Healthcare professionals’ stress and burnout

Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

Importance: Health care workers exposed to coronavirus disease 2019 (COVID-19) could be psychologically stressed. Objective: To assess the magnitude of mental health outcomes and associated factors among health care workers treating patients exposed to COVID-19 in China. Design, Settings, and Participants: This cross-sectional, survey-based, region-stratified study collected demographic data and mental health measurements from 1257 health care workers in 34 hospitals from January 29, 2020, to February 3, 2020, in China. Health care workers in hospitals equipped with fever clinics or wards for patients with COVID-19 were eligible. Main Outcomes and Measures: The degree of symptoms of depression, anxiety, insomnia, and distress was assessed by the Chinese versions of the 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder scale, the 7-item Insomnia Severity Index, and the 22-item Impact of Event Scale-Revised, respectively. Multivariable logistic regression analysis was performed to identify factors associated with mental health outcomes. Results: A total of 1257 of 1830 contacted individuals completed the survey, with a participation rate of 68.7%. A total of 813 (64.7%) were aged 26 to 40 years, and 964 (76.7%) were women. Of all participants, 764 (60.8%) were nurses, and 493 (39.2%) were physicians; 760 (60.5%) worked in hospitals in Wuhan, and 522 (41.5%) were frontline health care workers. A considerable proportion of participants reported symptoms of depression (634 [50.4%]), anxiety (560 [44.6%]), insomnia (427 [34.0%]), and distress (899 [71.5%]). Nurses, women, frontline health care workers, and those working in Wuhan, China, reported more severe degrees of all measurements of mental health symptoms than other health care workers (eg, median [IQR] Patient Health Questionnaire scores among physicians vs nurses: 4.0 [1.0-7.0] vs 5.0 [2.0-8.0]; P = .007; median [interquartile range {IQR}] Generalized Anxiety Disorder scale scores among men vs women: 2.0 [0-6.0] vs 4.0 [1.0-7.0]; P < .001; median [IQR] Insomnia Severity Index scores among frontline vs second-line workers: 6.0 [2.0-11.0] vs 4.0 [1.0-8.0]; P < .001; median [IQR] Impact of Event Scale-Revised scores among those in Wuhan vs those in Hubei outside Wuhan and those outside Hubei: 21.0 [8.5-34.5] vs 18.0 [6.0-28.0] in Hubei outside Wuhan and 15.0 [4.0-26.0] outside Hubei; P < .001). Multivariable logistic regression analysis showed participants from outside Hubei province were associated with lower risk of experiencing symptoms of distress compared with those in Wuhan (odds ratio [OR], 0.62; 95% CI, 0.43-0.88; P = .008). Frontline health care workers engaged in direct diagnosis, treatment, and care of patients with COVID-19 were associated with a higher risk of symptoms of depression (OR, 1.52; 95% CI, 1.11-2.09; P = .01), anxiety (OR, 1.57; 95% CI, 1.22-2.02; P < .001), insomnia (OR, 2.97; 95% CI, 1.92-4.60; P < .001), and distress (OR, 1.60; 95% CI, 1.25-2.04; P < .001). Conclusions and Relevance: In this survey of heath care workers in hospitals equipped with fever clinics or wards for patients with COVID-19 in Wuhan and other regions in China, participants reported experiencing psychological burden, especially nurses, women, those in Wuhan, and frontline health care workers directly engaged in the diagnosis, treatment, and care for patients with COVID-19.

