Resilience, Burnout and Mental Health in Nurses: A Latent Mediation Model.

Background/Objectives: The burnout syndrome in nurses has been related to the development of mental health problems. On the contrary, resilience is related to adequately coping with stressful situations and better mental health. The objective was to analyze the relationship between resilience and mental health problems in nurses and estimate the proportion mediated by burnout in the association. Methods: In 2021, a total of 1165 Spanish nurses were selected through a stratified random sampling method. Participants anonymously filled in the Resilience Scale (RS-14), the Maslach Burnout Inventory Survey, and the General Health Questionnaire. To test the hypothesis proposed and explain the mediating effect of burnout empirically, structural equation modeling (SEM) was applied. A latent mediation model was computed. Results: Resilience was negatively related to burnout and mental health problems. The direct relationship between burnout and the latent health variable was positive. In addition, in view of the total effect of resilience on mental health problems and the magnitude of the indirect effect, we stated that the proportion of this effect mediated by burnout ranged from 0.486 to 0.870. Conclusions: This study reveals that fostering resilience in nurses directly and indirectly reduces burnout and improves their mental health. The implementation of resilience programs and supportive institutional policies is recommended to improve working conditions and the quality of patient care.

Perception of Parental Attitudes and Self-Efficacy in Refusing Alcohol Drinking and Smoking by Spanish Adolescents: A Cross-Sectional Study.

Adolescents are particularly vulnerable to initiation of the use of substances harmful to health, and its increase is cause for concern. The objective of this study was to analyze the relationship between self-efficacy in refusing alcohol and the attitude of adolescents toward drugs and their perception of their parents' attitude toward refusal. The study was carried out in 2019 in a sample of 1287 students from 11 public high schools in the province of Almería (Spain). Students were aged 14 to 18 in their 3rd and 4th year of compulsory secondary education. The Drinking Refusal Self-Efficacy Questionnaire-Revised Adolescent version (DRSEQ-RA), Attitudes Toward Taking Drugs-Basic BIP Scale and the Parents' attitudes Toward Drug Use were administered. The results showed that family relationships seem to have a direct impact on adolescent patterns in smoking and drinking alcohol. However, a favorable attitude toward drugs is a risk factor for drinking alcohol and smoking tobacco. The self-efficacy dimension also acts as a protective factor against the probability of using alcohol or tobacco. The conclusions emphasized that communication within the family core can increase or decrease the risk of adolescents using substances harmful to health.

Aggression and burnout in nurses during COVID-19: A cross-sectional study.

Workplace violence against nurses, an ever-present problem in the healthcare workplace, has been increasing with COVID-19 and affects occupational health. This study analyzed the consequences of COVID-19 on violence against nurses, identifying its association with burnout, emphasizing the importance of work-related variables. A total of 1013 actively employed nurses in Spain with a mean age of 34.71 years filled out a computer-assisted web interviewing survey. Aggression as a consequence of their work was reported by 73.44% of the nurses. Those most affected were in primary care, and verbal aggression by patients and their families was the most frequent. Nurses who were attacked scored significantly higher in emotional exhaustion and depersonalization. Furthermore, 83.22% said that COVID-19 was an important factor in the increase in violence toward healthcare workers. Analysis showed that a perceived secure environment was a mediator between the belief that COVID-19 was an influential factor in the increase of violence and the depersonalization dimension of burnout. Increasing perceived security in the work environment among nurses can be effective in promoting well-being, work performance, and commitment to the profession.

Repercussions of perceived threat to health in the Spanish population.

Studies have shown that COVID-19 has had a worldwide psychological impact. Confinement due to COVID-19 has had important repercussions on the mental health of the general population, with high levels of stress, anxiety, depressive symptoms, post-traumatic stress disorder, and so forth. Similarly, important labor, economic and social changes taking place are affecting people's well-being. The objective of this study was to analyze the repercussions of perceived threat from COVID-19 on the mental health of the population, and to evaluate the mediating role of perceived economic impact. The participants were 1160 adult residents of Spain aged 18 to 82, 69.9% of whom were women. A sociodemographic questionnaire, the Questionnaire on Perception of Threat from COVID-19 and the General Health Questionnaire were administered. Perceived threat had a positive direct effect on all four health dimensions analyzed. Among the indirect effects, the perceived economic impact of COVID-19 mediated in the relationship between perceived threat and each of the health dimensions. The results of this study have demonstrated the need to promote joint action promoting public mental health to minimize the psychological repercussions of new outbreaks.

