Anxiety and depression among nursing students during the COVID-19 lockdown: A cross-sectional correlational study.

AIMS AND OBJECTIVES: To determine the prevalence and levels of anxiety and depression symptoms among nursing students during the coronavirus lockdown, and to examine factors associated with higher levels of anxiety and depression on this population. BACKGROUND: Nursing students deal with diverse stressors during their university lives. Confinement measures during COVID-19 outbreak may have influenced students' mental health and well-being. Anxiety and depression are common among nursing students due to different factors. Evidence relating to anxiety and depression in nursing student population during SARS-CoV-2 pandemic is limited. DESIGN: A cross-sectional descriptive co-relational study during the lockdown due to the coronavirus outbreak in Spain was conducted. METHODS: An online questionnaire was developed by using google forms. Sociodemographic characteristics form, and the Spanish version of the Hospital Anxiety and Depression Scale (HADS) were used. Spanish nursing students across the country were enrolled. Data collection was performed between 4 April 2020 and 21 April 2020. A multivariate analysis was performed to determine the association between sociodemographic variables, COVID-19 and HADS scores. RESULTS: 1319 participants were enrolled. The sample was formed by 87.1% female students with a mean age of 22 years (SD ± 5.677). We found a mean score of 8.47 ± 4.104 on Scale HADS-Anxiety and 6.80 ± 2.988 on HADS-Depression. 31.6% students presented abnormal scores of anxiety symptoms, and only 11.4% participants revealed abnormal scores on HADS-Depression. CONCLUSIONS: The reported prevalence of anxiety and depression symptoms on nursing students during the COVID-19 lockdown is 56.4% and 38.2%, respectively. 43.6% of the sample scored normal anxiety levels, and 61.8% obtained normal depression levels. Higher anxiety and depression levels were statistically associated with being a first-year student, being a smoker, feeling fear, feeling stress and having any close family member infected. RELEVANCE TO CLINICAL PRACTICE: These data should be valuable for detection and for further treatment decision of this disorders at the initial stage and could be important to prevent further damages to mental health and promote physical, psychological and well-being among this population.

Ethical conflict among critical care nurses during the COVID-19 pandemic.

BACKGROUND: Ethical conflict is a problem with negative consequences, which can compromise the quality and ethical standards of the nursing profession and it is a source of stress for health care practitioners', especially for nurses. OBJECTIVES: The main aim of this study was to analyze Spanish critical care nurses' level of exposure to ethical conflict and its association with sociodemographic, occupational, and COVID-19-related variables. Research Design, Participants, and Research context: This was a quantitative cross-sectional descriptive study conducted among 117 nurses working in critical care units. Data collection tools were sociodemographic, occupational, and COVID-19-related questionnaires and previously validated Spanish version of Ethical Conflict in Nursing Questionnaire-Critical Care Version. ETHICAL CONSIDERATIONS: We obtained permission from the Ethics Committee and participants' informed consent. FINDINGS: Data indicates a moderate level of exposure to ethical conflicts. The most frequent ethical conflicts were related to situations about "treatment and clinical procedures." The most intensity of ethical conflicts was related to situations about "treatment and clinical procedures" and "dynamics of the service and working environment." No statistical significance was identified between the socio-demographic variables and level of exposure to ethical conflicts. However, for critical care nurses working in ICU, nurses with perceived worked stress had a higher level of exposure to ethical conflicts. Likewise, critical care nurses whose family/friends were infected with COVID-19 had a higher level of exposure. CONCLUSIONS: Critical care nurses experience a moderate level of exposure to ethical conflicts which is consistent with the results of previous studies. A deeper understanding of ethical conflicts in conflictive situations allows recognition of the situations that occur in everyday clinical practice, identification of the ethical conflicts, and facilitation of the nurses working in the challenging clinical situation.

Spanish oncology nurses: Assessment and relationship between resilience and emotional labour status.

