Association of nurse managers' paternalistic leadership and nurses' perceived workplace bullying: The mediating effect of organizational climate.

AIMS: To explore the association between nurse managers' paternalistic leadership and nurses' perceived workplace bullying (WPB), as well as to examine the mediating role of organizational climate in this association. BACKGROUND: There is a lack of empirical evidence regarding the relationship between nurse managers' paternalistic leadership, organizational climate and nurses' perceived WPB. Clarifying this relationship is crucial to understand how paternalistic leadership influences WPB and for nursing managers to seek organizational-level solutions to prevent it. METHODS: A cross-sectional survey was performed from 4 January to 10 February 2022, in six tertiary hospitals in mainland China. Demographic information, Paternalistic Leadership Scale, Organizational Climate Scale and Negative Acts Questionnaire-Revised were used in the survey. Descriptive statistics, Spearman correlation analyses and a structural equation model were used for data analysis. RESULTS: A total of 5093 valid questionnaires were collected. Moral leadership and authoritarian leadership have both direct and indirect effects on WPB through the mediating effect of organizational climate. The former is negatively related to WPB and the latter is positively related to WPB. Benevolent leadership was only negatively associated with WPB via the mediating effect of organizational climate. CONCLUSION: The three components of paternalistic leadership have different effects on WPB through the mediating effect of organizational climate. Nurse managers are recommended to strengthen moral leadership, balance benevolent leadership, reduce authoritarian leadership and strive to create a positive organizational climate in their efforts to mitigate WPB among nurses. IMPACT: This study enhanced our comprehension of the relationship between different leadership styles and WPB. Greater emphasis should be placed on moral leadership in the promotion of nursing managers and nursing leadership training programs. Additionally, nursing managers should focus on establishing a positive organizational climate that helps to reduce WPB. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public.

Depression and anxiety between nurses and nursing assistants working in long-term care facilities during the COVID-19 pandemic.

AIM: This study investigated the levels of depression and anxiety in nurses and nursing assistants working in long-term care facilities during the COVID-19 pandemic. We also explored the potential causes of depression and anxiety in nurses and nursing assistants working in long-term care facilities during the pandemic. BACKGROUND: The COVID-19 pandemic has had a considerable impact on long-term care facilities. The high infection and mortality rates for COVID-19 have resulted in an increased workload for caregivers. INTRODUCTION: The COVID-19 pandemic exposed caregivers working in long-term care facilities to higher risks of anxiety and depression. Additionally, the high risk of infection in the work environment and concerns about spreading COVID-19 to family members and long-term care facility residents led to various forms of stress among caregivers. METHODS: The present study was a cross-sectional study. Questionnaires were used to investigate depression and anxiety among regarding nurses and nursing assistants working in long-term care facilities during the pandemic. RESULTS: The depression and anxiety levels of the nurses were higher than nursing assistants, but had no statistically significant difference (p = 0.551). The factors influencing levels of depression and anxiety in nurses contained facility affiliation and experience working. In terms of nursing assistants, age, marital status, and facility affiliation were correlated with the levels of depression and anxiety. DISCUSSION: The pandemic has severely impacted caregivers. In the process of implementing pandemic prevention measures and providing care for COVID-19 patients, safeguarding the psychological health of caregivers is also essential. CONCLUSION: The levels of depression and anxiety in nurses were higher than in nursing assistants working in long-term care facilities during the pandemic. IMPLICATION FOR NURSING AND HEALTH POLICY: Long-term care facilities managers are recommended to enhance the education and training process for caregivers. Managers are also recommended to ensure provision of sufficient amounts of pandemic prevention equipment and resources.

Functional Gastrointestinal Disorders Common Among Nurses With Poor Sleep Quality in Shanghai, China: A Pilot Study.

