'Mental health day' sickness absence amongst nurses and midwives: workplace, workforce, psychosocial and health characteristics

"Gutting It Out" Does Not Work: Why Mental Health Days are Needed

College student mental health issues negatively impact academic performance. Over half of college students in the U.S. report a mental health issue, with 60% reporting one at the two-year mark. Even when aware of such mental health issues, students are still hesitant to seek treatment. As such, investigating perceptions of mental health time off may illuminate perceived usefulness of such policies as well as potential processes for defining and implementing such policies. This study sought to answer the question, "What are the perspectives of time-off for mental health?" Using Reddit's responses, this study extracted (N = 392) quotes and used thematic analysis to identify four main themes. Implications include the need for school-level mental health time-off policies or integration of instructors' policies into their syllabi for transparency to students, which may alleviate student stress and further stigmatization.

The prevalence of and factors associated with depressive and anxiety symptoms during the COVID-19 pandemic among healthcare workers in South Africa

INTRODUCTION

Healthcare workers globally have experienced increased social and occupational stressors in their working environments and communities because of COVID-19 which has increased the risk of mental health concerns. This study aimed to explore the prevalence and correlates of depression and anxiety amongst healthcare workers during the COVID-19 pandemic in the Western Cape, South Africa. In addition, role-related stressors and coping strategies were explored.

MATERIAL AND METHODS

We conducted a cross-sectional survey of doctors and nurses working in public healthcare facilities across the Western Cape, South Africa. Participants completed the Generalized Anxiety Disorder-7 (GAD-7), the Center for Epidemiologic Studies Depression (CES-D), the Professional Quality of Life (PROQL-R-IV), and the Brief Coping Orientation to Problems Experienced (COPE-R) scales. Data were analysed using multivariable logistic regression analysis.

RESULTS

The sample comprised 416 health workers (303 nurses, 113 doctors). Almost 40% of the sample (n = 161) had CES-D scores suggestive of probable depression, and 45.9% (n = 186) had GAD-7 scores suggestive of anxiety. In the logistic regression model, the odds of probable depression were higher for female participants compared to men (OR = 2.26, 95% CI 1.00-5.10) and for participants who used behavioural disengagement as a coping strategy (OR = 1.50, 95% CI 1.14-1.97). More time spent working with COVID patients was associated with increased odds of having high levels of anxiety [OR = 1.13, 95% CI (1.02-1.25). Substance use (OR = 1.39, 95% CI 1.08-1.81), venting (OR = 1.31, 95% CI 1.01-1.70), and self-blame (OR = 1.42, 95% CI 1.08-1.87) were some of the coping strategies used by healthcare workers. High levels of secondary traumatic stress and burnout were found to increase the odds of both depression and anxiety.

CONCLUSION

Findings of this study suggest that there is a high prevalence of mental health issues among healthcare workers, and a critical need to focus on workplace mental health interventions to support these frontline workers.

The relationship between psychological resilience and professional quality of life among mental health nurses: a cross-sectional study

BACKGROUND

Mental health nursing is a demanding and stressful profession that impacts nurses' professional quality of life. Psychological resilience can be a protective factor. However, the relationship has not been extensively studied. This study aims to examine the relationship between psychological resilience and professional quality of life and identify potential predictors of ProQOL subscales among mental health nurses.

METHODS

The study employed a cross-sectional design to collect data from 179 mental health nurses. Data was collected using two standardized questionnaires: the Connor-Davidson resilience scale and the professional quality of life scale. Participants were recruited through convenient sampling during a 3-month period from April to June 2022, and the data were collected using an online survey tool called QuestionPro.

RESULTS

The study found a strong positive correlation between psychological resilience and compassion satisfaction (r = 0.632, P < 0.001). However, there was a negative significant correlation between resilience with burnout (r = -0.470, P < 0.001) and secondary traumatic stress (r = -0.210, P = 0.005). The study also found that higher resilience levels were associated with higher levels of compassion satisfaction and lower levels of secondary traumatic stress. Additionally, higher burnout scores were associated with higher levels of secondary traumatic stress. The study also identified that age and the number of children had weak associations with compassion satisfaction, while workplace was a significant predictor of burnout and secondary traumatic stress.

