Stress and Occupational Burnout of Nurses Working with COVID-19 Patients

Identification of the risk factors for insomnia in nurses with long COVID-19

PURPOSE

To investigate the prevalence of insomnia among nurses with long COVID-19, analyze the potential risk factors and establish a nomogram model.

METHODS

Nurses in Ningbo, China, were recruited for this study. General demographic information and insomnia, burnout, and stress assessment scores were collected through a face-to face questionnaire survey administered at a single center from March to May 2023. We used LASSO regression to identify potential factors contributing to insomnia. Then, a nomogram was plotted based on the model chosen to visualize the results and evaluated by receiver operating characteristic curves and calibration curves.

RESULTS

A total of 437 nurses were recruited. 54% of the nurses had insomnia according to the Insomnia Severity Index (ISI) score. Eleven variables, including family structure, years of work experience, relaxation time, respiratory system sequelae, nervous system sequelae, others sequelae, attitudes toward COVID-19, sleep duration before infection, previous sleep problems, stress, and job burnout, were independently associated with insomnia. The R-squared value was 0.464, and the area under the curve was 0.866. The derived nomogram showed that neurological sequelae, stress, job burnout, sleep duration before infection, and previous sleep problems contributed the most to insomnia. The calibration curves showed significant agreement between the nomogram models and actual observations.

CONCLUSION

This study focused on insomnia among nurses with long COVID-19 and identified eleven risk factors related to nurses' insomnia. A nomogram model was established to illustrate and visualize these factors, which will be instrumental in future research for identifying nurses with insomnia amid pandemic normalization and may increase awareness of the health status of healthcare workers with long COVID-19.

Exploration of Mental Health and Well-Being of Healthcare Professionals During the COVID-19 Pandemic

Introduction

In response to curbing the spread of SARS-CoV-2, healthcare professionals (HCPs) encounter a multitude of mental stresses. The primary intent was to explore the mental health and well-being experienced by HCPs in Ekiti State, Nigeria, amid the COVID-19 pandemic.

Methods

Data were analyzed using inductive qualitative methodology. The study was undertaken among HCPs in two teaching hospitals in Ekiti State during the SARS-CoV-2 outbreak. Convenience sampling techniques were employed to select participants for this study. A comprehensive interview ranging from 30 to 50 minutes per participant was administered to a sample of 14 HCPs (doctors and nurses) representing various departments within the hospital. The interviews were conducted between March 2020 and May 2020. COVID-19 stressful situations, the physiological consequences of stress, personality, disposition, stress management techniques, and coping mechanisms were evaluated.

Results

The study outcomes indicate that a significant proportion of HCPs currently face mental well-being. The primary sources of stress identified in this study included heavy workloads and pressure from social media platforms and government agencies. The outbreak crisis significantly influenced on their lives and work, with the fear of catching diseases and their anxiety about spreading infections to their loved ones.

Conclusions

HCPs require a secure working environment during the current circumstances, along with an enhanced support system to alleviate stressors. This study contributes to a significant proportion of HCPs currently facing stress.

Compassion Fatigue in a Cohort of South Italian Nurses and Hospital-Based Clinical Social Workers Following COVID-19: A Cross-Sectional Survey

Background/Objective: The COVID-19 pandemic has led to a significant increase in the workloads of healthcare workers (HCWs). The fear of contracting the new virus with the frequent medical consequences has affected their mental health. As a result, they are at high risk of compassion fatigue (CF). In this multicentric study, as a primary objective, we evaluate the incidence and/or prevalence of CF in a cohort of Italian nurses and HCWs (hospital-based clinical social workers of neurological patients) who have contracted SARS-CoV-2 infection. Our secondary aim is to evaluate the difference in experiencing CF between subjects with and without long-term COVID. Methods: In this study, 101 HCWs attending three different neurorehabilitation settings (the Neurorehabilitation Unit of the "Bonino Pulejo" Neurolesi Center of Messina, the Neurorehabilitation Department of Crotone, and the Psychiatric Unit of the University Hospital of Messina) were enrolled from May 2021 to May 2023. Data were collected through self-administered semi-structured interviews. Results: We observed high percentages of CF difficulties in both nurses and HCWs, related to mood alteration in 57.7%, headaches in 44.4%, and fatigue in 62%. Higher percentages were found in individuals with long-term COVID-19, including mood alteration in 93.9%, headache in 88.6%, and memory-related problems in 98.5%. Conclusions: The complexity of a patient's care pathway, especially in chronic disease situations, requires an enormous commitment that can lead to burnout and CF, which should be considered to initiate preventive interventions aimed at helping "those who help", for the well-being of patients, healthcare teams, and healthcare organizations.

