No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Depression in Hospital-Employed Nurses
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.
... 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. ...
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]. ...
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.
... Moreover, depression has been expected to become the second leading cause of disability and comorbidities in developing countries by 2030 (Luppa, Heinrich et al. 2007). As mentioned previously, nurses are at higher risk for developing depression with a rate twice as high as workers in other professions (Letvak, Ruhm et al. 2012). Based on two studies that were done in the USA, the prevalence of depression among nurses ranged between 18% and 41% (Ruggiero 2005, Letvak, Ruhm et al. 2012 among Brazilian nurses, and 10% in Canadian nurses (Maharaj, Lees et al. 2018). ...
... As mentioned previously, nurses are at higher risk for developing depression with a rate twice as high as workers in other professions (Letvak, Ruhm et al. 2012). Based on two studies that were done in the USA, the prevalence of depression among nurses ranged between 18% and 41% (Ruggiero 2005, Letvak, Ruhm et al. 2012 among Brazilian nurses, and 10% in Canadian nurses (Maharaj, Lees et al. 2018). In Lebanon, a cross sectional study conducted at the AUBMC, using the PHQ-9 scale to assess depressive symptoms, revealed a prevalence of 36.2% of these symptoms among nurses (Talih, Ajaltouni et al. 2018). ...
... Furthermore, depression may lead to judgment impairment and lapses in the workplace, producing serious injuries (Langlieb and DePaulo 2008). Nurses usually report productivity loss when suffering from a health problem which is known as presenteeism (Letvak, Ruhm et al. 2013), where they become more prone to medication errors, patient falls, and a decrease in the quality of care they provide (Letvak, Ruhm et al. 2012). ...
Research conducted during COVID times assessing depression and axiety among dialysis departement nurses.
... Introduction Work-related stress has been found to be significantly higher among healthcare workers (HCWs) than among the general population, which also impacts negatively on their mental health [1][2][3]. The effects of elevated work stress on HCWs can vary widely and can lead to post-traumatic stress disorder (PTSD), depression, substance abuse, sleep disorders, and even suicide [4][5][6]. Elevated occupational stress has also been linked to burnout syndrome, and to deterioration in work performance [4,7]. A longitudinal study, describing the relationship between burnout and work stress among UK physicians found circular causality: stress makes physicians more emotionally exhausted, and emotional exhaustion causes more stress [8]. ...
... The quality of relationships with co-workers as a protective factor against burnout was also emphasized by Poncet [46]. As a possible solution, confidential intervention and online mental health support [5] could be offered specifically to non-physician HCWs to help them to cope with increased work-related stress, especially because targeted mental health prevention has extreme importance. ...
Background
Work-related stress is significantly higher among healthcare workers (HCWs) than in the general population. Elevated occupational stress has been linked to burnout syndrome and depression. Moreover, medical professionals working during infectious disease outbreaks are at especially high risk for these problems. The aim of the present study was to examine the mental health status of HCWs and possible predictors of mental health status related to the COVID-19 outbreak utilizing a complex comprehensive model.
Methods
In a countrywide cross-sectional survey among HCWs (N = 2087), work-related stress, COVID-19 -related objective work factors (displacement, frontline working) and subjective work factors (insecurity, unpredictability, workload), perceived stress, work-related stress, burnout and depression were assessed between the second and third wave of COVID-19 pandemic in Hungary.
Results
COVID-19-related objective factors did not predict directly stress, burnout, and depression, whereas feelings of insecurity and unpredictability in relation to the COVID-19 situation at work had a significant medium-sized total effect (also considering the indirect effect via stress) on burnout and depression.
Conclusions
In order to prevent subsequent mental health problems during crisis situations, such as the COVID-19 pandemic, healthcare management should create a more predictable work environment and a safer work experience for healthcare workers and provide mental health support.
... 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). ...
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. ...
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. ...
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]. ...
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.
... 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]. ...
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). ...
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. ...
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. ...
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. ...
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. ...
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). ...
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]. ...
(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.
... 22 A survey of nurses employed by hospitals reported rates of depressive symptomatology of 18%, approximately twice that of the US population, with job satisfaction, body mass index, number of health problems, mental well-being, and health-related productivity significantly associated with depression scores. 23 The prevalence of depression among RNs is reported to be highest among those who are young, female, or working in intensive care or psychiatric units. 22 Nurses appear to be at higher risk for suicide than both physicians and the general public. ...
Background:
Occupational stress and diminished well-being among health care workers were concerning even before the coronavirus disease 2019 pandemic exacerbated existing stressors and created new challenges for this workforce. Research on the mental health of health care workers has focused on physicians and nurses, with less attention to other occupations.
Methods:
To assess pre-coronavirus disease mental health and well-being among workers in multiple health care occupations, we used 2017 to 2019 data from the Behavioral Risk Factor Surveillance System.
Results:
Across the health care workforce, insufficient sleep (41.0%) and diagnosed depression (18.9%) were the most common conditions reported. Counselors had the highest prevalence of diagnosed depression. Health care support workers had elevated prevalences for most adverse health conditions.
Conclusions:
Ensuring a robust health care workforce necessitates identifying and implementing effective occupation-specific prevention, intervention, and mitigation strategies that address organizational and personal conditions adversely affecting mental health.
... Depression can affect nurses' professional performances and leads to nursing errors and negligence. 1,2 It is important to manage a nurse's mental health not only for the nurse's health but also for the patient's health. Nurses are exposed to occupational risk factors for depression, such as long working hours, shift work, emotional labor, and high-intensity work stress. ...
Background:
This study was conducted to examine the relationship between chronotype and depressive symptoms to provide grounded knowledge in establishing nurses' health promotion strategies.
Methods:
The subjects of this study were 493 newly hired nurses working in 2 general hospitals within the university from September 2018 to September 2020. Sociodemographic and work-related characteristics were collected from a medical examination database and a self-reported questionnaire. These included sex, age, marital status, living situation, education level, alcohol consumption, physical activity, prior work experience before 3 months, workplace, and departments. To analyze the associations between the chronotype and depressive symptoms, multiple logistic regression analyses were performed to calculate odds ratios (ORs).
