Predicting Factors of Depression and Anxiety in Mental Health Nurses: A Quantitative Cross-Sectional Study

Comparing nurses attending a specialised mental health programme with and without substance use disorder: a retrospective, observational study in Spain

OBJECTIVES

To analyse the differences between nurses with and without substance use disorders (SUDs) admitted to a specialised mental health programme.

DESIGN

Retrospective, observational study.

SETTING

Specialised mental health treatment programme for nurses in Catalonia, Spain.

PARTICIPANTS

1091 nurses admitted to the programme from 2000 to 2021.

INTERVENTIONS

None.

PRIMARY AND SECONDARY OUTCOMES

Sociodemographic, occupational and clinical variables were analysed. Diagnoses followed Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision criteria.

RESULTS

Most nurses admitted to the programme were women (88%, n=960) and came voluntarily (92.1%, n=1005). The mean age at admission was 45 (SD=10.4) years. The most common diagnoses were adjustment disorders (36.6%, n=399), unipolar mood disorders (25.8%, n=282), anxiety disorders (16.4%, n=179) and SUDs (13.8%, n=151). Only 19.2% (n=209) of the sample were hospitalised during their first treatment episode. After multivariate analysis, suffering from a SUD was significantly associated with being a man (OR=4.12; 95% CI 2.49 to 6.82), coming after a directed referral (OR=4.55; 95% CI 2.5 to 7.69), being on sick leave at admission (OR=2.21; 95% CI 1.42 to 3.45) and needing hospitalisation at the beginning of their treatment (OR=12.5; 95% CI 8.3 to 20).

CONCLUSIONS

Nurses with SUDs have greater resistance to voluntarily asking for help from specialised mental health treatment programmes and have greater clinical severity compared with those without addictions. SUDs are also more frequent among men. More actions are needed to help prevent and promote earlier help-seeking behaviours among nurses with this type of mental disorder.

BURNOUT PREVALENCE IN INTENSIVE CARE UNIT, GENERAL SURGERY UNIT AND EMERGENCY UNIT. A ROMANIAN STUDY

Objective

This study aims to investigate the effect of job characteristics and protective factors on burnout, one of the common medical staff issues. So far, little attention has been paid to testing protective factors' role on medical staff exhaustion.

Design

Using a correlation design, these constructs were tested on a sample of 221 participants, doctors, and nurses.

Main Outcome

The present study revealed protective factors power in predicting burnout, over job characteristics, and the moderation effect of role-playing in the medical care unit and clinical department.

Measures

For assessing burnout were used a Romanian translated version of the Maslach Burnout Inventory - General Survey (MBI).

Results

Protective factors like physical activities, vacation, and hours spent with family introduced an explanatory model and had a predictive validity over job characteristics in predicting medical staff's burnout. Finally, the effect of physical activities on burnout was moderated both by the role played in the medical care unit and clinical department, while the effect of time served in other medical institutions was moderated only by the role played in the medical care unit.

Conclusion

These results provide guidance for better burnout programs interventions, which are addressed to medical healthcare experts.

COVID-19 Vaccination under Conditions of War in Ukraine

The COVID-19 pandemic, which spread around the world in 2020, changed the lives of millions of people and affected the life and functioning of all countries and people without exception. With the emergence of the opportunity to be vaccinated against COVID-19, the problem of making a decision about vaccination also appeared. But it has become increasingly clear that the coronavirus is moving into the group of annual viral epidemic diseases that occur every year in different countries during the seasonal wave of acute respiratory viral infections. The ongoing COVID-19 pandemic against the background of the adoption of serious quarantine measures indicates the need for large-scale vaccination of the population as the most effective way to protect against COVID-19. In this article, we pay special attention to vaccination, as the main factor in ensuring health, reducing the morbidity and severity of the course of the COVID-19 disease, and an important task of the state and modern public administration.

Current aspects of vaccination against Covid-19 under conditions of war in Ukraine: Problems and prospects

The pandemic of the coronavirus infection Covid-19, which spread around the world in 2020, changed the lives of millions of people and negatively affected the life and functioning conditions of all countries, people and nations without exception. With the emergence of the opportunity to be vaccinated against Covid-19, the problem of making a decision about vaccination also appeared. But recently, it has become increasingly clear that the coronavirus disease in the world is moving into the group of annual viral epidemic diseases that occur every year in different countries during the seasonal wave of acute respiratory viral infections. The ongoing Covid-19 pandemic against the background of the adoption of serious quarantine measures indicates the need for large-scale vaccination of the population as the most effective way to protect against Covid-19. In this article, we pay special attention to vaccination, as the main factor in ensuring health, reducing the morbidity and severity of the course of the Covid-19 disease, and an important task of the state and modern public administration. Plans regarding vaccination, under the conditions of the war in Ukraine, will not be implemented in full - this all the more requires attention to this issue.

