Mediating effects of self-efficacy, coping, burnout, and social support between job stress and mental health among young Chinese nurses

Novice nurses' transition shock and professional identity: The chain mediating roles of self-efficacy and resilience

AIMS AND OBJECTIVES

The aim of this study was to explore the association between transition shocks and professional identity and the mediating roles of self-efficacy and resilience among Chinese novice nurses.

BACKGROUND

Novice nurses experience transition shock when they start their careers, which might lead to decreased professional identity and ultimately turnover. By contrast, self-efficacy and resilience are excellent psychological resources that may be associated with higher professional identity. It is unclear how transition shock affects professional identity by influencing these two internal resources.

DESIGN

A cross-sectional survey.

METHODS

The STROBE guidelines were followed to report this study. Convenience sampling was used to recruit participants, and 252 novice nurses completed the Transition Shock of Novice Nurses Scale, the Professional Identity Assessment Scale, the General Self-Efficacy Scale and the Connor-Davidson Resilience Scale between April 2022 and May 2022. Influencing factors were primarily identified using independent-sample t-tests and a one-way ANOVA. Structural equation modelling was used to detect the mediating effects of self-efficacy and resilience.

RESULTS

Differences in novice nurses' levels of professional identity were found across age groups, hospitals and departments. Transition shock was negatively related to professional identity. Self-efficacy and resilience mediated the complete chain relationship between transition shock and professional identity.

CONCLUSION

To our knowledge, this study is the first to explore the mediating effect of self-efficacy and resilience on transition shock and professional identity. Higher transition shock may lead to lower professional identity by reducing self-efficacy and resilience.

RELEVANCE TO CLINICAL PRACTICE

Nursing managers ought to emphasise the significant role of psychological resources in the work adaptation process of novice nurses. It may be more effective to improve professional identity and maintain the stability of the health care system.

PATIENT OR PUBLIC CONTRIBUTION

Nursing administrators working at seven preselected hospitals actively assisted us in the process of collecting self-report questionnaires from novice nurses, such as by booking appointments and providing access for questionnaire administration. In addition, the participants were actively involved in the data collection process.

Male nurses' adaptation experiences after turnover to community institutions in Korea: A grounded theory methodology

We aimed to develop a substantive theory according to the associations between adaptation experience-related factors identified in male nurses after turnover to community institutions. From April through August 2019, data were collected through direct observations and in-depth interviews of 22 male nurse participants who were recruited purposively and analyzed simultaneously with the method proposed by Strauss and Corbin. Furthermore, 29 subcategories were derived from 11 categories, including: (1) leaving the clinical sector and changing jobs, (2) shaking while settling, (3) characteristics of the new job, (4) personal disposition, (5) support system, (6) finding my place, (7) solidifying my place, (8) demonstrating my professional competence, (9) stable settlement in my place, (10) preparing for a better future, and (11) still confused. The core category was identified as "putting down roots in another place for myself." The verification of this theory in this study's results indicates a need for research into the evaluation and development of professional development programs and related policies to provide support to male nurses who are pursuing opportunities in community institutions to maintain their nursing identity and further their efforts for developing a nursing specialty.

Relationship between psychological capital and mental health at higher education: Role of perceived social support as a mediator

Research in Positive Psychology has indicated a correlation between Psychological Capital (PsyCap) and Mental health (MH). However, the specific contribution of Perceived Social Support (PSS) in the connection between PsyCap and MH, particularly within higher education, remains uninvestigated. This study investigated how PSS could mediate the effect of PsyCap on students' MH using a cross-sectional research design. The sample encompassed 443 undergraduate graduate students at Huazhong University of Science and Technology in Wuhan, China. Results from Partial Least Squares Structural Equation Modeling (PLS-SEM) showed that both PsyCap (β = 0.815, t = 31.074, p < 0.000) and PSS (β = 0.405, t = 28.051, p < 0.000) have a positive impact on students' MH. Additionally, PSS was identified as a significant mediator in relation to students' MH (b = 0.080, t = 2.319, p < 0.020). This study emphasizes the importance of developing these factors in educational and support programs to enhance students' well-being. Moreover, the results offer significant conceptual and practical insights for higher education faculty, psychologists, and curriculum designers.

The relationship between social support and professional identity of health professional students from a two-way social support theory perspective: chain mediating effects of achievement motivation and meaning in life

BACKGROUND

Studies has suggested that receiving social support improves the professional identity of health professional students. According to the two-way social support theory, social support includes receiving social support and giving social support. However, the effect of the two-way social support on health professional students' professional identity has not been clarified yet.

METHODS

To explore the mechanism of how two-way social support affects health professional students' professional identity, an observational, cross-sectional study was conducted among a convenience and cluster sample of 1449 health professional students from two medical schools in western China. Measures included a short version of the two-way social support scale, a health professional students' professional identity questionnaire, an achievement motivation scale, and a meaning in life scale. Data were analyzed by use of SPSS26.0 software and PROCESSv4.0 plug-in.

RESULTS

Receiving social support, giving social support, achievement motivation, meaning in life, and professional identity were positively correlated with each other. Receiving and giving social support not only directly predicted health professional students' professional identity, but also indirectly predicted health professional students' professional identity through the mediating roles of achievement motivation and meaning in life, and the chain mediating roles of achievement motivation and meaning in life, respectively. The effectiveness of predicting health professional students' professional identity varied among different types of two-way social support, which could be depicted as two-way social support > mainly giving social support > mainly receiving social support > low two-way social support.

CONCLUSION

In the medical education, the awareness and ability of health professional students to receive and give social support should be strengthened. More attention should be drawn on the chain mediating effect of achievement motivation and meaning in life between two-way social support and professional identity. The current results shed new light on exploring effective ways of improving health professional students' professional identity, which suggested that more attention should be paid to the positive effects of mainly giving social support and two-way social support rather than only on the effects of receiving social support.

Prevalence and Determinants of Anxiety and Depression Among Healthcare Workers in Liaoning Province, China

Purpose

To assess the anxiety and depression and their predictors among healthcare workers in Liaoning Province, China.

Methods

In order to explore the influencing factors and prevalence of anxiety and depression among healthcare workers, a cross-sectional research design was used to survey 500 healthcare workers using the 14-item Hospital Anxiety Depression Scale (HADS), the Rosenberg Self-Esteem Scale (RSES), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Survey of Perceived Organizational Support (SPOS).

Results

About 47.12% of the healthcare workers suffered from anxiety and 71.63% suffered from depression. In our study, we found that the health status (OR: 0.540, 95% CI: 0.298-0.976), self-esteem (OR: 0.395, 95% CI: 0.251-0.619), PSS (OR: 0.621, 95% CI: 0.388-0.994), organizational support (OR: 0.533, 95% CI. 0.333-0.854) were protective factors for healthcare workers suffering from anxiety, and resistance to COVID-19 (OR: 1.703, 95% CI: 1.082-2.681) was a risk factor for healthcare workers suffering from anxiety, while good quality of life (OR: 0.385, 95% CI: 0.206-0.719) self-esteem (OR: 0.187, 95% CI: 0.110-0.317), and PSS (OR: 0.475, 95% CI: 0.267-0.847) were protective factors for healthcare workers suffering from depression, and at the age of 35-40 years (OR: 2.475, 95% CI: 1.140-5.369) and resistance to COVID-19 (OR: 2.219, 95% CI: 1.313-3.751) were risk factors for healthcare workers suffering from depression.

Conclusion

The anxiety and depression status of healthcare workers in China is poor, and hospital administrators should take positive measures to support healthcare workers and give positive expectations to alleviate negative emotions such as anxiety and depression.

