Nurses' job stress and its impact on quality of life and caring behaviors: a cross-sectional study

'Breakdown and healing' - adaptation experiences of postpartum nurses returning to work: a descriptive phenomenological study

BACKGROUND

Promoting the work adaptation of nurses returning to work after childbirth is key to improving their physical and mental health and ensuring the quality of nursing care. Although postpartum nurses have reported high work stress and poor adaptation after returning to work, little is known regarding the experiences, problems and further needs. This study aimed to explore the adaptation experiences of postpartum nurses returning to work.

METHODS

This was a qualitative study with descriptive phenomenological approach. Individual semi-structured interviews were conducted between March and May 2023 in four tertiary hospitals in Changsha, mainland China, which were selected using convenience sampling. A total of 16 postpartum nurses returning to work within one year were recruited using purposive sampling and maximum variation sampling. The interviews were analysed using the Colaizzi's 7-step method.

RESULTS

'Breakdown and healing' is a strong thread in postpartum nurses' work adaptation. It links 13 subthemes in the interview data, which can be grouped under three overarching themes: (a) changes and challenges of multiple roles; (b) self-coping and social support; and (c) further needs after returning to work. The phrase 'breakdown and healing' reflects the mutual relationship between stress and coping among postpartum nurses. The changes and challenges associated with being required to fulfil multiple roles of mothers, wives and nurses make the subjects feel on the verge of 'breakdown'. When returning to work, most of them move slowly towards 'healing' through positive self-management and support from their partners, families, supervisors and colleagues. Moreover, their ongoing demands and unsolved problems - such as their desire for a workplace that is friendly and serves their needs - were generated by the constant process of 'breakdown and healing'.

CONCLUSIONS

Understanding how postpartum nurses returning to work perceive adaptation experiences is essential for nursing managers, who can use the findings to implement targeted measures to shorten postpartum nurses' maladaptation period after returning to work and promote their work adaptation. This study underscores the critical importance of personalized return-to-work training, flexible work arrangements, support from colleagues and managers, well-established maternal facilities and services, and targeted policy efforts in enhancing postpartum nurses' work adaptation.

Comparison of Quality of Life and Coping Strategies among Firefighters and Emergency Medical Services Personnel in Saveh, Iran

Emergency medical service (EMS) personnel and firefighters (FFs) are first responders in dangerous and stressful situations. They experience high stress due to the nature of their jobs, which can affect their quality of life and various health dimensions. This study aimed to compare quality of life, job stress, and coping strategies in a sample of EMS personnel and FF employees in Iran. This cross-sectional study included 186 FFs and EMS, who were selected using a census sampling method. Our results showed that FFs had a better quality of life, lower perceived stress, and better coping skills than EMS. Individuals living in rural areas, government officials, and staff with regular work shifts also reported less perceived stress. Furthermore, our results indicated a negative and significant correlation between perceived stress and quality of life and a positive and significant correlation between stress management and quality of life in both groups. Given the inevitability of stress in EMS and FF jobs, policymakers need to take interventional measures to reduce anxiety and enhance the quality of life and work for these personnel. Occupational health policies in Iran generally follow the International Labor Organizational recommended standards, however, more attention to managerial interventions that reduce job demands and job stress combined with health promotion programs to improve coping are advised.

Nurse managers' managerial innovation and it's relation to proactivity behavior and locus of control among intensive care nurses

BACKGROUND

The nursing profession is undergoing rapid transformation, requiring innovation in management approaches and proactive behaviors among staff. Nurse Managers play a vital role through managerial innovation, but its impacts on intensive care nurses' proactivity and locus of control remain underexplored.

OBJECTIVES

This study aimed to assess the levels of Nurse Managers' managerial innovation and relate it to proactivity behaviors and locus of control orientations among intensive care nurses.

METHODS

A cross-sectional correlational design was adopted, recruiting 242 intensive care nurses from Tanta University Hospital, Egypt. Participants completed standardized questionnaires measuring perceived managerial innovation, proactivity behavior, and locus of control.

RESULTS

Nurse Managers demonstrated moderately high innovation across all dimensions, especially in continuous learning and development (mean = 4.65) and advanced technology use (mean = 4.56). Nurses exhibited sound proactivity levels, particularly in adaptability (mean = 4.40) and planning (mean = 4.35). The majority of nurses showed an internal locus of control (64.5%). Managerial innovation had significant positive correlations with nurses' proactivity (r = 0.45, p < 0.001) and internal locus of control (r = 0.42, p < 0.001). Regression analysis revealed age, gender, experience, education, and ICU type as significant predictors of proactivity and locus of control.

CONCLUSION

Innovative nursing leadership positively influences staff's proactivity levels and perceived control over their practice. This underscores the vital role of nurse managers in creating empowering environments in intensive care.

Determinants of work stress among emergency department nurses in Sleman, Yogyakarta, Indonesia

BACKGROUND

The nursing field is the fourth most stressful occupation in the health sector. Emergency department nurses often face crises and unpredictable situations that can negatively affect their quality of life and the quality of care. This study aimed to investigate the determinants of work stress among ED nurses in Sleman, Yogyakarta, Indonesia.

METHODS

A descriptive cross-sectional study was conducted. Participants (n = 122) were emergency nurses recruited through convenience sampling from four EDs in Sleman District, Yogyakarta, Indonesia. Data were gathered using an online self-administered survey consisting of the workload, self-efficacy, and work stress questionnaires. Hierarchical linear regression analysis with the entry method was used to examine the main determinants of work stress.

RESULTS

The average work stress (38.29 ± 8), workload (30.83 ± 9.21), and self-efficacy (32.47 ± 3.61) scores were at a moderate level. Hierarchical linear regression showed that workplace, being a head nurse, and workload were the main determinants that contributed to 25.4 % of work stress among ED nurses.

CONCLUSIONS

The study results confirm that having a high workload, working in a private hospital, and being a head nurse are the main determinants of work stress among ED nurses in Sleman, Indonesia.

Mitochondrial Health, Physical Functioning, and Daily Affect: Bioenergetic Mechanisms of Dementia Caregiver Well-Being

OBJECTIVE

Chronic stress adversely affects mental and physical well-being. However, health outcomes vary among people experiencing the same stressor. Individual differences in physical and emotional well-being may depend on mitochondrial biology, as energy production is crucial for stress regulation. This study investigated whether mitochondrial respiratory capacity corresponds to individual differences in dementia spousal caregivers' mental and physical health.

METHODS

Spousal caregivers of individuals with Alzheimer's disease and related dementias ( N = 102, mean age = 71, 78% female, 83% White) provided peripheral blood samples and completed self-report questionnaires on quality of life, caregiver burden, and a 7-day affect scale. Multiple and mixed linear regressions were used to test the relationship between mitochondrial biology and well-being.

RESULTS

Spare respiratory capacity ( b = 12.76, confidence interval [CI] = 5.23-20.28, p = .001), maximum respiratory capacity ( b = 8.45, CI = 4.54-12.35, p < .0001), and ATP-linked respiration ( b = 10.11, CI = 5.05-15.18, p = .0001) were positively associated with physical functioning. At average ( b = -2.23, CI = -3.64 to -0.82, p = .002) and below average ( b = -4.96, CI = -7.22 to 2.70, p < .0001) levels of spare respiratory capacity, caregiver burden was negatively associated with daily positive affect. At above average levels of spare respiratory capacity, caregiver burden was not associated with positive affect ( p = .65).

CONCLUSIONS

Findings suggest that higher mitochondrial respiratory capacity is associated with better psychological and physical health-a pattern consistent with related research. These findings provide some of the earliest evidence that cellular bioenergetics are related to well-being.

Impact of Sociodemographic Characteristics on the Quality of Life of Frontline Nursing Staff During COVID-19 in Saudi Arabia

Background The COVID-19 pandemic imposed unprecedented challenges on healthcare systems worldwide. The pandemic placed frontline nursing staff working in the ICU and ER at the epicenter of this global crisis. This study aimed to assess the multifaceted impact of sociodemographic characteristics on the quality of life (QOL) of nursing staff during the pandemic. Method A cross-sectional survey was conducted to evaluate the impact of sociodemographic characteristics on the QOL of 322 frontline nurses working in the ICU and ER of five Saudi hospitals from May to July 2022. Participants completed the electronic survey questionnaire including demographic characteristics and four domains of QOL from the World Health Organization Quality of Life Questionnaire (WHOQOL-BREFF). The data was evaluated using descriptive and inferential statistics. Results Among 322 nurse participants, the majority were female (84.8%), married (64.4%), and held a bachelor's degree (92.4%). Age (above 40 years), gender (male), and marital status (married) reported a higher individual domain and overall QOL scores which shows that these characteristics have a direct influence on QOL. Years of work experience, extra working hours, and direct contact with COVID-19 patients were additional significant factors. Pearson correlation coefficients among QOL domains ranged from 0.54 to 0.91, indicating a strong interrelation among these domains. The highest transformed score was in the social domain (70.10) while the lowest score was in the psychological domain (59.20). The overall QOL mean score (SD) was 3.49(0.14) and the mean score (SD) of general health was 3.46(0.15). Conclusion The findings of this study suggest that sociodemographic and work-related factors have a complex and multifaceted impact on the QOL of nurses during the COVID-19 pandemic in Saudi Arabia. It also presents an insight into developing specific interventions to enhance nurses' resilience and well-being amidst pandemic challenges and to improve their QOL.

