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Wu H, Qi K, Luan B, Liu Z, Zhao Q. Association between occupational stress and mental health of nurses during the COVID-19 pandemic: A cross-sectional research. Nurs Open 2023; 10:7694-7702. [PMID: 37767901 PMCID: PMC10643833 DOI: 10.1002/nop2.2010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 09/08/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023] Open
Abstract
AIM This study is aimed to explore the association between the occupational stress and mental health among Chinese nurses during the COVID-19 pandemic. DESIGN Cross-sectional study. METHODS There were 2913 nurse participants enrolled in the study. Demographic characteristics and other data were measured by a self-reported questionnaire. Occupational stress was measured by using the effort-reward imbalance (ERI) questionnaire. Mental health was measured by the Patient Health Questionnaire-9 and the General Anxiety Disorder-7. RESULTS Among the participants, 14.32% (417) experienced ERI; 8.1% (237) and 7.2% (210) reported depressive and anxiety symptoms, respectively. Compared with a reference group at the lowest quartile of the ERI, participants in the highest quartile had an adjusted odds ratio (OR) (95% CI) of 11.17 (4.42, 28.25) for incident depressive symptoms. For anxiety symptoms, the OR and 95% CI was 2.28 (1.21, 4.29). The ERI was shown to have a detrimental effect on mental health, especially depressive symptoms.
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Affiliation(s)
- Huiying Wu
- Department of NursingShengjing Hospital of China Medical UniversityShenyangChina
| | - Kewen Qi
- School of NursingChina Medical UniversityShenyangChina
| | - Bonan Luan
- Department of NursingShengjing Hospital of China Medical UniversityShenyangChina
| | - Zhengwen Liu
- Department of Delivery RoomShengjing Hospital of China Medical UniversityShenyangChina
| | - Qingyun Zhao
- Department of UrologyShengjing Hospital of China Medical UniversityShenyangChina
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Che H, Wu H, Qiao Y, Luan B, Zhao Q, Wang H. Association between long working hours and mental health among nurses in China under COVID-19 pandemic: based on a large cross-sectional study. BMC Psychiatry 2023; 23:234. [PMID: 37029359 PMCID: PMC10080503 DOI: 10.1186/s12888-023-04722-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 03/27/2023] [Indexed: 04/09/2023] Open
Abstract
OBJECTIVE Nurses were more likely to experience mental disorders due to long working hours and irregular schedules. However, studies addressing this issue are scarce; therefore, we aimed to investigate the association between long working hours and mental health in Chinese nurses during the coronavirus disease pandemic. METHODS A cross-sectional study was conducted with 2,811 nurses at a tertiary hospital in China from March to April 2022. We collected data on demographic, psychological characteristics, dietary habits, life, and work-related factors using a self-reported questionnaire and measured mental health using Patient Health Questionnaire-9 and General Anxiety Disorder-7. Binary logistic regression to determine adjusted odds ratios and 95% confidence intervals. RESULTS The effective response rates were 81.48%, 7.80% (219), and 6.70% (189) of the respondents who reported depression and anxiety, respectively. We categorized the weekly working hours by quartiles. Compared with the lowest quartile, the odds ratios and 95% confidence intervals across the quartiles for depression after adjustment were 0.98 (0.69, 1.40), 10.58 (2.78, 40.32), and 1.79 (0.81, 3.97) respectively, the P for trend was 0.002. The odds ratios across the quartiles for anxiety after adjustment were 0.87 (0.59, 1.30), 8.69 (2.13, 35.46), and 2.67 (1.26, 5.62), respectively, and the P for trend was 0.008. CONCLUSIONS This study demonstrated that extended working hours increased the risk of mental disorders among nurses during the coronavirus disease pandemic, particularly in those who worked more than 60 h per week. These findings enrich the literature on mental disorders and demonstrate a critical need for additional studies investigating intervention strategies.
