Factors influencing well-being in clinical nurses: A path analysis using a multi-mediation model

Pre-trauma memory contextualization as predictor for PTSD-like behavior in male rats

While many people experience potentially threatening events during their life, only a minority develops posttraumatic stress disorder (PTSD). The identification of individuals at risk among those exposed to trauma is crucial for PTSD prevention in the future. Since re-experiencing trauma elements outside of the original trauma-context is a core feature of PTSD, we investigate if the ability to bind memories to their original encoding context (i.e. memory contextualization) predicts PTSD vulnerability. We hypothesize that pre-trauma neutral memory contextualization (under stress) negatively relates to PTSD-like behavior, in a prospective design using the cut-off behavioral criteria rat model for PTSD. 72 male Sprague Dawley rats were divided in two experimental groups to assess the predictive value of 1) memory contextualization without acute stress (NS-group) and 2) memory contextualization during the recovery phase of the acute stress-response (S-group) for susceptibility to PTSD-like behavior. A powerful extension to regression analysis -path analysis-was used to test this specific hypothesis, together with secondary research questions. Following traumatic predator scent stress, 19.4% of the rats displayed PTSD-like behavior. Results showed a negative relation between pre-trauma memory contextualization and PTSD-like behavior, but only in the NS-group. Pre-trauma memory contextualization was positively related to fear association in the trauma environment, again only in the NS group. If the predictive value of pre-trauma contextualization of neutral information under non-stressful conditions for PTSD susceptibility is replicated in prospective studies in humans, this factor would supplement already known vulnerability factors for PTSD and improve the identification of individuals at risk among the trauma exposed, especially those at high trauma risk such as soldiers deployed on a mission.

The relationship between ethical leadership and nurse well-being: The mediating role of workplace mindfulness

AIM

The purpose of this study was to explore the relationship between nurses' well-being and their ethical leadership, and the mediating role of workplace mindfulness in this relationship.

DESIGN

This was a quantitative cross-sectional study.

METHODS

This cross-sectional study was conducted in three tertiary hospitals in central China from May 2022 to July 2022, and the Nurses' Workplace Mindfulness, Ethical Leadership and Well-Being Scale were distributed and collected via the Internet. A total of 1579 nurses volunteered to participate in this study. SPSS 26.0 statistical software was used to analyse the data by Z-test and Spearman's rank correlation; the internal mechanism of workplace mindfulness and ethical leadership on nurses' well-being was completed by AMOS 23.0 statistical software.

RESULTS

The scores of nurses' well-being, workplace mindfulness and ethical leadership were 93.00 (81.00, 108.00), 96.00 (80.00, 112.00) and 73.00 (67.00, 81.00) respectively. The professional title, age and department atmosphere affect their well-being. Spearman's analysis showed that nurses' well-being was positively correlated with ethical leadership (r = .507, p < .01) and workplace mindfulness (r = .600, p < .01); workplace mindfulness partially mediated the relationship between ethical leadership and nurses' well-being accounting for 38.5% of the total effect ratio [p < .001, 95% CI = (0.215, 0.316)].

CONCLUSION

Nurses' well-being was at a medium level, and had a higher score in ethical leadership and workplace mindfulness, and workplace mindfulness played a partial mediating role between ethical leadership and nurses' well-being.

IMPACT

This suggests that nursing managers need to pay attention to clinical nurses' well-being experience, actively focus on the relationship among ethical leadership, workplace mindfulness and well-being and integrate core values such as positivity and morality into nurses' daily routines, so as to improve the work enthusiasm and well-being experience of clinical nurses, enhancing the nursing quality and stabilizing the nursing team.

