Understanding individual resilience in the workplace: the international collaboration of workforce resilience model

Knowledge graph analysis of research on nurses' psychological resilience

In recent years, a surge in literature on psychological nurse resilience, largely driven by the COVID-19 pandemic, has prompted the need for a comprehensive understanding of the current state and emerging trends through reliable methodologies. The purpose of this study was to analyzes the research on nurses' psychological resilience through bibliometrics to understand the current situation, foundation, and hotspot of this research field. The Web of Science core collection database was used as the search source, and CiteSpace analysis software was employed to conduct bibliometric analysis on authors, countries, institutions, keywords, and references of nurse psychological resilience-related literature published from the establishment of the database to July 11, 2023. A total of 1060 articles were included in the final analysis. The study of nurses' psychological resilience had been highly popular and had formed a new and important research basis in recent years. China and the United States led in the number of publications and centrality respectively, with Monash Univ and Curtin Univ as top institutions in the number of publications and centrality respectively. The authors with the highest number of publications and the most frequently cited were Rees and Connor Km respectively. The most frequently cited article was Factors Associated with Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019 published by Lai, JB, etc. Important key keywords included mental health, resilience, stress, health, outbreak, acute respiratory syndrome, etc. The research topics in this field mainly focused on 4 aspects, including nurses' mental health, post-traumatic stress disorder, job burnout and job satisfaction, and intervention research on psychological resilience. The results of bibliometric analysis provide direct support for future scholars to explore and determine the research direction, hot spots, and find authoritative authors and institutions. At the moment, nurses' psychological resilience research has established a new foundation, primarily focusing on COVID-19-related topics. Given the potential prolonged coexistence of COVID-19 and other diseases, the main research focus remains innovating and validating effective psychological resilience intervention strategies for nurses' overall well-being.

Correlation analysis of mental toughness, family social support, and anxiety of nursing staff

OBJECTIVE

This study aims to explore the impact of family social support affects anxiety levels and mental toughness among nursing staff, and to identify the pathways of how mental toughness develops.

METHODS

We selected 256 nursing staff from the Third People's Hospital of Chengdu using a convenience sampling method. Participants completed a questionnaire assessing family social support, anxiety level and mental toughness of the nursing staff. The questionnaires included the general information questionnaire, Perceived Social Support Scale (PSSS), Self-Rating Anxiety Scale (SAS), and the Connor-Davidson resilience scale (CD-RISC). Then, we analyzed the correlation between nursing staff' family social support, anxiety symptoms and mental toughness by using Pearson correlation. Finally, we analyzed the effect of family social support on mental toughness and anxiety levels by using linear regression, and analyzed the path of family social support and psychological toughness on anxiety symptoms by using structural equation modeling.

RESULTS

We finally collected 246 valid questionnaires with a valid recovery rate of 96.09%. 116 (47.15%) nursing staff reported a moderate level of family social support, with a mean PSSS score of (58.98 ± 7.64). Anxiety risk was identified in 43.39% of participants, with a mean SAS score of 50.47 ± 10.96. In terms of mental toughness, 104 (42.28%) nursing staff exhibited a low level of mental toughness, and 116 (47.15%) demonstrated moderate level of mental toughness with CD-RISC score of (58.23 ± 10.12). Correlation analyses revealed a strong negative correlation between the family social support, mental toughness and their anxiety (r = -0.586, -0.516, respectively), and a strong positive correlation between family social support and mental toughness (r = 0.571). Regression analysis showed that family social support was a significant negative predictor for anxiety (β = -0.841, t = -9.488), but a significant positive predictor for mental toughness (β = 0.756, t = 11.669). Mediation analysis indicated that mental toughness mediated 26.28% of the relationship between family social support and anxiety levels.

CONCLUSION

Family social support can significantly reduce anxiety levels in nursing staff directly, as well as indirectly by increasing mental toughness.

Resilience, job satisfaction, occupational stress, and occupational accidents among healthcare professionals: A Bayesian network analysis

BACKGROUND

Occupational accidents remain a critical challenge for healthcare professionals.

OBJECTIVE

In the present study, using the Bayesian network (BN) approach association among resilience, job satisfaction, stress, and occupational accidents among healthcare professionals is examined.

METHODS

Data was gathered using several valid questionnaires. The BN approach was utilized to analyze the r5/31/2024ionships between the variables of the current study. The performance of BN analysis was evaluated using related indexes.

RESULTS

In total, 300 healthcare professionals participated in this study. Results showed that almost 23% of healthcare professionals had experienced occupational accidents. Results of the sensitivity analysis demonstrated that job satisfaction had the most significant influence on occupational accidents in healthcare settings. The belief updating analysis results showed that by increasing job satisfaction and decreasing stress of healthcare professionals the occurrence of occupational accidents decreased 9.8% and 6.4%, respectively. Moreover, decreasing the stress of healthcare professionals can lead to an increase in the level of job satisfaction. Evaluation indexes showed that the performance of the developed BN was acceptable (error rate: 16.09).

CONCLUSION

The Findings reveal that both job satisfaction and stress had a significant influence on occupational accidents in healthcare professionals. Moreover, by influencing job satisfaction and stress, resilience can indirectly affect occupational accidents.

Public Health in the Public Eye: Experiences of Ohio's Public Health Workforce During COVID-19

The COVID-19 pandemic was uniquely challenging for public health workers charged with enforcing recommendations. In the United States, media reports highlight frequent outbursts and threats from community members and elected officials regarding masking protocols, vaccine mandates, and other public health measures such as isolation/quarantining recommendations. Given this backdrop, the purpose of this study was to better understand the lived experiences of this critical workforce in the context of COVID-19. We conducted in-depth phone interviews with public health workers in Ohio (N = 11). Questions were designed to illicit workers' experiences and sense-making of the pandemic experience. We analyzed results using the techniques of interpretive phenomenological analysis. Five major themes focused on how workers experienced public perceptions of COVID-19 and the public health response. Three themes highlight the role of media and social media in polarizing public perceptions. These we note as: Dealing with Deadlock, Feeling Misunderstood and Misrepresented, and The Rollercoaster of Public Opinion. Getting on With the Work reveals strategies used to navigate public perceptions and misperceptions. This ranged from aggressive education and information sharing, to setting boundaries around the controversial or disputed aspects of the pandemic. Finally, After the Dust Settles comments on hopes for postpandemic transformations of public health and public perceptions thereof. These results can inform new pathways for public health. Paramount among these are effective strategies that address public knowledge, values, and worldviews. Such messaging must promote nuanced understanding and customized approaches for local realities, rather than relying on rigid dichotomies that further polarization and distrust.

Nurse and midwife navigator resilience, well-being, burnout, and turnover intent: A multi-methods study

PURPOSE

To explore levels of Navigator resilience, well-being, burnout, and turnover intent.

DESIGN

A longitudinal, multi-methods study concurrently collected quantitative and qualitative data over three years.

METHODS

A survey and Action Learning Groups.

FINDINGS

No statistically significant change in resilience, well-being, burnout, or turnover intent. Supports, self-care and leaving the position, were used to maintain well-being.

CONCLUSIONS

While quantitative measures did not change, qualitative data demonstrated how adaptive coping mechanisms maintain well-being. Recommendations for nurses working in Navigator, or similar community/public health roles include work-based programs targeting support, good leadership, governance systems including their impact on turnover intent.

CLINICAL EVIDENCE

Job turnover intent can be used as a mechanism to monitor resilience and well-being.

