[Depression and suicide risk among nursing professionals: an integrative review]

Investigating the association between Work Family Conflicts (WFC) and suicidal ideation in an Australian community-based cohort study

BACKGROUND

Suicidal ideation, a significant public health issue, necessitates further investigation of its correlates and precursors. Extensive research highlights the association between Work Family Conflicts (WFC) and psychological distress, including depression. However, research examining the correlation between high WFC experiences and suicidal ideation is sparse. This study explores the association between WFC and suicidal ideation within an occupation non-specific community sample.

METHODS

Community-based, representative data from the Australian-based Personality and Total Health (PATH) Through Life project formed the basis of this study. Participants eligible for the study (N = 1312) were employed either full-time or part-time and took part in an online questionnaire. Importantly, the data include robust measures of WFC, active suicidal ideation, and depression.

RESULTS

After adjusting for psychosocial job characteristics, history of suicidal ideation, and other socio-demographic factors, high WFC was associated with increased odds of active suicidal ideation (Model 4: OR: 1.58, CI: 1.04-2.40). Further, supplementary analyses indicated that depression is an important component of this relationship. Analyses exploring an interaction effect by gender showed that while a significant association between high WFC and suicidality was observed among men after adjustment for all covariates, this association was not evident for women.

LIMITATIONS

A small number of participants reported suicidal ideation, potentially affecting the statistical power to detect significant effects. WFC was measured at one time-point, prohibiting the exploration of its causal and/or chronic impact on suicidal ideation.

CONCLUSION

We find evidence that high WFC is linked to increased active suicidal ideation - specifically for men.

Moral injury and mental health outcomes in nurses: A systematic review

Introduction: Moral injury involves the adverse psychological, biological, spiritual, behavioural, and social consequences of actions that violate moral values. It can lead to anxiety, depression, burnout, and post-traumatic stress disorder. Nurses, who often face ethical dilemmas, are particularly vulnerable. Despite its significance, the relationship between moral injury and mental health outcomes in nurses remains underexplored. Aim: This systematic review aimed to describe the associations among moral injury, anxiety, depression, and quality of life in nurses. Methods: The review was registered in PROSPERO (CRD42023438731) and was conducted following the PRISMA guidelines. A literature search was performed in December 2023 across PubMed, CINAHL, Scopus, and Web of Science. Peer-reviewed primary research involving nurses, published in English or Italian, without time restrictions, was considered eligible. The risk of bias and the quality of evidence were assessed using the Joanna Briggs Institute checklist and the GRADE approach. Results: Out of 4730 articles identified, eight met the inclusion criteria. The analysis revealed significant positive associations between moral injury, anxiety, and depression, along with a significant negative association with quality of life. Conclusion: These findings highlight the need for healthcare systems to implement strategies that mitigate moral injury among nurses. Future research should prioritize longitudinal studies to explore causal relationships and develop targeted interventions. Additionally, standardizing the concept and measurements of moral injury is crucial for enhancing the comparability and understanding of this phenomenon.

Burnout among Nurses: A Bibliometric Analysis of the Global Publications

Objective

To investigate the current situation, trending subjects, and future directions in the field of burnout among nurses, and to serve as a resource for researchers conducting related research.

Methods

The bibliometric analysis was carried out using R package "bibliometrix", bibliometric online analysis platform (https://bibliometric.com/) and VOSviewer (1.6.18).

Results

The leading countries that had a significant impact on this field were the USA and China. University of Pennsylvania was the most influential institution. Journal of Nursing Management was the top productive journal. Critical care, oncology care, acute care, and infectious disease care were more likely to lead to symptoms of burnout among nurses. "Mental health", "job satisfaction", "stress", and "COVID-19" were the current hot topics in this field.

Conclusion

Our study not only provides a thorough outline to assist researchers in understanding the leading countries, institutions, journals, and potential collaborators, but it also examines the current and upcoming trends in this field and inspires researchers to select research directions.

Relationship between depression and burnout among nurses in Intensive Care units at the late stage of COVID-19: a network analysis

BACKGROUND

Mental health problems are critical and common in medical staff working in Intensive Care Units (ICU) even at the late stage of COVID-19, particularly for nurses. There is little research to explore the inner relationships between common syndromes, such as depression and burnout. Network analysis (NA) was a novel approach to quantified the correlations between mental variables from the perspective of mathematics. This study was to investigate the interactions between burnout and depression symptoms through NA among ICU nurses.

METHOD

A cross-sectional study with a total of 616 Chinese nurses in ICU were carried out by convenience sampling from December 19, 2022 to January19, 2023 via online survey. Burnout symptoms were measured by Maslach Burnout Inventory-General Survey (MBI-GS) (Chinese version), and depressive symptoms were assessed by the 9-item Patient Health Questionnaire (PHQ-9). NA was applied to build interactions between burnout and depression symptoms. We identified central and bridge symptoms by R package qgraph in the network model. R package bootnet was used to examined the stability of network structure.

