Diversity and limitations of electroencephalogram and event-related potential applications in nursing research: A scoping review

AIMS

This scoping review was conducted to provide a comprehensive summary of how electroencephalogram (EEG) and event-related potentials (ERPs) have been used in nursing research, with the goal of mapping the themes and methods of nursing research involving EEGs or ERPs as a measurement tool.

METHODS

The eligibility criteria were determined according to the Population, Concept, and Context principle. A systematic electronic search of articles in the PubMed, Web of Science, Embase, CINAHL, APA PsycInfo, and Scopus databases was carried out for the period from database establishment to November 21, 2022. The included studies were analyzed using descriptive statistics and content analysis.

RESULTS

The review process culminated in 45 articles, evidencing an increasing trend and dispersion characteristics of EEG in nursing research and reflecting five thematic domains of inquiry related to nursing. There was a deficiency of detailed reports of EEG recording and data analysis parameters in nursing research. The common EEG bands in nursing research were Delta, Theta, Alpha, Beta, Gamma. The ERP components used frequently were P3, P2, N1, N2, P1, N170, and feedback-related negativity.

CONCLUSIONS

The wide variety of EEG components used show broad potential for studying nursing questions. In the future, it will be necessary to increase the depth of the research content, the repeatability of the experiment and the standardization of the report. Nursing researchers should give full play to the characteristics of nursing and establish a systematic and complete EEG research system for nursing.

Moderating effects of perceived social support on self-efficacy and psychological well-being of Chinese nurses: a cross-sectional study

Introduction

Nurses experience significant physical and psychological stress that negatively influences their psychological well-being. The objective of this study was to explore the association between self-efficacy and psychological well-being among Chinese nurses and to assess the moderating effects of perceived social support (PSS).

Methods

In 2020, a hospital-based cross-sectional study using a multistage random sampling approach was performed in five regions of Liaoning, China. Of the 1,200 surveyed nurses, 1,010 completed questionnaires that evaluated the demographic information, 14-item Hospital Anxiety and Depression Scale, General Self-Efficacy Scale, and Multidimensional Scale of Perceived Social Support. To examine the factors associated with mental health parameters, hierarchical multiple regression analysis was performed. The interactions were visualized using a simple slope analysis.

Results

The mean depression and anxiety scores for Chinese nurses were 8.74 ± 3.50 and 6.18 ± 3.26, respectively. The association between self-efficacy and depression differed between the low perceived social support (PSS) group (1 SD below the mean, β = -0.169, p < 0.01) and high PSS group (1 SD above the mean, β = -0.077, p < 0.01). Similarly, the association between self-efficacy and anxiety differed between the low PSS group (1 SD below the mean, β = -0.155, p < 0.01) and high PSS group (1 SD above the mean, β = -0.044, p < 0.01).

Conclusion

We found that Chinese nurses experienced high levels of anxiety and depression. Furthermore, PSS moderates the relationship between self-efficacy and psychological well-being. Therefore, interventions targeting self-efficacy and PSS should be implemented to improve the psychological well-being of nurses.

Prevalence of psychological symptoms and associated risk factors among nurses in 30 provinces during the COVID-19 pandemic in China

BACKGROUND

With the outbreak of the coronavirus disease 2019 (COVID-19), nurses have won well-deserved recognition for their indispensable roles in providing humane and professional healthcare for patients. However, by the nature of their role working at the forefront of patient care, nurses are prone to experiencing mental health consequences. Therefore, we pay attention to measuring the magnitude of psychological symptoms and identifying associated factors among nurses in China.

METHODS

We launched a nationwide, cross-sectional survey of nurses who worked in secondary or tertiary hospitals and public or private hospitals from 30 provinces in China. The prevalence and severity of symptoms of burnout, depression, and anxiety were investigated, respectively. Multivariable logistic regression analyses were performed to identify factors associated with each psychological symptom.