Modeling the social determinants of resilience in health professions students: impact on psychological adjustment

Stressors inherent to training and stemming from the learning environment are associated with high rates of burnout, depression, and mental health problems in health professions students (HPS). There is evidence that disadvantaged or stigmatized groups are particularly affected. These problems not only impact students after graduation but may also have detrimental effects on patient outcomes. Resilience, conceptualized as the process of adapting well in the face of adversity, has inspired an increasing number of interventions aimed at addressing those problems in HPS. These interventions have mostly targeted individual students and their psychological traits while ignoring social and structural factors that may enhance or undermine individual resilience. To address this gap in the literature, the authors reviewed the evidence for psychosocial determinants of resilience and proposed a model inspired by the social determinants of health literature and the "upstream-downstream" metaphor. In this theoretical paper, the authors propose that upstream determinants such adverse childhood experiences and socioeconomic and sociodemographic markers of disadvantage have a direct effect on psychological adjustment and an indirect effect mediated by resilience. Additionally, the authors propose that the institutional downstream drivers of learning environment, social support, and sense of belonging moderate the direct and indirect effects of the upstream determinants on psychological adjustment. Future research should test these hypotheses and gather evidence that may guide the development of interventions. The authors present their model as part of a comprehensive response to recent calls to action to address diversity, equity and inclusion in health professions education.

Compassion fatigue and psychological resilience levels of nursing final students: A descriptive, cross-sectional, and relational study

OBJECTIVES

Nursing students often encounter real-life trauma situations during their clinical experience and similar workplace environment and climate as professional nurses. This research was carried out to determine the reflections of the compassion fatigue levels of nursing final year students on their psychological resilience levels.

METHODS

This research was conducted as descriptive and cross-sectional. The sample of the study consists of 250 final year nursing students. Data were collected using Personal Information Form, Compassion Fatigue Scale, and Resilience Scale. It was determined that the compassion fatigue and psychological resilience levels of nursing final year students were moderate.

RESULTS

It was determined that as the levels of compassion fatigue increased, psychological resilience decreased. A highly negative and significant correlation was found between the total and sub-dimension mean scores of compassion fatigue and psychological resilience (p = 0.001).

SIGNIFICANCE OF RESULTS

It was found that there was a negative and high level relationship between nursing students' compassion fatigue levels and all its sub-dimensions and psychological resilience. Resilience can improve psychosocial functioning and professional performance, including for nursing students facing stressful clinical experiences. It is important to determine the compassion fatigue and psychological resilience levels of nursing students, to determine the existing problems, and to take initiatives for this.

Theme-centered interaction and developmental tasks as research method and pedagogical tool regarding identity development in VET

This paper presents the methodology of a PhD project on identity development in German dual track VET. The mixed methods approach comprises theory-driven longitudinal case studies using qualitative and quantitative data and a document analysis of curricula. The study was part of a larger design-based research project and aimed to evaluate a newly developed and implemented VET curriculum for the retail sector from the learners' point of view. The new curriculum contained a special competence dimension to foster vocational identity development and a major interest was to investigate the extent to which the curriculum succeeded to do so. The paper will start with a summary and assessment of limitations and advantages of research designs applied in different existing studies examining identity development. The author will then outline identity-relevant theories and approaches that proved to be useful for her research interest. Subsequently, she will describe the resulting design for collecting and analyzing her data. The core result consists of a theme-centered process analysis visualizing the individual state of developmental tasks. With the presentation of three exemplary cases she will illustrate how her approach allowed her to deeply understand the identity of the respective person and at the same time generate general insights about identity development of learners in VET. Finally, strengths and limitations of her approach will be discussed. This research approach is also suited to supporting pedagogical design, representing major added value.

Perceived stress of mental demands at work, objective stress and resilience - an analysis of the LIFE-Adult-study

BACKGROUND

So far, previous research suggests positive effects of mental demands at the workplace. However, it may depend on how stressfull these demands are perceived on an individual level.

OBJECTIVE

The aim was to build on previous research by investigating how mental demands are related to stress, overload, and work discontent and whether this relationship is mediated by individuals resources, such as resilience.

METHOD

A sub-sample of the LIFE Adult Cohort (n = 480) was asked to answer questions on sociodemographic characteristics, objective stress (using the Trier Inventory of Chronic Stress (TICS)), and perceptions of stress with regard to verbal and executive mental demands at work.

RESULTS

According to generalized linear regression models, higher verbal as well as executive mental demands were associated with higher levels of chronic stress, work overload and discontent. Higher levels of resilience were associated with lower levels of these outcomes. Analyses regarding interaction effects revealed that the interaction between resilience and perceived stress of verbal mental demands was significant only in terms of work overload.

CONCLUSION

Higher perceived stressfulness of mental demands was associated with higher chronic stress, work overload and work discontent. Therefore, mental demands should be targeted by occupational interventions that aim to improve job conditions and employees' overall well-being. Besides resilience, other potential influencers or personal resources should be focused on in future studies to develop interventions.

Mindfulness and Subjective Well-Being of Indian University Students: Role of Resilience during COVID-19 Pandemic

The coronavirus (COVID-19) pandemic is presently a global health issue that negatively affects the mental health and well-being of students globally. The latest investigations have recognized the role of mindfulness in individual subjective well-being. This study explores the mediating role of resilience in the overall relationship between mindfulness and subjective well-being among Indian university students during the COVID-19 pandemic. The data was collected between 10 August 2020 to 24 October 2020 via a self-administered questionnaire from 589 university students in India. Results revealed that resilience has a partial mediating role between mindfulness and subjective well-being. The results substantiate that resilience has an important role in mindfulness, exercising its advantageous effects on mental health of the students in higher education institutions. This research adds to the knowledge base of mindfulness and subjective well-being of university students, especially in contingent times. Lastly, the study contributes to the existing mindfulness theory.

Effects of coping on nurses' mental health during the COVID-19 pandemic: Mediating role of social support and psychological resilience

BACKGROUND

Fighting against the COVID-19 pandemic, front-line nurses were under unprecedented psychological pressure. Therefore, it is necessary to promptly evaluate the psychological status of nurses during the COVID-19 epidemic period.

AIM

To investigate nurses' mental health during the COVID-19 pandemic, and to test the mediating role of social support and psychological resilience between coping and mental health.

DESIGN

This was a descriptive, cross-sectional survey which used a structural equation model.

METHOD

In total, 711 registered nurses were included. All participants were invited to complete a socio-demographic questionnaire, the general health questionnaire, the trait coping style questionnaire, the perceived social support scale and the Conner-Davidson Resilience scale.

RESULTS

In total, 50.1% nurses had high risk of mental health. Positive coping positively affected social support and psychological resilience, while it negatively affected mental health. Negative coping negatively affected social support and psychological resilience, while it positively affected mental health. Social support positively affected psychological resilience, while it negatively affected mental health. In addition, social support mediated coping and psychological resilience, and coping and mental health. Moreover, psychological resilience negatively affected mental health, and it mediated coping and mental health.

Predicting work engagement among young adult cancer survivors: A moderated mediation model

INTRODUCTION

Early research on cancer survivors was focused on exploring cancer treatments. More recently, attention has shifted to cancer survivorship research, focusing on cancer survivors as individual persons, including the multiple facets of survivors' quality of life but is inapplicable in the context of work-related role played in the young adult cancer survivors' lives. However, in recent studies on the outcomes of long-term survivorship, some of the main areas of cancer survivorship research revolves around employment issues of young adult cancer survivors. In the present study, the focus is given on the role of workplace spirituality as a mediator on the association of employee resilience and workplace social support on work engagement in a Malaysian setting, taking into consideration gender and age differences.

METHODS

Using a quantitative research paradigm, data were collected from 270 respondents at Pediatric Institute Kuala Lumpur Hospital. Data were analyzed using descriptive statistics and the Partial Least Square-Structural Equation Model (PLS-SEM) to test the direct, indirect, and mediation effects.

RESULTS AND DISCUSSION

The findings revealed that workplace spirituality did mediate the influence of employee resilience and workplace social support on work engagement. The findings also indicated that gender and age moderated the association of employee resilience and work engagement via workplace spirituality.

