The Psychological Status and Self-Efficacy of Nurses During COVID-19 Outbreak: A Cross-Sectional Survey

Job satisfaction, professional competence, and self-efficacy: a multicenter cross-sectional study among registered nurses in Sweden and Norway

BACKGROUND

Healthcare organizations worldwide face persistent challenges relating to turnover and intention to leave the nursing profession among registered nurses. Factors contributing to their retention and well-being at work include high job satisfaction, professional competence, and self-efficacy. Few multicenter studies have investigated these factors in relation to work experience in a Nordic context. Therefore, this study aimed to investigate job satisfaction, professional competence, and self-efficacy among registered nurses.

METHODS

This multicenter cross-sectional study survey was part of a larger overarching Swedish-Norwegian project, and was conducted among registered nurses (n = 1137) in September 2021. The participants worked in a variety of health care units, e.g., hospital units, primary health care, and home care. Data was subjected to descriptive and comparative statistical analysis; chi-square test, one-way between-groups analysis of variance (ANOVA) and Kruskal-Wallis test.

RESULTS

The findings show that job satisfaction is reported as lowest in registered nurses with medium-term work experience as compared to newly qualified and long-term work-experienced registered nurses. Professional competence and self-efficacy are reported as higher among registered nurses with long-term work experience as compared to those with medium-term work experience and newly qualified registered nurses. However, the participants reported their professional competence as highest in relation to the same factor - "Value-based nursing care" - regardless of their work experience.

CONCLUSIONS AND IMPLICATIONS

This study underscores the need for continuous support and professional development for registered nurses throughout their careers. Proactive support for newly qualified nurses may improve job satisfaction as they progress to being registered nurses with medium-term work experience. Tailored interventions to address the distinct needs of both newly qualified and medium-term work-experienced registered nurses are crucial for nurturing a sustainable nursing workforce.

Savoring mediates the mental health benefits of positive coping processes: A prospective population-based analysis

Positive coping (e.g., self-efficacy and positive reappraisal) and savoring could bear mental health implications under large-scale disasters such as COVID-19. The integrative affect-regulation framework of psychological resilience proposes that evaluative efforts regulate affect, which then predicts positive short-term consequences and better mental health. This two-wave study was done during the prolonged, intensive COVID-19 control rules in Hong Kong and examined (1) the prospective associations of positive coping processes (i.e., self-efficacy and positive reappraisal) (T1, March-August 2021) with subsequent psychiatric symptoms (T2, September 2021-February 2022) and (2) the mediating effect of T2 savoring in the associations. Path analyses revealed that T1 self-efficacy and positive reappraisal were inversely related to T2 psychiatric symptoms. T2 savoring partially mediated the effect of T1 self-efficacy but fully mediated the effect of T1 positive reappraisal. Self-efficacy could have more sustainable direct positive associations with mental health, whereas the benefit of positive reappraisal might need to be catalyzed by savoring over time. Our study offered concrete illustrations of the conceptual tenets of the affect-regulation framework.

Mental Health of Frontline Nurses in India During COVID-19: A Multisite Study

Background  The COVID-19 pandemic has been difficult for all healthcare providers. Nurses in Indian hospitals are at risk for mental health consequences of COVID-19-related stress. The study aimed to evaluate the mental health responses of Indian nurses working during the COVID-19 pandemic.  Method The study was carried out during the COVID-19 pandemic from November 2020 to February 2021. Frontline nurses (n=387) working in both government and private sectors were recruited from four hospital centers across Mangalore, India. Nurses were selected based on specific inclusion criteria, including active duty within wards and intensive care units designated for COVID-19 care or suspected cases of SARS-CoV-2 infection. Recruitment and data collection were facilitated by medical residents using a mix of physical and electronic survey methods. Results Nurses within the private sector with low personal protective equipment (PPE) security experienced heightened anxiety. Somatic symptoms were incrementally related to mental health depending on the workplace setting; private sector staff reported greater depression symptoms compared to those in government-run hospitals. Self-efficacy buffered against depression outcomes only in nurses within the private sector working within non-COVID units. Conclusions This study's findings showed differential responses to the stress of COVID-19 based on the setting. Future studies should further explore the factors associated with such differences. Somatic symptoms can be indicators of mental health adversity. Early detection and supportive interventions need to be taken into account.

Status and influencing factors of elder neglect by geriatric nursing assistants in Chinese nursing homes: a cross-sectional survey

Background

In nursing homes, elder neglect has come to the forefront. Currently, few studies have examined the impact of personal and organizational factors of geriatric nursing assistants on elder neglect. From the perspective of geriatric nursing assistants, this study aims to explore the current situation and influencing factors of elder neglect in Chinese nursing homes.

Methods

A convenience sampling method was used to recruit 412 geriatric nursing assistants from 50 nursing homes in China. Participants were surveyed using a demographic questionnaire, the Elder Neglect Scale for Geriatric Nursing Assistants, the General Self-Efficacy Scale (GSES), and the Proactive Personality Scale (PPS). Spearman correlation analysis and multiple linear regression were used to analyze the factors influencing elder neglect.

Results

Geriatric nursing assistants scored a median of 74 out of 85 on the Elder Neglect Scale. Multiple linear regression analyses showed that the main personal factors influencing geriatric nursing assistants' elder neglect were general self-efficacy (β = 0.312), proactive personality (β = 0.180), and advanced qualification (β = 0.084), while the main organizational factors included monthly salary ≤ 1,900 RMB (β = -0.256), no regular training after induction (β = -0.253), and the number of days off per month (3-4 days off β = 0.192, ≥ 5 days off β = 0.101).

Conclusion

Although geriatric nursing assistants are at low levels of elder neglect, it remains a cause for concern. Among the personal factors, geriatric nursing assistants who possessed proactive personalities, high self-efficacy and advanced qualifications, exhibited low levels of elder neglect. Among the organizational factors, those who possessed a high number of days off per month portrayed low levels of elder neglect. Conversely, those who received low monthly salaries and no regular training after induction portrayed high levels of elder neglect. To reduce the risk of elder neglect, nursing homes should give due consideration to candidates' self-efficacy and proactive personality traits when recruiting, and focus on fostering these personality traits in their employees during their work. In addition, strengthening regular training for geriatric nursing assistants, optimizing the salary structure, and arranging rest days in a reasonable manner are also necessary measures.

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

Introduction

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

Methods

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

Results

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

Conclusion

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

Relationship between Nurses Reflection, Self-efficacy and Work Engagement: A Multicenter Study

Introduction

Reflection is considered an essential element in nurses' practice with different positive outcomes, we decided to determine the level of nurses' reflection and then assess the relationship between nurses' reflection with their self-efficacy and work engagement.

Methods

In this cross-sectional study, a total of 240 nurses were selected from seven educational hospitals affiliated with Tabriz University of medical sciences (Iran). The stratified random sampling method was used to select the participants from hospitals. Data were collected through three questionnaires including Groningen Reflection Ability Scale (GRAS), Sherer's General Self-Efficacy Scale (SGSES), and Utrecht Work Engagement Scale (UWES). Data were analyzed using SPSS version 13.

Results

According to the results, the mean (SD) score of nurses' reflection was calculated as 86.51 (8.17) out of 115. The mean (SD) score of nurses' self-efficacy was 60.89 (11.11) out of 85. Moreover, the mean (SD) total score of nurses' work engagement in a possible range of 0 to 6 was 3.39 (1.36). There was a positive and significant relationship between the total reflection score with work engagement and self-efficacy scores.

Conclusion

According to the results, nurses working in different units showed different scores of reflection. Moreover, the results of the present study showed that nurses' reflection is associated with nurses' work engagement and self-efficacy. Therefore, nurse managers and nurse educators should improve nurses' skills in reflection and they should support the reflective practice in clinical settings.

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.

The Relationship between COVID-19 Exposure Risk and Burnout in Prehospital Emergency Medical Technicians

Introduction

Exposure to coronavirus disease 2019 (COVID-19) has caused many physical and psychological effects on front-line healthcare workers (HCWs). This study aimed to assess the relationship between the exposure risk to COVID-19 disease and burnout in prehospital emergency medical technicians (EMTs).

Methods

In this correlational study, 335 prehospital EMTs were selected by random sampling method from the 49 stations of emergency medical services in the northwest of Iran. Data were collected using a questionnaire developed by the world health organization for the risk assessment and management of exposure of health care workers to COVID-19. Moreover, Pines burnout measure was used for the assessment of participants' burnout. Data were analyzed using SPSS version 13.

Results

Results showed that 30.7 % of prehospital EMTs had a high burnout score against COVID-19 disease. The prehospital EMTs who had a high occupational exposure risk experienced a high risk of burnout (P=0.03). The results of the linear regression analysis showed that prehospital EMTs who had a low exposure risk of COVID-19 had a low burnout score (β=-9.30; P<0.001), and those who had less than 10 years of work experience showed less burnout (β=-10.54; P<0.001).

