A Cross-Sectional Study of Perceived Stress, Mindfulness, Emotional Self-Regulation, and Self-Care Habits in Registered Nurses at a Tertiary Care Medical Center

Nurses' self-regulation after engaging in end-of-life conversations with advanced cancer patients: a qualitative study

BACKGROUND

Self-regulation is crucial for nurses who engage in in-depth end-of-life conversations with advanced cancer patients, especially in cultural contexts featuring death taboos. An improved understanding of the self-regulation process of nurses can help them address negative emotions and promote self-growth more effectively. Therefore, this study aimed to explore nurses' self-regulation process after end-of-life conversations with advanced cancer patients.

METHODS

This study employed a descriptive, qualitative approach. Seventeen nurses from four hospitals and a hospice unit in mainland China were interviewed between September 2022 and June 2023. Data were collected through face-to-face semistructured interviews. A thematic analysis method was used to analyse the data following the guidance of regulatory focus theory.

RESULTS

Three main themes were developed: self-regulation antecedents include personality, experience, and support; promotion or prevention is a possible self-regulation process for nurses; both self-exhaustion and self-growth may be the outcomes of self-regulation, as did seven subthemes. Personality tendencies, life experience, and perceived support may affect nurses' self-regulation, thereby affecting their self-regulation outcomes.

CONCLUSIONS

Nurses exhibit different self-regulatory tendencies and self-regulation outcomes. The provision of peer support and counselling support to nurses is highly important with regard to achieving good self-regulation outcomes.

Effects of safety attitude on factors related to burnout among nurses working at a dedicated infectious disease control hospital during the COVID-19 pandemic

AIM

Repeated occupational exposure and increased stress and fatigue levels contribute to a high risk of coronavirus disease 2019 (COVID-19) infection among frontline nurses. This study aimed to explore the relationships among teamwork, work environment and resources, work-life balance, stress perception and burnout among nurses working at a dedicated infectious disease control hospital.

METHODS

The participants were 389 nurses at a dedicated infectious disease control hospital in Taipei City, Taiwan. This study adopted survey design with a questionnaire using the Safety Attitude Questionnaire.

RESULTS

The work-life balance among nurses at the dedicated hospital significantly mediated the effects of teamwork and work environment and resources on burnout. In addition, stress perception had interaction effects on work-life balance and burnout.

CONCLUSION

This study's results provide important recommendations for managing teamwork, work environment and resources, work-life balance, stress perception and burnout prevention in nurses to help them better prepare and cope with emergencies. Findings can serve as a reference for developing relevant hospital management policies.

A multi-method quasi-experimental study to assess compassion satisfaction/fatigue in nurses, midwives and allied health professionals receiving a narrative medicine intervention

AIMS

To: (1) measure the impact of a narrative medicine intervention on compassion fatigue and compassion satisfaction of nurses, midwives and allied health professionals; (2) explore participants' working experiences and (3) their impressions of the intervention.

DESIGN

Multi-methods, quasi-experimental before-after intervention design.

METHODS

The intervention consisted of 20 narrative medicine sessions (60 h). Healthcare providers (N = 48) from a mother-and-child hospital in Italy completed the 'Professional quality of life' questionnaire before and after the intervention (January 2020-April 2021). Baseline scores served as internal controls. Open-ended questions explored participants' touching experiences at work and their evaluation of the intervention. A thematic content analysis was performed. Reporting followed the TREND and SRQR guidelines.

RESULTS

The differences before-after intervention in compassion satisfaction or fatigue scores were not statistically significant. Three themes emerged from participants' touching experiences: "Witnessing death and sufferance"; "Witnessing violence" and "Organizational stressors during COVID-19". A statistically significantly higher median score for post-intervention compassion satisfaction was found among participants who reported at least one touching experience compared to those who had no touching experience. Four themes emerged from the reported strengths of the program: "Learning to exteriorize feelings"; "Team building"; "Useful to rework personal/professional journey" and "Develops professional empowerment". Two themes emerged from reported weaknesses: "Programme organization" and "Participants' difficulties in sharing experiences".