CONCLUSION

The study emphasizes the importance of resilience, burnout, and secondary traumatic stress in the well-being of healthcare professionals, especially nurses. The findings suggest that assessing nurses' resilience and professional quality of life can raise psychological resilience awareness and help managers create the necessary working conditions to improve nurses' professional quality of life.

A mixed-method study exploring barriers and facilitators to midwives' mental health in Ontario

BACKGROUND

There is a paucity of information regarding the mental health of midwives working in Ontario, Canada. Many studies have investigated midwives' mental health around the world, but little is known about how the model of midwifery care in Ontario contributes to or negatively impacts midwives' mental health. The aim of the study was to gain a deeper understanding of factors that contribute to and negatively impact Ontario midwives' mental health.

METHODS

We employed a mixed-methods, sequential, exploratory design, which utilized focus groups and individual interviews, followed by an online survey. All midwives in Ontario who had actively practiced within the previous 15 months were eligible to participate.

FINDINGS

We conducted 6 focus groups and 3 individual interviews, with 24 midwives, and 275 midwives subsequently completed the online survey. We identified four broad factors that impacted midwives' mental health: (1) the nature of midwifery work, (2) the remuneration model, (3) the culture of the profession, and (4) external factors.

DISCUSSION

Based on our findings and the existing literature, we have five broad recommendations for improving Ontario midwives' mental health: (1) provide a variety of work options for midwives; (2) address the impacts of trauma on midwives; (3) make mental health services tailored for midwives accessible; (4) support healthy midwife-to-midwife relationships; and (5) support improved respect and understanding of midwifery.

CONCLUSION

As one of the first comprehensive investigations into midwives' mental health in Ontario, this study highlights factors that contribute negatively to midwives' mental health and offers recommendations for how midwives' mental health can be improved systemically.

Australian cancer nurses' experiences of burnout: Exploring the job demands and job resources of metropolitan cancer nurses during 2019-2020

BACKGROUND

Existing studies that seek to understand nurses' experiences of burnout are dominated by cross-sectional, quantitative survey designs employing predetermined measures, often overlooking important job-related stressors that can be highly dependent on industry and professional contexts. Cancer nurses are a group of professionals who warrant special attention, as burnout in this profession is often attributed to high job demands and the challenge of caring for a vulnerable cohort of patients. A deeper understanding of the job demands associated with cancer nursing is required to provide insights about the work experiences of cancer nurses and identify aspects that mitigate burnout and stress.

PURPOSE

This study describes the antecedents of burnout among Australian cancer nurses by focusing on the demands and resources inherent in their work. We aim to build on the existing literature by identifying job resources that may serve to mitigate the antecedents of burnout.

METHODOLOGY/APPROACH

An in-depth interview study of cancer nurses across a spectrum of age and experience in Australian metropolitan public health care services was conducted over a 2-year period that coincided with the COVID-19 pandemic. The job demands and resources model framed this study of job-related factors associated with burnout and conversely job resources that may foster work engagement.

RESULTS

Patient aggression, workload, emotional demands, and abusive peers and managers were reported as distinct job demands, whereas job significance and supportive peers who demonstrated leadership, along with task variety, were identified as job resources.

CONCLUSION

Australian cancer nurses work in an environment where job demands are increasingly disproportionate to job resources, leading to significant risk of burnout.

PRACTICE IMPLICATIONS

Our study identifies modifiable strategies for improving work conditions for this group who play a critical role in the health care system.

