The relationship between structural empowerment and psychological empowerment for nurses: a systematic review

wagner j.i.j., cummings g., smith d.l., olson j., anderson l. & warren s. (2010) Journal of Nursing Management 18 , 448–462
The relationship between structural empowerment and psychological empowerment for nurses: a systematic review Aim To describe the findings of a systematic review examining the relationship between structural empowerment and psychological empowerment for registered nurses (RNs). Background Workplace empowerment research reveals a link between empowerment and positive work behaviours and attitudes. Research demonstrating the essential relationship between structural empowerment and psychological empowerment will provide direction for future interventions aimed at the development of a strong and effective health care sector. Methods Published research articles examining structural empowerment and psychological empowerment for nurses were selected from computerized databases and selected websites. Data extraction and methodological quality assessment were completed for the included research articles. Results Ten papers representing six studies reveal significant associations between structural empowerment and psychological empowerment for RNs. Implications for nursing management Creation of an environment that provides structural empowerment is an important organizational strategy that contributes to RNs’ psychological empowerment and ultimately leads to positive work behaviours and attitudes. Critical structural components of an empowered workplace can contribute to a healthy, productive and innovative RN workforce with increased job satisfaction and retention.     

Multiplex assay for genetic testing of thrombophilia: a method for routine clinical care

There is an increasing demand for genetic testing of patients with hypercoagulability. We have developed a multiplex-polymerase chain reaction (PCR) technique that incorporates the state-of-the art of genetic testing for thrombosis mutations (Factor V Leiden [FVL] and G20210A F2 and C46T F12). The sequences are detected by enzyme-linked immunosorbent assay (ELISA)-resolved colorimeter after hybridization with an amplification product labeled with digoxygenin. To evaluate the reliability of this method, we analyzed 122 deoxyribonucleic acid (DNA) samples of known genotypes for these three mutations. Six subjects initially assigned as heterozygous for FVL and two subjects assigned as normal for the G20210A F2 mutation showed discrepancies between the current techniques and our newly-developed ELISA-based technique. When these samples were sequenced the concordance using our method was 100%. Thus, initially they were assigned incorrectly based on the available methodologies. It is noteworthy that our method is adaptable to an Automated ELISA Analyzer that allows for routine processing of both small and large numbers of DNA samples. We present a robust, rapid, reproducible, cost-effective, and simple multiplex PCR ELISA method to simultaneously detect carriers of thrombotic genetic risk factors. Testing for thrombophilia should contribute to better diagnosis, prevention, and treatment strategies, providing valuable information to assess the risk of recurrence in the proband, and in family members who are asymptomatic.     

The Big Five personality factors and psychological well-being following stroke: a systematic review

Purpose: To identify and appraise studies investigating the relationship between the Big Five personality factors and psychological well-being following stroke and evidence for personality change.

Methods: Systematic searches of six databases (PsychINFO, CINAHL, Ovid Medline, Cochrane, PubMed, and Web of Science) were conducted from inception to June 2017. Studies involving adult stroke samples that employed a validated measure of at least one of the Big Five personality factors were included. Two reviewers independently assessed the eligibility and methodological quality of studies.

Results: Eleven studies were identified that assessed associations between personality and psychological well-being after stroke (nine studies) or post-stroke personality change (two studies). A consistent finding was that higher neuroticism was significantly related to poorer psychological well-being. The evidence for the other Big Five factors was mixed. In terms of personality change, two cross-sectional studies reported high rates of elevated neuroticism (38–48%) and low extraversion (33–40%) relative to normative data. Different questionnaires and approaches to measuring personality (i.e., self vs. informant ratings, premorbid personality vs. current personality) complicated comparisons between studies.

Conclusions: People high on neuroticism are at increased risk of poor psychological well-being after stroke. Prospective longitudinal studies are needed to address the limited research on post-stroke personality change.

• Implications for rehabilitation

• High neuroticism is associated with poorer psychological well-being after stroke.

• Assessing personality characteristics early after stroke may help to identify those at risk of poor psychological outcomes.

     

