Nurses´ stressors and psychological distress during the COVID-19 pandemic: The mediating role of coping and resilience

Personal and work-related factors associated with nurse resilience: An updated systematic review using meta-analysis and narrative synthesis

BACKGROUND

Nursing shortages and increased workforce turnover have significantly increased nurses' workloads, thus increasing the risk of burnout and stress, particularly during the COVID-19 pandemic. A systematic review published in 2019 suggested that resilience could act as a buffer to adversity; however, the factors associated with resilience during and after this global pandemic have not been identified.

OBJECTIVES

To identify personal and work-related factors associated with nurse resilience, including the period during and after the COVID-19 pandemic.

DESIGN

Systematic review.

DATA SOURCES

The search was conducted between January and February 2024 in the following databases: CINAHL Plus, MEDLINE (Ovid), PsycINFO, EMBASE, and Scopus, using the key terms 'resilience', 'hardiness', 'work', 'employ', 'occupation', 'job', and 'nursing'.

REVIEW METHODS

Quantitative studies with English full text, published between 2018 and 2024, were selected if they assessed resilience and its associated factors among nurses providing direct patient care. Two authors independently completed the data selection process. Studies with quality assessment grades of 3 or above were included for final analysis. A meta-analysis was utilised for the mean resilience levels from studies using the same measures of resilience, and a narrative synthesis was performed for the demographic and work-related factors.

RESULTS

Fifty-nine cross-sectional studies with a quality assessment score of 3 or above were included. Forty-seven studies were included in a meta-analysis, which reported an estimated mean resilience level of 20.69 using a random-effects model (95 % CI [18.53, 22.85], z = 18.79, p < 0.0001, I2 = 95.1 %). Twenty studies with the Connor Davidson Resilience Scale (CD-RISC)-25 and five with the CD-RISC-10 were meta-analysed for the mean resilience levels of 62.85 (95 % CI: [55.60, 70.10], z = 16.97, p < 0.0001, I2 = 31.70 %) and 26.34 (95 % CI: [20.85, 31.83], p < 0.0001, I2 = 0 %), respectively. A low mean resilience level was identified. Sixteen demographic factors were identified as associated with resilience. Twenty job demand factors negatively associated with resilience were determined and categorised into exhaustion, psychological factors, and work challenges. Thirty-two job resource factors positively related to resilience were identified and classified into the following categories: psychological factors, leadership, work performance, well-being and quality of life, and social and organisational support.

CONCLUSIONS

Understanding the job demand and resource factors can help organisations minimise the risks and develop institutional strategies to protect nurses from the negative impact of COVID-19 or future pandemics on nurses' well-being.

Association and interaction between resilience and psychological distress in disabled elderly-caregiver dyads: An actor-partner interdependence model

OBJECTIVES

This study examined the association and interaction between resilience and psychological distress in disabled elderly-caregiver dyads.

METHODS

A total of 246 disabled elderly individuals and their family caregivers were studied using the Resilience Scale and the Distress Thermometer and Problem List. The data analysis employed the actor-partner interdependence model (APIM) method based on structural equation modelling.

RESULTS

APIM revealed a mixed model. Resilience of disabled elderly individuals and caregivers is negatively associated with their psychological distress (association-actor effect), and the psychological distress of other member in the dyad (interaction-partner effect). Furthermore, the actor effect is twice as large as the partner effect.

CONCLUSION

This mixed model suggests that increased resilience and decreased psychological distress in caregivers may be associated with decreased psychological distress in disabled elderly individuals. Health professionals should design dyadic interventions focusing on resilience and interactions between disabled elderly individuals and caregivers to improve their mental health.

PATIENT OR PUBLIC CONTRIBUTION

Heighten public awareness of the interaction between resilience and psychological distress among disabled elderly-caregiver dyads. Based on these insights, advocate for enhanced mental health resources and improved policies to strengthen resilience and more effectively address psychological distress within this vulnerable community.

Impact of positive psychological capital and shared leadership on nurses' organizational well-being: a descriptive survey study

BACKGROUND

Organizational well-being is a critical issue that should be addressed within nursing organizations as it boosts the morale and work motivation of its members by enhancing their satisfaction and happiness.

AIM

This study aimed to evaluate the levels of positive psychological capital, shared leadership, and organizational well-being among nurses, and examine the impact of positive psychological capital and shared leadership on organizational well-being.

METHODS

A descriptive survey research design was used, involving 177 nurses with at least one year of work experience at highly specialized hospitals in Korea treating patients with severe conditions. Data were collected via an online survey from July 1 to August 31, 2023, using a questionnaire that included items on general characteristics, job-related characteristics, positive psychological capital, shared leadership, and organizational well-being. The collected data were analyzed using the SPSS 29.0 software, employing statistical measures such as frequency, percentage, mean, standard deviation, t-test, ANOVA, Pearson correlation coefficient, and hierarchical regression analysis.

RESULTS

The participants' scores were 3.32 ± 0.51 out of 5 for organizational well-being, 4.12 ± 0.58 out of 6 for positive psychological capital, and 3.64 ± 0.59 out of 5 for shared leadership. Factors identified that influenced organizational well-being included positive psychological capital (β = 0.462, p < .001) and shared leadership (β = 0.442, p < .001), which explained 58% of the total variance in the model (F = 48.74, p < .001).

CONCLUSIONS

To improve the organizational well-being of nurses, it is essential to develop capacity-building and intervention programs that boost positive psychological capital and shared leadership. Achieving this goal necessitates not only the individual efforts of organizational members but also robust organizational support, engagement, and proactive management.

Factor Structure of the Brief Coping Orientation to Problems Experienced Inventory (Brief-COPE) in Chinese Nursing Students

Background/Objectives: Coping strategies are influenced by sociocultural factors, and an understanding of how the Brief-COPE functions within the Chinese student population is important for its validity and reliability. This study aimed to explore the factor structure of the Brief Coping Orientation to Problems Experienced Inventory (Brief-COPE) in Chinese nursing students. Methods: A cross-sectional study design was adopted. A total of 284 college nursing students, aged 18 years or older, were recruited from a medical university in China using convenience sampling. Exploratory factor analysis (EFA) was conducted to identify the underlying domain structure of the Brief-COPE within those students. This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement. Results: The Brief-COPE demonstrated robust validity, revealing eight distinct factors: positive reframing coping, avoidant and passive coping, seeking social support, self-blame and emotional distress coping, denial and deflective coping, spirituality and humor coping, avoidance and emotional release coping, and adaptive acceptance with distraction. The scale exhibited good internal consistency, as indicated by a Cronbach's alpha of 0.759. Conclusions: The Brief-COPE is a valid tool for assessing coping strategies in Chinese nursing students. Nursing educators could benefit from training aimed at enhancing the use of appropriate strategies. Also, culturally tailored interventions, such as peer support groups and mentorship programs, could further promote coping skills and improve the emotional well-being of these students.

Occupational injuries, mental workload and coping strategies among the nursing workforce in the Eastern Region of Ghana: a multi-centre study

BACKGROUND

The nursing profession plays a crucial role in the quality of healthcare services. While nurses face occupational injury challenges globally, mental workload, which is often overlooked, plays a significant role in these injuries. Understanding nurses' coping strategies can help develop effective interventions. The study examined the influence of mental workload on occupational injuries and coping strategies among nurses.

METHODS

A multi-centre cross-sectional study was conducted in selected hospitals in the Eastern Region of Ghana. Using a stratified sampling technique, 317 nursing staff from 6 hospitals participated in the study. A researcher-developed occupational injury questionnaire, NASA Task Load Index and Brief COPE scale were used to measure occupational injury, mental workload and coping strategies among nurses. Descriptive statistics, Pearson moment-product correlations, and regression analysis were used to analyse the data at a statistical significance of 0.05.

RESULTS

Needle pricks, injuries from sharps, exposure to blood and other body fluids, and back pain and injury from patient handling tasks were shared among participants in the past year. The study also revealed a high level of mental workload among participants. A significant correlation was observed between mental workload and various occupational injuries. The participants adopted different coping strategies in dealing with the mental workload, with active coping and instrumental support being the most used coping strategies.

CONCLUSION

The findings underscore the importance of addressing mental workload in nursing to reduce occupational injuries. To achieve this, nurses must be provided with appropriate coping strategies and support to minimise mental stress.

IMPLICATION

Providing accessible and effective coping strategies tailored to nurses' needs can significantly improve their well-being and job performance. Healthcare administrators and policymakers should consider these results when designing interventions to support the nursing workforce.

Development of COVID-19 Infection Prevention and Control Training Program Based on ADDIE Model for Clinical Nurses: A Pretest-Posttest Study

Scientific and effective training is important to enhance the theoretical knowledge and practical skills of clinical nurses in coronavirus disease 2019 (COVID-19) prevention and control (IPC), so as to improve the IPC capacity. The study aimed to design and implement a COVID-19 IPC training program for clinical nurses based on the ADDIE model, and to evaluate its clinical application effects. This was a pretest-posttest study in which 389 clinical nurses were recruited through convenience sampling. The IPC training program for clinical nurses was developed based on the five stages of ADDIE model. Data were analyzed using pared-sample t test, McNemar's test, and Wilcoxon test. After training, nurses' theoretical scores and operational scores except for hand hygiene were improved significantly (p < 0.001). Compared to pre-training assessment, their job performances were also significantly improved (p < 0.001). And they had higher satisfaction with the program post-training. Under the situation of COVID-19, training based on the ADDIE model can effectively improve the IPC ability of clinical nurses. Besides, it provides new ideas, methods, and approaches for future clinical IPC training.