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Affiliation(s)
- Hongwei Che
- Department of Operating Room, Shengjing Hospital of China Medical University, Shenyang, Liaoning, P. R. China
| | - Huiying Wu
- Department of Operating Room, Shengjing Hospital of China Medical University, Shenyang, Liaoning, P. R. China
| | - Yu Qiao
- Department of Operating Room, Shengjing Hospital of China Medical University, Shenyang, Liaoning, P. R. China
| | - Bonan Luan
- Department of Operating Room, Shengjing Hospital of China Medical University, Shenyang, Liaoning, P. R. China
| | - Qingyun Zhao
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, P. R. China
| | - Hongyan Wang
- Department of Thoracic Surgery, Shengjing Hospital of China Medical University, 36 Sanhao Street, 110004, Shenyang, Liaoning, P. R. China.
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Kunzler AM, Chmitorz A, Röthke N, Staginnus M, Schäfer SK, Stoffers-Winterling J, Lieb K. Interventions to foster resilience in nursing staff: A systematic review and meta-analyses of pre-pandemic evidence. Int J Nurs Stud 2022; 134:104312. [PMID: 35853312 DOI: 10.1016/j.ijnurstu.2022.104312] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 05/30/2022] [Accepted: 06/09/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Given the chronic work-related stressors experienced by nursing staff in today's healthcare systems, international evidence suggests an elevated risk of developing stress-related mental symptoms. Therefore, identifying effective methods to foster resilience (i.e., maintenance or fast recovery of mental health despite stressor exposure) seems crucial. To date, little is known about the efficacy of these interventions in nurses. OBJECTIVE This systematic review aimed at summarizing the evidence on the pre-pandemic efficacy of psychological interventions to foster resilience, to improve mental symptoms and well-being as well as to promote resilience factors in nurses. Based on training programs with evidence for positive effects on resilience and mental health in meta-analyses, we aimed at identifying important and helpful intervention techniques. DESIGN Systematic review and meta-analyses based on a Cochrane review on pre-pandemic resilience interventions in healthcare professionals. DATA SOURCES MEDLINE, Embase, CENTRAL and 11 other databases were searched until June 2020 to identify eligible randomized controlled trials. Trial registers, reference lists and contact with authors were additional sources. REVIEW METHODS Two reviewers independently assessed study eligibility and extracted data. The Cochrane risk of bias assessment tool was used to evaluate the risk of bias of included studies. We conducted random-effects pairwise meta-analyses for five primary outcomes, including resilience. The intervention contents and techniques were narratively synthesized. RESULTS Of 39,794 records retrieved, 24 studies were included in the review (N = 1879 randomized participants), 17 in meta-analyses (n = 1020 participants). At post-intervention, we found very-low certainty evidence of moderate effects in favor of resilience training for resilience (standardized mean difference [SMD] 0.39; 95% CI [confidence interval] 0.12-0.66) and well-being (SMD 0.44; 95% CI 0.15-0.72), while there was no evidence of effects on symptoms of anxiety, depression and stress. The improvement of well-being was sustained in the short-term (≤3 months), with additional delayed benefits for anxiety and stress. There was no evidence of effects at later follow-ups, with the caveat of only three available studies. Among nine programs with evidence of positive moderate effect sizes, intervention contents included mindfulness and relaxation, psychoeducation, emotion regulation, cognitive strategies, problem-solving and the strengthening of internal and external resources. CONCLUSIONS Given the chronic stressor exposure in nursing staff, our findings may guide both the design and implementation of nurse-directed resilience interventions. To improve the certainty of evidence, more rigorous high-quality research using improved study designs (e.g., larger sample sizes, longer follow-up periods) is urgently needed. REGISTRATION PROSPERO 2017 CRD42017082827.
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Affiliation(s)
- Angela M Kunzler
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany.
