Assessing Tobacco Treatment Engagement in Assertive Community Treatment Programs.

OBJECTIVE: Despite high tobacco use prevalence among those with serious mental illnesses, few Assertive Community Treatment (ACT) programs provide tobacco treatment. Understanding the factors associated with the intentions to engage in tobacco treatment from both provider and consumer perspectives is important. The purpose was to examine ACT providers' intention to provide and consumer intention to engage in tobacco treatment. METHOD: A cross-sectional survey of ACT program providers (N = 51) and consumers (N = 43) from four community mental health centers. Multiple linear regression analyses were used to examine factors associated with the intentions to provide or engage in tobacco treatment from among attitudinal, subjective norms, and perceived behavioral control variables. RESULTS: Providers reported positive attitudes, high degree of perceived behavior control, and high intentions for delivering tobacco treatment, but poor perceptions of subjective norms. These results were like consumers' intentions to engage in tobacco treatment. In regression analysis, only subjective norms and perceived behavior control were significant predictors for providers' intentions to provide tobacco treatment, but there were no significant predictors of consumers' intentions to engage in tobacco treatment. Both providers and consumers endorsed poor implementation of evidence-based tobacco treatment. CONCLUSION: Poor engagement in tobacco treatment within ACT programs indicates the need for policymakers to support tobacco treatment within the services. This finding calls for training of mental and behavioral health providers while supporting tobacco-free initiatives in ACT treatment service settings.

Pilot Study Focused on Knowledge, Attitudes, and Health Access Behaviors of Psychiatric-Mental Health Nurses Regarding Suicide Prevention.

OBJECTIVE: The purpose of this pilot study was to evaluate the effect of a web-based education module on the knowledge, attitudes, and ratings of willingness to access help related to suicide prevention in psychiatric-mental health nurses. METHODS: A quasi-experimental pretest-posttest design was employed. Registered nurses from two academic health center units and a 239-bed Psychiatric Hospital were invited to participate. Scores on knowledge of suicide risk and prevention, attitudes, subjective norms, perceived behavioral control, and intent to seek help upon experiencing suicidal ideations were obtained before and after administering a 25-min web-based training. RESULTS: Twenty-nine participants completed the pre-survey, web-based education module, and post-survey. Significant increases from baseline in the scores on knowledge, attitudes, subjective norms, and intentions related to help-seeking behaviors for nurse suicide prevention were noted. Perceived behavioral control median scores increased but were not statistically significant. More than 40% of the participants reported having experienced suicidal thoughts. CONCLUSIONS: Further study is needed to determine contributors to this higher rate. Understanding the effectiveness of strategies to reduce nurse suicide can provide insights into building better nurse suicide prevention programs.

Tobacco use behavior among adults exposed to cumulative adverse childhood experiences: A systematic review and meta analysis.

BACKGROUND: Tobacco use remains one of the most used substances among adults globally and substantially impacts individuals and society. Adverse childhood experiences (ACEs) contribute to tobacco use. However, the association between cumulative ACEs and tobacco use behaviors (TUB) has not been established in the literature. In this review, we aimed to estimate the prevalence of ACEs among adult tobacco users and evaluated the relationship between cumulative ACEs and TUB. METHODS: We identified original articles published before October 2022 by searching PubMed, CINAHL, and Psych INFO databases. Inclusion criteria were: English language, adults and used instruments assessing for cumulative ACEs defined as four or more ACEs. RESULTS: Forty-two studies, totaling 674,087 participants; predominantly cohort and cross-sectional in study design (n = 33). Exposure to 4 ≥ ACEs was significantly associated with increasing the odds of current tobacco use (n = 35), ever or former tobacco use (n = 13), tobacco use initiation, (n = 3) nicotine dependence (n = 1), and ever using electronic cigarettes (n = 1). In the meta-analysis, as compared to those without ACEs, those with 4 ≥ ACEs were twice as likely to have ever used tobacco (OR = 2.16, 95 %CI:1.73-2.70) and approximately four times more likely to have used tobacco currently (OR = 3.73, 95 %CI:2.69-5.18). CONCLUSION: The cumulative ACEs exposure can increase the risk for TUB. However, the evidence is limited primarily to cigarette use. Ongoing research into the effects of cumulative ACEs on TUB is needed to integrate trauma-informed intervention in treating tobacco use and guide public health initiatives aimed to reduce the prevalence of ACEs and TUB among adults.

