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Park TK, Kim J, Pierce B, Lee H. Transformational Leadership, Secondary Traumatic Stress, and Burnout of Child Welfare Workers: Multilevel Moderation Effects. SOCIAL WORK 2024; 69:231-239. [PMID: 38697186 DOI: 10.1093/sw/swae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/19/2023] [Accepted: 11/08/2023] [Indexed: 05/04/2024]
Abstract
This study examines the moderating effects of distant leader's practice of transformational leadership on the relationship between secondary traumatic stress (STS) and burnout among child welfare workers. Caseworkers and supervisors in a Midwest U.S. state (N = 210) rated their regional director's use of transformational leadership skills using a survey. Given the nature of the clustered data, multilevel modeling was employed to examine the main effects of transformational leadership on worker burnout and its cross-level interaction effect on the association between worker STS and burnout. Multilevel modeling demonstrated that worker burnout was positively associated with STS and negatively associated with organizational-level transformational leadership. The cross-level interaction between transformational leadership and STS was significant. Specifically, the positive association between workers' STS and burnout decreased as transformational leadership increased. These findings suggest that organizational approaches such as transformational leadership can influence workforce results. Further research will guide child welfare policymakers to develop more sophisticated training programs in leadership skills and strategies.
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Affiliation(s)
- Tae Kyung Park
- Tae Kyung Park, PhD, is assistant professor, Department of Social Work, University of Colorado Colorado Springs, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918, USA
| | - Jangmin Kim
- Jangmin Kim, PhD, is assistant professor, School of Social Work, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Barbara Pierce
- Barbara Pierce, PhD, is professor, School of Social Work, Indiana University, Indianapolis, IN, USA
| | - Hyunji Lee
- Hyunji Lee, PhD, is assistant professor, Department of Social Welfare, Institute of Social Welfare, Kongju National University, Chungcheongnam-do, South Korea
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Fan J, Chang Y, Li L, Jiang N, Qu Z, Zhang J, Li M, Liang B, Qu D. The relationship between medical staff burnout and subjective wellbeing: the chain mediating role of psychological capital and perceived social support. Front Public Health 2024; 12:1408006. [PMID: 38975362 PMCID: PMC11224155 DOI: 10.3389/fpubh.2024.1408006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 06/12/2024] [Indexed: 07/09/2024] Open
Abstract
Background Medical staff play a crucial role in delivering healthcare services, especially during epidemics of infectious diseases such as coronavirus disease 2019 (COVID-19). However, there is a growing issue of burnout and low wellbeing among this group. While it is widely recognized that burnout has a negative impact on subjective wellbeing, the exact relationship between the two is not yet completely understood. The purpose of this study is to explore the chain mediating role of psychological capital and perceived social support between burnout and subjective wellbeing among medical staff. Methods Using the convenient sampling method, 604 medical staff were selected for a cross-sectional study. All participants completed a self-report questionnaire that collected demographic information, as well as data from the Maslach Burnout Inventory-Human Services Survey, General Wellbeing Schedule, Psychological Capital Questionnaire, and Perceived Social Support Scale. SPSS 27.0 and SPSS PROCESS macro were used for data analysis. Results There was a significant correlation between burnout, psychological capital, perceived social support, and subjective wellbeing (p < 0.01). Burnout not only has a direct negative impact on the subjective wellbeing of medical staff (effect: -0.2045; Bootstrap 95%CI: -0.2506, -0.1583), but also exerts an indirect influence on subjective wellbeing through three pathways: the independent mediating effect of psychological capital (effect: -0.0481; Bootstrap 95%CI: -0.0876, -0.0109), the independent mediating effect of perceived social support (effect: -0.0092; Bootstrap 95%CI: -0.0203, -0.0003), and the chained mediating effect of psychological capital and perceived social support (effect: -0.0092; Bootstrap 95%CI: -0.0183, -0.0019). Conclusion High burnout in medical staff can impair the level of psychological capital, leading to diminished perceived social support and ultimately reduced subjective wellbeing. The findings of this study contribute to understanding the potential pathways between burnout and subjective wellbeing and provide preliminary data support for developing strategies to improve the mental health of medical staff.
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Affiliation(s)
- Jia Fan
- The Second Hospital of Jilin University, Jilin, China
| | - Yuyang Chang
- The Second Hospital of Jilin University, Jilin, China
| | - Li Li
- The Second Hospital of Jilin University, Jilin, China
| | - Nan Jiang
- School of Nursing, Jilin University, Jilin, China
| | - Zhifei Qu
- School of Nursing, Jilin University, Jilin, China
| | - Jiaxin Zhang
- National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Meihua Li
- School of Nursing, Jilin University, Jilin, China
| | - Bing Liang
- School of Nursing, Jilin University, Jilin, China
| | - Danhua Qu
- The Second Hospital of Jilin University, Jilin, China
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Frangieh J, Hughes V, Edwards-Capello A, Humphrey KG, Lammey C, Lucas L. Fostering belonging and social connectedness in nursing: Evidence-based strategies: A discussion paper for nurse students, faculty, leaders, and clinical nurses. Nurs Outlook 2024; 72:102174. [PMID: 38761699 DOI: 10.1016/j.outlook.2024.102174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/14/2024] [Accepted: 04/20/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND The phenomenon of loneliness among healthcare providers, particularly nurses, has garnered increasing attention due to its detrimental effects on individual well-being and professional retention. The isolation experienced by nurses has been linked to heightened turnover rates and intentions to leave the profession, posing significant challenges to healthcare systems globally. Recognizing loneliness as an epidemic in 2023, the U.S. Surgeon General highlighted the urgency of addressing this issue within the healthcare workforce. PURPOSE This paper explores evidence-based strategies to mitigate loneliness and promote social connectedness among nurses, drawing insights from various stakeholders. It aims to offer actionable recommendations to enhance the nursing experience and retain professionals in the field. DISCUSSION Strategies include peer support programs, mentorship initiatives, wellness activities, and fostering open communication. Leveraging technology for virtual connections is also highlighted, especially in remote work scenarios. CONCLUSION A holistic approach is vital, combining individual, interpersonal, and systemic interventions to combat nurse loneliness. Prioritizing social connectedness fosters a supportive work environment, benefiting both nurses and patient care quality.