| | - Andrea Chmitorz
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Faculty of Social Work, Health Care and Nursing, Esslingen University of Applied Sciences, Esslingen, Germany
| | - Nikolaus Röthke
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - Sarah K Schäfer
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Jutta Stoffers-Winterling
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany; Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany; Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
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Etesam F, Arab Bafrani M, Akbarpour S, Tarighatnia H, Rajabi G, Dolatshahi M, Vahabi Z. Depression, Anxiety and Coping Responses among Iranian Healthcare Professionals during the Coronavirus Disease (COVID-19) Outbreak. IRANIAN JOURNAL OF PSYCHIATRY 2022; 17:446-454. [PMID: 36817811 PMCID: PMC9922354 DOI: 10.18502/ijps.v17i4.10694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 09/10/2021] [Accepted: 08/22/2022] [Indexed: 11/24/2022]
Abstract
Objective: This cross-sectional study aimed to assess the effects of different coping strategies on the mood states (anxiety and depression) of healthcare providers in the novel coronavirus disease (COVID-19) pandemic. Method : From February to April 2020, we asked medical staff in 4 referral hospitals in Iran to voluntarily complete online questionnaires including: Generalized Anxiety Disorder (GAD-2) questionnaire, Patient Health Questionnaire (PHQ-2) and the Coping Strategies Questionnaire-28. Univariate and multiple logistic regressions were applied to identify the associations of coping strategies and mood states. Results: 258 people filled out the online questionnaire. Of them, 39.9% and 39.1% reported anxiety and depression, respectively, with age as a risk factor. Overall, participants used more emotion-based coping strategies. Anxiety and depression were associated with applying more of emotion-based and less of problem-based coping mechanisms. The findings remained stable even after adjustment for confounding variables including age, gender and direct contact with COVID-19 patients. Conclusion: Providing social support to health workers, planning to reduce their perceived stigma, and educating them about how to use more effective coping mechanisms can be beneficial in reducing the psychological impact on this segment of the population in the event of COVID-19.
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Affiliation(s)
- Farnaz Etesam
- Department of Geriatric Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran., Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Melika Arab Bafrani
- Students' Scientific Research Center (SSRC), School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Samaneh Akbarpour
- Occupational Sleep Research Centre, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Helia Tarighatnia
- Department of Geriatric Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Gilda Rajabi
- Department of Geriatric Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Dolatshahi
- Students' Scientific Research Center (SSRC), School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. , NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Zahra Vahabi
- Department of Geriatric Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran., Cognitive Neurology and Neuropsychiatry Division, Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Corresponding Author: Address: Cognitive Neurology and Neuropsychiatry Division, Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran, Postal Code: 13337159140. Tel: 98-21 55176818, Fax: 98-21 55412756, ,
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Bourgeault IL, Atanackovic J, McMillan K, Akuamoah-Boateng H, Simkin S. The pathway from mental health, leaves of absence, and return to work of health professionals: Gender and leadership matter. Healthc Manage Forum 2022; 35:199-206. [PMID: 35678073 PMCID: PMC9237852 DOI: 10.1177/08404704221092953] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Health professions are ranked among the most stressful occupations and have a much higher likelihood of absenteeism from work. In this article, we present findings from four health professional case studies in our Healthy Professional Worker partnership, involving surveys with 1,860 respondents and 163 interviews with nurses, physicians, midwives, and dentists conducted between December 2020 and April 2021. We found that the pathway from mental health experiences through to the decision to take a leave of absence and return to work differed between the health professions and that both gender and leadership matter greatly. There is a need to de-stigmatize mental health issues and encourage greater awareness and support from supervisors and colleagues. Leadership can play an important role in mitigating mental health issues, and as such investment in both leadership training and mentorship are important first steps in acting upon our research findings.
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Affiliation(s)
| | | | - Kim McMillan
- 151181University of Ottawa, Ottawa, Ontario, Canada
| | | | - Sarah Simkin
- 151181University of Ottawa, Ottawa, Ontario, Canada
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Mohamed BES, Ghaith RFAH, Ahmed HAA. Relationship between work–family conflict, sleep quality, and depressive symptoms among mental health nurses. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00183-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Nursing has a reputation for being one of the most stressful occupations. As a result of their work, many nurses suffer from anxiety and depression. Nurses are also at risk of poor sleep owing to their work nature. This study aimed to examine the relationship between work–family conflict, sleep quality, and depressive symptoms among mental health nurses. A descriptive cross-sectional study design was utilized in this study. Setting/sample: This study was conducted at El Azazi Hospital for Mental Health, Al-Sharkia Governorate on 139 mental health nurses. Four tools were used in this study: Socio-demographic data sheet, Work–Family Conflict Scale, Arabic Pittsburgh Sleep Quality Index, and Arabic Center for Epidemiologic Studies Depression Scale.
