Occupational fatigue, compassion competence and caring behaviours of intensive care nurses: A structural equation modelling approach.

BACKGROUND: No previous study has examined the direct effect of occupational fatigue, inter-shift recovery and compassion competence on caring behaviours, including assurance, knowledge-skill, respect and commitment in intensive care nurses. AIM: We studied the direct effect of participating nurses' occupational fatigue, inter-shift recovery and compassion competence levels on their caring behaviours and the relationship among these variables. STUDY DESIGN: This was a descriptive correlational study. All nurses who were registered members of the Turkish Intensive Care Nurses Association were invited to participate in this online survey. This study was conducted with 315 intensive care nurses using convenience sampling between April and July 2022. The data were collected using the Occupational Fatigue Exhaustion/Recovery Scale, which consists of three subscales: acute fatigue, chronic fatigue and inter-shift recovery; the Compassion Competence Scale, including communication, sensitivity and insight subscales; and the Caring Behaviours Inventory-24. In addition, a structural equation model was established using variables correlating with caring behaviours. Independent variables were occupational fatigue, inter-ship recovery and compassion competence; and the dependent variable was caring behaviours in this hypothesized model. RESULTS: Three hundred and fifteen nurses completed the survey (315/1000) with a response rate of 31.5%. The increase in the inter-shift recovery levels of participants was statistically and positively associated with caring behaviours (95% confidence interval [CI]: 0.001-0.011, ß = .154 [moderate effect size], p < .05). The sub-dimensions of the Compassion Competence Scale, that is, communication (95% CI: 0.110-0.443, ß = .251 [moderate effect size]) and sensitivity (95% CI: 0.084-0.427, ß = .241 [moderate effect size]), were statistically and positively associated with the caring behaviours of participants (p < .05). In addition, independent variables accounted for 35% (large effect size) of the total change in caring behaviours (R2 = 0.350). CONCLUSIONS: This study suggests that the high inter-shift recovery and compassion competence levels of intensive care nurses are positively associated with their caring behaviours. RELEVANCE TO CLINICAL PRACTICE: Nursing managers should consider the direct effect of occupational fatigue, inter-shift recovery and the compassion competence levels of intensive care nurses on their caring behaviours to provide high-quality care.

Depression, anxiety, stress, and job performance among Turkish nurses in the early post-earthquake period.

BACKGROUND: Individual and social concerns can negatively affect nurses' mental health during a large-scale earthquake's early stages, making it challenging to perform their professional responsibilities. AIM: This cross-sectional correlational study aimed to examine the relationship between depression, anxiety, and stress levels Turkish nurses experienced during an earthquake's early period. The nurses participating in this study were not directly present in the earthquake-affected area. METHODS: The study was conducted on 232 nurses between February 10 and 25, 2023. The data were collected using the Depression, Anxiety, Stress-21 Scale and the Job Performance Evaluation Form developed by the researchers through a literature review. These were used to investigate nurses' work motivation changes due to the earthquake. The study followed the STROBE checklist for cross-sectional studies. RESULTS: The participants' depression levels were severe, anxiety levels were extremely severe, and stress levels were moderate following the earthquake. Nurses who felt exhausted experienced reduced energy levels toward their work and reported a decrease in their desire, effort, and work motivation to perform well. In addition, they had higher depression, anxiety, and stress scores (p < 0.005). CONCLUSION: Psychological difficulties, including depression, anxiety, and stress experienced by nurses not directly present in an earthquake-affected area, reduced their professional efforts and motivation and negatively affected the patient care process. Further studies should focus on conducting comparative studies in different cultures affected by natural disasters on the longitudinal analysis of the impacts of nurses' psychological distress on their job performance. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nursing policymakers should be aware of the negative psychological effects experienced by nurses during the early post-earthquake period, even if they are not directly present in the earthquake-affected area. The study recommended that nurses should be provided with psychological support to deal with the negative effects of natural disasters and maintain job performance, including the nursing care process.

Effectiveness of Interventions on Death Anxiety and Fear in Adults with Chronic Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

This systematic review and meta-analysis aimed to synthesize the outcomes of various interventions to alleviate death anxiety and fear. Studies published between January 2010 and June 2022 were searched in the ScienceDirect, Scopus, Web of Science, PubMed, Cochrane Library, and CHINAL databases. The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement guidelines were used in this meta-analysis. The results were examined using 95% confidence intervals, p-values, and fixed- or random-effects models based on the heterogeneity test. Sixteen studies involving 1262 participants were included in this systematic review. Interventions in seven studies using the Templer Death Anxiety Scale (TDAS) significantly decreased death anxiety levels in the intervention groups compared to the control groups (z = -4.47; p < 0.001; 95% CI: -3.36 to -1.31). This meta-analysis provides insights into implementing logotherapy, cognitive behavioral therapy, spirituality-based care, and educational interventions for death anxiety and the fear experienced by patients with chronic diseases.

Spiritual Well-being, Diabetes Burden, Self-management, and Glycemic Control Among Patients with Type 2 Diabetes in Turkey: A Descriptive and Correlational Study.

Spiritual well-being is considered a significant factor in helping to manage chronic diseases and cope with the disease process. This descriptive-correlational study aimed to investigate the relationship between spiritual well-being, diabetes burden, self-management, and among 300 outpatients with type 2 diabetes in Turkey. A significant relationship was found between the diabetes burden and self-management levels and the spiritual well-being of patients with diabetes (p < 0.005). Multiple linear regression analyses found that a high diabetes burden (ß = -0.106) decreased well-being, and high self-management increased well-being (ß = 0.415). Additionally, the results revealed that marital status, household members, performing daily life activities alone, hospitalization due to complications, diabetes burden, self-management, glycemic control, and blood lipid parameters explained 29% of the total variance in the spiritual well-being level. Accordingly, the present study recommended that health professionals should consider spiritual well-being to support disease management with a holistic approach to diabetes patients.

