test tools were applied: The 9-item patient health questionnaire, The 7-item generalized anxiety disorder, generalized self-efficacy scale, Connor Davidson resilience scale. Twenty-eight points twenty-six percentage of the nurses had mild depression, and 5.62% had moderate or severe depression. Twenty-one points seventy-four percentage of nurses had mild anxiety and 1.82% had moderate or severe anxiety. The average score of self-efficacies is negatively correlated with the average score of the 9-item patient health questionnaire (r = -0.303, P < .01), and the7-item generalized anxiety disorder (r = -0.275, P < .01). The average score of self-efficacies is correlated with the resilience score (R = 0.799, P < .01). Through multiple linear regression analysis, the tenacity dimension and monthly income are most closely related to the sense of self-efficacy. Nurses self-efficacy and resilience are important factors in promoting their psychological well-being. This study suggests that increasing the salary and providing some strategies to increase nurses mental tenacity can promote self-efficacy.

Evaluation of a Culturally Adapted Online Basic Psychosocial Skills Training Program for International Frontline Workers in Under-Resourced Contexts During the COVID-19 Pandemic

OBJECTIVE

Frontline workers report negative mental health impacts of being exposed to the risk of COVID-19, and of supporting people struggling with the effects of the virus. Uptake of psychological first-aid resources is inconsistent, and they may not meet the needs of frontline workers in under-resourced contexts. This study evaluates a culturally adapted basic psychosocial skills (BPS) training program that aimed to meet the needs of frontline workers in under-resourced settings.

METHODS

A cross-sectional survey administered to frontline workers who completed the program between 2020 and 2022, investigated their perceived confidence, satisfaction, and skill development, as well as their views on relevance to context and accessibility of the program.

RESULTS

Out of the 1000 people who had undertaken the BPS program, 118 (11.8%) completed the survey. Participants reported high levels of satisfaction and improved confidence in, and knowledge of, psychosocial skills. Participants reported that the BPS program was culturally and contextually relevant, and some requested expansion of the program, including more interactivity, opportunities for anonymous participation, and adaption to other cultural contexts, including translation into languages other than English.

CONCLUSION

Findings indicate a need for free, online, and culturally adapted psychosocial skills training program that is designed with key stakeholders to ensure relevance to social and cultural contexts.

Disseminating early interventions for disaster mental health response using the ECHO model

Extension for Community Healthcare Outcomes (ECHO)-based telementoring was evaluated for disseminating early disaster interventions, Psychological First Aid (PFA) and Skills for Psychological Recovery (SPR), to school professionals throughout rural, disaster-affected communities further affected by COVID-19. PFA and SPR complemented their Multitiered System of Support: PFA complemented tier 1 (universal) and SPR tier 2 (targeted) prevention. We evaluated the outcomes of a pretraining webinar (164 participants, January 2021) and four-part PFA training (84 participants, June 2021) and SPR training (59 participants, July 2021) across five levels of Moore's continuing medical education evaluation framework: (1) participation, (2) satisfaction, (3) learning, (4) competence, and (5) performance, using pre-, post-, and 1-month follow-up surveys. Positive training outcomes were observed across all five levels, with high participation and satisfaction throughout, and high use at the 1-month follow-up. ECHO-based telementoring may successfully engage and train community providers in these underused early disaster response models. Recommendations regarding training format and using evaluation to improve training are provided.

Disaster Preparedness Among Nurses in China: A Cross-Sectional Study

BACKGROUND

Increasingly frequent global disasters such as coronavirus disease 2019 pose a threat to human health and life. The World Health Organization has called on countries to formulate detailed plans to prepare for disasters. It is critical to investigate and evaluate the disaster preparedness of nurses.

PURPOSE

This study was designed to investigate the disaster preparedness and psychological condition of nurses in China and analyze the significant factors influencing their disaster preparedness.

METHODS

A cross-sectional survey was conducted in 2020, and 1,313 nurses were enrolled using convenience sampling. The study questionnaires were distributed and collected via a networking platform equivalent to Amazon Mechanical Turk. The disaster preparedness of the respondents was measured using the Disaster Preparedness Evaluation Tool, the Hospital Anxiety and Depression Scale was used to evaluate anxiety and depression status, and a self-designed questionnaire developed based on a review of the literature was used to explore the potential factors of influence on disaster preparedness.

RESULTS

The average score for disaster preparedness among the participants was 186.34 ( SD = 40.80), which corresponded with a moderate level, especially in skill (mean score = 42.01, SD = 12.39). Items with higher scores included support for the government, personal protection, and health education, whereas items with lower scores included nursing leadership in the community, capacity to cope with chemical or biological attacks, and assessment of posttraumatic stress disorder. Disaster preparedness was negatively related with mental health, including depression and anxiety. The main factors affecting disaster preparedness included educational background, nursing specialty, prior disaster training, prior disaster rescue experience, and depression level.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The disaster preparedness of Chinese nurses must be improved. More attention should be paid to disaster preparedness in nurses, and future tailored interventions are urgently needed to promote nursing leadership in the community, the ability to cope with chemical or biological attacks, and posttraumatic stress disorder assessments. Moreover, relieving negative emotions to promote the mental health of nurses should receive greater attention.

