Psychological impacts of transition to distance learning due to COVID-19 on nursing students

The purpose of this study was to assess the psychological impacts of the abrupt transition to distance learning due to COVID-19 and associated factors among Jordanian nursing students. A cross-sectional online survey with a sample of 224 nursing students in three universities was carried out. The survey measured students' depression, anxiety, stress, post-traumatic stress disorder (PTSD), academic self-efficacy, and demographic and distance learning-related data. Students have moderate levels of depression, anxiety, and stress. Depression, anxiety, stress, and PTSD were significantly associated with various demographic, disease-related, and distance learning-related variables. Further work is required to prepare professional psychological help for nursing students and develop future teaching plans that take into consideration factors underlying students' negative symptoms.     

The impact of covid-19 on psychosocial well-being and learning for australian nursing and midwifery undergraduate students: a cross-sectional survey

AimTo explore the impact of COVID-19 on psychosocial well-being and learning for nursing and midwifery undergraduate students in an Australian university.BackgroundThe World Health Organization has reported a substantial psychological impact of COVID-19 on healthcare professionals to date. Evidence is lacking, however, regarding university nursing and midwifery students of the pandemic and its impact on their educational preparation and/or clinical placement during the COVID-19 pandemic.DesignCross-sectional survey of nursing and midwifery undergraduate students enrolled in the Bachelor of Nursing suite of courses from the study institution in August- September 2020.MethodsA cross-sectional self-administered anonymous online survey was distributed to current nursing and midwifery undergraduate students. The survey included three open-ended questions; responses were thematically analysed.ResultsOf 2907 students invited, 637 (22%) responded with 288 of the respondents (45%) providing a response to at least one of the three open-ended questions. Three major themes associated with the impact of the pandemic on psychosocial well-being and learning were identified: psychosocial impact of the pandemic, adjustment to new modes of teaching and learning, and concerns about course progression and career. These themes were underpinned by lack of motivation to study, feeling isolated, and experiencing stress and anxiety that impacted on students’ well-being and their ability to learn and study.ConclusionsStudents were appreciative of different and flexible teaching modes that allowed them to balance their study, family, and employment responsibilities. Support from academic staff and clinical facilitators/mentors combined with clear and timely communication of risk management related to personal protective equipment (PPE) in a healthcare facility, were reported to reduce students’ stress and anxiety. Ways to support and maintain motivation among undergraduate nursing and midwifery students are needed.     

The Impact of the COVID-19 Pandemic on Surgeons' and Surgical Residents' Caseload,Surgical Skills,and Mental Health in Kuwait

IntroductionThe onset of the COVID-19 pandemic resulted in governments implementing new regulations to divert healthcare resources, which in return led to the postponement of elective and semi-elective surgical procedures. Therefore, many surgeons and as well as surgeons in training reported feeling redundant, which eventually resulted in psychological distress. This study aimed to assess the sociodemographic differences in the psychological impact resulting from the COVID-19 pandemic and outline the effect it had on surgical training.MethodsThis is a cross-sectional study conducted in Kuwait. Data were collected by distributing a questionnaire electronically to surgeons and surgeons in training. The survey included questions aimed at assessing both the effect of the pandemic on surgical training and the psychological impact it had on surgeons, assessing the latter using the Depression, Anxiety and Stress Scale-21 screening tool.ResultsThe response rate for the study was 52%, with the majority being junior male surgeons. A majority of surgeons in training reported postponement of their scheduled academic teaching sessions (78.9%) and pre-assigned surgical rotations (65.8%). In terms of the psychological impact of the pandemic, a majority of the participants reported an element of depression and stress, 61.2% and 55%, respectively, while approximately half, 48.1%, had symptoms associated with anxiety.ConclusionThe COVID-19 pandemic had a negative association with the psychological well-being of a significant proportion of surgeons and associated surgical training programs.     