Job strain and burnout in Spanish nurses during the COVID-19: resilience as a protective factor in a cross-sectional study.

BACKGROUND: Nurses are frequently exposed to chronic stress in the workplace generating harmful effects such as job strain and burnout. On the contrary, resilience has been shown to be a beneficial variable. The objective of this study was to analyze the relationship between dimensions of the Job Demand Control-Support model, resilience and burnout in nurses, and examine the mediating role of resilience between job strain and burnout. METHODS: A descriptive, cross-sectional study reported in line with the STROBE guidelines. Active nurses were invited to complete an online questionnaire in September, 2020. With snowball sampling, 1013 nurses, with a mean age of 34.71, filled out the Job Content Questionnaire, the Maslach Burnout Inventory and the Resilience Scale. RESULTS: The results showed the existence of four groups of professionals based on job strain. The nurses in the "High Strain" group (high demands and low control) showed higher scores in emotional exhaustion and cynicism, while those in the "Active Job" group scored higher in personal realization and resilience. The findings showed that job strain affects burnout in nurses, and this effect is mediated by resilience. CONCLUSIONS: The findings of this study showed that a high level of resilience could exert a fundamental role in ensuring well-being and proper job performance by nurses. Nursing managers should see to the personable variables or competencies that provide and favor an opportunity for nurses to widen and improve their practice, in pursuance of satisfying and responding better to people's needs and the systems they work for.

The "Mask Effect" of the Emotional Factor in Nurses' Adaptability to Change: Mental Health in a COVID-19 Setting.

During healthcare catastrophes, such as the current COVID-19 pandemic, nurses are exposed to highly stressful situations derived from their work and personal activity. Development of coping strategies for such situations can improve nurses' physical and mental health. This study analyzed nurses' adaptability to change, with attention to socio-demographic variables in a COVID-19 setting, and identified the repercussions on their health. This quantitative, observational and cross-sectional study had a sample of 351 nurses aged 22 to 64 with a mean age of 40.91 (SD = 10.98). The instruments used for the study were the ADAPTA-10 questionnaire and the General Health Questionnaire (GHQ-28). It was observed that age, sex, and having a stable partner significantly influenced scores on the emotional, cognitive-behavioral, and adaptation to change factors. Finally, the emotional factor mediated between positive COVID-19 in someone close and the presence of health problems. Understanding the elements that help adapt better to change and adversity enable effective interventions to be developed for improving emotional health of nurses, especially for those in whom there are positive cases of COVID-19 in their personal or work environment.

Emotional intelligence and self-esteem: Personal competencies necessary for physicians.

Introduction: Even though emotional intelligence and self-esteem are truly important variables in healthcare, the fact is that there are few studies on these constructs in Spanish physicians. The objective was to analyze the relationship between self-esteem and emotional intelligence in Spanish physicians, and their relationship with sociodemographic and employment variables. Methods: The study included a sample of 180 physicians with a mean age of 34.61, 76.7% of whom were women. The physician completed the Rosenberg self-esteem scale, the Brief Emotional Intelligence Inventory for Senior Citizens and a questionnaire on sociodemographic and work characteristics through a CAWI (Computer Assisted Web Interviewing). Results: The results showed that the interpersonal factor of emotional intelligence diminished with age and number of children. Furthermore, women scored significantly higher in interpersonal emotional intelligence and men in adaptability. Physicians with stable contracts (46.1%) scored higher in all the emotional intelligence variables, with almost a small effect size. In the relationship between self-esteem and emotional intelligence, it was found that global self-esteem of physicians was positively related to the Stress Management, Adaptability and Mood dimensions. Physicians with high self-esteem (72.8%) showed better Stress Management and Mood than those with low self-esteem (6.1%), while in the Adaptability factor, physicians with high global self-esteem scored higher than those with medium levels (21.1%). Conclusion: The need for a stable employment strategy was demonstrated, since this has repercussions on personal competencies of physicians as well as training in developing those consequences, since they improve physicians' quality of care and leadership, especially women with temporary contracts or with medium or low self-esteem.