FINDINGS

A total of 138 279 respondents who worked in 243 hospitals completed this survey. A substantial proportion of nurses reported symptoms of burnout (34%), depression (55·5%), and anxiety (41·8%). In line with the disproportionality of economic development, we noted that the middle or western region was an independent risk factor for depression and anxiety. Compared with those working in the secondary hospital, nurses who worked in tertiary hospitals were associated with a higher likelihood of burnout and depression.

INTERPRETATION

Nurses are experiencing emotional, physical, and mental exhaustion during the COVID-19 epidemic. Governments and health policymakers need to draw attention to reinforcing prevention and ameliorating countermeasures to safeguard nurses' health.

FUNDING

The strategic consulting project of the Chinese Academy of Engineering [2021-32-5]. Advanced Institute of Infomation Technology, Peking University, Zhejiang Province [2020-Z-17].

Prevalence and correlates of depressive symptoms among nurses during COVID-19 pandemic

Background

During any critical health care situation as COVID-19 pandemic, it is expected that the medical staff will be under a high level of stress. However, nurses specifically are under both physical and psychological pressure during this pandemic, with a risk of mental health problems, such as anxiety and depression. Accordingly, nurses exposed to patients with COVID-19 infection are expected to suffer from a high level of depressive symptoms. This cross-sectional study was applied on 456 nurses with age ranges from 18 to 60. They were divided into two groups: group 1 were composed of 228 nurses who were directly exposed to suspected or confirmed cases of COVID-19 patients, while group 2 were composed of 228 who were less exposed to suspected or confirmed cases of COVID-19 patients for comparison. Data were collected by personal interviews with nurses using Patient Health Questionnaire 9 (PHQ 9) scale for assessment of presence of depressive symptoms and its severity. We aimed to assess the both the prevalence and the predictors of depressive symptoms among nurses exposed to COVID-19 patients.

Results

We found a statistically significant higher percentage of depressive symptoms among nurses directly exposed to COVID-19 patients (61.8%) versus the less exposed group (18%). There was a statistically and significantly higher specific COVID-19 associated stressors score (SCAS) among nurses directly exposed to suspected or confirmed cases of COVID-19 patients compared to those who were less exposed; likewise, the PHQ-9 score was a statistically and significantly higher among directly exposed group compared to less-exposed group. Moderate and severe depressive symptoms were present in 23.2% and 22.4%, respectively, within the group of nurses with direct exposure; meanwhile, the less-exposed group showed 7.5% and 3.9%, respectively, with statistically higher significant difference. On doing a linear regression analysis, all the following predictors were significantly independently associated with higher PHQ-9 scores (with higher depressive symptoms severity) among nurses exposed to COVID-19: physical isolation (restrictions on touching others, even after working hours), exposure to a new COVID-19 patient, developing COVID-19-like symptoms, displaying COVID-19-like symptoms by colleagues, knowing that COVID mortality rate exceeds influenza, possible separation from family, concern about family members, fears about infection for patients, family, and friends.

Conclusions

COVID-19 pandemic has serious effects on the psychological well-being of nurses exposed to COVID-19 patients. There was an increased rate of depressive symptoms among them during the pandemic with its subsequent burden. Therefore, nurses exposed to COVID-19 patients are in a high need of care and support during the pandemic.

Effects of Mobile App-Based Mindfulness Practice on Healthcare Workers: a Randomized Active Controlled Trial

Objectives

Amidst the COVID-19 pandemic, healthcare workers (HCWs) may be at greater risk of suffering from psychological distress compared to the general population. This study aimed to investigate the effects of mindfulness practice as delivered using Headspace on psychological and cognitive outcomes among HCWs in Singapore.

Methods

A total of 80 HCWs were recruited and randomly assigned to engage in either 3 weeks (10 min/day) of mindfulness practice using Headspace or an active control condition (Lumosity; involving playing cognitive games). Participants were administered several self-report measures and two working memory (digit span) tasks at pre- and post-intervention, and one-month follow-up.

