Depression, Anxiety and Symptoms of Stress among Hong Kong Nurses: A Cross-sectional Study

Moral injury and mental health outcomes in nurses: A systematic review

Introduction: Moral injury involves the adverse psychological, biological, spiritual, behavioural, and social consequences of actions that violate moral values. It can lead to anxiety, depression, burnout, and post-traumatic stress disorder. Nurses, who often face ethical dilemmas, are particularly vulnerable. Despite its significance, the relationship between moral injury and mental health outcomes in nurses remains underexplored. Aim: This systematic review aimed to describe the associations among moral injury, anxiety, depression, and quality of life in nurses. Methods: The review was registered in PROSPERO (CRD42023438731) and was conducted following the PRISMA guidelines. A literature search was performed in December 2023 across PubMed, CINAHL, Scopus, and Web of Science. Peer-reviewed primary research involving nurses, published in English or Italian, without time restrictions, was considered eligible. The risk of bias and the quality of evidence were assessed using the Joanna Briggs Institute checklist and the GRADE approach. Results: Out of 4730 articles identified, eight met the inclusion criteria. The analysis revealed significant positive associations between moral injury, anxiety, and depression, along with a significant negative association with quality of life. Conclusion: These findings highlight the need for healthcare systems to implement strategies that mitigate moral injury among nurses. Future research should prioritize longitudinal studies to explore causal relationships and develop targeted interventions. Additionally, standardizing the concept and measurements of moral injury is crucial for enhancing the comparability and understanding of this phenomenon.

The role of mental health in the relationship between nursing care satisfaction with nurse-patient relational care in Chinese emergency department nursing

BACKGROUND

The relationship between a nurse and a patient is a key part of nursing that can impact how happy the patient is with the care they receive. It appears that the nurse's mental health can also affect this connection. However, there is little research on this topic. So, the aim of the present study was to determine the correlation of nurse's mental health with nurse-patient relational care and nursing care satisfaction.

METHODS

A total of 532 nurses and 532 patients from 13 Level-III hospitals of Hubei province (China) completed a China Mental Health Survey, general information questionnaire, the Nursing Care Satisfaction Scale, and Relational Care Scale.

RESULTS

Age, nurse working years, and night shift last month were correlated with mental health score (r = -0.142, r = -0.150, r = 0.164, p < 0.05). Nurse's mental health was correlated with relational care score and nursing care satisfaction score (r = -0.177, r = -0.325, p < 0.05). Also, relational care score, patients age and gender were correlated with nursing care satisfaction score (r = 0.584 and r = 0.143, x2 = 11.636, p < 0.05). Descriptive information of nurses had a direct impact on nurses' mental health (direct effect = 0.612, 0.419-0.713). Nurses' mental health had a direct effect on relational care score (direct effect = 0.493, 0.298-0.428) and an indirect effect on nursing care satisfaction score (indirect effect = 0.051, 0.032-0.074). Relational care score and patient's descriptive information had also a direct effect on nursing care satisfaction score (direct effect = 0.232, 0.057-0.172 and 0.057, 0.347-0.493).

CONCLUSION

This study showed that the better the mental health of nurses, the more patients feel satisfied with nursing services.

An Intervention to Improve Mental and Physical Health of Undergraduate Nursing Students

BACKGROUND

Nursing students experience poorer mental and physical health relative to students in other health-related disciplines and young adults of similar age outside post-secondary school. Compromised mental and physical health has numerous negative impacts on nursing students and can result in burnout and development of chronic diseases.

PURPOSE

To determine whether an asynchronous online yoga intervention would improve mental and physical health of students.

METHODS

An asynchronous online 6-week yoga intervention was carried out between January and December 2021, using a pre/post design. Participants' symptoms of depression, anxiety, stress, and self-compassion were assessed using the Depression, Anxiety, and Stress Scale and Self-Compassion Scale and core endurance was assessed using the Mackenzie Core Endurance Test prior to commencement and at the conclusion of the program.

RESULTS

Of 114 participants, 68 completed the online program and pre and post measures showed that the mean depression, anxiety, stress, self-compassion and core endurance scores improved significantly (p<0.001) between baseline and study completion.

CONCLUSION

A six-week virtual yoga program significantly improved mental and physical health of undergraduate nursing students. Targeted modifications to the yoga program might enhance participant retention.

The Effect of Laughter Yoga Applied to Intensive Care Nurses on Their Perceived Stress, Job Motivation, and Mental Well-being: Randomized Controlled Study

AIM

The aim of this study was to examine the effect of laughter yoga applied to intensive care nurses on perceived stress, job motivation, and mental well-being.

DESIGN

This study was a randomized controlled trial.

METHODS

The study was conducted with nurses working at the university hospital's surgical intensive care and anesthesia intensive care units of the third-level intensive care unit in Turkey. Data obtained from 30 participants in the intervention group and 33 participants in the control group were analyzed. The Nurse Introduction Form, Nurse Job Motivation Scale, Perceived Stress Scale, and Warwick-Edinburgh Mental Well-being Scale were used to collect data. Data obtained from the study were evaluated using the SPSS 22.0 package.

RESULTS

It was determined that there was no statistically significant difference in the average scores of the pretest/posttest 1/posttest 2 of the Perceived Stress Scale (13.70 ± 3.33 to 14.57 ± 4.57, P > .05; 13.50 ± 3.15 to 13.48 ± 4.59, P > .05; and 13.56 ± 3.15 to 13.15 ± 3.49, P > .05, respectively) and Work Motivation Scale (59.70 ± 7.58 to 59.69 ± 7.98, P > .05; 60.30 ± 8.07 to 58.48 ± 8.94, P > .05; and 60.56 ± 7.86 to 57.93 ± 9.54, P > .05, respectively) for both the intervention and control groups of nurses. A statistically significant difference was found in the average scores of the Warwick-Edinburgh Mental Well-Being Scale pretest/posttest 1/posttest 2 for the intervention group of nurses (50.90 ± 7.60, 51.50 ± 7.80, and 53.70 ± 7.08, respectively; F = 3.330, P = .043). However, the difference was found to be insignificant in pairwise comparisons in the further analysis (a = b = c). It was determined that there was no statistically significant difference in the average scores of the Warwick-Edinburgh Mental Well-Being Scale pretest/posttest 1/posttest 2 for the control group of nurses (52.21 ± 9.89, 51.93 ± 10.45, and 51.03 ± 9.63, respectively; P > .05).

CONCLUSIONS

The application of laughter yoga on intensive care nurses did not result in a significant change in perceived stress levels and work motivation. However, statistically significant differences were observed in the average mental well-being scores among the intervention group.

Factors associated with workplace stress and health promotion behaviours among Chinese emergency nurses: A cross-sectional study

THE AIM

To explore and describe workplace stress levels and health-promoting behaviours reported by emergency nurses in China, and to investigate factors associated with workplace stress and health-promoting lifestyle behaviours among emergency nurses.

METHODS

A cross-sectional study was conducted between October 2019 and January 2020. Nurses (n = 1565) were recruited from the emergency departments of 54 hospitals within the Sichuan Province of West China. Each subject completed the Chinese versions of the Nurse Workplace Stress Scale, the Health-Promoting Lifestyle Profile (HPLP-II) and demographic questions. Linear regression analyses were used to identify associations between workplace stress and the health-promoting lifestyle and risk factors correlated with these two measurements.

RESULTS

Workplace stress was negatively associated with health-promoting behaviours. Linear regression analysis showed that gender, marital status, whether wages met expected standards and professional rank were found to be associated with health promotion behaviours; marital status, whether income met expected standards, the number of night shifts per month and health promotion behaviours were found to be associated with workplace stress.

CONCLUSION

Higher levels of workplace stress are associated with lower levels of engagement in health-promoting behaviours, suggesting the potential for reducing workplace stress through the adoption of healthier habits. Policies should prioritize workplace stress by promoting healthy lifestyle initiatives.

Factors associated with anxiety disorders among healthcare workers (HCWS) involved in the first wave of the COVID-19 pandemic

BACKGROUND

In a context of reorganization of the activity, of increase of the psychological, emotional and physical constraints of the nursing staff induced by the first wave of the COVID-19 pandemic, an increase of the anxiety disorders could occur.

OBJECTIVE

This study aims to assess the prevalence of anxiety disorders in healthcare workers (HCWs) by wards and to investigate medical, personal, and occupational factors associated with anxiety disorder.

METHODS

In France, in May 2020, a monocentric observational cross-sectional study was proposed to 285 HCWs of the University Hospital of Saint Etienne, working in 3 types of randomly selected care wards. Information was collected using an anonymous self-questionnaire offered to eligible HCWs. Validated questionnaires were used to assess anxiety (Hospital anxiety and Depression Scale) and burnout (Maslach Burnout Inventory).

RESULTS

Of the 164 HCWs who participated in the study (57% participation rate), 69 (42%) caregivers had anxious symptomatology. The prevalence of anxiety disorders did not differ significantly by type of wards. Anxiety disorders are significantly associated with occupational factors (increased COVID-19 stress level, increased emotional load, increased mental load, high work/life stress during confinement, emotional exhaustion and loss of empathy), with medical factors (medical history of anxiety disorders, psychotropic treatment and impaired sleep quality) and personal factors (concern about working conditions and/or media reports).

CONCLUSIONS

Preventive actions focusing on organizational factors could be carried out to reduce the emotional and mental load, the level of stress and the burnout of HCWs.

