"Just pee in the diaper" - a constructivist grounded theory study of moral distress enabling neglect in nursing homes.

BACKGROUND: A growing body of evidence shows that many nursing home residents' basic care needs are neglected, and residents do not receive qualitatively good care. This neglect challenges nursing staff´s professional and personal ideals and standards for care and may contribute to moral distress. The aim of this study was to investigate how nursing staff manage being a part of a neglectful work culture, based on the research question: "How do nursing home staff manage their moral distress related to neglectful care practices?" METHODS: A qualitative design was chosen, guided by Charmaz´s constructivist grounded theory. The study was based on 10 individual interviews and five focus group discussions (30 participants in total) with nursing home staff working in 17 different nursing homes in Norway. RESULTS: Nursing staff strive to manage their moral distress related to neglectful care practices in different ways: by favouring efficiency and tolerating neglect they adapt to and accept these care practices. By disengaging emotionally and retreating physically from care they avoid confronting morally distressing situations. These approaches may temporarily mitigate the moral distress of nursing staff, whilst also creating a staff-centred and self-protecting work culture enabling neglect in nursing homes. CONCLUSIONS: Our findings represent a shift from a resident-centred to a staff-centred work culture, whereby the nursing staff use self-protecting strategies to make their workday manageable and liveable. This strongly indicates a compromise in the quality of care that enables the continuation of neglectful care practices in Norwegian nursing homes. Finding ways of breaking a downward spiralling quality of care are thus a major concern following our findings.

Salud Mental en enfermeras al cuidado de pacientes en área COVID: estudio de caso / Saúde mental dos enfermeiros que prestam cuidados a doentes na área da COVID: um estudo de caso / Mental Health in nurses caring for patients in the COVID area: case study

La enfermería es la labor que abarca la atención autónoma apersonas de todas las edades, familias, grupos y comunidades,la principal característica y esencia es el cuidado, implicaestablecer una relación de comprensión y acompañamiento demanera integral, convirtiéndolos en los principales cuidadoresformales en la asistencia, lo que pone de manifiesto lanecesidad de mirar su salud mental y bienestar del personalde enfermería. El objetivo fue describir el impacto en la saludmental de un profesional de la enfermería en la atencióna pacientes del área COVID en tiempos de pandemia, enel periodo 2022-2023. Se realizó un estudio cualitativo,primero mediante el análisis documental y posteriormentemediante el método fenomenológico, descriptivo con baseen el estudio de caso, considerando la temporalidad en tresmomentos, antes, durante y después de la pandemia porCOVID. Los hallazgos dan constancia, de cambios e impactosa nivel biológico, psicológico, social y espiritual que derivanen afectaciones en salud mental que se experimentaron,y, por otro lado, de la escasez acciones para dotar a losprofesionales de la salud de un acompañamiento, capacitacióny sensibilización en salud mental para la mejora de su labory bienestar personal.(AU)

A enfermagem é o trabalho que engloba o cuidado autônomoa pessoas de todas as idades, famílias, grupos e comunidades,a principal caraterística e essência é o cuidado, envolveo estabelecimento de uma relação de compreensão eacompanhamento de forma integral, tornando-os osprincipais cuidadores formais no cuidado, o que destaca anecessidade de olhar para sua saúde mental e bem-estar daequipe de enfermagem. O objetivo foi descrever o impactona saúde mental de um profissional de enfermagem nocuidado de pacientes na área da COVID em tempos depandemia, no período de 2022-2023. Realizou-se um estudoqualitativo, primeiro por meio de análise documental edepois pelo método fenomenológico, descritivo baseadono estudo de caso, considerando a temporalidade em trêsmomentos, antes, durante e após a pandemia da COVID. Osachados evidenciam mudanças e impactos a nível biológico,psicológico, social e espiritual que conduzem às afetaçõesde saúde mental vivenciadas e, por outro lado, a escassezde ações de acompanhamento, formação e sensibilizaçãoem saúde mental para os profissionais de saúde, com vistaà melhoria do seu trabalho e bem-estar pessoal.(AU)

