Association between job strain, mental health and empathy among intensive care nurses

The Relationship Between the Attitudes of Nursing Students Towards Providing Care for a Dying Patient and Their Empathic Tendencies

This study was planned to determine the relationship between the attitudes of nursing students towards death and dying patients and their empathic tendencies. This study was conducted with a descriptive and correlational design. The research was completed with 176 students. Positive significant relationship found between between the FATCOD and ETS scores. It was observed that a 1-point increase in the Empathic Tendency Scale score caused an increase of 0.502 points in the FATCOD score. İt is recommended providing training sessions with simulation applications for nursing students to prepare them for end-of-life care experiences.

Examining resilience among child protection professionals during COVID-19: A global comparison across 57 countries

BACKGROUND

The COVID-19 pandemic led to numerous challenges for child protection professionals (CPPs). However, limited research has investigated the interwoven concepts of coping, resilience, and mental distress among CPPs during COVID-19 on a global scale.

OBJECTIVES

This study aimed to explore CPPs' practice, resilience, and mental distress during COVID-19, the relationship between their resilience and mental distress, the global stability of the Multi-System Model of Resilience (MSMR), and how CPPs' resilience varied according to the Human Development Index (HDI).

METHODS

Data were collected from 420 CPPs in 57 countries across five continents between July and September 2021. Participants completed an online questionnaire on demographics, resilience, mental distress, coping, and perceptions of child protection during the pandemic in their native languages. The analyses compared the countries grouped according to HDI using means comparisons, correlations, and multiple linear regressions. A two-path analysis was also performed to identify variables associated with behavioral resilience engagement and mental distress.

RESULTS

The findings indicated that CPPs' perceptions of COVID-19's impact on child maltreatment varied in correlation with their country's HDI. There were also significant HDI-based differences regarding the perceived opportunity to engage in resilient behavior and its helpfulness. Years of professional experience, internal resilience, and external resilience were shown to be significant predictors of mental distress among CPPs during the pandemic, and resilience mediated how years of experience predicted mental distress.

CONCLUSIONS

This study emphasized the importance of experience and internal resilience for CPPs' psychological well-being. It also provides empirical evidence to support the MSMR theory on a global scale. Additionally, it demonstrates how the perceived changes in child maltreatment during COVID-19 may be associated with regional HDI. Lastly, the opportunities CPPs had to engage in resilient behavior and how much this helped them was associated with regional HDI, but not in the way originally predicted. Study results also hold implications for how practice and policy may be altered to help CPPs cope better during times of crisis and generally.

Well-being of veterinarians in rural and urban areas

Introduction

The field of veterinary medicine is characterized by a variety of challenging working conditions. The alarmingly low mental well-being of veterinarians has been examined from various perspectives. However, the influence of work location on the well-being of veterinary professionals has scarcely been investigated. The aim of the study was therefore to analyze the well-being of German veterinarians and to determine whether there is a correlation between well-being and work location.

Methods

As part of a cross-sectional study, 999 veterinary professionals answered questions regarding their work location (self-designed questions) and well-being (WHO-Five Well-being Index, WHO-5). A differentiation was made according to work location: urban cities (population > 100,000), medium/small cities (population < 100,000 inhabitants), and rural areas.

Results

Overall, the surveyed veterinarians had low well-being (ranging from 56.8% in rural areas to 61.3% in medium/small towns). The results of the general linear model indicated a significant difference in the WHO total score among veterinarians from different work locations (p < 0.001). However, when sex, age, type of employment, and field of specialization were included in the analysis, no significant between-subject effects were found.

Conclusion

According to the results, work location does not seem to have a significant influence on the well-being of veterinarians and therefore may be of lower priority in the development and implementation of interventions. However, further investigation of work-related predictors of the mental health of veterinarians is recommended, as the results indicate a low well-being among these professionals.

