Promoting and Risk Factors of Nurses' Hardiness Levels during the COVID-19 Pandemic: Results from an Italian Cohort

A study on optimism as a psychological strength in nurses through a prospective study from the outbreak of the COVID-19 pandemic to two years later

Aims and objectives

This study analyzes, in nurses, the influence of openness to experience and hardiness (assessed at baseline and one year after the COVID-19 pandemic respectively) on the development of optimism (assessed two years after the COVID-19 pandemic). Concerns about self-contagion were included as a moderating variable, given their relevance as a risk factor.

Background

Nurses have been among the healthcare professionals most affected by the COVID-19 pandemic. Most previous studies have focused on the variables contributing to psychological symptoms, whilst the attention given to the variables adding to the well-being of these professionals has been much scarcer.

Design

A prospective study was carried out.

Methods

This study was carried out using three data collection periods: Period 1 (From May to June 2020), Period 2 (From January 2021 to April 2021), and Period 3 (From April 2022 to July 2022), with the participation of 151 Spanish nurses, using online self-reporting questionnaires. The study followed the STROBE statement.

Results

The results showed that the proposed model was statistically significant. There was a positive effect of openness to experience (year 2020) on hardiness assessed one year later (year 2021). Similarly, hardiness had a positive effect on optimism assessed another year on (year 2022).

Conclusions

Concerns about self-contagion behaved as a moderator in the relationship between openness to experience and hardiness (the relationship between openness and hardiness was statistically significant when contagion concern was higher). Relevance to clinical practice: In-depth understanding of the psychological processes that trigger psychological strengths (i.e. optimism) as a result of adverse situations (i.e. COVID-19 pandemic) is essential in promoting the mental health of healthcare professionals. Interventions targeting resilient personality traits and cognitive flexibility are key to this goal. No Patient or Public Contribution: The participants contributed exclusively to the collection of the sample.

Systematic Review: Measurement Methods and Concept of Resilience Among Seafarers

Shipping is considered a demanding environment that can significantly impact seafarers' well-being and mental health. This review aims to examine existing literature on the resilience of seafarers, with a focus on the measurement methods used. Furthermore, this study intends to gain a comprehensive understanding of the current state of research in the field of seafarers' resilience, examining the variations in defining and conceptualizing resilience across different studies and contexts. The review identified 99 studies published between 2003 and 2023, with ten studies being included in the final analysis. These studies employed various measurement methods and provided definitions of resilience. Five questionnaires were identified, with the Dispositional Resilience Scale-15 (DRS-15) being the most commonly used. Two of the selected studies had a longitudinal follow-up, while eight were cross-sectional. Four studies related to tankers, and an additional four studies focused on naval vessels, while two studies did not specify the vessel type. The publications were distributed in the period between 2003 and 2013 (two papers) and between 2013 and 2023 (eight papers). The identified themes encompassed shipboard stressors (three papers), sleep problems (two papers), occupational groups or attitudes (two papers), experiences in war (two papers), and intervention measures (one paper), highlighting the multidimensional nature of resilience within the maritime field. This review suggests a research gap, as it reveals that the topic of resilience in seafaring has been sparsely represented. Despite an increasing interest in recent years, research remains limited, particularly in the civilian maritime sector. Therefore, this review highlights the importance of understanding and promoting resilience among seafarers. While the variety of questionnaires used was limited, achieving consensus and standardization in resilience measurement is essential for more comparable and consistent research findings. Recognizing resilience as a crucial resource can promote the development of targeted interventions and support systems, enhancing seafarers' well-being and mental health.

Sleep Quality and Its Relationship to Anxiety and Hardiness in a Cohort of Frontline Italian Nurses during the First Wave of the COVID-19 Pandemic

INTRODUCTION

The COVID-19 pandemic has had a considerable impact on the psychological and psychopathological status of the population and health care workers in terms of insomnia, anxiety, depression, and post-traumatic stress disorder. The primary aim of this study was to describe and evaluate the impact of the pandemic on insomnia levels of a cohort of Italian nurses, particularly those involved in the care of COVID-19 patients. The secondary aim was to identify the interaction between insomnia and hardiness, anxiety, and sleep disturbances.

