Prioritizing the Mental Health and Well-Being of Healthcare Workers: An Urgent Global Public Health Priority

Care Aides Compassion Fatigue, Burnout, and Compassion Satisfaction Related to Long-Term Care (LTC) Working Environment

Severe staff shortages, sustained stress, low compassion satisfaction, high compassion fatigue, and serious levels of burnout among healthcare workers were frequently reported during COVID-19. In this cross-sectional study with 760 care aides working in 28 LTC homes in Alberta, Canada, we used a two-level multilevel regression model to examine how working environments were associated with compassion fatigue, burnout, and compassion satisfaction measured with the Professional Quality of Life (ProQOL-9) scale. Our findings showed that higher compassion satisfaction and lower burnout were observed when care aides perceived a more supportive working culture. Care aides reported higher compassion fatigue when there was a lack of structural or staffing resources. We also found that perceptions of not having enough staff or enough time to complete tasks were significantly associated with higher levels of burnout. These findings suggest which elements of the working environment may be promising targets for improvement efforts.

The relationship between work requirements and mental distress in hospital staff: the chain mediating effects of rumination and work recovery classes

BACKGROUND

Heavy work requirements can lead to significant increases in depression anxiety and stress among hospital staff. However, there is limited research considering the role of work recovery (WR) and rumination in this relationship, particularly how poor WR can create a vicious cycle of negative psychological outcomes for medical staff.

OBJECTIVE

In this cross-sectional observational study, the aim is to explore high-risk WR classes among hospital staff. By constructing chain mediation models according to the WR classes, the study seeks to identify which class of medical staff is most affected by work requirements in terms of mental distress, and to examine the chain mediation effects of rumination and WR classes.

METHODS

The cross-sectional observational study utilized Latent Profile Analysis (LPA) and Structural Equation Modeling (SEM) to investigate the relationships among various constructs. It employed the Work Requirements Scale (WRS), the Recovery - Stress Questionnaire (RESTQ), the Depression Anxiety Stress Scales (DASS), and the Revised Emotion Control Questionnaire (RECQ) to survey a sample of 889 hospital staff at a tertiary hospital.

RESULTS

The findings revealed three distinct WR classes among hospital staff. Significant associations were found between work requirements and mental distress among medical staff in the low and moderate WR classes. Additionally, in these two classes, there were significant relationships in which rumination and WR classes had a chain-mediated nature about work requirements and mental distress. This suggests that future intervention studies should focus on these two classes and develop psychological health interventions for hospital staff according to different WR classes.

Exploring the Nexus of Professional Commitment, Emotional Labor, and Self-Efficacy Among Community Pharmacists: Implications for Healthcare Delivery

Objectives

This study aimed to explore the relationship between emotional labor, professional commitment, and self-efficacy among community pharmacists. Specifically, this study examined how self-efficacy influences professional commitment and the mediating role of emotional labor strategies in this relationship.

Materials and Methods

A cross-sectional survey design was used to collect data from 396 community pharmacists. The study used a convenience sampling method and included standardized measures of emotional labor, professional commitment, and self-efficacy. Descriptive statistics were used to examine the levels of these variables among the participants. Multiple regression analyses were conducted to assess the interdependencies and mediating effects of emotional labor strategies.

Results

General self-efficacy was positively correlated with emotional commitment (β=0.275, p<0.05) and continuance commitment (β=0.364, p<0.05), explaining 5% and 8% of their variances, respectively. A normative commitment was influenced by self-efficacy (β=0.464, p<0.05) and deep emotional labor (β=0.134, p<0.05), explaining 11% of its variance. Self-efficacy and deep emotional labor positively affected overall professional commitment (β=0.368, p<0.05), accounting for 15% of the variance.

Conclusion

The results highlight the crucial role of self-efficacy in managing the emotional demands of the pharmacy profession and in fostering stronger professional commitment. Enhancing pharmacists' self-efficacy and emotional management skills can improve their job satisfaction and commitment to the profession. These findings have clinical implications for the development of training interventions aimed at supporting pharmacists in coping with the emotional aspects of their work and improving their overall professional well-being.

General Practitioners' Mental Well-Being During Crises: Results of the PRICOV-19 Study Pilot in Serbia

BACKGROUND/AIMS

This study was conducted with the aim of assessing the mental well-being of general practitioners (GPs) amidst the COVID-19 pandemic in Serbia. These findings are intended to provide valuable insights to primary care stakeholders about the potential need for support interventions.

MATERIALS AND METHODS

In the context of the international cross-sectional survey on primary health care during the COVID-19 pandemic (PRICOV-19), our initial focus was on evaluating the appropriateness of employing the Mayo Clinic Well-Being Index (MWBI) for Serbian GPs. The Spearman test validated the correlation between the GPs' scores of the MWBI and Depression Anxiety Stress Scales-21 (DASS21) in the Serbian context. The univariate and multivariate linear regressions modeled the personal and job-related potential predictors of higher MWBI scores (p < 0.05).

RESULTS

A strong, positive, and significant correlation was found between the MWBI score; the total DASS21 score; and the scores for depression, anxiety, and stress (p < 0.001). In this pilot study, 71.3% of the GP respondents had poor mental well-being indicated with MWBI scores ≥ 2 (the mean was 3.3 ± 2.7). The likelihood of experiencing poor mental well-being among the GPs was found to be associated with decreases in their socioeconomic statuses (B = -0.893; p = 0.021). Furthermore, inadequate allocation of time for the review of scientific evidence and guidelines has been correlated with a decline in mental well-being among respondents (B = -1.137; p = 0.033).

CONCLUSIONS

The MWBI effectively assessed GPs' mental well-being amidst COVID-19 in Serbia. GPs with low socioeconomic statuses might most benefit from mental well-being support during crises. For better mental well-being, GPs need adequate time in their agendas to assess scientific evidence and adhere to established guidelines.

Effects and Acceptability of a 1-Week Home-Based Virtual Reality Training for Supporting the Management of Stress and Anxiety: Randomized Pilot Trial

BACKGROUND

Virtual reality (VR) is helpful for the management of stress and anxiety. However, current interventions have limitations related to location (ie, therapist's office or hospitals) and content (ie, virtual experiences only for relaxation).

OBJECTIVE

This randomized pilot trial aims to investigate the efficacy and acceptability of a brief remote VR-based training for supporting stress and anxiety management in a sample of Italian health care workers.

METHODS

A total of 29 doctors and nurses (n=21; 72% female; mean age 35.6, SD 10.3 years) were recruited and randomized to a VR intervention group or a control group in a passive control condition. Participants assigned to the VR intervention group received remote VR-based training consisting of 3 sessions at home delivered in 1 week using the VR psychoeducational experience "MIND-VR" and the 360° relaxing video "The Secret Garden." The primary outcome measures were stress, anxiety, depression, and the knowledge of stress and anxiety assessed at baseline and posttreatment. We also evaluated the immediate effect of the remote VR-based training sessions on the perceived state of anxiety and negative and positive emotions. The secondary outcome measure was the usability at home of the VR system and content.

RESULTS

The VR intervention significantly reduced stress levels as assessed by the Perceived Stress Scale (6.46, 95% CI 2.77 to 10.5; P=.046) and increased the knowledge of stress and anxiety, as evaluated by the ad hoc questionnaire adopted (-2.09, 95% CI -3.86 to -0.529; P=.046). However, the home-based VR training did not yield similar reductions in stress, anxiety, and depression levels as assessed by the Depression, Anxiety, and Stress Scale-21 items or in trait anxiety as evaluated through the State-Trait Anxiety Inventory Form Y-1. After the home training sessions with VR, there was a significant decrease in anxiety, anger, and sadness and an increase in happiness levels. Analyses of the questionnaires on usability indicated that the health care workers found using the VR system at home easy and without adverse effects related to cybersickness. Of 33 participants, 29 (88%) adhered to the protocol.

CONCLUSIONS

The results of this randomized pilot study suggest that a week-long home VR intervention, created with content created specifically for this purpose and available free of charge, can help individuals manage stress and anxiety, encouraging further research investigating the potential of remote VR interventions to support mental health.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04611399; https://tinyurl.com/scxunprd.

Assessment of post-traumatic stress disorder and well-being among Sudanese during the ongoing war: a cross-sectional study

BACKGROUND

Wars profoundly impact mental health with growing long lasting consequences. This study assessed the prevalence of post-traumatic stress disorder (PTSD) and well-being among Sudanese affected by the ongoing conflict, with a specific focus on healthcare workers (HCWs).

METHODS

A cross-sectional study was conducted between April 1 and June 30, 2024, using the validated Arabic versions of PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (PCL-5) and the World Health Organization (WHO)-5 Well-Being Index.

RESULTS

A total of 1022 participants were included, and 44% were recruitted through online questionnaire and face-to-face interviews. Their mean age was 31.4 ± 12.5 years, 63.4% were females, 16.3% were HCWs and 83.3% were displaced due to conflict. The mean score of PTSD was 35 ± 21.3 with 56.9% having PTSD. The mean well-being score was 55.0 ± 23.9 with 40% reporting poor well-being. Among HCWs, 60.5% suffered from PTSD and 27.5% experienced poor well-being. A significant negative correlation was observed between PTSD and well-being scores (r=-0.273, p < 0.001). Predictors of PTSD were being male [β = -10.91, 95% confidence interval (CI) (-13.44, -8.38); p < 0.001], urban area resident [β = -10.38, 95%CI (-18.78, -1.98); p = 0.016], non-medical profession [β = 5.07, 95%CI (1.46, 8.67); p = 0.006], living with 2 to 10 households [β = 6.69, 95%CI (0.46, 12.91); p = 0.035], living with more than 20 households [β = 13.20, 95%CI (4.17, 22.23); p = 0.004], insufficient income [β = 4.32, 95% CI (1.84,6.81); p = 0.001], living in conflict zones [β = 13.38 95%CI (8.83,17.92); p < 0.001], refugee resettlement [β = 13.18, 95%CI (9.98,16.38); p < 0.001], and well-being score [β = -0.20, 95%CI (-0.25, -0.15); p < 0.001]. Predictors of well-being scores were living with more than 20 households [β = -17.44, 95%CI (-28.83, -6.04); p = 0.003], being a HCW [β =-6.22, 95%CI (-11.87, -0.57); p = 0.031], being a student [β = -7.55, 95%CI (-12.94, -2.16), p = 0.006, insufficient income [β = -5.04, 95%CI (-8.17, -1.90); p = 0.002], and living in conflict zones [β = -8.22, 95%CI (-13.96, -2.48); p = 0.005].