Trends and determinants of nurses' mental health following the COVID-19 pandemic in China: a longitudinal, comparative study over a two-year period

Introduction

The COVID-19 pandemic has placed nurses at the forefront of healthcare, exposing them to various mental health challenges such as depression, anxiety, and post-traumatic stress disorder (PTSD). However the long-term effects and risk factors of the COVID-19 pandemic on nurses' mental health are unknown. The objective of our study is to investigate the enduring impact of the COVID-19 pandemic on the psychological distress and PTSD of nurses, while also identifying the factors that influence these outcomes.

Methods

To investigate this question, we conducted a self-reported questionnaire survey of 8785 registered nurses recruited using snowball sampling methodology from 22 provinces in China, at five time points (T0-T4). At all times, we took measures of general health, while at the last four times we also measured PTSD. And we used logistic regression analysis to explore their impacts.

Results

The incidence of whole levels psychological distress among nurses was 27.7% at T0, peaking at 57.6% at T4. For severe psychological distress, it began at 5.5% at T0 and rose to 9.5% at T4. PTSD rates among nurses were recorded at 7.8% in T1, reaching a maximum of 14.7% in T4. They all got progressively worse in the volatility. In all times, coping strategies are independent factors for various levels of psychological distress and PTSD, while social support is a key factor for severe psychological distress and PTSD.

Conclusions

Our findings indicated a gradual deterioration in the mental health of nurses following the COVID-19 outbreak. In all instances, coping strategies exhibit an independent correlation with all grades of psychological distress and post-traumatic stress disorder (PTSD), whereas social support emerges as an independent protective factor mitigating the risk of severe psychological distress and PTSD.

Understanding the Experiences of Nurses' Work: Development and Psychometric Evaluation of an End of Shift Survey

AIM

To explore and validate an end of shift survey with a low response burden, practical application and generated evidence of related associations between workload, quality of work and patient care, missed care and job satisfaction.

DESIGN

A retrospective cross-sectional survey of the experiences of nursing staff.

METHODS

Data were collected from 265 nurses who responded to a questionnaire at the end of their shift in 2022. Exploratory factor analysis was undertaken using IBM SPSS v.27 and confirmatory factor analysis was undertaken using IBM AMOS v27. Hypotheses testing was undertaken using IBM SPSS v.27 using multiple regression analyses.

RESULTS

All of the hypotheses were supported. There was a negative association between workload and quality of work and job satisfaction. Quality of work was negatively associated with workload and missed care and positively associated with job satisfaction. The association between missed care and job satisfaction was negative.

CONCLUSION

The EOSS is a valid and reliable tool with a low response burden. The tool supports previous research which demonstrated there is a negative relationship between level of workload and shift type with satisfaction, quality of work and potentially nurse retention.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

In the context of a global nursing shortage nursing leaders must ensure that care we provide is of the highest quality. We must take every action to address high workload to reduce the risk that fundamental care is not sacrificed, job satisfaction is improved and nurses remain in the profession. The EOSS gives nurse leaders a reliable, practical, consistent, applied tool that will better enable associations to be observed between resource configuration, workload and critical impacts on nursing and patient care.

REPORTING METHOD

We have adhered to the relevant EQUATOR guidelines using the STROBE reporting method.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Exploring the effects of the COVID-19 pandemic on nurse managers

BACKGROUND

Research shows that front-line nurses' workload and stress levels increased during the coronavirus disease 2019 (COVID-19) pandemic, however, there is little research of these factors in relation to nurse managers. Previous research undertaken in Austria found that some nurse managers working in nursing homes undertook clinical as well as managerial functions during the pandemic, a double burden that could have increased their stress levels and have had adverse psychological, physical and social consequences.

AIM

To investigate the effects of the COVID-19 pandemic on nurse managers' workload, perceptions of teamwork and stress levels, and the physical, psychological and social consequences of working during the pandemic.

METHOD

A cross-sectional design was used. Respondents (n=238) were sent an online questionnaire during the second wave of the pandemic (which in Austria was November 2020 to March 2021) containing questions on demographics and fear of infection, their current workload compared with pre-pandemic workload, their perceptions of the influence of the pandemic on teamwork, their levels of stress measured using the Perceived Stress Scale (PSS), and the physical, psychological and social consequences of working during the pandemic.

RESULTS

Most respondents (95%) had to undertake more or much more work than usual during the pandemic, while just over half (52%) perceived that the influence of the pandemic on teamwork had been positive throughout or partially positive. Overall, the respondents' level of stress was moderate, as measured by the PSS. Around 28% of respondents were afraid of infecting someone other than themselves, notably their families, employees and patients. Fear for themselves, their families and their patients or residents were commonly reported psychological consequences of working during the pandemic, while confusion due to information overload was the second most commonly reported psychological consequence.

CONCLUSION

Comparing results with previous research is difficult due to the lack of research of nurse managers' experiences of the pandemic. Fear appears to have been a major issue for nurse managers during the pandemic, particularly in relation to infection and information overload. This emphasises the need for healthcare organisations to focus on the mental health and well-being of nurse managers, as well as front-line staff, during and after crisis situations such as a pandemic. Organisations may consider reworking and adopting already-established COVID-19 regulations, schedules and local guidelines, particularly in terms of communication and infection control, which could help to reduce nurse managers' fear in future crisis situations.

The moderating role of psychological resilience in the relationship between fear of COVID-19 and psychological distress, in a cohort of rural and regional healthcare workers. During major lockdowns in Victoria, Australia 2020-2021

The emergence of the COVID-19 pandemic resulted in substantial pressures for healthcare workers across the world. The association between fear of COVID-19 and psychological distress, and the role of psychological resilience have gained research interest. The current study aimed to investigate the cross-sectional association between fear of COVID-19 and psychological distress, in Australian rural/regional healthcare workers and determine whether resilience modifies this association. Most participants were nurses (38.0%), mean age was 44.9 years, and 80.5% were female (N = 1313). An adjusted logistic regression analysis showed that the highest tertile of the Fear of COVID-19 scale was associated with higher odds of moderate to severe symptoms of anxiety (OR = 3.72, 95% CI = 2.27, 6.11; p < 0.001) and depression (OR = 3.48, 95% CI = 2.30, 5.28; p < 0.001). Healthcare workers with high level of fear of COVID-19 and low level of resilience were much more likely to report moderate to severe symptoms of anxiety (OR = 12.27, 95% CI = 6.65-22.65, p < 0.001) and depression (OR = 12.21, 95% CI = 6.93-21.50, p < 0.001) when compared to healthcare workers with low level of fear of COVID-19 and high level of resilience. A cross-sectional design was used and therefore cause and effect between fear of COVID-19 and psychological distress cannot be inferred. Longitudinal research is needed to investigate the possible causal relationship. These findings highlight the potential mental health effects of fear of COVID-19 on HCWs and demonstrate the importance of resilience as a possible moderator of these effects.

The Mediation Roles of Coping Modalities on the Relationship Between Stress and Quality of Life Among Jordanian Nurses

Nurses are at the frontline, dealing with people's most immense healthcare needs in stressful and demanding work environments. Consequently, it is essential to thoroughly examine how various coping mechanisms might affect the relationship between stress and quality of life (QOL). This study aimed to examine the mediation effect of both problem-focused coping (PFC) and emotion-focused coping (EFC) mechanisms on mitigating the effect of stress on the QOL among Jordanian nurses. A multisite cross-sectional descriptive correlational design was used in this study. An online survey was completed by 203 nurses using a convenience sampling technique between October 2023 and January 2024. The study included nurses working in different Jordanian healthcare sectors including governmental, private, and university-affiliated hospitals. Several measures were used to collect data, including questionnaires on sociodemographics, QOL, coping, and stress. Two models were hypothesized for this study. The two models were analyzed using Andrew Hayes Process Macro Model 4 for testing the mediation effects. Additionally, descriptive and correlational analyses were run prior to the main analysis. The results showed that coping significantly mediated the relationship between stress and QOL with variations between PFC and EFC. In conclusion, psychological distress symptoms were common among Jordanian nurses; psychological distress, coping, and QOL are correlating variables. Nurses' stress levels and coping modalities can predict QOL with a superior effect of PFC compared with EFC. Strategies should be put in place to improve effective coping to improve nurses' QOL. The results of this study have important implications for nursing education, practice, future research, and policy.

Promoting coping competence for psychological stressors in nursing training: a controlled pedagogical intervention

Background

Multiple stressors as well as health-and quality-impairing effects of strain in the nursing profession require the systematic acquisition of competence in dealing with these demands, starting at the stage of initial vocational training. This study investigates whether an instructional design, which merges didactic principles of nursing education with concepts and training measures from stress psychology, promotes the acquisition of stress coping competence more effectively than regular teaching on the relevant curricular field at nursing schools.

Methods

The quasi-experimental study design, based on the Solomon four-group plan, included 332 trainees in Germany. The assessment of stress coping competence at the beginning and at the end of the intervention provided a video-stimulated situational judgment test covering nursing-specific stressful situations. All were validated by field experts. Complementing group comparisons, regression analyses examined intervention effects at the individual level while controlling for other predictors of learning success.

Results

The highest solution rates for the two basic dimensions of stress coping competence, i.e., (1) situation assessment and (2) strategy selection and justification, occurred in the treatment classes without a pretest. At the individual level, treatment effects were confirmed for the first dimension. Students with a migration background showed lower competence gains than other students.

