Effects of Work-Related Stressors and Mindfulness on Mental and Physical Health Among Australian Nurses and Healthcare Workers.

PURPOSE: To examine the relative impact of work-related stressors and the personal resource of mindfulness on employees' mental and physical health. DESIGN: A cross-sectional survey design with nursing and healthcare workers in Victoria, Australia. METHODS: Data were collected from 702 respondents. Mean scores for work-related stressors and employee mental and physical health were compared with population norms. We used hierarchical linear regressions to examine the relative impact of demographics, work-related stressors, and mindfulness on employee mental and physical health. FINDINGS: Employees in this sample reported higher levels of work-related stress and poorer mental health compared to available norms, while their levels of physical health were within the normal range. Regression analyses showed that work-related stressors were important predictors of employee mental health, but mindfulness was the stronger predictor. There was a slightly stronger relationship between employee physical health and work-related stress compared to mindfulness. Furthermore, being younger and employed in a non-nursing role were associated with better physical health. CLINICAL RELEVANCE: Encouraging mindfulness as a health behavior practice among nurses and other healthcare workers could improve employee well-being and potentially enable them to more effectively fulfill the requirements of their demanding roles.

Postincident Support for Healthcare Workers Experiencing Occupational Violence and Aggression.

PURPOSE: To investigate the relative contributions of workplace type, occupational violence and aggression (OVA) strategies and interventions along with perceptions of the occupational health and safety (OHS) environment on the likelihood of receiving postincident support following the experience of OVA. DESIGN: We used a cross-sectional study design with an online survey to collect data from employees in nursing and midwifery in Victoria, Australia. METHODS: Survey data collected from 3,072 members of the Australian Nursing and Midwifery Federation (Victorian branch) were analyzed using logistic regression. FINDINGS: Of the 3,072 respondents who had experienced OVA in the preceding 12 months, 1,287 (42%) reported that they had received postincident support. Hierarchical logistic regression revealed that the OHS environment was the dominant factor that predicted the likelihood of workers receiving postincident support. Working in a positive OHS environment characterized by higher levels of leading indicators of OHS, prioritization of OHS, supervisor support for safety, and team psychological safety was the stronger predictor of postincident support. Being employed in a workplace that offered training in the management and prevention of OVA also increased the likelihood of receiving postincident support. CONCLUSIONS: While training in the management and prevention of OVA contributed to the likelihood of receiving postincident support, a greater emphasis on the OHS environment was more important in predicting the likelihood that workers received support. CLINICAL RELEVANCE: This study identifies workplace practices that facilitate the provision of postincident support for healthcare workers. Facilitating effective postincident support could improve outcomes for workers, their patients and workplaces, and society in general.

Occupational Violence and Aggression Experienced by Nursing and Caring Professionals.

PURPOSE: To examine the extent and source of occupational violence and aggression (OVA) experienced by nursing and caring professionals. This study also examines the relative contributions of demographic characteristics and workplace and individual safety factors in predicting OVA. DESIGN: A cross-sectional study design with data collected using an online survey of employees in the nursing and caring professions in Victoria, Australia. METHODS: Survey data collected from 4,891 members of the Australian Nursing and Midwifery Federation (Victorian branch) were analyzed using logistic regression. FINDINGS: Sixty-seven percent of respondents reported experiencing OVA in the preceding 12 months, with nearly 20% experiencing OVA on a weekly or daily basis. The dominant sources of OVA were patients (79%) or relatives of patients (48%). Logistic regression analysis revealed that respondents working in public hospitals and aged care facilities were more likely to experience OVA, compared to those working in other workplaces. While higher levels of safety compliance reduced the likelihood of experiencing OVA, role overload and workplace safety factors such as prioritization of employee safety and leading indicators of occupational health and safety were stronger predictors. CONCLUSIONS: The likelihood of healthcare workers experiencing OVA varies across demographic and workplace characteristics. While some demographic characteristics and individual safety factors were significant predictors, our results suggest that a greater reduction in OVA could be achieved by improving workplace safety. CLINICAL RELEVANCE: The study's outcomes identify workforce segments that are most vulnerable to OVA. The study also highlights workplace safety factors such as the prioritization of employee safety that might assist in the reduction of OVA.

Exploring the nurse endoscopist role: a qualitative approach.

BACKGROUND: Previously, gastrointestinal endoscopy was undertaken only by medical staff. The nurse endoscopist role has recently been developed and is now in great demand. Barriers and facilitators are identified in similar nursing roles, though little research has been undertaken on the nurse endoscopist role. AIM: To examine perceptions of UK nurse endoscopists regarding their experience of the role. This qualitative study involved semi-structured interviews with eight UK nurse endoscopists. Data gained were analyzed qualitatively. The following categories emerged: role structure, collaboration, experience, and education and training. RESULTS: The 'role structure' category showed that patient services were better where the nurse endoscopist role encompassed a more holistic approach. In the 'collaboration' category, the importance of relations with medical, nursing and management colleagues was observed. It was found that nurse endoscopists may be providing an inferior service due to being given lower priority than medical endoscopists. The 'experience' category showed nurse endoscopists valued their nursing experience, while specific endoscopy nursing experience prior to becoming an endoscopist was also useful. The 'education' category showed that degree-level education and training were important when accessed, in addition to prescribing courses. CONCLUSION: Nurses undertaking endoscopy have potentially satisfying roles, which allow them to perform effectively. The roles should be planned adequately and practitioners should receive appropriate degree-level education. Furthermore, patients should receive equitable treatment regardless of which profession undertakes the endoscopy.