Experiences of Healthcare Workers in Long-Term Care during COVID-19: A Scoping Review

Background: Although healthcare workers (HCWs) in long-term care (LTC) have experienced significant emotional and psychological distress throughout the pandemic, little is known about their unique experiences. Objective: This scoping review synthesizes existing research on the experiences of HCWs in LTC during the COVID-19 pandemic. Method: Following Arksey and O'Malley's framework, data published between March 2020 to June 2022, were extracted from six databases. Results: Among 3808 articles screened, 40 articles were included in the final analysis. Analyses revealed three interrelated themes: carrying the load (moral distress); building pressure and burning out (emotional exhaustion); and working through it (a sense of duty to care). Conclusion: Given the impacts of the pandemic on both HCW wellbeing and patient care, every effort must be made to address the LTC workforce crisis and evaluate best practices for supporting HCWs experiencing mental health concerns during and post-COVID-19.

Group Clinical Supervision for midwives and burnout: a cluster randomized controlled trial

Background

There are major shortfalls in the midwifery workforce which has been exacerbated by the COVID 19 pandemic. Midwives have high levels of burnout and many, often early career midwives, are planning to leave the profession. There are reports of a poor workplace culture in maternity units, including bullying. Support is essential for the welfare of the workforce to be able to cope with the demands of their jobs. Supportive strategies, such as Clinical Supervision, a recognised approach in healthcare, enable reflection in a facilitated, structured way, and can enhance professional standards. The purpose of this research is to study burnout levels in midwives, those exiting their workplace and perceptions of workplace culture in relation to access to, and attendance of, monthly Clinical Supervision.

Methods

This study will be a cluster randomised controlled trial of maternity sites within Sydney and the surrounding districts. Twelve sites will be recruited and half will receive monthly Clinical Supervision for up to two years. Midwives from all sites will be requested to complete 6-monthly surveys comprising validated measurement tools: the Copenhagen Burnout Inventory (CBI), the Australian Midwifery Workplace Culture (AMWoC) tool and the Clinical Supervision Evaluation Questionnaire (CSEQ) (the latter for intervention sites only). Primary outcomes are the levels of burnout in midwives (using the CBI). Secondary outcomes will be the quality of the intervention (using the CSEQ), perceptions of workplace culture (using the AMWoC tool) and midwives’ intention to stay in their role/profession, as well as sick leave rates and numbers of exiting staff. We will also determine the dose effect – ie the impact in relation to how many Clinical Supervision sessions the midwives have attended, as well as other supportive workplace strategies such as mentoring/coaching on outcomes.

Discussion

Through attending monthly Clinical Supervision we hypothesise that midwives will report less burnout and more positive perceptions of workplace culture than those in the control sites. The potential implications of which are a productive workforce giving high quality care with the flow-on effect of having physically and psychologically well women and their babies.

Trial registration

The ACTRN Registration number is ACTRN12621000545864p, dated 10/05/2021, 

Job engagement and satisfaction are associated with nurse caring behaviours: A cross-sectional study

BACKGROUND

There is a scarcity of literature assessing the impact of job engagement and satisfaction in the nurse's caring behaviours. This study aims to identify how these factors affect the caring behaviours of nurses.

METHODS

This study used a cross-sectional design and employed self-report questionnaires. A total of 549 nurses from private and government hospitals participated in the survey conducted in the year 2019. Descriptive and inferential statistics were utilized to analyse the data.

RESULTS

Results revealed that the nurses display high caring behaviours and job engagement and moderate sense of satisfaction. Remarkably, there are no profile variables significantly related to the nurse's caring behaviours. Findings suggest that job engagement and satisfaction are significantly associated with the nurses' caring behaviours.

CONCLUSION

Factors such as job engagement and satisfaction affect nurses' caring behaviours.

IMPLICATIONS TO NURSING MANAGEMENT

Health organisations must provide strategies to increase job engagement and satisfaction of nurses to yield high caring behaviours, which is vital to the achievement of patient safety.

Mental health shame, self-compassion and sleep in UK nursing students: Complete mediation of self-compassion in sleep and mental health

AIMS

To explore relationships between mental health problems, mental health shame, self-compassion and average length of sleep in UK nursing students. The increasing mental health problems in nursing students may be related to a strong sense of shame they experience for having a mental health problem. Self-compassion has been identified as a protective factor for mental health and shame in other student populations. Further, studies highlight the importance of sleep relating to mental health.