Conclusion

According to the results, the exposure risk to COVID-19 increases the prehospital EMT's burnout. As a result, reducing the exposure risk to COVID-19 by providing adequate access to personal protective equipment (PPE), development of training and following standards and protocols can be effective in controlling burnout in HCWs.

Professional Nursing Practice Environment and Work Engagement: The Mediating Roles of Self-Efficacy and Achievement Motivation

BACKGROUND

The shortage of nurses is a global problem. Increasing the level of work engagement is known to effectively reduce turnover rate among nursing staff. Strategies to improve work engagement based on the job demands-resources model may effectively improve nurses' job satisfaction and reduce staff turnover.

PURPOSE

A job demands-resources model was used in this study to test the hypothesis that work engagement is affected by both external resources (professional nursing practice environment) and internal resources (self-efficacy and achievement motivation). In addition, the mediating role of self-efficacy and achievement motivation in the relationship between professional nursing practice environment and work engagement was also verified.

METHODS

A cross-sectional survey employing a convenience sampling design was implemented. Five hundred fifteen registered nurses were recruited from four tertiary hospitals in Chengdu, China, from January to June 2020. The Practice Environment Scale of the Nursing Work Index, General Self-Efficacy Scale, Achievement Motive Scale, and Utrecht Work Engagement Scale were used to measure the four variables.

RESULTS

The results of the structural equation model showed that the degree of fit for each index model was good, indicating that all of the three variables, including professional nursing practice environment, self-efficacy, and achievement motivation, directly affected work engagement. In addition, the variable professional nursing practice environment was found to indirectly influence work engagement through the partial mediation of self-efficacy and achievement motivation.

CONCLUSIONS

The results may be used to guide health policymakers and nurse managers attempting to enhance the work engagement of nurses by providing a supportive working environment, improving the welfare mechanism, formulating a talent training plan, and fostering appropriate empowerment to improve the working environment, self-efficacy, and motivation in nurses.

Behind the scenes of the healthcare COVID-19 pandemic crisis: potential affecting factors of healthcare work sustainability in Romania during 2020-2022

Aim

The COVID-19 pandemic represented a great disturbance for medical systems around the world, putting medical personnel on the front lines of the fight against the SARS-Cov2 virus. This fight was particularly impactful in countries with medical systems already facing various challenges, including Romania; where the pandemic unfolded in five waves that severely affected the psychological and physical well-being of medical professionals in terms of overload and continuous exposure to health threats. Against this background, our research aims to identify the mediating role of potential affecting factors of healthcare work sustainability during the change-related uncertainty conditions generated by the COVID 19 crisis. Dynamics and relations of nine carefully selected constructs were tracked along all five pandemic waves in Romania, which span from March 2020 to April 2022. The tested variables and constructs are perception of healthcare workers of their own state of health, their workplace safety, the work-family conflict, the satisfaction of basic needs, the work meaningfulness and work engagement, patient care, pandemic stress and burnout.

Methods

This cross-sectional study is based on an online snowball sampling of 738 health workers from 27 hospitals. Panel research is limited to a maximum of 61 respondents for two successive waves. The analytical part is built on means comparison of analysed variables between all five pandemic waves and an in-depth model to explain the relationships between the variables.

Results

The results indicate statistically significant correlations between the perception of health risks and all selected factors excluding patient care, which seems to be above the own health perception. The factors' dynamics was followed along all five pandemic waves. The developed model identified that one's health status satisfaction is a mediator of the family-work conflict and, together, of work engagement. In turn, work engagement plays a significant role in satisfying basic psychological needs and supporting work meaningfulness. Also, work meaningfulness influences the satisfaction of basic psychological needs.

Discussion

Health workers with higher levels of positive perceived health are better at managing pandemic stress, burnout effects and work-family imbalances. Adaptive behaviors and attitudes towards COVID-19 pandemic threats could be identified in later pandemic waves due to the progress in terms of medical protocols and procedures.

Communication competence, self-efficacy, and spiritual intelligence: evidence from nurses

INTRODUCTION

Communication skills and acceptable levels of spiritual intelligence (SI) are the prerequisites of the nursing profession, which can significantly impact the individual and organizational performance of nurses. This study aimed to investigate the competency and self-efficacy of communication and its relationship with the SI of nurses.

METHODS

This cross-sectional study was conducted in 2021 and included 312 nurses working in a COVID-19 hospital in the south of Iran. The data collection instruments were the Standard Communication Competence Scale, Communication Self-Efficacy, and SI Questionnaires. Data were analyzed with SPSS software version 23 using descriptive and inferential statistics, and t-test, ANOVA, Pearson's correlation coefficient, and multiple linear regression were performed at 5% significance level.

RESULTS

The mean scores of nurses' communication competence, communication self-efficacy, and SI were 89.11 ± 7.32 out of 180, 64.45 ± 5.61 out of 120, and 147.13 ± 11.26 out of 210, respectively. A direct and significant correlation was observed between competence (r = 0.527, p<0.001) and communication self-efficacy (r = 0.556, p<0.001) with spiritual intelligence. The dimensions of spiritual intelligence, including the ability to deal with and interact with problems, self-awareness, love and affection, general thinking and doctrinal dimension, and dealing with moral issues, were identified as predictors of nurses' communicative competence and self-efficacy (p<0.05). There was a positive and significant correlation between nurses' competence and self-efficacy with their age (p<0.05). The nurses' mean communication competence and self-efficacy score were different regarding their level of education and the number of shifts (p<0.05). The mean scores of self-efficacy revealed a statistically significant difference between the participants' gender and the number of patients under observation (p<0.05). Moreover, the nurses' SI significantly correlated with age, and the mean scores of this intelligence had statistically significant differences regarding gender (p<0.05).

CONCLUSION

The nurses' communication competence and self-efficacy were at a moderate level. Considering the correlation and predictive role of SI and its dimensions, it is recommended to promote problem-solving skills, improve self-awareness, and pay attention to moral standards to nurture communication competence and self-efficacy among nurses.

Challenges for contactless online food delivery services during the COVID-19 pandemic in Taiwan: Moderating effects of perceived government response

The COVID-19 pandemic has affected numerous industries worldwide, altered consumer behavior, and increased demand for contactless online food delivery (OFD) services. COVID-19 information from the government may influence the public's information-seeking behavior regarding OFD services. Thus, exploring the relationship between contactless OFD and consumer perceptions of the government response during the pandemic is essential. This paper probed the effects exerted by three behavioral beliefs, namely health consciousness, self-efficacy, and perceived benefits, on consumers' intention and attitude toward contactless online food delivery (OFD) services. This study explored the moderating impact exerted by perceived government response to the COVID-19 pandemic on the relationship between attitude and intention toward OFD services. The study results indicated that self-efficacy and perceived benefits positively influenced the respondents' attitude toward contactless OFD services. Health consciousness negatively influenced their attitude toward these services. The respondents' attitude toward contactless OFD services to be positively related to their behavioral intention toward such services. Perceived government response to COVID-19 moderated the relationship between respondents' attitude and behavioral intention toward contactless OFD services. Based on the study findings, some suggestions are provided for governments, other relevant agencies, and OFD service providers herein.

Effects of Cognitive Appraisals on Perceived Self-Efficacy and Distress during the COVID-19 Lockdown: An Empirical Analysis Based on Structural Equation Modeling

During the COVID-19 lockdown, individuals and households had to responsibly manage the difficulties and problems caused by the restrictions on their mobility, such as the interruptions to work schedules, insecure food supplies, and the procurement of services and health care. The perceptions of risk as well as the fear of disease were strongly linked to worry, defined as a sequence of thoughts that evoke negative emotions and elevated levels of anxiety and distress. This study evaluated how different cognitive appraisals of an individual's sources of worry could influence their perceived self-efficacy and directly or indirectly moderate their perceived general distress. A sample of 544 participants completed a survey that included questions based on the generalized self-efficacy scale, the sources of concern during the epidemic, the cognitive appraisal scale in emergency, and perceived discomfort. Subsequently, a structural-equation-modeling (SEM) analysis was performed to test the moderating role of cognitive appraisals and perceived self-efficacy on participants' overall distress during a lockdown. Overall, the model reported acceptable fit values and confirmed the hypotheses of the study. An individual's worries activated either a dysfunctional threat appraisal, which prompted a fear-and-closure response that then increased their overall state of distress; or two other functional appraisals (i.e., adaptive or supportive) that contributed to significantly improving the individual's self-efficacy. Higher self-efficacy was shown to be associated with lower levels of perceived distress. For the purposes of prevention and distress containment, it would be appropriate to promote psycho-educational interventions that promote the adoption of appraisal strategies that are functional and beneficial for perceived self-efficacy.

The Relationship between Physical Activity and Mental Depression in Older Adults during the Prevention and Control of COVID-19: A Mixed Model with Mediating and Moderating Effects

BACKGROUND

Several studies have found a strong relationship between physical activity and mental depression in older adults. Despite this, the social isolation, limited physical activity, and decreased social interactions caused by the 2020 COVID-19 pandemic control measures of "home isolation and reduction unnecessary travel" had a significant mental impact on older adults.

