Educational and personal burnout and burnout regarding collaborating with fellow university nursing students during COVID-19 in 2020-2021.

BACKGROUND: Knowledge is lacking about the effects of COVID-19 on nursing students' burnout symptoms. Burnout can lead to negative feelings and behaviours towards learning and poor mental health. AIMS: To describe and compare nursing/midwifery students' burnout, explore differences and detect predictors at two time points through COVID-19. METHODS: Students were offered participation in the spring semesters of 2020 and 2021 (N = 2046), during COVID-19. The response rate was 30-33%. By using reliable and valid instruments, the students' stress and burnout were analysed as well as the students' health and perceived support. RESULTS: Symptoms of academic burnout were higher among 1st and 2nd year BSc students in 2021. On the contrary, 3rd and 4th year students had higher academic and personal burnout than graduate students as well as than 1st and 2nd year students. Regarding academic burnout, 47% of the variability was explained by educational level, support, stress and the interactional effect of stress and support. Collaborational burnout, predicted by the students' educational level and support, explained 7% of the variability in the outcome. Additionally, educational level, and stress, predicted 52% of the variability in personal burnout. CONCLUSION: Educators or student counsellors need to facilitate effective learning practices and offer academic support, specifically during 3rd and 4th year to boost helpful coping strategies and handle uncertainty and stressors related to crises such as COVID-19.

Core competencies of clinical nurse specialists: A comparison across three Nordic countries.

AIM: To describe and compare the clinical nurse specialist core competency use in Finland, Denmark and Iceland. BACKGROUND: Clinical nurse specialist roles were first developed more than 60 years ago in the United States. Within the Nordic countries, the clinical nurse specialist role emerged around 2000. There is scarcity of clinical nurse specialist competency descriptions outside of North America, and research has been limited to examine or validate established competencies across different countries. DESIGN: A descriptive correlational study. METHODS: An online survey was conducted from May to September 2019. A population sample of clinical nurse specialists in Finland, Denmark and Iceland was recruited. A validated self-report questionnaire of clinical nurse specialist competencies was used. The data were analysed using descriptive and inferential statistics, and the STROBE checklist was used as the reporting guideline. RESULTS: A total sample of 184 clinical nurse specialists, 52 from Finland, 95 from Denmark and 37 from Iceland, participated in the study (response rate = 72%, 35% and 48%, respectively). Overall, clinical nurse specialists utilised the organisational competency most frequently followed by the patient, clinical nursing leadership and scholarship competency. Univariate analysis of variance test between-country effects showed statistically significant difference in patient competency (p = .000) and in organisational competency (p < .05). There were no statistically significant differences between counties in the utilisation of clinical nursing leadership and scholarship competency. CONCLUSION: A small variability was found in the comparison of the clinical nurse specialist use of core competency in the spheres of patient, nursing, organisation and scholarship within three Nordic countries. RELEVANCE TO CLINICAL PRACTICE: The CNS competency scale may be utilised in benchmarking clinical nurse specialist roles and practice within and across countries. The long-term goal for the competency descriptions is to enhance the clinical nurse specialist role clarity, integration and evaluation as well as inform post-graduate education.

[Physical activity and depression among older community-dwelling adults in urban and rural areas: Population based study].