CONCLUSIONS

The study highlights an alarmingly high prevalence of PTSD among Sudanese including HCWs, with significant mental health consequences. These findings emphasize the urgent need for mental health interventions and humanitarian support to mitigate the psychological challenges faced by the conflict affected population.

Children's Risky Play and Resilience: Perspectives of Emergency Care Practitioners

BACKGROUND

Parents' perspectives on children's risky play can provide researchers with insight into their injury prevention and safety needs and support researchers in understanding how challenging and exciting play may positively shape children's physical, cognitive, and social development. To date, however, the perspectives of parents who witness severe injuries as part of occupational experiences, and who have medical training, are lacking within this scholarship. In this study, we worked with emergency room practitioners to understand their perspectives on children's risky play and resilience.

METHODS

A risk and sociocultural theoretical lens informed our approach and we conducted semi-structured interviews with doctors and nurses (n = 56) across Canada who had children between the ages of 4 and 13.

RESULTS

Findings from a thematic analysis were threefold: (1) learning to persevere through failure, (2) developing distress tolerance, and (3) supporting child autonomy and independence.

CONCLUSION

Findings indicate doctors and nurses can perceive children as more emotionally and physically equipped to cope with stressful and potentially injurious situations across their lifespan if they are exposed to challenging and exciting play during childhood. Further, while the practitioners believed it was important to intervene in play which could result in children experiencing severe injuries, they believed adults should support children in testing their physical and cognitive boundaries during risky play without adult interference.

Addressing the mental health needs of healthcare professionals in Africa: a scoping review of workplace interventions

Healthcare workers in Africa face considerable stress due to factors like long working hours, heavy workloads and limited resources, leading to psychological distress. Generally, countries in the global north have well-established policies and employee wellness programs for mental health compared to countries in the global south. This scoping review aimed to synthesize evidence from published and grey literature on workplace mental health promotion interventions targeting African healthcare workers using Social Ecological Model (SEM) and the Job Demands-Resources (JD-R) model as an underlying theoretical framework for analysis. Arksey and O'Malley framework for scoping reviews was used. The search was conducted across multiple databases. A total of 5590 results were retrieved from Ovid MEDLINE, Ovid Embase, Ovid PsycINFO, Cochrane Library, CINAHL, Scopus and Web of Science. Seventeen (17) studies from ten (10) African countries were included after title, abstract and full text screening. Thematic analysis identified 5 key themes namely training programs, counselling services, peer support programs, relaxation techniques and informational resources. In conclusion, even though limited workplace mental health interventions for healthcare professionals were identified in Africa, individual-level interventions have been notably substantial in comparison to organizational and policy-level initiatives. Moving forward, a multi-faceted approach unique to the African context is essential.

Indirect Interventions: Lifestyle Options to Treat Mental Disorders

Mental disorders are highly prevalent worldwide. Unfortunately, most people with these disorders do not receive any treatment. This is due in part to a large set of barriers (e.g., no access to therapists or clinics, lack of insurance, stigma) that impede seeking and obtaining mental health services. Many lifestyle interventions that are not part of traditional mental health services have indirect effects on reducing symptoms of mental disorders. These are interventions that target a direct focus (e.g., physical health, socialization, general well-being) but also have indirect and significant impact on reducing mental disorders. This article discusses indirect interventions as an additional way of reaching people in need of help with mental health problems. Interventions such as physical activity and exercise, diet, addressing sleep problems, yoga, tai chi, qigong, and volunteering have indirect beneficial effects. This article highlights the scope of mental illness as a background, introduces indirect interventions, and details three illustrations with evidence that targeting one focus with indirect effects on improving mental disorders. The interventions point to a category of interventions are not systematically used in the care of mental health problems. Among their many advantages is the prospect of their use at the levels of individuals and populations. Indirect interventions do not replace any of the current advances in treatment but add to ways of reaching people in need.

Health workers' conceptualisationand experiences of common mental symptoms and work-related psychosocial stressors in Central and Southern Ethiopian regions: a qualitative study

OBJECTIVES

Despite the growing recognition of mental health challenges among health workers, limited information regarding their self-identification of common mental symptoms (CMSs) and their perceptions of causal pathways to work-related psychosocial stressors exists. This study aimed to explore how health workers recognise CMSs, perceive their exposure to work-related psychosocial stressors, conceptualise causal pathways, evaluate the impact of these stressors on the professional quality of life (PQoL), employ coping strategies and encounter barriers to mitigating stressors and seeking support.

DESIGN AND SETTINGS

Our study employed an interpretive and descriptive phenomenological approach, informed by theoretical frameworks. We conducted focus group discussions (FGDs) and in-depth interviews (IDIs) with purposely selected health workers between January and February 2023. Interviews were audio recorded, transcribed and translated into English. Data was processed and analysed using MAXQDA 2020 software, with thematic findings supported by illustrative participants' quotations.

PARTICIPANTS

The study included 34 health workers who participated in 10 IDIs and three FGDs.

RESULTS

Five themes emerged from the study, guided by combined theoretical frameworks: (1) conceptualisation of occupational stress, anxiety and depression symptoms; (2) exposure to work-related stressors; (3) perceived impact of work-related stressors on PQoL; (4) experiences with coping strategies; and (5) barriers to mitigating stressors and seeking support. Accordingly, our findings revealed a low self-identification with CMSs (SICMSs), an increased perception to link work-related stressors with CMSs and their negative impact on PQoL, limited use of adaptive coping strategies and the presence of multiple barriers to effective coping and support-seeking practices among health workers across the respective themes.

CONCLUSIONS

The findings of this study highlight the need for targeted interventions, including updated training on CMSs, addressing resource-related stressors, improving workplace communication and conflict resolution, enacting policy reforms to ensure equitable compensation and promoting adaptive coping strategies to enhance health workers' mental well-being and their PQoL. Furthermore, we advocate for a more robust exploration of the perceived causal link supported by lived experiences of health workers with chronic occupational stress, occupational depression and occupational anxiety to provide stronger evidence using longitudinal qualitative and quantitative studies.

Examining the effects of anxiety and education level on mental health: The role of spiritual intelligence as an intervening variable in post COVID-19 patients in Indonesia

Background

The COVID-19 pandemic has profoundly affected global health systems and daily life, exacerbating vulnerabilities, particularly in Indonesia. This study investigates the impact of anxiety and education level on mental health, with spiritual intelligence as an intervening variable among post-COVID-19 patients in Indonesia.

Methods

Utilizing a cross-sectional design, data were collected from 390 post-COVID-19 patients in Indonesia. Structured questionnaires assessed anxiety, education level, spiritual intelligence, and mental health. Structural Equation Modeling (SEM) was used to analyze the relationships among these variables.

Results

The findings indicate that anxiety significantly affects both spiritual intelligence and mental health, with spiritual intelligence acting as a mediating factor. Additionally, higher educational attainment is positively associated with enhanced spiritual intelligence and improved mental health outcomes.

Conclusions

The study underscores the importance of incorporating spiritual development practices into mental health interventions and educational programs to boost resilience and overall well-being in the post-pandemic era. While these findings are promising, the cross-sectional design limits causal inferences, and future research should consider longitudinal studies to examine these relationships over time. These practices can help mitigate the adverse effects of anxiety and educational disparities on mental health.

Exploring Health-Seeking Behaviors Among Healthcare Workers and the General Population During the COVID-19 Pandemic: A Retrospective Quantitative Study

Background/objectives

Mental health issues are prevalent among healthcare workers, but help-seeking behavior in this groups remains under-researched. The purpose of this study was to explore predictors of and barriers to mental health help-seeking among healthcare workers in Canada, compared to workers from other sectors.

Design

This quantitative study analyzed cross-sectional data from Mental Health Research Canada (MHRC) from October 2022 to January 2024.

Methods

The total sample consisted of 8,191 workers from various sectors, including 419 healthcare workers. We examined prevalence of help-seeking, barriers to accessing mental health support, and predictors of help seeking using descriptive and inferential statistics. A multivariate logistic regression analysis was performed to explore the relationship between sociodemographic factors and help-seeking.

Results

Healthcare workers were more likely to seek mental help support compared to workers from other sectors (OR 1.73, 95% CI: 1.35, 2.20). Healthcare workers least likely to seek mental health support were male (OR 0.58, CI 0.52, 0.66), residing in Quebec (OR 0.49, 95% CI: 0.41, 0.59), or of older age (OR 0.40, 95% CI: 0.30, 0.52). Key barriers to mental health help-seeking identified among healthcare workers included concerns about exposure to COVID-19 (33%), preference for self-management (25%), concerns about the safety of care options (18%), and lack of knowledge on how or where to seek help (13%).

Conclusions

This study provides valuable insight into the barriers and predictors of mental help-seeking behavior among healthcare workers. Findings underscore the need for workplaces to foster safe, supportive, and inclusive environments to better support healthcare workers facing mental health challenges.

Connections between job satisfaction and depression, anxiety, and stress among nurses

Introduction

As a cornerstone of overall wellbeing, mental health significantly influences job satisfaction, vital for employee retention and organizational success. Recognizing this, managers prioritize initiatives to enhance job satisfaction and promote a healthy, productive work environment.