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.

Anxiety and Depression Levels and Coping Strategies among Polish Healthcare Workers during the COVID-19 Pandemic

During the COVID-19 pandemic, medical staff were commonly exposed to stress, work under pressure, and long shifts, and may have experienced a fear of infecting loved ones or a fear for their own health. All of these factors may have increased the likelihood that healthcare workers will experience the symptoms of depression, anxiety, or other mental health disorders. In this cross-sectional study, a group of respondents was gathered from the employees of 78 hospitals in Poland. A questionnaire was completed electronically by 282 people, aged between 20 and 78 years. The study used the Hospital Anxiety and Depression Scale (HADS) and the MiniCOPE questionnaire to examine anxiety and depression symptoms, and coping strategies, respectively. With age, the respondents declared fewer symptoms of anxiety and tended to have milder symptoms of depression. Participants with chronic illnesses, mood disorders, or anxiety disorders also reported higher levels of anxiety and depression symptoms. More than 20% of healthcare workers felt the need to consult with a psychologist. In the entire group of healthcare professionals surveyed, the most commonly used strategies for coping with stress were "denial", "psychoactive drug and alcohol use", and "cessation of activities", while the least used strategy was "acceptance". Given the most commonly used strategies in the surveyed group of healthcare professionals, they may be predictors for a deterioration in mental state in the long run. The obtained results also suggest that it is likely that pre-existing health problems had a greater impact on the mental health of medical staff during the COVID-19 pandemic than the profession itself. Therefore, taking care of the well-being and mental health of healthcare workers should be a priority for employers.

The Effect of Psychological Resilience and Coping Strategies on Mental Health of Nurses

INTRODUCTION

Nursing professional is considered to be stressful with impact on nurses' mental health.

AIM

The aim of this study was to investigate the effect of coping strategies and psychological resilience on anxiety and depression among nurses.

METHODS

In this descriptive and cross-sectional study, 378 nurses from two hospitals (a general and a psychiatric) in Greece completed the Patient Health Questionnaire-2 (PHQ-2), the Generalized Anxiety Disorder-2 (GAD-2), the Connor-Davidson Resilience Scale 25 (CD-RISC 25), and the Ways of Coping Questionnaire for evaluating the depression, anxiety, psychological resilience, and coping strategies, respectively. The study was carried out between October and December of 2019. Statistical analysis was performed with JASP version 0.14.01 and significance for all statistical tests was set at 0.05 or less.

RESULTS

Psychological resilience was significantly correlated with anxiety (r = -0.127, p = 0.014), Positive approach (r = -0.466, p<0.001), Seeking social support (r = -0.228, p < 0.001), Avoidance/Escape (r = -0.121, p = 0.020). Anxiety was positively correlated with Seeking social support (r = -0.112, p = 0.030), Prayer/Daydream (r = -0.132, p = 0.030), Avoidance/Escape (r = -0.164, p < 0.001), and Assertive problem solving (r =-0.195, p < 0.0010). Psychological resilience, Avoidance, and Assertive problem-solving were significant predictors of increasing of anxiety (β = -0.128, p = 0.013, β = 0.130, p = 0.027, β = 0.131, p = 0.020, respectively). Avoidance (β = 0.209, p < 0.001) and age (β = 0.208, p = 0.029) were significant predictors of depression.

CONCLUSIONS

Psychological resilience and coping strategies have a significant effect on nurses' mental health.

The other side of COVID-19: A cross-sectional study on mental health in a sample of Italian nurses during the second wave

Introduction

The COVID-19 pandemic has led to a drastic increase in the workload of healthcare professionals, particularly nurses, with serious consequences for their psychological well-being. Our study aimed to identify demographic and work-related factors, as well as clinical predictors of post-traumatic stress disorder (PTSD) and generalized anxiety disorder (GAD), in nurses employed during the COVID-19 pandemic.

Methods

We carried out a cross-sectional study between December 2020 and April 2021 on nurses employed during the COVID-19 second wave (October - December 2020). We evaluated PTSD and GAD using two validated questionnaires: i) the Impact of Event Scale - Revised (IES-R); and ii) General Anxiety Disorder -7 (GAD-7).