OBJECTIVE: To investigate nurses' resilience and emotional labour (EL) status in the oncology context as well as to examine the relationship between resilience and EL status. METHODS: Cross-sectional, correlational quantitative design. The selected setting is the oncology centre at a referral and teaching hospital in northern Spain. One hundred and two oncology nurses were included. Socio-demographic data were obtained from a questionnaire. Data for resilience and EL status were drawn from validated Spanish questionnaires. RESULTS: Oncology nurses reported a moderate to high level of resilience and experienced less intense EL. Professional rank was the only factor identified that influenced resilience (p < .05). Gender, educational level, shift work, work department, and oncology work experience were statistically significant when correlated with the EL of oncology nurses (p < .05). There was a positive correlation between resilience and two EL factors (p < .05). CONCLUSIONS: The information gained from this study may raise awareness of the importance of resilience and EL in the nursing profession. It would be important to develop a programme of resilience training and emotional regulation and integrate these programmes into educational systems in order to help enhance nursing students' and clinical nurses' resilience and emotional competency.

Presenteeism in nurses: comparative study of Spanish, Portuguese and Brazilian nurses.

AIM: To compare presenteeism levels among three samples of nurses and to identify the relationship between presenteeism and sociodemographic and professional characteristics. BACKGROUND: Presenteeism (going to work ill) is a phenomenon studied from different perspectives, and it has become especially important during the current COVID-19 outbreak; its connection to high healthcare costs, patient safety breaches and negative nurse well-being has been proved. INTRODUCTION: The nursing profession is particularly associated with caring for the culture of teamwork, loyalty to colleagues and professional identity. This condition enhances the 'super nurse phenomenon', even though nurses do not feel physically and psychologically able to work. METHODS: A multicentre, cross-sectional study was conducted in three different country contexts: Oviedo (Spain), Porto (Portugal) and São Paulo (Brazil). Nurses performing functions in hospitals and primary health care were enrolled. Informed consent and data collection questionnaires were hand delivered. The Stanford Presenteeism Scale-6 was applied. RESULTS: A total of 659 nurses participated. Portuguese nurses showed greater prevalence of presenteeism, followed by Brazilian and Spanish nurses. Younger nurses with less professional experience presented lower levels of presenteeism but greater psychological commitment. Male participants showed lower capacity to complete work when ill than female participants. CONCLUSIONS: Age and length of professional experience proved to be significant predictors of total presenteeism, although only professional experience revealed statistical significance in the adjusted model. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The knowledge of this phenomenon among nurses highlights the need for the development of strategies in the curriculum of nursing students and organizations. Resilience and ergonomic training should be applied in the training programmes of the students and reinforced by the health centre managers. It is essential that healthcare systems design worksite wellness programmes that pursue greater physical and mental well-being for healthcare professionals.

Face-to-face Information and Emotional Support from Trained Nurses Reduce Pain During Screening Mammography: Results from a Randomized Controlled Trial.

Pain and discomfort during breast examination can affect a woman's adherence to breast cancer-screening programs. The aim of this study was to determine whether a nursing intervention protocol that provides verbal information and support to women could reduce pain during mammography. A randomized controlled trial of 436 Spanish women aged 50-69 who attended a breast-screening program was performed. The experimental group received a customized nursing intervention that provided face-to-face information and emotional support during the examination. Pain and anxiety were measured using a visual analogue scale and the State-Trait Anxiety Inventory, respectively. Data regarding several potential confounders were also collected. The adjusted means of pain level in the study group were obtained from multiple linear regressions, and the adjusted odds ratios (OR) and 95% confidence intervals (CI) were obtained via logistic regression. After the intervention, the level of pain was significantly lower (p = .03) in the experimental group (0.98 ± 2.28) compared with the group treated with normal care (1.48 ± 2.29). Consequently, the probability of feeling pain during mammography was lower among women in the experimental group (OR = 0.44; 95% CI: 0.24-0.81). The intervention was more effective among women with the highest anxiety levels (OR = 0.33; 95% CI: 0.11-0.98), who did not expect pain (OR = 0.28; 95% CI: 0.08-0.97), and who did not fear the outcome of the mammography (OR = 0.18; 95% CI: 0.04-0.85). Providing verbal information, as well as supporting the women during the test, is a simple and achievable intervention for nurses and can help to reduce pain during screening mammography.

