Article

Depression in Hospital-Employed Nurses

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Abstract

Depression impacts 9.4% of the adult population in the United States, and it is known to impact work performance. Nurses with depression are not only likely to suffer themselves, but their illness may have an impact on their coworkers and potentially the quality of care they provide. Thus, the purpose of this study was to determine the prevalence of depression in a random sample of hospital-employed nurses to determine individual and workplace characteristics that are associated with depression. A cross-sectional survey design of 1171 registered nurses was used. Measures included individual characteristics, workplace characteristics, work productivity, and depression (9-item Patient Health Questionnaire). Data analysis demonstrated a depressive symptom rate of 18%. The linear regression model accounted for 60.6% of the variation in the 9-item Patient Health Questionnaire depression scores. Body mass index, job satisfaction, number of health problems, mental well-being, and health-related productivity had significant relationships with depression (P < .05). Hospital-employed nurses have higher rates of depressive symptoms than national norms. Advanced practice nurses can assist with educating nurses on recognizing depression and confidential interventions, including the use of computerized cognitive-based therapy.

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... Tai Chi, Pilates, and yoga are beneficial activities for older individuals. Yoga, a form of exercise performed in a state of calmness and relaxation, helps strengthen muscles, nerves, and internal organs (Letvak et al. 2012;Masten, 2001;. People of all ages and physical conditions can participate in yoga, which can enhance attention, strength, muscular endurance, proprioception, balance, flexibility, and mobility. ...
... The SF-36 questionnaire (Letvak et al. 2012) is a widely used general questionnaire that has been implemented in over 50 countries, including Iran. Its validity and reliability have been extensively confirmed. ...
... Yoga movements, which primarily focus on stretching muscles, have been found to improve both muscle strength and flexibility. Numerous studies have shown that practicing yoga exercises effectively supports and enhances the proper functioning of the skeletal-muscular system (Hazrati et al. 2022;Herrick & Ainsworth, 2003;Seyyedrezaei et al. 2021;Letvak et al. 2012;Masten, 2001;. This includes improving joint flexibility, increasing spine mobility, enhancing muscle attributes, and strengthening the biomechanical connections among muscles, joints, glands, tissues, and vital organs. ...
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Background and Purpose: To enhance the independent living of the elderly community, especially women who are more prone to balance issues, it is crucial to investigate and diagnose the factors affecting their balance. Therefore, addressing this matter is of significant importance. As a result, this study seeks to examine the effects of yoga practice on the balance and quality of life of older individuals with Parkinson's disease. Methods: The study conducted was of a semi-experimental nature, with a statistical population of 48 elderly individuals diagnosed with Parkinson's disease. The participants underwent a 6-week training program, with sessions held three times a week for a duration of 60 minutes each. Data was collected using standard questionnaires. The collected data was analyzed using SPSS software version 26, employing a correlated t-test at a significance level of P<0.05. Results: The findings indicated a significant distinction between the experimental and control groups regarding statis balance (t=-9.67, P<0.001), dynamic balance (t=5.67, P<0.001) and quality of life (t=13.67, P<0.001) after intervention, where experimental group showed significantly higher scores than control group. Conclusions: Practicing Hatha Yoga exercises can have a positive impact on improving balance and overall quality of life for elderly individuals with Parkinson's disease. This suggests that incorporating concentration exercises like yoga into their routine could serve as a significant external factor in enhancing their quality of life.
... Prolonged activation of inflammation is detrimental to physical and mental well-being (19,20). In recent years, nurses' awareness of the importance of depression has increased because it can increase the risk of missed nursing care as well as threaten their own health (21)(22)(23). ...
... The prevalence of depression is about twice as high among nurses as the general population (22,24,25). Nurses experience greater work stress than other healthcare professionals (21) and are at an increased risk of depression owing to shift work (26) and exhaustion owing to consistently caring for patients (27). ...
... Higher scores indicated greater symptoms of depression. The PHQ-9 comprises five categories of depression severity: none-minimal [0-4], mild [5][6][7][8][9], moderate [10][11][12][13][14], moderately severe [15][16][17][18][19], and severe [20][21][22][23][24][25][26][27] (32). In our study, Cronbach's alpha for the PHQ-9 was 0.95. ...
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Background Depression has been associated with the risk of developing physical illnesses and diseases. Inflammatory hypotheses of immunoactive and dysregulated cytokine production have been proposed to describe this association; however, data pertaining to the high prevalence of depression among nurses are limited. Objective This study aimed to use a comprehensive immune-profiling approach to determine whether an abnormal profile of circulating cytokines could be identified in nurses with self-reported depression and whether this profile is associated with the severity of depression. Methods We investigated a cohort of 157 female nurses in Korea. The self-report Patient Health Questionnaire was used to measure the depression levels of nurses. In addition, peripheral blood samples were collected and used to measure the cytokine profile using the Luminex multiplexing system. Generalized gamma regression analyses were conducted to evaluate the association between cytokine and depressive symptoms. Results Regarding severity of depressive symptoms, 28.0% of nurses had moderately severe depression while 9.6% had severe depression. Moderately-severe depressive symptoms in nurses were associated with elevated levels of interleukin-6 (B = 0.460, p = 0.003), interleukin-8 (B = 0.273, p = 0.001), and interleukin-18 (B = 0.236, p = 0.023), whereas interferon-gamma levels (B = −0.585, p = 0.003) showed the opposite profile. Participants with severe depressive symptoms presented decreased interferon-gamma levels (B = −1.254, p < 0.001). Conclusion This study demonstrated that proinflammatory cytokines were associated with depression among nurses. This calls for early detection and intervention, considering the mechanisms linking depression to physical illness and disease.
... The availability of healthcare workers, hospital beds, intensive care units, and respirator resources were vital to be able to treat these patients, and the need was expected to increase in correlation with the increased number of COVID-19 cases, exceeding capacity [1]. To date, there have been over 757 million confirmed cases of COVID-19 worldwide, and more then 6.9 million confirmed deaths, according to the world health organization [2]. ...
... The workload and distress increased for healthcare workers during the COVID-19 pandemic, and the burden on healthcare workers can have a serious impact on healthcare workers' mental health and quality of life. Previous studies have shown that the ongoing stress that they faced may have had negative effects on their psychological well-being, and may have affected the quality of care for patients and the practices of healthcare workers [2,3]. In addition, the heavily burdened health system may have led to increased risks to patients' safety [4]. ...
... Extreme stress may lead to insomnia, fatigue, irritation, anxiety, and depression [6], and nurses regularly experience a variety of workrelated stressors such as long shifts, irregular schedules, lack of professional support and the added work necessary to meet the patients' needs. Depressive symptoms among nurses have been reported to be between 18% and 41%, respectively, in two studies [2,3], and for physicians approximately 28% [7]. ...
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The COVID-19 pandemic occurred in 2020, and affected people’s daily life worldwide at work and at home. Healthcare workers are a professional group with heavy workloads, and during the COVID-19 pandemic, their burden increased. The literature from earlier outbreaks describes risks for affected mental health in frontline workers, and the main aim of this study is to examine healthcare workers’ quality of life during the COVID-19 pandemic. In addition, we sought to assess if there was any difference in working at a pandemic ward compared to anon-pandemic ward. In this longitudinal and descriptive study, a total of 147 healthcare workers assessed their perceived health every third month over one year using the RAND-36 health survey. RAND-36 is a general instrument that consists of 36 questions and is widely used for assessing quality of life. The healthcare workers in this study showed reductions in perceived quality of life during the first six months of the COVID-19 pandemic. Healthcare workers on a pandemic ward reported a lower score in RAND-36 compared to healthcare workers on a non-pandemic ward. Registered nurses and licensed practical nurses seemed more negatively affected in their quality of life than physicians. Compared to data from the general Swedish population, healthcare workers in this study had less energy during this period.
... The rise in the number of individuals utilizing handheld digital devices and smartphones, particularly among those aged 10 to 20, has resulted in various complications (Letvak et al. 2012;Masten, 2001;). These include musculoskeletal issues, addiction to smartphones, damage to social relationships, isolation, anxiety, and depression. ...
... The assessment tool known as the Mobile Phone Addiction Form was utilized to assess the level of dependency among users (Letvak et al. 2012;Masten, 2001). This form consists of 133 questions and 16 scales, with 11 numbers representing the lowest level of agreement and 6 numbers representing the highest level of agreement for each question. ...
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Background and Purpose: Neglecting to identify and adhere to preventive measures and necessary treatments for musculoskeletal disorders is a significant factor in the manifestation of additional symptoms and future problems. Hence, this study was designed to examine the effects of physical activity and the use of digital devices on skeletal-muscular disorders among adolescents. Methods: The descriptive-correlational method was utilized in a cross-sectional study. The sample size was calculated to be 362 students (including 171 girls). Data was collected using standard questionnaires. T tests and structural equation modeling were used to analyze data. Results: The average BMI of the participants was 22.49, suggesting that the students fell within the nearly normal range of BMI. Results demonstrated a significant inverse relationship between physical activity and neck scores, shoulder scores, and upper back scores. Moreover, results demonstrated a significant direct relationship between use of digital devices and neck scores, shoulder scores, and upper back scores. Conclusions: The findings of this study indicate that the neck, shoulder, and back area are the most commonly affected regions by skeletal-muscular disorders in teenagers. Also, physical activity can help increase the participation rate of teenagers and yield more effective results. Additionally, utilizing different methods for assessing posture is also advised.
... Numerous research studies have demonstrated that Pilates exercises offer a suitable approach for training the mind and body, enhancing postural control through the strengthening of the neuromuscular system, and improving sensorimotor control of trunk and central body muscles (Letvak et al. 2012;Masten, 2001;. Additionally, these exercises have been found to enhance balance in elderly individuals (Afsanepurak et al. 2012;Sadeghipor & Aghdam, 2021a, 2021bTaso et al. 2014). ...
... Strengthening these muscles also helps maintain stability in the pelvis and vertebrae, preventing anterior pelvic tilt and increasing hip flexion range of motion within the pelvis. Ultimately, this aids in increasing stride length in older individuals (Letvak et al. 2012;Masten, 2001). ...
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Background and Purpose: There has been limited focus on the influence of Pilates exercises on balance in older individuals who have previously fallen. Hence, the aim of this study was to assess the effects of participating in a Pilates exercise regimen on both static and dynamic balance in elderly individuals with a history of falls. Methods: The study conducted was semi-experimental in nature, utilizing a pre-test and post-test design with both control and experimental groups. 73 old adults aged over 65 were randomly assigned to either the experimental (37 individuals) or control group (36 individuals). The Pilates regimen consisted of a structured routine lasting 21 minutes, comprising 11 minutes for warming up, 41 minutes for Pilates exercises, and 11 minutes for cooling down. This regimen was followed three times a week for a duration of eight weeks. Data was collected using standard questionnaires. T tests was used to analyze data. Results: The BMI of the participants was higher than normal (mean=29.67). The results showed a significant distinction between the experimental and control groups in static balance (t=10.27, P<0.001) and dynamic balance (t=12.07, P<0.001) after intervention, where Pilates group had significantly higher scores than control group. Conclusions: The research findings indicate a significant improvement in both static and dynamic balance among the participants in the Pilates group. Consequently, it is imperative to incorporate these exercises into the routine of elderly individuals with a history of falls.
... The promotion of sports engagement within society and the encouragement of individuals to partake in such activities can potentially yield favorable outcomes for the social aspects of that particular society. Moreover, it has the potential to instigate alterations in an individual's social conduct when interacting with society (Letvak et al. 2012;Masten, 2001;. However, it is important to note that the extent of these changes is contingent upon the cultural norms, shared values, and social disposition of the individuals within that society. ...
... Encouraging participation in sports activities not only generates vitality but also aligns their behavior, interests, and needs with valuable and defined objectives. Therefore, meticulous and comprehensive planning is essential to ensure physical activity, and the more detailed and precise the planning, the more sustainable the progress and reinforcement of motivation for sports participation will be (Letvak et al. 2012;Masten, 2001;. ...
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Background and Purpose: Despite the significance and crucial role that engaging in sports activities holds in shaping children's social behaviors, limited studies have explored the impact of sports participation on the adjustment and social performance of children diagnosed with ADHD. Therefore, the aim of this study was to explore the effects of participation in physical activity and exercise on social and adaptive performance among children with ADHD. Methods: The current study employed a descriptive-correlational method. A total of 147 children with ADHD (62 girls) between the ages of 7 and 12 were chosen as the study's statistical population using a convenience sampling method. Data was collected using standard questionnaires. T tests and structural equation modeling were used to analyze data. Results: Results reveled that physical activity significantly affected academic performance (T= 6.482), relationships with peers (T= 5.294), relationships with family (T= 4.628) and household tasks/self-care (T= 6.417). Results of model fit indicated that the research model has good fit. Conclusions: These findings hold practical implications for professionals and physical education teachers. Hence, it is recommended that practitioners and physical education teachers actively encourage children with ADHD to participate in physical activity and sports to enhance their social and adaptive performance.
... Secondly, exercise induces changes in the cortical striatum, a brain region responsible for controlling voluntary movements. These two neurological changes have a positive impact on various aspects of Parkinson's disease, including improved balance, reduced risk of falls, enhanced walking ability, increased cognitive function, decreased sleep disturbances, and overall improvement in quality of life (Letvak et al. 2012;Masten, 2001;. ...
... Studies conducted on mice have also demonstrated that physical activity can substantially increase the number of synapses in Purkinje neurons and blood vessels. The inherent cognitive demands of sports and the execution of complex sports tasks may serve as a rationale for the positive correlation between physical activity and cognitive functions, particularly the efficient performance of executive functions such as working memory, which is associated with neural activity in specific regions of the frontal lobes, including the dorsolateral prefrontal cortex and anterior cingulate cortex (Letvak et al. 2012;Masten, 2001;. These regions are comprised of various cortical and subcortical structures, such as the thalamus, putamen, and cerebellum. ...