CONCLUSION

A time-limited narrative medicine intervention is not sufficient to produce significant changes in satisfaction or compassion fatigue, especially if implemented during a pandemic. However, such an intervention holds promise for supporting nurses and midwives' professional empowerment and promoting continuity of compassionate care.

IMPACT

For those at risk of compassion fatigue, policymakers need to invest in training in narrative medicine, which promotes team building, and employee well-being and thus favours compassionate care. Such programmes should be offered to undergraduate students to nurture compassion and attention to self.

PATIENT OR PUBLIC CONTRIBUTION

Does not apply as the study only includes health care providers.

Satisfaction with care quality and anxiety among family members during nursing home visiting restrictions: The chain mediating effect of emotional regulation and perceived stress

Introduction

This study aimed to investigate the psychological well-being (perceived stress and anxiety) of Chinese family members during nursing home visiting restrictions and to elucidate the relationships among satisfaction with care quality, emotion regulation, perceived stress, and anxiety.

Methods

An online survey was conducted with a cross-sectional study design. From 18 to 29 January 2022, a total of 571 family members of nursing home residents completed online questionnaires comprising socio-demographic characteristics, satisfaction with care quality, emotion regulation, perceived stress, and anxiety. Mediation analyses were performed to estimate the direct and indirect effects of satisfaction with care quality on anxiety using the PROCESS macro for SPSS.

Results

The results showed that approximately one-quarter of Chinese family members had anxiety symptoms during nursing home visiting restrictions. Satisfaction with care quality affected anxiety via three mediating paths: (a) through cognitive reappraisal (effect = 0.028); (b) through cognitive reappraisal and perceived stress sequentially (effect = −0.057); and (c) through perceived stress (effect = −0.212). The chain mediating effect (path b) accounted for 23.7% of the total effect.

Conclusions

These findings corroborated our hypothesis that cognitive reappraisal (a kind of emotion regulation strategy) and perceived stress mediated the relationship between satisfaction with care quality and anxiety during nursing home visiting restrictions. Efforts to address family members’ psychological well-being by focusing on cognitive reappraisal should be considered.

The mediator role of well-being in the effect of COVID-19 anxiety on occupational commitment: research in the aviation sector

The coronavirus (COVID-19) pandemic, which emerged in China in December 2019, has severely affected many industries across the world and created substantial psychological, social and economic impact on individuals. With the coronavirus outbreak labelled as a pandemic by the World Health Organization, the first measures have been taken for the aviation industry. The crisis environment created by the pandemic had a negative impact on aviation personnel. The main purpose of this research is to investigate the mediator role of employee well-being in the effect of COVID-19 anxiety on occupational commitment. The data were collected through a survey of cabin and cockpit staff (n = 3862). After the analyses, it was found that the effect of COVID-19 anxiety on well-being, and occupational affective and normative commitment was significant. Moreover, it is among the findings that well-being has a partial mediator role in the effect of COVID-19 anxiety on occupational affective and normative commitment.

The relationships among perceived stress, resilience, sleep quality and first-month retention of newly employed nurses: A cross-sectional survey

AIM

Newly employed nurses are subject to high workplace stress, which leads to a low retention rate. Resilience can reduce burnout among nurses. The aim of this study was to explore the relationships among perceived stress, resilience, sleep quality of new nurses during initial employment, and their impacts on first-month retention.

DESIGN

This is a cross-sectional study design.

METHODS

We used a convenience sampling method to recruit 171 new nurses between January and September 2021. The Perceived Stress Scale, Resilience Scale, and Pittsburgh Sleep Quality Inventory (PSQI) were conducted in the study. Logistic regression analysis was used to explore the impacts on first-month retention for newly employed nurses.