The Effects of a Non-Technical Skills Training Program on Emotional Intelligence and Resilience in Undergraduate Nursing Students.

There is a growing body of research on emotional intelligence and resilience in nursing students. However, there is little evidence of the development of these variables in intervention programs. This study aims to analyze the effects of a non-technical skills training program in emotional intelligence and resilience. Sixty students in the second year of Nursing Education from a Spanish public university completed this psychoeducational course. The pre-experimental design was longitudinal with pre- and post-intervention evaluation. The course consisted of 12 sessions of classroom education, three small-group workshops and a set of individual activities. Results in the emotional intelligence dimensions showed that Clarity (t = 3.10, p = 0.003) and Repair (t = 3.59, p < 0.001) increased significantly after participation in the program. Furthermore, the participants had a higher Resilience index when they had completed the program, with a statistically significant difference from the pre-course mean (t = 2.83, p = 0.006). This non-technical skills training program was an effective method of improving emotional intelligence and resilience in nursing students. Therefore, its use is recommended as a psychoeducational strategy for training undergraduate nursing students, as it improves their personal and professional competencies, resulting in higher-quality care.

Mental Health in Settings with COVID-19 Positive Cases in the Spanish Population: The Protective Role of the Capacity to Adapt to Change.

BACKGROUND: The capacity to adapt to change in complex, highly demanding situations, such as those derived from the COVID-19 pandemic, is essential in maintaining one's mental health. This study analyzed the mental health of the Spanish population in settings with COVID-19 positive cases and the protective role of adaptation to change. METHODS: The sample consisted of 1160 adult Spaniards aged 18 to 82 with a mean age of 38.29 (SD = 13.71). Data were collected by a CAWI (Computer Aided Web Interviewing) survey which included the General Health Questionnaire (GHQ-28), Adaptation to Change Questionnaire (ADAPTA-10), and an ad hoc questionnaire related to COVID-19 (perceived economic impact, COVID-19 positive diagnosis or not, and whether there was a positive case close to them). RESULTS: The data revealed that the perceived economic impact showed a negative association between the emotional factor and the total score in adaptation to change. Lastly, the emotional factor in adaptation to change operated as a protector from the effect that a setting with COVID-19 positive cases exerts on mental health. CONCLUSIONS: Coping with COVID-19 requires strengthening the capacity for adaptation to changes generated in the setting, especially emotional, as it could contribute to improving the mental health of individuals, especially in those settings where they find and know a COVID-19 positive case.

Mediating Role of Emotional Intelligence in the Relationship between Anxiety Sensitivity and Academic Burnout in Adolescents.

(1) Background: Increased stress and study overload during adolescence could be related to academic burnout. Anxiety sensitivity of students seems to affect burnout levels, while emotional intelligence enables emotion management under stressful conditions. The objective of this study is to analyze the roles of anxiety sensitivity and emotional intelligence in academic burnout. (2) Methods: In this quantitative cross-sectional study conducted in Spain, the sample comprised 1287 high school students aged 14 to 18 who filled out the Maslach Burnout Inventory-General Survey, the Spanish version adapted for high school students of the Anxiety Sensitivity Index-3, and Brief Emotional Intelligence Inventory. (3) Results: Anxiety sensitivity was significantly higher in cynicism and emotional exhaustion. Furthermore, the mediation analysis showed that high anxiety sensitivity directly affected student exhaustion, cynicism, and efficacy levels. These effects were mediated mainly through stress management but also through the effect of stress management on mood, both emotional intelligence factors. (4) Conclusions: The academic changes that occur during high school hinder engagement and performance. Promoting the development of emotional skills would enable young people to manage their emotions when they become overwhelming and diminish their lack of interest and exhaustion in the classroom.

Anxiolytic and Antidepressant Use and Burnout: Optimism as a Mediator in Spanish Nurses.

