A Multisample Path Analysis Including a Novel Psychological Indicator, Attitude Toward Life, After the First Wave of COVID-19.

Introduction: During the COVID-19 outbreak, China applied a unique volunteerism system in which nurses and physicians traveled to the epicenter to care for patients. During the same period, another group, nurse and physician nonvolunteers, stayed at their home hospitals outside of the epicenter and cared for patients without COVID-19. Yet only one Chinese study examined psychological responses comparing these groups. Objective: To explore whether relationships among compassion satisfaction, general health, attitude toward life, satisfaction with life, perceived stress, and posttraumatic stress disorder (PTSD) symptomatology differ between volunteers and nonvolunteers. Attitude toward life is examined for the first time in COVID-19 research. Methods: A cross-sectional study was conducted (259 nurse and physician volunteers, 330 nurse and physician nonvolunteers). Online survey data were analyzed using multisample path analysis. Results: There was no significant difference between volunteer and nonvolunteer models. In the volunteer model, paths significantly related to PTSD symptomatology included compassion satisfaction (total effect, ß = -0.12), general health (total effect, ß = -0.09), attitude toward life (direct effect, ß = -0.30; total effect, ß = -0.30), and perceived stress (direct effect, ß = 0.30; total effect, ß = 0.30), and in nonvolunteers included general health (direct effect, ß = -0.11; total effect, ß = -0.11) and attitude toward life (direct effect, ß = -0.47; total effect, ß = -0.47). Conclusion: No significant difference between models means both groups could benefit from psychological intervention. Within each model, significant paths were identified. For volunteers, counselors might focus on compassion satisfaction and perceived stress and, for both volunteers and nonvolunteers, on health and attitude toward life. Delivering counseling based on key indicators in China may help prevent or mitigate PTSD. Globally, researchers could identify factors to target and determine to whom long-term counseling might be directed. Findings about attitude toward life lay the groundwork for future research.

Factor Structure and Construct Validity of a Hospital Survey on Patient Safety Culture Using Exploratory Factor Analysis.

OBJECTIVE: Nurses' voluntary reporting of adverse events and errors is critical for improving patient safety. The operationalization and application of the concept, patient safety culture, warrant further study. The objectives are to explore the underlying factor structure, the correlational relationship, between items of the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture and examine its construct validity. METHODS: Exploratory factor analysis was conducted using secondary data from the instrument's database. Using pattern matching, factors obtained through exploratory factor analysis were compared with the 6-component Patient Safety Culture Theoretical Framework: degree of psychological safety, degree of organizational culture, quality of culture of safety, degree of high reliability organization, degree of deference to expertise, and extent of resilience. RESULTS: 6 exploratory factors, explaining 51% of the total variance, were communication lead/speak out/resilience, organizational culture and culture of safety-environment, psychological safety-security/protection, psychological safety-support/trust, patient safety, communication, and reporting for patient safety. All factors had moderate to very strong associations (range, 0.354-0.924). Overall, construct validity was good, but few exploratory factors matched the theoretical components of degree of deference to expertise and extent of resilience. CONCLUSIONS: Factors essential to creating an environment of transparent, voluntary error reporting are proposed. Items are needed, specifically focusing on deference to expertise, the ability of the person with the most experience to speak up and lead, despite hierarchy or traditional roles, and resilience, which is coping and moving forward after adversity or mistakes. With future studies, a supplemental survey with these items may be proposed.

Determination of Key Inflection Points for Maladaptive Responses in US Nurses During the Pandemic: A Network Analysis.

Introduction: During the pandemic, the nursing workforce is experiencing overwhelming workloads that carry a heavy psychological burden. A wide variety of psychological responses to the COVID-19 pandemic have been studied in nurses globally, but many are not studied or understudied in US nurses. Theoretical underpinnings of the current study are based on the disaster component of the Middle-Range Theory of Nurses' Psychological Trauma. Objective: To explore the associations of psychological responses (life satisfaction, perceived stress, posttraumatic stress disorder [PTSD] symptomatology, attitude toward life, and compassion satisfaction), years of experience, and general health in US nurses during the COVID-19 pandemic using network analysis. Methods: A cross-sectional study was conducted using an online survey from October to November 2020 in US nurses. Network analysis was used to model the data and analyze the centrality indices of betweenness, closeness, and strength. Data were reported according to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist. Results: In 128 nurses, 19.35% of nurses had probable PTSD. Network analysis showed strong significant correlations between life satisfaction and perceived stress (negative), between perceived stress and PTSD symptomatology (positive), and between attitude toward life and compassion satisfaction (positive). Conclusion: Low life satisfaction, high perceived stress, and low attitude toward life are key inflection points that signal the need for psychological intervention in the US nursing workforce during the continued pandemic. Based on 2021 Tri-Council of Nursing COVID-19 Report and the 2022 International Council of Nurses guideline, healthcare should implement scalable, system-level interventions to reduce psychological burden during the pandemic. The current study suggests targets for such intervention, which may promote a healthier, more effective US nursing workforce.