This study aimed to determine whether functional gastrointestinal disorders are more common among nurses with self-reported poor sleep. In total, 468 nurses working the day shift or rotating shifts completed two questionnaires: the questionnaire for irritable bowel syndrome (IBS) using Rome III criteria and the Pittsburgh Sleep Quality Index (PSQI). The prevalence of poor sleep was 41.04% (95% confidence interval, CI: [36.23, 45.85]), and poor sleep was significantly more common among rotating-shift nurses than among day-shift nurses (50.70% vs. 29.95%; p < .05). Among nurses with poor sleep, the prevalence of IBS and functional constipation was 35.15% (95% CI: [27.86, 42.44]) and 11.52% (95% CI: [6.65, 16.39]), respectively. After adjusting for age, work schedule, night pain, and psychological factors, IBS (odds ratio, OR: 1.88; 95% CI: [1.03, 2.49]) and functional constipation (OR: 1.77; 95% CI: [0.64, 2.57]) were significantly more common in nurses with poor sleep. We conclude that IBS and functional constipation are prevalent in nurses with poor sleep. Poor sleep was independently associated with IBS and functional constipation among nurses in Shanghai, China.

Knowledge, Practices, and Perceived Barriers in Cancer Pain Management at Oncology Units: A Cross-Sectional Survey of Medical Staff in China.

BACKGROUND: Despite the great signs of progress in cancer pain management in China, the associated pain remains under-treated. Poor knowledge among the medical staff is an important factor contributing to the under-treatment of cancer pain. This study aimed to evaluate the knowledge, practices, and perceived barriers in cancer pain management among the medical staff at oncology units in China. PATIENTS AND METHODS: A cross-sectional survey was conducted with the medical staff (including physicians, nurses, and pharmacists) at oncology units in tertiary hospitals of China between December 2020 and January 2021. The questionnaire assessed the knowledge, practices, and perceived barriers in cancer pain management. RESULTS: A total of 1262 medical staff responded to the questionnaire; the response rate was 94.2%. Most participants had good knowledge of the three-step analgesic ladder of the World Health Organization (WHO) and the National Comprehensive Cancer Network (NCCN) guidelines for Adult Cancer Pain. Knowledge deficit was prominent in questions on opioid dose titration and rotation and adverse effects of opioids; the correct response rate was less than 40%. Training, work experience in oncology, and education level were significantly related to knowledge of cancer pain management (all P < 0.001). In clinical practice for cancer pain management, approximately 57.2% of medical staff were unfamiliar with opioid dose titration and rotation; only 14.4% treated cancer pain through multidisciplinary collaboration. Poor medication compliance, difficult individualized analgesia protocols, and insufficient multidisciplinary participation were the most frequently perceived barriers by the medical staff for pain management. CONCLUSION: These findings suggested a further need for integrating recent guidelines to strengthen continued training (especially among juniors and those with low education levels) and patient education to improve the knowledge and clinical practices of cancer pain management among the medical staff in China. Multi-disciplinary management is required for the effective treatment of cancer pain.

Strategies of extensively drug-resistant TB risk management for health workers and other care givers.

Extensive drug resistance in TB is not a new phenomenon. It is created when patients with multidrug-resistant TB (MDR-TB) are treated with second-line anti-TB drugs but fail to be cured. The first principle in managing the risk of extensively drug-resistant TB (XDR-TB) is 'do not generate XDR-TB'. Once it is created, every effort must be made to prevent it from spreading. Health workers and care givers in long-term care facilities and prisons may have a considerable risk of exposure to TB, including XDR-TB. The principles in the control of TB transmission in healthcare settings, long-term care facilities and prisons include early identification and isolation of infectious TB patients, effective treatment of TB as soon as possible, environmental control with proper ventilation and personal protection of healthcare workers and others. Patients with the highest risk of developing XDR-TB are those MDR-TB patients who failed treatment using a second-line regimen and TB patients who have a history of contact with XDR-TB patients. The core principles in managing the risk of XDR-TB for health workers and care givers are reducing the risks of exposure to XDR-TB, becoming infected and developing XDR-TB. If TB has developed, the principles include promptly diagnosing XDR-TB and starting proper treatment.