Grateful Workers, Satisfied Workers? A Portuguese Study about Organizational Happiness during COVID-19 Quarantine

Although work satisfaction has been largely studied, gratitude is an emerging field within multiple sciences, including positive psychology, organizational behavior, and human resources marketing. This ex post facto study aims to characterize gratitude and understand its relations to job satisfaction in a non-probabilistic sample of 521 Portuguese workers (62.2% women), 30.90% and 69.10% in the public and private sector, respectively, mean ages of M = 43, SD = 12.6. Data were collected using anonymous questionnaires during the COVID-19 lockdown. Statistical analyses were performed in SPSS 26, and include Student's t-test, one-way ANOVA, Pearson's correlations, and a hierarchical linear regression model. Results confirm that Portuguese workers are grateful and satisfied at work. There were statistically significant differences between groups in sociodemographic (p < 0.001 and p < 0.05), professional (p < 0.01 and p < 0.001), and perceived living conditions variables (p < 0.05) regarding gratitude. Gratitude, alone, explains 8% of job satisfaction. According to the regression model (32.4%), perceptions of satisfaction initiatives and greater job security are also associated with higher levels of job satisfaction (23.6%). Implementation of gratitude-promoting strategies may increase job satisfaction, especially in the post-pandemic period. The investment in workers' organizational happiness, after the impacts of COVID-19 on work dynamics, is a differentiating organizations success dimension.

ANALYSIS OF DEFECTS IN THE DIAGNOSIS OF TRAUMATIC BRAIN INJURY FOR THE DECEASED WITHIN 24 HOURS FOLLOWING ADMISSION

OBJECTIVE

The aim: To conduct the analysis of medical records with the diagnosis of traumatic brain injury for the deceased within 24 hours following admission to Clinical Emergency Hospital.

PATIENTS AND METHODS

Materials and methods: The study was aimed at a retrospective analysis of 102 cases of the lethality of the deceased within 24 hours following admission to Clinical Emergency Hospital for 2012-2019 in cases of traumatic brain injury. Medical histories of the deceased and data from the forensic autopsy had been analyzed.

RESULTS

Results: There were 62 cases (60.8%) of isolated traumatic brain injury, and 40 cases (39.2%) of combined traumatic brain injury. The following defects were identified in the diagnosis: absence of a complete description of the local status with external injuries on the head, absence of a complete and qualitative assess¬ment and objectification of hemodynamics and the function of external breathing using laboratory indicators and electrocardiography, absence of neuroimaging.

CONCLUSION

Conclusions: The percentage of diagnostic defects prevailed among traumatic brain injury patients who died from acute blood loss. The maximum number of diagnostic defects for the patients with traumatic brain injury was observed in the polytrauma department, and the minimum - in the neurological department. The maximum number of defects of a diagnostic nature as a whole fall on those patients who were admitted to the hospital in the interval I - 6:00 a.m. - 9:59 a.m. and in the interval IV - 6:00 p.m. - 9:59 p.m.

The impact of emotional intelligence on life satisfaction among Chinese nurses: A chain mediating model

Introduction

Nurses' life satisfaction exerts a positive impact on their professional careers, and it seriously affects their physical and mental health. Low life satisfaction has become a key factor in the global shortage of nurses. Emotional intelligence may protect nurses from negative emotions that can affect the care they provide, as well as their life satisfaction. In this study, we aims to explore the impact of emotional intelligence on life satisfaction, and even verify the chain mediating effect of self-efficacy and resilience on this relationship among Chineses nurses.

Method

The Emotional Intelligence Scale, the General Self, Efficacy Scale, the Connor-Davidson Resilience Scale, and the Satisfaction with Life Scale were used to survey 709 nurses in southwest China. To analyze mediating effects, SPSS 26.0 and Process V3.3 were used for statistical processing.

Result

Emotional intelligence positively predicted life satisfaction. Meanwhile, it was also found that emotional intelligence and life satisfaction were continuously mediated by self-efficacy and resilience, and the indirect effect value was 0.033, accounting for 17.37%.

Conclusion

This study reveals how emotional intelligence affects nurses' life satisfaction. The results of this study have certain implications for nurses to better balance their career and life. Nursing managers should provide nurses with a favorable working environment from the perspective of positive psychology, improve their sense of self-efficacy and resilience, ultimately improve their life satisfaction.