The emotional impact of COVID-19 on Spanish nurses and potential strategies to reduce it

BackgroundAlthough the emotional and psychological impact of nurses’ work had been identified before the COVID-19 pandemic, the pandemic aggravated risk indicators for their mental health.AimThe objective of this study was to analyse the levels of anxiety, depression, post-traumatic stress and burnout of nurses in the Balearic Islands (Spain) during the pandemic to identify possible sociodemographic and related occupational factors.DesignA cross-sectional study of 892 nurses was conducted during four weeks from February to March 2021.MethodsSociodemographic data related to the pandemic were collected and anxiety, depression, burnout and post-traumatic stress were measured with validated scales. A multivariate and predictive analysis was carried out with risk estimates.FindingsAbout 75.6% of the nurses had experience in COVID-19 units, and 49.1% had worked for more than 10 months in a COVID-19 unit. Nurses in COVID-19 units (hospital ward or ICU) were more likely to report emotional fatigue (OR 1.9, p < 0.001) and anxiety (OR 1.5, p = 0.021). In general, moderate post-traumatic stress was evident in general nurses (p = 0.027), and severe post-traumatic stress was evident in ICU nurses (p = 0.027). A 1.24-month reduction in COVID-19 patient care predicted reduced levels of emotional fatigue (5.45 points), depersonalisation (1.87 points) and post-traumatic stress (4.65 points) in nurses.ConclusionGiven the occurrence of new waves of COVID-19, the need to establish preventive strategies that focus on the personal and occupational characteristics related to these indicators and to implement urgent psychological support strategies is demonstrated.ImpactGiven these findings, it is imperative solutions are urgently applied in order to prevent compounding risk to the health system.     

Australian and Danish nurses’ and midwives’ wellbeing during COVID-19: A comparison study

BackgroundMost investigations of nurses’ and midwives’ psychological wellbeing during the COVID-19 pandemic have been conducted in a single setting.AimTo assess and compare the psychological wellbeing of nurses and midwives in Australia and Denmark during the COVID-19 pandemic.MethodsNurses and midwives employed at four metropolitan health services in Australia and one in Denmark completed an anonymous online survey, which assessed depression, anxiety, and stress symptoms (The Depression, Anxiety and Stress Scale - 21 Items (DASS-21)), and sociodemographic and employment factors.FindingsCompleted surveys were received from 3001 nurses and midwives (1611 Australian and 1390 Danish). Overall, approximately one in seven of the nurses and midwives surveyed reported moderate to extremely severe levels of depression (n = 399, 13.5%), anxiety (n = 381, 12.9%) and stress (n = 394, 13.4%). Australian nurses’ and midwives’ scores on all DASS-21 subscales were significantly higher (representing higher levels of depression, anxiety and stress) than the scores for the Danish nurses and midwives. Fewer years of clinical experience, living in Australia and being employed on a part-time basis were significantly associated with higher levels of psychological distress.DiscussionA considerable proportion of nurses and midwives experienced distress during the COVID-19 pandemic; however, the proportion and severity varied by country. Australian nurses and midwives experienced higher levels of distress than their Danish colleagues.ConclusionNurses and midwives working in countries with relatively low numbers of COVID-19 cases and deaths are also likely to experience psychological distress. Nurses and midwives would benefit from targeted country-specific support and wellbeing initiatives.     

Psychological Risk Factors of Functional Impairment After COVID-19 Deaths

ContextPeople bereaved from COVID-19 report higher levels of grief than people bereaved from natural causes. The full impact of this onslaught of grief will not be known for some time. Ensuring high-quality bereavement care in the context of COVID-19 presents unprecedented challenges to end-of-life care.ObjectivesWe aimed to determine how psychological symptoms explain functional impairment.MethodsA sample of people bereaved through COVID-19 (N = 307) in the United States completed demographic questions and self-report measures of neuroticism; symptoms of depression, generalized anxiety, posttraumatic stress, separation distress, and dysfunctional grief; and functional impairment due to a COVID-19 loss.ResultsMost participants’ scores were in the clinical ranges for generalized anxiety, depression, dysfunctional grief, and functional impairment. Functional impairment scores were not associated with age, gender, and time since loss but were associated with being diagnosed with COVID-19, having received professional help with the loss, and a close relationship to the deceased. A logistic regression model showed that, after controlling for covariates, the odds of functional impairment significantly increased by 27% for higher scores in separation distress, 25% for higher scores in dysfunctional grief, and 13% for higher scores in posttraumatic stress.ConclusionPeople bereaved because of COVID-19 are at risk of functional impairment, especially if they have symptoms of separation distress, dysfunctional grief, and/or posttraumatic stress. Attention to identifying and treating functional impairment may be important in facilitating grieving persons’ full participation in social and economic life during and after the pandemic.     