Common stressors, coping processes, and professional help-seeking of medical professionals in Hong Kong: A qualitative study

Despite the high prevalence of perceived stress and mental health problems among medical professionals (MPs), their professional help-seeking is extremely low. This qualitative study explored MPs' stressors, stress-coping, barriers and facilitators of professional help-seeking. 10 MPs (30% male, Mage = 34.8 years) were recruited by purposive-sampling for views from different roles/settings. Thematic analyses revealed five central stressors: emerging novel diseases, challenges from technology-advancement, patient-communication difficulties, lack of workplace mental health care culture, excessive workload/manpower shortage. Participants predominantly used peer support/supervision and de-stress activities for stress-coping. Five factors affecting professional help-seeking were time constraint versus flexibility, mental health stigma versus de-stigmatization, concern over confidentiality/anonymity versus sense of privacy, worry about damage on professional role versus least work disruption, doubts of service providers versus perceived efficacy. All participants indicated a preference for online mental health service delivery. Results reflected unmet needs and service gaps from MPs' perspectives for the development of future interventions.

Evaluation of Sleep Quality Among People Living With Type 2 Diabetes Mellitus in Taif, Saudi Arabia: A Cross-Sectional Study

BACKGROUND

 Type 2 diabetes mellitus (T2DM) is characterized by high blood glucose levels, which are highly associated with poor sleep quality, cardiovascular disease, and pathological changes. This research examines the relationship between sleep quality and T2DM and compares it with nondiabetics within the Taif community. The findings of this study will provide valuable insights and recommendations to enhance the overall health quality in Taif, Saudi Arabia.

METHODOLOGY

 A cross-sectional study was conducted on 547 patients with T2DM between December 1, 2023, and April 1, 2024, in Taif. The sleep quality was assessed using the Sleep Quality Questionnaire (SQQ). Data were collected using an online questionnaire with two parts: primary demographic data and an assessment of sleep quality using the SQQ.

RESULTS

 Our study enrolled 814 participants, including 547 with T2DM and 267 nondiabetics. Participants with T2DM had poorer sleep quality, with a median score of 21 vs. 25 (P < 0.001). Significant factors affecting sleep quality included gender (P = 0.002), marital status (P = 0.023), and job status (P = 0.023). Nondiabetics had better sleep quality (76%) than participants with T2DM (61.1%). Males, married, and employed individuals reported higher sleep quality scores.

CONCLUSIONS

 Research indicates that individuals with T2DM experience lower sleep quality than the general population, particularly among female, unmarried, and unemployed individuals. To enhance sleep quality in patients with T2DM, it is essential to increase awareness, provide education on proper sleep habits, and highlight the importance of effective diabetes management, screening for sleep disorders, and consistent monitoring.

Prevalence of depression and associated factors among obstetric care providers at public health facilities in the West Arsi Zone, Ethiopia: Cross-sectional study

BACKGROUND

Depression is a severe and treatable mental illness that significantly affects individuals' daily activities. Obstetric care providers are the most vulnerable group for depression because they work in an emergency to save two lives at a time, share the stress of women during labor, and are at great risk for contamination.

OBJECTIVES

To assess depression and associated factors among obstetric care providers working in public health facilities.

METHOD AND MATERIALS

A cross-sectional study was conducted among 423 obstetric care providers working in public health facilities found in the West Arsi Zone, Ethiopia, from June 1 to 30, 2023. Study participants were selected through a simple random sampling technique. A pretested, face-to-face interviewer-administered structured questionnaire was used to collect data. Bi-variable and multivariable logistic regression analyses were employed to identify factors associated with depression. The level of statistical significance was declared at P < 0.05 with a 95% CI.

CONCLUSIONS AND RESULTS

Overall, the prevalence of depression among obstetric care providers was 31.1% (95% CI: 26.6%, 35.5%). Marital status not in union (AOR = 2.86, 95%CI: 1.66, 4.94), working more than 40 hours per week (AOR = 2.21, 95%CI: 1.23, 3.75), current substance use (AOR = 2.73, 95%CI: 1.64, 4.56), not being satisfied with their job (AOR = 3.52, 95%CI: 2.05, 6.07) and having burnout symptoms (AOR = 5.11, 95%CI: 2.95, 8.83) were factors significantly associated with depression.

RECOMMENDATIONS

We recommend that health professionals take care of themselves and avoid substance use. We also recommended that stakeholders enhance job satisfaction and avoid burnout by implementing various programs, like raising wages for workers, increasing staff members, offering various benefits, and regularly monitoring issues that arise.

The impact of negative affects on the high prevalence of anxiety, depression and stress in healthcare professionals

BACKGROUND

Psychiatric disorders are the conditions that most contribute to incapacity worldwide. While many healthcare professionals adapt in dealing with various demands, others do not. How much of these conditions is associated with affective experience needs to be studied.

OBJECTIVE

Assess the prevalence of anxiety, depression, and stress while investigating the relationship between the presence of positive and negative affect in healthcare professionals.

METHODS

This study's convenience sample consisted of 975 providers (including nursing, physicians, and multidisciplinary team) and administrative professionals (service and supervision teams) working at a general private hospital in Brazil. Data were collected in 2019 through a socio-demographic questionnaire, the Depression Anxiety and Stress Scale (DASS-21), and the Positive and Negative Affect Schedule (PANAS-X). The results are shown through multinomial regression with odds ratio, 95% confidence interval, and P-value.

RESULTS

The prevalence of depression, anxiety, and stress was 49.4%, 46.1%, and 49.8%, respectively, showing high prevalence. It was observed that a high presence of negative affect is associated with a greater likelihood of developing anxiety, depression, and stress, while a high presence of positive affect is associated with a lower likelihood of depression and stress prevalence.

CONCLUSIONS

The high prevalence of anxiety, depression and stress in healthcare professionals is associated with the presence of negative affects. Mental disorders should be measured, and practices adopted to ensure well-being and job performance.

Characteristics and Risk Factors of Functional Dyspepsia Fulfilling the Rome IV Criteria Overlapping With Gastroesophageal Reflux Disease, Irritable Bowel Syndrome, and Functional Constipation in South China

Background/Aims

Functional dyspepsia (FD) overlapping with other gastrointestinal disorders are quite common. The characteristics of FD overlap in Chinese population with latest Rome IV criteria were unclear. This large-scale outpatient-based study assessed the characteristics of FD overlap in South China.

Methods

Consecutive FD patients visited the Gastroenterology Clinic at 2 tertiary medical centers in Hangzhou, China who fulfilled the Rome IV criteria were enrolled. Complete questionnaires related to the gastrointestinal symptoms (Rome IV criteria), Reflux Disease Questionnaire, anxiety and depression, quality of sleep and life, and demographic information were collected.

Results

Among the total of 3281 FD patients, 50.69% overlapped with gastroesophageal reflux disease, 21.46% overlapped with irritable bowel syndrome, 6.03% overlapped with functional constipation. FD overlap had higher proportion of single/divorced/widowed rate, high education level, being employed, drinking, night shift, unhealthy dietary habit than FD only (P < 0.05). They had higher frequency of consultation and economic burden, as well as lower scores in quality of life (P < 0.001). Multivariate logistic regression showed that increasing age, female, low body mass index, history of gastroenteritis, anxiety, depression, and poor sleep quality were independent risk factors for FD overlap.

Conclusions

FD overlap was quite common in China with high economic burden and poor quality of life, FD patients with history of gastroenteritis, anxiety, depression, and poor sleep quality were more likely to have overlap disorders. Awareness of the physical and psychosocial stressors in overlapping condition would help optimize the management of FD overlap in clinical practice.

Relationship Between Sleep Problems and Memory Impairment Among Nurses

BACKGROUND

Sleep problems are common among nurses and can lead to various health problems. Further, the relationship between multiple sleep problems and memory impairment in clinical nurses remains unknown. Therefore, in this study, we aimed to explore the relationship between sleep problems and memory impairment among nurses.

METHODS

Multistage cluster-stratified random sampling was performed from tertiary hospitals in Shandong, China. Overall, a total of 1833 nurses were included in the final analysis. The Chinese version of the Pittsburgh Sleep Quality Index and prospective and retrospective memory questionnaire were administered to the participants.

RESULTS

The sleep quality of the nurses decreased during the normal epidemic prevention and control period compared with that before the epidemic in terms of sleep duration, sleep efficiency, and sleep disturbances. Nurses who reported cumulative or specific sleep problems (e.g., high sleep latency, sleep disturbances, and daytime dysfunction) and those in the "daily disturbances" and "poor sleep quality" groups had a higher risk of memory impairment than the others.

CONCLUSION

Sleep problems might be important for memory impairment among nurses. These findings may help identify nurses at considerable risk of memory impairment in clinical practice.

Prevalence and sociodemographic factors of depression, anxiety and stress in Saudi Arabia: a survey of respiratory therapists

Background

Depression, anxiety and stress are prevalent among healthcare providers but limited data is available regarding respiratory therapists (RTs). This study aimed to assess the prevalence of depression, anxiety and stress, and identify the associated sociodemographic factors among RTs in Saudi Arabia.

Methods

A cross-sectional online survey was distributed to RTs in Saudi Arabia. Data were summarized using frequency and percentages. Stress, anxiety, and depression prevalence rates were expressed as proportions with 95% confidence intervals (CI). The associated factors of stress, anxiety, and depression were subjected to logistic regression.

Results

Overall, 988 (91%) RTs, 661 (66.9%) males, completed the online survey. The prevalence (95% CI) of depression, anxiety and stress among RTs was 81.3% (0.787, 0.837), 89.6% (0.875, 0.914), and 45.5% (0.424, 0.487), respectively. RT staff who were ≥41 years old, divorced, widowed or separated, or had > 10 years of clinical experience were more likely to experience stress. RTs who were (divorced, widowed or separated), did not live with their family, were current smokers, or worked the night shift were more likely to experience anxiety. RTs who were (divorced, widowed or separated), were current smokers, had >10 years of clinical experience were more likely to experience depression.