Construction and evaluation of a predictive model for compassion fatigue among emergency department nurses: A cross-sectional study.

BACKGROUND: Compassion fatigue is a syndrome resulting from long-term work-related traumatic event stress exposure of medical staff. The emergency department is considered to be a high-risk, high-intensity and high-stress work environment, with a high prevalence of trauma and violence. Nurses in the emergency department are more prone to compassion fatigue than nurses in other departments. Compassion fatigue not only affects the physical and mental health, and job satisfaction of emergency department nurses, but also causes serious consequences for patients, such as poor patient outcome, medical errors, and increased patient mortality during hospitalization. OBJECTIVES: Our study aims to develop and evaluate a predictive model for compassion fatigue among emergency department nurses. DESIGN: A cross-sectional study. DATA SOURCES: The emergency department nurses (N = 1014) were recruited from 21 tertiary hospitals (from Chengdu, Chongqing, Guiyang, Guangzhou and Shanghai) in central, southwestern, southern, and eastern China from July 25, 2022 to October 30, 2022. METHODS: Univariate and multiple logistic regression analyses were used to determine the potential predictive factors associated with compassion fatigue in emergency department nurses. A nomogram was built based on the predictive factors and internally evaluated using a bootstrap resampling method (1000 bootstrap resamples). The performance of the predictive model was evaluated by measuring the Hosmer-Lemeshow goodness of fit test and calibration curve. RESULTS: The prevalence of compassion fatigue among emergency department nurses was 75.9 %. The multiple logistic regression analysis revealed that the independent predictive factors for compassion fatigue among emergency department nurses were working position, job satisfaction, diet habit, sleep hours per day, occupational stress, physical harassment and the level of workplace violence, all of which were identified to create the nomogram. The Hosmer-Lemeshow goodness of fit test indicated that the predictive model was well calibrated (χ2 = 11.520, P = 0.174). The bootstrap-corrected concordance index of nomogram was 0.821 (95 % CI: 0.791-0.851). The calibration curve of the nomogram showed good consistency between the predicted and actual probabilities. CONCLUSIONS: A predictive model of compassion fatigue among emergency department nurses has been developed, based on the general demographic, work-related and lifestyle characteristics, occupational stress, and workplace violence, with satisfactory predictive ability. This model can identify emergency department nurses who are at high risk of compassion fatigue. Our study provides an empirical basis for early detection, early diagnosis and early intervention of emergency department nurses at high risk of compassion fatigue.

The Relationship Between Trauma and Substance Use Among Healthcare Workers: A Cross-Sectional Analysis.

ABSTRACT: Trauma exposure is prevalent in the general population, but healthcare workers may be at greater risks for additional work-related trauma. Trauma is a known risk factor for substance use, particularly tobacco and risky alcohol use. Few studies have examined the relationship between trauma and substance use in healthcare workers. Among healthcare workers, the aims of our study were to examine (a) frequency of current tobacco use and risky alcohol use, (b) frequency and types of traumatic experiences, and (c) the associations between trauma experiences and current tobacco and risky alcohol use controlling for demographic factors. This study is a secondary analysis of cross-sectional survey data from healthcare workers (N = 850) in an academic medical center. Demographic and work-related variables, trauma experience, and substance use were examined. Multivariate logistic regression analysis examined associations between trauma exposure and tobacco and risky alcohol use controlling for demographic and work-related variables. Nearly 75% of respondents reported at least one lifetime traumatic experience, and one in 10 reported tobacco and risky alcohol use. When controlling for demographic and work-related variables, a dose-response relationship was observed such that the higher the number of traumatic experiences, there was a greater likelihood of reporting tobacco or risky alcohol use. Because healthcare providers have additional work-related trauma risk above the public, and greater trauma is associated with increased risk for substance use, it is important to screen for trauma and provide appropriate treatment resources to healthcare providers. Future research is needed to better delineate the relationship between specific traumas and risky substance use among healthcare providers.

Substance use outcomes among individuals with severe mental illnesses receiving assertive community treatment: A systematic review.