Public perceptions on Twitter of nurses during the COVID-19 pandemic.

BACKGROUND: The use of social media platforms to convey public opinions and attitudes has exponentially increased over the last decade on topics related to health. In all these social media postings related to the pandemic, specific attention has been focused on healthcare professionals, specifically nurses. OBJECTIVE: This study aimed to explore how the keyword 'nurse' is located in COVID-19 pandemic-related tweets during a selected period of the pandemic in order to assess public perception. METHODS: Tweets related to COVID-19 were downloaded from Twitter for the period January 1st, 2020, to November 11th, 2021. Sentiment analysis was used to identify opinions, emotions, and approaches expressed in tweet which included 'nurse', 'COVID-19', and 'pandemic' as either keyword or hashtags. RESULTS: A total of 2,440,696 most used unique words in the downloaded 582,399 tweets were included and the sentiment analysis indicated that 24.4% (n = 595,530) of the tweets demonstrated positive sentiment while 14.1% (n = 343,433) of the tweets demonstrated negative sentiment during COVID-19. Within these results, 17% (n = 416,366) of the tweets included positive basic emotion words of trust and 4.9% (n = 120,654) of joy. In terms of negative basic emotion words, 9.9% (n = 241,758) of the tweets included the word fear, 8.3% (n = 202,179) anticipation, 7.9% (n = 193,145) sadness, 5.7% (n = 139,791) anger, 4.2% (n = 103,936) disgust, and 3.6% (n = 88,338) of the tweets included the word surprised. CONCLUSIONS: It is encouraging to note that with the advent of major health crises, public perceptions on social media, appears to portray an image of nurses which reflects the professionalism and values of the profession.

Adverse Event Reporting Priorities: An Integrative Review.

OBJECTIVES: Adverse events remain the third leading cause of death in hospitals today, after heart disease and cancer. However, adverse events remain underreported. The purpose of this integrative review is to synthesize adverse event reporting priorities in acute care hospitals from quantitative, qualitative, and mixed-methods research articles. METHODS: A comprehensive review of articles was conducted using nursing, medicine, and communication databases between January 1, 1999, and May 3, 2021. The literature was described using standard reporting criteria. RESULTS: Twenty-nine studies met the eligibility criteria. Four key priorities emerged: understanding and reducing barriers, improving perceptions of adverse event reporting within healthcare hierarchies, improving organizational culture, and improving outcomes measurement. CONCLUSIONS: A paucity of literature on adverse event reporting within acute care hospital settings was found. Perceptions of fear of blaming and retaliation, lack of feedback, and comfort level of challenging someone more powerful present the greatest barriers to adverse event reporting. Based on qualitative studies, obtaining trusting relationships and sustaining that trust, especially in hierarchical healthcare systems, are difficult to achieve. Given that patient safety training is a common strategy clinically to improve organizational culture, only 4 published articles examined its effectiveness. Further research in acute care hospitals is needed on all 4 key priorities. The findings of this review may ultimately be used by clinicians and researchers to reduce adverse events and develop future research questions.

Implementing a novel self-care clock strategy as part of a trauma awareness intervention in a university setting.

PURPOSE: This study compared post- and preintervention trauma-informed care attitudes, explored relationships among outcomes, and identified self-care behavior changes participants are willing to make. DESIGN AND METHODS: A quasi-experimental study with content analysis was conducted with 96 adults that took part in a Trauma Awareness Intervention including a novel self-care clock. CONCLUSIONS: Participants' trauma-informed care attitudes improved (p ≤ 0.05) compared to baseline and were positively related to their post-intervention compassion scores (p < 0.05). Qualitative analyses revealed self-awareness, self-care, empathy, applying a trauma lens, changing the narrative, and student-centeredness as the main themes in participants' responses. PRACTICAL IMPLICATIONS: This university-based initiative had a positive impact on attitudes toward trauma and should be explored in other settings, as there is an unmet need for trauma-informed care strategies at the community level.

Nursing professionals' mental well-being and workplace impairment during the COVID-19 crisis: A Network analysis.