Nursing is the work that encompasses autonomous care topeople of all ages, families, groups and communities, themain characteristic and essence is care, it involves establishinga relationship of understanding and accompaniment in a comprehensive manner, making them the main formalcaregivers in assistance, which highlights the need to lookat their mental health and well-being of the nursing staff. Theobjective was to describe the impact on the mental health of anursing professional in the care of patients in the COVID areain times of pandemic, in the period 2022-2023. A qualitativestudy was conducted, first through documentary analysisand then through the phenomenological method, descriptivebased on the case study, considering the temporality in threemoments, before, during and after the COVID pandemic.The findings provide evidence of changes and impacts atthe biological, psychological, social and spiritual levels thatresult in mental health affectations that were experienced,and, on the other hand, of the scarcity of actions to providehealth professionals with accompaniment, training andsensitization in mental health to improve their work andpersonal wellbeing.(AU)

Staff Perceptions on the Effectiveness of GRiP-S, a New Approach to Clinical Supervision Incorporating Safewards: An Interpretive Phenomenological Analysis.

This study explored the impact of an innovative approach to clinical supervision for mental health nurses which integrates Safewards, named Group Reflective integrated Practice with Safewards - GRiP-S. Qualitative data was collected through 10 individual semi-structured interviews with nursing staff who had participated within the clinical supervision approach. Interviews provided insights into the nursing staff's perception and experience of the clinical supervision approach. Through interpretive phenomenological analysis six themes emerged (i) illuminating embodied practice of Safewards, (ii) building confidence through empowering connections, (iii) creating a culture of positive change, (iv) identifying internal motivation for and external barriers to supervision engagement, (v) navigating a global pandemic, and (vi) the transformative role of reflection. Findings demonstrated that the GRiP-S approach assisted mental health nurses' adoption of Safewards interventions in practice, while supporting the development of a cohesive staff team. The impact of COVID-19 within the study setting was addressed and nurses identified how the Safewards model assisted in navigating challenges during this time. Findings further supported prior research on the role of the supervisor and supervisee relationship. This study supports the integration of Safewards within reflective clinical supervision for mental health nursing staff to assist in Safewards fidelity and nursing staff personal and professional development.

Physical and psychological repercussions on Nursing workers' health in COVID-19 units: A mixed-methods research study. / Efectividad de las intervenciones contra la violencia laboral que sufren los profesionales de la salud y de apoyo: metanálisis.

OBJECTIVE: to analyze how Nursing workers in COVID-19 hospital units perceive the physical and psychological repercussions of work on their health, as well as to identify the factors associated with their perceptions. METHOD: a parallel-convergent mixedmethods study conducted with 359 Nursing workers from COVID-19 units in seven hospitals. For the collection of quantitative data, a questionnaire containing sociodemographic and labor variables and related to perceptions of physical and psychological repercussions were used, and for qualitative data, semi-structured interviews were used. For the analysis, inferential statistics and thematic content analysis were used. RESULTS: daytime workers, who had more than one employment contract and worked more than 41 hours/week perceived more moderate/intense physical repercussions, reporting overload and time off deficits. Nurses and CLT workers perceived psychological repercussions more moderately/intensely, mentioning managerial overload and job dissatisfaction. Women were 97% more likely to perceive physical repercussions and three times more likely to perceive psychological repercussions when compared to men, reporting household and family overloads. CONCLUSION: work and family overloads, intensified by the pandemic context, were associated with the intensity with which Nursing workers perceived physical and psychological repercussions.

Caring for COVID-19 patients: Nurses' perceptions of the most critical issues and their impact on their well-being and performance.

