Influencing factors on the psychosomatic health of medical staff since the normalized stage of COVID-19 in mainland China.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, there were under-recognized and unaddressed psychosomatic health problems among medical staff. The purpose of this study was to investigate their psychosomatic status. METHODS: An online questionnaire was performed to the medical staff of major hospitals in Jinan in January 2023. In total, 1244 valid questionnaires were collected, and their psychosomatic status was assessed by the Psychosomatic Symptom Scale (PSSS) and Perceived Stress Scale-10 (PSS-10). Finally, we analyzed the influencing factors for their psychosomatic status. RESULTS: The psychological health of the medical staff was poor, and the level of stress perception was intense, accompanied by obvious psychosomatic symptoms. Regression analysis indicated that age, gender, frontline involvement, work experience, marriage, presence of disease history and COVID-19 infection history were risk factors for psychosomatic symptoms, while education, frontline involvement and presence of disease history were risk factors for stress feeling. CONCLUSION: Medical staff often showed obvious psychosomatic symptoms and intense stress. Psychological health education and intervention should be given in order to improve their working quality.

Insider versus outsider workplace mistreatment and their impact on affective ill-being in healthcare professionals: Can personal resources act as buffers?

AIMS: Workplace stress can negatively impact healthcare providers' professionalism and quality of care. One source of workplace stress is the experience of workplace mistreatment. Drawing on the Job Demands-Resources theory, this study aimed to (a) investigate the impact of mistreatment frequency experienced by healthcare workers from insider sources (i.e. co-workers, supervisors) and outsider sources (i.e. patients, visitors) on affective ill-being and (b) the potential moderating role of trait resilience and trait self-efficacy, as personal resources, in the mistreatment-ill-being relationship. DESIGN: Lagged design. METHODS: We collected data from 153 Irish healthcare workers between January 2018 and June 2019 via three surveys, separated by 1-week intervals. Personal resources were measured at Time 1, frequency of mistreatment from the two sources was assessed at Time 2 and affective ill-being was assessed at Time 3. We used moderated regression analyses to evaluate the association of mistreatment frequency from the two sources and affective ill-being and the moderating effect of personal resources. RESULTS: Only insider mistreatment frequency was positively related to affective ill-being. Furthermore, the positive impact of insider mistreatment on affective ill-being was moderated by self-efficacy (but not by trait resilience). In contrast to our expectations, the relationship was stronger at high levels compared to low levels of self-efficacy. CONCLUSION: Mistreatment from co-workers and supervisors is linked to higher levels of affective ill-being. Additionally, healthcare workers with high self-efficacy were more vulnerable to the negative consequences of co-worker and supervisor mistreatment as it impacted their affective ill-being. IMPACT: These findings extend the literature on workplace mistreatment by integrating insider and outsider perpetrators of mistreatment and examining their differential impact on the employees' affective ill-being. It also highlights mistreatment from organizational insiders as a significant factor in the relationship between mistreatment and affective ill-being. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL COMMUNITY?: The findings underscore the detrimental impact of workplace mistreatment on the well-being of healthcare professionals. The study findings of higher frequency of insider mistreatment being associated with increased affective ill-being call for action, with line managers and supervisors being critical to achieving respective changes in healthcare workers' environment. The findings have implications for policymakers interested in developing a framework to support healthcare professionals in addressing workplace mistreatment, enabling them to effectively fulfil their role as care providers.

Latent class analysis of the sleep quality of night shift nurses and impact of shift-related factors on the occupational stress and anxiety.

AIMS: The objective of this study is to explore the various latent categories within the sleep quality of night shift nurses and to investigate whether shift-related factors predispose nurses to higher levels of occupational stress and anxiety. DESIGN: This is a cross-sectional study. METHODS: From November to December 2020, registered nurses from 18 tertiary hospitals and 16 secondary hospitals in Chongqing were selected through convenience sampling for this study. Latent class analysis was used to investigate the sleep quality of nurses working night shifts. Furthermore, univariate analysis and logistic multivariate analysis were utilized to identify the contributing factors to occupational stress and anxiety. RESULTS: The four latent categories of Pittsburgh Sleep Quality Index for night shift nurses were identified as 'Low Sleep Disorder Group' (56.34%), 'Moderate Sleep Disorder Group' (37.27%), 'High Sleep Disorder Non-Reliant on Sleeping medication Group' (4.89%) and 'High Sleep Disorder Reliant on Sleeping medication Group' (1.50%). The results showed that having a night-shift frequency of 3-4 times per month, night-shift durations of 9-12 h, sleep time delay after night shift (≥2 h), total sleep time after night shift less than 4 h were shift-related factors that increased the levels of occupational stress and anxiety. CONCLUSION: The sleep quality of night shift nurses demonstrates heterogeneity and can be classified into four latent categories. Higher frequency of night shifts, extended work hours and insufficient rest time are all associated with increased levels of occupational stress and anxiety. IMPACT: By identifying the four latent categories of sleep quality among night shift nurses, this study sheds light on the relationship between sleep patterns and levels of occupational stress and anxiety. These findings have important implications for healthcare institutions in the management of nurse well-being and work schedules. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

A theoretical framework for Acute Care Nurse Stress Appraisal: Application of the transactional model of stress and coping.