Effectiveness of Psychological First Aid e-Orientation among the General Population in Muntinlupa, the Philippines

This present study examined the effectiveness of the Psychological First Aid (PFA) e-orientation as well as face-to-face PFA orientation among the general population in Muntinlupa City, the Philippines. The e-orientation group consisted of 150 participants who received a two-hour PFA e-orientation (male: 47, female: 97, others: 6, mean age: 33.4 (SD = 12.1)), the face-to-face (F2F) group consisted of 139 participants who received a two-hour face-to-face PFA orientation (male: 41, female: 95, others: 3, mean age: 35.0 (SD = 13.8)), and the control group consisted of 117 participants who received a two-hour face-to-face health promotion orientation for obesity (male: 48, female: 65, others: 4, mean age: 34.2 (SD = 13.8)). In order to see the effect of these interventions, the confidence to provide PFAs was compared between the pre- and post-interventions in each group with paired t-tests. Further, the number of correct answers regarding the knowledge on PFA was also compared between the pre- and post-interventions utilizing a McNemar test. The results demonstrated that the mean scores on the confidence increased significantly in the e-orientation (pre: 25.1 (SD = 4.7), post: 26.1 (SD = 5.3), p = 0.02) and F2F (pre: 26.2 (SD = 6.0), post: 29.6 (SD = 6.9), p < 0.01) groups. Regarding knowledge on PFA, in the e-orientation group, the number of those who answered correctly increased significantly in a question (pre: 10, post: 24, p = 0.01), and there was a trend for improvement in another question (pre: 63, post: 76, p = 0.06). In the F2F group, the number of those who answered correctly increased significantly in two questions (pre: 21, post: 38, p < 0.01, and pre: 5, post: 14, p = 0.05), and there were trends for improvement in two questions (pre: 69, post: 82, p = 0.06, and pre: 17, post: 27, p = 0.09), while in the control group, there were no significant differences in any of the questions between pre- and post-intervention. The results suggest that both the PFA e-orientation and face-to-face orientation are effective for the general population in terms of increasing confidence and knowledge related to PFA.

Exploring effect of psychological first aid education on vocational nursing students: A quasi-experimental study

BACKGROUND

Psychological first aid (PFA) is an internationally recognized approach to providing initial psychological support to the general public by both professionals and non-professionals. With increasing psychological care needs under frequent global disasters, it is urgent to provide PFA training to community rescuers in resource-limited countries. Vocational nursing students account for the largest proportion of the reserve workforce serving the community. However, they were scarcely educated about PFA in public emergencies.

OBJECTIVES

To evaluate the impacts of PFA training on knowledge and competency, general self-efficacy, and resilience among vocational nursing students.

DESIGN

A quasi-experimental study with pre-posttest comparison.

SETTING

A provincial vocational college in XXXX.

PARTICIPANTS

One hundred and three sophomore vocational nursing students were recruited from a vocational college.

METHODS

The eligible participants were provided with the PFA educational program developed from international and national PFA guidelines. Before and after the intervention, researchers used the PFA of Orientation Pre/Post Test questionnaire, the General Self-Efficacy Scale, and the Connor-Davidson Resilience Scale to evaluate participants' learning outcomes. The paired t-test and Wilcoxon signed-rank test were used to compare the difference in outcomes between the pre- and post-test.

RESULTS

After the PFA educational intervention, the participants' scores on PFA-related knowledge and competence significantly increased (p < .001). There were also statistically significant differences in general self-efficacy, total resilience, tenacity, and optimism scores observed between the pre- and post-test (p < .001). However, there was no significant increase in strength scores after the intervention.

CONCLUSIONS

The PFA training effectively improved vocational nursing students' knowledge and competency, general self-efficacy, and resilience. Further studies with a control group and follow-ups are needed to explore the long-term effects of PFA education.

Facing flood disaster: A cluster randomized trial assessing communities' knowledge, skills and preparedness utilizing a health model intervention