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Background and Purpose: Given the significant challenges and limitations faced by elderly individuals with Parkinson's disease in terms of functional ability, coupled with the scarcity of research in this particular domain, the primary focus of this study is to investigate whether engaging in physical activity and sports can enhance functional memory and improve the quality of life for elderly individuals with Parkinson's disease. Methods: The present investigation utilized a descriptive-correlational approach. A total of 69 elderly individuals with Parkinson's disease (34 women) were selected as the statistical population for this study using a convenience sampling method. Data was collected using standard questionnaires. Independent t-test, Pearson correlation test and structural equation modeling were used for data analysis. Results: The average BMI for participants was 26.8, indicating overweight classification. BMIs varied from 16.3 (underweight) to 42.17 (obese). More than 60% of the participants in this study were either overweight or obese. Results reveled that physical activity significantly affected working memory (T= 4.394) and quality of life (T= 3.964). Results of model fit indicated that the research model has good fit. Conclusions: The findings of this study have confirmed the positive impact of physical activities on enhancing the functional readiness and overall quality of life for individuals with Parkinson's disease. This suggests that engaging in physical activities can significantly enhance daily performance, leading to increased self-confidence, independence, satisfaction, and overall quality of life for patients with Parkinson's disease.
... Among the methods of increasing innovation, one of the best methods is to create innovative work behavior and the life and success of organizations in the long term, depending on the employees. Innovative work behavior includes innovation and their innovative work behavior is exploring opportunities and generating new ideas, but it can also include behaviors aimed at implementing change, applying new knowledge, or improving processes to enhance personal or professional performance (Letvak, Ruhm, & Mccoy, 2012;Mikkelsen, et al. 2017;Newhan, et al. 2014;Ohler, et al. 2010). The contribution of employees in the development of organizational innovations refers to the work behavior of innovators, which includes all the work activities related to the development of innovation, which can ultimately lead to the improvement of employee performance as well as the overall performance of the company. ...
... The measurement of the innovative organizational climate questionnaire (Letvak, Ruhm, & Mccoy, 2012) consisted of 24 items. The respondents provided their answers using a five-point Likert scale, ranging from strongly disagree to strongly agree. ...
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Background and Aim: The purpose of this research was to investigate the impact of innovative organizational climate on the job performance of private sector employees, taking into account the mediating role of job motivation and self-efficacy. Methods: A descriptive-correlation approach was employed in the current investigation, utilizing structural equation modeling. The study consisted of 384 employees from the private sector, aged between 21 and 49 years (with a mean age of 35.11±8.17 years), who willingly participated. The research was conducted in Tehran, Iran, in the year 2023. The participants were selected through a convenience sampling method, adhering to the guidelines outlined by Krejci & Morgan. Standard questionnaires were used for data collection. Pearson correlation test and the structural equation modeling were used for data analysis. Results: Results reveled that innovative organizational climate significantly affected job performance (T=6.284). Moreover, innovative organizational climate significantly affected job motivation (T=11.594). Furthermore, innovative organizational climate significantly affected self�efficacy (T=9.509). In addition, job motivation has significantly mediated the relationship between innovative organizational climate and job performance (P<0.001). Finally, self-efficacy has significantly mediated the relationship between innovative organizational climate and job performance (P<0.001). Conclusion: Based on the findings of this research, it is recommended that market holders focus on promoting and enhancing the factors and components that contribute to the innovative organizational climate of private sector employees. Additionally, greater emphasis should be placed on job motivation and self-efficacy of the private sector employees.
... Depression is a significant psychological disorder that has garnered the attention of numerous researchers in the field of mental health. It has become one of the most prevalent mental illnesses affecting individuals worldwide (Letvak, Ruhm, & Mccoy, 2012;Mikkelsen, et al. 2017;Newhan, et al. 2014;Ohler, et al. 2010). Characterized by prolonged duration and specific symptoms, depression can severely impact an individual's functioning and overall well-being. ...
... The measurement of the participants' depression was conducted using the BDI-13 (Letvak, Ruhm, & Mccoy, 2012), which is a short 13-question Beck Depression Questionnaire. To make it more accessible for general use, Beck created a concise and straightforward self-assessment form. ...
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Background: It is crucial to prioritize the enhancement of teachers’ mental health within the education system. As a result, this study aims to examine the impact of a Pilates training course on the psychological and mental well-being of school teachers, encompassing aspects such as depression and self-esteem. Methods: The research was carried out using a semi-experimental approach. The study involved 60 elementary school teachers who were chosen through convenience sampling and then randomly and equally divided into two groups - experimental and control. Data was collected using standard questionnaires. T tests and ANCOVA were used to analyze data. Results: The results showed that there is no significant difference in both depression and self�esteem in the pretest (both P>0.05). However, it was observed that experimental group had significantly lower depression and higher self-esteem compared to control group in the posttest (both P=0.001). Finally, the results of ANCOVA showed significant differences between experimental and control groups in both depression and self-esteem (both P=0.001). Conclusions: These findings indicate that it is possible to recommend Pilates exercise and movement activities as a way to improve mental health, self-esteem, satisfaction with life, efficiency, positive mood and reduce mental and emotional tensions in school teachers.
... Essentially, resilience entails an individual's capacity to uphold a state of biological-psychological equilibrium amidst perilous situations. Moreover, resilience has been recognized as a safeguarding element in the realm of mental health and the facilitation of growth (Letvak, Ruhm, & Mccoy, 2012;Mikkelsen, et al. 2017;Newhan, et al. 2014;Ohler, et al. 2010). ...
... The assessment of depression was conducted using the Depression, Anxiety, Stress Scale-21 (DASS-21) (Letvak, Ruhm, & Mccoy, 2012). This specific subscale consists of seven items, with responses ranging from "did not apply to me at all" to "applied to me very much, or most of the time." ...
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Background: Identifying factors that can positively influence the mental health and resilience of healthcare workers is crucial. As such, this research aims to explore the impact of aerobic exercise on depression and resilience among healthcare workers. Methods: This study was conducted as an experiment, focusing on healthcare workers employed in hospitals in Tehran. A sample of 64 health care workers was selected using a convenience sampling method. These individuals were then randomly divided into two control groups (32 people each) and one experimental group (32 people). Data was collected using standard questionnaires. T tests and ANCOVA were used to analyze data. Results: The results showed that there is no significant difference in both depression and resilience in the pretest (both P>0.05). However, it was observed that experimental group had significantly lower depression and higher resilience compared to control group in the posttest (both P=0.001). Finally, the results of ANCOVA showed significant differences between experimental and control groups in both depression and resilience (both P=0.001). Conclusions: These results suggest that physical activity and sport can be considered as an important factor in coping with severe job-related conditions in healthcare workers. Therefore, by increasing physical activity and sport, better conditions can be created for healthcare workers to ensure their mental health.
... Cognitive behavioral therapy (CBT) is a form of psychotherapy that helps people learn how to identify and change destructive or disruptive thought patterns that negatively affect behavior and emotions (Herrick, et al. 2020). Cognitive behavioral therapy focuses on changing automatic negative thoughts that can lead to and worsen emotional problems, depression, and anxiety (Letvak, Ruhm, & Mccoy, 2012;Mikkelsen, et al. 2017;Newhan, et al. 2014;Ohler, et al. 2010). CBT is the most commonly utilized method to treat mental disorders such as anxiety and depression from children to older adults (Vasconcelos, et al. 2013;Sharma, 2014). ...
... The first part included six questions about demographic characteristics and the second part included the academic anxiety questionnaire for students. In this study, the standard School Anxiety Scale questionnaire (Letvak, Ruhm, & Mccoy, 2012) was used. This questionnaire contains 30 questions with yes and no answers, the maximum score of which is 30 and the minimum score is zero, and its scores are divided into mild (0 to 10), moderate (10 to 20) and severe (21 to 30). ...
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Background: Reports showed that a cognitive-behavioral therapy effectively helps patients overcome a wide variety of maladaptive behaviors such as anxiety. The aim of the present study was to further examine this issue by exploring the effects of a cognitive-behavioral therapy on academic anxiety of children with learning disorders. Methods: The quasi-experimental research design was pretest-posttest with a control group. The statistical population included 32 children (9-13 years) with academic anxiety (mild, moderate and severe) who were selected by convenience sampling method and randomly (using a coin-throwing method) assigned to two experimental and control groups. The standard School Anxiety Scale questionnaire was used to measure academic anxiety. The behavioral-cognitive therapy program was implemented for 12 sessions, 3 sessions of 45 minutes each week for the experimental group. After the intervention, all participants participated in posttest. Paired sample t test, independent t test, and analysis of covariance were used to analyze data. Results: The average of academic anxiety before the intervention in the experimental and control groups was 23.94±2.18 and 22.87±3.64, respectively, and the independent t-test did not show a significant difference (P=0.39). The average of the groups shows that the academic anxiety scores of the experimental group have decreased compared to the pre-test scores (t=16.58, P<0.001). Finally, the results of ANCOVA showed that a cognitive-behavioral therapy has led to a reduction in academic anxiety (P<0.001). Conclusion: Reconstructing children’s thoughts and beliefs helps them to identify their wrong thoughts about the exam and gradually replace them with correct beliefs and thoughts. Therefore, teachers and practitioners can use cognitive-behavioral therapy to help children with learning disorders to have less anxiety without feeling hurt from the negative evaluation of others.
... According to a report by the American National Institute of Health, operating room specialists rank 27 th out of 130 professions in seeking medical help for mental health issues. The stress factors in this line of work include personal reactions, personal concerns, work concerns, role fulfillment, and work concerns (Letvak, Ruhm, & Mccoy, 2012;Mikkelsen, et al. 2017;Newhan, et al. 2014;Ohler, et al. 2010). It is evident that the combination of these factors contributes to the high levels of stress experienced by operating room specialists. ...
... In this research, the revised occupational stress scale was used to measure occupational stress. The Revised Nursing Stress Scale is a revised version of the Occupational Stress Scale (Letvak, Ruhm, & Mccoy, 2012). Occupational stress scale is the first tool that was created to measure the stress of nurses and operating room experts instead of general occupational stress. ...
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Background: This research demonstrates that the practice of mindfulness training led to a notable decrease in occupational stress and an improvement in the overall quality of life for professionals working in operating rooms. Methods: The method of the present research was practical in nature and semi-experimental in the form of pretest-posttest with a control group. The statistical population of this research included all operating room experts in Tehran hospitals. 50 people from this community were selected by available sampling method and were randomly divided into two experimental (25 people) and control (25 people) groups. Data was collected using standard questionnaires. T tests and ANCOVA were used to analyze data. Results: The results showed that there is no significant difference in both occupational stress and quality of life in the pretest (both P>0.05). However, it was observed that experimental group had significantly lower occupational stress and higher quality of life compared to control group in the posttest (both P=0.001). Finally, the results of ANCOVA showed significant differences between experimental and control groups in both occupational stress and quality of life (both P=0.001). Conclusions: These findings indicate that mindfulness can play a crucial role in managing work�related stress among operating room experts. Consequently, by actively participating in mindfulness activities, it is plausible to create more favorable circumstances for professionals working in operating rooms in terms of their quality of life
... Nurses who work long daily and night shifts caring for patients with severe physical injuries are tasked with handling the care of dying patients, cardiorespiratory resuscitation, patients experiencing severe bleeding after surgery, and other high-stress situations that can lead to symptoms and physical ailments, eventually manifesting into psychological issues (Abdi et al., 2022;Afsanepurak et al., 2012;Dana & Shams, 2019;Dana et al., 2021). Nursing is a profession that exposes individuals to numerous mental health challenges, making nurses one of the most frequent groups to seek help from mental health professionals (Letvak et al., 2012;Mikkelsen et al., 2017;Newhan et al., 2014;Ohler et al., 2010). Furthermore, nurses tend to have poorer physical health compared to other sectors of society. ...
... The physical activity questionnaire: This questionnaire developed by Sharkey (Letvak et al., 2012) comprises four five-choice questions focusing on duration, intensity, number of sessions, and sports activity history. Responses are scored using a fivepoint Likert scale, with each qualitative value corresponding to a numerical value ranging from one to five. ...
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Objective: Despite numerous studies on the influence of regular engagement in physical activity and sports on mental health and quality of life across various demographics, there has been limited focus on its impact within the nursing profession. As a result, this study seeks to explore the effects of sports and physical activity participation on the mental health and quality of life of nurses. Methods: The current study utilized a descriptive correlational design and was conducted in a cross-sectional manner. The target population consisted of all nurses employed in the hospitals of Tehran. The research sample was selected using an available sampling method, specifically among nurses who expressed their willingness to participate in the study. A total of 384 male and female nurses took part in the research and successfully completed the provided questionnaires. Standard questionnaires were used for data collection. Pearson correlation test and the structural equation modeling were used for data analysis. Results: Results reveled that physical activity significantly affected depression (T= - 5.254), anxiety (T= - 6.471) and stress (T= - 4.527). In addition, physical activity significantly affected quality of life(T=3.627). Results of model fit are presented in Table 3 and indicated that the research model has good fit. Conclusion: This implies that nurses could greatly enhance their well�being through increased engagement in physical activity and a decrease in sedentary habits. As a result, we strongly urge healthcare policymakers to implement measures aimed at increasing physical activity levels among nurses.
... Depression often involves a loss of interest in activities that were once enjoyable, feelings of worthlessness or guilt, difficulty sleeping, changes in appetite, and decreased energy or motivation [2], and the high prevalence of depressive symptoms among nurses has become a global problem [3]. Previous studies found that the prevalence of depressive symptoms among American nurses was 18% [4], while that among Chinese nurses was significantly higher, 48.83% [5]. Depressive symptoms not only affect nurses' health and well-being, but also negatively impact work quality, for example, increased medical errors and reduced patient satisfaction [1]. ...
... Our results revealed that the prevalence of depressive symptoms among Chinese nurses was 45.9%, which was higher than the rate recorded among American nurses (18%) [4] and Japanese nurses (38%) [47]. An explanation for this phenomenon is the high workloads. ...