The aim of this study was to analyze the relationship between burnout, the use of drugs (anxiolytics and antidepressants) and optimism in nurses. At the end of 2018, a cross-sectional descriptive study was carried out with a sample of actively employed nurses recruited by snowball sampling. The sample consisted of 1432 nurses in Andalusia (Spain), aged 22-58, who were working at the time of data collection, 83.2% of whom were women. Data were collected anonymously in an ad hoc questionnaire about sociodemographic information and use of anxiolytics and/or antidepressives: the Brief Burnout Questionnaire-Revised for Nurses (CBB-R) and the Life Orientation Test-Revised (LOT-R). Descriptive, mediation and moderation analyses were performed, with significant results having a p-value less than 0.05. The results on burnout showed significant relationships with use of the drugs. In particular, personal impact, job dissatisfaction and motivational abandonment were positively related to use of certain of the anxiolytics and antidepressants presented, while the correlation with the social climate was negative. Furthermore, optimism correlated negatively with drug use. Knowing that optimism can alleviate the repercussions of the use of drugs opens up new lines of research and the possibility of developing programs aimed at promoting a positive disposition in the face of complicated events.

Adaptation to Change Questionnaire for Nurses: Validation and New Needs in the Context of COVID-19.

BACKGROUND: The worldwide pandemic caused by the SARS-CoV-2 coronavirus has challenged healthcare systems and the professionals who work in them. This challenge involves strong changes to which nurses have had to quickly adapt. Emotional and cognitive-behavioral factors influence the capacity for adaptation to change. Based on this model, the objective of this study was to validate the Adaptation to Change Questionnaire (ADAPTA-10) for identifying professionals in a population of nurses who have problems adapting to adverse situations such as those caused by COVID-19. METHODS: This study was performed with a sample of 351 nurses. (3) Results: The ADAPTA-10 questionnaire was found to have good psychometric properties, and to be an effective, useful tool for nurses in research and clinical practice. The two-dimensional structure proposed in the original model was confirmed. Scales are also provided by sex for evaluation of adaptation to change; the highest scores on the emotional component were among nurses who had not personally encountered the virus. CONCLUSIONS: This instrument will be able to detect of the needs for adaptation to the new reality associated with COVID-19, as well as other situations in which nurses are immersed that demand adaptation strategies.

Coping Strategies as a Mental Health Protection Factor of Spanish Nurses during COVID-19.

BACKGROUND: Due to the healthcare crisis caused by COVID-19, nurses have been exposed to stressful, uncertain situations. In such situations, emotional coping strategies are especially important due to their repercussion on health. The purpose of this study is analyze the relationships between nurses' coping strategies and health, with attention to factors related to perceived threat and/or someone close to them is COVID-19 positive. METHODS: This descriptive cross-sectional study was done with a sample of 351 nurses in Spain. In addition to the questionnaire on perception of threat from COVID-19, the Cognitive Emotion Regulation Questionnaire and the General Health Questionnaire, an ad hoc question asked them whether someone close to them was COVID-19 positive. RESULTS: Perceived threat and use of negative coping strategies were related, and these strategies were related to a greater presence of somatic symptoms, anxiety, social dysfunction, and depression. CONCLUSIONS: Given the work and personal influence of coping on nurses, interventions must be designed to promote adaptive strategies.

Emotional Intelligence Profiles and Mobbing in Nursing: The Mediating Role of Social Support and Sensitivity to Anxiety.

The prevalence of mobbing among nurses in various countries is around 17-20%. Some researchers have attempted to explain the success or failure of adaptation to the work environment and teamwork and to buffer the effects of psychological harassment in the workplace by incorporating emotional intelligence into the mobbing context. As its main objectives, this quantitative, observational, cross-sectional study analyzed the relationship between emotional intelligence and mobbing as perceived by nurses and sought to establish the mediating roles of other variables involved, such as social support and sensitivity to anxiety. The final sample consisted of 1357 Spanish, self-selected nurses aged 22-58 from multiple healthcare institutions. The questionnaires (Perceived Psychological Harassment Questionnaire, The Brief Emotional Intelligence Inventory, Brief Perceived Social Support Questionnaire, Anxiety Sensitivity Index-3) were implemented on a web platform, which enabled the participants to complete them online. Descriptive analyses and mediation models were estimated. Personal characteristics related to high sensitivity to anxiety and low emotional intelligence implied greater presence of mobbing at work. This mobbing may be buffered if the person perceives enough support from family, friends or significant others. Our results recommend reinforcing the social support network of nursing personnel to improve the work climate and training them in emotional intelligence in university and on-the-job programs.

