Hardiness, psychosocial factors and shift work tolerance among nurses - a 2-year follow-up study

Compassion fatigue in community nursing: what is it, who is susceptible, and what can be done?

Community nurses are at particular risk to compassion fatigue because their role attracts people who are compelled to help others, and because the work is emotionally challenging. This article explores the various ways in which compassion fatigue affects work and personal life, highlights three factors that make someone susceptible to it and provides recommendations on how to protect oneself from compassion fatigue. The authors also refer to their own research on super-helper syndrome to elucidate the understanding of what contributes to compassion fatigue.

Independent and joint trajectories of depression and anxiety symptoms among Chinese male sailors throughout a prolonged non-24-h rotating shift schedule at sea: a parallel-process growth mixture modeling approach

BACKGROUND

The predictive and protective effect of hardiness on mental health remains unclear among shift workers on non-24-h working schedules. The present study aimed to investigate the independent and joint trajectories of depression and anxiety symptoms and the role of hardiness during a prolonged period of non-24-h shift working schedule.

METHODS

Four hundred nine Chinese male sailors (working on 18-h watchstanding schedule) were recruited and completed all 5-wave tests through online questionnaires (at Day 1, 14, 28, 42, 55, respectively) during a 55-day sailing. The questionnaires included sociodemographic variables, hardiness, depression and anxiety symptoms. Independent and joint trajectories of depression and anxiety symptoms were estimated by latent growth mixture models. The effect of hardiness on trajectories was examined by logistic regression models.

RESULTS

2 and 3 latent trajectories were identified for depression and anxiety symptoms, respectively. Based on initial levels and development trends, 3 distinct joint trajectories of depression and anxiety were identifed and named as: "Low-Inverted U" group (73.6%), "Moderate-Deterioration" group (6.9%), and "High-Stable" group (9.5%). Sailors with higher levels of hardiness were more likely to follow the "Low-Inverted U" trajectory of depression and anxiety symptoms (all p < 0.001).

CONCLUSIONS

There existed individual differences in the trajectories of depression and anxiety. Hardiness may have a protective effect that can prevent and alleviate depression and anxiety symptoms. Therefore, hardiness-based intervention programs are encouraged among the shift workers on non-24-h working and rest schedules.

Comparing shift work tolerance across occupations, work arrangements, and gender

BACKGROUND

There are individual differences in shift work tolerance; however, we lack knowledge about how this is experienced across different occupations, sex and shift types.

AIMS

The aim was to describe and investigate shift work tolerance, and individual differences in shift work tolerance, in two occupations, between men and women and between day/evening workers and rotating shift workers.

METHODS

Cross-sectional questionnaire study. The sample was comprised of 315 retail workers and 410 police employees.

RESULTS

Shift work tolerance was higher among police employees compared to retail workers, among men compared to women, and among day workers compared to evening/rotating shift workers. The difference was larger between occupations than between sex and shift type. Evening workers had more symptoms of shift work intolerance than rotating shift workers. Neuroticism and autonomy were related to all symptoms of shift work tolerance among retail workers, but not police employees.

CONCLUSIONS

It is important to consider the type of occupation and the work context when tailoring work arrangements to the individual.

Association Between Nursing Discussions, Resilience, Workplace Social Support and Burnout: A Quantitative Study in Japan

Background

Although it is known that resilience is negatively associated with burnout, and that certain interventions can effectively increase resilience, little is known about online resilience-enhancing interventions during the COVID-19 crisis. The aim of this study was to identify the association between an online resilience-enhancing intervention and workplace social support, and burnout among nurses working in the mainland and remote islands of Japan during the COVID-19 crisis.

Methods

Pretest-posttest was conducted between April 2020 and February 2021, and the questionnaire survey included the bidimensional resilience scale, the Japanese version of Pine's Burnout Measure, and the workplace social support scale. Changes in burnout, resilience, and social support and the associations with nursing discussions as intervention were analyzed. Participants were 98 Nurses with 1 to 10 years of experience from Japan's mainland and remote island hospitals of Kagoshima Prefecture participated in a baseline survey in April 2020. Of these, 76 participated in a secondary survey in September 2020, and 69 participated in the intervention program and a third survey in February 2021. The online intervention over Zoom consisted of small-group nursing discussions based on the broaden-and-build theory.

Results

Changes in burnout showed a significant negative association with change in workplace social support (Coef. = -0.019, 95% CI -0.035- -0.003), as did the interaction between change in acquired resilience and intervention (Coef. = -0.088, 95% CI -0.164- -0.011).