The Impact of Multi-Quality Renewal Elements of Residence on the Subjective Well-Being of the Older Adults - A Case Study of Dalian

Background

With the expansion of comprehensive renovation projects in China's old residential areas, residents' actual sense of access and well-being has become a source of concern. As the population in old residential areas ages, the results of old renovation will have a significant impact on the older adults quality of life and subjective well-being.

Purpose

To date, most relevant studies have focused on urban and community scales, with little discussion of the impact of neighborhood-level renewal outcomes on the well-being of older adults. As a result, the purpose of this research is to optimize the quality renewal elements of existing old residential areas based on the results of their renovation in order to create a more livable living environment for older adults in existing old residential areas.

Methods

Based on a survey of old neighborhoods in Dalian, the study examines the mediating effect of psychological resilience between multi-quality renewal elements and the subjective well-being of the older adults, and it discusses the influence of multi-quality renewal elements on the subjective well-being of the older adults in different residential types.

Results

According to the findings, multi-quality renewal elements of residence positively predicted the subjective well-being of the older adults; there was a significant mediating effect of psychological resilience between the renewal elements and subjective well-being of the older adults. The study confirms that multiple quality renewal elements can contribute to older people's subjective well-being, and that psychological resilience plays an important role in the selection of multiple quality renewal elements and older people's subjective well-being.

Conclusion

The research provides guidance for the establishment of health-oriented approaches to environmental restoration in residential areas for the sustainable development of communities and cities.

Academic burnout, self-esteem, coping with stress and gratitude among Polish medical students – a cross sectional study

Introduction: Academic burnout is emerging as an essential obstacle in education process. Students of the most challenging fields of study with high degrees of stress are thought to be at the highest risk. Medical studies are considered one of them. The aim of the study was to measure the levels of academic burnout, stress and gratitude among Polish medical students of Medical University of Lublin, and determine their styles of coping with stress.

Materials and methods: A cross-sectional study was conducted using a questionnaire comprised of the following: Maslach Burnout Inventory – Student Survey (MBI-SS), Rosenberg Self-Esteem Scale (SES), a Coping Inventory for Stressful Situations (CISS) and a Gratitude Questionnaire Six-Item form (GQ-6). The data was obtained from 773 medical students.

Results: Total number of 169 students (21.86%) met criteria for academic burnout. When it comes to 354 participants, they displayed signs of low self-esteem (45.8%). The number of 18 students showed low level of gratitude, while gratitude level of the majority of them – 496 (64.17%) was high. The most common style of coping with stress was emotions-oriented style – 354 students (48.29%), followed by task-oriented style – 345 students (47.07%). Burnout subscales turned out to be associated with age, year of study, self-esteem, gratitude and different styles of coping with stress to the various extent.

Conclusions: The prevalence of academic burnout among Polish medical students is high compared with general population across various occupations. Utilisation of protective characteristics of high self-esteem, gratitude and healthy coping methods can result in development of efficient anti-burnout prevention strategies and intervention tools.

Burnout, resilience and the quality of life among Malaysian healthcare workers during the COVID-19 pandemic

Background

Healthcare workers have to deal with highly demanding work situations, making healthcare as one of the most challenging professions. Up to now, far too little attention has been paid to burnout, resilience and the quality of life among Malaysian healthcare workers. Therefore, this paper explores the correlation between burnout, resilience and quality of life among Malaysian healthcare workers during the COVID-19 pandemic.

Method

A total of 394 healthcare workers reported their responses on Maslach Burnout Inventory questionnaire, World Health Organization Quality of Life (WHOQOL)-BREF, and Brief Resilience Scale. Respondents were contacted through convenience sampling method and targeted population constituted Malaysian healthcare workers aged 18 years and above.

Results

For occupational exhaustion, about 50.5% of participants have moderate degree, 40.6% have high degree, and 8.9% have low degree of burnout. Health workers from age 25 to 35 years have lower physical health compared to health workers aged <25 years (coefficient = -0.77, p = 0.021). Similarly, healthcare workers who were working more than 10 h every day were more likely to report poor psychological health (coefficient = -2.49, p = 0.06). Positive correlation between physical and psychological health was observed. Further, a negative correlation was found between occupational exhaustion and the quality of life.

