Positive mental health among health professionals working at a psychiatric hospital

Assessing a Structured Mental Fitness Program for Academic Acute Care Surgeons: A Pilot Study

INTRODUCTION

There is a well-established positive correlation between improved physician wellness and patient care outcomes. Mental fitness is a component of wellness that is understudied in academic medicine. We piloted a structured mental fitness Positive Intelligence (PQ) training program for academic surgeons, hypothesizing this would be associated with improvements in PQ scores, wellness, sleep, and trainee evaluations.

METHODS

This is a single-institution, prospective, mixed-methods pilot study. All active Burn/Trauma/Acute & Critical Care Surgical faculty and fellows in our division were offered the PQ program and the option to participate in this research study. The 6-wk program consists of daily exercises on a smartphone application, weekly readings, and small-group meetings with a trained mindfulness coach. Study outcomes included changes in pretraining versus post-training PQ scores, sleep hygiene, wellness, and teaching scores. A Net Promoter Score was calculated to measure user overall experience (range -100 to 100; positive scores being supportive). For secondary analysis, participants were stratified into high versus low user groups by "muscle" scores, which were calculated by program use over time. A postintervention focus group was also held to evaluate perceptions of wellness and experience with the PQ program.

RESULTS

Data were analyzed for 15 participants who provided consent. The participants were primarily White (73.3%), Assistant Professors (66.7%) with Surgical Critical Care fellowship training (86.7%), and a slight female predominance (53.3%). Comparison of scores pretraining versus post-training demonstrated statistically significant increases in PQ (59 versus 65, P = 0.004), but no significant differences for sleep (24.0 versus 29.0, P = 0.33) or well-being (89.0 versus 94.0, P = 0.10). Additionally, there was no significant difference in teaching evaluations for both residents (9.1 versus 9.3, P = 0.33) and medical students (8.3 versus 8.5, P = 0.77). High versus low user groups were defined by the median muscle score (166 [Interquartile range 95.5-298.5]). High users demonstrated a statistically higher proportion of ongoing usage (75% versus 14%, P < 0.05). The final Net Promoter Score score was 25, which demonstrates program support within this group. Focus group content analysis established eight major categories: current approaches to wellness, preknowledge, reasons for participation, expected gains, program strengths, suggestions for improvement, recommendations for approaches, and sustainability.

CONCLUSIONS

Our pilot study highlighted certain benefits of a structured mental fitness program for academic acute care surgeons. Our mixed-methods data demonstrate significant improvement in PQ scores, ongoing usage in high user participants, as well as interpersonal benefits such as improved connectedness and creation of a shared language within participants. Future work should evaluate this program on a higher-powered scale, with a focus on intentionality in wellness efforts, increased exposure to mental fitness, and recruitment of trainees and other health-care providers, as well as identifying the potential implications for patient outcomes.

Development and validation of Vietnam teachers' resilience scale instrument: A four-factor model

Existing studies on resilience measures tailored explicitly to teachers are relatively scarce, and the development of teacher resilience scales in developing Asian nations is lacking. To address this gap, we developed the Vietnam Teachers' Resilience Scale (VITRS), drawing on the Teachers' Resilience Scale (Daniilidou & Platsidou, 2018) and the Multidimensional Teachers' Resilience Scale (Mansfield & Wosnitza, 2015; Peixoto et al., 2020). The VITRS comprises 20 items across four dimensions (Social, Professional, Emotional, and Motivational resilience), demonstrating psychometric properties. The VITRS exhibits high reliability and validity and can serve as a significant assessment tool for high school and university teachers. This enables them to measure their resilience and prepare effectively to face and adapt to adversity. Despite these limitations, this study opens new avenues for future research.

Are nursing students flourish or languish in their mental health?

Background

Positive mental health (PMH) is the presence of emotional, social, and psychological well-being.

Objective

To determine the level of positive mental health and associated factors among nursing students in a public university in Sri Lanka.