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Background The mechanisms underlying the relationship between workplace violence (WPV) and depressive symptoms in nurses have been less studied. This study aims to examine the mediating role of fear of future workplace violence (FFWV) and burnout in the association between WPV and depressive symptoms. Methods We conducted a cross-sectional web survey at 12 tertiary hospitals in Shandong province, China, in 2020. The Center for Epidemiologic Studies Depression Scale (CESD-10), the Chinese version of the Maslach Burnout Inventory-General Survey and the Fear of Future Violence at Work Scale were used to collect data. Descriptive statistics, independent sample t-test, one-way analysis of variance, Pearson’s correlation coefficient, and ordinary least squares regression with bootstrap resampling were used to analyze the data. Results The prevalence of depressive symptoms was 45.9% among nurses. The regression model showed that FFWV and burnout mediated the relationship between WPV and depressive symptoms. The total effects of WPV on depressive symptoms (3.109, 95% bootstrap CI:2.324 − 3.713) could be decomposed into direct (2.250, 95% bootstrap CI:1.583 − 2.917) and indirect effects (0.769, 95% bootstrap CI:0.543 − 1.012). Indirect effects mediated by FFWV and burnout were 0.203 (95% bootstrap CI:0.090 − 0.348) and 0.443 (95% bootstrap CI:0.262 − 0.642), respectively. Furthermore, serial multiple mediation analyses indicated that the indirect effect mediated by FFWV and burnout in a sequential manner was 0.123 (95% bootstrap CI:0.070 − 0.189). Conclusion The prevalence of depressive symptoms among Chinese nurses was high. The WPV was an important risk factor for depressive symptoms and its negative effect was mediated by FFWV and burnout. The importance of decreasing WPV exposure and level of FFWV and burnout was emphasized to prevent depressive symptoms among nurses. The findings implied that hospital managers and health policy makers should not only develop targeted interventions to reduce exposure to WPV in daily work among all nurses, but also provide psychological support to nurses with WPV experience to reduce FFWV and burnout.
... 16 Nurses regularly experience a variety of work-related stressors, including long hours, time constraints, meeting patient needs, irregular schedules, and a lack of professional support. [17][18][19][20] These demanding job conditions can profoundly affect the mental health and overall quality of life of healthcare professionals. [21][22][23] Previous research has shown that the constant stress these professionals experience can have a negative impact on their psychological well-being. ...
... 31 The dependent variable of this study is the stress level measured by the PSS 10 (Perceived Stress Scale) questionnaire. There are 10 questions with mild category values(1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14), moderate(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26), and severe (> 26).32 ...
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High mental workload implies significant mental resources and can lead to increased cognitive stress and fatigue. Nurses have the responsibility of managing a wide range of nursing care tasks, which frequently involve addressing anxiety, handling patient complaints, and managing patient defense mechanisms, all of which can lead to increased stress levels. This study aimed to identify the relationship between mental workload and the stress level of nurses in the Hospital Malang City. The research utilized a cross-sectional study design. The sampling technique employed was Total Sampling, involving 96 inpatient nurses at the hospital. Data collection involved the use of two questionnaires: the National Aeronautics and Space Administration Task Load Index (NASA-TLX) and the Perceived Stress Scale (PSS-10). Data analysis in this study was conducted using Pearson Correlation. The results indicated a positive relationship between mental workload and nurses' stress levels, supported by a significant p-value of 0.002 and a correlation coefficient of 0.312. A high mental workload can impact the level of job-related stress experienced by nurses. Effective stress management skills can help individuals mitigate this impact.
... The nursing profession is characterized by significant stress, demands and challenges, with job-related stress being closely associated with elevated rates of depression. Studies indicate that nurses encounter depressive symptoms at a rate double that of individuals in various other occupations [10,11]. The demanding nature of their work, long hours, frequent exposure to emotionally challenging situations, and making critical decisions under pressure can contribute to elevated stress levels and burnout in nurses [12,13]. ...
... In another study analyzing the depression scores of nurses working in hospitals, univariable regression analysis showed that nurses who were more satisfied with their jobs had lower depression scores. 20 Similarly, job satisfaction was associated with lower anxiety scores in our study. Although attempts have been made to identify the possible causes of work-related anxiety, few studies have investigated which type of anxiety is associated with work-related anxiety. ...
Article
Objective The present study evaluated the work-related anxiety scores of healthcare workers in emergency departments (ED) and aimed to determine the factors affecting these scores.Methods The data was obtained through a survey administered to the emergency staff. Beck’s Anxiety Inventory (BAI) and the Mini-International Neuropsychiatric Interview (MINI) work anxiety interview were used to predict and determine the type of anxiety experienced by the participants. The survey was administered to 147 volunteers, and questionnaires from 130 participants were included in the study.Results It was found that 43.8% of the participants had a BAI score greater than 7. The study results showed a negative correlation and a linear regression model between age and the BAI score. Additionally, the BAI score was significantly higher in female, singles, physicians, those who were dissatisfied with their jobs, and those who were dissatisfied with their salaries (p<0.05). The results also showed that having a history of anxiety disorder or depression, being a physician, and being dissatisfied with one’s job were 6.277, 5.583, and 4.005 times higher, respectively, in terms of suspicion of anxiety (p<0.001). In the MINI job anxiety interview, work-related posttraumatic stress disorder (38.6%) was predicted most frequently, and indiscriminative work-related social phobia (5.3%) was predicted least frequently in participants at risk for anxiety according to the BAI score.Conclusion This study suggests that teaching healthcare workers how to cope with workplace trauma and workplace-related situational phobias can be an effective solution to prevent anxiety disorders in healthcare workers working in ED.
... The researchers emphasize that depressive symptoms were already present among health professionals, particularly nurses, before the pandemic, but these symptoms increased significantly during the pandemic (Cheung & Yip, 2015;Côté et al., 2022;Letvak et al., 2012;Nourry et al., 2014). ...
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Introduction: After the emergence of the first COVID-19 case, the mental health of nurses was significantly impacted. Aim: To investigate the levels of anxiety, depression, and resilience among pediatric nurses. Methods: A cross-sectional descriptive study was conducted over a five-month period in one private and two public pediatric hospitals in Greece, involving a sample of 158 pediatric nurses. The data collection tool included sections for demographic and work-related information, as well as the Hospital Anxiety and Depression Scale (HADS), and the Connor-Davidson Resilience Scale (CD-RISC). Results: More than half of the participants reported normal levels of depression and anxiety. However, around one in five presented borderline abnormal levels of depression (22.2%) and anxiety (21.5%). The total score on the Connor-Davidson Resilience Scale was 67.8. Women scored significantly higher than men in both depression and anxiety, but lower in resilience. Significant differences in depression, anxiety, and resilience were also found based on various demographic and work-related characteristics. Multiple linear regression analyses revealed a significant negative association between certain CD-RISC subscales and both Depression (R = 0.562, R² = 0.316, Adjusted R² = 0.294) and Anxiety (R = 0.608, R² = 0.370, Adjusted R² = 0.349). Discussion: Approximately 20% of pediatric nurses experienced borderline abnormal levels of depression and anxiety during the COVID-19 pandemic in Greece. These percentages are lower than those reported in studies involving other nursing populations. Future research is recommended to further investigate the demographic and work-related characteristics that significantly influence pediatric nurses' anxiety and depression levels.
... Risk factors, such as burnout, in this sense are many, although represented in the literature often neglected in local and territorial realities. These risks Submitted July 2023, accepted July 2024 a high incidence of anxiety and depression (Letvak et al., 2012), Burnout syndrome or Secondary Traumatic Stress (STS) are capable of compromising the ability of the clinician to practice effectively (Conversano et al., 2020;Di Giuseppe et al., 2019;Gangemi et al., 2021;Gori et al., 2021;Merlo et al., 2020aMerlo et al., , 2021bRahnea-Nita et al., 2021;Shanafelt et al., 2002;Tarcan et al., 2017;Urban & Urban, 2020). ...
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Objective Euthymia is a transdiagnostic construct characterized by the presence of positive mood states, psychological flexibility and resilience. These components contribute to psychological wellbeing and support mental functioning. Exposure to suffering and high levels of stress can lead to the onset of burnout and secondary traumatic stress, but also lack of compassion satisfaction. The study aimed to test the existing relationships between euthymia, psychological well-being, and factors associated with quality of life of healthy participants involved in medical settings. Method The sample was composed of 177 healthy participants involved in medical settings, 118 women (66.7%) and 59 men (33.3%) aged between 19 and 69 years old (mean = 27.16; SD = 8.47). Standardized psychodiagnostics instruments were used to assess euthymia (Euthymia Scale-ES), psychological well-being (The Well-Being Index scale-WHO-5) and the quality of life of the involved participants (Professional Quality of Life Measure-ProQOL-5). Results The results showed that gender, well-being and psychological well-being were predictors of compassion satisfaction and secondary traumatic stress. Specifically, female gender predicted higher levels of compassion satisfaction. Well-being and psychological flexibility predicted higher levels of compassion satisfaction and lower secondary traumatic stress. Psychological well-being predicted higher levels of compassion satisfaction. Conclusions Promoting euthymia and well-being helps individuals to preserve psychological well-being and increase tolerance to stressful life situations. Results highlighted the need for promoting health care professionals’ euthymia and well-being. In line with evidence, encouraging interventions based on evidence appears relevant.
... The prevalence of depression, a common mental health disorder, is significant globally, affecting 14.6% of individuals in affluent countries and 11.1% in developing nations, with predictions suggesting it will become the second leading cause of disability by 2020. Among nurses, previous studies have reported varying prevalence rates of depressive symptoms, influenced by factors such as national healthcare systems, social and cultural variables, and individual personalities (4). ...
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Background: Nursing is a demanding profession that significantly impacts the mental and financial well-being of staff, particularly female nurses who face unique challenges balancing professional and personal responsibilities.Objective: To evaluate psychological and financial issues among female staff nurses working in government medical colleges (GMC) and private medical colleges (PMC) in Lahore.Methods: This observational descriptive study was conducted from October 12, 2023, to April 25, 2024, at the University of Lahore Teaching Hospital. A total of 130 female staff nurses were randomly selected from government and private medical colleges. Data on psychological issues (anxiety, stress, depression) and financial difficulties were collected through structured questionnaires validated by experts. The analysis was performed using SPSS version 25, employing descriptive and inferential statistics to explore relationships between socio-demographic characteristics and the reported issues.Results: In government medical colleges, 43.1% of nurses experienced anxiety, 47.7% experienced stress, and 18.5% experienced depression. In private medical colleges, the rates were 66.2%, 76.9%, and 30.8%, respectively. Financial difficulties were reported by 32.3% of nurses in government and 38.5% in private colleges.Conclusion: Psychological issues, particularly anxiety and stress, are more prevalent among nurses in private medical colleges. Targeted interventions are needed to address these challenges.
... Various studies suggest that genetic abnormalities, combined with environmental factors, play a role in the development of Parkinson's disease. Current treatment approaches aim to enhance the quality of life for patients through different methods, with exercise and physical activity playing a crucial role (Letvak et al. 2012;Masten, 2001;. While there is no definitive cure for Parkinson's disease, a combination of medication and complementary therapies, such as exercise, can lead to promising outcomes. ...
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Background and Purpose: As individuals grow older, they become more susceptible to psychological and cognitive challenges. Therefore, it is crucial to identify factors that can help alleviate these problems. The purpose of this study was to investigate the relationship between engaging in physical activity and sports and the mental health and resilience of elderly individuals with Parkinson's disease. Methods: The current investigation employed a descriptive-correlational approach. A total of 73 elderly individuals with Parkinson's disease (35 women) were chosen as the statistical population for this study using a convenience sampling method. Data was collected using standard questionnaires. T tests and structural equation modeling were used to analyze data. Results: the results of this study showed that participants exhibit low levels of physical activity, and moderate to low levels of mental health and resilience. Table 1 presents the mean and standard deviation of descriptive results across gender, where males were more physically active than females (P=0.001). Results reveled that physical activity significantly affected mental health (T= 7.674) and resilience (T= 5.697). Results of model fit indicated that the research model has good fit. Conclusions: It has been extensively documented that engaging in exercise or physical activity plays a crucial role in the healthcare of individuals suffering from Parkinson's disease. The advantages are numerous, with physical activity being proven to boost the physical, emotional, and social well-being of those dealing with this condition.
... Various studies suggest that genetic abnormalities, combined with environmental factors, play a role in the development of Parkinson's disease. Current treatment approaches aim to enhance the quality of life for patients through different methods, with exercise and physical activity playing a crucial role (Letvak et al. 2012;Masten, 2001;. While there is no definitive cure for Parkinson's disease, a combination of medication and complementary therapies, such as exercise, can lead to promising outcomes. ...
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Background and Purpose: As individuals grow older, they become more susceptible to psychological and cognitive challenges. Therefore, it is crucial to identify factors that can help alleviate these problems. The purpose of this study was to investigate the relationship between engaging in physical activity and sports and the mental health and resilience of elderly individuals with Parkinson's disease. Methods: The current investigation employed a descriptive-correlational approach. A total of 73 elderly individuals with Parkinson's disease (35 women) were chosen as the statistical population for this study using a convenience sampling method. Data was collected using standard questionnaires. T tests and structural equation modeling were used to analyze data. Results: the results of this study showed that participants exhibit low levels of physical activity, and moderate to low levels of mental health and resilience. Table 1 presents the mean and standard deviation of descriptive results across gender, where males were more physically active than females (P=0.001). Results reveled that physical activity significantly affected mental health (T= 7.674) and resilience (T= 5.697). Results of model fit indicated that the research model has good fit. Conclusions: It has been extensively documented that engaging in exercise or physical activity plays a crucial role in the healthcare of individuals suffering from Parkinson's disease. The advantages are numerous, with physical activity being proven to boost the physical, emotional, and social well-being of those dealing with this condition.
... Our study attempted to explore the mediating influence of basic psychological needs satisfaction with this link. Secondly, some studies have suggested that the prevalence of depression among nurses is higher than the prevalence in the general population (Drury et al., 2014;Holden, 2000;Letvak et al., 2012). Therefore, we chose nurses as subjects to explore the impact of nurses' basic psychological need satisfaction on the link of gratitude with depressive symptoms and hoped that the findings would provide strategies to alleviate depressive symptoms in nurses. ...