Conclusion

Change in workplace social support was significantly negatively associated with changes in burnout, as was the interaction of intervention and acquired resilience. Promotion of this intervention and making workplace social support more accessible may contribute to reduce burnout in nurses.

Profiling health professionals' personality traits, behaviour styles and emotional intelligence: a systematic review

BACKGROUND

Non-cognitive traits have been theorised to predict characteristics, career choice and outcomes of health professionals and could represent a homogenous group. This study aims to profile and compare personality traits, behaviour styles and emotional intelligence of health practitioners across a variety of professions.

METHODS

Empirical literature was systematically reviewed. A two-concept search strategy was applied to four databases (CINAHL, PubMed, Embase, ProQuest). Title/abstract and full text articles were screened against inclusion and exclusion criteria. Methodological quality was assessed using Mixed Methods Appraisal Tool. Data was synthesised narratively and meta-aggregated where feasible.

RESULTS

Three hundred twenty-one studies representing 153 assessment tools of personality (n = 83 studies), behaviour (n = 8), and emotional intelligence (n = 62) were included. Most studies (n = 171) explored personality (medicine, nursing, nursing assistants, dentistry, allied health, paramedics), revealing variation in traits across professions. Behaviour styles were least measured with only ten studies exploring these across four health professions (nursing, medicine, occupational therapy, psychology). Emotional intelligence (n = 146 studies) varied amongst professions (medicine, nursing, dentistry, occupational therapy, physiotherapy, radiology) with all exhibiting average to above-average scores.

CONCLUSION

Personality traits, behaviour styles and emotional intelligence are all key characteristics of health professionals reported in the literature. There is both heterogeneity and homogeneity within and between professional groups. The characterisation and understanding of these non-cognitive traits will aid health professionals to understand their own non-cognitive features and how these might be useful in predicting performance with potential to adapt these to enhance success within their chosen profession.

Sociodemographic and Psychological Predictors of Resilience Among Frontline Nurses Fighting the COVID-19 Pandemic

OBJECTIVE

According to a WHO report, the number of patients with coronavirus disease 2019 (COVID-19) has reached 456,797,217 worldwide as of 15 March, 2022. In Wuhan, China, large teams of health-care personnel were dispatched to respond to the COVID-19 emergency. This study aimed to determine the sociodemographic and psychological predictors of resilience among frontline nurses fighting the current pandemic.

METHODS

A total of 143 nurses were recruited from February 15 to February 20, 2020, to participate in this study. The 10-item Connor-Davidson Resilience Scale and the 21-item Depression Anxiety Stress Scale were used to estimate the participants' resilience and mental wellbeing.

RESULTS

Results showed that the nurses displayed a moderate resilience level. Their median depression, anxiety, and stress scores were 1, 2, and 3, respectively, which were negatively correlated with resilience. Female gender, being dispatched to Wuhan, and depression levels were the significant predictors of resilience.

CONCLUSIONS

The results suggest that particular attention should be given to nurses who were dispatched to Wuhan and who exhibited depression symptoms, and appropriate measures should be taken to boost their resilience.

Associations Between Fatigue and Disability, Depression, Health-Related Hardiness and Quality of Life in People with Stroke

BACKGROUND

Stroke is a common cause of mortality and morbidity which affects approximately 17 million people globally each year. Common symptoms associated with stroke are physical disabilities, impaired cognitive functions, depression, and fatigue, all of which can significantly impact health-related quality of life (HRQoL). To date, no research has explored the inter-relationship among fatigue, disability, depression, health-related hardiness, and quality of life in stroke survivors.

METHODS

Data was obtained from a sub-study of the 45 and Up Study; including 576 Australian adults who had been diagnosed with a stroke. The cross-sectional questionnaire obtained demographic and health status information, as well as clinical measures and stroke-related measures. Associations among fatigue and disability, depression, health-related hardiness and quality of life were analysed using a linear regression model.

RESULTS

In comparison to those participants with no stroke-related disability, those with slight (β = 1.141; p = 0.008), moderate (β = 3.250; p < 0.001) or severe (β = 3.526; p < 0.001) disability had significantly higher fatigue scores. For every one unit increase in the depression score, the fatigue score increased by 1.502 points (p < 0.001). For every one unit increase in the health-related hardiness score, the fatigue score decreased by 0.054 points (p = 0.044). For every one unit increase in the quality of life score, the fatigue score decreased by 0.068 points (p < 0.001).

CONCLUSION

This study found significant associations among fatigue and disability, depression, health-related hardiness, and quality of life in stroke survivors. Accurate detection and management of fatigue may help improve the rehabilitation of stroke survivors.