Aims

The study aims to explore the connections between depression, anxiety, stress, and job satisfaction among nurses, providing insights to improve their wellbeing and retention in the profession.

Methods

This quantitative survey study was conducted from June to September 2024, involving 643 nurses from healthcare facilities in Klaipėda County. Data were collected using two validated instruments: the Depression, Anxiety Stress Scales (DASS-42) and the Paul Spector Job Satisfaction Survey (JSS). Statistical analysis was performed using IBM SPSS Statistics Version 29.0.1.0.

Results

The study found that while the average levels of depression, anxiety, and stress among nurses were within normal limits, a significant portion of participants exhibited compromised mental health. Nearly one-third of the nurses experienced stress and/or depression, and almost half reported anxiety. Over one-sixth of the participants experienced high or very high levels of anxiety, while severe depression or stress was less common. Factors such as years of experience, workload, and work schedule were identified as significant influences on nurses' psychoemotional state. Moderate to strong positive correlations were observed between depression, anxiety, and stress levels. Additionally, the nurses' mental health was statistically significantly and negatively associated with most components of job satisfaction.

Conclusion

Despite average levels of depression, anxiety, and stress being within normal limits, many nurses face significant mental health challenges, particularly anxiety. Factors like workload and work schedules strongly influence their wellbeing. The negative link between mental health and job satisfaction highlights the need for better support to improve nurses' wellbeing and job satisfaction.

Development of a Web-Based Intervention for Middle Managers to Enhance Resilience at the Individual, Team, and Organizational Levels in Health Care Systems: Multiphase Study

BACKGROUND

Health care institutions face high systemic risk due to the inherent uncertainty and complexity of their operations. This often leads to stressful incidents impacting the well-being of health care professionals, which can compromise the effectiveness of health care systems. Enhancing resilience among health care professionals is essential for maintaining high-quality care and ensuring patient safety. The role of middle managers is essential to ensure the response capacity of individuals and teams.

OBJECTIVE

This study aims to develop a web-based intervention aimed at middle management to enhance individual, team, and organizational resilience.

METHODS

An observational study was conducted in 3 phases: design, validation, and pilot study. The study was initiated in February 2022 and concluded in June 2023. Phase 1 involved designing the content for the web-based tool based on a comprehensive review of critical elements around resilience. Phase 2 included validation by an international panel of experts who reviewed the tool and rated it according to a structured grid. They were also encouraged to highlight strengths and areas for improvement. Phase 3 involved piloting the tool with health care professionals in Ecuador to refine the platform and assess its effectiveness. A total of 458 people were invited to participate through the Institutional Course on Continuous Improvement in Health Care Quality and Safety offered by the Ministry of Public Health of Ecuador.

RESULTS

The tool, eResiliencia, was structured into 2 main blocks: individual and team resilience and organizational resilience. It included videos, images, PDFs, and links to dynamic graphics and additional texts. Furthermore, 13 (65%) of the 20 experts validated the tool, rating content clarity at an average of 4.5 (SD 0.7) and utility at an average of 4.7 (SD 0.5) out of 5. The average overall satisfaction was 9.3 (SD 0.6) out of 10 points, and feedback on improvements was implemented. A total of 362 health care professionals began the intervention, of which 218 (60.2%) completed preintervention and postintervention questionnaires, with significant knowledge increases (P<.001). Of the 362 health care professionals, 146 (40.3%) completed the satisfaction questionnaire, where overall satisfaction was rated at an average of 9.4 (SD 1.1) out of 10 points.

CONCLUSIONS

The eResiliencia web-based platform provides middle managers with resources to enhance resilience among their teams and their components, promoting better well-being and performance, even under highly stressful events. Future research should focus on long-term impacts and practical applications in diverse clinical settings.

Health care providers have faced the pandemic altruistically, but financial support is important for their well-being and motivation to work

OBJECTIVES

The COVID-19 pandemic has significantly stressed healthcare systems globally, placing unprecedented demands on healthcare workers (HCWs). This study investigated the effects of financial support (hazard pay) on the well-being, job satisfaction, and motivation of frontline HCWs during the Pandemic.

STUDY DESIGN

Cross-sectional study.

METHODS

A cross-sectional study was conducted using an online questionnaire from July to November 2022, involving 637 frontline HCWs from Kazakhstan. Measures included the Copenhagen Burnout Inventory, the DASS-21 scale, the WHO-5 Well-being Index, and scales for job satisfaction and work motivation. Statistical analysis employed descriptive statistics, Mann-Whitney U-tests, Bayesian statistics, χ2-test, correlation, and linear regression analyses, alongside generalized mediation models.

RESULTS

Most HCWs (80.1 %) reported receiving financial support, with varied satisfaction levels. Those without financial support exhibited significantly higher burnout levels and more severe symptoms of depression and anxiety compared to their supported colleagues. Satisfaction with financial support was positively associated with job satisfaction and negatively with burnout and DAS symptoms. Mediation analysis highlighted that job satisfaction and burnout significantly mediated the relationship between satisfaction with financial support and work motivation. Therefore, financial support was crucial in mitigating the adverse effects of the pandemic on HCWs' mental health and motivation.

CONCLUSION

The study emphasizes the role of financial support in enhancing HCWs' well-being and motivation to work, suggesting that well-structured financial incentive programs are essential for sustaining healthcare services during and beyond global health emergencies. The direct and mediated relationships underscore the importance of adequate financial incentives in maintaining healthcare workforce stability during crises.

The Impact of Job Demands, Job Resources, and Organisational Justice on Global Health and Turnover Intentions in Animal Care Workers

Animal care workers in sheltering, rescue, and management are exposed to occupational stressors which negatively impact health. While the negative mental health impacts have been previously documented in this population, physical health, and its contributing factors, have not. This study investigated how job demands, job resources, and organisational justice relate to mental and physical health, and how they subsequently affect turnover intentions. Of the 285 participants, aged 19 to 94 years, who completed the online anonymous questionnaire, below average mental and physical health was reported. Mental health, but not physical health, was inversely related to intentions to leave. After controlling for age, hierarchical multiple regressions showed high emotional demands and direct euthanasia exposure significantly predicted poorer mental and physical health, while high levels of social support predicted better mental and physical health. No additional variance in either health domain was accounted for by organisational justice. It was concluded that both physical and mental health may be negatively impacted in those who work in shelter, rescue, and management environments which could lead to high turnover and poor outcomes for individuals and organisations. Monitoring through ongoing health records to enable early intervention and accommodations should be considered to promote the health of these workers.

Non-traditional mental health clinical placements: An effective means for reducing self-stigma in pre-registration nursing students

WHAT IS KNOWN ON THE SUBJECT

Pre-registration nursing students report high rates of stigma, leading to low help-seeking attitudes when seeking help for mental health issues. Traditional mental health clinical placements can improve stigma related to attitudes and social distance for pre-registration nursing students.

WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE

There are nil recorded clinical placement interventions that have decreased self-stigma for pre-registration nursing students, with this study highlighting a clinical placement model that is effective in significantly decreasing self-stigma.

IMPLICATIONS FOR PRACTICE

The knowledge around the mental health struggles experienced by pre-registration nursing students, and the effect of a non-traditional mental health placement in decreasing self-stigmatizing attitudes in this population, is important for the future of retaining mental health nurses. There is an opportunity to use the clinical placement model presented, and design interventions for nursing students that aims to promote help-seeking behaviours.

ABSTRACT

INTRODUCTION: Traditional mental health clinical placements can improve pre-registration nurse stigma toward mental illness, particularly in measures of attitudes and social distance. However, they have not yet been shown to improve self-stigma, which affects mental health disclosure and help-seeking behaviour.

AIM

The present study investigates nursing students' stigma following a non-traditional mental health placement immersed alongside people living with mental illness.

METHODS

Three stigma subtypes were measured using the Opening Minds Scale for Healthcare Providers: Attitudes, Social Distance, and Disclosure/Help-seeking.

RESULTS

Pre-registration nurses (N = 848) completed the instrument pre- and post-placement. A multivariate analysis of variance (MANOVA) identified a large effect of placement on stigma (p < .001,η p 2 = .101). Post hoc pairwise comparisons revealed all three types of stigma decreased after the non-traditional placement (Attitudes: p < .001,η p 2 = 0.09, Social Distance: p < .001,η p 2 = 0.07, Disclosure/Help-seeking: p < .001,η p 2 = 0.04).

DISCUSSION

These findings emphasize that attending a non-traditional mental health clinical placement can effectively reduce multiple types of nursing student stigma.

LIMITATIONS

Further research in this area could focus on which attributes of the clinical placement setting foster positive help-seeking.

IMPLICATIONS

These results are noteworthy for stigma surrounding disclosure/help-seeking, as traditional (i.e. hospital-based) mental-health clinical placements have been found ineffective in reducing nursing student stigma in this domain.

RECOMMENDATIONS

Further research into the effectiveness of non-traditional clinical placements in reducing nursing students' stigma regarding mental health disclosure and help-seeking, is required.

Assessing the mental health literacy of healthcare workers at a Johannesburg tertiary hospital

Background

Good mental health literacy (MHL) has proven to aid in providing adequate and timely care, promote positive attitudes towards mental health and assist in the integration of mental healthcare with other services. Studies have shown that enhancing the MHL of healthcare workers (HCWs) can help alleviate the burden of mental illness.

Aim

The study aims to explore the MHL of HCWs at a tertiary hospital in Johannesburg.

Setting

The study was conducted at Helen Joseph Hospital.

Methods

A quantitative, descriptive, cross-sectional study via a self-administered questionnaire consisting of: (1) a demographic, work and exposure to mental illness and mental healthcare services questionnaire and (2) the Mental Health Literacy Scale (MHLS) was employed. The MHLS identifies people with low MHL who could benefit from further interventions.