OBJECTIVE

the goal of this study was to look into the complex effects of physical activity participation on mental health in older adults during COVID-19 prevention and control and the relationship between physical activity and mental depression in older adults through the mediating effect of self-efficacy and the moderating effect of social support.

METHODS

The Physical Activity Rating Scale (PARS-3), the Center for Streaming Depression Scale (CES-D), the Self-Efficacy Scale (GSES), and the Social Support Rating Scale (SSRS) were used to assess 974 older adults in five urban areas of Chengdu, China. The SPSS was used to analyze the collected data using mathematical statistics, linear regression analysis, and the AMOS to construct the research model.

RESULTS

The study's findings revealed that self-efficacy mediated the relationship between physical activity and mental depression in older adults (β = -0.101, 95%CI (-0.149, -0.058)), and social support moderated the relationship between physical activity and mental depression in older adults (t = -9.144, p < 0.01).

CONCLUSIONS

Physical activity reduces psychological depressive symptoms in older adults and modulates psychological depression in older adults via the mediation efficacy of self-efficacy and the moderating effect of social support.

Psychological Resilience and Coping Strategies with Anxiety among Malaysian Medical Students during the COVID-19 Pandemic

Coronavirus Disease 2019 (COVID-19) swept the world by storm and caused a myriad of devastating consequences, particularly disruptions in medical education. This study aims to examine the association between sociodemographic factors, psychological factors, coping strategies and anxiety among medical students, as well as to identify the predictors of anxiety among them. A cross-sectional study design was used. Self-rated Rosenberg Self-Esteem Scale (RSES), General Self-Efficacy Scale (GSES), Brief Coping Orientation to Problems Experienced Scale (Brief COPE), and General Anxiety Disorder-7 Scale (GAD-7) were used. A total of 371 respondents from a tertiary education center were recruited. The prevalence of anxiety was 37% which corresponded to 21.6% and 15.4% for moderate and severe anxiety, respectively. Sociodemographic factors such as age group and academic year were significantly associated with anxiety, while those with higher self-esteem (r_s = -0.487), self-competence (r_s = -0.407), self-liking (r_s = -0.499), and self-efficacy (r_s = -0.245) had lower anxiety. Inversely, those who adopted emotion-focused (r_s = 0.130) and dysfunctional coping styles (r_s = 0.559) showed higher anxiety. The main predictors of anxiety were self-liking as a protective factor (aOR = 0.81) and dysfunctional coping as a risk factor (aOR = 1.16). Therefore, resilience building and inculcating positive coping strategies are imperative in equipping our budding healthcare providers to weather through future unforeseeable disasters.

Social media use and mental health of urban residents during China's second COVID-19 outbreak

Background

A multitude of literature has shown that during the 2019 COVID-19 outbreak, people's reliance on social media has been closely related with serious psychological problems. The "information epidemic" has sparked each country's attention. These countries including China have tried to find the solution and taken a series of measures. In January 2021, the COVID-19 broke out again in Shijiazhuang, China. Has the impact of social media on mental health changed?

Methods

Our data are based on an online survey of Chinese in January 2021, with 904 valid samples from 18 different provinces in China. We applied the methods of structural equation model analysis and the tendency value matching to conduct systematic analysis.

Results

Our research found that 38.9% of the population suffered from depression and 12.61% of the population suffered from anxiety. Chinese urban residents are more dependent on social media, with up to 80.1% of participants using social media frequently. Our research found that the relationship between social media use and residents' mental health has dramatically changed. More use of social media has been significantly associated with less depression and anxiety, especially among young people and women. Our findings are the first to reveal the relation's change between social media and mental health.

Conclusions

These findings implied that changes in the social media environment probably lead to changes in relationship between social media use and mental health since the outbreak began in 2019. Truthful and comprehensive social media information and a healthy positive social media environment can contribute to residents' mental health improvement and the fight against "information epidemic."

Analysis of mental health effects among nurses working during the COVID-19 pandemic: A systematic review

WHAT IS KNOWN ON THE SUBJECT?: Working on the frontline during the pandemic has had a negative impact on the mental health of health professionals. A significant proportion experienced anxiety, insomnia, posttraumatic stress or depression. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Analysis and synthesis of the evidence of the impact of the COVID-19 pandemic on the mental health of nurses based on their work context. There exists a gap in the literature as no studies were found that analysed the effects on nurses' mental health according to the level of care they worked in (hospital-primary care-nursing home). WHAT ARE THE IMPLICATIONS FOR PRACTICE?: There is an urgent need to assess and respond to the impact of COVID-19 on the physical and mental well-being of nurses, and to monitor international policies for the improvement of nurses' working conditions. ABSTRACT: Introduction Health professionals have suffered negative consequences during the COVID-19 pandemic. No review has specifically addressed the impact of the pandemic on the mental health of nurses exclusively according to the work context. Aim To analyse the impact of the COVID-19 pandemic on the mental health of nurses who have worked in hospitals, primary care centres and social health centres. Method PubMed, CINAHL, PsychINFO and Cochrane databases were searched (Prospero number: CRD42021249513). Out of 706 papers, 31 studies (2020-2021) were included in the systematic review. A qualitative synthesis method was used to analyse the data. Results Most studies were conducted in hospitals or frontline settings. The prevalence of moderate-to-severe symptoms was for anxiety 29.55%, depression 38.79%, posttraumatic stress disorder 29.8%, and insomnia 40.66%. Discussion This review highlights the mental health effects among nurses working in acute hospital settings. It also evidences a data gap on mental health effects among nurses working in primary health care and in nursing homes. Implications for practice In the post phase of the pandemic, there is an urgent need to assess and respond to the impact on the mental well-being of nurses, and to monitor international policies for the improvement of nurses' working conditions.

Psychological capital has a positive correlation with humanistic care ability among nurses

Objective

With the improvement in health awareness, humanistic care ability of nurses has become a focus of public attention. The aim of the study was to confirm the relationship between psychological capital and humanistic care ability of nurses, and to provide suggestions on improving the humanistic care ability of nurses.

Methods

A cross-section survey was conducted. Three hundred thirty-nine nurses were recruited from a tertiary general hospital in Taizhou, China. Psychological capital and humanistic care ability were measured using a self-reported questionnaire. Correlation analysis and stepwise multiple regression analysis were performed to analyze the correlation between psychological capital and humanistic care ability.

Results

The psychological capital and humanistic care ability scores were 91.57 ± 13.96 and 189.08 ± 20.37, respectively. Differences in psychological capital scores across professional titles (F = 4.88, p = 0.01), departments (F = 3.69, p < 0.001), years of work (F = 4.68, p < 0.001), and marital status (t = 3.25, p < 0.001) were statistically significant. There were statistical differences for the humanistic care ability scores among nurses based on marital status (p = 0.01). The total psychological capital scores and the four sub-dimensions scores were positively correlated with the humanistic care ability scores among nurses. Self-efficacy was the main predictor of nurses’ humanistic care ability.

Conclusion

Psychological capital positively affected the humanistic care ability of nurses. Self-efficacy was the main predictor of humanistic care ability. Nursing managers can formulate strategies from the perspective of positive psychology to improve humanistic care ability of nurses.

Health Care Workers' Perceived Self-Efficacy to Manage COVID-19 Patients in Central Uganda: A Cross-Sectional Study

Background

The novel coronavirus disease 2019 (COVID-19) pandemic placed health workers at the frontline of the emergency task force response; a duty that requires professional expertise and confidence to rapidly identify and treat patients with COVID-19. This study explored perceived self-efficacy (PSE) of health care workers (HCWs) in the management of patients with COVID-19 and associated factors in central Uganda.

Methods

We recruited 418 HCWs from four national referral hospitals in Uganda. Multivariate linear regression analysis was utilized to determine factors associated with PSE. A p-value > 0.05 was considered statistically significant.

Results

Majority of the participants were female, about half were nurses/midwives, and had 10 years of work experience on average. Overall, HCWs reported moderate PSE in managing COVID-19 patients which reduced with increasing severity of the COVID-19 illness. Having a PhD, being a medical doctor, agreeing or completely agreeing that one has knowledge about COVID-19 management, and having COVID-19 management training were significantly associated with increase in one’s level of PSE.

Conclusion

This study highlights an unsatisfactory, moderate level of PSE among HCWs in the management of patients with COVID-19 in central Uganda. The health sector should focus on improving HCWs’ self-efficacy through continuous training of all HCWs in the clinical management of especially the severe and critically ill cases of COVID-19. Non-doctor HCWs should be given priority as they scored lower levels of PSE; yet they are the corner stone of the primary health care system and make majority of the health human resource in low- and middle-income countries. Interventions towards creating a safe working environment for HCWs through provision of adequate infection prevention and control strategies are essential in boosting HCWs confidence to manage COVID-19 patients.

