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Melnyk BM, Davidson JE, Mayfield C, Zisook S, Tucker S, Hsieh AP, Cooper A, Gray-Bauer R, Hoying J, Cuccia AF, Tan A. A study protocol for the modified interactive screening program plus MINDBODYSTRONG© RCT: A mental health resiliency intervention for nurses. PLoS One 2024; 19:e0303425. [PMID: 38843149 PMCID: PMC11156330 DOI: 10.1371/journal.pone.0303425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/22/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Nurses, the largest workforce in healthcare, are at high risk of depression, anxiety, burnout, and suicidal ideation. Suicide among nurses is higher than the general population. This randomized controlled trial pairs the MINDBODYSTRONG© cognitive-behavioral skills building program with the American Foundation for Suicide Prevention's (AFSP) Modified Interactive Screening Program (mISP) to reduce depression, suicidal ideation, post-traumatic stress, anxiety, and burnout, and improve healthy lifestyle beliefs, healthy lifestyle behaviors, and job satisfaction in nurses with moderate to high risk of suicide. AIMS This study aims to determine the effects of the mISP combined with the digitized MINDBODYSTRONG© program versus the mISP alone on depression, suicidal ideation, burnout, anxiety, post-traumatic stress, healthy lifestyle beliefs, healthy lifestyle behaviors, and job satisfaction in 364 U.S. nurses. METHODS A digitized version of MINDBODYSTRONG© combined with the mISP screening and referral platform will be compared to the AFSP mISP alone through a two-arm randomized controlled trial. Follow-up post-intervention data will be collected at week eight and months three, six, and 12. DISCUSSION If successful, this study's findings could assist nurses who are hesitant to use conventional mental health resources by providing them with confidential aid and learning opportunities to reduce suicidality, depression, anxiety, post-traumatic stress, and burnout and improve healthy lifestyle beliefs, healthy lifestyle behaviors, and job satisfaction. TRIAL/STUDY REGISTRATION The Ohio State University Protocol Record 2021B0417, Modified Interactive Screening Program Plus MINDBODYSTRONG: A Mental Health Resiliency Intervention for Nurses, is registered and posted at ClinicalTrials.gov Identifier: NCT05582343. First posted date is October 17, 2022.
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Affiliation(s)
- Bernadette Mazurek Melnyk
- Vice President for Health Promotion, The Ohio State University, Columbus, Ohio, United States of America
- Office of the Chief Wellness Officer, The Ohio State University, Columbus, Ohio, United States of America
- Helene Fuld Health Trust National Institute for Evidence-Based Practice, The Ohio State University, Columbus, Ohio, United States of America
- College of Nursing, The Ohio State University, Columbus, Ohio, United States of America
| | - Judy E. Davidson
- College of Nursing, The Ohio State University, Columbus, Ohio, United States of America
- University of San Diego Health, San Diego, California, United States of America
| | - Cora Mayfield
- College of Nursing, The Ohio State University, Columbus, Ohio, United States of America
| | - Sidney Zisook
- University of San Diego Health, San Diego, California, United States of America
| | - Sharon Tucker
- Helene Fuld Health Trust National Institute for Evidence-Based Practice, The Ohio State University, Columbus, Ohio, United States of America
- College of Nursing, The Ohio State University, Columbus, Ohio, United States of America
| | - Andreanna Pavan Hsieh
- College of Nursing, The Ohio State University, Columbus, Ohio, United States of America
| | - Andrea Cooper
- College of Nursing, The Ohio State University, Columbus, Ohio, United States of America
| | - Rosalind Gray-Bauer
- College of Nursing, The Ohio State University, Columbus, Ohio, United States of America
| | - Jacqueline Hoying
- College of Nursing, The Ohio State University, Columbus, Ohio, United States of America
| | - Alison F. Cuccia
- Nursing Programs, American Nurses Association Enterprise, Silver Spring, Maryland, United States of America
| | - Alai Tan
- College of Nursing, The Ohio State University, Columbus, Ohio, United States of America
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Deng Y, Frey JJ, Osteen PJ, Mosby A, Imboden R, Ware OD, Bazell A. Engaging Law Enforcement Employees in Mental Health Help-Seeking: Examining the Utilization of Interactive Screening Program and Motivational Interviewing Techniques. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024:10.1007/s10488-024-01384-0. [PMID: 38782797 DOI: 10.1007/s10488-024-01384-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2024] [Indexed: 05/25/2024]
Abstract
AIM The Interactive Screening Program (ISP) is an anonymous screening and dialogue platform used in workplaces to encourage mental health help-seeking. This study examined utilization of ISP among law enforcement workplaces and assessed how motivational interviewing techniques were associated with various help-seeking outcomes. METHOD This retrospective study used secondary ISP screening and dialogue data collected from 2013 to 2019 at four law enforcement workplaces or unions (N = 691). Independent variables include counselors' use of motivational interviewing techniques in their dialogue such as asking questions and showing empathy in their response. Help-seeking outcomes include requesting a referral, making a commitment to counseling services, decreased ambivalence about mental health services, and increased willingness to seek future services. RESULTS Two-thirds of participants screened within the high distress level of ISP. Among them, 53% responded to the counselor's initial email and 50% of those who responded requested a referral for future services. Binary logistic regression models showed that counselors' use of confrontation in the dialogue was associated with improved willingness to seek services among ISP users (OR = 2.88, 95% CI = 1.24, 6.64). Further, ISP users who accessed ISP through their workplace peer support program, as compared to their employee assistance program (EAP), are more likely to show decreased ambivalence about seeking future services over time (OR = 0.28, 95% CI = 0.09, 0.80). CONCLUSION This study demonstrates that the anonymous ISP program can successfully engage employees with high distress levels, including employees with suicidal ideation. Results highlight the importance of customizing ISP counselors' responses to be responsive for law enforcement employees.
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Affiliation(s)
- Yali Deng
- School of Social Work, University of Maryland, Baltimore, MD, USA.
| | - Jodi J Frey
- School of Social Work, University of Maryland, Baltimore, MD, USA
| | | | - Amanda Mosby
- School of Social Work, University of Maryland, Baltimore, MD, USA
| | | | - Orrin D Ware
- University of North Carolina, Chapel Hill, NC, USA
| | - Alicia Bazell
- School of Social Work, University of Maryland, Baltimore, MD, USA
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Hallett N, Rees H, Hannah F, Hollowood L, Bradbury-Jones C. Workplace interventions to prevent suicide: A scoping review. PLoS One 2024; 19:e0301453. [PMID: 38696511 PMCID: PMC11065308 DOI: 10.1371/journal.pone.0301453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 03/17/2024] [Indexed: 05/04/2024] Open
Abstract
OBJECTIVES To map organisational interventions for workplace suicide prevention, identifying the effects, mechanisms, moderators, implementation and economic costs, and how interventions are evaluated. BACKGROUND Suicide is a devastating event that can have a profound and lasting impact on the individuals and families affected, with the highest rates found among adults of work age. Employers have a legal and ethical responsibility to provide a safe working environment for their employees, which includes addressing the issue of suicide and promoting mental health and well-being. METHODS A realist perspective was taken, to identify within organisational suicide prevention interventions, what works, for whom and in what circumstances. Published and unpublished studies in six databases were searched. To extract and map data on the interventions the Effect, Mechanism, Moderator, Implementation, Economic (EMMIE) framework was used. Mechanisms were deductively analysed against Bronfenbrenner's socio-ecological model. RESULTS From 3187 records screened, 46 papers describing 36 interventions within the military, healthcare, the construction industry, emergency services, office workers, veterinary surgeons, the energy sector and higher education. Most mechanisms were aimed at the individual's immediate environment, with the most common being education or training on recognising signs of stress, suicidality or mental illness in oneself. Studies examined the effectiveness of interventions in terms of suicide rates, suicidality or symptoms of mental illness, and changes in perceptions, attitudes or beliefs, with most reporting positive results. Few studies reported economic costs but those that did suggested that the interventions are cost-effective. CONCLUSIONS It seems likely that organisational suicide prevention programmes can have a positive impact on attitudes and beliefs towards suicide as well reducing the risk of suicide. Education, to support individuals to recognise the signs and symptoms of stress, mental ill health and suicidality in both themselves and others, is likely to be an effective starting point for successful interventions.
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Affiliation(s)
- Nutmeg Hallett
- School of Nursing and Midwifery, University of Birmingham, Birmingham, United Kingdom
| | - Helen Rees
- Health and Allied Professionals, Nottingham Trent University, Nottingham, United Kingdom
| | - Felicity Hannah
- Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Lorna Hollowood
- School of Nursing and Midwifery, University of Birmingham, Birmingham, United Kingdom
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Woods MA, Hampton D, Okoli CTC, Heath J, Moreland G. Pilot Study Focused on Knowledge, Attitudes, and Health Access Behaviors of Psychiatric-Mental Health Nurses Regarding Suicide Prevention. J Am Psychiatr Nurses Assoc 2024:10783903241247216. [PMID: 38653730 DOI: 10.1177/10783903241247216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
OBJECTIVE: The purpose of this pilot study was to evaluate the effect of a web-based education module on the knowledge, attitudes, and ratings of willingness to access help related to suicide prevention in psychiatric-mental health nurses. METHODS: A quasi-experimental pretest-posttest design was employed. Registered nurses from two academic health center units and a 239-bed Psychiatric Hospital were invited to participate. Scores on knowledge of suicide risk and prevention, attitudes, subjective norms, perceived behavioral control, and intent to seek help upon experiencing suicidal ideations were obtained before and after administering a 25-min web-based training. RESULTS: Twenty-nine participants completed the pre-survey, web-based education module, and post-survey. Significant increases from baseline in the scores on knowledge, attitudes, subjective norms, and intentions related to help-seeking behaviors for nurse suicide prevention were noted. Perceived behavioral control median scores increased but were not statistically significant. More than 40% of the participants reported having experienced suicidal thoughts. CONCLUSIONS: Further study is needed to determine contributors to this higher rate. Understanding the effectiveness of strategies to reduce nurse suicide can provide insights into building better nurse suicide prevention programs.