Conclusion

Stress, anxiety and depression are prevalent among RTs. Several sociodemographic factors are associated with the incidence of stress, anxiety and depression.

The effect of a mindfulness-based intervention on stress overload, depression, and mindfulness among nurses: A randomized controlled trial

BACKGROUND

Nurses experience various health-related issues due to the nature of their work.

AIM

This study aimed to examine the effect of a mindfulness-based intervention on stress overload, depression and mindfulness among nurses. A secondary objective was to examine the role of the setting (i.e., in and out of the hospital as a natural setting) on mindfulness-based intervention effectiveness.

METHODS

A randomized controlled trial with three groups' pretest-posttest design was used in this study. A total of 195 nurses were recruited-65 intervention-inside hospital, 60 intervention-outside hospital, and 63 control. The mindfulness-based intervention was delivered by a certified mindfulness practitioner over 4 weeks in Jordan. Data were collected using a demographics questionnaire, the Stress Overload Scale Short, the Center for Epidemiologic Studies Depression Scale-Revised, and the Five Facet Mindfulness Questionnaire.

RESULTS

Multivariate analysis showed a statistically significant effect of the intervention on the linear combination of the dependent variables V = 0.44, F[6, 368] = 17.56, p < .001. Follow-up analyses showed that a mindfulness-based intervention significantly decreased stress overload, depression, and increased mindfulness levels among nurses in intervention groups compared with the control group. In addition, conducting a mindfulness-based intervention outside the hospital has a better effect on mindfulness levels than the inside hospital.

LINKING EVIDENCE TO ACTION

The effect of a mindfulness-based intervention on stress overload, depression, and mindfulness should be considered when planning for nurses' well-being and the quality of care provided. Nurse managers are encouraged to use the study's findings to promote nurses' well-being.

Job satisfaction, depression severity and quality of life ratings of perioperative nurses in robotic-assisted and laparoscopic surgery

The rapid introduction of technological developments into healthcare systems adds another layer of complexity to the already demanding jobs of nurses, particularly for those working in perioperative care. In the present study, our primary aim is job satisfaction, whereas the secondary outcomes are psychological well-being and quality of life (QoL) ratings of perioperative nurses who take part in robotic-assisted and pure laparoscopic surgery. A total of 101 perioperative nurses in six different centers were included in the study. Fifty-one of the nurses were working in robotic-assisted laparoscopic surgery and 50 of them were working in pure laparoscopic surgery. All participants responded to Minnesota Job Satisfaction Questionnaire (MJSQ), Beck Depression Inventory (BDI) and SF-36 QoL Measurement Survey. The two groups did not differ in their total MJSQ, BDI and SF-36 QoL scores (pMJSQ:0.066, pBDI:0.329, pSF-36-QoL:0.136). In addition, there were no differences between the two groups in their intrinsic job satisfaction and extrinsic job satisfaction sub-scores (pintrinsic: 0.473, pextrinsic:0.121). Overall, 18.9% of the nurses reported having moderate to extreme depressive symptoms and most of them (87.1%) had low to moderate levels of job satisfaction. Finally, QoL ratings was generally at moderate levels. Perioperative nurses who work in robotic-assisted laparoscopic surgery do not differ from those working in pure laparoscopic surgery in terms of their job satisfaction, psychological well-being, and QoL ratings. In addition, across groups' psychological well-being, job satisfaction, and QoL ratings were not particularly high, suggesting that more attention needs to be paid to improving the work conditions of perioperative nurses.

Job demands and temporomandibular disorders: mediating and moderating effects of psychological distress and recovery experiences

OBJECTIVES

This study examined the relationship between recovery experience, job demands, psychological distress, and temporomandibular disorders (TMD) in Japanese workers.

METHODS

It used cross-sectional data from the fourth survey of a multi-wave longitudinal project, conducted using the registered monitors of an internet research company. Finally, 1278 respondents' data were analyzed (655 males, 623 females; mean [SD] age = 41.63 [10.31] years). We utilized Sugiaski's TMD screening question to assess TMD prevalence, Brief Job Stress Questionnaire to assess job demands, Kessler Psychological Distress Scale (K6) to assess psychological distress, and the Japanese version of the Recovery Experience Questionnaire to assess recovery experiences. The moderated mediation analysis was conducted using the Process macro program for SPSS developed by Preacher and Hayes, examining the effect of job demands on TMD through psychological distress, moderated by the recovery experience.

RESULTS

The results showed that 13.1% (n = 168) of the respondents had TMD. Mediation analysis indicated high job demands were associated with an increased TMD prevalence through psychological distress. The moderated mediation analysis revealed that relaxation and control moderated the relationship between job demands and psychological distress.

CONCLUSIONS

This cross-sectional study established the relationship between job demands, psychological distress, and TMD among Japanese workers. The findings suggest that increased job demands contribute to high TMD prevalence through the mediation of psychological distress, moderated by relaxation and control.

The moderating role of trait and state mindfulness between daily sleep and physical pain symptoms: an ecological momentary assessment and actigraphy study

Objective: Poorer sleep quality and insufficient sleep increase the risk of physical pain. The current study examined the daily associations between sleep and physical pain symptoms and tested the moderating role of trait and state mindfulness in this relationship. Methods: Sixty hospital nurses (Mage=35.4 ± 11.8 years) completed 14-day ecological momentary assessment (EMA) and sleep actigraphy. EMA measured physical pain frequency and interference (1×/day) and state mindfulness (3×/day). Multilevel modelling was used to examine the associations at the between-person and within-person levels. Results: After nights with poorer sleep quality, lower sleep sufficiency, and more insomnia symptoms, the frequency of physical pain symptoms and pain interference were greater than usual. Overall, those with poorer sleep quality, lower sleep sufficiency, and more insomnia symptoms reported more physical pain symptoms and greater pain interference. Higher state mindfulness buffered the negative within-person association between sleep efficiency and physical pain frequency. There was evidence that the joint moderating effects of trait and state mindfulness yielded more protective benefits in the relationship between sleep quality and physical pain than trait or state mindfulness alone. Conclusion: Even without mindfulness training, one's mindfulness may be protective against the adverse effects of poor sleep quality on physical pain.

Exploring the Association Between Behavioural Modification in Response to the Prevailing Economic Crisis and Mental Health Outcomes of Nurses from Teaching Hospitals, Sri Lanka

Introduction

The nursing profession is a cornerstone in the healthcare workforce. Yet, it remains vulnerable to severe mental health challenges, stemming from a complex interplay of social and occupational factors. It is evident that crisis situations have profound influence on the mental-wellbeing of nurses.

Objective

To explore the association between behavioural modification in response to the prevailing economic crisis and mental health outcomes of nurses from teaching hospitals, Sri Lanka.

Methods

This cross-sectional study was carried out among nursing professionals (n = 261) who are employed in distinct teaching hospitals (n = 7) in Sri Lanka. Considering the bed-capacity of each hospital, participants were purposively selected and invited to complete an online-based self-administered questionnaire to collect demographic characteristics and lifestyle modifications to deal with the economic crisis, while Depression, Anxiety, and Stress Scale (DASS-21) a set of three self-reported scales to assess the level of depression, anxiety, and stress, was used. Data was analyzed using the SPSS 23.0 version, Descriptive analysis was performed to present frequencies of both demographic characteristics and lifestyle and symptoms of depression, anxiety, and stress, while the Chi-square test was used to determine the association between selected independent variables and mental health outcomes. A multivariate regression model was performed to determine the predictors of mental health outcomes of the study participants.

Results

There were a total of 261 participants, 86.2% were married, and 66.2% had children. The proportion of mild to extreme depression, anxiety, and stress were 58.2%, 65.9%, and 72.0% respectively. In response to the economic challenges, 91.6% of study participants reported reducing expenditures on general household needs, while the proportion of participants who curtailed spending on food, monthly savings, and entertainment were 75.9%, 79.3%, and 73.6% respectively. Notably, 81.6% of participants initiated the process of applying for overseas employment, and 50.6% pursued academic programs to be eligible for foreign placements.

Conclusion

The present study observed a higher level of depression, anxiety and stress among nurses from teaching hospitals in Sri Lanka. It was noted that nurses had taken steps to respond to financial strain by reducing essential elements of their routine. Additionally, study participants chose to seek foreign placements as a solution to the economic burden, as a result just over half of the respondents completed an academic program in order to be qualified for jobs abroad. Further, these initiatives are significantly associated with negative emotional disorders of the participants. Therefore, interventions should be implemented to promote positive mental health outcomes of nursing professionals in Sri Lanka.

Anxiety Symptoms and Associated Psychological and Job-Related Factors Among Hospital Nurses

OBJECTIVE

Recently, burnout and mental health issues regarding nurses are reported increasingly. This study aimed to investigate the prevalence of anxiety symptoms among hospital nurses and determine their association with psychological and job-related factors.

METHODS

Data on demographics, job-related characteristics, burnout, Type A behavior patterns, self-esteem, and happiness were collected from 515 nurses working at a university hospital in Korea. Anxiety symptoms were assessed using the anxiety subscale of the Hospital Anxiety and Depression Scale, with scores of 8 or higher indicating the presence of anxiety symptoms. Demographic, job-related, and psychological factors were compared according to the presence of anxiety. Logistic regression was conducted to identify factors associated with anxiety symptoms.