Modifiable work stress factors and psychological health risk among nurses working within 13 countries

INTRODUCTION

Nurses are identified as having higher work stress and poor mental health risk among health care workforce globally. It remains unclear which modifiable stress factors pose the greatest risk for poor psychological health among nursing workforce and needed to inform targeted practice and policy change. To determine which occupation-related or personal stress factors precipitate higher risk for burnout, depression, anxiety, job satisfaction or intention to leave one's position among nurses globally.

DESIGN

A cross-sectional anonymous survey was administered via email using a snowball recruitment strategy.

METHODS

Academic researchers and clinical industry leaders across 3 global regions collaborated to generate an email listserv of professional nursing contacts for survey distribution. The survey included valid and reliable measures to scale stress factors (Work Stress Questionnaire), and screen for burnout (single item), depression (Patient Health Questionnaire-2), anxiety (Generalized Anxiety Disorder-2), resilience (Brief Resilience Scale) and intention to leave one's job (single item). We used logistic regression, first unadjusted and then adjusted for personal and professional characteristics, to determine associations between stress factors and psychological health risk.

RESULTS

The final sample consisted of responses from 2864 nurses working across 13 countries. Most respondents reported working as a clinical nurse in the Philippines (n = 2275), United States (n = 424) and Saudi Arabia (n = 104). One third of nursing respondents endorsed high burnout and intention to leave their job. Those reporting work conflict had significantly higher odds of burnout (odds ratio 3.18; 95% CI 2.22-4.54) and three times more likely to screen positive for depression (odds ratio 3.02; 95% CI 1.36-6.72) and anxiety (odds ratio 2.92; 95% CI 1.57-5.43). Those endorsing difficulty sleeping were 15 times more likely to screen positive for depression (odds ratio 15.63; 95% CI 2.09-117.06). Lack of social support was significantly associated to higher risk for burnout, job dissatisfaction, depression, anxiety, and intention to leave one's position.

CONCLUSIONS

Nurses remain at risk for burnout and poor psychological health stemming from work stress. Factors such as clear workplace goals and assignments, increased engagement, good sleep health and social support may serve as protective factors against suboptimal psychological health, and in-turn poor workforce retention.

CLINICAL RELEVANCE

Nurses reporting conflict in the workplace are three times more likely to screen positive for burnout, depression, and anxiety. Nurses reporting difficulty sleeping are 15 times more likely to screen positive for depression. Several modifiable factors can be targeted to reduce poor psychological health and high workforce turnover among nurses across countries.

Exploring the concept and management strategies of caring stress among clinical nurses: a scoping review

Objective

The concept of caring stress and its specific management has received less attention than other dimensions of stress in nurses. Therefore, to clarify the concept of caring stress, a scoping review study was designed. This scoping review aimed to investigate the concept of caring stress among clinical nurses and examine the strategies used for its management.

Methods

This review employed a scoping review methodology to comprehensively map the essential concepts and attributes of the phenomenon by drawing on a wide range of sources. International databases including PubMed, Scopus, Web of Science, Google Scholar, and Scientific Information Database (SID) were searched to gather relevant studies published until October 1, 2023. MESH terms included "caring stress", "care", "stress", "nurse", and "stress management" were used. Two reviewers independently collected data from full-text papers, ensuring that each paper underwent assessment by at least two reviewers.

Results

Out of 104,094 articles initially searched, 22 articles were included in this study. High workloads, transmitting the infection, stressful thoughts, stressful emotions, and stressful communications were the significant concepts and factors of caring stress among nurses. Also, rest breaks during patient care shifts, playing music in the ward, and denial of critical situations were examples of positive and negative coping and management ways to reduce caring stress.

Conclusion

Effective stress management strategies can lead to better patient care and safety. Stressed nurses are more likely to make errors or become less vigilant in their duties, impacting patient outcomes. By addressing caring stress, clinical practice can prioritize patient well-being. Further research is required to delve deeper into this critical issue concerning nurses in the future.

The influence of anxiety and depression on critical care nurses' performance: A multicenter correlational study

BACKGROUND

Anxiety and depression among critical care nurses (CCNs) negatively affect performance because of association with clinical medical errors, ineffective communication, absenteeism from work, and burnout.

OBJECTIVES

The aim of this study was to investigate the prevalence of anxiety and depression and their associated factors as well as their impact on the CCNs' performance in Hail city, Saudi Arabia.

METHODS

A cross-sectional correlational study was conducted among 262 CCNs from April to June 2023.

RESULTS

The mean scores of anxiety and depression were significantly higher among male and Saudi CCNs than among their counterparts (p < 0.05). CCNs caring for patients in a ratio of 1:5 or more had significantly higher anxiety scores than those with lower nurse-to-patient ratios (p = 0.004). CCNs who were working night shifts had significantly higher mean scores of anxiety (p = 0.005) and lower mean scores of performance (p = 0.041) than their counterparts. Borderline anxiety and depression were prevalent among 43.1% and 38.5% of CCNs, respectively. In contrast, abnormal anxiety and depression were prevalent among 8.8% and 5.7% of CCNs, respectively. CCNs' mental, general, and total performance showed a significant negative correlation with both anxiety ([r = -0.247, p <0.001], [r = -0.183, p = 0.003], and [r = -0.172, p = 0.005], respectively) and depression (r = -0.287, p <0.001), (r = -0.207, p <0.001), and (r = -0.180, p = 0.003), respectively.

CONCLUSIONS

Anxiety and depression levels are significantly higher among male, Saudi CCNs, higher nurse-to-patient ratios, those who work night shifts than among their counterparts. Less than half of CCNs experience borderline anxiety and/or depression that had significantly negative correlation with their performance. Anxiety and depression in shift nurses may be treated by reducing workload, causes of stress during night shifts, and giving practical coping mechanisms for typical nurse job pressures.

Exposure to secondary traumatic stress and its related factors among emergency nurses in Saudi Arabia: a mixed method study

BACKGROUND

Emergency department (ED) nurses are exposed to the risk of secondary traumatic stress (STS), which poses a threat not only to nurses' health and psychological well-being but also adversely affects the execution of their professional duties. The quality and outcome of their nursing services are negatively affected by STS.

PURPOSE

The purpose of this study is to comprehensively investigate the prevalence and intensity of Secondary Traumatic Stress (STS) among Emergency Department (ED) nurses. It aims to identify and analyze the socio-demographic, occupational, and psychological factors that influence the severity and variation of STS experienced by these nurses.

METHODS

The study utilized a sequential explanatory mixed methods approach, including two phases. Phase 1 employed a cross-sectional study design, utilizing a convenience sample of 181 nurses to explore the levels of STS and the factors associated with it. Following this, Phase 2 was structured as a qualitative descriptive study, which involved conducting semi-structured interviews with a purposefully selected group of ten ED nurses. Data collection took place at three major hospitals in Saudi Arabia during the period from January to June 2022.

RESULTS

A total of 181 participants were included in the study. The mean STSS score reported by the nurses was 51 (SD = 13.23) out of the maximum possible score of 85, indicating severe STS among ED nurses. Factors associated with an increase in the levels of STS among ED nurses included being female, older in age, married, possessing higher education and experience, having a positive relationship with colleagues, receiving organisational support, and dealing with a higher number of trauma cases. Several themes emerged from the qualitative interviews including: ED Characteristics: Dual Impact on STS, Emotional Resonance and Vulnerability, Personal Life Stressors, The Ability to Cope, and Social Support.

CONCLUSION AND IMPLICATIONS FOR PRACTICE

Future strategies and interventions targeting STS should be prioritized to effectively manage its impact on ED nurses. It is crucial to develop targeted interventions that address the specific factors contributing to STS, as identified in this study. Additionally, these findings aim to enhance awareness among nursing administrators, managers, and supervisors about the critical factors associated with STS. This awareness is essential for accurately assessing and developing interventions that mitigate STS among nursing staff.

Digital Interventions to Understand and Mitigate Stress Response: Protocol for Process and Content Evaluation of a Cohort Study

BACKGROUND

Staffing and resource shortages, especially during the COVID-19 pandemic, have increased stress levels among health care workers. Many health care workers have reported feeling unable to maintain the quality of care expected within their profession, which, at times, may lead to moral distress and moral injury. Currently, interventions for moral distress and moral injury are limited.

OBJECTIVE

This study has the following aims: (1) to characterize and reduce stress and moral distress related to decision-making in morally complex situations using a virtual reality (VR) scenario and a didactic intervention; (2) to identify features contributing to mental health outcomes using wearable, physiological, and self-reported questionnaire data; and (3) to create a personal digital phenotype profile that characterizes stress and moral distress at the individual level.