Relationship between depression and burnout among nurses in Intensive Care units at the late stage of COVID-19: a network analysis

BACKGROUND

Mental health problems are critical and common in medical staff working in Intensive Care Units (ICU) even at the late stage of COVID-19, particularly for nurses. There is little research to explore the inner relationships between common syndromes, such as depression and burnout. Network analysis (NA) was a novel approach to quantified the correlations between mental variables from the perspective of mathematics. This study was to investigate the interactions between burnout and depression symptoms through NA among ICU nurses.

METHOD

A cross-sectional study with a total of 616 Chinese nurses in ICU were carried out by convenience sampling from December 19, 2022 to January19, 2023 via online survey. Burnout symptoms were measured by Maslach Burnout Inventory-General Survey (MBI-GS) (Chinese version), and depressive symptoms were assessed by the 9-item Patient Health Questionnaire (PHQ-9). NA was applied to build interactions between burnout and depression symptoms. We identified central and bridge symptoms by R package qgraph in the network model. R package bootnet was used to examined the stability of network structure.

RESULTS

The prevalence of burnout and depressive symptoms were 48.2% and 64.1%, respectively. Within depression-burnout network, PHQ4(Fatigue)-MBI2(Used up) and PHQ4(Fatigue)-MBI5(Breakdown) showed stronger associations. MBI2(Used up) had the strongest expected influence central symptoms, followed by MBI4(Stressed) and MBI7 (Less enthusiastic). For bridge symptoms. PHQ4(Fatigue), MBI5(Breakdown) and MBI2(Used up) weighed highest. Both correlation stability coefficients of central and bridge symptoms in the network structure were 0.68, showing a high excellent level of stability.

CONCLUSION

The symptom of PHQ4(Fatigue) was the bridge to connect the emotion exhaustion and depression. Targeting this symptom will be effective to detect mental disorders and relieve mental syndromes of ICU nurses at the late stage of COVID-19 pandemic.

Feasibility of an oral health promotion program among older people in geriatric care facilities, Shanghai, China: a pre/post-implementation study

BACKGROUND

The oral health of older people is closely related to their overall health. Timely and effective intervention in oral issues is necessary to maintain their overall health. This study aimed to evaluate the feasibility and effectiveness of an Oral Health Promotion Program (OHPP) in Geriatric Care Facilities (GCFs).

METHODS

The OHPP was implemented in two GCFs and evaluated using a pre/post-design. Questionnaires on self-efficacy and attitude for providing oral care were sent to 42 nurse participants before and three months after the implementation of the OHPP. Outcomes of 295 patient participants were assessed at four time points (T1-baseline, T2-one month, T3-two months, and T4-three months post-implementation) including Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE), and Oral Health Assessment Tool (OHAT).

RESULTS

The oral health and daily activity ability of patient participants showed an improving trend at four time points pre/post-implementation of the OHPP. The proportion of patients with healthy mouths (OHAT: 0-3 points) increased from 29.8 to 67.8% and their scores of OHAT and ADL were significantly better at T4 compared to T1, T2, and T3 (p < 0.001). Self-efficacy (SE-PMC: T1 = 18.93 ± 3.18, T4 = 28.83 ± 6.56, p < 0.001) and attitude (A-PMC: T1 = 18.78 ± 3.09, T4 = 28.20 ± 6.03, p < 0.001) for oral care among nurse participants improved after the implementation of the OHPP.

CONCLUSIONS

This study highlights the feasibility of implementing OHPP within GCFs, potentially enhancing the oral health and daily living activities of older individuals. Integrating the OHPP into routine care in geriatric settings is not only practical but also widely acceptable, offering a proactive approach to address oral health disparities among older residents. Stakeholders can maximize the impact of the OHPP by fostering collaboration among healthcare professionals, administrators, and residents, ultimately improving oral health outcomes and overall quality of life of older residents.

TRIAL REGISTRATION

ChiCTR2000035236 (registration date: 04/08/2020).

The mediating effect of hope agency on perceived stress and professional burnout among Polish corporate employees

Job burnout is considered an outcome of prolonged exposure of employees to stress. Although many studies have focused on the presence of a direct association between stress and burnout, we still know very little about mediators that indirectly play a role in this relationship. Previous analyses have determined that self-efficacy acts as a mechanism that explains the overall relationship between stress and burnout. However, there is no such evidence to support the mediatory function of hope. Therefore, the main aim of the current study was to verify whether self-efficacy, hope pathways, and hope agency are mediators in this relationship. The study included 408 Polish-speaking adults who completed the Perceived Stress Scale, the Maslach Burnout Inventory, the Generalized Self-Efficacy Scale, and the Dispositional Hope Scale. The outcomes indicated a positive correlation of stress with the overall burnout score, as well as all subscales. Moreover, hope agency was a mediator, thus suggesting that there is also an indirect relationship between stress and job burnout. Therefore, it can be assumed that higher stress is associated with lower motivation to generate and sustain the actions needed to reach the goals. Consequently, lower hope agency may lead stressed employees to greater exhaustion and reduced personal accomplishment.

Peer Teasing and Restrained Eating among Chinese College Students: The Chain Mediating Role of Negative Coping Styles and Negative Physical Self

This study aimed to determine whether negative coping styles and negative physical self sequentially mediate the relationship between peer teasing and restrained eating among Chinese university students. In total, 1127 participants (66.9% women, average age = 18.43 years; age range, 14-26 years) completed the Perception of Teasing Scale, Coping Style Questionnaire, Negative Physical Self Scale, and the Chinese version of the Restraint Scale. The mediational analysis showed that, after controlling for age, sex, and body mass index (BMI), peer teasing was related to restrained eating behaviors through (a) the mediating effect of negative coping styles, (b) the mediating effect of negative physical self, and (c) the chain-mediating effect of negative coping styles and negative physical self. This study showed for the first time that negative coping styles and negative physical self may chain mediate the association between peer teasing and restrained eating. It also provides suggestions for clinical practices as to strategies for controlling restrained eating.

Psychological capital among clinical nurses: A latent profile analysis

AIM

To determine the psychological capital level of nurses and explore the latent profiles of nurses regarding their psychological capital scores.

BACKGROUND

The use of individual-centered analysis for the connotation of nurses' psychological capital structure is less studied and still needs to be further explored.

METHODS

By the convenience sampling method, 494 clinical nurses from 7 general hospitals in Sichuan province were selected. The study was conducted from December 2022 to February 2023. Latent profile analysis was used for data analysis. We followed STROBE guidelines in this research.

RESULTS

The total mean score of nurses' psychological capital is 5.17 (SD = 0.8). The following four latent profiles were identified: "poor" (4.5%), "medium" (22.9%), "well-off" (41.5%), and "rich" (31.1%). Multiple logistic regression showed that the number of hours worked per day and the number of night shifts per month were negative predictors of psychological capital, and psychological training and job satisfaction were protective factors of psychological capital.

DISCUSSION

Our study found that the four profiles can be distinguished by "poor," "well-off," "medium," and "rich" levels of psychological capital. Among them, more than 70% of the nurses belonged to the well-off and rich profiles, and the number of the poor profile was the lowest.

CONCLUSION

The overall psychological capital of clinical nurses is at a medium-high level. Each profile is influenced by multiple sociodemographic factors (i.e., age, working hours, monthly income, psychological training, and job satisfaction).

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Administrators should develop enhancement strategies to improve the mental health of nurses based on the characteristics of their psychological capital profiles.

Chain mediations of perceived social support and emotional regulation efficacy between role stress and compassion fatigue: insights from the COVID-19 pandemic

Background

Nurses at the frontline faced high risks of the COVID-19 infection, undertook heavy workloads of patient care, and experienced tremendous stress that often led to compassion fatigue.

Aim

This study was to explore the role of positive psychosocial resources (i.e., perceived social support and emotional regulation efficacy) in the relationship between role stress and compassion fatigue.