DESIGN

A cross-sectional design.

METHODS

A convenient sampling of 182 nursing students at a university in the East Midlands completed a paper-based questionnaire regarding these four constructs, from February to April 2019. Correlation, regression and mediation analyses were conducted.

RESULTS

Mental health problems were positively related to shame and negatively related to self-compassion and sleep. Mental health shame positively predicted and self-compassion negatively predicted mental health problems: sleep was not a significant predictor of mental health problems. Lastly, self-compassion completely mediated the impacts of sleep on mental health problems (negative relationship between mental health problems and sleep was fully explained by self-compassion).

CONCLUSION

The importance of self-compassion was highlighted as it can reduce mental health problems and shame. Self-compassion can protect nursing students from mental distress when they are sleep deprived.

IMPACT

Nurses and nursing students are required to work irregular hours (e.g. COVID-19) and mental distress can cause serious consequences in clinical practice. Our findings suggest that nurturing self-compassion can protect their mental health and the negative impacts of sleep deprivation on mental health.

Differential aspects of chronic work-related stress predict depression in registered and geriatric nurses

Background: Chronic work stress is a problem which persists among nurses for several reasons and studies suggest that both levels of stress and depression remain on an ongoing high level. However, not much is known about the impact of differential aspects of chronic work-related stress on levels of depression when investigating geriatric and registered nurses. Aim: The aim of this study was to analyse the relationship between various aspects of chronic work stress and levels of depression in geriatric and registered nurses. Methods: A cross-sectional online survey among 370 nurses was carried out. Besides demographic information, several aspects of chronic work stress were assessed with the Trier Inventory of Chronic Stress and levels of depression with the Beck Depression Inventory-II. Statistical analyses included multiple linear regression. Results: Most important work-related predictors of depression scores in nurses were 'Work dissatisfaction' (ß = .237; 95 %-CI: [.194; .280]) and 'Work overload' (ß = .161; 95 %-CI: [.124; .198]) within blockwise multiple regression analysis. A previously diagnosed psychiatric disorder (ß = -.268; 95 %-CI: [-.313; -.223]) proved to be the strongest predictor of nurses' depression experience. Our model explained 37 % of variance in depression scores. However, being a geriatric or registered nurse did not predict levels of depression. Conclusions: Different aspects of chronic work stress seem to be associated with levels of depression in nurses. This should be taken into account when working on the improvement of working conditions for nurses.

Identifying the evidence base of interventions supporting mental health nurses to cope with stressful working environments: A scoping review

AIM

To scope the evidence on interventions used to help mental health nurses cope with stressful working environments.

BACKGROUND

Nursing managers may implement interventions to support mental health nurses cope in their role. However, the evidence supporting these interventions has not been recently reviewed.

METHODS

A scoping review was conducted which entailed searching and selecting potential studies, undertaking data extraction and synthesis.

RESULTS

Eighteen studies published since 2000 were identified. They employed different designs, ten used quasi-experimental methods. Interventions involving active learning appeared beneficial, for example stress reduction courses and mindfulness. However, small sample sizes, short follow-up periods and variation in outcome measures make it difficult to identify the optimum interventions. No studies have considered cost-effectiveness.

CONCLUSION

There is some evidence that mental health nurses benefit from interventions to help them cope with stressful working environments. However, higher quality research is needed to establish the effectiveness and cost-effectiveness of different interventions.

IMPLICATIONS FOR NURSING MANAGEMENT

Managers should provide opportunities and encourage mental health nurses to engage in active learning interventions, for example mindfulness to help them cope with stressful working environments. Nurses also want managers to address organisational issues; however, no research on these types of interventions was identified.

Nurses' physical activity exploratory study: Caring for you so you can care for others

BACKGROUND

Nurses report the greatest stress of all health care workers. Although physical activity (PA) is associated with health benefits among other populations, nurses have stressors that other occupations do not typically encounter. It is important for nurses to identify techniques for stress management since stressors negatively impact their health and patient care.

OBJECTIVE

We aimed to examine the relationship between PA levels and physical, mental, and occupational health among nurses.