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Affiliation(s)
| | | | | | | | | | - Laura Lucas
- Johns Hopkins School of Nursing, Baltimore, MD
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Nazari S, Zamani A, Farokhnezhad Afshar P. The relationship between received and perceived social support with ways of coping in nurses. Work 2024:WOR230337. [PMID: 38669503 DOI: 10.3233/wor-230337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Stress is inevitable in the nursing profession, and ways of coping are one of the solutions to reduce stress. Social support is one of the influencing factors on coping strategies, but there is probably a difference between the effects of received or perceived social support on coping strategies. OBJECTIVE The aim was to investigate the relationship between received and perceived social support with ways of coping in nurses. METHODS This is a cross-sectional descriptive-correlational study. The sample consisted of 292 nurses by simple random sampling. The data collection tool included Zimmet's multidimensional perceived social support scale, McCain and Marklin's perceived social support questionnaire, and Lazarus' ways of coping questionnaire. Data were analyzed using Pearson correlation and multiple regression tests in SPSS v.22. RESULTS The results showed that received social support (β= 0.20, p < 0.001) and perceived social support (β= 0.35, p < 0.001) are able to explain changes in the dimension of seeking social support. Received social support (β= 0.16, p = 0.005) and perceived social support (β= 0.22, p < 0.001) are able to explain changes after positive reappraisal, but only received social support could explain changes in accepting responsibility (β= 0.15, p = 0.01). CONCLUSION This study showed that received and perceived social support have a significant correlation with ways of coping, but only able to explain the changes in social support seeking dimensions, positive reappraisal, accepting responsibility. Both types of social support are necessary, but that received social support covered more adaptive coping strategies.
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Affiliation(s)
- Shima Nazari
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Aida Zamani
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Pouya Farokhnezhad Afshar
- Department of Gerontology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
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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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Hamama-Raz Y, Ben-Ezra M, Bibi H, Swarka M, Gelernter R, Abu-Kishk I. Vigor among health-care professionals at the workplace: the role of intra- and inter-personal resources. PSYCHOL HEALTH MED 2023; 28:2964-2976. [PMID: 36576138 DOI: 10.1080/13548506.2022.2159454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 12/13/2022] [Indexed: 12/29/2022]
Abstract
Feeling vigorous throughout the workday in a medical facility despite exposure to daily job-related stress is essential for productive work-related behavior and for the subjective well-being of health-care professionals. The current study explored the contribution of an intra-personal resource (i.e. coping flexibility) and an inter-personal resource (i.e. social support) to the explained variance of vigor among nurses and physicians. Two hundred two hospital personnel completed self-report questionnaires regarding personal and professional data, vigor, coping flexibility and social support. The results revealed that the intra-personal resource coping flexibility, was positively associated with vigor while the inter-personal resource social support was not found to be associated with vigor. In addition, older age and higher self-rated health positively associated with feeling vigor. The current study shed light on the role of intra-personal resources in feeling vigorous throughout stressful workdays that characterize the workplace of hospital personnel. Tailoring interventions that may enhance coping flexibility among hospital personnel can increase their vigor which in turn may beneficially contribute to their job performance.
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Affiliation(s)
| | | | - Haim Bibi
- Pediatric Intensive Care Unit, Mayanei Hayeshua Medical Center, Bnei Brak, Israel, affiliated to the Adelson school of Medicine, Ariel University, Ariel, Israel
| | - Muhareb Swarka
- Internal Medicine Department "F", Shamir (Assaf Harofeh) Medical Center, Zerifin Israel, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Renana Gelernter
- Pediatric Emergency Unit, Shamir (Assaf Harofeh) Medical Center, Zerifin Israel, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ibrahim Abu-Kishk
- Pediatric Intensive Care Unit, Shamir (Assaf Harofeh) Medical Center, Zerifin Israel, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Schroeder S, Kelly D, Leighton K. Influence of years of experience and age on hospital workforce compassion satisfaction, anxiety, depression, stress, and burnout during pandemic: Implications for retention. PSYCHOL HEALTH MED 2023; 28:1741-1754. [PMID: 36550684 DOI: 10.1080/13548506.2022.2159988] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
The hospital workforce is experiencing overwork and burnout in response to COVID-19. It is imperative to identify those experiencing mental duress and determine protective factors to promote mental wellness and workforce retention. Our research aim was to identify the mental wellness and professional quality of life among hospital staff working during a global health pandemic, and to determine if age or years of experience served as protective factors. We electronically surveyed hospital staff in North Dakota during Summer 2021. Participants reported demographic data and completed clinically validated behavioral health screening tools assessing anxiety, depression, perceived stress, and work-related quality of life. The survey was administered to all 47 hospitals in North Dakota and received 771 complete responses. All hospital staff ages 18 and older were invited to participate. Age and years of experience were collected categorically in line with research on the topic. Years of experience had a significant influence (p < 0.05) on compassion satisfaction, burnout, and perceived stress. Compassion satisfaction was lowest for those who had worked 5-10 years, and then began to increase incrementally every 10 years thereafter. Hospital staff with 21-30 years of experience reported the highest mean score for both perceived stress and depression. Age had a significant influence (p < 0.05) on scores for anxiety, depression, compassion satisfaction, burnout, secondary traumatic stress, and perceived stress. Those closest to retirement (the oldest and those with the greatest years of experience) reported higher compassion satisfaction, while the youngest cohorts reported experiencing greater stress and burnout and may subsequently leave the profession. This may impact access to, and quality of, care. This study demonstrates the need to implement interventions with a focus on defending healthcare workers from the psychological effects of their caring profession.