Methods

A descriptive cross-sectional study was conducted among 185 nursing students. Data was collected using a self-administered questionnaire. Students were categorized as Flourished, Moderate and Languished.

Results

Out of 185 students 170 responded. Mean age was 23.5 years (SD = 1.3). Of them 25.3% flourished and 32.7% languished. Students who engaged in leisure activities and social activities were more flourished whereas students who have diagnosed with chronic illness/es, mental illness/es and had any family member/s suffering with a severe illness/es were more languished.

Conclusion

Involvement in leisure activities, social activities, status of physical and mental health and family member health status were associated with the level of positive mental health.

Mediating role of emotion regulation in the relationship between mindfulness and mental well-being among formal caregivers of psychiatric patients

Professional caregivers of psychiatric patients are often exposed to circumstances and environments that threaten their mental well-being in the course of carrying out their professional duties. In this study, we examined the mediating role of emotion regulation in the association between mindfulness and mental well-being among professional caregivers of psychiatric patients. Three hundred and seven professional caregivers of psychiatric patients whose ages ranged between 22 and 63 years (mean age = 39.21 years; SD = 10.09 years) participated in the study. They completed measures of mindfulness, emotion regulation and mental well-being in addition to supplying relevant demographic information. Results of mediation analysis showed that expressive suppression dimension of emotion regulation mediated the relationship between mindfulness and mental well-being. This indicates that mindfulness was associated with increased mental well-being via the pathway of reduced expressive suppression. These findings suggest that expressive suppression may represent an effective way to strengthen the link between mindfulness and mental well-being among professional caregivers and ultimately provide a means to improve their well-being.

Personality traits and dimensions of mental health

Individuals are different in a relatively constant pattern of thoughts, feeling, and behaviors, which are called personality traits. Mental health is a condition of well-being in which people may reach their full potential and deal effectively with stress, work efficiently, and contribute to their communities. Indeed, the link between personality and mental health as indicated by the 12-item version of the general health questionnaires (GHQ-12) has been well-established according to evidence found by decades of research. However, the GHQ-12 comprises many questions asking about different dimensions of mental health. It is unclear how personality traits relate to these dimensions of mental health. In this paper, we try to address this question. We analyzed data from 12,007 participants from the British Household Panel Study (BHPS) using a confirmatory factor analysis (CFA) and generalized linear models. We replicated the factor structure of GHQ-12 labeled as GHQ-12A (social dysfunction & anhedonia; 6 items), GHQ-12B (depression & anxiety; 4 items), and GHQ-12C (loss of confidence; 2 items). Moreover, Neuroticism was positively related to all dimensions of mental health issues, Extraversion was negatively related to GHQ-12A (social dysfunction & anhedonia) and GHQ-12B (depression & anxiety), Agreeableness and Conscientiousness were negatively related to GHQ-12A (social dysfunction & anhedonia) and GHQ-12C (loss of confidence), and Openness was negatively related to GHQ-12B (depression & anxiety). These results contribute to theories including the predisposition/vulnerability model, complication/scar model, pathoplasty/exacerbation model, and the spectrum model, which propose that personality traits are linked to mental health and explained possible reasons. Psychologists may use results from this study to identify individuals who may be at high risk of developing various non-psychiatric mental health issues and intervene to avoid negative outcomes.

Nursing students' perceptions on clinical learning environment and mental health: a multicenter study

OBJECTIVE

this study aimed at evaluating the perceptions of Nursing students from public universities in three European Union countries on mental health and clinical learning environments, a topic that has been rarely investigated in the literature.

METHOD

data collection took place using a demographic data form, the Clinical Learning Environment, Supervision and Nurse Teacher Scale, and the Mental Health Continuum Short Form. A total of 571 participants from Turkey, Lithuania and Portugal were included in the study.