Floods occur when a body of water overflows and submerges normally dry terrain. Tropical cyclones or tsunamis cause flooding. Health and safety are jeopardized during a flood. As a result, proactive flood mitigation measures are required. This study aimed to increase flood disaster preparedness among Selangor communities in Malaysia by implementing a Health Belief Model-Based Intervention (HEBI). Selangor's six districts were involved in a single-blinded cluster randomized controlled trial Community-wide implementation of a Health Belief Model-Based Intervention (HEBI). A self-administered questionnaire was used. The intervention group received a HEBI module, while the control group received a health talk on non-communicable disease. The baseline variables were compared. Immediate and six-month post-intervention impacts on outcome indicators were assessed. 284 responses with a 100% response rate. At the baseline, there were no significant differences in ethnicity, monthly household income, or past disaster experience between groups (p>0.05). There were significant differences between-group for intervention on knowledge, skills, preparedness (p<0.001), Perceived Benefit Score (p = 0.02), Perceived Barrier Score (p = 0.03), and Cues to Action (p = 0.04). GEE analysis showed receiving the HEBI module had effectively improved knowledge, skills, preparedness, Perceived Benefit Score, Perceived Barrier Score, and Cues to Action in the intervention group after controlling the covariate. Finally, community flood preparedness ensured that every crisis decision had the least impact on humans. The HEBI module improved community flood preparedness by increasing knowledge, skill, preparedness, perceived benefit, perceived barrier, and action cues. As a result, the community should be aware of this module. Clinical trial registration: The trial registry name is Thai Clinical Trials Registry, trial number TCTR20200202002.

Effectiveness and Cost-Effectiveness of Mental Health Interventions Delivered by Frontline Health Care Workers in Emergency Health Services: A Systematic Review and Meta-Analysis

This systematic review is to evaluate the effectiveness and cost-effectiveness of mental health interventions delivered by frontline health care workers in disasters and public health emergencies. Six databases and trial registries were searched, and manual searches were conducted. Of the 221 studies identified, 21 were included. Meta-analyses assessed differences between the intervention and control in terms of PTSD outcomes. Eleven studies of 1802 participants were incorporated in the meta-analysis. Interventions delivered or prompted by specialist health care workers showed significant and large effects in improving PTSD-related symptoms with a SMD = 0.99 (95% CI: 0.42-1.57, p = 0.0007). Interventions delivered or prompted by frontline non-specialist health care workers showed significant but small effects in improving PTSD-related symptoms with SMD of 0.25 (95% CI: 0.11-0.39; p = 0.0007). The results showed that most mental health interventions delivered by frontline health care workers effectively supported affected people. Mental health interventions delivered by mental health care professionals are effective in reducing PTSD-related disorders in natural disasters. Future adequately powered RCTs are needed to evaluate the effectiveness of mental health interventions delivered by trained non-specialists. Economic modelling may be useful to estimate cost effectiveness in low- and middle-income countries given the difficulties of conducting studies in disaster and emergency settings.

Development study of psychological first aid application self-efficacy scale

PURPOSE

The aim of this study is to develop a measurement tool that can be utilized to determine in the psychological first aid application of self-efficacy.

DESIGN AND METHOD

The development of scale consisted of the following stages: literature reviews, examination of the conceptual structure, creation of scale items, expert advice, and individual and focus group interviews.

FINDINGS

A measurement tool was obtained by factor analysis, consisting of one factor and 35 items. The obtained scales were statistically significant, thereby providing a sensitive measurement (p < 0.05).

PRACTICE IMPLICATIONS

This measurement tool would assist in determining the self-efficacy of psychological first aid administered by aid providers working in disaster situations, thereby increasing the quality of their intervention.

The Effects of Disaster Nursing Education Program on Beliefs in General Disaster Preparedness, Disaster Response Self-Efficacy, and Psychological Resilience in Nursing Students: A Single-Blind, Randomized Controlled Study

AIM

This study was conducted to evaluate the effects of a disaster nursing and management education program on beliefs in general disaster preparedness, disaster response self-efficacy, and psychological resilience in nursing students.

METHOD

The sample consisted of nursing students receiving undergraduate education in Istanbul, Turkey. Participants were randomly divided into the intervention ( n = 65) and control ( n = 66) groups. The intervention group was given an eight-module education program with theoretical and applied components. Data were collected using the Belief in General Disaster Preparedness Scale, the Disaster Response Self-Efficacy Scale, and the Brief Resilience Scale.

RESULTS

The mean Belief in General Disaster Preparedness Scale, Disaster Response Self-Efficacy Scale, and Brief Resilience Scale scores of the intervention group were higher than those of the control group.

CONCLUSION

The disaster nursing and management education program provided to nursing students was determined to increase beliefs in general disaster preparedness, disaster response self-efficacy, and psychological resilience.

Psychological First Aid Training of Police Officers

A significant lack of evidence regarding the effectiveness of psychological first aid (PFA) training of first responders to emergency settings has been reported. The aim of the present study was to assess the effectiveness of a PFA training program on the feeling of confidence on providing help in crisis, knowledge, attitudes, and skills of police officers. Fifty police officers were trained in PFA, using an adapted version of the World Health Organization's program, and they were compared to a control group of 53 police officers. A PFA questionnaire was used to compare the two groups, before and after the implementation of the PFA training. Results revealed significant improvementson confidence, knowledge, attitudes, and skills of trained police officers, in comparison to controls. Thus, the present results suggest that PFA training programs are effective and should be offered to police officers in order to enhance their capacity to provide PFA in emergency settings.