Results

There were no significant between-condition changes on any outcome variables from pre- to post-intervention. From pre-intervention to 1-month follow-up, there were significantly greater improvements among Headspace participants on fear of COVID-19 (p = .005), compassion satisfaction (p = .007), trait mindfulness (p = .002), self-compassion (p = .005), sleep quality (p = .002), and the forward digit span task (p < .001). Several outcomes were mediated by increases in trait mindfulness or self-compassion.

Conclusions

Use of Headspace may lead to downstream benefits in reducing distress and improving psychological health outcomes among HCWs. The findings have implications for improving psychological support resources for HCWs amidst a pandemic.

Trial Registration

ClinicalTrials.gov (Identifier: NCT04936893).

Factors associated with stress, anxiety and depression in nursing professionals in the hospital context

OBJECTIVE

to determine the factors associated with stress, anxiety and depression, concomitantly, in nursing professionals who work in the hospital context.

METHODS

a quantitative and cross-sectional study with 353 nursing professionals from a hospital. A sociodemographic questionnaire and the Depression, Anxiety and Stress Scale-21 were used. Data were subjected to descriptive statistical analysis, difference and correlation tests.

RESULTS

the main factors associated with stress, anxiety and depression, concomitantly, were being female, compromised family and social support, lack of autonomy at work, hostile relationship with colleagues, lack of professional recognition and satisfaction, feeling of being overwhelmed and insecurity.

CONCLUSIONS

demographic, physiological, social and work factors impact the levels of stress, anxiety and depression in nursing professionals. The adoption of coping strategies for modifiable factors should be considered, in order to provide better quality of life for these professionals.

The association between health status and job satisfaction among female workers: A nationwide cross-sectional study

The purpose of this study was to determine the job satisfaction among female workers in Korea and the association between health status and job satisfaction. The Korean Longitudinal Survey of Women and Families was used for this nationwide cross-sectional study. Data from 1570 female workers were analyzed to determine job satisfaction and examine the association between health status and job satisfaction, controlling for other variables such as personal characteristics, work attributes, job opportunities, and work conditions. Analyses included descriptive statistics, independent t-tests, ANOVA, Pearson's correlation, and multivariate regression. Subjective health status was positively related, while diagnosed disease and depressive symptoms were negatively associated with job satisfaction. Monthly salary, work hours, fringe benefits, and geographical region were also significantly related to female workers' job satisfaction, and commute distance was related to job satisfaction with a small effect size. This study thus found that subjective health status, diagnosed disease, and depressive symptoms were related to female workers' job satisfaction. Health promotion and supporting mental health among female workers may be important managerial strategies for supporting increased job satisfaction in female workers.

Electroencephalographic prediction of global and domain specific cognitive performance of clinically active Australian Nurses

OBJECTIVE

To investigate the relationship between EEG activity and the global and domain specific cognitive performance of healthy nurses, and determine the predictive capabilities of these relationships.

APPROACH

Sixty-four nurses were recruited for the present study, and data from 61 were utilised in the present analysis. Global and domain specific cognitive performance of each participant was assessed psychometrically using the Mini-mental state exam and the Cognistat, and a 32-lead monopolar EEG was recorded during a resting baseline phase and an active phase in which participants completed the Stroop test.

MAIN RESULTS

Global cognitive performance was successfully predicted (81%-85% of variance) by a combination of fast wave activity variables in the alpha, beta and theta frequency bands. Interestingly, predicting domain specific performance had varying degrees of success (42%-99% of the variance predicted) and relied on combinations of both slow and fast wave activity, with delta and gamma activity predicting attention performance; delta, theta, and gamma activity predicting memory performance; and delta and beta variables predicting judgement performance.

SIGNIFICANCE

Global and domain specific cognitive performance of Australian nurses may be predicted with varying degrees of success by a unique combination of EEG variables. These proposed models image transitory cognitive declines and as such may prove useful in the prediction of early cognitive impairment, and may enable better diagnosis, and management of cognitive impairment.

