Aggression and burnout in nurses during COVID-19: A cross-sectional study.

Workplace violence against nurses, an ever-present problem in the healthcare workplace, has been increasing with COVID-19 and affects occupational health. This study analyzed the consequences of COVID-19 on violence against nurses, identifying its association with burnout, emphasizing the importance of work-related variables. A total of 1013 actively employed nurses in Spain with a mean age of 34.71 years filled out a computer-assisted web interviewing survey. Aggression as a consequence of their work was reported by 73.44% of the nurses. Those most affected were in primary care, and verbal aggression by patients and their families was the most frequent. Nurses who were attacked scored significantly higher in emotional exhaustion and depersonalization. Furthermore, 83.22% said that COVID-19 was an important factor in the increase in violence toward healthcare workers. Analysis showed that a perceived secure environment was a mediator between the belief that COVID-19 was an influential factor in the increase of violence and the depersonalization dimension of burnout. Increasing perceived security in the work environment among nurses can be effective in promoting well-being, work performance, and commitment to the profession.

Job strain and burnout in Spanish nurses during the COVID-19: resilience as a protective factor in a cross-sectional study.

BACKGROUND: Nurses are frequently exposed to chronic stress in the workplace generating harmful effects such as job strain and burnout. On the contrary, resilience has been shown to be a beneficial variable. The objective of this study was to analyze the relationship between dimensions of the Job Demand Control-Support model, resilience and burnout in nurses, and examine the mediating role of resilience between job strain and burnout. METHODS: A descriptive, cross-sectional study reported in line with the STROBE guidelines. Active nurses were invited to complete an online questionnaire in September, 2020. With snowball sampling, 1013 nurses, with a mean age of 34.71, filled out the Job Content Questionnaire, the Maslach Burnout Inventory and the Resilience Scale. RESULTS: The results showed the existence of four groups of professionals based on job strain. The nurses in the "High Strain" group (high demands and low control) showed higher scores in emotional exhaustion and cynicism, while those in the "Active Job" group scored higher in personal realization and resilience. The findings showed that job strain affects burnout in nurses, and this effect is mediated by resilience. CONCLUSIONS: The findings of this study showed that a high level of resilience could exert a fundamental role in ensuring well-being and proper job performance by nurses. Nursing managers should see to the personable variables or competencies that provide and favor an opportunity for nurses to widen and improve their practice, in pursuance of satisfying and responding better to people's needs and the systems they work for.

Communication Styles Inventory-Brief: Adaptation and validation for Spanish nursing.

Healthcare attention is sometimes considered purely technical, but communication has proven to be closely related to clinical results and patient satisfaction. Therefore, evaluation of communication in the scope of healthcare is a priority. The purpose of this study was to validate and adapt the Spanish version of the Communication Styles Inventory in a sample of nursing professionals. The sample was made up of 2313 nursing professionals selected at random from various medical centres in Spain, and is therefore a sample actively employed at the time data were acquired. We started out from the Communication Style Inventory, a questionnaire for evaluating the predominance of certain individual communication behaviours on six scales (expressiveness, preciseness, verbal aggressiveness, questioningness, emotionality and impression manipulativeness). Confirmatory Factor Analysis of the model proposed showed god fit indices. The reliability of the model shown by the Cronbach's alpha of α = 0.81 was adequate, and so was single-level and aggregate consistency. Finally, in the analysis of variance by type of contract, configural, metric and scalar invariance was acceptable, but not strict invariance. This instrument progresses in measuring non-technical attributes, such as communication styles, in nursing personnel.

The mediating role of cognitive and affective empathy in the relationship of mindfulness with engagement in nursing.