RESULTS

there was a significant difference among the three groups regarding clinical learning environment and mental health status (p<.001). Supervision was the most valued element. The Portuguese students presented the highest mean in the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores (p<.001). Age, gender and mental health were effective in the Clinical Learning Environment, Supervision and Nurse Teacher Scale scores.

CONCLUSION

the results indicated that the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores obtained by the Portuguese Nursing students were higher. It was also revealed that the students' perceptions on the clinical learning environment were affected by age and gender, and that their perceptions on mental health were influenced by the Clinical Learning Environment, Supervision and Nurse Teacher scale scores.

Percepciones de estudiantes de enfermería sobre el Ambiente de Aprendizaje Clínico y la salud mental: estudio multicéntrico

Resumen Objetivo: este estudio tuvo como objetivo evaluar las percepciones de estudiantes de enfermería de universidades públicas de tres países de la Unión Europea sobre la salud mental y los Ambientes de Aprendizaje Clínico, tema poco estudiado en la literatura. Método: la recolección de datos se realizó mediante un formulario de datos demográficos, la Escala de Evaluación de Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería y el Mental Health Continuum Short Form. Se incluyeron en el estudio un total de 571 participantes de Turquía, Lituania y Portugal. Resultados: hubo una diferencia significativa entre los tres grupos con respecto al Ambiente de Aprendizaje Clínico y al estado de salud mental (p < 0,001). La supervisión fue el elemento más valorado. Los estudiantes portugueses obtuvieron los puntajes promedio más altos en el Mental Health Continuum Short Form y Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería (p<0,001). La edad, el sexo y la salud mental influyeron en los puntajes de Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería. Conclusión: los resultados indicaron que los estudiantes de Enfermería portugueses obtuvieron los puntajes más altos en el Mental Health Continuum Short Form y Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería. También se reveló que las percepciones de los estudiantes sobre el Ambiente de Aprendizaje Clínico se vieron afectadas por la edad y el género, y que sus percepciones sobre la salud mental fueron influenciadas por los puntajes de la escala de evaluación de Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería.

Nursing students’ perceptions on clinical learning environment and mental health: a multicenter study

Objective:

this study aimed at evaluating the perceptions of Nursing students from public universities in three European Union countries on mental health and clinical learning environments, a topic that has been rarely investigated in the literature.

Method:

data collection took place using a demographic data form, the Clinical Learning Environment, Supervision and Nurse Teacher Scale, and the Mental Health Continuum Short Form. A total of 571 participants from Turkey, Lithuania and Portugal were included in the study.

Results:

there was a significant difference among the three groups regarding clinical learning environment and mental health status (p<.001). Supervision was the most valued element. The Portuguese students presented the highest mean in the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores (p<.001). Age, gender and mental health were effective in the Clinical Learning Environment, Supervision and Nurse Teacher Scale scores.

Conclusion:

the results indicated that the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores obtained by the Portuguese Nursing students were higher. It was also revealed that the students’ perceptions on the clinical learning environment were affected by age and gender, and that their perceptions on mental health were influenced by the Clinical Learning Environment, Supervision and Nurse Teacher scale scores.

The Relationship Between Workplace Bullying and Positive Mental Health Among Registered Nurses

BACKGROUND

Workplace bullying is a highly prevalent occupational burden in health care settings. It is associated with various negative consequences in nurses, but its unique relationship with nurses' positive mental health (PMH) has yet to be established.

AIM

The purpose of this study was to examine the unique relationship between bullying at the workplace and positive mental health among registered nurses.

METHOD

A descriptive, correlational, and cross-sectional design was used. A sample of 231 registered nurses was recruited from two governmental hospitals, two private hospitals, and two teaching hospitals. Self-reported data were obtained about nurses' demographic variables, their experience of bullying at the workplace, and their perceived positive mental health.