RESULTS

The prevalence of burnout and depressive symptoms were 48.2% and 64.1%, respectively. Within depression-burnout network, PHQ4(Fatigue)-MBI2(Used up) and PHQ4(Fatigue)-MBI5(Breakdown) showed stronger associations. MBI2(Used up) had the strongest expected influence central symptoms, followed by MBI4(Stressed) and MBI7 (Less enthusiastic). For bridge symptoms. PHQ4(Fatigue), MBI5(Breakdown) and MBI2(Used up) weighed highest. Both correlation stability coefficients of central and bridge symptoms in the network structure were 0.68, showing a high excellent level of stability.

CONCLUSION

The symptom of PHQ4(Fatigue) was the bridge to connect the emotion exhaustion and depression. Targeting this symptom will be effective to detect mental disorders and relieve mental syndromes of ICU nurses at the late stage of COVID-19 pandemic.

The Prevalence and Correlation of Suicidal Ideation Among Nurses in King Saud University Medical City

Objectives The aim of the study is to measure the prevalence of suicidal ideation among nurses at King Saud University Medical City, compare its prevalence between male and female nurses, and identify the potential risk factors. Methods We conducted a cross-sectional study. The questionnaire was distributed to nurses via email. It consisted of demographics, Depression, Anxiety and Stress Scale (DASS21), and Suicidal Ideation Scale (SIS). We used the Statistical Package for the Social Sciences (SPSS) statistical software for analysis. Results The total number of participants was 419. The estimated prevalence of suicidal ideation among nurses was 24.58%. The prevalence among female and male nurses was 24.67% and 23.68%, respectively. Moreover, we found that nurses who are non-Muslim, single, and living by themselves are highly correlated with suicidal ideation. Depression, stress, and anxiety are also significantly associated with suicidality, with depression being the most significantly related to suicidal ideation. Conclusion Nurses who experienced depression, anxiety, and stress had an increased likelihood of suicidal ideation. This study demonstrates the need to raise awareness of depression, anxiety, and stress in order to prevent suicidal ideation among nurses. Further research is needed to develop measures of successful monitoring and prevention.

Exploring the Mental Health Challenges of Emergency Medicine and Critical Care Professionals: A Comprehensive Review and Meta-Analysis

Burnout and depression are global problems affecting healthcare providers, especially those working in stressful departments such as emergency departments (EDs) and critical care units (CCUs). However, pooled data analysis comparing healthcare providers operating in the ED and CCU is yet to be conducted. Therefore, this meta-analysis was systematically conducted to investigate and compare the prevalence of burnout and depression among emergency medicine (EM) and critical care medicine (CCM) professionals. We systematically searched for articles related to our research topic using the database search method and manual search method, which involved reviewing the reference lists of articles from electronic databases for additional studies. After screening the literature from the databases using the eligibility criteria, a quality appraisal using the Newcastle-Ottawa scale was performed on the eligible studies. In addition, a meta-analysis using the Review Manager software was performed to investigate the prevalence rates of burnout and depression. A total of 10 studies with 1,353 EM and 1,250 CCM professionals were included for analysis in the present study. The pooled analysis did not establish any considerable differences between EM and CCM healthcare workers on the prevalence of high emotional exhaustion (EE) (odds ratio (OR) = 1.01; 95% confidence interval (CI) = 0.46-2.19; p = 0.98), high depersonalization (OR = 1.16; 95% CI = 0.61-2.21; p = 0.64), low personal accomplishment (PA) (OR = 0.87; 95% CI = 0.67 - 1.12; p = 0.28), and depression (OR = 1.20; 95% CI = 0.74-1.95; p = 0.45). Moreover, pooled data showed no considerable differences in EE scores (mean difference (MD) = -1.07; 95% CI = -4.24-2.09; p = 0.51) and depersonalization scores (MD = -0.31; 95% CI = -1.35-0.73; p = 0.56). However, EM healthcare workers seemed to have considerably lower PA scores than their CCM counterparts (MD = 0.12; 95% CI = 0.08-0.16; p < 0.00001). No considerable difference was recorded in the prevalence of burnout and depression between EM and CCM healthcare workers. However, our findings suggest that EM professionals have lower PA scores than CCM professionals; therefore, more attention should be paid to the mental health of EM professionals to improve their PA.

Recognition of Facial Expressions of Emotion and Depressive Symptoms among Caregivers with Different Levels of Empathy

OBJECTIVES

To assess differences in the recognition of facial expressions of emotion among caregivers of older people with different levels of empathy.

METHODS

A cross-sectional study was conducted with 158 caregivers of older adults who provided care in family residences or nursing homes. The caregivers were divided into three groups based on the score of the multidimensional Interpersonal Reactivity Index: "lower empathy", "intermediate empathy", and "higher empathy". Data collection involved the administration of a sociodemographic questionnaire, the Emotion Recognition Test, and the Patient Health Questionnaire.

RESULTS

No significant differences were found among the groups in terms of sociodemographic variables. Regarding clinical characteristics, the "higher empathy" group had more depressive symptoms than the other groups (p = .001). Moreover, the "higher empathy" group exhibited greater accuracy at recognizing the expression of sadness than the "lower empathy" group (p = .033). The recognition of sadness remained significant in the analysis of variance adjusted for depressive symptoms (p < .05).