Conclusion

It is important to target physical as well as psychological wellbeing of the healthcare workers. Also, it is important to understand the contribution of long working hours in declining the quality of life of the healthcare workers. Thus, allocating fixed working hours for healthcare workers would bring a much-required change.

Communication competence and resilience are modifiable factors for burnout of operating room nurses in South Korea

Background

Burnout negatively impacts the personal and professional life of nurses. Job stress and resilience have been determined to be associated with nurse burnout. Given the importance of communication competence in operating room (OR) nurses, the associations of job stress, resilience, and communication competence with burnout have not been examined.

Purpose

To determine the relationships of job stress, resilience, and communication competence to burnout of OR nurses in South Korea.

Methods

This was a cross-sectional, descriptive study of 146 OR nurses. A series of self-reported questionnaires was used to assess job stress, resilience, communication competence, and burnout. Pearson correlation coefficient and a hierarchical linear regression were used for data analysis.

Results

Communication competence was correlated with resilience (r = 0.65, p < .001) and burnout (r = -0.44, p < .001), and resilience was correlated with burnout (r = -0.48, p < .001). Resilience (β = -0.22, p = .027) and communication competence (β = -0.33, p < .001) were associated with burnout of OR nurses in a hierarchical linear regression (F = 6.28, p < .001).

Conclusions

Increased resilience and communication competence were associated with lower burnout of perioperative nurses. To prevent and reduce burnout of OR nurses, it is necessary to develop and implement a program targeting for communication competence and resilience.

Implications for nursing management

Nurse leaders should provide programs fostering communication competence and resilience to OR nurses and encourage them to actively participate in such job trainings.

How Dispositional Gratitude Shapes Employee Well-being and Organizational Commitment: The Mediating Roles of Leader-Member Exchange and Coworker Exchange

Dispositional gratitude has recently emerged as a variable of interest in organizational contexts. However, it remains unclear whether dispositional gratitude is predictive of employee well-being, with limited theoretical and empirical elucidation of the underlying mechanisms. To address these limitations, the present study investigated dispositional gratitude as a predictor of employee well-being and organizational commitment. Drawing on the broaden-and-build theory of positive affect, the study also examined whether the social bonding resources of leader-member exchange (LMX) and coworker exchange (CWX) mediated these effects. The participating employees ( N = 300) completed the survey in three waves at one-week intervals. The results of structural equation modeling (SEM) confirm that dispositional gratitude is positively related to employee well-being and organizational commitment and that these effects are mediated by LMX and CWX. The paper concludes by discussing the theoretical and practical implications of these findings, the study’s limitations, and future research directions.

Relationship between stress and alexithymia, emotional processing and negative/positive affect in medical staff working amid the COVID-19 pandemic

The psychological burden of the COVID-19 pandemic may have a lasting effect on emotional well-being of healthcare workers. Medical personnel working at the time of the pandemic may experience elevated occupational stress due to the uncontrollability of the virus, high perceived risk of infection, poor understanding of the novel virus transmission routes and unavailability of effective antiviral agents. This study used path analysis to analyze the relationship between stress and alexithymia, emotional processing and negative/positive affect in healthcare workers. The sample included 167 nurses, 65 physicians and 53 paramedics. Sixty-two (21.75 %) respondents worked in COVID-19-designated hospitals. Respondents were administered the Toronto Alexithymia Scale-20, Cohen's Perceived Stress Scale, Emotional Processing Scale, and the Positive and Negative Affect Schedule. The model showed excellent fit indices (χ2 (2)=2.642, p=0.267; CFI=0.999, RMSEA=0.034, SRMR=0.015). Multiple group path analysis demonstrated physicians differed from nurses and paramedics at the model level (X2diff (7)=14.155, p<0.05 and X2diff (7)=18.642, p<0.01, respectively). The relationship between alexithymia and emotional processing was stronger in nurses than in physicians (difference in beta=0.27; p<0.05). Individual path χ2 tests also revealed significantly different paths across these groups. The results of the study may be used to develop evidence-based intervention programs promoting healthcare workers' mental health and well-being.