AIMS: (1) Exploring nurses' perceptions of issues that impacted the quality of patient care and their own performance on COVID-19 wards; (2) examining nurses' perceptions of how these issues impacted their psychological state and level of performance; and (3) presenting recommendations for improving healthcare policies. BACKGROUND: Nurses played a critical role in caring for hospitalized COVID-19 patients and managing the disease. METHODS: Semistructured interviews were conducted with 50 nurses (32 females), aged 31-58 years, 6-37 years' tenure, from eight hospitals across Israel. Prior to working in COVID-19 wards, they worked in internal medicine, emergency rooms, or intensive care units. Based on the COREQ checklist, these interviews were recorded and transcribed, and categorized into themes and subthemes. FINDINGS: The findings indicate that the unpreparedness of healthcare systems for the pandemic outbreak rendered nurses paying a high price at the personal and professional levels, which in turn may have impacted the levels of care that they provided. CONCLUSION: The rich, qualitative data source revealed important interactions between clinical, personal, social, and familial factors in determining distress levels and performance impairment. A nuanced understanding of the link between these stressors is key to developing and implementing policies that could mitigate deficiencies in the management of epidemics and pandemics in the future. IMPLICATIONS FOR NURSING AND HEALTH POLICIES: Changes should be made to government directives and healthcare policies, with an emphasis on increasing the nursing workforce, providing emotional support, ensuring availability of equipment and beds, optimizing work practices, developing transparent means of communication within teams, and clearly defining the areas of responsibility of nurses-in times of routine and crises.

Administrative burden in Swiss nursing homes and its association with care workers' outcomes-a multicenter cross-sectional study.

BACKGROUND: Care workers in nursing homes often perform tasks that are rather related to organizational or management activities than 'direct patient care'. 'Indirect care activities', such as documentation or other administrative tasks are often considered by care workers as a burden, as they increase overall workload and keep them away from caring for residents. So far, there is little investigation into what kind of administrative tasks are being performed in nursing homes, by which type of care workers, and to which extent, nor how administrative burden is associated with care workers' outcomes. PURPOSE: The objective of this study was to describe care workers' administrative burden in Swiss nursing homes and to explore the association with four care worker outcomes (i.e., job dissatisfaction, emotional exhaustion, intention to leave the current job and the profession). METHODS: This multicenter cross-sectional study used survey data from the Swiss Nursing Homes Human Resources Project 2018. It included a convenience sample of 118 nursing homes and 2'207 care workers (i.e., registered nurses, licensed practical nurses) from Switzerland's German- and French-speaking regions. Care workers completed questionnaires assessing the administrative tasks and burden, staffing and resource adequacy, leadership ability, implicit rationing of nursing care and care worker characteristics and outcomes. For the analysis, we applied generalized linear mixed models, including individual-level nurse survey data and data on unit and facility characteristics. RESULTS: Overall, 73.9% (n = 1'561) of care workers felt strongly or rather strongly burdened, with one third (36.6%, n = 787) reporting to spend 2 h or more during a "normal" day performing administrative tasks. Ratings for administrative burden ranged from 42.6% (n = 884; ordering supplies and managing stocks) to 75.3% (n = 1'621; filling out the resident's health record). One out of four care workers (25.5%, n = 561) intended to leave the profession, whereby care workers reporting higher administrative task burden (OR = 1.24; 95%CI: 1.02-1.50) were more likely to intend to leave the profession. CONCLUSION: This study provides first insights on care workers' administrative burden in nursing homes. By limiting care workers' burdensome administrative tasks and/or shifting such tasks from higher to lower educated care workers or administrative personnel when appropriate, nursing home managers could reduce care workers' workload and improve their job satisfaction and retention in the profession.

Qualitative evaluation of a brief positive psychological online intervention for nursing staff.

AIM: The aim of this study is to evaluate a brief positive psychological intervention with regard to the mental health of nursing staff in German hospitals. It addresses the question of how positive-psychological online exercises should be designed. BACKGROUND: Nurses in hospitals are known to suffer from mental strain and risk depressive as well as anxiety disorders. The covid-19-pandemic leads to a further aggravation of the situation. Opposed to that, positive psychological interventions can increase resilience by promoting self-management competences and mental strength. RESEARCH METHODS: A 90 min positive-psychological workshop was conducted with six nurses who worked in German hospitals. It consisted of imparting knowledge on positive psychology and learning different positive psychological practices. Afterwards, guideline-based interviews were conducted with six nurses. The outcomes of interest were how the intervention was evaluated, to what extent the intervention led to a reflection and a promotion of self-management competences and whether it allowed the participants to transfer the learnings into everyday life. RESULTS: The intervention led to a reflection of the application competence of positive-psychological techniques by the participating nurses. A promotion of the competences could not be reached. Especially the reflection and promotion of humour competence manifested itself as difficult. CONCLUSION: Despite its short-term nature, the online intervention resulted in a reflection of the nurses' application competence of positive psychology indicating its resource-promoting potential. Follow-up exercises or peer groups should be used for further development, while a training of humour competence might be part of a separate intervention.

