Health and wellbeing of staff working at higher education institutions globally during the post-COVID-19 pandemic period: evidence from a cross-sectional study.

BACKGROUND: The ongoing global crisis of Higher Education (HE) institutions during the post-COVID-19 pandemic period has increased the likelihood of enduring psychological stressors for staff. This study aimed to identify factors associated with job insecurity, burnout, psychological distress and coping amongst staff working at HE institutions globally. METHODS: An anonymous cross-sectional study was conducted in 2023 with staff at HE institutions across 16 countries. Job insecurity was measured using the Job Insecurity Scale (JIS), burnout using the Perceived Burnout measure question, psychological distress using the Kessler Psychological Distress Scale (K10), and coping using the Brief Resilient Coping Scale. Multivariable logistic regression with a stepwise variable selection method was used to identify associations. RESULTS: A total of 2,353 staff participated; the mean age (± SD) was 43(± 10) years and 61% were females. Most staff (85%) did not feel job insecurity, one-third (29%) perceived burnout in their jobs, more than two-thirds (73%) experienced moderate to very high levels of psychological distress, and more than half (58%) exhibited medium to high resilient coping. Perceived job insecurity was associated with staff working part-time [Adjusted Odds Ratio 1.53 (95% Confidence Intervals 1.15-2.02)], having an academic appointment [2.45 (1.78-3.27)], having multiple co-morbidities [1.86 (1.41-2.48)], perceived burnout [1.99 (1.54-2.56)] and moderate to very high level of psychological distress [1.68 (1.18-2.39)]. Perceived burnout was associated with being female [1.35 (1.12-1.63)], having multiple co-morbidities [1.53 (1.20-1.97)], perceived job insecurity [1.99 (1.55-2.57)], and moderate to very high levels of psychological distress [3.23 (2.42-4.30)]. Staff with multiple co-morbidities [1.46 (1.11-1.92)], mental health issues [2.73 (1.79-4.15)], perceived job insecurity [1.61 (1.13-2.30)], and perceived burnout [3.22 (2.41-4.31)] were associated with moderate to very high levels of psychological distress. Staff who perceived their mental health as good to excellent [3.36 (2.69-4.19)] were more likely to have medium to high resilient coping. CONCLUSIONS: Factors identified in this study should be considered in reviewing and updating current support strategies for staff at HE institutions across all countries to reduce stress and burnout and improve wellbeing.

Mental health nurses' empathy towards consumers with dual diagnosis: A descriptive study.

AIM: This study aimed to assess mental health nurses' empathy towards consumers with dual diagnosis in Australian mental health settings. The research question was What is mental health nurses' empathy towards consumers with co-existing mental health and drug and alcohol problems? DESIGN AND METHODS: A cross-sectional survey was carried out to understand mental health nurses' empathy. The convenience sample included 96 mental health nurses from various mental health settings with experience working with consumers with dual diagnosis. We assessed empathy using the Toronto Empathy Questionnaire. We utilised SPSS™ software to analyse both the descriptive data and multiple-regression. RESULTS: The mean empathy score was 47.71 (SD 8.28). The analysis of the association between demographic variables and individual subscales showed an association between the clinical setting and empathy (p = .031) and sympathetic physiological arousal (p = .049). The work sector was associated with sympathetic physiological arousal (p = .045) and conspecific altruism (p = .008). Emotional contagion (ß = .98, p < .001), emotional comprehension (ß = 1.02, p < .001), sympathetic physiological arousal (ß = 1.01, p < .001) and conspecific altruism (ß = 10.23, p < .001) predicted mental health nurses' empathy. CONCLUSIONS: This study found that most mental health nurses showed empathy towards consumers with dual diagnosis. Mental health nurses who are more empathetic towards their consumers experience emotional contagion. They understand emotions better, show sympathetic physiological responses and exhibit kind behaviour towards consumers. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: Further research is required to understand how mental health nurses adapt to consumers' emotional states in different mental health settings. This information can help clinicians make better decisions about care quality for consumers with dual diagnosis. IMPACT: This study addressed mental health nurses' empathy towards consumers with dual diagnosis. Mental health nurses showed increased empathy towards consumers with dual diagnosis. The empathy levels vary based on age, clinical setting, work sector and work experience. Mental health nurses' empathy levels were predicted by emotional contagion, emotion comprehension, sympathetic physiological arousal and conspecific altruism. Empathy enhancement among mental health nurses, particularly towards consumers with dual diagnosis, is crucial and should be regarded as a top priority by healthcare leaders and educators. REPORTING METHOD: Outlined by the Consensus-Based Checklist for Reporting of Survey Studies (CROSS). PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Culturally and Linguistically Diverse Community Access and Utilisation of the Mental Health Service: An Explanation Using Andersen's Behavioural Model.