Burnout and Life Satisfaction among Healthcare Workers Related to the COVID-19 Pandemic (Silesia, Poland)

Background

The phenomenon of burnout among healthcare workers during the COVID-19 pandemic is a widespread problem with several negative consequences for the healthcare system. The many stressors of the pandemic have led to an increased development of anxiety and depressive disorders in many healthcare workers. In addition, some manifested symptoms of the so-called postpandemic stress syndrome and the emergence of occupational burnout syndrome, commonly referred to as "COVID-19 burnout." The aim of this study was to assess the burnout and life satisfaction of healthcare workers during the COVID-19 pandemic.

Materials and Methods

The study was conducted in 2020-2022 among medical staff working in hospitals in Silesia, Poland. The instruments used to assess life satisfaction and burnout were the Satisfaction with Life Scale (SWLS) and the Maslach Burnout Inventory (MBI), which assesses three dimensions: emotional exhaustion (EE), depersonalisation (DEP), and sense of reduced professional accomplishment (SRPA).

Results

The study group included 900 participants. There were 300 physicians (mean age 38 ± 7 years), 300 nurses (mean age 35 ± 6 years), and 300 paramedics (mean age 31 ± 5 years). Life satisfaction as measured by the SWLS was lowest among nurses and paramedics in 2021 and among doctors in 2022. Male respondents and those with fewer years of work had higher levels of life satisfaction. People with more years of work had higher scores in EE and DEP and lower scores in SRPA (p = 0.001). We found a negative correlation between life satisfaction and EE (p = 0.001), DEP (p = 0.001), and SRPA (p = 0.002).

Conclusions

The results highlight the need for further research into the causes of burnout among medical professionals and the need for effective interventions to promote well-being and prevent burnout in this group.

Determinants of intention to leave among nurses and physicians in a hospital setting during the COVID-19 pandemic: A systematic review and meta-analysis

BACKGROUND

The global outbreak of COVID-19 has brought to light the profound impact that large-scale disease outbreaks can have on healthcare systems and the dedicated professionals who serve within them. It becomes increasingly important to explore strategies for retaining nurses and physicians within hospital settings during such challenging times. This paper aims to investigate the determinants of retention among nurses and physicians during the COVID-19 pandemic.

METHOD

A systematic review of other potential determinants impacting retention rates during the pandemic was carried out. Secondly, a meta-analysis on the prevalence of intention to leave for nurses and physicians during the COVID-19 pandemic.

FINDINGS

A comprehensive search was performed within four electronic databases on March 17 2023. Fifty-five papers were included in the systematic review, whereas thirty-three papers fulfilled the eligibility criteria for the meta-analysis. The systematic review resulted in six themes of determinants impacting intention to leave: personal characteristics, job demands, employment services, working conditions, work relationships, and organisational culture. The main determinants impacting the intention to leave are the fear of COVID-19, age, experience, burnout symptoms and support. Meta-analysis showed a prevalence of intent to leave the current job of 38% for nurses (95% CI: 26%-51%) and 29% for physicians (95% CI: 21%-39%), whereas intention to leave the profession for nurses 28% (95% CI: 21%-34%) and 24% for physicians (95% CI: 23%-25%).

CONCLUSION

The findings of this paper showed the critical need for hospital managers to address the concerning increase in nurses' and physicians' intentions to leave during the COVID-19 pandemic. This intention to leave is affected by a complex conjunction of multiple determinants, including the fear of COVID-19 and the confidence in and availability of personal protective equipment. Moreover, individual factors like age, experience, burnout symptoms, and support are maintained in this review. Understanding the influence of determinants on retention during the COVID-19 pandemic offers an opportunity to formulate prospective strategies for retaining nurses and physicians within hospital settings.

The Impact of Moral Injury on Self-reported Work Performance in Hospital Nurses Following the Global Pandemic Surge

OBJECTIVE

The aim of this study was to determine relationships between moral injury (MI) and self-reported nurse work performance (NWP) among hospital nurses after the COVID-19 pandemic surges.

BACKGROUND

Previously studied in the military, nurse MI became evident due to the pandemic. No previous studies have examined the impact of MI on NWP. Few studies have attended to how MI in nurses can be addressed by nursing leadership.

METHODS

A convenience sample of 191 nurses from 7 hospitals in Southern California participated in a multisite correlational survey-design study.

RESULTS

Significant levels of MI occurred in 57% (n = 114) of participants. Increased levels of MI were a significant predictor of decreased levels of self-reported NWP. Younger and less experienced nurses reported greater levels of MI.