Methods

A cross-sectional design was conducted in Hubei Province, China between May and September 2021. The Role Stress Questionnaire, the Perceived Social Support Scale, the Emotional Regulation Efficacy Scale, and the Professional Quality of Life Scale were used to measure key variables of interest. Nurse socio-demographic data were also collected. Structural equation modeling was used to explore the relationships, including potential mediating effect, among role stress, perceived social support, emotional regulation efficacy, and compassion fatigue.

Results

A total of 542 nurses participated in this investigation, and 500 were eventually enrolled in the analysis. The incidence of compassion fatigue among nurses was 94.2%, including 65.8% of nurses reporting at least moderate compassion fatigue. Univariate analysis showed that educational level, marital status, hospital rank, sleep time were the factors affecting compassion fatigue of the nurses. The structural equation modeling revealed that: Role stress had a direct positive effect on compassion fatigue; Perceived social support and emotional regulation efficacy partially mediated the link between role stress and compassion fatigue respectively; And there was a chain mediating role of perceived social support and emotional regulation efficacy between role stress and compassion fatigue.

Conclusion

The incidence of compassion fatigue was high during the COVID-19 pandemic among bedside nurses in China. Improving social support and enhancing the efficacy of emotion regulation may help alleviate compassion fatigue directly and/or via buffering the impact of role stress.

The mediation effect analysis of nurse's mental health status and burnout under COVID-19 epidemic

Aim

The objective of this study is to investigate the mental health status of nurses during the outbreak of novel coronavirus pneumonia. Additionally, we aim to analyze the relationship between anxiety, depression, and burnout among nurses. The findings will provide a scientific basis for promoting the psychological health of nurses.

Methods

Using a cross-sectional study, nurses in Quanzhou in May 2020 completed a general information questionnaire, the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and the Maslach Burnout Inventory (MBI). Data analysis was conducted using structural equation model.

Results

372 questionnaires were returned, with a response rate of 92.5%. The prevalence of anxiety and depression among the participants were 45.2 and 41.4%, respectively. The prevalence of severe burnout among nurses was found to be 7.3%. There was a correlation between nurses' anxiety, depression, and job burnout. The correlation coefficients between anxiety and job burnout, depression and job burnout, and anxiety and depression were found to be statistically significant (p < 0.001). Depression plays a mediating role between anxiety and jod burnout (0.584/1.413, 41.3%).

Conclusion

The COVID-19 epidemic has resulted in moderate to high levels of job burnout among nurses. In this context, depression has been found to play a mediating role in the relationship between anxiety and job burnout. It is imperative for hospital administrators to prioritize the mental health of nurses and the provide necessary support to ensure their well-being.

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

Introduction

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

Methods

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

Results

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

Conclusion

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

The mediating role of coping styles in the relationship between second victim experience and professional quality of life among nurses: a cross-sectional study

BACKGROUND

Studies have shown that second-victim experiences could increase risks of the compassion fatigue while support from individuals and organisations is most often protection. However, the risk for poor compassion satisfaction and increased compassion fatigue in nurses aroused by adverse events remains an underestimated problem, meanwhile, litter known about the role of positive and negative coping styles among nurses suffering from adverse events. This study aims to investigate the effect of second-victim experiences on the professional quality of life among nurses and to determine the mediating role of coping styles in the relationship between second-victim experiences and professional quality of life.

METHODS

Multistage sampling was used to recruit registered nurses from Hunan province in China. Registered nurses who identified themselves as experiencing adverse events from nine tertiary hospitals were included in this study. Participants were recruited to complete a survey on the second victim experience and support tool, the simplified coping style questionnaire, and the professional quality of life scale. The stress coping theory was used to develop the framework in this study. The structural equation modelling approach was used for conducting the mediating effects analysis via IBM SPSS Statistics 26.0 and Mplus 8.3.

RESULTS

In total, 67% (n = 899) of nurses reported a second victim experience during their careers. In a bivariate analysis, both second-victims experiences and coping styles were significantly associated with their professional quality of life. The results showed that the effects of second victim experiences on their professional quality of life were fully mediated by coping styles. A total of 10 significantly indirect pathways were estimated, ranging from -0.243 to 0.173.

CONCLUSIONS

Second-victim experiences are common among nurses in this study. Since the mediating effects of coping styles were clarified in this study, it is imperative to promote the perception of negative coping styles and encourage nurses to adopt more positive coping styles with adequate support systems.

Depression and burnout among Chinese nurses during COVID-19 pandemic: a mediation and moderation analysis model among frontline nurses and nonfrontline nurses caring for COVID-19 patients

BACKGROUND

During the COVID-19 pandemic, nurses' workload increased dramatically, and nurses faced the risk of infection and multiple ethical dilemmas. In such a situation, nurse burnout was elevated, which tended to exacerbate depression in nurses. Although previous studies have demonstrated the relationship between burnout and depression among nurses, the exact mechanisms remain unclear. Furthermore, environmental factors are also essential to a person's psychological health. Therefore, this study intended to investigate the potential mechanisms of depression caused by nurse burnout and whether burnout among frontline nurses during the COVID-19 pandemic exacerbated its effect on depression in nurses as an environmental factor.

METHODS

A total of 4517 nurses were enrolled in this study. A moderated mediation model was established to investigate the relationship between burnout and positive coping styles, interpersonal relationships, and depression utilizing the SPSS PROCESS 3.3 macro. The direct effect of burnout on depression was also investigated with the moderated mediation model.

RESULTS

The indirect effects of positive coping styles (β = 0.04, 95% CI: 0.03 to 0.04) and interpersonal relationships (β = 0.12, 95% CI: 0.10 to 0.13) were revealed. Being a frontline nurse caring for COVID-19 patients moderated the direct effect of burnout on depression (β = 0.12, 95% CI: 0.08 to 0.16).

CONCLUSION

This study offers strong evidence for the mediating role of positive coping styles and interpersonal relationships in the relationship between nurse burnout and depression, in addition to illustrating the need for more psychological support for frontline nurses caring for COVID-19 patients.

Association between work stress and mental health in Chinese public health workers during the COVID-19 epidemic: mediating role of social support and self-efficacy

Background

Little is known about the mediating mechanisms underlying the association between work stress and mental health, especially among primary public health workers (PHWs). We aimed to evaluated the association between work stress and mental health among PHWs, and explore the mediating roles of social support and self-efficacy.

Methods

A large-scale cross-sectional survey was conducted among 3,809 PHWs from all 249 community health centers in 16 administrative districts throughout Shanghai, China. Pearson correlation and hierarchical linear regression were used to explore the associations among work stress, social support, self-efficacy and mental health. Structural equation modeling (SEM) was conducted to examine the mediation effects.

Results

The prevalence of depression and anxiety symptoms among primary PHWs was 67.3 and 55.5%, respectively. There is a significant positive direct effect of work stress on mental health (β = 0.325, p < 0.001). Social support and self-efficacy partially mediated the relationship between work stress and mental health, respectively. Meanwhile, the chained mediating effects of social support and self-efficacy also buffered the predictive effects of work stress on anxiety and depression symptoms (β = 0.372, p < 0.001).

Conclusion

Work stress has significant direct and indirect effects on mental health among primary PHWs. Enhancing social support and self-efficacy may be effective psychological interventions to mitigate the effects of work-related stress on mental health. These findings highlight the severity of mental health problems among primary public health workers and provide new evidence for early prevention and effective intervention strategies.

Socioeconomic factors, perceived stress, and social support effect on neonatal nurse burnout in China: a cross-sectional study

BACKGROUND

Neonatal nurses' working environments are highly stressful, and burnout is common. This study examines the effect of socioeconomic factors, perceived stress, and social support on neonatal nurse burnout.