BACKGROUND: The work of health professionals is characterized by a high demand for psychological and emotional resources and high levels of stress. Therefore, the promotion of commitment and job well-being through strategies such as increased mindfulness, is important among nursing workers. Although mindfulness has shown positive effects in the health field, few studies have explored the mechanisms and processes underlying these results. We investigated the mediating role of empathy (cognitive/affective) in the effect of mindfulness on the dimensions of engagement in nursing professionals. METHODS: Sample was comprised of 1268 Spanish nurses between 22 and 62 years old, that completed the Utrecht Labor Engagement Scale and the adapted versions of Mindful Attention Awareness Scale and Basic Empathy Scale. The relationship between variables to be included in the regression analyses, bivariate correlations were carried out, and the descriptive statistics of these variables were also found. To estimate the mediation model was used, in this case for multiple mediation effects. RESULTS: Mindfulness is found to affect the Vigor and Dedication factors of engagement through cognitive empathy. While for the Absorption factor, the affective component of empathy also exerts a mediating role, although weaker than cognitive empathy. Cognitive empathy, as an individual factor, was shown to have a mediating effect between mindfulness and the factors of engagement in healthcare workers. CONCLUSIONS: The level of mindfulness influences engagement of nursing professionals positively, and this result is mediated mainly by cognitive empathy. Both mindfulness and empathy are modifiable individual factors, so their intervention by designing and implementing specific programs, can increase the commitment and wellbeing of professionals generating benefits to workers and to their patients.

Self-Efficacy and Emotional Intelligence as Predictors of Perceived Stress in Nursing Professionals.

Background: Nursing professionals face a variety of stressful situations daily, where the patients' own stresses and the demands of their family members are the most important sources of such stress. Methods: The main objectives pursued were to describe the relationships of self-efficacy and emotional intelligence with perceived stress in a sample of nursing professionals. We also developed predictive models for each of the components of perceived stress based on the dimensions of emotional intelligence and self-efficacy, for the total sample, as well as samples differentiated by sex. This study sample consisted of 1777 nurses and was conducted using multiple scales: the perceived stress questionnaire, general self-efficacy scale, and the brief emotional intelligence survey for senior citizens. Results: The variables stress management, mood, adaptability, intrapersonal skills, and self-efficacy explained 22.7% of the variance in the harassment-social component, while these same variables explained 28.9% of the variance in the irritability-tension-fatigue dimension. The variables mood, stress management, self-efficacy, intrapersonal, and interpersonal explained 38.6% of the variance in the energy-joy component, of which the last variable offers the most explanatory capacity. Finally, the variables stress management, mood, interpersonal, self-efficacy and intrapersonal skills explained 27.2% of the variance in the fear-anxiety dimension. Conclusion: The results of this study suggest that one way to reduce stress in professionals would be to help them improve their emotional intelligence in programs (tailored to consider particularities of either sex) within the framework of nursing, enabling them to develop and acquire more effective stress coping strategies, which would alleviate distress and increase the wellbeing of health professionals.

Resilience, Burnout and Mental Health in Nurses: A Latent Mediation Model.

Background/Objectives: The burnout syndrome in nurses has been related to the development of mental health problems. On the contrary, resilience is related to adequately coping with stressful situations and better mental health. The objective was to analyze the relationship between resilience and mental health problems in nurses and estimate the proportion mediated by burnout in the association. Methods: In 2021, a total of 1165 Spanish nurses were selected through a stratified random sampling method. Participants anonymously filled in the Resilience Scale (RS-14), the Maslach Burnout Inventory Survey, and the General Health Questionnaire. To test the hypothesis proposed and explain the mediating effect of burnout empirically, structural equation modeling (SEM) was applied. A latent mediation model was computed. Results: Resilience was negatively related to burnout and mental health problems. The direct relationship between burnout and the latent health variable was positive. In addition, in view of the total effect of resilience on mental health problems and the magnitude of the indirect effect, we stated that the proportion of this effect mediated by burnout ranged from 0.486 to 0.870. Conclusions: This study reveals that fostering resilience in nurses directly and indirectly reduces burnout and improves their mental health. The implementation of resilience programs and supportive institutional policies is recommended to improve working conditions and the quality of patient care.

Perception of Parental Attitudes and Self-Efficacy in Refusing Alcohol Drinking and Smoking by Spanish Adolescents: A Cross-Sectional Study.

