Protective Predictors Associated With Posttraumatic Stress and Psychological Distress in Chinese Nurses During the Outbreak of COVID-19

Work engagement and sense of coherence as predictors of psychological distress during the first phase of the COVID-19 pandemic in Chile

Objectives

The aim of this study was to analyse the relationship between sense of coherence, work engagement, and work environment variables as predictors of the level of psychological distress during the first phase of the COVID-19 pandemic in Chile.

Methods

Cross-sectional descriptive study collected between April 22 and December 16, 2020, using non-probabilistic snowball sampling. The study variables and instruments were socio-demographic variables, work engagement (UWES-9 scale), sense of coherence (Antonovsky SOC-13 scale), and psychological distress (GHQ-12 scale). Multivariate analysis and binary logistic regression were performed including the scores of the three questionnaires and other variables such as effectiveness, safety, stress, health perception, and sex. Finally, the CHAID technique was applied to create a segmentation tree.

Results

72.7 % of participants had high levels of psychological distress, more predominantly among women, with work stress and low sense of coherence acting as the most influential mediators in generating psychological distress, and even more so when both were combined. Low work engagement and the availability of safe and effective means to prevent infection were predictors of psychological distress among workers.

Conclusion

During the first phase of the COVID-19 pandemic, factors that contributed to psychological distress in the Chilean population were identified. These included a fair or poor perception of health, being a woman, work-related stress, availability of safety measures, low level of work engagement, and low level of sense of coherence. Identifying these factors may help prevent similar effects in future phases of the current pandemic or in future pandemics.

Prevalence and correlates of mental health problems among different occupations of medical workers during COVID-19 outbreak in China

Background

Health workers involved in the fight to prevent the COVID-19 outbreak were exposed to hazards. Detailed information on mental health problems in different medical occupations is crucial. To examined the prevalence of mental health issues in three medical occupations as well as the relationships between mental health problems and correlates in each occupation.

Methods

This study utilizing the Questionnaire Star program was conducted among medical workers working at medical institutions in China from February 17 to 24, 2020. The Self-Reporting Questionnaire (SRQ-20), the Zung Self-rating Anxiety Scale (SAS), and the Zung Self-rating Depression Scale (SDS) were used to assess mental health problems.

Results

The prevalence of any mental health problems in the three occupations was 43.6, 34.6, and 32.9% for nurses, paramedical workers (PMWs), and doctors, respectively. Three occupations shared some correlates, such as being overworked, not having enough time to rest, support from colleagues, and previous mental health status. There were specific factors for each occupation. For doctors, age, educational level, living status, support from family, and previous physical status were related factors in mental health problems. Working in a designated hospital for treating COVID-19, having COVID-19 event exposures, and receiving support from family were associated with the mental health problems of the nurses. PMWs' mental health problems was linked to educational level and care from supervisors or heads of department.

Conclusion

Different medical occupations have distinct impacts on mental health issues. Policy makers and mental health professionals working to prepare for potential disease outbreaks should be aware of multiple factors in different occupations.

Prevalence and influencing factors of post-traumatic stress disorder among Chinese healthcare workers during the COVID-19 epidemic: a systematic review and meta-analysis

Background

Post-traumatic stress disorder is an important psychological problem affecting the physical mental health of Chinese healthcare workers during the COVID-19 pandemic.

Aims

To estimate the prevalence and influencing factors of post-traumatic stress disorder (PTSD) among Chinese healthcare workers during COVID-19.

Methods

Search of Chinese and English literature in PubMed, EMbase, Web of Science, Medline, Elsevier, SpringerLink, China Biomedical Literature Database, CNKI, Wan-fang, and CQVIP for the period from December 2019 to August 2023. Stata 14.0 software was used for data analysis. The methodological quality of each study was scored, and data were extracted from the published reports. Pooled prevalence was estimated using the Random-effects model. Publication bias was evaluated using Egger's test and Begg's test.

Results

Twenty-one studies included 11841 Chinese healthcare workers in this review. First, the overall prevalence of Post-traumatic stress disorder among Chinese healthcare workers during the COVID-19 epidemic was 29.2% (95% CI: 20.7% to 33.7%). Twelve factors included in the meta-analysis were found to be protective against PTSD among Chinese healthcare workers: female, nurse, married, front-line work, less work experience, family or friend diagnosed with COVID-19, history of chronic disease and fear of COVID-19. Conversely, outside Hubei, higher education, social support and psychological resilience are protective factors.