METHODS

A total of 311 neonatal nurses participated in this study. They were administered a validated Maslach Burnout Inventory. The study employed a 14-item perceived stress scale (PSS-14) and a social support rate scale (SSRS) to examine stress, socioeconomic factors, and lifestyles.

RESULTS

Of the neonatal nurses, 40.19% had burnout, 89.60% had mild burnout, and 10.40% had moderate burnout; no neonatal nurse experienced severe burnout. Young nurses and those with low technical skills, poor interpersonal relationships, irregular diet, and insufficient rest were exposed to burnout (all p < 0.05).Most burnout nurses experienced moderate-severe perceived stress, and their PSS-14 scores were higher (all p < 0.05).The scores for objective social support, subjective social support, utilization of social support, total SSRS scores, and the level of social support were all lower in burnout nurses (all p < 0.05). Perceived stress was correlated positively and significantly with emotional exhaustion and personal accomplishment (all p < 0.05). Social support correlated significantly with and reduced personal accomplishments (p < 0.05). Age, poor interpersonal relationships, perceived stress, and social support were all independent factors associated with neonatal nurse burnout (all p < 0.05).

CONCLUSION

The prevalence of burnout in neonatal nurses was higher than average. Socioeconomic factors, higher perceived stress, and lower social support contribute to neonatal nurse burnout. Nursing managers should pay attention to socioeconomic factors, perceived stress, and social support among neonatal nurses and employ strategies to reduce neonatal nurse burnout.

A Cross-Level Study of the Consequences of Work Stress in Police Officers: Using Transformational Leadership and Group Member Interactions as an Example

Purpose

The objective of this study was to investigate the effect of work stress on job burnout and quality of life and the effect of moderating group factors (transformational leadership and group member interactions) on the relationship between work stress, job burnout, and quality of life. This study takes front-line border police as the research object, adopts a cross-level perspective, and takes work stress as a key factor affecting work efficiency and health indicators.

Methods

It collected data through questionnaires, with questionnaires for each research variable adapted from existing research scales, such as multifactor leadership questionnaire developed by Bass and Avolio. A total of 361 questionnaires were filled out and collected in this study, including 315 male participants and 46 female participants. The average age of the participants was 39.52. Hierarchical linear modeling (HLM) was used to test the hypotheses.

Results

First, it was found that work stress has a significant impact on job burnout and quality of life. Secondly, leadership style and group member interactions have a direct, cross-level effect on work stress. Third, it found that leadership style and group member interactions have an indirect, cross-level effect on the relationship between work stress and job burnout. However, these are not indicative of quality of life. The results of this study highlight the particular impact of the nature of police work on the quality of life, and further enhance the value of this study.

Conclusion

The two major contributions of this study are: 1) it shows the original characteristics of the organizational environment and the social context of Taiwan's border police and, 2) in terms of the research implication, it is necessary to re-examine the cross-level impact of group factors on individual work stress.

An Association Between Job Stress and Poor Social Support Among Healthcare Workers in Northeastern Malaysia

INTRODUCTION

Job stress is an important occupational health problem globally. Hence, identification of workers at risk of developing job stress is paramount to the decision-makers. This study aims to estimate the proportion of job stress and its relationship with different categories of healthcare workers (HCWs) in the primary care and public health settings in northeastern Malaysia.

METHODOLOGY

A cross-sectional study involving 520 HCWs across all categories was conducted in Kelantan State, Malaysia. A proforma and validated Malay version of the Job Content Questionnaires were administered to obtain the data. The participants were then classified into four categories of workers according to Karasek's job demands-control model classification which were active, passive, high strain, and low strain.

RESULTS

We found that a total of 145 (28.5%) HCWs in the study have job stress (high-strain job type). HCWs with a degree or higher qualification had the highest proportion of job stress (41.2%), while the diploma group has the lowest proportion of job stress among the four academic qualification groups (22.9%). Pearson chi-square shows a significant association between Karasek's job types and the level of social support from their supervisors (p < 0.05) but no association between job strain and the level of supervisor's social support (p > 0.05).

CONCLUSION

Job stress among HCWs is prevalent, and the professional group had the highest percentage of risk job stress as compared to other groups. There is a significant association between the supervisor's social support and Karasek's job strain categories.

Psychosocial model of burnout among humanitarian aid workers in Bangladesh: role of workplace stressors and emotion coping

BACKGROUND

While trauma exposure is an established predictor of poor mental health among humanitarian aid workers (HAWs), less is known about the role of psychosocial work-related factors. This study aims to establish a psychosocial model for burnout and psychological distress in HAWs that tests and compares the effects of adversity exposure and workplace stressors in combination, and explores the potential mediating role of individual coping styles.

METHODS

Path analysis and model comparison using cross-sectional online survey data were collected from full-time international and local HAWs in Bangladesh between December 2020 and February 2021. HAWs self-reported on exposure to adversities, workplace psychosocial stressors (Third Copenhagen Psychosocial Questionnaire), coping styles (Coping Inventory for Stressful Situations), burnout (Maslach Burnout Inventory-Human Services Survey), and psychological distress (Kessler-6).

RESULTS

Among N = 111 HAWs, 30.6%, 16.4%, 12.7%, and 8.2% screened positive for moderate psychological distress (8 ≤ Kessler-6 ≤ 12), emotional exhaustion (EE ≥ 27), depersonalization (DP ≥ 13), and severe psychological distress (K-6 ≥ 13), respectively. 28.8% reported a history of mental disorder. The preferred model showed distinct pathways from adversity exposure and workplace stressors to burnout, with negative emotion-focused coping and psychological distress as significant intervening variables. While greater exposure to both types of stressors were associated with higher levels of burnout and distress, workplace stressors had a stronger association with psychological outcomes than adversity exposure did (β = .52, p ≤ .001 vs. β = .20, p = .032). Workplace stressors, but not adversities, directly influenced psychological distress (β = .45, p ≤ .001 vs. β = -.01, p = .927). Demographic variables, task-focused and avoidance-focused coping were not significantly associated with psychological outcomes.

CONCLUSIONS

Compared to exposure to adversities, workplace stressors primarily influenced occupational stress syndromes. Reducing workplace stressors and enhancing adaptive coping may improve psychological outcomes in humanitarian staff.

Educational degree differences in the association between work stress and depression among Chinese healthcare workers: Job satisfaction and sleep quality as the mediators

Background

Depressive status of medical personnel worldwide and especially in China is an important public health and social problem. There is a strong relationship between education and depression, but no studies have studied grouping healthcare workers (HCWs) with different educational degree to discuss whether there are differences in the factors that affect depression. This study aims to examine the role of job satisfaction and sleep quality in the relationship between work stress and depression among Chinese HCWs, and teste whether the mediation models are differed by the differences of educational degree.

Methods

Patient Health Questionnaire-9 (PHQ-9) scale was used to test depression. Work stress was assessed using the Challenge-blocking stress scale (CBSS). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). HCWs’ satisfaction with their current work was assessed using the Job Satisfaction Index (JSI). The representative sample of HCWs was chosen using a multi-stage stratified cluster random sampling procedure and 844 HCWs were utilized to the statistical analysis of the study.

Results

In the overall sample, sleep quality could mediate the relationship between work stress and depression in healthcare workers (p &lt; 0.001, CMIN/DF = 3.816, GFI = 0.911, AGFI = 0.886, IFI = 0.943, TLI = 0.933, CFI = 0.942, RMSEA = 0.058, SRMR = 0.055, AIC = 1039.144), and the mediating effect accounted for 36.5%. After grouping educational qualifications, the model with sleep quality and job satisfaction as mediating variables reported a better fit in the group with low educational qualifications. The intermediary effect accounted for 50.6 and 4.43%, respectively. The highly educated group only has sleep quality as an intermediary variable in the structural model, and the mediating effect accounted for 75.4% (p &lt; 0.001, CMIN/DF = 2.596, GFI = 0.887, AGFI = 0.857, IFI = 0.937, TLI = 0.926, CFI = 0.937, RMSEA = 0.044, SRMR = 0.056, AIC = 1481.322).