Results

Overall, 400 nurses, whose mean age was 34.3 years (SD ± 11.7), were included in the study. Most were female (78.5%), unmarried (58.5%) and employed in the central (61.5%) regions of Italy. A total of 56.8% of all participants had clinical predictors of PTSD, recording a median IES-R score (IQR) of 37.0 (22.0, 51.0) (range 1-84; cut-off >33 for PTSD). Furthermore, 50% of respondents reported moderate-to-severe symptoms consistent with GAD, recording a median GAD-7 score (IQR) of 9.5 (6.0,14.0) (range 0-21; cut-off >10 for GAD). Multivariable analysis showed that moderate-to-severe GAD (aOR = 4.54, 95% CI: 2.93 - 7.05), being employed in the critical care area (aOR = 1.74, 95% CI: 1.01 - 3.00) and being female (aOR= 1.88, 95% CI: 1.09 - 3.22) were significantly associated with the presence of clinical predictors of PTSD.

Discussion

The levels of PTSD symptoms and anxiety among nurses were high during the pandemic. PTSD and GAD represent a public health problem that should be addressed in the post-pandemic period. Healthcare organizations need to activate specific support and rehabilitation networks and programs for healthcare professionals employed during the COVID-19 pandemic.

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.

Talent Management in the Hospitality Sector: Predicting Discretionary Work Behaviour

Hospitality organisations have suffered a lot of setbacks, such as low performance caused by the COVID-19 pandemic, during which most management took drastic decisions to retrench talent, and these decisions have engendered low discretionary work behaviour and low emotional labour display amongst its talent. These maladies would have been averted if talent management practices were implemented effectively by hospitality organisations. It is based on this premise that this study investigates the effect of talent management on discretionary work behaviour in hospitality organisations in Nigeria using a survey research design. A sample frame of 820 was drawn from 60 registered hospitality organisations in the south-eastern part of Nigeria. A sample size of 263 was drawn from the sample frame. Linear regression was employed to analyse the formulated hypotheses with the aid of IBM statistical package for the social sciences version 20.0. The findings of the study show that talent management dimensions have significant effects on discretionary work behaviour in hospitality organisations in Nigeria. The study concludes that talent management measured in terms of talent attraction, talent development and talent retention have significant effects on the indicators of discretionary work behaviour. The study recommends that human resource professionals and organisational leaders should utilize talent management as a strategy to enhance discretionary work behaviour in their respective organisations.

Prevalence and determinants of depression, anxiety and stress among psychiatric nurses in Ghana: a cross-sectional study

Background

The job demand and stress associated with the nursing profession expose nurses to an increased risk of psychiatric morbidities such as anxiety and depression. This study assessed the prevalence of depression, anxiety and stress among psychiatric nurses in Ghana.

Methods

A cross-sectional survey was conducted in three psychiatric hospitals in Ghana between March 2020 and May 2021. Simple random sampling technique were used to select 311 psychiatric nurses. Beck’s Depression Inventory, Beck’s Anxiety Inventory and Perceived Stress Scale were used to assess depression, anxiety and stress, respectively. Data were analysed using SPSS version 23.0.

Results

The results showed that 19.6% of psychiatric nurses experienced mild to severe depression, 27% mild to severe anxiety and 42% mild to high stress. Regression analysis showed that participants with a diploma qualification had higher odds of having moderate depression compared to those with a master’s degree. In terms of stress, participants with a diploma qualification were 29.6% less likely to have moderate stress compared to those with a master’s degree. Those with a bachelor’s degree were 7.1% less likely to have moderate stress compared to those with a master’s degree.

Conclusion

Psychiatric nurses experience depression, anxiety and stress to varying degrees. Education level was identified as a determinant of depression, anxiety and stress. Therefore, preventive strategies should be designed to reduce the risk of these conditions.

Relationship between work–family conflict, sleep quality, and depressive symptoms among mental health nurses

Background

Nursing has a reputation for being one of the most stressful occupations. As a result of their work, many nurses suffer from anxiety and depression. Nurses are also at risk of poor sleep owing to their work nature. This study aimed to examine the relationship between work–family conflict, sleep quality, and depressive symptoms among mental health nurses. A descriptive cross-sectional study design was utilized in this study. Setting/sample: This study was conducted at El Azazi Hospital for Mental Health, Al-Sharkia Governorate on 139 mental health nurses. Four tools were used in this study: Socio-demographic data sheet, Work–Family Conflict Scale, Arabic Pittsburgh Sleep Quality Index, and Arabic Center for Epidemiologic Studies Depression Scale.

Results

Results revealed that, a significant percentage of mental health nurses suffered from poor sleep quality and depressive symptoms, there were highly statistically significantly positive correlations between work–family conflict (WFC) and both of Pittsburgh Sleep Quality Index (PSQI) and depressive symptoms among nurses.

Conclusions

Working with psychiatric patients affected their nurses, which disturbed their sleep quality and led to depressive symptoms. As well, increasing work–family conflict in mental health nurses leads to poor sleep quality and depressive symptoms. Family interference with work, sleep quality, and work interference with family were statistically significant predictors of depressive symptoms.