Article
Background A common psychological problem among nurses is depression, potentially affecting their well‐being and job performance. It is vital to explore how to alleviate nurses' depressive symptoms. Aim The current research explored the mediating impact of basic psychological needs satisfaction on the link of gratitude with depressive symptoms. Methods The nurses in this study were from mainland China. A total of 724 subjects completed an online questionnaire, which included measures of depressive symptoms, basic psychological needs satisfaction and gratitude. Results Our research found that gratitude was negatively linked to depressive symptoms. Furthermore, basic psychological needs satisfaction had a partial mediation effect on the link of gratitude with depressive symptoms after controlling for five demographic variables. These results suggest that gratitude may influence depressive symptoms via basic psychological needs satisfaction. Linking Evidence to Action Our study found that basic psychological need satisfaction partially mediates the gratitude‐depression relationship in nurses. The result means that hospital administrators and nurse leaders should design gratitude interventions to alleviate nurses' depressive symptoms. They also help nurses decrease depressive symptoms by creating an environment that meets their basic psychological needs.
... (2) The prevalence of depression by using the PHQ-9 questionnaire is equal to 17.3%. Compared to previous studies, the study of Letvak S, et al. (11) is close to the results of this study. The study conducted in the United States by the PHQ9 questionnaire, found that the prevalence of depression is 18.0 %. ...
... Age has consistently been reported as a significant contributor to depression in nurses, with depression being more likely in younger nurses [23]. It is quite plausible that younger nurses, with less work experience, would be more vulnerable to depressive symptoms due to work environment factors such as jobrelated stress or role overload [31]. ...
Article
Purpose: This study aimed to compare missed nursing care between nurses with and without depressive symptoms. Methods: A cross-sectional survey was conducted with shift-working nurses at a general hospital in South Korea. Data from 184 nurses were analyzed using the independent t-test, the x 2 test and the Fisher’s exact test. Results: The most frequently missed nursing care items reported by hospital nurses were, in descending order, monitoring intake/output, assessing the effectiveness of medications, bathing and skin care, washing hands. The order of missed nursing care items was similar between groups with and without depressive symptoms, but there were statistically significant differences between the two groups in the mean scores for vital signs, bedside glucose monitoring, turning patients every 2 hours, providing emotional support to patients, skin/wound care, patient discharge planning, response to the call light, and pro re nata (PRN) medication requests acted on. Conclusion: Nurses’ mental health needs to be monitored and managed more closely, as it is correlated to missed nursing care. Health institutions and nursing departments should support nurses through strategies that can quickly detect and manage nurses’ depressive symptoms. Systematic resources incorporating social support among nurse colleagues could also be used as strategies to reduce depressive symptoms and missed nursing care.
... All the participants had the same cultural background. Nurses with depression or malignant disease may not only suffer, but their illness may affect their colleagues, as well as the quality of care they provide [26,27]. Therefore, these nurses were excluded from this study. ...
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The rise in the number of hemodialysis (HD) patients underscores the importance of culturally competent HD nurses. This study aimed to examine the effectiveness of a situated simulation program on HD nurses’ cultural competence. This was a quasi-experimental pilot study with a total of 40 participants who met the inclusion criteria from an HD center in northern Taiwan. Participants took part in two separate 3 h education programs. The first program focused on the basic concepts of cultural competence, while the second program involved situated simulations utilizing the Gather–Analyze–Summarize (GAS) method of debriefing. The generalized estimating equations (GEEs) were employed to estimate the intervention effect. The baseline scores were divided into low-score and high-score groups using the median score for subgroup analysis. The subgroup analysis revealed that a significant group-time interaction was identified regarding cultural competence and subscale, verifying the situated simulation’s immediate effect. In this study, an integration of the GAS method of debriefing and situated simulation teaching was implemented. The results showed that this approach empowered HD nurses with the ability to foster positive attitudes and demonstrate professional expertise in an organized manner when facing similar clinical scenarios in the future.
... Their contribution to the prevention and protection of individual and community health is of great importance (Ghods et al., 2017). However, heavy workloads, unstable schedules, and a lack of support and recognition can lead them to present certain psychological disorders (Gong et al., 2014;Letvak et al., 2012). ...
... The estimated prevalence of depression among resident doctors in a systematic review published in 2015 was 28.8%, ranging from 20.9 to 43.2%, depending on the assessment tools used (16). Many studies have reported that the prevalence of depression among nurses ranges from 18 to 64.8% (17)(18)(19)(20)(21), and some studies have suggested that the prevalence of depression among nurses is nearly twice that among other professional individuals (22). The prevalence of depressive symptoms among Chinese nurses between 1996 and 2019 was approximately 43.8% (23). ...
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Objective This cross-sectional survey aimed to investigate the prevalence of depression among medical staff and its risk factors as well as the association between depression, anxiety, headache, and sleep disorders. Methods Stratified random cluster sampling was used to select medical staff from various departments of four hospitals in Sanya City. The Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and Pittsburgh Sleep Quality Index (PSQI) were used to quantitatively assess depression, anxiety, and sleep disorders. Correlation and regression analyses were performed to determine factors affecting the depression occurrence and scores. Results Among 645 medical staff members, 548 (85%) responded. The 1-year prevalence of depression was 42.7% and the prevalence of depression combined with anxiety, headache, and sleep disorders was 23, 27, and 34.5%, respectively. The prevalence of depression in women, nurses, the unmarried or single group, and the rotating-shift population was significantly higher than that in men (48.3% vs. 27.1%, odds ratio OR = 2.512), doctors (55.2% vs. 26.7%, OR = 3.388), the married group (50.5% vs. 35.8%, OR = 1.900), and the day-shift population (35.2% vs. 7.5%, OR = 1.719). The occurrence of depression was correlated with anxiety, sleep disorders, headache, and migraines, with anxiety having the highest correlation (Spearman’s Rho = 0.531). The SDS was significantly correlated with the SAS and PSQI (Spearman’s Rho = 0.801, 0.503) and was also related to the presence of headache and migraine (Spearman Rho = 0.228, 0.159). Multiple logistic regression indicated that nurse occupation and anxiety were risk factors for depression, while grades of anxiety, sleep disorders and nurse occupation were risk factors for the degree of depression in multiple linear regression. Conclusion The prevalence of depression among medical staff was higher than that in the general population, especially among women, nurses, unmarried people, and rotating-shift workers. Depression is associated with anxiety, sleep disorders, headache, and migraines. Anxiety and nursing occupation are risk factors for depression. This study provides a reference for the promotion of occupational health among medical professionals.
... 1 The rate at which the nurse population reports symptoms of depression is double that of the general population. 2 In the Kingdom of Saudi Arabia (Saudi Arabia), a recent spate of violent assaults on medical personnel has drawn global attention. 3 A survey of 738 Saudi nurses found that 11.1% and 32.9% experienced physical and nonphysical violent incidents, respectively. ...
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Purpose Poor sleep and depressive symptoms are two negative effects of night shift work on physical and mental health. This study evaluated the correlation between sleep quality and depression symptoms among nurses in Saudi Arabia. Specifically, we assessed depressive symptoms and sleep quality observed among nurses who worked night shifts and compared the outcomes with those who worked exclusively day shifts in hospital settings. Patients and Methods A total of 191 participants (55.5% men, 44.5% women) participated. The response rate was 63.6%. The hospital anxiety and depression scale (HADS) and Pittsburgh Sleep Quality Index (PSQI) were used to assess depression score and sleep quality, respectively. Results Nurses who worked night shifts had substantially higher PSQI ratings (p<0.05) than those who worked day shifts. In addition, there was a clear relationship between the HADS and PSQI scores. According to the binary logistic regression, longer working hours and inadequate sleep were both independently linked to depressive symptoms among nurses. Conclusion Poor sleep quality brought on by night shifts may explain why Saudi nurses who work night shifts experience higher rates of depression than those who work day shifts only.
... Work-related stressors that frequently affect Faculty include but are not limited to: work hours that are too long, limited time, meeting the needs of patients and student, inconsistent schedules, and a lack of professional support 2,5,6,7 The ongoing strain experienced by healthcare professionals may have a significant impact on their mental health and quality of life due to their demanding occupations. 8,9 Studies conducted in the past 10,11 have demonstrated that the ongoing stress experienced by these professionals can have a negative impact on their psychological health. ...
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Objective: To assess depression level in work force of a Teaching hospital. Study Design: Experimental study. Setting: Al-Tibri Medical College and Hospital. Period: June 2021 to August 2021. Material & Methods: Total 250 faculty members of 7 different medical colleges and teaching hospital across the Sindh, Pakistan participates in the survey from 7 different medical colleges. Survey was conducted thorough online google form. Data was statistically analyzed by SPSS and Chi-square was performed to analyze the relationship between the professional environment and mental health. Results: It was observed that the 10% clinical faculty members and only 1% basic science faculty were statistically significant at p level p<0.005 and p<0.001 respectively. While other demographic factors were also found to be statistically significant at p<0.001. Conclusion: The results revealed the clinical faculty is at higher risk mental health issues then the faculty of the basic sciences. Since the clinical environment is to relate to the public dealing and handling or listening the traumatic cases on regular basis which might affect the mental health of the working personnel.
... In the context of the new health care reform, nursing staff are most likely to experience severe perceived stress, anxiety, and depressive symptoms [4] and are significantly more likely than the general population [5]. Mental health, job satisfaction, health-related productivity and patient safety among nurses may be negatively impacted by depression [6,7]. A recent qualitative study conducted in a tertiary care hospital found that nurses still held positive attitudes towards maintaining motivation at work [8]. ...
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Background Nurses in tertiary hospitals are at high risk for depression. Understanding sleep quality and perceived stress may contribute to nurses’ mental health and health-related nursing productivity. The aim of this study was to investigate the role of sleep quality and perceived stress on depressive symptoms among nurses in tertiary hospitals. Methods A total of 2,780 nurses (overall response rate = 91.1%) were recruited through a cross-sectional survey in 23 tertiary hospitals in China. Questionnaires included the Self-Rating Depression Scale, the Pittsburgh Sleep Quality Index, and the Chinese Perceived Stress Scale. Variables that were significant in Chi-square tests were further entered into binary logistic stepwise regression. Results The prevalence of depressive symptoms was 60.3% (n = 1,676), of which 97.4% (n = 1,633) were female, and 77.8% were younger than 35 years (n = 1,304). Nurses who had moderate, poor, severe sleep quality and poor perceived pressure were more likely to be depressed. Master’s degree, 6–10 years of work, and physical activity were protective factors, while the opposite was the case for shift work and high dissatisfaction. Conclusions More than half of nurses working in tertiary care hospitals reported depressive symptoms, and lower sleep quality and higher perceived stress were more associated with this. Perceived stress is an interesting concept, which may provide a new entry point for the well-known idea that there is a relationship between poor sleep quality and depression. It is possible to reduce depressive symptoms among public hospital nurses by providing information on sleep health and stress relief.
... Psychological distress and burnout symptoms are common among nurses (1)(2)(3). Before the beginning of the coronavirus disease (COVID- 19) pandemic, observational studies estimated the rate of burnout in nurses to be as high as 50%, and nurses reported insomnia, depressive symptoms, and anxiety at significantly higher rates than the general public (4)(5)(6)(7)(8). During the COVID-19 pandemic, emotional distress and burnout in nurses have worsened dramatically worldwide, with those nurses caring directly for patients with COVID-19 reporting the highest rates of anxiety, depression, and burnout (9)(10)(11)(12)(13)(14). ...
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Rationale: The COVID-19 pandemic exacerbated psychological distress and burnout in frontline healthcare workers. Interventions addressing psychological distress and burnout among these workers are lacking. Objective: Determine feasibility and explore impact of mobile mindfulness to treat psychological distress and burnout among nurses in frontline COVID-19 units. Methods: Pilot randomized trial of 102 nurses working in COVID-19 units at a single hospital between May 2021 and January 2022. Participants were randomized to mobile mindfulness (intervention) or waitlist (control). The primary outcome was feasibility, assessed by comparing rates of randomization, retention, and intervention completion to predefined targets. Secondary outcomes were changes in psychological distress (Patient Health Questionnaire-9 [PHQ-9], General Anxiety Disorder-7 [GAD-7], Perceived Stress Scale-4 [PSS-4]) and burnout symptoms (Maslach Burnout Inventory [MBI]) after one month. Main results: We randomized 102 of 113 consented individuals (90%, target 80%), and 88 completed follow-up (86%, target 80%). Among 69 intervention participants, 19 completed ≥1 mindfulness session per week (28%, target 60%) and 13 completed ≥75% of mindfulness sessions (19%, target 50%). Intervention participants had greater decreases in PHQ-9 scores than controls (Difference in differences [DID] = -2.21; 95% CI, -3.99, -0.42; p = 0.016), but the MBI-depersonalization scores decreased more in controls arm compared to intervention (DID = 1.60; 95% CI, 0.18, 3.02; p = 0.027). There were no other changes in emotional distress or burnout symptoms. Conclusion: This trial of mobile mindfulness in frontline nurses met feasibility targets for randomization and retention, but participants had modest intervention usage. Intervention participants had a reduction in depression symptoms, but not burnout. This article is open access and distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/). Clinical trial registration available at www. Clinicaltrials: gov, ID: NCT04816708.
... Nurses were likely to experience mental disorders due to high levels of occupational stress [20,21]. They inevitably worked long hours, had time constraints, and irregular schedules [7,22]. Mental disorders are a critical issue for nurses and the safety of patients [9]. ...
