Determinants of psychological injury among health and social care workers in community settings: A systematic review.

BACKGROUND: Health and Social Care (HSC) workers face psychological health risks in the workplace. While many studies have described psychological injuries in HSC workers, few have examined the determinants. Previous research has primarily focused on hospitals, lacking systematic reviews of community-based settings. OBJECTIVE: To systematically identify and appraise current evidence on the determinants of psychological injuries among HSC workers in community settings. METHODS: Searches were conducted in three bibliographic databases, supplemented by citation searches. Included studies focused on community-based HSC workers, reporting statistical associations between psychological injury and personal, health, occupational, or organizational factors. Quantitative studies published in English between January 1, 2000 and August 15, 2023 were included. Quality appraisal was undertaken using the JBI critical appraisal checklist. RESULTS: Sixty-six studies were included. Study quality was highly variable, and all studies were cross-sectional. Twenty-three studies linked psychological injury with occupational factors (e.g. low job control, high job demands and low job satisfaction). Thirteen studies observed an association between work environment and psychological injury, and a further eleven between workplace social support and psychological injury. Fewer studies have examined the relationship between psychological injury and personal/individual factors. CONCLUSION: Occupational and organisational factors are significantly associated with psychological health among HSA workers, in community settings. These aspects of job design, work environment and workplace relationships are modifiable, suggesting an opportunity for work design interventions to improve workers' psychological health and reduce the prevalence of psychological injury in this sector.

Flaws and all: How mindfulness reduces error hiding by enhancing authentic functioning.

Hiding errors can undermine safety by amplifying the risks of undetected errors. This article extends research on occupational safety by investigating error hiding in hospitals and applies self-determination theory to examine how mindfulness decreases error hiding through authentic functioning. We examined this research model in a randomized control trial (mindfulness training vs. active control group vs. waitlist control group) within a hospital setting. First, we used latent growth modeling to confirm that our variables were related as hypothesized, both statically or cross-sectionally as well as dynamically as they evolved over time. Next, we analyzed whether changes in these variables were a function of the intervention and confirmed the effects of the mindfulness intervention on authentic functioning and indirectly on error hiding. To elaborate on the role of authentic functioning, in a third step, we qualitatively explored the phenomenological experience of change experienced by participants in mindfulness and Pilates training. Our findings reveal that error hiding is attenuated because mindfulness encourages a receptive view of one's whole self, and authentic functioning enables an open and nondefensive way of relating to positive and negative information about oneself. These results add to research on mindfulness in organizations, error hiding, and occupational safety. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Trajectory of Pain, Functional Limitation, and Parental Coping Resources Following Pediatric Short-stay Surgery: Factors Impacting Rate of Recovery.

OBJECTIVES: Although there are many benefits of short-stay hospital admissions for high volume, pediatric surgical procedures, this model of care places greater responsibility on parents for the management of children's pain. This study aimed to document the trajectory of child pain outcomes and a range of parent-reported functional outcomes following discharge from a short-stay surgical admission. Moreover, we aimed to document the trajectory of parental perceived personal coping resources. Second, we assessed whether parental dispositional factors, assessed before hospital discharge, predicted the child's pain intensity and parent-reported functional recovery. METHODS: Participants included children (aged 4 to 14 y) admitted for a short-stay tonsillectomy or appendectomy, and their parents. Parents completed a questionnaire before discharge from hospital. Demographic and surgical information was recorded from medical records. Following discharge, daily assessments of pain and functioning were carried out over a 10-day period using iPods or mobile phones. Predischarge and postdischarge data were obtained for 55 child and parent dyads. RESULTS: Pain intensity scores returned to low levels (2/10 or less) by day 5 for appendectomy and day 10 for tonsillectomy. Parents' perceived personal coping resources increased more slowly following tonsillectomy than appendectomy. Controlling for time since surgery and parental coping resources, parental pain-related catastrophizing was a significant predictor of child pain and functional recovery. DISCUSSION: Short-stay surgery results in parents facing considerable burden in managing their child's pain and functional impairment over a 10-day period. The potential value of screening for parental pain-related catastrophizing before discharge from hospital warrants further consideration and may enable identification of children likely to experience poorer recovery.

Nursing students' socialisation to emotion management during early clinical placement experiences: A qualitative study.

AIMS AND OBJECTIVES: To explore nursing students' subjective experience of emotions during first-year clinical placements, strategies used to manage their emotions and socialisation to emotion management. BACKGROUND: Emotion regulation is a key source of stress for early career and student nurses. Clinical placement experiences can elicit strong emotions in nursing students; however, they may be unprepared for the challenge of regulating their emotions in real-world practice. How nursing students learn to manage their emotions in the clinical setting, whether they receive support for this, and how they are socialised to manage their emotions during placements are not well known. DESIGN: An exploratory qualitative study. METHODS: Semi-structured interviews (n = 19) were conducted with first-year nursing students, exploring their experiences of emotion management during clinical placement. Interview transcripts were analysed using conventional qualitative content analysis. Reporting adheres to the COREQ Checklist. RESULTS: Interactions with patients and staff often elicited negative feelings. Structured guidance for emotion management by supervising staff was scarce. Students used informal self-reflection and interpretation to guide emotion management. CONCLUSIONS: In the absence of strategic socialisation and formal support for effective emotion management, students used emotional labour strategies that can negatively impact on well-being. A focus on adequately preparing nursing students for emotion work is a necessary component of classroom and clinical learning environments. Structured debriefing during clinical placements may provide a relevant context to discuss emotions arising during clinical work and to learn emotion management strategies. RELEVANCE TO CLINICAL PRACTICE: Emotional competence, a fundamental ability for registered nurses and students, supports personal health maintenance and strengthens professional practice. Students are exposed to clinical environments and interpersonal encounters that evoke strong emotions. They need situated learning strategies and formal support to develop knowledge and strengthen capability for emotion management, as this is essential for promoting professional development and patient care.