Andersen's Behavioural Model of Health Service Use (ABMHSU) is a multilevel model that helps understand the factors influencing health service access and utilisation. This framework is a widely used model for health service use in general, as well as in immigrant populations and vulnerable populations. ABMHSU, in this project, provided a framework to explain how the mental health nurses' cultural competence can influence the Victorian CALD community members' mental health care access and utilisation. A unique model of ABMHSU in the current multiple-method project provided a theoretical framework for examining the factors associated with people from the CALD community accessing mental health services in an Australian context to answer the research questions. The key findings of the research were discussed with reference to the extant literature and with triangulation of research results with the ABMHSU in the context of Victoria. The researchers argue that even though predisposing, enabling, and need factors are necessary to determine whether a person is selected for expert care for mental health issues, these factors alone are insufficient. Ongoing research is essential to ascertain the potential of mental health nurses' cultural competence education and cultural responsiveness in addressing the mental health service access and utilisation of the heterogeneous CALD communities. Additional research is advocated to identify the supplementary factors, as there is a dearth of research exploring the potential of ABMHSU worldwide.

Mental Health Nurses' Attitudes on Consumers with Dual Diagnosis: A Thematic Analysis.

BACKGROUND: The issue of dual diagnosis continues to be a global health concern. There is a lack of empirical research on mental health nurses' attitudes toward consumers with dual diagnosis. OBJECTIVE: This study aimed to answer the following research question: How do mental health nurses describe their attitude toward consumers with co-existing mental health and drug and alcohol problems? DESIGN: This qualitative study employed purposive sampling to recruit participants. Semi-structured interviews were conducted to explore mental health nurses' attitudes toward consumers with dual diagnosis. SETTING: This study focused on mental health nurses employed in mental health settings. It placed a particular emphasis on mental health nurses who had experience in caring for consumers with dual diagnosis. Seventeen mental health nurses participated in the interview. METHODS: Interviews were transcribed verbatim and coded using NVivo™ 12 Plus software. Thematic analysis was used to generate codes and themes inductively. RESULTS: Three major themes with a total of eight sub-themes were identified: (1) satisfaction and connection, with three subthemes; (2) combating negativity in others, with two subthemes; and (3) working to improve outcomes, with three subthemes. CONCLUSIONS: Participants were concerned about their peers' sense of fear and frustration, stigmatized language, and lack of consistency in providing dual diagnosis training for mental health nurses. There is a need to investigate effective strategies to address mental health nurses' stigmatized attitudes, fear, and frustration toward consumers with dual diagnosis.

Psychological Distress, Fear and Coping Strategies among Hong Kong People During the COVID-19 Pandemic.

The COVID-19 pandemic contributed to potential adverse effects on the mental health status of a wide range of people. This study aimed to identify factors associated with psychological distress, fear and coping strategies during the COVID-19 pandemic in Hong Kong. A cross-sectional online survey was conducted among general population in Hong Kong. Psychological distress was assessed using the Kessler Psychological Distress Scale; level of fear was evaluated using the Fear of COVID-19 scale; and coping strategies were assessed using the Brief Resilient Coping Scale. Multivariable logistic regression was used to identify key factors associated with these mental health variables. Of the 555 participants, 53.9% experienced moderate to very high levels of psychological distress, 31.2% experienced a high level of fear of COVID-19, and 58.6% showed moderate to high resilient coping. Multivariable logistic regression indicated that living with family members, current alcohol consumption, and higher level of fear were associated with higher levels of psychological distress; perceived stress due to a change in employment condition, being a frontline worker, experiencing 'moderate to very high' distress, and healthcare service use to overcome the COVID-19 related stress in past 6 months were associated with a higher level of fear; and perceived better mental health status was associated with a moderate to high resilient coping. This study identified key factors associated with distress, fear and coping strategies during the pandemic in Hong Kong. Mental health support strategies should be provided continuously to prevent the mental impact of the pandemic from turning into long-term illness. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-021-02338-7.

Job experiences, challenges, revelations and narratives of nurse academics. A qualitative study.