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Objective Nurses were more likely to experience mental disorders due to long working hours and irregular schedules. However, studies addressing this issue are scarce; therefore, we aimed to investigate the association between long working hours and mental health in Chinese nurses during the coronavirus disease pandemic. Methods A cross-sectional study was conducted with 2,811 nurses at a tertiary hospital in China from March to April 2022. We collected data on demographic, psychological characteristics, dietary habits, life, and work-related factors using a self-reported questionnaire and measured mental health using Patient Health Questionnaire-9 and General Anxiety Disorder-7. Binary logistic regression to determine adjusted odds ratios and 95% confidence intervals. Results The effective response rates were 81.48%, 7.80% (219), and 6.70% (189) of the respondents who reported depression and anxiety, respectively. We categorized the weekly working hours by quartiles. Compared with the lowest quartile, the odds ratios and 95% confidence intervals across the quartiles for depression after adjustment were 0.98 (0.69, 1.40), 10.58 (2.78, 40.32), and 1.79 (0.81, 3.97) respectively, the P for trend was 0.002. The odds ratios across the quartiles for anxiety after adjustment were 0.87 (0.59, 1.30), 8.69 (2.13, 35.46), and 2.67 (1.26, 5.62), respectively, and the P for trend was 0.008. Conclusions This study demonstrated that extended working hours increased the risk of mental disorders among nurses during the coronavirus disease pandemic, particularly in those who worked more than 60 h per week. These findings enrich the literature on mental disorders and demonstrate a critical need for additional studies investigating intervention strategies.
... Among HCWs, depression is a prevalent mental illness with nuanced causes. A rate 2-3 times greater than the general population, over 30% of resident doctors and 20% of hospital-based nurses experience depression (6,7). Factors that contribute to depression include work stress, chronic illness, the doctor-patient interaction, workload, job satisfaction, sleep quality, and loneliness (8)(9)(10). ...
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Background Depressive status of medical personnel worldwide and especially in China is an important public health and social problem. There is a strong relationship between education and depression, but no studies have studied grouping healthcare workers (HCWs) with different educational degree to discuss whether there are differences in the factors that affect depression. This study aims to examine the role of job satisfaction and sleep quality in the relationship between work stress and depression among Chinese HCWs, and teste whether the mediation models are differed by the differences of educational degree. Methods Patient Health Questionnaire-9 (PHQ-9) scale was used to test depression. Work stress was assessed using the Challenge-blocking stress scale (CBSS). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). HCWs’ satisfaction with their current work was assessed using the Job Satisfaction Index (JSI). The representative sample of HCWs was chosen using a multi-stage stratified cluster random sampling procedure and 844 HCWs were utilized to the statistical analysis of the study. Results In the overall sample, sleep quality could mediate the relationship between work stress and depression in healthcare workers (p < 0.001, CMIN/DF = 3.816, GFI = 0.911, AGFI = 0.886, IFI = 0.943, TLI = 0.933, CFI = 0.942, RMSEA = 0.058, SRMR = 0.055, AIC = 1039.144), and the mediating effect accounted for 36.5%. After grouping educational qualifications, the model with sleep quality and job satisfaction as mediating variables reported a better fit in the group with low educational qualifications. The intermediary effect accounted for 50.6 and 4.43%, respectively. The highly educated group only has sleep quality as an intermediary variable in the structural model, and the mediating effect accounted for 75.4% (p < 0.001, CMIN/DF = 2.596, GFI = 0.887, AGFI = 0.857, IFI = 0.937, TLI = 0.926, CFI = 0.937, RMSEA = 0.044, SRMR = 0.056, AIC = 1481.322). Conclusion In the overall sample, sleep quality could mediate the relationship between work stress and depression in HCWs. Among HCWs with technical secondary school education and below, job satisfaction can mediate the positive relationship between work stress and depression, while this mediating effect is not significant among HCWs with college degree and above.
... This is not surprising as empirical research had already shown that during major infection outbreaks (such as the Severe Acute Respiratory Syndrome (SARS) or the Middle East Respiratory Syndrome (MERS)), it was common for HPs to experience high levels of anxiety and depressive symptoms [60,61]. In fact, the WHO already alerted that, while the global prevalence of anxiety and depression had increased significantly by 25% in the first year of the COVID-19 pandemic [62], HPs usually experienced higher rates of anxiety and depression when compared with the general population [63,64]. This called for closer attention to the impact of anxiety and depression on HPs' mental health for their sustainable performance in the long run of anti-COVID-19 measures. ...
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Introduction Burnout in healthcare providers (HPs) might lead to negative consequences at personal, patient-care and healthcare system levels especially during the COVID-19 pandemic. This study aimed to investigate the prevalence of burnout and the contributing variables, and to explore how, from health workforce management perspective, HPs’ experiences related to carrying out COVID-19 duties would be associated with their burnout. Methods A cross-sectional, open online survey, informed by physical and psychological attributes reportedly related to burnout, the Copenhagen Burnout Inventory (CBI) and the Hospital Anxiety and Depression Scale (HADS), was completed by HPs in Macau, China during October and December 2021. Factors associated with burnout were analysed using multiple logistic regressions. Results Among the 498 valid responses, the participants included doctors (37.5%), nurses (27.1%), medical laboratory technologist (11.4%) and pharmacy professionals (10.8%), with the majority being female (66.1%), aged between 25-44years (66.0%), and participated in the COVID-19 duties (82.9%). High levels of burnout (personal (60.4%), work-related (50.6%) and client-related (31.5%)), anxiety (60.6%), and depression (63.4%) were identified. Anxiety and depression remained significantly and positively associated with all types of burnout after controlling for the strong effects of demographic and work factors (e.g. working in the public sector or hospital, or having COVID-19 duties). HPs participated in COVID-19 duties were more vulnerable to burnout than their counterparts and were mostly dissatisfied with the accessibility of psychological support at workplace (62.6%), workforce distribution for COVID-19 duties (50.0%), ability to rest and recover (46.2%), and remuneration (44.7%), all of which were associated with the occurrence of burnout. Conclusions Personal, professional and health management factors were found attributable to the burnout experienced by HPs during the COVID-19 pandemic, requiring actions from individual and organizational level. Longitudinal studies are needed to monitor the trend of burnout and to inform effective strategies of this occupational phenomenon.
... Worldwide, there is a high occurrence of depressive symptoms among nurses. Previous studies found that 32.4% of Australian nurses, 18% of American nurses, and 43.83% of Chinese nurses experienced depressive symptoms (3)(4)(5). Therefore, hospital administrators and scholars worldwide should pay attention to nurses' mental health. ...
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Background Inequalities may exist in social and health status among nurses with different employment types. Few studies have investigated the relationship between social support and depressive symptoms among formally employed nurses compared with those in contract-based employment. This study aimed to examine the associations between social support and depressive symptoms among Chinese nurses with different forms of employment. Methods The present cross-sectional study was performed with 1,892 nurses from 12 tertiary hospitals in Shandong Province, China. The Social Support Rating Scale and the 10-item Center for Epidemiologic Studies Depression Scale were used to measure social support and depressive symptoms, respectively. The association between social support and depressive symptoms among participants was explored using multiple linear regression analysis. Results The prevalence of depressive symptoms was 45.7%. The mean score for total social support was 40.16 (SD = 7.47), which was lower than the norms in the general Chinese population. Formally employed participants’ total social support scores were statistically significantly higher than those of contract-based employees (p ≤ 0.05). After controlling for confounding factors, the multiple linear regression analysis showed that subjective support and support utilization scores were inversely associated with depressive symptoms. Objective support scores were negatively associated with depressive symptoms only among contract-employment nurses. Conclusion Chinese nurses have a higher prevalence of depressive symptoms and lower social support than the Chinese general population. Compared with contract-employment nurses, formally employed nurses had higher social support. Inverse associations exist between social support and depressive symptoms among nurses with different types of employment. It is suggested that improving Chinese nurses’ social support levels and reducing their depressive symptoms, especially for nurses employed through contracts, are critical.
... 16 One study published well before the pandemic showed that nurses experience depressive symptoms at a rate twice as high as individuals in other professions. 17 There is a paucity of data specifically on the prevalence of depressive symptoms of US nurses during the pandemic, however. ...
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The coronavirus disease 2019 pandemic has drawn attention to many of the inadequacies of the US health-care system. Perhaps, no profession has felt these shortcomings more than nurses. This female-dominated profession has the potential to suffer a high attrition rate for several reasons, including declining mental health and increasing workplace violence. Nurses have already begun to leave the bedside. Unless significant changes can be made quickly to prevent more of these caregivers from leaving the profession, the health and safety of the US population are at risk.
... A doubled prevalence of depressive symptoms in nurses than in the general population might explain why they referred to personal experience on antidepressants, as well as their side effects, more often. 80,81 It was also reported that social media played an important role in releasing stress for healthcare providers, especially during the isolation period of the COVID-19 pandemic. 18 Besides, Kocemba et al. suggested that physicians' professionalism may be compromised if they publicly reveal personal details. ...
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Background: Antidepressants are the primary treatment for depression, and social support from social media may offer another support route. Whilst Twitter has become an interactive platform for healthcare providers and their patients, previous studies found low engagement of healthcare providers when discussing antidepressants on Twitter. This study aims to analyse the Twitter posts of healthcare providers related to antidepressants and to explore the healthcare providers' engagement and their areas of interest. Method: Tweets within a 10-day period were collected through multiple searches with a list of keywords within Twitter. The results were filtered against several inclusion criteria, including a manual screening to identify healthcare providers. A content analysis was conducted on eligible tweets where correlative themes and subthemes were identified. Key findings: Healthcare providers contributed 5.9% of the antidepressant-related tweets (n = 770/13,005). The major clinical topics referred to in the tweets were side effects, antidepressants for the treatment of COVID-19, and antidepressant studies of psychedelics. Nurses posted more tweets sharing personal experiences with commonly negative attitudes, in contrast to physicians. Links to external webpages were commonly used among healthcare providers, especially users representing healthcare organisations. Conclusions: A relatively low proportion of healthcare providers' engagement on Twitter regarding antidepressants (5.9%) was identified, with a minimal increase throughout the COVID-19 pandemic when compared to previous studies. The major clinical topics referred to in the tweets were side effects, antidepressants for the treatment of COVID-19 and antidepressant studies of psychedelics, which have been made publicly available. In general, the findings confirmed that social media platforms are a mechanism by which healthcare providers, organisations and students support patients, share information about adverse drug effects, communicate personal experiences, and share research. It is plausible that this could impact the belief and behaviours of people with lived experience of depression who may see these tweets.
... Although the discrepancy in depressive symptoms prevalence among nurses across countries may partly be due to the vast diversity of criteria used to measure depressive symptoms, it also indicates that there may be discrepancies in the incidence of depressive symptoms among nurses in different countries, which may be associated with social-cultural factors, nurses' personalities, and the healthcare system. Therefore, it is necessary to conduct further studies in different areas to obtain more comprehensive knowledge about the epidemiology and risk factors for depressive symptoms among nurses (Letvak et al, 2012). ...
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The working environment is one of the most important recourses of occupational stress. Nurse’s environment includes an enclosed atmosphere, time, pressures, excessive noise, sudden swings from intense to mundane tasks, no second chance, unpleasant sights and sounds and long standing hours. Nurses are trained to deal with these factors but stress takes a toll when there are additional stressors. Stress is known to cause emotional exhaustion to nurses and this leads to negative feelings toward those in their care. The aim of the study was to assess the psychological and financial problems among female staff nurses working in selected government and private medical colleges of Madhya Pradesh. A descriptive survey was used. The 50 female staff nurses were selected by simple random sampling. The findings showed that 12 (48%) staff nurses were suffering from anxiety, 16 (64%) from stress and 5 (20%) staff nurses facing financial problem in government medical college whereas 10 (40%) staff nurses were suffering from anxiety, 8 (32%) from stress, 24 (96%) from depression and 10 (40%) were facing financial problem in private medical college.
... Moreover, several studies showed that the prevalence of depressive symptoms during the COVID-19 pandemic was higher in females and nurses than among males and doctors [19,21,22]. Studies prior to the pandemic showed that the prevalence of depressive symptoms in nurses was relatively high; 38% in China and 18% in the USA [43,44], and the prevalence of depression was 10% in Canada [45]. Those employed in roles that involve interaction with the general public are at an elevated risk of psychological distress during the COVID-19 pandemic [46]. ...
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(1) Background: The COVID-19 pandemic has distressed many populations worldwide, and since its beginning, many institutes have performed cross-sectional studies to assess mental health. We longitudinally examined psychological distress and depressive symptoms among university staff in Japan from 2019 to 2021, before and during the COVID-19 pandemic.; (2) Methods: Participants were teachers and hospital staff working at institutions related to Kobe University, who completed the Brief Job Stress Questionnaire (BJSQ) from 2019 to 2021. This study used the definition recommended by the guideline to identify high-stress. We analyzed the relationship between those who identified as having high-stress before versus during the COVID-19 pandemic using logistic regression analysis (adjusted for age, sex, and occupation).; (3) Results: Results showed that Stress Reaction scores increased slightly in 2020 and significantly in 2021. Time and other factors had a synergistic effect on mental health. The increase in Stress Reaction was significantly associated with females and nurses over the three years. Those with high-stress in 2019 had approximately twenty-fold odds ratios (OR) of having high-stress in 2020 and 2021.; (4) Conclusions: The long-term COVID-19 pandemic may disturb university staff’s mental health. Those who originally experienced high levels of stress were vulnerable to the negative effects of the COVID-19 pandemic.
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Key workers are vulnerable to adverse mental health. To ensure service sustainability during COVID-19, Resilience Hubs were established across England offering outreach, screening, and mental health support. This evaluation aimed to describe wider service use, associated costs, and satisfaction among Hub clients (key workers) accessing Hub support. Clients accessing support across four Hubs were invited to complete a service use questionnaire, between 5 and 8 months post referral, collecting satisfaction, wider service use and cost data. Exploratory linear regression assessed the relationship between demographic variables and service use. Most Hub clients reported Hub contact post referral (219/299, 73.2%), with many accessing mental health support (171/299, 57.2%) or on waitlists (34/299, 11.4%). Satisfaction was high, with median helpfulness rated 92 (out of 100), and many stating that Hubs either fully (148/299, 49.5%) or partially (54/299, 18.1%) met their needs. Mental health support accounted for most service use, with higher total service use and costs when including Hub services (£514 versus £213). Key workers have complex needs. Hub services helped clients to access support, with high reported satisfaction indicating that Hubs met clients needs. Further research is required to assess how service use varies according to occupation or demographic characteristics, and whether Hubs are clinically and cost-effective.