Conclusion

The instructional design and the competence test provide valuable foundations for promoting and for diagnosing coping skills. Nevertheless, subsequent studies should examine adaptive support for different learner groups. Furthermore, additional observational phases should focus on the deliberate practice of acquired coping strategies in the practical training settings of nursing education.

A theoretical framework for Acute Care Nurse Stress Appraisal: Application of the transactional model of stress and coping

AIM

To develop a framework for understanding the stress appraisal process among acute care nurses during the COVID-19 pandemic.

DESIGN

A secondary analysis of open-ended responses from a cross-sectional survey of 3030 frontline, acute care nurses in New Jersey and the effect of burnout during the COVID-19 pandemic.

METHODS

Lazarus and Folkman's transactional model of stress and coping guided the study. Thematic analysis was used to analyse 1607 open-ended responses.

RESULTS

Nine themes emerged during the secondary appraisal of stress. Five themes contributed to distress and burnout including (1) high patient acuity with scarce resources, (2) constantly changing policies with inconsistent messaging, (3) insufficient PPE, (4) unprepared pandemic planning and (5) feeling undervalued. Four themes led to eustress and contributed to post-traumatic growth including (1) team nursing to ensure sufficient resource allocation, (2) open channels of communication, (3) sense- of-duty and (4) personal strength from new possibilities.

CONCLUSION

The COVID-19 pandemic was a traumatic event for patients and the nursing workforce. Internal and external demands placed on acute care nurses increased burnout, however, a subset of nurses with adequate support experienced personal growth.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Beyond mental health interventions for acute care nurses, organizational interventions such as reevaluation of emergency action plans to optimize resource allocation, and work environment strategies such as improved communication and decision-making transparency are necessary.

IMPACT

To better understand how frontline acute care nurses experienced stress during COVID-19, a data-informed framework was developed that included a primary and secondary appraisal of stress. Themes contributing to distress and burnout were identified, and themes leading to eustress and post-traumatic growth were also identified. These findings can assist nurse leaders in optimizing strategies to reduce burnout and promote post-traumatic growth in the post-COVID years.

REPORTING METHOD

No patient or public contribution.

Exploring the impact of the mentoring new nurses for transition and empowerment program led by clinical nurse educators in South Korea: A mixed-methods study

BACKGROUND

"New nurses" are those with less than a year of work experience at a hospital. To address the challenges of new nurses caused by their limited experience, the Mentoring New Nurses for Transition and Empowerment Program (MNTEP) was designed based on the Stress-Appraisal-Coping Model of Lazarus and Folkman.

OBJECTIVES

This study aimed to explore the impact of the MNTEP, in which clinical nurse educators teach stress-coping strategies, on the clinical transition of new nurses in South Korea.

DESIGN

This study used a mixed-methods design with a pretest-posttest non-equivalent comparison group and focus group interviews (FGIs).

SETTINGS

The research was conducted at a hospital in South Korea.

PARTICIPANTS

The intervention and comparison groups comprised 30 and 28 new nurses, respectively. Also, 12 MNTEP participants were subjected to three separate FGIs.

METHODS

To comprehensively assess the program's effects, quantitative data were collected through self-report surveys, while qualitative data were obtained from March 2022 to March 2023 using semi-structured interviews that allowed for open-ended responses.

RESULTS

There were significant differences in mean self-efficacy scores (t = 2.45, p = 0.017) and perceived social support from clinical nurse educators (F = 4.51, p = 0.038) between the intervention and comparison groups. Additionally, significant changes were observed in the field adaptation pre-test and post-test scores within the intervention group (t = -3.12, p = 0.004). However, there was no statistically significant difference between the groups in terms of active and passive coping strategies. FGIs yielded two main themes: (1) gaining positive energy through empowerment and solidarity; and (2) clinical nurse educators sharing strategies for improved role adaptation and capacity building.

CONCLUSIONS

MNTEP led by clinical nurse educators positively influenced new nurses' self-efficacy and facilitated their transition to clinical settings. These findings underscore the importance of mentorship programs and clinical nurse educators.

A national survey of pandemic fear and cyberchondria after ending zero-COVID policy: The chain mediating role of alexithymia and psychological distress

BACKGROUND

More than half the domestic population in China were infected with COVID-19 in two months after ending "zero-infection policy", which severely overwhelmed frontline healthcare providers with stress and fear. However, there is no study to date investigating the associations between nurses' fear of pandemic and cyberchondria. This study aimed to 1) investigate the correlations between fear pandemic and cyberchondria among frontline nurses, and 2) discover its potential mechanism.

METHODS

A cross-sectional sample of frontline nurses (N = 8161) was recruited from 98 hospitals across China in February 2023. Participants were invited to complete an online, self-rated standardized questionnaire focused on pandemic fear, alexithymia, psychological distress, and cyberchondria. Environmental, clinical and socioeconomic information were collected for adjustment while conducting chain mediation analysis.

RESULTS

When other covariates were controlled, it was found that fear of the pandemic significantly contributed to cyberchondria (b = 0.58, 95%CI [0.56, 0.60], p < .001). The chain mediation model suggested that both alexithymia and psychological distress were mediating factors between pandemic fear and cyberchondria.

CONCLUSIONS

The higher the perceived fear, the greater the cyberchondria, which suggests that reducing fear about the pandemic and providing adequate support could reduce the incidence of cyberchondria. As alexithymia and psychological distress may be transdiagnostic mechanisms between fear and cyberchondria, targeted interventions focused on expression dysregulation and emotional identification could be useful.

Effect of occupational stress and resilience on insomnia among nurses during COVID-19 in China: a structural equation modelling analysis

OBJECTIVES

To explore the effects of occupational stress and resilience on insomnia among Chinese nurses during the COVID-19 pandemic.

DESIGN, SETTINGS AND PARTICIPANTS

A quantitative description study. The data were collected via a cross-sectional survey. A total of 725 front-line nurses at three tertiary hospitals in western China were included from December 2022 to January 2023. The Connor-Davidson Resilience Scale, Job Content Questionnaire, and Athens Insomnia Scale were used to collect data from a self-reported online questionnaire.

OUTCOME MEASURES

The outcome variable was insomnia, and structural equation modelling was used to assess the associations among resilience, occupational stress and insomnia.

RESULTS

The prevalence of insomnia among the participants was 58.76%. The structural equation model showed that resilience had a negative direct effect on insomnia and occupational stress, and occupational stress had a positive direct effect on insomnia. Involvement in COVID-19-related work has a positive effect on insomnia through occupational stress. In contrast, higher education levels improved insomnia through increased resilience.

CONCLUSION

A significantly higher prevalence of insomnia has been observed among Chinese nurses during the COVID-19 pandemic. Our study suggests that better resilience may improve insomnia by relieving occupational stress, and implementing measures to promote resilience is essential to reduce occupational stress in nurses and improve their sleep quality.

Efficacy of a program in increasing coping strategies in firefighters: randomized clinical trial

OBJECTIVE

to evaluate the effectiveness of a program in increasing coping strategies focused on military firefighters' problems and emotions.

METHOD

randomized, parallel, single-masked clinical trial. The sample consisted of 51 participants in the intervention group and 49 in the control group. The intervention group received the intervention program including coping strategies based on the Nursing Interventions Classification, lasting six consecutive weeks, one day a week. The control group followed the Service Unit routine. Descriptive statistics, Student's T test with Welch's correction and the Mann-Whitney test were used for the analyses. The magnitude of the intervention effect was calculated using Cohen's d index. A p-value of ≤0.05% was considered.

RESULTS

in the analysis of the mean difference between the scores in the groups, the means of the intervention group increased significantly for the coping strategies: social support (p = 0.009), acceptance of responsibility (p = 0.03), problem solving (p = 0.05) and positive reappraisal (p = 0.05). The impact of the intervention was moderate in magnitude for social support (d = 0.54).

CONCLUSION

the intervention program enabled the increase of coping strategies focused on military firefighters' problems and emotions. ReBEC: RBR-8dmbzc. (1) The intervention program increases coping strategies. (2) The study included military firefighters. (3) Social support was the main strategy of the study. (4) Intervention group presented better results than the control group. (5) The use of the Nursing Intervention Classification was effective.

Linking COVID-19 stress and Chinese nurses' life well-being: The influence of work-family conflict and work centrality

The COVID-19 pandemic has placed enormous stress on health workers, exposing them to high levels of work-family conflict (WFC), which in turn affects their life well-being（LWB). To date, whether WFC is involved in the association between COVID-19 stress and the well-being of life has not been investigated. The purpose of this paper was to explore the connection between COVID-19 stress and LWB in Chinese nurses and to analyse the mediating role of WFC and the moderating effect of work centrality. The link between COVID-19 stress and LWB was examined by performing multiple regression analysis, common method bias analysis, and confirmatory factor analysis on data for 227 nurses.COVID-19 stress exerted a remarkable direct impact on nurses' LWB, and WFC mediated the link between COVID-19 stress and nurses' LWB. Work centrality moderated the link between COVID-19 stress and nurses' WFC. COVID-19 stress decreases nurses' LWB and increases their WFC, which also decreases their LWB. For nurses with higher work centrality, the connection of COVID-19 stress to work-family conflict was stronger. Hospital managers should focus on nurses' work-family balance and pay particular attention to the work-family balance of work-centered nurses to avoid compromising their LWB.

Coping strategies, resilience and quality of life: reaction to the COVID-19 pandemic among Romanian physicians

BACKGROUND

The COVID-19 pandemic has presented multiple psychological challenges for healthcare workers, such as anxiety, depression, burnout, and substance use disorders. In this research, we investigate the different ways Romanian physicians dealt with the difficult period of the COVID-19 pandemic. We also analyze how positive and negative stress-reducing strategies, as well as demographic variables, affect their psychological resilience and quality of life. Our goal is to provide a comprehensive overview of how physicians coped with the unprecedented global health challenges.

