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Hjörleifsdóttir E, Sigurðardóttir Þ, Óskarsson GK, Halapi EC. Stress, burnout and coping among nurses working on acute medical wards and in the community: A quantitative study. Scand J Caring Sci 2024; 38:636-647. [PMID: 38977380 DOI: 10.1111/scs.13281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 06/23/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND Psychological distress can cause burnout, which affects mental and physical well-being. It is important to identify factors associated with psychological distress and physical discomfort and how nurses deal with these problems. AIM The aim was to investigate distress, burnout and coping among community nurses (CN) and hospital nurses (HN). APPROACH AND METHODS In this cross-sectional study, 409 nurses completed three questionnaires: Perceived Stress Scale (PSS), Copenhagen Burnout Inventory (CBI) and Ways of Coping (WOC). FINDINGS Participants younger than 40 demonstrated significantly more distress and burnout than those older than 40 years. Participants who had moderate and high distress on the PSS were significantly more at risk for experiencing personal, work-related and patient-related burnout. A significant positive correlation was found between distress and behavioural escape-avoidance, cognitive escape-avoidance and distancing. Significant positive correlations were also seen between all the subscales of the CBI and behavioural escape-avoidance, cognitive escape-avoidance and distancing. Positive significant correlation was also obtained between staff resources and distress and personal-related and work-related burnout. Negative correlation was demonstrated between staff resources and patient-related burnout. Participants with longer work experience were less likely to report moderate or high distress, and those who scored higher on personal burnout and behavioural escape-avoidance were more likely to have moderate or high distress. CONCLUSION The results of this study call for increased attention to the younger generation in the nursing profession. The results also validate the need to investigate further the correlation between distress, burnout and coping and how these issues might influence each other among nurses working in the community and hospitals. Findings should be taken with precaution, they do not describe in detail what underlying factors contribute to distress and discomfort found in this study, they do, however, indicate certain coping strategies nurses use to deal with distress and burnout.
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Affiliation(s)
| | - Þórhalla Sigurðardóttir
- Accident and Emergency Nursing, School of Health, Business and Natural Sciences-Faculty of Nursing, University of Akureyri, Akureyri, Iceland
| | | | - Eva Charlotte Halapi
- School of Health, Business and Natural Sciences-Faculty of Nursing, University of Akureyri, Akureyri, Iceland
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Hamaideh SH, Abu Khait A, Al-Modallal H, Masa'deh R, Hamdan-Mansour A, ALBashtawy M. Perceived Stress and Resilience Among Psychiatric Nurses Working in Inpatients Units. Hosp Top 2024:1-9. [PMID: 39076024 DOI: 10.1080/00185868.2024.2383912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
The aim of this study is to assess the levels, relationships, and predictors of resilience and perceived stress among psychiatric nurses working in inpatient units. A descriptive, cross-sectional, predictive design was employed to collect data from 140 psychiatric nurses through a self-reported questionnaire. The questionnaire consisted of sociodemographic and work-related variables, Connor-Davidson Resilience Scale (CD-RISC-25), and perceived stress scale (PSS-10). The total mean score of the perceived stress was 22.73 (SD = 3.54) indicating a moderate level. The total mean score of the resilience was 49.49 (SD = 15.31) indicating a low level. Resilience correlated positively with educational level and job satisfaction; and negatively with intention to leave psychiatric settings. Significant differences were found in resilience with educational level, intention to leave psychiatric settings, and job satisfaction. Three independent variables predicted resilience: educational level, ward/unit, and job satisfaction; and only one variable (intention to leave psychiatric settings) predicted the perceived stress.
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Affiliation(s)
- Shaher H Hamaideh
- Community and Mental Health Nursing Department, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Abdallah Abu Khait
- Community and Mental Health Nursing Department, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Hanan Al-Modallal
- Community and Mental Health Nursing Department, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
- Nursing Department, Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia
| | - Rami Masa'deh
- School of Nursing, Applied Science Private University, Amman, Jordan
| | - Ayman Hamdan-Mansour
- Community Health Department, School of Nursing, The University of Jordan, Amman, Jordan
| | - Mohammed ALBashtawy
- Nursing and Community Health, Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
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Wangel AM, Persson K, Duerlund S, Fhager J, Mårdhed E, Sjögran L, Sjöström K, Glantz A, Örmon K, Sunnqvist C. The Core Elements of Psychiatric and Mental Health Nursing: Time, Honest Engagement, Therapeutic Relations, Professional Nursing and Lifetime-Perspective. Issues Ment Health Nurs 2024; 45:399-408. [PMID: 38363803 DOI: 10.1080/01612840.2024.2305934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Defining psychiatric and mental health nursing has been a challenge for decades, and it is still difficult to find a comprehensive definition. We have identified a possibility to clarify psychiatric and mental health nursing based on humanistic philosophy in a general psychiatric care context. The aim was therefore to identify and synthesize the theoretical frameworks from which psychiatric and mental health nursing models are developed. We systematically collected and evaluated articles based on Grounded Theory (GT) methodology regarding psychiatric or mental health nursing. The PRISMA statement for systematic reviews was used and the formal process of synthesis, as a three-step process of identifying first -, second - and third-order themes following the examples of Howell Major and Savin-Baden. The synthesis resulted in a model describing five core elements of psychiatric and mental health nursing: 'professional nursing', 'therapeutic relationships' and 'honest engagement', with time as the all-encompassing theme, including the patients' 'lifetime perspective'. Psychiatric and mental health nursing is a caring support towards recovery, where the patient's lifetime perspective must be in focus during the caring process with a relationship built on an honest engagement. Time is therefore essential for psychiatric and mental health nursing.