RESULTS

About 73.6% of the participants were exposed to workplace bullying. Regarding the positive mental health subscales, the spirituality subscale had the highest mean score (M = 4.93, SD = 1.11), while the global affect had the lowest mean score (M = 3.55, SD = 1.17). Factors associated with the total PMH or at least one of its subscales were gender, experience, working shift, type of hospital, and the position of the participant. There was a significant negative relationship between bullying at the workplace and positive mental health (r = -.16, p < .05). After controlling participants' characteristics, workplace bullying accounted for significant variance in PMH.

CONCLUSION

Regardless of the nurses' characteristics, bullying at the workplace has a negative impact on nurses' mental health and well-being.

Psychological aspect of common people during lockdown

BACKGROUND

Lockdown was implemented to restrict the transmission of COVID-19. This brought upon many unforeseen hurdles, including mental health problems.

AIM

The aim of the study is to assess the impact of lockdown on mental health.

MATERIALS AND METHODS

A cross-sectional study was conducted using Google Form, which the participants were requested to complete online. The questionnaire included sociodemographic information and general health questionnaire (GHQ)-12, which was used to screen for mental health.

RESULTS

A total of 343 participants took part in the study in which 113 participants (32.9%) were having GHQ score of less than or equal to 12. The study showed that people aged less than 41 years were able to concentrate more during lockdown (75.6%) as compared to people aged more than 41 years (65%). Younger participants who were less than 41 years reported sleep disorders associated with late-night entertainment and TV viewing (24.5%). Many experienced stress during lockdown, but it was more in people over 60 years (63.7%).

CONCLUSIONS

An appreciable proportion of the participants faced stress during lockdown. Elderly people were more affected. Sleeping disorders were associated with late-night entertainment and TV viewing in younger people.

Association between well-being and compliance with COVID-19 preventive measures by healthcare professionals: A cross-sectional study

IMPORTANCE

Knowledge and attitude influence compliance and individuals' practices. The risk and protective factors associated with high compliance to these preventive measures are critical to enhancing pandemic preparedness.

OBJECTIVE

This survey aims to assess differences in mental health, knowledge, attitudes, and practices (KAP) of preventive measures for COVID-19 amongst healthcare professionals (HCP) and non-healthcare professionals.

DESIGN

Multi-national cross-sectional study was carried out using electronic surveys between May-June 2020.

SETTING

Multi-national survey was distributed across 36 countries through social media, word-of-mouth, and electronic mail.

PARTICIPANTS

Participants ≥21 years working in healthcare and non-healthcare related professions.

MAIN OUTCOME

Risk factors determining the difference in KAP towards personal hygiene and social distancing measures during COVID-19 amongst HCP and non-HCP.

RESULTS

HCP were significantly more knowledgeable on personal hygiene (AdjOR 1.45, 95% CI -1.14 to 1.83) and social distancing (AdjOR 1.31, 95% CI -1.06 to 1.61) compared to non-HCP. They were more likely to have a positive attitude towards personal hygiene and 1.5 times more willing to participate in the contact tracing app. There was high compliance towards personal hygiene and social distancing measures amongst HCP. HCP with high compliance were 1.8 times more likely to flourish and more likely to have a high sense of emotional (AdjOR 1.94, 95% CI (1.44 to 2.61), social (AdjOR 2.07, 95% CI -1.55 to 2.78), and psychological (AdjOR 2.13, 95% CI (1.59-2.85) well-being.

CONCLUSION AND RELEVANCE

While healthcare professionals were more knowledgeable, had more positive attitudes, their higher sense of total well-being was seen to be more critical to enhance compliance. Therefore, focusing on the well-being of the general population would help to enhance their compliance towards the preventive measures for COVID-19.