METHODS

We carried out a national cross-sectional study of 265 physicians in Romania between January 2021 and January 2022 using a web-based questionnaire. The study employed a web-based questionnaire to assess coping mechanisms using the COPE inventory, resilience through the Connor-Davidson Resilience Scale 25 (CD-RISC 25), and quality of life via the WHOQOL-BREF scale. The COPE inventory, consisting of 60 items across 15 subscales, categorizes coping strategies into problem-focused, emotion-focused, and dysfunctional types, with each item rated on a 4-point scale. The CD-RISC 25 measures resilience on a 5-point Likert scale, with total scores ranging from 0 to 100. WHOQOL-BREF assesses quality of life through 26 items in 4 domains: physical, mental, social relations, and environmental, scored from 1 to 5 and converted to a 0-100 scale for domain scores. Univariate and multivariate linear regression models were employed to discern the intricate relationships between coping strategies, resilience levels, quality of life dimensions, and pertinent demographic factors.

RESULTS

The average CD-RISC score among participants was 66.2. The mean scores for the values for the QOL subscales were 64.0 for physical well-being, 61.7 for psychological well-being, 61.2 for social relationships, and 64.7 for environment. Individuals tend to use problem-focused and emotion-focused coping more than dysfunctional mechanisms, according to the COPE inventory. Problem-focused and emotion-focused coping are positively correlated with resilience, while dysfunctional coping is negatively correlated. Resilience is significantly influenced by gender and professional status, with males and senior specialists reporting higher levels while younger physicians and residents reporting lower levels.

CONCLUSIONS

Our data points to specific protective characteristics and some detrimental factors on physicians' resilience and quality of life during the pandemic.

Effects of the Need for Support From the Workplace and Resilience on Psychological Distress in Japanese Employees: A 1-Year Prospective Study

PURPOSE

This study examines workplace support and resilience's influence on psychological distress in Japanese employees.

METHOD

A 1-year prospective online cohort study was conducted. Logistic regression analyzed prevalence odds ratios and 95% confidence intervals for psychological distress. Participants were grouped based on their support and resilience levels.

RESULTS

Prevalence odds ratios for psychological distress followed this pattern for low and high resilience groups: "necessary but not received" (prevalence odds ratio and 95% confidence interval for low/high resilience: 9.71, 6.88-13.69 and 4.72, 2.97-7.52, respectively), "received" (6.65, 4.29-10.29 and 2.27, 1.21-4.25), and "not necessary" (4.43, 3.30-5.95 and reference). Workplace support had a stronger impact on psychological distress in low-resilience employees.

CONCLUSIONS

We provided evidence that the combination of the need for support from the workplace and resilience affects psychological distress in employees.

Communication Self-Efficacy and Job Satisfaction among Nurses during the COVID-19 Pandemic

Introduction

The outbreak of COVID-19 has led to various challenges for healthcare workers, including nurses. Nurses play a critical role in the fight against this disease, and their communication of self-efficacy and job satisfaction has garnered significant attention. This study aimed to investigate the relationship between communication self-efficacy and job satisfaction of Iranian nurses during the COVID-19 pandemic.

Methods

This study was conducted using a cross-sectional design. A total of 500 nurses working in hospitals in Iran were selected using a convenience sampling method. The communication self-efficacy scale and the job satisfaction scale were used to collect data.

Results

The study found that nurses with higher communication self-efficacy exhibited better performance and job satisfaction in various work challenges (r = 0.56, p < 0.001). However, nurses holding a master's degree or higher reported the lowest average communication self-efficacy and job satisfaction scores during the COVID-19 epidemic. The study also explored the impact of shift work on job satisfaction among nurses and found that nurses working exclusively on the morning shift reported the highest average job satisfaction score.

Conclusion

The findings of this study suggest that communication self-efficacy is an important factor in predicting job satisfaction among Iranian nurses during the COVID-19 pandemic. Therefore, it is recommended that healthcare organizations provide effective communication training sessions and mental health interventions to enhance nurses' communication self-efficacy and job satisfaction. This can ultimately lead to improved performance and better patient outcomes.

"I feel broken": Chronicling burnout, mental health, and the limits of individual resilience in nursing

Healthcare systems and health professionals are facing a litany of stressors that have been compounded by the pandemic, and consequently, this has further perpetuated suboptimal mental health and burnout in nursing. The purpose of this paper is to report select findings from a larger, national study exploring gendered experiences of mental health, leave of absence (LOA), and return to work from the perspectives of nurses and key stakeholders. Given the breadth of the data, this paper will focus exclusively on the qualitative results from 53 frontline Canadian nurses who were purposively recruited for their workplace insight. This paper focuses on the substantive theme of "Breaking Point," in which nurses articulated a multiplicity of stress points at the individual, organizational, and societal levels that amplified burnout and accelerated mental health LOA from the workplace. These findings exemplify the complexities that underlie nurses' mental health and burnout and highlight the urgent need for multipronged individual, organizational, and structural interventions. Robust and timely interventions are needed to restore the health of the nursing profession and sustain its future.

Psychosocial etiology of post-traumatic stress disorder caused by war trauma among Iran-Iraq war immigrants in Mehran, Iran

Background

Post-traumatic stress disorder (PTSD) is one of the most important and common disorders caused by war trauma. The aim of this study was to determine the relationship between psychosocial factors and PTSD in war-torn immigrants in Mehran, Iran.

Method

The present study was conducted by descriptive and correlational method. The data were collected from 245 people (121 women and 124 men) from war-torn immigrants 45 years and older who migrated from Mehran to Ilam during the Iran-Iraq war. The measuring tools were as follows: Post Traumatic Stress Disorder Scale, Multidimensional Scale of Perceived Social Support (MDPSS), Coping Strategies Scale (CSS-R), Multidimensional Health Locus of Control scale.

Results

The prevalence rate of PTSD among war-torn immigrants in Mehran was 35.1 %. A significant negative correlation was observed between perceived social support and PTSD (p < .01). Coping strategies, including seeking social support, reappraisal/adaptation, problem-focused coping, and active coping, all showed significant negative correlations with PTSD (p < .01). Conversely, a significant positive correlation was found between avoidance coping strategies and self-control and PTSD (p < .01). In addition, there was a significant positive correlation between the external locus of control (believing in chance) and PTSD (P < 0.01) and significant negative correlation between internal locus of control and PTSD (P < .01).

Conclusion

Weakness in social support, locus of control and also inappropriate coping strategies against war trauma were among the strong risk factors for PTSD. Therefore, social and behavioral interventions are recommended to increase social support, teaching problem-solving skills and strengthen individual control among war-torn immigrants to reduce the risk of developing PTSD.

The evolution of professional identity in intensive care nurses during COVID-19 - An interpretive phenomenological study

OBJECTIVES

This study explored the meaning behind professional identity in intensive care nurses who cared for patients with COVID-19.

RESEARCH METHODOLOGY/DESIGN

The exploration was conducted using a qualitative interpretive phenomenological approach with guidance from hermeneutics.

SETTING

Semi-structured audiovisual interviews were conducted with intensive care unit nurses (n = 20) throughout the United States of America, spanning nurse experiences of caring for patients with COVID-19 between 2019 and 2022.

OUTCOME MEASURE

Outcome measures were codes and themes which emerged from data using Benner's interpretive phenomenology method for nursing and Heidegger's hermeneutic circle.

FINDINGS

Four critical findings of this study were the themes a) Keep Them Alive, b) We Are Survivors, c) I Am An Intensive Care Unit Nurse, and d) I Was Meant For This.

CONCLUSION

Findings suggest that professional identity is evolving for nurses as they care for patients in the intensive care and that evolution affects nursing professionals' quality of life.

IMPLICATIONS FOR CLINICAL PRACTICE

The findings of this study have important implications for nursing practice. These themes highlight intensive care nurses' deep commitment and strong professional identity, which can positively impact nurse retention and foster a sense of purpose and fulfillment. Understanding the meaning attached to nurses' experiences can allow nurse leaders and mentors to enhance their roles and aid in the preparation of future intensive care nurses, helping future nurses find focus and satisfaction in their professional identities. Recognizing and nurturing nurses' strong professional identity may positively impact nurse retention and fulfillment. To achieve this, nurse leaders must comprehend and support nurses' experiences, cultivating an environment that empowers these caregivers to thrive and make a lasting impact on patient care.

Psychological distress as a mediator between workplace violence and turnover intention with caring for patients with COVID-19

The Coronavirus Disease 2019 (COVID-19) outbreak exacerbated workplace violence and turnover intention among nurses, particularly affecting greater levels of psychological distress. This study aimed to examine psychological distress as a mediator of the relationship between workplace violence and turnover intention among clinical nurses, and to investigate whether caring for patients with COVID-19 moderates this relationship through the lens of the affective events theory. We conducted an online survey of 325 Korean registered nurses (mean age = 30.75; female = 92.6%) who work in clinical settings between August and October 2021 using the convenience sampling method. Psychological distress was measured using the 21-item Depression Anxiety Stress Scale and workplace violence using one dichotomous item adopted from the Workplace violence questionnaire. We measured turnover intention using the six-item Anticipated Turnover Scale. Caring for patients with COVID-19 was determined using one dichotomous item. The research hypotheses assume that the relationship between workplace violence and turnover intention could be mediated by psychological distress and moderated by caring for patients with COVID-19 among Korean nurses. We performed a moderated mediation analysis with workplace violence as the independent variable, turnover intention as the dependent variable, psychological distress as a potential mediator, and caring for patients with COVID-19 as a potential moderator. The analysis revealed that nurses' psychological distress among 308 nurses had a statistically significant mediating effect on the relationship between workplace violence and turnover intention. Furthermore, caring for patients with COVID-19 had a significant further moderating effect on this relationship. These findings highlight the need for psychological support services for clinical nurses at institutional and organizational levels amidst the ongoing COVID-19 pandemic. It is hoped that these findings can contribute to the development of tailored interventions for nurses caring for patients with COVID-19 to attenuate their psychological distress in a timely and effective manner.

