From students to nurses under pressure: Nursing students' entry into employment during the first COVID-19 wave

AIMS AND OBJECTIVE

To describe the experiences of nursing students and their mental health as they entered employment during the first wave of the COVID-19 pandemic (May-June 2020).

BACKGROUND

As other healthcare professionals, nursing students who worked during the first COVID-19 wave suffered from dysfunctional mental health symptoms.

DESIGN

Sequential, mixed-method, multicentre study.

METHODS

The study population comprised 92 students in the third and fourth year of the Nursing degree at three Spanish universities, who entered employment during the pandemic. Data were collected between May and June 2020. In the quantitative phase, data were collected using an online questionnaire containing both validated anxiety and stress scales. In the qualitative phase, semi-structured interviews were conducted with 18 participants. A descriptive analysis of the quantitative data and a reflexive thematic analysis of the qualitative data were carried out, and analyses were combined. COREQ checklist was used for reporting.

RESULTS

The combined quantitative and qualitative results were organised into five thematic areas: (1) Interruption of clinical placements, (2) Entering employment on a healthcare assistant contract, (3) Preventing contagion, (4) Adapting to the situation and managing emotions, and (5) Lessons learned.

CONCLUSION

The students had a positive overall experience of entering employment, as they were able to develop their nursing skills. However, they had an emotional impact in form of stress caused by excessive responsibility, academic uncertainty, lack of personal protective equipment and training in its use, and the possibility of spreading disease to their family members.

RELEVANCE TO CLINICAL PRACTICE

In the current context, changes must be made in study programmes to instruct nursing students to be able to cope with extreme clinical situations, such as pandemics. The programmes should include a more extensive coverage of epidemics and pandemics and management of emotional aspects such as resilience.

NANDA nursing diagnoses associated with the occurrence of psychomotor agitation in patients with severe mental disorder: a cross-sectional study

BACKGROUND

Psychomotor agitation is increased psychomotor activity, restlessness and irritability. People with psychomotor agitation respond by overreacting to intrinsic and extrinsic stimuli, experiencing stress and/or cognitive impairment. the aim was to analyse the association of nursing diagnoses with the disinhibition dimension, the aggressiveness dimension and the lability dimension of the Corrigan Agitated Behaviour Scale.

METHODS

This study was conducted in Spain using a multicentre cross-sectional convenience sample of 140 patients who had been admitted to psychiatric hospital units and had presented an episode of psychomotor agitation between 2018 and 2021.

RESULTS

The Corrigan Agitated Behaviour Scale was used to assess psychomotor agitation. Associated nursing diagnoses, violence directed at professionals and the environment are shown to be predictive values for the severity of the agitation episode. Moderate-severe psychomotor agitation episodes are shown as predictors of violence directed mainly at professionals and the environment.

CONCLUSIONS

There is an urgent need for mental health nurses to have knowledge of the extended clinic in order to care for users and improve their health conditions in dealing with people, with their social, subjective and biological dimension.

Health and well-being of refugees, asylum seekers, undocumented migrants, and internally displaced persons under COVID-19: a scoping review

Objectives

The objective of this scoping review was to identify what is known about the impact of COVID-19 on the physical and mental well-being of refugees, asylum seekers, undocumented migrants, and internally displaced persons. The aim was also to identify barriers influencing access to treatment or prevention.

Methods

The search was conducted using PubMed/Medline, CINAHL, Scopus, and ScienceDirect. A mixed methods appraisal tool was used to assess methodological rigor. The study findings were synthesized using a thematic analysis approach.

Results and Discussion

This review comprised 24 studies and were conducted utilizing a mixed method approach incorporating both quantitative and qualitative methodologies. Two major themes were identified related to the impact of COVID-19 on the health and wellbeing of refugees, asylum seekers, undocumented migrants, and internally displaced persons and the key barriers influencing access to treatment or prevention of COVID-19. They often have barriers to accessing healthcare due to their legal status, language barriers, and limited resources. The pandemic has further strained already limited health resources, making it even more challenging for these populations to receive healthcare. This review reveals that refugees and asylum seekers in receiving facilities face a higher risk of COVID-19 infection than the general population due to their less favorable living conditions. The various health impacts stem from a lack of access to accurate information about the pandemic, misinformation, and the exacerbation of pre-existing mental health issues caused by heightened stress, anxiety, and uncertainty, fear of deportation among undocumented migrants, and overcrowding camps and detention facilities that increase exposure risk. Social distancing measures are difficult to implement in these settings, and inadequate sanitation, hygiene, and a lack of personal protective equipment further compound the problem. Moreover, the pandemic has had significant economic consequences for these populations. Many of them rely on informal or precarious employment, which has been disproportionately affected by the pandemic. Job losses and reduced working hours, and limited access to social protection can lead to increased poverty, and food insecurity. Children faced specific challenges, such as disruptions to education, additionally, interruptions in support services for pregnant women. Some pregnant women have avoided seeking maternity care due to fears of contracting COVID-19, resulting in increased home births and delays in accessing healthcare services. Factors that play a role in vaccination reluctance include uncertainty of undocumented migrants' inclusion in vaccination programs, furthermore, a growing vaccine hesitancy in the population; skepticism about the safety of vaccines, inadequate knowledge/education, a variety of access barriers such as language barriers, and logistical challenges including remote locations, and inaccurate information.