Nurses' perceptions of social rejection, resilience and well-being during COVID-19: A national comparative study

AIMS AND OBJECTIVES

To determine the level of social rejection and well-being of nurses, whether resilience is a mediator between them and to compare nurses who worked versus did not work on COVID-19 wards.

BACKGROUND

During the COVID-19 pandemic health care workers reported psychological distress and social rejection.

METHODS

An online survey was sent to nursing social media groups in Israel. Respondents completed a Demographic, Social Rejection, Resilience and General Well-being questionnaire.

RESULTS

Two hundred and forty-seven nurses responded. The majority were female with a mean age of 43.6 years Approximately one-third were worried about infecting their family members and many agreed that their family fears that the nurse will infect them. Nurses reported their partner, family members, neighbours and the public physically distanced themselves from them. Approximately one quarter reported feeling lonely. Statistically significant differences were found between those who worked versus not work on a COVID-19 unit on general well-being, and social rejection. No differences were found in resilience scores.

CONCLUSIONS

Social rejection was felt by many nurses as shown by an inverse relationship between the closeness of the relationship and the sense of social rejection and a high level of loneliness and depression. A higher level of social rejection and lower well-being were found among nurses working on COVID-19 wards as opposed to those who did not. General well-being was found to be exceptionally low during COVID-19. Resilience did not mediate the relationship between social rejection and general well-being.

RELEVANCE TO CLINICAL PRACTICE

Perceived social rejection might be associated with decreased well-being. The level of resilience is related to the level of well-being among nurses in general. Nurses not working in COVID-19 wards have higher levels of well-being and less social rejection compared with nurses working in these wards.

Healthcare worker resilience during the COVID-19 pandemic: An integrative review

AIM

The purpose of this review was to examine resilience among healthcare workers during the coronavirus-disease-2019 (COVID-19) pandemic.

BACKGROUND

The COVID-19 pandemic has caused an unprecedented strain on healthcare workers internationally. Rising infection rates, inadequate personal protective equipment, and the lack of availability of hospital beds has resulted in further deterioration of the already-fragile mental health of healthcare workers. Resilient workers have lower rates of burnout and improved patient outcomes.

EVALUATION

PubMed and the Cumulative Index to Nursing and Allied Health Literature databases were searched using the terms resilience, nurse and COVID-19 to identify studies on resilience during the COVID-19 pandemic. Results were organized by outcome measures for comparison.

KEY ISSUES

Resilience scores among frontline healthcare workers worldwide during the COVID-19 pandemic in the studies reviewed were overall found to be in the moderate range. Data from the United States showed a decrease in nurse resilience, whereas participants from China had increased resilience compared with pre-pandemic levels.

CONCLUSIONS

Building resilience in nurses and other healthcare workers can serve as a protective factor against negative outcomes related to the job, including burnout, anxiety and depression, and can improve patient outcomes.

IMPLICATIONS FOR NURSING MANAGEMENT

Strategies for building resilience in healthcare workers are discussed.

Working Hours, Job Burnout, and Subjective Well-Being of Hospital Administrators: An Empirical Study Based on China's Tertiary Public Hospitals

(1) Purpose: To analyze the role of job burnout in connection with working hours and subjective well-being (SWB) among hospital administrators in China’s tertiary public hospitals. (2) Methods: A multi-stage, stratified, cluster random sampling method was used to select 443 hospital administrators in six tertiary public hospitals for study. The data were collected and analyzed using the working hours measuring scale, Maslach burnout, and the subjective well-being schedule. Pearson correlation, structural equation model, and bootstrap tests were conducted to examine the association between job burnout, working hours, and SWB. (3) Results: Among the 443 respondents, 330 worked more than 8 h per day on average (76.2%), 81 had the longest continuous working time more than 16 h (18.7%), and 362 worked overtime on weekends (82.2%). The prevalence of job burnout in hospital administrators was 62.8%, among which, 59.8% have mild burnout and 3.00% have severe burnout. In the dimension of emotional exhaustion, depersonalization, and reduced personal achievement, the proportion of people in high burnout was 21.0% (91/433), 15.0% (65/433), and 45.3% (196/433), respectively. Job burnout has a mediating effect between working hours and SWB, which accounted for 95.5% of the total effect. (4) Conclusion: Plagued by long working hours and severe job burnout, the hospital administrators in China’s tertiary public hospitals may have low SWB. Working hours have a negative direct impact on job burnout and SWB, and an indirect impact on SWB through job burnout as a mediator. Targeted strategies should be taken to adjust working hours to promote the physical and mental health of hospital administrators.