Challenges and Counteracting Strategies Including Optimum Health Service Practices for Frontline Nurses During the Mpox Outbreak and Futuristic Vision

INTRODUCTION

Monkeypox (mpox) is an evolving infectious disease caused by the monkeypox virus (MPXV). On July 23, 2022, the WHO declared the recent mpox outbreaks a public health emergency of international concern (PHEIC), which terminated on May 11, 2023. As of July 11, 2023, 88,288 confirmed cases and 149 deaths have been reported from 112 countries and territories. Currently, mpox is not a PHEIC, as the outbreak and its impacts are nearly over. Nurses played significant roles during the mpox 2022 outbreak as frontline workers.

PURPOSE

In light of the impending mpox global outbreak in 2022, this brief report provides an update on the enormous difficulties faced by frontline nurses while playing a crucial role in handling the mpox outbreak and some potential solutions to these difficulties. The methodological framework employed in this narrative brief report involves conducting a comprehensive analysis and synthesis of relevant literature and hypothetical scenarios. The aim is to put forth practical strategies that can effectively tackle the difficulties encountered by frontline nurses in the context of the mpox outbreak. Additionally, the report seeks to envision a healthcare system that is more resilient in the face of future challenges.

CONCLUSION

It is important to understand the challenges the nurses face from their perspective. As frontline health care workers, the various health issues of nurses and their concerns must be taken care of appropriately by adopting optimum health service practices, adequate safety measures, recommended precautionary measures, and boosting them mentally while handling mpox patients. Counseling and the arrangement of workshops are required. Appropriate care should be taken to address the various health issues concerning nurses by adopting health service practices at optimum levels. Side by side, recommended safety and precautionary measures should be followed.

Alleviating the Effects of the COVID-19 Pandemic on the Physical, Psychological Health, and Wellbeing of Students: Coping Behavior as a Mediator

BACKGROUND

Public health procedures under the COVID-19 pandemic lockdown policy negatively affect people's health. Students' physical issues have been increased due to restrictions which further impact their psychological and overall well-being.

OBJECTIVE

The research looks at the influence of coping behavior in mitigating the impact of the COVID-19 epidemic on students' physical/psychological health and general well-being.

METHODS

The study's participants were chosen from a pool of 2200 people using convenience sampling. Using an anonymous online poll, the main data were gathered. The collected data were analyzed by using Smart-PLS.

RESULTS

From eight direct correlations, seven were found to be true, except the route pandemic -> overall wellbeing, which was not true. Furthermore, it was shown that the mediating effect of coping behavior was statistically significant in the routes of mediation.

CONCLUSION

Coping strategies have a significant role in how a person responds to trying circumstances. Our study's results suggest that coping strategies had a statistically significant mediation role in reducing the effects of the COVID-19 pandemic. It is concluded that appropriate coping strategies are an effective adaptation of a protective barrier against the damaging effects of COVID-19 on health.

Fear of COVID-19, Stress and Coping Strategies among Nurses during the COVID-19 Pandemic's Second Wave: A Quasi-Intervention Study

Background

The COVID-19 pandemic and its related consequences caused a higher risk of mental health problems for nurses. Hence, this study aims to reduce the level of fear and stress related to the COVID-19 pandemic and promote active coping among Egyptian nurses.

Methods

This quasi-intervention study was conducted on 125 nurses working at Benha's University hospitals, who were selected by a systematic random sampling technique within the time interval of March 2021 to July 2021. The study was conducted using the fear of COVID-19 scale, the stress scale of depression, anxiety and stress scales, and the Brief (COPE) inventory scale.

Results

The mean ages of the studied nurses were 36.70 ± 9.50. Almost half of the studied nurses were males and married. Before the intervention, 47.2% of nurses had severe stress levels while 82.4% had a high level of fear of COVID-19. Experience years, type of department, and worries about vaccine side effects were the predictors of the fear of COVID-19. A significant difference (p = .000) was found between both mean stress and fear scores pre-intervention (15.27 ± 5.47 and 25.56 ± 6.13) and post-intervention (4.87 ± 2.14 and 11.92 ± 2.43). The most prevalent coping strategies among nurses before the intervention were self-distraction (5.03 ± 1.53), followed by behavioral disengagement and self-blaming. However, after the intervention, religion was found to be the utmost coping mechanism (6.12 ± 1.17), followed by positive reframing and acceptance.

Conclusion

The majority of the nurses in the study reported a significant fear of COVID-19, and around half of the nurses had severe stress as a result. After the intervention, the stress and fear scores were reduced by half or even less. Age, longer work experience, and worries about the vaccine were the predictors of fear of COVID-19. The coping strategies used after the intervention shifted toward active coping strategies. Clinical Trial Registration Number: 10-11-008-701.

The influence of meaningful work on the mental health of SME employees in the COVID-19 era: can coping strategies mediate the relationship?

BACKGROUND

Stress, depression, and anxiety are prevalent issues among SME employees during the COVID-19 pandemic. Even while having meaningful work that expressively contributes to individual growth has been related to improving mental health, employees' work may also need to adopt coping strategies to increase outcomes. The purpose of this study was to examine the relationship between meaningful work (positive meaning, meaning-making, and greater good motivations) and mental health, as well as coping strategies (problem-focused and emotion-focused) as a mediator of this relationship.

METHODS

Meaningful work, coping strategies, and mental health were evaluated in empirical research based on a sample of 462 SME employees working in Malaysia. Structured questionnaires were used to collect the data and analyze it through Structural Equation Modelling (SEM) using AMOS 21.0.

RESULTS

The findings of the study show the importance of meaningful work in influencing the mental health of SME employees, particularly during a crisis like the COVID-19 pandemic. This suggests that the more they value and see their work as meaningful, the more capable they are of dealing with limitations and mental health problems associated with crises. The study also discovered a partial mediating role for coping strategies between employees' mental health and meaningful work.

CONCLUSION

This study encourages employees to constantly feel connected and discover continued possibilities to work and learn even during crisis situations. In order to improve human resource efficiency in emerging markets, managers and owners of SMEs must implement the model developed by the researchers.

Emotions, Perceived Stressors, and Coping Strategies Among Nursing Staff in Saudi Arabia During the COVID-19 Pandemic

Objective The COVID-19 pandemic resulted in heightened stress for nurses and other healthcare workers, particularly during the initial phase of the crisis. Despite the adoption of various coping strategies, psychological distress persisted, affecting nurses' well-being and jeopardizing the overall resilience of the healthcare system. This study assessed the emotional response, perceived stressors, and coping strategies among nurses' staff who worked during the first wave of COVID-19 pandemic. Method A cross-sectional study was carried out among nurses who worked during the initial phase of the COVID-19 crisis (June - August 2020), at a tertiary care center in Western Saudi Arabia. The questionnaire explored five main sections. The first section (15 items) assessed emotions experienced during the initial wave of COVID-19, capturing both positive and negative sentiments, such as "joy" or "fear." The second section (20 items) examined the presence of stressors, like "lack of protective equipment" or "fear of infection." The third section (14 items) evaluated the perceived effectiveness of certain stress-reducing factors, including "peer support" or "training." In the fourth section (13 items), participants rated their usage frequency of various coping strategies, such as "meditation" or "seeking advice." Lastly, the fifth section assessed the hypothetical impact of 10 incentives, like "financial bonuses" or "additional training," in motivating nurses' involvement in future epidemic responses. The questionnaire was completed with demographic and professional data. A convenience sampling method was employed, and 315 nurses participated in the study. Descriptive statistics were carried out using SPSS version 24 for Windows (IBM Corp., Armonk, NY). Result The most commonly experienced emotion was a feeling of responsibility and ethical duty, reported by 97.5% of the participants, followed by nervousness and fear (83.8%), anger (73.3%), and stigma (70.2%). On the other hand, 86.7% were expecting a financial compensation. The most common stressors were related to the nurses' own safety, or the safety of their families and colleagues, reported by 92.4-95.2% of the participants. The perceived uncontrollability of COVID-19 was also a significant stressor. The improvement of the health status of infected colleagues (98.1%) or patients (97.5%) were the most common factors associated with the reduction in nurses' stress. Among the coping strategies, five were almost systematically deployed by the nurses (>95%), all consisting of cognitive and behavioral mechanisms to enhance own knowledge and safety and avoid being infected. The most crucial determinants for commitment in future pandemics are the availability of a cure or vaccine (93.3%), family support (91.4%), adequate personal protective equipment from the hospital (90.8%), and exemption from overtime (90.2%). Conclusion The first wave of COVID-19 exerted a tremendous psychological stress on nurses, due to concerns about safety, disease uncertainties, and social isolation. Analyzing these impacts offers insights for enhancing institutional and national crisis strategies, emphasizing staff safety and psychological well-being, especially for first responders like nurses. Policy implications include prioritizing mental health support and preparedness in future crisis plans. Additionally, ensuring continuous training and strategic workload management is crucial for maintaining frontline commitment.