Results:
Among participants, 9.1% had depressive symptoms and 16.4% had insomnia. The subjects are divided into morningness (30.2%), intermediate (48.7%), and eveningness (21.1%). The multiple logistic regression analysis controlling for age, living status, education level, alcohol consumption, physical activity, workplace, prior work experience before 3 months, and insomnia, revealed that the OR of depressive symptoms in the eveningness group was 3.71 (95% confidence interval [CI]: 1.50-9.18) compared to the morningness group, and the R2 value was 0.151. It also can be confirmed that insomnia symptoms have a statistically significant effect on depressive symptoms (OR: 2.16, 95% CI: 1.03-4.52).
Conclusions:
Our findings suggest that evening-type nurses are more likely to have depression than morning-type nurses. We should consider interventions in a high-risk group such as the evening type nurses to reduce depressive symptoms in nurses.
... This study was designed to explore the question of whether lower frequency, online mindfulness instruction and practice over a short period of time would impact perceived stress and/or immune-related biomarkers. We chose to specifically recruits nurses for this study given the high rates of burnout and mental health disorders among this group, especially exacerbated by the recent pandemic (McHugh et al., 2011;Letvak et al., 2012;Al Maqbali et al., 2021). ...
Objectives
Prior studies of mindfulness meditation have demonstrated anti-inflammatory and immunoregulatory effects but whether meditation courses delivered online can exert similar effects is poorly understood. Barriers to large scale implementation of traditional mindfulness meditation programs has created an increased interest in the effect of less time- and resource-intensive online meditation courses. The purpose of this study was to determine whether a 6-week online mindfulness program with low time demands on nurses would lead to changes in gene expression, cytokine profiles, telomerase activity, and cortisol profiles.
Methods
This was a randomized, parallel pilot study comparing an online mindfulness-based stress management program to an active control group from December 2018 to May 2019. Healthy nurses with above average levels of perceived stress were randomized to receive a 6-week online mindfulness-based stress management program including ≥5 minutes daily meditation practice or listen to relaxing music for ≥5 minutes daily as the control arm. Blood samples were collected at baseline and after 6 weeks, and various self-reported measures of stress, physical and emotional health were collected at baseline, after 6 weeks, and after 12 weeks. Whole transcriptome mRNA sequencing of whole blood at baseline and after 6 weeks was performed along with measurement of plasma IL-6, IL-8, IL-10, TNF-α, and IFN-γ. Peripheral blood mononuclear cells were isolated, and telomerase activity was measured. Diurnal salivary cortisol profiles were assessed at baseline and after 6 weeks. The primary outcome was change over time in a pre-determined set of 53 genes representative of the immune-related changes seen with stress, which was analyzed using a mixed linear model. Secondary outcomes included all other self-reported measures and biomarkers mentioned above.
Results
A total of 61 nurses were randomized, with 52 having sufficient data to include in the final analysis. After 6 weeks, nurses in the control group reported significant reductions in stress as measured by the Perceived Stress Scale while those in the mindfulness group did not. However, after 12 weeks, the mindfulness group also showed a significant reduction in stress. When compared to the control group, no significant changes in RNA gene expression or any other biomarkers were observed in the nurses who participated in the mindfulness program.
Conclusions
Our study found that this brief online mindfulness-based intervention was effective in reducing stress in nurses, albeit with a delayed effect compared to listening to relaxing music. Regarding immunoregulatory effects, there were no significant differences between treatment and control groups in transcriptomic or other tested biomarkers of immune function. This study provides evidence for a floor effect of mindfulness on transcriptional and circulating biomarkers of immune function.
... Indeed, healthcare workers were ranked third for depressive episodes of all occupations between 2004 and 2006 [6]. It has been proven that the depression will be the second disability-adjusted life years lost by the year 2020 [7]. ...
Introduction: People with depression have persistent sadness which interferes with productivity and daily activity. Subsequently decreasing work accuracy or increasing the medical errors in the medical field. The increasing amount of medical errors that was suggestive of depression encouraged us to estimate the extensiveness of depression among health workers in the hospitals in Kuwait. Aim: To provide basic data that will contribute to the design of preventive measures that will reduce the prevalence of Depression among health workers. Study Design: Cross sectional study. Materials and Methods: The research was conducted in AlFarwaniya Hospital & Mubarak AlKabeer Hospital in 2016. Data was performed using IPad and analyzed using SPSS. Results: The highest percentage of depression is among the ones whose ages are between 30 to 39 which is 12% (37) out of 52.4 % (162). It shows that females had depressive symptoms more than males, 7.1% of males were depressed compared to the 12.2% who were females. It seems that Kuwaiti health workers show depressive symptoms more than the non-Kuwaiti. It shows that doctors have highest depression rate (28%) then the nurse and finally the other careers. Married individuals show 68% are depressed which is the highest, single individuals with (28%) and divorced with (1.7%). Smokers were with 25% and nonsmokers with (19%) of depression. Chronic diseases don’t show significant effect on depression. Conclusion: This study showed that there is a difference in the prevalence of depression between the genders as well as the social status. Establishment of new rules to decrease working hours and held workshops and seminars on overcoming depression are great solutions to reduce stress among health workers.
... Meanwhile, the changes and challenges to health care brought about by the dramatic increase in natural and artificial disasters also place an additional psychosocial burden on nurses (Deng et al., 2019;Hill et al., 2022). Many studies have assessed and reported high levels of stress (Kemper et al., 2011;McTiernan and McDonald, 2015;Mahdizadeh et al., 2016), depressive symptoms (Letvak et al., 2012;Cheung and Yip, 2015) and anxiety symptoms (Gao et al., 2012;Alhroub et al., 2022) among health care workers worldwide. Despite cultural and organizational differences, nurses worldwide are a population with higher stress and emotional symptoms (Creedy et al., 2017;Poursadeghiyan et al., 2017;Han et al., 2020;Abraham et al., 2021;Jokwiro et al., 2021;Marvaldi et al., 2021). ...