Development of the Chinese, Malay and Tamil translations of the Positive Mental Health Instrument: Cross-cultural adaptation, validity and internal consistency

This study describes the development and validation of Chinese, Malay and Tamil translations of the Positive Mental Health Instrument (PMHI) in a general population sample in Singapore. Translations were performed using two independent forward translations followed by expert panel discussions and tested for content, construct and language appropriateness using focus group discussions. The final translated tools were field-tested among 220 residents per language using self-administered questionnaires comprising the translated PMHI and other validity measures. Missing data, floor and ceiling effects, confirmatory factor analysis (CFA), internal consistency, item response theory differential item functioning (IRT-DIF) and criterion validity were assessed. A total of 10 PMHI-Chinese items, 26 PMHI-Malay items and six response categories and six PMHI-Tamil items were modified based on expert panel and focus group discussions. PMHI had low missing data and showed negative but acceptable skewness (<2) and kurtosis (<7) for all translations, except for the PMHI-Malay "spirituality" subscale (skewness: -2.8; kurtosis: 12.5). CFA showed that all three PMHI translations fulfilled the original six-factor-higher-order structure (RMSEA = 0.05, CFI = 0.962, TLI = 0.96). Cronbach's alpha coefficients for total PMHI were 0.958, 0.954, 0.945 and 0.949 in the overall sample and the Chinese, Malay and Tamil translations, respectively. The three translations of the PMHI showed expected and significant positive (r = 0.116 to 0.663) and negative correlations (r = -0.137 to -0.574) with established measures. The findings show that the Chinese, Malay and Tamil translations of the PMHI have high internal consistency and validity in this multi-ethnic population.

Sobrecarga em trabalhadores de saúde de um complexo hospitalar psiquiátrico no Nordeste brasileiro

Resumo Objetivo este artigo visa identificar os aspectos que causam a sobrecarga laboral em um complexo psiquiátrico e verificar estratégias de minimização desta sobrecarga. Método os dados foram coletados com trabalhadores de um complexo hospitalar psiquiátrico na cidade de João Pessoa, Paraíba, Brasil. Aplicou-se a Escala de Avaliação do Impacto do Trabalho em Serviços de Saúde Mental (IMPACTO-BR) na coleta de dados, os quais foram processados no software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ) e submetidos à análise de conteúdo. Resultados os resultados foram sistematizados em duas categorias temáticas: Aspectos de sobrecarga laboral e Estratégias para amenizar a sobrecarga. Foi relevado que as maiores causas de sobrecarga são do contexto organizacional, enquanto que o menor impacto advém do paciente. Conclusão e implicações para a prática as estratégias sugeridas discorreram desde a aquisição de um trabalho digno, com direitos trabalhista, até as ações voltadas para um melhor atendimento para o paciente. Sugere-se que sejam implementadas ações políticas e institucionais de incentivo à integração da equipe, valorização do trabalho e cuidado da saúde física e mental do trabalhador.

Development and validation of the Rapid Positive Mental Health Instrument (R-PMHI) for measuring mental health outcomes in the population

Background

The multidimensional Positive Mental Health Instrument (PMHI) has 47 items and six subscales. This study aimed to develop and validate a short unidimensional version of the PMHI among Singapore’s adult resident population.

Methods

Using pooled data from three earlier studies (n = 1050), PMHI items were reduced by Partial Credit Rasch Model (PCRM) runs in a random split-half sample, while psychometric properties of the resulting measure were tested through confirmatory factor analysis (CFA), item response theory-graded response model and internal consistency reliability in the other half. Its reliability, construct and concurrent validity, agreement with the original scale, floor and ceiling effect, and scale estimates were further investigated in an external representative general population sample (n = 1925).

Results

The average age of the participants was around 41 years. Four PCRM re-runs for item selection resulted in a 6-item unidimensional Rapid PMHI (R-PMHI). CFA confirmed the unidimensional structure of the R-PMHI in the internal (RMSEA = 0.075, CFI = 0.985, TLI = 0.974) and external (RMSEA = 0.051, CFI = 0.992, TLI = 0.987) validation samples. In the external validation sample, the R-PMHI met concurrent validity criteria, showing high agreement with the 47-item version with intra-class correlation coefficient of 0.872 (95% CI: 0.861 to 0.882) and low floor and ceiling effects. Weight-adjusted mean (SE, 95% CI) R-PMHI score in the population was 4.86 (0.2, 4.82–4.90).