METHODS

This will be a single cohort, pre- and posttest study of 100 nursing professionals in Ontario, Canada. Participants will undergo a VR simulation that requires them to make morally complex decisions related to patient care, which will be administered before and after an educational video on techniques to mitigate distress. During the VR session, participants will complete questionnaires measuring their distress and moral distress, and physiological data (electrocardiogram, electrodermal activity, plethysmography, and respiration) will be collected to assess their stress response. In a subsequent 12-week follow-up period, participants will complete regular assessments measuring clinical outcomes, including distress, moral distress, anxiety, depression, and loneliness. A wearable device will also be used to collect continuous data for 2 weeks before, throughout, and for 12 weeks after the VR session. A pre-post comparison will be conducted to analyze the effects of the VR intervention, and machine learning will be used to create a personal digital phenotype profile for each participant using the physiological, wearable, and self-reported data. Finally, thematic analysis of post-VR debriefing sessions and exit interviews will examine reoccurring codes and overarching themes expressed across participants' experiences.

RESULTS

The study was funded in 2022 and received research ethics board approval in April 2023. The study is ongoing.

CONCLUSIONS

It is expected that the VR scenario will elicit stress and moral distress. Additionally, the didactic intervention is anticipated to improve understanding of and decrease feelings of stress and moral distress. Models of digital phenotypes developed and integrated with wearables could allow for the prediction of risk and the assessment of treatment responses in individuals experiencing moral distress in real-time and naturalistic contexts. This paradigm could also be used in other populations prone to moral distress and injury, such as military and public safety personnel.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05923398; https://clinicaltrials.gov/study/NCT05923398.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/54180.

The relationship between satisfaction with life, dietary attitude, and comfort level in hemodialysis patients: Analysis with machine learning approach

INTRODUCTION

Hemodialysis (HD) patients have become a serious public health problem, the number of which is increasing every year worldwide. This study aimed to determine the relationship between satisfaction with life, dietary attitude, and comfort level in patients receiving HD treatment.

METHODS

This research was conducted in a relational cross-sectional descriptive design. The research was conducted with 174 patients (85% of the population) receiving HD treatment between March 20 and September 30, 2023. In the study, hierarchical regression analysis was performed with SPSS 25.0. Machine learning analysis and prediction were performed using R programming language, version 4.1.3.

RESULTS

The model used to determine the factors affecting satisfaction with life was significant and usable (F(2,171) = 25.855, p = 0.001). Attitudes of HD patients toward dietary therapy and their HD comfort levels together explained 22.3% of the total variance of satisfaction with life. In the regression model, according to the results of the t-test regarding the significance of the regression coefficient, the increase in the HD comfort levels of the participants (t = 2.668, p = 0.008) and the increase in the attitude of the HD patients toward dietary therapy (t = 5.897, p = 0.001) caused a statistical increase in "satisfaction with life." According to Shapley values, the most important variable in the prediction of satisfaction with life variable is attitude for the dietary attitude.

CONCLUSION

It was determined that the increase in the comfort levels of HD patients and their positive dietary attitudes increased satisfaction with life. It is recommended to provide education to increase patients' diet attitudes and comfort levels.

Nurses quality of life, sleep disturbance, and intention to leave critical care units: A cross-sectional moderated mediation analysis

OBJECTIVES

This study aims to explore the complex relationships between personal and demographic factors, intermediary factors such as quality of life (depression, anxiety, stress, burnout), and the mediating impact of sleep disturbance on nurses' intention to leave critical care units.

DESIGN

Cross-sectional quantitative survey.

SETTING

Data were collected from registered nurses at a major university hospital in southern Italy. Seven inpatient critical care units were sampled.

MAIN OUTCOME MEASURES

Intention to leave critical care units.

RESULTS

We included 160 participants recruited over five weeks in May and June 2023. The data showed that most were female, married, and possessed a bachelor's degree in nursing. The mean quality of life score was moderate, while stress, anxiety, and burnout were mild. A significant percentage of nurses reported poor sleep quality. Logistic regression indicates that service length did not significantly impact the intention to leave. The structural equation model showed that stress positively correlated with emotional exhaustion, whereas job quality was negatively associated with emotional exhaustion and the intention to leave. Sleep disturbance did not explain the relationship between stress and emotional fatigue; however, the results revealed that male gender moderated sleep mediation.

CONCLUSIONS

This study investigated factors influencing intention to leave among critical care unit nurses. The results suggest that the role of sleep disturbance should always be considered when assessing the issue. In this chain of causes, sleep disturbance explains the relationship between stress and emotional exhaustion. Furthermore, the strength of this mediation was influenced by gender, particularly by the male gender.

IMPLICATIONS FOR CLINICAL PRACTICE

Stress and emotional exhaustion significantly impact nurses' working quality of life, particularly when sleep quality is taken into account. This leads to a higher intention to leave critical care units. To reduce this tendency, healthcare managers could implement specific evidence-based interventions to promote a good climate of work, which would positively affect stress, emotional exhaustion and sleep disturbance. The likelihood of intention to leave decreased with achieving personal self-fulfilment among nurses.

Investigating the role of organizational stress in nurses' psychosomatic complaints: Evidence from a study in northeastern Italy

Background

Nursing is pivotal to healthcare delivery but is often associated with high levels of organizational stress. In this cross-sectional study, we aimed to investigate the associations between exposure to organizational stressors, measured using the Health and Safety Executive Management Standards Indicator Tool, and psychosomatic complaints among nurses in a medium-sized city hospital in northeastern Italy.

Methods

A total of 215 nurses participated in the study, completing self-report questionnaires assessing organizational stressors and the prevalence of psychosomatic complaints experienced over the preceding six months.

Results

Significant associations were observed between various organizational stressors and psychosomatic complaints among nurses. Specifically, the Relationships factor emerged as a significant predictor of palpitations, irritability, anxiety, physical and mental tiredness, and headache. Additionally, Demands and Managers' support were identified as significant predictors of specific psychosomatic complaints.

Conclusion

This study highlights the critical role of addressing organizational stressors, particularly those related to interpersonal relationships, in promoting nurse well-being and optimizing patient care delivery. Despite its strengths, including the use of a well-established measurement tool and a comprehensive assessment of psychosomatic complaints, limitations such as the cross-sectional design and self-report measures warrant consideration. By prioritizing supportive work environments and implementing targeted interventions, healthcare organizations can cultivate a culture of well-being among nurses, ultimately enhancing the quality and safety of healthcare delivery.

Job Demands and Mental Health Deterioration: Investigating the Mediating Role of Resiliency

Introduction

In the past decade, China has witnessed a significant surge in the popularity of food delivery apps, with its industry now thrice the size of the U.S, employing approximately 7 million drivers navigating urban landscapes on electric bikes and scooters. Predominantly, the market is governed by two main players: Meituan Dianping (backed by Tencent) and Ele.me (supported by Alibaba). Notably, stress and absenteeism stand out as significant challenges in this service sector, with implications for occupational health that translate into considerable costs for both healthcare systems and companies. Existing research has largely overlooked how job demands affect the mental health of food delivery workers in China, and how resilience plays a role in this process. The present study addresses this gap by examining the direct impact of Workload Volume and Pace on the mental health of these workers, and by exploring how personal resilience can mediate this relationship. Furthermore, it delves into the mediating role of Resilience, a personal strength, in this relationship.

Methods

Using a correlational design with 206 participants, multiple regression analysis suggested a notable variance in Mental Health Decline.

Results

Subsequent bootstrapping-mediated analysis confirmed resilience's mediating role, highlighting its importance in managing stress from workload.

Discussion

The results underscore the critical role of personal strengths in managing work-related stress, which can significantly impact both job performance and mental well-being.

Influence of Personal and Work Environments on Work-Life Balance Among Emergency Medical Technicians

Introduction Work-life balance (WLB) is a critical concern for emergency medical technicians (EMTs) because it significantly affects the provision of comprehensive emergency medical services (EMS). This study investigated personal and work-related factors influencing work-to-family negative spillover (WFNS), a key element of WLB, among EMTs. Methods A web-based survey was conducted from July 26 to September 13, 2021, among EMTs in Hokkaido, Japan. The study included 21 facilities that were randomly selected from 42 fire stations. The Japanese version of the Survey Work-Home Interaction-NijmeGen (SWING-J) was used to measure WFNS. Personal background factors, such as age, sex, years of work experience, and education, were surveyed. We also evaluated work environment factors, such as weekly working hours, monthly night shifts, monthly overtime hours, and yearly paid vacation days. Unpaired Student's t-tests, one-way analysis of variance (ANOVA), and multilevel generalized linear model (MGLM) analyses were used to explore the relationships between WFNS and personal and work-related factors. Results A total of 912 respondents were included in our analysis. They were predominantly male (98.2%), with an average EMT work experience of 12.7 years and a mean WFNS score of 1.16 (standard deviation (SD) = 1.67). MGLM analysis, adjusting for covariates, identified years of work experience (β = -0.129, p = 0.001), monthly overtime hours (β = 0.184, p < 0.001), and yearly paid vacation days (β = -0.170, p < 0.001) as independent factors associated with WFNS. Conclusion This study suggested that adjusting WFNS among EMTs could be achieved by reducing overtime hours and fostering an organized approach to paid leave within the work environment.