Staff Training Interventions to Prevent or Reduce Behavioural and Psychological Symptoms of Dementia in Nursing Home Residents: A Mixed Methods Systematic Review.

INTRODUCTION: Nursing home (NH) staff mention knowledge deficits regarding the management of behavioural and psychological symptoms of dementia (BPSDs) in residents with neurocognitive disorders (NCDs). Staff training therefore appears to be necessary. However, existing evidence on best training practices and their outcomes remains scattered. This systematic review aimed to (1) identify the best clinical practices and theoretical bases of staff training interventions on BPSD management in NHs and (2) summarize the effects of these interventions on resident and staff outcomes. METHODS: A mixed methods systematic review was conducted. Two nurse researchers independently searched nine electronic databases to identify studies on the efficacy of staff training interventions aimed at BPSD management in NHs, on a variety of resident and staff outcomes. The search was conducted for articles published between 1996 and 2022, using selected keywords, MeSH terms, and predefined eligibility criteria. The methodological quality of the retrieved studies was assessed using JBI checklists. RESULTS: Overall, 39 studies in 47 articles were included. Ten categories of trainings were identified, of which three demonstrated the most promising results on both residents and staff: (1) structured protocols and models, (2) person-centred bathing, and (3) communication techniques. The methodological quality of the retrieved studies was generally weak. Issues with intervention feasibility and reproducibility were also noted. CONCLUSION: Training interventions incorporating structured protocols and models, person-centred bathing, and communication techniques are associated with better staff and resident outcomes. However, there is a strong need for high-quality research to strengthen existing evidence and ensure feasibility and reproducibility.

'Making the most of time during personal care': nursing home staff experiences of meaningful engagement with residents with advanced dementia.

OBJECTIVES: Dementia progressively affects cognitive functioning, including the ability to communicate. Those who struggle to communicate are often considered unable to relate to other people. Frontline care workers are in a position to connect with residents. However, we know little about their perspectives. The aim of this study was to understand how and when nursing home staff meaningfully engaged with residents with advanced dementia. METHODS: Semi-structured interviews, supplemented by informal conversations, were conducted with 21 staff from seven nursing homes. Inductive thematic analysis identified themes in the accounts. RESULTS: Four themes related to how staff engaged with residents with advanced dementia (initiating meaningful engagement, recognising subtle reactions, practising caring behaviours, patience and perseverance). Two themes related to when meaningful engagement occurred (lacking time to connect, making the most of time during personal care). CONCLUSION: A key barrier to implementing formal interventions to improve care is lack of staff time. Staff overcome this by using personal care time for meaningful engagement with residents. Their approach, developed through experience, is consonant with person-centred dementia care. Building on this, future research should use participatory approaches building on practice wisdom to further develop and evaluate meaningful engagement with residents with advanced dementia.

Safeguarding patients while implementing mechanical restraints: A qualitative study of nurses and ward staff's perceptions and assessment.

AIMS AND OBJECTIVES: To explore nurses' and ward staff's perceptions and assessments of patient care while implementing mechanical restraints. BACKGROUND: To prevent the risks associated with the use of restraints in psychiatry and ensure safe mental health care, it is necessary to know more about how the nursing staff experiences, comprehends and intervenes in managing patients subjected to coercive measures. DESIGN: This study employed a qualitative descriptive design, in accordance with the COREQ guidelines. METHODS: Semi-structured interviews were conducted with 18 nurses and ward staff aged between 22 and 45 years old, who had experience implementing mechanical restraints. Data were digitally audio-recorded and transcribed verbatim. Inductive thematic analysis was conducted using NVivo 12. RESULTS: The participants believed that mechanical restraints should be used as a last resort and that safeguarding patients during implementation is important; however, their assessments of the patients' physical and mental conditions varied. A clear difference emerged in how management qualified professionals handled situations prior to and during the implementation of mechanical coercive measures. CONCLUSIONS: The findings emphasise the need to focus on the assessment of patients prior to and during restraint, ensure the quality of safe implementation in a risk-of-harm situation, prioritise competence in education, and practice, and improve management. RELEVANCE TO CLINICAL PRACTICE: The findings highlight the importance of assessing the physical and mental condition of patients while implementing restraints, as well as aiding the management, nurses and ward staff in tailoring safety procedures.

