The relationship between self-esteem of nurses and their choice of strategies to cope with workload burden

Nurses experiences regarding ideal clinic project implementation in eThekwini district

Background

The South African National Department of Health introduced the ideal clinic realisation and maintenance (ICRM) programme in response to primary health care (PHC) services and to lay a strong foundation for the National Health Insurance implementation. The progress report 2015-2016 on the implementation of this programme indicated that achieving the 50% target in selected vital areas such as staffing, resource allocation, and utilisation was not achieved.

Aim

The study aimed to explore and describe nurses' experiences regarding the ideal clinic project (ICP) implementation.

Setting

The study was conducted in 18 PHC clinics in eThekwini district, KwaZulu-Natal.

Methods

An exploratory descriptive, contextual qualitative design was employed guided by Donabedian's structure, process, and outcomes model. Data were collected using semi-structured interviews with 24 nurses between 15 September and 25 October 2020 following receipt of ethics and analysed using Tesch's open coding approach.

Results

The three themes that emerged included structural limitations, processes involved in running the clinic, and support offered to the PHC clinics. These were highlighted as challenges experienced by nurses during the implementation of an ICP.

Conclusion

Nurses' negative experiences and perceptions made it difficult for them to accomplish the ICP standards.

Contribution

The findings from the study highlighted critical actions by the health care institution management which if instituted, could facilitate improved implementation of the ICP and achievement of the 50% target in selected vital areas.

Exploring Resilience in Care Home Nurses: An Online Survey

Resilience is considered a core capability for nurses in managing workplace challenges and adversity. The COVID-19 pandemic has brought care homes into the public consciousness; yet, little is known about the resilience of care home nurses and the attributes required to positively adapt in a job where pressure lies with individuals to affect whole systems. To address this gap, an online survey was undertaken to explore the levels of resilience and potential influencing factors in a sample of care home nurses in Northern Ireland between January and April 2022. The survey included the Connor-Davidson Resilience Scale, demographic questions and items relating to nursing practice and care home characteristics. Mean differences and key predictors of higher resilience were explored through statistical analysis. A moderate level of resilience was reported among the participants (n = 56). The key predictors of increased resilience were older age and higher levels of education. The pandemic has exposed systemic weakness but also the strengths and untapped potential of the care home sector. By linking the individual, family, community and organisation, care home nurses may have developed unique attributes, which could be explored and nurtured. With tailored support, which capitalises on assets, they can influence a much needed culture change, which ensures the contribution of this sector to society is recognised and valued.

Factors of maladaptive coping in emergency healthcare professionals: A systematic review

BACKGROUND

Emergency healthcare professionals (EHPs) face significant occupational stressors requiring the skilled use of adaptive coping strategies. Some EHP resort to maladaptive coping (MC) strategies that negatively impact their mental health, yet MC strategies are not clearly defined in the literature. Examining factors that predispose EHP to MC can support interventions to improve coping and well-being.

OBJECTIVE

This systematic review examined MC among EHP working in pre-hospital and hospital-based settings. The primary aim was to identify factors associated with MC strategies used by EHP.

METHODS

Embase, Ovid, CINAHL Plus, PsychInfo, and the Cochrane Library were systematically searched for quantitative studies measuring MC use among EHP. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 checklist was used to guide the review. Studies were included if they: (a) targeted licensed healthcare professionals providing patient care, (b) occurred in emergency department or pre-hospital emergency setting, and (c) examined provider coping. Studies were excluded if they: (a) did not include EHPs, (b) did not differentiate results in mixed samples, (c) did not clearly measure coping strategies, (d) failed to include MC strategies in the results, or (e) were not available in full text. Risk of bias and study quality was appraised using Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Bandura's Social Cognitive Theory (SCT) guided the final synthesis, drawing conclusions from the evidence to identify factors associated with MC in EHP.

RESULTS

A total of 14 cross-sectional studies, published between 2003 and 2021, were included in the review. Included studies were conducted in either pre-hospital, hospital, or a combination of both settings. Most studies included mixed samples or emergency physicians. A variety of coping strategies were significantly correlated with poor mental health outcomes including venting, denial, disengagement, self-blame, and substance use. Among personal factors, EHPs who were female, older than 50, living alone, with personal trauma history were significantly more likely to use MC strategies. Additionally, EHP with children, work experience, higher life satisfaction, and resilience were negatively associated with MC. Environmental factors positively associated with MC included work stress, workload, and poor benefits. Trauma exposure had a positive, but non-significant relationship.

CONCLUSIONS

Emergency healthcare professionals use a variety of coping strategies, many of which are maladaptive and significantly related to poor mental health outcomes. Several personal and environmental factors contribute to behavior that reflect the use of MC strategies, but findings are sparse. Researchers should consider current limitations and challenges, particularly mental health stigma, when designing future studies.

CLINICAL RELEVANCE

The evidence in this review suggests that certain factors predispose EHP for use of MC strategies. This review highlights an important research gap necessitating more robust studies to identify MC risk factors among EHP in chronically high-stress environments.

Global Self-Esteem and Stress Intensity in a Group of Polish Nurses-A Mediatory Role of a Sense of Coherence

(1) Owing to their resistance resources, nurses can reduce the effects of stress, increase their commitment to work and improve their functioning in the face of challenges in the workplace. The aim of this study was to determine the mediatory role of a general sense of coherence and a sense of comprehensibility, manageability and meaningfulness correlated with global self-esteem and the perceived stress intensity in a group of Polish nurses aged 45–55 years. (2) The research using the diagnostic survey method was conducted on a group of 176 nurses (M = 49.1; SD = 3.1) working in seven hospitals located in Olsztyn (Poland). The following were used for data collection: Perceived Stress Scale - PSS-10, Rosenberg’s Self-Esteem Scale and Antonovsky’s Sense of Coherence (SOC-29) Questionnaire. (3) According to 21.02% of the nurses, their stress level at the workplace was low, 44.89% reported it was medium and 34.09% reported it was high. The self-esteem of nearly half of the nurses included in the study (48.30%) was at a medium level, 31.82% felt it was high and 19.89% felt it was low. The mediation analysis showed that a general sense of coherence and a sense of comprehensibility, manageability and meaningfulness have a mediator status in a correlation between global self-esteem and stress intensity. However, their mediatory role is partial. It is desirable for safe work environment promotion programmes to reinforce nurses’ personal resources, which can be helpful in coping with stressors.