Role of Personality and Positive and Negative Affects in Coping Strategies of Nurses: A Cross-Sectional Study.

Nurses are exposed to many highly stressful events. Individual variables, such as personality and affective state, have been related to vulnerability to maladaptive coping. Therefore, the objectives of this study were to analyze the relationships between the personality, positive and negative affects, and coping strategies of nurses and to establish the mediating role of affective state in the relationship between personality and coping. The sample was made up of 1,268 Spanish nurses aged 22-63 years who completed the Coping Strategies Inventory, the Positive and Negative Affect Schedule, and the 10-item Big Five Inventory. Descriptive analyses, correlations, and mediation models were estimated. The results showed relationships between the Big Five personality factors, positive and negative affects, and coping strategies. Negative affect was confirmed as a mediator between personality and less adaptive strategies and positive affect was confirmed on positive strategies. This study emphasizes the need to develop actions directed at teaching nurses adequate problem-solving strategies and training them in the ability to assign a different emotional value to complex situations.

Mood and Affective Balance of Spaniards Confined by COVID-19: A Cross-Sectional Study.

The aim of this study was to analyze the mood and affective balance of Spaniards in quarantine and determine the predictive role of sociodemographic variables and mood on the negative affective balance. This cross-sectional study was carried out with a sample of 1014 Spanish adults, 67.2% were women and 32.8% men. The age ranged from 17 to 76. The instruments used were the Mood Assessment Scale and the Affective Balance Scale, which were implemented as a CAWI survey (Computer Aided Web Interviewing). Results showed that age correlated negatively with Sadness-Depression, Anxiety, and Happiness. Women had more Sadness-Depression, Anxiety, and negative affect, while men showed more Happiness and higher positive affect. Thus, the risk of a negative affective balance during confinement was greater for women and those who showed an emotional state marked by sadness-depression and anxiety, while older age and higher scores in happiness were associated with lower risk. In conclusion, knowing which groups are at risk of emotional and affective alteration can facilitate the detection and prevention of later disorders, such as severe stress and posttraumatic stress disorder, avoiding their generalized presence, and becoming a new public health problem derived from COVID-19.

El objetivo de este trabajo fue analizar el estado de ánimo y el balance afectivo de los españoles en cuarentena y determinar el papel predictivo de las variables sociodemográficas y de los estados anímicos, sobre el balance afectivo negativo. Se trata de un estudio transversal, con una muestra de 1014 adultos españoles, siendo el 67.2% mujeres y el 32.8% restante, hombres. El rango de edad estuvo entre 18 y 76 años. Los instrumentos empleados fueron la Escala de Evaluación del Estado de Ánimo y la Escala de Equilibrio Afectivo, empleando para su implementación una encuesta CAWI (Computer Aided Web Interviewing). Los resultados mostraron que la edad correlaciona negativamente con la Tristeza-Depresión, la Ansiedad y Alegría. Las mujeres presentan mayor nivel de Tristeza-Depresión, Ansiedad y afecto negativo, mientras que los hombres presentan más Alegría y mayor nivel de afecto positivo. Por lo tanto, el riesgo de presentar un balance afectivo negativo durante el confinamiento es mayor entre mujeres y entre quienes manifiestan un estado emocional marcado por la tristeza-depresión y la ansiedad, mientras que tener mayor edad y mostrar puntuaciones elevadas en alegría se asocia con menor riesgo. En conclusión, conocer los grupos de riesgo en alteraciones emocionales y afectivas puede facilitar la detección y prevención de trastornos posteriores, como estrés agudo y trastorno de estrés postraumático, evitando la presencia generalizada, y que esto se convierta en un nuevo problema de Salud Pública derivado del COVID-19.

Emotional intelligence as a mediator in the relationship between academic performance and burnout in high school students.