The Impact of Sociodemographic Characteristics on Coping Strategies Used by Nurses Working at COVID and Non-COVID Hospital Departments during COVID-19 Pandemic: A Cross-Sectional Study

Background: The aim of our study was to compare coping strategies applied by nurses working during the COVID-19 pandemic at COVID-19 (CoV) and non-COVID-19 (non-CoV) hospital departments with regards to their sociodemographic characteristics in order that the system can provide them better support in future similar situations. Methods: A total of 380 out of 1305 nurses participated in the survey during December 2020. Coping Inventory for Stressful Situations (CISS) was used. Stepwise regression analysis was used to determine the interaction between sociodemographic characteristics and coping strategies. Results: The CoV married nurses (62.2%) used problem- (p = 0.010) and emotion- (p = 0.003) focused coping more and avoidance coping less (p = 0.007). CoV nurses with master’s degrees (11.1%) used both problem- and emotion-focused coping less (p < 0.01), and older nurses used emotional coping more than the younger nurses (p = 0.027), whereas younger nurses used more avoidance coping (p < 0.01). CoV nurses without children (41%) used avoidance strategies more than nurses who had 2−3 children (p < 0.001). Among non-CoV nurses, less use of emotional coping was recorded in nurses with master’s degrees (4%) than in those with a high school diploma (44.2%) (p = 0.002). Avoidance coping was also used more by married non-CoV nurses (79.1%) (p < 0.001) and those without children (p < 0.001). Conclusions: Sociodemographic factors such as working experience, age, level of education and marital status influenced chosen coping strategies during the health crisis.

Factors Affecting Nurses' Health Promotion Behavior during the COVID-19 Pandemic Based on the Information-Motivation-Behavioral Skills Model

Background and Objectives: The COVID-19 pandemic has emerged as a major threat to nurses’ health. This study aimed to investigate the factors affecting nurses’ health promotion behaviors during the coronavirus disease 2019 (COVID-19) pandemic. Material and Methods: The participants were clinical nurses who had direct contact with patients at a university hospital in G province, Korea. Data were collected from March 16 to April 16, 2021, and the final analysis included data from 162 nurses. The general and lifestyle characteristics of the participants were analyzed using descriptive statistics, and the effect on health promotion behavior was analyzed using multiple regression with SPSS/WIN 21.0. Results: The results showed that the factors influencing nurses’ health promotion behavior during the COVID-19 pandemic were social support (β = 0.40, p < 0.001), self-efficacy (β = 0.27, p = 0.014), being married (β = 0.18, p = 0.018), having good health (β = 0.31, p < 0.001), and not skipping meals (β = 0.20, p = 0.001). The explanatory power of the variables was 51.4%. Therefore, health promotion programs to promote social support and self-efficacy are needed to improve nurses’ health promotion behaviors during the COVID-19 pandemic. Conclusions: These results indicate that the development of additional management strategies for health promotion among nurses during the COVID-19 pandemic is necessary. It is necessary to prepare organizational policies and manage self-care to improve nurses’ irregular eating habits during the ongoing pandemic.

Stress coping strategies used by nurses during the COVID-19 pandemic

Introduction

The risk of getting SARS-CoV-2 infection, worries about exposing loved ones, anxiety and frustration, emotional and physical exhaustion, burn out, a feeling of being overwhelmed, and struggles and challenges with parenting are a few among many factors that affect nurses' personal lives and professional functioning. The aim of the research is to assess nurses' level of stress during the COVID-19 pandemic and their sense of self-efficacy, and to learn what coping strategies they use.

Methodology/Methods

The study was carried out online and based on the diagnostic poll method, using an original survey questionnaire, the General Self-Efficacy Scale (GSES 10-40), the Mini-COPE questionnaire (0-3), and the Perceived Stress Scale PSS-10 (0-40). The respondent group was made up of nurses (n = 220) who provide health services in inpatient and outpatient health care institutions in the northeastern region of Poland. The statistical analysis was performed using the STATISTICA 13.0 package (StatSoft). The distribution of variables was checked with Shapiro-Wilk tests. The Mann-Whitney U test was used to compare two independent samples, while the Kruskal-Wallis test was used to compare more samples. The adopted statistical significance level was p < 0.05. Multivariate regression analysis was applied to determine which factors were related to the level of stress.

Results

The mean age of the participants was 43.3 years. The vast majority were women (96.4). The mean work experience of the nurses was over 20 years (58.2%). A total of 62.3% worked directly with patients in hospitals, including 11.8% respondents working at COVID-19 units and 37.7% working at primary care institutions. The analyses show that the respondents represented a high level of stress (PSS-10 - 20.9), related to their work experience as a nurse (β -0.250, p = 0.014), the number of hours worked a month (β 0.156, p = 0.015), and self-assessed health status (β -0.145, p = 0.037). They declared an average sense of self-efficacy (GSES - 29.1), which significantly depended on the nurses' places of employment (p = 0.044). Out of stress coping strategies (Mini-COPE), the younger nurses mentioned venting (p = 0.010), instrumental support (p = 0.011), sense of humour (p = 0.013) and self-blame (0.031). Practice nurses also chose the strategy of behavioral disengagement (p = 0.032), and nurse managers chose the strategy of planning (p = 0.018).

Conclusions

The experience of the COVID-19 pandemic highlights the need to implement some strategies to protect nurses' mental health and to take extensive prevention measures in critical situations. Special attention should be given to nurses who are younger and have shorter work experience. It is also important to monitor nurses' working time and health status, and those who work at outpatient health care institutions should be given more support and information.

Self-Efficacy and Professional Identity Among Freshmen Nursing Students: A Latent Profile and Moderated Mediation Analysis

This study was designed to estimate the associations between self-efficacy and professional identity. A total of 1,051 freshmen nursing students (FNSs) from the Be Resilient to Nursing Career (BRNC) program were recruited from four universities between September and November 2020. A latent profile and moderated meditation analysis were performed. Four profiles of self-efficacy were identified and named as Lowest (15.6%), Med-low (45.0%), Med-high (32.7%), and Highest (6.7%). The mediating role of resilience and the moderating effect of role models were also identified. Therefore, self-efficacy, resilience, and role models may be three important factors to professional identity in FNSs and these relationships should be further validated in longitudinal or interventional studies.

Psychosocial predictors of anxiety and depression in a sample of healthcare workers in Botswana during the COVID-19 pandemic: A multicenter cross-sectional study

Objectives:

This study aimed to investigate the psychological impact of the COVID-19 outbreak on healthcare workers across multiple hospitals in different districts in Botswana.

Methods:

We conducted a cross-sectional study in five public-funded hospitals from three districts in Botswana from 1 June 2020 to 30 October 2020. We used the neuroticism subscale of the 44-item Big Five Inventory, Patient Health Questionnaire, the Oslo 3-item Social Support Scale, the Anxiety Rating Scale, and the 14-item Resilience Scale to obtain data from 355 healthcare workers.

Results:

The participants’ mean age (standard deviation) was 33.77 (6.84) years. More females (207, 59%) responded than males (144, 41%). Anxiety and depression were experienced by 14% and 23% of the participants, respectively. After multiple regression analyses, neuroticism predicted depression (B = 0.22; p < 0.01) and anxiety disorder (B = 0.31; p < 0.01). Lower educational status (B = −0.13; p = 0.007) predicted anxiety and younger age (B = −0.10; p = 0.038) predicted depression, while resilience negatively correlated with both disorders.

Conclusion:

There is a need to develop and implement interventions targeted at these identified risk and protective factors that can be easily delivered to healthcare workers during this pandemic.

Technology as a Double-Edged Sword: Understanding Life Experiences and Coping With COVID-19 in India

The two waves of COVID-19 in India have had severe consequences for the lives of people. The Indian State-imposed various regulatory mechanisms like lockdowns, encouraged remote work, online teaching in academic institutions, and enforced adherence to the COVID protocols. The use of various technologies especially digital/online technologies not only helped to adapt to the "new normal" and cope with the disruptions in pursuing everyday activities but also to manage one's well-being. However, the availability and accessibility of digital technologies to various sections of the population were not uniform. This paper reports a series of three studies examining the nature of pandemic stress, the impact of technology use on people's emotional well-being during turbulent times, and the effects of technology use on psychological resources like resilience, self-efficacy, motivation to work, and emotional well-being. The differences in the residential background (Urban/Rural) and SES (Low/High) in the extent of the use of technology and strength of psychological resources were assessed. The findings indicated that the most common causes of concern included worrying about family, friends, partners, fears of getting and giving the viral infection to someone; frustration and or boredom; and changes in normal sleep patterns. It was noted that technology was a double-edged sword and created barriers as well as opportunities for the people. Also, self-efficacy mediated the relationship between the use of technology and emotional wellbeing. The results have policy implications for building resilient communities in the post COVID period.