Assessing how Spirituality Affects Resiliency in the Pediatric Healthcare Practitioner

A literature review was conducted to examine the role of spirituality with resiliency in the pediatric workplace. Two themes emerged from the literature review: healthcare practitioners desire to have a sense of belonging at work and the utilization of chaplains is helpful. This study aims to discover how practitioners experience spiritual health in the workplace and identify interventions that enhance resiliency with the challenges of pediatrics. Implications from this study are applied to chaplaincy and research.

Analysis and comparison of web searches in Google Trends in the business and industrial category for the word's "resilience" and "wellbeing" during COVID-19

OBJECTIVE

The comparison of Google internet searches for worker wellbeing and resilience during COVID has not previously been undertaken. It is important to understand interest in wellbeing and resilience as both constructs influence health and burnout. Our objective to investigate internet interest in both wellbeing and resilience during COVID. Using Google Trends, data on global search English word queries we compared "worker wellbeing" or "wellbeing" versus "resilience" or "psychological resilience". Two time periods were compared, the last 5 years and the last 12 months, both up until the end of April 2022. The relationship between web search interest, reflected by search volume index (SVI) for all categories versus the business and industrial category evaluated.

RESULTS

Open category searches on Google trends for the key words "worker wellbeing" or "wellbeing" demonstrated increased SVI peaks for COVID periods. Sub-group analyses demonstrated the category business and industrial had less web search interest in wellbeing and an increase in search terms related to resilience but not psychological resilience. Online interest in wellbeing and resilience represents a complex search metric. There are differing search interests depending on whether the category business and industrial is chosen versus the general Google Trends category.

Defining the influence of external factors on nurse resilience

In the context of pressures faced by the nursing profession including increasing patient acuity and global nursing shortages, the importance of nurse resilience has gained attention in research and practice. Resilience is viewed as a protective factor that enables individuals to avoid psychological harm and continue in their work. There is limited evidence on the impact of external factors such as work conditions on nurse resilience. This study aimed to explore how external factors influence nurse resilience and to incorporate this knowledge into an updated definition of nurse resilience. As part of a two-phase mixed methods study, focus groups were conducted to obtain qualitative data to explore nurse's perceptions of resilience and factors they felt affected their resilience. Data analysis identified three main themes derived from 10 subthemes: Perceptions of Resilience, Pressures and Challenges, and Support and Strategies contributed to understanding how external factors can affect nurse resilience. A range of factors emerged including the impact of workplace conditions, organizational philosophy, the performance of managers, and the teams nurses work within, which were not reflected in an earlier definition of nurse resilience derived through a concept analysis. These factors were incorporated in an updated definition of nurse resilience. Understanding resilience in the nursing profession and the external factors that affect it is critical to the development of effective research, policies, interventions, and work environments to protect nurse well-being, promote nurse retention, and ensure the provision of quality patient care.

A Scoping Review of Vicarious Trauma Interventions for Service Providers Working With People Who Have Experienced Traumatic Events

Health and human service providers who aid traumatized individuals frequently experience vicarious trauma (VT). Although VT plays a critical role in service providers' mental health and well-being, as well as in the quality of their service provision, little information is available concerning the development and implementation of VT interventions for service providers. To advance the development of evidence in this area, we undertook a scoping review in which we reviewed existing interventions intended to address VT among service providers working with traumatized clients. Searches of electronic databases were conducted to identify studies published in peer-reviewed journals, with no date restrictions. Over 1,315 citations were reviewed, and a total of 27 studies were included in the final review. The findings show that VT interventions in the literature can be divided broadly into four categories: psychoeducation, mindfulness intervention, art and recreational programs, and alternative medicine therapy. The VT interventions reviewed generally showed promise in their key outcomes, including reductions in secondary trauma stress, compassion fatigue, burnout, and other mental health outcomes. However, the current body of research is lacking both in rigor and in specificity regarding the definition of VT. Furthermore, existing VT interventions are generally self-care based and tend to focus on general stress management rather than addressing the specific effects of VT. Therefore, we call for an increase in efforts to tailor VT interventions to different service settings and participant characteristics, as well as greater attention to developing primary VT interventions at the organizational level.

Secondary traumatic stress and dissociative coping strategies in nurses during the COVID-19 pandemic: The protective role of resilience

During the COVID-19 pandemic, nurses are repeatedly exposed to acute stress at their workplace, and therefore, they are at high risk for developing mental health symptoms. The prolonged exposure of healthcare professionals may lead to Secondary Traumatic Stress (STS). STS is an aspect of "cost of care", the natural consequence of providing care to people who suffer physically or psychologically. The purpose of this study was to investigate the levels of STS in nurses during the first phase of the COVID-19 pandemic in Greece and to detect aggravating and protective factors. Participants were 222 nurses (87.4 % women; mean age 42.3 years) who completed an online survey. The questionnaire comprised of the Secondary Traumatic Stress Scale, the Brief Resilience Scale, and the Brief Coping Orientation to Problems Experienced Inventory. Nurses had high levels of STS. The hierarchical regression analyses showed that STS and its dimensions Avoidance and Arousal were positively predicted mainly by denial and self-distraction coping strategies and inversely by resilience. Resilience exhibited a protective (partial mediation) effect on the strong relationship between the dissociative coping strategies (denial, self-distraction, venting and behavioral disengagement) and STS. Trauma-informed care psychosocial interventions are needed to support the already overburdened nursing staff during the coronavirus pandemic.

Exploring the working environment of Hospital Managers: a mixed methods study investigating stress, stereotypes, psychological safety and individual resilience

Background

Hospital managers are responsible for the delivery of organisational strategy, development of clinical services and maintaining quality standards. There is limited research on hospital managers, in particular how stress manifests and impacts managers and the presence of individual resilience. Managers must work closely with clinical colleagues, however these relationships can be hindered by the perception of stereotyping and differing priorities. This study aimed to explore the working environment of hospital managers, focusing upon the unique stresses faced, psychological safety and the presence of resilience.

Methods

This study utilised mixed methodology using an embedded approach. Participants were purposively recruited from all levels of hospital management within one National Health Service Trust in London, United Kingdom. An exploration of managers experiences was undertaken using semi-structured qualitative interviews. Psychological safety and individual resilience were additionally assessed using validated surveys. Qualitative data were analysed iteratively using inductive thematic analysis, and triangulated with quantitative data. Kruskal-Wallis statistical analysis was performed to evaluate differences in resilience and psychological safety according to seniority and background experience.

Results

Twenty-two managers were recruited and interviewed, with 20 returning completed surveys. Key findings from the thematic analysis included the importance of good working relationships with clinical colleagues, the persistence of some stereotyping, and feeling unsupported in times of challenge. Stresses described included the bureaucracy involved when delivering change, conflict with colleagues and target driven expectations.

Participants described their own psychological safety as lower than desired, supported by quantitative data; but recognised its importance and strived to create it within their own teams. Sixteen participants had ‘normal’ scores for resilience, with senior managers more likely to have higher scores than those more junior (p=0.011).

Conclusion

Positive working relationships, high psychological safety and individual resilience are important for organisational safety and individual wellbeing. Our data illustrate unique stressors faced by hospital managers, provide detail on sometimes challenging working relationships, and demonstrate scope to improve both the psychological safety and resilience of those in managerial positions. A map for senior healthcare leaders was constructed, facilitating the identification of modifiable areas within their organisation to promote good working relationships and improve the working environment of hospital managers.

An investigation of the level of burnout and resilience among hospital based nurse managers after COVID 19 - A cross-sectional questionnaire-based study

AIM

We aim to investigate burnout and resilience among hospital based nurse managers post COVID-19 in order to suggest appropriate person-centred leadership support.

BACKGROUND

Nurse leaders are central to establishing safe and caring environments for patients and staff. Therefore, their own wellbeing is crucial, particular in times of crisis where they must provide support and guidance.