新型冠状肺炎疫情对一线医务人员心理状态影响

目的：探究新冠疫情对驰援武汉一线的医务人员心理状态影响,探究各个心理状态间是否存在联系。 方法：受访者为复旦大学附属中山医院援助武汉医务人员,采用一般情况调查表、匹兹堡睡眠质量指数、广泛焦虑量表、病人健康问卷-9、创伤应激后障碍量表进行评估。数据分析采用Mann-Whitney U检验、Kruskal-Wallis H检验以及多重线性回归。结果采取双侧检验,p＜0.05认为具有统计学上显著差异。 结果：采用Mann-Whitney U检验,发现在睡眠质量上,性别间差异具有统计学意义（p＜0.05,U=1500）。采用Kruskal-Wallis H检验,发现不同教育程度对PCL-5得分存在影响（H=7.901,p=0.048）;对不同教育程度组采用Mann-Whitney U检验进行两两比较,创伤应激后障碍量表得分在专科组与学士组中存在差异。多重线性回归分析显示,睡眠质量、焦虑对抑郁存在影响,匹兹堡睡眠质量指数斜率为0.072,广泛焦虑量表斜率为0.778,截距为-0.016。回归模型具有统计学意义,F=65.467, p=0.000, 调整R2=0.481。 结论：本研究显示医务工作者心理状态总体处于良好水平,受疫情影响并不显著。可能与他们并未受到疫情爆发时的直接冲击,有较长准备时间;医务人员受到社 会各界广泛支持;临床工作繁重,医务人员无暇顾及心理状态以及党员在其中起到带头作用有关。     

不同妊娠期女性心理卫生状况调查

目的　观察不同妊娠期女性心理变化。方法　对 2 5名早期妊娠、31名中期妊娠、36名晚期妊娠女性和 30名健康未孕女性进行SCL 90、SAS、CES D量表评定 ,并加以统计分析。结果　 92名不同妊娠期女性在焦虑、恐怖、躯体化因子方面显著高于对照组 (P <0 .0 1) ,处于早期的孕妇在焦虑、恐怖、躯体化因子分方面显著高于其他妊娠期女性 (P <0 .0 1)。结论　不同妊娠期女性存在着不同程度的焦虑、恐怖、躯体化症状。提示 :对不同妊娠期女性开展广泛、深入的孕期知识和心理卫生知识教育是十分必要的     

The effects of forest bathing on psychological well-being: A systematic review and meta-analysis

Globally, around half (55%) of the population live in fast-paced urban settings where many people find it challenging to manage their stress and respond to crises with a positive mindset. This resulted in prolonged distress where anxiety and fatigue caused physical and mental health concerns. Nature walks involving immersive exposure in the forest, and green spaces have been posited to offer physiological and psychological benefits. Therefore, in this systematic review, we evaluated the effects of forest bathing on psychological and physiological outcomes. We searched four English and five non-English databases (Chinese and Korean) for peer-reviewed studies published between January 2000 and March 2021. This review adhered to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-analysis Statement 2020. The primary outcomes explored in this review were mainly psychological, including anxiety, depression, mood and quality of life. The secondary outcomes were physiological outcomes such as blood pressure and heart rate. We conducted a meta-analysis on each outcome using the random-effects model. Heterogeneity was assessed by the I² statistic. Thirty-six articles (21 in English, 3 in Chinese and 12 in Korean) with 3554 participants were included in this review. Our meta-analysis suggested that forest bathing can significantly reduce symptoms of depression and anxiety. However, we did not observe as many benefits in physiological outcomes. Against the background of the negative effects of urbanization on mental well-being, this review highlighted the potential therapeutic role of forests in the contemporary world, lending further evidence-based support for forest conservation.     

Protecting healthcare workers' mental health against COVID-19-related stress: The effects of stress mindset and psychological resilience

Healthcare workers have been on the frontline of the battle against COVID-19 disease. However, this has taken a toll on them, resulting in elevated stress and poor mental health. We argue that healthcare workers' stress mindset and resilience could mitigate negative outcomes of COVID-19-related stress by helping them view this stressful situation in a more positive light and appraise it as a challenge rather than a threat. Accordingly, we hypothesized that both a stress-is-enhancing mindset about COVID-19-related stress and resilience would improve healthcare workers' appraisal of their personal resources and increase their challenge appraisals, positively contributing to their mental health. We collected data from 160 healthcare workers and performed structural equation modeling for hypothesis testing. The results indicate that both a stress-is-enhancing mindset about COVID-19-related stress and psychological resilience are indirectly related to better mental well-being and lower health-related anxiety through challenge appraisals. This study contributes to research in mental health by suggesting that protecting and promoting healthcare workers' mental health is possible by empowering them through increasing personal resources such as a positive mindset about stressful situations and resilience.     

Deliberate self-harm in adolescence: a systematic review of psychological and psychosocial factors

AIMS: This paper is a systematic review of the research literature that identifies psychological and psychosocial factors associated with adolescent deliberate self-harm (DSH). The aims of this review were to identify the key psychological and psychosocial factors that aid the identification of individuals at risk of DSH, and suggest specific strategies for intervention. BACKGROUND: Research has highlighted a parallel rise in rates of DSH referrals to general hospitals and rates of successful suicides in the younger age groups and gender groups. It is also highlighted that pressure on services in responding to these increases may be resulting in an inadequate response to both first-episode DSH and repetition of self-harm. One cause for concern is the lack of adequate psychosocial assessment for adolescents presenting at hospital following a DSH incident. Research of the literature suggests that there may be a paucity of research into after-care strategies in self-harm to prevent repetition and escalation of self-destructive behaviour. METHODS: A systematic review of the literature was conducted to identify the psychological and psychosocial factors relating to DSH. Results. The results found typical psychological and psychosocial factors associated with DSH in adolescents, although psychosocial factors were less consistently measured because of the breadth of tools and methods used. CONCLUSIONS: It is discussed whether associated factors are causative of DSH or the accompanying symptoms in DSH. It is suggested that positive psychosocial factors may have a part to play in providing protection against DSH behaviour. Therapeutic responses to DSH are suggested as preventative measures against repeat episodes.     