RESULTS

Two hundred and four (39.6%) participants had anxiety symptoms. Self-esteem and happiness were associated with a lower risk of anxiety symptoms, whereas burnout was associated with a higher risk of anxiety symptoms. Furthermore, being female, having a career of less than five years, and requiring counseling due to stress were associated with a higher risk of anxiety symptoms. Being younger, female, or a basic nurse; having a career of less than five years; partaking in shift work; experiencing job dissatisfaction; requiring counseling due to stress; being exposed to higher levels of burnout; and having lower levels of self-esteem and happiness were all found to be significantly correlated with anxiety symptoms.

CONCLUSION

These findings suggest that promoting self-esteem and happiness while reducing burnout may be beneficial in preventing and managing anxiety symptoms among hospital nurses.

Nightmare distress, insomnia and resilience of nursing staff in the post-pandemic era

Introduction

The pandemic has led to notable psychological challenges among healthcare professionals, including nurses.

Objective

Our aims of this study were to assess insomnia and nightmare distress levels in nurses and investigate their association with mental resilience.

Methods

Nurses participated in an online survey, which included the Nightmare Distress Questionnaire (NDQ), Brief Resilience Scale (BRS) and Athens Insomnia Scale (AIS). Demographic information, such as age, professional experience and gender, was also collected.

Results

The study included 355 female and 78 male nurses. Findings revealed that 61.4% had abnormal AIS scores, 7% had abnormal NDQ scores and 25.4% had low BRS scores. Female nurses had higher AIS and NDQ scores but lower BRS scores compared to males. BRS demonstrated negative correlations with both AIS and NDQ. Multiple regression analysis indicated that NDQ accounted for 24% of the AIS variance, with an additional 6.5% explained by the BRS. BRS acted as a mediator, attenuating the impact of nightmares on insomnia, with gender moderating this relationship.

Conclusions

Nursing staff experienced heightened sleep disturbances during the pandemic, with nightmares and insomnia being prevalent. Nightmares significantly contributed to insomnia, but mental resilience played a vital role in mitigating this effect. Strategies are warranted to address the pandemic's psychological impact on nursing professionals.

Psychopathological Burden among Healthcare Workers during the COVID-19 Pandemic Compared to the Pre-Pandemic Period

This retrospective observational study on hospital staff requesting an "application visit" (from 2017 to 2022) at the Occupational Medicine department aimed at comparing a "pre-COVID group" (2017-2019) with a "COVID group" (2020-2022) regarding (a) sociodemographic data (i.e., age, sex, occupation, years of employment at the hospital), (b) rate and type of psychiatric diagnoses in both groups and rate of psychiatric diagnoses per subject, and (c) rate of drug/psychotherapeutic prescriptions. Two hundred and five healthcare workers (F = 73.7%; mean age = 50.7 ± 10.33) were visited. Compared with the pre-COVID group, healthcare workers evaluated during COVID-19 were significantly younger and reported fewer years of employment at the hospital. Although rates of primary psychiatric diagnoses were similar in both samples, an increased number of psychopathologies per subject and associated treatment prescriptions in the COVID group was observed. In the COVID group, 61% had one psychiatric diagnosis, and 28% had 2+ psychiatric diagnoses, compared with 83.8% and 6.7% of pre-COVID. Furthermore, 56.2%/1.9% in pre-COVID and 73%/6% in the COVID group were prescribed drugs/psychotherapy, respectively. The findings of the present study highlighted an increase in both younger workers' requests and psychiatric comorbidities during the pandemic, representing a burden on the Italian healthcare system. It is thus relevant to address the mental health challenges of healthcare workers accordingly.

Understanding nurse suicide using an ideation-to-action framework: An integrative review

OBJECTIVE

The purpose of this integrative review was to explore, appraise and synthesize the current literature on correlates of suicide risk in nurses.

DESIGN

Integrative literature review.

DATA SOURCES

Cumulative Index to Nursing and Allied Health Literature (CINAHL), Joanna Briggs Institute, PubMed, PsycInfo and Scopus electronic databases were searched for abstracts published between 2005 and 2020. Reference lists were hand searched.

REVIEW METHODS

The integrative review was based on the Whittemore and Knafl review methodology. Primary qualitative and quantitative studies about suicidal behaviour in nurses published in peer-reviewed journals were included. The methodological quality of included articles was assessed using the Mixed Methods Assessment Tool.

RESULTS

Separate correlates of risk and protective factors were identified for suicidal ideation, suicide attempt and death by suicide in nurses.

IMPLICATIONS

Due to a number of factors at the individual, interpersonal and work levels, nurses are uniquely positioned to be at risk of dying by suicide. The ideation-to-action framework provides a theoretical guide to understand the interplay between correlates and the effect it has on increasing a nurses' capability for suicide.

CONCLUSIONS

This review integrates the empirical literature to elucidate the concept of suicidal behaviour as it applies to nurses.

A cognitive-behavioral skills building program improves mental health and enhances healthy lifestyle behaviors in nurses and other hospital employees

BACKGROUND

Mental health outcomes in nurses have historically indicated a greater prevalence of anxiety, depression, and suicide than the general population. It is vital to provide programming for healthcare workers to gain the necessary skills to reduce burnout and improve their mental and physical health.

AIMS

The aims of this study were to evaluate mental health outcomes and healthy lifestyle beliefs and behaviors among nurses and other hospital employees who completed MINDBODYSTRONG, a cognitive-behavioral skill building program.

METHODS

A pre-experimental, pre- and poststudy design was used to examine mental health and well-being outcomes among 100 hospital personnel who participated in MINDBODYSTRONG, a program designed to improve coping and resiliency and decrease stress, anxiety, and depressive symptoms. Outcomes measured included healthy lifestyle behaviors, healthy lifestyle beliefs, anxiety, depression, stress, and burnout.

RESULTS

One hundred hospital personnel, including 93 nurses, completed the pre- and post-survey. Among all participants, post- MINDBODYSTRONG scores for healthy lifestyle beliefs (p = .00; Cohen's d = 0.52) and healthy lifestyle behaviors (p = .00; Cohen's d = -0.74) increased significantly with medium effects, while depression (p = .00; Cohen's d = -0.51), anxiety (p = .00; Cohen's d = -0.54), stress (p = .00; Cohen's d = -0.33), and burnout (p = .00; Cohen's d = -0.37) decreased significantly with small and medium effects. The program produced even stronger positive effects on mental health outcomes for participants who started the study with higher levels of depression and anxiety.

LINKING EVIDENCE TO PRACTICE

Anxiety, depression, stress, and burnout decreased significantly postintervention. Participants also significantly improved their healthy lifestyle beliefs and behaviors with the MINDBODYSTRONG program. MINDBODYSTRONG is an effective program that reduces anxiety, depression, burnout, and stress and improves healthy lifestyle beliefs and behaviors in hospital-based clinicians. It is of utmost importance to provide evidence-based programs to improve mental resiliency and decrease stress, anxiety, burnout, and depressive symptoms, which will ultimately improve the safety and quality of health care.

The relationship of stress coping styles on substance use, depressive symptoms, and personality traits of nurses in higher education institution

AIM

This study examined the collective characteristics of nurses and their stress coping style.

METHODS

We conducted a cluster analysis of the stress coping strategies of 841 nurses belonging to Dokkyo Medical University Hospital, as measured by the Brief COPE (Coping Orientation to Problems Experienced). We also conducted multivariate analyses of each cluster's sociodemographic characteristics, personality traits, depressive symptoms, work attitudes, sense of fairness, and turnover intention.

RESULTS

The results of cluster analysis using the standardized z scores of the Brief COPE demonstrated that the study participants were classified into three clusters. The "emotional-response type" tended to favor the use of emotional support, venting, and self-blame. The "reality-escape type" tended to prefer alcohol and substance use, behavioral resignation, use of instrumental support, and lack of acceptance. The "problem-solving type" tended to prefer planning, positive reframing, and acceptance and to dislike "alcohol and substance use" and behavioral disengagement. A multinomial logistic regression analysis revealed that compared to the problem-solving type, the emotional-response type had a lower job title, a higher "neuroticism" score on the TIPI-J, and a higher K6 score. However, compared to the problem-solving type, the reality-escape type was younger, consumed more alcohol and substances, and had a higher K6 score.

CONCLUSIONS

Stress coping styles were found to be associated with substance use, depressive symptoms, and personality traits among nurses in higher education institutions. Thus, the results suggest that nurses who choose maladaptive stress coping styles require mental support and early identification of depressive symptoms and alcohol problems.

Association between 14 candidate genes, PM2.5, and affective disorders: a study of the Taiwan Biobank

BACKGROUND

Most studies have focused on the risk factors, treatment, and care of affective psychosis, and several have reported a relationship between ambient air quality and this psychosis. Although an association has been reported between psychosis and genes, studies mainly explored the associations between one type of psychosis and one gene; few have identified genes related to affective psychosis. This study investigates the genetic and environmental factors of affective psychosis.

METHODS

In this retrospective longitudinal study, 27 604 participants aged 30-70 were selected from Taiwan Biobank. The participants' propensity scores were calculated based on their demographic information, and propensity score matching was performed to divide the participants into an experimental (i.e., affective psychosis) and control group at a 1:5 ratio. Plink was used to analyze the major and minor types of gene expression related to affective psychosis, and PM2.5 exposure was incorporated into the analyses.

RESULTS

According to the generalized estimating equation analysis results, 8 single nucleotide polymorphisms (SNPs) belonging to the ANK3, BDNF, CACNA1C, and GRID1 genotypes were significantly correlated with depressive disorder (P < .001), with the majority belonging to the ANK3 and CACNA1C. A total of 5 SNPs belonging to the CACNA1C, GRID1, and SIRT1 genotypes were significantly correlated with bipolar disorder (P < .001), with the majority belonging to the CACNA1C. No significant correlation was identified between ambient air pollution and affective psychosis.