Results

Two hundred and fifty-two HCWs participated in the study. The overall median MHLS score was 129, in keeping with a previous study conducted in SA and Zambia. Younger HCWs with less than 5 years of experience scored higher. Among the various professions, doctors scored highest and nurses lowest. The anaesthetic and psychiatric departments obtained the highest MHLS scores. Personal exposure to mental illness and mental health services was associated with higher MHLS scores.

Conclusion

This study highlighted areas where mental health awareness and education are lacking, which are crucial for improving MHL. Targeted interventions to fill these identified gaps are therefore recommended.

Contribution

To our knowledge, this was the first South African study to assess MHL among tertiary-level HCWs across various professions.

Gender stereotypes and professional experiences of female nurses in Türkiye

Introduction

Gender roles and stereotypes play a significant role in shaping the nursing profession, perpetuating systemic inequities that negatively impact professional experiences and healthcare system efficiency. In Türkiye, patriarchal norms and systemic disparities exacerbate these workplace challenges, particularly for female nurses.

Methods

This qualitative study utilized semi-structured interviews with 13 female nurses working in intensive care units to examine the influence of societal expectations, workplace discrimination, and institutional policies on gender inequities in nursing.

Results

The findings reveal that cultural norms, family influence, and constrained career planning often channel women into nursing, reinforcing perceptions of the profession as an extension of caregiving roles. While participants rejected the notion of nursing as a "women's profession," their narratives highlighted the pervasive impact of gendered expectations. Additionally, political favoritism and nepotism were identified as factors exacerbating workplace challenges, reflecting broader systemic issues in Türkiye's labor market. The normalization of gender norms and their internalization by female nurses further complicate efforts to combat discrimination.

Discussion

The study underscores the necessity for policy interventions to address systemic gender inequities in nursing. Recommendations include implementing mandatory gender equality education within healthcare institutions, stricter enforcement of anti-violence laws, and the establishment of psychological and legal support systems for workplace violence victims. Additional measures, such as childcare support and regulations against marital status-based discrimination, are essential to mitigate inequities. By addressing societal, cultural, and institutional factors, this research provides actionable strategies for healthcare organizations and policymakers to promote equity and improve sector efficiency.

Stigma and fear during the COVID-19 pandemic: a qualitative study on the perceptions of healthcare workers in Canada and Singapore

Introduction

We sought to explore healthcare providers (HCPs)' perceptions of and experiences with stigma during the COVID-19 pandemic in Canada and Singapore.

Methods

We conducted a qualitative study (May 2020-February 2021) with HCPs in Canada and Singapore and developed a semi-structured interview guide rooted in the Health Stigma and Discrimination Framework (HSDF). We recruited participants online and through word of mouth via newsletters, blogs and social media. Participants were eligible to participate if they worked as a healthcare provider in Singapore or Canada during COVID-19. Following participant consent, data were recorded, transcribed verbatim, and coded using a framework approach. Coded data were charted into a framework matrix and used to compare themes in each country.

Results

We conducted 51 interviews (23 in Canada; 28 in Singapore). HCPs perceived that patient fears coupled with mistrust of the health system impacted health behaviors. HCPs reported discrimination and stigmatization of population subsets. In Singapore, this included Chinese tourists and migrant workers and in Canada, this included people of Chinese ethnicity and people experiencing homelessness. This stigma was often attributed to pre-existing prejudices including perceptions that these populations were at increased risk of COVID-19 or not adhering to public health recommendations. HCPs feared spreading COVID-19 to family, peers and patients, often resulting in participants choosing to isolate from social circles. HCPs in both countries experienced occupation-based stigma, including stigma related to public health practices (masking, testing); in Canada, this intersected with race-based prejudice for participants of Chinese ethnicity. HCPs in both samples witnessed and experienced stigmatizing behavior; some participants also experienced discrimination.

Conclusions

Secondary stigma related to occupation was experienced by HCPs during COVID-19. HCPs experienced intersecting stigma based on race/ethnicity and observed stigmatization of marginalized patient populations. Most themes were consistent across Canada and Singapore. Strategies to mitigate COVID-19 related stigma toward HCPs and at-risk patient populations are warranted.

Inequalities in the Distribution of the Nursing Workforce in Albania: A Regional Analysis Using the Gini Coefficient

Background/Objectives: The uneven distribution of nurses in Albania is a major problem that compromises equitable access to health services. Rural and less developed regions suffer from a chronic shortage of nursing staff, while urban areas attract health professionals. This study aims to quantify the inequalities in the distribution of nurses in Albania, analyzing the nurse-to-population ratio and its impact on the quality of healthcare. The main objective of this study is to examine the distribution of the nursing workforce in Albania and assess regional disparities, using the Gini coefficient and the Human Development Index (HDI) to measure and compare inequalities between regions. Methods: This descriptive-analytical study was conducted in 2024. The data were collected from official sources, including the Albanian Ministry of Health and the World Health Organization (WHO). The Gini coefficient and the Lorenz curve were used to analyze the distribution of nurses in relation to the population and HDI of the different regions. The analysis included data on the number of nurses, population, and regional socioeconomic conditions. Results: The average nurse-to-population ratio in Albania is 28 nurses per 10,000 inhabitants, with significant variations between regions. Tirana has the highest ratio (60 nurses per 10,000 inhabitants), while Kukës and Dibër have the lowest values (10 per 10,000 inhabitants). The calculated Gini coefficient is 0.0228, indicating a very low level of inequality in the distribution of the nursing workforce. Conclusions: Inequalities in the distribution of nurses in Albania require targeted policy interventions. Policies are needed that incentivize health workers to work in less developed regions, through economic incentives, infrastructure improvements, and lifelong learning programs. These interventions are essential to reduce disparities and ensure equitable access to health services across the country.

Occupational injuries, mental workload and coping strategies among the nursing workforce in the Eastern Region of Ghana: a multi-centre study

BACKGROUND

The nursing profession plays a crucial role in the quality of healthcare services. While nurses face occupational injury challenges globally, mental workload, which is often overlooked, plays a significant role in these injuries. Understanding nurses' coping strategies can help develop effective interventions. The study examined the influence of mental workload on occupational injuries and coping strategies among nurses.

METHODS

A multi-centre cross-sectional study was conducted in selected hospitals in the Eastern Region of Ghana. Using a stratified sampling technique, 317 nursing staff from 6 hospitals participated in the study. A researcher-developed occupational injury questionnaire, NASA Task Load Index and Brief COPE scale were used to measure occupational injury, mental workload and coping strategies among nurses. Descriptive statistics, Pearson moment-product correlations, and regression analysis were used to analyse the data at a statistical significance of 0.05.

RESULTS

Needle pricks, injuries from sharps, exposure to blood and other body fluids, and back pain and injury from patient handling tasks were shared among participants in the past year. The study also revealed a high level of mental workload among participants. A significant correlation was observed between mental workload and various occupational injuries. The participants adopted different coping strategies in dealing with the mental workload, with active coping and instrumental support being the most used coping strategies.

CONCLUSION

The findings underscore the importance of addressing mental workload in nursing to reduce occupational injuries. To achieve this, nurses must be provided with appropriate coping strategies and support to minimise mental stress.

IMPLICATION

Providing accessible and effective coping strategies tailored to nurses' needs can significantly improve their well-being and job performance. Healthcare administrators and policymakers should consider these results when designing interventions to support the nursing workforce.

Beyond image: evaluating the perceived effectiveness of workplace mental health programs in the insurance sector

BACKGROUND

Mental health programs in the workplace have gained increasing attention as organizations strive to support employee well-being. However, the effectiveness and reception of these initiatives from the employee perspective still need to be studied.

METHODS

A qualitative study used 30 semi-structured interviews with individuals from large insurance companies in Portugal. It focused on their perceptions of workplace mental health programs, stress, and time management training. The participants ranged in age from 25 to 55 years (average 38), with a slightly more significant proportion of women, reflecting the gender distribution in the Portuguese insurance sector. The sample had an average of 10 years of industry experience, from entry-level to middle-management roles. Thematic analysis with an audit trail and thick description was used to analyse data.

RESULTS

The findings revealed a significant disconnect between the intended benefits of these programs and employee experiences. Many viewed the initiatives as primarily beneficial for the company's image rather than employee well-being. A common concern was that workload remained unchanged after training, leading employees to prioritize work over program participation. Additional key findings included generational differences in program perception, with younger employees expressing more frustration over the lack of follow-through. Most participants reported that initiatives failed to address the root causes of stress. More than half of the interviewees felt a lingering stigma around discussing mental health at work, whereas a majority mentioned increased stress due to rapid industry digitalization. Notably, many participants perceived a significant gap between upper management's promotion of mental health initiatives and their understanding of daily employee challenges.

CONCLUSIONS

These findings highlight a critical gap between implementing workplace mental health programs and their perceived value among employees. Organizations need to reevaluate their mental health initiatives to ensure that they provide tangible benefits and address underlying workplace stressors. Future research should explore strategies to better align mental health programs with the insurance sector's employee needs and work realities.

Relation Between Humor Styles and Psychopathological Symptoms in Healthcare Professionals: A Cross-Sectional Study

Background/Objectives: Being a healthcare professional often involves exposure to complex situations that can contribute to the development of psychological problems. Evidence suggests that both mental and physical health are crucial for the well-being of these professionals, which in turn influences the quality of care they provide to patients. The main aim of this study was to examine the association between adaptive and maladaptive forms of humor and psychopathological disorders among healthcare workers. Methods: A cross-sectional and descriptive correlational design was employed. The participants consisted of 250 healthcare professionals at a general hospital. Humor styles and the presence of psychological and psychosomatic symptoms were assessed. Data were collected using the Humor Styles Questionnaire (HSQ), the Short Checklist of Symptoms (LSB-50), and sociodemographic information. Spearman correlation analysis and linear regression analysis were conducted. Results: Healthcare professionals were more inclined to use affiliative and self-enhancing humor styles compared to self-defeating and aggressive humor. Affiliative and self-enhancing humor styles were negatively correlated with psychological symptoms, whereas aggressive humor and, to a lesser extent, self-defeating humor styles showed a significantly positive correlation with most psychological symptoms. Regression analysis revealed that positive humor styles negatively predicted all severity indices of the LSB-50. In contrast, negative humor styles, particularly self-defeating humor, positively predicted the severity indices. Being female, working night shifts, and having temporary contracts were positive predictors of most global indices of the LSB-50. Conclusions: This study highlights the importance of considering different types of humor as a potential strategy for improving the mental health of healthcare professionals, as well as the influence of other independent variables related to their personal and work environment. Positive humor styles, specifically affiliative and self-enhancing humor, are associated with a lower prevalence of psychological symptoms among healthcare professionals. Negative humor styles are correlated with a higher prevalence of these symptoms.