Theory-based nursing interventions in adults with coronary heart disease: A systematic review and meta-analysis of randomized controlled trials.

PURPOSE: This systematic review and meta-analysis aimed to synthesize the outcomes of theory-based nursing interventions for coronary heart disease management. DESIGN AND METHODS: Web of Science, Scopus, Science Direct, and PubMed databases were electronically searched from January 2013 to August 2021. The Preferred Reporting Item for Systematic Reviews and Meta-analyses statement guidelines was followed for this meta-analysis. Randomized controlled trials on patients with coronary heart disease, using a theory-based nursing intervention were eligible. Methodological quality was examined by two authors using the Modified Jadad Scale. Based on the heterogeneity test, the results were analyzed using a pool of data with 95% confidence intervals, p-values, and fixed or random-effect models (PROSPERO registration number X). FINDINGS: A total of 1030 studies were initially retrieved, and 8 randomized controlled trials were eventually included in the meta-analysis after screening. The big majority (81.3%) of participants were males, and the mean age was 54.8 (SD = 8.7) years. This meta-analysis found theory-based nursing interventions had no significant effect on blood lipid profile, blood pressure, and healthy lifestyle. However, these interventions significantly reduced fasting blood glucose, and body mass index and improved the physical and psychological domains of quality of life. CONCLUSIONS: The evidence from this meta-analysis reveals that theory-based nursing interventions have a positive effect on fasting blood glucose, body mass index, and quality of life. However, their effects on blood lipid profile, blood pressure, and a healthy lifestyle are inconclusive. The results of this metanalysis are largely based on a few trials and were limited in terms of the number of outcomes. Conducting well-designed randomized controlled trials with adequate power is needed to make a firm conclusion on the influence of theory-based nursing interventions on patient outcomes in the CHD population. CLINICAL RELEVANCE: Considering the high mortality and morbidity of coronary heart disease, nurses may play a significant role in coronary heart disease management by providing interventions that are based on a certain theoretical framework. This meta-analysis provides insights into the implementation of theory-based nursing interventions in heart attack survivors or those newly diagnosed with coronary heart disease led by nurses and lasting longer than 6 months in coronary heart disease. In addition, future studies should consider enhancing the content of training programs for a healthy lifestyle within the theory-based nursing interventions and compare the effects of these interventions on acute and chronic coronary syndromes.

Classical Massage and Relaxation Exercise on Symptom Status and Quality of Life in Advanced Stage Patients With Heart Failure: A Randomized Controlled Trial.

This randomized controlled study aimed to investigate the effects of classical massage (CM) and Benson relaxation exercise (BRE) on symptom status and quality of life (QoL) in patients with heart failure (HF). Seventy-two patients with HF were recruited from 4 hospitals in Ankara, Turkey. The study sample was allocated to a CM (n = 24), BRE (n = 26), or control group (n = 22) based on the New York Heart Association classification of HF (stages III and IV) through stratified randomization. The intervention groups received either CM or BRE twice daily for 7 days (total of 14 sessions). The control group received only routine care. The scores of symptom status decreased in the CM and BRE groups at the end of the intervention (first week) as compared with the control group (P < .05). Nevertheless, at the end of the monitoring period, no significant differences were detected between the 3 study groups at baseline (P = .474), week 1 (P = .936), and week 3 (P = .668) in terms of QoL scores. The CM and BRE showed beneficial effects in the management of HF symptoms in advanced stage HF patients who were hospitalized and received intensive treatment.

Effects of Aloe vera in adults with mucocutaneous problems: A systematic review and meta-analysis.

AIMS: To analyse the different types of Aloe vera (AV) effects on various mucocutaneous problems among adults. DESIGN: A systematic review and meta-analysis. DATA SOURCES: An exhaustive scanning of PubMed, Medline, ScienceDirect, and Google Scholar databases was conducted from January 2000-December 2019. REVIEW METHODS: Randomized controlled trials (RCTs) publishing reports on the effects of AV in various mucocutaneous problems, psoriasis, burn, wound-healing were included. The standardized mean differences (SMD) with 95% confidence Intervals (CIs) were determined for the main outcomes, heterogeneity was analysed using the I2 test and the risk of bias in the studies was reviewed by the Cochrane risk of bias assessment tool. RESULTS: The study included 23 trials with a total of 4,023 participants. Six trials were included in the meta-analysis. The results indicated no significant differences in pain scores as assessed by the Visual Analog Scale (VAS) (SMD = 0.11, 95% CI: -0.37 to 0.59). The Psoriasis Area Severity Index (PASI) scores were significantly lower following AV gel application in two of the studies (SMD = -1.32 95% CI: -1.86 to -0.78). Considering results in a systematic manner, AV accelerated tissue epithelialization and wound-healing process (N = 3), reduced oral mucositis (N = 3), and improved quality of life (N = 1). CONCLUSION: AV might have beneficial effects in reducing pain scores and the severity of mucocutaneous problems compared with placebo, especially with limited mild to moderate adverse effects. IMPACT: AV may be used as an alternative and integrative approach to reducing symptom severity in mucocutaneous problems and the wound-healing process. High quality and well-designed RCTs are still needed to elucidate the effects of AV in a variety of dosages and forms among adults with mucocutaneous problems.