Depressive symptoms in helping professions: a systematic review of prevalence rates and work-related risk factors

OBJECTIVE

The aim of this study is twofold. Our first aim is to provide an overview of the prevalence rate of depression in a wide array of helping professions. Our second aim is to identify work organization conditions that seem to be associated with this depression risk.

METHODS

Four databases were searched (CINAHL, PsycInfo, PubMed, and Web of Science) yielding 87,626 records in total. We were interested in identifying depression prevalence rates and work-related variables that have been found to contribute to depression in helping professions.

RESULTS

In total, this systematic review included 17,437 workers in more than 29 countries. Depression prevalence rate varied between 2.5% and 91.30%. The two most frequently reported professions were nurses and doctors with 73.83% and 30.84% of studies including nurses and doctors in their sample. Work factors contributing to depression included: skill utilization, decision authority, psychological demands, physical demands, number of hours worked, work schedule (irregular or regular), work schedule (daytime or night time), social support from coworkers, social support from supervisor and the family, job insecurity, recognition, job promotion, and bullying.

CONCLUSION

The results of this study highlight alarmingly high rates of depression in helping professions and should serve as a reminder to pay close attention to the mental health of those workers. Investing in employees' mental health by preventing and reducing depression risk could prove to be a valuable investment from an employer's point of view, as it is likely to increase productivity and reduce absenteeism among a host of other positive outcomes.

Shift work tolerance

BACKGROUND

Shift work is widespread due to 24-h work in many occupations. Understanding differences in individual shift work tolerance (SWT) can help develop coping strategies for shift workers.

AIMS

This in-depth qualitative review elucidates the architecture of SWT, providing an overview of the research advances in the last decade (2011-2021).

METHODS

We searched Google Scholar, PubMed and Medline for different word combinations concerning SWT. Genome-wide association studies (GWAS) for the potential genetic basis of SWT were additionally searched in GWAS Central and GWAS Catalogue.

RESULTS

Eleven new studies were published since 2011, with the proportion of longitudinal studies on SWT having more than doubled in the past decade. They consolidate prior findings (e.g. hardiness most consistently associated with SWT) and discovered additional aspects of SWT like resistance to change and job stress. The 15 large-scale GWAS identified, most of which using UK Biobank (UKB) and 23andMe data, involved mapped genes showing overlap especially within analysis of the same phenotype (e.g. PER2/3 for morningness, PAX8 for sleep duration and LINGO1 for neuroticism). Individual GWAS for additional traits such as resilience have also been published though assessments of gene overlap are not yet possible.

CONCLUSIONS

Progress regarding longitudinal studies on SWT has been made though a more consistent definition of SWT remains crucial for future research. Non-genetic studies on SWT suggest several important traits and factors; many of which have now also been explored using GWAS. Such evidence could serve as basis for individualized risk prediction and disease prevention approaches for night-shift workers.

Bullying, supervisor support, relaxation, and personal and work outcomes: Testing a moderated mediation model

AIM

To test a mediated moderation model in which bullying and supervisor support interact to predict nurses' personal and work outcomes with relaxation during off-job time mediating these effects.

BACKGROUND

Bullying is a pervasive problem in the nursing profession. We integrate and extend past research addressing the question of how bullying and perceived supervisor support affect nurses' functioning.

METHOD

Cross-sectional data were collected from a sample of 290 nurses who completed measures of bullying, perceived supervisor support, relaxation, need for recovery, sleeping problems, job satisfaction, emotional exhaustion and work performance.

RESULTS

Results revealed that bullying was significantly linked to job satisfaction, sleeping problems, need for recovery and emotional exhaustion through relaxation, but only among nurses who perceived high levels of supervisor support.

CONCLUSION

These results revealed that high supervisor support may be detrimental for nurses adding up to a negative cycle of stressors to maladaptive outcomes through lack of relaxation.

IMPLICATIONS FOR NURSING MANAGEMENT

Health care organisations and managers should consider addressing work environment factors, such as bullying, in addition to supervisor support in their efforts to facilitate the positive effects of nurses' relaxation during non-work time.

Relationship between stressors, stress reactions and hardiness in Japanese mothers of early neonatal babies: A cross-sectional study

AIM

Mothers of early neonatal babies are often in stressful situations. The stress of child rearing has been reported to influence the mental health of mothers. Hardiness, one of the individual factors affecting the cognitive evaluation of stress, may relate to stress for mothers of early neonatal babies. The aim of the present study is to clarify the relationship between stressors, stress reactions and hardiness of mothers with early neonatal babies.