The Relationship Among Spirituality, Self-Efficacy, COVID-19 Anxiety, and Hopelessness During the COVID-19 Process in Turkey: A Path Analysis

This study explores the relationship among spirituality, self-efficacy, COVID-19 anxiety, and hopelessness. The participants are comprised of 418 individuals (282 females and 136 males) in Turkey whose ages range between 18 and 61 years old. The participants completed the following surveys: The Coronavirus Anxiety Scale, the General Self-Efficacy Scale, the Beck Hopelessness Scale, and the Spiritual Orientation Inventory. The relationships among the variables have been examined using path analysis. According to the results, spirituality, self-efficacy, and COVID-19 anxiety have direct effects on hopelessness. The analysis also shows self-efficacy to mediate the relationship between spirituality and hopelessness. The proposed model has good fit indices. The findings are discussed in the context of the literature on COVID-19, spirituality, self-efficacy, and hopelessness, with practical implications for mental health professionals being provided.

Moderating Effect of Burnout on the Relationship between Self-Efficacy and Job Performance among Psychiatric Nurses for COVID-19 in National Hospitals

Background and Objective: The unprecedented spread of infectious diseases, such as the COVID-19 pandemic, in psychiatric units has affected the self-efficacy, burnout, and job performances of psychiatric nurses. We conducted a survey to investigate the moderating effect of burnout on the relationship between the self-efficacy and job performances of psychiatric nurses. Materials and Methods: Validated and structured questionnaires were used to collect data from 186 nurses in psychiatric units for COVID-19. The data were analyzed using descriptive statistics, Pearson’s correlation coefficient, and a series of multiple linear regression analyses based on Baron and Kenny’s method using the SPSS 26.0 program. Results: Job performance was positively correlated with self-efficacy (r = 0.75, p < 0.001) but had no significant correlation with burnout (r = −0.11, p = 0.150). Self-efficacy was negatively correlated with burnout (r = −0.22, p = 0.002). Burnout among psychiatric nurses had significant moderating effects on self-efficacy and job performance (β = −0.11, p = 0.024). Conclusions: These findings indicate a need to prevent burnout and to enhance self-efficacy in psychiatric nurses to increase their job performances and serve as a basis for establishing strategies to deploy medical staff in the future.

Carative Caring and Cognitive Behavior Therapy on Self Efficacy and Self Care of Covid-19 Patients

Introduction: The COVID-19 pandemic in Indonesia is increasing in which it has an impact on psychosocial conditions for everyone. COVID-19 patients feel low and afraid because of without family assistance while being treated in the room so that the patient's self-efficacy and confidence decrease in carrying out patient self-care. Objective: This study aims to analyze the effect of giving carative caring and cognitive behavioral therapy on self-efficacy and self-care for COVID-19 patients. Methods: The sampling technique used consecutive sampling to determine the sample according to the inclusion and exclusion criteria, with a total sample of 106 respondents who were divided into 53 intervention groups and 53 control group respondents. The instruments used in this study were the caring behaviors assessment tool to measure carative caring. General self-efficacy was used to measure self-efficacy and exercise of self-care agency was used to measure self-care for COVID-19 patients. The data were analyzed using the t-test with a significant level of p<0.5. Main Findings: The results showed that in the group the difference in the mean self-efficacy before and before the intervention was 10.17, while the difference in the mean of self-care before and after the intervention was 10.81. In the control group, the difference in the mean of self-efficacy before and after the intervention was 0.13, while the difference in the mean of self-care before and after the intervention was 0.02. Analysis of the data obtained showed that carative caring and cognitive-behavioral therapy had an effect on self-efficacy and self-care for COVID-19 patients with a p-value = 0.00. Conclusion: Research that aims to analyze the effect of giving carative caring and cognitive behavioral therapy on self-efficacy and self-care for COVID-19 patients proves that carative caring and cognitive behavioral therapy have an effect on self-efficacy and self-care for COVID-19 patients.

Prevalence of Depression and Anxiety in Nurses during the First Eleven Months of the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

The high risk of coronavirus (COVID-19) infection can increase the physical and psychological strain on nurses in professional practice, which can lead to mental health problems. The purpose of this systematic review and meta-analysis is to establish and estimate the combined incidence of depression and anxiety among nurses during the COVID-19 pandemic using standard measurement tools. A systematic search of the electronic databases PubMed, Web of Science, and SCOPUS was carried out to identify cross-sectional studies in the period from 3 March 2020 to 18 February 2021. Two reviewers independently and critically evaluated the studies which have been included, using the Agency for Healthcare Research and Quality checklist. We have identified twenty-three studies (n = 44,165) from nine countries. The combined incidence of depression among nurses was 22% (95% CI 0.15–0.30, I² = 99.71%), and anxiety symptoms 29% (95%CI 0.18–0.40, I² = 99.92%). No significant difference was observed in the percentage of depression and anxiety between the study subjects working on the frontlines vs. those in a mixed group (those working on the frontlines and behind the lines). This meta-analysis shows that over one-fifth of nurses in professional practice during the COVID-19 epidemic suffer from depression disorders, and almost one-third experience anxiety symptoms. This underscores the importance of providing comprehensive psychological support strategies for nurses working in pandemic conditions. Further longitudinal research is necessary to assess the severity of mental health symptoms related to the COVID-19 epidemic factor.

Mental Health Symptoms and Workplace Challenges among Australian Paramedics during the COVID-19 Pandemic

BACKGROUND

Paramedics are vital to the health system response to the COVID-19 pandemic; however, the pressures on this workforce have been intense and challenging. This study reports on mental health symptoms and the working environment among Australian paramedics during the COVID-19 pandemic and explores their experiences of work and wellbeing during this time.

METHODS

An anonymous, online survey of frontline healthcare workers examined work environment, psychological wellbeing, and contained four open-ended qualitative items. Using a mixed method approach, quantitative data were analysed descriptively and qualitative data were analysed using content analysis.

RESULTS

This paper reports findings from 95 paramedics who provided complete quantitative data and 85 paramedics who provided free-text responses to at least one qualitative item. Objectively measured mental health symptoms were common among paramedics, and almost two thirds of paramedics self-reported experiencing burnout. Qualitative analysis highlighted key issues of safety and risk in the workplace, uncertainty and upheaval at work and at home, and lack of crisis preparedness. Qualitative analysis revealed four themes; 'the pervasiveness of COVID-19 disruptions across all life domains'; 'the challenges of widespread disruption at work'; 'risk, uncertainty and feeling unsafe at work', and 'the challenges of pandemic (un)preparedness across the health system'.

CONCLUSIONS

The COVID-19 pandemic resulted in considerable occupational disruption for paramedics and was associated with significant negative impacts on mental health. Findings emphasise the need for more adaptive working conditions, mental health support for paramedics, and enhanced crisis preparedness across the health system for future crises.

Impact of Fear of COVID-19 Pandemic on Job Insecurity and Subjective Well-Being

Earlier research on the novel coronavirus (COVID-19) mainly focused on fear and its psychological impact on frontline health workers. However, the uncertainty of COVID-19, job insecurity and its effects on non-frontline employees' perception of their well-being is rarely explored. This study aims to assess the relationship between subjective well-being and the fear of the COVID-19 outbreak. Furthermore, this study explores how employees' awareness of their job insecurity influences this relationship. Structural Equation Modelling (SEM) and Confirmatory Factor Analysis (CFA), and Spearman's correlation analyses were used to examine the significance of the relationships between fear of COVID-19 and subjective well-being and the moderating role of job insecurity in this relationship. The findings indicate that greater fear of COVID-19 is associated with a lower level of perceived subjective well-being. However, a higher perception of fear of COVID-19 and its interaction with job insecurity are associated with a higher risk of employees' well-being. Our study highlights the factors such as fear of COVID-19 and job insecurities that undermine their well-being. Our study provdies practical implications for employees', managers, and healthcare policymakers to adopt effective strategies to reduce stress among employees. These recommendations include using practical tactics to safeguard the employees health and jobs while effectively coping with the pandemic.

Professional and psychological perceptions of emergency nurses during the COVID-19 pandemic: A qualitative study

AIM

To explore the changing roles and responsibilities, difficulties, feelings, and coping strategies of emergency nurses during the COVID-19 pandemic.

METHODS

This study was conducted as a qualitative study using a phenomenological approach. A total of 12 emergency nurses were recruited using purposive sampling from a COVID-19-designated hospital in Konya, Turkey for qualitative study. Data were collected through semi-structured individual interviews in January 2021. The data were analyzed using the content analysis method with the MAXQDA 2020 software program. The study conforms to the consolidated criteria for reporting qualitative research checklist.

RESULTS

Four theme categories emerged from the data analysis: (a) "Increasing roles and responsibilities as an emergency nurse"; (b) "Difficulties of working in pandemic conditions"; (c) "Emotional responses in the pandemic"; and (d) "Strategies for coping with the effects of the pandemic". In this study, it was determined that emergency nurses had increased roles and responsibilities due to physicians being in the background, fulfilled their roles and responsibilities in a chaotic working environment, experienced many positive and negative feelings together or gradually, and applied individual coping strategies.