METHODS

Nurses (N = 62) completed measures of anthropometrics, demographics, and domains of physical, mental, and occupational health. Pearson correlations determined the relationship between PA and measures health along with the relationship between PA and health among active versus inactive nurses.

RESULTS

Fatigue was significantly correlated with moderate-to-vigorous PA (r = -0.27, p < 0.05). Relationships were found between mental health and light and moderate intensity PA (r = 0.40, p < 0.001; r = 0.30, p < 0.05).

CONCLUSIONS

Stress is prevalent among nurses and negatively impacts a nurse's health along with patient care. Findings suggest health benefits associated with PA among nurses. PA interventions among nurses may be needed to fully see the effects of PA on physical, mental, and occupational health, and ultimately patient health and safety.

Individual Circadian Preference, Shift Work, and Risk of Medication Errors: A Cross-Sectional Web Survey among Italian Midwives

Background: In order to explore the possible association between chronotype and risk of medication errors and chronotype in Italian midwives, we conducted a web-based survey. The questionnaire comprised three main components: (1) demographic information, previous working experience, actual working schedule; (2) individual chronotype, either calculated by Morningness–Eveningness Questionnaire (MEQ); (3) self-perception of risk of medication error. Results: Midwives (n = 401) responded “yes, at least once” to the question dealing with self-perception of risk of medication error in 48.1% of cases. Cluster analysis showed that perception of risk of medication errors was associated with class of age 31–35 years, shift work schedule, working experience 6–10 years, and Intermediate-type MEQ score. Conclusions: Perception of the risk of medication errors is present in near one out of two midwives in Italy. In particular, younger midwives with lower working experience, engaged in shift work, and belonging to an Intermediate chronotype, seem to be at higher risk of potential medication error. Since early morning hours seem to represent highest risk frame for female healthcare workers, shift work is not always aligned with individual circadian preference. Assessment of chronotype could represent a method to identify healthcare personnel at higher risk of circadian disruption.

Role of Global Self-Esteem, Professional Burnout and Selected Socio-Demographic Variables in the Prediction of Polish Nurses' Quality of Life - A Cross-Sectional Study

Purpose

The aim of the study was to analyze the role of global self-esteem and professional burnout in predicting Polish nurses’ quality of life.

Materials and Methods

The research involved 1806 nurses who were employed in 23 hospitals in north-eastern Poland. Forty-seven percent of nurses, aged ≤44 years, were qualified to Group 1, while 53% of nurses, aged ≥45 years, were included in Group 2. A diagnostic survey was applied as a research method. For the collection of data, the WHOQoL-Bref questionnaire, the Rosenberg Self-Esteem Scale and the Copenhagen Professional Burnout Inventory were used. For the statistical analysis, the significance level of P < 0.05 was adopted.

Results

Global self-esteem had a positive orientation towards the prediction of the quality of life among the younger nurse group in the psychological and social domains by explaining 20% (ßeta = 0.33; R² = 0.20) and 15% (ßeta = 0.28; R² = 0.15) of the result variation, respectively. In the older nurse group, personal burnout, which took a negative orientation in the somatic (ßeta = −0.33 R² = 0.19), social (ßeta = −0.37; R² = 0.17) and environmental domains (ßeta = −0.28; R² = 0.32), had the greatest share in predicting the quality of life.

Conclusion

There is a need for the implementation of professional burnout prevention programs, as professional burnout adversely affects the quality of life in the somatic, social and environmental domain, particularly in the older nurse group.

"We try our best to offer them the little that we can" coping strategies of Ghanaian community psychiatric nurses: a qualitative descriptive study

Introduction

Community psychiatric nurses work in extremely stressful environments with intense patient relationships as they try to prevent self-harm and manage aggressive behaviors. In order to improve their ability to manage the stressful work environments, community psychiatric nurses need to incorporate formal coping strategies into their daily work routines. With evidence-based coping strategies, community psychiatric nurses can effectively manage the stressful situations in their work environment to increase their work longevity. The purpose of this study was to explore the individual coping strategies currently used by community psychiatric nurses in practice in order to develop an intervention strategy for future implementation.