As at a high-risk group of psychological distress, nurses generally experience varying degrees of stress, anxiety, and depression. This paper identifies the positive factors that may negatively regulate the psychological pain of clinical nurses and their mechanisms of action, providing reliable references for clinical nurse support management. The effects and mechanisms of hope and the two components of grit consistency of interest and perseverance of effort) on clinical nurses’ psychological distress (depression, anxiety, and stress) were observed in this study. A total of 635 Chinese clinical nurses (90.4% female) completed an anonymous questionnaire for the survey. As expected, hope, consistency of interest, and perseverance of effort were negatively correlated with the three indicators of psychological distress ( r = −0.21 ~ −0.38, p < 0.01). Path analysis results showed that hope significantly mediated the negative effect of consistency of interest on psychological distress, with an effect of 12.96%. Hope also covered up the perseverance of effort on psychological distress, the effect of 110.63%. In the influence of consistency of interest and perseverance of effort on psychological distress, hope contributed a vital mediating. Based on these results, it can be concluded that grit and hope have protective effects on psychological distress in clinical nurses. Significantly increasing the level of hope or grit may effectively prevent and reduce psychological distress in clinical nurses.
... Die interne Konsistenz ist hier mit α = 0,89 -im Gegensatz zur englischsprachigen Version -als mittelmäßig zu bewerten. In der Querschnittstudie von Letvak et al. (2012), bei der amerikanische Diplomkrankenpfleger:innen auf Depression gescreent wurden, betrug die Depressions-Prävalenz 18 % (Cut-Off ≥ 10). Zum Einsatz kam der PHQ-9-Fragebogen. ...
Sufficient studies are currently available that summarize and compare the mental health
of the population and hospital staff during the COVID-19 pandemic, but mostly
insufficiently compare them with the time before the pandemic. There is currently no
study that compares the mental health of the population and hospital staff of a country
internationally during and before the pandemic. In this work, (1) the mental health
(stress, depression, anxiety, mental well-being, mental quality of life) of Austrian
hospital staff is empirically assessed using questionnaires (PSS-10, PHQ-9, GAD-7,
WHO-5, WHOQOL-BREF), compared to an Austrian population sample and checked
for differences. The Austrian hospital staff (N= 1.037) differs significantly from the
Austrian population in all outcomes (stress ↑, depression ↑, quality of life ↑, anxiety ↓,
mental well-being ↓), except for the degree of insomnia, with a small effect size
(Hedges g: -0.33-0.02). The results were then (2) compared internationally and to the
pre-pandemic period using a systematic literature review. The mental health of the
Austrian (stress ↑, depression ↑, anxiety ↑, quality of life ↓) and global (depression ↑,
anxiety ↑, insomnia ↑) population, as well as of hospital staff (depression ↑, anxiety ↑)
has worsened in all comparable outcomes compared to the time before the pandemic. In
an international comparison, the Austrian population has shown better mental health in
the period of the pandemic so far (depression ↓, anxiety ↓). In an international
comparison, the Austrian hospital staff is less anxious in times of high stress, with a
similar prevalence of depression and insomnia. The results should be interpreted with
caution due to the lack of representativeness. For the Austrian population and hospital
staff, it will be essential in the future that mental health is promoted more, that the taboo
on mental treatment is broken and that outpatient and inpatient mental care is
significantly expanded.
... Despite the potentially detrimental effects at an individual level (e.g., developing chronic and lifelong mental health conditions), poor mental health among medical staff may further cause a considerable negative impact on patients and the whole health care system. Specifically, poor mental health may contribute to aversive consequences such as making medical errors and an overall deterioration of patient care quality and safety (Goulia et al., 2010;Letvak et al., 2012;Sun et al., 2022). Understanding mechanisms that underlie common mental health problems, such as depression and anxiety, may lead to improvements in early detection and the development of effective intervention strategies. ...
Existing research proposed that moving from a disorder-level analysis to a symptom-level analysis may provide a more fine-grained understanding of psychopathology. This study aimed to explore the relations between two dimensions (i.e., cognitive reappraisal, CR; expressive suppression, ES) of emotion regulation (ER) and various symptoms of depression and anxiety among medical staff during the late stage of COVID-19 pandemic. We examined depression symptoms, anxiety symptoms and ER among 420 medical staff during the late stage of COVID-19 pandemic. Two networks (i.e. ER-depression network and ER-anxiety network) were constructed in the present study. Bridge centrality index was calculated for each variable within the two networks. Among the present sample, the prevalences of depression and anxiety are 39.5% and 26.0%. Within ER-depression/anxiety networks, CR is only negatively linked with depression/anxiety symptoms while ES is both positively and negatively linked with depression/anxiety symptoms. Results of bridge centrality revealed that in both of two networks, CR has a negative bridge expected influence value while ES has a positive bridge expected influence value. The results revealed the specific role of CR and ES in relation to depression and anxiety at a symptom level. Implications for clinical preventions and interventions are discussed.
... Although this prevalence is lower than the U.S. adult population, it is still high and noteworthy. Moreover, nursing staff report higher rates of insufficient sleep and mental illness such as depression, compared to the general public (Letvak et al., 2012;Zhang et al., 2017). These are likely to contribute to poor health and well-being, and lead to further adverse effects on coworkers, patients, and potentially impact the quality of care. ...
Aims
This exploratory study, using mixed methods research, aimed to (1) examine the associations among self‐efficacy, social support and regular leisure‐time physical activity of nursing staff, and (2) identify motivators and barriers to leisure‐time physical activity.
Background
It is important to engage nursing staff in regular leisure‐time physical activity as a countermeasure against high occupational stress and poor health. Limited research has examined nursing staff's participation in leisure‐time physical activity and associated factors.
Methods
Nursing staff employed at a community hospital in the northeastern United States were invited to participate in this cross‐sectional survey with close‐ and open‐ended questions in March 2016.
Results
A total of 363 nurses and nursing assistants responded, among whom, 59.8% reported regular leisure‐time physical activity. Poisson regression models suggested that self‐efficacy and social support had an interactive association with increased prevalence of regular leisure‐time physical activity.
Conclusion
Self‐efficacy and social support have an important synergistic association with regular leisure‐time physical activity of nursing staff. Effective interventions intending to facilitate nursing staff's leisure‐time physical activity should consider improving their self‐efficacy and social support. Qualitative comments suggested that work‐out areas in the workplace with release time and organized activity may promote regular leisure‐time physical activity of nursing staff.