The influence of workplace stress and coping on depressive symptoms among registered nurses in Bangladesh

Background

Nurses report high levels of workplace stress, which has been linked to an increased risk for experiencing depressive symptoms. Nurses' workplace stress is also linked to increased absenteeism and decreased job satisfaction.

Objectives

The objectives of this study were to examine: (1) the incidence of depressive symptoms among hospital-based registered nurses in Bangladesh; (2) common sources of workplace stress and their relationships to individual characteristics and depressive symptom scores; and (3) the potential mediating roles of coping strategies in the relationship between workplace stress and depressive symptoms.

Methods

A cross-sectional study design involved three hundred and fifty-two registered nurses. Data were collected using a demographic questionnaire and three standardized tools measuring sources of nurses' workplace stress, coping strategies, and depressive symptoms.

Results

More than half of the participants scored ≥ 16 on the CES-D, which was associated with a major depression episode. Total NSS scores had a small but significant influence on scores on the depression scale. Coping strategies had no mediated effect on the relationship between workplace stress and scores on the depression scale. Low-reliability coefficients for subscales of two of the standardized tools highlight the challenge for researchers in developing countries to address contextual differences that may influence the meanings attached to individual items.

Conclusion

Findings suggest that the mental health of registered nurses in Bangladesh requires immediate attention in part by attending to workplace stressors. Further research should focus on a deeper understanding of Bangladeshi registered nurses' work experiences and the unique contribution that workplace stressors have on their physical and mental health.

"It Is Difficult to Always Be an Antagonist": Ethical, Professional, and Moral Dilemmas as Potentially Psychologically Traumatic Events among Nurses in Canada

AIMS

We explore social and relational dynamics tied to an unexplored potentially psychologically traumatic event (PPTE) that can impact nurses' well-being and sense of their occupational responsibilities: namely, the moral, ethical, or professional dilemmas encountered in their occupational work.

DESIGN

We used a semi-constructed grounded theory approach to reveal prevalent emergent themes from the qualitative, open-ended component of our survey response data as part of a larger mixed-methods study.

METHODS

We administered a national Canadian survey on nurses' experiences of occupational stressors and their health and well-being between May and September 2019. In the current study, we analyzed data from four open text fields in the PPTE section of the survey.

RESULTS

In total, at least 109 participants noted that their most impactful PPTE exposure was a moral, professional, and/or ethical dilemma. These participants volunteered the theme as a spontaneous addition to the list of possible PPTE exposures.

CONCLUSIONS

Emergent theme analytic results suggest that physicians, other nurses, staff, and/or the decision-making power of patients' families can reduce or eliminate a nurse's perception of their agency, which directly and negatively impacts their well-being and may cause them to experience moral injury. Nurses also report struggling when left to operationalize patient care instructions with which they disagree.

IMPACT

Nurses are exposed to PPTEs at work, but little is known about factors that can aggravate PPTE exposure in the field, impact the mental wellness of nurses, and even shape patient care. We discuss the implications of PPTE involving moral, professional, and ethical dilemmas (i.e., potentially morally injurious events), and provide recommendations for nursing policy and practice.

Depression and empathy in health professionals who work in the long-term care institutions for older adults

Empathy is an important factor to guarantee the quality of care provided in the long-term care institutions (LTCIs) for older adults, and depression is a factor that affects the health of the professional and, consequently, the care. Thus, it is important that studies are conducted on the relationship of these variables in this context.

Mental health nurses' psychological well-being, mental distress, and workplace resilience: A cross-sectional survey

Mental health nurses (MHNs) frequently face emotional adversity and stressors at work that can negatively impact their psychological well-being and result in mental distress. This can affect their capacity for therapeutic work, professional relationships, and overall work performance. In the context of work, resilience is a dynamic process of positive adaptation to adversity that can lead to psychological well-being and increased work performance. There is limited knowledge, however, on MHNs' psychological well-being and resilience from an Australian perspective. This study aimed to investigate the levels of, and relationships between, psychological well-being, mental distress, and workplace resilience in Australian MHNs. A cross-sectional online survey using Ryff's Scales of Psychological Well-being (PWS) 18, Depression, Anxiety and Stress (DASS) 21, and Resilience at Work measures was completed by registered nurses (n = 482) working in a mental health setting or role. Mean scores were 85.38 for psychological well-being and 70.27 for workplace resilience, with more than half reporting levels above the mean. However, some participants scored in the severe to extremely severe categories for depression (7.8%), anxiety (8.7%) or stress (7.3%). Psychological well-being had strong positive and negative associations, respectively, with workplace resilience (r = 0.571, P < 0.01) and depression (r = -0.563, P < 0.01). Having a postgraduate specialist qualification was positively associated with psychological well-being. Postgraduate speciality education may be a key protective factor that can increase MHNs' psychological well-being. Strengthening workplace resilience is an important strategy for organizations to implement to support MHNs' psychological well-being and reduce the risk of mental distress.