CONCLUSIONS

This study indicated that emergency nurses fulfilled their increasing roles and responsibilities on the frontlines in a chaotic working environment during the pandemic. Despite many negative feelings, it was determined that they tried to show psychological adjustment and resilience with a strong professional commitment and social support.

Examining Emotional Labor in COVID-19 through the Lens of Self-Efficacy

The ongoing COVID-19 pandemic has dealt a significant blow to the restaurant industry, with many restaurants suspending operations or closing altogether. This study was aimed to investigate the effects of emotional labor on employees’ well-being and the mediating role of self-efficacy in the context of chain restaurants. Data were collected in 2020 through an online survey in China, and results revealed that emotional labor had a significant impact on well-being that was measured in life and job satisfaction. Self-efficacy not only had a significant positive impact on employees’ job- and life-related well-being but also played a fully mediating role between deep acting and life satisfaction, with a partial mediating role between deep acting and job satisfaction. Job-related well-being also played a fully mediating role between deep acting and life satisfaction, with a partial mediating role between deep acting and job satisfaction. It is important for restaurant employees to develop deep acting skills and improve self-efficacy and job satisfaction Restaurant managers must establish a healthy working environment by providing better job support and creating a more relaxed working atmosphere.

Psychological impact of COVID-19 and contributing factors of students' preventive behavior based on HBM in Gondar, Ethiopia

BACKGROUND

The Ethiopian Federal government has locked down schools as one measure to contain Covid-19 pandemic. Psychological effect of COVID-19 on students is increased due to the reopening of schools. The psychological effect of the pandemic is increasing along with physical aspect of health. Therefore, this study aimed to assess the psychological impact of Covid-19 and its contributing factors of students' behavior in Ethiopia.

METHODS

A cross sectional design was conducted from November to December 2020. Data were collected using pre tested self- administered questionnaire from secondary school students in Gondar city North West Ethiopia. Stratified simple random sampling technique was used to select 403 secondary school students. Data were entered and cleaned with Epidata version 4.62 and exported for analysis STATA version 14. Multivariable logistic regression and multiple linear regression were used to show the association of dependent and independent variables. Independent variables in relation to dependent variable measured using odd ratios and B coefficient with 95% confidence interval for Covid-19 anxiety and preventive behavior of Covid-19 respectively were used.

RESULTS

A total of 370 students were participated giving response rate of 92%. The prevalence of Covid-19 anxiety and obsession among secondary school students were 38.1% and 40.27% respectively. Being 11thgrade 54% (AOR = 0.46; 95%CI:0.22, 0.95) and increased knowledge16% (AOR = 0.84;95%CI: 0.77, 0.89) score associated with decreased COVID-19 anxiety while Covid-19 obsession, 14.51 times (AOR = 14.51;95%CI: 8.05, 26.17), and being female 1.6 times (AOR = 1.6; 95%CI: 1.01, 2.51) increased Covid-19 Anxiety. Furthermore, increased self-efficacy 0.5 times (B = 0.5; 95%CI: 0.28, 0.62), and increased cues to action 0.4 times (B = 0.4; 95% CI: 0.19, 0.69) increased preventive behavior of Covid-19 while perceived barrier 0.1 times (B = -0.1; 95%CI:-0.22, 0.01) decrease preventive behavior of Covid-19.

CONCLUSION

Almost two individuals of five participants developed COVID-19 anxiety and COVID-19 obsession. Being grade 11th and knowledge were negatively associated with anxiety while being female and being obsessed with COVID-19 were positively associated with anxiety. No variable was associated with obsession of Covid-19. Intervention is needed to reduce anxiety among females. Furthermore, perceived barrier, self-efficacy and cues to action were significant factors of preventive behaviour of Covid-19. Therefore, to increase preventive behaviour of Covid-19, information, education and communication and behavioural change communication should be targeted on reducing barriers and increasing motivations and confidences.

Healthcare worker stress, anxiety and burnout during the COVID-19 pandemic in Singapore: A 6-month multi-centre prospective study

Aim

The long-term stress, anxiety and job burnout experienced by healthcare workers (HCWs) are important to consider as the novel coronavirus disease (COVID-19) pandemic stresses healthcare systems globally. The primary objective was to examine the changes in the proportion of HCWs reporting stress, anxiety, and job burnout over six months during the peak of the pandemic in Singapore. The secondary objective was to examine the extent that objective job characteristics, HCW-perceived job factors, and HCW personal resources were associated with stress, anxiety, and job burnout.

Method

A sample of HCWs (doctors, nurses, allied health professionals, administrative and operations staff; N = 2744) was recruited via invitation to participate in an online survey from four tertiary hospitals. Data were gathered between March-August 2020, which included a 2-month lockdown period. HCWs completed monthly web-based self-reported assessments of stress (Perceived Stress Scale-4), anxiety (Generalized Anxiety Disorder-7), and job burnout (Physician Work Life Scale).

Results

The majority of the sample consisted of female HCWs (81%) and nurses (60%). Using random-intercept logistic regression models, elevated perceived stress, anxiety and job burnout were reported by 33%, 13%, and 24% of the overall sample at baseline respectively. The proportion of HCWs reporting stress and job burnout increased by approximately 1·0% and 1·2% respectively per month. Anxiety did not significantly increase. Working long hours was associated with higher odds, while teamwork and feeling appreciated at work were associated with lower odds, of stress, anxiety, and job burnout.

Conclusions

Perceived stress and job burnout showed a mild increase over six months, even after exiting the lockdown. Teamwork and feeling appreciated at work were protective and are targets for developing organizational interventions to mitigate expected poor outcomes among frontline HCWs.

Psychological distress among healthcare providers during COVID-19 in Asia: Systematic review and meta-analysis

INTRODUCTION

COVID-19 pandemic is having a devastating effect on the mental health and wellbeing of healthcare providers (HCPs) globally. This review is aimed at determining the prevalence of depression, anxiety, stress, fear, burnout and resilience and its associated factors among HCPs in Asia during the COVID-19 pandemic.

MATERIAL AND METHODS

We performed literature search using 4 databases from Medline, Cinahl, PubMed and Scopus from inception up to March 15, 2021 and selected relevant cross-sectional studies. Publication bias was assessed using funnel plot. Random effects model was used to estimate the pooled prevalence while risk factors were reported in odds ratio (OR) with 95% CI.

RESULTS

We included 148 studies with 159,194 HCPs and the pooled prevalence for depression was 37.5% (95%CI: 33.8-41.3), anxiety 39.7(95%CI: 34.3-45.1), stress 36.4% (95%CI: 23.2-49.7), fear 71.3% (95%CI: 54.6-88.0), burnout 68.3% (95%CI: 54.0-82.5), and low resilience was 16.1% (95%CI: 12.8-19.4), respectively. The heterogeneity was high (I2>99.4%). Meta-analysis reported that both females (OR = 1.48; 95% CI = 1.30-1.68) and nurses (OR = 1.21; 95%CI = 1.02-1.45) were at increased risk of having depression and anxiety [(Female: OR = 1.66; 95% CI = 1.49-1.85), (Nurse: OR = 1.36; 95%CI = 1.16-1.58)]. Females were at increased risk of getting stress (OR = 1.59; 95%CI = 1.28-1.97).

CONCLUSION

In conclusion, one third of HCPs suffered from depression, anxiety and stress and more than two third of HCPs suffered from fear and burnout during the COVID-19 pandemic in Asia.

Personal Protective Equipment and Nurse Self-efficacy due to Coronavirus Disease-19 Pandemic: A Systematic Review

BACKGROUND: High number of nurses who infected and died from contracting covid-19 put them in a difficult situation during the covid-19. Personal protective equipment is the final line protection for nurses from the risk of Healthcare Associated Infections, while self-efficacy plays an important role in surviving from stressors during the pandemic. AIM: This review aims to analyze factors related to the use of personal protective equipment and nurse self-efficacy during Covid-19 pandemic. METHODS: A systematic and comprehensive search using Preferred Reporting Items for Systematic Reviews and Meta-Analyses with six electronic databases were used. Nine cross-sectional, three cohort and survey, one case control, one surveillance study met the inclusion criteria. RESULTS: From 104 articles screened, 16 articles were included in this review. The high self-protection was the main factor preventing nurses from contracting Covid-19 infection. Lack of personal protective equipment and low cautiousness was the primary factor for nurses of contracting Covid-19. Increased stress, anxiety, depressive symptoms, and insomnia were associated with nurse’s low self-efficacy. CONCLUSION: The best protection for nurses from Covid-19 exposure is the availability and consistent use of personal protective equipment. Moreover, the consideration for designing staff training programmes and psychological support were recommended for building nurses self-efficacy.   Keywords: Health Associated Infections, Personal Protective Equipment, Nurse, Self-efficacy, Covid-19