CONCLUSIONS

This study relates MI in nurses to NWP. There is a need for further research to assist nursing administrators in ameliorating MI in nurses and in preparing for the impact of MI on the nursing workforce in future emergent situations.

Work-related stress among nurses in the COVID-19 pandemic: What are the contributing factors?

OBJECTIVE

To analyze the contributing factors of work-related stress among nurses in the COVID-19 pandemic.

METHODS

A cross-sectional study was conducted with 101 nurse practitioners from two hospitals in West Java, Indonesia. We distributed an online questionnaire to evaluate work-related stress and the data were analyzed using ordinal logistic regression.

RESULTS

More than half of the nurses experienced moderate work-related stress. The study revealed that nurses aged over 35 years old had a lower likelihood of experiencing work-related stress (AOR: 0.173; 95%CI: 0.038-0.782). Married nurses had a higher likelihood (AOR: 7.156; 95% CI: 1.456-35.163). Additionally, nurses with low and moderate workloads had a lower likelihood (AOR: 0.003; 95%CI: 0.000-0.051) and (AOR: 0.025; 95%CI: 0.005-0.116), respectively.

CONCLUSION

The consideration of age, marital status, and workload is essential in effectively addressing work-related stress among nurse practitioners.

Perceived occupational stressors among nurses in a level-1 trauma center under normalized COVID-19 epidemic prevention and control in China: A qualitative study

Background

Nurses in trauma centers encounter emergency patients and are exposed to occupational stressors under normalized pandemic control and prevention.

Objective

The objective of this study was to examine the occupational stressors that nurses perceived during the COVID-19 pandemic in a level-1 trauma center in China.

Methods

From December 2020 to May 2021, a qualitative study was conducted, employing conventional content analysis as the research methodology. A total of twelve nurses were purposefully selected from a trauma center at a major hospital in Beijing to participate in semi-structured interviews (40-50 min' duration). The data collected in this study were analyzed using the conventional content analysis approach proposed by Graneheim and Lundman.

Results

After analyzing the data, two themes emerged: 1) Critical conditions under normalized pandemic prevention and control; 2) Concerns about loved ones and colleagues, along with financial problems. Both these themes further revealed four categories: the complexity and uncertainty of epidemic prevention and health hazards in the former, and concerns for and from families and colleagues, and financial stress in the latter.

Conclusions

The results of this study provide valuable insights into the practical implementation of epidemic prevention and control measures in Chinese trauma centers and shed light on the psychological stress faced by nurses. Improving the tripartite support system of hospital, family, and society, and providing emotional support may help reduce stress among nurses, thereby improving their health and care quality.

Burnout and Professional Engagement during the COVID-19 Pandemic among Nursing Students without Clinical Experience: A Cross-Sectional Study

Burnout affects many healthcare professionals, especially nurses, causing serious health problems and disrupting the work environment. Academic burnout may also be experienced, leading students to feel unable to cope with their education. As a result, they may lose interest and even consider abandoning their studies. Hence, burnout syndrome can affect both the mental health and the professional future of those affected. To evaluate academic burnout in nursing students who had no clinical experience before starting their practical training, a cross-sectional study involving 212 third-year nursing students at the University of Granada was conducted. Data were collected using the Granada Burnout Questionnaire, the Utrecht Work Engagement Scale, the NEO Five-Factor Inventory, the Hospital Anxiety and Depression Scale, and the Fear of CoronaVirus-19 Scale. High levels of burnout were present in 37.8% of the students. Moreover, 21.5% and 8.7% had borderline cases of anxiety or depression, respectively. Another 30.8% and 9.2%, respectively, were considered likely to present these conditions. According to the predictive models of burnout dimensions obtained, neuroticism is a predictor of all three burnout dimensions. Furthermore, anxiety, depression, extraversion, responsibility and engagement are predictors of some dimensions of the syndrome. Many nursing students present high levels of burnout, which is related to certain personality variables and to the presence of anxiety and/or depression. The level of professional engagement is inversely associated with the impact of burnout. The participants in this study have normalised their return to the pre-pandemic study routine (in-person classes), and fear of COVID-19 was not a significant predictor of any dimension of burnout.