... depending on the assessment tools used (11). Many researches have reported that the prevalence of depression among nurses ranges from 18-64.8% (12)(13)(14)(15)(16), and some studies have suggested that the prevalence of depression among nurses was nearly twice that of other professional individuals (17). The prevalence of depressive symptoms among Chinese nurses between 1996 and 2019 was about 43.8%(18). ...
Background
The aim of this cross-sectional survey was to investigate the prevalence of depression in 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 in 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 score the depression, anxiety and sleep disorders. Correlation analysis and regression analysis were performed on the factors affecting the occurrence and severity of depression.
Results
Among 645 medical staff, 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%. The prevalence of depression in females, nurses, unmarried or single group, and rotating-shift population was significantly higher than that in males(48.3% vs 27.1%, OR = 2.512), doctors(55.2% vs 26.7%, OR = 3.388), married group(50.5% vs 35.8%, OR = 1.900), and day-shift population(35.2% vs 7.5%, OR = 1.719). The occurrence of depression was correlated with anxiety, sleep disorder, headache and migraine, with anxiety being the most significant (Spearman Rho = 0.531). The SDS was significantly correlated with SAS and PSQI (Spearman Rho = 0.801, 0.503), and also related to the presence of headache and migraine (Spearman Rho = 0.228, 0.159). Multivariate 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 depression degree in multiple linear regression.
Conclusion
The prevalence of depression in medical staff is higher than that in the general population especially among females, nurse occupation, unmarried people and rotating-shift population. Depression is associated with anxiety, sleep disorders, headache and migraine. Anxiety and nurse occupation are risk factors for depression. This study might provide a reference for the promotion of occupational health among medical staff.
... In this context where anxiety takes part in daily life, HCWs have been affected by various disorders even before the pandemic [25][26][27], so there may be differences according to the profession and healthcare role. Our results showed no differences between occupations. ...
Introduction: Anxiety can affect front-line healthcare workers (HCWs) during the COVID-19 pandemic mainly in settings with influencing factors. Living with COVID-19 patients in hospital settings could affect mental health during lockdown. The present study aimed to estimate the anxiety levels of HCWs of the care center for COVID-19 Villa Panamericana during the first outbreak of COVID-19 in Peru. Methods: This is a descriptive and correlational study. Ninety-six HCWs were enrolled in this study (mean age 30±5.6 years). The care center for COVID-19 Villa Panamericana houses COVID-19 patients and HCWs in the same environment. We used the 14-item Hamilton anxiety rating scale questionnaire. Professionals were interviewed directly at the VP-19 rest towers. SPSS V.23 were used to analyze the data. Results: Fifty-four (56.3%) were male and the most frequent age group was 26-35 years (81.3%). Thirty-nine (40.6%) were nurses, 28 (29.2%) were nursing technicians, 15 (15.6%) were physicians, and 14 (14.6%) were medical technologists. Of the total, 66 (68.8%) HCWs had a mild level of anxiety, while 6 (6.3%) had severe anxiety. Medical technologists and nursing technicians had the highest level of severe anxiety (14.3% and 7.1%), while nurses had the highest level of mild anxiety (76.9%). We report that 32 (33.3%) HCWs had COVID-19 while 93.7% had symptoms of anxiety [3(9.4%) mild to moderate, 21(65.6 %) moderate to severe, and 6(18.8%) severe]. We found a significant difference in anxiety levels between HCWs with and without COVID-19 (p=0.001). Conclusions: Levels of moderate and severe anxiety significantly increased in HCWs infected with COVID-19 during their coexistence with COVID-19 patients in the health center that houses both at the same time.
... In addition, the need to continually combat the increasing number of suspected and positive COVID-19 infection cases in Malaysian public hospitals has further aggravated this situation. As a result, the health status of nurses will be affected, including their job performance and quality of patient care 44 . Moreover, when employees face high levels of stressors, in this case, workload, their resources in terms of strength would be depleted. ...
Nurses act as customer-contact employees who are responsible for providing round-the-clock service to patients. Their empathy and competency skills have a significant impact on the quality of services provided to patients. The purpose of this study is to examine the role of empathy and competency in determining task performance and contextual performance of public hospital nurses in Malaysia. A survey using self-administered questionnaires was used to collect data from a sample of 354 staff nurses working in Malaysian public hospitals. Hypotheses were tested using the partial least square technique. Findings indicated that empathy has a positive relationship with task performance but not with contextual performance. Competency, however, has a positive relationship with task performance and contextual performance respectively. Empathy and competency are essential elements in predicting both task performance and contextual performance. The findings of this study highlighted the importance of empathy and competency in improving job performance among nurses in Malaysian public hospitals.
... Depressive Erkrankungen unter Pflegekräften weisen weltweit hohe Prävalenz raten im Vergleich zur Allgemeinbevölkerung auf (Shields u. Wilkins 2006;Letvak et al. 2012;Shari et al. 2017;Grobe u ...
... 3,4 Depression, anxiety and stress are the most prevalent mental disorders among nurses. 5,6 Mental disorders are found associated with absence from work, intention to leave, and high turnover 7,8 and these mental health problems can contribute to occupational accidents and quality of services. 9,10 Some studies have measured and reported all three 11 and other studies have reported findings separately on stress, anxiety and depression. ...
Background: Nurse’s professionals experience an overwhelming level of stress due to socio-demographic and work place related factors. This cross-sectional hospital-based study was designed to assess perceived level of stress and influencing factors among nightshift working nurses in Kathmandu, Nepal. Methods: A cross-sectional hospital-based study using multistage sampling techniques among 266 randomly sampled nightshift working nurses was conducted. Perceived Stress Scale used to assess level of stress and associated factors. Self-administered Perceived Stress Scale was pretested and finalized before data collection. Data analyzed by using IBM SPSS verson-20 and relevant statistical test applied. Results: Mean age of nurses was 24.46 years ± 3.771 S.D. Most of the nurses (41.3%) were between 22-26 years and 70.9% of nurses were unmarried. Nearly eighty percent of the nurses had moderate level perceived stress followed by low level (15.5%) and high level (4.9%) stress. There is significance association between sleeping hours of the nurses and stress (p= 0.013). Conclusions: Prevalence of moderate level perceived stress was highest among nightshift working nurses in hospitals of Kathmandu, Nepal. There is significance association between sleeping hours of the nurses and stress. Longer working hours in nightshift, shorter sleeping hours, unequal and overloaded duty were main factors related to higher rates of self reported stress.