Results
Results revealed that, a significant percentage of mental health nurses suffered from poor sleep quality and depressive symptoms, there were highly statistically significantly positive correlations between work–family conflict (WFC) and both of Pittsburgh Sleep Quality Index (PSQI) and depressive symptoms among nurses.
Conclusions
Working with psychiatric patients affected their nurses, which disturbed their sleep quality and led to depressive symptoms. As well, increasing work–family conflict in mental health nurses leads to poor sleep quality and depressive symptoms. Family interference with work, sleep quality, and work interference with family were statistically significant predictors of depressive symptoms.
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Kakemam E, Navvabi E, Albelbeisi AH, Saeedikia F, Rouhi A, Majidi S. Psychometric properties of the Persian version of Depression Anxiety Stress Scale-21 Items (DASS-21) in a sample of health professionals: a cross-sectional study. BMC Health Serv Res 2022; 22:111. [PMID: 35078477 PMCID: PMC8789546 DOI: 10.1186/s12913-022-07514-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 01/18/2022] [Indexed: 12/21/2022] Open
Abstract
Background Although the Depression Anxiety Stress Scale-21 Items (DASS-21) has been used in different countries and translated into different languages, the Persian version of this scale has not been validated for healthcare professions in Iran. Therefore, the purpose of this study was to examine the psychometric properties of the Persian version of DASS-21 for nurses. Methods This cross-sectional study was conducted among 1135 nurses working in public hospitals, who were selected through convenience sampling. DASS-21, which consists of 21 items and three dimensions (depression, anxiety, and stress), has been translated into Persian, and there is an online version available. A confirmatory factor analysis (CFA) was performed to examine the factor structure of this scale. Cronbach’s alpha coefficient was also measured to establish internal consistency. Besides, the intraclass correlation coefficient (ICC) was calculated to assess the test-retest reliability. Results The Cronbach’s alpha coefficient was acceptable for anxiety (0.79), stress (0.91), and depression (0.93). An acceptable test-retest reliability (0.740-0.881, P < 0.01) was also reported for DASS-21 and its three dimensions. The results of CFA showed acceptable model fit (χ2/(df) = 1457/(186), P < 0.001), root mean square error of approximation (RMSEA = 0.078), Tucker-Lewis index (TLI = 0.906), comparative fit index (CFI = 0.917), and standardized root mean square residual (SRMR = 0.047). Fifty-seven nurses were included in the test-retest. The ICCs for all dimensions ranged from 0.75 to 0.86, indicating the acceptable test-retest reliability of the scale. Conclusion The Persian version of DASS-21 showed good psychometric characteristics, and it was confirmed as a valid and reliable tool for evaluating depression, anxiety, and stress among Iranian nurses. However, further validation studies of the Persian DSASS-21 are needed among other healthcare professionals, including physicians, midwives, and allied health professionals.
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Affiliation(s)
- Edris Kakemam
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elahe Navvabi
- Imam Hussein Hospital, Shahid Beheshti University of Medical sciences, Tehran, Iran
| | | | - Faeze Saeedikia
- Department of Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amin Rouhi
- Deputy of Treatment, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Soheila Majidi
- District Health Center of Hamadan City, Health Center of Hamadan City, Hamadan University of Medical Sciences, Hamadan, Iran.
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8
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Havaei F, Ma A, Leiter M, Gear A. Describing the Mental Health State of Nurses in British Columbia: A Province-Wide Survey Study. ACTA ACUST UNITED AC 2021; 16:31-45. [PMID: 34129477 DOI: 10.12927/hcpol.2021.26500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A cross-sectional province-wide survey study of 3,978 British Columbia (BC) nurses was conducted to explore the mental health state of the nursing workforce in BC. About one third of nurses reported depression and anxiety; about half reported symptoms of post-traumatic stress disorder and at least one third reported high levels of one or more dimensions of burnout. Mental health problems were about 1.5 to 3 times more prevalent among BC nurses compared to their peers nationally. Improving nurses' mental health requires multi-factorial and multi-level efforts. Evidence-based and workplace-specific policies and interventions that better support nurses at risk are recommended.