Academic stress,COVID-19 anxiety,and quality of life among nursing students: The mediating role of resilience

Aim

This study investigated the mediating role of resilience in the relationship between academic stress, COVID-19 anxiety, and quality of life (QoL) among Filipino nursing students during the COVID-19 pandemic.

Background

The COVID-19 pandemic has impacted the QoL of nursing students who are experiencing mental health issues. The mediating role of resilience in mitigating the effects of academic stress and COVID-19 anxiety on nursing students’ QoL remains understudied.

Methods

This study employed a correlational cross-sectional design, with a convenience sample of 611 Filipino nursing students. Data were collected using the scales Connor and Davidson Resilience, Brunnsviken Brief Quality of Life, COVID-19 Anxiety, and Perception of Academic Stress and analyzed using Pearson's r, bivariate analysis, and multistage regression analyses.

Results

Academic stress and COVID-19 anxiety negatively correlated with QoL and resilience. Resilience was positively associated with QoL and reduced the effect of academic stress on QoL, indicating that resilience is a crucial mediating variable between academic stress and QoL. Finally, resilience had a significant mediating influence on QoL, as evidenced by a reduction in the effect of COVID-19 anxiety on QoL among nursing students.

Conclusions

Filipino nursing students' QoL was affected by academic stress and COVID-19–related anxiety. However, resilience mediated this impact, preserving QoL.

Implications for nursing and health policy

Nursing colleges and affiliated hospitals must collaborate to monitor academic stress and pandemic-related anxiety. Nursing students should be provided with programs such as seminars and team-building activities to enhance their resilience.     

The effect of anxiety on thriving levels of university students during the COVID-19 pandemic

BackgroundDuring the COVID-19 pandemic, university students struggle with unexpected changes in their lives, which have adverse effects on their levels of anxiety and thriving. Thriving with its two subdimensions, namely vitality and learning, is a prominent concept for university students due to contributing the academic achievement and wellbeing.AimThis study aimed to examine the effect of anxiety on thriving levels of university students during the COVID-19 pandemic.MethodsAn analytical and cross-sectional study was conducted between December 1, 2020 and January 6, 2021. Data were collected using online surveys with convenience sampling method. The sample consisted of 322 university students from a health sciences school of a public university in Turkey.FindingsThe students’ anxiety and thriving levels were found to be moderate with 10.38 ± 5.24 and 3.41 ± 0.85, respectively. The results also indicated that anxiety had negative and significant effect on thriving and its subdimensions of vitality and learning. In addition, anxiety level differed significantly according to gender, worried about getting COVID-19 virus and following the COVID-19 cases on a daily basis while thriving level only differed significantly according to the gender.DiscussionConsistent with previous literature, university students experienced high level of anxiety during the COVID-19 pandemic according to the current study. The students with high level of anxiety had lower vitality and learning scores comparing to their peers with low level of anxiety. This result is crucial, because students with high levels of thriving can cope with stress and feel themselves better psychologically than others.ConclusionThis study showed that the students exhibited higher anxiety symptoms and had lower levels of thriving. Therefore, interventions, psychological support, and instrumental support are recommended to improve psychological health of university students.     