Association Between Occupational Stress and Sleep Quality: A Systematic Review

Occupational stress and sleep quality are prevalent issues that can impact the physical and mental well-being of adults. An association between occupational stress and sleep quality has been found. However, this association is not entirely the same across different occupational groups. Additionally, variations are present in the research design and instruments employed.This systematic review aims to investigate the association between these two factors and identify gaps and limitations in current research. Articles published between January 1, 2011, and December 31, 2022, were retrieved from the WOS, Scopus, and PubMed databases. Out of 1225 articles, 38 studies met the predetermined inclusion and exclusion criteria and were included in the review. In the study, research designs, samples, instruments, and associations between occupational stress and sleep quality were statistically analyzed.These studies encompassed a diverse range of occupations, including both blue-collar and white-collar workers. Cross-sectional study is the most common research method. The Pittsburgh Sleep Quality Index (PSQI) was the most frequently utilized tool for assessing sleep quality, while there was a wide variety of measurement tools employed to assess occupational stress. The association between occupational stress and sleep quality consistently demonstrated a negative association, although the specific dimensions varied among studies. Moreover, several other factors were identified to have direct or indirect effects on occupational stress and sleep quality. For future research in this field, we propose four recommendations: (1) Consider utilizing objective measures to assess occupational stress and sleep quality. (2) Employ controlled experiments to further validate the causal relationship between occupational stress and sleep quality. (3) Investigate occupational groups that have received less attention. (4) Take into account the potential influence of other factors on occupational stress and sleep quality.

Does workplace violence, empathy, and communication influence occupational stress among mental health nurses?

Workplace violence is a major cause of occupational stress among mental health nurses, particularly those working in acute care. This study investigated the occurrence of occupational stress among mental health nurses in psychiatric hospitals and explored whether workplace violence, empathy, and communication skills influenced occupational stress levels in this population. A socio-demographic questionnaire and the Chinese Nursing Work Stress Scale, Workplace Violence Scale, Jefferson Scale of Empathy - Health Professions version, and Nurses' Clinic Communication Competence Scale were administered to 539 mental health nurses from three top-grade tertiary research hospitals in the Beijing-Tianjin-Hebei region. The analysis revealed a high level of job stress (3.06 ± 0.69) and a moderate prevalence of workplace violence (6.21 ± 2.94) existed among participants when compared with among other nurses. Meanwhile, participants' empathy (114.78 ± 15.99) and communication (4.31 ± 0.60) abilities were similar to or higher than those of other nursing populations. Mental health nurses with varying years of practice experience distinct levels of job stress. A linear regression analysis revealed that, while practice years (β = 0.104; P < 0.05) and workplace violence (β = 0.264; P < 0.01) aggravated occupational stress levels, empathy (β = -0.147; P < 0.01) facilitated reductions in stress. Results suggest that reducing workplace violence and improving empathy in therapeutic relationships can limit the pervasiveness of occupational stress among mental health nurses. Having both psychological support and organizational support after a violent incident is essential, and the importance of professional education should be stressed.

An Integrative Review of How Healthcare Organizations Can Support Hospital Nurses to Thrive at Work

Background: Solutions that address the anticipated nursing shortage should focus on thriving at work: a positive psychological state characterized by a sense of vitality and learning, resulting in higher levels of work engagement, commitment, and wellbeing. Purpose: To synthesize international evidence on organizational factors that support hospital nurse wellbeing and to identify how the Social Embeddedness of Thriving at Work Model can support health managers to develop management approaches that enable nurses to thrive. Method: Conduct an integrative review of literature published between 2005–2019. Results: Thematic analysis identified five key themes: (1) Empowerment; (2) Mood of the organization; (3) An enabling environment; (4) Togetherness with colleagues; and (5) Leaders’ connectivity. Conclusions: The Social Embeddedness of Thriving at Work Model supports managers to develop management approaches that enable their nurses to thrive. Health managers should consider strategies to support nurses to thrive at work to improve nurse work engagement and wellbeing.

Nurses' Empathy in Different Wards: A Cross-Sectional Study

Background:

Empathy is an important component of the nurse-client relationship and nursing care. The current study aimed to compare nurses' level of empathy with patients in critical care units, psychiatric, and emergency wards.