... depending on the assessment tools used (11). Many researches have reported that the prevalence of depression among nurses ranges from 18-64.8% (12)(13)(14)(15)(16), and some studies have suggested that the prevalence of depression among nurses was nearly twice that of other professional individuals (17). The prevalence of depressive symptoms among Chinese nurses between 1996 and 2019 was about 43.8%(18). ...
Background: Our previous studies reported the prevalence of primary headache and risk factors among medical staff in South China. The aim of this cross-sectional survey was to learn more about the prevalence of depression in medical staff and its risk factors, as well as to investigate the association between depression, anxiety, headache, and sleep disorders.
Methods: Stratified random cluster sampling was used to select medical staff from various departments in four hospitals in Sanya City. Based on previously study, the Self-rating Depression Scale（SDS）, Self-rating Anxiety Scale (SAS), Pittsburgh Sleep Quality Index (PSQI) were used to quantitatively score the depression, anxiety and sleep disorders. Non-parametric Spearman correlation analysis and regression analysis were performed on the factors affecting the occurrence and severity of depression.
Results: Among 645 medical staff, 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%. The prevalence of depression in females, nurses, unmarried or single group, and rotating-shift population was significantly higher than that in males(48.3% vs 27.1%, OR=2.512), doctors(55.2% vs 26.7%, OR=3.388), married group(50.5% vs 35.8%, OR=1.900), and day-shift population(35.2% vs 7.5%, OR=1.719). The occurrence of depression was correlated with anxiety, sleep disorder, headache and migraine, with anxiety being the most significant (Spearman Rho = 0.531). The SDS was significantly correlated with SAS and PSQI (Spearman Rho = 0.801, 0.503), and also related to the presence of headache and migraine (Spearman Rho = 0.228, 0.159). Multivariate 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 depression degree in multiple linear regression.
Conclusion: The prevalence of depression in medical staff is higher than that in the general population especially among females, nurse occupation, unmarried people and rotating-shift population. Depression is associated with anxiety, sleep disorders, headache and migraine. Anxiety and nurse occupation are risk factors for depression. This study might provide a reference for the promotion of occupational health among medical staff.
... Nevertheless, physicians and nurses experience high rates of adverse effects on their mental health such as burnout, stress and depression due to workplace conditions such as excessive workload, workplace violence and so on Shi, Li, et al., 2020). Conditions like these produce negative effects on the overall happiness and well-being of workers (Gray et al., 2019;Letvak et al., 2012;Yasin et al., 2019). Moreover, such issues can impact how workers perform their work and result in poor patient safety outcomes, such as medical errors (Hall et al., 2016). ...
Aims:
To investigate the impact of occupational exposure on job satisfaction and overall happiness, and to identify related factors of job satisfaction and overall happiness among physicians and nurses.
Background:
Occupational exposure against physicians and nurses has become one of the most serious public health issues worldwide.
Methods:
A cross-sectional study was conducted among physicians and nurses from 14 public tertiary hospitals using purposive sampling. Propensity score matching was used to compare job satisfaction and overall happiness among physicians and nurses with and without occupational exposure. Furthermore, binary logistic regression analysis was used to identify and analyze the influencing factors of job satisfaction and overall happiness.
Results:
A total of 2139 physicians and nurses (55.59%) from 3791 participants had experienced occupational exposure hazards. Before matching, the job satisfaction and overall happiness among the physicians and nurses was 38.54% and 42.14%, respectively. Participants who experienced occupational exposure were more likely to develop job dissatisfaction (OR = 1.08, 95%CI: 0.90-1.28) and overall unhappiness (OR = 1.24, 95%CI: 1.05- 1.46) than those who did not. Participants' work experience, self-evaluated health status, satisfaction with the work environment, evaluation of doctor-patient relationship, and stress were common factors affecting job satisfaction and overall happiness.
Conclusions:
Our findings suggest that physicians and nurses who experience occupational exposure are more likely to develop job dissatisfaction and overall unhappiness, especially if they have shorter work experience and a tense or neutral relationship with patients.
Implications for nursing management:
It is necessary to pay attention to the occupational exposure. When physicians and nurses experience occupational exposure, managers could provide support to prevent job dissatisfaction and unhappiness.
... Nurses are among health workers who are at risk of emotional mental disorders. The prevalence of the disorders among nurses is high-18% in the United States and 30% in Australia (Letvak et al., 2012;Maharaj et al., 2019). In Indonesia, the prevalence of emotional mental disorders among nurses was 23.5% (Fitriani et al., 2020). ...
Aim:
The aim of this study was to examine the relationship between intake of vitamins B1, B6, B9 and B12 with emotional mental disorders among nurses in Indonesia.
Design:
This cross-sectional study included nurses who have worked at least six months at a private hospital in Indonesia from March to April 2021.
Methods:
We used the Food Frequency Questionnaire, Self-Reporting Questionnaire 20 and the Expanded Nursing Stress Scale questionnaire to assess the B-vitamin intake, emotional mental disorders and work-related stress.
Results:
Of 80 interviewed nurses, 8.8% experienced severe work-related stress, and 22.5% had emotional mental disorders. Most nurses had inadequate intake of vitamins B1 and B9 but had adequate intake of vitamins B6 (72.5%) and B12 (56.3%). Emotional mental disorders are more probably to occur in nurses with less intake of vitamins B6 and B12, with respective aOR of 20.06, 95% CI 4.14-97.09 (p < .001) and 4.49, 95% CI 1.19-16.83 (p = .026).
... While the preparation of handling a surge of patients in hospitals is central, evidence suggests monitoring the emotional and psychological burden on staff is equally essential [13][14][15]. Overall, HCWs exhibit higher rates of anxiety, depression, burnout, and suicidal ideation when compared to the general population [16][17][18]. During infectious outbreaks, there are significant psychological impacts across all population groups, with HCWs bearing a disproportionate burden [19][20][21]. ...