Depression, Anxiety and Quality of Life in Staff of a Hospital in Athens: A Study in the Aftermath of the Debt Crisis Era

Background

Several studies investigated the mental health needs of hospital staff in Greece during the debt crisis era. Yet, no relevant data are available regarding the mental health of hospital staff after this period. The aims of this study are: 1) To investigate the prevalence of clinically significant depression and anxiety in healthcare workers in a general hospital in Athens, Greece; 2) to search for the association of quality of life with anxiety and depression in those workers; 3) to investigate the association of sociodemographic characteristics with those parameters.

Methods

The Zung Depression Rating Scale, the Zung Anxiety Rating Scale, the Short-Form Survey-12, assessing quality of life, and sociodemographic assessments were administrated in 110 workers of a public hospital in Athens, Greece. The assessments were completed during January, 2020.

Results

Of the study participants, 38.2% had clinically significant anxiety and 6.4% had clinically signifi-cant depression. Males had lower scores of depression compared to females (p=0.003). As for the effects of educational level, differences were noted in psychological quality of life between secondary education participants when compared to tertiary education (Mean Difference -3.527, p=0.021), post-graduate (Mean Difference -3.937, p=0.012) and PhD participants (Mean Difference -5.100, p=0.007). Quality of life and its psychological and physical health subscales had strong inverse associations with depression and anxiety (p=0.000).

Conclusions

Relevant interventions are necessary to decrease anxiety in hospital staff, which is elevated in the aftermath of the debt crisis period. In addition, health policy makers have to reduce the gender gap in mental health between male and female workers, since the latter had higher levels of depression.

Relations between Stress and Depressive Symptoms in Psychiatric Nurses: The Mediating Effects of Sleep Quality and Occupational Burnout

This study examines the parallel multiple mediators of quality of sleep and occupational burnout between perceived stress and depressive symptoms in psychiatric nurses. Nurses are more likely to experience depression, anxiety, decreased job satisfaction, and reduced organizational loyalty as a result of the stressful work environment and heavy workload. A total of 248 psychiatric ward (PW) nurses participated in this cross-sectional survey study. Structural equation modelling was used for data analysis. In the model of parallel multiple mediators for depressive symptoms, quality of sleep and occupational burnout played mediating roles, and these two mediators strengthened the effect of stress on depressive symptoms, with the final model showing a good fit. Stress, occupational burnout, and quality of sleep explained 46.0% of the variance in psychiatric nurses’ depressive symptoms. Stress had no significantly direct effect on psychiatric nurses’ depressive symptoms, but it had a completed mediation effect on their depressive symptoms through occupational burnout and quality of sleep. This study showed that reduction of occupational burnout and improvement of quality of sleep play important roles against depressive symptoms among PW nurses. Healthcare managers should provide PW nurses with a better environment for improving quality of sleep and reducing occupational burnout.

Mental health matters: A cross-sectional study of mental health nurses' health-related quality of life and work-related stressors

Mental health nursing is widely recognized as a stressful occupation; however, little is known about the relationship between work-related stress and health-related quality of life of mental health nurses (MHN). This study aimed to identify MHN health-related quality of life (HR-QoL) and work-related stressors; associations between stressors and HR-QoL; and predictors of HR-QoL. An online cross-sectional survey collected demographic data, work-related stressors and HR-QoL (SF-12v2) of n = 498 Australian MHN. Prominent consumer/carer-related stressors were verbal (90%) and physical aggression (85%). Collegial stressors included staff conflict (71%) and bullying (55%), and colleague-perpetrated verbal (34%) and physical aggression (7%). Key organizational stressors included high workloads (74%), lack of organizational support (60%) and lack of adequate resources to perform nursing role (58%). The mean physical health score was 52.62 (SD = 8.30), and mental health score was 43.59 (SD = 11.34), with mental health substantially lower than national norms (mean difference = 10.11). There were statistically significant negative correlations between the number of work-related stressors and HR-QoL. Younger (21-30 years) and less experienced (<1-4 years) MHN had substantially lower mental health. Higher mental health was predicted with < 15 stressors, >4 years' experience and working in the community. The poorer mental health of MHN has concerning implications for the well-being, retention and practice of the largest group in the mental health workforce. There is a critical need for organizations to enact effective policy and initiatives to reduce workplace aggression, improve staff psychological and physical safety, and strengthen well-being and resilience. New graduates are a priority group for urgent intervention.