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Affiliation(s)
- Marc A Woods
- Marc A. Woods, DNP, MSN, RN, NEA-BC, UK Healthcare, Lexington, KY, USA
| | - Debra Hampton
- Debra Hampton, PhD, MSN, RN, NEA-BC, CENP, FACHE, FAONL, University of Kentucky, Lexington, KY, USA
| | - Chizimuzo T C Okoli
- Chizimuzo T. C. Okoli, PhD, MPH, MSN, PMHNP-BC, APRN, NCTTP, FAAN, Eastern State Hospital and University of Kentucky, Lexington, KY, USA
| | - Janie Heath
- Janie Heath, PhD, APRN-BC, FAAN, FNAP, FAANP, University of Kentucky, Lexington, KY, USA
| | - Gwen Moreland
- Gwen Moreland, DNP, RN, NEA-BC, UK Health care, Lexington, KY, USA
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Mao F, Wan J, Sun Y, Yang B, Wang Y, Cao F. Association between transition patterns of sleep problems and suicidal ideation in Chinese female nurses: A prospective study. J Clin Psychol 2024; 80:279-290. [PMID: 37847787 DOI: 10.1002/jclp.23612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/23/2023] [Accepted: 09/30/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVE Suicidal ideation and sleep problems are both common in nurses. However, few longitudinal studies are available to examine the temporal association between sleep and suicidal ideation in nurses. METHOD Data from the Health Longitudinal Survey of Nurses in Shandong Province was analyzed, involving 623 female nurses who had completed data of concern in 2018 (T1) and 2019 (T2). Sleep problem was assessed by the Pittsburgh Sleep Quality Index, in which the transition patterns for global and specific sleep component and the cumulative number of sleep component problems were defined. Suicidal ideation was measured by the ninth item of the Patient Health Questionnaire. Binary logistic regression was used to explore the association between sleep and suicidal ideation. RESULTS Chronic and deteriorated global sleep problems is associated with a greater risk of suicidal ideation. For the specific component of sleep, sleep disturbance and short sleep duration are associated with a higher risk of suicidal ideation. The higher number of cumulative sleep component problems is associated with a higher risk of suicidal ideation. CONCLUSION Findings indicate sleep disturbance and short sleep duration may be pathways to suicidal ideation. Initiatives that target at sleep problems may be important to reduce suicidal ideation in nurses.
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Affiliation(s)
- Fangxiang Mao
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Juan Wan
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Yaoyao Sun
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Bei Yang
- West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | | | - Fenglin Cao
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
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Lykins AB, Seroka NW, Mayor M, Seng S, Higgins JT, Okoli CTC. Compassion Satisfaction, Burnout, and Secondary Traumatic Stress Among Nursing Staff at an Academic Medical Center: A Cross-Sectional Analysis. J Am Psychiatr Nurses Assoc 2024; 30:63-73. [PMID: 34931579 DOI: 10.1177/10783903211066125] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although several studies have recently described compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) in nurses, few to date have examined these issues across nursing specialties. Such examination is needed to inform future nursing-subspecialty tailored interventions. AIMS To examine (1) differences in CS, BO, and STS across nursing specialties and (2) differences associated with demographic, work-related, and behavioral factors among nurses. METHOD A secondary analysis of survey responses from nurses (N = 350) at an academic medical center. Demographic, behavioral, work-related, and professional quality of life variables were analyzed using hierarchical regression analyses. RESULTS CS, BO, and STS scores significantly varied across specialties with emergency nurses experiencing significantly elevated rates of BO and STS, and lowest rates of CS; scores were also differentially associated with demographic, work-related, behavioral, and workplace violence variables. CONCLUSIONS Key differences in CS, BO, and STS by nursing specialty suggests the importance of tailoring BO and STS mitigative interventions. BO and STS risk factors should be assessed in nurses (e.g., behavioral health problems and poor sleep quality) and specialty-specific interventions (e.g., reducing workplace violence exposure in emergency settings) may be considered to improve CS while reducing BO and STS among nurses.
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Affiliation(s)
- Amanda B Lykins
- Amanda B. Lykins, DNP, RN, UK Healthcare, Lexington, KY, USA
| | | | - Mark Mayor
- Mark Mayor, MSN, BSc, BA, RN, University of Louisville, Louisville, KY, USA
| | - Sarret Seng
- Sarret Seng, BSN, BA, RN, University of Kentucky, Lexington, KY, USA
| | - Jacob T Higgins
- Jacob T. Higgins, PhD, BSN, RN, CCRN-K, University of Kentucky, Lexington, KY, USA
| | - Chizimuzo T C Okoli
- Chizimuzo T. C. Okoli, PhD, MPH, MSN, APRN, PMHNP-BC, FAAN University of Kentucky, Lexington, KY, USA
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Guastello AD, Brunson JC, Sambuco N, Dale LP, Tracy NA, Allen BR, Mathews CA. Predictors of professional burnout and fulfilment in a longitudinal analysis on nurses and healthcare workers in the COVID-19 pandemic. J Clin Nurs 2024; 33:288-303. [PMID: 35949164 PMCID: PMC9538120 DOI: 10.1111/jocn.16463] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 05/14/2022] [Accepted: 06/27/2022] [Indexed: 01/22/2023]
Abstract
AIMS AND OBJECTIVES (1) To investigate the vulnerability of nurses to experiencing professional burnout and low fulfilment across 5 months of the COVID-19 pandemic. (2) To identify modifiable variables in hospital leadership and individual vulnerabilities that may mitigate these effects. BACKGROUND Nurses were at increased risk for burnout and low fulfilment prior to the COVID-19 pandemic. Hospital leadership factors such as organisational structure and open communication and consideration of employee opinions are known to have positive impacts on work attitudes. Personal risk factors for burnout include symptoms of depression and anxiety. METHODS Healthcare workers (n = 406 at baseline, n = 234 longitudinal), including doctors (n = 102), nurses (n = 94), technicians (n = 90) and non-clinical administrative staff (n = 120), completed 5 online questionnaires, once per month, for 5 months. Participants completed self-report questionnaires on professional fulfilment and burnout, perceptions of healthcare leadership, and symptoms of anxiety and depression. Participants were recruited from various healthcare settings in the southeastern United States. The STROBE checklist was used to report the present study. RESULTS Both at baseline and across the 5 months, nurses working during the COVID-19 pandemic reported increased burnout and decreased fulfilment relative to doctors. For all participants, burnout remained largely steady and fulfilment decreased slightly. The strongest predictors of both burnout and fulfilment were organisational structure and depressive symptoms. Leadership consideration and anxiety symptoms had smaller, yet significant, relationships to burnout and fulfilment in longitudinal analyses. CONCLUSIONS Burnout and reduced fulfilment remain a problem for healthcare workers, especially nurses. Leadership styles and employee symptoms of depression and anxiety are appropriate targets for intervention. RELEVANCE TO CLINICAL PRACTICE Leadership wishing to reduce burnout and increase fulfilment among employees should increase levels of organisational support and consideration and expand supports to employees seeking treatment for depression and anxiety.
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Affiliation(s)
- Andrea D. Guastello
- Department of PsychiatryCollege of Medicine, University of FloridaGainesvilleFloridaUSA
- Univeristy of Florida, Evelyn F. and William L. McKnight Brain InstituteGainesvilleFloridaUSA
- UF Center for OCD, Anxiety, and Related DisordersUniversity of FloridaGainesvilleFloridaUSA
| | - Jason Cory Brunson
- Laboratory for Systems MedicineCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Nicola Sambuco
- Univeristy of Florida, Evelyn F. and William L. McKnight Brain InstituteGainesvilleFloridaUSA
- UF Center for OCD, Anxiety, and Related DisordersUniversity of FloridaGainesvilleFloridaUSA
- Department of Clinical and Health PsychologyCollege of Public Health and Health Professions, University of FloridaGainesvilleFloridaUSA
| | - Lourdes P. Dale
- Department of PsychiatryCollege of Medicine‐Jacksonville, University of FloridaJacksonvilleFloridaUSA
| | - Natasha A. Tracy
- Department of PsychiatryCollege of Medicine, University of FloridaGainesvilleFloridaUSA
- Univeristy of Florida, Evelyn F. and William L. McKnight Brain InstituteGainesvilleFloridaUSA
- UF Center for OCD, Anxiety, and Related DisordersUniversity of FloridaGainesvilleFloridaUSA
| | - Brandon R. Allen
- Department of Emergency MedicineCollege of Medicine, University of FloridaGainesvilleFloridaUSA
| | - Carol A. Mathews
- Department of PsychiatryCollege of Medicine, University of FloridaGainesvilleFloridaUSA
- Univeristy of Florida, Evelyn F. and William L. McKnight Brain InstituteGainesvilleFloridaUSA
- UF Center for OCD, Anxiety, and Related DisordersUniversity of FloridaGainesvilleFloridaUSA
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Bryant VE, Sorna MJ, Dana A, Leon KG, Guastello AD, Sambuco N, Huxhold A, Allen B, Cuffe SP, Mathews CA, Dale LP. Protective and risk factors associated with substance use coping among healthcare workers during the COVID-19 pandemic. Front Psychol 2023; 14:1228517. [PMID: 38173849 PMCID: PMC10761529 DOI: 10.3389/fpsyg.2023.1228517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024] Open
Abstract
Background Healthcare workers (HCWs) experienced high levels of stress and mental health consequences associated with the COVID-19 pandemic, which may have contributed to unhealthy coping behaviors, such as substance use coping (SUC). This study aimed to understand the extent of and predictors of SUC. Methods The sample consisted of 263 HCWs in North Central Florida. Univariable and multivariable logistic regression analyses investigated whether moral injury and other work risk factors, protective factors, and clinically relevant symptoms (i.e., work exhaustion, interpersonal disengagement, depression, anxiety, and/or PTSD) were associated with likelihood of SUC. Results Clinically relevant levels of interpersonal disengagement and anxiety increased the likelihood of SUC. Mediational analyses found that interpersonal disengagement and anxiety explained 54.3% of the relationship between Self Moral Injury and SUC and explained 80.4% of the relationship between professional fulfillment and SUC. Conclusion Healthcare supervisors should be aware that providers who are experiencing moral injury and less professional fulfillment may be experiencing significant interpersonal disengagement and anxiety, which could lead to SUC. Future studies should examine the effects of implementing targeted prevention and treatment interventions, along with longitudinal outcomes related to SUC behaviors.