Depressive symptoms, professional quality of life and turnover intention in Korean nurses

AIM

The purpose of this study was to identify the effects of depressive symptoms and professional quality of life on turnover intention.

BACKGROUND

The high turnover rate of nurses is a critical healthcare issue globally.

INTRODUCTION

Nurses often experience depressive symptoms and compassion fatigue due to the efforts of patient care. The impact of such psychological health issues on turnover intention needs to be confirmed.

METHODS

Participants were 10 163 female nurses who completed an online or mobile survey using the Korea Nurses' Health Study. To identify the influencing factors on the turnover intention of nurses, descriptive statistics, spearman's correlation coefficients and multivariable ordinal logistic regression were performed.

RESULTS

The turnover intention increased by about 2.81-4.60 times when depressive symptom was moderate or more, 1.14 times when secondary traumatic stress disorder was moderate or more, and 1.54 times when burnout was moderate or more. When compassion satisfaction was moderate or high, the turnover intention decreased by 0.72 and 0.52 times.

DISCUSSION

Korean nurses demonstrated high levels of depressive symptoms, secondary traumatic stress and burnout, while demonstrating lower levels of compassion satisfaction. The results of this study demonstrate that depressive symptoms, secondary traumatic stress, burnout and compassion satisfaction affect turnover intention.

CONCLUSIONS

To reduce nurses' turnover intention, it is necessary to reduce depressive symptoms and enhance the quality of professional life.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Hospital managers need to maintain adequate nurse-to-patient ratios and provide nurses with a supportive work environment. Also, health policymakers need to identify factors affecting hospital nurses' turnover intention and provide strategies to address them. These conditions may reduce the excessive workload placed on nurses, thereby preventing depression and burnout and improving nurses' quality of work-life.

Psychological Capital Mediates the Association between Job Stress and Burnout of among Korean Psychiatric Nurses

This study examined the mediating effect of psychological capital in the relationship between job stress and burnout of psychiatric nurses. The participants were 108 psychiatric nurses working in three psychiatric hospitals located in South Korea. Data were collected from 10 August to 15 September 2018 using self-report questionnaires. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson’s correlation coefficient, and multiple linear regression by IBM SPSS 24.0 program. In addition, a bootstrapping test using the SPSS PROCESS macro was conducted to test the statistical significance of the mediating effect. There was significant correlation between job stress, psychological capital, and burnout. Psychological capital showed partial mediating effects in the relationship between job stress and burnout. Job stress explained 29.7% of the variance in burnout, and the model including job stress and psychological capital explained 49.6% of the variance in burnout. The bootstrapping showed that psychological capital was a significant sub-parameter and decreased job stress and burnout (LLCI = −0.1442, ULCI = −0.3548). These findings suggest that psychiatric nurses’ burnout can be reduced by implementing various health care programs designed to increase psychological capital.

Prevalence and Risk Factors of Depression, Anxiety, and Stress in a Cohort of Australian Nurses

Nurses remain at the forefront of patient care. However, their heavy workload as a career can leave them overworked and stressed. The demanding nature of the occupation exposes nurses to a higher risk of developing negative mental states such as depression, anxiety, and stress. Hence, the current study aimed to assess the prevalence and risk factors of these mental states in a representative sample of Australian nurses. The Depression Anxiety Stress Scale was administered to 102 nurses. Information about demographic and work characteristics were obtained using lifestyle and in-house designed questionnaires. Prevalence rates of depression, anxiety, and stress were found to be 32.4%, 41.2%, and 41.2% respectively. Binominal logistic regressions for depression and stress were significant (p = 0.007, p = 0.009). Job dissatisfaction significantly predicted a higher risk of nurses developing symptoms of depression and stress respectively (p = 0.009, p = 0.011). Poor mental health among nurses may not only be detrimental to the individual but may also hinder professional performance and in turn, the quality of patient care provided. Further research in the area is required to identify support strategies and interventions that may improve the health and wellbeing of nursing professionals and hence the quality of care delivered.