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Affiliation(s)
- Farinaz Havaei
- Assistant Professor, School of Nursing, University of British Columbia, Vancouver, BC
| | - Andy Ma
- Master of Arts Student in Measurement, Evaluation and Research Methodology, University of British Columbia, Vancouver BC
| | - Michael Leiter
- Honorary Professor of Organizational Psychology, Deakin University, Geelong, Australia
| | - Adriane Gear
- Case and Contact Management, Pandemic Response, Island Health; Former Consultant, Former Executive Councillor of Occupational Health and Safety, British Columbia Nurses' Union, Burnaby, BC
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Tian Y, Yue Y, Liao X, Wang J, Ye M, Liu Y, Li Y, Zhou J. Mental health service use and its associated factors among nurses in China: a cross-sectional survey. PeerJ 2021; 9:e11181. [PMID: 33868823 PMCID: PMC8029656 DOI: 10.7717/peerj.11181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/08/2021] [Indexed: 01/26/2023] Open
Abstract
Background To facilitate mental health service planning for nurses, data on the patterns of mental health service use (MHSU) among nurses are needed. However, MHSU among Chinese nurses has seldom been studied. Our study aimed to explore the rate of MHSU among Chinese nurses and to identify the factors associated with MHSU. Methods A self-designed anonymous questionnaire was used in this study. MHSU was assessed by the question, “Have you ever used any kind of mental health services, such as mental health outpatient services or psychotherapies, when you felt that your health was suffering due to stress, insomnia, or other reasons?” The answer to the question was binary (yes or no). Sleep quality, burnout, and depressive symptoms were assessed using the Chinese version of the Pittsburgh Sleep Quality Index , the Chinese version of the Maslach Burnout Inventory-General Survey and the two-item Patient Health Questionnaire, respectively. Chi-square tests and binary logistic regression were used for univariate and multivariate analyses. Results A total of 10.94% (301/2750) of the nurses reported MHSU. 10.25% (282/2750) of the nurses had poor sleep quality, burnout and depressive symptoms, and only 26.95% of these nurses reported MHSU. Very poor sleep quality (OR 9.36, 95% CI [5.38-16.29]), mid-level professional title (OR 1.48, 95% CI [1.13-1.93]) and depressive symptoms (OR 1.66, 95% CI [1.28-2.13]) were independent factors associated with MHSU. Conclusions Most of the nurses have experienced burnout, poor sleep quality or depressive symptoms and the MHSU rate among them was low. Interventions to improve the mental health of nurses and to promote the use of mental health services are needed.
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Affiliation(s)
- Yusheng Tian
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.,Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Yuchen Yue
- Department of Psychiatry at the Center for Addiction & Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - Xiaoli Liao
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China.,Clinical Nursing Teaching and Research Section, The second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jianjian Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Man Ye
- Clinical Nursing Teaching and Research Section, The second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yiting Liu
- Clinical Nursing Teaching and Research Section, The second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jiansong Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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Xie N, Qin Y, Wang T, Zeng Y, Deng X, Guan L. Prevalence of depressive symptoms among nurses in China: A systematic review and meta-analysis. PLoS One 2020; 15:e0235448. [PMID: 32634150 PMCID: PMC7340293 DOI: 10.1371/journal.pone.0235448] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 06/15/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Depression is one of the most common mental disorders, profoundly impacting an individual's performance and quality of life. Due to their unique working conditions, nursing is counted among the occupational groups at high risk for developing depression. Because of the shortage of nursing resources in China, Chinese nurses suffer from heavy daily workloads more than those in many other countries. Therefore, this study aimed to evaluate the overall prevalence of depressive symptoms and analyse the potential risk factors of depressive symptoms in Chinese nurses. METHODS A systematic literature search in PubMed, EMBASE, Web of Science, the Chinese BioMedical Literature Database (CBM), the China National Knowledge Infrastructure (CNKI), and the Weipu and Wanfang databases up to Dec 31st, 2019 was performed regarding the prevalence of depressive symptoms in Chinese nurses. Eligibility assessment and data extraction were performed independently by 2 researchers, and meta-analysis was used to synthesize the data. Heterogeneity was evaluated using Cochran's Q test and quantified using the I2 statistic. To explore the potential source of heterogeneity, subgroup analyses were also performed. In addition, both funnel plot and Egger's tests were adopted to assess publication bias. RESULTS A total of 102 studies published from 1996 to 2019 covering 22 provinces were included for further analysis. The total number of participants was 52,592, with a range of 46 to 7205 per study. The overall prevalence of depressive symptoms in Chinese nurses was 43.83% (95%CI: 40.26%-47.42%), and 31.12% (95%CI: 27.30%-35.07%) were classified as mild degrees of depressive symptoms. The prevalence of depressive symptoms may be significantly affected by region, province or municipality and department marital status. Moreover, an increasing trend in the prevalence of depressive symptoms was observed in recent years. CONCLUSION The results presented a high prevalence of depressive symptoms among Chinese nurses, which suggests interventional programmes by health decision-makers to improving the mental state of nurses is needed urgently, especially in nurses with high risk factors for depressive symptoms. Furthermore, the nationwide investigation of depressive symptoms prevalence should be performed with a standard diagnostic tool, which may be more useful for policy makers and planners.