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Affiliation(s)
- Vaughn E. Bryant
- Department of Psychiatry, College of Medicine – Jacksonville, University of Florida, Jacksonville, FL, United States
| | - Michael J. Sorna
- Department of Psychiatry, College of Medicine – Jacksonville, University of Florida, Jacksonville, FL, United States
| | - Audrey Dana
- Department of Psychology, University of North Florida, Jacksonville, FL, United States
| | - Kalie G. Leon
- Department of Psychology, University of North Florida, Jacksonville, FL, United States
| | - Andrea D. Guastello
- Department of Psychiatry, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Nicola Sambuco
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Ashley Huxhold
- Department of Psychiatry, College of Medicine – Jacksonville, University of Florida, Jacksonville, FL, United States
| | - Brandon Allen
- Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Steven P. Cuffe
- Department of Psychiatry, College of Medicine – Jacksonville, University of Florida, Jacksonville, FL, United States
| | - Carol A. Mathews
- Department of Psychiatry, Center for OCD, Anxiety and Related Disorders, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Lourdes P. Dale
- Department of Psychiatry, College of Medicine – Jacksonville, University of Florida, Jacksonville, FL, United States
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Hofstetter T, Mayer NL. CE: Suicide Prevention: Protecting the Future of Nurses. Am J Nurs 2023; 123:30-36. [PMID: 37934871 DOI: 10.1097/01.naj.0000996556.74490.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
ABSTRACT Nurse suicide is an alarming issue that remains largely underexplored and underaddressed. Moreover, rates of suicide among nurses, which are higher than those in the general population, may increase due to additional stressors caused by the COVID-19 pandemic. There is a decided lack of data regarding nurse suicide or the efficacy of evidence-based prevention programs. This article examines the state of nurse suicide and explores the latest statistics on nurse suicide rates; contributing factors to nurse suicide; and current suicide prevention programs, such as the Critical Incident Stress Management and Healer Education Assessment and Referral programs.
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Affiliation(s)
- Tifphany Hofstetter
- Tifphany Hofstetter is a community health nurse coordinator for the Portland VA Medical Center, Portland, OR. Noralynn L. Mayer is a hospice nurse at St. Barnabas Hospice Care, Gibsonia, PA. The authors and planners have disclosed no potential conflicts of interest, financial or otherwise
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Basu N, Barinas J, Williams K, Clanton C, Smith PN. Understanding nurse suicide using an ideation-to-action framework: An integrative review. J Adv Nurs 2023; 79:4472-4488. [PMID: 37278387 DOI: 10.1111/jan.15681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 02/20/2023] [Accepted: 04/07/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The purpose of this integrative review was to explore, appraise and synthesize the current literature on correlates of suicide risk in nurses. DESIGN Integrative literature review. DATA SOURCES Cumulative Index to Nursing and Allied Health Literature (CINAHL), Joanna Briggs Institute, PubMed, PsycInfo and Scopus electronic databases were searched for abstracts published between 2005 and 2020. Reference lists were hand searched. REVIEW METHODS The integrative review was based on the Whittemore and Knafl review methodology. Primary qualitative and quantitative studies about suicidal behaviour in nurses published in peer-reviewed journals were included. The methodological quality of included articles was assessed using the Mixed Methods Assessment Tool. RESULTS Separate correlates of risk and protective factors were identified for suicidal ideation, suicide attempt and death by suicide in nurses. IMPLICATIONS Due to a number of factors at the individual, interpersonal and work levels, nurses are uniquely positioned to be at risk of dying by suicide. The ideation-to-action framework provides a theoretical guide to understand the interplay between correlates and the effect it has on increasing a nurses' capability for suicide. CONCLUSIONS This review integrates the empirical literature to elucidate the concept of suicidal behaviour as it applies to nurses.
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Affiliation(s)
- Natasha Basu
- University of South Alabama, Mobile, Alabama, USA
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Melnyk BM, Hsieh AP, Tan A, Dirks M, Gampetro PJ, Gawlik K, Lightner C, Newhouse RP, Pavek K, Semin JN, Simpson V, Teall AM, Tschannen D. State of Mental Health, Healthy Behaviors, and Wellness Support in Big 10 University Nursing and Health Sciences Faculty, Staff, and Students During COVID-19. J Prof Nurs 2023; 48:152-162. [PMID: 37775230 DOI: 10.1016/j.profnurs.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 07/12/2023] [Accepted: 07/16/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Federal and national entities urge organizations to assess healthcare professionals' mental health and well-being as the COVID-19 pandemic has compounded the issue. AIMS This study aimed to (1) describe rates of mental health issues, healthy lifestyle behaviors, and perceptions of COVID-19's impact among Big 10 University nursing and health sciences faculty, staff, and students; (2) identify predictors of depression, anxiety, stress, and burnout; and (3) assess the relationships among perceived school wellness support, healthy lifestyle behaviors, physical/mental health, and mattering. METHODS A cross-sectional descriptive correlational design was used. Nursing and health science deans emailed invitations to faculty, staff, and students concerning an anonymous wellness assessment survey. Correlation coefficients tested associations among mental health indicators and wellness cultures. Multiple linear regression examined factors associated with mental health indicators. RESULTS Faculty, staff, and students responded (N = 1345). Findings indicated that most respondents were not getting adequate sleep, meeting physical activity recommendations, or eating the daily recommended number of fruits/vegetables. Fourteen to 54.9 % of participants reported depression, anxiety, and burnout. Overall, students, faculty and staff at colleges that operated under a strong wellness culture had better outcomes. CONCLUSION Wellness cultures impact the mental and physical health of faculty, staff, and students.
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Affiliation(s)
- Bernadette Mazurek Melnyk
- College of Nursing, The Ohio State University, 300N Heminger Hall, 1577 Neil Avenue, Columbus, OH 43210, United States of America.
| | | | - Alai Tan
- Center of Research and Health Analytics, College of Nursing, The Ohio State University, United States of America.
| | - Mary Dirks
- College of Nursing, University of Iowa, Iowa City, United States of America.
| | - Pamela J Gampetro
- University of Illinois Nursing, 845 S. Damen Avenue, Room 844, MC802, Chicago, IL 60612, United States of America
| | - Kate Gawlik
- The Ohio State University, Columbus, OH 43210, United States of America.
| | - Christina Lightner
- Ross and Carol Nese College of Nursing, Pennsylvania State University, United States of America.
| | - Robin P Newhouse
- Indiana University IUPUI, 600 Barnhill Drive, Indianapolis, IN 46202, United States of America
| | - Katie Pavek
- School of Nursing, University of Wisconsin-Madison, United States of America.
| | - Jessica N Semin
- University of Nebraska Medical Center College of Nursing, Omaha, NE 68198, United States of America.
| | - Vicki Simpson
- School of Nursing, Purdue University, West Lafayette, United States of America.
| | - Alice M Teall
- The Ohio State University, Columbus, OH 43210, United States of America.
| | - Dana Tschannen
- University of Michigan School of Nursing, Ann Arbor, MI, United States of America.
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Gregory DD, Zborowsky T, Stichler JF. Integrating the Environmental Domain Into the Nursing Well-Being Model: A Call to Action. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:15-23. [PMID: 37122230 DOI: 10.1177/19375867231154499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
| | | | - Jaynelle F Stichler
- Caster Institute for Nursing Excellence, Sharp HealthCare, San Diego, CA, USA
- School of Nursing, San Diego State University, San Diego, CA, USA
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13
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Groves S, Lascelles K, Hawton K. Suicide, self-harm, and suicide ideation in nurses and midwives: A systematic review of prevalence, contributory factors, and interventions. J Affect Disord 2023; 331:393-404. [PMID: 36933670 DOI: 10.1016/j.jad.2023.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/08/2023] [Accepted: 03/11/2023] [Indexed: 03/20/2023]
Abstract
BACKGROUND Nurses have been identified as an occupational group at increased risk of suicide. This systematic review examines the prevalence of, and factors influencing, suicide and related behaviours among nurses and midwives (PROSPERO pre-registration CRD42021270297). METHODS MEDLINE, PsycINFO, and CINAHL were searched. Articles published from 1996 onwards exploring suicidal thoughts and behaviours among nurses and midwives were included. Quality of included studies was assessed. Articles were subjected to narrative synthesis informed by suicide data examined, study design, and quality. PRISMA guidelines were followed. RESULTS A total of 100 studies were eligible for inclusion in the review. Articles examining suicide exclusively among midwives were absent from the literature. Several studies confirmed that nursing professionals, especially female, are at increased risk of suicide, particularly by self-poisoning. Factors contributing to risk include psychiatric disorders, alcohol and substance misuse, physical health problems, and occupational and interpersonal difficulties. In studies of non-fatal suicidal behaviours, including during the COVID-19 pandemic, psychiatric, psychological, physical and occupational factors were contributory. There has been little investigation of interventions for prevention of suicide in nurses. LIMITATIONS Only articles published in English language were reviewed. CONCLUSIONS The findings highlight the risk of suicide in nurses. They also show a combination of factors contribute to suicide and non-fatal suicidal behaviour in nurses, with psychiatric, psychological, physical health, occupational and substance misuse (especially alcohol) problems being particularly important. The limited evidence regarding prevention measures indicates a major need to develop primary and secondary interventions for this at-risk occupational group, for example, education regarding enhancing wellbeing and safe alcohol use, alongside accessible psychological support.
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Affiliation(s)
- Samantha Groves
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford OX3 7JX, United Kingdom of Great Britain and Northern Ireland
| | - Karen Lascelles
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford OX3 7JX, United Kingdom of Great Britain and Northern Ireland
| | - Keith Hawton
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford OX3 7JX, United Kingdom of Great Britain and Northern Ireland; Centre for Suicide Research, University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, United Kingdom of Great Britain and Northern Ireland.
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Abstract
COVID-19 has increased the interest in the wellbeing of health professionals (HPs) as they have experienced stress, loss, and fatigue-related symptoms. Research evidence from previous epidemics points to an increase in the prevalence of affective, anxiety, and addictive disorders among them. HPs are trained to care for others and to recover from severe stressors. However, they tend to neglect self-care and have difficulties in seeking appropriate help when need it. This new scenario becomes an opportunity to promote a new culture of professionalism whereby caring for the caregivers becomes a priority both at a personal and institutional level.