Conclusion

In the overall sample, sleep quality could mediate the relationship between work stress and depression in HCWs. Among HCWs with technical secondary school education and below, job satisfaction can mediate the positive relationship between work stress and depression, while this mediating effect is not significant among HCWs with college degree and above.

The Switch to Online Learning during the COVID-19 Pandemic: The Interplay between Personality and Mental Health on University Students

The switching from traditional to online learning during the COVID-19 pandemic was challenging for students, determining an increase in physical and mental health problems. The current paper applied a two-step cluster analysis in a large sample of n = 1028 university students (Mage = 21.10 years, SD = 2.45 years; range: 18-30 years; 78.4% females). Participants responded to an online survey exploring neuroticism, trait/state anxiety, general self-efficacy, academic motivation, fear of COVID-19, the impact of the COVID-19 pandemic on physical and mental health, and the help requests. Results showed two significant clusters of students having a Maladaptive Academic Profile (n = 456; 44.4%) or an Adaptive Academic Profile (n = 572; 55.6%). Significant differences were found between the two clusters, where students belonging to the Maladaptive Academic Profile reported higher levels of neuroticism, higher dispositional and situational anxiety, and fear of COVID-19, and lower self-efficacy and academic motivation than students of the Adaptive Academic Profile cluster. In addition, more physical or mental health problems and help requests, mainly to partners during the COVID-19 pandemic, were found in the Maladaptive Academic Profile cluster compared to the Adaptive Academic Profile. Finally, the practical implications of the study's results in implementing university counseling services as protective measures to contrast psychological distress in the long-term COVID-19 pandemic are discussed.

Effects of coping on nurses' mental health during the COVID-19 pandemic: Mediating role of social support and psychological resilience

BACKGROUND

Fighting against the COVID-19 pandemic, front-line nurses were under unprecedented psychological pressure. Therefore, it is necessary to promptly evaluate the psychological status of nurses during the COVID-19 epidemic period.

AIM

To investigate nurses' mental health during the COVID-19 pandemic, and to test the mediating role of social support and psychological resilience between coping and mental health.

DESIGN

This was a descriptive, cross-sectional survey which used a structural equation model.

METHOD

In total, 711 registered nurses were included. All participants were invited to complete a socio-demographic questionnaire, the general health questionnaire, the trait coping style questionnaire, the perceived social support scale and the Conner-Davidson Resilience scale.

RESULTS

In total, 50.1% nurses had high risk of mental health. Positive coping positively affected social support and psychological resilience, while it negatively affected mental health. Negative coping negatively affected social support and psychological resilience, while it positively affected mental health. Social support positively affected psychological resilience, while it negatively affected mental health. In addition, social support mediated coping and psychological resilience, and coping and mental health. Moreover, psychological resilience negatively affected mental health, and it mediated coping and mental health.

A Two-Wave Study On The Associations Of Burnout With Depression And Anxiety: The Mediating And Moderating Role Of Perceived Family Support

Studies have shown strong associations between burnout and depression and burnout and anxiety but their exact interrelationships still remain unclear. Few studies have examined the psychosocial mechanisms that might underlie these two relationships. Non-work social factors such as perceived family support can affect mental health. The present study investigated the distinctiveness and the reciprocal associations between burnout and depression, and burnout and anxiety by collecting data twice over an 8 month interval. Perceived family support was examined as a mediating and a moderating factor underlying the two relationships. The Maslach Burnout Inventory-General Survey, the Hospital Depression and Anxiety Scale, and the Julkunen Family Support Scale were administered to employees of the general working population (N = 52). First, our results revealed moderate associations between burnout and depression, and burnout and anxiety, supporting the distinctiveness of burnout from the two psychological phenomena. Second, the exhaustion and cynicism burnout dimensions showed reciprocal associations with depression. Moreover, anxiety was found to be a consequence of cynicism while it presented reciprocal associations with the exhaustion dimension of burnout. Perceived family support did not mediate the burnout-depression and burnout-anxiety relationships. However, it moderated the depression-exhaustion relationship in a direction opposite from our hypothesis.

Professional Quality of Life, Work-Related Stress, and Job Satisfaction among Nurses in Saudi Arabia: A Structural Equation Modelling Approach

Objective

To examine the interrelated impacts of work-related stress, compassion satisfaction (CS), and job satisfaction on burnout (BO) and secondary traumatic stress (STS) among nurses using structural equation modelling (SEM).

Methods

A cross-sectional design was used to survey 727 nurses at a teaching hospital in eastern Saudi Arabia. Three scales were used: the Quality of Life (ProQOL) scale, the Nursing Stress Scale (NSS), and the Job Satisfaction Survey (JSS). Data were analysed using SPSS and Analysis of Moment Structures (AMOS), and SEM analysis was conducted to confirm the interrelations among variables.

Results

The final model had a good fit for the obtained data (X ² = 2.726, RMSEA = 0.032). Stress is directly related to BO and STS, and the following variables were directly related to STS: job satisfaction, BO, and CS. Lastly, BO mediated the relationship between stress and STS.

Conclusion

It is crucial to analyze the effect of stress, CS, and job satisfaction which seems to have a positive and negative impact on nurses' BO and STS. Therefore, implementing a management strategy to manage stress and satisfaction can enhance nurses' quality of life, support the maintenance of positive attitudes, and enhance the standard of patient care.

Burnout and Mental Health and Well-Being of School Nurses After the First Wave of the COVID-19 Pandemic: A National Cross-Sectional Survey

The aim of this study was to examine the associations between job stressors, COVID-19-related concerns, burnout, and mental health and well-being among school nurses, and whether any of these associations are mediated by burnout. Based on stratified proportional sampling, data collection was conducted by an online questionnaire distributed to 600 school nurses in Taiwan. A total of 256 participants aged between 27 and 62 years (mean = 47.08; standard deviation = 7.28) returned questionnaires. Results showed that burnout was the main mediating variable that fully mediated the relationship between COVID-19-related concerns and mental health and well-being. The effects of job stressors on mental health and well-being included direct negative effects (β = -.29) and indirect negative effects (β = -.67) through mediating factors. School health managers should be more aware of burnout and mental health and well-being among school nurses under the impact of COVID-19.

Association of psychological symptoms with job burnout and occupational stress among coal miners in Xinjiang, China: A cross-sectional study

Objective

The study aimed to investigate the influencing factors of psychological symptoms in relation to job burnout and occupational stress among coal miners in Xinjiang, so as to provide data support for enterprises in an effort to help them identify internal psychological risk factors and improve the mental health of coal miners.

Methods

A cross-sectional study was carried out. A total of 12 coal mines were selected using the stratified cluster random sampling method and 4,109 coal miners were investigated by means of online electronic questionnaires. The Symptoms Check List-90 (SCL-90), Chinese Maslach Burnout Inventory (CMBI), and Job Demand-Control (JDC) model were respectively used to measure the status of psychological symptoms, job burnout, and occupational stress among coal miners. The mediation analysis was performed through structural equation modeling (SEM) by using Analysis of Moment Structure (AMOS).

Results

The prevalence of psychological symptoms was higher in the occupational stress group than in the non-occupational stress group, and increased with job burnout (P < 0.05). The multivariate logistic regression analysis results showed that mild (OR = 1.401, 95% CL: 1.165, 1.685), moderate (OR = 2.190, 95% CL: 1.795, 2.672), or severe levels of burnout (OR = 6.102, 95% CL: 3.481, 10.694) and occupational stress (OR = 1.462, 95% CL: 1.272, 1.679) were risk factors for psychological symptoms in coal miners. The results of structural equation modeling indicated that occupational stress (β = 0.11, P = 0.002) and job burnout (β = 0.46, P = 0.002) had significant positive direct effects on psychological symptoms, and job burnout was an intermediate variable between occupational stress and psychological symptoms.