Promoting Mental Health of Nurses During the Coronavirus Pandemic: Will the Rapid Deployment of Nurses' Training Programs During COVID-19 Improve Self-Efficacy and Reduce Anxiety?

Introduction The nursing profession is extremely demanding and stressful. Nurses have been facing a tremendous amount of fear and anxiety during the ongoing coronavirus disease 2019 (COVID-19) pandemic. General self-efficacy is considered one of the most influential factors that can modify the impact of anxiety on nurses' mental health. In this study, we aimed to determine the predictors of self-efficacy and anxiety among nurses during the current COVID-19 pandemic. Methods We conducted a cross-sectional survey involving 368 nurses working in a tertiary care hospital. The General Self-Efficacy scale (GSE) and Generalized Anxiety Disorder Scale-7 (GAD-7) were used for assessing self-efficacy and anxiety. The chi-square test followed by bivariate and multivariable regression analyses was performed to identify the determinants of self-efficacy and anxiety. Results The mean age of the nurses was 28.91 years (SD=3.68), with a mean working experience in the nursing field of 5.32 years (SD=2.48). The mean self-efficacy and anxiety scores were 32.19 (SD=4.53) and 3.82 (SD=2.87), respectively. Multivariable analysis showed that higher age (>30 years, p=.003), professional education acquired through a diploma course instead of a graduate degree (p<.001), and lack of training on handling COVID-19 patients (p=.003) were significant determinants of higher anxiety among nurses. Similarly, higher economic status (p=.001), sufficient COVID-19 training (p=.049), having family members tested positive for COVID-19 (p=.012), professional experience (≤5 years, p<0.001), and quarantine period (≤14 days, p=.002) were revealed to be independent determinants of a higher sense of self-efficacy among nurses during the COVID-19 pandemic. Conclusion Receiving adequate levels of training on COVID-19 plays a vital role in improving self-efficacy and reducing anxiety among nurses during the ongoing pandemic. Managing anxiety, increasing self-efficacy, and ensuring more exposure to COVID-19-related training may improve nurses' mental health and prepare them for fighting pandemics in a much better and more efficient manner.

Exposures to Potentially Psychologically Traumatic Events Among Nurses in Canada

BACKGROUND

Nurses are regularly exposed to diverse potentially psychologically traumatic events (PPTEs) as a function of their work. Cumulative exposure to PPTEs can lead to clinically significant symptoms of mental disorders.

PURPOSE

We designed the current study to investigate the prevalence of different PPTEs among Canadian nurses and estimate the associations between diverse exposures and several mental disorders.

METHODS

Canadian nurses (i.e., registered nurses, registered psychiatric nurses, licensed practical nurses, nurse practitioners) completed an online, self-reported survey. In total, 4067 participants (94.8% women) completed all relevant survey measures.

RESULTS

Nurses reported exposures to several PPTE categories including severe human suffering, life threatening illness or injury, and physical assault, often 11 or more times. There were significant (p<.05) associations between diverse traumatic events and all mental disorders (i.e., Posttraumatic Stress Disorder, Major Depressive Disorder, Generalized Anxiety Disorder, Panic Disorder) except Alcohol Use Disorder.

CONCLUSIONS

The current findings suggest that Canadian nurses are substantially exposed to traumatic events, which vary by several sociodemographic categories. PPTE exposures were significantly associated with mental disorders; that is, if PPTEs were eliminated among Canadian nurses in the sample, symptoms would be reduced between 42.0% and 58.0%.

Mental Disorder Symptoms Among Nurses in Canada

Background

Nurses face regular exposures to potentially psychologically traumatic events as part of their occupational responsibilities. Cumulative stress due to repeated exposure to such events is associated with poor mental health and an increased risk of developing clinically significant symptoms consistent with some mental disorders.

Purpose

The current study was designed to estimate rates of mental disorder symptoms among nurses in Canada and identify demographic characteristics that are associated with increased risk for mental disorder symptoms.

Method

An online survey was conducted with Canadian nurses in both English and French. Participants were recruited largely through the Canadian Federation of Nurses Unions (CFNU) member unions, non-CFNU member unions, and social media. The survey assessed current mental disorder symptoms using well-validated screening measures.

Results

A total of 4267 participants (93.8% women) completed the survey. Almost half of participants screened positive for a mental disorder (i.e., 47.9%). No gender differences emerged. Significant differences in proportions of positive screens based on each measure were found across demographic groups (e.g., age, province of residence, type of nurse).

Conclusions

The rate of positive screens appears much higher than mental disorder prevalence rates in the general Canadian population, but there were important methodological differences. The current results provide potentially important information to support researchers and healthcare administrators to investigate possible ways to mitigate and manage mental health in nursing workplaces.