AIM: To develop a framework for understanding the stress appraisal process among acute care nurses during the COVID-19 pandemic. DESIGN: A secondary analysis of open-ended responses from a cross-sectional survey of 3030 frontline, acute care nurses in New Jersey and the effect of burnout during the COVID-19 pandemic. METHODS: Lazarus and Folkman's transactional model of stress and coping guided the study. Thematic analysis was used to analyse 1607 open-ended responses. RESULTS: Nine themes emerged during the secondary appraisal of stress. Five themes contributed to distress and burnout including (1) high patient acuity with scarce resources, (2) constantly changing policies with inconsistent messaging, (3) insufficient PPE, (4) unprepared pandemic planning and (5) feeling undervalued. Four themes led to eustress and contributed to post-traumatic growth including (1) team nursing to ensure sufficient resource allocation, (2) open channels of communication, (3) sense- of-duty and (4) personal strength from new possibilities. CONCLUSION: The COVID-19 pandemic was a traumatic event for patients and the nursing workforce. Internal and external demands placed on acute care nurses increased burnout, however, a subset of nurses with adequate support experienced personal growth. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Beyond mental health interventions for acute care nurses, organizational interventions such as reevaluation of emergency action plans to optimize resource allocation, and work environment strategies such as improved communication and decision-making transparency are necessary. IMPACT: To better understand how frontline acute care nurses experienced stress during COVID-19, a data-informed framework was developed that included a primary and secondary appraisal of stress. Themes contributing to distress and burnout were identified, and themes leading to eustress and post-traumatic growth were also identified. These findings can assist nurse leaders in optimizing strategies to reduce burnout and promote post-traumatic growth in the post-COVID years. REPORTING METHOD: No patient or public contribution.

Moral distress among acute mental health nurses: A systematic review.

Moral distress has been identified as an occupational hazard for clinicians caring for vulnerable populations. The aim of this systematic review was (i) to summarize the literature reporting on prevalence of, and factors related to, moral distress among nurses within acute mental health settings, and (ii) to examine the efficacy of interventions designed to address moral distress among nurses within this clinical setting. A comprehensive literature search was conducted in October 2022 utilizing Nursing & Allied Health, Embase, CINAHL, PsychInfo, and PubMed databases to identify eligible studies published in English from January 2000 to October 2022. Ten studies met inclusion criteria. Four quantitative studies assessed moral distress among nurses in acute mental health settings and examined relationships between moral distress and other psychological and work-related variables. Six qualitative studies explored the phenomenon of moral distress as experienced by nurses working in acute mental health settings. The quantitative studies assessed moral distress using the Moral Distress Scale for Psychiatric Nurses (MDS-P) or the Work-Related Moral Stress Questionnaire. These studies identified relationships between moral distress and emotional exhaustion, depersonalization, cynicism, poorer job satisfaction, less sense of coherence, poorer moral climate, and less experience of moral support. Qualitative studies revealed factors associated with moral distress, including lack of action, poor conduct by colleagues, time pressures, professional, policy and legal implications, aggression, and patient safety. No interventions targeting moral distress among nurses in acute mental health settings were identified. Overall, this review identified that moral distress is prevalent among nurses working in acute mental health settings and is associated with poorer outcomes for nurses, patients, and organizations. Research is urgently needed to develop and test evidence-based interventions to address moral distress among mental health nurses and to evaluate individual and system-level intervention effects on nurses, clinical care, and patient outcomes.

Unlocking Prevalence Data: Describing the Job Stress and Well-being of U.S. Correctional Nurses.

