The Association between Mental Health Symptoms and Quality and Safety of Patient Care before and during COVID-19 among Canadian Nurses

'Breakdown and healing' - adaptation experiences of postpartum nurses returning to work: a descriptive phenomenological study

BACKGROUND

Promoting the work adaptation of nurses returning to work after childbirth is key to improving their physical and mental health and ensuring the quality of nursing care. Although postpartum nurses have reported high work stress and poor adaptation after returning to work, little is known regarding the experiences, problems and further needs. This study aimed to explore the adaptation experiences of postpartum nurses returning to work.

METHODS

This was a qualitative study with descriptive phenomenological approach. Individual semi-structured interviews were conducted between March and May 2023 in four tertiary hospitals in Changsha, mainland China, which were selected using convenience sampling. A total of 16 postpartum nurses returning to work within one year were recruited using purposive sampling and maximum variation sampling. The interviews were analysed using the Colaizzi's 7-step method.

RESULTS

'Breakdown and healing' is a strong thread in postpartum nurses' work adaptation. It links 13 subthemes in the interview data, which can be grouped under three overarching themes: (a) changes and challenges of multiple roles; (b) self-coping and social support; and (c) further needs after returning to work. The phrase 'breakdown and healing' reflects the mutual relationship between stress and coping among postpartum nurses. The changes and challenges associated with being required to fulfil multiple roles of mothers, wives and nurses make the subjects feel on the verge of 'breakdown'. When returning to work, most of them move slowly towards 'healing' through positive self-management and support from their partners, families, supervisors and colleagues. Moreover, their ongoing demands and unsolved problems - such as their desire for a workplace that is friendly and serves their needs - were generated by the constant process of 'breakdown and healing'.

CONCLUSIONS

Understanding how postpartum nurses returning to work perceive adaptation experiences is essential for nursing managers, who can use the findings to implement targeted measures to shorten postpartum nurses' maladaptation period after returning to work and promote their work adaptation. This study underscores the critical importance of personalized return-to-work training, flexible work arrangements, support from colleagues and managers, well-established maternal facilities and services, and targeted policy efforts in enhancing postpartum nurses' work adaptation.

Shared Trauma: An evolutionary model concept analysis in light of COVID-19

Shared trauma (ST) is a term historically applied to social work experiences, but other healthcare professionals (HCP) also experience ST. With the occurrence of COVID-19, ST has impacted HCP globally and has led to new discoveries and more questions regarding its scope, impact and duration. This article aims to explore the concept of ST applied to nurses in light of COVID-19 using the Rogers and Knafl Evolutionary Model for Concept Analysis. Further examination and evolution of 'shared trauma', particularly during COVID-19, has led to the development of an adapted model to explore the implications of ST on health-related outcomes for nurses.

An Intersectional Analysis of Moral Distress and Intention to Leave Employment Among Long-Term Care Providers in British Columbia

Objectives: In this study, we aimed to explore the relationship between intersectional inequities and moral distress among those working in Long-Term Care (LTC) in British Columbia, Canada. Methods: This was a cross-sectional and retrospective study. We assessed moral distress, of 1678 respondents, using a modified Moral Distress Scale, and an equivalent distress mitigation score, at the intersections of gender and racial/ethnic identity. Then, we explored which worker attributes were more predictive of intention to leave work. Results: We found notable difference in experiences of moral distress across intersecting identities, including high moral distress scores among Indigenous men and women, and white women. Significant differences in mitigation scores were also found by intersectional identities. Discussion: Moral distress was the most important predictor of intention to leave work. The differences across racial and gender identity groups suggest the need for tailored interventions to address moral distress among LTC providers.

Postpandemic fear of COVID-19, psychological distress, and resilient coping among frontline health workers in Ghana: An analytical cross-sectional study

Background and Aims

The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the psychological well-being of healthcare workers globally. However, little is known about the mental health state of frontline health workers in the postpandemic era. The purpose of this study was to examine postpandemic COVID-19-related psychological distress and fear among frontline health workers in Ghana.

Methods

Data were collected from 245 frontline healthcare workers in the Western region of Ghana. COVID-19-related fear, psychological distress, and resilient coping were assessed with the fear of COVID-19 scale, Kessler Psychological Distress Scale, and the Brief Resilient Coping Scale, respectively. Multiple linear regression was used to assess the association between psychological distress and fear of COVID-19 as well as the moderating effects of resilient coping.

Results

Participants were mostly female (57.1%), aged between 21 and 30 years (50.6%), and not married (58.0%). We found that 52.2% of frontline healthcare workers experienced mild-to-severe fear, while 40% experienced psychological distress. Fear of COVID-19, previous contact with COVID-19 patients, and earning a monthly income between 501 and 1000 Ghanaian cedis were significantly associated with higher psychological distress. The positive association between fear of COVID-19 and psychological distress was stronger among frontline health workers who had higher resilient coping.

Conclusion

There is the need to provide frontline health workers with mental health support services to promote their psychological well-being and enhance their ability to provide quality care during the postpandemic era.

Stressors and learned resourcefulness in baccalaureate nursing students: a longitudinal study

OBJECTIVE

This correlational longitudinal study examined levels and relationships of Learned Resourcefulness (LR), stressors, and academic performance in baccalaureate nursing students at a North Carolina university.

METHOD

Gadzella's Student-life Stress Inventory (SSI) and Rosenbaum's Self-Control Scale (SCS) administered to 85 students in two groups upon admission and graduation.

RESULTS

LR increased, while stress decreased significantly in both groups (p < 0.05). Both groups (95.3% female, 85.8% Caucasian) reported similarly high frustration, pressure, and emotional reactions to stress. Significant relationship between taking tests and stress (p < 0.01). Stressors (p < 0.05) and age (p < 0.01) significant predictors of academic performance. Significant correlations of LR and work status (p < 0.01), and increased self-esteem (p < 0.05). No significant relationships among LR, stressors, and academic performance.

CONCLUSION

Results validate high levels of stress and suggest that higher LR enhances coping skills and decreases stress longitudinally, which can improve academic performance and retention.

IMPLICATIONS FOR INTERNATIONAL AUDIENCE

Trends and relationships in stressors and LR should be explored internationally in larger, more diverse samples of college students in nursing and other majors in relation to depression, anxiety, health-related behaviors, demographics, and academic performance. LR can be assessed, taught, learned, and enhanced. Greater numbers of qualified, competent nursing graduates with stronger clinical judgment, coping, and problem-solving skills will address the critical global nursing shortage and improve the quality, safety, and access of health care worldwide.

Exploring Nurses’ Working Experiences during the First Wave of COVID-19 Outbreak

During the COVID-19 outbreak, nurses employed in the clinical sector faced a number of difficulties associated with excessive workload, increased stress, and role ambiguity, which impacted nurses themselves and patient care. The aim of the present study was to investigate how Greek hospital nurses working in non-COVID units experienced the virus outbreak during the first wave of the pandemic. A descriptive qualitative research design was applied using a content analysis approach. To recruit the study participants a purposive sampling strategy was used. Ten nurses participated in the study. Data collection was conducted through semi-structured interviews. Content analysis revealed three themes namely, (a) emotional burden, (b) professional commitment, and (c) abrupt changes. Six subthemes were formulated and assimilated under each main theme respectively. Organizational changes, emotional burdens and feelings of fear and uncertainty, appeared to have a crucial effect on nurses and patient care. However, the professional commitment and the nurses’ effort to provide excellent nursing care remained high. Nurses demonstrated that despite the burdens caused by the COVID-19 outbreak, the pandemic era created opportunities for thoroughness and accuracy in nursing care.