METHODS

Cross-sectional questionnaire included ward managers. Data collected were burnout inventory, brief resilience score and demographic data. To analyse data, we used descriptive statistics.

RESULTS

51.2% answered the questionnaire. Of those, 32.3% displayed symptoms of high personal burnout and 29% of work-related burnout. 6.5% showed signs of high employee-related burnout. As a group, ward managers showed moderate to high resilience.

CONCLUSION

Personal and work-related burnout was highly prevalent among ward managers. Results suggest that the cause of their burnout symptoms cannot be attributed to low individual resilience. We thus suggest a shift in focus from strengthening individual leadership resilience to the establishment of healthful and resilient cultures in accordance with person-centred leadership.

IMPLICATIONS FOR NURSING MANAGEMENT

Person-centred leadership has the potential to shift the focus from the resilience of individual leaders to that of collective responsibility for creating a healthful and resilient culture.

Identification of hyper-ramified microglia in the CA1 region of the mouse hippocampus potentially associated with stress resilience

Recent studies have indicated that some individuals are less affected by stress, and such individuals are called resilient. This study aimed to determine whether the specific phenotype of microglia might be involved in resilience using the social defeat stress paradigm. Male C57BL/6J (B6) mice were attacked by aggressive male ICR mice for five consecutive days. After stress exposure, the social behaviour was reduced in about half of the B6 mice (vulnerable), whereas no such change was observed in the remaining half of the B6 mice (resilient). Anxiety-like behaviour was increased in vulnerable mice compared with resilient mice and non-stressed controls. However, depression-related behaviour was comparable between the three groups. The morphological characteristics of microglia in the CA1 region of the dorsal hippocampus in non-stressed controls and resilient mice differed from those in vulnerable mice. Interestingly, the voxel densities of GABAergic and glutamatergic synaptic puncta colocalized with microglia were higher in resilient mice than in non-stressed controls and vulnerable mice. Microglia were then objectively classified into three morphological types by hierarchical cluster analysis. The appearance of type I microglia resembled the so-called resting ramified microglia and represented the major population of microglia in non-stressed controls. Type II microglia exhibited a de-ramified morphology and accounted for 60% of the microglia in vulnerable mice. Type III microglia showed a hyper-ramified morphology and represented more than half of the microglia in resilient mice. These results suggest that hyper-ramified microglia in the hippocampus may be associated with stress resilience via the modulation of synaptic transmission.

Resilience and job satisfaction among out-of-hospital emergency medical service professionals: A cross-sectional multi-centric study

AIM

We aim to describe the relationship between job satisfaction and compare levels of resilience among out-of-hospital emergency medical service professionals.

BACKGROUND

The study of the impact of the working environment on health professionals has raised great interest. Job-related variables and resilience can be a protective factor against stressful and demanding events at work.

METHODS

A cross-sectional survey comprising sociodemographic and job-related variables was conducted among 406 workers (doctors, nurses, psychologists, and ambulance technicians) from the out-of-hospital emergency medical system in Spain. Resilience was self-reported using the Connor-Davidson Resilience Scale.

RESULTS

Nursing professionals were less resilient compared with ambulance technicians (score difference 1.709, p = .008). As age increased, resilience was lower (r = -.118). Professionals with higher resilience scores were more satisfied in their work (OR = 1.06, 95% CI: 1.02-1.11), and professionals with higher psychological strength, gained from working with other colleagues, also showed greater job satisfaction (OR = 5.47, 95% CI: 2.55-11.73).

CONCLUSION

There was a positive association between resilience, job satisfaction and collaborative work. Professionals with greater psychological strength, gained from working with other colleagues, also showed higher levels of job satisfaction.

IMPLICATIONS FOR NURSING MANAGEMENT

Managers can use these results to influence the work environment to enhance job satisfaction and hence improve the resilience of the out-of-hospital emergency health care professionals.

Assessment of resilience levels among Sri Lankan nurses: Is there room for improvement?

BACKGROUND

Developing resilience at work is an effective primary preventive measure for occupational stress. The study aimed to adopt a tool and measure current resilience levels and determine the association of work-related characteristics on resilience among Sri Lankan nurses.

METHODS

Translated, culturally adapted and validated Resilience at Work Scale- Sinhala version (RAW-S) was used to measure resilience levels in a sample of 855 government nurses from a health district. The mean RAW-S scores were calculated and appropriate cut off points were used to determine the prevalence of 'high', 'moderate' and 'low' resilience. Chi square test was used to determine the associations.

RESULTS

The overall mean RAW-S score was 69.6 (95% CI = 68.9-70.3) and the scores ranged from 28.5 to 90.3. Only 28.4% (95% CI = 25.4-31.6) of nurses showed 'high' level of resilience at work, while 55.6% (95% CI = 52.1-58.9) & 16.0% (95% CI = 13.7-18.7) had shown 'moderate' and 'low' levels of resilience respectively. The resilience levels differed significantly (p < 0.05) by type of ward that they work and by work experience.

CONCLUSIONS

This was the first study that examined the resilience levels in any health care worker category in Sri Lanka. The need of targeted, well-designed resilience building programme for ever burdened government sector nurses is clearly shown from the results, as more than two thirds of nurses had 'moderate' or 'low' level of resilience, which may not be good enough to combat the constant work stress they face on daily basis.

Relationships between self-efficacy, coping-style and quality of work-life among nursing managers in China: A cross-sectional study

AIM

To investigate the quality of work-life among nursing managers in China and analyze the relationships between self-efficacy, coping-style, and quality of work-life.

BACKGROUND

Self-efficacy, coping-style, and quality of work-life play significant roles in the stability of nursing teams, the quality of clinical care, and patient safety. Although some factors influencing quality of work-life have been identified, there is no large-scale study of the relationships among self-efficacy, coping-style, and quality of work-life of nursing managers. Strategies to strengthen the quality of work-life of nursing managers should be developed by exploring the relationships between the three variables.

METHODS

A nationwide cross-sectional study was conducted. A total of 1498 nursing managers from 51 tertiary general hospitals in 20 provinces in China were selected for the study using multistage stratified proportional sampling. Registered full-time nursing managers with more than one year of management experience were eligible for the study. The participants completed online questionnaires to assess their self-efficacy, coping-style, and work-related quality of life. The data were analyzed using descriptive analysis, Pearson's correlation, hierarchical multiple linear regression, and structural equation modelling to verify the relationships between variables.

RESULTS

The quality of work-life score for the nursing managers surveyed was 3.74 ± 0.56 out of a possible five. Self-efficacy was positively correlated with quality of work-life (β = 0.484, P < 0.01) over all demographic variables. Positive coping was also positively associated with quality of work-life (β = 0.404, P < 0.01). Self-efficacy and positive coping explained 22.7% and 14.2% of the variance in the quality of work-life, respectively. Structural equation modelling indicated that self-efficacy positively and directly predicted the quality of work-life (β = 0.395, P < 0.001), and indirectly affected quality of work-life via positive coping (β = 0.186, P < 0.001), but not via negative coping (β = 0.005, P > 0.05). The final model could explain 44% of the variance in the quality of work-life.

CONCLUSION

Self-efficacy was positively correlated with quality of work-life among Chinese nursing managers, and positive coping partially mediated this relationship. The results suggest that self-efficacy and positive coping are pivotal facilitators for improving the quality of work-life and need to be taken into account in measures to improve the quality of work-life of nursing managers.

IMPLICATIONS FOR NURSING MANAGEMENT

Hospital administrators should recognize the importance of nursing managers' work-life quality to promote both the stability of nursing teams and the quality of clinical care and safety provided. They should help nursing managers foster self-efficacy and active coping abilities through incentive measures and provide positive coping training courses to enhance their quality of work-life.