Perceived Quality of Life in Intensive Care Medicine Physicians: A French National Survey

Purpose: There is a growing interest in the quality of work life (QWL) of healthcare professionals and staff well-being. We decided to measure the perceived QWL of ICU physicians and the factors that could influence their perception. Methods: We performed a survey coordinated and executed by the French Trade Union of Intensive Care Physicians (SMR). QWL was assessed using the French version of the Work-Related Quality of Life (WRQoL) scale, perceived stress using the French version of 10 item-Perceived Stress Scale (PSS-10) and group functioning using the French version of the Reflexivity Scale, the Social Support at Work Questionnaire (QSSP-P). Results: 308 French-speaking ICU physicians participated. 40% perceived low WRQoL, mainly due to low general well-being, low satisfaction with working conditions and low possibility of managing the articulation between their private and professional lives. Decreased QWL was associated with being a woman (p = .002), having children (p = .022) and enduring many monthly shifts (p = .022). Conclusions: This work highlights the fact that ICU physicians feel a significant imbalance between the demands of their profession and the resources at their disposal. Communication and exchanges within a team and quality of social support appear to be positive elements to maintain and/or develop within our structures.

Psychometric validation of the nursing care behavior questionnaire during emerging disease epidemics: A theory of planned behavior approach

Background and objective

The Covid-19 pandemic could compromise the quality of care by impacting nurses' intention to provide care. Hence, investigating nurses' behavioral intentions when caring for patients during epidemics is essential. This research aims to assess the psychometrics of the "Nursing Care Behavior in Epidemics of Emerging Diseases" questionnaire, based on the constructs of the Theory of Planned Behavior.

Methods

This cross-sectional study involved 311 nurses working in Covid-19 wards of selected hospitals in Ilam City, all of whom were enrolled through a census in 2021. The questionnaire underwent initial translation from English to Persian, followed by evaluations of its face, content, and construct validities. The nursing caring behavior questionnaire, comprising 46 items, was designed to assess behavioral beliefs, normative beliefs, control beliefs, behavioral attitudes, subjective norms, perceived behavioral control, and nurses' intentions to care for Covid-19 patients. Data were analyzed for face, content, and construct validity using the Theory of Planned Behavior and Pearson correlation. Reliability was determined by calculating the Cronbach's alpha coefficient.

Results

The intention to care dimension demonstrated an inverse correlation with the behavioral attitude dimension (p < 0.001). The most robust correlations were observed between the following paired dimensions: behavioral attitude and perceived power (p < 0.001), subjective norms and intention to care (p < 0.001), perceived behavioral control and subjective norms (p < 0.001), care intention and behavioral beliefs (p < 0.001), behavioral beliefs and behavioral outcome evaluation (p < 0.001), and normative beliefs with motivation to comply (p = 0.001). The Cronbach's alpha coefficient of the instrument exceeded 0.75.

Conclusion

According to the Theory of Planned Behavior, the nursing care behavior questionnaire proved to be a valid and reliable tool for evaluating nurses' care behaviors amidst emerging disease epidemics.

The effect of the intensive care unit nurse manpower on care behaviours and stress level on the nurses

BACKGROUND

Nurses working in the intensive care units (ICU) regarding the work-index-nursing work environment, the effect level ICU environment has on the nurses' care behaviors and stress levels of the nurses should be determined.

OBJECTIVE

The study aimed to investigate the effect of the nurse manpower on care behaviours and stress level of the nurses working in the ICU.

METHODS

This was a cross-sectional and correlational study. The sample of the study consisted of 123 nurses working in the ICUs. The data were collected using the survey form, Distress Thermometer (DT), The Practice Work Environment Scale of the Nursing Work Index (PES-NWI), and Caring Behaviors Scale-24 (CBS-24).

RESULTS

The mean age of nurses in the ICU was 30.2±5.6 and the mean of working time in the intensive care unit of nurses in the ICU was 3.7±3.1 years. The mean of the DT was 4.8±3.4, and the mean score of PES-NWI was 2.6±1.0 and the mean score of CBS-24 was 4.7±1.1 in nurses in the ICU. The regression model which was studied to investigate the relationship between caring behaviors and stress and nurse manpower of nurses working in intensive care unit was significant.

CONCLUSION

Care behaviors and stress levels of nurses working in intensive care units are negatively affected by insufficient nurse manpower.

Depression, professional self-efficacy, and job performance as predictors of life satisfaction: the mediating role of work engagement in nurses

Background

The life satisfaction and job performance of nursing professionals are affected by a multitude of factors, including work engagement, self-efficacy, and depression. The Job Demands-Resources (JD-R) model provides a theoretical framework to explore these relationships.

Objective

Our study aimed to analyze the primary goal of this research, which is to examine the mediating role of work engagement in the relationship between depression, professional self-efficacy, job performance, and their impact on life satisfaction in nurses, using the JD-R theory as a guide.

Methods

This cross-sectional study involved 579 participants aged between 21 to 57 years (M = 39, SD = 9.95). Mediation analysis was used to examine the influence of depression, self-efficacy, and job performance on work engagement, and in turn, its effect on life satisfaction.

Results

Findings indicated that work engagement plays a crucial mediating role between depression, self-efficacy, job performance, and life satisfaction. Interventions to increase work engagement could assist nurses in better managing depression and improving their performance and life satisfaction.

Conclusions

Our study highlights the need for workplace policies and strategies that foster work engagement and self-efficacy among nurses while effectively managing job demands to prevent depression. Moreover, these findings underscore the importance of the JD-R theory to understand and improve nurses' job satisfaction and performance, and suggest areas for future research, including exploring other potential factors and applying these findings across different contexts and cultures.

Emergency room nurses' caring ability and its relationship with patient safety outcomes: A cross-sectional study

INTRODUCTION

Nurse caring ability plays a crucial role in providing quality care and ensuring patient safety. However, further research is warranted to understand the specific impact of caring ability on patient safety in the emergency department.

AIM

This study has two-fold purposes: (a) to examine the association between nurses' demographic characteristics and their perceptions of their caring ability, and (b) to explore the relationship between nurses' caring ability and nursing care quality, as well as its impact on adverse patient events and missed care.

METHODS

This cross-sectional study included a convenience sample of emergency room nurses working in select hospitals in the Philippines. Descriptive statistics and regression analyses were performed to analyze the data.

RESULTS

A total of 164 out of the 200 emergency nurses invited responded to the survey. The mean score for the caring ability inventory was 67.89 out of 80. Nurses' demographic characteristics, including job status (working part-time) and hospital size (working in small and medium-sized hospitals), were associated with higher levels of caring ability. Higher levels of nurses' caring ability were associated with better nursing care quality (β = 0.259, p <.001), a reduction in adverse events (β = -0.169, p <.05), and a decrease in instances of missed care (β = -0.158, p <.01).

CONCLUSION

This study emphasizes the significance of nurses' characteristics in influencing nurse caring abilities. Additionally, the results underscore the importance of nurse caring ability in the emergency department and its association with nursing care quality and patient safety outcomes. Organizational strategies directed toward promoting and enhancing nurse caring ability in the emergency department can have positive implications for nursing practice, including improved nursing care quality, reduced adverse events, and decreased instances of missed care.

Influence of work-related stress on patient safety culture among nurses in a tertiary hospital: a cross-sectional study

BACKGROUND

One of the global issues facing the nursing profession is work-related stress because it interferes with care quality and organisational competency. These kinds of stressful situations can cause damage to the mental ability of the affected individual resulting in low job productivity. In a Nigerian healthcare setting, patient safety is under-researched.

AIM

This study aimed to assess the influence of work-related stress on patient safety culture among nurses in a tertiary hospital.

MATERIALS AND METHODS

The study adopted a descriptive cross-sectional survey. The Population of the study was nurses who are currently serving as employees at Federal Medical Center Birnin-Kebbi. Proportional and systematic sampling methods were used in the selection of the sample of the study. The tools used for this study were adapted Hospital Survey on Patient Safety (HSOPS) and Nurses' Occupational Stressor Scale. Ethical approval was obtained from the research ethical committee of the hospital.

RESULTS

The moderate stress experience was having the highest percentage (45.0%). The highest percentage of the nurses (69.9%) practised a moderate safety culture. There were weak or very weak significant negative correlations (P < 0.01) between patient safety culture practices and occupational stress across all the subscales of the nurses' occupational stressors scale except in the occupational hazards subscale in which there was extremely weak and non-significant negative correlation. Work-family conflict was a significant predictor of patient safety culture, t (208) = -2.341, P < 0.05. Difficulty in taking leave was a significant predictor of patient safety culture, t (208) = -2.190, P < 0.05.

CONCLUSION

There was a significant negative correlation between stress and safety practice which implies that as stress increased safety practice decreased. These study findings can be used to develop ongoing strategies and targeted interventions in addressing work-related stress.

Decent work, work engagement, and turnover intention among registered nurses: a cross-sectional study

BACKGROUND

Nurses face substantial career challenges arising from global pandemics, economic crises, and their roles in conflict-ridden areas. In this context, the rights of nurses pertaining to decent work, such as freedom, fairness, safety, and dignity, are not adequately safeguarded. This study examines decent work status among Chinese nurses and its links to demographics, work engagement, and turnover intention.

METHODS

A cross-sectional study design was used following STROBE guidelines. Through a convenient sampling method, a total of 476 nurses were surveyed. These participants were drawn from three esteemed tertiary Grade A hospitals in Hangzhou, with data collection spanning from June to August in 2023. We used a comprehensive set of assessment instruments, encompassing an evaluation of demographic characteristics, the Decent Work Perceptions Scale (DWPS), the Utrecht Work Engagement Scale (UEWS), and turnover intention questionnaire. Bootstrapping procedures were used to ensure the robustness and reliability of the model.