CONCLUSIONS

Caregivers with higher levels of empathy showed greater accuracy at recognizing sadness emotion compared to caregivers with lower levels of empathy. Additionally, caregivers with greater empathy have more depressive symptoms.

CLINICAL IMPLICATIONS

The recognition of facial expressions of sadness may give caregivers a skill to infer possible needs in older care recipients. However, a higher level of empathy may exert a negative psychological impact on caregivers of older people, which could have repercussions regarding the quality of care provided.

Frontline nurses' burnout and its associated factors during the COVID-19 pandemic in South Korea

Background

The Coronavirus disease pandemic is a global health crisis with psychological consequences for healthcare workers.

Purpose

To identify the prevalence and potential factors influencing burnout among frontline nurses in South Korea.

Methods

This cross-sectional study comprised 161 nurses who voluntarily participated in the survey through advertisements at a general hospital. Data on sociodemographic and professional characteristics, insomnia, depression, anxiety, stress, and burnout were collected via an online questionnaire in 2021.

Results

Among the participants, 90 had a high level of burnout. Overall, 59.6 %, 23.0 %, 36.0 %, and 17.4 % of nurses experienced insomnia, depression, anxiety, and stress, respectively. The results showed that the assigned number of patients, insomnia, and depression were the major factors affecting burnout levels of nursing staff.

Conclusions

Frontline nurses were the main force in the fight against public health emergencies. The government and medical institutions must consider professional and psychological factors in ameliorating burnout and safety for nurses.

Detect-S: an mHealth application to assist health professionals to identify suicide risk in hospitalized patients

INTRODUCTION

Suicide is a serious public health problem that affects the whole world. This study describes development of the prototype for an mHealth application (app) intended to assist healthcare professionals to identify suicide risk in hospitalized patients and reports on testing of the app by some of these professionals, conducted to confirm its functionality.

METHOD

This is applied exploratory research into use of Information Technology within the healthcare field, based on application prototyping for mobile devices. The research was conducted at the Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) from 2017 to 2019. Six healthcare professionals, one data scientist, and three undergraduate students in Biomedical Informatics took part in the study. All research participants signed the free and informed consent form.

RESULTS

The main findings show that the development team created a prototype named Detect-S, which became a cross-platform application (iOS and Android) offering 16 functions.

CONCLUSION

It can be concluded that Detect-S has the potential to be a positive technological instrument that can be tested in a hospital setting to assist healthcare professionals to identify and manage patients with at risk of suicide.

Burnout and depression in nurses: A systematic review and meta-analysis

BACKGROUND

Nurses work in stressful and demanding settings and often suffer from depression and burnout. Despite overlapping symptoms, research has been inconclusive regarding the discriminant validity of measures of burnout with regard to measures of depression. Such inconclusive discriminant validity might cause clinicians to fail to recognize and manage depression separately from burnout.

OBJECTIVES

This meta-analysis aimed to clarify the distinctiveness of burnout as a separate construct by examining the size of the relationship between burnout and depression among nurses as well as potential moderators.

METHOD

A stepwise method was used by searching 4 databases (PubMed, CINAHL, PsycINFO, and EMBASE) to retrieve published papers in English examining the relationship between burnout and depression among nurses and reporting the effect sizes of their findings.

RESULTS

We identified a total of 37 eligible studies. The pooled estimate showed a positive association between burnout and depression among nurses (r = 0.403, 95% CI [0.327, 0.474], p < 0.0001) and a slightly higher correlation coefficient for the Emotional Exhaustion subscale of the Maslach Burnout Inventory (MBI) measure (0.494, 95% CI [0.41, 0.57]).

CONCLUSIONS AND IMPLICATIONS

This review confirms a large burnout - depression correlation in nursing samples, adding to existing literature encompassing a variety of occupations. Future studies should focus on path analysis to assess the causal relationship as well as investigate potential moderators.

Risk Factors of Metabolic Syndrome among Polish Nurses

The metabolic syndrome, also known as syndrome X or the insulin resistance, is defined by the World Health Organization as a pathologic condition characterized by abdominal obesity, insulin resistance, hypertension, and hyperlipidemia. Both all over the world and in Poland, there is a shortage of nurses; most of those employed are in the pre-retirement age. However, the requirements in this profession and the patient’s right to care at the highest level remain unchanged and do not take into account the poor condition or age of working nurses, so special attention should be paid to the state of health in this professional group. There is an emphasis on the importance of the adopted attitude toward health and the resulting behaviors, such as regular weight control, following dietary recommendations, regular physical activity and participation in preventive examinations. The aim of the study was to assess the frequency of the occurrence of the metabolic syndrome, its individual components and determining the factors influencing its development in Polish nurses. The research conducted among the nurses in question included DXA (Dual Energy X-ray Absorptiometry) measurements, assessment of glucose concentration, lipid profile, blood pressure and a questionnaire survey. Almost half of the surveyed nurses have metabolic syndrome, which significantly increases the risk of developing cardiovascular diseases or diabetes. After multivariate analysis, it was found that being overweight and obesity were significant factors influenced the MS (metabolic syndrome) occurrence among Polish nurses. Being overweight increases the chances of MS occurrence 8.58 times in relation to BMI (Body Mass Index) <25, obesity increases the chances of MS occurrence 8.085 times in relation to BMI <25, and obesity class II/III increases the chances of MS occurrence 16.505 times in relation to BMI <25. Preventive and supportive measures for this professional group are needed.