CONCLUSIONS

CACNA1C and GRID1 are common SNP genotypes for depressive disorder and bipolar disorder and should be considered associated with affective psychosis.

Psychometric testing of the 10-item perceived stress scale for Chinese nurses

BACKGROUND

Nurses bear a lot of stressors at work. The 10-item Perceived Stress Scale (PSS-10) is a widely used self-reported scale for measuring the global perception of stress. However, there is a lack of use of the PSS-10 in Chinese nurses. This study aimed to test the psychometric properties of the PSS-10 among Chinese nurses.

METHODS

A total of 708 Chinese nurses completed the PSS-10, the Big Five Inventory (BFI), and the Depression Anxiety and Stress Scale (DASS). Confirmatory factor analysis (CFA) tested the factor structure of the PSS-10. Cronbach's α and test-retest correlation examined the scale reliability. Pearson correlation and hierarchical regression analyses tested the convergent, discriminant and criterion validity of the PSS-10.

RESULTS

CFA revealed that a two-factor model fits the structure of the PSS-10 in Chinese nurses (χ2/df = 6.25, p < 0.001; comparative fit index [CFI] = 0.94, non-normal fit index [NNFI] = 0.92, Tucker-Lewis index [TLI] = 0.91, root mean square error of approximation [RMSEA] = 0.08, standardized root mean square residual [SRMR] = 0.05). The scale demonstrated adequate internal consistency (α = 0.86) and test-retest reliability (r = 0.66, p < 0.001), satisfactory convergent and discriminant validity with relations to Big Five personalities, as well as good criterion validity such that the PSS-10 score could explain incremental variance in predicting anxiety, depression and stress.

CONCLUSIONS

Our findings suggest that PSS-10 is a reliable and valid measure of perceived stress among Chinese nurses and can be used in future research and practice on stress management and coping in Chinese nurses.

Work anxiety factors, coronavirus anxiety and job satisfaction of Polish nurses facing COVID-19 pandemic outbreak

BACKGROUND

During the SARS-CoV-2 pandemic, as in past disasters and emergencies, nurses around the world play an important role. What is more, the unprecedented pressure exerted by the pandemic on healthcare systems in every country brings big challenges to nurses, which may affect their well-being, work efficacy and job satisfaction.

OBJECTIVE

The main objective of the presented studies was to describe anxiety factors related to the work of nurses during the SARS-CoV-2 pandemic; to assess the intensity of coronavirus anxiety and job satisfaction experienced by nurses at that time; to assess predictors of job satisfaction of nurses during the COVID-19 pandemic; to assess the differences in the intensity of job satisfaction and coronavirus anxiety depending on the selected variables related to their experiences during the COVID-19 pandemic.

DESIGN

Anonymous questionnaire surveys were conducted online among the participants between 23 June 2020 and 23 March 2022 in Poland.

PARTICIPANTS

433 nurses from 15 Polish provinces were included in the studies (age range 22-68; M = 41.63). Nursing seniority M = 18.6.

METHODS

The studies were based on: Satisfaction with Job Scale (SSP), Coronavirus Anxiety Scale (CAS), and a self-report structured questionnaire.

RESULTS

The most respondents indicated that they were afraid of becoming infected with SARS-CoV-2 (25.4 %), transmitting infection to the family (22.4 %), becoming sick with COVID-19 and experiencing health complications (6.7 %) and of excessive work responsibilities and physical fatigue (6.5 %). Based on the bivariate correlation, it can be concluded that job satisfaction of the respondents during the COVID-19 pandemic was on an average level (M = 19.9); coronavirus anxiety was on an average level (M = 4.9), and stress at work was on a high level (M = 7.1). Coronavirus anxiety did not constitute statistically significant predictors of job satisfaction of subjects studied during the pandemic (SE = 0,048; β = 0,05; p = 0.942).

CONCLUSIONS

Coronavirus anxiety wasn't associated with job satisfaction of nurses directly. Job satisfaction of nurses during the COVID-19 pandemic was likely to be shaped by a range of different factors.

TWEETABLE ABSTRACT

In Polish nurses coronavirus anxiety was average and wasn't associated with their job satisfaction.

Predictors of Suicide Risk and Mental Health Outcomes among Hong Kong Veterinarians: A Cross-Sectional Study

The professional quality of life (ProQOL) in the veterinary profession has gained increasing attention, yet little is known about its association with the mental health status of Hong Kong veterinarians. This study aimed to examine the impact of elements that make up ProQOL on the risk of suicide, depression, and anxiety among Hong Kong veterinarians. All veterinarians registered and practicing in Hong Kong at the time of recruitment were eligible to take part in the e-survey study between 1 January and 31 March 2022. Binary logistic regression was used to analyze the data from 56 participants. The results showed that 22.0% of the participants were at risk of suicide, 19.6% had current suicidal ideation, 29.4% had depression, and 29.4% had anxiety symptoms. The findings suggested poor mental health status among Hong Kong veterinarians and were comparable to or more prevalent than those reported in Anglophone and European countries. Results from the binary logistic regression suggested that burnout was a predictor of depressive symptoms, and that secondary traumatic stress showed potential in predicting suicide risk. Our study, however, did not find conclusive evidence supporting compassion satisfaction as a predictor of reduced symptoms of common mental issues. Further investigation into contextual factors affecting the mental health of veterinarians in Hong Kong is warranted. Improving the profession's mental health literacy and self-efficacy should be prioritized as a suicide prevention strategy to enhance mental health awareness.

Cytokine associated with severity of depressive symptoms in female nurses in Korea

Background

Depression has been associated with the risk of developing physical illnesses and diseases. Inflammatory hypotheses of immunoactive and dysregulated cytokine production have been proposed to describe this association; however, data pertaining to the high prevalence of depression among nurses are limited.

Objective

This study aimed to use a comprehensive immune-profiling approach to determine whether an abnormal profile of circulating cytokines could be identified in nurses with self-reported depression and whether this profile is associated with the severity of depression.

Methods

We investigated a cohort of 157 female nurses in Korea. The self-report Patient Health Questionnaire was used to measure the depression levels of nurses. In addition, peripheral blood samples were collected and used to measure the cytokine profile using the Luminex multiplexing system. Generalized gamma regression analyses were conducted to evaluate the association between cytokine and depressive symptoms.

Results

Regarding severity of depressive symptoms, 28.0% of nurses had moderately severe depression while 9.6% had severe depression. Moderately-severe depressive symptoms in nurses were associated with elevated levels of interleukin-6 (B = 0.460, p = 0.003), interleukin-8 (B = 0.273, p = 0.001), and interleukin-18 (B = 0.236, p = 0.023), whereas interferon-gamma levels (B = -0.585, p = 0.003) showed the opposite profile. Participants with severe depressive symptoms presented decreased interferon-gamma levels (B = -1.254, p < 0.001).

Conclusion

This study demonstrated that proinflammatory cytokines were associated with depression among nurses. This calls for early detection and intervention, considering the mechanisms linking depression to physical illness and disease.

Correlations between childhood trauma and depression, anxiety, and stress levels in nurses

AIMS

This study aims to determine correlations between childhood trauma and depression, anxiety, and stress levels in nurses.

METHODS

This cross-sectional study was conducted among nurses in Turkey from August to September 2022. A total of 395 nurses were included in the study. Data were collected through an online survey using a personal information form, the Childhood Trauma Questionnaire (CTQ-28), and the Depression, Anxiety, and Stress Scale (DASS 21).

RESULTS

The mean score of the CTQ-28 total scale was 51.6, and emotional neglect was the most common type of abuse. The prevalence of moderate-to-extremely severe depression, anxiety, and stress was 34.7 %, 42.2 %, and 18.3 %, respectively. Emotional abuse and emotional neglect subscales of the CTQ were independently related to all three DASS subscale scores.

CONCLUSION

This study revealed that the emotional abuse and neglect experienced in childhood are related to the nurses' current stress, anxiety, and depression levels.

Translation and validation of the Turkish forms of the International Depression Questionnaire (IDQ) and the International Anxiety Questionnaire (IAQ)

BACKGROUND

The 11th version of the International Classification of Diseases (ICD-11) included revised formulations of single episode depressive disorder (DD) and generalized anxiety disorder (GAD). Consequently, the International Depression Questionnaire (IDQ) and International Anxiety Questionnaire (IAQ) have been developed as self-report measures which directly align with the ICD-11 description of DD and GAD, respectively.

OBJECTIVE

The current study sought to (1) test the factorial validity of the Turkish translations of the IDQ and IAQ, (2) evaluate their internal reliability, (3) determine how meeting diagnostic requirements for ICD-11 DD and ICD-11 GAD vary across different demographic variables, and (4) determine the convergent validity of the Turkish translations of the IDQ and IAQ.

METHODS

Participants were a community sample of 1455 Turkish adults and largely comprised of university students. This study used confirmatory factor analysis (CFA) to test the latent structure of both scales. Prevalence rates of ICD-11 GAD and DD were also estimated, and differences in prevalence rates according to gender and relationship status were examined.

RESULTS

The CFA results indicated that both scales were unidimensional. Both scales demonstrated high levels of internal consistency. The prevalence of ICD-11 DD and GAD was 26.6 % and 28.5 %, respectively. Rates of probable ICD-11 DD and GAD were highest for females and single participants. Convergent validity was indicated by strong associations with external measures of depression and anxiety.