BACKGROUND: Little is known about the health and well-being of U.S. correctional nurses. To protect correctional nurses, a better understanding of organizational characteristics, job stress, and well-being must be undertaken. METHOD: A cross-sectional design was used in the form of an online survey. Correctional nurses were conveniently recruited using national listservs and snowball sampling. Variables were measured with the Health & Safety Executive Management Standards Indicator Tool, Nurse Wellbeing Index, and the Perceived Stress Scale. Data were analyzed using descriptive statistics and analyses of variance. FINDINGS: Two hundred seventy participants (142 registered nurses, 83 licensed practical nurses/licensed vocational nurses, and 42 advanced practice nurses) completed the survey. Job stress scored moderate (M = 16.26, SD = 7.14), and well-being levels were just below the risk for adverse events (M = 1.8, SD = 3.06). Lower scores were noted for managerial support (M = 3.13, SD = 0.35) and job demands (M = 3.56, SD = 0.92), but slightly better for job control (M = 3.57, SD = 0.77), peer support (M = 3.85, SD = 0.64), and workplace relationships (M = 3.73, SD = 0.95). CONCLUSIONS: Significant differences between organizational characteristics, job stress, and well-being were found across nursing licensure, workplace environments, biological sex, and employment through state or private agencies. Registered nurses working in U.S. prisons experienced the highest job stress and worse well-being. APPLICATION TO PRACTICE: This work is an essential next step in promoting healthy workspaces, urging the need for further research establishing the impact of organizational characteristics and job stress on nurse well-being.

Job stressors in relation to burnout and compromised sleep among academic physicians in India.

BACKGROUND: Burnout among physicians, especially in the academic setting, is an urgent concern, with adequate sleep one of the key focal points. OBJECTIVE: To identify job stressors contributing to burnout and compromised sleep among academic physicians, using a comprehensive, theory-based instrument, the Occupational Stressor Index (OSI), whose specific form was created 'for physicians by physicians'. METHODS: This parallel mixed-methods cross-sectional investigation was conducted among 109 physicians employed in a public teaching hospital, Jodhpur, India. Work conditions were evaluated by the physician-specific OSI (part I). The Copenhagen Burnout Index and Pittsburgh Sleep Quality Index (PSQI) were the outcome instruments (part II). Seventy-six physicians completed parts I and II. RESULTS: The physicians were from wide-ranging specialties, and 82% of the cohort were residents. Mean total OSI scores were 87.4±8.1, with unit-change yielding adjusted odds-ratios (95% confidence-intervals) for personal (1.10 (1.02-1.18)) and work-related burnout (1.12 (1.04-1.22)), and PSQI (1.09 (1.01-1.17)). Significant multivariable associations with burnout and/or sleep indices included: working 7 days/week, lacking work-free vacation, insufficient rest breaks, interruptions, many patients in intensive-care, no separate time for non-clinical duties, pressure to publish, injury/suicide attempts of colleagues/staff, performing pointless tasks. The latter were described as administrative/clerical. Lacking genuine rest breaks was mainly patient-related, further compromised by emergency work and lacking separate time for non-clinical duties. Long workhours and exhausting schedule were cited as most difficult parts of work, while reducing workhours, improving work schedule, and hiring more staff most frequently recommended. CONCLUSION: Specific working conditions potentially contributory to burnout and compromised sleep among physicians working in academic medicine are identified using a methodologically-rigorous, in-depth approach. These findings inform evidence-based interventions aimed at preserving physician mental health and work capacity.

Evaluating the association between effort-reward imbalance and suboptimal health status among hospital nurses: a cross-sectional study.

OBJECTIVES: Occupational stress is a common complaint in nurses, who perceived more sense of effort-reward imbalance (ERI). Suboptimal health status (SHS) is a state between health and disease. However, the correlation between ERI and SHS is unclear. Therefore, the aim of this study was to examine the prevalence of SHS and ERI and evaluate the relationship between ERI and SHS in clinical nurses by a cross-sectional study. MATERIAL AND METHODS: The current cross-sectional study was conducted through an online survey at Dongping People's Hospital in China. A total of 633 completed surveys were received. Effort-reward imbalance was measured by subscales of the ERI questionnaire. SHS was measured by the Suboptimal Health Status Questionnaire - 25 (SHSQ-25). The relationship between ERI and SHS in nurses was subsequently assessed by Spearman's correlation coefficient and logistic regression model. RESULTS: The mean age of the optimal health status (OHS) group (M±SD 26.3±7.3 years) was younger than the SHS group (M±SD 30.3±6.9 years). The prevalence of SHS was 54.5% (345/633). Female nurses aged ≥30 years, a junior college or university graduate educational level, smokers, and nurses without regular exercise were at a higher risk of SHS. In Spearman's correlation analysis, ERI reflected by the effort-reward ratio was correlated with SHSQ-25 score (r = 0.662, p < 0.001). In logistic regression, ERI was strongly associated with SHS after potential confounding factors adjusting (OR 27.924, 95% CI 22.845-34.132). CONCLUSIONS: The prevalence of SHS was significantly high in clinical nurses. Administrators should pay more attention to health status of female nurses aged ≥30 years, with a junior college or bachelor's degree, smoking, and without regular exercise to reduce the SHS and ERI. Int J Occup Med Environ Health. 2024;37(2):166-75.