Decline in the mental health of nurses across the globe during COVID-19: A systematic review and meta-analysis

BACKGROUND

Nurses represent the major proportion of frontline health care professionals delivering 24/7 services to patients with an increased vulnerability towards COVID-19 infection. Mental health issues among nurses during the COVID-19 pandemic are poorly reported across the globe. Henceforth, a systematic review and meta-analysis was performed to explore the prevalence and determinants of mental health outcomes (anxiety, stress, depression, PTSD, insomnia) among nurses across the globe due to the COVID-19.

METHODS

A PRISMA compliant systematic review (PROSPERO-CRD 42020204120) was carried out to identify articles from multiple databases reporting the prevalence of mental health outcomes among nurses. Proportion random effect analysis, I2 statistic, quality assessment, and sensitivity analysis were carried out.

RESULTS

Pooled data on mental health outcomes were generated from 25 cross-sectional studies: 32% anxiety (95% confidence interval (CI) = 21%-44%, n (number of studies) = 21, N (sample size) = 13 641), 40.6% stress (95% CI = 25.4%-56.8%, n = 10, N = 4204), 32% depression (95% CI = 21%-44%, n = 17, N = 12 294), 18.6% PTSD (95% CI = 4.8%-38%, n = 3, N = 638), 38.3% insomnia (95% CI = 5.8%-78.6%, n = 2, N = 261) and significant risk factors for mental ailments includes; caring for COVID-19 patients, being a female, low self-efficacy, resilience, social support and having physical symptoms (sore-throat, breathlessness, cough, lethargy, myalgia, fever).

CONCLUSION

The study results highlighted a higher proportion of poor mental health outcomes namely, anxiety, stress, depression, PTSD and insomnia among nurses from different parts of the world. Poor mental health outcomes among nurses warrants the need to implement proactive psychological interventions to deter the collapse of health care systems in responding to the pandemic and in particular all possible efforts should be undertaken to mitigate the risk factors. Health care organizations should provide support to nurses with sufficient flexibility. The disaster preparedness plan envisaged by nations should have provisions to address the mental health of nurses. Greater investment in addressing the global shortage of nurses should be given priority in national health policies. Attractive salary packages should be offered to nurses to prevent their emigration from low- and middle-income countries (LMICs).

REGISTRATION

PROSPERO (CRD42020204120).

Burnout and presenteeism among healthcare workers in Nigeria: Implications for patient care, occupational health and workforce productivity

Background: Burnout and presenteeism are two emerging occupational health challenges which share same locus among healthcare workers, and the trend is rising. We aim to define the magnitude of burnout and presenteeism among frontline members of the health workforce and explore any correlation between the two in order to provide empirical data from our socioeconomic and geographical background.

Design and Methods: We used self-administered questionnaire to conduct a cross-sectional study among the physicians and nurses in a regional trauma centre in Enugu, Eastern Nigeria; with the respondents selected by stratified random sampling. The Oldenburg burnout inventory and Stanford presenteeism scale were used to measure burnout and presenteeism respectively, while the 2-item patient-health questionnaire (PHQ-2) was used to screen for depression. The level of statistical significance was determined by a p value of <0.05.

Results: Among the healthcare workers surveyed (n=155); 34 (21.9%) were physicians, while 121 (78.1%) were nurses. Burnout prevalence was 69%. Burnout was associated with self-rated health status and length of years in professional service but not the occupation or depression screen status of the worker. Sixty-two healthcare workers (40%) screened positive for depression. A positive screen for depression was the only factor that had significant association with lower presenteeism scores (p=0.002). The mean presenteeism scores had strong negative correlation with both the exhaustion (p<0.001) and disengagement (p<0.001) domains of burnout.

Conclusion: Burnout is high among the healthcare workers and correlates with presenteeism scores. The mental health of the workforce greatly impaired their productivity.

Frequency of suicide attempts and attitudes toward suicidal behaviour among doctors and nurses in Lagos, Nigeria

Background

Competence and attitudes toward suicidal behaviour affect practice. These attitudes may influence the consideration of suicide during personal crisis among doctors and nurses.

Aim

The attitudes of doctors and nurses towards suicidal behaviour was assessed using the Attitudes Toward Suicide Scale (ATTS), which was validated in another study by the authors, evaluated for the possible factors affecting this relationship and estimated the frequency of suicide attempts among doctors and nurses.

Setting

Lagos State University Teaching Hospital Lagos, Nigeria.

Methods

The cross-sectional survey about attitudes toward suicide was done among 226 doctors and nurses working at a tertiary institute hospital in Lagos, Nigeria, using the ATTS. Sociodemographic profile and self-rated competence, commitment, empathy and irritation toward suicide were obtained. Stratified random sampling was used, data were analysed using Statistical Package for Sociological Sciences. Data was summarised, reliability of the ATTS was assured and variables compared by t-test and ANOVA. Independent predictors were identified via multiple regression (p ≤ 0.05).