Conclusion

These recent findings increase our understanding of the psychological status of Chinese healthcare workers and encourage that long-term monitoring and long-term interventions should be implemented to improve the mental health of Chinese healthcare workers in the aftermath of the COVID-19.

The influence of grit on nurse job satisfaction: Mediating effects of perceived stress and moderating effects of optimism

Introduction

Nurse job satisfaction, defined as the positive emotional state experienced by nurses regarding their profession, factors related to job performance and outcomes, can affect their career planning and development. Grit, defined as an individual's relentless effort and enduring enthusiasm for long-term goals, is essential for developing nurses' competence, increasing job satisfaction, and reducing the willingness to leave the profession. The present study aims to explore the correlation between grit and job satisfaction, whether perceived stress could act as a mediator of the relationship and whether optimism moderated the mediating effect among nurses working in hospitals in southwest China.

Methods

The cross-sectional study utilized self-reported data gathered from 709 nurses in southwest China. To analyze mediating and moderating effects, bootstrapping regressions were conducted.

Results

Perceived pressure mediated the relationship between grit and job satisfaction (indirect effect = 0.195, 95%CI [0.145,0.250]). Furthermore, moderated mediated analysis revealed that optimism moderated grit's impact on perceived stress (moderating effect = 0.036, 95% CI [0.010, 0.061]).

Discussion

Low levels of grit might reduce nurses' job satisfaction as their perceived stress levels increase. However, optimism among nurses could diminish this negative effect. Nursing managers should actively seek to improve the grit and optimism of hospital nurses while reducing their perceived pressure, thereby improving job satisfaction.

Post-traumatic stress in healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis

The SARS-CoV-2 (COVID-19) pandemic has increased healthcare worker (HCW) susceptibility to mental illness. We conducted a meta-analysis to investigate the prevalence and possible factors associated with post-traumatic stress disorder (PTSD) symptoms among HCW during the COVID-19 pandemic. We searched PubMed, SCOPUS and EMBASE databases up to May 4th, 2022. We performed random effects meta-analysis and moderator analyses for the prevalence of PTSD-relevant symptoms and severe PTSD symptoms. We identified 1276 studies, reviewed 209 full-text articles, and included 119 studies (117,143 participants) with a total of 121 data points in our final analysis. 34 studies (24,541 participants) reported prevalence of severe PTSD symptoms. Approximately 25.2% of participants were physicians, 42.8% nurses, 12.4% allied health professionals, 8.9% auxiliary health professionals, and 10.8% "other". The pooled prevalence of PTSD symptoms among HCWs was 34% (95% CI, 0.30-0.39, I² >90%), and 14% for severe PTSD (95% CI, 0.11 - 0.17, I² >90%). The introduction of COVID vaccines was associated with a sharp decline in the prevalence of PTSD, and new virus variants were associated with small increases in PTSD rates. It is important that policies work towards allocating adequate resources towards protecting the well-being of healthcare workers to minimize adverse consequences of PTSD.

Common mental disorders and associated factors in nursing workers in COVID-19 units

OBJECTIVE

To analyze the interfaces between mental illness, based on common mental disorder screening, and sociodemographic, health and life habits aspects of nursing workers at COVID-19 units.

METHOD

A mixed methods study, carried out with 327 nursing workers from COVID-19 units of seven public and philanthropic, medium and large hospitals in Brazil. The collection included a socio-employment, health and lifestyle questionnaire, the Self-Reporting Questionnaire, and interviews. chi-square and Fisher's exact tests were applied to quantitative data and thematic content analysis, with the help of NVivo in the qualitative ones.

RESULTS

Common mental disorders were screened in 35.5% of the sample and were associated with female sex (p = 0.004), age up to 40 years (p = 0.003), nurse (p = 0.014), reporting previous illness (p = 0.003), using psychoactive drugs (p < 0.001), medication that was not used before the pandemic (p < 0.001) and reporting poor sleep/eating quality (p < 0.001). The impacts of the pandemic on social and family life presented interfaces with mental illness.

CONCLUSION

The presence of psychological illness is suggested, possibly associated with the repercussions of the pandemic on work and personal life.