The impact of implicit theories on resilience among Chinese nurses: The chain mediating effect of grit and meaning in life

Implicit theories refer to assumptions people hold about different domains, also known as mindsets. There are two implicit theories on the malleability of one’s ability: entity theory and incremental theory. They constrain and regulate people’s understanding and responses to an individual’s behavior, leading to different social cognitive patterns and behavioral responses. Resilience is a positive adaptation in highly stressful situations that represents mechanisms for coping with and transcending difficult experiences, i.e., a person’s ability to successfully adapt to change, resist the adverse effects of stressors, avoid significant dysfunction, and be chronically affected by considered a protective factor for mental health. Although previous studies showed that individuals’ implicit theories are associated with resilience, this relationship has received little attention in the nursing population. It is unclear which variables may contribute to explaining the relationship between implicit theories and resilience. Therefore, the current study aims to deeply explore the relationship between implicit theories and the resilience of Chinese nurses. In addition, we also seek to demonstrate the chain mediating effects of grit and meaning in life on this relationship. We surveyed 709 Chinese nurses through online questionnaires using the self-made demographic questionnaire, the Implicit Theories Scale, the Short Grit Scale, the Meaning in Life Questionnaire, and the 10-item Connor-Davidson Resilience Scale. After controlling for demographic variables such as age, gender, educational background, marital status, professional title, and working years, the results reveal positive associations between Chinese nurses’ implicit theories and their resilience, and grit and meaning in life play a partial mediating role in this relationship, respectively. Furthermore, grit and meaning in life play a chain mediating role between implicit theories and resilience. These findings contribute to understanding the psychological impact mechanism of implicit theories on nurses’ resilience and provide a theoretical basis for nursing managers to formulate strategies to improve nurses’ psychological resilience.

Psychological Resilience and Career Success of Female Nurses in Central China: The Mediating Role of Craftsmanship

Background

Nurses’ career success is an important factor affecting the quality of nursing services and the stability of the nursing workforce, and enhancing nurses’ career success level is of key significance to the development of the nursing discipline. As psychological resilience and craftsmanship are important spiritual traits in the process of nurses’ career development, it is important to understand the mechanism of their effects on nurses’ career success level.

Objective

To explore the current situation of craftsmanship, psychological resilience and career success levels of female nurses in central China, and to verify the mediating role of craftsmanship between psychological resilience and female career success using structural equation model.

Methods

A cross-sectional study was conducted among 2359 female nurses from three hospitals in central China through an online questionnaire, including craftsmanship, psychological resilience and career success scale. The data were analyzed by Z-test and Spearman rank correlation with SPSS 23.0 statistical software, and the mechanism of the effect of craftsmanship and psychological resilience on career success was completed by AMOS 23.0 statistical software.

Results

The scores of career success, psychological resilience, and craftsmanship of female nurses in central China were 68.00 (61.00, 75.00), 74.00 (64.00, 84.00), and 83.00 (79.00, 95.25). Spearman rank correlation analysis showed that Chinese female nurses’ career success was positively correlated with craftsmanship (r = 0.511, P < 0.01) and psychological resilience (r = 0.595, P < 0.01). Craftsmanship played a mediating role between psychological resilience and career success, accounting for 39.3% of the total effect ratio.

Conclusion

The scores of career success and psychological resilience of female nurses in central China are at a moderate level, and craftsmanship plays a mediating role between psychological resilience and career success. It is suggested that nursing managers should pay attention to the importance of career success to nurses’ self-development and nursing team stability, and improve their sense of career success by effectively improving nurses’ psychological resilience and craftsmanship.

Extending the Transformative Potential of Mindfulness Through Team Mindfulness Training, Integrating Individual With Collective Mindfulness, in a High-Stress Military Setting

Mindfulness has come to be considered an important approach to help individuals cultivate transformative capacity to free themselves from stress and suffering. However, the transformative potential of mindfulness extends beyond individual stress management. This study contributes to a broadening of the scope of contemplative science by integrating the prominent, individually focused mindfulness meditation literature with collective mindfulness scholarship. In so doing, it aims to illuminate an important context in which mindfulness interventions are increasingly prevalent: workplaces. Typically, the intended effect of workplace mindfulness training is to help workers manage stress better. Since mindfulness in organizations impacts individual and collective processes, the study blends the above literatures to create a cross-level “next-generation” Team Mindfulness Training (TMT) pilot. Its potential in helping individuals and teams to manage work stress better is investigated via a two-phase mixed-methods research study in high-stress military work populations, and compared to a conventional (“first-generation”) 8-week mindfulness meditation program based on mindfulness-based stress reduction (MBSR). Results suggest that compared to the “first-generation” mindfulness program, TMT seems no less effective in raising individual stress management skills, and may hold more promise in generating collective capacity to manage stress and unexpected difficulty, linked to an apparent interdependence between collective and individual mindfulness capacity development. Based on these empirical results, the study contributes to theory in three important ways: first, it outlines how individual and collective mindfulness in workplaces may be interdependent. Second, it explains why “next-generation” workplace training interventions should apply a cross-level approach. And third, it illustrates how its transformative potential for people at work, individually as well as collectively, can be extended by moving beyond an inward-looking meditation focus in mindfulness training. The study contributes to practice by providing a detailed outline of the pilot TMT program, and offers a series of follow-up research opportunities to inspire further scientific innovation in workplace mindfulness training, especially for high-stress work populations. The study’s ultimate aim is to prompt a shift away from adapting clinically oriented, self-focused “first-generation” mindfulness training protocols, and towards mindfulness as team sport: a more prosocially oriented mindfulness science intent on generating wisdom and compassion, for one and all.

Emotional well-being, spiritual well-being and resilience of advanced clinical practitioners in the United Kingdom during COVID-19: an exploratory mixed method study

AIM

To investigate the emotional and spiritual well-being and resilience of advanced clinical practitioners during COVID.

BACKGROUND

Resilience is a protective factor for emotional and spiritual well-being. The pandemic has taken a toll on health professionals due to significant physical and psychological pressures. The impact of COVID-19 on well-being and resilience of advanced clinical practitioners is not known.

METHOD

Three validated scales assessed resilience, emotional and spiritual well-being. Seven hundred and thirty-four responses were analysed.

RESULTS

Participants have low levels of emotional and spiritual well-being. Participants with higher levels of spirituality reported greater resilience and those with higher levels of resilience reported greater well-being.

CONCLUSION

Advanced clinical practitioners' emotional and spiritual well-being and resilience has been impacted significantly during the pandemic. Interventions are needed at team, service and systems levels to enhance well-being and resilience.

IMPLICATIONS FOR NURSING MANAGEMENT

Worryingly low levels of well-being and resilience in advanced clinical practitioners have been found; support to increase well-being and resilience is needed. Our findings can inform policies, resources and interventions aimed at enabling positive adaptation and enhanced resilience. Understanding and responding to the scale and impact of COVID-19 on health care workers has become a key government recommendation following the pandemic.

Challenge Demands and Resilience

Abstract. This study investigates the relationship of challenge demands (i. e., time pressure, job complexity) on employee resilience. We provide insights into potential pathways (i. e., learning, cognitive irritation) for how challenge stressors influence employee resilience. We employed a two-wave, time-lagged design to examine the influences of challenge stressors and explanatory pathways on employee resilience 2 months later. The data from 359 participants (52.1 % male) were analyzed using a Bayesian time-lagged path model. Results indicate that time pressure and job complexity are negatively related to employee resilience via cognitive irritation. In contrast, we found a positive, indirect effect of job complexity and resilience via learning. This paper contributes to existing employee resilience and stress research by highlighting the roles of learning and cognitive irritation to explain the relationships of challenge stressors on employee resilience. Moreover, the results provide us with a deeper understanding of which factors foster or drain employee resilience.