The importance of reflecting on practice: How personal professional development activities affect perceived teamwork and performance.

AIMS AND OBJECTIVES: To examine the relationships between participation in personal professional development activities (e.g., coaching, mentoring), teamwork and performance; to investigate the mediating and moderating effects of reflective thinking and perceived usefulness of development activities. BACKGROUND: Professional development is associated with better performance and attitudes towards one's work. This study adds to this research by focusing on understanding this effect and the conditions under which this occurs. DESIGN: Cross-sectional survey study. METHODS: Participants were 244 nurses working in a large, metropolitan acute public hospital. They completed a questionnaire consisting of validated measures and provided information on frequency of participation and perceived usefulness of personal professional development activities. We analysed data using regression-based moderated mediation analyses. RESULTS: The relationship between frequency of participation in personal professional development activities and both perceived teamwork and performance was mediated by reflective thinking. Perceived usefulness of development activities moderated the relationship between frequency of participation in personal professional development activities and reflective thinking. CONCLUSION: Our results highlight the importance of professional development activities that go beyond knowledge- or skill-based training. Activities that cater to nurses' personal professional development needs are also associated with more positively perceived teamwork and performance. Results provide insights into the mediating mechanisms: Participation in personal professional development activities encouraged reflective thinking, which was associated with better perceived teamwork and performance. This association between personal professional development activities and reflective thinking was even stronger where nurses perceived the activities as useful. RELEVANCE TO CLINICAL PRACTICE: Personal professional development activities enhance reflection in and on practice as these activities were linked with higher perceived quality of care and teamworking. It is important to ensure that the positive effects of personal professional development activities should target nurses' professional development needs and need to be perceived as useful by those who undertake them.

A framework to create more mentally healthy workplaces: A viewpoint.

Mental illness is now the leading cause of long-term sickness absence among Australian workers, with significant costs to the individual, their employers and society more broadly. However, to date, there has been little evidence-informed guidance as to what workplaces should be doing to enhance their employees' mental health and wellbeing. In this article, we present a framework outlining the key strategies employers can implement to create more mentally healthy workplaces. The five key strategies outlined are as follows: (1) designing work to minimise harm, (2) building organisational resilience through good management, (3) enhancing personal resilience, (4) promoting early help-seeking and (5) supporting recovery and return to work. A narrative review is utilised to outline the theoretical evidence for this framework and to describe the available research evidence for a number of key example interventions for each of the five strategies. While each workplace needs to develop tailored solutions, the five strategy framework proposed in this review will hopefully provide a simple framework for employers and those advising them to use when judging the adequacy of existing services and considering opportunities for further enhancements.

"That was a good shift".

Purpose The purpose of this paper is to investigate a boundary spanning, interprofessional collaboration between advanced practice nurses (APNs) and junior doctors to support junior doctors' learning and improve patient management during the overtime shift. Design/methodology/approach A mixed methods evaluation of an intervention in an adult tertiary referral hospital, to enhance interprofessional collaboration on overtime shifts. Phase 1 compared tasks and ward rounds on 86 intervention shifts with 106 "regular" shifts, and examined the effect on junior doctor patient management testing a model using regression techniques. Phase 2 explored the experience of the intervention for stakeholders. 91 junior doctors participated (89 percent response rate) on 192 overtime shifts. Junior doctors, APNs and senior medical professionals/administrators participated in interviews. Findings The intervention was associated with an increase in self-initiated ward rounds by junior doctors, partially explained by junior doctors completing fewer tasks skilled nurses could also complete. The intervention significantly reduced doctors' engagement in tasks carried over from day shifts as well as first year (but not more experienced) junior doctors' total tasks. Interviews suggested the initiative reduced junior doctors' work pressure and promoted a safe team climate, situation awareness, skills, confidence, and well-being. Originality/value Junior doctors overtime shifts (5 p.m. to 11 p.m.) are important, both for hospitals to maintain patient care after hours and for junior doctors to learn and develop independent clinical decision making skills. However, junior doctors frequently report finding overtime shifts challenging and stressful. Redesigning overtime shifts to facilitate interprofessional collaboration can improve patient management and junior doctors' learning and well-being.

Learning and development: promoting nurses' performance and work attitudes.

AIM: This paper is a report of a study of the relations of coaching and developing clinical practice on nurses' work place attitudes and self-reported performance, as mediated by role breadth self-efficacy and flexible role orientation. BACKGROUND: Previous research into the effectiveness of nurses' learning and development activities has mainly focused on specific skill and knowledge acquisition outcomes. Few studies investigate the relationship between learning and development activities and work attitudes or performance, or explore mediating mechanisms in this process. Previous literature suggests that malleable cognitive and motivational constructs may be important mechanisms for improving work attitudes and proactive performance. METHOD: We surveyed 404 qualified nurses from a large, metropolitan public hospital in Australia in 2006 using validated measures from previous research. Descriptive statistics, correlation analysis and hierarchical regression analyses were conducted. RESULTS: The results show a clear association between learning and development activities and work attitudes and performance. Developing clinical practice improved self-rated performance and coaching improved work attitudes. In addition, role breadth self-efficacy and flexible role orientation mediated these relationships and emerge as important mechanisms in the link between learning and development and work attitudes and performance. CONCLUSION: Investment in learning and development activities for nurses improves outcomes for nurses, the organization and patients.