Pain,mental health and healthcare utilization: Impact of the COVID-19 pandemic on youth with chronic pain,parents and siblings

Background

Paediatric chronic pain was a public health emergency before the novel coronavirus (COVID-19) pandemic, and this problem is predicted to escalate. Pain tends to occur intergenerationally in families, and youth with chronic pain and their parents have high rates of mental health issues, which can further exacerbate pain. Siblings of youth with chronic pain have been largely overlooked in research, as well as the impact of the pandemic on posttraumatic stress disorder (PTSD) symptoms and healthcare utilization.

Methods

This cross-sectional study examined pain, mental health and healthcare utilization in three groups: youth with chronic pain (n = 357), parents of youth with chronic pain (n = 233) and siblings of youth with chronic pain (n = 156) during the COVID-19 pandemic in Canada.

Results

More so than with pain symptoms, the results revealed high levels of mental health symptoms (i.e. anxiety, depressive, and PTSD), particularly in individuals more personally impacted by the pandemic. The largest effect was seen on PTSD symptoms for all groups. For parents with chronic pain, greater personal COVID-19 impact was related to worse pain interference. Reported rates of healthcare utilization were strikingly high, with youth with chronic pain, parents (reporting on behalf of their children with chronic pain), and siblings of youth with chronic pain reporting that most consultations were due to pain.

Conclusions

Longitudinal research assessing these outcomes across continued waves of the pandemic is needed to ensure timely, tailored and equitable access to pain and mental health assessment and treatment.

Significance

This study examined pain, mental health, substance use and healthcare utilization in youth with chronic pain, siblings and parents during the COVID-19 pandemic. Greater personal impact of the pandemic was not largely associated with poorer pain outcomes; however, it was associated with mental health, with the largest effect on PTSD symptoms. The high rates and significant association of COVID-19 impact with PTSD symptoms underscore the importance of including PTSD assessment as part of routine screening practices in pain clinics.     

The impact of the first COVID-19 surge on the mental well-being of ICU nurses: A nationwide survey study

ObjectivesTo determine the impact of the first COVID-19 surge (March through June 2020) on mental well-being and associated risk factors among intensive care unit nurses.Research methodologyIn September 2020, a nationwide cross-sectional survey study among Dutch intensive care nurses was carried out to measure prevalence rates of symptoms of anxiety, depression, posttraumatic stress disorder, and need for recovery (NFR), objectified by the HADS-A, HADS-D, IES-6 and NFR questionnaires, respectively. Associated risk factors were determined using multivariate logistic regression analyses.ResultsSymptoms of anxiety, depression, and post traumatic stress disorder were reported by 27.0%, 18.6% and 22.2% of the 726 respondents, respectively. The NFR was positive, meaning not being recovered from work, in 41.7%. Working in an academic hospital, being afraid of infecting relatives and experiencing insufficient numbers of colleagues were associated with more mental symptoms, while having been on holiday was associated with reduced depression symptoms and need for recovery.ConclusionThe first COVID-19 surge had a high impact on the mental well-being of intensive care nurses, increasing the risk for drop out and jeopardising the continuity of care. Effort should be made to optimize working conditions and decrease workload to guarantee care in the next months of the COVID-19 pandemic.     

Factors associated with nurses emotional distress during the COVID-19 pandemic

BackgroundNurses are among the frontline healthcare workers directly impacted by the burden of the coronavirus disease of 2019 (COVID-19) pandemic. This study aimed to examine the prevalence of emotional distress and the associated factors among nurses practicing in South Dakota during the COVID-19 pandemic.MethodsAn online survey was conducted among practicing, licensed nurses in South Dakota during the pandemic (July 2020 – August 2020). Emotional distress was measured using the Depression, Anxiety, and Stress Scale (DASS-21). Logistic regression models were performed to examine the association of emotional distress and the three DASS-21 subscales with: sociodemographic and work environment factors (e.g., work setting, job satisfaction, number of COVID-19 cases seen at the facility, preparedness, concerns with worsening pre-exiting mental health conditions due to the pandemic, and contracting the illness).ResultsAmong 1505 participants, overall emotional distress was reported by 22.2%, while anxiety, depression and stress were 15.8%, 14.5% and 11.9%, respectively. Factors associated with moderate to severe emotional distress, depression, anxiety, and stress were as follows: concerns for worsening of pre-existing mental health conditions, job dissatisfaction, encountering higher number of COVID-19 cases at one's work facility, feeling unprepared for the pandemic, and concern for contracting the illness (all p < 0.05).ConclusionsOur study suggests a high prevalence of emotional distress among nurses and highlights the factors associated with emotional distress during the COVID-19 pandemic. Promoting appropriate support is imperative to reduce nurses' emotional distress and promote psychological well-being during the COVID-19 world health crisis and in future pandemics.     

