Cross-cultural differences in nurse burnout and the relationship with patient safety: An East-West comparative study.

AIMS: To compare levels of nurse burnout across eastern and western cultures, as well as examine the influence of burnout on patient safety cross-culturally. DESIGN: Comparative cross-sectional study. METHODS: Survey data were collected from nurses between August and October 2017 in Australia (n = 730) and between April and October 2019 in China (n = 1107). Variables included burnout (emotional exhaustion, depersonalization, personal accomplishment), nurse leadership and support, staffing and resource adequacy, and perceived patient safety. Data were analysed separately for each jurisdiction using bootstrapped hierarchical regressions, which tested the relationships between burnout indicators and patient safety, controlling for support resources. RESULTS: Emotional exhaustion and depersonalization scores were significantly higher in the Australian sample compared with the Chinese sample. Australian participants reported significantly lower patient safety grades than Chinese participants and were less likely to agree that support resources were present in their current job. Separate regressions indicated that patient safety was significantly associated with staffing and resource adequacy, nurse leadership and support, and depersonalization among Australian participants (30% of variance explained in the final regression model), while staffing and resource adequacy, nurse leadership and support, personal accomplishment and emotional exhaustion predicted patient safety for Chinese participants (22% of variance explained in the final model). CONCLUSION: Australian nurses are at greater risk of burnout than Chinese nurses. Burnout dimensions are differentially associated with patient safety across cultures. Culturally relevant interventions may be more optimal than universal approaches for improving burnout and patient safety in nursing. IMPACT: This study increased understanding of cross-cultural differences in nurse burnout and the relationship with patient safety. Australian nurses were at greater risk of burnout than Chinese nurses. Emotional exhaustion, depersonalization and personal accomplishment influenced patient safety distinctively across the countries. These findings inform interventions designed to reduce nurse burnout and improve patient safety internationally.

Effectiveness of public health messaging and communication channels during smoke events: A rapid systematic review.

Exposure to smoke emitted from wildfire and planned burns (i.e., smoke events) has been associated with numerous negative health outcomes, including respiratory symptoms and conditions. This rapid review investigates recent evidence (post-2009) regarding the effectiveness of public health messaging during smoke events. The objectives were to determine the effectiveness of various communication channels used and public health messages disseminated during smoke events, for general and at-risk populations. A search of 12 databases and grey literature yielded 1775 unique articles, of which 10 were included in this review. Principal results were: 1) Smoke-related public health messages are communicated via a variety of channels, but limited evidence is available regarding their effectiveness for the general public or at-risk groups. 2) Messages that use simple language are more commonly recalled, understood, and complied with. Compliance differs according to socio-demographic characteristics. 3) At-risk groups may be advised to stay indoors before the general population, in order to protect the most vulnerable people in a community. The research included in this review was observational and predominantly descriptive, and is therefore unable to sufficiently answer questions regarding effectiveness. Experimental research, as well as evaluations, are required to examine the effectiveness of modern communication channels, channels to reach at-risk groups, and the 'stay indoors' message.

Psychosocial factors that influence men's help-seeking for cancer symptoms: a systematic synthesis of mixed methods research.

OBJECTIVE: Effectiveness of cancer control partly depends upon early identification and treatment. Men appear to be more likely to delay help-seeking for symptoms, resulting in later diagnosis. This review aims to provide a mixed research synthesis of the psychosocial barriers to and facilitators of help-seeking for cancer symptoms among men. METHODS: Systematic methods were followed, including a predefined research question and search strategy. Searches retrieved 7131 international records from online databases: MEDLINE (n = 3011), PubMed (n = 471), SCOPUS (n = 896), Informit (n = 131), PsychINFO (n = 347), and Web of Science (n = 2275). Forty studies were eligible for inclusion in the review (25 qualitative studies, 11 quantitative studies, and 4 mixed-method studies). RESULTS: There was strong observational evidence for several psychosocial barriers to men's help-seeking behaviour: low cancer knowledge and inaccurate symptom interpretation, embarrassment and fear, and conformity to masculine gender role norms. The strongest facilitating factor associated with men's help-seeking behaviour was encouragement and support of spouses and family members. The majority of research was qualitative and used small samples, making generalisations to the wider population difficult. CONCLUSIONS: Men's help-seeking for cancer symptoms is influenced by several psychosocial factors, which, in part, may be gender-specific. Health promotion initiatives to improve help-seeking behaviour among men should aim to increase cancer knowledge, reduce embarrassment and fear, address social norms deterring timely help-seeking, and acknowledge informal help-seeking with spouses and family members. Increasing the theoretical grounding of research could aid cohesion across the research area and the design of effective health promotion interventions. Copyright © 2015 John Wiley & Sons, Ltd.