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Rationale Identifying whether perceived stigma or personal stigma more significantly affects nurses' attitudes towards seeking psychological help is essential for effectively addressing current challenges and facilitating early intervention for the well‐being of nurses and their patients. Aims and Objectives The aim of this study was to explore the mediating roles of personal stigma and depression in the relationship between perceived stigma among nurses and their attitudes towards seeking psychological help. Methods The sample of this descriptive cross‐sectional study consisted of 302 nurses working in a university hospital in southern Turkey, selected using the purposive sampling method, between April 1 and May 1, 2021. Data collection tools were Personal Information Form, Attitudes Towards Seeking Psychological Help Scale‐Short Form, Depression Stigma Scale, and Beck Depression Inventory. The data were analyzed using SPSS version 26.0. Correlation and regression analyzes were used to examine the relationships between attitudes towards seeking psychological help, personal stigma, perceived stigma, and Beck depression levels. Mann–Whitney U and Kruskal–Wallis tests were employed to compare scale scores across socio‐demographic variables. The mediation models were tested with variables such as perceived stigma, personal stigma, and Beck depression levels as mediators. Results were presented with 95% confidence intervals, and significance was set at p < 0.05. Results Attitudes towards seeking psychological help were negatively influenced by nurses' stigma levels, especially, by personal stigma levels. Additionally, nurses' attitudes were positively influenced by their unit of work and the presence of a chronic illness, while being male and experiencing higher levels of personal stigma had a negative impact. No significant relationships were found between perceived stigma, personal stigma, and depression levels. Conclusion High levels of personal stigma negatively affect attitudes towards seeking psychological help; however, when considered alongside working in oncology and having a chronic illness, the impact of personal stigma becomes positive. Future research should delve deeper into these dynamics to develop targeted strategies for reducing personal stigma and enhancing help‐seeking behaviors among nurses. Interventions are necessary to foster positive help‐seeking attitudes among nurses and reduce stigma. Aligned with the findings of this study, training and awareness initiatives aimed at improving mental health literacy among nurses can play a pivotal role in reducing stigma and encouraging proactive use of mental health resources.
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Background: Nurse suicide, a complex occupational health concern, is urgently in need of research due to the personal and occupational suicide risk factors experienced by nurses, namely mental health problems (e.g., depression), job problems, and substance misuse. Therefore, the study aims were to determine the contextual characteristics and circumstantial factors associated with nurse suicide in Kentucky. Methods: Secondary suicide data were obtained from the Kentucky Violent Death Reporting System (KYVDRS) from 2005 to 2019. Nurse suicide cases were identified using the Bureau of Labor Statistics Standard Occupational Classification. A mixed-methods analysis using descriptive statistics and qualitative evaluation was conducted to determine the distributions of demographic, injury, and weapon characteristics, followed by a qualitative analysis of the KYVDRS incident narrative text of nurse suicide decedents. Results: There were 88 decedents identified with a nursing occupation. The predominant means of death for male (59%) and female (45%) nurses involved firearms. Thematic analysis showed nurse decedents experienced a mental health problem (51%) and premeditated (50%) suicide preceding death. Incidentally, 51% of all cases experienced multiple circumstantial factors (e.g., relationship problems and premeditation) preceding their death by suicide. Discussion/Application to Practice: Nurse suicide decedents experienced multifactorial risk factors preceding their death by suicide, namely depression, premeditated suicide, and relationship problems. Occupational health practitioners and health care organizations can implement individual and organizational prevention efforts to help prevent nurse suicide.
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Health care workers experience high rates of burnout and psychiatric distress. A large health care system in the southwest United States developed a comprehensive mental health service model for employees. Services offered range from traditional benefits (eg, Employee Assistance Program), resiliency and well-being initiatives, and innovative technology solutions, to access to peer support services for professional practice issues. The latest innovation in services is a free, self-insured outpatient mental health clinic designed exclusively for health care workers and their dependents. In this article, the authors describe the development of expanded mental health programming for health care workers and discuss how this unique service model proactively reduces common barriers to the receipt of high-quality care. This approach to caring for the workforce may serve as a model for other health care organizations across the United States. By providing mental health support to employees, health care organizations are mitigating the risk of burnout and related consequences to the system.
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Nurses are at increased risk for developing depressive symptoms. While previous research has suggested that strength use may be inversely related to these symptoms, the longitudinal impact of strength use on nurses' depressive symptoms remains under-explored. This study sought to examine the longitudinal relationship between strength use and depressive symptoms among Chinese nurses. Using a two-wave cross-lagged design from 2020 to 2023, 321 nurses participated in an online questionnaire survey. Using structural equation modeling, our results supported the hypothesized reciprocal model, indicating that strength use can significantly predict a reduction in depressive symptoms and vice versa. Given these findings, there's an urgent need for nurse leaders to emphasize the importance of using nurses' strengths as a strategy to alleviate depressive symptoms.
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Background: Healthcare workers (HCWs) have been significantly impacted by the pandemic. Elderly health care workers carry out a variety of duties at work and have years of clinical expertise. Anxiety and insomnia are among the more commonly encountered problems in senior physicians and other geriatric medical professional populations. Objective: The study aims to determine the effect of vagal nerve stimulation on anxiety and sleep disturbances among geriatric medical professionals. Method: 42 Participants were enrolled in this study based on the inclusion and exclusion criteria. The participants were divided into two groups using the closed envelope approach, and they took part in therapy sessions lasting 30 minutes, three times per week for a period of four weeks. The Experimental group A received non-invasive transcutaneous auricular vagal nerve stimulation(taVNS) and Control group A received Jacobson's progressive muscle relaxation technique. Results: With a p value of 0.001, transcutaneous auricular vagal nerve (taVNS) stimulation significantly improved sleep quality and reduced anxiety after 4 weeks.The post-intervention assessment revealed a highly significant improvement in Group A, with a T value of 251 (p < 0.001). Conclusion: The findings suggest that taVNS may be an effective intervention for addressing anxiety and sleep issues in geriatric medical professionals. These results contribute to the exploration of non-invasive strategies to enhance the well-being of healthcare professionals working in demanding environments.
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Background: There is limited research on the effects of nationally oriented health care workforce interventions on RNs' perceptions of their work systems and health-related quality of life (HRQOL). Purpose: Guided by a systems framework, we examined the association of being affiliated with an organization partnered with the American Nurses Association's Healthy Nurse, Healthy Nation (HNHN) program on RNs' perceptions of their work systems and HRQOL. Methods: We performed a correlational, cross-sectional secondary analysis of a national RN sample (N = 2,166) with case-control matching. We used multiple linear and logistic regressions to evaluate our research questions. Discussion: Affiliation with an HNHN partner organization was directly associated with more desirable work system perceptions, and indirectly associated with greater HRQOL. Organization-level workplace interventions hold promise to improve RN working conditions and well-being. Conclusion: There is an ongoing need to continue developing and evaluating scalable workplace well-being interventions for health care organizations.
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Race, ethnicity, religion, sexual orientation, gender, and disability are just a few of the many issues that fall under the umbrella of "cultural issues." We refer to a group's beliefs and practices as having a distinct culture. In several chosen supermarkets in Iraqi Kurdistan, this study focuses on the consequences of depression and anxiety on business management about one of the cultural issues' components, gender, and potential solutions. A quantitative analysis method was implemented in this study. A literature review is also conducted to understand the obstacles and current state of knowledge while focussing on the missing knowledge gap to fill in. Therefore, the sample in this study was a collective of 200 respondents from different supermarkets in Northern Iraq from both genders. Results show that the workforce's 2-week incidence of any depressive illness in the two selected supermarkets was assessed to be very high, followed by severe depression coming in second, critical depressive disorders in incomplete recurrence or recurring (2.5%), and dysthymia (3.6%). Women were nearly twice as likely as males to have any depression, despite serious depression being significantly more regular in women. It is concluded that depression seriously damages any business management and needs to be treated to attain maximum profit gain. Business owners must include it in the business plan to provide solutions to the problems related to depression, considering gender.
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Purpose: This study aimed to examine the effectiveness of the training program which was based on cognitive behavioral theory on accepting and expressing emotions in terms of nurses' psychological resilience and depression levels. Design and methods: The study is an intervention study with a control group conducted with pretest, posttest, and two-year follow-up test design in line with Consolidated Standards of Reporting Trials (CONSORT). The participants in the intervention group attended an eight-week accepting and expressing emotions training program, while those in the control group did not. The Psychological Resilience Scale for Adults (RSA) and Beck's Depression Inventory (BDI) were applied to both groups as pre-test, post-test and 6-month follow-up (T2), 12-month follow-up (T3) and 24-month follow-up (T4). Results: It was determined that there was a significant change in RSA scale scores of the intervention group, and that the effect of group ∗ time interaction for all scores was significant. An increase in the total score was found for all follow-up periods with respect to T1. A significant decrease was determined in BDI scores of the intervention group, and the effect of group-time interaction for all scores was found to be significant. It was found that there was a decrease in the scores of the intervention group in all follow-up periods with respect to T1. Conclusions: The results obtained from the study showed that the training program conducted with groups on accepting and expressing emotions was effective on the nurses' psychological resilience and depression scores. Practice implications: Training programs that develop the skills of accepting and expression emotions can help nurses find their thoughts underlying their emotions. Thus, depression levels of nurses can decrease, and their psychological resilience can improve. This situation can help in terms of reducing workplace stress of nurses and can cause their working life to be more effective.
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Cognitive-behavioral therapy (CBT) is the most effective nonpharmacological treatment for almost all mental disorders, especially anxiety and depression. The treatment is time limited, encourages self-help skills, is problem focused, is inductive, and requires that individuals develop and practice skills in their own environment through homework. However, most of those with mental health issues are unable to seek help because of factors related to treatment availability, accessibility, and cost. CBT is well suited to computerization and is easy to teach to nurses. In this article we describe outcome studies of computer-assisted CBT (cCBT), outline the current technologies available, discuss concerns and resistance associated with computerized therapy, and consider the role of nurses in using cCBT.
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We investigated whether, over time, baseline obesity is associated with change in depressive symptoms or if baseline symptoms of depression are associated with change in body mass index (BMI) and waist circumference. We used latent growth curve modeling to examine data from years 5, 10, 15, and 20 of the Coronary Artery Risk Development in Young Adults study (n = 4643). We assessed depressive symptomatology with the Center for Epidemiological Studies Depression scale. Respondents who started out with higher levels of depressive symptoms experienced a faster rate of increase in BMI (for Whites only) and waist circumference (for Blacks and Whites) over time than did those who reported fewer symptoms of depression in year 5. Initial BMI and waist circumference did not influence the rate of change in symptoms of depression over time. Depressive symptomatology likely plays a role in the development of physical health problems, such as cardiovascular disease, through its association with increases in relative weight and abdominal obesity over time.
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Cognitive-behavioral therapy (CBT) is the most effective nonpharmacological treatment for almost all mental disorders, especially anxiety and depression. The treatment is time limited, encourages self-help skills, is problem focused, is inductive, and requires that individuals develop and practice skills in their own environment through homework. However, most of those with mental health issues are unable to seek help because of factors related to treatment availability, accessibility, and cost. CBT is well suited to computerization and is easy to teach to nurses. In this article we describe outcome studies of computer-assisted CBT (cCBT), outline the current technologies available, discuss concerns and resistance associated with computerized therapy, and consider the role of nurses in using cCBT.
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This report assessed whether hospital ward overcrowding predicts antidepressant use among hospital staff. The extent of hospital ward overcrowding was determined using administrative records of monthly bed occupancy rates between 2000 and 2004 in 203 somatic illness wards in 16 Finnish hospitals providing specialized health care. Information on job contracts for personnel was obtained from the employers' registers. Comprehensive daily data on purchased antidepressant prescriptions (World Health Organization's Anatomical Therapeutic Chemical classification code N06A) for nurses (N=6,699) and physicians (N=641) was derived from national registers. Cox proportional hazards models were used to examine the association between bed occupancy rate and subsequent antidepressant treatment. Monthly bed occupancy rates were used as a time-dependent exposure that could change in value over the course of observation. Hazard ratios were adjusted for sex, age, occupation, type and length of employment contract, hospital district, specialty, and calendar year. Exposure over 6 months to an average bed occupancy rate over 10% in excess of the recommended limit was associated with new antidepressant treatment. This association followed a dose-response pattern, with increasing bed occupancy associated with an increasing likelihood of antidepressant use. There was no evidence of reverse causality; antidepressant treatment among employees did not predict subsequent excess bed occupancy. The increased risk of antidepressant use observed in this study suggests that overcrowding in hospital wards may have an adverse effect on the mental health of staff.
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To evaluate the efficacy of two internet interventions for community-dwelling individuals with symptoms of depression--a psychoeducation website offering information about depression and an interactive website offering cognitive behaviour therapy. Randomised controlled trial. Internet users in the community, in Canberra, Australia. 525 individuals with increased depressive symptoms recruited by survey and randomly allocated to a website offering information about depression (n = 166) or a cognitive behaviour therapy website (n = 182), or a control intervention using an attention placebo (n = 178). Change in depression, dysfunctional thoughts; knowledge of medical, psychological, and lifestyle treatments; and knowledge of cognitive behaviour therapy. Intention to treat analyses indicated that information about depression and interventions that used cognitive behaviour therapy and were delivered via the internet were more effective than a credible control intervention in reducing symptoms of depression in a community sample. For the intervention that delivered cognitive behaviour therapy the reduction in score on the depression scale of the Center for Epidemiologic Studies was 3.2 (95% confidence interval 0.9 to 5.4). For the "depression literacy" site (BluePages), the reduction was 3.0 (95% confidence interval 0.6 to 5.2). Cognitive behaviour therapy (MoodGYM) reduced dysfunctional thinking and increased knowledge of cognitive behaviour therapy. Depression literacy (BluePages) significantly improved participants' understanding of effective evidence based treatments for depression (P < 0.05). Both cognitive behaviour therapy and psychoeducation delivered via the internet are effective in reducing symptoms of depression.