Assertive Community Treatment (ACT) is a multidisciplinary treatment approach to support people with severe mental illnesses (SMI) in their recovery. While the majority of ACT recipients report co-morbid substance use issues, limited reviews have evaluated the impact of receiving ACT services on substance use outcomes. The purpose of this systematic review was to evaluate the impact of ACT involvement on substance use outcomes among people with SMI. A systematic literature search was conducted including articles published prior to April 2021. Twenty-nine studies were included in this review. Of them, 15 studies implemented a controlled design (six studies demonstrated high quality) and 14 studies implemented a cohort design. From a synthesis of the reviewed studies, five areas of changes associated with substance use emerged including reduced alcohol and drug use severity, lower prevalence of alcohol and drug use, increased stage of change in substance use treatment, and fewer days of hospitalization and intoxication. Thus, future studies should examine the integration of substance use treatment services as part of ACT interventions for opportunities to enhance recovery outcomes among individuals with SMI.

Enhancing Provider Delivery of Tobacco Treatment Within the Inpatient Psychiatric Setting.

People with mental illnesses (MI) smoke at higher rates than the general population. However, few mental health providers (MHPs) deliver tobacco treatment to patients with MI especially within inpatient psychiatric settings. According to evidence, fewer than half of MHPs in the US mental and behavioral health settings provide the recommended evidence-based tobacco treatment interventions to their clients with MI. This paper uses the theory of planned behavior to examine factors associated with provider intentions to deliver and their experiences in providing evidence-based tobacco treatment to clients with MI. Data were obtained from a cross-sectional survey of 219 providers in a state psychiatric hospital in Kentucky. Attitudes, subjective norms, and perceived behavioral control were associated with providers' intentions to deliver tobacco treatment when controlling for demographic and work-related variables. However, only profession, subjective norms, and attitudes were associated with reported provision of evidence-based tobacco treatment. Given the underuse of routine tobacco treatment for this vulnerable population, understanding factors influencing provider delivery of tobacco treatment is needed to guide strategies for reducing the disproportionate rates of tobacco use and related burden among people with MI.

The Impact of a Nurse-Led Service on Tobacco Treatment Provision Within a Psychiatric Hospital: A Time Series Study.

INTRODUCTION: Psychiatric hospitalization is an opportunity to provide evidence-based tobacco treatment to optimize cessation efforts among people living with mental illnesses (MI). The purpose of this study was to examine the effectiveness of nurse-driven initiatives to enhance tobacco treatment within an inpatient psychiatric setting. AIMS: We assessed the 4-year impact of implementing a nurse-led tobacco treatment service offered to 11,314 inpatients at admissions in a tobacco-free psychiatric facility in Kentucky. METHOD: Through a time-series design, we compared the differences in rates of screening for tobacco use and providing treatment from September to December 2015 (prior to implementing the nurse-led tobacco treatment services) to each subsequent year in a 4-year period (2016-2019). RESULTS: Approximately 60.0% of inpatients were persons using tobacco during the assessment period. Although there were no changes in tobacco use prevalence over the 4-year evaluation duration, there were significant increases in the provision of practical counseling and Food and Drug Administration-approved nicotine replacement therapies for persons using tobacco. CONCLUSIONS: Our findings support the effectiveness of implementing tobacco treatment programs at the organizational level. Psychiatric hospitalizations provide an opportunity to optimize nurse-driven efforts to deliver tobacco treatment to people with MI. Similar models of nurse-led tobacco treatment services can be adopted within inpatient and other mental and behavioral health settings.

Evaluating Simulation-Based Tobacco Treatment Scenarios for Providers Delivering Treatment for People Living With Mental Illnesses.