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Affiliation(s)
- María Dolores Braquehais
- Integral Care Program for Health Care Professionals, Galatea Foundation, Galatea Clinic, Palafolls Street, 15-19, 08017, Barcelona, Spain; Mental Health and Addiction Research Group, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron University Hospital, Vall Hebron Hospital Campus, Passeig Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
| | - Sebastián Vargas-Cáceres
- Adult Mental Health Service, Benito Menni Mental Health Services, Santiago Ramon y Cajal Street, 27-29, 080902, L'Hospitalet de Llobregat, Catalonia, Spain
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Wathelet M, Dezetree A, Guénard C, Duhem S, Chouraki V, Thomas P, Aly P, Notredame C. The mental health and suicide prevention training module of the French sanitary service: Effectiveness on health students. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Marielle Wathelet
- CHU Lille Department of Psychiatry Lille France
- PSY Lab, Lille Neuroscience & Cognition Centre, INSERM U1172 Lille University Lille France
- Centre National de Ressources et Résilience Lille France
- Fédération de Recherche en Psychiatrie et Santé Mentale des Hauts‐de‐France St‐André‐Lez‐Lille France
| | - Arnaud Dezetree
- Fédération de Recherche en Psychiatrie et Santé Mentale des Hauts‐de‐France St‐André‐Lez‐Lille France
| | | | - Stéphane Duhem
- Centre National de Ressources et Résilience Lille France
- Fédération de Recherche en Psychiatrie et Santé Mentale des Hauts‐de‐France St‐André‐Lez‐Lille France
| | - Vincent Chouraki
- CHU Lille Epidemiology and Public Health Department Lille France
| | - Pierre Thomas
- CHU Lille Department of Psychiatry Lille France
- PSY Lab, Lille Neuroscience & Cognition Centre, INSERM U1172 Lille University Lille France
| | - Pierrine Aly
- Fédération de Recherche en Psychiatrie et Santé Mentale des Hauts‐de‐France St‐André‐Lez‐Lille France
| | - Charles‐Edouard Notredame
- CHU Lille Department of Psychiatry Lille France
- PSY Lab, Lille Neuroscience & Cognition Centre, INSERM U1172 Lille University Lille France
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16
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Heath J, Walmsley LA, Braido C, Brouwer K, Wiggins AT, Butler KM. Cultivating practices for resilience with baccalaureate nursing students: A pilot study. Perspect Psychiatr Care 2022; 58:1529-1536. [PMID: 34613628 DOI: 10.1111/ppc.12960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/17/2021] [Accepted: 08/20/2021] [Indexed: 12/01/2022] Open
Abstract
PURPOSE The purpose of Cultivating Practices for Resilience (CPR) was to develop, implement, and evaluate college-wide strategic initiatives to promote wellness and resilience and improve mental health outcomes in baccalaureate nursing students. DESIGN AND METHODS Six hundred and fifty-four students were invited to complete a 24-item survey over 3 weeks in 2021. Descriptive statistics/logistic regression were used for data analysis. FINDINGS One hundred and thirty-one students completed the survey; 61% were sophomores. White students (p = 0.024) and males (p = 0.023) had higher intentions to refer colleagues to mental health services. Those perceiving CPR programming more helpful had higher intentions to refer (p < 0.001) and embrace the ANA's Healthy Nurse Healthy Nation™ campaign (p < 0.001). PRACTICE IMPLICATIONS Stronger strategic efforts are needed to help shape an academic culture for cultivating practices for resilience among baccalaureate nursing students, especially females and underrepresented population groups.
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Affiliation(s)
- Janie Heath
- University of Kentucky, College of Nursing, Lexington, Kentucky, USA
| | - Lee A Walmsley
- University of Kentucky, College of Nursing, Lexington, Kentucky, USA
| | - Cara Braido
- Children's Hospital, University of Kentucky, Lexington, Kentucky, USA
| | - Kent Brouwer
- UK Chandler Hospital, University of Kentucky, Lexington, Kentucky, USA
| | - Amanda T Wiggins
- University of Kentucky, College of Nursing, Lexington, Kentucky, USA
| | - Karen M Butler
- University of Kentucky, College of Nursing, Lexington, Kentucky, USA
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17
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Braquehais MD, Mozo X, Gausachs E, Santiago R, Llavayol E, González-Irizar O, Nieva G, Valero S, Ramos-Quiroga JA, Bruguera E. Nurse admissions at a specialized mental health programme: A pre-Covid-19 retrospective review (2000-2019). J Adv Nurs 2022; 78:2807-2814. [PMID: 35174899 DOI: 10.1111/jan.15189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 12/23/2021] [Accepted: 01/29/2022] [Indexed: 11/29/2022]
Abstract
AIMS Nursing is a stressful and emotionally demanding profession. To date, few mental health treatment interventions have been developed for them worldwide. This study aims to explore referral trends in nurses with mental disorders admitted to a pioneer specialized mental health programme in Europe from 2000 to 2019. DESIGN A retrospective observational study of 1297 medical e-records of nurses with mental health disorders admitted to the Galatea Care Programme in Barcelona was conducted. METHODS Three periods were analysed: 2000-2006, 2007-2012 and 2013-2019. Socio-demographic and clinical variables were compared. Diagnoses followed Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria. RESULTS Gender and age at referral did not change over time. Self-referrals grew from 85.1% in the first period to 95.3% in the last period; inpatient admissions decreased from 24.1% to 18.2%, although this was not significant; nurses were less frequently on sick leave on admission over time (59.1% vs. 45.7%); they were more likely to have a temporary contract in the second period (9.5% vs. 4.8% and 4%) and prevalence of main diagnosis changed with a considerable decrease in affective and substance use disorders after 2006 and a progressive increase in adjustment disorders during the whole period. CONCLUSION Free, voluntary, highly confidential programmes for nurses with mental disorders may enhance voluntary and earlier help seeking. These findings can be considered when implementing specialized interventions for them in other settings. WHAT PROBLEM DID THE STUDY ADDRESS?: Nursing is a stressful and emotionally demanding profession. To date, few specialized mental health services have been developed for them worldwide. This study aims to explore referral trends in nurses with mental disorders admitted to a pioneer programme in Europe, the Galatea Care Programme in Barcelona, from 2000 to 2019. WHAT WERE THE MAIN FINDINGS?: The number of referrals to the programme grew especially after the first 7-year period. Admissions were more likely to be voluntary during the last period. Prevalence of substance use disorders at admission dropped steadily while prevalence of adjustment disorders progressively increased over the two decades. Nurses were also less likely to be on sick leave at admission. WHERE AND ON WHOM WILL THE RESEARCH HAVE IMPACT?: Free, voluntary, highly confidential programmes for nurses with mental disorders may enhance voluntary and earlier help seeking. These findings can be considered when implementing specialized interventions for them in other settings.
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Affiliation(s)
- M Dolores Braquehais
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Galatea Foundation, Barcelona, Spain.,Department of Psychiatry, Mental Health and Addiction Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Xulián Mozo
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Galatea Foundation, Barcelona, Spain
| | - Eva Gausachs
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Galatea Foundation, Barcelona, Spain
| | - Regina Santiago
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Galatea Foundation, Barcelona, Spain
| | - Enric Llavayol
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Galatea Foundation, Barcelona, Spain
| | - Olga González-Irizar
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Galatea Foundation, Barcelona, Spain
| | - Gemma Nieva
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Galatea Foundation, Barcelona, Spain.,Department of Psychiatry, Mental Health and Addiction Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Sergi Valero
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Galatea Foundation, Barcelona, Spain.,ACE Alzheimer Center BarcelonaResearch Center and Memory Clinic, Fundació ACE, Barcelona Alzheimer Treatment and Research Centre, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - José A Ramos-Quiroga
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Galatea Foundation, Barcelona, Spain.,Department of Psychiatry, Mental Health and Addiction Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Avenida de Monforte de Lemos 3-5, Madrid, Spain.,Departmen of Psychiatry, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eugeni Bruguera
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Galatea Foundation, Barcelona, Spain.,Department of Psychiatry, Mental Health and Addiction Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
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18
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Rubanovich CK, Zisook S, Bloss CS. Associations Between Privacy-Related Constructs and Depression and Suicide Risk in Health Care Professionals, Trainees, and Students. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:239-246. [PMID: 34789664 DOI: 10.1097/acm.0000000000004513] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE The University of California, San Diego screens health care professionals, trainees, and students for depression and suicide risk. Individuals complete a voluntary, anonymous online screening tool and choose whether to provide personal demographic information. This study assessed the relationship between privacy-related constructs and self-rated depression and suicide risk. METHOD The authors analyzed responses to the screening tool collected from January 2018 to December 2019. Measures of depression, suicidal ideation and behaviors, and worry about stigma for seeking mental health services (i.e., privacy-related concern) were gathered. The number of demographic item nonresponses (i.e., age, gender, ethnicity/race, professional position) was operationalized as privacy-related behavior. Linear and logistic regression models were used to determine associations between privacy-related constructs (concern and behavior) and depression and suicide measures. RESULTS A total of 1,224 respondents were included. On average, respondents reported mild depression (mean = 9.12, standard deviation = 5.94), but 43% (524/1,224) reported at least moderate depression. One in 5 respondents (248/1,224) reported worry about stigma for seeking mental health services, and more than 17% (212/1,224) skipped at least 1 demographic question. Privacy-related concern was statistically significantly and positively associated with recent depression and suicidal ideation and behaviors (odds ratios [ORs] = 3.13-7.02; 95% confidence interval [CI], 2.23-19.20; P's < .001) and with lifetime suicide attempts (OR = 1.76; 95% CI, 1.08-2.86; P = .02). Privacy-related behavior was statistically significantly and positively associated with suicide action (OR = 2.23; 95% CI, 1.24-4.02; P = .008). CONCLUSIONS Privacy-related constructs may be meaningful correlates of mental health as respondents who endorsed these constructs had increased odds of worse depression and suicidal ideation and behaviors. Considering privacy-related constructs may be useful for identifying health care professionals, trainees, and students experiencing distress and in need of imminent mental health resources.
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Affiliation(s)
- Caryn Kseniya Rubanovich
- C.K. Rubanovich is a doctoral student, Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, San Diego, California; ORCID: https://orcid.org/0000-0002-0975-6416
| | - Sidney Zisook
- S. Zisook is distinguished professor, Department of Psychiatry, and director, Healer Education Assessment and Referral (HEAR) program, University of California, San Diego, La Jolla, California; ORCID: https://orcid.org/0000-0003-3341-9185
| | - Cinnamon S Bloss
- C.S. Bloss is professor, Herbert Wertheim School of Public Health and Human Longevity Science, director, Center for Empathy and Technology, and associate director, T. Denny Sanford Institute for Empathy and Compassion, University of California, San Diego, La Jolla, California; ORCID: https://orcid.org/0000-0003-1315-8387
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19
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Melnyk BM, Hsieh AP, Tan A, Teall AM, Weberg D, Jun J, Gawlik K, Hoying J. Associations Among Nurses' Mental/Physical Health, Lifestyle Behaviors, Shift Length, and Workplace Wellness Support During COVID-19: Important Implications for Health Care Systems. Nurs Adm Q 2022; 46:5-18. [PMID: 34551423 PMCID: PMC8647526 DOI: 10.1097/naq.0000000000000499] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Work cultures supportive of wellness and shorter shift length have been associated with better mental/physical health outcomes in nurses, but how the coronavirus disease-19 (COVID-19) pandemic impacted such outcomes is not known. This study's aims were to (1) describe the mental/physical health, well-being, and healthy lifestyle behaviors of nurses during the pandemic; (2) explore the pandemic's impact on their health and healthy lifestyle behaviors; and (3) determine the associations of perceived workplace wellness support and shift length with nurses' health, well-being, and healthy lifestyle behaviors. A cross-sectional descriptive design was used with 264 nurses associated with Trusted Health. Nurses completed a survey containing valid and reliable scales measuring depression, anxiety, burnout and quality of life, perceived wellness culture, and healthy lifestyle behaviors. Results indicated that more than 50% of nurses had worsening mental/physical health relating to the pandemic. Compared with nurses whose workplaces provided little/no wellness support, nurses with workplaces that supported their wellness were 3 to 9 times as likely to have better mental/physical health, no/little stress, no burnout, and high quality of life. Nurses who worked longer shifts had poorer health outcomes. These findings indicate that workplace wellness support and shorter shifts positively impacted nurse mental/physical health and professional quality of life amidst the pandemic.