Results

Frequency of suicide attempts of 7.50% was found among respondents with a mean age of 35.84 ± 6.76 years. Attitudes toward suicidal behaviour were slightly positive (77.92 ± 9.90) and the independent predictors of less positive attitudes were nursing profession (β = 0.025, p < 0.001) and high self-rated irritation toward suicide (β = 0.18, p < 0.01).

Conclusion

The frequency of suicide attempts is higher among doctors and nurses when compared to the general population. Doctors and nurses reported slightly positive attitudes toward suicidal behaviour with significant differences in the type of profession and levels of self-rated irritation toward suicide.

Depressive disorders as cause of absenteeism among public sector health care workers in Sergipe, Brazil, from 2009 to 2017

Background

Health care workers are available to provide care to patients, but lack of concern with their lives, work organization and difficult interpersonal relationships make them susceptible to physical or mental diseases.

Objective

To establish the profile of health care workers in the public sector in Sergipe, Brazil, granted sick leave due to depression, frequency of relapse and characteristics of absenteeism.

Methods

Cross-sectional and descriptive study in which we analyzed secondary data for the period from 2009 2017 available in the State Secretariat of Planning, Budget and Management electronic records.

Results

Sixty-three workers required sick leave, representing a total of 290 medical legal examinations. Workers who required sick leave were mostly female (90.5%), married (54.0%), had a master's degree (33.3%) and were nursing technicians (34.9%). The most frequent diagnosis as per the International Classification of Diseases (ICD-10) was single major depressive disorder (F32), 26.5%. The average number of recurrent spells was 3.6 per worker.

Conclusion

The prevalence of depression among the analyzed health care workers was high and thus represents a cause of concern requiring intervention.

Common mental disorders in nursing students of the professionalizing cycle

ABSTRACT Objectives: to verify the suspicion of common mental disorders in nursing students of the professionalizing cycle and the association with sociodemographic features. Method: cross-sectional study with a sample of 85 students from a public university in the state of Rio de Janeiro (RJ) who responded to the Self-Report Questionnaire-20 and sociodemographic questions. Results: the suspicion prevalence of common mental disorders (CMD) in the sample was 55.3% and it was identified the association with the consumption of alcohol. Of the most frequent SRQ-20 complaints, 95.3% reported “feeling nervous, tense or worried”, 72.9% “having difficulty making decisions”, 60% “sleeping poorly” and 37.6% “having lost interest by things “. Conclusion: high prevalence of CMD in the sample and the association with the consumption of alcohol requires preventive and therapeutic actions among the students that minimize the possibility of severe mental disorders related to the consumption of alcohol and other drugs.

Lagged versus concurrent changes between burnout and depression symptoms and unique contributions from job demands and job resources

Burnout and depression pose significant threats to emotional and occupational functioning; however, questions exist over how these 2 conditions are associated with each other over time, and how these are related to underlying job stressors. The job demands-resources model provides a useful framework for understanding how job demands and job resources may lead to burnout, but questions remain about their distinct association with depression symptoms. The current study examined these questions in a sample of 402 nursing workers. The Exhaustion subscale of the Oldenburg Burnout Inventory, the Patient Health Questionnaire-9 depression assessment, and items reflecting job demands and job resources from the Copenhagen Psychosocial Questionnaire were assessed at baseline; additionally, Oldenburg Burnout Inventory Exhaustion and Patient Health Questionnaire-9 depression were assessed over 12 monthly follow-ups. Linear mixed models assessed longitudinal bidirectional associations between burnout and depression in both concurrent and lagged models. Longitudinal models found bidirectional relationships between burnout and depression symptoms over time, with relatively stronger associations for concurrent models relative to lagged models. Job demands and job resources each predicted unique variance in burnout and depression symptoms over time. Results provide evidence that burnout and depression symptoms change in the same direction, in tandem, rather than one condition having a distinctly stronger temporal association over the other. Results also indicate that both job demands and job resources are associated with depression symptoms independent from their association with burnout symptoms. Our results highlight the importance of considering burnout symptoms, depression symptoms, and job stressors concurrently in evaluating worker mental health. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Prevalence and factors associated with suicide among medical professionals in low/middle-income countries: a systematic review protocol

INTRODUCTION

A number of studies in low/middle-income countries (LMICs) have reported varying prevalence of suicide among medical professionals with low rates. This may be because of the methods used in suicide assessment and the stigma associated with it. For this study, the prevalence of suicidal ideation, attempt and completed suicide, as well as the factors associated with suicidality and methods used during suicidal acts, will be documented.

METHODS AND ANALYSIS

Studies published in peer-reviewed journals in which the prevalence and factors associated with suicidal ideation, attempt and completion among medical professionals in LMICs will be included. The Cochrane Library (CENTRAL), PsychINFO, PubMed and Embase will be systematically searched. We will search for all the papers available in the databases up to March 31 2019. Methodological quality of the articles will be assessed using the quality in prognostic studies tool. The risk of bias of the articles will be assessed using Cochrane risk of bias assessment tool for non-randomised studies. In the event of no statistical heterogeneity, a meta-analysis of the findings will be conducted.