Influencing factors of high PTSD among medical staff during COVID-19: evidences from both meta-analysis and subgroup analysis

Background

PTSD (Post-traumatic stress disorder, PTSD) had a great impact on health care workers during the COVID-19 (Corona Virus Disease 2019, COVID-19). Better knowledge of the prevalence of PTSD and its risk factors is a major public health problem. This study was conducted to assess the prevalence and important risk factors of PTSD among medical staff during the COVID-19.

Methods

The databases were searched for studies published during the COVID-19, and a PRISMA (preferred reporting items for systematic review and meta-analysis) compliant systematic review (PROSPERO-CRD 42021278970) was carried out to identify articles from multiple databases reporting the prevalence of PTSD outcomes among medical staff. Proportion random effect analysis, I² statistic, quality assessment, subgroup analysis, and sensitivity analysis were carried out.

Results

A total of 28 cross-sectional studies and the PTSD results of doctors and nurses were summarized from 14 and 27 studies: the prevalences were 31% (95% CI [confidence interval, CI]: 21%–40%) and 38% (95% CI: 30%–45%) in doctors and nurses, respectively. The results also showed seven risks (p < 0.05): long working hours, isolation wards, COVID-19 symptoms, nurses, women, fear of infection, and pre-existing mental illness. Two factors were of borderline significance: higher professional titles and married.

Conclusion

Health care workers have a higher prevalence of PTSD during COVID-19. Health departments should provide targeted preventive measures for medical staff away from PTSD.

The Relationship Between Workplace Incivility and Psychological Distress: The Moderating Role of Servant Leadership

BACKGROUND

The relationship between workplace incivility and psychological distress among nurses has been well-documented in the nursing literature. Management practices to reduce the negative impact are less clear. This study aimed to examine perceived servant leadership as a moderator between workplace incivility and psychological distress among nurses in Chinese hospitals.

METHODS

This study used a cross-sectional design and was conducted between September and October 2020. We recruited 1,604 nurses from 13 Chinese hospitals across different regions in China ranging from 18 to 55 years in age (M = 28.48 years, SD = 6.53 years). Multiple linear regression was used to analyze the data.

FINDINGS

The results showed that workplace incivility (β = 0.40, p < .001) and perceived servant leadership (β = -0.13, p < .001), as well as their interaction (β = -0.11, p = .002), predicted nurses' psychological distress. Perceived servant leadership moderates the relationship between workplace incivility and psychological distress.

CONCLUSIONS/APPLICATION TO PRACTICE

Servant leaders can create an ethical work climate, display empathy and compassion, and facilitate resilience. Our findings can assist hospital management with support from occupational health providers to recruit, train, and assess nursing supervisors. Also, occupational health providers in collaboration with nursing administration can monitor incivility, psychological distress, servant leadership levels, and impact.

Transtornos mentais comuns e fatores associados em trabalhadores de enfermagem de unidades COVID-19

RESUMO Objetivo: Analisar as interfaces entre o adoecimento mental, a partir do rastreamento de transtornos mentais comuns, e aspectos sociodemográficos, de saúde e hábitos de vida de trabalhadores de enfermagem de unidades COVID-19. Método: Estudo de métodos mistos, realizado com 327 trabalhadores de enfermagem de unidades COVID-19 de sete hospitais do Brasil, públicos e filantrópicos, de médio e grande porte. A coleta incluiu um questionário sociolaboral, de saúde e hábitos de vida, o Self-Reporting Questionnaire, e entrevistas. Foram aplicados Testes Qui-Quadrado e Exato de Fisher nos dados quantitativos e análise temática de conteúdo, com auxílio do software NVivo nos qualitativos. Resultados: Os transtornos mentais comuns foram rastreados em 35,5% da amostra e se associaram ao sexo feminino (p = 0,004), idade de até 40 anos (p = 0,003), enfermeiro (p = 0,014), relatar doença prévia (p = 0,003), usar psicoativos (p < 0,001), medicamentos que não utilizava antes da pandemia (p < 0,001) e relatar má qualidade do sono/alimentação (p < 0,001). Os impactos da pandemia na vida social e familiar apresentaram interfaces com o adoecimento mental. Conclusão Sugere-se a presença de adoecimento psíquico, possivelmente associado às repercussões da pandemia no trabalho e na vida pessoal.