Methods

This was an exploratory qualitative study using an interpretative approach. A purposive sampling method was used to identify participants from the community psychiatric nurses in a region of Ghana. Participants were recruited and interviewed, guided by semi-structured questions, until saturation was reached. The interviews were audio-taped, transcribed verbatim, and analyzed thematically.

Results

A total of 13 participants, 10 women and 3 men ages 26 to 60 years, were interviewed for this study. From the inductive analysis, four coping themes emerged from the data including: 1) self-disguise, 2) reliance on religious faith, 3) self-motivation, and 4) reduction in the number of home visits. The participants described their work environment as stressful, almost to the point of overwhelming. In this regard, they identified the individual coping strategies as critical daily practices for self care to manage their high stress levels.

Conclusion

Individual coping strategies are often used by community psychiatric nurses in daily practice. The participants identified personal coping strategies as critical interventions to manage stress and to decrease their risk for burnout. However, community psychiatric nurses must develop.personal-mastery in various coping strategies to care for themselves, as well as motivate them despite the challenging working environment. The individual coping strategies adopted by community psychiatric nurses was not only helped them deliver care, but also protected their clients so people would not label them as 'mental patients.' Collectively, the four strategies reported in this study need to be developed into a cohesive and comprehensive intervention.

Fatores associados ao absenteísmo-doença de trabalhadores da saúde: revisão de escopo

Objetivo: identificar os fatores associados ao absenteísmo-doença de trabalhadores da saúde.Síntese de conteúdo: esta revisão de escopo da literatura realizada nas bases de dados Medline via PubMed incluiu 106 estudos, que totalizaram 388.381 profissionais de saúde. Foi identificado que os fatores individuais e interpessoais, relacionados ao cargo e à função, assim como os fatores ambientais e organizacionais influenciam a ocorrência do absenteísmo-doença no ambiente hospitalar.Conclusões: os fatores individuais e interpessoais, relacionados ao cargo e à função, assim como os fatores ambientais e organizacionais influenciam no absenteísmo-doença dos trabalhadores da saúde, com impacto tanto sobre a produtividade quanto sobre a continuidade da assistência prestada por esses profissionais. A ausência não programada destes leva à necessidade de contratação de outros servidores ou ao pagamento de horas excedentes para atender à demanda, o que pode agravar a situação econômica e financeira do sistema de saúde, e afetar diretamente a saúde de toda a população que depende desse sistema.

Effect of Workplace Violence and Psychological Stress Responses on Medical-Surgical Nurses' Medication Intake

BACKGROUND

Workplace violence is a prevalent phenomenon in the health-care sector globally, but few studies have examined its impact on nurses' use of prescribed and/or over-the-counter medications to manage signs and symptoms.

PURPOSE

The purpose of this study was to examine the direct and indirect effect of workplace violence, through the pathway of psychological stress responses, on nurses' frequencies of medication intake. An occupational stress and health outcomes model was tested in this study.

METHODS

A secondary analysis of cross-sectional survey data from 551 medical-surgical nurses in British Columbia was conducted. Both emotional and physical workplace violence were examined. Emotional exhaustion and posttraumatic stress disorder were psychological stress responses to workplace violence.

RESULTS

Emotional and physical violence from patients and/or families were the most prevalent sources of workplace violence. Physical violence and psychological stress responses increased the frequency of medication intake after controlling for nurse characteristics. Emotional violence was not related to medication intake over and above the effect of psychological stress responses. Physical and emotional violence elicited psychological stress responses resulting in increased medication use.

CONCLUSION

Workplace violence triggers psychological stress responses with adverse outcomes on nurses' health and well-being.