The Impact of Psychological First aid Training on the Providers: A Systematic Review

OBJECTIVE

The consensus is that psychological first aid is a practical, early psychosocial intervention to mitigate the distress caused by disasters. This review aimed to investigate PFA training's efficacy in the existing studies and evaluate these programs' impact on trainees.

METHODS

MEDLINE (National Library of Medicine, Bethesda, MD), EMBASE (Elsevier, Amsterdam, Netherlands), PsycInfo (American Psychological Association, Washington, DC), and Cochrane Library (John Wiley & Sons, Hobken, NJ, USA) were searched on August 1, 2020 without language and date limitation. The Cochrane Risk of Bias tool for randomized controlled trials and the Risk of Bias in Non-Randomized Studies - of Interventions (ROBINS-I) (Cochrane, London, UK) were used to assess the quality of the studies included. SPSS (IBM Corp., Endicott, NY, USA) was used for descriptive, comparative, and correlational summaries.

RESULTS

From 376 articles, only 9 studies met the criteria and were included after screening. The most common outcome was knowledge improvement, followed by increased confidence, and competence. Other outcomes encompassed Attitude, preparedness, and therapeutic engagement.

CONCLUSION

PFA is the most suggested early intervention aftermath and could be acquired by professionals and non-professionals in the mental health area. Nonetheless, to obtain the desired outcome, PFA training programs' quality is vital. This review revealed that most training programs' duration was short, without scenario-based interactions and post-training supervisions. More controlled trials are required to measure the effectiveness of PFA training on the providers.

Stress, PTSD, and COVID-19: the Utility of Disaster Mental Health Interventions During the COVID-19 Pandemic

Purpose of review

In the context of an ongoing, highly uncertain pandemic, disaster mental health measures can increase community capacity for resilience and well-being, support formal mental health treatment, and help address the risk for mental health reactions in high-stress occupations. The purpose of this review is to summarize the literature on disaster mental health interventions that have been helpful both prior to and during the pandemic in a broad range of applications, including for use with high-stress occupations in an effort to mitigate risk for post-traumatic stress disorder (PTSD) and other mental health sequelae.

Recent findings

Evidence-based and evidence-informed disaster mental health interventions, frameworks, and treatments have been studied in pilot studies, non-randomized trials, and randomized clinical trials prior to and in the context of the current COVID-19 pandemic. The studies have demonstrated feasibility and acceptability of these modalities and improved perceived support, as well as significant reductions in distress, and mental health symptoms such as depression, anxiety, and PTSD.

Summary

A disaster mental health approach to the COVID-19 pandemic can generate opportunities for prevention and support at multiple levels with timely interventions tailored for different concerns, cultures, and available resources.

The ABCDE psychological first aid intervention decreases early PTSD symptoms but does not prevent it: results of a randomized-controlled trial

BACKGROUND

Early Psychological First Aid (PFA) has been widely recommended for preventing posttraumatic stress disorder (PTSD). However, its lack of empirical evidence of safety and effectiveness has been criticized.

OBJECTIVES

To assess the effectiveness of PFA-ABCDE, an original PFA protocol, for preventing PTSD one month after the intervention and decreasing PTSD symptoms at one and six months of follow up.

METHODS

We assessed the eligibility of 1,140 adult survivors of recent trauma (≤ 72 hours) consulting five emergency departments in Chile. Two hundred twenty-one were randomized to receive either PFA-ABCDE (active listening, breathing retraining, categorization of needs, referral to ancillary services, and psychoeducation) or only psychoeducation. We used the Composite International Diagnostic Interview (CIDI) to assess PTSD diagnosis. The Posttraumatic Checklist (PCL), the Beck Depression Inventory-II (BDI-II), and a 0-10 points analogue visual scale were used to assess PTSD symptoms, depressive symptoms, and immediate distress relief after the intervention.

RESULTS

We found no difference between the experimental and control groups in the frequency of PTSD one month after the intervention (PFA-ABCDE = 23/76 [30.3%], psychoeducation = 18/75 [24.0%], adjusted odds ratio = 1.39, 95% confidence interval = 0.63-3.07, p = .408). Immediately after the intervention, participants who received PFA-ABCDE reported greater distress relief (PFA-ABCDE mean = 9.06, psychoeducation mean = 8.55, Cohen's d = 0.30, p = .038). Fewer PTSD symptoms were reported by those who received PFA-ABCDE one month after the intervention (PFA-ABCDE mean = 36.26, psychoeducation mean = 43.62, Cohen's d = 0.42, p = .033). We found no difference in depressive symptoms at one-month follow up (p = .713) nor in PTSD symptoms six months after the intervention (p = .986).

CONCLUSIONS

PFA-ABCDE does not prevent PTSD diagnosis, but it provides immediate distress relief and decreases PTSD symptoms in the short term.

Psychological first aid training in disaster preparedness for nurses working with emergencies and traumas

AIM

This study aimed at evaluating the effects of a modified psychological first aid (PFA) training program on nurses' psychological preparedness for emergencies and disasters.