ETHICS AND DISSEMINATION

Ethical permission will not be required since this work does not involve the use of participant data that can be used to identify individuals. Findings from this study will be available for clinicians and other medical professionals, scientists and policy makers. On request, a data set of the study can be provided.

TRIAL REGISTRATION NUMBER

CRD42018095990.

Construction and validation of a tool to assess nursing interpersonal relations

OBJECTIVE

construct and validate a tool to identify the factors that influence interpersonal relations and the health of nursing workers in a University Hospital in the South of Brazil.

METHOD

methodological study, in nine steps. The face validation was carried out, with the participation of five experts, professor nurses doctors in Nursing, content with 26 nurses, stricto sensu Nursing Postgraduate students, and the validation of the construct was performed through a quantitative approach with 213 nursing workers. We used the exploratory factorial analysis and the Cronbach's Alpha in the validation of the construct.

RESULTS

the tool consisted of 29 questions and six constructs were identified. The Cronbach's Alpha value.879 showed satisfactory internal consistency.

CONCLUSION

the tool was valid and reliable for use in the assessment of interpersonal relations among nursing workers in Brazilian University Hospitals.

The effect of night shift on sleep quality and depressive symptoms among Chinese nurses

PURPOSE

Night shift is associated with adverse physical and psychological health outcomes such as poor sleep quality and depressive symptoms. We aimed to compare sleep quality as well as depressive symptoms in nurses working night shifts to those working day shifts only and explore the association between sleep quality and depressive symptoms among nurses.

PATIENTS AND METHODS

Eight hundred sixty-five nurses were enrolled in the current study. Sleep quality and depressive symptoms among nurses were evaluated by the Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depressive Disorders Rating Scale (HADS), respectively.

RESULTS

PSQI and HADS scores were both significantly higher in the nurses working night shifts (P<0.05) than in those working day shifts only. Besides, there was a positive correlation between PSQI and HADS scores. Binary logistic regression showed that night shift and poor sleep quality were independent risk factors of depressive symptoms among nurses.

CONCLUSION

Higher rates of depression among Chinese nurses working night shifts may be associated with poor sleep quality induced by night shift.

The role of the personality traits and work characteristics in the prediction of the burnout syndrome among nurses-a new approach within predictive, preventive, and personalized medicine concept

BACKGROUND

The burnout syndrome is characterized by emotional exhaustion, depersonalization, and lack of personal accomplishment. It was identified in some professional categories, the most often being affected those in public health services.

OBJECTIVES

This study mainly aims to identify and analyze the value of the personality traits and work characteristics as predictive factors for the occurrence of the burnout syndrome in nurses, under the new approach of predictive, preventive, and personalized medicine.

METHOD

A total of 192 nurses were included in the study. The NEO-Five-Factor Inventory, the Copenhagen Burnout Inventory, and the Inventory of Nursing Work Characteristics were administered to all of the participants.

RESULTS

Some personality traits proved to be predictive factors for the occurrence of the burnout syndrome. Neuroticism, negative self-esteem, and negative emotionality predict burnout vulnerability. The negative correlations between sociability and the burnout dimensions show that the positive affectivity of the extraverted individuals and the strong positive orientation of the extraverts towards others are protective factors against burnout. There are also significant associations between certain personality traits and nursing work characteristics (work overload, the existence of problems in the department, and satisfaction in the professional and family life), which could be defined, also, as predictive factors for burnout.

CONCLUSIONS

This study confirms the influence of the Big Five personality traits and nursing work characteristics as predictive factors of the burnout occurrence, opening real possibilities to perform a targeted prevention and provide personalized interventions as organizational services.

Are Burnout Syndrome and Depression Predictors for Aggressive Behavior Among Mental Health Care Professionals?

AIM

This study aims to examine the possible relation between depression and burnout as predictors to aggressive behaviors among mental healthcare professionals.

METHODS

For the purposes of this study 72 mental health care professionals were recruited and were evaluated in three questionnaires which were provided to them online. Firstly regarding depression, the Center for Epidemiologic Studies Depression Scale (CES-D) was administered, secondly, concerning burnout, Maslach Burnout Inventory (MBI) was applied and finally, regarding aggression, the Aggression Questionnaire (GAQ) was employed. Statistical data analysis was performed using the IBM SPSS Statistics Version 19. The level of statistical significance was set at up at 0.05.

RESULTS

The results showed that depression is considered to be a statistically significant predictor of aggressive behaviors. However, burnout was not found to be a statistically significant predictor of aggression. In addition, a statistically significant relationship was found between burnout and depression.

CONCLUSIONS

It seems to be of essential importance for mental healthcare professionals to be provided with support and assistance in order to diminish the potential high-stress levels and in that way to overcome depression and burnout of those who work in mental health settings.