AIM: To explore the views and experiences of nurse academics about their professional work life. DESIGN: A qualitative exploratory interview study. METHODS: Data were collected during 2018/2019 using a semi-structured interview method with 19 experienced academic nurses from a range of academic levels in Australia. All interviews were audio recorded, transcribed verbatim and thematically analysed using a narrative approach. Ethics approval was granted by the relevant University Human Research Ethics Committee. RESULTS: Participants provided detailed insights into the type of daily job stressors they faced. They shared narratives about their personal job experiences and how, at times, they chose to remain silent to maintain a cordial working relationship with some of their senior colleagues and leaders. The main themes were identified included a lack of work-life balance, incivility towards staff, increasing workloads and inequitable distribution, lack of recognition, negative workplace culture, lack of awareness of the importance of political astuteness and lack of leadership skills. CONCLUSION: To ensure a sustainable academic nursing workforce and provide a clearer understanding of job stress and what contributes to faculty decision to leave, areas of priority and strategies that needed attention were identified. These included effective mentoring of less-experienced staff and leadership styles that promote greater inclusiveness, being heard, valued and recognized, improved work-life balance and the need to have a sense of belonging. IMPACT: The study explored the job experiences of nurse academics and identified occupational stressors that directly influenced their daily work life. The findings have global implications for the recruitment and sustainability of nurse academics. This also impacts on their professional and work-life balance.

Quality of life in cancer patients with different preferences for nurse spiritual therapeutics: The role of psychological capital.

AIM: To explore the status of quality of life and psychological capital and analyse the different effects of psychological capital on the quality of life of cancer patients with different preferences for nurse spiritual therapeutics. DESIGN: A cross-sectional survey was used. METHODS: Two hundred and eight cancer patients were recruited using convenience sampling from a tertiary Chinese hospital, between March and July 2019. Data on preferences for nurse spiritual therapeutics (PNST), psychological capital (PsyCap) and quality of life (QoL) were collected using paper questionnaires. Hierarchical multiple regression was employed to investigate the different influences of PsyCap on QoL of cancer patients with various levels of PNST. RESULTS: Compared with patients having high PNST, patients with mild-moderate PNST experienced lower self-efficacy, hope, optimism, PsyCap and social/family well-being. PsyCap significantly explained the variance on QoL of patients with various levels of PNST. Age, gender, presence of caregiver were significant factors influencing physical, social/family and emotional well-being of patients with high PNST. CONCLUSION: The present study demonstrates disparities in PsyCap and QoL between cancer patients with mild-moderate and high PNST. It is essential to be aware of the positive influences of PsyCap on QoL and develop effective interventions for patients to improve their QoL, especially for those with mild-moderate PNST. IMPACT: It is necessary to realize the benefits of PsyCap on QoL of cancer patients with various levels of PNST. Appropriate training for nurses needs to be developed to promote their spiritual care competencies. Moreover, supportive interventions should be developed for cancer patients to improve their PsyCap and QoL.

Evaluation of interprofessional student teams in the emergency department: opportunities and challenges.

BACKGROUND: Interprofessional education opportunities are commonly university-based and require further development during clinical practice. Many clinical contexts offer the potential for meaningful learning of both collaborative and discipline-specific practice. The emergency department (ED) demands efficient teamwork, so presents a logical location for interprofessional learning. METHODS: An interprofessional clinical placement program was implemented with the aim to enhance students' capacity and self-efficacy for collaborative practice. Fifty-five medical and nursing students participated as interdisciplinary pairs in a two-week clinical placement in the ED. Students' perceptions of the learning environment were measured pre- and post-placement with the Self-efficacy for Interprofessional Experiential Learning Scale and the Interprofessional Clinical Placement Learning Inventory was completed post-placement. Non-parametric tests were used to establish change differences. RESULTS: The Placement Learning Inventory revealed positive outcomes; the majority (16/19) agreed/agreed strongly that the placement provided sufficient learning opportunities, was interesting, and made them feel as if they belonged and most (14/19) reported they achieved the discipline specific learning objectives set by the university. Self-efficacy improved significantly (p = 0.017), showing promise for future use of the placement model Challenges were identified in the organisation and supervision of students. In the absence of additional dedicated student supervision, this model of interprofessional student pairs in the ED was challenging. CONCLUSIONS: Interprofessional clinical placements in ED are an effective clinical learning approach for final year undergraduate medicine and nursing students. Recommendations for improvements for students' clinical supervision are proposed for the placement model.