Meaning, Joy, and Critical Care Nurse Well-Being: A Call to Action

Healthy nurses are essential for optimizing population health, patient care experiences, and health care cost-efficiency. Critical care nurses are at increased risk of developing physical and psychological symptoms due to their high-stress work environment and exposure to traumatic events. There is growing recognition for the value of implementing nurse-centered, team-based, and organizational-wide levels of intervention designed to mitigate the impact of high work stress and trauma on health professionals. The central assertion of this article is that meaning and joy in nursing practice are contributors to professional well-being and part of the solution for achieving the quadruple aim.

Prevalence of somatic and psychiatric morbidity across occupations in Switzerland and its correlation with suicide mortality: results from the Swiss National Cohort (1990-2014)

BACKGROUND

Suicide is a major and complex public health problem. In Switzerland, suicide accounts for about 1000 deaths yearly and is the fourth leading cause of mortality. The first nationwide Swiss study of suicides identified eight male and four female occupations with statistically significant excess of suicide compared to the general Swiss population. Working time, self-employer status, low socio-economic status and low skill level required for occupation were associated with increase in suicide risk. Presently, we aim to compare the distribution of suicide risk across occupations with the prevalence of somatic and psychiatric morbidity in Swiss working-aged adults. We hypothesized that some diseases would cluster in particular occupations, indicating potential work-relatedness of suicides found in these occupations.

METHODS

We used the Swiss National Cohort (SNC) and included 10575 males and 2756 females deceased by suicide between 1990 and 2014. We estimated the prevalence of 16 categories of concomitant diseases in each occupation, using national mortality records, and assessed the homogeneity of diseases distribution across occupations. For diseases, which prevalence varied significantly across occupations, we analyzed the correlation with the distribution of suicide risk, estimated as the standardized mortality ratio (SMR) of suicide.

RESULTS

Mental and behavioral disorders were the most commonly reported concomitant diseases in our population. In men, the prevalence of these disorders and more specifically, the prevalence of substance-related and addictive disorders, and of psychotic disorders varied significantly across occupations and was correlated with the SMR of suicide. The prevalence of malignant neoplasms and the prevalence of diseases of the musculoskeletal system and connective tissue also varied significantly across male occupations, while in women, such a variation was observed for neoplasms of uncertain or unknown behavior and diseases of the nervous system and sense organs, without being correlated with the SMR of suicide.

CONCLUSION

Some of the identified morbidities can be occupation-related and could negatively affect the working capacity and the employability, which in turn could be related to the suicide. Disentangling concomitant diseases according to their work-relatedness and relationship with the suicide risk is important for identifying occupation-related suicides, understanding their characteristics, and developing appropriated interventions for their prevention.

Suicidal Behaviors Among Nurses in Canada

BACKGROUND

Nurses are regularly exposed to potentially psychologically traumatic events, experience high rates of burnout, and may be at an elevated risk of death by suicide. Few studies have assessed for suicidal behaviors among Canadian nurses, and factors that may increase risk for suicidal behaviors are unknown.

PURPOSE

The current study was designed to assess past-year and lifetime suicidal behavior (i.e., ideation, plans, and attempts) using a large sample of Canadian nurses.

METHOD

Participants (n = 3969; 94.3% women) completed an online survey including measures of suicidal behavior and symptoms of mental disorders.

RESULTS

Considerable proportions of participants reported past-year and/or lifetime suicidal ideation (10.5%, 33.0%), plans (4.6%, 17.0%), and attempts (0.7%, 8.0%), considerably higher than general population estimates. Significant differences were identified across age groups, years of service, marital status, regional location, and nursing type (e.g., registered psychiatric nurses, licensed practical nurses, registered nurses). Participants who screened positive for almost all measured mental disorders had significantly higher rates of suicidal behavior.

CONCLUSIONS

The results necessitate further research to evaluate risk factors contributing to suicidal behavior in Canadian nurses and methods to decrease the risk (e.g., developing effective monitoring and prevention measures).

Assessment of the relation between religiosity, anxiety, depression and psychological resilience in nursing staff

The nursing profession is considered to be an emotionally demanding profession often lead to various psychological difficulties and extend level stress. Religiosity and religion in general, have been associated with positive outcomes in an individual's life such as higher self-esteem, better quality of life and psychological wellbeing. The purpose of this study was to examine the relation between nurses' religiosity, psychological resilience, and psychological wellbeing. In this cross-sectional study, 378 nurses participated. Dada were collected by using Centrality of Religiosity Scale, The Patient Health Questionnaire Two-Item Depression Scale, The Generalized Anxiety Disorder Questionnaire, Connor-Davidson Resilience Scale 25. Percentages, means, and standard deviations were calculated. In addition the parametric t-test and ANOVA were used. Also, logistic regression analyses were used to determine which factors affect the depression and anxiety of nurses. Results indicated differences with a probability of less than or equal to 0.05 were accepted as significant. For statistical analysis, we used the statistical program SPSS 25. According to our results although religious practices can be a protective factor for both depression and anxiety, religious beliefs and experiences can increase the levels of depression and anxiety as well.