Background: People living with mental illnesses (PMI) experience elevated tobacco use and related morbidity and mortality. Despite the availability of effective and safe tobacco treatments along with evidence that PMI are motivated and able to quit successfully, few Mental and behavioral healthcare providers (MHPs) engage PMI in such treatment. MHPs may lack the confidence or skills to engage their clients in tobacco treatment. Currently, there are limited training modalities to prepare MHPs in delivering tobacco treatment for PMI. However, animated scenario-based simulated encounters can bridge this gap to effectively provide tailored MHP training to enhance treatment delivery. Hence, the purpose of this study was to evaluate simulated tobacco treatment education scenarios tailored to MHPs. Methods: For this evaluation, we used a pretest-posttest design to assess changes in MHPs tobacco treatment knowledge and behavioral intentions after viewing simulated treatment encounters. We developed four animated scenarios, using brief tobacco treatment interventions, simulating treatment encounters with PMI. MHPs were primarily recruited from mental or behavioral healthcare facilities and were asked to complete a web-based questionnaire. Their knowledge, views, and experiences in providing tobacco treatment were assessed prior to viewing the animated scenarios. Participants were then asked to evaluate the desirability, acceptability, and applicability of the animated scenarios; and thereafter, their knowledge of and intentions to provide evidence-based tobacco treatment (i.e., ASK, ADVISE, ASSESS, ASSIST, ARRANGE) were again assessed. Results: Participants (N = 81) were on average 41.0 years of age, mostly female (79.0%), and non-Hispanic White (86.4%). Nearly a quarter endorsed current tobacco use and few had tobacco treatment training (14.8%). Overall knowledge of tobacco treatment scores significantly increased before and after viewing the videos (M = 3.5 [SD = 1.0] to M = 4.1 [SD = 1.0], p < 0.0001). After viewing the simulated scenario videos, participants endorsed moderate to high mean scores (ranging from 4.0-4.2 on a 0 to 5 scale) on the desirability, acceptability, and applicability of the different animated scenarios. In addition, after viewing the scenarios the proportion of participants who endorsed that they intended to occasionally/very often engage clients in evidence based tobacco treatment were high for ASK (94.9%), followed by ADVISE and ASSESS (84.7% each), followed by ASSIST (81.4%), and ARRANGE (74.6%). Evaluation scores significantly differed by type of animated scenario and participants' work settings and discipline. Conclusions: These findings suggest that the use of brief animated scenarios may be a useful modality to enhance MHPs knowledge acquisition and treatment delivery intentions. Such approaches may be integrated into tobacco treatment trainings for MHPs.

Factors associated with workplace violence among healthcare workers in an academic medical center.

PURPOSE: We examined demographic, work-related, and behavioral factors associated with witnessing and/or experiencing workplace violence among healthcare workers. DESIGN AND METHODS: Utilizing a correlational design, we analyzed the data to determine the associative factors related to workplace violence among the participants. FINDINGS: More than half of the participants (54.5%) reported witnessing (23.8%) or experiencing (30.7%) workplace violence. There were significant differences between health provider groups in witnessing or experiencing workplace violence (Χ2 = 41.9[df12], p < 0.0001). Moreover, the experience of workplace violence differed by practice setting (Χ2 = 65.9[df14], p < 0.0001), with highest rates occurring in psychiatric (45.1%) and emergency (44.1%) services. PRACTICE IMPLICATIONS: Findings may inform research, policies, and practice interventions to assess risks for workplace violence and implement preventative policies within high-risk professional groups and settings.

Associations of tobacco use and consumption with rurality among patients with psychiatric disorders: Does smoke-free policy matter?

PURPOSE: People with psychiatric disorders (PDs) have high risks for tobacco use and associated health effects; however, little is known about differences in tobacco use status and consumption by urban or rural residence. Among patients with PDs, we examined the association of smoke-free policy on tobacco use by rural/urban residence METHOD: A cross-sectional retrospective study (N = 2060) among patients in a psychiatric facility was conducted. Multi-logistic and multilinear regression analyses assessed differences in outcomes stratified by rural/urban status. RESULTS: Among rural residents, a substance use history (odds ratios [ORs[ = 2.82, 95% CI: 2.01-3.96), high school education (OR = 0.71, 95% CI: 0.51-0.98), older age (OR = 0.99, 95% CI: 0.98-1.00), and longer length of hospital stay (OR = 0.99, 95% CI: 0.98-1.00) were associated with tobacco use. Among urban residents, male sex (OR = 1.38, 95% CI: 1.02-1.86), a substance use history (OR = 2.61, 95% CI: 1.86-3.66), and externalizing disorder diagnosis (OR = 2.72, 95% CI: 1.35-5.48) correlated with tobacco use. Increased tobacco consumption among rural residents was associated with being male (ß = 0.12, p = 0.007) and having less than a high school education (ß = 0.14, P = 0.001). Whereas, White ethnicity (ß = 0.14, p = 0.006), having less than a high school education (ß = 0.11, p = 0.022), and a psychotic disorder diagnosis (ß = 0.25, p = 0.038) were associated with greater tobacco consumption in urban residents. Smoke-free policy was not associated with tobacco use (OR = 1.08, 95% CI: 0.87-1.34) and consumption (ß = 0.05, p = 0.134). CONCLUSIONS: Despite higher rates of tobacco use among rural patients with PDs, they have similar risk factors as their urban counterparts. However, residing in a location with a smoke-free policy may not contribute to tobacco use behaviors among those with PDs.