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Affiliation(s)
- Shawnda Schroeder
- Department of Indigenous Health, University of North Dakota , School of Medicine & Health Sciences, Grand Forks, North Dakota, USA
| | - Daniel Kelly
- McKenzie County Healthcare Systems, Inc, Watford City, North Dakota
| | - Kristen Leighton
- Health Care Workforce Group, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA
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Delgado-Gallegos JL, Avilés-Rodriguez G, Padilla-Rivas GR, De Los Ángeles Cosío-León M, Franco-Villareal H, Nieto-Hipólito JI, de Dios Sánchez López J, Zuñiga-Violante E, Islas JF, Romo-Cardenas GS. Application of C5.0 Algorithm for the Assessment of Perceived Stress in Healthcare Professionals Attending COVID-19. Brain Sci 2023; 13:brainsci13030513. [PMID: 36979323 PMCID: PMC10046351 DOI: 10.3390/brainsci13030513] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
Coronavirus disease (COVID-19) represents one of the greatest challenges to public health in modern history. As the disease continues to spread globally, medical and allied healthcare professionals have become one of the most affected sectors. Stress and anxiety are indirect effects of the COVID-19 pandemic. Therefore, it is paramount to understand and categorize their perceived levels of stress, as it can be a detonating factor leading to mental illness. Here, we propose a computer-based method to better understand stress in healthcare workers facing COVID-19 at the beginning of the pandemic. We based our study on a representative sample of healthcare professionals attending to COVID-19 patients in the northeast region of Mexico, at the beginning of the pandemic. We used a machine learning classification algorithm to obtain a visualization model to analyze perceived stress. The C5.0 decision tree algorithm was used to study datasets. We carried out an initial preprocessing statistical analysis for a group of 101 participants. We performed chi-square tests for all questions, individually, in order to validate stress level calculation (p < 0.05) and a calculated Cronbach's alpha of 0.94 and McDonald's omega of 0.95, demonstrating good internal consistency in the dataset. The obtained model failed to classify only 6 out of the 101, missing two cases for mild, three for moderate and one for severe (accuracy of 94.1%). We performed statistical correlation analysis to ensure integrity of the method. In addition, based on the decision tree model, we concluded that severe stress cases can be related mostly to high levels of xenophobia and compulsive stress. Thus, showing that applied machine learning algorithms represent valuable tools in the assessment of perceived stress, which can potentially be adapted to other areas of the medical field.
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Affiliation(s)
- Juan Luis Delgado-Gallegos
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey 64260, Mexico
| | - Gener Avilés-Rodriguez
- Escuela de Ciencias de la Salud, Universidad Autónoma de Baja California, Ensenada 22890, Mexico
| | - Gerardo R Padilla-Rivas
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey 64260, Mexico
| | - María De Los Ángeles Cosío-León
- Universidad Politécnica de Pachuca, Carretera, Carretera Ciudad Sahagún-Pachuca Km. 20, Ex-Hacienda de Santa Bárbara, Zempoala 43830, Mexico
| | - Héctor Franco-Villareal
- Althian Clinical Research, Calle Capitán Aguilar Sur 669, Col. Obispado, Monterrey 64060, Mexico
| | - Juan Iván Nieto-Hipólito
- Facultad de Ingeniería, Arquitectura y Diseño, Universidad Autónoma de Baja California, Carr. Transpeninsular 391, Ensenada 22860, Mexico
| | - Juan de Dios Sánchez López
- Facultad de Ingeniería, Arquitectura y Diseño, Universidad Autónoma de Baja California, Carr. Transpeninsular 391, Ensenada 22860, Mexico
| | - Erika Zuñiga-Violante
- Facultad de Ingeniería, Arquitectura y Diseño, Universidad Autónoma de Baja California, Carr. Transpeninsular 391, Ensenada 22860, Mexico
| | - Jose Francisco Islas
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey 64260, Mexico
| | - Gerardo Salvador Romo-Cardenas
- Facultad de Ingeniería, Arquitectura y Diseño, Universidad Autónoma de Baja California, Carr. Transpeninsular 391, Ensenada 22860, Mexico
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Bai C, Bai B. Strength use and workers' job burnout in the Centers for Disease Control and Prevention: The mediating role of psychological capital. J Adv Nurs 2023; 79:2328-2336. [PMID: 36762675 DOI: 10.1111/jan.15586] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 11/25/2022] [Accepted: 01/25/2023] [Indexed: 02/11/2023]
Abstract
AIM This research aimed to explore the link of strength use with job burnout and investigate the role of psychological capital in the strength use-job burnout relationship among Chinese workers at the Centers for Disease Control and Prevention. DESIGN A descriptive, cross-sectional design. METHOD This study was conducted from September to October 2020. A total of 351 employees working at Centers for Disease Control and Prevention from five cities in China completed a series of valid and reliable instruments, namely, Strengths Use Questionnaire, Positive Psychological Capital Questionnaire and Job Burnout Questionnaire. The PROCESS macro was used to test our hypotheses. RESULTS We found that people with higher strength use had lower job burnout compared with those with lower levels of strength use. Furthermore, resilience and hope acted as mediators of the relationship between strength use and job burnout. Moreover, resilience and hope played equally important roles in the strength use-job burnout relationship. CONCLUSION Resilience and hope mediate the association of strength use with job burnout in workers of Chinese Centers for Disease Control and Prevention. IMPACT Health authorities can alleviate employees' job burnout by encouraging strength use and building their psychological capital, especially resilience and hope.