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Affiliation(s)
- Anne-Marie Wangel
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Karin Persson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Sara Duerlund
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Johan Fhager
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Emma Mårdhed
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Lotta Sjögran
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Karin Sjöström
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Andreas Glantz
- Department of Nursing, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Karin Örmon
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Götaland Region Competence Centre on Intimate Partner Violence, Gothenburg, Sweden
| | - Charlotta Sunnqvist
- The Region Skåne Committee on Psychiatry, Habilitation and Technical Aids, Lund, Sweden
- Department of Clinical Sciences Psychiatry, Lund University, Lund, Sweden
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Dominguez-Lara S, Merino-Soto C, Torres-Villalobos G. Structural analysis and reliability of the Perceived Stress Scale in nursing professionals from Peru. ENFERMERIA CLINICA (ENGLISH EDITION) 2022; 32:152-160. [PMID: 35568353 DOI: 10.1016/j.enfcle.2022.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 01/16/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The objective was to provide psychometric evidence of the 14-item and 10-item version of the Perceived Stress Scale in nursing professionals from Peru. METHOD Data on 2848 professionals (92.275% women) between 23 and 69 years old (M = 21.876; SD = 10.763) was extracted from ENSUSALUD 2015. An exploratory structural equation modelling (ESEM) was applied with Mplus 7.0 software to analyse several measurement models in the PSS: unidimensional, bidimensional, models with method factor, and bifactor. Finally, the reliability was analysed. RESULTS The two-factor structure obtained adequate fit indices, and acceptable factorial loadings (>.50), while the unidimensional model has poor statistical support. The construct and score reliability was also adequate. CONCLUSION The two-factor model of the PSS-10 and PSS-14 presents adequate psychometric properties to expand its use to empirical research.
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Affiliation(s)
- Sergio Dominguez-Lara
- Universidad Privada San Juan Bautista, Lima, Peru; Universidad San Martín de Porres, Lima, Peru.
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5
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Dominguez-Lara S, Merino-Soto C, Torres-Villalobos G. Análisis estructural y de fiabilidad de la Escala de estrés percibido (PSS) en profesionales de enfermería del Perú. ENFERMERIA CLINICA 2022. [DOI: 10.1016/j.enfcli.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hood C, Patton R. Exploring the role of psychological need fulfilment on stress, job satisfaction and turnover intention in support staff working in inpatient mental health hospitals in the NHS: a self-determination theory perspective. J Ment Health 2021; 31:692-698. [PMID: 34565267 DOI: 10.1080/09638237.2021.1979487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Meeting psychological needs for autonomy, competence and relatedness as described by Self-Determination Theory (SDT) has been associated with increased well-being and job satisfaction in mental health staff and improved care outcomes for patients. AIMS The study investigated whether psychological need satisfaction predicted stress, turnover intention and job satisfaction in health care assistants (HCA) working in inpatient mental health hospitals in the United Kingdom including full time (FT) and temporary agency worker (TAW) staff. METHODS A cross-sectional survey explored need satisfaction between FT (n = 63) and TAW (n = 39) staff using the Work-Related Basic Need Satisfaction Scale. Multiple regression was used to explore whether satisfaction of the needs for autonomy, competence and relatedness predicted scores on measures of stress, job satisfaction and turnover intention. RESULTS Results were comparable between FT and TAW staff. Autonomy was the need least satisfied, a need which predicted self-reported job satisfaction, stress and turnover intention. Relatedness also predicted job satisfaction and turnover intention. CONCLUSIONS Recommendations are made to explore experiences of (and barriers to) autonomy and relatedness in inpatient HCA staff to target and improve autonomy and relatedness in this workforce. Implications of doing so are considered at a staffing, organisational and patient level.