BACKGROUND

Nurses need to be psychologically prepared in order to mitigate the impact of conflicts and disasters. The PFA training could ensure their psychological preparedness in responding to different emergencies and disasters.

DESIGN

A nonequivalent controlled group trial was conducted between July 2019 and August 2019.

METHODS

Nurses working in the trauma units from five hospitals in Palestine were allocated into two arms: a control arm and an intervention arm incorporating a 9-hour modified PFA training program. Both groups were assessed at start (pretest) and upon completion of the program (post test) using a number of validated self-reports.

RESULTS

Eighty-four nurses were allocated to each arm, and 75 in each arm completed baseline data (n = 150). The results of generalized estimating equation estimates revealed that PFA training imposed a significant group-by-time effect on psychological preparedness (p = 0.013). The mean scores of psychological preparedness showed greater improvement in the intervention group than in the control group at posttest (37.81 vs. 32.64). Improved group-by-time effect was further identified in relation to optimism (p = 0.009), self-esteem (p = 0.008), and self-efficacy (p = 0.033). The intervention effect was large (Cohen d = 1.41).

CONCLUSION

PFA training may help to build nurses' capacity in being better prepared to respond to psychological issues during and after emergencies and disasters.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Nurses should be adequately equipped with knowledge and skills to deal with different emergencies and disasters. Health policy needs to address psychological preparedness for emergencies and disasters of all healthcare workers. Healthcare policymakers and educators could adopt PFA training on a regular basis to consolidate psychological preparedness of nurses.

Between Personality Traits and Postpartum Depression: The Mediated Role of Maternal Self-Efficacy

PURPOSE

Postpartum depression is related to many factors, which affect the health of mothers and infants. The purpose of this study is to test the mediated effect of self-efficacy in the relationship between vulnerable personality and postpartum depression.

PATIENTS AND METHODS

A cross-sectional survey was conducted with pregnant women aged ≥20 years from February to April 2021 in Zhengzhou, China. We recruited 587 pregnant women, and 429 pieces of data were available. The demographic characteristics questionnaire, General Self efficacy Scale (GSES) and Vulnerable Personality Style Questionnaire (VPSQ) were distributed in the prenatal survey. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen postpartum depression symptoms at one month through WeChat and telephone follow-up. A mediated model was constructed to explain the relationship of variables and test the mediated effect of self-efficacy.

RESULTS

The valid questionnaires were 429 (effective response rate: 90.7%). The vulnerable personality and low self-efficacy were related to postpartum depression (all P< 0.01). The self-efficacy of pregnant women was inversely associated with vulnerable personality (β= -0.415) and postpartum depression (β= -0.216). The vulnerable personality and self-efficacy can explain 29.0% of the variation in postpartum depression. It was confirmed that a partial mediating effect of self-efficacy accounted for 18.0% (0.090/0.501) of the total effect.

CONCLUSION

Maternal self-efficacy partly mediates the relationship between vulnerable personality traits and postpartum depression. The study implies the importance of targeted interventions to improve self-efficacy for women with vulnerable personality traits to reduce the risk of postpartum depression.

Nursing Students' Perceived Disaster Preparedness and Response: Pilot study in Oman

Objectives

This study aimed to assess the perceived level of disaster preparedness and response among nursing students in Oman, as the country is disaster prone and experiences disasters every three to five years.

Methods

A descriptive cross-sectional pilot study was conducted from May to June 2019 using a stratified cluster sampling method among nursing students recruited from two government nursing colleges in Muscat, Oman. The Disaster Preparedness Evaluation Tool and Disaster Response Self-Efficacy Scale were used to assess the knowledge, skill, disaster management and self-efficacy in handling disasters.

Results

A total of 51 students participated in this study. Most students (78.4%) had experienced a disaster while at home. Overall, the students had moderate levels of knowledge (3.17 ± 1.49), skill (3.12 ± 1.52), post-disaster management (3.22 ± 1.44) and self efficacy in responding to disaster (2.93 ± 1.16).

Conclusion

Nursing students in Oman have experienced disasters and are willing to respond when called upon though they possess moderate knowledge and confidence in handling disasters.

