Adaptation to Change Questionnaire for Nurses: Validation and New Needs in the Context of COVID-19

Network analysis of resilience, anxiety and depression in clinical nurses

BACKGROUND

Resilience is a protective feature against anxiety and depression disorders. However, the precise relationship and structure of resilience and anxiety and depression remain poorly understood. This study sought to investigate the link among resilience' components and anxiety as well as depression.

METHODS

1,279 clinical nurses were recruited. 10-item Connor-Davidson Resilience Scale, Generalized Anxiety Disorder 7, and Patient Health Questionnaire 9 were employed to evaluate resilience, anxiety, and depression, respectively. The regularized partial-correlation network was generated utilizing data from cross-sectional survey and the bridge expected influence index was utilized to quantify bridge components.

RESULTS

The rates of anxiety and depression within clinical nurses were 67.3% and 67.2%, accordingly. Four strongest bridge edges appeared in the resilience-anxiety network, like "Adapt to change"- "Fear that something might happen", and "Stay focused under pressure"- "Uncontrollable worry". Two strongest bridge edges appeared in the resilience-depression network, like "Adapt to change"- "Concentration difficulties" and "Stay focused under pressure"- "Fatigue". "Adapt to change" was recognized as bridging nodes in both the resilience-anxiety network and the resilience-depression network.

CONCLUSIONS

Interventions targeting the bridge component "Adapt to change" within resilience, may mitigate the intensity of anxiety and depression symptoms among clinical nurses.

Interpersonal competence as a moderator in the relation between occupational stress and organizational adaptation among nurses: A cross-sectional study

Purpose

This study examined the relationship between occupational stress and organizational adaptation among nurses and analyzed the moderating effects of interpersonal competence on this association.

Background

In the rapidly changing medical industry, nurses must adapt to their healthcare organizations and competently provide care. Higher levels of stress in nurses, which have been reported recently, can decrease their organizational adaption levels. This highlights the need for more research examining ways to address the impacts of nurses' occupational stress on organizational adaptation. Since interpersonal competence has been shown to mitigate the negative consequences of job stress, we hypothesized that improved interpersonal competence would moderate the relationship between occupational stress and organizational adaptation.

Design and methods

We employed a cross-sectional study design using online survey data from 500 nurses in Korea, recruiting participants through a recruitment advertisement on a mobile application widely used by nurses. We used descriptive statistics and multiple linear regression to conduct our data analysis, testing eight models to fit occupational stress (7 subdomains and overall), interpersonal competence, organizational adaptation, and the interaction term (stress*interpersonal competence) while controlling for demographic variables.

Results

Of the 500 sampled nurses, most were female with a mean age of 27 and four years of nursing work experience. All models tested were significant, explaining 52-61 % of the variance in organizational adaptation. As hypothesized, our analysis revealed negative relationships between occupational stress (overall and subdomain scores) and organizational adaptation. Nurses' interpersonal competence had significant moderating effects on the negative relationships between all subdomains of occupational stress and organizational adaptation, except job insecurity and interpersonal conflict.

Conclusions

To raise nurses' organizational adaptation levels, stakeholders should address occupational stressors. Cultivating interpersonal competence will alleviate the negative impacts of stress in nurses. Stakeholders should acknowledge the importance of interpersonal competence for nurses and prioritize providing continuing education in schools and hospitals to foster interpersonal competence.

The Impact of SARS-CoV-2 Pandemic on Patients Undergoing Radiation Therapy for Advanced Cervical Cancer at a Romanian Academic Center: A Four-Year Retrospective Analysis

Background and Objectives: Throughout the COVID-19 pandemic, health systems worldwide adapted to support COVID-19 patients while continuing to provide assistance to patients with other potentially fatal illnesses. While patients with cancer may be at an elevated risk of severe COVID-19-related complications, their oncologic therapies generally cannot be postponed indefinitely without a negative effect on outcomes. Taking this into account, a thorough examination of the therapy management of various cancers is necessary, such as cervical cancer. Therefore, we aimed to develop a retrospective cohort study to measure the impact of the COVID-19 pandemic on the delivery of cancer care services for women diagnosed with cervical cancer staged IB2-IVA, necessitating chemo- and radiotherapy in Romania, as well as determine the difference in cervical cancer staging between the pandemic and pre-pandemic period. Materials and Methods: Using a multicentric hospital database, we designed a retrospective study to compare the last 24 months of the pre-pandemic period to the first 24 months of the SARS-CoV-2 pandemic to evaluate the variation in the proportion of women diagnosed with cervical cancer and the percentage of inoperable cases requiring chemotherapy and radiotherapy, as well as to detail their clinical presentation and other findings. Results: We observed that the likelihood of cervical cancer patients requiring radiation therapy at a later stage than before the pandemic increased by about 20% during the COVID-19 pandemic. Patients at an advanced FIGO stage of cervical cancer had a 3.39 higher likelihood of disease progression after radiotherapy (CI [2.06−4.21], p-value < 0.001), followed by tumor size at diagnosis with a hazard ratio (HR) of 3.12 (CI [2.24−4.00], p-value < 0.001). The factors related to the COVID-19 pandemic, postponed treatment and missed appointments, were also identified as significant risk factors for cervical cancer progression (HR = 2.51 and HR = 2.24, respectively). Conclusions We predict that there will be a considerable rise in cervical cancer cases over the next several years based on existing data and that expanding screening and treatment capacity will attenuate this with a minimal increase in morbidity and fatality.

The COVID-19 Pandemic and Professional Nursing Practice in the Context of Hospitals

The COVID-19 pandemic has imposed challenges to health systems and institutions, which had to quickly create conditions to meet the growing health needs of the population. Thus, this study aimed to assess the impact of COVID-19 on professional nursing practice environments and to identify the variables that affected their quality. Quantitative, observational study, conducted in 16 Portuguese hospitals, with 1575 nurses. Data were collected using a questionnaire and participants responded to two different moments in time: the pre-pandemic period and after the fourth critical period of COVID-19. The pandemic had a positive impact on the Structure and Outcome components, and a negative trend in the Process component. The variables associated with the qualification of the components and their dimensions were predominantly: work context, the exercise of functions in areas of assistance to COVID-19 patients, length of professional experience and length of experience in the service. The investment in professional practice environments impacted the improvement of organizational factors, supporting the development of nurses' work towards the quality of care. However, it is necessary to invest in nurses' participation, involvement and professional qualifications, which are aspects strongly dependent on the institutions' management strategies.