Adolescents are particularly vulnerable to initiation of the use of substances harmful to health, and its increase is cause for concern. The objective of this study was to analyze the relationship between self-efficacy in refusing alcohol and the attitude of adolescents toward drugs and their perception of their parents' attitude toward refusal. The study was carried out in 2019 in a sample of 1287 students from 11 public high schools in the province of Almería (Spain). Students were aged 14 to 18 in their 3rd and 4th year of compulsory secondary education. The Drinking Refusal Self-Efficacy Questionnaire-Revised Adolescent version (DRSEQ-RA), Attitudes Toward Taking Drugs-Basic BIP Scale and the Parents' attitudes Toward Drug Use were administered. The results showed that family relationships seem to have a direct impact on adolescent patterns in smoking and drinking alcohol. However, a favorable attitude toward drugs is a risk factor for drinking alcohol and smoking tobacco. The self-efficacy dimension also acts as a protective factor against the probability of using alcohol or tobacco. The conclusions emphasized that communication within the family core can increase or decrease the risk of adolescents using substances harmful to health.

Repercussions of perceived threat to health in the Spanish population.

Studies have shown that COVID-19 has had a worldwide psychological impact. Confinement due to COVID-19 has had important repercussions on the mental health of the general population, with high levels of stress, anxiety, depressive symptoms, post-traumatic stress disorder, and so forth. Similarly, important labor, economic and social changes taking place are affecting people's well-being. The objective of this study was to analyze the repercussions of perceived threat from COVID-19 on the mental health of the population, and to evaluate the mediating role of perceived economic impact. The participants were 1160 adult residents of Spain aged 18 to 82, 69.9% of whom were women. A sociodemographic questionnaire, the Questionnaire on Perception of Threat from COVID-19 and the General Health Questionnaire were administered. Perceived threat had a positive direct effect on all four health dimensions analyzed. Among the indirect effects, the perceived economic impact of COVID-19 mediated in the relationship between perceived threat and each of the health dimensions. The results of this study have demonstrated the need to promote joint action promoting public mental health to minimize the psychological repercussions of new outbreaks.

The Effects of a Non-Technical Skills Training Program on Emotional Intelligence and Resilience in Undergraduate Nursing Students.

There is a growing body of research on emotional intelligence and resilience in nursing students. However, there is little evidence of the development of these variables in intervention programs. This study aims to analyze the effects of a non-technical skills training program in emotional intelligence and resilience. Sixty students in the second year of Nursing Education from a Spanish public university completed this psychoeducational course. The pre-experimental design was longitudinal with pre- and post-intervention evaluation. The course consisted of 12 sessions of classroom education, three small-group workshops and a set of individual activities. Results in the emotional intelligence dimensions showed that Clarity (t = 3.10, p = 0.003) and Repair (t = 3.59, p < 0.001) increased significantly after participation in the program. Furthermore, the participants had a higher Resilience index when they had completed the program, with a statistically significant difference from the pre-course mean (t = 2.83, p = 0.006). This non-technical skills training program was an effective method of improving emotional intelligence and resilience in nursing students. Therefore, its use is recommended as a psychoeducational strategy for training undergraduate nursing students, as it improves their personal and professional competencies, resulting in higher-quality care.

Emotional intelligence and self-esteem: Personal competencies necessary for physicians.

Introduction: Even though emotional intelligence and self-esteem are truly important variables in healthcare, the fact is that there are few studies on these constructs in Spanish physicians. The objective was to analyze the relationship between self-esteem and emotional intelligence in Spanish physicians, and their relationship with sociodemographic and employment variables. Methods: The study included a sample of 180 physicians with a mean age of 34.61, 76.7% of whom were women. The physician completed the Rosenberg self-esteem scale, the Brief Emotional Intelligence Inventory for Senior Citizens and a questionnaire on sociodemographic and work characteristics through a CAWI (Computer Assisted Web Interviewing). Results: The results showed that the interpersonal factor of emotional intelligence diminished with age and number of children. Furthermore, women scored significantly higher in interpersonal emotional intelligence and men in adaptability. Physicians with stable contracts (46.1%) scored higher in all the emotional intelligence variables, with almost a small effect size. In the relationship between self-esteem and emotional intelligence, it was found that global self-esteem of physicians was positively related to the Stress Management, Adaptability and Mood dimensions. Physicians with high self-esteem (72.8%) showed better Stress Management and Mood than those with low self-esteem (6.1%), while in the Adaptability factor, physicians with high global self-esteem scored higher than those with medium levels (21.1%). Conclusion: The need for a stable employment strategy was demonstrated, since this has repercussions on personal competencies of physicians as well as training in developing those consequences, since they improve physicians' quality of care and leadership, especially women with temporary contracts or with medium or low self-esteem.