Psychological well-being and coping strategies of healthcare students during the prolonged COVID-19 pandemic

BackgroundThis study aimed to investigate the psychological well-being, and stress coping strategies, as well as their relationships, among healthcare students during prolonged COVID-19 pandemic.MethodsAn online questionnaire was used to assess psychological well-being (the Ryff Scale) and coping strategies (the brief Coping Orientation to Problems Experienced Inventory [COPE] Scale). COPE scores were categorized to identify the primary coping strategies: “approach” indicates more active coping strategies; “avoidant” indicates more dysfunctional and maladaptive mechanisms.ResultsA total of 202 valid questionnaire were collected. Those with lower academic confidence and lower self-rated peer and family relationship scores during the COVID-19 pandemic had lower Ryff scores, indicating poorer psychological well-being. Nursing students reported the lowest psychological well-being and the highest levels of adopting avoidant coping strategies (26.4%).ConclusionThe study's findings may help educators identify the healthcare students most vulnerable to stress and develop interventions to empower students to adopt problem-focused stress coping strategies.     

Opportunities for the advanced practice nurse in improving the wellbeing of older adults during the COVID-19 pandemic

The prevalence of stress, anxiety, and depression have increased during the coronavirus disease (COVID-19) pandemic across age groups. Older adults may additionally be experiencing accelerated cognitive decline and increased behavioral and psychological symptoms of dementia related to the pandemic and associated isolation precautions. The advanced practice nurse has an opportunity to holistically intervene to mitigate the negative effects of isolation and promote older adults’ wellbeing during challenging times.     

The COVID-19 pandemic – A focus on nurse managers’ mental health,coping behaviours and organisational commitment

BackgroundThe emergence of COVID-19 has substantially impacted frontline health care workers, including nurse managers. To date, no studies have been conducted to examine the impact COVID-19 has had on Nurse Managers’ mental health, coping strategies and organisational commitment.AimTo investigate the mental health, coping behaviours, and organisational commitment among Nurse Managers during the COVID-19 pandemic.MethodsCross-sectional study involving 59 Nursing Managers from one Local Health District in Sydney Australia during the first wave of the COVID-19 pandemic. Data were collected relating to demographics, anxiety, coping strategies and organisational commitment.ResultsOverall, approximately three quarters of the Nurse Managers had high anxiety scores. Managers who had worked longer as a nurse had higher scores for adaptive coping strategies and 41% of Nurse Managers considered leaving their jobs.ConclusionsStrategies to minimise anxiety and enable coping as part of organisational disaster, emergency or crisis planning for Nurse Managers may result in decreased anxiety and stress levels, increased use of adaptive coping strategies and lower intent to leave the organisation and the nursing profession.     

Post-traumatic stress disorder in healthcare workers of emergency departments during the pandemic: A cross-sectional study