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Affiliation(s)
- Chengzhi Bai
- Department of Psychology, School of Philosophy, Wuhan University, Wuhan, China
| | - Baoyu Bai
- Department of Psychology, School of Philosophy, Wuhan University, Wuhan, China
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“Was Definitely Different Because They Were Kids”: Caring for Patients From a School Shooting. J Trauma Nurs 2022; 29:252-261. [DOI: 10.1097/jtn.0000000000000673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Wood RE, Brown RE, Kinser PA. The connection between loneliness and burnout in nurses: An integrative review. Appl Nurs Res 2022; 66:151609. [DOI: 10.1016/j.apnr.2022.151609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 01/06/2022] [Accepted: 06/21/2022] [Indexed: 11/16/2022]
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Sun R, Lv K, He Z, Liao L, Wang H, Lan Y. The Mediating Role of Worker-Occupation Fit in the Relationship Between Occupational Stress and Depression Symptoms in 1988 Medical Workers: A Cross-Sectional Study. Front Public Health 2022; 10:843845. [PMID: 35655447 PMCID: PMC9152027 DOI: 10.3389/fpubh.2022.843845] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Occupational stress is generally acknowledged as a global phenomenon with significant health and economic consequences. The medical worker is a vulnerable group at a high-level risk for depression symptoms. This study aimed to examine the mediating effect of worker-occupation fit (WOF) in relation to occupational stress and depression symptoms among 1988 medical workers in China. Methods A multi-center cross-sectional study was conducted during June and October 2020 in Henan Province, China. The participants were medical workers from four targeted hospitals (included one general and three specialized hospitals). The Depression, Anxiety, and Stress Scale (DASS-21 Scale), Worker-Occupation Fit Inventory (WOFI), as well as questions about demographic and occupational information were administered in questionnaires distributed to 1988 medical workers. Hierarchical linear regression analysis was used to examine the mediating role of worker occupation fit. Results In this study, there are 43.5% (n = 864) of medical workers experienced depression symptoms. The mean score of WOF was 31.6 ± 7.1, characteristic fit, need supply fit and demand ability fit were 11.3 ± 2.5, 10.1 ± 2.7, 12.9 ± 2.2, respectively. The occupational stress was negatively related to worker occupation fit (r = -0.395, P < 0.001), characteristic fit (r = -0.529, P < 0.001), need supply fit (r = -0.500, P < 0.001), and demand ability fit (r = -0.345, P < 0.001). The occupational stress and depression symptoms have a positive relationship (r = 0.798, P < 0.001). The proportion of worker occupation fit mediation was 6.5% of total effect for depression symptoms. Conclusion Occupational stress has been identified as a risk factor for depression symptoms. Practical strategies for improving medical workers' WOF level would help them better cope with various work-related stressors to reduce depression symptoms. Hospital administrators could reduce medical workers' depression symptoms by taking comprehensive measures to improve the WOF.
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Affiliation(s)
- Ruican Sun
- Department of Preventive Medicine, School of Public Health, Chengdu Medical College, Chengdu, China
| | - Keyao Lv
- Department of Environmental Health and Occupational Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Zirui He
- Department of Preventive Medicine, School of Public Health, Chengdu Medical College, Chengdu, China
| | - Liang Liao
- Department of Preventive Medicine, School of Public Health, Chengdu Medical College, Chengdu, China
| | - Hongping Wang
- Department of Preventive Medicine, School of Public Health, Chengdu Medical College, Chengdu, China
| | - Yajia Lan
- Department of Environmental Health and Occupational Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Secondary Traumatic Stress and Vigor Among Neonatal Intensive Care Unit Personnel: The Moderator Role of Coping Flexibility. Adv Neonatal Care 2022; 22:E86-E93. [PMID: 34417354 DOI: 10.1097/anc.0000000000000924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The demanding and highly stressful work environment of the neonatal intensive care unit (NICU) has led to the identification of a possible psychological stress reaction among NICU nurses and physicians, termed secondary traumatic stress (STS). PURPOSE The current study aimed to explore the association between vigor at work (as an energy resource) and STS, while considering their association with the professional role (nurses/physicians-as a condition resource) as well as with coping flexibility (as a personal resource). METHODS In this cross-sectional study physicians and nurses working in NICUs across Israel completed a questionnaire comprising sections on demographics and professional characteristics, self-rated health, STS, coping flexibility, and vigor. RESULTS Of 280 physicians and nurses approached, 70% (195) completed the questionnaire. No significant differences between nurses and physicians were found in STS adjusted for gender, being in a committed relationship, and seniority in the NICU. Vigor was negatively correlated with STS-both in the entire sample and for each professional role alone. Coping flexibility was a statistically significant moderator between vigor and STS, whereas the interaction between vigor and professional role was not significant. Specifically, the negative relationship between vigor and STS was significant when coping flexibility was more than 10.10 (61% of the participants) but not significant at lower values. IMPLICATIONS FOR PRACTICE AND RESEARCH The understanding of the relationship between vigor and STS, with coping flexibility as its moderator, encourages an intervention aimed at reducing stress by increasing these resources.
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Chen D, Lin Q, Yang T, Shi L, Bao X, Wang D. Distributive Justice and Turnover Intention Among Medical Staff in Shenzhen, China: The Mediating Effects of Organizational Commitment and Work Engagement. Risk Manag Healthc Policy 2022; 15:665-676. [PMID: 35444476 PMCID: PMC9015103 DOI: 10.2147/rmhp.s357654] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/04/2022] [Indexed: 12/17/2022] Open
Abstract
Background Turnover of medical staff is a vital issue in the global healthcare system. Previous evidence has confirmed the critical effect of distributive justice on turnover intention, but few studies have focused on the mediating mechanism behind this relationship or the medical staff. This study aimed to examine the mediating roles of organizational commitment and work engagement in the relationship between distributive justice and turnover intention of medical staff, and explore potential occupational differences. Methods Stratified random sampling was adopted to select qualified medical staff from each clinical department of a large general hospital in Shenzhen, China, at a physician-to-nurse ratio of 1:1.5. The medical staff were surveyed using the Distributive Justice Scale, the Organizational Commitment Scale, the Work Engagement Scale, and the Turnover Intention Scale from May to July 2020. Of the 500 medical staff sampled, 480 responded (response rate: 96.00%), and 457 were finally included for analysis (effective response rate: 95.21%). A mediation analysis was performed using Model 6 of the SPSS macro PROCESS program. Results There were significant positive correlations among distributive justice, organizational commitment, and work engagement and significant negative correlations among distributive justice, organizational commitment, work engagement, and turnover intention. Distributive justice directly and negatively affected the turnover intention of physicians and nurses, but there were occupational differences in the underlying mechanism between distributive justice and turnover intention. Distributive justice indirectly affected turnover intention among physicians mainly through the mediating effect of organizational commitment, and indirectly among nurses through three different pathways: the mediating effect of organizational commitment, the mediating effect of work engagement, and the chain mediating effect of organizational commitment and work engagement. Conclusion The relationship between distributive justice and turnover intention was found to be mediated by organizational commitment and work engagement among medical staff in Shenzhen, with variations between physicians and nurses. Thus, appropriately targeted interventions are needed for physicians and nurses to reduce turnover intention.