INTRODUCTION: The aim was to explore physical activity (PA) in different daily contexts, among older adults in Northern Iceland; and by urban-rural living, age-group and sex. Moreover, to study the association between PA and depression. MATERIAL AND METHODS: The study was cross-sectional, population based and data was collected in 2017-'18 in Northern Iceland. The 175 community-dwelling participants (participation rate 59.7%) were 65-92 years old, 43% were women, and 40% lived in rural areas. The Physical Activity Scale for the Elderly (PASE) was used to obtain a total PA score and three subs-scores reflecting PA associated with leisure-time, household and work. The Geriatric Depression Scale was used to detect depressive symptoms. RESULTS: Total PA was the same for urban and rural people, men were more active than women, and the 65-74 years age-group was more active than the 75-92 years age-group. People in rural areas were more likely to do work-related PA than people in urban areas, as was the 65-74 years age-group compared to the 75-92 years age-group. Men were more PA during household than women. Higher total PA and the sub-scores of PASE had significant association with fewer depressive symptoms. PA in leisure-time was the only PASE sub-score with a significant and independent association with fewer depressive symptoms. CONCLUSION: The results improve the knowledge on PA among older community-dwelling adults, and its relationship with depressive symptoms. Although PA in different contexts has various health benefits, an emphasis on leisure-time PA may have the most beneficial effect on mental health.

Integrative Nursing Principles in Action: A Summary From the First International Integrative Nursing Symposium.

The first International Integrative Nursing Symposium was held in May 2015 in Reykjavík, Iceland, to foster discourse about providing whole person/whole systems care that is relationship-based and person-centered. A discussant format was used to ensure that symposium participants could fully operationalize the principles of integrative nursing in practice, research, education, and policy development. Sessions varied widely to communicate the full spectrum of nursing scholarship with participants envisioning a future when all nursing care is integrative.

Predictability of Seasonal Mood Fluctuations Based on Self-Report Questionnaires and EEG Biomarkers in a Non-clinical Sample.

Induced by decreasing light, people affected by seasonal mood fluctuations may suffer from low energy, have low interest in activities, experience changes in weight, insomnia, difficulties in concentration, depression, and suicidal thoughts. Few studies have been conducted in search for biological predictors of seasonal mood fluctuations in the brain, such as EEG oscillations. A sample of 64 participants was examined with questionnaires and electroencephalography in summer. In winter, a follow-up survey was recorded and participants were grouped into those with at least mild (N = 18) and at least moderate (N = 11) mood decline and those without self-reported depressive symptoms both in summer and in winter (N = 46). A support vector machine was trained to predict mood decline by either EEG biomarkers alone, questionnaire data from baseline alone, or a combination of the two. Leave-one-out-cross validation with lasso regularization was used with logistic regression to fit a model. The accuracy for classification for at least mild/moderate mood decline was 77/82% for questionnaire data, 72/82% for EEG alone, and 81/86% for EEG combined with questionnaire data. Self-report data was more conclusive than EEG biomarkers recorded in summer for prediction of worsening of depressive symptoms in winter but it is advantageous to combine EEG with psychological assessment to boost predictive performance.

Prevalence of Childhood Maltreatment and Posttraumatic Stress Symptoms Among Male Inmates in Iceland.

INTRODUCTION: Childhood maltreatment is highly correlated with adult criminal behavior, and the prevalence of childhood maltreatment within prison populations is high. Furthermore, studies have repeatedly shown a higher prevalence of posttraumatic stress disorder (PTSD) symptoms in samples of prisoners compared with the general public. PURPOSE AND METHODOLOGY: The aims of the current study were to determine the frequency of childhood maltreatment among male inmates in Iceland and the percentage of male inmates meeting screening criteria for PTSD. The Icelandic versions of the Childhood Trauma Questionnaire-Short Form and the PTSD Symptom Scale-Self-Report (PSS-SR) were used in the study. RESULTS: Results show a high prevalence of childhood maltreatment among the sample (N = 48), where 87% of participants reported having experienced at least one of the five categories listed (M = 2.33, SD = 1.68). Approximately 52% had experienced emotional abuse, 27% had experienced physical abuse, 48% had experienced sexual abuse, and over half reported experiencing neglect in their childhood. Two thirds of the participants were above the cutoff score for PTSD on the PTSD Symptom Scale-Self-Report, all of whom expressed a reduced quality of life and/or functional impairment because of their symptoms. DISCUSSION: The results indicate that most male inmates in Icelandic prisons were maltreated during their childhood and that many of them report severe posttraumatic stress symptoms. CONCLUSION: By integrating trauma-focused interventions into Iceland's Prison Service, mental health nurses and other mental health professionals have an opportunity to profoundly affect prisoners' functioning and quality of life, thereby potentially reducing the likelihood of recidivism for a large part of this population in the future.