Conclusion

This review highlights that the physical health of refugees, asylum seekers, undocumented migrants, and internally displaced persons has been significantly impacted by various barriers to healthcare access during the pandemic. These barriers include legal and administrative challenges, such as a lack of documentation. Additionally, the shift to digital tools has introduced new obstacles, not only due to language barriers or limited technical knowledge but also because of structural barriers, such as the requirement of a bank ID that is often inaccessible to these groups. Other factors contributing to limited healthcare access include financial constraints, language barriers, and discrimination. Additionally, limited access to accurate information about health services, prevention measures, and available resources may hinder them from seeking care or following public health guidelines. Misinformation and lack of trust in healthcare systems can also contribute to a reluctance to access care or vaccination programs. There is concerning evidence regarding vaccine hesitancy that needs to be addressed to reduce any future pandemic outbreak, in addition there is a need to explore the factors that play a role in vaccination reluctance among children in these populations.

Health and social needs of asylum seekers and Ukrainian refugees in Lithuania: A mixed-method protocol

Refugees, asylum seekers, and migrants often do not end up in the places they expected. Because of the pandemic impacts, their exposure to COVID-19 may be increased as a result of crowded camps and detention centers. A total of 4,537 undocumented migrants entered Lithuania via Belarus from June 2021 to November 30, 2022. In the period 24 February 2022 to 30 November 2022, Lithuania's Immigration Department registered 71,386 Ukrainian refugees. This study investigates the healthcare and social needs of recent asylum seekers who have crossed the Belarusian border and Ukrainian refugees in Lithuania. This is a study protocol for a mixed-methods study which will involve qualitative interviews with asylum seekers who crossed from Belarus in June 2021 and Ukrainian refugees. During a quantitative phase, refugees and asylum seekers will be asked to complete questionnaires. In this study, validated questionnaires will be used, including the Hopkins Symptom Checklist (HSCL-25), the Harvard Trauma Questionnaire (HTQ), and the Short Form 36 (SF-36). Participants will also be asked to self-report sociodemographic information. As a result of the findings of this study, it is possible to provide guidelines for improving access to health care services, including prevention (i.e., vaccination programs) and treatment of chronic and acute illnesses, through primary and secondary healthcare delivery, thereby reducing negative health outcomes. This study may shed light on the social needs of asylum seekers and refugees in Lithuania. In addition, this may provide insight into how they are integrating into the community, such as what their employment and educational prospects are.

Sleep quality among inpatients of Spanish public hospitals

Sleep is a complex process and is needed both in health and illness. Deprivation of sleep is known to have multiple negative physiological effects on people's bodies and minds. Despite the awareness of these harmful effects, previous studies have shown that sleep is poor among hospitalised patients. We utilized an observational design with 343 patients recruited from medical and surgical units in 12 hospitals located in nine Spanish regions. Sociodemographic and clinical characteristics of patients were collected. Sleep quality at admission and during hospitalisation was measured by the Pittsburgh Sleep Quality Index. Sleep quantity was self-reported by patients in hours and minutes. Mean PSQI score before and during hospitalisation were respectively 8.62 ± 4.49 and 11.31 ± 4.04. Also, inpatients slept about an hour less during their hospital stay. Lower educational level, sedative medication intake, and multi-morbidity was shown to be associated with poorer sleep quality during hospitalisation. A higher level of habitual physical activity has shown to correlate positively with sleep quality in hospital. Our study showed poor sleep quality and quantity of inpatients and a drastic deterioration of sleep in hospital versus at home. These results may be helpful in drawing attention to patients' sleep in hospitals and encouraging interventions to improve sleep.