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Affiliation(s)
- Dongxue Chen
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Qian Lin
- Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Tiecheng Yang
- The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, People’s Republic of China
| | - Lushaobo Shi
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Xiaolu Bao
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- Institute of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- Correspondence: Dong Wang, School of Health Management, Southern Medical University, No. 1023 Shatai Road, Guangzhou, Guangdong, 510515, People’s Republic of China, Tel/Fax +0086-020-61647576, Email
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15
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Bock C, Zimmermann T, Kahl KG. The impact of post-traumatic stress on the mental state of university hospital physicians - a cross sectional study. BMC Psychiatry 2022; 22:85. [PMID: 35114970 PMCID: PMC8815118 DOI: 10.1186/s12888-022-03719-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 01/20/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Hospital physicians have an increased risk for post-traumatic stress caused by work-related trauma. This study examines the frequency of reported traumatic events (TE), post-traumatic stress (PTS) and its possible consequences for the mental state and work ability of physicians at a university hospital. METHODS As part of the mandatory psychological risk assessment, n = 145 physicians (n = 56 female; 38.6%) were examined at a university hospital in Germany in a cross sectional study. TE, PTS and symptoms of depression and anxiety were assessed using the self-report questionnaires "Freiburger Screening Fragebogen to identify patients at risk for the development of a post-traumatic stress disorder in the group of severely injured patients" (PTBS-13), the "Patient Health Questionnaire" (PHQ-2) and the "Generalized Anxiety Disorder scale" (GAD-2). Work ability was assessed using a modified version of the questionnaire for workplace analysis (KFZA). The response rate was 52%. RESULTS Traumatic events were experienced by n = 125 physicians (86.2%) throughout their whole career. Of these, 19 physicians (15.2%) reported PTS. PTS is reported by 12 of 56 female physicians (63.2%), compared to 7 of 89 reports of PTS by male physicians (36.8%). Physicians with PTS symptoms had higher depression scores (p = 0.007) compared to physicians without TE or with TE, but without PTS. Physicians with PTS reported significantly reduced work ability caused by constantly interrupted work (p = 0.03). Female gender was the greatest risk factor for the development of PTS. (p = 0.001). CONCLUSIONS Physicians - especially females - with PTS may have an increased risk of developing depressive symptoms. Therefore, interventions aimed at reducing trauma-related stress symptoms may be helpful in improving mental health of hospital physicians. Further studies with more physicians from different hospitals are necessary to support the results.
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Affiliation(s)
- Christian Bock
- Department of Occupational Safety, Hannover Medical School, Hannover, Germany.
| | - Tanja Zimmermann
- grid.10423.340000 0000 9529 9877Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Kai G. Kahl
- grid.10423.340000 0000 9529 9877Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
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16
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Stokar YN, Pat-Horenczyk R. Themes of end-of-life care in memorable cases of medical health professionals: A mixed methods approach. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-021-02566-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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We must practice what we preach: a framework to promote well-being and sustainable performance in the public health workforce in the United States. J Public Health Policy 2022; 43:140-148. [PMID: 34983961 PMCID: PMC8724584 DOI: 10.1057/s41271-021-00335-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2021] [Indexed: 11/21/2022]
Abstract
The COVID-19 pandemic, along with efforts to address systemic racism and social injustice, has required the public health workforce to mobilize an unprecedented and extensive frontline response while simultaneously delivering core services and addressing natural disasters and other emergent threats. Research conducted among health care professionals during the COVID-19 pandemic indicates an increase in anxiety, depression, and burnout, but mental health effects of the pandemic on the public health workforce are less well understood. Left unaddressed, secondary traumatic stress resulting from exposure to the trauma of those we serve, as well as burnout stemming from work-related factors, may hinder our ability to fulfill our mission to serve the population at large. This Viewpoint provides a framework for shifting our culture to prioritize the well-being and sustainable performance of the public health workforce to foster resilience and mitigate stressors.