ObjectiveEmergency departments (EDs) were the first application center for Covid-19 patients, as in almost all diseases. For this reason, a serious mental burden has arisen for ED workers. This study was conducted to determine the possible rate of Posttraumatic Stress Disorder (PTSD) and factors that may be associated with PTSD symptom severity in physicians and nurses working in EDs.MethodsThis cross-sectional study was conducted with a total of 783 participants, including 406 physicians and 377 nurses working in EDs. The PTSD Checklist for DSM-5; Depression, Anxiety and Stress Scale-21; and a structured questionnaire on sociodemographic and work-related characteristics were administered to the participants.ResultsThe probable PTSD rate in the total sample was found to be 19.2%. The rate of probable PTSD in physicians (22.9%) was significantly higher than in nurses (15.1%). However, PTSD symptom total scores and PTSD symptom clusters were higher in physicians than in nurses, but there was no difference between the two groups in terms of depression, anxiety and stress levels. High anxiety level, being diagnosed with COVID-19, high depression level, female gender, and having additional chronic disease were predictors of high PTSD symptom severity in physicians. For nurses, high anxiety level, being diagnosed with COVID-19, working with 24-h shifts, high depression level, low work experience (years), low monthly income and having additional chronic disease were the predictors of high PTSD symptom severity.ConclusionThe results of our study showed that both profession groups are at risk for PTSD, and contrary to the existing literature, this rate may be higher in physicians than in nurses. HCWs in the EDs needed protective and supportive mental health models in terms of PTSD.     

新冠肺炎疫情对医务工作者心理健康的影响

医务人员在新冠肺炎疫情中不仅仅是逆行的抗疫者，更多的是较普通人群面临更高的感染风险和更大的压力与挑战，需要承受长时间和超负荷工作，经历身心的疲惫和耗竭。本文复习国内外相关研究，围绕医务人员在疫情期间的心理健康问题，提出可从管理流程、心理/社会支持、心理承受力，以及作息和情绪管理等方面综合干预和预防，促进医务人员的身心健康。     

Pandemia COVID-19 sobre profesionales sanitarios en un hospital de tercer nivel en España: cambios laborales durante la primera ola,salud mental a los 4 meses y seguimiento a los 9 meses

ObjectiveTo determine the impact that the COVID-19 pandemic has had on health professionals, in terms of work changes and mental health.Method1) Cross-sectional study and 2) longitudinal prospective study on health professionals who worked directly with patients affected by COVID-19 pandemic during the period between March-June 2020 in a tertiary hospital in Barcelona. Baseline (July-November 2020) and follow-up (November 2020-March 2021) data were collected. Data related to the job and toxic habits were collected with ad hoc questionnaires, and data related to perceived stress, post-traumatic stress, depression, and anxiety using validated questionnaires.ResultsIn the baseline group (cross-sectional study), 90 professionals participated, 76% nurses. More than a third were on sick leave or took drugs to manage stress. Half of smokers increased tobacco use, and one in 5 increased alcohol consumption. Habitual shift change is significantly associated with depression, professional profile with anxiety, and perceived stress with age. In the longitudinal prospective study, the follow-up group (n = 64) shows high levels of stress and anxiety, which are maintained or even significantly increased over time.ConclusionsThe structural changes that occurred in the hospital during the first wave of the COVID-19 pandemic had a strong impact on professionals, many of them presenting an increase in toxic habits, as well as impaired mental health that is maintained over time.     

Final-year nursing students called to work: Experiences of a rushed labour insertion during the COVID-19 pandemic

The first COVID-19 case was confirmed in China in December 2019, and countries around the world rapidly diagnosed new cases from January 2020 onwards. The World Health Organization (WHO) declared an international emergency, characterising it as a pandemic in March 2020. In Spain, final-year Medicine and Nursing students were recruited to reinforce the healthcare system.Using a qualitative phenomenological approach we aimed to clarify the experiences of these final-year year nursing students employed to provide nursing care during the COVID-19 pandemic in Spain. A total of 20 interviews were conducted with final-year students from six universities who were employed by Catalan Hospitals.Data was analyzed using Colaizzi's method. Analysis identified the meta-category ‘feeling the commitment’ from the interaction of two categories, ‘facing the unknown’ and ‘being and feeling like a nurse’, and five subcategories. Students felt highly committed to fighting the COVID-19 pandemic, volunteering to work as nurses despite facing the unknown and not yet having finished their studies. Future Spanish nursing programmes should include ‘pandemic and disaster management’ content to increase students' preparedness for such scenarios.