RESULTS

The study revealed that nurses' perceptions of decent work significantly impacted work engagement (β = 0.603, p < 0.001) and turnover intention (β = -0.275, p < 0.001). Work engagement operated as a mediator between decent work and turnover intention, decreasing the likelihood of nurses leaving their positions (β = -0.062, p < 0.001). Factors such as age, years of working experience, professional title, job category, and attendance at professional conferences significantly influenced nurses' perceptions of decent work (all p < 0.05).

CONCLUSIONS

This study examines factors affecting decent work among nurses and explores its connection with work engagement and the intention to leave. Despite limitations (sample, social desirability bias), the study offers valuable insights for nursing practice. This suggests managers improve decent work for young nurses through rational shift schedules and continuous education. Policymakers should consider adjusting nursing policies for better employment conditions.

The Mediating Role of Anxiety in the Relationship between Job Satisfaction and Psychosocial Functions of Nurses and Pediatricians in PICUs

Background

Job satisfaction refers to an individual's overall attitude towards their job. It is influenced by various factors such as work environment, job role, work-life balance, compensation, anxiety, opportunities for growth and development. However, low levels of job satisfaction can have a significant impact on an individual's mental health and overall well-being.

Objective

We contacted this study in order to assess the effect of PICU nurses' and pediatricians' job satisfaction on their psychosocial functioning and to examine the role of anxiety as a mediating factor in this relationship.

Methods

A sample of 155 nurses and pediatricians at 7 University Hospitals in Greece has consented to participate in the study. Socio-demographic data, Hamilton Rating Scale for Anxiety, Minnesota Satisfaction Questionnaire -short form and a Brief Inventory of Psychosocial Functioning were used to evaluate anxiety, job satisfaction and psychosocial functions.

Results

According to our results, participants with moderate or severe levels of anxiety showed moderate or low job satisfaction, while moderate or severe anxiety was also associated with low levels of participants' psychosocial functioning. Job satisfaction is a dynamic situation that is affected by the levels of anxiety of each worker in PICU.

Conclusion

The presence of anxiety may be related to comorbid mental health disorders since it affects the psychosocial functions of the worker. We propose a longer rest period, a change of department in case an employee wishes it or shows symptoms of increased stress or another mental health disorder, regular assessments by mental health experts for all PICU's staff and support after a diagnosis of a mental health problem.

Effect of Occupational Stress on Work Behavior as Perceived by Nurses at Benue State University Teaching Hospital Makurdi

Background

Every work environment, especially in hospital settings must be conducive, friendly, and stress-free in order to promote quality care and the well-being of healthcare workers, whose job demands are increasing by the day.

Aims

The purpose of this study was to determine the perceived effect of occupational stress on work behavior among nurses at Benue State University Teaching Hospital in Makurdi.

Methods

From the facility's population of nurses, a quantitative survey randomly chose 150 respondents nurses, for the purpose of gathering information and testing the hypothesis, a well- developed and validated questionnaire was employed to gather data. Using SPSS, the data were descriptively analyzed, and an inferential analysis with a significance level of 5% was performed using Pearson's Chi-square test (0.05).

Results

The majority of participants (56.6%) were men with a higher level of education. This study also shows the effect of occupational stress on work behavior as poor work performance 142 (94.7%), counterproductive work behavior 139 (92.7%), increases the incidence of absenteeism 112 (74.7%), high occurrence of medication error 120 (80%), Negative effect on teamwork 98 (65.3%), increases the incidence of Substance use disorders 95 (63.3), and aggressive attitude toward patients during nursing care 137 (91.3). Furthermore, there is a significant association between occupational stress and job satisfaction (x2 = 25.49, df = 8, and p < 0.001), patient safety (x2 = 51.07, df = 8, and P = 0.002), and nurses' attitudes toward their patients (x2 = 86.67, df = 12, and P = 0.012).

Conclusion

We discovered that workplace stress can affect how happy nurses are with their jobs and how they behave while providing nursing care. We recommend that hospital administrators implement a plan to create a stress-free working environment for nurses.

The Association between Nursing Students' Happiness, Emotional Intelligence, and Perceived Caring Behavior in Riyadh City, Saudi Arabia

BACKGROUND

Caring behavior is a major focus of the nursing profession and an important dimension of nursing practice that sets nurses apart from other healthcare professionals. Effective patient-centered care requires ensuring nurses have the emotional intelligence and happiness to address the daily demands of practice. The purpose of this study is to examine the emotional intelligence and happiness among nursing students and their relationship with caring behaviors.

METHODS

A cross-sectional, descriptive correlational study was conducted on nursing students (n = 363) from Riyadh, Kingdom of Saudi Arabia, via an online survey. Measures include demographic data survey, Oxford Happiness Questionnaire, Trait Emotional Intelligence Questionnaire, and Caring Behaviors Inventory scale. Descriptive and multiple regression analyses were conducted for this study.

RESULTS

Nursing students reported their highest degree of caring was in terms of 'respectful differences to others', while their lowest was in 'knowledge and skills'. Emotional intelligence and happiness were significant predictors of caring behaviors and explained the variance in assurance of human presence (17.5%), knowledge and skills (17.5%), respectful differences to others (18%), and positive connectedness (12.9%). In the final regression model, emotional intelligence and happiness were significant predictors of caring behaviors and explained 19.5% of the variance.

CONCLUSIONS

Emotional intelligence and happiness among nursing students were found to be important factors to improve their caregiving behaviors. Therefore, nursing educators should consider integrating emotional intelligence and happiness interventions for students into their curriculum.

Work-related stress among nurses in the COVID-19 pandemic: What are the contributing factors?

OBJECTIVE

To analyze the contributing factors of work-related stress among nurses in the COVID-19 pandemic.

METHODS

A cross-sectional study was conducted with 101 nurse practitioners from two hospitals in West Java, Indonesia. We distributed an online questionnaire to evaluate work-related stress and the data were analyzed using ordinal logistic regression.

RESULTS

More than half of the nurses experienced moderate work-related stress. The study revealed that nurses aged over 35 years old had a lower likelihood of experiencing work-related stress (AOR: 0.173; 95%CI: 0.038-0.782). Married nurses had a higher likelihood (AOR: 7.156; 95% CI: 1.456-35.163). Additionally, nurses with low and moderate workloads had a lower likelihood (AOR: 0.003; 95%CI: 0.000-0.051) and (AOR: 0.025; 95%CI: 0.005-0.116), respectively.

CONCLUSION

The consideration of age, marital status, and workload is essential in effectively addressing work-related stress among nurse practitioners.

Quality of life of critical care nurses and impact on anxiety, depression, stress, burnout and sleep quality: A cross-sectional study

OBJECTIVES

To investigate how anxiety, depression, stress, burnout, and sleep quality impact on Quality of life of critical care nurses.

BACKGROUND

Several studies reported that critical care nurses are exposed to a high risk of anxiety, depression, burnout, stress, and sleep quality, but we do not know the impact of critical care nurses.

DESIGN

A cross-sectional study.

METHODS

We have included all critical care nurses working in the intensive care unit for at least six months. Data were collected from December 1, 2021, to March 18, 2022. We evaluated the critical care nurses using the Depression Anxiety Stress Scale (DASS), Maslach Burnout Inventory scale, Pittsburgh Sleep Quality Index and Nurse Quality of Life. The primary endpoint is Quality of Life. Associations were tested using multivariate modelling.

RESULTS

A total of 140 critical care nurses were included. Multivariate regression showed the relation between emotional QoL and emotional exhaustion and DASS total score [OR = 0.14; 95% CI (0.03-0.73); p = 0.019 and OR = 3.64; 95% CI (1.07-12.32); p = 0.038, respectively]. Personal accomplishment and DASS total score have a direct relationship on quality of work-life [OR = 0.21; 95% CI (0.05-0.82); p = 0.024 and OR = 4.18; 95% CI (1.01-17.33); p = 0.049, respectively].

CONCLUSIONS

The physical quality of life is not optimal in critical care nurses, while burnout and the DASS score directly impact the emotional and work-life quality of life.

IMPLICATIONS FOR CLINICAL PRACTICE

Our research has highlighted the importance of detecting the quality of life of critical care nurses. The nurses should take proper care of their health by adopting the right health behaviours to create correct work conditions and increase the quality of care for critically ill patients.

Difficulties in emotional regulation mediates the impact of burden on quality of life and mental health in a sample of family members of people diagnosed with Borderline Personality Disorder

Background

Although it has been suggested that family members of persons suffering from Borderline Personality Disorder (BPD) endure high levels of burden, however, the process and the impact of this burden in their lives, and specifically the relation between the burden and emotional regulation has not been broadly investigated among this population. The main objective of this study is to examine the impact of burden on quality of life and depression, anxiety and stress, as mediated by difficulties in emotional regulation in family members of persons diagnosed with BPD.