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Affiliation(s)
- Charlotte Hood
- Faculty of Health and Medical Sciences (School of Psychology), University of Surrey, Guildford, Surrey, UK
| | - Robert Patton
- Faculty of Health and Medical Sciences (School of Psychology), University of Surrey, Guildford, Surrey, UK
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7
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Hallett N, Dickens GL. The violence prevention climate of mental health wards: a cross-sectional study of staff and patient views. Soc Psychiatry Psychiatr Epidemiol 2021; 56:97-107. [PMID: 32232505 DOI: 10.1007/s00127-020-01860-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 03/11/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE Ward climate can shape the behaviour of both staff and patients. A subset of the ward climate is the violence prevention climate, the unique characteristics that are perceived by the people within the environment as contributing towards the prevention of violence. The aim of this study was to explore differences between and within staff and patient groups in terms of their perceptions of the violence prevention climate. METHODS A cross-sectional survey was conducted with staff (n = 326) and patients (n = 95) in mental health care pathways within one charitable trust. All participants completed the VPC-14 to measure perceptions of the violence prevention climate, a validated 14-item two-factor scale (staff actions and patient actions). Staff demographic information was collected on the VPC-14 front sheet; patient demographic, clinical and violence data were collected from electronic case records. Bivariate analyses were conducted to compare within- and between-group variables. Significant staff and patient variables were entered into multiple hierarchical regression analyses to assess their relationship with VPC-14 factors. RESULTS Staff had a more positive view than patients of staff actions and patients had a more positive view of patient actions than did staff; staff- or patient-group membership was the best predictor of staff action scores. Individual staff characteristics accounted for a small amount of the variance in staff and patient action scores; individual patient characteristics explained more variance, but this was still below 20%. CONCLUSIONS Staff perceive their violence prevention-related contributions more positively than patients and vice versa. This has implications for staff; they may need to better articulate their role in violence prevention to patients, as well as recognise the role that patients play. However, within staff and patient groups, individual variables only make up a small amount of variance of perceptions of the violence prevention climate. This suggests that the violence prevention climate is a valid construct, i.e. that despite differences in individual variables, individuals within the patient group have similar perceptions of the VPC, as do those within the staff group.
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Affiliation(s)
- Nutmeg Hallett
- St Andrew's Healthcare, Cliftonville Road, Northampton, NN1 5DG, UK. .,University of Northampton, Park Campus, Boughton Green Road, Northampton, NN2 7AL, UK. .,School of Nursing, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Geoffrey L Dickens
- Centre for Applied Nursing Research, Western Sydney University and South West Sydney Local Health District, 1 Campbell Street, Liverpool, NSW, 2170, Australia
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8
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Molin J, Hällgren Graneheim U, Ringnér A, Lindgren BM. Time Together as an arena for mental health nursing - staff experiences of introducing and participating in a nursing intervention in psychiatric inpatient care. Int J Ment Health Nurs 2020; 29:1192-1201. [PMID: 32618398 DOI: 10.1111/inm.12759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/26/2020] [Accepted: 06/06/2020] [Indexed: 11/30/2022]
Abstract
A lack of meaningful activities for people with mental ill health admitted to psychiatric inpatient care has been related to feelings of boredom and 'doing nothing' and is not in line with recovery-oriented care. Staff in psychiatric inpatient care report having limited time, ambiguous responsibilities, and insufficient support that counteracts their ideals of good nursing care and puts them at risk for high levels of stress and stress of conscience. Research highlights a need for interactions between patients and staff, but few nursing interventions with such a focus are described in the literature. This qualitative study aimed to illuminate staff experiences of introducing and participating in the nursing intervention Time Together, via qualitative content analysis of 17 individual semi-structured interviews with nursing staff in psychiatric inpatient care. The results show that these staff members experienced Time Together as an arena for mental health nursing. They prepared for the introduction of the intervention by laying a framework for success. Although the actual implementation led to them feeling burdened, they found that Time Together fostered relationships between patients and staff. For successful implementation, mental health nurses need to advocate the intervention. As Time Together constitutes an arena for mental health nursing, play and conversations based on reciprocity and equality can contribute to patients' recovery.