Conclusion

High levels of job burnout and occupational stress were risk factors for psychological symptoms. Both occupational stress and job burnout had direct effects on psychological symptoms, and occupational stress could also have an indirect effect on coal miners' psychological symptoms through the intermediate variable of job burnout.

Status and related factors of burnout among palliative nurses in China: a cross-sectional study

Background

Burnout occurs frequently in nurses and seems more common in nurses providing palliative care. However, to our knowledge, there is a lack of understanding regarding the factors influencing burnout among palliative nurses in China.

Methods

A cross-sectional design was conducted. A total of 331 palliative nurses from 25 hospitals participated in this study. Anonymous data were collected through a self-designed social-demographic questionnaire, the Nursing Burnout Scale, the Perceived Social Support Scale, the General Self-Efficacy Scale, the Connor-Davidson Resilience Scale, and the Simplified Coping Style Questionnaire. Independent sample t tests, one-way ANOVA, Pearson correlations, and multiple linear regressions were performed to identify the related factors of the three dimensions of burnout.

Results

In the results of multiple linear regression, resilience, health condition, coping style, and pessimistic personality were common related factors; in addition, end-of-life care training, social support, and income satisfaction were statistically significantly associated with burnout. These factors could explain 38.6%, 27.8%, and 34.5% of the total variance in emotional exhaustion, depersonalization, and reduced personal accomplishment, respectively.

Conclusions

The findings of this study help policy makers and nurse managers better understand burnout among palliative nurses in China. The results highlighted the importance of implementing culture-oriented training programs, providing perceived organizational support, and building a reasonable salary system to decrease burnout among palliative nurses, increase the quality of nursing and promote the development of Chinese palliative care.

Mediating effect of circadian rhythm between work stress and sleep quality in Chinese shift-working nurses: A cross-sectional survey

AIM

This study examined the mediating effect of circadian rhythm amplitude (LV) and stability (FR) between work stress and sleep quality among Chinese shift-working nurses (SWNs).

DESIGN

A cross-sectional study.

METHODS

Three-hundred and seventy-nine nurses working in shifts were investigated by convenient sampling from six hospitals in Shanghai, China. The mediating effect was analysed using the structural equation model with bootstrapping procedures.

RESULTS

Work stress could directly affect shift nurses' sleep quality and indirectly affect sleep quality through circadian rhythm amplitude and stability. The total indirect effects of work stress on sleep quality accounted for 36.7% of the total effect. The study revealed that poor sleep quality is very common among SWNs, which deserves attention. The mediating effect of the circadian rhythm provides new insights to improve sleep quality, not only by lightening the work stress but also by improving circadian rhythm in SWNs.

The relationship between information overload and state of anxiety in the period of regular epidemic prevention and control in China: a moderated multiple mediation model

This study aimed to examine the relationship between information overload and individual state anxiety in the period of regular epidemic prevention and control and mediating effect of risk perception and positive coping styles. Further, we explored the moderating role of resilience. 847 Chinese participated in and completed measures of information overload, risk perception, positive coping styles, state anxiety, and resilience. The results of the analysis showed that information overload significantly predicted the level of individual state anxiety (β = 0.27, p < 0.001). Risk perception partially mediate the relationship between information overload and state anxiety (B = 0.08, 95%CI = [0.05, 0.11]) and positive coping styles also partially mediate the relationship between information overload and state anxiety(B = -0.14, 95%CI = [-0.18, -0.10]). In addition, resilience moderated the mediating effects of risk perception (β = -0.07, p < 0.05) and positive coping styles (β = -0.19, p < 0.001). Resilience also moderated the effect of information overload on state anxiety (β = -0.13, p < 0.001). These results offer positive significance for understanding the internal mechanism of the influence of information overload on individual state anxiety in the epidemic environment and shed light on how to reduce people's state anxiety during an epidemic.

Wellbeing and Stress Coping among Healthcare and Pharmacy Workers: Experiences during the First COVID-19 Lockdown in Lithuania

(1) Background. During the COVID-19 pandemic, healthcare professionals faced psychological and social challenges in addition to a sharp increase in workload. The aim of this work was to reveal how healthcare and pharmacy workers assessed their wellbeing and the methods of coping they employed to overcome stress during quarantine. (2) Methods. The mixed-method study was conducted between August and October 2020, integrating quantitative (n = 967) and qualitative (n = 27) strategies. Doctors, nurses, healthcare administrative staff, pharmacy specialists, and other employees of the healthcare system were interviewed retrospectively about their experiences during and following lockdown (March–June 2020). (3) Results. Overall, 38.7% of the respondents reported a decrease in psychological wellbeing, while 23.4% of the respondents reported a decrease in physical wellbeing during quarantine. The healthcare professionals’ narratives identified a shift from nonspecific fears at the beginning of the pandemic to the more concrete fear of contracting COVID-19, of infecting others, and about their loved ones, as well as undifferentiated fear. Multivariate analysis revealed that a subjective decrease in wellbeing was typical in professionals who had had direct contact with patients infected with COVID-19, as well as those with stronger fears, and those who were more likely to employ compulsive distancing and substance use as ways to cope with stress. (3) Conclusions. The results suggest that lockdown had a negative impact on healthcare workers’ wellbeing during the first pandemic wave in 2020.

The influence of workplace stress and coping on depressive symptoms among registered nurses in Bangladesh

Background

Nurses report high levels of workplace stress, which has been linked to an increased risk for experiencing depressive symptoms. Nurses' workplace stress is also linked to increased absenteeism and decreased job satisfaction.

Objectives

The objectives of this study were to examine: (1) the incidence of depressive symptoms among hospital-based registered nurses in Bangladesh; (2) common sources of workplace stress and their relationships to individual characteristics and depressive symptom scores; and (3) the potential mediating roles of coping strategies in the relationship between workplace stress and depressive symptoms.

Methods

A cross-sectional study design involved three hundred and fifty-two registered nurses. Data were collected using a demographic questionnaire and three standardized tools measuring sources of nurses' workplace stress, coping strategies, and depressive symptoms.

Results

More than half of the participants scored ≥ 16 on the CES-D, which was associated with a major depression episode. Total NSS scores had a small but significant influence on scores on the depression scale. Coping strategies had no mediated effect on the relationship between workplace stress and scores on the depression scale. Low-reliability coefficients for subscales of two of the standardized tools highlight the challenge for researchers in developing countries to address contextual differences that may influence the meanings attached to individual items.

Conclusion

Findings suggest that the mental health of registered nurses in Bangladesh requires immediate attention in part by attending to workplace stressors. Further research should focus on a deeper understanding of Bangladeshi registered nurses' work experiences and the unique contribution that workplace stressors have on their physical and mental health.

Psychometric Properties of the Korean Version of the Nursing Profession Self-Efficacy Scale

BACKGROUND

Self-efficacy in the nursing profession has been reported to have a positive effect on personal performance in terms of clinical performance and decision-making abilities, nursing performance, professional intuition, organizational commitment, and turnover intention.

PURPOSE

The purpose of this study was to verify the validity and reliability of the Korean version of the Nursing Profession Self-Efficacy Scale (K-NPSES).

METHODS

This methodological study used questionnaires collected from 307 nurses at medical institutions in South Korea. The content validity of the questionnaire was verified using the averaging method, whereas the criterion-related validity was evaluated by calculating the correlation with the Sherer General Self-Efficacy Scale. The construct validity was determined by analyzing the explanatory and confirmatory factors. Reliability was verified using Cronbach's α and test-retest by calculating intraclass correlation coefficients.