Psychological resilience mediates the association between sleep quality and anxiety symptoms: A repeated measures study in college students

OBJECTIVE

To explore the association between sleep quality and anxiety symptoms, and the mediation effect of psychological resilience on this association by a repeated measures study.

METHODS

In this study, 127 college students were randomly recruited and their sleep quality and psychological status were repeatedly collected using the Pittsburgh Sleep Quality Index (PSQI) scale, Connor-Davidson resilience scale (CD-RISC), and 7-items generalized anxiety disorder scale (GAD-7). Linear mixed-effects models were used to explore the association between sleep quality and anxiety symptoms, and a mediated effects analysis was used to explore the role played by psychological resilience in this association.

RESULTS

This study found a positive association between sleep quality and anxiety symptoms (β = 0.40, 95% confidence interval: 0.27, 0.52). Psychological resilience scores and its various dimensions play a significant mediating role in this association.

CONCLUSIONS

Although the role of sleep quality in anxiety disorders is not fully understood, this study highlights the importance of improving sleep quality while enhancing psychological resilience to prevent the onset of anxiety symptoms in college students.

Physicians' Resilience as a Positive Effect of COVID-19

People devoid of COVID-19 may exhibit mental health problems, such as anxiety disorders, depression, panic attack, insomnia, emotional disorder, and suicidal actions. Healthcare workers (HCWs) may also exhibit these problems. Physicians should be careful an "at-risk" population. Physicians revealed higher levels of resilience than the popular workers. Humans with stronger resilience have lower feeling of anxiety and depression. We investigated the risk to physicians from an infected environment to infected patients during the pandemic. The social and psychological support of all HCWs, particularly physicians, is significant in the fight against this pandemic. Physicians working with patients with COVID-19 should set enough time to relax, sleep, and spend time with family. Resilience in physicians facing COVID-19 can induce post-traumatic growth in the future.

The relationship between intergenerational financial support and depressive symptoms among older adults: Evidence from China Health and Retirement Longitudinal Study, 2011-2018

OBJECTIVE

Aimed to investigate the effect of intergenerational financial support on depressive symptoms among older adults over time.

METHODS

Data were obtained from China Health and Retirement Longitudinal Study (CHARLS) 2011, 2013, 2015, and 2018. A finite distributed lag (FDL) model was employed, long-run cumulative effect was evaluated. 1426 respondents followed in four waves were included in FDL model. CES-D score was used to measure depressive symptoms, intergenerational financial support was defined as financial support received from older adults' children or grandchildren. Sociodemographic characteristics, health behaviors, social insurance, and social contact factors were controlled in the model.

RESULTS

More than a third older adults in China had a CES-D score of 10 or higher. Intergenerational financial support has a significant long-run cumulative negative effect on older adults' depressive symptoms (CES-D scores: coef. = -0.674, P < 0.001; % with CES-D scores ≥10: Coef. = -0.154, P = 0.018). While, the intergenerational financial support in previous period exhibited a significant negative association with depressive symptoms, the 2, 3, and 4 periods did not reach statistical significance.

CONCLUSIONS

Intergenerational financial support has a significant negative effect on older adults' depressive symptoms over time, while the effect may diminish. Programs need to be explored to support home-based eldercare to mitigate this diminished effect.

Exploring the impact of COVID-19 on the psychological well-being of oncology healthcare professionals

AIMS

To explore how psychological well-being is maintained by healthcare professionals (HCPs) employed in a cancer setting during the COVID-19 pandemic.

DESIGN

A qualitative design using diaries and interviews to collect data was used to gain insights into how HCPs managed their well-being during the pandemic.

METHODS

Interpretative Phenomenological Analysis (IPA) was used to analyse diaries and interviews completed by 66 HCPs during the second pandemic lockdown period (December 2020-April 2021). A total of 102 HCPs were recruited, drawn from five groups: nursing staff, radiographers, medical staff, allied health professionals (AHPs) (non-radiographers) and support staff.

RESULTS

The majority of participants adjusted to the challenges of the pandemic using positive coping strategies, although difficult days required the mobilization of additional resources. Emotion management was regulated through peer relationships, professional roles and the workplace, sustained through communities of practice involving knowledge exchange, shared goals and social interactions. Maintaining high-quality patient care was a source of job satisfaction, providing a route through which positive emotions could be channelled; however, it was juxtaposed with threats to well-being from busy workloads and variable organizational responsiveness. Work routines provided a platform for well-being, underpinned by the sharing of problems and solutions within peer networks.

CONCLUSION

This study has highlighted the dynamic nature of well-being amongst HCPs during the pandemic. Well-being interventions should build on the preferred coping strategies of HCPs, focusing on the way individuals coalesce in groups to learn from and support one another.

IMPACT

HCPs may experience different psychological responses when exposed to a pandemic situation. This study identifies the strategies used by HCPs to maintain positive psychological well-being within professional roles, whilst adjusting to emerging well-being threats. Key components of HCP's well-being are addressed, which are relevant to clinical practice and the broader healthcare workforce.

PATIENT OR PUBLIC CONTRIBUTION

Research team members included public representatives who contributed to the development, methods, data collection and analysis of the study. They supported the development of the Research Assistant by providing mock interview skills training.

Perceived occupational stressors among nurses in a level-1 trauma center under normalized COVID-19 epidemic prevention and control in China: A qualitative study

Background

Nurses in trauma centers encounter emergency patients and are exposed to occupational stressors under normalized pandemic control and prevention.

Objective

The objective of this study was to examine the occupational stressors that nurses perceived during the COVID-19 pandemic in a level-1 trauma center in China.

Methods

From December 2020 to May 2021, a qualitative study was conducted, employing conventional content analysis as the research methodology. A total of twelve nurses were purposefully selected from a trauma center at a major hospital in Beijing to participate in semi-structured interviews (40-50 min' duration). The data collected in this study were analyzed using the conventional content analysis approach proposed by Graneheim and Lundman.

Results

After analyzing the data, two themes emerged: 1) Critical conditions under normalized pandemic prevention and control; 2) Concerns about loved ones and colleagues, along with financial problems. Both these themes further revealed four categories: the complexity and uncertainty of epidemic prevention and health hazards in the former, and concerns for and from families and colleagues, and financial stress in the latter.

Conclusions

The results of this study provide valuable insights into the practical implementation of epidemic prevention and control measures in Chinese trauma centers and shed light on the psychological stress faced by nurses. Improving the tripartite support system of hospital, family, and society, and providing emotional support may help reduce stress among nurses, thereby improving their health and care quality.

Perceived professional benefits and their associated factors among Chinese registered nurses caring for women diagnosed with gynecological cancer

PROPOSE

Registered nurses (RNs) are considered to be a major source of professional supportive care for women diagnosed with gynecological cancer (GC). This study described the level of perceived professional benefits and explored association between perceived professional benefits, sense of coherence (SOC), and coping strategies in Chinese RNs caring for women diagnosed with GC.

METHOD

A cross-sectional survey was employed to collect data using the Nurses' Perceived Professional Benefits Questionnaire (NPPBQ), Sense of coherence scale (SOC-13), and Brief Coping Orientation to Problems Experienced (Brief COPE). The questionnaires were administered to 250 RNs in China. The correlations between NPPBQ, SOC-13, and Brief COPE were evaluated with Pearson's correlation coefficient. Multiple regression analysis was performed to assess the relative contribution of each possible factor in explaining variance in the increased NPPBQ.

RESULTS

The total score for the NPPBQ was 142.4 (range 33.0-165.0). SOC, dysfunctional coping strategies, and problem-focused coping strategies were recognized as predictors of RNs' perceived professional benefit, while, emotion-focused coping strategies were not significantly associated with RNs' perceived professional benefits.

CONCLUSIONS

The findings indicate that RNs who have high levels of SOC, dysfunctional coping strategies, and problem-focused coping strategies tend to experience more perceived professional benefit. These findings propose new perspectives for nursing managers to promote RNs' perceived professional benefit by helping RNs to find meaningfulness when caring for women diagnosed with GC, increasing RNs' communication skills to improve their relationship with patients, and training RNs to use coping strategies effectively.

From students to nurses under pressure: Nursing students' entry into employment during the first COVID-19 wave

AIMS AND OBJECTIVE

To describe the experiences of nursing students and their mental health as they entered employment during the first wave of the COVID-19 pandemic (May-June 2020).

BACKGROUND

As other healthcare professionals, nursing students who worked during the first COVID-19 wave suffered from dysfunctional mental health symptoms.

DESIGN

Sequential, mixed-method, multicentre study.

METHODS

The study population comprised 92 students in the third and fourth year of the Nursing degree at three Spanish universities, who entered employment during the pandemic. Data were collected between May and June 2020. In the quantitative phase, data were collected using an online questionnaire containing both validated anxiety and stress scales. In the qualitative phase, semi-structured interviews were conducted with 18 participants. A descriptive analysis of the quantitative data and a reflexive thematic analysis of the qualitative data were carried out, and analyses were combined. COREQ checklist was used for reporting.

RESULTS

The combined quantitative and qualitative results were organised into five thematic areas: (1) Interruption of clinical placements, (2) Entering employment on a healthcare assistant contract, (3) Preventing contagion, (4) Adapting to the situation and managing emotions, and (5) Lessons learned.

CONCLUSION

The students had a positive overall experience of entering employment, as they were able to develop their nursing skills. However, they had an emotional impact in form of stress caused by excessive responsibility, academic uncertainty, lack of personal protective equipment and training in its use, and the possibility of spreading disease to their family members.