CONCLUSION

Findings from this study provide support for the validity and reliability of the Turkish versions of the IDQ and IAQ in a large community sample.

Feeling stressed and depressed? A three-wave follow-up study of the beneficial effects of voluntary work

While symptoms of stress are a major risk factor in the onset of depressive symptoms and major depression, a better understanding of intervening mechanisms in breaking down this positive association is urgently required. It is within this literature that we investigate (1) how symptoms of stress are associated with depressive symptoms and the onset of major depression, and (2) the buffering effect of hours spent on voluntary work on the stress-depression relationship. Using 3-wave longitudinal data, we estimated a direct and reverse auto-regressive path model. We found both cross-sectional and longitudinal support for the positive association between symptoms of stress and depressive symptoms. Next, we found that individuals who experienced more symptoms of stress at T1, T2, and T3 were 1.64 (95%CI [1.46;1.91]), 1.49 (95%CI [1.24;1.74]), and 1.40 (95%CI [1.21;1.60]) times more likely to be prescribed an anti-depression treatment at T3, respectively. Moreover, we found that the number of hours spent volunteering mitigated the (1) longitudinal-but not cross-sectional-stress-depression relationship, and (2) cross-sectional-but not the longitudinal-association between symptoms of stress at T3 and the likelihood of being prescribed an anti-depression treatment. These results point toward the pivotal role of voluntary work in reducing the development of depressive symptoms and major depression in relation to the experience of symptoms of stress.

Assessment of mental health status among Chinese nursing staff in the intensive care unit: a network analysis

Backgrounds

Nursing is the key group to provide healthcare services, and it is easy for nursing staff to develop mental health problems.

Aims

The study aimed to evaluate prevalence of psychological symptoms in nurses working in an intensive care unit (ICU) and the inter-relationship of associations of psychological symptoms using network analysis.

Methods

This study is a cross-sectional design study. The Chinese version of the Symptom Check List-90 (SCL-90) was used to measure the psychological status of ICU nurses. The network structure of psychological symptoms was characterised, and indices of 'Expected influence' were used to identify symptoms central to the network. Network stability was examined using a case-dropping bootstrap procedure.

Results

Multiple logistic regression analysis found those who had worked more than 15 years were less likely to experience positive psychological symptoms, whereas nurses working in emergency ICU and other ICUs, nurses working in departments with over 16 beds were more likely to develop psychological symptoms. In addition, 'Anxiety', 'Mental degeneration' and 'Depression' were central symptoms in the network.

Conclusions

ICU nurses reported a high level of psychological symptoms, which may affect the quality of their work and worsen public health problems.

Psychological problems and associated factors among high school students during COVID-19 pandemic in Sawla town, Gofa zone, southern Ethiopia

Background

Depression, anxiety, and stress (DAS) are common among high school students, and they have a negative impact on their academic performance and future lives. Pandemics, such as coronavirus disease 2019 (COVID-19), exacerbate these issues. Although psychological problems are studied in developed countries, they are overlooked in developing countries such as Ethiopia. Therefore, this study was aimed to assess the prevalence of psychological problems and associated factors among high school students during the COVID-19 pandemic in Sawla town, Gofa zone, southern Ethiopia.

Methods

A facility-based cross-sectional study was conducted among 663 randomly selected high school students from March 1 to 31, 2021. The data was collected using the depression, anxiety, and stress scale (DASS-21) questionnaire and analyzed using SPSS version 26.0. Bivariable and multivariable analyses were computed to identify factors associated with DAS. An adjusted odds ratio with 95% CI was used to see the strength of the association and statistical significance was declared at p-value <0.05.

Results

The overall prevalence of depression, anxiety, and stress were 52.1% [95% CI: 48.3, 55.98], 52.6% [95% CI: 48.8, 56.4], and 22.6% [95% CI: 19.4, 25], respectively. Being rural residence (AOR: 4.88, 95% CI: 3.02, 7.88), living in a prison house or with a husband (AOR: 5.94, 95% CI: 1.65, 21.3), having a lower academic level (AOR: 6.23, 95% CI: 3.42), having poor knowledge about COVID-19 (AOR: 1.75, 95% CI: 1.21, 2.53) and poor COVID-19 prevention practices (AOR: 1.74, 95% CI: 1.09, 2.79) were associated with depression. Similarly, being a rural resident (AOR: 3.73, 95% CI: 2.38, 5.84), being a lower academic level (AOR: 2.54, 95% CI: 1.50, 4.30), having poor knowledge about COVID-19 (AOR: 1.54, 95% CI: 1.08, 2.19), and poor COVID-19 prevention practices (AOR: 2.12, 95% CI: 1.36, 3.32) were associated with anxiety. Furthermore, stress was associated with rural residence (AOR: 2.24, 95% CI: 1.42, 3.53), lower academic level (AOR: 4.70, 95% CI: 2.12, 10.4), and poor knowledge of COVID-19 (AOR: 1.71, 95% CI: 1.13, 2.58).

Conclusions

Depression, anxiety, and stress were all prevalent among high school students in the area. Rural residence, lower academic level, and poor knowledge about COVID-19, as well as poor COVID-19 prevention practices, all increase the likelihood of DAS. As a result, school-based psychological counseling interventions, particularly during pandemics, are critical.

The relationships between the healthy nurse, Healthy Nation program, RN perceptions of their work system, and health-related quality of life

BACKGROUND

There is limited research on the effects of nationally oriented health care workforce interventions on RNs' perceptions of their work systems and health-related quality of life (HRQOL).

PURPOSE

Guided by a systems framework, we examined the association of being affiliated with an organization partnered with the American Nurses Association's Healthy Nurse, Healthy Nation (HNHN) program on RNs' perceptions of their work systems and HRQOL.

METHODS

We performed a correlational, cross-sectional secondary analysis of a national RN sample (N = 2,166) with case-control matching. We used multiple linear and logistic regressions to evaluate our research questions.

DISCUSSION

Affiliation with an HNHN partner organization was directly associated with more desirable work system perceptions, and indirectly associated with greater HRQOL. Organization-level workplace interventions hold promise to improve RN working conditions and well-being.

CONCLUSION

There is an ongoing need to continue developing and evaluating scalable workplace well-being interventions for health care organizations.

The Effectiveness of Electrical Vestibular Stimulation (VeNS) on Symptoms of Anxiety: Study Protocol of a Randomized, Double-Blinded, Sham-Controlled Trial

The prevalence of symptoms of anxiety is increasing, especially during the COVID-19 pandemic. A home use transdermal neurostimulation device might help to minimize the severity of anxiety disorder. To the best of our knowledge, there is no clinical trial using transdermal neurostimulation to treat individuals with symptoms of anxiety in Asia. This gives us the impetus to execute the first study which aims at evaluating the efficacy of Electrical Vestibular Stimulation (VeNS) on anxiety in Hong Kong. This study proposes a two-armed, double-blinded, randomized, sham-controlled trial including the active VeNS and sham VeNS group. Both groups will be measured at baseline (T1), immediately after the intervention (T2), and at the 1-month (T3) and 3-month follow-up (T4). A total of 66 community-dwelling adults aged 18 to 60 with anxiety symptoms will be recruited in this study. All subjects will be computer randomised into either the active VeNS group or the sham VeNS group in a 1:1 ratio. All subjects in each group will receive twenty 30 min VeNS sessions during weekdays, which will be completed in a 4-week period. Baseline measurements and post-VeNS evaluation of the psychological outcomes (i.e., anxiety, insomnia, and quality of life) will also be conducted on all participants. The 1-month and 3-month follow-up period will be used to assess the long-term sustainability of the VeNS intervention. For statistical analysis, ANOVA with repeated measures will be used to analyze data. Missing data were managed with multiple mutations. The level of significance will be set to p < 0.05. Results of this study will be used to determine whether this VeNS device can be considered as a self-help technological device to reduce perceived anxiety in the general population in the community setting. This clinical Trial was registered with the Clinical Trial government, identifier: NCT04999709.

Levels of Anxiety and Stress Experienced by Nurses in Inpatient Units

Objective: To assess state-trait anxiety levels and their correlation with occupational stress and socio-biographical and occupational factors in nursing professionals. Materials and Methods: This quantitative, cross-sectional, analytical study was conducted in the inpatient units of a university hospital in southern Brazil, with the participation of 162 nursing professionals. For data collection, socio-biographical and occupational forms, the Stress-Symptom Scale, the Workplace Stress Scale, and the State-Trait Anxiety Inventory were used. The data were analyzed based on descriptive and inferential statistics. Results: Nursing professionals have moderate levels of state-trait anxiety. There is a positive correlation between state-trait anxiety scores, stress scores, and stress dimensions (rho = 0.811, p < 0.001). “Trait” anxiety is associated with years of experience in nursing (PR 0.97) and psychic-mental health follow-up (PR 1.97). “State” anxiety is associated with sex (PR 0.54), education (PR 2.26), and hours of sleep (PR 0.92). Conclusions: “State” anxiety is associated with sex, age, higher education level, and psychic-mental health follow-up; however, years of experience in nursing and hours of sleep were found to be protective factors.

Prevalence and associated factors of stress and anxiety among female employees of hawassa industrial park in sidama regional state, Ethiopia

BACKGROUND

Work-related stress and anxiety are emerging global public health problems causing serious social and economic consequences. Working women bear a heavy burden due to high social disparity, gender inequality, and an important responsibility to balance work and family life in undeveloped society.

OBJECTIVE

To assess the prevalence and associated factors of work related stress and anxiety among female employees of Hawassa industrial park in Sidama Region, Ethiopia, 2021.