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Affiliation(s)
- Bernadette Mazurek Melnyk
- Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare (Dr Melnyk) and Center of Research and Health Analytics (Dr Tan), College of Nursing (Ms Hsieh and Drs Teall, Jun, Gawlik, and Hoying), The Ohio State University (Dr Weberg), Columbus; and Trusted Health Inc, San Francisco, California (Dr Weberg)
| | - Andreanna Pavan Hsieh
- Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare (Dr Melnyk) and Center of Research and Health Analytics (Dr Tan), College of Nursing (Ms Hsieh and Drs Teall, Jun, Gawlik, and Hoying), The Ohio State University (Dr Weberg), Columbus; and Trusted Health Inc, San Francisco, California (Dr Weberg)
| | - Alai Tan
- Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare (Dr Melnyk) and Center of Research and Health Analytics (Dr Tan), College of Nursing (Ms Hsieh and Drs Teall, Jun, Gawlik, and Hoying), The Ohio State University (Dr Weberg), Columbus; and Trusted Health Inc, San Francisco, California (Dr Weberg)
| | - Alice M. Teall
- Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare (Dr Melnyk) and Center of Research and Health Analytics (Dr Tan), College of Nursing (Ms Hsieh and Drs Teall, Jun, Gawlik, and Hoying), The Ohio State University (Dr Weberg), Columbus; and Trusted Health Inc, San Francisco, California (Dr Weberg)
| | - Dan Weberg
- Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare (Dr Melnyk) and Center of Research and Health Analytics (Dr Tan), College of Nursing (Ms Hsieh and Drs Teall, Jun, Gawlik, and Hoying), The Ohio State University (Dr Weberg), Columbus; and Trusted Health Inc, San Francisco, California (Dr Weberg)
| | - Jin Jun
- Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare (Dr Melnyk) and Center of Research and Health Analytics (Dr Tan), College of Nursing (Ms Hsieh and Drs Teall, Jun, Gawlik, and Hoying), The Ohio State University (Dr Weberg), Columbus; and Trusted Health Inc, San Francisco, California (Dr Weberg)
| | - Kate Gawlik
- Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare (Dr Melnyk) and Center of Research and Health Analytics (Dr Tan), College of Nursing (Ms Hsieh and Drs Teall, Jun, Gawlik, and Hoying), The Ohio State University (Dr Weberg), Columbus; and Trusted Health Inc, San Francisco, California (Dr Weberg)
| | - Jacqueline Hoying
- Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare (Dr Melnyk) and Center of Research and Health Analytics (Dr Tan), College of Nursing (Ms Hsieh and Drs Teall, Jun, Gawlik, and Hoying), The Ohio State University (Dr Weberg), Columbus; and Trusted Health Inc, San Francisco, California (Dr Weberg)
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Kim HS, Bae HJ, Kang KH. [How Should We Approach Nurse Suicide in Korea: With the Aspect of Prevention-Intervention-Postvention Management]. J Korean Acad Nurs 2021; 51:408-413. [PMID: 34497250 DOI: 10.4040/jkan.21171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 11/09/2022]
Abstract
Recently, nurse suicide has emerged as one of the major issues. We tried to review the status of nurse suicide and its management in Korea through inspecting related web sites, news articles, and research. However, there were no sufficient reports or statistics along with the research throughout the country. Moreover, there were no organized nurse suicide management systems or programs including suicide prevention, suicide intervention, suicide postvention management. In other countries, there were various trials and successful experiences about nurse suicide programs, and those have been managed in organized and integrated ways. It gave us a lot of implications. To effectively prevent and manage the nurse suicide in Korea, nursing workforce, nursing managers, and nursing researchers should be concerned about nurse suicide. Furthermore, discussions and the research must be made actively. Based on such efforts, appropriate programs, organized manage systems, and policies must be devised at institution and national level.
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Affiliation(s)
- Hyoung Suk Kim
- School of Nursing, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Hyun Ji Bae
- Department of Nursing, College of Bioscience, Andong National University, Andong, Korea
| | - Kyeong Hwa Kang
- School of Nursing · Research Institute of Nursing Science, Hallym University, Chuncheon, Korea.
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21
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Croke L. Supporting the mental health of nurses. AORN J 2021; 113:P8-P11. [PMID: 33788248 DOI: 10.1002/aorn.13381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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22
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Grabbe L, Higgins MK, Baird M, Pfeiffer KM. Impact of a Resiliency Training to Support the Mental Well-being of Front-line Workers: Brief Report of a Quasi-experimental Study of the Community Resiliency Model. Med Care 2021; 59:616-621. [PMID: 33827106 PMCID: PMC8191373 DOI: 10.1097/mlr.0000000000001535] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Front-line workers (FLW) are at risk for secondary traumatic stress, burnout, and related psychiatric sequelae: depression, anxiety, suicidality, posttraumatic stress disorder, and sleep and substance use disorders. FLW are in need of self-care programs to support their mental health. METHODS Quasi-experimental study to assess the impact of a simple mental well-being and emotional regulation training, the Community Resiliency Model (CRM), using a convenience sample of FLW. Baseline scores of mental well-being and stress measures were compared with follow-up scores at 3 time points. Outcomes were psychological wellness (World Health Organization-5 Well-being Index); resilience (Connor-Davidson Resilience Scale-10); traumatic stress (Secondary Traumatic Stress Scale); physical symptoms (Somatic Symptom Scale-8). RESULTS Of the 104 participants who enrolled and attended the CRM training, 73 (70.2%) completed at least 1 posttest. Well-being scores increased at 1 year with a small-moderate effect size (Cohen d=0.32). Resilience scores increased with a small-moderate effect size by 1 year (Cohen d=0.36). Secondary traumatic stress scores declined, with the largest effect at 1 week (Cohen d=0.49). Somatic symptoms decreased at each posttest, with the largest change occurring from baseline to 1 week (d=0.39). Participants reported an awareness of body sensations helped them when overwhelmed as a means of calming themselves. CONCLUSIONS After a 3-hour CRM training, participants reported improved mental well-being and decreased secondary traumatic stress and somatic symptoms. This simple body awareness intervention may be a good resource during the COVID-19 pandemic.
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Affiliation(s)
- Linda Grabbe
- Nell Hodgson Woodruff School of Nursing, Emory University
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23
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Braun BI, Hafiz H, Singh S, Khan MM. Health Care Worker Violent Deaths in the Workplace: A Summary of Cases From the National Violent Death Reporting System. Workplace Health Saf 2021; 69:435-441. [PMID: 33942679 DOI: 10.1177/21650799211003824] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Violent workplace deaths among health care workers (HCWs) remain understudied in the extant literature despite the potential for serious long-term implications for staff and patient safety. This descriptive study summarized the number and types of HCWs who experienced violent deaths while at work, including the location in which the fatal injury occurred. METHODS Cases were identified from the Centers for Disease Control and Prevention's National Violent Death Reporting System between 2003 and 2016. Coded variables included type of HCW injured, type of facility, and location within the facility and perpetrator type among homicides. Frequencies were calculated using Excel. FINDINGS Among 61 HCW deaths, 32 (52%) were suicides and 21 (34%) were homicides; eight (13%) were of undetermined intent. The occupations of victims included physicians (28%), followed by nurses (21%), administration/support operations (21%), security and support services (16%), and therapists and technicians (13%). Most deaths occurred in hospitals (46%) and nonresidential treatment services (20%). Within facility, locations included offices/clinics (20%) and wards/units (18%). Among homicide perpetrators, both Type II (perpetrator was client/patient/family member) and Type IV (personal relationship to perpetrator) were equally common (33%). CONCLUSION/ APPLICATIONS TO PRACTICE Suicide was more common than homicide among HCW fatal injuries. Workplace violence prevention programs may want to consider both types of injuries. Although fatal HCW injuries are rare, planning for all types of violent deaths could help minimize consequences for staff, patients, and visitors.
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24
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Rassy J, Bardon C, Dargis L, Côté LP, Corthésy-Blondin L, Mörch CM, Labelle R. Information and Communication Technology Use in Suicide Prevention: Scoping Review. J Med Internet Res 2021; 23:e25288. [PMID: 33820754 PMCID: PMC8132980 DOI: 10.2196/25288] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/10/2021] [Accepted: 03/16/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The use of information and communication technology (ICT) in suicide prevention has progressed rapidly over the past decade. ICT plays a major role in suicide prevention, but research on best and promising practices has been slow. OBJECTIVE This paper aims to explore the existing literature on ICT use in suicide prevention to answer the following question: what are the best and most promising ICT practices for suicide prevention? METHODS A scoping search was conducted using the following databases: PubMed, PsycINFO, Sociological Abstracts, and IEEE Xplore. These databases were searched for articles published between January 1, 2013, and December 31, 2018. The five stages of the scoping review process were as follows: identifying research questions; targeting relevant studies; selecting studies; charting data; and collating, summarizing, and reporting the results. The World Health Organization suicide prevention model was used according to the continuum of universal, selective, and indicated prevention. RESULTS Of the 3848 studies identified, 115 (2.99%) were selected. Of these, 10 regarded the use of ICT in universal suicide prevention, 53 referred to the use of ICT in selective suicide prevention, and 52 dealt with the use of ICT in indicated suicide prevention. CONCLUSIONS The use of ICT plays a major role in suicide prevention, and many promising programs were identified through this scoping review. However, large-scale evaluation studies are needed to further examine the effectiveness of these programs and strategies. In addition, safety and ethics protocols for ICT-based interventions are recommended.