RESULTS

The content validity index of the K-NPSES was found to be greater than .95, and the criterion-related validity was satisfactory (coefficient = .57, p < .001). The original Nursing Profession Self-Efficacy Scale has two subfactors, and the K-NPSES analyzed in this study has four subfactors. The data were appropriate for factor analysis using Kaiser-Meyer-Olkin (.87) and Bartlett's sphericity test (χ2 = 1236.01, df = 137, p < .001). The model fit was acceptable (normed chi-square [χ2/df] = 2.22, root mean square residual = .05, root mean square error of approximation = .09, comparative fit index = .88, Tucker-Lewis index = .86, goodness-of-fit index = .83). Regarding reliability, Cronbach's α was .91 and the intraclass correlation coefficient was .78 (p < .001).

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The findings of this study confirmed the K-NPSES as having acceptable validity. In addition to predicting nursing clinical performance, a well-established nursing profession self-efficacy scale may be used to improve the quality of clinical nursing.

The Impact of COVID-19-Related Work Stress on the Mental Health of Primary Healthcare Workers: The Mediating Effects of Social Support and Resilience

Objective

The psychological condition of healthcare workers since the COVID-19 pandemic has attracted the attention of many studies. However, few have reported on psychosocial problems of primary healthcare workers in the COVID-19 pandemic. This study aimed to examine the mediating roles of social support and resilience in COVID-19-related work stress and symptoms of anxiety and depression.

Methods

A total of 840 primary healthcare workers in 17 community health centers in Guangzhou, China, were recruited from May to July 2021. Data on demographic characteristics, COVID-19-related work stress, social support, resilience, anxiety and depression were collected. A structural equation model was used for mediation analysis.

Results

More than half of participants reported mild or more severe (at least borderline abnormal) symptoms of anxiety (68.1%) and depression (55.6%). Social support and resilience mediate the association between COVID-19-related work stress and symptoms of anxiety and depression, respectively. Furthermore, the association between work stress and symptoms of anxiety and depression was also mediated by an accumulation of social support and resilience. The indirect effect of COVID-19-related work stress on anxiety and depression through resilience was much greater than other indirect effects.

Conclusion

Anxiety and depression were prevalent among primary healthcare workers. This study highlights the psychological impact of the COVID-19-related psychosocial work environment on primary healthcare workers. There is an urgent need to improve working conditions for primary healthcare workers in the COVID-19 and to implement intervention strategies aimed at increasing individual resilience alongside the establishment of external supportive work environments.

Multi-level analysis of individual and work environment factors associated with nurses' perceived emotional exhaustion

BACKGROUND

Several factors at the individual- and work environment-level were suggested to correlate with emotional exhaustion development in nurses.

AIM

To explore nurses' perceived emotional exhaustion and associated factors by employing hierarchical modelling techniques.

METHODS

1539 nurses completed the cross-sectional survey. Generalized Linear Mixed Model was performed to identify predictors of emotional exhaustion.

RESULTS

At the individual level, female gender, high workload and emotional job demands increased the risk of emotional exhaustion; instead, higher education, satisfaction with the role of follower, perceiving nursing profession as meaningful, feeling independent at work, and group closeness were protective factors. At the work environment level, hospital ward type did not affect emotional exhaustion.

CONCLUSIONS

Emotional exhaustion is largely influenced by ward culture and organizational policies, and to a lower extent by socio-demographic variables. Moreover, it emerges as an intrinsic risk of the nursing profession rather than being associated with the clinical area profile.

Validity and reliability of Psychiatric Nurse Self-Efficacy Scales: cross-sectional study

OBJECTIVES

To develop the Psychiatric Nurse Self-Efficacy Scales, and to examine their reliability and validity.

DESIGN

We developed the Improved Self-Efficacy Scale (ISES) and Decreased Self-Efficacy Scale (DSES) using existing evidence. Statistical analysis was conducted on the data to test reliability and validity.

SETTING

The study's setting was psychiatric facilities in three prefectures in Japan.

PARTICIPANTS

Data from 514 valid responses were extracted of the 786 responses by psychiatric nurses.

OUTCOME MEASURES

The study measured the reliability and validity of the scales.

RESULTS

The ISES has two factors ('Positive changes in the patient' and 'Prospect of continuing in psychiatric nursing') and the DSES has three ('Devaluation of own role as a psychiatric nurse', 'Decrease in nursing ability due to overload' and 'Difficulty in seeing any results in psychiatric nursing'). With regard to scale reliability, the Cronbach's alpha coefficient was 0.634-0.845. With regard to scale validity, as the factorial validity of the ISES and DSES, for the ISES, χ²/df (110.625/37) ratio=2.990 (p<0.001), goodness-of-fit index (GFI)=0.962, adjusted GFI (AGFI)=0.932, comparative fit index (CFI)=0.967 and root mean square error of approximation (RMSEA)=0.062; for the DSES, χ²/df (101.982/37) ratio=2.756 (p<0.001), GFI=0.966, AGFI=0.940, CFI=0.943, RMSEA=0.059 and Akaike Information Criterion=159.982. The concurrent validity of the General Self-Efficacy Scale was r=0.149-0.446 (p<0.01) for ISES and r=-0.154 to -0.462 (p<0.01) for DSES, and the concurrent validity of the Stress Reaction Scale was r=-0.128 to 0.168 for ISES, r=0.214-0.398 for DSES (p<0.01).Statistical analyses showed the scales to be reliable and valid measures.

CONCLUSIONS

The ISES and DSES can accurately assess psychiatric nurses' self-efficacy. Using these scales, it is possible to formulate programmes for improving psychiatric nurses' feelings of self-efficacy.

Role Stress and Psychological Distress Among Chinese Nurses During the COVID-19 Pandemic: A Moderated Mediation Model of Social Support and Burnout

OBJECTIVE

Nurses are at high risk of psychological distress including stress, depression, and anxiety due to low personnel density and high work demand. Despite mounting evidence showing that role stress is a risk factor for nurses' psychological distress, the mediating and moderating mechanisms underlying this relationship are less known. This study tests the mediation effect of burnout in the association between role stress and psychological distress, and whether this mediation is moderated by social support.

METHODS

A sample of 623 Chinese nurses were recruited from all hepatological surgery departments in Hunan Province and filled out an online questionnaire to collect data on socio-demographics, role stress, burnout, psychological distress, and social support. Mediation and moderation analyses were carried out in SPSS macro-PROCESS.

RESULTS

Burnout partially mediated the positive association between role stress and psychological distress. Social support moderated the indirect effect of role stress on psychological distress via burnout, with the effect being stronger for nurses with low social support than those with high social support.

CONCLUSIONS

These findings demonstrated how role stress contributed to nurses' psychological distress both directly and indirectly through burnout, and how this indirect effect was moderated by social support. The results provide important practical implications for future prevention and intervention programs to improve nurses' mental health from multiple aspects such as decreasing role stress and burnout while increasing social support.

Nurses experience of caring for patients with COVID-19: A phenomenological study

INTRODUCTION

COVID-19 has impacted all dimensions of life and imposed serious threat on humankind.

BACKGROUND

In Jordan, understanding how nurses experienced providing care for patients with COVID-19 offers a framework of knowledge about similar situations within the context of Arabic culture.

AIM

To explore nurses' experience with providing hands-on care to patients with active COVID-19 infection in an Arabic society.

METHODS

A descriptive phenomenological study interviewed 10 nurses through a purposive sampling approach until data saturation was reached. The research site was hospital designated to receive patients with active COVID-19 infection. Semi-structured interviews were used to collect the data.