Factors associated with posttraumatic growth among healthcare workers at an academic-medical center: A correlational study.

PURPOSE: Posttraumatic growth (PTG) can occur after experiencing traumatic events. Our purpose was to examine factors associated with PTG experiences of healthcare workers within an academic-medical center. DESIGN AND METHODS: A correlational study was conducted using a convenience sample of 479 healthcare workers at a large academic-medical center. FINDINGS: Having children living at home, serving the pediatric population, longer duration of alcohol abstinence, and having received treatment for trauma were significantly associated with greater PTG scores. Compared to nondirect care staff, advance practice providers, nursing staff, social work/psychologists, and pharmacy staff had significantly lower PTG scores. PRACTICE IMPLICATIONS: Understanding the positive psychological changes that occur in workers after trauma experiences may provide insight to guide interventions that promote healthcare worker wellbeing.

The effect of long-acting injectable antipsychotic medications compared with oral antipsychotic medications among people with schizophrenia: A systematic review and meta-analysis.

Long-acting injectable (LAI) antipsychotic medications may be an important modality of reducing costs, improving symptoms, and fostering quality of life outcomes for those with schizophrenia. Our objective was to systematically review and conduct a meta-analysis of the effectiveness of LAIs compared with oral antipsychotics on medication adherence, symptom remission/relapse, rehospitalization, outpatient visits, emergency department visits, healthcare costs, and social functioning. We performed a systematic search of PsycInfo, CINAHL, PubMed, and Scopus databases to examine studies meeting inclusion criteria prior to August 30th, 2020. Randomized controlled trials, retrospective studies, prospective studies among people with schizophrenia with at least 6-month follow-up data were obtained. Overall effect sizes and associated 95% confidence intervals (CI) were estimated with random-effects modeling. We found 75 articles meeting our inclusion criteria, including 341 730 individuals with schizophrenia. Systematic review results indicated that LAIs compared with orals improved medication adherence (25/29 studies), symptom remission/relapse (10/18 studies), rehospitalizations (26/49 studies), emergency department visits (9/17 studies), medical costs (11/15 studies), and social functioning (5/9 studies); however, LAIs also increased outpatient visits (7/16 studies) and pharmacy costs (10/10 studies). Meta-analytic results of studies with similar outcome measures did not find differences between LAIs and orals in respect to outcomes, except lowering emergency department visits and increasing pharmacy costs. The differences between the results of the narrative synthesis and the meta-analyses were possibly because of the low availability of studies with similar outcomes in the pooled analyses. Our overall results suggest that LAIs are at least comparable to orals in supporting important healthcare outcomes for those with schizophrenia. These findings support clinical practice in encouraging providers to prescribe LAIs when indicated.

Compassion Satisfaction, Burnout, and Secondary Traumatic Stress Among Nursing Staff at an Academic Medical Center: A Cross-Sectional Analysis.

BACKGROUND: Although several studies have recently described compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) in nurses, few to date have examined these issues across nursing specialties. Such examination is needed to inform future nursing-subspecialty tailored interventions. AIMS: To examine (1) differences in CS, BO, and STS across nursing specialties and (2) differences associated with demographic, work-related, and behavioral factors among nurses. METHOD: A secondary analysis of survey responses from nurses (N = 350) at an academic medical center. Demographic, behavioral, work-related, and professional quality of life variables were analyzed using hierarchical regression analyses. RESULTS: CS, BO, and STS scores significantly varied across specialties with emergency nurses experiencing significantly elevated rates of BO and STS, and lowest rates of CS; scores were also differentially associated with demographic, work-related, behavioral, and workplace violence variables. CONCLUSIONS: Key differences in CS, BO, and STS by nursing specialty suggests the importance of tailoring BO and STS mitigative interventions. BO and STS risk factors should be assessed in nurses (e.g., behavioral health problems and poor sleep quality) and specialty-specific interventions (e.g., reducing workplace violence exposure in emergency settings) may be considered to improve CS while reducing BO and STS among nurses.

Nursing Staff Attitude, Subjective Norms, Perceived Behavior Control, and Intention to Provide Tobacco Treatment in a Psychiatric Hospital.