Associations between perceived overqualification, organisational commitment and work passion of nurses: A multicentre cross-sectional study.

AIM: To investigate the associations between perceived overqualification, organisational commitment and work passion of nurses. BACKGROUND: Few studies have considered the effects of perceived overqualification and organisational commitment on work passion of nurses, especially in developing countries. METHODS: This is a multicentre cross-sectional study. A total of 4511 nurses from eight tertiary hospitals were recruited. The Scale of Perceived OverQalification (SPOQ), the Organizational Commitment Scale (OCS) and the Work Passion Scale (WPS) were used to collect the data. Hierarchical multiple regression were employed. RESULTS: Perceived overqualification and organisational commitment were the main predictors for both harmonious and obsessive passions (each p < .001). The unique effect of organisational commitment (ßharmonious  = .608, ßobsessive  = .556) on work passion were six to eight times larger than these of perceived overqualification (ßharmonious = -.079, ßobsessive = .085). CONCLUSION: Our findings indicate that high perceived overqualification clearly reduces nurses' harmonious passion and increases their obsessive passion, whereas high organisational commitment significantly promotes nurses' harmonious and obsessive passions. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should distinguish the different effects of perceived overqualification and organisational commitment on work passion. Effective intervention should be developed to release nurses' potential abilities and improve their organisational commitment and work passion. Chinese Clinical Trial Registry: ChiCTR2100047974.

Associations between perceived overqualification, transformational leadership and burnout in nurses from intensive care units: A multicentre survey.

AIMS: To explore whether perceived overqualification increases the risk of burnout and whether transformational leadership negatively moderates this relationship. BACKGROUND: Perceived overqualification might contribute to burnout and lead to poor experience of transformational leadership, and transformational leadership might be associated with burnout. However, these relationships have not yet been confirmed. METHODS: A multicentre cross-sectional study. A total of 321 nurses from intensive care units were recruited from six tertiary hospitals. Scale of Perceived OverQualification, Transformational Leadership Questionnaire and emotional exhaustion subscale of the Maslach Burnout Inventory-General Survey were employed to collect the data. Hierarchical multiple regression and bootstrap resampling were applied to analyse the data. RESULTS: Burnout was positively associated with perceived overqualification and negatively associated with transformational leadership (each p < 0.05). Transformational leadership significantly mediated the relationship between perceived overqualification and burnout (b = -0.6389, 95% confidence interval: -0.8706, -0.4072). CONCLUSION: Our findings indicated that perceived overqualification and transformational leadership directly or indirectly affect burnout among nurses from intensive care units. IMPLICATIONS FOR NURSING MANAGERS: Personal and organizational-oriented interventions utilizing nurses' overall qualifications and implementing transformational leadership should be employed by nurse managers to alleviate burnout and promote the work performance of nurses from intensive care units.

Severity of illness and distress in caregivers of patients with schizophrenia: Do internalized stigma and caregiving burden mediate the relationship?

AIMS: To test a multiple mediation model of internalized stigma and caregiving burden in the relationship between severity of illness and distress among family caregivers of persons living with schizophrenia. DESIGN: This is a cross-sectional study. METHODS: Data were collected from a consecutive sample of 344 Chinese family caregivers of persons living with schizophrenia between April-August 2018. Instruments used in this research included the Clinical Global Impression-Severity of Illness, the Internalized Stigma of Mental Illness Scale, the Caregiver Burden Inventory, and the Distress Thermometer. Data analysis was conducted using descriptive statistics, the Spearman correlation, and regression analysis to estimate direct and indirect effects using bootstrap analysis. RESULTS: This research found that internalized stigma and caregiving burden can separately and sequentially mediate the relationship between severity of illness and distress. Moreover the mediation of internalized stigma plays the largest role among the multiple mediations. CONCLUSION: The severity of illness, internalized stigma, and caregiving burden are significant factors of distress among family caregivers of persons living with schizophrenia. The future intervention studies which be designed aiming at the three factors may be beneficial for family caregivers of persons living with schizophrenia. IMPACT: This research examined the psychosocial development of distress and indicated that interventions improving patients' symptoms and decreasing internalized stigma and caregiving burden can help to prevent or reduce distress among family caregivers.

Nursing Education to Enhance Culturally and Linguistically Diverse (CALD) Community Access to Mental Health Services: A Scoping Review.