Mediating Role of Emotional Intelligence in the Relationship between Anxiety Sensitivity and Academic Burnout in Adolescents.

(1) Background: Increased stress and study overload during adolescence could be related to academic burnout. Anxiety sensitivity of students seems to affect burnout levels, while emotional intelligence enables emotion management under stressful conditions. The objective of this study is to analyze the roles of anxiety sensitivity and emotional intelligence in academic burnout. (2) Methods: In this quantitative cross-sectional study conducted in Spain, the sample comprised 1287 high school students aged 14 to 18 who filled out the Maslach Burnout Inventory-General Survey, the Spanish version adapted for high school students of the Anxiety Sensitivity Index-3, and Brief Emotional Intelligence Inventory. (3) Results: Anxiety sensitivity was significantly higher in cynicism and emotional exhaustion. Furthermore, the mediation analysis showed that high anxiety sensitivity directly affected student exhaustion, cynicism, and efficacy levels. These effects were mediated mainly through stress management but also through the effect of stress management on mood, both emotional intelligence factors. (4) Conclusions: The academic changes that occur during high school hinder engagement and performance. Promoting the development of emotional skills would enable young people to manage their emotions when they become overwhelming and diminish their lack of interest and exhaustion in the classroom.

Mental Health in Settings with COVID-19 Positive Cases in the Spanish Population: The Protective Role of the Capacity to Adapt to Change.

BACKGROUND: The capacity to adapt to change in complex, highly demanding situations, such as those derived from the COVID-19 pandemic, is essential in maintaining one's mental health. This study analyzed the mental health of the Spanish population in settings with COVID-19 positive cases and the protective role of adaptation to change. METHODS: The sample consisted of 1160 adult Spaniards aged 18 to 82 with a mean age of 38.29 (SD = 13.71). Data were collected by a CAWI (Computer Aided Web Interviewing) survey which included the General Health Questionnaire (GHQ-28), Adaptation to Change Questionnaire (ADAPTA-10), and an ad hoc questionnaire related to COVID-19 (perceived economic impact, COVID-19 positive diagnosis or not, and whether there was a positive case close to them). RESULTS: The data revealed that the perceived economic impact showed a negative association between the emotional factor and the total score in adaptation to change. Lastly, the emotional factor in adaptation to change operated as a protector from the effect that a setting with COVID-19 positive cases exerts on mental health. CONCLUSIONS: Coping with COVID-19 requires strengthening the capacity for adaptation to changes generated in the setting, especially emotional, as it could contribute to improving the mental health of individuals, especially in those settings where they find and know a COVID-19 positive case.

The "Mask Effect" of the Emotional Factor in Nurses' Adaptability to Change: Mental Health in a COVID-19 Setting.

During healthcare catastrophes, such as the current COVID-19 pandemic, nurses are exposed to highly stressful situations derived from their work and personal activity. Development of coping strategies for such situations can improve nurses' physical and mental health. This study analyzed nurses' adaptability to change, with attention to socio-demographic variables in a COVID-19 setting, and identified the repercussions on their health. This quantitative, observational and cross-sectional study had a sample of 351 nurses aged 22 to 64 with a mean age of 40.91 (SD = 10.98). The instruments used for the study were the ADAPTA-10 questionnaire and the General Health Questionnaire (GHQ-28). It was observed that age, sex, and having a stable partner significantly influenced scores on the emotional, cognitive-behavioral, and adaptation to change factors. Finally, the emotional factor mediated between positive COVID-19 in someone close and the presence of health problems. Understanding the elements that help adapt better to change and adversity enable effective interventions to be developed for improving emotional health of nurses, especially for those in whom there are positive cases of COVID-19 in their personal or work environment.