Self-Efficacy and Professional Identity Among Freshmen Nursing Students: A Latent Profile and Moderated Mediation Analysis

This study was designed to estimate the associations between self-efficacy and professional identity. A total of 1,051 freshmen nursing students (FNSs) from the Be Resilient to Nursing Career (BRNC) program were recruited from four universities between September and November 2020. A latent profile and moderated meditation analysis were performed. Four profiles of self-efficacy were identified and named as Lowest (15.6%), Med-low (45.0%), Med-high (32.7%), and Highest (6.7%). The mediating role of resilience and the moderating effect of role models were also identified. Therefore, self-efficacy, resilience, and role models may be three important factors to professional identity in FNSs and these relationships should be further validated in longitudinal or interventional studies.

Global emotional and spiritual well-being and resilience of Advanced Practice Nurses during the COVID-19 pandemic: A cross-sectional study

Aim

To evaluate the impact of the COVID‐19 pandemic on the emotional and spiritual well‐being and resilience of a global sample of Advanced Practice Nurses.

Design

A web‐based cross‐sectional mixed methods study. Survey data were collected from Advanced Practice Nurses globally over a 2‐month period ending on 31 August 2020.

Methods

The Warwick‐Edinburgh Mental Well‐being Scale, FACIT‐12 Spiritual Well‐being Scale and Connor‐Davidson Resilience Scale 10 were used to quantify emotional and spiritual well‐being and resilience of Advanced Practice Nurses' globally. The survey was distributed internationally using snowball sampling via a secure platform (Qualtrics). Results were analysed using various bivariate tests for associations and group differences.

Results

Nine hundred and twenty‐eight Advanced Practice Nurses from 53 countries participated in the study. Study participants reported meaningfully lower scores in resilience and emotional well‐being compared with non‐pandemic scores. Participants from countries with well‐developed Advanced Practice Nurses roles reported lower resilience and well‐being scores compared with those from countries where Advanced Practice Nurses roles are still being developed. Each scale revealed significant positive associations with the other scales.

Conclusions

Emotional and spiritual well‐being and resilience of Advance Practice Nurses has been significantly impacted during the COVID‐19 pandemic. Regardless of their work location, work hours, credential or demographics, the APNs in our study reported lower levels of resilience and mental well‐being compared with typical scores on the instruments.

Heterogeneity in Psychological Resilience and Mental Health among Newly Graduated Nursing Students: A Latent Profile and Generalized Additive Model Analysis

Background

Psychological resilience is important to mental health and professional development in newly graduated nursing students (NGNSs). However, the association between psychological resilience and mental health in NGNSs is less explored.

Purpose

The current study was designed to determine mental health profiles measured by the Kessler 10 scale (K10) and evaluate the non-linear association between psychological resilience and mental health in NGNSs.

Methods

A total of 472 NGNSs from the Be Resilient to Nursing Career program were assessed using the K10 and ten-item Connor–Davidson Resilience Scale (CD-RISC 10). Latent profile analysis and generalized additive model analysis were performed.

Results

A four-class model based on the K10 was identified: lowest (28.0%), lower-middle (36.4%), upper-middle (26.1%), and highest (9.5%) subgroups. Academic degree and psychological resilience were significant indicators of mental health profiles. Psychological resilience was negatively and nonlinearly correlated with mental health when the CD-RISC 10 score was >17.

Conclusion

There exists heterogeneity in NGNSs’ mental health. The negative and nonlinear association between psychological resilience and mental health can only be confirmed in NGNSs with moderate and high resilience levels.

Prevalence and factors associated with compassion satisfaction and compassion fatigue among Chinese oncology healthcare professionals: A cross-sectional survey

Objective

This cross-sectional study examined the prevalence and factors associated with compassion satisfaction and fatigue among oncology healthcare professionals (doctors and nurses) in mainland China.

Methods

A total of 337 subjects were recruited via convenience sampling from the oncology departments of five general hospitals in Guangzhou, Guangdong, China. They were invited to complete a survey that included demographic characteristics, the Profession Quality of life Scale, the Brief Cope Questionnaire, and the Connor-Davidson Resilience Scale.

Results

The findings showed medium levels of compassion satisfaction, burnout, and secondary traumatic stress among oncology healthcare professionals in China, reaching rates of 78.34%, 63.50% and 75.96%, respectively. Multiple regression analyses suggested that active coping, positive reframing, and strength were the significant factors of compassion satisfaction, explaining 48.6% of the total variance (P ​< ​0.001). Substance use and self-blame were the significant factors of burnout, explaining 45.1% of the total variance (P ​< ​0.001). Venting, denial, substance use, self-blame, and strength were the significant factors of secondary traumatic stress, explaining 37.6% of the total variance (P ​< ​0.001).

Conclusions

The high prevalence of compassion fatigue warrants the attention of the hospitals' senior management. The effective coping styles identified may be considered when developing strategies to improve the professional quality of life among oncology healthcare professionals.

Performance of Academic Staff during COVID-19 Pandemic-Induced Work Transformations: An IPO Model for Stress Management

The COVID-19 pandemic has adversely affected all spheres of services-related business, including the higher education sector. As a pre-emptive measure, almost all traditional educational institutions have been transformed into virtual organizations. This pandemic-induced work transition has created stress among academic staff and has hampered their performance. The present study aims to examine the impact of leadership behaviors, e-training, and employment security on the stress management process, consequently improving employee performance during and after the pandemic. Based on the IPO (input–process–output) model, this study examines the effect of leadership behavior, e-training, and employment security on teaching staff’s tasks and adaptive and contextual performance, mediated by stress management. To test the conceptual model, data were collected from the teaching staff of Malaysian universities. The structural equation modeling technique was used for data analysis, while bootstrapping with the maximum likelihood estimator was used to confirm the mediational role of stress management. The study revealed that task- and relation-oriented leadership behavior, e-training, and employment security positively influence stress management and employee performance in virtual organizations. Moreover, stress management acts as a full mediator in the relationship between leadership behavior and employee performance, while partial mediation occurs between e-training, employment security, and employee performance. This study offers valuable insights into the literature by proposing leadership behavior, e-training, and employment security as input in the stress management process to attain the performance output of teaching staff. Higher education institutions should come forward to assist their teaching employees in managing their stress levels for better outcomes.

COVID-19 workplace adaptation and recovery in the resort municipality of Whistler, BC, Canada

Purpose

The COVID-19 pandemic changed how many of us work, where we work and what we need and expect from the workplace. In this paper, the researchers sought to describe how employers and employees experienced their changing workplace environments in the early days of the pandemic, with a focus on adaptation and recovery in Whistler in British Columbia, Canada. In addition, the authors aimed to develop a new model to inform other organizations undergoing the consequences of major catastrophes.

Design/methodology/approach

Applying a qualitative approach, the authors gathered data in a total of seven focus groups. Employer focus groups were held in June 2020, and employee focus groups were held in November 2020. A thematic analysis was completed by three researchers.

Findings

After completing an analysis of the employer focus group transcripts, the authors identified the themes of staffing and coordination, adaptability and connection, uncertainty, communication and community and strategies. The employees' concerns and experiences related to the themes of challenges, changes and community, communication, involvement in decisions, future employment and support and connection.

Originality/value

This study captured descriptions of workplace adaptation and recovery for employers and employees during the pandemic, generalizability is limited by the number of participants. These accounts depicted a period of significant change in working conditions, communications, and employment practices. This paper offers a new conceptual model, C4AR, exploring the role of communicate, coordinate, connect and community in supporting workplace adaptation and recovery.

Single Versus Multiple Resilience Factors: An Investigation of the Dimensionality of the Academic Resilience Scale

The Academic Resilience Scale (ARS) was developed to measure resilience factors in educational contexts. However, there is no clarity on whether the scale could be used as a measure of unidimensional academic resilience scores or just to obtain multidimensional academic resilience factors. How a scale is scored can affect the validity of inferences based on scores obtained by using the scale in research and practice. This study uses confirmatory factor analysis (CFA) and ancillary bifactor measures to examine the dimensionality of the scale. There was no sufficient support for using the scale to obtain unidimensional academic resilience score. Rather, the scale should only be considered as a measure of multiple dimensions of academic resilience factors.