METHODS

We conducted a cross-sectional study using self-administered questionnaires. Survey items included demographic characteristics, hardiness, stressors, and stress reactions. A total of 226 mothers returned the completed questionnaire. Data analyzed correlation, t tests and multiple regression using SPSS 24.0.

RESULTS

The mothers' hardiness was not related to their demographic characteristics. Hardiness had a negative correlation with stressors and stress reactions. Hardiness mitigated especially anxiety/uncertainty and depression/feeling of insufficiency. Compared with those with high levels of hardiness, mothers with low hardiness exhibited higher levels of newborn baby stressors, breast-feeding stressors, anxiety/uncertainty and depression/feeling of insufficiency.

CONCLUSION

Hardiness showed a buffering relationship with stressors and stress reactions, especially anxiety. Understanding hardiness levels may be useful for choosing which nursing care methods are implemented as each mother begins child rearing.

Clinical nurses's critical thinking level according to sociodemographic and professional variables (Phase II): A correlational study

Critical thinking ability is one of the basic competencies of clinical nurse and is widely accepted as being associated with the provision of quality care, however, the few evidence-based data related to the relationship between level of critical thinking ability and nurses' sociodemographic and professional characteristics. The aim of this study was to identify the level of critical thinking among nurses in clinical practice according to sociodemographic and professional variables. Descriptive cross-sectional and correlational study was carried out in a sample of 339 nurses from medical, surgical and critical care units at a tertiary care hospital. This study is related to a previous publication that presents psychometric analysis. Data were compiled using the Nursing Critical Thinking in Clinical Practice Questionnaire and ad hoc form for the recording of sociodemographic and professional characteristics. The statistical analysis of the data was performed using frequency, Mann-Whitney U Test, Kruskal-Wallis Test, and Pearson's correlation coefficients. Nurses reported moderate levels of critical thinking. Older nurses, with 11-15 years of experience in the actual unit, with continuous shift work, a permanent contract and master's degree indicated a higher level of critical thinking. Critical thinking skills are related to certain socio-demographic and professional variables, particularly age, years of experience, shift work, type of contract and educational level.

Systemic assessment of depressive symptoms among registered nurses: A new situation-specific theory

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.

Working Time Society consensus statements: Individual differences in shift work tolerance and recommendations for research and practice

There is no standard definition of shift work universally, and no validated report of complete biological adjustment to shift work in workers. Similarly, the evidence for shift work tolerance is limited due to a small number of studies and a narrow range of outcome measures. This paper discusses evidence to date regarding individual differences in shift work tolerance and highlights areas for future research and recommendations for workplace practice. The few factors that are consistently associated with perceived or actual shift work tolerance are young age, low scores of morningness or being a late chronotype, low scores of languidity and neuroticism, high scores on extraversion, internal locus of control and flexibility and male sex. An important first step is to differentiate between factors that are potentially modifiable, such as those that are determined by lifestyle choices, and those factors specific to the working time arrangement. Identifying determinants of shift work tolerance and the ability to adjust to shift work, whether they are innate and/or acquired mechanisms, is important so workers who are less likely to tolerate shift work well can be self-identified and supported with appropriate harm/risk minimization strategies. This paper also identifies important areas for future research with the goal of increasing the evidence base on which we can develop evidence-based harm mitigation strategies for shift workers.

Individual vulnerability to insomnia, excessive sleepiness and shift work disorder amongst healthcare shift workers. A systematic review

Shift workers often experience reduced sleep quality, duration and/or excessive sleepiness due to the imposed conflict between work and their circadian system. About 20-30% of shift workers experience prominent insomnia symptoms and excessive daytime sleepiness consistent with the circadian rhythm sleep disorder known as shift work disorder. Individual factors may influence this vulnerability to shift work disorder or sleep-related impairment associated with shift work. This paper was registered with Prospero and was conducted using recommended standards for systematic reviews and meta-analyses. Published literature that measured sleep-related impairment associated with shift work including reduced sleep quality and duration and increased daytime sleepiness amongst healthcare shift workers and explored characteristics associated with individual variability were reviewed. Fifty-eight studies were included. Older age, morning-type, circadian flexibility, being married or having children, increased caffeine intake, higher scores on neuroticism and lower on hardiness were related to a higher risk of sleep-related impairment in response to shift work, whereas physical activity was a protective factor. The review highlights the diverse range of measurement tools used to evaluate the impact of shift work on sleep. Use of standardised and validated tools would enable cross-study comparisons. Longitudinal studies are required to establish causal relationships between individual factors and the development of shift work disorder.