AI Interventions to Alleviate Healthcare Shortages and Enhance Work Conditions in Critical Care: Qualitative Analysis

BACKGROUND

The escalating global scarcity of skilled health care professionals is a critical concern, further exacerbated by rising stress levels and clinician burnout rates. Artificial intelligence (AI) has surfaced as a potential resource to alleviate these challenges. Nevertheless, it is not taken for granted that AI will inevitably augment human performance, as ill-designed systems may inadvertently impose new burdens on health care workers, and implementation may be challenging. An in-depth understanding of how AI can effectively enhance rather than impair work conditions is therefore needed.

OBJECTIVE

This research investigates the efficacy of AI in alleviating stress and enriching work conditions, using intensive care units (ICUs) as a case study. Through a sociotechnical system lens, we delineate how AI systems, tasks, and responsibilities of ICU nurses and physicians can be co-designed to foster motivating, resilient, and health-promoting work.

METHODS

We use the sociotechnical system framework COMPASS (Complementary Analysis of Sociotechnical Systems) to assess 5 job characteristics: autonomy, skill diversity, flexibility, problem-solving opportunities, and task variety. The qualitative analysis is underpinned by extensive workplace observation in 6 ICUs (approximately 559 nurses and physicians), structured interviews with work unit leaders (n=12), and a comparative analysis of data science experts' and clinicians' evaluation of the optimal levels of human-AI teaming.

RESULTS

The results indicate that AI holds the potential to positively impact work conditions for ICU nurses and physicians in four key areas. First, autonomy is vital for stress reduction, motivation, and performance improvement. AI systems that ensure transparency, predictability, and human control can reinforce or amplify autonomy. Second, AI can encourage skill diversity and competence development, thus empowering clinicians to broaden their skills, increase the polyvalence of tasks across professional boundaries, and improve interprofessional cooperation. However, careful consideration is required to avoid the deskilling of experienced professionals. Third, AI automation can expand flexibility by relieving clinicians from administrative duties, thereby concentrating their efforts on patient care. Remote monitoring and improved scheduling can help integrate work with other life domains. Fourth, while AI may reduce problem-solving opportunities in certain areas, it can open new pathways, particularly for nurses. Finally, task identity and variety are essential job characteristics for intrinsic motivation and worker engagement but could be compromised depending on how AI tools are designed and implemented.

CONCLUSIONS

This study demonstrates AI's capacity to mitigate stress and improve work conditions for ICU nurses and physicians, thereby contributing to resolving health care staffing shortages. AI solutions that are thoughtfully designed in line with the principles for good work design can enhance intrinsic motivation, learning, and worker well-being, thus providing strategic value for hospital management, policy makers, and health care professionals alike.

Perspectives and Practices of Healthcare Leaders in Supporting Healthcare Worker Well-Being: A Reality Check

Introduction

The well-being of healthcare workers (HCWs) is a critical concern. While healthcare leaders can play a crucial role in influencing employees' well-being, it remains unclear how leaders are leveraging this influence. This study aims to unravel the current perspectives and practices of healthcare leaders in supporting HCW well-being.

Methods

Semi-structured interviews were conducted with healthcare leaders at various levels within a university medical center. The interviews focused on exploring three key topics: factors influencing HCW well-being, data sources utilized for information gathering, and strategies leaders employ to influence HCW well-being. Our study design was grounded in constructionist epistemology and adopted a phenomenological approach. The methodology primarily involved a data driven, inductive thematic analysis to discern patterns and themes from the collected data.

Results

Fifteen interviews with healthcare leaders revealed a multitude of factors influencing HCW well-being, categorized into three domains: personal, socioeconomic, and work-related factors. Leaders reported a variety of data sources, including "contact data", data derived from regular and sporadic interpersonal interactions, and "investigation data", entailing formal inquiries conducted within the healthcare organization. Interestingly, while leaders acknowledge their potential to positively influence well-being, particularly in work-related aspects, there was a notable trend of deflecting responsibility, often redirecting it towards other leaders or placing it back on the individual employee.

Conclusion

Healthcare leaders show a comprehensive understanding of factors affecting employee well-being. However, healthcare leaders have a predominantly reactive approach to managing employees' well-being. Data collection is often sporadic, lacking consistency, and there is a tendency to redirect responsibility for well-being, revealing a discrepancy between acknowledgement of influence and its actual implementation. We argue that it is essential for leaders at all hierarchical levels to assume responsibility actively and collectively for employee well-being, transitioning to a proactive approach in promoting and safeguarding the well-being of HCWs.

Stress and Burnout Among Anesthesia Technologists, Technicians, and Trainees: A Cross-Sectional Study in a Tertiary Hospital in Saudi Arabia

Background/Objectives: Occupational burnout poses a significant burden to healthcare personnel, institutions, and service users. Anesthesia technologists and technicians work in the shadow of the perioperative team, and a lack of attention to anesthesia support personnel may pose a significant risk to their wellbeing and the quality of care delivered. To date, only a few studies have investigated the prevalence of burnout among anesthesia technologists and technicians worldwide and in Saudi Arabia. Thus, the aim of this cross-sectional study was to assess the prevalence and contributing factors to burnout among anesthesia technologists and technicians in a single tertiary hospital in Saudi Arabia. Methods: The study utilized the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) to assess burnout and a 10-point scale to assess stress levels. The MBI-HSS inventory consists of three subscales: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). Univariate and multivariate linear regression analyses were used to identify correlates of each burnout subscale. Gender was included in the multivariable regression analysis in addition to significant variables from univariable analysis. Results: A total of 89 participants completed the survey. Based on each subscale of the MBI-HSS, more than 60% of the participants reported high to moderate EE, and more than half reported high to moderate DP. For PA, only 25.8% of participants reported low PA. We found that age (β = -0.58, 95% CI: -0.95, -0.20; p = 0.003) and stress (β = 3.3, 95% CI: 2.1, 4.5; p < 0.001) were independently associated with EE. In addition, night shift (β = 3.3, 95% CI: 0.44, 6.1; p = 0.024) and stress (β = 0.73, 95% CI: 0.13, 1.3; p = 0.017) were independently associated with DP. Independent factors for PA were identified including night shifts (β = 6.6, 95% CI: 1.4, 12; p = 0.014) and stress levels (β = -1.3, 95% CI: -2.4, -0.12; p = 0.03). Conclusions: This research underscores the alarmingly high prevalence of burnout and the strong link between elevated EE and DP rates and workplace stress, emphasizing the necessity to identify and mitigate these stressors. It is therefore crucial to evaluate the effectiveness of the current wellbeing and mental health initiatives and programs in Saudi Arabia to ensure that they address evolving challenges and the overall mental health of healthcare personnel.

Prevalence, consequences, and contributing factors beyond verbal and physical workplace violence against nurses in peripheral hospitals

Background

Globally, nearly one-third of workplace violence (WPV) occurs in the health sector. Exposure to WPV among Jordanian nurses has been widely speculated to be underreported. Understanding of the factors contributing to WPV among nurses and their consequences is limited.

Objectives

This study aimed to examine the consequences and contributing factors of WPV and explore suggestions for reducing WPV among nurses working in peripheral hospitals.

Methods

This descriptive, cross-sectional study included 431 Jordanian nurses. Data were collected using a self-report instrument between December 2022 and June 2023. A modified version of the ILO/ICN/WHO/PSI Workplace Violence in the Health Sector Country Case Study Questionnaire developed and validated in 2003 was used.

Results

The ages of the participants ranged from 20 to 49 years. A total of 349 nurses (81%) had experienced verbal violence, while 110 (25.5%) had experienced physical violence. Of the 110 nurses who were physically attacked, 44 (40 %) reported that an investigation was conducted to determine the cause of the incident. Approximately 38.2% of incidents involving physical violence in the last 12 months involved the use of weapons. The current study revealed that 59.6% of the nurses reported that verbal incidents were common in their workplace. The highest level of agreement among all participants was leniency in applying penalties to perpetrators of violence inside hospitals. The majority of participants (95.8%) agreed that improving staff-patient communication skills would effectively reduce violence.

Conclusion

Creating awareness among healthcare professionals, patients, and the general public regarding the impact of WPV and the importance of respect and professionalism is crucial.

The well-being of polish general practitioners during the COVID-19 pandemic-cross-sectional questionnaire-based study

BACKGROUND

The COVID-19 pandemic has caused psychological distress to the population and healthcare workers. Physicians' well-being is essential and contributes significantly to overall health. This study aimed to assess the strain on Polish general practitioners from the effects of the COVID-19 pandemic and to ascertain the potential predictors of their distress.

METHODS

Data was collected using a self-reported online questionnaire from 162 GPs in Poland between December 2020 and August 2021 as part of the international PRICOV-19 study. General practitioners' well-being was evaluated using the validated Mayo Clinic's expanded 9-item well-being index (eWBI). Spearman's correlation was used to measure the strength and direction of association between general practitioners' distress level and continuous variables, and for ordinal variables, Gamma correlation was recommended for many tide ranks. We also checked the association of the level of distress with continuous variables by categorizing them and applying the Kruskal-Wallis test likewise for a comparison of the distress in different practice locations.