Determinant of Stress and Burnout among Nurses at the Second Wave of the Indonesian COVID-19 Pandemic: A National Web-based Survey

BACKGROUND: COVID-19 pandemic has developed into a major public health threat. Nurses who work to combat COVID-19 are frequently under pressure. The high stresses caused by the consequences of transmission of the COVID-19 put nurses at risk of developing burnout syndrome. AIM: The purpose of this study was to evaluate the level of anxiety and burnout experienced by nurses during the COVID-19 pandemic. METHODS: This study was conducted using a cross-sectional design. An online web-based survey was used to collected data in the national sample of nurses (n = 243, response rate = 78.6%). This study used a convenience sampling technique. The Hamilton Anxiety Rating Scale and the Maslach Burnout Inventory were also employed. Multiple linear regressions were used to determine characteristics associated with burnout. RESULTS: The participants’ average age was 34.62 years (SD = 7.91). The mean anxiety score was 7.89 (SD = 2.94). The mean score of emotional exhaustion was 14.35 (SD = 7.72), the depersonalization means score was 8.81 (SD = 5.11), and the professional accomplishment mean score was 13.51 (SD = 7.51). Education and job experience had a substantial effect on emotional exhaustion and depersonalization, with R2 values of 10.8% and 18.5%, respectively. When anxiety was included in the model, the R2 for emotional exhaustion increased to 20.4% and the R2 for depersonalization increased to 22.2%, respectively. Work experience had a little effect on professional accomplishment (R2 = 10.3%) but had a much larger effect when the variable of anxiety was included in the model (R2 = 18.3%). CONCLUSION: This study revealed that during the COVID-19 epidemic, nurses experienced many emotional states, including exhaustion, depersonalization, and anxiety. Efforts should be made by governments and policymakers in this regard in better preparing health-care systems, persons, and nursing to respond to the COVID-19 pandemic in the future.

The COVID-19 Global Pandemic and Its Impact on the Mental Health of Nurses in Malaysia

The Coronavirus disease 2019 (COVID-19) global pandemic since its onset has had a dramatic and often devastating impact, both physical and psychological, on all healthcare workers. This study aimed to assess the impact of psychological distress that COVID-19 has on nurses, as well as the coping strategies that they employed. This is a cross-sectional national online survey. A total of 859 nurses actively involved in caring for patients with suspected or confirmed COVID-19 in Malaysia participated in the study. More than three-quarters of the nurses experienced stress (77.2%). A total of 88.7% and 7.2% of nurses revealed a moderate and high stress level, respectively. Approximately one in eight (12.1%) nurses reported feeling depressed. Nurses working in the outpatient departments reported significantly higher stress levels than nurses working in inpatient care departments. Nurses having chronic health problems reported significantly higher depression levels than nurses with no chronic health problem. Highly stressed or depressed nurses tend to adopt avoidance coping strategies while religion and emotional support were used regardless of the stress or depression levels experienced. The findings of the study provide insight into the mental health and coping strategies of nurses actively involved in caring for patients with suspected or confirmed COVID-19 in Malaysia. This would be of tremendous help to nursing administrators in implementing mental health services for nurses during and following the COVID-19 global pandemic.

Identify the Disaster Nursing Training and Education Needs for Nurses in Taif City, Saudi Arabia

Introduction

Nursing is considered the healthcare profession with the most members. Emergency nurses constitute the first line of treatment in healthcare facilities when catastrophic events bring disaster victims in need of medical attention. Therefore, these nurses must be well educated and trained efficiently to be able to deal with disastrous situations properly. This study aimed to distinguish the most important elements of education and training for preparing emergency nurses to face disasters in the Kingdom of Saudi Arabia (KSA), specifically, the city of Taif.

Methods

This study employed a tool to measure nurses’ most important training and education needs that was created by the authors based on a literature review and was approved by an expert panel in disaster nursing. Questionnaires were distributed to emergency nurses in four hospitals run by the Ministry of Health in Taif city. Survey responses were received from 210 participants, and the data were analyzed using a principal component analysis (PCA). A one-way ANOVA was used to determine the differences between groups according to their experiences.

Results

The following three factors were extracted from the data after redundant items were loaded and excluded: incident management systems (IMSs), disaster triage, and disaster drills. Nurses with less than three years of experience have a significant need to learn about these elements in order to be able to cope with disasters.

Conclusion

Understanding different types of disasters and how to deal with these catastrophic events is crucial. Significant differences existed between ED nurses in their understanding of the basic elements of disaster management based on their level of experience in an ED. Therefore, disaster education must be included in nursing curricula, and more training courses, mock drills, and simulations must be conducted in hospitals for nurses, especially nurses with less experience, so they can learn to manage their responsibilities during disasters.

Promoting Mental Health of Nurses During the Coronavirus Pandemic: Will the Rapid Deployment of Nurses' Training Programs During COVID-19 Improve Self-Efficacy and Reduce Anxiety?