Comparative cross-sectional study of knowledge, attitudes and perceptions among mental health and ward nursing staff towards smoking.

AIM: The aim of the study was twofold: to estimate smoking prevalence among nurses and to compare their knowledge, perceptions and attitudes towards smoking. BACKGROUND: Given the critical role nurses have in the process of patients' smoking cessation both as counsellors and behavioural models, data are needed on their smoking rates and behaviour. DESIGN: A cross sectional, comparative study was conducted. METHODS: A convenience sample of 847 nurses working in various psychiatric and public hospitals in Northern Greece participated in the study. Data were collected between April and June 2020 using a battery of questionnaires. RESULTS: Mental health nurses were less likely to consider quitting smoking within the next 6 months (P < 0.001), despite the fact that they reported higher levels of the importance of stop smoking compared to ward nurses (P < 0.05). However, ward nurses were more likely to quit smoking because of the cost of cigarettes (P = 0.024) and for personal reasons (P = 0.040). CONCLUSION: Prevalence of smoking in nurses is high. Training and educational programmes are needed to develop the appropriate culture of health promotion among nurses, thus provide a more active support to patients who smoke.

Feasibility of RESTORE: An online Acceptance and Commitment Therapy intervention to improve palliative care staff wellbeing.

BACKGROUND: Acceptance and Commitment Therapy is a form of Cognitive Behavioural Therapy which uses behavioural psychology, values, acceptance and mindfulness techniques to improve mental health and wellbeing. Acceptance and Commitment Therapy is efficacious in treating stress, anxiety and depression in a broad range of settings including occupational contexts where emotional labour is high. This approach could help palliative care staff to manage work-related stress and promote wellbeing. AIM: To develop, and feasibility test, an online Acceptance and Commitment Therapy intervention to improve wellbeing of palliative care staff. DESIGN: A single-arm feasibility trial of an 8-week Acceptance and Commitment Therapy based intervention for staff, consisting of three online facilitated group workshops and five online individual self-directed learning modules. Data was collected via online questionnaire at four time-points and online focus groups at follow-up. SETTING/PARTICIPANTS: Participants were recruited from Marie Curie hospice and nursing services in Scotland. RESULTS: Twenty five staff commenced and 23 completed the intervention (93%). Fifteen participated in focus groups. Twelve (48%) completed questionnaires at follow-up. Participants found the intervention enjoyable, informative and beneficial. There was preliminary evidence for improvements in psychological flexibility (Cohen's d = 0.7) and mental wellbeing (Cohen's d = 0.49) between baseline and follow-up, but minimal change in perceived stress, burnout or compassion satisfaction. CONCLUSION: Online Acceptance and Commitment Therapy for wellbeing is acceptable to palliative care staff and feasible to implement using Microsoft Teams in a palliative care setting. Incorporating ways to promote long-term maintenance of behaviour changes, and strategies to optimise data collection at follow-up are key considerations for future intervention refinement and evaluation.

Afrontamiento del estrés en personal de enfermería durante la Covid-19: adaptación psicométrica del Coping / Strategies Indicator – Short (CSI-S) Stress coping in Covid-19 and nursers: Psychometric adaptation of a short measure