RELEVANCE TO CLINICAL PRACTICE

In the current context, changes must be made in study programmes to instruct nursing students to be able to cope with extreme clinical situations, such as pandemics. The programmes should include a more extensive coverage of epidemics and pandemics and management of emotional aspects such as resilience.

Factors protecting Swiss nurses' health during the COVID-19 pandemic: a longitudinal study

BACKGROUND

The COVID-19 pandemic reached Europe in early 2020 and impacted nurses over a prolonged period, notably causing heavy work overloads. Exposure to sources of stress in such situations is inevitable, which can put nurses' health at risk. The present study took a salutogenic approach to investigating nurses' health and the principal factors protecting it found in the literature (i.e., resilience, post-traumatic growth, social support, and certain organizational factors), as well as how those elements evolved from February 2021 to September 2022.

METHODS

All nurses working at eight French-speaking Swiss hospitals who accepted to disseminate the study to their employees were invited to complete an online questionnaire at four time points (February 2021, September 2021, March 2022, and September 2022: T0, T1, T2, and T3, respectively) and respond to items measuring their health, factors protecting their health, and their perceived stress levels. Data were analyzed using random-intercept linear regression models.

RESULTS

A cumulated total of 1013 responses were collected over all measurement points (625 responses at T0; 153 at T1; 146 at T2; 89 at T3). Results revealed that nurses' health had not changed significantly between measurements. However, their perceived stress levels, feelings of being supported by their management hierarchies, and belief that they had the means to deliver a high quality of work all diminished. At every measurement point, nurses' health was negatively associated with perceived stress and positively associated with resilience, perceived social support, and the belief that they were provided with the means to deliver a high quality of work.

CONCLUSION

Despite the difficult conditions caused by the pandemic, the factors recognized as protective of nurses' health played their role. The lack of improvements in nurses' health in periods when the pandemic's effects lessened suggests that the pressure they were experiencing did not drop during these moments. This phenomenon may have been due to the need to clear backlogs in scheduled surgery and the work overloads caused by prolonged staff absences and nurses quitting the profession. Monitoring changes in nurses' health is thus crucial, as is establishing measures that promote factors protective of their health. Organizational factors influencing nurses' working conditions are also key and should not be neglected.

Unmet Psychosocial Needs of Health Care Professionals in Europe During the COVID-19 Pandemic: Mixed Methods Approach

BACKGROUND

The COVID-19 pandemic severely affected everyday life and working conditions for most Europeans, particularly health care professionals (HCPs). Over the past 3 years, various policies have been implemented in various European countries. Studies have reported on the worsening of mental health, work-related stress, and helpful coping strategies. However, having a closer look is still necessary to gain more information on the psychosocial stressors and unmet needs of HCPs as well as nonmedical staff.

OBJECTIVE

This study aimed to obtain quantitative information on job-related stressors of physicians and nurses and the coping strategies of HCPs and nonmedical staff at 2 periods of the COVID-19 pandemic. By further analyzing qualitative comments, we wanted to gain more information on the psychosocial stressors and unmet needs of HCPs as well as nonmedical staff on different levels of experience.

METHODS

A cross-sectional survey was conducted at 2 time points during the COVID-19 pandemic in several European countries. The first study period (T1) lasted between April 1 and June 20, 2020, and the second study period (T2) lasted between November 25, 2021, and February 28, 2022. On a quantitative level, we used a questionnaire on stressors for physicians and nurses and a questionnaire on coping strategies for HCPs and nonmedical staff. Quantitative data were descriptively analyzed for mean values and differences in stressors and coping strategies. Qualitative data of free-text boxes of HCPs and nonmedical staff were analyzed via thematic analysis to explore the experiences of the individuals.

RESULTS

T1 comprised 609 participants, and T2 comprised 1398 participants. Overall, 296 participants made 438 qualitative comments. The uncertainty about when the pandemic would be controlled (T1: mean 2.28, SD 0.85; T2: mean 2.08, SD 0.90) and the fear of infecting the family (T1: mean 2.26, SD 0.98; T2: mean 2.02, SD 1.02) were the most severe stressors identified by physicians and nurses in both periods. Overall, the use of protective measures (T1: mean 2.66, SD 0.60; T2: mean 2.66, SD 0.60) and acquiring information about COVID-19 (T1: mean 2.29, SD 0.82; T2: mean 1.99, SD 0.89) were identified as the most common coping strategies for the entire study population. Using thematic analysis, we identified 8 themes of personal experiences on the micro, meso, and macro levels. Measures, working conditions, feelings and emotions, and social climate were frequently mentioned topics of the participants. In T1, feelings of isolation and uncertainty were prominent. In T2, feelings of exhaustion were expressed and vaccination was frequently discussed. Moreover, unmet psychosocial needs were identified.

CONCLUSIONS

There is a need for improvement in pandemic preparedness. Targeted vocational education measures and setting up of web-based mental health support could be useful to bridge gaps in psychosocial support needs in future crises.

Nurses´ Performance: The Importance of Personal Resources for Coping with Stressors

The health crisis caused by the COVID-19 pandemic has negatively influenced the work of health staff, especially nurses. Stressors that affect nurses have been intensified and new stressors have also emerged, threatening their well-being and job performance. The main objective of this study is to analyze the role of nurses´ personal resources in the relationship between job stressors and job performance during the COVID-19. Sample is composed of 438 nurses from 39 Spanish cities. This is a cross-sectional study. The results confirm the full mediation of resilience in the relationship between stressors and job performance, and the moderation of self-efficacy in the relationship between resilience and job performance, and in the full mediation. This study highlight the role played by self-efficacy as the main personal resource in buffering the effect of stressors on nurses´ performance. Resilience only becomes crucial in individuals with low levels of self-efficacy beliefs. Managers of health institutions and hospitals are invited to invest resources in strengthening the personal resources of health staff, especially self-efficacy beliefs, and resilience to ensure that their performance remains adequate.

Compassion Fatigue Influences the Mental Health and Turnover Intention of Nurses in the COVID-19 Pandemic

Background

Compassion fatigue is a true phenomenon experienced by overworked and exhausted nurses.

Objective

This study assessed frontline nurses' compassion fatigue, stress, mental health, and turnover intention during the second year of the COVID-19 outbreak.

Methods

Using a cross-sectional design, an online survey was administered in the first quarter of 2021 to 259 hospital nurses in the Central Philippines using standardized scales to gather the necessary data.

Results

Nurses were found to have moderate levels of compassion fatigue and turnover intention, high stress, and good mental health. Results revealed that compassion fatigue was associated with poor mental health (r = -5.05, p = 0.01), higher stress levels (r = 0.54, p = <0.001), and turnover intention (r = 0.27, p = <0.001).

Conclusion

Pandemic-related compassion fatigue in nurses increases their stress, worsens their mental health, and heightens their intentions to leave their jobs. Organizations should address compassion fatigue through a supportive work climate.

Intensive care nurse managers' experiences during the first wave of the Covid-19 pandemic: Implications for future epidemiological crises

BACKGROUND

Nurse managers play an important role in coordinating the multidisciplinary teamwork, which is specifically important in emergency and crises situations like the COVID-19 pandemic. The aim of this qualitative study is twofold: (1) to explore the experiences of the Intensive care units (ICU) nurse managers regarding their work during the first wave of the COVID-19 pandemic, and (2) to analyse what implications might be provided based on experiences of nurse managers for future possible epidemiological crises.

METHODS

In-depth phone interviews were conducted to explore the experiences of ward managers-nurses (n = 15) working in different hospitals across Poland. Interviews were taped and transcribed verbatim, and then qualitatively analysed.

RESULTS

Three main categories were identified: (1) Challenge of working with the unknown, (2) Nurse managers' expectations, and (3) Methods of coping and received support. The COVID-19 pandemic strongly affected the work of ICU nurse managers and uncovered the malfunctioning of the healthcare system.

CONCLUSION

It is important to improve the knowledge and competence of hospital management personnel through exercises and in-service training on how to handle emergencies in order to improve the management of healthcare facilities, increase the safety of patients and employees, and the quality of healthcare.

Exploring Novice Nurses' Experiences During the First Wave of the COVID-19 Pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic affected how nurses learn and prepare for their future careers. This study explored the experiences of college-prepared, novice nurses pursuing a baccalaureate degree during the first wave of the pandemic.

METHOD

This qualitative descriptive study analyzed students' individual reflective assignments describing the effects of the COVID-19 pandemic on novice nurses' personal, professional, and educational lives.

RESULTS

Three themes emerged: (1) emotions generated in the clinical workplace due to the lack of control and the unknown of working as novice nurses during a pandemic; (2) cognitive dissonance of the nursing role regarding novice nurses' moral distress and their growing empowerment within the scope of practice; and (3) a disconcerted image of nursing with contrasting views of nursing from the public's perspective and a disconnect between frontline workers and decision makers.

CONCLUSION

Novel pedagogical strategies are needed to help novice nurses cope with stress, uncertainty, and role challenges to foster healthy learning in academic and working environments. [J Nurs Educ. 2023;62(8):461-466.].

Association between proactive personality and professional identity of nursing undergraduates: The mediating role of resilience and irrational belief

AIM

To examine the relationship between proactive personality and professional identity of undergraduate nursing students, including the role of psychological resilience and irrational belief as mediators.

BACKGROUND

Personality has been shown to play a crucial role in determining professional identity. However, the influence of proactive personality on professional identity in the nursing field is poorly understood and requires further investigation.

DESIGN

We conducted a cross-sectional study in China. Between July and December of 2021, 860 nursing undergraduates participated in an online questionnaire survey.