Method

Participants were 167 family members of persons diagnosed with BPD. The Burden Assessment Scale, Difficulties in Emotion Regulation Scale, Multicultural Quality of Life Index, and Depression Anxiety Stress Scale-21 were filled out. Mediation analysis was conducted using the Maximum Likelihood estimator, bootstrap method and listwise deletion for missing data.

Results

Burden showed a significant, negative effect on quality of life and positive on depression, anxiety and stress. Difficulties in emotion regulation significantly mediated these relations. After accounting for the mediating role of difficulties in emotion regulation, burden still had an impact on quality of life, depression, anxiety and stress. Women showed a higher level in both burden and stress than men. The caregivers with secondary and higher studies showed higher levels in burden than those with no studies. Not significant differences in burden, emotion regulation, depression, anxiety and stress were found related to marital status.

Conclusion

Difficulties in emotion regulation mediate the relations between burden and quality of life, depression, anxiety, and stress. Family members could engage in group interventions designed specifically for family members of people with BPD, oriented toward understanding the disorder or learning skills.

Occupational Stress among Hospital-Based Nurses in Hawai'i during the COVID-19 Pandemic: A Cross-Sectional Survey

The Coronavirus Disease 2019 (COVID-19) pandemic has caused unprecedented disruption in health care systems and may continue to do so. Nurses, the largest contingent of the nation's health care workforce, have borne the brunt of those disruptions, which have caused increased workload and resultant occupational stress. This study identified differences in nurses' occupational stress by practice specialty, time spent caring for patients with COVID-19, and nurses' demographic characteristics. A descriptive cross-sectional online survey of RNs and APRNs (N=328) was conducted at a Level 1 Trauma Center on the island of O'ahu, Hawai'i in September and October of 2021. Participants completed the 57-item Expanded Nursing Stress Scale (ENSS). Nurses reported an average overall stress score of 2.11 out of 4. The ENSS subscales of workload, patients and their families, inadequate preparation, and uncertainty concerning treatment all had higher mean scores than the total scale. Nurses working in perioperative/procedural areas and obstetrics reported lower overall occupational stress scores than nurses in other specialties. Nurses who spent > 50% of their time caring for patients with COVID-19 reported higher overall occupational stress scores than nurses who spent ≤ 50% of their time caring for patients with COVID-19 (F = 8.21, P < .001). Nurses over the age of 50 reported less stress than their younger counterparts (F = 5.75, P = .004). Understanding how occupational stress impacts acute care nurses can aid employers in allocating resources to address the problem, and thus improve workforce retention.

Evaluation of occupational stress and job performance in Iranian nurses: the mediating effect of moral and emotional intelligence

BACKGROUND

Nurses' Job performance could be affected by occupational stress. Previous studies reported contradictory results in this regard. Factors such as moral and emotional intelligence could impact occupational stress. However, the extent of any mediating effect is unclear. Thus, this study aimed to determine the effect of occupational stress on nurses' Job performance and the mediating impact of moral and emotional intelligence.

METHODS

This cross-sectional study was conducted in Urmia teaching hospitals (Imam Khomeini, Motahari, Taleghani, Kosar, and Seyed al-Shohada Hospitals). Six hundred twenty-one nurses were selected using quota sampling from February 2022 to April 2022. Data were collected using demographic questionnaires, the Nursing Stress Scale, Paterson's Job Performance Questionnaire, Siberia Schering's Emotional Intelligence Standard Questionnaire, and Lennik and Keil's Moral Intelligence Questionnaire. Data were analyzed using SPSS ver. 23 and SmartPLS ver. 2.

RESULTS

Occupational stress had a positive, direct, and minor effect on nurses' job performance (β = 0.088, t-value = 2.245, p < 0.01). Occupational stress had a positive and direct impact on moral intelligence (β = 0.161, t-value = 2.945, p < 0.01) and a negative and direct effect on emotional intelligence (β = -0.351, t-value = 7.484, p < 0.01). Occupational stress negatively and indirectly affected job performance through moral intelligence (β =-0.560, t-value = 14.773, p < 0.01). Occupational stress also positively and indirectly impacted job performance through emotional intelligence (β = 0.098, t-value = 2.177, p < 0.01).

CONCLUSIONS

Occupational stress slightly affects nurses' job performance, and emotional and moral intelligence mediates the impact of occupational stress and improves nurses' job performance. Low occupational stress improves nurses' job performance, but too much occupational stress could harm nurses' job performance. Healthcare administrators should work to help reduce nurses' occupational stress and improve their job performance by adopting practical strategies to help nurses manage and control their stress. Holding stress reduction classes, eliminating the nursing shortage, reducing working hours, reducing workload, and providing financial and spiritual support to nurses would be recommended. It is also recommended to provide theoretical and practical emotional and moral intelligence-oriented courses for nursing students and hold training workshops for nurses to improve their emotional and moral intelligence.

The associations among nurse work engagement, job satisfaction, quality of care, and intent to leave: A national survey in the United States

Objectives

Employee work engagement, job satisfaction, quality of care, and intent to leave are critical indicators for healthcare organizational performance. This study aimed to analyze the current state of nurses' work engagement and its factors to examine the associations among nurses' work engagement, job satisfaction, quality of care, and intent to leave in the United States (US).

Methods

This is a quantitative descriptive cross-section design. Data were collected online from the US registered nurses from March to September 2022. Measures comprised the Utrecht Work Engagement Scale, the demographics, and questions regarding job satisfaction, perceived quality of care, and intent to leave.

Results

Nine hundred nurses participated in the online survey. Among the participants, 79.2% reported holding a specialty certification, 59.4% scored high/very high on job satisfaction, 82.2% expressed high/very high on the perceived quality of nursing care, and 28.4% conveyed likely/very likely to leave in the following year. Nurses' work engagement was positively associated with nurses' job satisfaction and their perceived quality of care but negatively associated with intent to leave. More certified nurses reported high or very high job satisfaction than non-certified nurses. As for demographics, the linear regression analysis showed that nurses who were older, identified as White, and held doctorate degrees reported higher levels of work engagement in comparison to their counterparts.

Conclusions

This study shows that nurses' work engagement is associated with their job satisfaction, perceived quality of care, and intent to leave. Nurses' work engagement in this study is lower than in other studies, especially before the COVID-19 pandemic, which may indicate a possible association with the COVID-19 impact. Because nurses' work engagement is significantly associated with job satisfaction, nurse leaders need to find ways to promote nurses' job satisfaction and retention.

Spiritual Intelligence as a Coping Strategy to Manage Job Stress for Midwives in Northern Iran: A Cross-Sectional Study

This study aimed to explore whether spiritual intelligence could help midwives cope with job-related stress. A cross-sectional study was done with 143 midwives in Babol, Iran. The sampling method was non-random and convenience samples were used. Amram and Dreyer's spiritual intelligence and health and safety executive occupational stress questionnaires were used. The response rate of subjects was 90.51%. Results showed that the most predictors of job stress were total spiritual intelligence (β = 0.507, p = 0.001) and the ratio of midwives to patients on the night shift (β =  - 0.224, p = 0.033). High levels of spiritual intelligence were associated with a low level of stress, which could help midwives adapt to job-related challenges.

Chronic stress and coping mechanisms among nurses in Lango sub-region, northern Uganda

AIM

This study aimed to assess chronic stress and coping mechanisms among nurses in Lango sub-region, northern Uganda, conducted between May and June 2022.

DESIGN

Institutional-based cross-sectional design conducted between May and June 2022.

METHODS

The study included 498 participants recruited from six health facilities. A 12-Item Short Form Survey tool was used to collect data on chronic stress, while a researcher-developed questionnaire was used to collect data on coping strategies. Descriptive statistics, binary logistic regression and multiple regression were conducted for data analysis. A p-value of 0.05 was considered statistically significant.

RESULTS

Out of 498 participants, 153 (30.7%) were aged between 31 and 40 years, 341 (68.5%) were female, 288 (57.8%) were married, and 266 (53.4%) had less than Diploma. Of the 498 participants, 351 (70.5%) experienced chronic stress. The protective factors against chronic stress were being married (AOR: 0.132; 95% CI: 0.043-0.408; p < 0.001), optimizing shift length (AOR: 0.056; 95% CI: 0.027-0.115; p < 0.001), religiosity/Spirituality (AOR: 2.750; 95% CI: 1.376-5.497; p = 0.004), and regular exercise and breaks (AOR: 0.405; 95% CI: 0.223-0.737; p = 0.003).

Associations among stressors, perceived stress, and psychological distress in nursing students: a mixed methods longitudinal study of a Hong Kong sample

Background

Nursing students are at risk for high-stress levels and psychological distress. Limited longitudinal studies have been conducted examining factors associated with stress levels and psychological distress of nursing students in their course of study.

Purpose

The purpose of this study was to examine the levels of stress and corresponding stressors, particularly those predicting psychological distress, among nursing students over their 5 years of study.

Methods

A longitudinal design, using questionnaires and focus group interviews of a single cohort of nursing students in Hong Kong and following them over their 5 years of training. The Stressors in Nursing Students Scale-Chinese version and the Chinese version of General Health Questionnaire-12 were used to assess stress levels and psychological distress, respectively.