RESULTS

The initial perceived stress, resilience, and sleep quality of the newly employed nurses were not correlated with the first-month retention rate. Forty-four per cent of the newly recruited nurses had sleep disorders. Resilience, sleep quality, and perceived stress of newly employed nurses were significantly correlated. Newly employed nurses assigned to their desired wards had lower perceived stress than their peers.

Nurses' well-being during the coronavirus (2019) pandemic: A longitudinal mixed-methods study

AIM

To determine prevalence, predictors and change over time of nurses' and student nurses' mental health and well-being, and explore nurses' perceptions, barriers and enablers of well-being.

DESIGN

Longitudinal mixed-methods survey.

METHODS

Forty-nine students and registered nurses participated from Victoria, Australia. Data were collected from December 2019 to July 2020. Validated psychometrics and free-text response questions were employed. Analysis used latent growth curve modelling, Pearson product-moment correlations and thematic analysis.

RESULTS

A strong positive correlation was found between self-determination and work well-being, and a strong negative correlation between work well-being and flight risk. Several moderate relationships were found; a moderate positive correlation between work well-being and nurse manager ability, leadership and support, and a moderate negative correlation between burnout and staffing and resource adequacy. Collegial nurse-physician relationships deteriorated. Three themes, physical health, psychological well-being and social connection, were identified as important for nurses' well-being.

COVID-19 pandemic and health worker stress: The mediating effect of emotional regulation

Background/Introduction

Psychological and physical well-being of health personnel has been significantly affected by COVID-19. Work overload and continuous exposure to positive COVID-19 cases have caused them fatigue, stress, anxiety, insomnia and other detriments. This research aims: 1) to analyze whether the use of cognitive reevaluation and emotional suppression strategies decreases and increases, respectively, stress levels of health personnel; 2) to quantify the impact of contact with patients with COVID-19 on stress levels of medical staff.

Method

Emotion regulation strategies (cognitive reevaluation and emotional expression) and stress levels were evaluated in 155 Dominican physicians who were treating people infected with COVID-19 at the moment of the study (67.9% women and 32.1% men; mean age = 34.89; SD = 9.26). In addition, a questionnaire created by the researchers quantified the impact that contact with those infected had on their stress levels.

Results

Contact with patients with COVID-19 predicts increased use of emotion suppression strategies, although is not associated with the use of cognitive reevaluation. These findings lead to an even greater increase in stress on health care providers.

Conclusions

Contextual contingencies demand immediate responses and may not allow health personnel to use cognitive re-evaluation strategies, leaning more towards emotion suppression. However, findings regarding high levels of stress require the implementation of intervention programs focused on the promotion of more functional emotion regulation strategies. Such programs may reduce current stress and prevent post-traumatic symptoms.

Mindfulness at Methodist-A Prospective Pilot Study of Mindfulness and Stress Resiliency Interventions in Patients at a Tertiary Care Medical Center

Individuals with chronic medical conditions like cancer often experience heightened stress levels that can impact medical decision-making. The aim of this study was assess the impact of mindful stress-reduction interventions in cancer patients and support group participants (which included current and former cancer patients and their caregivers). A pilot study was conducted in which participants were provided a mindful stress-reduction intervention to determine whether they reduced stress, anxiety, and communication issues. Participants were provided a one-hour mindful stress-reduction intervention by a licensed physical therapist. Surveys were given to participants immediately before and after, and again 7-days after the intervention. Perceived stress was ascertained by asking participants: "Which emotional/mental state do you most frequently find yourself in?" Anxiety and communication abilities were measured using Neuro-QoL™ Anxiety and Communication v.1 instruments. Fifty-nine participants with a mean age of 60.6 years completed the study. Of these, 30.5%, 6.8%, 23.7%, and 39% were diagnosed (or were a caregiver to someone diagnosed) with pancreas, liver, breast, or unknown cancers, respectively. The surveys showed that participants' perceived stress scores (p < 0.001), anxiety levels (p = 0.0067), and pain scores (p < 0.0001) were reduced after the mindful stress-reduction intervention. Larger studies with control groups are needed to confirm the interventions' benefits.