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Affiliation(s)
- Jessica Rassy
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Research Center, Institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
- School of Nursing, Université de Sherbrooke, Longueuil, QC, Canada
- Quebec Network on Nursing Intervention Research, Montréal, QC, Canada
| | - Cécile Bardon
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Luc Dargis
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
| | - Louis-Philippe Côté
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Laurent Corthésy-Blondin
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Carl-Maria Mörch
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
- Algora Lab, Université de Montréal, Montréal, QC, Canada
- Mila, Quebec Artificial Intelligence Institute, Montréal, QC, Canada
| | - Réal Labelle
- Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, QC, Canada
- Research Center, Institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
- Department of Psychiatry, Université de Montréal, Montréal, QC, Canada
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Davidson JE, Ye G, Parra MC, Choflet A, Lee K, Barnes A, Harkavy-Friedman J, Zisook S. Job-Related Problems Prior to Nurse Suicide, 2003-2017: A Mixed Methods Analysis Using Natural Language Processing and Thematic Analysis. JOURNAL OF NURSING REGULATION 2021. [DOI: 10.1016/s2155-8256(21)00017-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Wild P, Bovio N, Guseva Canu I. Part-time work and other occupational risk factors for suicide among working women in the Swiss National Cohort. Int Arch Occup Environ Health 2021; 94:981-990. [PMID: 33523245 PMCID: PMC8238695 DOI: 10.1007/s00420-020-01629-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 12/06/2020] [Indexed: 12/13/2022]
Abstract
Objective The aim of this study was to describe the factors associated with mortality by suicide among working women focusing on work-related factors. Methods The study population consisted in all Swiss residents recorded in the 1990 and/or the 2000 compulsory national censuses and were linked to emigration and mortality registers. We selected all women aged 18–65 and at work at the official census dates. Following work-related variables were available: socio-economic status, weekly hours of work, the sector of activity and the job title coded according to the International Standard Classification of Occupations (ISCO). The risk of suicide was modelled using negative binomial regression. Results The cohort comprised 1,771,940 women and 2526 deaths by suicide corresponding to 24.9 million person-years. The most significant non-occupational predictors of suicide were age, period, civil status, religion, nationality and geographical regions. Adjusted on these factors, part-time work was associated with increased suicide rates. According to job codes, health and social activities, in particular care-worker had the highest suicide risks. Conclusion Suicide among working women depended on work-related factors even taking into account other socio-demographic factors.
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Affiliation(s)
- Pascal Wild
- Institut National de Recherche et Sécurité (INRS), Vandoeuvre lès Nancy, France.
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland.
| | - Nicolas Bovio
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Irina Guseva Canu
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
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Neres BSP, Aquino MLA, Pedroso VSP. Prevalence and factors associated to depression and suicidal behavior among medical students. JORNAL BRASILEIRO DE PSIQUIATRIA 2021. [DOI: 10.1590/0047-2085000000351] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective: Depression and suicidal behavior have been described as major problems among medical students. The aim of this study was to assess the prevalence of depression and suicidal behavior among medical students of an institution and to investigate possible associated variables. Methods: The authors carried out a cross-sectional study through a self-administered questionnaire, including the Beck Depression Inventory (BDI) and the Beck’s Suicide Intent Scale (BSIS) instruments. The diagnosis of depression was based on an instrument adapted according to the DSM-IV and ICD-10 criteria. Logistic regression was performed to search for depression predictor variables. Results: In a total of 381 students, the prevalence of depression was 27.6%. Suicidal ideation of moderate to severe intensity was observed in 10.5% of the sample. About 6% of students had previously attempted suicide. Consumption of licit and illicit drugs was frequent among the participants, reaching 78% and 24% of the sample, respectively. The demand for specialized treatment was lower than expected among students with depression. Logistic regression revealed that female gender, reduced interpersonal contact with friends, reduced physical activity, difficulty in facing new situations and high perception of personal pressure were risk factors for depression. Conclusion: The prevalence of depression and suicidal behavior among medical students is higher than in the general population. There is a need for further studies to enable a better understanding of the risk factors and variables at play, which is fundamental for the development of early intervention strategies and support for students.
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Awan S, Diwan MN, Aamir A, Allahuddin Z, Irfan M, Carano A, Vellante F, Ventriglio A, Fornaro M, Valchera A, Pettorruso M, Martinotti G, Di Giannantonio M, Ullah I, De Berardis D. Suicide in Healthcare Workers: Determinants, Challenges, and the Impact of COVID-19. Front Psychiatry 2021; 12:792925. [PMID: 35185638 PMCID: PMC8850721 DOI: 10.3389/fpsyt.2021.792925] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/21/2021] [Indexed: 12/16/2022] Open
Abstract
The Coronavirus disease-19 (COVID-19), which first appeared in Wuhan, China, and was later declared a pandemic, has caused significant morbidity and mortality worldwide. Numerous efforts have been made worldwide to understand the disease's physical manifestation. However, less emphasis has been placed on the pandemic's mental health challenges for healthcare workers (HCWs) who played a critical role in fighting the disease. Existing literature shows the detrimental psychological impact and increased incidence of depression and anxiety among HCWs. It is expected that the mental health crisis will become a serious issue affecting HCWs, with long-term negative consequences following COVID. Physicians and nurses already represent the highest risk groups of suicide among the general population, and suicide can be regarded as an occupational hazard in the healthcare industry. Increased workload, burnout and fatigue, multifaceted challenges women HCWs, and increased substance abuse are contributing factors to suicide ideation. In this article, we identify the risk factors of suicide among HCWs, discuss mental health challenges exacerbated by the pandemic and its impact on suicide ideation.
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Affiliation(s)
- Sana Awan
- Department of Internal Medicine, Dow Medical College, Karachi, Pakistan
| | | | - Alifiya Aamir
- Department of Internal Medicine, Dow Medical College, Karachi, Pakistan
| | - Zoha Allahuddin
- Department of Internal Medicine, Dow Medical College, Karachi, Pakistan
| | - Muhammad Irfan
- Department of Internal Medicine, Hayatabad Medical Complex, Peshawar, Pakistan
| | - Alessandro Carano
- Department of Mental Health, Azienda Sanitaria Unica Regionale 5 Marche, San Benedetto Del Tronto, Italy
| | - Federica Vellante
- Department of Mental Health, Mental Health Center of Ortona, Azienda Sanitaria Locale Chieti, Chieti, Italy
| | | | - Michele Fornaro
- Laboratory of Molecular and Translational Psychiatry, Unit of Treatment-Resistant Psychosis, Section of Psychiatry, University of Naples Federico II, Naples, Italy
| | - Alessandro Valchera
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Irfan Ullah
- Department of Internal Medicine, Kabir Medical College, Gandhara University, Peshawar, Pakistan
| | - Domenico De Berardis
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy.,Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, Hospital "G. Mazzini", Teramo, Italy
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Original Research: Suicide Among RNs: An Analysis of 2015 Data from the National Violent Death Reporting System. Am J Nurs 2020; 120:24-28. [PMID: 32976149 DOI: 10.1097/01.naj.0000718624.25806.3f] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Suicide is now the 10th leading cause of death in the United States. Suicide rates for health care providers are thought to be higher than for people in other occupations because of job strain and burnout. Despite the National Academy of Medicine's Action Collaborative on Clinician Well-Being and Resilience, which focuses on reducing stress and preventing suicide, a shortage of data limits our understanding of nurse suicide. Neither employers nor professional nursing associations track suicide data. PURPOSE To determine the number of suicides and estimated rate of suicide among RNs, using data from the National Violent Death Reporting System (NVDRS). METHODS We extracted data from the NVDRS, which is based on death certificates, coroner reports, and law enforcement reports, for the year 2015. The National Institute for Occupational Safety and Health's Industry and Occupation Computerized Coding System was used to code the data. Industry and occupation coding experts reviewed the coding for accuracy. RESULTS Analysis of 2015 NVDRS data from 17 states showed that among civilian employed nurses ages 16 to 64 years, the estimated suicide rates for female and male nurses (11.4 and 29.3 per 100,000 nurses, respectively) were each higher than the rates for the comparable total population (8.2 and 26.1 per 100,000 people, respectively). CONCLUSIONS Our findings indicate that RNs may die by suicide at higher rates than the total employed population in the 16-to-64-year age range. Implementation of evidence-based approaches to prevent suicide are warranted.
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Health personnel-targeted education interventions on inpatient suicide prevention in general hospitals: A scoping review. Int J Nurs Sci 2020; 7:477-483. [PMID: 33195761 PMCID: PMC7644556 DOI: 10.1016/j.ijnss.2020.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 08/03/2020] [Accepted: 09/15/2020] [Indexed: 12/11/2022] Open
Abstract
Background Inpatient suicide is an important part of patient safety management in general hospitals. Incidence of inpatient suicide can be decreased by health personnel mastering inpatient suicide prevention strategy. To enhance health personnel’s inpatient suicide prevention strategy, education intervention is a common method. Educational interventions in the researches varied in contents, duration and outcome measurements. However, there has been not synthesis of education interventions targeting health personnel on inpatient suicide prevention. Objective Prevention of inpatient suicide is a critical priority in patient safety management in general hospitals. Incidence of inpatient suicide can be decreased by effective strategies mastered by health personnel through education interventions. Educational interventions in researches varied in contents, duration and outcome measurements. We aimed to review education interventions targeting health personnel on inpatient suicide prevention. Methods A scoping review was used to analyze existing researches on education interventions targeting health personnel focusing on inpatient suicide prevention in general hospitals. Cochrane Library, PubMed, Embase, CINAHL, China National Knowledge Infrastructure, WanFang, and Chinese Scientific Journal Database were searched in Oct 2019. According to the inclusion and exclusion criteria, the searched studies were screened by two reviewers. And then, two researchers conducted the data extraction independently by using a table format, including the first author, year of publication, study design, participants, education intervention, etc. Results Twelve studies were included in this scoping review. The contents of education interventions on inpatient suicide prevention included three aspects: suicide knowledge, suicide assessment, and skills for coping with suicide. The duration of education interventions ranged from 1.5-h to 32.0-h. The effects of education interventions were mainly focused on participants’ knowledge, attitudes and skills of suicide prevention. Conclusion The evidence showed that education interventions on inpatient suicide prevention had positive impact on health personnel’s knowledge, attitude and skills about inpatient suicide prevention in general hospitals. However, the best health personnel-targeted education intervention on inpatient suicide prevention in general hospitals was yet to be determined. In the future, it is necessary to combine evidence in this review and the actual condition in clinical practice.