Background
The COVID-19 pandemic has inundated the capacity of hospitals across the globe, exhausting resources, and placing extreme burden on health care workers (HCWs). Hospital preparedness during infectious disease outbreak involves development and implementation of appropriate strategies, procedures, and adequate training for HCWs. Reliable and valid tools to evaluate the perception of HCWs on the effectiveness of hospital preparedness strategies are imperative and literature is yet to fill that gap.
Methods
Items for ‘The Staff Questionnaire for Infectious Disease Outbreak Readiness and Preparedness (SQIDORP)’ were selected from literature that addressed hospital preparedness during novel pandemic outbreaks. The SQIDORP was distributed within a regional hospital in Victoria, Australia. Psychometric evaluation included estimates of reliability and factor analysis while factors associated with the questionnaire were explored using regression analysis.
Results
Omega coefficient of 0.89, Cronbach’s alpha coefficient of 0.88 and item-total correlations (> 0.3) indicated adequate reliability of the SQIDORP. Factor Analysis yielded three meaningful latent factors that are effectiveness of training (Factor 1), self-confidence (Factor 2) and risk to self and stress (Factor 3). Demographic factors did not influence the correlation with SQIDORP. However, rating ‘ the current plan for management of COVID-19 in your ward ’ and ‘ personal knowledge/skills in caring for patients with COVID-19 ’ had significant positive correlation and accounted for 33% of the variance in readiness and preparedness using SQIDORP (R2 = 0.33, F = 10.227, P < 0.001).
Conclusion
Most of the items of SQIDORP questionnaire achieved adequate internal consistence reliability. This is a valuable tool that can be utilized by hospitals to explore aspects of preparedness and give insights to the knowledge, skills, and mental health of HCWs, as perceived by the HCW themselves.
... Sarsangi et al. [31] in Iran and Ballangrud et al. [40] in Sweden reported that the lowest score was obtained by reporting the errors and mistakes, while this factor obtained the highest score in our study. The result was consistent with Kavari et al. [41] and was inconsistent with some other studies [42][43][44]. Moreover, Kudo et al. conducted a study in Japanese hospitals and found that communication with nurses obtained the lowest score [45]. ...
BACKGROUND: Safety climate is a common insight of staff that indicates individuals' attitudes toward safety and priority of safety at work. OBJECTIVE: Nursing is a risky job where paying attention to safety is crucial. The assessment of the safety climate is one of the methods to measure the safety conditions in this occupation. The aim of this study was to assess the safety climate of rehabilitation nurses working in hospitals in Tehran. METHODS: This is a cross-sectional study which was carried out on 140 rehabilitation nurses selected from all hospitals and clinics in Tehran in 2019. To collect the required data, a two-section questionnaire was used. The first section was related to demographic factors and the second part (22 statements) was to measure the safety climate using nurses' safety climate assessment questionnaire. The collected data were analyzed by SPSS V16 using independent t-test, ANOVA, Kruskal-Wallis and Mann-Whitney U test at the 5% level. RESULT: Findings showed that the total mean of safety climate was 3.06 ± 0.56. According to the results, a significant difference was found between the positive and negative satisfaction of nurses with safety climates (P-value = 0.03), communication with nurses (P-value = 0.01) and supervisors' attitude (P-value = 0.02). Furthermore, a significant difference in safety climate between the individual with the second job and the individual without second could be observed (P-value = 0.01). CONCLUSION: The results indicated that the safety climate was not at an acceptable level. Thus, it is essential to introduce safety training courses (e.g. safety, work-rest balance, and so on) and to improve the safety performance at work.
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.
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.
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.
Objectives
Although many studies have examined the association between shift work and depression or insomnia, few studies have examined the relationship between quick return (QR) to work and depressive symptoms, regardless of shift work. Thus, in this study, we aimed to assess the association between depressive symptoms (DS)/sleep disturbances (SDs) and QR.
Methods
Data from the 6 th Korean Working Conditions Survey (2020) were used for this study. Paid workers aged between 20 and 65 years were included. DS were defined using the World Health Organization Well-Being Index (WHO-5) with a cut-off 50, and SD was defined as the occurrence of the following symptoms several times per month: difficulty in falling asleep, waking up in the middle of the night, or feeling tired even after waking up. QR was defined as “at least one case where the working interval between leaving work and the next day's work was < 11 h in the past month.” Multivariable logistic regression was performed to estimate the adjusted odd ratios (aORs) and 95% confidence intervals (CIs). Mediation analysis was conducted to examine whether SD was a significant mediator in the association between QR and DS.
Results
Among the 27,554 participants, DS occurred in 8,277 patients, while SD occurred in 6,264 patients. The aORs (95% CIs) of DS and SD by QR were 2.01 (1.78–2.27) and 3.24 (2.87–3.66), respectively, after adjusting for age, gender, income, education, working hours, job status, working duration, region, shift work, and occupation. SD was a significant mediator in the association between QR and DS.
Conclusion
QR is significantly associated with DS or SD regardless of demographic factors and the working environment. The significant relationship between QR and DS may be mediated by SD.
Introduction
The mental health status of nurses affects not only their well-being but also the organisational outcomes and the quality of patient care. Hence, stress management strategies are critical as a universal prevention measure that address an entire population and are not directed at a specific risk group to maintain nurses’ mental health in the workplace. No systematic review or meta-analysis has been conducted to evaluate the effect of cognitive–behavioural therapy (CBT) that specifically focuses on universal prevention. Therefore, the aim of this study is to examine the effectiveness that is reported in published randomised controlled trial (RCT) studies.
Methods and analysis
This systematic review and meta-analysis will analyse published studies selected from electronic databases (ie, Cochrane Central Register of Controlled Trials, PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, PsycARTICLES, Web of Science and the Japan Medical Abstracts Society). The inclusion criteria for studies are that they (1) were conducted to assess the effect of CBT on the mental health of nurses as a universal prevention, (2) used an RCT design and (3) provided sufficient results (sample sizes, means and SD) to estimate the pooled effect sizes with 95% CIs. Studies will be excluded if they only targeted nurses who had been screened as being at high risk in terms of their mental health and indicated that they required the prevention. The methodological quality of the included studies will be assessed using the Cochrane Collaboration’s risk of bias tool.