A retrospective analysis of coping competence among community health centers during the COVID-19 pandemic in Shanghai, China: Coping strategies for future public health emergency events

This study aims to investigate the coping competence of 12 community health centers through nursing workforce, emergency preparation, emergency response training, and emergency support in a district of Shanghai during the coronavirus disease 2019 (COVID-19) pandemic in 2022 to propose coping strategies and implication for Future Public Health Emergency Events for community health centers. A cross-sectional survey was conducted on June 2022, and 12 community health centers (servicing a population of 104,472.67 ± 41,421.18, with 125 ± 36 health care providers per center) were then divided into group A (n = 5, medical care ratio ≥ 1:1) and group B (n = 7, medical care ratio < 1:1) according to collected data, and the nursing human resources management and coping competence of the centers with COVID-19 of both groups were retrospectively analyzed. Nursing shortages were obvious across all 12 centers. Certain deficiencies in the coping competence of community health centers with emergencies must be addressed (possession rate < 70% in both groups, p > 0.05). Community health centers need to enhance hospital-to-hospital collaboration and the ability to transport emergency staff to the post promptly during outbreaks. Emergency coping assessments, emergency drills at different levels, and mental health support need to be implemented regularly among community health centers, and effective donation management should be pursued as well. We expect that this study could support efforts by leaders of community health centers to conclude coping strategies including increasing nursing workforce, optimizing human recourse management, and identifying areas of improvement of centers for emergency coping during public health events.

Psychosocial risks emerged from COVID-19 pandemic and workers' mental health

This paper examines the impact of work in a pandemic context on workers' mental health. Psychosocial risks have always been a challenging aspect of workplace health and safety practices. Moreover, the COVID-19 pandemic has affected workplaces in all sectors causing unexpected changes in work organization and working conditions, leading to the emergence of new psychosocial risks for health and wellbeing of workers. This mini-review aims to identify the main work stressors during pandemic period and related mental health problems to suggest recommendations and adjust health and safety practices regarding workplace mental health. A literature search has been performed using MEDLINE/PubMed, ResearchGate and Google Scholar databases, selecting articles focusing on work-related stressors and workers' mental health problems related to the pandemic. Specific psychosocial risks have been identified, including fear of contagion, telework-related risks, isolation and stigmatization, rapid digitalization demands, job insecurity, elevated risk of violence at work or home, and work-life imbalance, among others. All those risks can lead to elevated levels of stress among workers and affect their mental health and wellbeing, especially in terms of psychological distress, anxiety, and depression. As one of the social determinants of health, the workplace has an important and moderating role in workers' health. Therefore, in the pandemic context more than ever health protection practices at the workplace should be devoted to mental health problems. Recommendations provided in this study are expected to contribute to workplace practices to preserve and promote workers' mental health.

Lessons Learned from the COVID-19 Outbreak as Experienced by ICU Nurses: Manifest Qualitative Content Analysis

From the moment the World Health Organization (WHO) declared the coronavirus (COVID-19) a global pandemic, intensive care unit (ICU) nurses struggled to care for the COVID-19 patients. As the pandemic became increasingly critical, the task of daily care for critically ill patients fell upon the shoulders of ICU nurses. Understanding the lived experience of ICU nurses, as well as their perception of the experience, is important to identify key lessons to further improve ICU nurses' psychological well-being and resilience. This study explored the lived experiences of ICU nurses who cared for COVID-19 patients using exploratory manifest qualitative content analysis. The findings of this study revealed that these ICU nurses offer important information concerning the crucial role of nurses' family support and religious-spiritual practices in helping them to maintain well-being and cope with the intense situations caused by the pandemic. The lessons emerging from the study findings show that family support and religious-spiritual practices are resources for coping and resilience in times of future pandemics. This implies that ICU nurses who provide care during stressful emergency surges require relief by nurses working in other areas to provide them the opportunity to rest, reconnect with family and become emotionally re-energized.

Psychosocial Burden and Quality of Life of Surveyed Nurses during the SARS-CoV-2 Pandemic

This study analyzes the impact of occupational burnout on the quality of life (QOL) of nurses surveyed during the SARS-CoV-2 pandemic. A total of 668 active nurses employed in public hospitals in Podkarpackie voivodeship (Poland) were surveyed. Throughout the pandemic, all wards where responders worked had a division into so-called "clean" and "dirty" zones, as well as balanced working hours. The research used the authors' survey questionnaire Maslach Burnout Inventory (MBI) and the Polish version of the World Health Organization Quality of Life Instrument Short Form (WHOQOL-BREF). Descriptive statistics were used in the analysis of the collected material, while correlations between ordinal or quantitative variables were made using Spearman's-rho coefficient. According to 94.0% of respondents, stress is an integral part of the nursing profession. The mean of the respondents' MBI burnout was 50.83 +/- 9.05 pts. The respondents' overall quality of life also averaged 65.74 +/- 13.12 pts. There were negative statistically significant correlations between the MBI and BREF domains, most of which were characterized by clear strengths of association. Higher exhaustion in various occupational aspects is associated with poorer quality of life in individual domains.