Conclusion

The unidimensional 6-item R-PMHI offers brevity over the original multidimensional measure while appropriately representing the positive mental health construct. Prospective studies are needed to assess its responsiveness and test-retest reliability.

The factor structure of the general health questionnaire (GHQ12) in Saudi Arabia

Background

The General Health Questionnaire-12 (GHQ-12) is one of the most unique and extensively used self-report instruments for evaluating psychological disorders and strains. However, the factor structure of GHQ-12 has not been fully explored. The current study aims to assess the factorial structure of GHQ-12 in a large cross-sectional data-set extracted from Al Kharj central region of Saudi Arabia.

Methods

Population based cross sectional data was extracted from January 2016 to June 2016 from Al Kharj population recruiting 1019 respondents aged 18 and above. Exploratory factor analysis (EFA) was applied together with multiple regression analysis to extract and retain factors. Mean GHQ-12 score for demographic and health-related traits were used for assessing this association. Statistical analysis was carried out using STATA version 12.1.

Results

Three factors, including social dysfunction, anxiety, and loss of confidence were extracted from the factor structure. 55% of the overall variance was obtained through these factors. Total score of GHQ-12 ranged from 0 to 32 with a mean score of 12.

Conclusion

Investigation of the factor structure of GHQ-12 demonstrated that GHQ-12 is a good measure for evaluating the general health of Saudi population. Future studies based on a larger sample size of non-clinical respondents will be useful to evaluate the practical effectiveness of GHQ-12 factors.

Attitudes to mental illness among mental health professionals in Singapore and comparisons with the general population

Background

Similar to the general public, mental health professionals sometimes also have negative attitudes towards individuals with mental illness; which could ultimately affect the quality of care received by the patients. This study aims to explore attitudes to mental illness among mental health professionals in Singapore; make comparisons with the general population; and investigate the significant correlates.

Methods

A cross-sectional design was used. Eligible participants were recruited from the Institute of Mental Health, Singapore. Attitudes to mental illness among the mental health professionals were measured using an adapted 26-item Attitudes to Mental Illness questionnaire (AMI). An earlier study amongst the general population in Singapore had used the same tool; however, factor analysis suggested a 20-item, 4-factor structure (AMI-SG) was the best fit. This 4-factor structure was applied among the current sample of mental health professionals to allow comparisons between the professionals and the general population.

Data were collected through an online survey tool ‘Questionpro’ from February to April 2016, and 379 participants were included in the current analysis. Attitudes to mental illness among these professionals were compared to those of the general population, which were captured as part of a national study conducted from March 2014 to April 2015.

Results

The 20-item, 4-factor structure AMI-SG derived from the general population was applicable among the mental health professionals in Singapore. Compared to the general population, mental health professionals had significantly more positive attitudes to mental illness; however their scores on ‘social distancing’ did not differ from the general population. Indian ethnicity was negatively associated with ‘social distancing’ and ‘social restrictiveness’ among the professionals; while higher education was negatively related to ‘prejudice and misconception’. Compared to nurses, doctors showed significantly more positive attitudes on ‘social restrictiveness’ and ‘prejudice and misconception’. Having family or close friends diagnosed with mental illness was negatively associated with ‘social distancing’ among the professionals.

Conclusion

The AMI-SG is an effective tool to measure attitudes to mental illness among mental health professionals in Singapore. Although the professionals had significantly more positive attitudes to mental illness than the general public in Singapore, their attitudes on ‘social distancing’ resembled closely that of the general public. Professionals tended to have more negative attitudes if they were nurses, less educated, and of Chinese ethnicity. More studies are needed to explore the underlying reasons for the differences and to generalize these findings among mental health professionals elsewhere.