Introduction The nursing profession is extremely demanding and stressful. Nurses have been facing a tremendous amount of fear and anxiety during the ongoing coronavirus disease 2019 (COVID-19) pandemic. General self-efficacy is considered one of the most influential factors that can modify the impact of anxiety on nurses' mental health. In this study, we aimed to determine the predictors of self-efficacy and anxiety among nurses during the current COVID-19 pandemic. Methods We conducted a cross-sectional survey involving 368 nurses working in a tertiary care hospital. The General Self-Efficacy scale (GSE) and Generalized Anxiety Disorder Scale-7 (GAD-7) were used for assessing self-efficacy and anxiety. The chi-square test followed by bivariate and multivariable regression analyses was performed to identify the determinants of self-efficacy and anxiety. Results The mean age of the nurses was 28.91 years (SD=3.68), with a mean working experience in the nursing field of 5.32 years (SD=2.48). The mean self-efficacy and anxiety scores were 32.19 (SD=4.53) and 3.82 (SD=2.87), respectively. Multivariable analysis showed that higher age (>30 years, p=.003), professional education acquired through a diploma course instead of a graduate degree (p<.001), and lack of training on handling COVID-19 patients (p=.003) were significant determinants of higher anxiety among nurses. Similarly, higher economic status (p=.001), sufficient COVID-19 training (p=.049), having family members tested positive for COVID-19 (p=.012), professional experience (≤5 years, p<0.001), and quarantine period (≤14 days, p=.002) were revealed to be independent determinants of a higher sense of self-efficacy among nurses during the COVID-19 pandemic. Conclusion Receiving adequate levels of training on COVID-19 plays a vital role in improving self-efficacy and reducing anxiety among nurses during the ongoing pandemic. Managing anxiety, increasing self-efficacy, and ensuring more exposure to COVID-19-related training may improve nurses' mental health and prepare them for fighting pandemics in a much better and more efficient manner.

Psychological First Aid Training: A Scoping Review of Its Application, Outcomes and Implementation

Worldwide commitment to disseminate Psychological First Aid (PFA) training to enable frontline workers to support distressed individuals and/or manage their own self-care is increasing, but the evidence base of PFA training is uncertain. Method: a scoping review was undertaken by searching seven databases and hand-searching grey literature to maximise coverage of potential studies. Results: Twenty-three studies met the inclusion criteria. Three PFA training models were commonly used in research studies. A broad selection of PFA training outcomes were observed including learning, behavior, satisfaction and practice in crisis mental and behavior health preparedness. Conclusions: Research evidence of reasonable quality demonstrates that PFA training significantly improves knowledge of appropriate psychosocial response and PFA skills in supporting people in acute distress, thereby enhancing self-efficacy and promoting resilience. However, this review highlights inadequate guidance on how PFA training should be applied and adapted, significant shortcomings of reporting PFA training delivery, limited training evaluation and unclear training outcomes. Whilst behavioral, knowledge and system impact of the PFA training are promising, methodologically stronger evaluations which include systematic training adaptation and selection of sensitive outcome measures is needed to strengthen future implementation of PFA training and thereby enhance population preparedness for future emergencies.

Development of disaster nursing education and training programs in the past 20 years (2000-2019): A systematic review

BACKGROUND

Nurses play a pivotal role in disaster management across the globe. With the call for all nurses to be prepared for disasters, disaster nursing education and training programs have expanded globally. However, a clear picture of the development and coverage of disaster nursing education and training programs is lacking.

OBJECTIVES

This study aimed to establish an overall picture of the development of disaster nursing education and training programs in the last 20 years, outline the contents included, approaches adopted and outcomes reported.

METHODS

A systematic search for relevant literature published between January 2000 to December 2019 was conducted using electronic databases including the CINAHL, MEDLINE, PubMed, Web of Science, and Scopus with the keywords on disaster nursing education and training.

FINDINGS

A total of 75 eligible studies were identified from 3395 potentially relevant articles. The numbers of disaster nursing education and training programs increased gradually over the past 20 years. They were offered in various countries with an unbalanced geographical distribution. Most of the existing programs focused on disaster preparedness and response, especially on the skills of triage during disaster response, instead of addressing the full spectrum of disaster management that included mitigation, preparedness, response, and recovery phases. Multiple approaches and technologies were adopted, including competency-based, all-hazard, inter-professional, flipped classroom, simulation, tabletop exercises, and virtual reality ones. Nearly half of the included programs adopted a pre- and post-test evaluation to examine the outcomes of learning and all of the programs reported significant increases in nursing professionals' knowledge and skills of related content on disaster management covered in the training programs.

CONCLUSIONS

This review provides nurse leaders, educators and researchers in nursing with an understanding of the state-of-art of the existing disaster nursing education and training programs. More disaster nursing research are necessary to enhance the knowledge, skills and readiness of the nursing professionals for disaster management in meeting global disaster challenges.

Nurses' burnout and associated risk factors during the COVID-19 pandemic: A systematic review and meta-analysis

AIMS

To examine the nurses' burnout and associated risk factors during the COVID-19 pandemic.

DESIGN

We followed the Cochrane criteria and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for this systematic review and meta-analysis.

DATA SOURCES

PubMed, Scopus, ProQuest, Cochrane COVID-19 registry, CINAHL and pre-print services (medRχiv and PsyArXiv) were searched from January 1 to November 15, 2020 and we removed duplicates.

REVIEW METHODS

We applied a random effect model to estimate pooled effects since the heterogeneity between results was very high.