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18
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Carmassi C, Dell'Oste V, Bertelloni CA, Pedrinelli V, Barberi FM, Malacarne P, Dell'Osso L. Gender and occupational role differences in work-related post-traumatic stress symptoms, burnout and global functioning in emergency healthcare workers. Intensive Crit Care Nurs 2021; 69:103154. [PMID: 34895972 DOI: 10.1016/j.iccn.2021.103154] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 08/01/2021] [Accepted: 09/08/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To explore gender and occupational role impact on work-related Post-Traumatic Stress Symptoms, Post-Traumatic Stress Disorder, burnout and global functioning in a sample of emergency healthcare workers. DESIGN A cross-sectional study. PARTICIPANTS/SETTING 126 healthcare workers of the Emergency Department, including Intensive Care Unit, Emergency Room and Emergency Medicine, of a major University Hospital in central Italy were recruited. MAIN OUTCOME MEASURES Participants were assessed by means of the: Trauma and Loss Spectrum-Self Report (TALS-SR) to explore Post-Traumatic Stress Spectrum Symptoms, Professional Quality of Life (ProQOL) Scale to assess Compassion Satisfaction, Burnout and Compassion Fatigue and Work and Social Adjustment Scale (WSAS) to measure global functioning. RESULTS The present findings showed females were more prone to develop Post-Traumatic Stress Symptoms, particularly re-experiencing (p = .010) and hyperarousal (p = .026) symptoms and medical doctors reporting higher Burnout (p < .001) and lower Compassion Satisfaction (p = .009) mean scores than nurses. Higher levels of functioning impairment emerged amongst medical doctors rather than nurses, in both social (p = .029) and private (p = .020) leisure activities. Linear correlations highlighted relationships between the TALS-SR, ProQOL and WSAS scores. Finally, medical doctor status was significantly associated with lower Compassion Satisfaction (p = .029) and higher Burnout (p = .015). CONCLUSION Our results highlight high post-traumatic stress symptoms and burnout levels in emergency healthcare workers with a relevant impact of female gender and occupational role, supporting the need for preventive strategies, also in light of the current COVID-19 pandemic.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | | | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Paolo Malacarne
- Anaesthesia and Intensive Care Unit, Azienda Ospedaliero-Universitaria Pisana (AOUP), Pisa, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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19
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Yang L, Wu D. Grit and Meaning in Life of Chinese Nurses: The Chain Mediating Effect of Social Support and Hope. Front Psychol 2021; 12:769707. [PMID: 34858295 PMCID: PMC8631816 DOI: 10.3389/fpsyg.2021.769707] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 10/11/2021] [Indexed: 12/12/2022] Open
Abstract
Grit is defined as perseverance and passion for long-term goals, and it may affect the stability of the nursing workforce and the physical and mental health of nurses continuously. Meaning in life has received considerable attention from scholars, which is an important component in positive psychology. This study aimed to delve into the relationship between grit and the meaning in life of Chinese nurses. Additionally, we also sought to prove the chain mediating effect of social support and hope on this relationship. An online questionnaire survey was used to collect data from 704 Chinese nurses using the self-made demographic questionnaire with Short Grit Scale (Grit-S), the Perceived Social Support Scale (PSSS), Adult Dispositional Hope Scale (ADHS), and Meaning in Life Questionnaire (MLQ). Moreover, Process version 3.3 plug-in SPSS 25 was used to test the mediation effect between variables. The results showed a strong positive relationship between grit and meaning in life and verified the mediating effect of social support and hope on grit and meaning in life. The results also confirmed the chain mediating model between grit, social support, hope, and meaning in life.
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Affiliation(s)
- Lei Yang
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Dongmei Wu
- Department of Nursing, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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20
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Charmer L, Jefford E, Jomeen J. A scoping review of maternity care providers experience of primary trauma within their childbirthing journey. Midwifery 2021; 102:103127. [PMID: 34425458 DOI: 10.1016/j.midw.2021.103127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/21/2021] [Accepted: 08/03/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine and summarise available literature on maternity care practitioners having experienced primary trauma during their childbirthing journey and whether this impacts their mental well-being and/or care provision when subsequently caring for childbearing women. BACKGROUND Birth trauma affects 1 in 3 women; 1 in 20 women show post-traumatic stress disorder symptoms by 12 weeks after birth. However, what is not known is what percentage of these women are maternity care providers experiencing or having experienced personal trauma during their child birthing journey. This scoping review aims to examine and summarise available literature on maternity care practitioners having experienced primary trauma during their childbirthing journey and whether this impacts their mental well-being and/or care provision when subsequently caring for childbearing women. METHODS Arksey and O'Malley (2005) six-stage scoping review framework was revised and utilised. A search of the relevant databases (MEDLINE Embase, CINAHL, APA PsycInfo, Scopus) was undertaken with several keywords related to trauma and personal experience. Reference lists were also searched of studies identified for reading the full text. FINDINGS The search strategy identified 2983 articles. The studies excluded were considered to be unrelated to the topic directly. A total of 352 articles were reviewed by abstract, and 29 additional studies were identified from reference lists; 32 were reviewed by full text. A total of 0 studies met the inclusion criteria for the scoping review. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The scoping review identified a gap in the literature as maternity care practitioners personal experience of trauma during the child birthing journey has not been researched. Research is needed to explore and conceptualise the experiences of maternity care practitioners having experienced trauma and the ongoing implications this may have on their personal and professional lives.
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Affiliation(s)
- Lisa Charmer
- Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia.
| | - Elaine Jefford
- Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia
| | - Julie Jomeen
- Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia
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21
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Sarabia-Cobo C, Pérez V, de Lorena P, Fernández-Rodríguez Á, González-López JR, González-Vaca J. Burnout, Compassion Fatigue and Psychological Flexibility among Geriatric Nurses: A Multicenter Study in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147560. [PMID: 34300009 PMCID: PMC8305508 DOI: 10.3390/ijerph18147560] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/08/2021] [Accepted: 07/14/2021] [Indexed: 02/02/2023]
Abstract
Nurses working at nursing homes are one of the most vulnerable populations for suffering burnout and compassion fatigue. In Spain, the concept of compassion fatigue and psychological flexibility related to stress in geriatric nurses has not been fully explored until now. It is important to analyze their situation in order to design robust coping and management strategies. The aim was to analyze the relationship between burnout, compassion fatigue and psychological flexibility in geriatric nurses in Spain. Participants included 291 nurses from 97 centers in 51 cities across Spain. Psychological flexibility (AAQ-II), burnout (MBI) and compassion fatigue (ProQOL) were evaluated. Responses were recievced from 281 nurses (91% women), with an average of 7.6 years of work experience. The MBI results were average (26.71), and the ProQOL scores were average for compassion fatigue (40.2%) and high for compassion satisfaction (70.3%), whereas for AAQ-II, the mean score was 37.34 (SD 4.21). The correlation was significant and negative for flexibility, burnout and compassion fatigue, and positive for compassion satisfaction. The ANOVA indicated a significant association between all variables (p < 0.05). We can conclude that geriatric nurses suffer from medium levels of burnout and compassion fatigue, together with high levels of psychological flexibility, which appears to act as a stress reliever, supporting compassion satisfaction.