Clinical and Sociodemographic Profile of Psychomotor Agitation in Mental Health Hospitalisation: A Multicentre Study

Psychomotor agitation is characterised by an increase in psychomotor activity, restlessness and irritability. People with psychomotor agitation respond by over-reacting to both intrinsic and extrinsic stimuli, experiencing stress and/or altered cognition. The objective of this study is to assess the clinical and sociodemographic profile of psychomotor agitation in patients with severe mental disorders. The study was carried out in Spain by means of multicentre cross-sectional convenience sampling involving 140 patients who had been admitted to psychiatric hospital units and had experienced an episode of psychomotor agitation between 2018 and 2021.Corrigan's Agitated Behaviour Scale was used to assess psychomotor agitation. The results show that the predominant characteristic in psychomotor agitation is aggressiveness, which is also the most reported factor in patients with severe mental disorder. Patients who also have anxiety develop psychomotor agitation symptoms of moderate/severe intensity. The clinical and sociodemographic profile found in our study is consistent with other studies on the prevalence of psychomotor agitation.

Cultural competency among Lithuanian nurses and preparedness to work with intercultural immigrants: A quantitative study protocol

Introduction

Health care providers are increasingly required to provide care to patients from diverse cultural backgrounds. A culturally competent approach could be used to address gaps in the health care of migrants, whether they are refugees, asylum seekers, or undocumented migrants. From June 2021 onward, there are estimated to be 4,300 asylum seekers in Lithuania who crossed the Belarusian border. Furthermore, ~65 thousand Ukrainians registered within 6 months of the beginning of the war on 24 February 2022.

Aim

To determine the cultural competence of Lithuanian nurses using the Nurse Cultural Competence Scale (NCCS) questionnaire.

Methods

A quantitative study evaluating the cultural competency of nursing professionals will be conducted using the Lithuanian version of the Nurse Cultural Competence Scale (NCCS). The study will be conducted in Lithuanian municipalities and will involve primary, secondary, and tertiary health care providers.

Discussion

This study will provide data that can guide the development and evaluation of interventions designed to reduce health disparities among migrants, including the need to identify the appropriate type of cultural competency training for nurses. In addition to the results of this study, it may provide an indication of other cultural competency required for nurses. This includes consideration of religion, sexual orientation, gender identity, household classifications on the basis of urban vs. rural areas, language spoken, and country of origin.

Psychometric Characteristics and Sociodemographic Adaptation of the Corrigan Agitated Behavior Scale in Patients With Severe Mental Disorders

Background: Severe mental disorder (SMD) is understood in a first approximation as a disorder of thought, emotion, or behavior of long duration, which entails a variable degree of disability and social dysfunction. One of the most widely used assessment scales for agitated behavior, in its English version, is the Corrigan Agitated Behavior Scale (ABS); several studies have demonstrated solid psychometric properties of the English version, with adequate internal consistency. Objective: The objective of this study was to evaluate the psychometric properties of the Spanish version of the ABS Corrigan scale, in a sample of patients with severe mental disorders. The psychometric analyses of the Spanish version of the ABS Corrigan included tests of the reliability and validity of its internal structure. Results: The structure of the factorial loads of the analyzed elements is consistent with the hypothesized three-dimensional construction referred to in the original ABS. The results suggest that the reliability and validity of the three dimensions are acceptable (First 0.8, Second 0.8, and Third 0.7). The internal consistency of the Spanish version of the complete ABS and of each of the three domains that compose it is high, with values very close to those found in the original version, with approximate figures of 0.9. Conclusion: In our study, the three domains aim to explain 64.1% of the total variance of the scale, which exceeds the 50% found in the original version.

Burnout and job satisfaction among nurses in three Spanish regions

AIMS

To determine the levels of job satisfaction and burnout syndrome and related factors among nurses in three Spanish regions.

BACKGROUND

The nursing profession involves high work stress due to emotional involvement, workload and available resources.

METHODS

Descriptive multicentric cross-sectional study. Sociodemographic and migration data were collected and participants completed the Job Satisfaction Questionnaire S20/23 and Maslach Burnout Inventory. The data were analysed using descriptive statistical methods using the program SPSS.

RESULTS

The sample included 228 nurses (187 women and 41 men), with a mean age of 37.11 ± 10.87. Reported job satisfaction was medium to high. Overall, values were low in emotional fatigue and medium in depersonalization and personal fulfilment. In terms of migration, 21.59% of the participants had already moved to other Spanish regions or another country, while 18.58% had the intention of doing so.

CONCLUSION

Nurses with a temporary contract showed a high burnout rate, and high levels of emotional fatigue, depersonalization and lack of personal fulfilment.

IMPLICATIONS FOR NURSING MANAGEMENT

Strategies are needed to improve working and contractual conditions such as enhancing teamwork, management and leadership skills in nurses; achieving internal promotion; and having higher participation in decision-making and a better balance of power between health institution managers and health professionals.