Psychosocial Impact of COVID-19 Pandemic in Libya: A Cross-Sectional Study

Background: Since the outbreak of COVID-19 were announced in Wuhan, China, the virus has spread in most countries. After one year of restrictive measures applied by governments, it is unclear how this prolonged social distancing has affected the mental health of individuals in Libya. Therefore, the present study aims to assess the levels of perceived stress, depression, sleep disturbance, and self-efficacy associated with the pandemic in Libya and their association with the demographic factors. Methods: A cross-sectional study was conducted between October 10 and November 10, 2020 in 21 cities in Libya using an online survey. The survey collected socio-demographic variables and other important psychological variables using valid scales: namely, the Perceived Stress scale, the PROMIS Depression scale, the PROMIS Sleep Disturbance scale, and self-efficacy 6-item scale. Additionally, data were collected regarding eating and smoking habits, housing and living situations, and the preparedness of the public to manage the upcoming waves of the pandemic. Results: The questionnaire was accessed 746 times, and a total of 683 completed questionnaires were analyzed (response rate of 91.6%), with ages ranging from 18 to 94 years (Mean ± SD = 27.09 ± 10.57). Among the respondents, 58.4% were females and 77% were from the age group 18-29 years. The perceived stress, depression, and sleep disturbance symptoms were high in overall population. For stress, 52.7 and 17.1% of respondents reported moderate and high stress, and for sleep quality 28.8 and 8.1% reported moderate and high sleep disturbance, respectively. For depression, the overall median score was 20 (out of 40). The perceived stress, depression, and sleep disturbance were more prevalent among females and the younger age groups (18-29 years old). The overall self-efficacy median total score was 6.67 (out of 10), with a significantly higher median total score for males than females (7 vs. 6.33, p = 0.001). About 14.5% of the respondents were regular cigarette smokers, and most of them (79.8%) described their smoking habits during the previous month as more than typical. In addition, the reported eating habits of almost half of the respondents (43%) had changed, with about one-third (29.6%) reporting that their eating habits had become less healthy during the pandemic. Conclusion: The findings of this research suggest increased levels of stress, depression, and sleep disturbances as well as COVID-19-related fear during the pandemic, especially among young females. This alarming finding urgently calls for safe and low-barrier interventions to help mentally burdened individuals. This study makes a significant contribution in providing essential data on the psychological and social impacts on the Libyan population due to the COVID-19 pandemic.

Parenting stress, self-efficacy and COVID-19 health risks as predictors of general stress among nurses

AIM

The purpose of the study was to examine the influence of parenting stress, self-efficacy and COVID-19 health risks on general stress among nurses in the Midwest, United States, during the pandemic.

BACKGROUND

As frontline workers amidst the coronavirus disease 2019 (COVID-19) pandemic, nurses have been subject to stressors at home and at work.

METHOD

This quantitative, cross-sectional study included 896 nurses with at least one child below 18 years of age. Using purposive sampling, participants answered an online survey composed of demographic questions, perception of COVID-19 health risks, measures of self-efficacy, general stress and parenting stress. Bivariate correlation and multiple regression were conducted. Data were collected from July 13 to August 13, 2020.

RESULTS

The four predictors, along with eight demographic covariates, accounted for 40% of the variance in general stress. Parenting stress and COVID-19 health risks were positively related to general stress, while self-efficacy was negatively associated with general stress.

CONCLUSIONS

Results highlight the negative influence of parenting stress on nurses' general stress and the importance of self-efficacy in reducing stress. Findings suggest that support services for nurses should focus not only on work-related stressors but also consider parenting stressors, work-home imbalances and self-efficacy.

Stress and quality of life of intensive care nurses during the COVID-19 pandemic: Self-efficacy and resilience as resources

Background

Health care workers employed in the COVID‐19 emergency are at a high risk of stress.

Aims and objectives

To explore the mediating roles of self‐efficacy and resilience between stress and both physical and mental quality‐of‐life components in intensive care nurses during the COVID‐19 pandemic.

Design

Cross‐sectional survey design.

Methods

The stress subscale (depression, anxiety, and stress scale in Spanish Scale, DASS‐21), the summary components (physical and mental) of health‐related quality of life (SF‐36), the general self‐efficacy scale (GSES), and the resilience scale (RS‐14) were administered in 308 intensive care nurses. Serial multiple mediator models were used.

Results

There was a significant indirect effect of levels of perceived stress on both physical and mental health components through self‐efficacy and resilience. Specifically, greater perception of self‐efficacy was associated with a lower perception of stress and greater resilience, while higher resilience was associated with greater physical and mental health (B = −0.03; SE = 0.02; 95% confidence interval [CI] = [−0.07, −0.01]; B = −0.03, SE = 0.01, 95% CI = [−0.07, −0.01], respectively). It was observed that self‐efficacy alone also mediates the relationship of the perception of stress on the components of physical and mental health (B = −0.07; SE = 0.05; 95% CI = [−0.18, −0.03]; B = −0.09; SE = 0.04; 95% CI = [−0.17, −0.24], respectively). However, resilience alone was not a significant mediator of these associations.

Conclusions

It can be concluded that stress is linked to the physical and mental health components related to quality of life through self‐efficacy and resilience.

Relevance to clinical practice

These psychological resources would allow the nursing staff to maintain a good quality of life despite high levels of stress. These findings have implications for future research in terms of both model testing and clinical application.

The role of fortitude, loneliness, and depression in the association between risk perception of contracting COVID-19 and life satisfaction: serial mediation analysis

Recently, the COVID-19 pandemic has been found to have a negative impact on both physical wellbeing and mental health. Increased risk perception of contracting the virus has been associated with adverse psychological outcomes and reduced life satisfaction. However, susceptibility to psychological distress is influenced by personality-related characteristics. This study focuses on fortitude as a potential protective factor. The aim of this study is to investigate the parallel and serial mediating roles of fortitude, loneliness, and depression in the relationship between risk perception and life satisfaction. The participants were young adults ( N = 337) who have completed five self-report questionnaires: University of California Los Angeles Loneliness Scale, Centre for Epidemiological Studies Depression Scale, Fortitude Questionnaire, Satisfaction with Life Scale, and COVID-19 Risk Perception Scale. Descriptive statistics were generated, and structural equation modelling was used to examine the parallel and serial mediating roles of loneliness, depression, and fortitude. Positive associations were found between risk perception and loneliness and depression, and fortitude was found to mediate the relationship between risk perception and life satisfaction, between loneliness and life satisfaction, and between depression and life satisfaction. The overall serial mediation was also found to be significant, thereby supporting the hypothesis that those who perceive themselves to be at a risk of contracting COVID-19 have higher loneliness scores, which in turn is associated with higher depression scores. These findings confirm that fortitude is a salient protective factor and suggest that improving the perception of the ability to manage the risk of infection can enhance psychological wellbeing.

Mental Health in Health Students during Coronavirus Disease-19: Systematic Review

Purpose: This study aims to examine the description of mental health characteristics of health students who conducted studies during the COVID-19 pandemic. Methods: The design of this study is to use a systematic review approach by collecting several articles from a database that has been selected consisting of Springer. , ScienceDirect and ProQuest with articles published in 2020. Search for articles was carried out by entering the keyword "mental health AND student AND COVID-19". The search for this article was limited to inclusion criteria and exclusion criteria. The inclusion criteria in this study were health students who were still conducting studies during the COVID-19 pandemic and a cross-sectional study design, while the exclusion criteria were non-health students, only abstracts and books, and letters to the editor. Results: After a search on the selected database, the results are 677 Springer articles, 554 direct articles, and 1348 ProQuest articles. 11 were removed for duplicates, 444 full texts were reviewed and 6 articles matched inclusion and exclusion criteria. The results of the 6 articles that were reviewed showed that the majority of health students reported mental health problems such as anxiety, depression, stress, and another emotional status. Where moderate and severe levels of anxiety were experienced by some Health students who carried out education during the Covid-19 pandemic. Conclusion: The COVID-19 pandemic has an impact on psychological conditions, especially on health students who are carrying out their education. Students report poor mental health conditions while carrying out home education by learning online during the COVID-19 pandemic.

Prevalence of Depression among Healthcare Workers during the COVID-19 Outbreak: A Systematic Review and Meta-Analysis

Background: There is evidence of a high psychological toll from the COVID-19 pandemic in healthcare workers. This paper was aimed at conducting a systematic review and meta-analysis of studies reporting levels of depression among healthcare workers during the COVID-19 and estimating the pooled prevalence of depression. Methods: We searched for cross-sectional studies listed on PubMed from 1 December 2019 to 15 September 2020 that reported prevalence of depression in healthcare workers, nurses, medical doctors, and COVID-19 frontline professionals. The pooled proportions of depression were calculated with random effects models. Results: We identified 57 studies from seventeen countries. The pooled prevalence of depression in healthcare workers was 24% (95% CI: 20–28%), 25% for nurses (95% CI: 18–33%), 24% for medical doctors (95% CI: 16–31%), and 43% for frontline professionals (95% CI: 28–59%). Conclusions: The proportion of depression in nurses and medical doctors during the COVID-19 pandemic was similar to that found in the general population as previously reported in other meta-analyses conducted with smaller numbers of studies. Importantly, almost half of the frontline healthcare workers showed increased levels of depression. There is need for a comprehensive, international response to prevent and treat common mental health problems in healthcare workers.