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Affiliation(s)
- Jenny Molin
- Department of Nursing, Umeå University, Umeå
| | - Ulla Hällgren Graneheim
- Department of Nursing, Umeå University, Umeå.,Department of Health Sciences, University West, Trollhättan
| | - Anders Ringnér
- Department of Nursing, Umeå University, Umeå.,Department of Pediatrics, Umeå University Hospital, Umeå, Sweden
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9
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Dickens GL, Tabvuma T, Hadfield K, Hallett N. Violence Prevention Climate in General Adult Inpatient Mental Health Units: Validation study of the VPC-14. Int J Ment Health Nurs 2020; 29:1101-1111. [PMID: 32536025 PMCID: PMC7687075 DOI: 10.1111/inm.12750] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/06/2020] [Accepted: 05/15/2020] [Indexed: 11/30/2022]
Abstract
Ward social climate is an important contributor to patient outcomes in inpatient mental health services. Best understood as the general 'vibe' or 'atmosphere' on the unit, social climate has been subject to a significant research aimed at its quantification. One aspect of social climate, the violence prevention climate, describes the extent to which the ward is perceived as safe and protective against the occurrence of aggression by both the patients and the staff. The violence prevention climate scale (VPC-14), developed in a UK forensic setting, was used in this study in a test of its validity in an Australian general mental health setting. The VPC-14 was administered across eleven wards of one metropolitan Local Health District in Sydney, NSW. N = 213 valid responses from nursing staff and patients were returned (response rates 23.4 and 24.3%, respectively). The VPC-14 demonstrated good internal reliability, and convergent validity was evidenced through moderate correlations with the WAS's anger and aggression subscale and the GMI total score. Concurrent validity was demonstrated by expected staff-patient differences in VPC-14 rating and by correlations between incidents of conflict and containment on wards and the VPC-14 ratings of staff and patients from those wards. Rasch analysis suggested that future tool development should focus on identifying ways to discriminate between ratings at the high end of the scale. The VPC-14 supplies valid and useful information about the violence prevention climate in general adult mental health wards.
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Affiliation(s)
- Geoffrey L Dickens
- Centre for Applied Nursing Research, Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.,School of Nursing and Midwifery, Western Sydney University, Penrith South, NSW, Australia.,South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Tracy Tabvuma
- Centre for Applied Nursing Research, Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.,South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Kylie Hadfield
- South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Nutmeg Hallett
- School of Nursing, University of Birmingham, Birmingham, UK
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10
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Lindgren BM, Molin J, Lundström M, Strömbäck M, Salander Renberg E, Ringnér A. Does a new spatial design in psychiatric inpatient care influence patients' and staff's perception of their care/working environment? A study protocol of a pilot study using a single-system experimental design. Pilot Feasibility Stud 2018; 4:191. [PMID: 30607254 PMCID: PMC6307228 DOI: 10.1186/s40814-018-0383-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 12/07/2018] [Indexed: 11/21/2022] Open
Abstract
Background Research shows that worn-out physical environments are obstacles to psychiatric inpatient care. Patients want better relationships with staff and things to do; staff want an environment that offers hope, a calm atmosphere, and joint activities. A county council in northern Sweden and Philips Healthcare partnered to create solutions to the environmental challenges of psychiatric inpatient care. One ward at a county psychiatric clinic was selected for a pilot project to test solutions that could improve the care environment for patients, staff, and relatives. The aim of the overall project is to evaluate the effects of a newly designed psychiatric inpatient ward on patients and staff in terms of quality of care and stress. In this study, we focus on the feasibility through testing questionnaires and exploring barriers to recruiting staff and patients. Methods This study had a single-system experimental design, comparing a psychiatric unit pre- and post-implementation of the novel spatial design, using repeated measures with the same questionnaires twice a week during baseline and intervention phases. Primary outcomes were quality interactions (patients) and perceived stress (staff). Secondary outcomes were levels of anxiety and depression (patients), and stress of conscience (staff). A process evaluation was aimed to describe contextual factors and participant experiences of the new design. Data was collected using questionnaires and semi-structured individual interviews with patients and focus group discussions with staff. Both visual and statistical methods were used to analyse the quantitative data and content analysis for the qualitative data. Discussion The findings will contribute insights into whether and how a new spatial design might contribute to quality interactions and reduced stress. This is relevant both nationally and internationally, as similar interventions are needed but sparse. The findings will be disseminated through peer-reviewed publications and conference presentations. Trial registration ClinicalTrials.gov, NCT03140618, registered 4 May 2017
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Affiliation(s)
- Britt-Marie Lindgren
- 1Department of Nursing, The Caring Science Building, Umeå University, 901 87 Umeå, SE Sweden
| | - Jenny Molin
- 1Department of Nursing, The Caring Science Building, Umeå University, 901 87 Umeå, SE Sweden
| | - Mats Lundström
- 1Department of Nursing, The Caring Science Building, Umeå University, 901 87 Umeå, SE Sweden
| | - Maria Strömbäck
- 2Division of Psychiatry, Department of Clinical Sciences, Umeå University, Umeå, Sweden.,3Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | | | - Anders Ringnér
- 1Department of Nursing, The Caring Science Building, Umeå University, 901 87 Umeå, SE Sweden
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Molin J, Lindgren BM, Graneheim UH, Ringnér A. Time Together: A nursing intervention in psychiatric inpatient care: Feasibility and effects. Int J Ment Health Nurs 2018; 27:1698-1708. [PMID: 29691976 DOI: 10.1111/inm.12468] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/06/2018] [Indexed: 12/01/2022]
Abstract
The facilitation of quality time between patients and staff in psychiatric inpatient care is useful to promote recovery and reduce stress experienced by staff. However, interventions are reported to be complex to implement and are poorly described in the literature. This multisite study aimed to evaluate the feasibility and effects of the nursing intervention Time Together, using mixed methods. Data consisted of notes from participant observations and logs to evaluate feasibility, and questionnaires to evaluate effects. The primary outcome for patients was quality of interactions, and for staff, it was perceived stress. The secondary outcome for patients was anxiety and depression symptom levels, and for staff, it was stress of conscience. Data were analysed using visual analysis, percentage of nonoverlapping data, and qualitative content analysis. The results showed that Time Together was a feasible intervention, but measurements showed no effects on the two patient outcomes: quality of interactions and anxiety and depressive symptoms and, questionable effects on perceived stress and stress of conscience among staff. Shared responsibility, a friendly approach, and a predictable structure enabled Time Together, while a distant approach and an unpredictable structure hindered the intervention. In conclusion, the intervention proved to be feasible with potential to enable quality interactions between patients and staff using the enabling factors as supportive components. It also had some effects on perceived stress and stress of conscience among staff. Further evaluation is needed to build on the evidence for the intervention.