Objetivo: Aportar con el primer estudio de adaptación del Coping Strategies Indicator – Short (CSI-S) para medir las estrategias de afrontamiento al estrés, en personal de enfermería que atienden de casos con Covid-19. Metodología: Fueron 79 enfermeras vinculados directa o indirectamente en la atención a casos con Covid-19. Las instrucciones de respuesta del CSI-S fueron modificadas para orientarlo al trabajo de las enfermeras en la atención de casos con Covid-19. Resultados: Se halló que dos de sus dimensiones fueron robustas (solución de problemas y búsqueda de apoyo), con confiabilidades adecuadas, mientras que la dimensión evitación fue estructuralmente débil, con confiabilidad baja. La correlación entre estas estrategias fue baja, indicando independencia conceptual; y la relación con medidas de síntomas de ansiedad y depresión fue teóricamente convergente. Conclusión: Excepto el puntaje de Evitación, las puntuaciones del CSI-S pueden ser apropiadas para la descripción de grupos, y para un primer acercamiento del estado de afrontamiento al estrés.(AU)

Objective: Contribute with the first adaptation study of the Coping Strategies Indicator - Short (CSI-S) to measure coping strategies for stress, in nurses who handle Covid-19 cases. Method: There were 79 nurses directly or indirectly involved in handling these cases. The CSI-S response instructions were modified to target the work of nurses in the care of cases with Covid-19. Results: Two of its dimensions (Problem Solving and Seeking Social Support) were found to be solid with adequate reliability. On the other hand, its Avoidance dimension was structurally weak with low reliability. The correlation between these strategies was low, indicating conceptual independence. Additionally, the relationship with measures of symptoms of anxiety and depression was theoretically convergent. Conclusions: Except Evitation score, the CSI-S scores may be appropriate for the description of groups, and for a first appraisal to the state of coping with stress.(AU)

Nursing Staff's Experiences of Caring for People with Mental Ill-Health in General Emergency Departments: A Qualitative Descriptive Study.

While people with mental ill-health report unsatisfying experiences and poor treatment in general emergency departments, nursing staff report a lack of adequate knowledge and training. This study describes nursing staff's experiences caring for people with mental ill-health in general emergency departments. A qualitative descriptive design was used and 14 interviews were subjected to qualitative content analysis. Results show that nursing staff are dealing with uncertainty and competing priorities when caring for people with mental ill-health. Nursing staff must both take and be given the opportunity to maintain and develop confidence and independence and need support in promoting mental health recovery.

How about an Educational Framework for Nursing Staff in Long-Term Care Facilities to Improve the Care of Behavioral and Psychological Symptoms of Dementia?

Behavioral and psychological symptoms of dementia (BPSD) are common in residents of long-term care facilities (LTCFs). In LTCFs, nursing staff, including nurses and care workers, play a crucial role in managing BPSD as those most in contact with the residents. However, it is ambiguous where their focus should be for effective BPSD care. Thus, this paper aims to reveal BPSD care competencies for nursing staff in LTCFs and to outline an initial frame of education. A multiphase mixed-methods approach, which was conducted through topic modeling, qualitative interviews, and a Delphi survey, was used. From the results, a preliminary educational framework for nursing staff with categories of BPSD care competence was outlined with the four categories of BPSD care competence: using knowledge for assessment and monitoring the status of residents, individualizing approaches on how to understand residents and address BPSD, building relationships for shared decision-making, and securing a safe environment for residents and staff in LTCFs. This preliminary framework illuminates specific domains that need to be developed for competent BPSD care in LTCFs that are centered on nursing staff who directly assess and monitor the changing and deteriorating state of residents in LTCFs.

Commitment, job satisfaction and personality: A cross sectional study of generational cohorts in nursing students.

BACKGROUND: The current domestic nursing workforce is the most generational diversity in history with a wide range of life experiences. PURPOSE: The purpose of this study was to investigate generational differences in organizational commitment, job satisfaction and personality traits in a sample of nursing students preparing for the workforce. METHODS: This cross-sectional study used data collected from pre-licensure final semester nursing students and degree completion students (n = 313) from three different schools about job satisfaction, personality traits and organizational commitment. RESULTS: Findings showed the scores between the generations were not significantly different for job satisfaction (p = 0.86) and organizational commitment (p = 0.40). Significant differences were found between the generations for the personality measures of agreeableness (p = 0.02), conscientiousness (p = 0.01), and emotional stability (p = 0.00). DISCUSSION/CONCLUSIONS: Understanding generational differences in nursing students entering the workforce can serve academia and practice partners to focus curriculum and resources appropriately to prepare the next generation of nurses for the challenges in a time of crisis.