Stress and coping strategies among nursing students: an international study

BACKGROUND: Mounting literature on stress and coping in nursing students are available; however, most of the findings are confined to a single cultural group. AIMS: This study was conducted to determine the level of stress, its sources and coping strategies among nursing students from three countries: Greece, the Philippines and Nigeria. METHODS: Using a descriptive, comparative research design, 547 nursing students (161 Greek nursing students, 153 Filipino nursing students, 233 Nigerian nursing students) participated in the study from August 2015 to April 2016. Two standardized instruments were used, the Perceived Stress Scale (PSS) and the Coping Behavior Inventory (CBI). RESULTS: Findings revealed that the degree of stress and the type of stressors and coping styles utilized by nursing students differ according to the country of origin. The year of study predicted overall stress (β = -0.149, p < 0.001) while advanced age predicted overall coping (β = 0.008, p = 0.037) in the nursing students. CONCLUSIONS: Strengthening nursing students' positive coping skills may be helpful for them to effectively deal with various stressors during their educational experiences while maximizing learning. Implementing empirically tested approaches maybe useful to prevent the recurrence of stress and lessen its impact such as stress management counseling, counseling programs, establishing peer and family support systems, and formulating hospital policies that will support nursing students.

Examining stress perceptions and coping strategies among Saudi nursing students: A systematic review

A cross-country comparative study on stress and quality of life in nursing students

PURPOSE: This study was conducted to compare perceptions of stress and quality of life (QoL) among nursing students from three countries (the Philippines, Greece, and Nigeria) and to examine the impact of stress on their QoL. DESIGN AND METHODS: A comparative, cross-sectional research design was used in this study. Data were collected from 547 nursing students from three countries using the perceived stress scale (PSS) and the quality of life evaluation skill (QOLES). FINDINGS: Students' perceptions of stress and QoL were different across the three countries. Furthermore, higher stress perceptions were identified from taking care of patients, the clinical environment, and faculty, peer, and staff encounters, which predicted a negative QoL. PRACTICE IMPLICATIONS: The findings emphasized the need for empirically tested and culturally tailored interventions to effectively reduce stress and enhance the QoL in nursing students.

Determinants of depression among nursing students in Cameroon: a cross-sectional analysis

Abstract Background Nursing students are highly susceptible to depression given the heavy workload and clinical demands of the curriculum. Depression has negative impacts on their health and academic performance. This study aimed to determine the determinants of depression amongst nursing students in the English-speaking regions of Cameroon. Methods A cross-sectional analysis of 447 nursing students recruited from a combination of state-owned and private nursing institutions in the English-speaking regions of Cameroon from January – April 2018 was carried out. Independent correlates of depression were determined using multivariable regression analysis, with the level of significance set at 95%. Results The overall prevalence of depression (Patient Health Questionnaire - 9 &gt; 4) and major depressive disorder (Patient Health Questionnaire - 9 &gt; 9) in these students was 69.57 and 26.40% respectively. Independent correlates of depression were found to be: total Oldenburg Burnout Inventory score (aOR: 1.18; 95% CI: 1.11, 1.25; p value &lt; 0.01); level of studies (aOR: 0.72; 95% CI: 0.55, 0.94; p value = 0.02) and occurrence of a life-changing crises (aOR: 2.13; 95% CI: 1.28, 3.55, p value &lt; 0.01). Conclusion The prevalence of depression amongst nursing students in Cameroon is high. Determinants proposed in this study require further assessment to facilitate early identification and management of depression in this high-risk group, in order to limit the negative effects linked with the condition.

Stressors and Counseling Needs of Undergraduate Nursing Students in Ibadan, Nigeria

Existing evidence suggests that nursing students have high levels of stress and that counseling and other support services should be made available to them. However, the stressors and counseling needs of undergraduate nursing students in Nigeria have yet to be explored. This study used a questionnaire to investigate the stressors, counseling needs, and desired counseling facilities of undergraduate nursing students at the University of Ibadan. Common stressors included excessive schoolwork, financial problems, inadequate recreational facilities, and overcrowded accommodations. There was an association between reporting inconsiderate, insensitive lecturers as stressors and evidence of psychological distress. Nearly 60% of the respondents felt counseling would help them, and most desired counseling for academics, finances, and relationships. Most (78%) of the respondents preferred an independent facility with trained counselors. Desired characteristics for the services included accessibility, affordability, confidentiality, and a friendly atmosphere. Educators and administrators should use this information to design counseling facilities for students.