Guaranteeing dignity and decent work for migrant nurses and health care workers beyond the COVID-19 pandemic

Factors influencing decent work among psychiatric nurses in China: a cross-sectional study

AIMS

This study aimed to investigate the current status of decent work among psychiatric nurses and analyze its influencing factors.

METHODS

In February 2024, a cross-sectional study was conducted with a cluster sample of 358 nurses from a tertiary Grade A psychiatric hospital in Hangzhou, Zhejiang Province, China. Data were collected using a custom-made nurse demographic scale to gather demographic information. The Effort-Reward Imbalance Questionnaire (ERIQ) was used to assess the imbalance between effort and reward through the effort-reward ratio (ERR). The Social Support Rating Scale (SSRS) measured subjective support, objective support, and support utilization. The Decent Work Perception Scale (DWPS) was used to evaluate nurses' perceptions of decent work. T-tests, one-way ANOVA, Pearson's correlation analysis, and multiple linear regression analyses were employed for data analysis.

RESULTS

The study found that the correlation between decent work and social support was positive (r = 0.360, p < 0.001), while it was negative for effort-reward imbalance (r = -0.584, p < 0.001). Factors influencing perceptions of decent work included years of work experience (β = -0.164, p = 0.046 for < 5 years; β = -0.157, p = 0.040 for > 25 years), social support (β = 0.259, p < 0.001), and the effort-reward imbalance (β=-0.458, p < 0.001). These factors collectively explained 40.2% of the variance in perceptions of decent work. Furthermore, social support plays a mediating role between effort-reward imbalance and decent work (β=-0.062, Bootstrap 95% CI: -0.107, -0.023).

CONCLUSION

The findings suggest that years of work experience, social support, and the effort-reward imbalance are factors influencing decent work among psychiatric nurses. By offering career development opportunities, fostering supportive work environments, and ensuring fair compensation, we can empower psychiatric nurses to navigate job challenges effectively and sustain a sense of decency in their work.

Dignity as a Central Issue in Treating Patients with Dementia Associated with COVID-19 Infection

COVID-19 was initially considered a primary respiratory disorder associated with various short- and long-term complications, affecting many patients and imposing a significant burden. Patients who have dementia are especially vulnerable to the SARS-CoV2 infection, which is associated with an increased risk for neuropsychiatric complications. These patients need a unique approach to managing ethical issues related to the COVID-19 pandemic, including autonomy, veracity, non-maleficence, justice, compassion, and dignity. The latter is one of the most elusive and misunderstood concepts in medical ethics and is extremely important in debates surrounding the proper management of patients with dementia. However, it is often left out of ethical analysis, as most clinicians, when debating issues associated with clinical practice, often evaluate only the "classical" principles of biomedical ethics. In this article, we aim to assess the unique features of dignity in treating this group of patients during the COVID-19 pandemic. We will briefly analyze dignity as a bioethical concept. We will further explore its principal axes, namely compassion, creating a humane and purposeful environment, employing persuasion to meet the person's essential needs, exerting a certain degree of mild restraint to meet the person's critical needs, minimizing harm in terminal care, and justice, through the lens of people who had dementia during the COVID-19 pandemic. Applying this principle in clinical practice requires significant commitment from all healthcare workers. New approaches to the analysis of dignity, such as through the Ring Theory of Personhood, may facilitate its understanding by practitioners and aid its implementation in populations with multiple vulnerabilities, such as dementia patients, during an infectious outbreak that generates significant social and medical changes.