AIM: To investigate the effects of years of nursing experience and mental health on work impairment among nurses during the COVID-19 crisis. BACKGROUND: During the COVID-19 crisis, nurses experience a greater psychological burden than other health care workers. Studies have not yet investigated the effects of years in nursing and mental health on potential work impairment during the COVID-19 crisis in nurses. METHODS: A survey was administered to 83 nurses on active duty during the COVID-19 crisis. The graphical LASSO and the DAG helped estimate the associations between years of nursing experience, mental health and work impairment. RESULTS: A moderate negative correlation emerged between years of nursing experience, avoidance and work impairment. A direct effect was observed between anxiety and work impairment. A moderate positive correlation emerged between anxiety, depression and work impairment. An indirect effect was observed between depression, burnout, insomnia, years of nursing experience and work impairment. CONCLUSIONS: In the present sample, nurses' work impairment decreased with greater years of nursing experience and increased with higher anxiety, depression, burnout and avoidance levels. IMPLICATIONS FOR NURSING MANAGEMENT: These findings can help design effective infectious disease management programmes for students and professionals in nursing to prevent breakdowns and avoid work impairment.

Implementation science: Changing practice in oral health.

Caries remain the most common preventable chronic childhood disease. One state oral health program including fluoride varnish showed a decrease in presence of decay and improvement in overall oral health; however, early childhood caries did not improve. Implementation of an oral health preventive program during well-child medical visits may address this gap.

High correlations between MRI brain volume measurements based on NeuroQuant® and FreeSurfer.

NeuroQuant® (NQ) and FreeSurfer (FS) are commonly used computer-automated programs for measuring MRI brain volume. Previously they were reported to have high intermethod reliabilities but often large intermethod effect size differences. We hypothesized that linear transformations could be used to reduce the large effect sizes. This study was an extension of our previously reported study. We performed NQ and FS brain volume measurements on 60 subjects (including normal controls, patients with traumatic brain injury, and patients with Alzheimer's disease). We used two statistical approaches in parallel to develop methods for transforming FS volumes into NQ volumes: traditional linear regression, and Bayesian linear regression. For both methods, we used regression analyses to develop linear transformations of the FS volumes to make them more similar to the NQ volumes. The FS-to-NQ transformations based on traditional linear regression resulted in effect sizes which were small to moderate. The transformations based on Bayesian linear regression resulted in all effect sizes being trivially small. To our knowledge, this is the first report describing a method for transforming FS to NQ data so as to achieve high reliability and low effect size differences. Machine learning methods like Bayesian regression may be more useful than traditional methods.

Passion for Academics and Problematic Health Behaviors.

According to the Dualistic Model of Passion (39), passion entails valuing, liking, and spending time on an activity. The Dualistic Model also posits two types of passion for activities: harmonious passion (individual voluntarily engages in the activity) and obsessive passion (individual is compelled to engage in the activity). The purpose of the present study was to examine the possible links between college students' passion for academic activities and problematic health behaviors including smoking, excessive drinking, exercise addiction, disordered eating, and sleepiness, which is a possible indicator of sleep deprivation. Participants (n = 502) completed a survey gauging passion type and health behaviors. Regression analyses revealed obsessive passion for academic activities was positively associated with scores on measures of excessive drinking (ß = .15, p= .008), exercise addiction (ß = .19, p<.001), and disordered eating (ß = .17, p < .001) but was not associated with sleep deprivation (ß = .07, p = .15). Harmonious passion for academic activities, in contrast, was negatively associated with excessive drinking behavior (ß = -.16, p = .002) and sleep deprivation (ß = -.13, p = .007) but was not associated with exercise addiction (ß = .002, p = .97) and disordered eating (ß = -.04, p = .37). These findings provide further support for the Dualistic Model of Passion. Students who are obsessively passionate about their academic activities are more likely to engage in poor health behaviors and, in turn, may experience greater negative outcomes than students who are harmoniously passionate about their academics.

Effects of a Supportive Audience on a Handgrip Squeezing Task in Adults.

The role of social facilitation by way of audience effect in select exercise-related variables during an isometric handgrip task was assessed using a mixed design. Fifty three moderately active participants (Mage= 21.76 ± 5.27) were recruited from the Midwestern United States. Participants were randomly assigned to one of two groups: supportive audience or control. Audience members provided positive verbal encouragement to participants in the experimental condition throughout the task performance. Participants in the control group performed the task in the absence of an audience and did not receive any verbal encouragement. Participants provided anxiety ratings pre- and post-task using the State-trait anxiety inventory for adults (STAI). Participants' ratings of perceived exertion (RPE) and heart rate (HR) were monitored and assessed at 30-second intervals. Upon task completion, sustained effort in the form of time on task was recorded in seconds. A repeated measures analysis of variance (RM ANOVA) revealed that there was a time effect within groups of HR = ( F(2.64, 131.85) = 189.3, p <0.001) and within groups of RPE = (F(2.97, 139.42) = 2189.43 p <0.001). An independent sample T-test revealed significant differences in HR at 0, 30 and 60 seconds between the groups. An independent sample T-test revealed no significant differences in anxiety and RPE between the groups. These results partially support the notion of social facilitation and may have implications for research and practice.