The effect of nurses' perceived stress on their work engagement and perceived professional benefit during the routine management of the COVID-19 pandemic.

BACKGROUND: In a previous study, more attention has been given to the psychological state of doctors than to that of nurses although the workload, working hours, and patient contact time are generally higher for nurses than doctors. The current status of nurses' perceived stress, work engagement, and perceived professional benefit during the routine management of the Coronavirus disease 2019 (COVID-19) pandemic and how their perceived stress affects the other two variables are topics that merit research attention. OBJECTIVE: In this study, the status of nurses' perceived stress, work engagement, and perceived professional benefit during the routine management of the COVID-19 pandemic was investigated to explore whether their perceived stress level has any effect on the other two variables. METHODS: The convenience sampling method was adopted, and 669 nurses from the First People's Hospital of Jingzhou were selected to participate in this study. Questionnaires on perceived stress, work engagement, and perceived professional benefit were used in the survey, and the data were processed using the SPSS 20.0 program for the descriptive statistics, independent sample t-test, analysis of variance. RESULTS: The total score of the nurses' perceived stress was 18.58±4.37 points. The total scores of their work engagement (43.32±14.01) and perceived professional benefit (140.23±17.75). CONCLUSION: The nurses' total perceived stress score was at an upper-middle level, and their total work engagement and perceived professional benefit scores were relatively high. Overall, perceived stress has a negative effect on nurses' work engagement and perceived professional benefit. That is, the higher the pressure perception of nurses, the lower the degree of work engagement and perceived professional benefit.

Association between occupational stress, occupational burnout, and depressive symptoms among medical staff during COVID-19: A cross-sectional study in Chongqing, China.

BACKGROUND: Studies have extensively examined the factors contributing to the onset of occupational stress, burnout, and depression. However, the relationship between these variables is limited. OBJECTIVE: This study aimed to explore the association between occupational stress, burnout, and depressive symptoms and to investigate the mediating effect of burnout between occupational stress and depressive symptoms in medical staff. METHODS: A cross-sectional survey was conducted among medical staff in Chongqing, China. The Core Occupational Stress Scale (COSS), Maslach Burnout Inventory: General Survey (MBI-GS), and Patient Health Questionnaire-9 (PHQ-9) were used to assess the status of occupational stress, burnout, and depressive symptoms, respectively. The bootstrapping analyses using SPSS PROCESS macros version 3 were conducted to examine mediating effects. RESULTS: The study conducted on medical staff in Chongqing revealed that the detection rates of occupational stress, occupational burnout, and depressive symptoms were 31.8%, 23.3%, and 30.3%, respectively. Hierarchical regression analysis revealed that occupational stress and burnout accounted for 19.3% (p < 0.001) and 18.8% (p < 0.001) of the variance in depressive symptoms, respectively. Mediation analysis showed that occupational stress indirectly affected depressive symptoms through the mediating effect of occupational burnout, with a mediation effect value of 0.13 (bootstrap 95% CI: 0.116-0.144) and the mediation effect accounting for 44.8% of the total effect. CONCLUSION: Our results indicated that occupational stress and burnout were predictors of depressive symptoms. Occupational stress had a significant indirect effect on depressive symptoms via burnout. These results suggest that reducing occupational stress and burnout could be effective strategies for preventing depression among medical staff.

Impact of the COVID-19 pandemic on infection control nurses: A path analysis of job stress, burnout, and turnover intention.

BACKGROUND: A infection control nurse (ICN) has played substantial roles in infection control and epidemiology programs in hospitals to protect patients and coworkers during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to explore the association between intention to leave in ICNs and job stress and burnout. METHODS: This cross-sectional study was conducted among ICNs working in hospitals with ≥200 beds in South Korea from October 1 to 22, 2021. Variables included were related to general and job characteristics specific to COVID-19, as well as measures of job stress, burnout, and turnover intention for ICNs from previous studies. Path analysis was used to examine the relationships between job stress, burnout, turnover intention, and COVID-19-related work characteristics. RESULTS: A total of 203 participants were included, of whom 95% were women. The results showed that work intensity in COVID-19 infection control was significantly associated with job stress (P<.001) and burnout (P = .035). Furthermore, job stress (P = .019) and burnout (P < .001) were positively correlated with turnover intention. CONCLUSIONS: In a pandemic with emerging infectious diseases, strategies to reduce turnover among ICNs and ensure a sufficient workforce are crucial to reducing work intensity, considering the factors that affect job stress and burnout.