MATERIALS AND METHODS

A descriptive-exploratory study was conducted using an online survey during the first wave of the COVID-19 pandemic (March to July 2020). The questionnaire consisted of multiple-choice, open-ended, closed, and semi-closed questions. The psychometric tools administered were the Dispositional Resilience Scale (DRS-15), the State-Trait Anxiety Inventory (STAI-Y), and the Insomnia Severity Index (ISI).

RESULTS

a cohort of 1167 nurses fully completed the questionnaire (86.2% of total respondents). The insomnia scale survey showed an increase in post-pandemic scores compared to those before the pandemic, implying that insomnia levels increased after the first pandemic wave. Insomnia scores were directly correlated with anxiety levels (r = 0.571; p ≤ 0.05) and inversely correlated with hardiness levels (r = -0.324; p < 0.001). Multivariate analysis revealed the following protective factors: not having worked in COVID-19 wards, high levels of hardiness (commitment), and the presence of high pre-pandemic insomnia disorder. The main risk factor for insomnia reported in the analysis was a high anxiety score.

DISCUSSION AND CONCLUSION

Anxiety represented the main risk factor for insomnia severity in our sample, while hardiness was confirmed as a protective factor. Thus, it is necessary to design further studies to identify additional risk factors for poor sleep quality and to develop educational courses and strategies aimed at enhancing rest and sleep quality, especially for frontline nurses.

Evaluation of Medical Staff Satisfaction for Workplace Architecture in Temporary COVID-19 Hospital: A Case Study in Gdańsk, Poland

This article analyses the architecture that was used in the temporary AmberExpo hospital in Gdańsk, Poland which was installed during the COVID-19 pandemic. The construction of this type of facility is often based on experimental approaches, aimed at caring for patients suffering from an infectious disease in emergency conditions. In order to assess the level of employee satisfaction with the architectural and technical elements used in the first period of the hospital's activity, medical staff were asked to fill out a questionnaire. The analysis of the survey's results indicated that the majority of employees expressed satisfaction with the architectural and technical elements, with the design of the spatial layout of the individual medical zones receiving the most positive feedback. However, frequently selected drawbacks in the design included the lack of natural daylight, the artificial light that was used and the acoustics of the facility. This detailed examination of the satisfaction and feedback from medical employees working in this type of emergency facility enables the development of solutions that in the future will allow for the improved adaptive reuse and implementation of such structures, with enhanced time and economic efficiency, and most importantly, the ability to provide a safer workplace.

Nurses’ Personal Perceptions of Clinical Work Adaptation During COVID-19

Background

Objective

Methods

Results

Conclusion

Is Team Resilience More Than the Sum of Its Parts? A Quantitative Study on Emergency Healthcare Teams during the COVID-19 Pandemic

Due to the COVID-19 pandemic, emergency healthcare workers have come under even more pressure than before, threatening the workers' mental health and the continuity of care delivered by their teams. This study aims to investigate what conditions increase individual and team resilience, referring to the ability to "bounce back" from stressful situations. We also assess whether team resilience is the sum of the individual resilience of team members, or whether other conditions enhance team resilience and thus continuity of care, despite limited individual resilience. We collected survey data from 129 emergency healthcare team members in the Netherlands to examine to what extent transformational leadership and team familiarity influence the level of team resilience, either directly or mediated by individual resilience, accounting for psychological characteristics and social support. The results show two distinct pathways to enhance team resilience, directly by familiarizing team members with each other and by mobilizing family support, and indirectly but with a much weaker effect, by encouraging team members' individual resilience through transformational leadership and staffing optimistic team members with high levels of self-efficacy.