Results

Ninety-seven participants completed the questionnaires 5 times. Quantitative findings revealed that the overall stress levels of the nursing students increased over 5 years (from mean = 3.08 to 3.33), with the highest levels in the second wave (mean = 3.33). Nursing students experienced higher stress during years 2 (p = 0.006) and 4 (p = 0.037). Psychological distress was the highest in year 3 (sum score = 18.47) (p = 0.002) but declined from year 4 (p < 0.001). Thematic analysis revealed that academic performance issues, coping challenges, unfavorable learning environments, relationships were identified as the stressors. However, nursing students also used positive coping strategies to pursue success and seek support.

Conclusion

This study suggests that the year of study is a significant predictor of stress levels among nursing students, especially during the first and senior years due to heavy academic workload. Psychological distress was observed among nursing students, and those who worked more part-time jobs tended to report higher levels of distress. The junior year was associated with higher levels of distress related to financial and time-related stress, while academic and personal problems were more prevalent during the senior year.

Perceived Stress Mediating the Association Between Mindfulness and Resilience Among Registered Nurses

Purpose

Resilience continues to be an important concept in the nursing profession due to its significant role in personal healthcare, patients' healthcare, and leadership. The present study examined the mediating role of perceived stress in the association between mindfulness and resilience among registered nurses in order to understand their importance among those in the Taiwanese nursing profession.

Materials and Methods

Between October and November 2021, a total of 816 registered nurses participated in a cross-sectional survey including psychometric measures assessing perceived stress (Chinese Perceived Stress Scale-10), mindfulness (Chinese Mindful Attention Awareness Scale), and resilience (Chinese Questionnaire of Resilience).

Results

Results indicated that perceived stress mediated the association between mindfulness and resilience (standardized coefficient = 0.251, p<0.001), although there was no significant association between mindfulness and resilience (standardized coefficient = 0.042, p=0.16). This suggests that perceived stress may function as both distress and eustress because mindfulness was not directly associated with resilience but indirectly via perceived stress.

Conclusion

Nurses and their administrators should focus on different ways of coping with stress so that they become more resilient in facing other stressors. Future studies may be conducted to examine the mediating role of perceived stress in the association between other coping strategies and resilience among registered nurses.

Prevalence and Risk Factors for Anxiety Symptoms among Student Nurses in Gauteng Province of South Africa

Background: Globally, mental disorders are common among nursing students; therefore, effective prevention and early detection are urgently needed. However, the prevalence rate of anxiety symptoms has not been investigated in South African nursing colleges. Aim: The study aimed to assess the prevalence of anxiety symptoms and their sociodemographic risk factors among nursing students in Gauteng province, South Africa. Methods: This cross-sectional descriptive study was conducted at Chris Hani Baragwanath and SG Lourens nursing colleges in the first week of June 2022. A purposeful sampling technique selected the third- and fourth-year nursing students aged ≥ 18 years registered at the two nursing colleges. The seven-item Generalised Anxiety Disorder scale was used to assess anxiety symptoms. Results: The prevalence of anxiety symptoms was 74.7% (95% confidence interval: 69.9-78.9). Being a student at nursing college B, being in the fourth academic year of study and use of substances were identified as predictors of anxiety symptoms in these nursing students. Conclusions: The prevalence of anxiety symptoms in this study is relatively high, with predictors of developing anxiety being a student at nursing college B, in the fourth academic year and current use of psychoactive substances were predictors of anxiety symptoms. These findings highlight the need to develop interventions and strategies to promote mental health assessments and management to prevent and reduce the problem of mental disorders among nursing students.

The Impact of Nurses Job Stress Level on Patients Care in Tertiary Care Hospital

Nursing is dynamic in nature and nurses are often in high level of job stress because of hard job, work load and burden of responsibilities. These stressors can have negative effect on patient care. The focus of study was to evaluate the correlation of nurses’ job stress and quality of care delivered to patients. Objective: To assess the nurses job stress level and the association of job stress and patient care at tertiary care hospital. Methods: The descriptive cross-sectional study was conducted with 144 participants working in tertiary care hospital. The nurses were selected via convenient sampling technique. The duration of study was 6 months. The data were collected by demographic characteristics, Caring Dimension Inventory (CDI-25) and NIOSH Generic Job Stress Questionnaire. Results: The results of this study showed that numbers of females were more 126 (87.5%) and majority of participants in age limit of 21-30 were 92 (63.9%). Most of the participants were bachelor degree holder 137 (95.1) and official job holders were 127 (88.2) at that institute. Large numbers of participants were bed side nurses 124 (86.1%). Most of the nurses felt moderate level of job stress (76.4%) and provide poor patient care (43.1%). The p-value of 0.001 was indication of the conclusion that there were association between nurses’ job stress and patient care delivered to patient. Conclusions: There was significant relation between the job stress and patient care. The job stress had negative effect on patient care delivered to patient by nurses. It also reduced the nurses’ performance which maybe factor of poor patients’ outcome

The Moderating Effects of Self-Care on the Relationships between Perceived Stress, Job Burnout and Retention Intention in Clinical Nurses

This study determines the importance of nurses' self-care by identifying its effects as a moderating variable on the relationships between perceived stress, job burnout, and retention intention in clinical nurses. Hence, 174 clinical nurses who worked at two university hospitals and one general hospital located in Seoul, South Korea, participated in this study. As the hospitals required the use of recruitment notices, convenience sampling methods were adopted to recruit volunteers. The data were collected using the perceived stress scale, the burnout assessment tool, the nurse retention index, and the self-care assessment worksheet. Descriptive statistics were used to analyze the general characteristics of participants, and t-test and analysis of variance were conducted for comparisons. Moderated multiple regression was conducted to verify the moderating effects of self-care on the relationships between perceived stress and retention intention and between job burnout and retention intention. The results revealed that the effect of perceived stress on retention intention and the moderating effect of self-care on the relationship between perceived stress and retention intention were not significant, whereas job burnout had a direct effect on retention intention, and self-care had a positive moderating effect on job burnout. Therefore, it is necessary to consider an instructional program on the importance of self-care and conduct campaign activities at the organizational level. Moreover, various support structures should be provided at the organizational level such that nurses can reduce their levels of job burnout.

Factors Associated with Job Stress and Their Effects on Mental Health among Nurses in COVID-19 Wards in Four Hospitals in Korea

Increased workload during the COVID-19 pandemic has threatened nurses' mental health. This study aimed to identify factors associated with job stress in COVID-19 nurses compared to other nurses. Nurses were recruited from four hospitals in Republic of Korea in November 2020. The general sociodemographic questionnaire, job stress, anxiety (GAD-7), and depression (PHQ-9) were used to conduct an online survey. Stepwise multiple regression analysis was used to identify the factors associated with job stress. A total of 290 participants were analyzed: 122 in the dedicated ward and 168 in the nondedicated ward nurse groups. Job stress, anxiety, and depression were higher in nurses dedicated to COVID-19 (4.19 ± 0.59, 5.98 ± 3.92, and 6.97 ± 4.47, respectively) than in the nondedicated group (3.92 ± 0.72 (p = 0.001), 4.98 ± 4.20 (p = 0.042), and 5.92 ± 4.36 (p = 0.047), respectively). Among COVID-19 nurses, job stress levels were higher in 30-39 year olds than in 20-29 year olds (3.71 ± 0.43 vs. 4.04 ± 0.54, p = 0.006) and in non-smokers compared with smokers (3.85 ± 0.49 vs. 3.38 ± 0.53, p = 0.24). Anxiety (β = 0.34, standard error (SE) = 0.01, p < 0.001) and clinical experience of 5-10 years (β = 0.23, SE = 0.10, p = 0.004) were associated with job stress. These findings can be applied when devising response strategies for infectious diseases and developing psychological and organizational intervention programs for alleviating job stress in nurses.

The impact of the pandemic on the perception of stress and danger, and the adjustment of psychiatric and general medical staff of German military hospitals

Introduction

The COVID-19 pandemic changed not only the working conditions but also the private conditions we live in. Health care professionals especially were confronted with multiple stressors, e.g., the risk of infection, lack of staff, and high workloads.

Methods

To estimate some of the pandemic-related impacts this anonymous personnel survey was conducted in two German military hospitals (Hamburg and Berlin). This study presents a comparative analysis of the hospital staff in general vs. the psychiatric personnel (N = 685) at two measurement time points (MTPs) in April 2021 (n = 399) and December 2021 (n = 286). The survey contains the German version of the Covid Stress Scale (CSS) to assess the perceived level of pandemic-related stress, the Patient Health Questionnaire (German Version: PHQ-D) to screen for three major mental disorders, and the adjustment disorder-New Module (ADNM) to estimate the problems of adaptation to change.

Results

The results showed a process of adaptation over the two MTPs with significant stress reduction at MTP2 in the general staff. The psychiatric staff did not report significantly higher pandemic-related symptoms. Quite the contrary, not only did the CSS show significantly lower xenophobia, traumatic stress, and compulsive checking, but the PHQ also showed lower stress symptoms and somatic symptoms at both MTPs. Also, the ADNM scores delivered evidence for a more effective adaptation process in psychiatric personnel (e.g., depressive mood, avoidance, anxiety).