Depressive symptoms and drug use among nursing staff professionals

Abstract Objectives: To evaluate possible relationships between drug abuse, symptoms suggestive of depression and gender in nursing team professionals. Method: A cross-sectional study conducted in a general hospital with 416 participants. Used questionnaire with sociodemographic information, ASSIST, AUDIT-C and PHQ-2 tests. Used Fisher's Exact Tests, Chi-Square Test, and Multivariate Logistic Regression Analysis. Results: The female gender presented decreased odds ratios for alcohol consumption in the binge pattern and use of marijuana; and double odds ratios for feelings of lack of interest and pleasure. Symptoms suggestive of depression presented potential risks for the use of sedatives. Conclusion: Drug abuse and symptoms of depression are associated and manifest differently, according to gender among nursing staff professionals. Implications for practice: Social and gender roles influence the mental health conditions of these professionals.

Update on the UC San Diego Healer Education Assessment and Referral (HEAR) Program

Burnout, depression and suicide are rampant amongst health care professionals. Current evidence shows the problem is worsening. In the aftermath of physician suicides, the Physician Wellbeing Committee created the UC San Diego Healer Education Assessment and Referral (HEAR) Program in 2009 in collaboration with the American Foundation for Suicide Prevention (AFSP). This article chronicles the HEAR program from inception through June 2017. Initially created to address medical students, residents and faculty physician duress, HEAR has now expanded to embrace pharmacists, nurses and clinical staff within UC San Diego Health. HEAR operates through two mechanisms: 1) a program of ongoing education and outreach, and 2) encouragement of all personnel to annually engage in the online, anonymous, interactive screening program, created by the AFSP (known as SDSQ at UC San Diego Health). Since inception in May 2009 through June 2017, 1,537 UC San Diego health care personnel have been screened, 320 individuals have dialogued with a counselor either in person, by phone or electronically, and more than 300 have been referred confidentially for evaluation and treatment by a mental health professional, usually a community psychiatrist. While tracking death by suicide remains challenging, we have reason to believe that the prevalence of suicide has diminished during this time. The UC San Diego HEAR Program is one cost-effective model for addressing this current crisis in U.S. health care. This AFSP model has been adopted by many other schools of medicine and is now ready for use with clinicians of all disciplines.And whoever saves a life, it is considered as if he saved an entire world.— Mishnah Sanhedrin 4:5; Babylonian Talmud Tractate Sanhedrin 37a

Mental status and suicide probability of young people: A cross-sectional study

OBJECTIVE

The most important determinant of suicide ideation, tendency and initiative is the presence of mental disorders. Since the number of those who lost their lives due to suicide in the world rose rapidly among the young population, the World Health Organization emphasizes the importance of assessing young people in the high-risk age group to prevent suicidal behavior. This study aimed to determine psychological symptom levels and suicide probability in young people.

METHOD

The cross-sectional research consisted of 15-24 year-old individuals (N=348), who have sought a psychiatric clinic between February and June, 2015. The Research Data was collected by applying Data Collection Form, Suicide Probability Scale (SPS) and Brief Symptom Inventory (BSI). SPSS 22.0 statistical package program was used for data analysis.

RESULTS

There was a statistically significant difference (p<0.05) between the mean SPS scores according to education, psychiatric treatment, self-harm, smoking and drinking status of the participants in the study. Apart from this, there was also a statistically significant correlation between anxiety, depression, negative self and hostility according to the SPS and BSI subscales (p<0.001, r=0.739; p<0.001, r=0.729; p<0.001, r=0.747; p<0.001, r=0.715; respectively).

CONCLUSION

The results of our study show that suicide risk is significantly higher in young people with depression, anxiety, negative self-perception and hostility symptoms. In this regard, we suggest the relevance of assessing the suicide risk of young people seeking a psychiatric clinic, with thorough attention to those who have high potential for suicide.

ANÁLISE DO GRAU DE COMPLEXIDADE DO CUIDADO, ESTRESSE E COPING DA ENFERMAGEM NUM HOSPITAL SUL-RIOGRANDENSE

RESUMO Objetivo: verificar a relação entre grau de complexidade do cuidado de pacientes, nível de estresse e coping nos profissionais de enfermagem em unidades de internação adulto de um hospital universitário de Porto Alegre. Método: pesquisa quantitativa transversal, desenvolvida em três unidades de internação clínica, totalizando 89 profissionais de enfermagem, sendo 28 (31,5%) enfermeiros e 61 (68,5%) auxiliares e/ou técnicos de enfermagem. O grau de complexidade do cuidado dos pacientes foi obtido através do instrumento do Sistema de Classificação de Pacientes de Perroca. A avaliação dos níveis de estresse e coping foram por meio dos instrumentos Inventário de Estresse em Enfermeiros e Inventário de Respostas de Coping no Trabalho. Resultados: ao compararmos os níveis de complexidade dos cuidados semi-intensivo e intensivo entre as unidades, obtivemos que a unidade B apresentou valores mais altos que a A e C, sendo que estas apresentaram graus semelhantes (p<0,001). Tanto em relação ao nível de estresse total (p=0,180) quanto à utilização das estratégias de coping (p=0,315), não houve diferença entre as categorias profissionais. Ao comparar o nível de estresse conforme a unidade de trabalho observou-se que os profissionais da unidade B apresentaram maiores níveis de estresse (2,87±0,66; p=0,030). Quando avaliada sobre a utilização de estratégias de coping, a unidade B não apresentou diferença no escore total comparada às outras duas unidades. Conclusão: os profissionais que cuidavam de pacientes com maior grau de complexidade do cuidado estavam expostos ao maior nível de estresse.