Occupational Burnout and Its Related Factors Among Iranian Nurses: A Cross-Sectional Study in Shahroud, Northeast of Iran

BACKGROUND

Good physical and mental health of employees is one of the major characteristics of a healthy organisation.

AIM

Due to the importance of occupational burnout and its potentially negative consequences, the aim of this study was to assess occupational burnout and its related factors among Iranian nurses.

METHODS

In this cross-sectional study, 205 nurses who were working in two educational hospitals affiliated with Shahroud University of Medical Sciences were included. Forty-two of the nurses were male, and 163 were female (mean age: 31 years). Maslach Occupational Burnout Inventory, demographic and job characteristics questionnaires were completed for each nurse. Questionnaires were then collected, and data were analysed statistically by SPSS, version 22.

RESULTS

In the assessment of occupational burnout, the highest level was observed in emotional exhaustion and then in personal performance. There was a significant difference between the frequency of nurses' emotional exhaustion domain in terms of gender (P < 0.05), so that, women suffered more from emotional exhaustion. There was a significant difference between the frequencies of nurses' performance in terms of marital status (P < 0.05) so that married people had more personal performance disorder.

CONCLUSION

The results of this study showed that nurses suffered from low occupational burnout. Female gender, sleeping disorders, awakening at night and employment in stressful wards such as the emergency ward was associated with a higher level of occupational burnout in nurses.

Feasibility of Online Mental Wellness Self-assessment and Feedback for Pediatric and Neonatal Critical Care Nurses

PURPOSE

The primary goal of this study was to test the feasibility of an educational online self-assessment of burnout, resilience, trauma, depression, anxiety, and common workplace stressors among nurses working in a pediatric intensive care unit or neonatal intensive care unit setting. The secondary, exploratory objectives were to estimate the prevalence of psychiatric symptoms in this sample and to identify those variables that most strongly predict burnout.

DESIGN AND METHODS

Data from optional and anonymous online measures were analyzed for 115 nurses (67.9% aged 25-44; 61.7% Caucasian) working in an urban children's hospital pediatric or neonatal ICU. Multiple linear regressions identified demographic variables and workplace stressors that significantly predicted each of three components of burnout.

RESULTS

Most respondents found the educational assessment and feedback to be helpful. Choosing nursing as a second career was associated with better resilience. Having worked in ICU settings longer and being older were both linked to lower levels of anxiety. Predictors of burnout varied across the three burnout subscales.

CONCLUSIONS

Implementation of an online self-assessment with immediate educational feedback is feasible in critical care settings. The variability of predictors across the three burnout subscales indicates the need for tailored interventions for those at risk. Future research may include follow-up of nurses to examine changes in scores over time and expansion of the tool for other medical personnel.

PRACTICE IMPLICATIONS

An educational online self-assessment can be a helpful tool for pediatric critical care nurses experiencing varying degrees of burnout and distress.

A cross-sectional study for the impact of coping strategies on mental health disorders among psychiatric nurses

Several studies report that psychiatric nursing is a highly stressful occupation. The ways that nurses use in order to deal with stressful situations have a serious effect on their psychological mood and their health status. The purpose of this study was to investigate the coping strategies in predicting of depression and anxiety among mental health nurses working in public psychiatric hospitals. A descriptive, cross-sectional study was conducted in Athens, Greece from April to May 2017. A questionnaire consisting of the socio-demographic and work-related characteristics, the Patient Health Questionnaire-2, the Generalized Anxiety Disorder-2, and the 38-items Ways of Coping Questionnaire - Greek version, was completed by a total of 110 mental health nurses. Univariate and multivariate analyses were performed using the logistic regression model. Coping strategies focused on the problem (positive re-evaluation, positive approach, problem solving, and seeking social support) were the most commonly used by the mental health nurses. Strategies focused on emotion (prayer/daydream, prayer, avoidance/escape, resignation, and denial) were positively associated with depression and anxiety outcomes. Also, the coping skills of problem solving (Adjusted Odds Ratio, AOR=0.402), and seeking social support (AOR=3.719) were significant predictors only for elevated anxiety symptoms. The results from the study demonstrated the importance of coping behaviours in mental health problems of psychiatric nurses.