BACKGROUND: Although the nursing staff is fundamental in assisting individuals with mental illnesses (MI) to stop tobacco use, they often have mixed feelings about providing tobacco treatment (TT) services to people with MI in inpatient psychiatric settings. OBJECTIVE: Therefore, this study aimed to understand factors associated with nursing staff's intentions to provide TT interventions for individuals diagnosed with MI in a psychiatric facility using the constructs of the theory of planned behavior (TPB). METHOD: Secondary data analysis was performed using cross-sectional data collected from 98 nursing staff who worked in a state inpatient psychiatric facility. A 15-item questionnaire was used to assess nursing staff intentions to provide TT services based on TPB constructs, including attitudes (four items), subjective norms (four items), perceived behavioral controls (four items), and intentions (three items) toward providing TT. The mean scores of each subscale ranged from 1 to 7. A logistic regression analysis was used to examine the relationship between TBP constructs and nursing staff intentions to provide TT for people with MI. RESULTS: Nursing staff had an acceptable mean score in the intentions subscale (4.34 ± 2.01). Only two constructs of TPB explained nursing staff intentions to provide TT: subjective norms (OR = 2.14, 95% CI [1.46, 3.13]) and perceived behavioral control (OR = 2.33, 95% CI [1.32, 4.12]). CONCLUSIONS: The constructs of the TPB, the subjective norms, and the perceived behavior control were able to predict nurses' intentions to provide TT for inpatients in a psychiatric setting. Accordingly, we suggest implementing policies that make TT a normative practice while supporting the confidence and competence of nurses to deliver TT in psychiatric facilities.

The prevalence of compassion satisfaction and compassion fatigue among nurses: A systematic review and meta-analysis.

BACKGROUND: Compassion fatigue is a consequence of chronic work-related stress exposure among healthcare providers. Nursing is a high-risk, stressful profession which increases nurses' vulnerability to compassion fatigue symptoms compared to other healthcare workers. Compassion fatigue has serious consequences for nursing staff, patients and healthcare organizations. Though several studies on the prevalence of compassion fatigue among nurses have been published, the reported data vary considerably across studies; and few meta-analysis have examined the prevalence of compassion satisfaction and compassion fatigue among nurses with large sample sizes. OBJECTIVES: To systematically assess the prevalence of compassion satisfaction and compassion fatigue among nurses, and to evaluate the effect of different geographical regions, years and departments on the prevalence of compassion fatigue. DESIGN: Systematic review and meta-analysis DATA SOURCES: The Cochrane Library, PubMed, EMbase, Web of Science, CINAHL, PsyclNFO, China Knowledge Resource Integrated Database (CNKI), Wanfang Database, Weipu Database (VIP), and Chinese Biomedical Database (CBM) were searched in the systematic review. The time frame for the searches included all literature before January 31st, 2020. REVIEW METHODS: The reviewers independently completed study selection, quality assessments, data extraction and analysis of all included literature. The mean scores and standard deviations of the three subscales of the Professional Quality of Life (ProQOL) scale were pooled using random effects meta-analysis in Stata 16.0 software package. Finally, subgroup analyses were conducted to explore the sources of between-study heterogeneity. RESULTS: A total of 79 studies were included in the systematic review and meta-analysis, consisting of 28,509 nurses worldwide from 11 countries. In our studies, the pooled mean scores of compassion satisfaction, burnout and secondary traumatic stress were 33.12 (95% CI: 32.22-34.03), 26.64 (95% CI: 26.01-27.27) and 25.24 (95% CI: 24.69-25.79), respectively. In addition, the Asian region had the lowest levels of compassion satisfaction but the highest levels of compassion fatigue symptoms, while the Americas and Europe had the lowest levels of compassion fatigue but highest compassion satisfaction. Levels of compassionate fatigue in nurses increased gradually from 2010 to 2019, reaching the highest level in 2019; and nurses from ICU had the highest levels of compassion fatigue symptoms among all nurses. CONCLUSION: The levels of compassion satisfaction and compassion fatigue among nurses are moderate. Nurses from the Asian region and in ICUs suffer from severe compassion fatigue symptoms, and the prevalence of compassion fatigue has increased over time. These findings may provide hospital administrators with the theoretical basis for the management and treatment of compassion fatigue. REGISTRATION NUMBER: PROSPERO [CRD42020164327].

The Impact of Psychiatric Disorder Diagnosis on Motivation to Quit and Stage of Change Among Patients at a Hospital-Based Outpatient Smoking Cessation Clinic.