METHODS

Four main variables (proactive personality, psychological resilience, irrational belief and professional identity) and two covariates (willingness to choose nursing profession and family attitude towards nursing) were assessed. The assessment tools chosen are both valid and reliable. To test the proposed multi-mediation model, linear regression analysis by Hayes's SPSS macro-PROCESS was used.

RESULTS

The results revealed that PP, PR and PI were positively connected with one another, but negatively with IB. PP positively predicted PI through direct and indirect paths, after controlling for two covariates. The percentage of indirect path (78.72%) outweighed the direct path (21.28%). The indirect effect of PR (72.51%) was higher than that of PR and IB (6.21%). PI was also positively predicted by students' "Yes" willingness and families' "supportive" attitude towards nursing.

CONCLUSION

This study stated that nursing educators should take nursing students' PP seriously, which would allow for activities to be taken to improve their PR and decrease their IB, hence continuously enhancing their PI. In addition, respecting students' professional aspirations and improving family support may also be valuable ways to boost their PI.

Pandemic Lessons for Future Nursing Shortage: A Prospective Cohort Study of Nurses' Work Engagement before and during 16 Months of COVID-19

Aim

To measure how nurses' work engagement developed during the first three COVID-19 waves and to compare this with the data collected just before the outbreak.

Background

The shortage of nurses is a threat to population health. COVID-19 posed nurses with personal and professional challenges that affected their work engagement. Insights into how the pandemic affected their work engagement may help hospitals retain and recruit nurses in the future.

Methods

A single centre prospective survey study was conducted using the UWES-9.

Results

In total, 1,697 nurses (90.5% female, mean age 41 years) completed four assessments. Each assessment showed a significant decrease in work engagement compared with that before COVID-19. Work engagement stabilized in the last two assessments.

Conclusion

Work engagement decreased significantly compared with that in March 2020, just before the outbreak. Although the decrease stabilized from the 8th month to the 16th month, it did not return to pre-COVID-19 levels. Whether this stabilization was the beginning of a recovery in work engagement or reflected a permanent decline needs to be established. Implications for nursing management. Nurse leaders should facilitate nurses' self-regulation processes and encourage them to develop resources in order to maintain work engagement at a high level.

Repercussions of Pandemic and Preventive Measures on General Well-Being, Psychological Health, Physical Fitness, and Health Behavior: Mediating Role of Coping Behavior

BACKGROUND

Pandemic prevention measures increased physical inactivity due to travel restrictions that led to negative physical fitness, health behavior, psychological health, and general well-being. The mediating role of coping behavior must be identified before developing interventional strategies for this pandemic.

OBJECTIVE

The study investigates the mediating role of coping behavior to mitigate the Coronavirus disease impact on physical fitness, health behavior, psychological health, and general well-being.

METHODS

A web-based survey was used under convenience sampling to collect the primary data. Smart-PLS 3.0 was used to analyze the collected data.

RESULTS

All 14 direct correlations (H1-H14) were correct, and coping behavior's mediating impact was shown to be statistically significant (H9a- H14d).

CONCLUSION

Our study findings indicate that mediating role of coping behavior in mitigating the pandemic impacts was statistically significant. It is concluded that coping behavior is a healthy adaptation to protecting the barrier against COVID-19 adverse effects on health.

Self-efficacy in Clinical Nurse Specialists During the COVID-19 Pandemic

PURPOSE

The purpose of this study was to examine the perceived self-efficacy of the clinical nurse specialist working in the United States during the COVID-19 pandemic and explore whether there was any difference in self-efficacy based on practice focus (spheres of impact) and if differences existed between self-efficacy and demographics.

DESIGN

This study used a nonexperimental, correlational, cross-sectional design utilizing a voluntary, anonymous, 1-time survey administered through Qualtrics (Qualtrics, Provo, UT).

METHODS

The National Association of Clinical Nurse Specialists and 9 state affiliates distributed the electronic survey starting late October 2021 through January 2022. Survey content consisted of demographics and the General Self-efficacy Scale, which measures the individual's perceived ability to cope and execute tasks when faced with hardship or adversity. Sample size was 105.

RESULTS

Results included a high perception of self-efficacy of the clinical nurse specialist working during the pandemic, no statistical significance in practice focus, and a statistically significant difference in the scores of self-efficacy for participants with previous infectious disease experience compared with those without experience.

CONCLUSIONS

Clinical nurse specialists with previous infectious disease experience can guide policy, be utilized in multifaceted roles to support future infectious disease outbreaks, and develop training to prepare and support clinicians during crises such as pandemics.

Anxiety, depression, and insomnia among nurses during the full liberalization of COVID-19: a multicenter cross-sectional analysis of the high-income region in China

Introduction

Frontline nurses fighting against the epidemic were under great psychological stress. However, there is a lack of studies assessing the prevalence rates of anxiety, depression, and insomnia among frontline nurses after the full liberalization of COVID-19 in China. This study demonstrates the impact of the full liberalization of COVID-19 on the psychological issues and the prevalence rate and associated factors of depressive symptoms, anxiety, and insomnia among frontline nurses.

Methods

A total of 1766 frontline nurses completed a self-reported online questionnaire by convenience sampling. The survey included six main sections: the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder (GAD-7), the 7-item Insomnia Severity Index (ISI), the 10-item Perceived Stress Scale (PSS-10), sociodemographic information, and work information. Multiple logistic regression analyses were applied to identify the potential significantly associated factors for psychological issues. The study methods were compliant with the STROBE checklist.

Results

90.83% of frontline nurses were infected with COVID-19, and 33.64% had to work while infected COVID-19. The overall prevalence of depressive symptoms, anxiety and insomnia among frontline nurses was 69.20%, 62.51%, and 76.78%, respectively. Multiple logistic analyses revealed that job satisfaction, attitude toward the current pandemic management, and perceived stress were associated with depressive symptoms, anxiety, and insomnia.

Conclusions

This study highlighted that frontline nurses were suffering from varying degrees of depressive symptoms, anxiety, and insomnia during full liberalization of COVID-19. Early detection of mental health issues and preventive and promotive interventions should be implemented according to the associated factors to prevent a more serious psychological impact on frontline nurses.

Work-related psychosocial challenges and coping strategies among nursing workforce during the COVID-19 pandemic: a scoping review

BACKGROUND

Nurses and midwives have been stretched by the COVID-19 pandemic amidst the heroic roles they have played during the peak of the COVID-19 pandemic. Nurses stood tall among their peers in the healthcare industry saving lives. The pandemic has had a toll on nurses physically, psychologically, and socio-economically. The numerous deaths have traumatized nurses coupled with the fear of possible infection. Nurses have seen their colleagues and loved ones lose their lives to the pandemic, nevertheless, they still render care to patients no matter the circumstances. Due to that, it is imperative to ascertain the extent to which nurses who are much needed in healthcare delivery have been affected by this pandemic. This scoping review used Arksey and O'Malley's review methodology to investigate the nature of work-related psychosocial challenges nurses encountered during the peak of the pandemic, noting the major contributors to the challenges and the coping strategies used to address them.

METHODS

We performed a scoping review and searched for articles from five databases including PUBMED, CINAHL, SCOPUS, Google Scholar, and Grey literature from December 2019 to December 2021. A total of 7,334 articles were retrieved for the study but 45 met the inclusion criteria.

RESULTS

Work-related psychosocial challenges identified included stress, burnout (emotional exhaustion and depersonalization), Post-Traumatic Stress Disorder, depression, sleeplessness, and anxiety. Factors that accounted for the challenges were inadequate personal protective equipment (PPEs), discomfort using the PPEs, extreme workload, and fatigue. Nurses experienced job insecurity, business closure, and separation from family and loved ones, and these contributed to their challenges. Strategies used to deal with the challenges centred on emotion-focused and problem-focused coping.

CONCLUSIONS

The study recommends regular counselling and support for all nurses working at the frontline to help them better cope with the devastating effects of the pandemic so that they could build resilience towards future pandemics.

COVID-19-associated impact and post-traumatic stress symptoms 39 days after pandemic in a sample of home-quarantined Chinese college students: the mediating effecting of past stressful events, psychological resilience, and social support

BACKGROUND

During the COVID-19 outbreak, most Chinese college students were home-quarantined to prevent the spread of the virus. COVID-19-associated impact has been shown to be a risk factor for the development of post-traumatic symptoms disorder (PTSD). However, little is known about the psychological processes that mediate this association. This study investigated the association between COVID-19-associated impact and PTSD and examined whether past stressful events, psychological resilience, and social support have mediating effects on this association.

METHODS

The 12,397 valid responses from 31cities in China via an online survey assessed PTSD symptoms, past stressful events, psychological resilience, social support and social-demographic variables. AMOS was used to test the hypotheses of mediating effects.

RESULTS

On the 39th day of the declared COVID-19 epidemic in China, 6.75% of the surveyed sample showed PTSD symptoms. A positive mediating effect of past stressful events was found between COVID-19-associated impact and PTSD, whereas psychological resilience and social support had negative mediating effects. The fit indices for the path model were found to be significant (β = 0.28, p < 0.001), COVID-19-associated impact indirectly affects the risk of PTSD through mediating pathways (past stressful events → psychological resilience → social support) on PTSD.

CONCLUSIONS

Attention should be paid to the effects of past stressful events of Chinese college students who were home-quarantined during the COVID-19 epidemic, and strategies should also be implemented to improve social support and develop psychological resilience.

TRIAL REGISTRATION

The study was approved by the ethics committee of the Southwest Minzu University.