Discussion

The presented results must be interpreted while taking the unique situations of German military clinics into account. The supply of protective material was sufficient and there was no dramatic shortage of psychiatric staff during the pandemic. The inpatients were quite often (40%) elective treatments for trauma-related disorders, which could be discontinued in the case of a COVID-19 infection. The results of this study showed good adaptative skills among the psychiatric staff in military hospitals, which could be interpreted as a sign of good resilience. This might have led to lower stress-related symptoms during the COVID-19 pandemic.

Disaster preparedness in healthcare professionals amid COVID-19 and beyond: A systematic review of randomized controlled trials

BACKGROUND

Disasters like COVID-19 are oftentimes inevitable, which makes disaster preparedness indispensable to global health and social stability. However, there is a dearth of understanding of how well healthcare professionals, who often have to work at the epicenter of disasters as they evolve, are trained to be sufficiently prepared for these crises. To this end, this study aims to examine the characteristics and effectiveness of existing interventions that aim to improve healthcare professionals' disaster preparedness.

METHODS

We searched RCTs that aim to improve healthcare professionals' disaster preparedness in databases including PubMed, PsycINFO, CINAHL and Scopus. Results were screened against the eligibility criteria. The review was registered with PROSPERO (CRD42020192517) and conducted following the PRISMA guidelines.

RESULTS

A total of 7382 articles were screened for eligibility, among which, 27 RCTs, incorporating 35,145, met the inclusion criteria. Review results show that most of the eligible RCTs were conducted in high-income countries. Only two RCTs were developed in disaster contexts that share similarities with COVID-19. Most of the interventions did not address critical disaster coping abilities, such as how can healthcare professionals protect or improve their personal or the general public's mental health amid pandemics. Furthermore, almost half of the disaster preparedness RCTs failed to generate statistically significant outcomes.

CONCLUSIONS

Albeit inevitable, disasters are preventable. Our study results underscore the imperative of designing and developing effective and comprehensive interventions that could boost healthcare professionals' disaster preparedness, so that these frontline workers can better protect personal and public health amid global crises like COVID-19.

Gender similarities and differences in the perception of caring among nurses during the COVID-19 pandemic: a mixed-methods study

BACKGROUND

Caring is the essence and core of nursing. Current studies on the effect of gender on nurses' perception of caring have been inconsistent. Most of these studies were quantitative and conducted before the COVID-19 pandemic. The study aimed to explore the gender similarities and differences in nurses' perception of caring during the COVID-19 pandemic.

METHODS

In 2020, a cross-sectional mixed-method study was conducted in 11 cities in China using structured online questionnaire (n = 8030) and face-to-face individual interview (n = 42). Data collection tools included the Caring Dimensions Inventory and semi-structured interview.

RESULTS

In stepwise multivariable linear regression analysis, female nurses scored 1.93 points higher on caring than male nurses, after completely controlling for the other factors. The interview results showed that both male and female nurses agreed that caring was to deal with three kinds of relationships, namely nurses and people, nurses and themselves, nurses and society. There were gender differences in the connotation of caring between nurses and themselves, but not in the connotations of caring between other relationships. The ranking of the importance of caring connotations among these relationships showed no gender difference except between nurses and themselves.

CONCLUSION

The quantitative findings suggest that gender influences nurses' perception of caring. The qualitative findings demonstrate that nurses regard themselves as both recipients and implementers of caring. The qualitative results indicate nurses of different genders have similarities and differences in their perception of caring, and the biggest difference lies in the relationship between nurses and themselves.

Emotional Freedom Technique (EFT): Tap to relieve stress and burnout

The effects of the COVID-19 pandemic have exponentially increased stress, anxiety and burnout levels for all healthcare professionals and students. The psychological effects of working with COVID-19 patients and the physical stress of working under distressing conditions exacerbate an already stressed workforce. Working long hours, shift work, short staffing, demanding workloads, dealing with death and dying and conflicts with management, other staff and disciplines and poor communication between disciplines are among the issues that can lead to burnout, anxiety and depression. Emotional Freedom Technique (EFT) or tapping is a holistic practice that is easy to learn and apply to self and produces relief from stress, anxiety and the symptoms of burnout within in minutes. There are many websites, videos, and tutorials which can teach and support the healthcare practitioner in the practice of EFT.

Factors contributing to depressive symptoms among undergraduate nursing students: A cross-sectional study

AIM

To investigate predictive factors of student's academic year, interest in the field of nursing, stress, self-efficacy, and problem-focused and emotion-focused coping on the depressive symptoms among undergraduate nursing students.

BACKGROUND

As the burden of depression among students has increased worldwide, depressive symptoms have become a standard part of mental health problems in college and university students. Among the various fields of medical sciences, nursing students face more stressors during their study period and are more at risk of suffering depressive symptoms than other students.

DESIGN

A cross-sectional design.

METHODS

A total of 230 undergraduate nursing students from a university in Myanmar were recruited from August to September 2021. The data were collected using standard research instruments, including a Demographic Questionnaire, Student Nurse Stress Index Questionnaire, General Self-efficacy Scale, Brief COPE Inventory, and Center for Epidemiology Studies Depression Scale (CES-D). Descriptive statistics were used to describe the sociodemographic characteristics of the participants. Inferential statistics were used to identify the predictive effect of academic year, interest in the field of nursing, stress, self-efficacy, problem-focused coping, and emotion-focused coping on depressive symptoms, using multiple linear regression analysis.

RESULTS

Academic year, interest in the field of nursing, stress, self-efficacy, and problem-focused and emotion-focused coping accounted for 31.5% of the variance of depressive symptoms (F(8, 221) = 12.704, p < .001) with an R² = .315. Stress was the factor that most influenced student's depressive symptoms (β = .407, p < .001). Self-efficacy (β = -.244, p < .001) and emotion-focused coping (β = .199, p < .05) were also critical factors contributing to depressive symptoms among undergraduate nursing students.

CONCLUSIONS

The results of this study provide insight and knowledge about depressive symptoms and factors that can contribute to depressive symptoms among undergraduate nursing students. Results suggest that nurse educators and community mental health nurses should focus on reducing stress, increasing self-efficacy, and enhancing proper coping strategies among students to prevent depressive symptoms.

Perception of Work-Related Stress and Quality of Life among Nurses during COVID-19 Pandemic-An International, Multicenter Prospective Study

The major focus of the study was the impact of the COVID-19 pandemic on healthcare workers' mental health. Nurses are the workers who were exposed to pandemic-related stress, being the most affected. The present cross-sectional study was focused on finding out the differences of the level of work-related stress and quality of life in nurses of the three Central European states, specifically the Czech Republic, the Slovak Republic, and Poland. A structured anonymous online questionnaire was created, and then the link was distributed to the target population through executives. Data analysis was performed by using the R programme-version 4.1.3. The study found that nurses from the Czech Republic achieved lower stress levels and had a higher quality of life than nurses from Poland and Slovakia.

(Dis)Agreement with Dysthanasia, Religiosity and Spiritual Experience as Factors Related to Nurses' Workload during End-of-Life Care

This study intended to investigate whether the workload of nurses in the course of providing end-of-life care correlated with their religiousness, spiritual experience and level of agreement with dysthanasia procedures. The respondents included 279 nurses from four Croatian hospitals. A structured and validated instrument was applied. Almost 90% of respondents are religious, and almost 45% of them have daily spiritual experiences. Respondents, especially those with high levels of religiousness and spiritual experience, express a low level of agreement with dysthanasia (mean = 58.21; score = 25−125). Moreover, nurses self-rated (on a scale of 1−5) their workload as quite high, especially when performing contradictory tasks imposed on them by their superiors (mean = 3.05) and during direct contact with dying patients and their family members (mean = 2.56). This significantly highest level of workload was experienced by the youngest nurses (p = 0.01) and nurses with little work experience (p < 0.01). This study also indicated that nurses who agree with dysthanasia experienced a higher level of workload when providing end-of-life care (r = 0.178; p < 0.01), while more frequent spiritual experiences reduced the level of workload (r = −0.205; p < 0.01). A deeper understanding of nurses’ attitudes toward dysthanasia, as well as of their religiousness and spiritual experiences, may ensure the collection of data beneficial to the timely identification of potential risks caused by workload.

Psychoeducational interventional programme during the COVID-19 pandemic for nurses with severe occupational stress: A randomized controlled trial

BACKGROUND

Occupational stress is generally acknowledged as a major issue in the health sector that may have a detrimental impact on nurses' psychological and physical health, particularly during the COVID-19 epidemic.

AIM

This study evaluated the effectiveness of a psychoeducational interventional programme in decreasing occupational stress and improving coping methods among nurses during the COVID-19 pandemic.

METHODS

This study used a cluster-randomized approach. Data were collected from 80 nurses working in two public health-care centres from May to August 2020 in Jordan. Two centres were assigned randomly to the intervention and control groups. The psychoeducational programme was delivered to the intervention group in six sessions over 6 days for 2 weeks. The collected data were analysed using SPSS through descriptive and inferential statistics. Occupational stress and coping strategies were measured.

RESULTS

Repeated-measures analysis of variance (ANOVA) indicated that the degrees of occupational stress and coping strategies significantly differed between study groups over the three points of data collection.

CONCLUSION

This psychoeducational interventional programme is a valuable noninvasive method that can improve individual coping strategies to manage stress in practice during the COVID-19 pandemic.