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Intensive care unit (ICU) nurses work in a demanding environment where they are repetitively exposed to traumatic situations and stressful events. The psychological effects on nurses as a result of working in the ICU are relatively unknown. To determine whether there is an increased prevalence of psychological symptoms in ICU nurses when compared with general nurses. We surveyed ICU and general nurses from three different hospitals (n=351) and then surveyed ICU nurses throughout the metropolitan area (n=140). In both cohorts of nurses, we determined the prevalence of symptoms of post-traumatic stress disorder (PTSD), anxiety, and depression using validated survey instruments. Within our hospital system, 24% (54/230) of the ICU nurses tested positive for symptoms of PTSD related to their work environment, compared with 14% (17/121) of the general nurses (p=0.03). ICU nurses did not report a greater amount of stress in their life outside of the hospital than general nurses. There was no difference in symptoms of depression or anxiety between ICU and general nurses. In the second survey of ICU nurses from our metropolitan area, 29% (41/140) of the respondents reported symptoms of PTSD, similar to our first cohort of ICU nurses. ICU nurses have an increased prevalence of PTSD symptoms when compared with other general nurses. These results may increase awareness of these symptoms in nurses and lead to future interventions that improve their mental health and job satisfaction and help retain ICU nurses in their profession.
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This study examines risk factors for post-traumatic stress disorder (PTSD), depression, and mental health care use among health care workers deployed to combat settings. Anonymous surveys were administered to previously deployed workers at a military hospital. PTSD and depression were assessed by using the PTSD Checklist and the Patient Health Questionnaire depression scale, respectively. Deployment exposures and perceived threats during deployment were also assessed. There were 102 respondents (36% response rate). Nine percent (n=9) met the criteria for PTSD and 5% (n=5) met the criteria for depression. Direct and perceived threats of personal harm were risk factors for PTSD; exposure to wounded or dead patients did not increase risk. Those who met the criteria for PTSD were more likely to seek mental health care after but not before their deployment. For health care workers returning from a warfare environment, threat of personal harm may be the most predictive factor in determining those with subsequent PTSD.
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We determined the proportion of workers meeting criteria for major depressive episodes in the past year and examined the association between psychosocial work-stress variables and these episodes. Data were derived from the Canadian Community Health Survey 1.2, a population-based survey of 24324 employed, community-dwelling individuals conducted in 2002. We assessed depressive episodes using the Composite International Diagnostic Interview. Of the original sample, 4.6% (weighted n=745948) met criteria for major depressive episodes. High job strain was significantly associated with depression among men (odds ratio [OR]=2.38; 95% confidence interval [CI]=1.29, 4.37), and lack of social support at work was significantly associated with depression in both genders (men, OR=2.70; 95% CI=1.55, 4.71; women, OR=2.37; 95% CI=1.71, 3.29). Women with low levels of decision authority were more likely to have depression (OR=1.59; 95% CI=1.06, 2.39) than were women with high levels of authority. A significant proportion of the workforce experienced major depressive episodes in the year preceding our study. Gender differences appear to affect work-stress factors that increase risk for depression. Prevention strategies need to be developed with employers and employee organizations to address work organization and to increase social support.
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Key findings: Data from the National Health and Nutrition Examination Survey, 2005-2006. In any 2-week period, 5.4% of Americans 12 years of age and older experienced depression. Rates were higher in 40-59 year olds, women, and non-Hispanic black persons than in other demographic groups. Rates of depression were higher among poor persons than among those with higher incomes. Approximately 80% of per sons with depression reported some level of functional impairment because of their depression, and 27% reported serious difficulties in work and home life. Only 29% of all persons with depression reported contacting a mental health professional in the past year, and among the subset with severe depression, only 39% reported contact. Depression is a common and debilitating illness. It is treatable, but the majority of persons with depression do not receive even minimally adequate treatment. Depression is characterized by changes in mood, self-attitude, cognitive functioning, sleep, appetite, and energy level. The World Health Organization found that major depression was the leading cause of disability worldwide. Depression causes suffering, decreases quality of life, and causes impairment in social and occupational functioning. It is associated with increased health care costs as well as with higher rates of many chronic medical conditions. Studies have shown that a high number of depressive symptoms are associated with poor health and impaired functioning, whether or not the criteria for a diagnosis of major depression are met.
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Objective: While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. Measurements: The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. Results: As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. Conclusion: In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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Accessible summary Nursing is associated with high levels of emotional strain and heavy workloads. Work‐related behaviour is linked to health. Nurses with unhealthy work‐related behaviour and experience have a higher risk of reduced mental and physical health. Prevention of burnout and illness needs to focus on both the individual and the working conditions. Abstract Nursing is associated with high levels of emotional strain and heavy workloads. Changing working conditions raise the importance of investigating job satisfaction, stress and burnout and its consequences for nurses. The aim of the study was to investigate whether work‐related behaviour and experience patterns are associated with mental and physical health status in nurses. A sample of 356 nurses in four German hospitals were interviewed using questionnaires regarding work‐related behaviour and experience patterns, work stress, depression, anxiety and physical symptoms (‘Work‐related Behaviour and Experience Pattern’– AVEM and ERI). The main result of this study is that unhealthy work‐related behaviour and experience patterns (i.e. the excessive ambitious type and the resigned type) are associated with reduced mental and physical health. Preventive, as well as intervention, strategies are needed that focus both on the individual as well as on working conditions.
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Aims The purpose of this study was to (i) describe the weight, weight-related perceptions and lifestyle behaviours of hospital-based nurses, and (ii) explore the relationship of demographic, health, weight and job characteristics with lifestyle behaviours. Background The obesity epidemic is widely documented. Worksite initiatives have been advocated. Nurses represent an important part of the hospital workforce and serve as role models when caring for patients. Methods A sample of 194 nurses from six hospitals participated in anthropometric measurements and self-administered surveys. Results The majority of nurses were overweight and obese, and some were not actively involved in weight management behaviours. Self-reported health, diet and physical activity behaviours were low, although variable by gender, age and shift. Reports of co-worker norms supported low levels of healthy behaviours. Conclusions Findings reinforce the need to address the hospital environment and culture as well as individual behaviours for obesity control. Implications for nursing management Nurse managers have an opportunity to consider interventions that promote a climate favourable to improved health habits by facilitating and supporting healthy lifestyle choices (nutrition and physical activity) and environmental changes. Such efforts have the potential to increase productivity and morale and decrease work-related disabilities and improve quality of life.
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Obesity is understood as a major medical and public health challenge, but the stigma attached to it also creates extraordinary suffering. The pervasiveness of morally negative views toward the overweight and obese, such as laziness and lack of self-control, are undeniable in mainstream U.S. society, situated both institutionally (such as health care barriers or media stereotypes) and interpersonally (such as the negative comments of others). To test basic pathways related to the etiology of women's vulnerability to feeling "fat-stigma" in interpersonal relationships, we present a study conducted between August and November 2009 that combines social network, anthropometric, body image, and interview data for 112 women aged 18-45 years, living in Phoenix, Arizona, U.S., and linked follow-up interviews with 823 of their social ties. Based on the proposition that some social network characteristics should amplify the personal experience of stigma, and others should ameliorate it, we ask: what relationship qualities make women more sensitive to the judgments of others about their weight? We find that what others say about women has only a very limited influence on how women judge others' negative views of their weight once actual body size is taken into account, but that women are more influenced by the opinions of those they are closer to and interact with more often. Ultimately, the degree to which women perceive themselves to be judged by others regarding their weight is not well explained by the actual opinions of people in their networks, either known or unknown to them. The assumption that social network norms exert considerable influence on people's stigma experiences needs to be carefully evaluated, at least in the domain of overweight and obesity.
Article
Depression is reported to be a major cause of illness-related sub-optimal work performance (presenteeism). However, the majority of studies examining presenteeism have relied on self-report measures of work performance. Furthermore, employers currently face a number of practical challenges in attempting to facilitate early identification of depression. To test whether a web-based screening tool for depression could be used successfully in the workplace and whether it was possible to detect an association between rates of depression and objective measures of impaired workgroup performance. All permanent employees of a telecommunications company with UK-based call centres were encouraged to complete a web-based psychological assessment using the Patient Health Questionnaire depression scale (PHQ-9). In addition to confidential individual level results, the tool was able to provide anonymized summary statistics for each workgroup. Four objective measures of work performance were collected for each workgroup. During the study period, 1161 web-based PHQ-9 questionnaires were completed. There was a negative linear relationship between rates of depressive symptoms and the overall performance of a workgroup (P < 0.001). The linear relationship between depression and workgroup performance remained after controlling for gender balance, percent of temporary staff, employees' perceived level of engagement and satisfaction with their line manager (P < 0.01). Workgroups with high levels of depressive symptoms tend to perform poorly. Computer-aided web-based screening for symptoms of depression is feasible in a work setting.
Article
It is amply documented that mood disorders adversely affect job satisfaction, workforce productivity, and absenteeism/presenteeism. It is also well documented that mood disorders are an independent risk factor for several chronic medical disorders (e.g., obesity, diabetes mellitus, cardiovascular disease). Emerging evidence indicates that the workforce dysfunction associated with depression is partially mediated by medical comorbidity. We conducted a PubMed search of all English-language articles published between 2005 and July 2009 with the following search terms: major depressive disorder and depression, cross-referenced with work productivity, disability, economic cost, absenteeism, presenteeism, and medical comorbidity. Articles selected for review were based on adequacy of sample size, the use of standardized experimental procedures, validated assessment measures, and overall manuscript quality. Mood disorders are the most impairing condition amongst working adults. It is estimated that approximately 35-50% of employees with depression will take short-term disability leave at some point during their job tenure. Moreover, 15-20% of the workforce will receive short-term disability benefits during any given year; the annual income of individuals affected by depression is reduced by approximately 10% when compared to unaffected employees. Chronic stress-sensitive conditions independently contribute to workforce maladjustment and associated disability. The mood disorder population is differentially affected by several stress-related medical conditions resulting in greater impairment in the workforce. Disability modelling in the depressed employee has emphasized the complex interrelationship between depressive symptoms, workforce stress, and consequent disability. A more refined model must include the effects of chronic medical conditions as a powerful mediator and/or moderator of workforce impairment. Multidisciplinary interventions have been demonstrated to reduce, but not eliminate workforce disability related to depression, underscoring the need for elucidating other modifiable factors. Screening, treatment, and prevention initiatives need to target chronic medical conditions in depressed employees in order to reduce overall workforce disability.
Article
The impact of personal, organizational, and economic factors on nurses' job satisfaction have been studied extensively, but few studies exist in which the effects of physical work environment--including perceptions of architectural, interior design, and ambient features on job satisfaction-are examined. The purpose of this study was to examine the effect of perceived physical work environment on job satisfaction, adjusting for multiple personal, organizational, and economic determinants of job satisfaction. A cross-sectional, predictive design and a Web-based survey instrument were used to collect data from staff registered nurses in a large metropolitan hospital. The survey included 34 questions about multiple job satisfaction determinants, including 18 Likert-type measures with established good validity (comparative fit index = .97, Tucker-Lewis index = .98, root mean square error of approximation = .06) and reliability (r ≥ .70). A response rate of 48.5% resulted in a sample of 362, with 80% power to detect a medium effect of perceived physical environment on job satisfaction. On average, nurses had negative perceptions of physical work environment (M = 2.9, SD = 2.2). Although physical environment was related positively to job satisfaction (r =.256, p = .01) in bivariate analysis, in ordered probit regression, no effect of physical work environment on job satisfaction was found. In future studies, this relationship should be examined in larger and more representative samples of nurses. Qualitative methods should be used to explore how negatively perceived physical work environment impacts nurses. Rebuilding of U.S. hospitals, with a planned investment of $200 billion without considering how physical environment contributes to nurse work outcomes, threatens to exacerbate organizational nurse turnover.
Article
In this study, we tested the following hypotheses among psychiatric nurses: (1) job stress would be positively correlated with depression; (2) coping behaviour would be significantly correlated with depression and moderate the relationship between job stress and depression; (3) social support would be significantly negatively correlated with depression and was a significant moderator on the relationship between job stress and depression. Most studies in Taiwan related to depression have focused on the general public rather than nurses. The main effect of job stress (coping behaviour, social support) on level of depression has been documented in some population, but the moderating effects of coping behaviours and social support on the relationship between job stress and depression have not been well studied among nurses, especially among psychiatric nurses. A cross-sectional research design was employed. A self-report questionnaire was adopted to measure personal characteristics, depression (Beck Depression Inventory), job stress (Taiwanese Nurse Stress Checklist), coping behaviour (Jalowiec Coping Scale) and social support (short form, Interpersonal Support Evaluation List). Eligible subjects were female, non-supervisory, inpatient ward nurses in a psychiatric hospital in southern Taiwan. One hundred and fifty-four questionnaires were distributed, and the response rate was 91.6%. After adjusting for covariates, we found that: (1) Job stress and affective-oriented coping were significantly positively correlated with BDI-II scores. (2) Coping behaviour was not a significant moderator on the relationship between job stress and depression scores among psychiatric nurses, but social support was. Depression scores were correlated with job stress and affective-oriented coping, but social support could work to reduce the effect of stress on depression among psychiatric nurses. Nursing managers should explore both ways of reducing job stress and techniques for building social support networks in the institution to protect their members against stress and depression.
Article
To investigate the relationships between workplace psychosocial factors, work/family conflicts, depression, and health-related presenteeism in a sample of employees who were randomly selected from the communities. A cross-sectional study of 4032 employees representative of the working population aged 25 to 64 years in Alberta, Canada. Data about workplace characteristics, depression, and health-related presenteeism were collected through telephone. In the participants, 47.3% and 42.9% reported some degree of impaired job performance in completing work and avoiding distraction, respectively. Major depression is the strongest factor associated with avoiding distraction. Job strain and effort-reward imbalance seemed to affect job performance through severity of depression but not major depression. Negative work environment may directly and indirectly affect job performance. Workplace health promotion activities should target organizational factors such as job strain and effort-reward imbalance and work/family conflicts so as to reduce the risk of depression and the direct and indirect effects of these risk factors and depression on productivity.