Research has found that training health care professionals can enhance the access of the culturally diverse community to appropriate mental health services. Yet, little research has been conducted that explicitly focuses on improving nursing knowledge, skills, attitudes, and behaviours that can enhance the access of the Culturally and Linguistically Diverse (CALD) community. This scoping review aims to locate, summarise, and recap what is known in the academic literature about educational interventions and programs to improve mental health nurses' cultural competence. Examining how educational interventions and programs can improve mental health nurses' knowledge, skills, attitudes, and behaviours to facilitate Culturally and Linguistically Diverse (CALD) community access to mental health services can also identify gaps in knowledge to report future research areas. Fifteen studies included in the review reported a positive effect of cultural competence interventions; however, it was difficult to establish a single effective intervention method due to the significant heterogenicity in cultural competence intervention strategies. Most studies in this scoping review included nurses as participants. However, only one study solely focussed on cultural competence intervention for mental health nurses. Two other studies included mental health nurses as participants, along with other mental health professionals. Henceforth, there is a prerequisite for more research focussing on enhancing mental health nurses' cultural competency. Additional research is required to evaluate educational interventions' impact on improving cultural competence attributes on specific practitioner behaviours and the effects on health care and health care outcomes. This review can form a basis for future research studies that will emphasise the impact of cultural competence interventions for mental health nurses.

Mental Health Nurses' Attitudes towards Consumers with co-Existing Mental Health and Drug and Alcohol Problems: A Scoping Review.

Consumers with co-existing mental health and drug/alcohol problems are exposed to more stigma than those with any other health problems. This scoping review aimed to systematically map the available literature regarding mental health nurses' attitudes, empathy, and caring efficacy towards consumers with a dual diagnosis. Twenty studies reported outcomes regarding nurse attitudes; however, none reported nurses' empathy or caring efficacy towards consumers with a dual diagnosis. Further research is required to advance the evidence on the impact of mental health nurses' attitudes, empathy and caring effectiveness, and the outcomes should lead to improved service delivery for consumers with a dual diagnosis.

Strategies for Implementing Consumer Involvement in Nursing Handover on Acute Mental Health In-Patient Units.

Consumer participation in the process of care delivery is crucial to recovery-oriented care. Nursing handover is an important process during the delivery of care on acute in-patient units. Despite the importance of involving consumers in this process, it remains a relatively new concept within mental health. This is due to the complexities involved in the provision of care within the mental health setting. There is a paucity of research on how to successfully implement consumer involvement in nursing handover within mental health settings even though this practice has been occurring within generalist settings for some time now. This paper reports on the findings on the implementation of consumer involvement on an acute in-patient unit. The views of consumers and mental health nurses about the process have already being reported. This current paper describes how a new handover system was implemented using a modified version of the model for successful change to bedside handover by McMurray et al. which was based on Lewin's force-field model of unfreezing, moving and refreezing and Kotter's model of change. The key elements of successful implementation are discussed. There is a need to carefully design and implement consumer involvement in nursing handover within acute in-patient units. There are lessons to be learnt in the process adopted and described in this paper.

Association between psychological capital and spiritual care competencies of clinical nurses: A multicentre cross-sectional study.

AIMS: To investigate the status of spiritual care competencies among clinical nurses and their relationships with psychological capital. BACKGROUND: Limited knowledge is about the influence of positive personal characteristics on nurses' spiritual care competencies. METHODS: A multicentre cross-sectional study. A total of 1717 nurses were recruited from nine separate Chinese hospitals. Online questionnaires were delivered through a local nursing association to assess socio-demographics, spiritual care competencies and psychological capital of nurses. RESULTS: Nurses had mild-to-moderate levels of spiritual care competencies and moderate levels of psychological capital. Psychological capital and its two metrics (self-efficacy and hope), spiritual care education, professional qualification and shift work were the main predictors of spiritual care competencies (each p < .05). CONCLUSION: The findings of the study show a positive relationship between psychological capital and spiritual care competencies of clinical nurses. Strengthening nurses' psychological capital could improve their spiritual care competencies. IMPLICATIONS FOR NURSING MANAGERS: Nurse managers and hospital administrators should better understand the value of psychological capital for nurses' capacity development. Effective interventions need to be implemented separately or combined with spiritual care education programmes to improve nurses' psychological capital and spiritual care competencies.