Workplace stressors, psychological well-being, resilience, and caring behaviours of mental health nurses: A descriptive correlational study

There is widespread recognition that workplace stress can have profound negative impacts on nurses' well-being and practice. Resilience is a process of positive adaptation to stress and adversity. This study aimed to describe mental health nurses' most challenging workplace stressors, and their psychological well-being, workplace resilience, and level of caring behaviours, explore the relationships between these factors, and describe differences in workplace resilience for sociodemographic characteristics. In a descriptive correlational study using convenience sampling, data were collected from N = 498 nurses working in mental health roles or settings in Victoria Australia via an online cross-sectional survey. Key findings included weak to strong (r = 0.301 to r = 0.750) positive relationships between workplace resilience with psychological well-being across all stressor categories (consumer/carer; colleague; organizational role; and organizational service). Psychological well-being was moderately high, but lower for nurses indicating consumer/carer-related stressors as their most stressful challenge. There were weak to moderate (r = 0.306 to r = 0.549) positive relationships between workplace resilience and psychological well-being, and no relationship between resilience and caring behaviours. Workplace resilience was lower (P < 0.05) for less experienced nurses compared with those with >5 years' experience, and lower for younger nurses compared with those aged ≥40 years. To improve their resilience and prevent psychological distress, there is prime opportunity to support nursing students with well-being and resilience-building strategies during their undergraduate education, and to support new graduates with similar programmes when they enter the workforce.

Prevalence and Predictors of Burnout in Midwives: A Systematic Review and Meta-Analysis

The prevalence of burnout in midwives has been briefly studied. Given the negative effects of burnout syndrome in the physical and mental health, and also related to the quality of care provided, rates of absenteeism and sick leave; identifying related factors for the syndrome are needed. The aim was to determine the prevalence, levels, and factors related to the burnout syndrome, measured with the Copenhagen Burnout Inventory in midwives. A systematic review and meta-analysis were selected from CINAHL, LILACS, ProQuest, PsycINFO, PubMed, SciELO, and Scopus databases, with the search equation “burnout AND (midwife OR midwives OR nurses midwives)”. Fourteen articles were found with a total of 8959 midwives. Most of the studies showed moderate levels of personal burnout. The prevalence obtained was 50% (95% CI = 38–63) for personal burnout; 40% (95% CI = 32–49) for work-related burnout; and 10% (95% CI = 7–13) for client-related burnout. Midwives’ age, less experience, and living alone constitute the main related factors, as well as, the scarcity of resources, work environment, and the care model used. Most midwives present personal and work-related burnout, which indicates a high risk of developing burnout. Personal factors and working conditions should be taken into account when assessing burnout risk profiles of midwives.

A national survey of the nurses' mental health - The case of Portugal

AIM

To understand Portuguese nurses' perceptions of their mental health.

BACKGROUND

The impact of nurses' health and well-being on the quality and safety of the care they provide is well known. In Portugal, there are no representative studies regarding nurses' mental health.

MATERIALS AND METHODS

Transversal, analytical, and observational methods were used, with a quantitative approach. Participants answered questions through an online form. We collected data concerning social-professional characterization, general health status, and mental health. The General Health Questionnaire-28 (GHQ-28) was used.

RESULTS

A total of 1264 nurses participated in a nonrandomized sample. Two-thirds revealed a negative perception of their mental health. Of these, 22.2% reported severe depression symptoms, 71.6% indicated significant somatic symptoms, 76% showed significant anxiety, and 94.1% presented some kind of social dysfunction.

CONCLUSION

Better mental health is associated with being part of a larger household, enjoying more hours of sleep, having more free weekends, being male, working as a specialist, and engaging in leisure activities. Worse mental health is associated with being older, having a longer career, working more hours, and practicing in the hospital context.

IMPLICATIONS FOR NURSING PRACTICE

The professionals' living and working conditions must be addressed by their managers.