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Braquehais MD, González-Irizar O, Nieva G, Mozo X, Llavayol E, Pujol T, Cruz CM, Heredia M, Valero S, Casas M, Bruguera E. Assessing high risk of suicide amongst physicians and nurses in treatment. Psychiatry Res 2020; 291:113237. [PMID: 32619824 DOI: 10.1016/j.psychres.2020.113237] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/08/2020] [Accepted: 06/13/2020] [Indexed: 11/19/2022]
Abstract
Little is known about the suicidal behaviour of health professionals admitted to specialised programmes. This study aims to describe the factors associated with high risk of suicide (HRS) of physicians and nurses in treatment at the Galatea Care Programme. We conducted a retrospective naturalistic study with data from 1,214 electronic medical records of physicians and nurses working in Catalonia and in treatment at the Galatea Clinic during 2017 and 2018. HRS was registered in the medical record according to the screening criteria of the Catalonia Risk Suicide Code; 62.4% (n = 757) were physicians and 37.6% (n = 457) were nurses. HRS was identified in 5% physicians and 5.2% nurses. Patients who were in a relationship or were not on a sick leave were less likely to have HRS, whereas those with affective disorders were more likely to have HRS compared with those with anxiety disorders or substance use disorders. Patients with HRS were more likely to have concurrent mental disorders. Specialised treatment programmes for health professionals should regularly screen for suicide risk, especially amongst those having affective disorders, comorbid mental disorders or when their working and interpersonal life areas are impaired.
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Affiliation(s)
- Maria Dolores Braquehais
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Vall Hebron Research Institute, Barcelona, Spain.
| | - Olga González-Irizar
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Barcelona, Spain.
| | - Gemma Nieva
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Vall Hebron Research Institute, Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron. Barcelona, Spain.
| | - Xulián Mozo
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Barcelona, Spain.
| | - Enric Llavayol
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Barcelona, Spain.
| | - Tània Pujol
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Barcelona, Spain.
| | - Cristo M Cruz
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Barcelona, Spain.
| | - Meritxell Heredia
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Barcelona, Spain.
| | - Sergi Valero
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Barcelona, Spain; Research Center and Memory Clinic, Fundació ACE, Insitut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain.
| | - Miquel Casas
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Vall Hebron Research Institute, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Eugeni Bruguera
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Vall Hebron Research Institute, Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron. Barcelona, Spain.
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Stelnicki AM, Jamshidi L, Angehrn A, Nicholas Carleton R. Suicidal Behaviors Among Nurses in Canada. Can J Nurs Res 2020; 52:226-236. [PMID: 32552154 DOI: 10.1177/0844562120934237] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Nurses are regularly exposed to potentially psychologically traumatic events, experience high rates of burnout, and may be at an elevated risk of death by suicide. Few studies have assessed for suicidal behaviors among Canadian nurses, and factors that may increase risk for suicidal behaviors are unknown. PURPOSE The current study was designed to assess past-year and lifetime suicidal behavior (i.e., ideation, plans, and attempts) using a large sample of Canadian nurses. METHOD Participants (n = 3969; 94.3% women) completed an online survey including measures of suicidal behavior and symptoms of mental disorders. RESULTS Considerable proportions of participants reported past-year and/or lifetime suicidal ideation (10.5%, 33.0%), plans (4.6%, 17.0%), and attempts (0.7%, 8.0%), considerably higher than general population estimates. Significant differences were identified across age groups, years of service, marital status, regional location, and nursing type (e.g., registered psychiatric nurses, licensed practical nurses, registered nurses). Participants who screened positive for almost all measured mental disorders had significantly higher rates of suicidal behavior. CONCLUSIONS The results necessitate further research to evaluate risk factors contributing to suicidal behavior in Canadian nurses and methods to decrease the risk (e.g., developing effective monitoring and prevention measures).
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Affiliation(s)
- Andrea M Stelnicki
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Laleh Jamshidi
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Andréanne Angehrn
- Anxiety and Illness Behaviour Lab (AIBL), University of Regina, Regina, SK, Canada
| | - R Nicholas Carleton
- Anxiety and Illness Behaviour Lab (AIBL), University of Regina, Regina, SK, Canada
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Abstract
Nurses face workplace stressors that contribute to job dissatisfaction, burnout, and turnover, impacting not only patient safety but the nurses' physical and emotional well-being. At the 2018 American Academy of Nursing conference, a policy dialogue "Creating Healthy Work Environments to Address the Quadruple Aim" was convened focusing on creating healthy work environments by addressing stressors such as violence and bullying. That discussion is encapsulated in this article, providing proven and practical strategies for reducing risk.
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Grabbe L, Higgins MK, Baird M, Craven PA, San Fratello S. The Community Resiliency Model® to promote nurse well-being. Nurs Outlook 2020; 68:324-336. [DOI: 10.1016/j.outlook.2019.11.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 10/28/2019] [Accepted: 11/10/2019] [Indexed: 12/14/2022]
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Marcon G, Massaro Carneiro Monteiro G, Ballester P, Cassidy RM, Zimerman A, Brunoni AR, von Diemen L, Hauck S, Passos IC. Who attempts suicide among medical students? Acta Psychiatr Scand 2020; 141:254-264. [PMID: 31797353 DOI: 10.1111/acps.13137] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/01/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To identify factors associated with a history of suicide attempt in medical students. METHODS A Web-based survey was sent out to a sample of medical students. A multi-predictor Poisson regression was performed to identify factors associated with a history of suicide attempt. In addition, an elastic net regularization was used to build a risk calculator to identify students at risk for attempted suicide. RESULTS A total of 4,840 participants were included in the study. Prevalence of suicide attempts in the sample was 8.94%. Risk factors associated with past suicide attempt in the multi-predictor Poisson regression were as follows: female gender (P < 0.001); homosexuality (P < 0.001); low income (P = 0.026); bullying by university peers (P = 0.006); childhood (P = 0.001) or adult (P = 0.001) trauma; family history of suicide (P = 0.005); suicidal ideation within the last month (P < 0.001); daily tobacco use (P = 0.037); and being at severe risk for alcohol abuse (P = 0.023). Our elastic net model performed well with an AUC of 0.83. CONCLUSIONS This study identifies a number of key factors associated with a history of suicide attempts among medical students. Future longitudinal studies should assess the causal relationship between these factors and suicide attempts. Additionally, these results demonstrate that current available data on suicide attempts among medical students can be used to develop an accurate risk algorithm.
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Affiliation(s)
- G Marcon
- Post-Graduation Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - G Massaro Carneiro Monteiro
- Post-Graduation Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - P Ballester
- Post-Graduation Program in Computer Science, School of Technology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - R M Cassidy
- Medical Scientist Training Program, University of Texas M.D. Anderson Cancer Center and McGovern Medical School, Houston, TX, USA
| | - A Zimerman
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Centro de Pesquisa Experimental (CPE), Porto Alegre, Brazil
| | - A R Brunoni
- Departments of Internal Medicine and Psychiatry, Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, Brazil
| | - L von Diemen
- Post-Graduation Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - S Hauck
- Post-Graduation Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - I C Passos
- Post-Graduation Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Centro de Pesquisa Experimental (CPE), Porto Alegre, Brazil
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Davidson JE, Proudfoot J, Lee K, Terterian G, Zisook S. A Longitudinal Analysis of Nurse Suicide in the United States (2005–2016) With Recommendations for Action. Worldviews Evid Based Nurs 2020; 17:6-15. [DOI: 10.1111/wvn.12419] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2019] [Indexed: 02/02/2023]
Affiliation(s)
- Judy E. Davidson
- University of California San Diego Health La Jolla CA USA
- Department of Psychiatry University of California San Diego School of Medicine La Jolla CA USA
| | - James Proudfoot
- Shiley Eye Institute University of California San Diego La Jolla CA USA
| | - Kelly Lee
- Skaggs School of Pharmacy and Pharmaceutical Sciences University of California San Diego La Jolla CA USA
| | | | - Sidney Zisook
- Department of Psychiatry University of California San Diego School of Medicine La Jolla CA USA
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Davidson JE, Accardi R, Sanchez C, Zisook S, Hoffman LA. Sustainability and Outcomes of a Suicide Prevention Program for Nurses. Worldviews Evid Based Nurs 2020; 17:24-31. [DOI: 10.1111/wvn.12418] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2019] [Indexed: 01/31/2023]
Affiliation(s)
- Judy E. Davidson
- Department of Psychiatry University of California San Diego School of Medicine La JollaCA USA
| | - Rachael Accardi
- Department of Psychiatry and University of California San Diego Health Risk Management University of California San Diego School of Medicine La JollaCA USA
| | - Courtney Sanchez
- Department of Psychiatry and University of California San Diego Health Risk Management University of California San Diego School of Medicine La JollaCA USA
| | - Sidney Zisook
- Department of Psychiatry University of California School of Medicine La JollaCA USA
| | - Laura A. Hoffman
- Interactive Screening Program American Foundation for Suicide Prevention New York NY USA
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Davidson JE, Proudfoot J, Lee K, Zisook S. Nurse suicide in the United States: Analysis of the Center for Disease Control 2014 National Violent Death Reporting System dataset. Arch Psychiatr Nurs 2019; 33:16-21. [PMID: 31711588 PMCID: PMC7927355 DOI: 10.1016/j.apnu.2019.04.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/03/2019] [Accepted: 04/18/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study explored nurse suicide in the United States. METHODS Characteristics were compared between occupations using 2014 National Violent Death Reporting System data. RESULTS Female nurse suicides were significantly higher (11.97/100,000) than in the female population (7.58/100,000) (p < 0.001); similarly male nurses (39.8/100,000) compared to the male population (28.2/100,000) (p < 0.001). Benzodiazepines and opioids were the most commonly used substances used in clinician suicide. CONCLUSION These results suggest a public health imperative for future research and development of effective preventative strategies for nurses; a largely understudied population.