Predictors of university nursing students burnout at the time of the COVID-19 pandemic: A cross-sectional study.

BACKGROUND: Little is known about the stress and burnout experienced by undergraduate and graduate nursing students during the COVID-19 pandemic. Academic burnout among nursing students can have an impact on students' learning ability, health, and wellbeing and on the quality of care and intention to leave the profession post-graduation. OBJECTIVES: Evaluate the predictors of nursing students' personal, academic, and collaboration-related burnout during the COVID-19 pandemic. DESIGN: Cross-sectional two-site study. SETTINGS: Icelandic universities offering nursing education. PARTICIPANTS: Graduate and undergraduate nursing students in Iceland (N = 1044) were asked to participate in the study, with a response rate of 32.7%. METHODS: An online survey was used to evaluate the students' stress and burnout in spring 2020. RESULTS: The main findings show that 51% of the variability in the students' personal burnout was explained by their perceived stress, mental health, and perceived support. Furthermore, the students' perceived stress, support, and educational levels predicted 42% of the variability in their academic burnout. Burnout related to collaborating with fellow-students was explained by the nursing students' physical health and by their educational level, explaining 6% of the variability in fellow-students burnout. CONCLUSION: University administrators might consider adding academic support facilities into their undergraduate nursing programs and teaching their students healthy coping skills.

Self-rated health and socio-economic status among older adults in Northern Iceland.

Little is known about self-rated health (SRH) of older people living in more remote and Arctic areas. Iceland is a high-income country with one of the lowest rates of income inequality in the world, which may influence SRH. The research aim was to study factors affecting SRH, in such a population living in Northern Iceland. Stratified random sample according to the place of residency, age and gender was used and data collected via face-to-face interviews. Inclusion criteria included community-dwelling adults ≥65 years of age. Response rate was 57.9% (N = 175), average age 74.2 (sd 6.3) years, range 65-92 years and 57% were men. The average number of diagnosed diseases was 1.5 (sd 1.3) and prescribed medications 3.0 (sd 1.7). SRH ranged from 5 (excellent) to 1 (bad), with an average of 3.26 (sd 1.0) and no difference between the place of residency. Lower SRH was independently explained by depressed mood (OR = 0.88, 95% CI = 0.80-0.96), higher body mass index (OR = 0.93, 95% CI = 0.87-0.99), number of prescribed medications (OR = 0.88, 95% CI = 0.78-1.00) and perception of inadequate income (OR = 0.45, 95% CI = 0.21-0.98). The results highlight the importance of physical and mental health promotion for general health and for ageing in place and significance of economic factors as predictors of SRH.

Adolescent alcohol and cannabis use in Iceland 1995-2015.

INTRODUCTION: Over the past two decades, alcohol consumption of Icelandic adolescents has decreased dramatically. The aim of this study was to quantify the extent of this reduction and compare it with the trend in cannabis use over a 20 year period and to identify possible explanations. METHODS: We used data from the Icelandic participants to the European School Survey Project on Alcohol and Other Drugs study (collected via paper-and-pencil questionnaires in classrooms). The sample included all students in the 10th grade (54-89% response rate). RESULTS: The percentage of participants who had never used alcohol during their lifetime rose from 20.8% in 1995 to 65.5% in 2015. Similarly, there was a decline in the proportion of students who had consumed alcohol 40 times or more, from 13.7% to 2.8%. During the same period, the number of students who had never used cannabis rose from 90.2% to 92.0%. In contrast, we found a small, but statistically significant, increase in the prevalence of those who had used cannabis 40 times or more, from 0.7% in 1995 to 2.3% in 2015. Parental monitoring increased markedly between 1995 and 2015, but availability of alcohol decreased. Perceived access to cannabis and youth attitudes towards substance use remained unchanged. DISCUSSION: Although Iceland has enjoyed success in lowering alcohol use among adolescents over the past decades, and somewhat fewer claim to have ever tried cannabis, there has been a threefold increase among heavy users of cannabis. Increased parental monitoring and decreased availability of alcohol explain some of the changes seen.