Sources of satisfaction, dissatisfaction and well-being for UK advanced practice nurses: A qualitative study

AIMS

To examine and explore organisational and role conditions that promote or inhibit job satisfaction and workplace well-being for advanced practice nurses.

BACKGROUND

The advanced practice role is common across the world. Research shows it is well regarded by patients and improves patient outcomes, but there is little evidence about what the role is like for nurses.

METHODS

A subsample of an existing cohort of advanced practice nurses were invited for interview. Twenty-two nurses were interviewed over the phone. Interviews transcripts were analysed using thematic analysis.

RESULTS

Four themes were derived from the data; 'the advanced nurse role and professional identity', 'feeling exposed', 'support for the advancement of the role' and 'demonstrating impact'.

CONCLUSION

Nurses report considerable dissatisfaction with role identity and concerns relating to isolation on a daily basis, and these negatively affect well-being. However, they also identified significant satisfaction with the role, particularly when well supported and able to recognize the unique contribution that they made to the lives of patients and to their organisations.

IMPLICATIONS FOR NURSING MANAGEMENT

Clear role definitions, provision of high-quality clinical supervision and addressing issues of isolation are likely to improve the job satisfaction of advanced practice nurses.

Insomnia, fatigue and psychosocial well-being during COVID-19 pandemic: A cross-sectional survey of hospital nursing staff in the United States

AIMS AND OBJECTIVES

To describe the levels of insomnia, fatigue and intershift recovery, and psychological well-being (burnout, post-traumatic stress and psychological distress), and to examine differences in these measures based on work-related characteristics among nursing staff during COVID-19 pandemic in the United States.

BACKGROUND

The COVID-19 pandemic has created a major physical and psychological burden on nursing staff in the United States and worldwide. A better understanding of these conditions will lead to tailored support and resources for nursing staff during and after the pandemic.

DESIGN

Cross-sectional study.

METHODS

Hospital nurses and nursing assistants (N = 587) were recruited online between May-June 2020. The survey included measures on insomnia (Insomnia Severity Index) fatigue and intershift recovery (Occupational Fatigue and Exhaustion Recovery-15), burnout (Maslach Burnout Inventory-Human Services Survey), post-traumatic stress (Short Post-Traumatic Stress Disorder Rating Interview) and psychological distress (Patient Health Questionnaire-4), and questions on work and demographics. The STROBE checklist was followed for reporting.

RESULTS

The sample had subthreshold insomnia, moderate-to-high chronic fatigue, high acute fatigue and low-to-moderate intershift recovery. The sample experienced increased emotional exhaustion and depersonalisation, increased personal accomplishment, moderate psychological distress and high post-traumatic stress. Nurses who cared for COVID-19 patients had significantly scored worse on almost all measures than their co-workers. Certain factors such as working hours per week and the frequency of 30-min breaks were significant.

CONCLUSION

Nursing staff experienced poor sleep, fatigue and multiple psychological problems during the COVID-19 pandemic. Moreover, staff who were involved in the care of COVID-19 patients, worked more than 40 h per week and skipped 30-min breaks showed generally worse self-reported outcomes.

RELEVANCE TO CLINICAL PRACTICE

Nursing administration is recommended to monitor for fatigue and distress on nursing units, re-visit current scheduling practices, reinforce rest breaks and provide access to mental health and sleep wellness resources with additional support for their front-line nursing groups.