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Affiliation(s)
- Judy E Davidson
- University of California San Diego Health, United States of America; University of California San Diego School of Medicine, Department of Psychiatry, United States of America.
| | - James Proudfoot
- Clinical Translational Research Institute, University of California San Diego, United States of America
| | - Kelly Lee
- University of California San Diego, Skaggs School of Pharmacy and Pharmaceutical Sciences, United States of America
| | - Sidney Zisook
- University of California San Diego School of Medicine, Department of Psychiatry, United States of America
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Ross R, Letvak S, Sheppard F, Jenkins M, Almotairy M. Systemic assessment of depressive symptoms among registered nurses: A new situation-specific theory. Nurs Outlook 2019; 68:207-219. [PMID: 31543282 DOI: 10.1016/j.outlook.2019.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 08/09/2019] [Accepted: 08/25/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND A mentally-healthy nursing workforce is vital to providing quality healthcare. While there has been research conducted internationally on depressive symptoms in nurses, most studies have lacked a theoretical framework. PURPOSE The purpose of this article is to describe the development of a situation-specific theory, the Systemic Assessment of Depressive Symptoms among Registered Nurses (SAD-RN). METHODS The SAD-RN was developed through theory synthesis using the Roy's Adaptation Model (RAM) as a framework. Sixty-four research articles were selected to abstract relevant concepts based on a priori RAM concepts. FINDINGS Using depressive symptoms as the anchor concept, related emergent concepts of SAD-RN include context, stressors, protective factors, negative health outcomes, and low patient care quality. DISCUSSION SAD-RN is an evidence-based comprehensive model that offers researchers a guiding theory to be used in their future research on depressive symptoms among RNs.
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Affiliation(s)
- Ratchneewan Ross
- School of Nursing, University of North Carolina Greensboro, Greensboro, NC.
| | - Susan Letvak
- School of Nursing, University of North Carolina Greensboro, Greensboro, NC
| | - Francine Sheppard
- Francine Sheppard's affiliation to Western Carolina University, Cullowhee, NC
| | - Marjorie Jenkins
- School of Nursing, University of North Carolina Greensboro, Greensboro, NC
| | - Monir Almotairy
- School of Nursing, University of North Carolina Greensboro, Greensboro, NC
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Lee E, Daugherty J, Eskierka K, Hamelin K. Compassion Fatigue and Burnout, One Institution's Interventions. J Perianesth Nurs 2019; 34:767-773. [DOI: 10.1016/j.jopan.2018.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 11/16/2018] [Accepted: 11/18/2018] [Indexed: 11/29/2022]
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Testing of A Caregiver Support Team. Explore (NY) 2019; 15:19-26. [DOI: 10.1016/j.explore.2018.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 07/12/2018] [Accepted: 07/16/2018] [Indexed: 11/23/2022]
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Bursch B, Emerson ND, Arevian AC, Aralis H, Galuska L, Bushman J, Sinclair M, Grimley K, Lester P, Bulut Y. Feasibility of Online Mental Wellness Self-assessment and Feedback for Pediatric and Neonatal Critical Care Nurses. J Pediatr Nurs 2018; 43:62-68. [PMID: 30473158 DOI: 10.1016/j.pedn.2018.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 09/03/2018] [Accepted: 09/04/2018] [Indexed: 11/18/2022]
Abstract
PURPOSE The primary goal of this study was to test the feasibility of an educational online self-assessment of burnout, resilience, trauma, depression, anxiety, and common workplace stressors among nurses working in a pediatric intensive care unit or neonatal intensive care unit setting. The secondary, exploratory objectives were to estimate the prevalence of psychiatric symptoms in this sample and to identify those variables that most strongly predict burnout. DESIGN AND METHODS Data from optional and anonymous online measures were analyzed for 115 nurses (67.9% aged 25-44; 61.7% Caucasian) working in an urban children's hospital pediatric or neonatal ICU. Multiple linear regressions identified demographic variables and workplace stressors that significantly predicted each of three components of burnout. RESULTS Most respondents found the educational assessment and feedback to be helpful. Choosing nursing as a second career was associated with better resilience. Having worked in ICU settings longer and being older were both linked to lower levels of anxiety. Predictors of burnout varied across the three burnout subscales. CONCLUSIONS Implementation of an online self-assessment with immediate educational feedback is feasible in critical care settings. The variability of predictors across the three burnout subscales indicates the need for tailored interventions for those at risk. Future research may include follow-up of nurses to examine changes in scores over time and expansion of the tool for other medical personnel. PRACTICE IMPLICATIONS An educational online self-assessment can be a helpful tool for pediatric critical care nurses experiencing varying degrees of burnout and distress.
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Affiliation(s)
- Brenda Bursch
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
| | - Natacha D Emerson
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Armen C Arevian
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Hilary Aralis
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Lee Galuska
- Nursing Administration, UCLA Health, Los Angeles, CA, USA
| | - Jessica Bushman
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Maegan Sinclair
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Karen Grimley
- Nursing Administration, UCLA Health, Los Angeles, CA, USA
| | - Patricia Lester
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Yonca Bulut
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Supplemental Resource: Report and Recommendations of the FSMB Workgroup on Physician Wellness and Burnout. ACTA ACUST UNITED AC 2018. [DOI: 10.30770/2572-1852-104.2.37] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Norcross WA, Moutier C, Tiamson-Kassab M, Jong P, Davidson JE, Lee KC, Newton IG, Downs NS, Zisook S. Update on the UC San Diego Healer Education Assessment and Referral (HEAR) Program. ACTA ACUST UNITED AC 2018. [DOI: 10.30770/2572-1852-104.2.17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Burnout, depression and suicide are rampant amongst health care professionals. Current evidence shows the problem is worsening. In the aftermath of physician suicides, the Physician Wellbeing Committee created the UC San Diego Healer Education Assessment and Referral (HEAR) Program in 2009 in collaboration with the American Foundation for Suicide Prevention (AFSP). This article chronicles the HEAR program from inception through June 2017. Initially created to address medical students, residents and faculty physician duress, HEAR has now expanded to embrace pharmacists, nurses and clinical staff within UC San Diego Health. HEAR operates through two mechanisms: 1) a program of ongoing education and outreach, and 2) encouragement of all personnel to annually engage in the online, anonymous, interactive screening program, created by the AFSP (known as SDSQ at UC San Diego Health). Since inception in May 2009 through June 2017, 1,537 UC San Diego health care personnel have been screened, 320 individuals have dialogued with a counselor either in person, by phone or electronically, and more than 300 have been referred confidentially for evaluation and treatment by a mental health professional, usually a community psychiatrist. While tracking death by suicide remains challenging, we have reason to believe that the prevalence of suicide has diminished during this time. The UC San Diego HEAR Program is one cost-effective model for addressing this current crisis in U.S. health care. This AFSP model has been adopted by many other schools of medicine and is now ready for use with clinicians of all disciplines.And whoever saves a life, it is considered as if he saved an entire world.— Mishnah Sanhedrin 4:5; Babylonian Talmud Tractate Sanhedrin 37a
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Affiliation(s)
- William A. Norcross
- Dr. Norcross is Clinical Professor of Family Medicine and Public Health at UC San Diego School of Medicine, and Director of the UC San Diego Physician Assessment and Clinical Education (PACE) Program
| | - Christine Moutier
- Dr. Moutier is Chief Medical Officer at the American Foundation for Suicide Prevention
| | - Maria Tiamson-Kassab
- Dr. Tiamson-Kassab is Clinical Professor of Psychiatry at UC San Diego School of Medicine
| | - Pam Jong
- Dr. Jong is Professor of Internal Medicine at UC San Diego School of Medicine, and San Diego VA Healthcare
| | - Judy E. Davidson
- Dr. Davidson is Evidence-based Practice/Research Nurse Liaison at UC San Diego Health
| | - Kelly C. Lee
- Dr. Lee is Professor of Clinical Pharmacy and Associate Dean at UC San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences
| | - Isabel G. Newton
- Dr. Newton is Assistant Clinical Professor, Department of Radiology, and Co-Mentor of the UC San Diego Radiology Wellness Program at UC San Diego School of Medicine
| | - Nancy S. Downs
- Dr. Downs is Clinical Professor of Psychiatry at UC San Diego School of Medicine, and Section Chief of the College Mental Health Program
| | - Sid Zisook
- Dr. Zisook is Professor of Psychiatry at UC San Diego School of Medicine
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Mortali M, Moutier C. Facilitating Help-Seeking Behavior Among Medical Trainees and Physicians Using the Interactive Screening Program. ACTA ACUST UNITED AC 2018. [DOI: 10.30770/2572-1852-104.2.27] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Physician and trainee distress, from burnout and depression to suicide risk, has been recognized as a serious threat to physicians, health care systems and to the optimal delivery of health care. To address this problem, the American Foundation for Suicide Prevention (AFSP) adapted the Interactive Screening Program (ISP) for use by medical schools nationwide. Much is known about the problem, but less is known about the effectiveness of programs and solutions. This program evaluation utilized data from six medical schools' implementation of ISP over a seven-year period (2007–2013) to quantify openness to help-seeking and engagement with each step of program outreach. Descriptive statistics were used to quantify participants' engagement: reviewing the counselor's response; exchanging dialogue messages with the counselor; requesting to meet with the counselor in person; and requesting referral for mental health treatment. Chi-square distribution tests were used to determine differences in level of risk and rates of engagement among medical students, residents and fellows, and faculty physicians. A total of 1,449 individuals, including medical students, residents and faculty physicians, completed the questionnaire; 1,413 (97.5%) were designated as having high or moderate distress and only 5.3% were receiving any type of counseling or therapy. Among program participants, prevalence rates of high distress were higher among medical students and residents versus faculty physicians. The rate of program engagement was high overall with 81.2% reviewing the counselor's response; further engagement was highest among those most distressed, with 32.2% engaging in online dialogue with a program counselor. ISP was a feasible tool for engaging at-risk medical students, residents and physicians who were not currently utilizing mental health services.
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Affiliation(s)
- Maggie Mortali
- Ms. Mortali is Director of the Interactive Screening Program at the American Foundation for Suicide Prevention
| | - Christine Moutier
- Dr. Moutier is Chief Medical Officer at the American Foundation for Suicide Prevention
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Abstract
OBJECTIVE The aim of this study was to test a strategy for quantifying incidence of nurse suicide using San Diego County data as a pilot for national investigation. BACKGROUND Worldwide, 1 person dies by suicide every 40 seconds; more than 1 000 000 suicides occur yearly. Suicide rates for nurses in the United States have not been evaluated. This methodological article tested a strategy to identify incidence of nurse suicide compared with those of physicians and the general public. METHOD Deidentified San Diego County Medical Examiner data from 2005 to 2015 were analyzed with a descriptive epidemiologic approach. RESULTS Overall RN (18.51) and physician (40.72) incidences of suicide per 100 000 person-years were higher than the San Diego general population, excluding nurses (15.81) normalized to 100 000 person-years. CONCLUSIONS Establishing incidence of nurse suicide is confounded by variation in reporting mechanisms plus incomplete availability of nurse gender data. Relatively small outcome numbers compared with the general population may underestimate results. Research using a larger sample is indicated. Nurse executives may decrease risk by proactively addressing workplace stressors.
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