[The diversion of prescribed stimulant medications of 10th graders in Iceland].

INTRODUCTION: ADHD is a neurodevelopmental disorder that usually surfaces before seven years of age. Stimulants are commonly used medications for the treatment of this disorder in Iceland, but they carry with them a significant risk of both abuse and diversion - i.e. when it is used by an individual other than it was prescribed for by a physician. The purpose of this study was to estimate the prevalence of diversion amongst Icelandic adolescents. MATERIAL AND METHODS: This study is based on data collected in the Icelandic portion of the European School Survey Project on Alcohol and Other Drugs (ESPAD) focused on the drug and alcohol use of 10th graders in Europe. RESULTS: Of the 2,306 students that participated in the study 91% (2,098) claimed they had never been prescribed stimulant medications while 9% (208) claimed they had. Boys were twice as likely to get a stimulant prescription compared to girls. Almost 18% of the participants that had been prescribed simulants said they had at some point in time diverted their stimulant medication. CONCLUSION: The diversion of stimulants by 10th graders in Iceland is quite common compared to studies from other countries where the prevalence is closer to 5-10%. These findings demonstrate the importance of carefully overseeing stimulant use of adolescents, for the benefit of both those who divert as well as those diverted to.

Perceptions of an Adapted Mindfulness Program for Persons Experiencing Substance Use Disorders and Traumatic Brain Injury.

BACKGROUND: Of the 1.4 million Americans who sustain traumatic brain injuries (TBIs) each year up to half experience substance use disorders (SUDs). This often leads to various issues such as increased rates of mental health problems and delay or lack of return to full employment. AIMS: The purpose of this program evaluation was to describe Vinland National Center's (Vinland's) client and staff perceptions of a 4-week mindfulness-based intervention adapted from the original mindfulness-based stress reduction program for persons experiencing SUDs and TBIs. It focused on the possible relevance and applicability of mindfulness practice for this population. METHOD: Four focus groups were conducted based on Krueger's methods in conducting focus groups: two with Vinland staff members and two focus groups with residents. RESULTS: The analysis of staff focus groups revealed general staff satisfactions with the intervention. A general consensus was that the mindfulness intervention fitted well with the needs of Vinland's clients and their current program. Client feedback further revealed general satisfaction with the mindfulness curriculum. No adverse effects were noted related to the mindfulness intervention. CONCLUSIONS: The results of this program evaluation suggest that implementing a mindfulness-based intervention for persons experiencing SUDs/TBIs warrants further investigation.

Stress management techniques in the prison setting.

BACKGROUND: The percentage of incarcerated individuals in the United States is currently close to an all time high, and more stressful places than prisons are hard to find. Because registered nurses and advance practice nurses are often the only healthcare providers readily available to prison inmates, nurses need a repertoire of effective strategies to minimize prisoners' stress-related symptoms and behaviors. PURPOSE: The purpose of this critical literature review was to identify the state of knowledge about using stress management techniques (SMTs) in the prison setting for reducing psychological problems and/or behavioral problems in male and female adult prison populations. METHODS: A comprehensive, systematic integrated literature search was performed using multiple relevant databases to identify studies using various SMTs for incarcerated adults. FINDINGS: Although clinical practice recommendations for the use of SMTs in the prison setting cannot be made with strong certainty, nurses working in the prison setting should continue to incorporate muscle relaxation, Transcendental Meditation, and certain Eastern meditative practices in the care of their clients because of the safety and possible positive impacts and practicality these methods have in this setting.