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Affiliation(s)
- Carmen Sarabia-Cobo
- Facultad de Enfermería, IDIVAL, Universidad de Cantabria, Avda Valdecilla s/n, 39011 Cantabria, Spain;
- Correspondence:
| | | | | | | | - José Rafael González-López
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, C/Avenzoar nº6, 41009 Seville, Spain;
| | - Julia González-Vaca
- Departament D’Ínfermeria Medicoquirurgica, Campus Bellvitge, Universidad de Barcelona, 08907 Barcelona, Spain;
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22
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Factors Affecting Secondary Traumatic Stress of Nurses Caring for COVID-19 Patients in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136843. [PMID: 34202283 PMCID: PMC8297365 DOI: 10.3390/ijerph18136843] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/21/2021] [Accepted: 06/24/2021] [Indexed: 11/16/2022]
Abstract
The secondary traumatic stress (STS) of nurses caring for COVID-19 patients is expected to be high, and it can adversely affect patient care. The purpose of this study was to examine the degree of STS of nurses caring for COVID-19 patients, and we identified various factors that influence STS. This study followed a descriptive design. The data of 136 nurses who had provided direct care to COVID-19 patients from 5 September to 26 September 2020 were collected online. Hierarchical regression analysis was conducted to identify the factors influencing STS. Participants experienced moderate levels of STS. The regression model of Model 1 was statistically significant (F = 6.21, p < 0.001), and the significant factors influencing STS were the duration of care for patients with COVID-19 for more than 30 days (β = 0.28, p < 0.001) and working in an undesignated COVID-19 hospital (β = 0.21, p = 0.038). In Model 2, the factor influencing STS was the support of a friend in the category of social support (β = -0.21, p = 0.039). The nurses caring for COVID-19 patients are experiencing a persistent and moderate level of STS. This study can be used as basic data to treat and prevent STS.
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23
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Epstein EG, Haizlip J, Liaschenko J, Zhao D, Bennett R, Marshall MF. Moral Distress, Mattering, and Secondary Traumatic Stress in Provider Burnout: A Call for Moral Community. AACN Adv Crit Care 2021; 31:146-157. [PMID: 32525997 DOI: 10.4037/aacnacc2020285] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Burnout incurs significant costs to health care organizations and professionals. Mattering, moral distress, and secondary traumatic stress are personal experiences linked to burnout and are byproducts of the organizations in which we work. This article conceptualizes health care organizations as moral communities-groups of people united by a common moral purpose to promote the well-being of others. We argue that health care organizations have a fundamental obligation to mitigate and prevent the costs of caring (eg, moral distress, secondary traumatic stress) and to foster a sense of mattering. Well-functioning moral communities have strong support systems, inclusivity, fairness, open communication, and collaboration and are able to protect their members. In this article, we address mattering, moral distress, and secondary traumatic stress as they relate to burnout. We conclude that leaders of moral communities are responsible for implementing systemic changes that foster mattering among its members and attend to the problems that cause moral distress and burnout.
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Affiliation(s)
- Elizabeth G Epstein
- Elizabeth G. Epstein is Associate Professor and Department Chair, University of Virginia School of Nursing; and Associate Professor, School of Medicine Center for Health Humanities and Ethics, 202 Jeanette Lancaster Way, Charlottesville, VA 22903
| | - Julie Haizlip
- Julie Haizlip is Clinical Professor of Nursing and Associate Professor of Pediatrics, University of Virginia, Charlottesville, Virginia
| | - Joan Liaschenko
- Joan Liaschenko is Professor, University of Minnesota Center for Bioethics and School of Nursing, Minneapolis, Minnesota
| | - David Zhao
- David Zhao is an undergraduate student at the University of Chicago, Chicago, Illinois
| | - Rachel Bennett
- Rachel Bennett is a doctoral student at University of Virginia School of Nursing, Charlottesville, Virginia
| | - Mary Faith Marshall
- Mary Faith Marshall is Emily Davie and Joseph S. Kornfeld Professor of Biomedical Ethics, University of Virginia School of Medicine Center for Health Humanities and Ethics; and Professor of Nursing, University of Virginia School of Nursing, Charlottesville, Virginia
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Abstract
OBJECTIVE The provision of end-of-life (EOL) care has complex effects on both the professional and personal well-being of medical health personnel (MHP). Previous studies have mostly focused on negative or positive influences as mutually exclusive effects. This study offers a new conceptualization by applying a dialectical lens, looking at secondary traumatic stress (STS) and post-traumatic growth (PTG) as dual possible coexisting phenomena. The creation of four theoretically possible profiles, based on the combinations of high or low levels in each dimension, offers a practical translation of this idea toward intervention development. METHOD Data were collected at a large tertiary pediatric medical center (n = 1,123) aiming at assessing all personnel. Research methods included collecting demographic data and using validated scales to assess STS, PTG, burnout, compassion satisfaction, and both personal and professional social support. RESULTS We classified four response profiles according to the STS and PTG levels: (1) Dialectical-impact, high STS/high PTG, (2) Growth-dominant, high PTG/low STS, (3) Stress-dominant, high STS/low PTG, and (4) Limited-impact, low STS/low PTG. The four profiles differed based on profession, but not other demographics. Physicians were represented significantly higher in the Stress-dominant profile; nurses were highly represented in the Dialectical-impact profile. A significant difference was found when adding reported EOL care as a distinct factor with a higher relative proportion of the "dialectical" response among those reporting providing EOL care. SIGNIFICANCE OF RESULTS Findings from this study point toward the recognition and understanding of the complexity resulting from the provision of EOL care. A more complex profile classification, including the dialectical profile, may reflect a broader tendency to ways that MHP are affected by their work. Introducing "dialectical thinking" can lead to more personalized and precise intervention planning for MHP. Tailored interventions promoting personal and professional well-being, based on individual profiles, can contribute to more effective interventions and better resource utilization.