METHODS

Institution-based cross-sectional study design was conducted among 417 female employees using structured interviewer-administered questionnaires and depression, Anxiety, and Stress scale (DASS) 21 items. A simple random sampling technique was used through the computer-generated random method. The outcome variables were work related stress and anxiety. Work related stress and anxiety were ascertained using the DASS 21( stress ≥ 15 &anxiety8 - 14). The associated factors assessed included sociodemographic, behavioral factor, job and organization related factors, past illness and social support related factors. Bivariate and multivariable logistic regression analyses were done. The strength of association was declared by using an adjusted odds ratio (AOR) with a 95% confidence interval and, the statistical significance of P-value < 0.05.

RESULT

The prevalence of work-related stress and anxiety were 59.3% [95% CI: (54.7, 63.9)] and 79.8% [95% CI: 75.5, 83.6)] respectively. Respondents with single marital status [AOR = 5.31, 95% CI: (1.68, 16.86)], having chronic illness [AOR = 4:00, 95% CI: (1.24, 12.9)], and current alcohol drinking [AOR = 12.5, 95% CI: (4.56, 34.2)] were significantly associated with stress. Likewise, being single in marital status [AOR = 1.99, 95% CI: (1.15, 3.46)], poor social support [AOR = 3.78, 95% CI: (1.53, 9.35)], overtime work [AOR = 2.31, 95% CI: (1.12, 4.74)], having work experience (3-4 years) [AOR = 4.71, 95% CI: (1.49, 14.84)], and fear of losing job [AOR = 1.72, 95% CI: (1.01, 2.93)] were significantly associated with anxiety.

CONCLUSION

The prevalence of work-related stress and anxiety was high in the study area. Marital status, alcohol drinking, and chronic illnesses were factors associated with work-related stress. In contrast the fear of losing a job, work experience, overtime work, and having poor social support were factors associated with anxiety.. The significant factors identified in this study can be targeted to reduce the occurrence of work related stress and anxiety among women through designing preventive programs and strategies which includes acknowledging the importance of mental health services for the welfare of the public, screening for work related stress and anxiety, counselling, and the provision of support for women as well as lifestyle modification.

The effects of mindfulness-based interventions on nurses' anxiety and depression: A meta-analysis

OBJECTIVE

This meta-analysis aimed to determine the effect of mindfulness interventions on nurses' levels of depression and anxiety.

DESIGN

Meta-analysis of randomised controlled trials.

METHODS

The following Chinese and English databases were searched: PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Internet (CNKI). The retrieval period was from database construction to 30 March 2022. Two researchers screened the relevant literature and extracted the data. After a cross-check, data were input into Stata version 16.0 for meta-analysis.

RESULTS

Twelve randomised controlled trials from 2017 to 2021 were included, which involved 807 subjects (405 and 402 in the intervention and control groups, respectively). Meta-analysis results showed that nurses' anxiety reduced by mindfulness-based interventions was significantly higher compared to that of the control group (SMD = 0.91, 95% CI: 0.27-1.55, p < 0.05). Furthermore, an 8-week mindfulness-based intervention (SMD = 1.43, 95% CI: 0.61-2.24) reduced the level of anxiety significantly more compared to a 4-week intervention (SMD = 1.03, 95% CI: 0.36-1.71). Mindfulness-based interventions were better compared to conventional intervention to reduce the level of depression (SMD = 1.02, 95% CI: 0.42-1.61, p < 0.05), and an 8-week mindfulness intervention (SMD = 1.81, 95% CI: 0.78-2.84) reduced the level of depression significantly more compared to a 4-week intervention (SMD = 0.82, 95% CI: 0.29-1.35). Since limited studies had interventions longer than 8 weeks, results on longer mindfulness interventions in reducing nurses' anxiety and depression are inconclusive. In conclusion, mindfulness intervention for 8 weeks or less can significantly reduce nurses' anxiety and depression levels.

PATIENT OR PUBLIC CONTRIBUTION

None.

Psychological distress experienced by nurses amid the fifth wave of the COVID-19 pandemic in Hong Kong: A qualitative study

Introduction

The fifth wave of COVID-19 has significantly overburdened the health care system in Hong Kong. Health care professionals, particularly nurses continue to experience significant levels of psychological distress when tackling this ongoing outbreak. Yet, no study has explored the psychological experiences of nurses during the most recent outbreak of the highly transmissible Omicron variant in Hong Kong. The aim of this qualitative study was to explore the psychological distress experienced by nurses during the fifth wave of the COVID-19 pandemic in Hong Kong.

Methods

Twenty-two nurses (14 female and 8 male nurses; average age, 36.7 ± 8.5 years) were recruited to attend the one-to-one semi-structured telephone interviews from June to July, 2022. Data were analyzed using thematic analysis.

Results

Four main themes emerged from the interview: (1) Intense fear, worry, and anxiety; (2) Feeling worn out and psychologically distress; (3) Impact on psychosocial and physical health; and (4) Limited options to cope with psychological distress during the difficult times.

Discussion

Our study findings may provide concerned stakeholders with useful insights into reducing the psychological distress experienced by nurses in Hong Kong. Offering psychological support is of paramount importance to address the unmet psychological needs of nurses and reduce their psychological distress during the pandemic, particularly when they are working under high levels of workplace stress.

Authentic Leadership and Its Role in Registered Nurses' Mental Health and Experiences of Workplace Bullying

Introduction

Bullying is a widespread problem in healthcare organizations, resulting in nurses' poor mental health. Effective leadership, such as authentic leadership, may help to overcome this problem.

Objective

To examine the relationship between authentic leadership, workplace bullying, and nurses' mental health, controlling for demographic characteristics.

Methods

A descriptive correlational design was utilized with a sample of 170 nurses. Nurses were recruited from four private hospitals in Jordan and completed a survey about their perception of managers' authentic leadership, their experience of workplace bullying, and their mental health.

Results

About 48.8%, 25.9%, and 25.3% were categorized as "not bullied," "occasionally bullied," and "severely bullied," respectively. Participant nurses had mild depression (m = 12.11) and moderate anxiety (m = 10.92). Workplace bullying was higher among nurses who earn less than 600 Jordanian dinars and nurses working in the smallest hospital, with 130 beds. Authentic leadership explains 6% of the variance of workplace bullying, 3% of anxiety, 7% of stress, and 7% of depression above and beyond the variance explained by other variables.

Conclusions

Healthcare organizations are facing a challenge in providing a healthy work environment. Employing authentic leadership in the workplace could be one of the factors that could help in addressing this issue.

Prevalence of psychological symptoms and associated risk factors among nurses in 30 provinces during the COVID-19 pandemic in China

BACKGROUND

With the outbreak of the coronavirus disease 2019 (COVID-19), nurses have won well-deserved recognition for their indispensable roles in providing humane and professional healthcare for patients. However, by the nature of their role working at the forefront of patient care, nurses are prone to experiencing mental health consequences. Therefore, we pay attention to measuring the magnitude of psychological symptoms and identifying associated factors among nurses in China.

METHODS

We launched a nationwide, cross-sectional survey of nurses who worked in secondary or tertiary hospitals and public or private hospitals from 30 provinces in China. The prevalence and severity of symptoms of burnout, depression, and anxiety were investigated, respectively. Multivariable logistic regression analyses were performed to identify factors associated with each psychological symptom.

FINDINGS

A total of 138 279 respondents who worked in 243 hospitals completed this survey. A substantial proportion of nurses reported symptoms of burnout (34%), depression (55·5%), and anxiety (41·8%). In line with the disproportionality of economic development, we noted that the middle or western region was an independent risk factor for depression and anxiety. Compared with those working in the secondary hospital, nurses who worked in tertiary hospitals were associated with a higher likelihood of burnout and depression.

INTERPRETATION

Nurses are experiencing emotional, physical, and mental exhaustion during the COVID-19 epidemic. Governments and health policymakers need to draw attention to reinforcing prevention and ameliorating countermeasures to safeguard nurses' health.

FUNDING

The strategic consulting project of the Chinese Academy of Engineering [2021-32-5]. Advanced Institute of Infomation Technology, Peking University, Zhejiang Province [2020-Z-17].

Mental health status of mental health nurses in China: Results from a national survey

INTRODUCTION

It has been acknowledged in China that actions should be taken immediately to ease the critical shortage of psychiatric nurses. However, with national data lacking, little is known about nurses' mental health status.

AIM

To evaluate psychiatric nurses' mental health status by measuring their burnout, depression, anxiety and stress.

METHODS

All psychiatric nurses in the 41 selected hospitals in China were invited to participate in the survey. The Maslach Burnout Inventory-Human Service Survey and Depression Anxiety Stress Scale were used to assess variables of interest.

RESULTS

38.6% of psychiatric nurses met the criteria for burnout. The rates of depression, anxiety and stress were 26.3%, 36.4% and 12.5%, respectively. It was found that workplace region, educational level, working years, longer working hours and night shifts were associated with risk of burnout and DASS.

CONCLUSIONS

More than a quarter of psychiatric nurses are suffering from burnout, depression or anxiety in China. Policymakers and hospital administrators should design a flexible schedule and restrict working hours for psychiatric nurses to achieve work-life balance.

IMPLICATIONS FOR PRACTICE

The study informs policymakers and administrators on addressing the nursing shortage by identifying nurses immersed in negative emotions and preventing mental health problems.

Quality of life and its health and occupational determinants among hospital-based nurses during the COVID-19 pandemic

BACKGROUND

Nurses worldwide were exposed to increased levels of occupational stress during the COVID-19 pandemic which could have hindered their level of health-related quality of life (HRQoL).