RESULTS

Sixteen studies, including 18,935 nurses met the inclusion criteria. The overall prevalence of emotional exhaustion was 34.1%, of depersonalization was 12.6% and of lack of personal accomplishment was 15.2%. The main risk factors that increased nurses' burnout were the following: younger age, decreased social support, low family and colleagues readiness to cope with COVID-19 outbreak, increased perceived threat of Covid-19, longer working time in quarantine areas, working in a high-risk environment, working in hospitals with inadequate and insufficient material and human resources, increased workload and lower level of specialized training regarding COVID-19.

CONCLUSION

Nurses experience high levels of burnout during the COVID-19 pandemic, while several sociodemographic, social and occupational factors affect this burnout.

IMPACT

We found that burnout among nurses is a crucial issue during the COVID-19 pandemic. There is an urgent need to prepare nurses to cope better with COVID-19 pandemic. Identification of risk factors for burnout could be a significant weapon giving nurses and health care systems the ability to response in a better way against the following COVID-19 waves in the near future.

Psychosocial support for providers working high-risk exposure settings during a pandemic: A critical discussion

Psychological first aid is a form of support designed to lessen disaster‐related distress. In a pandemic, providers may need such support but with the high risk of exposure, such a program is offered only virtually. The research is scant for traditional post‐disaster support and non‐existent for virtual; therefore, by using related research this discussion considers the likelihood of providers accessing and benefiting from this program. The virtual platform is heralded as the responsible way to provide support in a pandemic but this standard may be ineffective and is inherently inequitable. As a global event, pandemics require containment strategies applicable on an international level; therefore, psychosocial support should also be developed with an international audience in mind. Online psychosocial support falls short of being such a strategy as it incorrectly assumes global internet access. Many low‐income areas such as Sub‐Saharan Africa will need support strategies which compliment local frontline staff and fit with community‐driven initiatives, whereas wealthier countries may use a combination of onsite and online support. Provider psychosocial support needs in a pandemic, if articulated, are globally similar but how this support is offered requires contextually sensitive considerations not yet found in the literature.

The effect of the disaster management training program among nursing students

OBJECTIVE

This study investigated the effect of the Jennings Disaster Nursing Management Model-based and learning management system-assisted six-module training programme on nursing students' disaster preparedness perceptions and response self-efficacy.

DESIGN AND SAMPLE

This randomized controlled trial used a two group comparison design, experimental group (n = 127), and control group (n = 108), carried out with third-year nursing students in a city in the west of Turkey.

MEASURES

Data included a socio-demographic form, the Disaster Preparedness Perception Scale in Nurses (DPPSN) and the Disaster Response Self-Efficacy Scale (DRSES).

RESULTS

After the training, disaster preparedness perceptions and the response self-efficacy of the EG increased significantly (p < .05). This study had a moderate effect on participants' knowledge and self-efficacy.

CONCLUSION

Public health nurses are health professionals with important roles and responsibilities in the stages of disaster preparedness, response, and recovery that is all stages of disaster management. This theoretical-based program can be considered for both students and nursing professionals.

Frontline nurses' burnout, anxiety, depression, and fear statuses and their associated factors during the COVID-19 outbreak in Wuhan, China: A large-scale cross-sectional study

BACKGROUND

During the Coronavirus Disease 2019 (COVID-19) pandemic, frontline nurses face enormous mental health challenges. Epidemiological data on the mental health statuses of frontline nurses are still limited. The aim of this study was to examine mental health (burnout, anxiety, depression, and fear) and their associated factors among frontline nurses who were caring for COVID-19 patients in Wuhan, China.

METHODS

A large-scale cross-sectional, descriptive, correlational study design was used. A total of 2,014 eligible frontline nurses from two hospitals in Wuhan, China, participated in the study. Besides sociodemographic and background data, a set of valid and reliable instruments were used to measure outcomes of burnout, anxiety, depression, fear, skin lesion, self-efficacy, resilience, and social support via the online survey in February 2020.

FINDINGS

On average, the participants had a moderate level of burnout and a high level of fear. About half of the nurses reported moderate and high work burnout, as shown in emotional exhaustion (n = 1,218, 60.5%), depersonalization (n = 853, 42.3%), and personal accomplishment (n = 1,219, 60.6%). The findings showed that 288 (14.3%), 217 (10.7%), and 1,837 (91.2%) nurses reported moderate and high levels of anxiety, depression, and fear, respectively. The majority of the nurses (n = 1,910, 94.8%) had one or more skin lesions, and 1,950 (96.8%) nurses expressed their frontline work willingness. Mental health outcomes were statistically positively correlated with skin lesion and negatively correlated with self-efficacy, resilience, social support, and frontline work willingness.

INTERPRETATION

The frontline nurses experienced a variety of mental health challenges, especially burnout and fear, which warrant attention and support from policymakers. Future interventions at the national and organisational levels are needed to improve mental health during this pandemic by preventing and managing skin lesions, building self-efficacy and resilience, providing sufficient social support, and ensuring frontline work willingness.