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25
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Vitous CA, Dinh DQ, Jafri SM, Bennett OM, MacEachern M, Suwanabol PA. Optimizing Surgeon Well-Being: A Review and Synthesis of Best Practices. ANNALS OF SURGERY OPEN 2021; 2:e029. [PMID: 36714393 PMCID: PMC9872854 DOI: 10.1097/as9.0000000000000029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/19/2020] [Indexed: 02/01/2023] Open
Abstract
Through a systematic review and mixed-methods meta-synthesis of the existing literature on surgeon well-being, we sought to identify the specific elements of surgeon well-being, examine factors associated with suboptimal well-being, and highlight opportunities to promote well-being. Background Suboptimal surgeon well-being has lasting and substantial impacts to the individual surgeon, patients, and to society as a whole. However, most of the existing literature focuses on only 1 aspect of well-being-burnout. While undoubtedly a crucial component of overall well-being, the mere absence of burnout does not fully consider the complexities of being a surgeon. Methods We performed a literature search within Ovid Medline, Elsevier Excerpta Medica dataBASE, EBSCOhost Cumulative Index to Nursing and Allied Health Literature, and Clarivate Web of Science from inception to May 7, 2020, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies with primary data examining surgeon well-being were included. Using a predetermined instrument, data were abstracted from each study and compared using thematic analysis. Results A total of 5369 abstracts were identified and screened, with 184 full articles (172 quantitative, 3 qualitative, 9 mixed methods) selected for analysis. Among these, 91 articles measured burnout, 82 examined career satisfaction, 95 examined work-related stressors, 44 explored relationships and families, and 85 assessed emotional and physical health. Thematic analysis revealed 4 themes: professional components, personal components, work-life balance, and impacts to well-being. Conclusions Surgeon well-being is complex and multifaceted. This nuanced examination of surgeon well-being highlights the critical need to develop and provide more long-term support to surgeons-with interventions being tailored based on individual, institutional, and systemic factors.
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Affiliation(s)
- C. Ann Vitous
- From the Department of Surgery, University of Michigan, Ann Arbor, MI
| | | | - Sara M. Jafri
- Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI
| | | | - Mark MacEachern
- Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI
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26
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Fortune DG, Richards HL, Wormald A, O Connor K, McKiernan M, Najt P, O Dwyer A, O Dea E, Burke P, Eustace J. An investigation of psychological responses to COVID-19 in Irish healthcare workers: longitudinal quantitative and nested qualitative study. HRB Open Res 2021; 4:15. [PMID: 34109298 PMCID: PMC8150119 DOI: 10.12688/hrbopenres.13204.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2021] [Indexed: 12/23/2022] Open
Abstract
COVID-19 is an unprecedent occurrence in modern times and individuals who work within healthcare settings, face a broad array of challenges in responding to this worldwide event. Key information on the psychosocial responses of such healthcare workers (HCWs) in the context of COVID-19 is limited and in particular there is a need for studies that utilise longitudinal methods, an overarching theoretical model, and use of a cohort of participants within a defined geographical area across acute and community settings. The work packages making up the current research project use quantitative and qualitative methods to examine the psychological sequelae for HCWs in the context of COVID-19 in geographically adjacent healthcare areas (South and Mid-West of Ireland) across four time points (induction, 3 months, 6 months, and 1 year follow-up). The quantitative arm of the project (WP 1) utilises the Common-Sense Model of Self-Regulation (CSM-SR) and examines a number of key psychological factors pertinent to this model including perceptions about COVID-19 and infection more generally, coping, formal and informal support and a number of impact variables including mood, sleep quality, and perceptions of stigma. The qualitative study (WP 2) will address HCWs experiences of working during the pandemic, ascertain any additional areas of psychological functioning, environmental and workplace factors and resources that may be utilised by HCWs and that are not assessed by the quantitative study protocol, focusing particularly on those staff groups typically underrepresented in previous studies.
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Affiliation(s)
- Donal G Fortune
- Psychology, University of Limerick, Limerick, Ireland.,Clinical Psychology, HSE Mid West Community Healthcare, Limerick, Ireland
| | | | | | | | | | - Pablo Najt
- Psychology, University of Limerick, Limerick, Ireland
| | | | - Edmond O Dea
- Clinical Psychology, HSE Mid West Community Healthcare, Limerick, Ireland
| | - Paul Burke
- Clinical Education and Research Centre, University of Limerick Hospitals Group, Limerick, Ireland
| | - Joseph Eustace
- Medicine and HRB CRF, University College Cork, Cork, Ireland
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27
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The interaction effect between gender and profession in posttraumatic growth among hospital personnel. Prim Health Care Res Dev 2020; 21:e35. [PMID: 32967750 PMCID: PMC7576536 DOI: 10.1017/s1463423620000377] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Aim: To explore if there is an interaction effect between gender (men and women) and profession (nurses and physicians) in posttraumatic growth (PTG). Background: PTG is defined as a positive psychological change experienced as a result of struggling with highly challenging life circumstances. It may take the form of improved self-image, a deeper understanding of self, increased spirituality, and/or enhanced interpersonal relationships. Gender and profession were found separately to be associated with PTG, but to date were not examined under interaction effect. Methods: We employed a cross-sectional study conducted in the tertiary medical center in Israel using a convenience sample. One hundred and twenty-eight nurses and seventy-eight physicians gave their consent and agreed to fill out self-report questionnaires regarding personal and professional data and PTG Inventory. Findings: The correlation matrix revealed that being a woman was associated with higher PTG total scale (r = 0.242; P ≤ 0.001) and its subscales except for spiritual change that showed no evidence of statistical effect. Similar pattern was found for being a nurse with PTG total scale (r = 0.223; P ≤0.001) and its subscales except for relating to others that showed no evidence of statistical effect. However, the interaction effect revealed that among men, there was no difference in the level of PTG and its subscales based on profession (Physicians men = 62.54 (20.82) versus Nurses men = 60.26 (22.39); F = 9.618; P = 0.002). Among women, nurses had a significantly higher scores in PTG (Physicians women = 61.81 (18.51) versus Nurses women = 73.87 (12.36); F = 9.618; P = 0.002) and its subscales in comparison to physicians except for subscale relating to other. Conclusions: Our findings suggest implications for research and practice namely exploring PTG among nurses and physicians would benefit from applying interaction effect of gender and profession. For practice, advocating PTG within the health care organization is needed to be tailored with gender and professional sensitivity.
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