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Affiliation(s)
- Jenny Molin
- Department of Nursing, Umeå University, Umeå, Sweden
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12
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AL-Sagarat AY, Barmawi M, Al Hadid LAE, Qaddumi JAS, Moxham L. Validating the psychiatric nurses methods of coping questionnaire: Arabic version. BMC Psychiatry 2017; 17:410. [PMID: 29282025 PMCID: PMC5745852 DOI: 10.1186/s12888-017-1573-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 12/08/2017] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The aim of the study was to undertake a psychometric analysis of the Psychiatric Nurses Methods of Coping Questionnaire (PNMCQ) - Arabic version when used to measure coping skills in psychiatric nurses in Jordan. METHOD A descriptive, cross-sectional design was adopted in this study. A demographic questionnaire and the 35-item PNMCQ -Arabic were the measures used to collect data. RESULT The PNMCQ demonstrated valid and reliable values when administered to psychiatric nurses in Jordan after it had been submitted to factor analysis. CONCLUSION The development of PNMCQ: Arabic Version adequately measures coping skills in psychiatric nurses from a culturally appropriate context. Use of the tool can determine coping skills in psychiatric nurses with the view to positive staff development. Strategies identified based on results of the PNMCQ could ultimately result in better nurse retention and patient outcomes.
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Affiliation(s)
- Ahmad Yahya AL-Sagarat
- Community and Mental Health Nursing Department, Faculty of Nursing, Mutah University, Al-Karak, Jordan
| | - Marwa Barmawi
- Faculty of Nursing- Al-Zaytoonah University of Jordan (ZUJ), Amman, Jordan
| | - Lourance A. E. Al Hadid
- Princess Aisha Bint Al-Hussein College of Nursing and Health Sciences, Al-Hussein Bin Talal University, Ma’an, Jordan
| | - Jamal A. S. Qaddumi
- Faculty of Medicine and Health Sciences, An-Najah National University, PO box 7, Nablus, Palestine
| | - Lorna Moxham
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Ave, Wollongong, NSW 2522 Australia
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Golding SE, Horsfield C, Davies A, Egan B, Jones M, Raleigh M, Schofield P, Squires A, Start K, Quinn T, Cropley M. Exploring the psychological health of emergency dispatch centre operatives: a systematic review and narrative synthesis. PeerJ 2017; 5:e3735. [PMID: 29062596 PMCID: PMC5649589 DOI: 10.7717/peerj.3735] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 08/04/2017] [Indexed: 01/25/2023] Open
Abstract
Background The study objective was to investigate and synthesize available evidence relating to the psychological health of Emergency Dispatch Centre (EDC) operatives, and to identify key stressors experienced by EDC operatives. Methods Eight electronic databases (Embase, PubMed, Medline, CINAHL, PsycInfo, PsycArticles, The Psychology and Behavioural Sciences Collection, and Google Scholar) were searched. All study designs were included, and no date limits were set. Studies were included if they were published in English, and explored the psychological health of any EDC operatives, across fire, police, and emergency medical services. Studies were excluded if they related solely to other emergency workers, such as police officers or paramedics. Methodological quality of included studies was assessed using checklists adapted from the Critical Appraisal Skills Programme. A narrative synthesis was conducted, using thematic analysis. Results A total of 16 articles were included in the review. Two overarching themes were identified during the narrative synthesis: ‘Organisational and Operational Factors’ and ‘Interactions with Others’. Stressors identified included being exposed to traumatic calls, lacking control over high workload, and working in under-resourced and pressured environments. Lack of support from management and providing an emotionally demanding service were additional sources of stress. Peer support and social support from friends and family were helpful in managing work-related stress. Discussion EDC operatives experience stress as a result of their work, which appears to be related to negative psychological health outcomes. Future research should explore the long-term effects of this stress, and the potential for workplace interventions to alleviate the negative impacts on psychological health. PROSPERO Registration Number CRD42014010806.