Article
According to the American Nurses Association, the entire profession of nursing exists to serve and improve society's health. Thus, to become a nurse, individuals must master a body of knowledge surrounding numerous health aspects. While acquiring the unique knowledge, skills, and values of their profession, nurses form perceptions of personal adequacy in their role, known as professional or nurse self-concept. Given the centrality of health to the profession, it would seem logical that nurses would personally value health and integrate core health behaviors into their professional self-concept and everyday lives. Yet the prevailing evidence leaves in question whether nurses associate their personal health and lifestyles with their professional roles. This article explores the relationships among nurse self-concept, health status, and healthy lifestyle practices in a sample of Midwestern nurses in an attempt to better understand if nurses who integrate healthy behaviors into their everyday lives feel a stronger sense of professional adequacy relative to nurses who do not.
Article
Few studies have analysed the association between the organisational work environment and depression in hospital workers and we still have little understanding of how processes in the practice environment are related to depressive disorders. However, individual perception of an imbalance between efforts made and expected rewards has been associated with incident depression. The main goal of this study was to test the hypothesis that some organisational constraints at the work-unit level may be related to depressive symptoms in hospital workers, either directly or through individual perceptions of effort-reward imbalance (ERI). In 2006, 3316 female registered nurses and nursing aids working in 190 work units in seven French university hospitals, recruited from the baseline screening of an epidemiological cohort study (the ORSOSA study), responded in 2006 to valid self-report questionnaires (CES-D, ERI). The organisational work environment was assessed with the self-rated Nursing Work Index - Extended Organisation (NWI-EO) aggregated at the work unit level. Multilevel models were used. We found that poor relations between workers within work units were associated with higher CES-D score, independently of perceived ERI. Low level of communication between workers in the unit was associated with individual perceptions of ERI and indirectly associated with depressive symptoms. Understaffing and non-respect of planned days off and vacations were associated with perceived ERI but these organisational constraints were not associated with depressive symptoms. Our study allowed us to identify and quantify organisational factors that have a direct effect on hospital workers' depressive symptoms, or an indirect effect through perceived ERI. Better understanding of the effect of organisational factors on health through perceived ERI would provide targets for successful interventions. Organisational approaches may be more effective in improving mental health at work and may also have a longer-lasting impact than individual approaches.
Article
This study aims to inventory aspects of work functioning of nurses and allied health professionals that are affected by common mental disorders. A systematic review of psychological and occupational health literature was performed. A sensitive systematic literature search based on index terms and text words was conducted in four electronic databases: PubMed, PsycINFO, Embase, and Cinahl. The literature search was limited to journal articles published between 1998 and 2008, written in English, German, or Dutch. For inclusion, studies had to examine a relationship between common mental disorders and a measure of work functioning in nurses or allied health professionals. No restrictions on study design were handled. Methodological quality was assessed for each study. The data were categorized into themes, for which the strength of evidence was assessed using six levels of evidence. Sixteen of 2792 studies met the inclusion criteria, of which 13 had a cross-sectional design, 1 was a vignette study, and 2 were narrative reviews. In all studies, the subjects were nurses. The retrieved aspects of sub-optimal work functioning due to common mental disorders were merged into 15 themes. Strong evidence was found for five themes: general errors, medication errors, near misses, patient safety, and patient satisfaction. Moderate evidence was found that common mental disorders are associated with complex motor skills and with general performance; while evidence for an association between common mental disorders and needle stick injuries was inconclusive. Seven themes had only narrative evidence: interpersonal behaviour, energy, focus on goals and responsibility, work speed, avoiding work while on the job, coping with emotions, and motivation. Common mental disorders were found to be associated with various impairments in work functioning in nurses, these include task-related, intrapersonal and interpersonal aspects of work. In particular, strong evidence was found for an association between common mental disorders and general errors, medication errors, near errors, patient safety, and patient satisfaction. These results provide input for preventive actions to improve both health and work functioning in health care workers.
Article
Stigma and discrimination toward obese persons are pervasive and pose numerous consequences for their psychological and physical health. Despite decades of science documenting weight stigma, its public health implications are widely ignored. Instead, obese persons are blamed for their weight, with common perceptions that weight stigmatization is justifiable and may motivate individuals to adopt healthier behaviors. We examine evidence to address these assumptions and discuss their public health implications. On the basis of current findings, we propose that weight stigma is not a beneficial public health tool for reducing obesity. Rather, stigmatization of obese individuals threatens health, generates health disparities, and interferes with effective obesity intervention efforts. These findings highlight weight stigma as both a social justice issue and a priority for public health.
Predictors of depressive symptoms were identified in a sample of 150 female medical-surgical hospital nurses. Participants completed a demographic questionnaire and instruments to measure occupational stress (Nursing Stress Scale), major life events (Social Readjustment Rating Scale), somatic symptoms (Patient Health Questionnaire-15), and depressive symptoms (Center for Epidemiologic Studies-Depression Scale; CES-D) during a one time survey. Thirty-five percent of the nurses scored > or = 16 on the CES-D, the cutoff for mild to moderate depressive symptoms. Fatigue or low energy (43%), pain in their extremities or joints (30%), trouble sleeping (29%), back pain (28%), and headaches (18%) were the primary somatic complaints. Depressive symptoms were positively correlated with somatic symptoms (r = .55, p < .01), major life events (r = .41, p < .01), and occupational stress (r = .29, p < .01). Years employed in the hospital setting (r = -.22, p < .01) and household income (r = -.18, p < .05) were inversely related to depressive symptoms. Hierarchical multiple regression was used to identify predictors of nurses' depressive symptoms. Somatic symptoms (beta = .39, p < .01), occupational stress (beta = .18, p < .05), major life events (beta = .18, p < .05), and income (beta = -.15, p < .05) accounted for 34% of the variance in nurses' depressive symptom scores. The information from this study can guide the development of interventions to reduce depressive symptoms among hospital nurses. Reductions in depressive symptoms can advance health and quality of life for the hospital nurse. Symptom alleviation or reduction may improve nursing care delivery when distressing symptoms interfere with professional performance among nurses.
Article
KEY FINDINGS: Data from the National Health and Nutrition Examination Survey, 2005-2006. In any 2-week period, 5.4% of Americans 12 years of age and older experienced depression. Rates were higher in 40-59 year olds, women, and non-Hispanic black persons than in other demographic groups. Rates of depression were higher among poor persons than among those with higher incomes. Approximately 80% of per sons with depression reported some level of functional impairment because of their depression, and 27% reported serious difficulties in work and home life. Only 29% of all persons with depression reported contacting a mental health professional in the past year, and among the subset with severe depression, only 39% reported contact. Depression is a common and debilitating illness. It is treatable, but the majority of persons with depression do not receive even minimally adequate treatment. Depression is characterized by changes in mood, self-attitude, cognitive functioning, sleep, appetite, and energy level. The World Health Organization found that major depression was the leading cause of disability worldwide. Depression causes suffering, decreases quality of life, and causes impairment in social and occupational functioning. It is associated with increased health care costs as well as with higher rates of many chronic medical conditions. Studies have shown that a high number of depressive symptoms are associated with poor health and impaired functioning, whether or not the criteria for a diagnosis of major depression are met.
Article
In a recent randomized trial, we were unable to confirm the previously reported high effectiveness of CCBT. Therefore, the aim of the current study was to have a closer look at usage and acceptability (i.e. expectancy, credibility, and satisfaction) of the intervention. Depressed participants (N=200) were given login codes for unsupported online CCBT. A track-and-trace system tracked which components were used. We used a 9-month follow-up period. Uptake was sufficient, but dropout was high. Many usage indices were positively associated with short-term depressive improvement, whereas only homework was related to long-term improvement. Acceptability was good and expectancy could predict long-term, but not short-term outcome. Associations between use of CCBT and improvement are merely correlational. Our sample was too depressed in relation to the scope of the intervention. We relied on online self-report measures. Analyses were exploratory in nature. Although CCBT might be a feasible and acceptable treatment for depression, means to improve treatment adherence are needed for moderately to severely depressed individuals.
Article
Effective internet-based programs for depression usually incorporate a component that provides telephone or email contact. Open access websites, without such contact, show high rates of attrition and poorer outcomes. The present study was designed as an exploratory investigation of the parameters that influence the effectiveness and retention of users on open access websites. We investigated whether brief cognitive behaviour therapy (CBT) was as effective as an extended version, whether add-on components of behaviour therapy or stress management contributed to positive outcomes, and whether longer programs were associated with greater attrition. An online randomized controlled trial (RCT) was conducted between 13 January 2005 and 26 May 2005 (19 weeks). A total of 2794 registrants (1846 women and 948 men; median age category 35-44 years) with elevated scores on the Goldberg Depression Scale of 5.96 (S.D.=2.09) elected online to be randomized to one of six versions of a CBT website. The versions were compiled consisting of various components of brief CBT, extended CBT, behaviour strategies, stress management and problem solving. A total of 20.4% of participants completed the assigned intervention. The interaction of measurement occasion and treatment version was significant [F(13,131)=2.20, p=0.01]. A single module of brief introductory CBT was not effective in reducing depression symptoms. However, extended CBT with or without the addition of behaviour strategies resulted in the reduction of depression. Brief CBT-based interventions are not as effective as extended interventions. However, longer programs are associated with higher rates of dropout.
Article
Rates of depression have been rising, as have rates of work stress. We tested the influence of work stress on diagnosed depression and anxiety in young working adults. Participants were enrolled in the Dunedin study, a 1972-1973 longitudinal birth cohort assessed most recently in 2004-2005, at age 32 (n=972, 96% of 1015 cohort members still alive). Work stress (psychological job demands, work decision latitude, low work social support, physical work demands) was ascertained by interview. Major depressive disorder (MDD) and generalized anxiety disorder (GAD) were ascertained using the Diagnostic Interview Schedule (DIS) and diagnosed according to DSM-IV criteria. Participants exposed to high psychological job demands (excessive workload, extreme time pressures) had a twofold risk of MDD or GAD compared to those with low job demands. Relative risks (RRs) adjusting for all work characteristics were: 1.90 [95% confidence interval (CI) 1.22-2.98] in women, and 2.00 (95% CI 1.13-3.56) in men. Analyses ruled out the possibility that the association between work stress and disorder resulted from study members' socio-economic position, a personality tendency to report negatively, or a history of psychiatric disorder prior to labour-market entry. Prospective longitudinal analyses showed that high-demand jobs were associated with the onset of new depression and anxiety disorder in individuals without any pre-job history of diagnosis or treatment for either disorder. Work stress appears to precipitate diagnosable depression and anxiety in previously healthy young workers. Helping workers cope with work stress or reducing work stress levels could prevent the occurrence of clinically significant depression and anxiety.
Article
A growing body of evidence supports the efficacy of computerized cognitive behavioural therapy (CCBT). This technology has the potential to increase the capacity of mental health services, and to overcome some of the barriers to accessing mental health services, including stigma, traveling time for rural patients, treatment delays, and the low availability of skilled clinicians. This review discusses key issues around the implementation of CCBT in current mental health services, and summarizes recent evidence for the efficacy of CCBT in anxiety and depression. Many CCBT systems exist, and the evidence for each varies in quality and quantity. It is concluded that CCBT, particularly guided by a therapist, represents a promising resource. However, considerable work needs to be done to develop CCBT techniques that are appropriate to Australasian populations, acceptable to patients and clinicians, easy to use, and are clinically and cost effective. Suggestions are made for further research and useful website addresses are provided to assist clinicians in familiarizing themselves with CCBT.
Article
Subthreshold depression is a highly prevalent condition and a risk factor for developing a major depressive episode. Internet-based cognitive behaviour therapy may be a promising approach for the treatment of subthreshold depression. The current study had two aims: (1) to determine whether an internet-based cognitive behaviour therapy intervention and a group cognitive behaviour therapy intervention are more effective than a waiting-list control group; and (2) to determine whether the effect of the internet-based cognitive behaviour therapy differs from the group cognitive behaviour therapy intervention. A total of 191 women and 110 men with subthreshold depression were randomized into internet-based treatment, group cognitive behaviour therapy (Lewinsohn's Coping With Depression course), or a waiting-list control condition. The main outcome measure was treatment response after 10 weeks, defined as the difference in pre- and post-treatment scores on the Beck Depression Inventory (BDI). Missing data, a major limitation of this study, were imputed using the Multiple Imputation (MI) procedure Data Augmentation. In the waiting-list control group, we found a pre- to post-improvement effect size of 0.45, which was 0.65 in the group cognitive behaviour therapy condition and 1.00 within the internet-based treatment condition. Helmert contrasts showed a significant difference between the waiting-list condition and the two treatment conditions (p=0.04) and no significant difference between both treatment conditions (p=0.62). An internet-based intervention may be at least as effective as a commonly used group cognitive behaviour therapy intervention for subthreshold depression in people over 50 years of age.
Article
Internet-based cognitive behaviour therapy (CBT) is a promising new approach for the treatment of depressive symptoms. The current study had two aims: (1) to determine whether, after 1 year, an internet-based CBT intervention was more effective than a waiting-list control group; and (2) to determine whether the effect of the internet-based CBT differed from the group CBT intervention, 1 year after the start of treatment. A total of 191 women and 110 men (mean age=55 years, s.d.=4.6) with subthreshold depression were randomized into internet-based treatment, group CBT (Lewinsohn's Coping with Depression Course), or a waiting-list control condition. The main outcome measure was treatment response after 1 year, defined as the difference in pretreatment and follow-up scores on the Beck Depression Inventory (BDI). Missing data were imputed using the multiple imputation procedure of data augmentation. Analyses were performed using multiple imputation inference. In the waiting-list control group, we found a pretreatment to follow-up improvement effect size of 0.69, which was 0.62 in the group CBT condition and 1.22 with the internet-based treatment condition. Simple contrasts showed a significant difference between the waiting-list condition and internet-based treatment (p=0.03) and no difference between both treatment conditions (p=0.08). People aged over 50 years with subthreshold depression can still benefit from internet-based CBT 1 year after the start of treatment.