Materials and Methods:

The present cross-sectional study was conducted on 112 nurses selected by convenience sampling in three educational hospitals affiliated with Isfahan University of Medical Sciences, Iran from June to September 2017. Data collection tool was a two-part questionnaire consisting of sociodemographic data (such as age, gender, and work experience) and Jefferson Scale of Empathy (JSE) containing 20 items, scored according to Likert scale from totally agree (7 points) to totally disagree (1 point). In total, the maximum score was 140 and the minimum score was 20. Data were analyzed using SPSS version 16 as well as descriptive and analytical statistical tests (multiple regression).

Results:

The mean (SD) empathy score of nurses working in critical care units, emergency, and psychiatric wards was 87.51 (6.65), 87.59 (4.90), and 90.71 (7.12), respectively. Regarding the regression models, it was observed that only the work experience was a significant predictor for empathy (β = 0.19, p = 0.04). This model predicted 3.50% of variances in the nurses' empathy.

Conclusions:

Nurses' level of empathy in this study was above average with equal scores in different wards. Therefore, increasing the nurses' level of empathy is essential in interventional studies.

Factors Associated With Intent to Leave in Registered Nurses Working in Acute Care Hospitals: A Cross-Sectional Study in Ontario, Canada

Background: The work environment factors associated with nurses' intention to leave their jobs are not well understood because most studies have used non-probabilistic sampling methods, thus restricting the generalizability of the results. This study examined the relationship between work environment factors and intent to leave among nurses working in acute care hospitals in Ontario, Canada. Methods: This study included a random sample of 1,427 registered nurses who were part of a larger cross-sectional study and who responded to a mailed survey that included measures of resource availability, interprofessional collaboration, job satisfaction, and demographics. Results: Most of the respondents were female (94.8%), with an average age of 45.6 years, and 14.5 years of nursing experience at their current workplace, which included mostly urban (94.6%) and non-teaching hospitals (61.8%). In the multivariate model, we observed that the work environment variables explained 45.5% of the variance in nurses' intent to leave scores, F(9, 1362) =125.41, p < .01, with an R² of .455 or 45.5%. Job satisfaction (p < .01), flexible interprofessional collaborative relationships (p = .030), and resource availability (p < .01) were significantly associated with nurses' intent to leave scores. Conclusion/Application to Practice: Nurses who reported greater job satisfaction, flexible interprofessional relationships, and resource availability were less likely to express an intent to leave their hospital workplaces. Employers and health policy makers may use these findings as part of a broader strategy to improve the work environment of nurses. Occupational health nurses are ideally positioned to demonstrate leadership in promoting retention efforts in the workplace by advocating for the importance of job satisfaction, flexible interprofessional relationships, and resources.

"I had the feeling that I was trapped": a bedside qualitative study of cognitive and affective attitudes toward noninvasive ventilation in patients with acute respiratory failure

Background

Noninvasive ventilation (NIV) is the application of mechanical ventilation through a mask. It is used to treat certain forms of acute respiratory failure in intensive care units (ICU). NIV has clinical benefits but can be anxiogenic for the patients. This study aimed at describing cognitive and affective attitudes toward NIV among patients experiencing NIV for the first time in the context of an ICU stay.

Methods

Semi-structured interviews were conducted in 10 patients during their ICU stay and soon after their first NIV experience. None of the patients had ever received NIV previously. Evaluative assertion analysis and thematic analysis were used to investigate cognitive and affective attitudes toward NIV before, during, and after the first NIV experience, as well as patient attitudes toward caregivers and relatives.

Results

Before their first NIV session, the cognitive attitudes of the patients were generally positive. They became less so and more ambiguous during and after NIV, as the patients discovered the actual barriers associated with NIV. Affective attitudes during NIV were more negative than affective attitudes before and after NIV, with reports of dyspnea, anxiety, fear, claustrophobic feelings, and reactivation of past traumatic experiences. The patients had more positive attitudes toward the presence of a caregiver during NIV, compared to the presence of a family member.

Conclusion

This study corroborates the possibly negative—or even traumatic—nature of the NIV experience, with emphasis on the role of affective attitudes. This is a rationale for evaluating the impact of NIV-targeted psychological interventions in ICU patients with acute respiratory failure.