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Affiliation(s)
- Sarah E Golding
- School of Psychology, Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Claire Horsfield
- School of Health Sciences, Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Annette Davies
- School of Health Sciences, Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Bernadette Egan
- School of Psychology, Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Martyn Jones
- School of Nursing & Health Sciences, University of Dundee, Dundee, United Kingdom
| | - Mary Raleigh
- School of Health Sciences, Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Patricia Schofield
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Allison Squires
- Rory Meyers College of Nursing, New York University, New York City, United States of America
| | - Kath Start
- School of Health Sciences, Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Tom Quinn
- Faculty of Health, Social Care and Education, Kingston University London and St George's, University of London, London, United Kingdom
| | - Mark Cropley
- School of Psychology, Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom
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Molin J, Lindgren BM, Graneheim UH, Ringnér A. Does 'Time Together' increase quality of interaction and decrease stress? A study protocol of a multisite nursing intervention in psychiatric inpatient care, using a mixed method approach. BMJ Open 2017; 7:e015677. [PMID: 28851774 PMCID: PMC5724076 DOI: 10.1136/bmjopen-2016-015677] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Despite the long-known significance of the nurse-patient relationship, research in psychiatric inpatient care still reports unfulfilled expectations of, and difficulties in, interactions and relationships between patients and staff. Interventions that create structures to allow quality interactions between patients and staff are needed to solve these problems. The aim of this project is to test effects of the nursing intervention Time Together and to evaluate the intervention process. METHODS AND ANALYSIS This is a multisite study with a single-system experimental design using frequent measures. The primary outcomes are quality interactions for patients and perceived stress for staff. Secondary outcomes are levels of symptoms of anxiety and depression for patients and stress of conscience for staff. A process evaluation is performed to describe contextual factors and experiences. Data are collected using questionnaires, participant observations and semistructured interviews. For analysis of quantitative data, both visual and statistical methods will be used. Qualitative data will be analysed using qualitative content analysis. ETHICS AND DISSEMINATION Ethical approval was granted by the Ethical Review Board in the region (Dnr 2016/339-31). The findings will contribute to the development of nursing interventions in general, but more specifically to the development of the intervention. This is relevant both nationally and internationally as similar interventions are needed but sparse. The findings will be disseminated through conference presentations and peer-reviewed publications. TRIAL REGISTRATION NUMBER NCT02981563.
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Affiliation(s)
- Jenny Molin
- Department of Nursing, Umeå University, Umeå, Sweden
| | | | | | - Anders Ringnér
- Department of Nursing, Umeå University, Umeå, Sweden
- Department of Paediatrics, Umeå University Hospital, Umeå, Sweden
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Molin J, Graneheim UH, Ringnér A, Lindgren BM. From ideals to resignation - interprofessional teams perspectives on everyday life processes in psychiatric inpatient care. J Psychiatr Ment Health Nurs 2016; 23:595-604. [PMID: 27785861 DOI: 10.1111/jpm.12349] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/16/2016] [Indexed: 11/30/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Psychiatric inpatient care has been described by both ward staff and patients as being demanding and disorganized, lacking opportunities for quality interactions in everyday life through joint activities. Qualitative research on interprofessional teams' perspectives on everyday life processes in psychiatric inpatient care is lacking. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Staff have ideals about care and collaboration, but the obstacles they face in everyday life, such as a poor environment, power asymmetry, lacking structure and the demands of managing chaos, mean that they appear to resign and shift focus from the patients' best interests to self-survival. Different professions in general describe the same obstacles in everyday life on the wards but there are also profession-specific perspectives on distancing and feelings of abandonment. To our knowledge, these findings have not been reported in the international evidence. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Given these findings we suggest interventions such as Protected Engagement Time as well as reflective dialogues within interprofessional teams. This would help staff to resume their caring role in everyday life in psychiatric inpatient care and put their ideals into practice. ABSTRACT Introduction Patients and ward staff describe psychiatric inpatient care as demanding, characterized by unpredictable events, yet research on interprofessional teams perspectives of everyday life processes in psychiatric inpatient care lacks. Aim This study aims to explore everyday life processes in psychiatric inpatient care, as reported by staff in interprofessional teams. Method A grounded theory design was used and 36 participants were interviewed. Results The analysis resulted in a process-oriented core category From ideals to resignation. Related to this core category were three further categories: Knowing where to go, Walking a path of obstacles and Shifting focus from the patient's best interests to self-survival. The staff had ideals about care and collaboration, but a poor environment, power asymmetry, lacking structure and demands of managing chaos meant that they appeared to resign from putting their ideals into practice. Discussion Different professions in general describe the same obstacles in everyday life on the wards but there are also profession-specific perspectives on distancing and feelings of abandonment. To our knowledge similar findings have not been reported in the international evidence. Implications In order to support interprofessional teams to work according to their ideals, interventions such as Protected Engagement Time and reflective dialogues within the teams are suggested.