RESULTS

A vast majority (80%) of respondents were considered at risk of distress during the COVID-19 outbreak, with an eWBI score of 2 or more. Higher distress scores were exhibited among general practitioners who reported increased responsibilities during the COVID-19 pandemic and perceived need for additional training. The experience of collaboration with neighbouring practices and the provision of adequate governmental support emerged as significant protective factors against distress. No correlation was observed between Polish general practitioners' distress level and years of professional experience, number of patients in the practice, number of doctors working there, the practice's location, or working with more vulnerable patient populations.

CONCLUSIONS

Our findings proved that COVID-19 placed an extraordinary emotional burden on Polish general practitioners and highlighted the importance of targeted support services and resource allocation to primary healthcare in Poland in case of any potential future crisis similar to the COVID-19 pandemic.

Prevalence of Alcohol Use Disorder among Medical Students in New Delhi: A Cross-Sectional Study

Background

Amid the global concern over alcohol consumption's ramifications for public health, the escalating prevalence of alcohol misuse among young individuals, especially students, is alarming. This study examines the prevalence of alcohol use disorder (AUD) among medical students, exploring its link to depression, anxiety, and socioeconomic factors.

Material and Methods

We conducted this cross-sectional study at a medical college in New Delhi in the month of June, 2023. We determined a sample size of 425 using prevalence estimates for AUD, a 4% margin of error, and a 15% nonresponse rate. We selected participants using simple random sampling from the MBBS enrollment list and provided them with self-administered questionnaires. We utilized validated screening tools, including PHQ-9, GAD-7, AUDIT-C, and CAGE, to assess depression, anxiety, and AUD. Statistical analysis was performed using STATA 18. AUD prevalence was presented with 95% confidence intervals. Associations between AUD and variables were examined using Chi-square tests. Significant variables (P < 0.2) in univariate analysis were considered in multivariate logistic regression (P < 0.05).

Results

In our study, 413 students participated. The prevalence of AUD was 13.6%, depression was 31.5%, and anxiety was 24.2%. Univariate and multivariate logistic regression revealed significant associations between AUD and factors such as gender, current living space, tobacco use, and anxiety.

Conclusion

The current study highlights worrisome levels of AUD, depression, and anxiety among medical students in New Delhi. Our research also reveals connections between AUD and factors like gender, living situation, tobacco use, and anxiety.

Misaligned Supports: Differences in Reported Health Care Worker Well-being Supports Provided and Needed During the COVID-19 Pandemic

PURPOSE

To describe the well-being supports provided to health care workers (HCWs) during the COVID-19 pandemic in health centers and hospitals.

DESIGN

Cross-sectional qualitative interviews before and after implementation of a peer-based support intervention.

SETTING

Purposively sampled hospitals and health centers across the US.

PARTICIPANTS

28 site leaders and 56 HCWs sampled from 16 hospitals and 12 health centers.

METHOD

Site leaders and HCWs were asked to describe supports available to HCWs during the COVID-19 pandemic. Thematic and content coding and analysis of interview responses were conducted using Dedoose.

RESULTS

Both site leaders and HCWs identified a range of support resources available. Communication resources were the most frequently cited in both groups. Health care workers reported bi-directional communication, while one-way communication was emphasized by site leaders. Hospitals highlighted counseling support, particularly Employee Assistance Programs (EAP), while health centers prioritized community support. Wellness activities were more prevalent in hospital settings, while health centers offered specific workplace-provided training for HCWs. Health care workers encountered barriers when accessing support, including limited time, fear of stigma, and disruptions to their existing support networks attributable to the pandemic.

CONCLUSION

While there are resources for HCWs, the available supports may not align with their needs and barriers to access may limit the effectiveness of these supports. Continued engagement between leaders and HCWs could help better align resources with needs.

A Longitudinal Analysis of Long Working Hours and the Onset of Psychological Distress

OBJECTIVES

There is a paucity of longitudinal studies examining the relationship between working hours and the development of psychological distress (PD) among US workers. This study utilized a longitudinal approach to examine this relationship.

METHODS

The 2010-2019 Medical Expenditure Panel Survey (MEPS) data was utilized. PD was analyzed among full-time US employees without PD at baseline using a fixed effect approach.

RESULTS

The sample comprised 27,548 full-time workers. Individuals working 61 hours or more weekly had the highest risk of PD onset, at 9.9% (95% CI = 1.9%-17.8%, P < 0.05), compared to those working 30 to 35 hours weekly. Interestingly, an increased risk of PD onset was found among individuals working 36 to 40 hr/wk at 6.6% (CI = 1.5%-11.6%%, P < 0.05).

CONCLUSIONS

Long working hours were associated with the increased development of PD.

Job Demands and Resources Shape the Risk of Burnout in Italian Child Neuropsychiatrists

Objectives: To evaluate the influence of job demands and resources on burnout risk among Italian pediatric neuropsychiatrists. Methods: This cross-sectional study was conducted between December 2023 and February 2024 and involved Italian pediatric neuropsychiatrists. The study applied the Job Demands-Resources (JD-R) model to assess the impact of job demands (such as work-family conflict, time pressure, and job uncertainty) and job resources (like organizational support and perceived job meaning) on burnout. Burnout was measured through emotional exhaustion, depersonalization, and personal accomplishment subscales. Demographic data, including gender and career stage, were analyzed for their association with burnout. Results: High job demands were significantly associated with increased emotional exhaustion and depersonalization, while greater job resources correlated with lower burnout levels and higher personal accomplishment. Gender differences emerged, with female neuropsychiatrists reporting significantly higher emotional exhaustion and lower personal accomplishment than male neuropsychiatrists. Seniority was not a strong predictor, but early-career professionals, particularly residents, exhibited higher susceptibility to emotional exhaustion. Perceived job meaning and organizational support were protective factors across all burnout subscales, buffering the effects of job demands. Conclusions: Burnout risk in Italian pediatric neuropsychiatrists is shaped by both job demands and resources. Addressing work-family conflict, job uncertainty, and time pressure alongside enhancing organizational support and fostering job meaning is crucial to mitigate burnout. Special attention should be given to early-career professionals and female neuropsychiatrists to reduce their emotional exhaustion and improve their well-being. These findings provide valuable insights for developing targeted strategies to improve well-being in this field, ultimately enhancing patient care.

Impact of Work-Family Balance on Nurses' Perceived Quality of Life During the COVID-19 Pandemic: A Scoping Review

BACKGROUND/OBJECTIVES

The COVID-19 pandemic has put nurses under extreme pressure, especially affecting them by significantly increasing their workload and compromising their well-being. The lack of balance between work and personal life has caused greater stress and burnout in these professionals, deteriorating their quality of life and the care they provide. This study aims to synthesize the scientific evidence on the relationship between work-family balance and the perceived quality of life of nurses during the COVID-19 pandemic.

METHODS

A scoping review was carried out based on the Joanna Briggs Institute methodology, following the PRISMA-ScR guidelines in the PubMed, CINAHL, SCOPUS, WOS, Cochrane Library, and PsycINFO databases. The quality of the articles was assessed using the Mixed Methods Appraisal Tool (MMAT).

RESULTS

Five studies involving 1641 nurses from Spain, India, Jordan, South Korea, and Turkey focused on three key areas: (1) work-life balance, (2) quality of life, and (3) factors associated with quality of life during the COVID-19 pandemic.

CONCLUSIONS

The pandemic exacerbated pre-existing challenges related to work-life balance and quality of life, particularly for nurses with rigid and extended work hours, increasing stress and negatively impacting their well-being. The study emphasizes the need for flexible labor policies, psychological support, and strong social networks to prevent burnout and improve nurses' quality of life.

Sleep of Nurses: A Comprehensive Scoping Review

AIM

To map the extent, range and nature of studies that examine sleep of nurses and identify how sleep has been examined in relation to the different aspects of nurses' health and nursing work and practice.

DESIGN

A scoping review.

DATA SOURCES

A search of five electronic databases including MEDLINE, Embase, EMcare, PsycINFO (using the Ovid platform) and Scopus was undertaken in May 2023 to identify primary studies that examined nurses' sleep.

REVIEW METHODS

This review was undertaken in accordance with the Joanna Briggs Institute methodology for scoping reviews and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist.

RESULTS

This review included 1040 studies from a wide range of countries. Most studies were observational in design and examined nurses working in the acute care sector. Studies were mostly descriptive (32%) or discussed sleep as a workforce issue (21%) or lifestyle behaviour that is important for the health of nurses working clinically (27%). A range of different sleep parameters were examined, with sleep quality the focus of most studies, especially in relation to well-being.

CONCLUSION

There has been an exponential increase in the number of studies that examine nurses' sleep. Efforts to examine the sleep of nurses are beginning to align with contemporary understandings and methodological approaches to examining sleep. However, this field of research could benefit from better consistency in the definition and reporting of sleep, prioritising objective measures of sleep and improving understanding of the relative and combined importance of different dimensions of sleep.

IMPACT

This review provides a comprehensive overview of studies that examine nurses' sleep. Findings highlight areas of growing interest, areas in need of further research and methodological considerations to strengthen research in this field.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution. REGISTRATION DOI: https://doi.org/10.17605/OSF.IO/RZC4M.