A Quantitative Measurement of Physical Therapists' Empathy and Exploration of the Relationship With Practice Setting and Work Engagement

Clinical empathy has been studied in a number of health-care disciplines suggesting that higher practitioner empathy leads to improved patient health and wellness and improved patient outcomes. While some aspects of the physical therapist-patient relationship have been described, evidence of quantitative assessment of clinical empathy in physical therapists is scarce. To investigate the level of self-reported clinical empathy in physical therapists and its relationship to practice environment and workplace engagement, the Jefferson Scale of Empathy-Health Provider version (JSE-HP) and the Oldenburg Burnout Inventory (OLBI) were used. Study participants were 123 physical therapists working full time at either an acute care setting, a rehabilitation hospital, or an outpatient clinic. These physical therapists demonstrated a mean JSE-HP score of 118.5 (9.1) and a mean OLBI score of 15.63 (3.5). This mean empathy score was found to be higher than reported empathy level of some health disciplines such as nursing and pharmacy yet lower than others such as mental health workers, psychiatrists, and pediatricians. Practice setting was not found to be a significant factor regarding empathy levels in physical therapists. As reported in previous studies, there was a positive correlation between being female and having higher empathy levels. A positive correlation was found between age and work disengagement. Finally, our hypothesis regarding a negative correlation between empathy and work disengagement was confirmed, suggesting that workplace disengagement may diminish a physical therapist's empathy, which may then negatively affect patient clinical outcomes.

The development and psychometric validation of a Chinese empathy motivation scale

AIMS AND OBJECTIVES

To develop and validate an instrument to measure nurses' empathy motivation in China (See Supporting Information Appendix S1).

BACKGROUND

Nurses are increasingly expected to empathise with patients in clinical settings. However, research investigating nurses' empathy motivation in China is lacking, and no specific instrument exists worldwide.

DESIGN

Two-stage cross-sectional study, which follows the STROBE guidelines. Instrument development and psychometric evaluation were used (See Supporting Information Appendix S1).

METHODS

A literature review and qualitative interviews with nurses were conducted to generate the initial items. Convenience samples of 340 (for item analysis) and 640 (for psychometric evaluation) clinical nurses working at four tertiary hospitals in Anhui Province were recruited. The scale was validated by content validity, surface validity and item analysis. A total of 640 participants were randomly divided into two equal groups. Exploratory factor analysis (EFA) was used with varimax rotation, confirmatory factor analysis (CFA) and internal consistency reliability to analyse the psychometric properties of the scale (See Supporting Information Appendix S1).

RESULTS

From the initial 90-item pool, 27 items were retained by the item analysis. The EFA (N = 290) showed the following six factors on the scale explained 71.266% of the overall variance: amotivation, external regulation, introjected regulation, identified regulation, integrative regulation and intrinsic motivation. Furthermore, when limited to three factors, that is autonomy motivation, controlled motivation and amotivation, 56.578% of the variance was explained. The findings showed high internal consistency. The six-factor solution and three-factor solution of the scale, including 27 items, were both confirmed by the CFA, for example χ² /df = 1.744, 2.261; RMSEA = 0.051, 0.066; GFI = 0.882, 0.847; TLI = 0.942, 0.902; and RMR = 0.039, 0.049, respectively.

CONCLUSIONS

The nurses' empathy motivation scale presents good psychometric properties and can be used to explore nurses' empathy motivation in China (See Supporting Information Appendix S1).

RELEVANCE TO CLINICAL PRACTICE

This study offers insight into nurses' complicated reasons for exhibiting empathy.

Effects of a Multimodal Program Including Simulation on Job Strain Among Nurses Working in Intensive Care Units: A Randomized Clinical Trial

Importance

Nurses working in an intensive care unit (ICU) are exposed to occupational stressors that can increase the risk of stress reactions, long-term absenteeism, and turnover.

Objective

To evaluate the effects of a program including simulation in reducing work-related stress and work-related outcomes among ICU nurses.

Design, Setting, and Participants

Multicenter randomized clinical trial performed at 8 adult ICUs in France from February 8, 2016, through April 29, 2017. A total of 198 ICU nurses were included and followed up for 1 year until April 30, 2018.