Lack of bystander effects from high-LET radiation for early cytogenetic end points.

The aim of this work was to study radiation-induced bystander effects for early cytogenetic end points in various cell lines using the medium transfer technique after exposure to high- and low-LET radiation. Cells were exposed to 20 MeV/ nucleon nitrogen ions, 968 MeV/nucleon iron ions, or 575 MeV/nucleon iron ions followed by transfer of the conditioned medium from the irradiated cells to unirradiated test cells. The effects studied included DNA double-strand break induction, gamma-H2AX focus formation, induction of chromatid breaks in prematurely condensed chromosomes, and micronucleus formation using DNA repair-proficient and -deficient hamster and human cell lines (xrs6, V79, SW48, MO59K and MO59J). Cell survival was also measured in SW48 bystander cells using X rays. Although it was occasionally possible to detect an increase in chromatid break levels using nitrogen ions and to see a higher number of gamma-H2AX foci using nitrogen and iron ions in xrs6 bystander cells in single experiments, the results were not reproducible. After we pooled all the data, we could not verify a significant bystander effect for any of these end points. Also, we did not detect a significant bystander effect for DSB induction or micronucleus formation in these cell lines or for clonogenic survival in SW48 cells. The data suggest that DNA damage and cytogenetic changes are not induced in bystander cells. In contrast, data in the literature show pronounced bystander effects in a variety of cell lines, including clonogenic survival in SW48 cells and induction of chromatid breaks and micronuclei in hamster cells. To reconcile these conflicting data, it is possible that the epigenetic status of the specific cell line or the precise culture conditions and medium supplements, such as serum, may be critical for inducing bystander effects.

Effect of a daily supplement of soy protein on body composition and insulin secretion in postmenopausal women.

OBJECTIVE: To determine whether a supplement of soy protein improves body composition, body fat distribution, and glucose and insulin metabolism in postmenopausal women without diabetes compared with an isocaloric casein placebo. DESIGN: Randomized, double-blind, placebo-controlled 3-month trial. SETTING: Clinical Research Center. PATIENT(S): Fifteen postmenopausal women. INTERVENTION(S): Computed tomographic scans at L4/L5, dual energy x-ray absorptiometry, hyperglycemic clamps. MAIN OUTCOME MEASURE(S): Total fat, total abdominal fat, visceral fat, subcutaneous abdominal fat, and insulin secretion. RESULT(S): Weight by dual energy x-ray absorptiometry did not change between groups (+1.38 +/- 2.02 kg for placebo vs. +0.756 +/- 1.32 kg for soy, mean +/- SD). Total and subcutaneous abdominal fat increased more in the placebo group than in the soy group (for differences between groups in total abdominal fat: +38.62 +/- 22.84 cm(2) for placebo vs. -11.86 +/- 31.48 cm(2) for soy; subcutaneous abdominal fat: +22.91 +/- 28.58 cm(2) for placebo vs. -14.73 +/- 22.26 cm(2) for soy). Insulin secretion, visceral fat, total body fat, and lean mass did not differ between groups. Isoflavone levels increased more in the soy group. CONCLUSION(S): A daily supplement of soy protein prevents the increase in subcutaneous and total abdominal fat observed with an isocaloric casein placebo in postmenopausal women.

Long-term care and dementia services: an impending crisis.

BACKGROUND AND OBJECTIVES: since the transfer of long-stay care to the independent sector, provision of places in care homes in the United Kingdom has varied in response to market trends, and has shown a consistent fall in the past 10 years. People with dementia constitute the largest diagnostic group affected by these changes, and are also likely to be the group that will determine future need. We therefore estimated the number and proportion of older residents in care homes who suffer from dementia relative to all those with dementia in the United Kingdom and projected future levels of demand on the basis of this data. DESIGN AND METHOD: the number of dementia cases in long-stay care was estimated from a random sample survey in south-east England and compared with data on age-specific prevalence. Projections of future demand were based on UK population projections for the next 40 years. MAIN RESULT: over half of all people with dementia in the United Kingdom are in care homes. The number of available long-stay places in care homes has fallen by one-sixth over the past decade. Projection of future demand suggests that well over double the present total places in care homes would be required by 2043 to maintain the present ratio of institutional to community services for dementia. CONCLUSION: this finding suggests an impending crisis of availability. A more realistic scenario calls for investment in affordable domiciliary care of good quality, but it will also depend on the acceptance of the fact that the main function of long-stay care for old people is now to provide for advanced cases of dementia, with consequent requirement for improvement in staff ratios and training.