Ethics and dissemination
Ethical approval is not required because this study is based on information obtained from previous studies. The results and findings of this study will be submitted for publication in a peer-reviewed international scientific journal. Results from this study will be helpful when implementing CBT strategies for nurses as a universal preventative measure in the workplace and for managing stress-related outcomes.
PROSPERO registration number
CRD42020152837.
Objectives:
This study investigated the effects of effort-reward imbalance (ERI) on emergency nurses' turnover intention and the role of depressive symptoms between ERI and turnover intention.
Background:
Turnover intention is crucial for clinical practice due to its relationship with turnover behaviour and destructive effect on stability of nursing staff. The ERI is a mainstream model to explain job stress, which seems to be one of the key variables, but the direct evidence is not adequate. In addition, there have been only a few studies looking into the complexity of the relationship between ERI and turnover intention, and more research is needed.
Methods:
This is a cross-sectional study conducted from July to August 2018, and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were followed. We employed a standardised questionnaire to collect sociodemographic information and target turnover intention. Hierarchical multiple logistic regression and mediation analyses were performed for the data analyses.
Results:
This study included responses from 17,582 emergency nurses in China. On turnover intention, ERI exerted both direct effect and indirect mediating effect. The results also indicate that depressive symptoms partially mediated the effect of ERI on turnover intention, and that 27.4% of this effect can be explained by mediating effects.
Conclusions:
To improve the turnover intention, it is necessary to consider reducing ERI and depressive symptoms of emergency nurses as powerful measures not to be ignored.
Relevance to clinical practice:
This study provides important insights regarding how nursing administrators should better reduce the workload of caregivers and improve depressive symptoms to avoid turnover intention.
The current study investigated occupational stress, anxiety, and depression among psychiatric nurses and explored the intermediary role of general self-efficacy between occupational stress, anxiety, and depression. In November 2020, 171 psychiatric nurses completed a self-report questionnaire. Spearman's correlation analysis was used to determine the relationship between the four variables and the bootstrap method was used to test the intermediary hypothesis. Results showed that 35.1% of psychiatric nurses had health risk stress. Among participants, detection rates of anxiety and depression were 24% and 46.8%, respectively. There was a positive correlation between occupational stress and anxiety (r = 0.577, p < 0.05) and depression (r = 0.653, p < 0.05). There was a negative correlation between general self-efficacy and anxiety (r = -0.358, p < 0.05) and depression (r = -0.500, p < 0.05), and general self-efficacy had a significant mediating effect between occupational stress and depression. However, the mediating effect of general self-efficacy on anxiety was not significant. Nurse managers should be aware of the importance of nurses' general self-efficacy and self-confidence. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].
Background:
American healthcare workers face unprecedented stress and trauma in the workplace during COVID-19, putting nurses at increased risk for poor mental health. Examining trends of mental health from before and during COVID-19 can illuminate the toll of the pandemic on nurses well-being.
Methods:
Nurses enrolled in Healthy Nurse, Healthy Nation receive a prompt to take an annual survey (n = 24,289). Mental health was assessed by active diagnoses of anxiety and depressive disorder, and feeling sad, down or depressed for two or more weeks in the past year. Logistic regression models were used to calculate predictive probabilities of health outcomes in year 4 (May 1, 2020 - April 30, 2021) compared to years 1-3 (each from May 1 to April 30), controlling for age, sex, race/ethnicity, and nurse type. Models were also stratified by work setting and nurse type.
Results:
In year 4, nurses had a 19.8% probability of anxiety disorder, significantly higher than year 3 (16.3%, p < .001), year 2 (13.7%, p < .001), and year 1 (14.0%, p < .001). Similarly, nurses had a 16.7% probability of depression disorder in year 4, significantly higher than year 2 (12.9%, p < .001) and year 1 (13.9%, p < .01). Year 4 nurses had a 34.4% probability of feeling sad, down or depressed for two weeks, significantly higher than previous years (year 1 = 26.8%, year 2 = 25.9%, year 3 = 29.7%, p < .001). Trends in probabilities of mental health indicators were similar among each nurse type and work setting. Nurses in medical/surgical work settings and those with licensed practical nurse and licensed vocational nurse titles consistently had the highest probability of poor mental health.
Linking action to evidence:
In 2020-2021, nurses faced challenges unlike any experienced in previous years. Unsurprisingly, nurses reported increased instances of poor mental health indicators. Positive disruptive strategies are needed to systemically change organizational culture and policy to prioritize and support nurses' well-being.
Nursing is a highly stressful profession. Stress can impede nurses’ ability to work effectively leading to workplace errors, burnout and nurses leaving the profession. Self-care activities can help promote the mental and physical health of nurses thereby enabling them to better cope with stress. Self-care activities include self-compassion, mindfulness, general healthy habits such as quality sleep, a balanced healthy diet, regular exercise, attending to one’s basic needs to list a few. Self-care must become inherent to nurses to equip them to better care for others.
Background
Depressive symptoms have a series of negative effects and are considered especially severe among nurses, whereas there is a lack of quantitative studies comparing the risk of depressive symptoms between nurses and the general population.
Methods
We respectively conducted a nationwide cross-sectional online survey among 17,582 Chinese nurses from July to August 2018, and 101,120 Chinese community residents from January to February 2019. The questionnaire covered social-demographic characteristics and depressive symptoms for both, work-related factors and life-related factors for nurses. Propensity Score Matching was performed to match nurses and residents by gender, age, educational level, marital status, and habitual residence.
Results
Before Propensity Score Matching, the risk of depressive symptoms in nurses was higher than residents (OR, 2.16; 95% CI, 2.07–2.26). After matching, there were 15,256 nurses and residents respectively, and the risk in nurses was higher (OR, 2.14; 95% CI, 2.02–2.27). Logistic regression showed that longer years of service (OR, 1.54; 95% CI, 1.30–1.83), higher night shift frequency (OR, 1.48; 95% CI, 1.35–1.64), perceived shortage of nurses (OR, 1.98; 95% CI, 1.84–2.13), suffered verbal violence (OR, 2.43; 95% CI, 2.21–2.66) and physical violence (OR, 1.80; 95% CI, 1.64–1.98) were risk factors for depressive symptoms in nurses.