Job Demands, Work Functioning and Mental Health in Dutch Nursing Home Staff during the COVID-19 Outbreak: A Cross-Sectional Multilevel Study.

COVID-19 posed enormous challenges for nursing home staff, which may have caused stress and mental health problems. This study aimed to measure the prevalence of mental health problems among nursing home staff and investigate the differences in job demands, work functioning and mental health between staff with and without COVID contact or COVID infection and across different levels of COVID worries. In this cross-sectional study, 1669 employees from 10 nursing home organizations filled in an online questionnaire between June and September 2020. The questionnaire measured the participants' characteristics, COVID contact, infection and worries, job demands, work functioning, depressive symptoms and burnout. Differences were investigated with multilevel models to account for clustering at the organization level. Of the participants, 19.1% had high levels of depressive symptoms and 22.2% burnout. Job demands, work functioning, depressive symptoms and burnout differed between participants who never worried and participants who often or always worried about the COVID crisis. Differences were smaller for participants with and without COVID contact or infection. Most models improved when clustering was accounted for. Nursing homes should be aware of the impact of COVID worries on job demands, work functioning and mental health, both at the individual and organizational level.

Working Conditions and the Components of Burnout Among Nursing Staff in a Public Hospital in Mexico City.

BACKGROUND: Working conditions in public hospitals in Mexico City are highly demanding. The need for healthcare is pressing, materials and instruments are scarce, and exposure to pain and suffering is constant. These adverse conditions have an adverse impact on the physical and mental health of healthcare professionals. The nursing staffs are among those who are most affected, and they frequently experience burnout syndrome or one of its several dimensions, including emotional exhaustion, depersonalization, and reduced personal accomplishment. PURPOSE: The aim of this research was to analyze the relationship among working conditions, related stress, and the dimensions of burnout syndrome in a tertiary care public hospital in Mexico City. METHODS: A cross-sectional design was applied on a random sample of 190 nurses in a public hospital in Mexico City. Working conditions and burnout syndrome were evaluated using standardized instruments. Adjusted prevalence ratios were calculated. Three clusters, one for each burnout dimension, were generated and then evaluated using a correspondence analysis with labor characteristics. RESULTS: One quarter (25%) of the participants self-reported a sense of personal accomplishment, and 12% reported emotional exhaustion and depersonalization. The labor variables that were found to be associated with the dimensions of burnout were workload, performing potentially hazardous work, and conducting tedious tasks. Positive conditions were shown to decrease the prevalence of burnout in all three dimensions. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Working conditions for nursing staff impact the mental health of nurses and affect the quality of the healthcare they provide. The set of work demands and stressors to which they are exposed should be controlled and modified to ensure a healthy work environment.

Staff experiences related to implementation of a recovery-oriented nursing programme in psychiatric inpatient care.

Nursing in psychiatric inpatient care is peripheral to a dominating biomedical model of care. Efforts are being made to implement nursing models based on core values and theories for nursing, such as recovery-oriented practices. The aim of the study was to explore experiences of a recovery-oriented nursing programme (Steps Towards Recovery, STR) among nursing staff in psychiatric inpatient care and their ratings of stress (Maslach Burnout Inventory scores), quality of care (Quality of Psychiatric Care - Inpatient staff scores) and satisfaction with nursing care (Satisfaction with Nursing Care and Work scale scores), before and after the implementation-and compare with ratings from reference wards. A quasi-experimental and prospective, pretest-post-test design was used. Specific questions about the nursing programme were answered by staff at the intervention wards. Staff reported predominantly positive experiences of the nursing programme. At follow-up, higher ratings were reported in two dimensions of quality of care in the STR group, and lower ratings in one dimension of stress were evident in the reference group. No differences in ratings between the STR and reference wards were found. Staff members' positive experiences of STR and higher ratings regarding participation and secure environment after implementation suggest that STR is a well-accepted and promising nursing programme. It is important to implement and evaluate recovery-oriented interventions in psychiatric inpatient care, where a focus on symptom relief still prevails. The results indicate that there is potential for further exploration of STR in this context.

Resilience Will Not Erase Structural Racism.

Acknowledging underlying inequities is crucial.