OBJECTIVE: Smoking is among the greatest international public health concerns, causing excessive levels of preventable premature death, disability, and economic costs. The prevalence of tobacco use among people with psychiatric disorders (PDs) remains persistently high relative to the general population, highlighting the need to improve smoking cessation (SC) strategies in this group. We aimed to assess the associations between having a PD and baseline motivation to quit (MtQ) smoking and Prochaska's stage of change (SoC), two clinically important metrics linked to SC outcomes. Methods: This retrospective chart review included patients who completed a baseline visit at a hospital-based outpatient SC clinic (N = 896). Multivariate hierarchical logistic and linear regression models were developed to assess variables associated with MtQ (importance and confidence in quitting) and SoC, primarily PD category (externalizing, internalizing, externalizing/internalizing, psychotic or no PD) and secondarily, demographics, physical health history, and tobacco use/dependence metrics. Results: The variables negatively associated with MtQ were female sex (p = .011), older age (p = .038), deriving income from social assistance (p < .001), and age at smoking initiation (p = .005), whereas ≥ 1 quit attempt in the past year predicted higher MtQ (p < .0001). Being in the preparative/action SoC (versus the pre-contemplative/contemplative) was associated with income from social assistance (OR 0.39, p = .001), more daily cigarettes smoked (OR 0.98, p = .005) and ≥ 1 past-year quit attempt (OR 1.69, p = .013). Conclusions: Having a PD was not associated with either MtQ or SoC. Deriving income from social assistance predicted lower MtQ and SoC. Having made ≥ 1 quit attempt in the past year was associated with higher MtQ and SoC. Our study suggests that people with PDs are as motivated to quit smoking and ready for change as people without PDs, and smoking cessation efforts should be amplified in this group to address the disproportionately high level of tobacco use, especially because having at least one quit attempt may enhance MtQ and SoC.

Quit and win contests in community-dwelling mental and behavioral health populations: A systematic review and pilot feasibility findings.

BACKGROUND: People with mental illnesses (MI) benefit from incentives to promote tobacco cessation. "Quit and Win" contests are community-based approaches that incentivize cessation. However, little is known about "Quit and Win" contest effectiveness among people with MI. AIM: To examine the utility of "Quit and Win" contests among people with MI. METHOD: This study had two phases: (a) a systematic literature review to explore the potential effectiveness of "Quit and Win" contests for people with MI and (b) a pilot feasibility study of implementing a "Quit and Win" contest among people with MI from a community mental health program (CMHP). RESULTS: In phase 1, no reviewed study specifically included people with MI in their sample. Of the four cohort and five randomized controlled studies in the review, the mean reported participant quit rates at the end of "Quit and Win" contests were 76.8% and 28.3%, respectively. In phase 2, within a CMHP, four out of seven participants completed a "Quit and Win" contest, and one individual achieved cessation. CONCLUSION: People with MI may benefit from incentive-based tobacco cessation programs. Implementing a "Quit and Win" contests within a CMHP is important and requires more studies to determine feasibility and effectiveness.

Correlates of post-traumatic growth among nursing professionals: A cross-sectional analysis.

AIMS: Among nursing professionals, our aims were to examine (a) self-reported traumatic experiences, (b) differences in post-traumatic growth (i.e. positive psychological growth after experiencing a traumatic event) by nursing professional level and (c) demographic, work-related, behavioural and traumatic experience covariates of post-traumatic growth. BACKGROUND: Trauma experience among nursing professionals is higher than observed in the general population. Due to the nature of their work environment, workplace trauma rates are particularly alarming. Understanding post-traumatic growth among nursing professionals may guide interventions to enhance well-being. METHOD: A secondary analysis of cross-sectional survey data from nursing professionals (N = 299). Demographic, work-related, behavioural, trauma experience categories and post-traumatic growth variables were examined. RESULTS: Advanced practice nurses and clinical nurses reported higher rates of workplace trauma, as compared to nursing assistants. Higher post-traumatic growth scores were associated with having a postgraduate degree, serving the paediatric population and lower frequency of alcohol use. Lower post-traumatic growth scores were associated with being married/widowed, being an advanced practice provider or clinical nurse, working in the intensive care unit and reporting workplace, family/personal stress and undisclosed trauma. CONCLUSIONS: Nursing professionals have several demographic, work-related, behavioural and traumatic experience-related variables associated with and that explain variances in post-traumatic growth. IMPLICATION FOR NURSING MANAGEMENT: Targeted screening and individualized treatment based on nursing professional level should be considered to support trauma recovery and post-traumatic growth.