Role of resilience in healthcare workers' distress and somatization during the COVID-19 pandemic: A cross-sectional study across Flanders, Belgium

AIM

To evaluate the impact and the possible role of psychological resilience in the COVID-19 pandemic outbreak on healthcare workers' mental and physical well-being in Belgium.

DESIGN

This cross-sectional, survey-based study enrolled 1376 healthcare workers across Belgium from 17 April 2020 to 24 April 2020.

METHODS

The study sample consisted of direct care workers (nurses and doctors), supporting staff and management staff members. The main outcomes are resilience, distress and somatization.

RESULTS

Higher educational level was associated with lower symptoms of distress and somatization. Physicians exhibited the lowest risk of experiencing heightened levels of distress and somatization. Controlling for confounding factors, higher levels of resilience were associated with a 12% reduced chance of increased distress levels and 5% lower chance of increased somatization levels. Our results suggest the potentially buffering role of mental resilience on those working on the frontline during the COVID-19 pandemic outbreak.

Exploring Protective Factors in Wellbeing: How Sensory Processing Sensitivity and Attention Awareness Interact With Resilience

The aim of the study is to analyze the relationship between sensory processing sensitivity (SPS), attention awareness, and resilience and to determine whether attention awareness may moderate the relation between sensitivity and resilience. The sample consisted of 273 adults (239 women; M_age=24.12, SD=6.59years). The highly sensitive person scale, the resiliency assessment scale, and the mindful attention awareness scale were used in the study. The results indicate significant relationships between SPS and resilience; emotional reactivity is especially associated with lower resilience, whereas sensing the subtle is associated with higher resilience. The regression analyses revealed that SPS is a significant predictor of resilience, but diverse aspects of sensitivity explain resilience differently. Attentional awareness was found to be a significant moderator that strengthens the positive relationship between sensing the subtle and tolerance of negative emotions. The consequences of high sensitivity include high levels of distress, anxiety, and a sense of overload; therefore, searching for protective factors is important to maintain the wellbeing of highly sensitive people. As one of the characteristics of highly sensitive persons, sensing the subtle may be an important resource that allows to them to deal effectively with difficult situations. Training on attention awareness and conscious presence may be an important way to deal with negative emotions and develop personal competences. The results indicate that these strategies may be of high significance for improving wellbeing and protecting highly sensitive persons against various stress factors.

The relationship between resilience and psychological characteristics of paramedicine students

BACKGROUND

Paramedics' continued exposure to occupational stressors can have a detrimental effect on their psychological well-being. Resilience can provide for better coping. Understanding individual differences provides explanations why some individuals thrive while others are more at risk.

AIM

To explore the effect of Personality according to the Big-Five, Ways of Thinking and Occupational Preference according to Holland's RIASEC Model, on resilience.

METHOD

Using a quantitative cross-sectional design, The Big-Five Inventory, Ways of Thinking, Brief RIASEC Marker Scales and Connor Davidson CD-RISC were administered.

RESULTS

Standard Multiple Regression showed that resilience is more likely to be seen in those who score high in Conscientiousness and low in Neuroticism. Modelling also showed that resilience is more likely to be seen in those who score high in Surgency (β = 0.364, p = .001) followed by the Freethinker (β = 0.312, p = .001), Scientific (β = 0.112, p = .027) and Controlled (β = 0.105, p = .040) ways of thinking. Although the RIASEC model was not a strong predictor of resilience, the Social (β = 0.252, p = .001) and Investigative (β = 0.153, p = .020) factors were highlighted as contributing towards a paramedic's resilience.

CONCLUSION

The paramedicine students that participated in this study report higher levels of some of the personality traits inherently protective in facilitating resilience.

Association between resilience and burnout of front-line nurses at the peak of the COVID-19 pandemic: Positive and negative affect as mediators in Wuhan

The outbreak of coronavirus disease 2019 (COVID-19) is having a dramatic effect on the mental health of healthcare workers (HCWs). Upon the emergence of the COVID-19 pandemic, the Chinese government dispatched about 42 000 HCWs to Wuhan City and Hubei Province to fight this pandemic. This study briefly examines front-line nurses who experienced burnout, with the main objective of investigating the mediating roles of positive and negative affect in the relationship between resilience and burnout in Wuhan hospitals at the peak of the COVID-19 pandemic. A total of 180 front-line nurses voluntarily participated via a social media group. They completed the online questionnaires, including the Maslach Burnout Inventory-General Survey (MBI-GS), the Positive and Negative Affect Schedule (PANAS), the Connor-Davidson Resilience Scale (CD-RISC), demographics, and work-related characteristics. Structural equation modelling (SEM) analysis was used to examine the mediating effect of positive and negative affect on the relationship between resilience and burnout. The total prevalence of burnout was 51.7%, of which 15.0% were severe burnout. These preliminary results revealed that positive and negative affect fully mediated the effects of resilience on burnout, emotional exhaustion, depersonalization, and reduced personal accomplishment of front-line nurses. It is necessary to know the impact of resilience on HCWs with burnout through the positive and negative affect of individual backgrounds and situations, and how policymakers can deploy resilience interventions to support front-line HCWs.

Balancing adaptation and innovation for resilience in healthcare - a metasynthesis of narratives

BACKGROUND

Adaptation and innovation are both described as instrumental for resilience in healthcare. However, the relatedness between these dimensions of resilience in healthcare has not yet been studied. This study seeks to develop a conceptual understanding of adaptation and innovation as a basis for resilience in healthcare. The overall aim of this study is therefore to explore how adaptation and innovation can be described and understood across different healthcare settings. To this end, the overall aim will be investigated by identifying what constitutes adaptation and innovation in healthcare, the mechanisms involved, and what type of responses adaptation and innovation are associated with.

METHODS

The method used to develop understanding across a variety of healthcare contexts, was to first conduct a narrative inquiry of a comprehensive dataset from various empirical settings (e.g., maternity, transitional care, telecare), that were later analysed in accordance with grounded theory. Narrative inquiry provided a contextually informed synthesis of the phenomenon, while the use of grounded theory methodology allowed for cross-contextual comparison of adaptation and innovation in terms of resilience in healthcare.

RESULTS

The results identified an imbalance between adaptation and innovation. If short-term adaptations are used too extensively, they may mask system deficiencies and furthermore leave the organization vulnerable, by relying too much on the efforts of a few individuals. Hence, short-term adaptations may end up a barrier for resilience in healthcare. Long-term adaptations and innovation of products, processes and practices proved to be of a lower priority, but had the potential of addressing the flaws of the system by proactively re-organizing and re-designing routines and practices.

CONCLUSIONS

This study develops a new conceptual account of adaptation and innovation as a basis for resilience in healthcare. Findings emerging from this study indicate that a balance between adaptation and innovation should be sought when seeking resilience in healthcare. Adaptations can furthermore be divided into short-term and long-term adaptations, creating the need to balance between these different types of adaptations. Short-term adaptations that adopt the pattern of firefighting can risk generating complex and unintended outcomes, but where no significant changes are made to organization of the system. Long-term adaptations, on the other hand, introduce re-organization of the system based on feedback, and therefore can provide a proactive response to system deficiencies. We propose a pattern of adaptation in resilience in healthcare: from short-term adjustments, to long-term reorganizations, to innovations.

WITHDRAWN: Mental resilience analysis and health risk prediction of college students assisted by mental health education

Ahead of Print article withdrawn by publisher.