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OBJECTIVES: There are almost one million families who lost their only child in China, and 65.6% of them had severe and long lasting depression and needed timely psycho-intervention. This study aims to explore the relationship among resilience and its influential factors, and to compare their effect on depression. METHODS: A total of 212 only-child loss person in 9 administrative regions in Changsha were assessed by using Connor-Davidson Resilience Scale, Zung Self-rating Depression Scale, Simplified Coping Style Questionnaire, Simplified Eysenck Personality Questionnaire, Social Support Rating Scale, and General Self-efficacy Scale. A hypothetical model was tested based on Kumpfer resilience framework and stress-coping theory. RESULTS: The influential factors of resilience were: positive coping (the total effect value was 0.480), support utilization (the total effect value was 0.359), neuroticism (the total effect value was -0.326), negative coping (the total effect value was 0.279), extraversion (the total effect value was 0.219), and objective support (the total effect value was 0.077). The process of individual-environment interaction showed a greater impact on resilience, which had a direct effect on depression (the total effect value was -0.344, 67.1%), and also indirect effect through self-efficacy (the total effect value was -0.169). The total effect of resilience accounted for 20.1% of the total effect of all variables. CONCLUSIONS: Resilience mainly impacts depression directly, and can negatively predict depression in only-child loss parents. Resilience, located before self-efficacy, is a significant stress mediating variables. Personality traits and support utilization indirectly impact resilience via negative and positive coping. The key to promote the reorganization of resilience is the process of individual-environmental interaction, involving support utilization, positive coping, and some sorts of negative coping strategies, which plays an important role in developing a resilience intervention program and can improve the depression of the only-child loss person.

Factors associated with psychological distress, fear and coping strategies during the COVID-19 pandemic in Australia.

BACKGROUND: The COVID-19 pandemic disrupted the personal, professional and social life of Australians with some people more impacted than others. OBJECTIVES: This study aimed to identify factors associated with psychological distress, fear and coping strategies during the COVID-19 pandemic in Australia. METHODS: A cross-sectional online survey was conducted among residents in Australia, including patients, frontline health and other essential service workers, and community members during June 2020. Psychological distress was assessed using the Kessler Psychological Distress Scale (K10); level of fear was assessed using the Fear of COVID-19 Scale (FCV-19S); and coping strategies were assessed using the Brief Resilient Coping Scale (BRCS). Logistic regression was used to identify factors associated with the extent of psychological distress, level of fear and coping strategies while adjusting for potential confounders. RESULTS: Among 587 participants, the majority (391, 73.2%) were 30-59 years old and female (363, 61.8%). More than half (349, 59.5%) were born outside Australia and two-third (418, 71.5%) completed at least a Bachelor's degree. The majority (401, 71.5%) had a source of income, 243 (42.3%) self-identified as a frontline worker, and 335 (58.9%) reported financial impact due to COVID-19. Comorbidities such as pre-existing mental health conditions (AOR 3.13, 95% CIs 1.12-8.75), increased smoking (8.66, 1.08-69.1) and alcohol drinking (2.39, 1.05-5.47) over the last four weeks, high levels of fear (2.93, 1.83-4.67) and being female (1.74, 1.15-2.65) were associated with higher levels of psychological distress. Perceived distress due to change of employment status (4.14, 1.39-12.4), alcohol drinking (3.64, 1.54-8.58), providing care to known or suspected cases (3.64, 1.54-8.58), being female (1.56, 1.00-2.45), being 30-59 years old (2.29, 1.21-4.35) and having medium to high levels of psychological distress (2.90, 1.82-5.62) were associated with a higher level of fear; while healthcare service use in the last four weeks was associated with medium to high resilience. CONCLUSIONS: This study identified individuals who were at higher risk of distress and fear during the COVID-19 pandemic specifically in the State of Victoria, Australia. Specific interventions to support the mental wellbeing of these individuals should be considered in addition to the existing resources within primary healthcare settings.

Validation of the distress thermometer for caregivers of children and adolescents with schizophrenia.