Psychological impact of COVID19 on community pharmacists and pharmacy technicians.

BACKGROUND: The unique situation related to the COVID-19 outbreak and the consequent worldwide lockdown can have a psychological impact on specific populations. Community pharmacists and pharmacy technicians, as essential healthcare workers on the front line who continue to do their jobs during this pandemic, can also experience psychological distress. Few data are available on the mental health impact of the COVID-19 pandemics on this population. OBJECTIVES: This study aimed to assess the psychological impact of COVID-19 on Spanish community pharmacists and pharmacy technicians during lockdown, and to identify factors contributing to psychological distress. METHODS: A cross-sectional, quantitative, correlational study was designed including 1162 pharmacy team members. The Impact of Event Scale revised was used to assess the psychological impact. Data collection was performed by emailing the instrument to individuals or by using social networks. RESULTS: Overall participants, almost 70% revealed severe levels of psychological impact. The outbreak of COVID-19 has significantly affected community pharmacy workers, the degree of which is related to gender, age, and feelings of fear/stress. CONCLUSIONS: In the initial phase of the lockdown associated with the COVID-19 outbreak, the majority of the respondents rated the psychological impact as severe. Our findings allow for the identification of factors associated with a greater psychological impact.

Emotional Burden among Pharmacists and Pharmacy Technicians during the COVID-19 Lockdown: A Cross Sectional Study.

This study aims to investigate the prevalence of depression and anxiety symptoms among Spanish community pharmacists and pharmacy technicians during the coronavirus disease 2019 (COVID-19) lockdown. A descriptive cross-sectional quantitative study was designed. An online survey was administered to participants from 4 to 21 April 2020 using a questionnaire assessing sociodemographic information and the Spanish version of the Hospital Anxiety and Depression Scale (HADS). Informed consent to participate was requested. Participants comprised 1162 pharmacy staff from Spain with an average age of 39.15 ± 9.718, from 20 to 65 years old, of whom 83% were women, and 50.6% were married. More than half of the participants expressed symptoms of depression (62.7%) and anxiety (70.9%). An important prevalence of anxiety and depression symptoms has been detected among Spanish pharmacists and pharmacy technicians during the COVID-19 lockdown. Being a woman, smoking, feeling fear, feeling stress and believing that pharmacists/pharmacy technicians are very exposed to COVID-19 seem to be associated with higher HADS scores.

Discuten la información diagnóstica brindada al paciente oncológico / Discussion of diagnosis with an oncological patient

Introducción: El proceso de información sobre el diagnóstico de cáncer está sujeto a diferencias geográficas o culturales y, en muchas ocasiones, esta acción está además determinada por las connotaciones negativas que conlleva la palabra “cáncer”. Objetivo: Conocer la información oncológica proporcionada por facultativos hospitalarios del Principado de Asturias así como su opinión y autoevaluación en este proceso. Materiales y métodos: Se realizó un estudio descriptivo transversal en 46 facultativos de Oncología Médica, Cirugía General y Radioterapia de 4 hospitales públicos: Universitario Central de Asturias, Cabueñes, Jove y San Agustín. Resultados: El 65.2% de los médicos revela habitualmente el diagnóstico. Sólo 10 facultativos (21.7%)proporcionan al paciente toda la información completa de forma habitual aunque únicamente 2 (4.3%) emplean la palabra “cáncer”. El 58.7% refiere conocer la ley 41/2002, pero sólo el 10.2% registra en la historia la información. Más de la mitad se autoevalúa con buena capacidad para comunicar malas noticias, y sólo 11 (23.9%) declaran formación al respecto. Conclusiones: Un porcentaje considerable de facultativos revelan el diagnóstico al paciente, aunque evitan proporcionar la información completa, utilizando excepcionalmente el término “cáncer”. Poco más de la mitad conoce la ley 41/2002. Sólo 1 de cada 4 facultativos ha recibido formación sobre cómo dar malas noticias.