Interventions

The ICU nurses who had at least 6 months of ICU experience were randomized to the intervention group (n = 101) or to the control group (n = 97). The nurses randomized to the intervention group received a 5-day course involving a nursing theory recap and situational role-play using simulated scenarios (based on technical dexterity, clinical approach, decision making, aptitude to teamwork, and task prioritization), which were followed by debriefing sessions on attitude and discussion of practices.

Main Outcomes and Measures

The primary outcome was the prevalence of job strain assessed by combining a psychological demand score greater than 21 (score range, 9 [best] to 36 [worst]) with a decision latitude score less than 72 (score range, 24 [worst] to 96 [best]) using the Job Content Questionnaire and evaluated at 6 months. There were 7 secondary outcomes including absenteeism and turnover.

Results

Among 198 ICU nurses who were randomized (95 aged ≤30 years [48%] and 115 women [58%]), 182 (92%) completed the trial for the primary outcome. The trial was stopped for efficacy at the scheduled interim analysis after enrollment of 198 participants. The prevalence of job strain at 6 months was lower in the intervention group than in the control group (13% vs 67%, respectively; between-group difference, 54% [95% CI, 40%-64%]; P < .001). Absenteeism during the 6-month follow-up period was 1% in the intervention group compared with 8% in the control group (between-group difference, 7% [95% CI, 1%-15%]; P = .03). Four nurses (4%) from the intervention group left the ICU during the 6-month follow-up period compared with 12 nurses (12%) from the control group (between-group difference, 8% [95% CI, 0%-17%]; P = .04).

Conclusions and Relevance

Among ICU nurses, an intervention that included education, role-play, and debriefing resulted in a lower prevalence of job strain at 6 months compared with nurses who did not undergo this program. Further research is needed to understand which components of the program may have contributed to this result and to evaluate whether this program is cost-effective.

Trial Registration

ClinicalTrials.gov Identifier: NCT02672072.

Leisure-time physical inactivity and psychological distress in female-dominated occupations in Lithuania

Poor mental health, manifesting as psychological distress, has become a leading problem recently; therefore, determining associated factors is important, especially in female-dominated occupations, as women are more prone to psychological distress than men, in part due to demands of both professional and domestic tasks. The objective of the present study was to investigate associations between leisure-time physical inactivity and psychological distress, accounting for the possible relation of psychosocial factors at work (job demands, job control, social support at work, workplace bullying) and life events in representative samples of family physicians, internal medicine department nurses and secondary-school teachers in Lithuania. In total, 323 family physicians, 748 internal medicine department nurses and 517 secondary-school teachers were interviewed during 2012-2014 in Lithuania. Godin leisure-time exercise, Goldberg General Health, Job content, and Negative acts questionnaires were administered. Logistic regression was used. A high proportion of family physicians, nurses and teachers were physically inactive during leisure. Leisure-time physical inactivity was strongly associated with psychological distress, adjusting for age, workplace bullying, job demands, job control, social support at work and traumatic life events in all three female-dominated occupations. Efforts to increase leisure-time physical activity level in medical occupations could be beneficial.

Associations between occupational stress, burnout and well-being among manufacturing workers: mediating roles of psychological capital and self-esteem

BACKGROUND

Occupational stress is an important risk factor for mental health among occupational population. Exploring related mediators of workers' mental health are important to improve their health and performance. Our study aims to explore the relationships between work stress, positive psychological resources, burnout and well-being.

METHODS

The study was performed during the period of June and July in 2015. A questionnaire that consisted of the Effort-reward Imbalance Scale, the Maslach Burnout Inventory-General Survey, the Psychological Capital Questionnaire, the Rosenberg Self-esteem Scale, the Flourishing Scale, as well as demographic and working factors.

RESULTS

Psychological capital mediated the associations of effort-reward imbalance and emotional exhaustion, cynicism, professional efficacy and well-being. Self-esteem mediated the associations of effort-reward imbalance ratio with cynicism, professional efficacy and well-being, and mediated the associations of overcommitment and cynicism, professional efficacy and well-being.

CONCLUSIONS

The findings indicated that enhancing positive psychological resources could be considered in developing intervention strategies for psychological health among manufacturing employees.