AIM: To develop and psychometrically test the distress thermometer for caregivers (DT-C) and document the distress level in primary caregivers of children and adolescents diagnosed with schizophrenia. DESIGN: A validation diagnostic accuracy study and descriptive cross-sectional survey. METHODS: DT-C was adopted based on Harverman's distress thermometer for parents. The cut-off score was detected by using receiver operating characteristic analysis with the Depression Anxiety Stress Scale-21 as a reference standard in a sample of 324 caregivers of children and adolescents diagnosed with schizophrenia in China collected between Jan 2017 and Feb 2018. RESULTS: One-item DT of DT-C indicated a good retest reliability (r = 0.86) and one-item DT and the Problem List (PL) indicated good convergent validity (r = 0.67-0.88). Overall and individual PL domains showed good internal consistency (KR 20 values ranged from 0.70-0.90). Setting seven as the cut-off score, the values of sensitivity (0.72-0.81), specificity (0.86-0.90), Youden's index (0.61-0.70), positive predictive value (0.67-0.74), and negative predictive value (0.84-0.92) were most satisfactory and area under curve values showed significantly excellent discrimination (0.88-0.90). The average DT score for the 324 participants was 6.34 (SD 2.49), with 46.9% of the participants above the cut-off. Caregivers above the cut-off score faced significant multiple problems in practical, family/social, cognitive, emotional, and parenting domains. CONCLUSION: The DT-C, with six domains containing 35 items in Problem List and with the cut-off score at seven, can be a rapid screening tool to measure distress in these caregivers. The level of distress in caregivers was relatively high. Psychoeducation on specific needs and a solid mutual support network are recommended for mitigating caregivers' distress. IMPACT: This study adapted a reliable DT-C to measure distress of caregivers, which has the potential to be introduced to caregivers of other types of child and adolescent mental disorders in research, assessments and care planning for health professionals.

Occupational stress facing nurse academics-A mixed-methods systematic review.

AIM: To better understand occupational stress faced by nurse academics. METHODS: A mixed-methods systematic review, following the Joanna Briggs Institute [JBI], (Joanna Briggs Institute Reviewers' Manual: 2014 edition, 2014) process. Studies were assessed for quality and risk of bias by using standardised critical appraisal instruments from the Joanna Briggs Institute. In addition, processes and reporting were checked against the Equator guidelines. See Appendix S1. RESULTS: The review revealed that nursing academics do experience occupational stress, including burnout. Occupational stress for academic nurses is associated with various factors including work-life balance, workload issues, resources and support, and adapting to change. However, much of the literature focuses on nurses during the initial transition from clinical to academic environment, with rather less focus on established mid-to-late career nurse academics. DISCUSSION: Occupational stress and burnout are evident in the university academic workforce, adversely affecting the well-being of academic nurses, and the long-term sustainability of the academic nursing workforce. While there is considerable literature focusing on the novice academic nurse, particularly during the transition period, rather less is known about occupational stress among academic nurses across the career trajectory. Various strategies to deal with the negative consequences of occupational stress are identified, including (a) quality mentors for novice and younger nursing academics; (b) training in resilience building for novice academics; (c) supporting collegial relationships and reducing bullying; (d) assistance for professional development and research; (e) better support and resources to overcome increasing workloads; and (f) greater work-related empowerment to enhance job satisfaction. CONCLUSION: There is a need for a broader whole-of-career research focus to more fully identify, explore and mitigate the occupational stressors that negatively affect the academic nurse workforce. RELEVANCE TO CLINICAL PRACTICE: A strong and resilient academic nurse workforce is essential for the sustainability of the profession. Organisations should review their work practices and provide greater work-related empowerment to reduce occupational stressors among nursing academics.

Impact of WeChat-based 'three good things' on turnover intention and coping style in burnout nurses.

BACKGROUND: Few studies have considered functions of nurses' positive personality and behaviours on addressing their turnover intention. AIMS: To explore the effects of WeChat-based 'three good things' (3GT) on burnout nurses' turnover intention and coping styles. METHODS: A randomized controlled trial. 73 nurses were included in the intervention group (n = 33) and the control group (n = 40). The intervention group received WeChat-based 3GT. Turnover intention and coping style were measured before and after the intervention. RESULTS: WeChat-based 3GT effectively reduced turnover intention and negative coping style (each p < .05). Positive coping style was promoted after the intervention (p < .05). Time effects as well as intervention and time interactions were significant in turnover intention and negative coping style (each p < .05). CONCLUSION: Benefits of WeChat-based 3GT on turnover intention and coping style in burnout nurses were found. Nurses experienced lower levels of turnover intention and negative coping style and increased the usage of positive coping style after the intervention. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should incorporate 3GT intervention with popular social communication programmes to improve nurses' coping strategies towards clinical issues and maintain the stability of nursing teams.