Low performance of high school students and repeating a year are major problems in the education system. Low performance in the classroom generates negative emotions in young people and has been related to development of school burnout. The objective of this study was to analyze the repercussions of academic performance on burnout in high school students, and establish the role of emotional intelligence in this relationship. The sample was made up of 1287 high school students aged 14 to 18, who filled out questionnaires for evaluation of these variables. The results showed that youths who had failed a subject or had repeated a year showed more exhaustion and cynicism than their classmates with better performance and higher academic efficacy. A relationship was also found between school burnout and emotional intelligence in these adolescents, positive for self-efficacy and negative for cynicism and exhaustion. The model results showed that low academic performance affected burnout level, and that stress management and mood in emotional intelligence acted as a mediator in this relationship. In conclusion, development of emotional intelligence programs in the educational context is proposed as a measure for preventing burnout in the face of adverse high school academic events, such as failing or repeating a year.

Communication and humanization of care: Effects over burnout on nurses.

BACKGROUND: Healthcare professionals may have certain psychological characteristics which contribute to increasing the quality of their professional performance. OBJECTIVE: Study the effect that humanization of care and communication have on the burnout syndrome in nursing personal. METHODS: The sample included a total of 330 Spanish nurses. Analytical instruments used were the Health Professional's Humanization Scale (HUMAS), Communication Styles Inventory Revised (CSI-R) and Brief Burnout Questionnaire Revised (CBB-R). RESULTS: Two broad nursing profiles could be differentiated by their level of humanization (those with scores over the mean and those with scores below it in optimistic disposition, openness to sociability, emotional understanding, self-efficacy, and affection), where the largest group had the high scores. A communication repertoire based on verbal aggressiveness impacted indirectly on the effect of humanization on burnout, mainly in the personal impact component. We observed the relation of humanization profiles in nursing staff with the job dissatisfaction and burnout components. Besides that, some communication styles, verbal aggressiveness and questioningness, have an indirect effect on the relationship between humanization profiles and job dissatisfaction. CONCLUSIONS: The results on the relationship between communication styles and burnout, and the mediator effect of communication styles on the relationship between humanization of care and burnout in nursing personnel are discussed.

Interpersonal Support, Emotional Intelligence and Family Function in Adolescence.

BACKGROUND: During adolescence, although the peer group exerts a strong influence on how the individual thinks and feels and on personal social values, the family still exerts a sustaining and supporting role. This study analyzed the relationships established between family function, emotional intelligence and perceived interpersonal support in adolescence. METHOD: The sample was made up of 1287 high school students aged 14 to 18 (M = 15.11; SD = 0.91) in the province of Almeria (Spain). RESULTS: The results showed moderate correlations between the intrapersonal emotional intelligence dimension and perceived availability of support (advice or orientation), and between the mood dimension of emotional intelligence and the three interpersonal support dimensions (appraisal, belonging and tangible). In addition, significant positive correlations were found between family function and the intrapersonal and mood dimensions of emotional intelligence, with medium and large effect sizes, respectively. Apart from that, the data revealed that students who could count on a more functional family referred to high empathy and acceptance by others and greater support in material or financial matters, followed by those with moderate family function. In addition, students from homes with severely dysfunctional families perceived less available support. Finally, students who said they could count on strong family function also scored higher on the intrapersonal factor of emotional intelligence. CONCLUSIONS: The implications of these findings for the development of emotional intelligence in early adolescence are discussed from the family context, considering the relationship between emotional intelligence and social support.

Coping Strategies in the Spanish Population: The Role in Consequences of COVID-19 on Mental Health.

The worldwide health emergency caused by COVID-19 is a new challenge for humanity which individuals respond to in a diversity of ways. The type of coping people use in such a situation could lead to positive or negative consequences to their health. Our objective was to analyze the use of coping strategies in the general population with attention to sociodemographic variables, and to test the capacity of these strategies for mediating in repercussions on mental health. The 1,160 adults who participated in this study answered the Cognitive Emotion Regulation Questionnaire (CERQ-S) and General Health Questionnaire (GHQ-28). The data were collected in a CAWI (Computer Aided Web Interviewing). The results suggest that the coping strategies they used the most differed depending on sociodemographic characteristics, such as age, sex and education. Furthermore, two mediation models were estimated for positive and negative coping strategies in the relationship between the presence of COVID-19 near them and mental health. The "negative" coping strategies were found to exert an indirect effect as mediators in the impact that COVID-19 positive cases near them had on their health. The consequences to mental health of the impact of coping with adverse situations should not be underestimated and it is important to design programs to educate the population in coping strategies that promote their health.