The Psychological Impact of COVID-19 Pandemic on Health Care Workers: A Systematic Review and Meta-Analysis

Objective: The COVID-19 epidemic has generated great stress throughout healthcare workers (HCWs). The situation of HCWs should be fully and timely understood. The aim of this meta-analysis is to determine the psychological impact of COVID-19 pandemic on health care workers.

Method: We searched the original literatures published from 1 Nov 2019 to 20 Sep 2020 in electronic databases of PUBMED, EMBASE and WEB OF SCIENCE. Forty-seven studies were included in the meta-analysis with a combined total of 81,277 participants.

Results: The pooled prevalence of anxiety is 37% (95% CI 0.31–0.42, I² = 99.9%) from 44 studies. Depression is estimated in 39 studies, and the pooled prevalence of depression is 36% (95% CI 0.31–0.41, I² = 99.6%). There are 10 studies reported the prevalence of insomnia, and the overall prevalence of insomnia is 32% (95% CI 0.23–0.42, I² = 99.5%). The subgroup analysis showed a higher incidence of anxiety and depression among women and the frontline HCWs compared to men and non-frontline HCWs respectively.

Conclusions: The COVID-19 pandemic has caused heavy psychological impact among healthcare professionals especially women and frontline workers. Timely psychological counseling and intervention ought to be implemented for HCWs in order to alleviate their anxiety and improve their general mental health.

COVID-19 and mental well-being of nurses in a tertiary facility in Kenya

BACKGROUND

The 2019 coronavirus disease (COVID-19) epidemic is a global health emergency which has been shown to pose a great challenge to mental health, well-being and resilience of healthcare workers, especially nurses. Little is known on the impact of COVID-19 among nurses in sub-Saharan Africa.

METHODS

A cross sectional study was carried out between August and November 2020 among nurses recruited from the Aga Khan University Hospital, Nairobi. The survey questionnaire consisted of six components- demographic and work title characteristics, information regarding care of COVID-19 patients, symptoms of depression, anxiety, insomnia, distress and burnout, measured using standardized questionnaires. Multivariable logistic regression analysis was performed to identify factors associated with mental health disorders.

RESULTS

Of 255 nurses, 171 (67.1%) consented to complete the survey. The median age of the participants was 33.47 years, 70.2% were females and 60.8% were married. More than half, 64.9% were frontline workers directly engaged in COVID-19 care. Only 1.8% reported a prior history or diagnosis of any mental health disorder. Depression, anxiety, insomnia, distress, and burnout were reported in 45.9%, 48.2%, 37.0%, 28.8% and 47.9% of all nurses. Frontline nurses reported experiencing more moderate to severe symptoms of depression, distress and burnout. Furthermore, females reported more burnout as compared to males. Multivariate logistic regression analysis showed that after adjustment, working in the frontlines was an independent risk variable for depression and burnout.

CONCLUSION

This is one of the few studies looking at mental health outcomes among nurses during the COVID-19 pandemic in Kenya. Similar to other studies from around the world, nurses directly involved with COVID-19 patients reported higher rates of mental health symptoms. Burnout threatens to exacerbate the pre-existing severe nursing workforce shortage in low-resource settings. Cost-effective and feasible mitigating strategies, geared to low-middle income countries, are urgently needed to help cope with mental health symptoms during such a pandemic.

Differences in levels of psychological distress, perceived safety, trust, and efficacy amongst hospital personnel during the COVID-19 pandemic

The COVID-19 pandemic poses significant challenges to healthcare systems worldwide. A key consideration is the adverse psychological impact on healthcare workers (HCWs). This study aimed to investigate the variable levels of psychological distress, perceived safety, trust, and self- and collective-efficacy during the COVID-19 crisis amongst varied HCWs. A survey was disseminated to nurses, physicians, interns, and administrative and logistical staff at an acute-care hospital in Israel during the first wave of COVID-19. The survey consisted of items on a 5-point Likert scale, measuring HCW's perceptions concerning the aforementioned variables as well as demographic information. A total of 716 hospital personnel completed the survey. Nurses reported higher levels of psychological distress and lower levels of trust in the hospital's COVID-19 guidelines compared to physicians (2.3 vs. 2.0 and 3.7 vs. 4.0, respectively). Nurses and interns felt the least safe when working in the hospital. Nurses reported the highest levels of concern regarding fear of uncontrollable spread, infection, and family transmission of the virus. Interns reported the lowest levels of self- and collective-efficacy. In a regression model, the variables that predicted 32% of distress among nurses were age, gender, level of religiosity, indices of perceived safety, and self-efficacy. This study demonstrated differences in distress and perceived safety, trust, and efficacy between varied HCWs during COVID-19. This variability should be considered when designing policies to protect HCWs' wellbeing during future pandemics.

Intention to Care for COVID-19 Patients Among Nurses Working at Health Care Institutions of Debre Tabor Town, North Central Ethiopia

Background

Coronavirus disease 2019 (COVID-19) has caused many challenges for health care providers. Nurses meet patients with coronavirus disease and offer care for newly communicable diseases. Despite global and national efforts to prevent the spread, the outbreak is still on a rise, and studies on the health care behaviors of nurses were scarce in the study setting. Therefore, this study was intended in addressing nurses’ intention to care for coronavirus disease 19 patients and its determinants among nurses working at Debre Tabor town Health Care Institutions, 2020.

Methodology

An institutional-based cross-sectional study was conducted among 163 nurses working at health care institutions of Debre Tabor Town, from June 01 to 15/2020. The data were collected using tools with a self-administration questionnaire adapted from the theory of planned behavior and different kinds of literatures. All nurses working at Debre Tabor health care institutions were included. Data were entered using Epi-data 4.2.0.0 statistical software, and analysis was done by Stata version 14 statistical software. Binary logistic regression model was used for analysis. Strength of association was measured using the odds ratio with 95% CI, and the level of significance was estimated at P-value ≤0.05.

Results

Nurses’ intention to care for COVID-19 patient was 59.5% (95% CI; 58.7:60.3). Having better working experience (adjusted odds ratio (AOR) =2.3:95% CI; 1.120, 4.910), caring experience for infectious disease (AOR=2.5; 95% CI: 1.10, 5.50), good perceived behavioral control (AOR=2.33; 95% CI: 1.13, 4.8), and subjective norms (AOR= 2.14; 95% CI: 1.05, 4.36) were significantly associated with intention of caring behavior.

Conclusion

Nurses’ intention to care for COVID-19 patients was low. Working experience, the experience of caring for infectious disease, self-efficacy, and subjective norm were independently related with nurses’ caring intention. The government should work on improving nurse’s confidence in disaster management, design disaster management nursing education, and frequent support of nurses.

Analysis of mental health symptoms and insomnia levels of intensive care nurses during the COVID-19 pandemic with a structural equation model

Background

Faced with this critical situation and directly involved in the treatment and care of COVID‐19 patients, front‐line healthcare workers are at high risk in terms of mental health symptoms.

Aims and Objectives

To determine the stress, anxiety, depression, and insomnia levels of intensive care nurses during the pandemic with a structural equation model.

Design

A multi‐site survey study.

Methods

The study was performed with 194 nurses working in the intensive care units of five hospitals in Istanbul in July 2020. Data were collected using the Depression Anxiety Stress‐21 Scale and Insomnia Severity Index electronically. The data were evaluated with descriptive statistics in SPSS package program. In order to test the structural model and hypotheses of the research, path analysis was performed with LISREL statistical software program. A validation study for the suitability of these scales to the study sample was done by the researchers using the confirmatory factor analysis method. The study conforms to the TREND checklist.

Results

In this study, the majority of the intensive care nurses had moderate to extremely severe depression (65.5%), anxiety (58.3%) and stress (72.3%) scores; in addition, 39.7% of the nurses experienced moderate or severe insomnia. Within the framework of a structural model; the effects of stress, anxiety and insomnia on depression, which is the dependent variable, were found to be statistically significant (p < .001).

Conclusions

It was found that the majority of the intensive care nurses fighting COVID‐19 on the front‐line experienced stress, anxiety, depression and insomnia at levels ranging from moderate to extremely severe; in addition, it was determined that there is a positive relationship between stress, anxiety, insomnia and depression.

Relevance to clinical practice

This study, in which we have determined the mental health symptoms and insomnia levels of intensive care nurses, who are in the front‐line during the COVID‐19 pandemic, constitutes the scientific basis for the effective coping strategies that the authorities will take in this subject.