FINDINGS

Three themes were generated from the data: the impact of the COVID-19 outbreak on nurses' health; unfamiliar work and social environments; and conforming to professional standards.

DISCUSSION

There are specific risks to the physical and mental wellbeing of nurses who provide hands-on care to patients with COVID-19 in an Arabic society.

IMPLICATION FOR NURSING AND HEALTH POLICY

Health care institutions should consider establishing programs that promote nurses' wellbeing and support their productivity in a crisis. A danger pay allowance should be considered for nurses during extraordinary circumstances, such as pandemics.

Risk factors for digital stress in German public administrations

OBJECTIVE

As the digitization of the working world progresses, the demands on employees change. Not least, this is true for the setting of public administrations in Germany, which is currently affected by the transformation to E-Government. This study aims to identify and describe a risk cluster of digitally stressed employees in public administrations.

METHODS

An online sample of 710 employees from three public administrations in North Rhine-Westphalia were surveyed about digital stress (7 items) and several potential risk factors (19 items) derived from the current research. In the first step, a hierarchical agglomerative cluster analysis is used to detect the risk cluster. This is followed by a comparison to the group of the remaining employees regarding their risk profiles.

RESULTS

The analysis states that the digitally stressed cluster accounts for approximately ten percent of the public administration's employees of the total sample. Employees in the risk cluster are less satisfied with on-site work overall, experience less collegial support on-site, experience less collegial support in the home office, resign more often, are more likely to feel overwhelmed, are less educated, are older in age and more often have relatives in need of care.

CONCLUSION

This work was able to identify and describe a group of digitally stressed rather than left-behind employees in public administrations to bring awareness to potentially destructive factors in the digital transformation process but eventually to social inequalities. The findings offer the basis for interventions to arise and evoke potential for further research.

The association of gratitude with perceived stress among nurses in Korea during COVID-19 outbreak

BACKGROUND

During the COVID-19 pandemic, nurses might experience added emotional stress. This study examined the relationship between gratitude and psychological stress to explore effective psychological support among nurses.

METHODS

A cross-sectional survey assessed the level of psychological distress in 646 nurses in Gwangju, South Korea, using the Perceived Stress Scale-10 (PSS-10), Gratitude Questionnaire-6 (K-GQ-6), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Maslach Burnout Inventory-General Survey (MBI-GS). Sociodemographic factors and COVID-19-related experiences were also examined. A linear regression model was used to determine the factors influencing perceived stress.

RESULTS

The mean PSS-10 score was 19.0 ± 4.4. Linear regression analyses revealed that the MBI-GS-Exhaustion, PHQ-9, and GAD-7 scores were positively associated with perceived stress, while the MBI-GS-Professional efficacy score was inversely associated with perceived stress. Gratitude disposition using the K-GQ-6 score negatively predicted PSS-10 (β = 0.829, p < 0.001).

CONCLUSIONS

Psychological interventions that help cultivate gratitude and professional efficacy among nurses can help promote stress resilience throughout the course of the COVID-19 pandemic.

Determinant of Stress and Burnout among Nurses at the Second Wave of the Indonesian COVID-19 Pandemic: A National Web-based Survey

BACKGROUND: COVID-19 pandemic has developed into a major public health threat. Nurses who work to combat COVID-19 are frequently under pressure. The high stresses caused by the consequences of transmission of the COVID-19 put nurses at risk of developing burnout syndrome. AIM: The purpose of this study was to evaluate the level of anxiety and burnout experienced by nurses during the COVID-19 pandemic. METHODS: This study was conducted using a cross-sectional design. An online web-based survey was used to collected data in the national sample of nurses (n = 243, response rate = 78.6%). This study used a convenience sampling technique. The Hamilton Anxiety Rating Scale and the Maslach Burnout Inventory were also employed. Multiple linear regressions were used to determine characteristics associated with burnout. RESULTS: The participants’ average age was 34.62 years (SD = 7.91). The mean anxiety score was 7.89 (SD = 2.94). The mean score of emotional exhaustion was 14.35 (SD = 7.72), the depersonalization means score was 8.81 (SD = 5.11), and the professional accomplishment mean score was 13.51 (SD = 7.51). Education and job experience had a substantial effect on emotional exhaustion and depersonalization, with R2 values of 10.8% and 18.5%, respectively. When anxiety was included in the model, the R2 for emotional exhaustion increased to 20.4% and the R2 for depersonalization increased to 22.2%, respectively. Work experience had a little effect on professional accomplishment (R2 = 10.3%) but had a much larger effect when the variable of anxiety was included in the model (R2 = 18.3%). CONCLUSION: This study revealed that during the COVID-19 epidemic, nurses experienced many emotional states, including exhaustion, depersonalization, and anxiety. Efforts should be made by governments and policymakers in this regard in better preparing health-care systems, persons, and nursing to respond to the COVID-19 pandemic in the future.

Factors related to job burnout among older nurses in Guizhou province, China

Background

The nursing workforce shortage has long been a global concern, and with the aging of nurses, this problem has become more prominent. Nursing is recognized as a high-stress occupation, and nurses experience high levels of job burnout, which reduces their professional identity. Older nurses are an indispensable talent force for nursing teams and are extremely important for the stability of nursing teams and improvement in nursing quality. Exploring the mental health and influencing factors of older nurses is very beneficial for the stability and development of nurse teams and patients’ clinical outcomes.

Purpose

This study aimed to investigate the level of job burnout and its influencing factors among older nurses in Guizhou Province, China and confirm the correlations among job burnout, professional identity and stress level.

Methods

From July to August 2019, 520 registered nurses aged over 40 years in Guizhou Province, China were surveyed through the Questionnaire Star platform. The questionnaire contained the following four parts: a general information questionnaire, the Maslach Burnout Inventory (MBI), a professional identity scale, and a job stressors scale.

Results

The results showed that the job burnout score of the 520 older nurses was 55.44 ± 18.62, which was moderate. The level of job burnout was positively correlated with the level of nurse stress and negatively correlated with the level of professional identity, which was influenced by various personal and social factors.

Conclusions

This study not only revealed that job burnout was still at a moderate level, but also revealed its current status and influencing factors among older nurses in China.

Impact of nurses' emotional intelligence on the implementation of a professional practice model in cancer care

AIM

To examine the impact of emotional intelligence on the effective implementation of a professional practice model in a specialised cancer centre.

METHODS

The study used a cross-sectional design with 580 frontline nurses at King Hussein Cancer Center, Jordan. The sample was selected using a convenience sampling technique. Data were collected using two self-administered questionnaires to measure emotional intelligence and professional practice.

RESULTS

The overall mean value of emotional intelligence was 5.60 out of 6 (SD=0.78), while the overall mean value for the implementation of the professional practice model was 4.76/5 (SD=0.59). The results showed that the overall mean value of emotional intelligence had a significant positive correlation with the effective implementation of the professional practice model (r=0.580, P<0.001), even after adjusting for the participants' demographics (P<0.001).

CONCLUSION

Emotional intelligence can be considered a predictor for the effective implementation of a professional practice model.

Work Environment Characteristics and Emotional Intelligence as Correlates of Nurses' Compassion Satisfaction and Compassion Fatigue: A Cross-Sectional Survey Study

This cross-sectional survey study examined the relationship between Canadian nurses' work environment characteristics, emotional intelligence, compassion fatigue and compassion satisfaction (n = 1271). Psychological demands, decision latitude, supervisor and coworker support, and emotional intelligence (EI) were significantly correlated with nurses' compassion satisfaction and compassion fatigue, except for two EI subscales. Furthermore, these relationships were stronger for compassion satisfaction than compassion fatigue, suggesting that they are influenced by different factors. Our results highlight the importance of creating reasonable psychological demands, empowering nurses to make decisions in their jobs, supportive relationships at work, and fostering the development of nurses' EI.