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Affiliation(s)
- Jenny Molin
- Department of Nursing, Umeå University, Umeå, Sweden
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Trzpuc SJ, Wendt KA, Heitzman SC, Skemp S, Thomas D, Dahl R. Does Space Matter? An Exploratory Study for a Child-Adolescent Mental Health Inpatient Unit. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2016; 10:23-44. [PMID: 27081193 DOI: 10.1177/1937586716634017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this study is to explore design elements and spaces as a contributing influence to behavior and well-being for patients, staff, and families in a child-adolescent mental health unit. BACKGROUND The University of Minnesota Masonic Children's Hospital Child-Adolescent Mental Health Inpatient Unit embarked on a renovation project to relocate the hospital's child and adolescent mental health units. Evidence-based strategies were employed for the design of the new unit to enhance the experience for patients, staff, and families and to support changes in operational and procedural strategies. METHODS A mixed-methods approach was utilized to explore the influence of several design strategies intended to induce calm feelings for patients, staff, and families. A comprehensive literature review informed the design process and study design. Methods include patient image surveys (PIS; n = 188), online staff surveys (n = 48), and face-to-face staff interviews (n = 25). RESULTS Several design elements and spaces were identified through the image survey as influential in eliciting feelings of calm among patients. Additionally, staff were also influenced by the new unit design, generating feelings of calm, safety, and pride in the work environment. CONCLUSION Results suggest that design features in which patients have choice and control offer greater perceptions of calm during their stay in the unit. Staff were positively influenced by the colors and artwork throughout the unit as well as the upgraded security and safety features. Findings also show the space has a positive influence on families, demonstrated by its welcoming character and features that help to facilitate better interaction with patients.
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Affiliation(s)
- Stefnee J Trzpuc
- University of Minnesota, Minneapolis, MN, USA North Dakota State University, Fargo, ND, USA BWBR, Saint Paul, MN, USA
| | - Karen A Wendt
- North Dakota State University, Fargo, ND, USA St. Catherine University, Saint Paul, MN, USA University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA
| | - Susan C Heitzman
- University of Minnesota, Minneapolis, MN, USA University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA University of Iowa, Iowa City, IA, USA
| | - Sophia Skemp
- University of Minnesota, Minneapolis, MN, USA BWBR, Saint Paul, MN, USA
| | - Don Thomas
- BWBR, Saint Paul, MN, USA University of Wisconsin-Stout, Menomonie, WI, USA
| | - Rick Dahl
- North Dakota State University, Fargo, ND, USA BWBR, Saint Paul, MN, USA
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Eklund M, Bäckström M, Tuvesson H. Psychometric properties and factor structure of the Swedish version of the Perceived Stress Scale. Nord J Psychiatry 2014; 68:494-9. [PMID: 24460116 DOI: 10.3109/08039488.2013.877072] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The Perceived Stress Scale (PSS) measures general stress and the Swedish version, although used in several studies, has not been extensively evaluated for psychometric properties. AIMS This study aimed to investigate psychometric properties and the factor solution of the Swedish 14-item version when used with two samples, namely a mixed Internet sample of women and men (n = 171) and another of women with stress-related disorders (n = 84). Classical test theory, including confirmatory factor analysis, was employed. RESULTS The factor structure supported a two-factor model for the PSS and confirmed other language versions of the PSS, although one items showed a low item-total correlation. The PSS showed to be feasible with the investigated samples and the results indicated no ceiling or floor effects and good internal consistency of the PSS. Several aspects of construct validity were shown. An association of - 0.66 between the PSS and a measure of coping indicated good concurrent validity. Criterion validity was demonstrated through a statistically significant difference (P < 0.001) between the women with stress-related disorders and the Internet sample. Predictive validity of the PSS could be demonstrated in a short-term perspective. Based on the sample with stress-related disorders, sensitivity to change was shown through a statistically significant stress reduction (P < 0.001) from entering work rehabilitation to discharge. CONCLUSIONS The Swedish version of the PSS showed satisfactory psychometric properties and may be recommended for use with people with and without known stress-related disorders.