Integrative psycho-biophysiological markers in predicting psychological resilience

The hypothalamic-pituitary-adrenal (HPA) and parasympathetic nervous systems have been reported to play important roles in emotion regulation and stress coping. Yet, their direct relationship with psychological resilience remains unclear. These biophysiological features should be considered together with the traditional psychometric properties in studying resilience more comprehensively. The current study aimed to examine the role of these systems during a laboratory stress task and to determine the prediction power of resilience by combining psychological and biophysiological features. One hundred and seven (52 females) university students without psychiatric disorders underwent the Trier Social Stress Task (TSST). Psychometric properties of resilience were measured at rest; vagal heart rate variability (HRV), salivary cortisol, and dehydroepiandrosterone (DHEA) levels were captured at baseline, during, and after TSST. Multivariate linear regression as well as support vector regression machine-learning analyses were performed to investigate significant predictors and the prediction power of resilience. Results showed that positive and negative affects, HRV during the anticipatory phase of stress, and the ratio of cortisol/DHEA at the first recovery time point were significant predictors of resilience. The addition of biophysiological features increased the prediction power of resilience by 1.2-fold compared to psychological features alone. Results from machine learning analyses further demonstrated that the increased prediction power of resilience by adding the ratio of cortisol/DHEA was significant in "cortisol responders"; whereas a trend level was observed in "cortisol non-responders". Our findings extend the knowledge from the literature that high vagal activity during the anticipating phase of stress and the ability to restore the balance between cortisol and DHEA after a stress event could be an important feature in predicting resilience. Our findings also further support the need of combining psychological and biophysiological features in studying/predicting resilience.

Resilience and mindfulness in nurse training on an undergraduate curriculum

PURPOSE

The aim is to investigate what relationships exist between resilience and mindfulness in undergraduate nurse training and how these might contribute to well-being.

DESIGN AND METHODS

One hundred and six students participated in this cross-sectional study. Multivariate and bivariate procedures were utilized to assess the differences between students' demographics, academic resilience, and mindfulness.

FINDINGS

The findings suggested that acceptance and attention within mindfulness were important for resilience. Students who had higher levels of academic resilience also had higher indexes of mindfulness.

PRACTICE IMPLICATIONS

A key implication is that learning and practice areas should ensure that well-being, mindfulness, and resilience literacy are key issues for students in training. This is at a time when mental health support and staff retention are foremost in policymakers' minds.

The Q-Life experience: An evaluation of an employee resilience program

BACKGROUND

Many employers are turning to training programs to help them cope or flourish in life. Many programs on the market have not been validated.

OBJECTIVE

The objective was to evaluate the effect building awareness and skill development can have on sustaining high resilience within a group of employees.

METHODS

524 participants completed the 44 itemed Q-Life assessment. A CFA model was conducted to determine whether the Q-Life score, adequately describes the data. 116 employees signed up to the Q-Life experience with 64 completing all requirements.

RESULTS

The RMSEA index was less than 0.08, RMSEA = 0.07, 90%CI = [0.07, 0.07], which is indicative of a good model fit. The mean of score for resilience on the first test (M = 249.91) was significantly lower than the mean of post-test (M = 264.91).

CONCLUSIONS

The results indicated that the model demonstrated acceptable fit to the data and can be used as an assessment tool for the Q-Life. The Q-Life experience showed significant improvement in resilience.

The Relationship Between Psychological Resilience and Professional Quality of Life in Nurses

The current descriptive study investigated the correlation between psychological resilience and quality of professional life in clinic nurses. Nurses should have psychological resilience to have high compassion satisfaction and low burnout and compassion fatigue. The sample comprised 280 hospital nurses in Istanbul. Data were analyzed using descriptive statistics and Pearson correlation coefficient. Psychological resilience was positively correlated with compassion satisfaction (r = 0.372; p < 0.01) and negatively correlated with burnout (r = -0.379; p < 0.01) and compassion fatigue (r = -0.336; p < 0.01). Psychological resilience was positively correlated with professional quality of life. Managerial interventions and training should be developed and implemented to help nurses develop psychological resilience to create a positive organizational culture. [Journal of Psychosocial Nursing and Mental Health Services, 59(6), 31-36.].

The Relationship Between Musculoskeletal Discomfort and Professional Quality of Life Among Nurses

BACKGROUND

Harsh working conditions lead nurses to experience musculoskeletal discomfort and impair their professional quality of life.

AIMS

The aim was to determine musculoskeletal discomfort of nurses and to compare its relationship with their professional quality of life in terms of their socio-demographic characteristics.

DESIGN

It is a cross-sectional, descriptive, and correlative study.

SETTINGS

Different units of a public hospital.

PARTICIPANTS

333 nurses working at different units.

METHODS

The data were collected from 333 nurses working at different units in a public hospital between July and December 2018. The data collection tools include an 8-question participant information form, Cornell Musculoskeletal Discomfort Questionnaire, and Professional Quality of Life Scale.

RESULTS

The nurses suffered mostly from lower back pain (90.4%) and their pain slightly interfered with their works (49.8%). There was a weak positive but significant correlation between musculoskeletal discomfort and professional quality of life of the nurses (r = 0.215; p < .001). The nurses, who were younger, were male, were working in executive positions, had less institutional and professional experience, and had higher mean score of musculoskeletal discomfort (p < .05).

CONCLUSIONS

The professional quality of life of the nurses experiencing musculoskeletal discomfort in their bodies was negatively affected. For example, as the musculoskeletal disorders increase, the levels of burnout and compassion fatigue, which constitute the quality of life, also increase.

Association of demographic, career, and lifestyle factors with resilience and association of resilience with mental health outcomes in veterinarians in Canada

OBJECTIVE

To investigate the association of demographic, career, and lifestyle factors with resilience and the association of resilience with mental health outcomes in Canadian veterinarians.

SAMPLE

1,130 veterinarians in clinical practice across Canada.

PROCEDURES

An online questionnaire was used to collect participant data and included 5 validated psychometric scales to evaluate resilience (through the Connor-Davidson Resilience Scale [CD-RISC]), perceived stress (through the Perceived Stress Scale), emotional distress (through the Hospital Anxiety and Depression Scale), burnout (through the Maslach Burnout Inventory), and secondary traumatic stress (through the Professional Quality of Life Scale). A multivariable linear regression model was used to investigate associations between CD-RISC scores and demographic, career, and lifestyle characteristics. Univariable linear regression models were used to assess the relationship between resilience scores and other mental health outcomes.

RESULTS

The strongest positive association was between CD-RISC score and overall health. The level of satisfaction with support from friends and workplace resources had positive associations with the CD-RISC score. The presence of mental illness had the strongest negative association with the CD-RISC score. Being married, working in a small animal practice, or having an associate role were negatively associated with the CD-RISC score. The CD-RISC score had negative associations with scores for perceived stress, anxiety, depression, burnout, and secondary traumatic stress.

CONCLUSIONS AND CLINICAL RELEVANCE

Models provided evidence for the role of resilience in protecting against negative mental health outcomes in veterinarians. Both personal and workplace factors were associated with resilience, presenting opportunities for intervention at each of these levels.

Resilience and burnout in healthcare students and inpatient psychiatric nurses: A between-groups study of two populations

BACKGROUND

Stressful environments can have significant effects on an individual and lead to burnout. Psychological consequences of burnout include trauma reactions, depression, anxiety and substance use disorders. Resilience, a protective mechanism can mitigate the negative impact of burnout.

METHOD

This study utilizes an exploratory correlational design to determine whether or not there is 1) a similar correlation between resilience and burnout between psychiatric nurses working in a high stress environment and students who are naive to the high stress academic environment and 2) a higher level of resilience in the psychiatric nurses compared to the healthcare students.

RESULTS

A significant inverse relationship was observed with respect to resilience and burnout in both the professional nurse and student groups. However, the inpatient psychiatric nurse group was not found to have a higher level of resilience than the student group, when controlling for age.

CONCLUSION

This suggests that resilience to burnout is not related to the work environment but life experience (age) was found to be a factor related resilience in this sample.