Coping Strategies in the Spanish Population: The Role in Consequences of COVID-19 on Mental Health.

The worldwide health emergency caused by COVID-19 is a new challenge for humanity which individuals respond to in a diversity of ways. The type of coping people use in such a situation could lead to positive or negative consequences to their health. Our objective was to analyze the use of coping strategies in the general population with attention to sociodemographic variables, and to test the capacity of these strategies for mediating in repercussions on mental health. The 1,160 adults who participated in this study answered the Cognitive Emotion Regulation Questionnaire (CERQ-S) and General Health Questionnaire (GHQ-28). The data were collected in a CAWI (Computer Aided Web Interviewing). The results suggest that the coping strategies they used the most differed depending on sociodemographic characteristics, such as age, sex and education. Furthermore, two mediation models were estimated for positive and negative coping strategies in the relationship between the presence of COVID-19 near them and mental health. The "negative" coping strategies were found to exert an indirect effect as mediators in the impact that COVID-19 positive cases near them had on their health. The consequences to mental health of the impact of coping with adverse situations should not be underestimated and it is important to design programs to educate the population in coping strategies that promote their health.

Coping Strategies as a Mental Health Protection Factor of Spanish Nurses during COVID-19.

BACKGROUND: Due to the healthcare crisis caused by COVID-19, nurses have been exposed to stressful, uncertain situations. In such situations, emotional coping strategies are especially important due to their repercussion on health. The purpose of this study is analyze the relationships between nurses' coping strategies and health, with attention to factors related to perceived threat and/or someone close to them is COVID-19 positive. METHODS: This descriptive cross-sectional study was done with a sample of 351 nurses in Spain. In addition to the questionnaire on perception of threat from COVID-19, the Cognitive Emotion Regulation Questionnaire and the General Health Questionnaire, an ad hoc question asked them whether someone close to them was COVID-19 positive. RESULTS: Perceived threat and use of negative coping strategies were related, and these strategies were related to a greater presence of somatic symptoms, anxiety, social dysfunction, and depression. CONCLUSIONS: Given the work and personal influence of coping on nurses, interventions must be designed to promote adaptive strategies.

Mood and Affective Balance of Spaniards Confined by COVID-19: A Cross-Sectional Study.

The aim of this study was to analyze the mood and affective balance of Spaniards in quarantine and determine the predictive role of sociodemographic variables and mood on the negative affective balance. This cross-sectional study was carried out with a sample of 1014 Spanish adults, 67.2% were women and 32.8% men. The age ranged from 17 to 76. The instruments used were the Mood Assessment Scale and the Affective Balance Scale, which were implemented as a CAWI survey (Computer Aided Web Interviewing). Results showed that age correlated negatively with Sadness-Depression, Anxiety, and Happiness. Women had more Sadness-Depression, Anxiety, and negative affect, while men showed more Happiness and higher positive affect. Thus, the risk of a negative affective balance during confinement was greater for women and those who showed an emotional state marked by sadness-depression and anxiety, while older age and higher scores in happiness were associated with lower risk. In conclusion, knowing which groups are at risk of emotional and affective alteration can facilitate the detection and prevention of later disorders, such as severe stress and posttraumatic stress disorder, avoiding their generalized presence, and becoming a new public health problem derived from COVID-19.