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Affiliation(s)
- Mona Eklund
- Mona Eklund, Ph.D., Professor, Department of Health Sciences, Lund University , Lund , Sweden
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Implementation of Mindfulness Training for Mental Health Staff: Organizational Context and Stakeholder Perspectives. Mindfulness (N Y) 2014; 6:861-872. [PMID: 26500708 DOI: 10.1007/s12671-014-0330-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Occupational stress and burnout adversely impacts mental health care staff well-being and patient outcomes. Mindfulness training reduces staff stress and may improve patient care. However, few studies explore mental health setting implementation. This qualitative study used focus groups to evaluate stakeholders' perceptions of organizational factors affecting implementation of an adapted version of Mindfulness-Based Stress Reduction (MBSR) for staff on adolescent mental health units. Common facilitators included leadership securing buy-in with staff, allocating staff time to participate, and quiet space for training and practice. Other facilitators were past staff knowledge of mindfulness, local champions, and acculturating staff with mindfulness through a non-mandatory training attendance policy. Common barriers were limited staff time to attend training sessions and insufficient training coverage for some staff. Staff also reported improved focus when interacting with adolescents and improved social cohesion on the units. We conclude that a mindfulness-based program for reducing occupational stress can be successfully implemented on adolescent mental health units. Implementation appeared to change the social context of the units, including staff and patient interactions. More broadly, our findings highlight the importance of environmental factors in shaping attitudes, diffusion of innovation, and acculturation of wellness program implementations.
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Abstract
It has been clearly acknowledged and well-documented that physical, emotional, and psychological violence is a central theme and an expected workplace hazard for registered nurses working in acute inpatient mental health care facilities. Limited research, however, has focused on how registered nurses have been able to cope within this environment and adequately protect themselves from harm. A critical feminist research project recently explored the lived experience of 13 Australian, female, registered nurses working in a busy metropolitan acute inpatient mental health care facility. "Fear" was exposed as the precursor to violence and aggression, both "fear as experienced by the nurse" and "fear as experienced by the patient." The participants reported experiencing a sense of fear when they could not accurately or confidently anticipate a patient response or reaction. They identified this relationship with fear as being "part of the job" and part of the unpredictable nature of caring for people experiencing complex distortions in thinking and behavior. The participants believed, however, that additional workplace pressures complicated the therapeutic environment, resulting in a distraction from patient care and observation. This distraction could lead to nurse-patient miscommunication and the potential for violence. This article discusses a major theme to emerge from this study, "Better the devil you know!" The theme highlights how mental health nurses cope with violence and why they choose to continue working in this complex care environment.
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Affiliation(s)
- Louise Ward
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
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Zarea K, Nikbakht-Nasrabadi A, Abbaszadeh A, Mohammadpour A. Facing the challenges and building solutions in clinical psychiatric nursing in Iran: a qualitative study. Issues Ment Health Nurs 2012; 33:697-706. [PMID: 23017047 DOI: 10.3109/01612840.2012.698371] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Psychiatric nurses play an important role in the process of caring for mentally ill patients and are continually faced with the numerous challenges and complex issues related to this field. This study aimed to understand the perspectives of psychiatric nurses regarding the issues they face while providing care and examine the possible solutions for improvement of inpatient care in clinical settings. The study adopted a qualitative approach that utilized a content analysis of audio taped, semi-structured interviews that had been conducted with 24 nurses. Two main themes emerged from the data. The first, Challenges in Providing Care within Psychiatric Wards, had the following subthemes: Politics and Rules of Organization, Safety and Security Issues, Uncertainty about the Role, Lack of Trained Staff, and Sociocultural Issues. The second theme, Solutions for Improving Psychiatric Care, had the subthemes of Empowerment across four domains: Psychiatric Nurses, Mentally Ill Patients and their Families, The Psychiatric Mental Health System, and the Cultural Context. The results indicated that if nurses are expected to provide optimal nursing care within a psychiatric ward, then there is a need for a stable and responsible organizational structure, skilled psychiatric nurses, and community-based care along with an anti-stigma program.
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Affiliation(s)
- Kourosh Zarea
- Ahvaz Jundishapur University of Medical Sciences, School of Nursing and Midwifery, Ahvaz, Islamic Republic of Iran. [corrected]
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Tuvesson H, Eklund M, Wann-Hansson C. Stress of Conscience among psychiatric nursing staff in relation to environmental and individual factors. Nurs Ethics 2012; 19:208-19. [DOI: 10.1177/0969733011419239] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present study aimed at investigating the relationship between environmental and individual factors and Stress of Conscience among nursing staff in psychiatric in-patient care. A questionnaire involving six different instruments measuring Stress of Conscience, the ward atmosphere, the psychosocial work environment, Perceived Stress, Moral Sensitivity, and Mastery was answered by 93 nursing staff at 12 psychiatric in-patient wards in Sweden. The findings showed that Sense of Moral Burden, Mastery, Control at Work and Angry and Aggressive Behavior were related to Stress of Conscience. We conclude that Mastery and Control at Work seemed to work as protective factors, while Sense of Moral Burden and perceptions of Angry and Aggressive Behavior made the nursing staff more vulnerable to Stress of Conscience. Future research should investigate whether measures to increase the level of perceived control and being part of decision making will decrease the level of Stress of Conscience among the staff.
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