The Role of Dietary Antioxidants, Food Supplements and Functional Foods for Energy Enhancement in Healthcare Professionals

Healthcare professionals frequently experience significant work overload, which often leads to substantial physical and psychological stress. This stress is closely linked to increased oxidative stress and a corresponding decline in energy levels. This scoping review investigates the potential impact of dietary antioxidants and food supplements in conjunction with diet in controlling these negative effects. Through an analysis of the biochemical pathways involved in oxidative stress and energy metabolism, the paper emphasizes the effectiveness of targeted dietary interventions. Key dietary antioxidants, such as vitamins C and E, polyphenols, and carotenoids, are evaluated for their ability to counteract oxidative stress and enhance energy levels. Additionally, the review assesses various food supplements, including omega-3 fatty acids, coenzyme Q10, and ginseng, and their mechanisms of action in energy enhancement. Practical guidelines for incorporating energy-boost dietary strategies into the routine of healthcare professionals are provided, emphasizing the importance of dietary modifications in reducing oxidative stress and improving overall well-being and performance in high-stress healthcare environments. The review concludes by suggesting directions for future research to validate these findings and to explore new dietary interventions that may further support healthcare professionals under work overload.

The Role of Nurse Implementation Scientists in Leading Health System Transformation in Atlantic Canada and Beyond: A Discussion Paper

AIM

To discuss and provide examples of how nurse implementation scientists can support health system transformation.

DESIGN

Discussion paper.

METHODS

Using Prince Edward Island's health system strategic plan as a case exemplar, selected key priorities in the strategic plan were mapped with examples and discussion of how nurse implementation scientists can support health system transformation on Prince Edward Island and beyond.

CONCLUSION

Accelerating the development and delivery of evidence-informed services that support health system transformation is needed. Nurse implementation scientists are ideally positioned to lead these efforts. Appropriate resourcing and compensation are essential to fully embrace nurse implementation scientist roles, collaboration, and buy-in from health system leaders.

IMPLICATIONS FOR NURSING

Practical examples of how nurse implementation scientists can lead health system transformation in a rigorous, evidence-informed way are identified.

IMPACT

Literature providing examples of how nurse implementation scientists can make meaningful impacts within health systems, particularly in rural contexts, is limited. Nurse implementation scientists are ideally positioned to collaborate with and lead health system transformation by virtue of their knowledge, skills, qualifications and experience. Implications of this work extend beyond nursing to other health disciplines, health organisations, government leaders, researchers and populations. The discussion and examples provided may be applicable to similar contexts.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Predictors of dropout in cognitive behavior and interpersonal online brief psychotherapies for essential professionals during the COVID-19 pandemic

Premature dropout from psychotherapy can harm patients and increase mental health costs. This study identified predictors of dropout in brief online psychotherapy for essential workers during the COVID-19 pandemic. This was a secondary analysis of a randomized trial on 4-week CBT or IPT protocols. Participants provided sociodemographic data and completed the Patient-Reported Outcomes Measurement Information System and Burnout Assessment Tool Short-Form. Predictors were analyzed in three blocks: sociodemographic, clinical, and therapist characteristics using bivariable and multivariable analyses. The sample included 804 individuals who attended at least the first session of either CBT (n = 403) or IPT (n = 401). A total of 17.2% (n = 138) of the participants dropped out during the protocol. Significant predictors of dropout included having children (IRR = 1.48; 95% CI: 1.07-2.05; p = 0.016), residing in specific regions of Brazil (Northeast IRR = 1.44; 95% CI:1.04-2.00; p = 0.02 and Midwest IRR = 1.73; 95%CI: 1.13-2.64; p = 0.01), therapist male sex (IRR = 2.04; 95% CI: 1.47-2.83; p = < 0.001), second wave of Covid-19 (IRR = 1.54; 95% CI: 1.01-2.34; p = 0.04) and low life satisfaction (IRR = 1.63; 95% CI: 1.06-2.50; p = 0.02). Our findings underscore the necessity for culturally tailored strategies, support for those with children, and targeted therapy for individuals with low life satisfaction. Implementation of these strategies may reduce dropout rates and improve treatment outcomes for essential workers in crisis.

Using journalling to support nurses' mental well-being and self-care in challenging times

Nurses frequently experience multiple challenges and face numerous demands in their professional role, which may lead to adverse effects such as stress, depression, anxiety and burnout. Therefore, it is important to identify effective and accessible strategies that can support them. This article explores how nurses can use journalling as a tool for navigating the challenges they experience in their practice. It offers a step-by-step guide that provides nurses with an accessible and effective approach to journalling, which they can use to support their mental well-being and self-care.

Physical Activity and Sedentary Behavior on Well-Being and Self-Rated Health of Italian Public Health Medical Residents During the COVID-19 Pandemic: The PHRASI Study

High workloads and extended work shift greatly limit the opportunities for medical residents to adopt a healthy lifestyle by practicing regular physical exercise. Using data from the Public Health Residents' Anonymous Survey in Italy (PHRASI), this research assessed the associations between physical activity levels and sedentary behavior, well-being, and self-rated health among Italian public health residents (PHRs) during the COVID-19 pandemic. Employing a cross-sectional design, this study utilized the International Physical Activity Questionnaire, the WHO-5 Well-being Index, and the single-item self-rated health to measure physical activity, sedentary behavior, self-rated health, and well-being among PHRs. The study included 379 PHRs. Multiple logistic regressions adjusted for age and sex were applied to explore the associations among the variables of interest. While 74% of PHRs were sufficiently active, 50% reported good well-being. We found a positive association between physical activity (specifically walking and intense activities) and well-being (aOR 1.292, p = 0.032). At the same time, sedentary behavior was negatively associated with self-rated health (aOR 0.948, p = 0.022) and well-being (aOR 0.945, p = 0.005). This study contributes valuable insights into the role of physical activity and sedentary behavior in PHRs' mental health, calling for targeted public health strategies to support their well-being.

Factors Influencing Staff Perceptions of Inpatient Psychiatric Hospitals: A Meta-Review of the Literature

Staff perceptions of inpatient psychiatric hospitals ultimately impact a range of organisational and care-related variables, including staff retention and quality of care for inpatients. The aim of this study was to conduct a meta-review to synthesise themes reported by staff to influence their perceptions of inpatient psychiatric hospitals. The review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines for systematic reviews. PsycINFO, CINAHL, MEDLINE and EMBASE were systematically searched. Reviews were eligible for inclusion if they examined the perception/experience of paid staff involved in caring for adults with mental illnesses admitted to an inpatient psychiatric hospital. Eligible reviews were assessed for methodological quality and bias. Thematic synthesis was used to merge thematically similar findings into an aggregate summary. Fifteen reviews were included, from which seven themes were reliably extracted: staff and patient safety, views on inpatients' experiences, relationships on the ward, ward rules, knowledge and experience, service delivery issues and coercive measures. Confidence in the evidence underlying each theme was analysed using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) criteria. Results indicate that staff perceptions of inpatient psychiatric hospitals overlap with inpatients' perspectives, particularly regarding the therapeutic relationship, coercive measures and ward safety, in addition to unique experiences. Factors identified can help guide ways to improve staff retention, satisfaction and quality of treatment.

Common mental health problems in medical students and junior doctors - an overview of systematic reviews

BACKGROUND

Common mental health problems (CMHP) are prevalent among junior doctors and medical students, and the COVID-19 pandemic has brought challenging situations with education disruptions, early graduations, and front-line work. CMHPs can have detrimental consequences on clinical safety and healthcare colleagues; thus, it is vital to assess the overall prevalence and available interventions to provide institutional-level support.

AIMS

This overview summarises the prevalence of CMHPs from existing published systematic reviews and informs public health prevention and early intervention practice.

METHODS

Four electronic databases were searched from 2012 to identify systematic reviews on the prevalence of CMHPs and/or interventions to tackle them.

RESULTS

Thirty-six reviews were included: 25 assessing prevalence and 11 assessing interventions. Across systematic reviews, the prevalence of anxiety ranged from 7.04 to 88.30%, burnout from 7.0 to 86.0%, depression from 11.0 to 66.5%, stress from 29.6 to 49.9%, suicidal ideation from 3.0 to 53.9% and one obsessive-compulsive disorder review reported a prevalence of 3.8%. Mindfulness-based interventions were included in all reviews, with mixed findings for each CMHP.

CONCLUSIONS

The prevalence of CMHPs is high among junior doctors and medical students, with anxiety remaining relatively stable and depression slightly increasing during the COVID-19 pandemic. Future research on mindfulness-based interventions is required for a resilient and healthy future workforce.

PRISMA/PROSPERO

the researchers have followed PRISMA guidance. This overview was not registered with PROSPERO as it was conducted as part of an MSc research project.

How positive mental well-being influences professional identity and the mediating mechanisms in Chinese nursing students

AIM

To examine the association between positive mental well-being and professional identity in nursing students. The mediating effects of resilience and nurse-patient relationship were explored.

BACKGROUND

Professional identity of nursing students can influence their pursuit of a nursing career. Negative mental health problems, such as anxiety, depression, and high stress, are known risk factors for professional identity. Few studies have examined the association of professional identity with positive mental well-being and underlying mechanisms.

METHODS

This was a cross-sectional study of Chinese nursing students on clinical placement. The Warwick-Edinburgh Mental Well-being Scale, Professional Identity Scale, Connor-Davidson Resilience Scale, Nurse-Patient Relationship Scale, and Patient Health Questionnaire were used, and demographic and study-related characteristics were measured. Multivariable linear regression and mediation analyses analyzed the associations. We followed the STROBE reporting guidelines.

RESULTS

Of 208 participants, the total scores of positive mental well-being and professional identity were at a moderate level. Positive mental well-being was associated with professional identity after adjusting for confounders including the main reason for choosing nursing and negative mental health. Resilience was a full mediator of the association between positive mental well-being and professional identity, whereas nurse-patient relationship was a partial mediator.

DISCUSSION AND CONCLUSION

Positive mental well-being was associated with professional identity in Chinese nursing students on clinical placement, mediated through resilience and nurse-patient relationship. Positive mental well-being can be a facilitator for the professional identity of nursing students, and resilience and nurse-patient relationship could be potential mechanisms for nurse professional development.

IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY

Nurse researchers, educators, and policymakers are informed to increase the awareness of positive mental well-being and develop interventions targeting resilience and nurse-patient relationship for building a stable and satisfied nursing team.