Resilience and mental health nursing: An integrative review of international literature

Mental health nurses work in challenging and potentially high stress settings. Stressors can occur in the context of consumer, family, and/or staff relationships, as well as the work environment and organization. The cumulative effects of stress and professional challenges can lead to harmful impacts for mental health nurses including burnout and poorer physical and mental health. Resilience involves a process of positive adaptation to stress and adversity. The aims of this integrative review were to examine understandings and perspectives on resilience, and explore and synthesize the state of knowledge on resilience in mental health nursing. Following systematic search processes, screening, and data extraction, 12 articles were included. Constant comparative analysis and synthesis of the data resulted in two key categories: Theoretical concepts of resilience and Knowledge on mental health nurses' resilience. In mental health nursing, resilience has been variously constructed as an individual ability, collective capacity, or as an interactive person-environment process. Resilience was most often reported as low-moderate, with positive correlations with hardiness, self-esteem, life and job satisfaction, and negative correlations with depression and burnout. A resilience programme improved mental health nurses' coping self-efficacy and capacity to regulate thoughts and emotions and developed their resilient practice. Use of contemporary resilience definitions will inform more consistent investigation and progressively scaffold knowledge of this emergent construct in mental health nursing. Future research on the implementation of resilience programmes and resilience-building strategies for mental health nurses at the individual, work unit, and organizational levels is needed.

On PAR: A feasibility study of the Promoting Adult Resilience programme with mental health nurses

Mental health settings are recognized as complex, unpredictable environments, and challenging interpersonal situations are common for nurses in acute adult mental health services. Occupational stressors include verbal aggression and physical assault and are correlated with poor physical and mental health outcomes for nurses. There is a clear need for proactive approaches that address the negative impacts of stressors on the mental health nursing workforce. Resilience interventions are a preventive approach to strengthening skills for addressing workplace stress, improving health and well-being, and preventing adverse outcomes associated with occupational stressors. The aim of this study was to evaluate the feasibility of a workplace resilience education programme for nurses in high-acuity adult mental health settings. The outcomes were measured using a single-group pretest post-test design with follow-up at 3 months postintervention. The feasibility and acceptability of the programme were identified with descriptors of mental health, well-being, resilience, facilitator fidelity checklists, and participant satisfaction questionnaires. The programme was found to be feasible for nurses working in high-acuity inpatient settings. There were significant changes to mental health, well-being, and workplace resilience. The programme was delivered with fidelity by facilitators and accepted with high levels of satisfaction by participants. The study findings indicated that nurses can benefit from resilience education that equips them with cognitive, emotion regulation, and relational skills, in conjunction with available external supports and resources, to address workplace challenges. There is a need for comprehensive organizational approaches that include individual, work unit, and organizational-level strategies to support staff well-being.

Proposta de gestão do absenteísmo da enfermagem hospitalar: uma revisão sistemática

Resumo Objetivo: Investigar na literatura o conhecimento disponível sobre a interdependência dos agentes desencadeantes do absenteísmo da enfermagem hospitalar para inferir, a partir de uma perspectiva multicausal, possíveis ações de gestão e controle. Métodos: Revisão sistemática compreendendo o recorte temporal de 2013 à 2017, utilizando descritores operacionalizados em bases de dados indexadas do portal da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). A busca seguiu a metodologia Statement Preferred Reporting items For Systematic Reviews And Meta-Analyses (PRISMA) auxiliada pelo software EndNote®. Resultados: Finalizado o processo de depuração dos 269 artigos recuperados, 39 atenderam aos critérios de inclusão estabelecidos e, deles, 23,08% atribuiu a origem do absenteísmo a causas diversas não específicas. A organização do trabalho foi identificada como causa em 20,51% do material analisado, os adoecimentos musculoesqueléticos 15,38% e, os transtornos mentais e comportamentais totalizaram 10,26%. A síndrome de Burnout, 7,69% dos artigos, a satisfação no trabalho e os aspectos psicossociais 5,13% cada, relacionamento com demais membros das equipes, assédio e resiliência, ambiente laboral, fadiga e conflitos com o paciente, cada um, com 2,56% dos artigos analisados na revisão sistemática. Conclusão: Pelos resultados obtidos, concluiu-se que o absenteísmo deve ser tratado a partir de uma perspectiva múltipla, holística, epidemiológica e prospectiva através de variáveis organizacionais, físicas e cognitivas compatíveis com as análises multicausais.