El objetivo de este trabajo fue analizar el estado de ánimo y el balance afectivo de los españoles en cuarentena y determinar el papel predictivo de las variables sociodemográficas y de los estados anímicos, sobre el balance afectivo negativo. Se trata de un estudio transversal, con una muestra de 1014 adultos españoles, siendo el 67.2% mujeres y el 32.8% restante, hombres. El rango de edad estuvo entre 18 y 76 años. Los instrumentos empleados fueron la Escala de Evaluación del Estado de Ánimo y la Escala de Equilibrio Afectivo, empleando para su implementación una encuesta CAWI (Computer Aided Web Interviewing). Los resultados mostraron que la edad correlaciona negativamente con la Tristeza-Depresión, la Ansiedad y Alegría. Las mujeres presentan mayor nivel de Tristeza-Depresión, Ansiedad y afecto negativo, mientras que los hombres presentan más Alegría y mayor nivel de afecto positivo. Por lo tanto, el riesgo de presentar un balance afectivo negativo durante el confinamiento es mayor entre mujeres y entre quienes manifiestan un estado emocional marcado por la tristeza-depresión y la ansiedad, mientras que tener mayor edad y mostrar puntuaciones elevadas en alegría se asocia con menor riesgo. En conclusión, conocer los grupos de riesgo en alteraciones emocionales y afectivas puede facilitar la detección y prevención de trastornos posteriores, como estrés agudo y trastorno de estrés postraumático, evitando la presencia generalizada, y que esto se convierta en un nuevo problema de Salud Pública derivado del COVID-19.

The repercussions of perceived threat from COVID-19 on the mental health of actively employed nurses.

In the confrontation with the COVID-19 pandemic, threat perceived by the nursing population, and its association with sociodemographic and contextual characteristics, must be measured and evaluated as well as their repercussions on their mental health. Therefore, the purpose of this study was to analyse the repercussion of perceived threat from COVID-19 on the mental health of actively employed nurses, considering a COVID-19 diagnosis, whether their own or of someone close to them. The sample was comprised of 351 nurses. Sociodemographic data were collected, and the Questionnaire on Perception of Threat from COVID-19 and the General Health Questionnaire were administered. The three demographic and contextual variables mentioned were related to mental health, mediated in some symptoms by perceived threat. These results provide important information for implementing measures or psychoeducational programs for nurses, essential in the present pandemic for improving psychological adaptation and reducing the effects on their mental health.

Predictors of Threat from COVID-19: A Cross-Sectional Study in the Spanish Population.

One of the first measures for fighting the worldwide spread of the COVID-19 pandemic is social isolation or quarantine. The perceived threat from COVID-19 in this situation, maintained over time, generates uncertainty and fears, etc., which could lead to mental disorders in the population. This study evaluated the perceived threat from COVID-19 in the Spanish population. The study design was cross-sectional and observational. The sample of 1014 participants recruited in Spain had a mean age of 40.87 (SD = 12.42). The gender distribution was 67.2% (n = 681) women and 32.8% (n = 333) men. Data were collected with an online survey. The instrument used was the Perception of Threat from COVID-19 Questionnaire, validated for the Spanish population. Our data showed a clear correlation between perceived threat with female gender, having children in one's care and level of education. However, no association was observed with age or marital status. Finally, we concluded that there is a greater perception of threat from COVID-19 by women with a lower education who have children in their care, and that they are also more sensitive to minor mental disorders, such as anxiety or stress, appearing.

Interpersonal Support, Emotional Intelligence and Family Function in Adolescence.

BACKGROUND: During adolescence, although the peer group exerts a strong influence on how the individual thinks and feels and on personal social values, the family still exerts a sustaining and supporting role. This study analyzed the relationships established between family function, emotional intelligence and perceived interpersonal support in adolescence. METHOD: The sample was made up of 1287 high school students aged 14 to 18 (M = 15.11; SD = 0.91) in the province of Almeria (Spain). RESULTS: The results showed moderate correlations between the intrapersonal emotional intelligence dimension and perceived availability of support (advice or orientation), and between the mood dimension of emotional intelligence and the three interpersonal support dimensions (appraisal, belonging and tangible). In addition, significant positive correlations were found between family function and the intrapersonal and mood dimensions of emotional intelligence, with medium and large effect sizes, respectively. Apart from that, the data revealed that students who could count on a more functional family referred to high empathy and acceptance by others and greater support in material or financial matters, followed by those with moderate family function. In addition, students from homes with severely dysfunctional families perceived less available support. Finally, students who said they could count on strong family function also scored higher on the intrapersonal factor of emotional intelligence. CONCLUSIONS: The implications of these findings for the development of emotional intelligence in early adolescence are discussed from the family context, considering the relationship between emotional intelligence and social support.