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Affiliation(s)
- Nanzhen Xie
- Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing, People’s Republic of China
| | - Yan Qin
- Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing, People’s Republic of China
| | - Taiwu Wang
- Center for Disease Control and Prevention of Eastern Theater Command, Nanjing, People’s Republic of China
| | - Ying Zeng
- Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing, People’s Republic of China
| | - Xia Deng
- Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing, People’s Republic of China
| | - Li Guan
- Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing, People’s Republic of China
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Stanulewicz N, Knox E, Narayanasamy M, Shivji N, Khunti K, Blake H. Effectiveness of Lifestyle Health Promotion Interventions for Nurses: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:E17. [PMID: 31861367 PMCID: PMC6981404 DOI: 10.3390/ijerph17010017] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 12/15/2019] [Accepted: 12/15/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Prior research has investigated various strategies to improve health, wellbeing and the job-related outcomes of nurses. However, the scope of this evidence is not clear and the types of intervention most likely to have positive outcomes are unknown. OBJECTIVE To provide an overview and synthesis of the effectiveness of interventions conducted with the goal of improving health, wellbeing and the job-related outcomes of nurses. METHODS A systematic database search was conducted from January 2000 to December 2018, with pre-defined criteria (Cochrane Central Register of Controlled Trials; MEDLINE and PubMed; EMBASE; CINAHL; PsycINFO; and BioMed Central). In total, 136 intervention studies with a total sample of 16,129 participants (range 9-3381) were included and evaluated. Data extraction, quality assessment and risk of bias analyses were performed. RESULTS Studies included randomised controlled trials (RCTs; n = 52, 38%), randomised crossover design studies (n = 2, 1.5%) and non-randomised pre-post studies with a control group (n = 31, 23%) and without a control group (n = 51, 37.5%). The majority of interventions focused on education, physical activity, mindfulness, or relaxation. Thirty-seven (27%) studies had a multimodal intervention approach. On average, studies had relatively small samples (median = 61; mode = 30) and were conducted predominantly in North America (USA/Canada, n = 53). The findings were mixed overall, with some studies reporting benefits and others finding no effects. Dietary habits was the most successfully improved outcome (8/9), followed by indices of body composition (20/24), physical activity (PA) (11/14), and stress (49/66), with >70% of relevant studies in each of these categories reporting improvements. The lowest success rate was for work-related outcomes (16/32). Separate analysis of RCTs indicated that interventions that focus solely on education might be less likely to result in positive outcomes than interventions targeting behavioural change. CONCLUSIONS Interventions targeting diet, body composition, PA, or stress are most likely to have positive outcomes for nurses' health and/or wellbeing. The methodologically strongest evidence (RCTs) is available for body composition and stress. Interventions relying solely on educational approaches are least likely to be effective. Organisational outcomes appear to be more challenging to change with lifestyle intervention, likely requiring more complex solutions including changes to the work environment. There is a need for more high-quality evidence since many studies had moderate or high risk of bias and low reporting quality.
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Affiliation(s)
- Natalia Stanulewicz
- School of Applied Social Sciences, De Montfort University, Leicester LE1 9BH, UK
| | - Emily Knox
- Infant Nutrition and Metabolism, University of Granada, 52005 Granada, Spain;
| | - Melanie Narayanasamy
- School of Health Sciences, University of Nottingham, Nottingham NG7 2RD, UK; (M.N.); (H.B.)
| | - Noureen Shivji
- School of Primary, Community and Social Care, Keele University, Staffordshire ST5 5BG, UK;
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester LE1 7RH, UK;
| | - Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham NG7 2RD, UK; (M.N.); (H.B.)