Attitudes toward genetic testing for thrombophilia in asymptomatic members of a large family with heritable protein C deficiency

BACKGROUND: Little research has been performed regarding the psychological consequences of knowing that one is at an increased risk for venous thrombosis. OBJECTIVES: The aim of this study was to explore attitudes toward genetic testing for protein C deficiency. METHODS: Questionnaires about genetic testing attitudes, dispositional anxiety, risk perception, and thrombosis-related worry were completed by 168 asymptomatic members of a North-American kindred with a high incidence of heritable protein C deficiency conferring a high lifetime risk of venous thrombosis. A total of 76 subjects (45%) had not been tested for protein C deficiency before participating in our study whereas the other 92 subjects (55%) had been tested prior to filling in the questionnaire, of whom 34 people had protein C deficiency, while 58 did not. Results: Family members with protein C deficiency perceived a higher risk of suffering venous thrombosis and scored higher on thrombosis-related worry than family members without protein C deficiency. Participants who had not been tested did not report excessive thrombosis-related worry. Participants with protein C deficiency reported a belief in the psychological and health benefits of testing, and felt that they experienced low psychological distress following the genetic test. High psychological distress following the test was related to dispositional anxiety and thrombosis-related worry. Participants without protein C deficiency were relieved after finding out that they did not have the deficiency. CONCLUSION: There seem to be few negative psychological consequences of knowing that one is at an increased risk for venous thrombosis, except in vulnerable individuals.     

Hereditary thrombophilia and fetal loss: a prospective follow‐up study

Summary. Background: As the placental vessels are dependent on the normal balance of procoagulant and anticoagulant mechanisms, inherited thrombophilia may be associated with fetal loss. Objectives: We performed a prospective study to investigate the relation between inherited thrombophilia and fetal loss, and the influence of thromboprophylaxis on pregnancy outcome. Patients and methods: Women were enrolled in the European Prospective Cohort on Thrombophilia (EPCOT). These included women with factor (F)V Leiden or a deficiency of antithrombin, protein C or protein S. Controls were partners or acquaintances of thrombophilic individuals. A total of 191 women (131 with thrombophilia, 60 controls) had a pregnancy outcome during prospective follow‐up. Risk of fetal loss and effect of thromboprophylaxis were estimated by frequency calculation and Cox regression modelling. Results: The risk of fetal loss appeared slightly increased in women with thrombophilia without a previous history of fetal loss who did not use any anticoagulants during pregnancy (7/39 vs. 7/51; relative risk 1.4; 95% confidence interval 0.4, 4.7). Per type of defect the relative risk varied only minimally from 1.4 for FV Leiden to 1.6 for antithrombin deficiency compared with control women. Prophylactic anticoagulant treatment during pregnancy in 83 women with thrombophilia differed greatly in type, dose and duration, precluding solid conclusions on the effect of thromboprophylaxis on fetal loss. No clear benefit of anticoagulant prophylaxis was apparent. Conclusions: Women with thrombophilia appear to have an increased risk of fetal loss, although the likelihood of a positive outcome is high in both women with thrombophilia and in controls.     

The significance of thrombophilia in paediatric thromboembolism

The role of thrombophilia in paediatric thromboembolic disease remains controversial. The objective of the present study was to investigate the prevalence of thrombophilia and other risk factors among children with a thromboembolic event. We systematically examined the medical records and laboratory results of 126 children (≤15 years) referred to Aarhus University Hospital, Denmark with a recent thromboembolic event during 2005–2016. Among the 126 children with thrombosis, 99 (79%) had arterial thrombosis, 66 (52%) being in the neonatal period. Remarkably, 48 (38%) children had occurrence of acute illness or underlying disease prior to the thromboembolic event. In total, 11 (11%) children with arterial thrombosis had a hereditary or acquired thrombophilia with a non-significant odds ratio compared with the general population, while 9 of the 27 (33%) children with venous thrombosis had a hereditary or acquired thrombophilia being significantly higher than in the general population. Acute illness or underlying diseases seem to induce increased risk of thromboembolic disease in children. The present study does not support that thrombophilia is associated with arterial thrombosis. However, the results support thrombophilia testing in children with venous thromboembolism.