Nurses Supporting Nurses: A Model for Providing Mental Health Services During War

Nurses routinely face psychological challenges as part of their work, acutely so during times of crises when nurses may treat many severely injured and dying patients. While the need for such support is well documented in the literature, mental health support programmes aimed at healthcare workers, even when available, are often underutilised, especially by nurses. To gain insights about needed mental health supports for nurses and programme implementation, this study examines a programme launched following a surprise attack on Israel on 7 October, 2023, resulting in thousands of deaths and injuries and precipitating a war. The programme deployed 30 volunteer nurses trained in cognitive behavioural therapy, trauma support and mental health first aid to offer up to three, anonymous, 30-min online therapy sessions to nurses around Israel in December 2023. Using a qualitative descriptive design, we engaged 22 of these volunteers in one of the three focus groups lasting 60-90 min each. Our findings highlight a range of mental health issues-among both the volunteers and therapy recipients-as well as barriers to providing mental health support to nurses. The importance of normalising the pursuit of mental health support in nursing education and ensuring the availability of support in healthcare organisations was emphasised.

How are motivational interviewing techniques associated with US healthcare employees' mental health help-seeking behaviours when using the interactive screening programme

Introduction

Suicide rates for healthcare workers, coupled with mental health challenges, continue to increase in the USA. This study aimed to assess how the Interactive Screening Programme (ISP) is being used by US healthcare employees and how ISP counsellors' use of motivational interviewing (MI) techniques was associated with employee help-seeking outcomes.

Methods

We used a retrospective one-group study to analyse secondary deidentified ISP interactive counselling dialogue (written communications between the ISP counsellor and ISP user) (time frame 2009-2019) from 5922 healthcare employees at 15 US workplaces. Help-seeking outcomes included referral requests, commitment to mental health services and improved willingness to seek mental health services. Key exposures included counsellors' use of MI techniques.

Results

45% of ISP users scored in high distress on their ISP screening. Among ISP users in high distress, over 25% engaged in ISP dialogue and 63% of those who engaged in dialogue requested a referral. Bivariate analysis showed ISP users more likely to request referrals included women, younger employees, those with higher distress levels and those not currently receiving mental health services. Counsellors' use of the MI technique, asking questions, was associated with approximately three times the odds of requesting referral (OR=3.12, p<0.001), higher odds of service commitment (OR=2.18, p<0.001) and improved willingness towards services (OR=2.21, p<0.001), compared with no questions asked during ISP dialogue. Asking questions also demonstrated a large effect size for all three dependent variables.

Conclusion

Results support the use of the MI techniques, especially asking questions, with ISP dialogue to encourage healthcare employees' mental health help-seeking.

Virtual nourishment: Paediatric feeding disorder management with telepractice amidst COVID-19: An allied health perspective

PURPOSE

The rapid adoption of telepractice services by health professionals was necessary to maintain service continuity for children with paediatric feeding disorders during the COVID-19 pandemic, during periods where in-person therapy was restricted. The aim of this study was to explore clinical perspectives and reflections on the use of telepractice for managing paediatric feeding disorders during the pandemic.

METHOD

A post-positivist qualitative approach using thematic analysis was adopted. This study seeks to understand participants' experiences and thoughts from allied health professionals from speech-language pathology, occupational therapy, and dietetics working with paediatric feeding in Western Australia. All participants delivered at least 10 telepractice sessions to children from birth to 12 years with a paediatric feeding disorder. Braun and Clarke's six-step thematic analysis process was used to analyse the data inductively.

RESULT

Eleven allied health professionals representing eight clinical settings in Western Australia, including speech-language pathology, occupational therapy, and dietetics, working with paediatric feeding were recruited. The results revealed four themes: families becoming the catalyst of change, clinician comfort over confidence, insights into authentic mealtimes, and the paradox of choice.

CONCLUSION

This study highlighted the need to build clinicians' confidence and competence, and the provision of service guidelines and training. Although many clinicians had positive experiences with telepractice, most returned to in-person delivery once COVID-19 restrictions were lifted, emphasising the importance of comfort in service delivery selection. We recognise that the findings of this study are constrained by the fact that it was conducted in a single geographical region and utilised a small qualitative sample. While telepractice was successful in managing paediatric feeding disorders, further development and implementation of telepractice guidelines are needed for telepractice to be a viable service delivery option for families and children with feeding disorders.

A cross-sectional study of satisfaction with life among 1st year students and doctors of a teaching hospital of the national capital region

OBJECTIVES

With rising work pressure, balancing personal life is not easy for any professional. Aspirations at the time of admission into professional college do not last for long, as we observe doctors who are less satisfied than enthusiastic first-year students at dental college. The present study aimed to determine subjective well-being and comparison of satisfaction with life among first professional dental students and doctors of a teaching hospital in the National Capital Region, India.

METHODS

The current study was conducted for one month among 100 1st year dental students and 100 junior doctors, including the faculty of a teaching hospital in the National Capital Region, India. Satisfaction with Life Scale (SWLS) was used to assess the level of satisfaction in their lives. Associated factors which might affect this satisfaction were also enquired for.

RESULTS

The mean age of first professional dental students and doctors was 19.3 ± 1.6 and 27.52 ± 2.54 years, respectively. 76 (76%) 1st professional students and 68 (68%) doctors were found to be satisfied with their lives when assessed over SWLS. Odds of being satisfied were significantly more in the age group of 20-25 years. Those students and doctors who had opted for dental, taking it as a reputed profession or as their ambition, were found to be more satisfied with their lives. Students who were satisfied with the hostel accommodation were significantly more satisfied with their lives. Among doctors, those who were either married or were in a relationship and who were satisfied with their income were more satisfied.

CONCLUSIONS

A significant proportion of doctors and 1st professional dental students were satisfied with their lives. More students were satisfied with their lives than doctors. Factors like satisfaction with income and reason for joining the dental profession were found to have significant associations.

Iridium oxide-modified reference screen-printed electrodes for point-of-care portable electrochemical cortisol detection

Cortisol is a well-known stress biomarker; this study focuses on using electrochemical immuno-sensing to measure the concentration of cortisol selectively and sensitively in artificial samples. Anti-cortisol antibodies have been immobilised on polycrystalline Au electrodes via strong covalent thiol bonds, fabricating an electrochemical bio-immunosensor for cortisol detection. IrOx was then anodically electrodeposited as a reference electrode on a commercial screen-printed electrode and electrochemical impedance spectrometry (EIS) studies were used to correlate the electrochemical response to cortisol concentration and the induced changes in charge transfer resistance (Rct). A linear relationship between the Rct and the logarithm of cortisol concentration was found in concentrations ranging from 1 ng/mL to 1 mg/mL with limit of detection at 11.85 pg/mL (32.69 pM). The modification of the reference electrode with iridium oxide has greatly improved the reproducibility of the screen-printed electrode. The sensing system can provide a reliable and sensitive detection approach for cortisol measurements.

Innovative public strategies in response to COVID-19: A review of practices from China

The COVID-19 pandemic presented unparalleled challenges to prompt and adaptive responses from nations worldwide. This review examines China's multifaceted approach to the crisis, focusing on five key areas of response: infrastructure and system design, medical care and treatment, disease prevention and control, economic and social resilience, and China's engagement in global health. This review demonstrates the effectiveness of a top-down command system at the national level, intersectoral coordination, a legal framework, and public social governance. This study also examines medical care and treatment strategies, highlighting the importance of rapid emergency response, evidence-based treatment, and well-planned vaccination rollout. Further discussion on disease prevention and control measures emphasizes the importance of adaptive measures, timely infection control, transmission interruption, population herd immunity, and technology applications. Socioeconomic impact was also assessed, detailing strategies for disease prevention, material supply, livelihood preservation, and social economy revival. Lastly, we examine China's contributions to the global health community, with a focus on knowledge-sharing, information exchange, and multilateral assistance. While it is true that each nation's response must be tailored to its own context, there are universal lessons to be drawn from China's approach. These insights are pivotal for enhancing global health security, especially as the world navigates evolving health crises.

Mediating Role of Job Satisfaction in the Relationship Between Leisure-Time Physical Activity and Emotional State of Healthcare Workers: A Cross-Sectional Survey

BACKGROUND

Work-related stress among healthcare employees can lead to burnout, worsened mood, and job dissatisfaction. Although physical activity is known to enhance mood and mental health, its impact on job satisfaction and emotional well-being in healthcare workers is under-researched. This study aimed to explore the associations between leisure-time physical activity (LTPA), job satisfaction, and emotional state and to investigate the mediating role of job satisfaction in the effect of LTPA on the emotional state of healthcare workers.

METHODS

A self-administered questionnaire, including items on LTPA, job satisfaction, and the emotional state, was distributed to 98 healthcare workers affiliated with the Bari Polyclinic Hospital (Mean age = 46.3; SD = 15.4 years). Composite measures of global job satisfaction and emotional state were extracted by Factor Analysis using the principal components method. The relationship between LTPA, job satisfaction, and the emotional state was investigated through General Linear Model (GLM) mediation models.

RESULTS

There was no significant direct effect of LTPA on negative emotional states (β = -0.08, p = 0.37). However, job satisfaction significantly mediated this relationship (β = -0.09, p = 0.04), indicating that engaging in LTPA increased job satisfaction, which in turn reduced negative emotional states. Similarly, LTPA did not have a significant direct effect on positive emotional states (β = 0.06, p = 0.48), but it indirectly resulted in increased positive emotional states through its positive impact on job satisfaction (β = 0.12, p = 0.03).

CONCLUSIONS

The findings indicate that LTPA indirectly influences both negative and positive emotional states through job satisfaction. Engaging in LTPA enhances job satisfaction, which subsequently leads to reductions in negative emotional states and increases in positive emotional states among healthcare workers. These results underscore the importance of promoting physical activity as a strategy to improve job satisfaction (JS) and the emotional well-being of healthcare workers.