Limitations
Convenience sampling and online survey were adopted in this cross-sectional study, which may diminish the representativeness of samples.
Conclusions
Compared with the general population, nurses have a higher risk of depressive symptoms in China. Reasonable work allocation, adequate staffing, scientific shift system and violence emergency system should be implemented.
Aims
Although medical professionals possess a positive attitude toward SDM, they lack of a complete understanding of conceptual shared decision making (SDM). Therefore, a related knowledge base must be constructed to enhance service education. We aimed to examine the effectiveness of an educational program with situational simulation video on nurses' SDM attitude.
Methods
A randomized controlled trial with single-blind study design was conducted, and permuted block randomization was employed. Participants were randomly assigned to an experimental group (n = 50) or control group (n = 50). Only the experimental group received education programs within 2 weeks, with the first covering the basic concept of SDM and the second comprising situation simulation teaching. In both groups, data were collected prior to intervention as baseline, immediately after intervention to evaluate its immediate effects, and 2 months after intervention to test the delay effect. A generalized estimating equation, subgroup analysis and descriptive statistics were used to analyse data.
Results
A significant main effect over time was discovered. Nevertheless, no significant group-time interaction was noted between the two groups after a 2-month interval. Subgroup analysis reveals that the SDM attitude scores in both the experimental and control groups increase for within group. The improvement of SDM attitude score in the experiment group was better than control group at follow test.
Concisions
The findings of this study might provide a reference for health care providers when designing service education courses to improve the execution strategies of SDM and thus the quality of care provided.
Background: The COVID-19 pandemic has inundated the capacity of hospitals across the globe, exhausting resources, and placing extreme burden on health care workers (HCWs). Hospital preparedness during infectious disease outbreak involves development and implementation of appropriate strategies, procedures, and adequate training for HCWs. Reliable and valid tools to evaluate the perception of HCWs on the effectiveness of hospital preparedness strategies are imperative and literature is yet to fill that gap.
Methods: Items for ‘The Staff Questionnaire for Infectious Disease Outbreak Readiness and Preparedness (SQIDORP)’ were selected from literature that addressed hospital preparedness during novel pandemic outbreaks. The SQIDORP was distributed within a regional hospital in Victoria, Australia. Psychometric evaluation included estimates of reliability and factor analysis while factors associated with the questionnaire were explored using regression analysis.
Results: Omega coefficient of 0.89, Cronbach’s alpha coefficient of 0.88 and item-total correlations (>0.3) indicated adequate reliability of the SQIDORP. Factor Analysis yielded three meaningful latent factors that are effectiveness of training (Factor 1), self-confidence (Factor 2) and risk to self and stress (Factor 3). Demographic factors did not influence the correlation with SQIDORP. However, rating ‘the current plan for management of COVID-19 in your ward’ and ‘personal knowledge/skills in caring for patients with COVID-19’ had significant positive correlation and accounted for 33% of the variance in readiness and preparedness using SQIDORP (R2=0.33, F=10.227, P<0.001).
Conclusion: Most of the items of SQIDORP questionnaire achieved adequate internal consistence reliability. This is a valuable tool that can be utilized by hospitals to explore aspects of preparedness and give insights to the knowledge, skills, and mental health of HCWs, as perceived by the HCW themselves.
Background and Aims: Nurses play an essential role in developing care, treatment, and community health during the outbreak of COVID-19. Also, because they are in the front line of dealing with this disease, they are more likely to suffer from psychological disorders and anxiety. Therefore, taking care of their mental health is very important. This study aimed to compare the level of professional ethics, depression, anxiety, and stress in athlete and non-athlete nurses working in selected hospitals in Tehran during COVID-19 disease in 1399.
Methods: The sample size was 80 in the athlete group and 70 in the non-athlete group. Data collection tools included a demographic questionnaire, a depression, anxiety, and stress questionnaire(DASS-42), and 21 ethics questions in the nursing profession Jahanpour et al. Also, to analyze the data, SPSS v. 22 software and descriptive statistics methods (mean, standard deviation, etc.) and Clomogrov Smirnov and T-independent test were used in inferential statistics.
Results: The results showed that depression, stress, and anxiety were higher in non-athlete nurses compared to nursing athletes (P<0001). The results also showed improved professional ethics in athlete nurses compared to non-athlete nurses (P<0001).
Conclusion: Given the critical role of nurses in improving and promoting people's health in the actual situation of COVID–19 disease, encouraging them to exercise according to a regular schedule with the support of sports coaches is considered a health priority.
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.
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.
A class of robust estimates for the linear model is introduced. These estimates, called MM-estimates, have simultaneously the following properties: (i) they are highly efficient when the errors have a normal distribution and (ii) their breakdown-point is 0.5. The MM-estimates are defined by a three-stage procedure. In the first stage an initial regression estimate is computed which is consistent robust and with high breakdown-point but not necessarily efficient. In the second stage an M-estimate of the errors scale is computed using residuals based on the initial estimate. Finally, in the third stage an M-estimate of the regression parameters based on a proper redescending psi-function is computed. Consistency and asymptotical normality of the MM-estimates assuming random carriers are proved. A convergent iterative numerical algorithm is given. Finally, the asymptotic biases under contamination of optimal bounded influence estimates and MM-estimates are compared.
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.
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.
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.
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.
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.
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.
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.
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.
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.AbstractNursing 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
To determine the return on investment (ROI) of Highmark Inc.'s employee wellness programs.
Growth curve analyses compared medical claims for participants of wellness programs versus risk-matched nonparticipants for years 2001 to 2005. The difference was used to define savings. ROI was determined by subtracting program costs from savings and alternative discount rates were applied in a sensitivity analysis.
Multivariate models estimated health care expenses per person per year as $176 lower for participants. Inpatient expenses were lower by $182. Four-year savings of $1,335,524 compared with program expenses of $808,403 yielded an ROI of $1.65 for every dollar spent on the program.
Using sophisticated methodology, this study suggests that a comprehensive health promotion program can lower the rate of health care cost increases and produce a positive ROI.