Minor psychiatric disorders in nursing: prevalence and associated factors

ABSTRACT Objective: to investigate the prevalence of Minor Psychiatric Disorders and associated factors in nursing workers. Method: observational and analytical sectional study. Data were collected from 285 nursing workers. A questionnaire containing sociodemographic, occupational, psychosocial aspects of work and mental health was used. Bivariate and multivariate analysis were performed by binary logistic regression. Results: the global prevalence of suspected Minor Psychiatric Disorders among nursing workers was 32.6%. Higher prevalence rates were found among female, young, married/common-law married individuals, in the nursing assistant/technician categories, with income up to four minimum wages, developing high-demand work with low social support, high effort-reward imbalance, and over-commitment. Conclusion: the variables that remained associated with the mental health outcome in the final model were: female gender, married/common-law married, high-demand work, high effort-reward imbalance, and over-commitment.

Ambiente ocupacional e o consumo de substâncias psicoativas entre enfermeiros

Resumo Objetivo Analisar a relação entre o ambiente de trabalho e o consumo de substâncias psicoativas entre enfermeiros hospitalares. Métodos Estudo transversal e descritivo, realizado com enfermeiros de três instituições hospitalares públicas localizados em um município da Região Sul do Brasil, sendo duas de média complexidade e uma de alta complexidade. A população deste estudo foi composta por 221 enfermeiros. Com base nesse número, calculou-se o tamanho amostral por estratos, considerando-se a proporção de 50%, nível de confiança de 95% e erro máximo de 5%, o que resultou no número mínimo de 175 participantes. Mediante a estratificação proporcional por instituição definiu-se o mínimo de 103 enfermeiros da alta complexidade e 36 de cada instituição de média complexidade. Adotou-se como critérios de inclusão: trabalhar na instituição há pelo menos um ano e não estar afastado por licença. A coleta de dados foi realizada entre outubro de 2015 e abril de 2016. Na coleta de dados utilizaram-se informações sociodemográficas e ocupacionais, o Nursing Work Index - Revised e o Alcohol, Smoking and Substance Involvement Screening Test. Os dados foram analisados no programa Statistical Package for Social Sciences, versão 20.0. Inicialmente, verificou-se a normalidade pelo teste de Kolmogorov-Smirnov. Foram realizadas análises descritivas, por frequências absoluta e relativa para as variáveis categóricas; e medianas e medidas de dispersão para as numéricas. Resultados Álcool, tabaco e sedativos foram as substâncias mais consumidas. Renda mensal apresentou correlação positiva com o consumo de álcool entre enfermeiros dos hospitais de média complexidade (p=0,01). No hospital de alta complexidade, o consumo de álcool relacionou-se negativamente a relação médico-enfermeiro (p=0,03). Autonomia, relação médico-enfermeiro e suporte organizacional estiveram correlacionados negativamente ao uso de sedativos (p<0,01; p<0,01; p=0,02, respectivamente). Conclusão Quanto mais desfavorável o ambiente de trabalho do enfermeiro, sobretudo na relação com médicos, suporte organizacional e autonomia, maior foi o consumo de substâncias psicoativas.

Relationship of work-family conflict, self-reported social support and job satisfaction to burnout syndrome among medical workers in southwest China: A cross-sectional study

BACKGROUND

Burnout is a psychosomatic syndrome widely observed in Chinese medical workers due to the increasing cost of medical treatment, excessive workload, and excessive prescribing behavior. No studies have evaluated the interrelationship among occupational burnout, work-family conflict, social support, and job satisfaction in medical workers. The aim of this study was to evaluate these relationships among medical workers in southwest China.

METHODS

This cross-sectional study was conducted between March 2013 and December 2013, and was based on the fifth National Health Service Survey (NHSS). A total of 1382 medical workers were enrolled in the study. Pearson correlation analysis and general linear model univariate analysis were used to evaluate the relationship of work-family conflict, self-reported social support, and job satisfaction with burnout syndrome in medical workers.

RESULTS

We observed that five dimensions of job satisfaction and self-reported social support were negatively associated with burnout syndrome, whereas three dimensions of work-family conflict showed a positive correlation. In a four-stage general linear model analysis, we found that demographic factors accounted for 5.4% of individual variance in burnout syndrome (F = 4.720, P<0.001, R2 = 0.054), and that work-family conflict, self-reported social support, and job satisfaction accounted for 2.6% (F = 5.93, P<0.001, R2 = 0.080), 5.7% (F = 9.532, P<0.001, R2 = 0.137) and 17.8% (F = 21.608, P<0.001, R2 = 0.315) of the variance, respectively. In the fourth stage of analysis, female gender and a lower technical title correlated to a higher level of burnout syndrome, and medical workers without administrative duties had more serious burnout syndrome than those with administrative duties.

CONCLUSIONS

In conclusion, the present study suggests that work-family conflict and self-reported social support slightly affect the level of burnout syndrome, and that job satisfaction is a much stronger influence on burnout syndrome in medical workers of southwest China.