- NIHR Nottingham Biomedical Research Centre, Nottingham NG7 2UH, UK
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Ross R, Letvak S, Sheppard F, Jenkins M, Almotairy M. Systemic assessment of depressive symptoms among registered nurses: A new situation-specific theory. Nurs Outlook 2019; 68:207-219. [PMID: 31543282 DOI: 10.1016/j.outlook.2019.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 08/09/2019] [Accepted: 08/25/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND A mentally-healthy nursing workforce is vital to providing quality healthcare. While there has been research conducted internationally on depressive symptoms in nurses, most studies have lacked a theoretical framework. PURPOSE The purpose of this article is to describe the development of a situation-specific theory, the Systemic Assessment of Depressive Symptoms among Registered Nurses (SAD-RN). METHODS The SAD-RN was developed through theory synthesis using the Roy's Adaptation Model (RAM) as a framework. Sixty-four research articles were selected to abstract relevant concepts based on a priori RAM concepts. FINDINGS Using depressive symptoms as the anchor concept, related emergent concepts of SAD-RN include context, stressors, protective factors, negative health outcomes, and low patient care quality. DISCUSSION SAD-RN is an evidence-based comprehensive model that offers researchers a guiding theory to be used in their future research on depressive symptoms among RNs.
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Affiliation(s)
- Ratchneewan Ross
- School of Nursing, University of North Carolina Greensboro, Greensboro, NC.
| | - Susan Letvak
- School of Nursing, University of North Carolina Greensboro, Greensboro, NC
| | - Francine Sheppard
- Francine Sheppard's affiliation to Western Carolina University, Cullowhee, NC
| | - Marjorie Jenkins
- School of Nursing, University of North Carolina Greensboro, Greensboro, NC
| | - Monir Almotairy
- School of Nursing, University of North Carolina Greensboro, Greensboro, NC
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Tsaras K, Daglas A, Mitsi D, Papathanasiou IV, Tzavella F, Zyga S, Fradelos EC. A cross-sectional study for the impact of coping strategies on mental health disorders among psychiatric nurses. Health Psychol Res 2018; 6:7466. [PMID: 30596156 PMCID: PMC6247012 DOI: 10.4081/hpr.2018.7466] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 06/15/2018] [Indexed: 02/03/2023] Open
Abstract
Several studies report that psychiatric nursing is a highly stressful occupation. The ways that nurses use in order to deal with stressful situations have a serious effect on their psychological mood and their health status. The purpose of this study was to investigate the coping strategies in predicting of depression and anxiety among mental health nurses working in public psychiatric hospitals. A descriptive, cross-sectional study was conducted in Athens, Greece from April to May 2017. A questionnaire consisting of the socio-demographic and work-related characteristics, the Patient Health Questionnaire-2, the Generalized Anxiety Disorder-2, and the 38-items Ways of Coping Questionnaire - Greek version, was completed by a total of 110 mental health nurses. Univariate and multivariate analyses were performed using the logistic regression model. Coping strategies focused on the problem (positive re-evaluation, positive approach, problem solving, and seeking social support) were the most commonly used by the mental health nurses. Strategies focused on emotion (prayer/daydream, prayer, avoidance/escape, resignation, and denial) were positively associated with depression and anxiety outcomes. Also, the coping skills of problem solving (Adjusted Odds Ratio, AOR=0.402), and seeking social support (AOR=3.719) were significant predictors only for elevated anxiety symptoms. The results from the study demonstrated the importance of coping behaviours in mental health problems of psychiatric nurses.
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Affiliation(s)
- Konstantinos Tsaras
- Department of Nursing, Technological Educational Institute of Thessaly, Larissa
| | | | | | | | | | - Sofia Zyga
- Department of Nursing, University of Peloponnese, Sparta
| | - Evangelos C Fradelos
- Psychiatric Department, "Sotiria" Athens General Hospital for Chest Diseases, Department of Nursing, University of Peloponnese, Sparta, Greece
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