OBJECTIVES

This project investigated HRQoL level in nurses during the COVID-19 pandemic and its health and occupational predictors.

METHODS

A cross-sectional design was adopted and targeted full-time nurses in Jordan. Study collected data included demographics, 12-item Short Form health survey (SF-12) to measure HRQoL, Nordic musculoskeletal questionnaire (NMQ), nurses' evaluation of work conditions during COVID-19, and Depression Anxiety Stress Scale (DASS21). Data was analyzed descriptively to summarize main outcome measures and using multiple linear regression model to identify factors significantly associated with HRQoL.

RESULTS

In total 245 nurses successfully completed the survey, 39.6% were males with a mean age of 35±6 years. Participant SF12 scores were 65.94±17.85 for physical component and 50.09±19.36 mental component. The statistical model significantly explained 53.2% of variance in HRQoL (r2 = 0.534, F = 57.849, p < 0.001). Better sleep quality self-evaluation was significantly associated with higher HRQoL levels, while increased levels of depression, musculoskeletal pain, and financial burden on family were significantly associated with worse HRQoL level.

CONCLUSION

Jordanian nurses' HRQoL level was relatively low during COVID-19. Sleep quality, mental health status, musculoskeletal health status, and financial status were identified as factors possibly influenced HRQoL among nurses during the COVID-19 pandemic. Nurses' quality of life along with their mental and physical health should be considered by healthcare administrators in the remaining period of COVID-19 and in future similar emergencies.

Emotional distress symptoms and their determinants: screening of non-clinical hospital staff in an Egyptian University hospital

BACKGROUND

Non-clinical hospital staff were rarely studied despite their potential exposure to workplace stressors. We aimed to measure the prevalence of depression, anxiety, and stress (emotional distress symptoms) and determine their association with perceived job stress level and socioeconomic factors among non-clinical hospital staff.

METHODS

This cross-sectional study was conducted in Ain-Shams University Hospitals from March to May 2019. Tools were the Arabic Depression, Anxiety, and Stress Scale-21, Workplace Stress Scale, and Socioeconomic status scale. Independent correlates were determined using multivariable ordinal regression.

RESULTS

Out of 462 participants, 72.5% reported receiving insufficient income and 54.8% showed Effort-reward imbalance. Job stress was scored as severe/potentially dangerous by 30.1%. The prevalence of depression, anxiety, and stress were 67.5, 69.0, and 51.7%; and the severe/extremely severe levels were 20.8, 34.6, and 17.6% respectively. Across all the severity levels, the likelihood of depression, anxiety, and stress were progressively higher with more serious levels of income insufficiency [in debt versus able to save, OR:5.82 (95%CI:2.35-14.43), OR:3.84 (95%CI:1.66-8.91), and OR:3.01 (95%CI:1.20-7.55) respectively] and with higher job stress levels. Specifically, the likelihood of depression, anxiety, and stress increased by 74, 56, and 53% respectively with feelings of unpleasant/unsafe work conditions and by 64, 38, and 62% respectively with the presence of work-life conflict; while the likelihood of depression and stress increased by 32 and 33% respectively when there was difficult communication with superiors; and only the likelihood of depression increased by 23% with underutilization of skills.

CONCLUSION

Non-clinical hospital staff were commonly affected by emotional distress symptoms with high rates of severe/very severe levels, and they often considered their workplace stress as severe/potentially dangerous. Workplace stress and income insufficiency were strong correlates with emotional distress symptoms. Decreasing work-life conflict, enhancing leadership skills, and mitigation of the economic hardship are needed.

The relationship between nurses' risk assessment and management, fear perception, and mental wellbeing during the COVID-19 pandemic in Saudi Arabia

During this pandemic, it is crucial to implement early interventions to help nurses manage their mental wellbeing by providing them with information regarding coping skills, preventive risk assessment approaches (such as hospital preparedness and rapid risk assessment), and the ability to respond. This study evaluated the effect of fear and risk assessment management on nurses' mental wellbeing during the COVID-19 pandemic in Saudi Arabia. A total of 507 nurses who worked in tertiary public hospitals were asked to take a descriptive design survey. Three survey scales were used to assess the survey: the Risk Assessment Scale, the Fear of COVID-19 Scale, and the Warwick-Edinburgh Mental Wellbeing Scale. Independent t-tests and a one-way ANOVA were used to examine the association between fear of COVID-19 and nurses' demographic characteristics on their mental wellbeing. A multiple regression analysis was performed to examine the predictors associated with mental wellbeing. Findings revealed that almost half of the participants showed moderate positive mental wellbeing, 49.7%, while only 14% had low levels of fear on the Warwick-Edinburgh Mental Well being Scale. Most of the respondents had low levels of fear on the Fear of COVID-19 Scale, 45%, while only 15% had high levels of fear on the scale. Then, some demographic variables, such as "age," "nationality," "total years of experience in the current hospital," and "region you work at" had statistically significant differences with p < 0.5. Meanwhile, risk assessment is also associated with mental wellbeing scores. All items on the Fear of COVID-19 Scale showed no significant difference with a P > 0.05. In conclusion, most nurses providing direct patient care to a patient with COVID-19 emphasized the importance of wearing PPE and performing hand hygiene before and after any clean or aseptic procedure. Meanwhile, although almost all nurses were vaccinated, they were still afraid of a COVID-19 infection. Additionally, the results reported that the older the nurses are, the better their mental wellbeing scores. Non-Saudi nurses had higher perceived mental wellbeing scores than Saudi nurses, and different working environments corresponded to different mental wellbeing scores. Finally, nurses' risk assessment was associated with mental wellbeing scores.

Mental health among healthcare workers during the prolonged COVID-19 pandemic: A cross-sectional survey in Jilin Province in China

Background

The prolonged COVID-19 pandemic has seriously impacted the mental health of healthcare workers. This study aimed to explore the mental health status of healthcare workers, compare the differences in mental health between physicians and nurses, and verify the impact of risk perception on mental health in the long-term COVID-19 pandemic in Jilin Province, China.

Methods

A stratified random sample was used to conduct an on-site questionnaire survey in December 2020 to measure the mental health status, risk perceptions, and demographic characteristics of healthcare workers in Jilin Province, China. A total of 3,383 participants completed the questionnaire survey, of which 3,373 were valid questionnaires.

Results

A total of 23.6% (n = 795) of participants had symptoms of depression, 27.4% (n = 923) had symptoms of anxiety, and 16.3% (n = 551) had symptoms of stress. Physicians reported significantly higher rates of depression and anxiety than nurses (p = 0.023, p = 0.013, respectively). There was no significant difference in the proportion of participants with stress between physicians and nurses (p = 0.474). Multivariate logistic regression results showed that healthcare workers who had a high level of risk perception were more likely to have symptoms of depression (AOR = 4.12, p < 0.001), anxiety (AOR = 3.68, p < 0.001), and stress (AOR = 4.45, p < 0.001) after controlling for other variables.

Conclusion

At least one in six healthcare workers experienced mental health problems, and physicians were more likely than nurses to suffer from depression during the prolonged COVID-19 epidemic. Risk perception was highly predictive of depression, anxiety, and stress symptoms in medical staff. Public health interventions are needed to mitigate the long-term psychological impact of the COVID-19 pandemic.

The protective effect of grit on clinical nurses' occupational psychological distress: Mediating and suppressing effects of Hope

As at a high-risk group of psychological distress, nurses generally experience varying degrees of stress, anxiety, and depression. This paper identifies the positive factors that may negatively regulate the psychological pain of clinical nurses and their mechanisms of action, providing reliable references for clinical nurse support management. The effects and mechanisms of hope and the two components of grit consistency of interest and perseverance of effort) on clinical nurses' psychological distress (depression, anxiety, and stress) were observed in this study. A total of 635 Chinese clinical nurses (90.4% female) completed an anonymous questionnaire for the survey. As expected, hope, consistency of interest, and perseverance of effort were negatively correlated with the three indicators of psychological distress (r = -0.21 ~ -0.38, p < 0.01). Path analysis results showed that hope significantly mediated the negative effect of consistency of interest on psychological distress, with an effect of 12.96%. Hope also covered up the perseverance of effort on psychological distress, the effect of 110.63%. In the influence of consistency of interest and perseverance of effort on psychological distress, hope contributed a vital mediating. Based on these results, it can be concluded that grit and hope have protective effects on psychological distress in clinical nurses. Significantly increasing the level of hope or grit may effectively prevent and reduce psychological distress in clinical nurses.

Nonattachment at Work on Well-being Among Working Adults in Hong Kong

Objectives

Nonattachment has been found to be a potentially important mental quality in mitigating psychological distress and promoting well-being across student and community adult populations. This study investigated the relationships between nonattachment and three workplace-related variables, namely control at work, psychological safety, and supervisor support, on mental well-being of a representative sample of working adults in Hong Kong.

Methods

This is a cross-sectional investigation using the data provided by 1008 working adults who participated in a population-based telephone survey. Structural equation modeling (SEM) was performed to test how nonattachment may be related to mental well-being of working adults, with the relationship being mediated by three workplace-related variables.

Results

Results indicated that nonattachment was positively associated with flourishing. This association was mediated by perceived supervisor support and control at work. In addition, nonattachment was negatively related to depression and anxiety symptoms and the association was only mediated by perceived supervisor support. Psychological safety did not significantly mediate the effect of nonattachment on mental well-being.

Conclusions

This study provides suggestive evidence that staff’s perception towards supervisors and level of control at work can bridge the relationship between nonattachment and employee well-being. Potential cultural nuance that may have contributed to the nonsignificance of psychological safety was discussed.