Subjectivity About Turnover Intention Among Male Nurses in South Korea: A Q-Methodological Study

Purpose

Around the world, male nurses face a variety of difficulties within clinical settings; accordingly, a large number of male nurses consider changing their occupation. In particular, male nurses in a number of Asian countries with a Confucian heritage experience difficulties. Thus, the purpose of this study was to explore individual differences in turnover intention among male nurses in one such country, South Korea, and on that basis to suggest concrete strategies for reducing turnover among male nurses in Confucian cultures.

Critical Clinical Events and Resilience Among Emergency Nurses in 3 Trauma Hospital-Based Emergency Departments: A Cross-Sectional Study

IntroductionEmergency nurses experience occupational stressors resulting from exposures to critical clinical events. The purpose of this study was to identify the critical clinical events for emergency nurses serving 3 patient populations (general, adult, pediatric) and whether the resilience of these nurses differed by the patient population served.MethodsThis study used a cross-sectional survey design. A total of 48 emergency nurses were recruited from 3 trauma hospital-based emergency departments (general, adult, pediatric). Clinical Events Questionnaire, Connor-Davidson Resilience scale, and an investigator-developed demographic questionnaire were used to collect data from respondents.ResultsAll respondents were female (n = 48, 100%), and most were White (n = 46, 96%). The average age of participants was 39.6 years, the average number of years as a registered nurse was 12.7 years, and the average number of years as an emergency nurse was 8.8 years. Clinical events considered most critical were providing care to a sexually abused child, experiencing the death of a coworker, and lack of responsiveness by a colleague during a serious situation. The least stress-provoking event was incidents with excessive media coverage. Nurses were less affected by the critical events they experienced more frequently at work. Nurses in the 3 trauma settings had high level of resilience, with no statistically significant differences between groups.DiscussionThe occupational stress from exposure to significant clinical events varied with the patient population served by emergency nurses. It is important that interventions be adopted to alleviate the effect of work-related stressors and promote the psychological health of emergency nurses.     

A Prospective Study of Factors Influencing Return to Work After Traumatic Spinal Cord Injury in Taiwan

Lin M-R, Hwang H-F, Yu W-Y, Chen C-Y. A prospective study of factors influencing return to work after traumatic spinal cord injury in Taiwan.

Objective

To examine comprehensively the effects of physical, psychologic, and sociologic characteristics on employment among persons after a traumatic spinal cord injury (SCI) in Taiwan.

Design

A prospective study with follow-up telephone interviews over a 3-year period.

Setting

To register people who had sustained an SCI, medical records of 4 hospitals were reviewed using codes of the International Classification of Diseases–9th Revision–Clinical Modifications from 806.0 to 806.9 and from 952.0 to 952.9.

Participants

Subjects (N=219) employed at the time of injury.

Interventions

Not applicable.

Main Outcome Measures

Employment status after an SCI.

Results

The employment rate was 32.9%. After controlling for other variables, education level (relative rate [RR]=4.018.17), autonomy in transportation (RR=5.13), professional licensure (RR=1.86), and thrill and adventure-seeking trait (RR=1.12) were positively and significantly associated with employment, while subjects with more severe overall injury severity (RR=0.95), preinjury chronic conditions (RR=0.20), necessity for aids for daily living (RR=0.31), and depression (RR=0.38) were less likely to have been employed than their counterparts.

Conclusions

In addition to education level and traditional physical factors, overall injury severity and psychologic factors such as thrill and adventure seeking and depression can also influence the return to work after an SCI.     

Factors Associated With ED Use Among New Asian Immigrants in New Zealand: A Cross-Sectional Analysis of Secondary Data

IntroductionNew Zealand has an ethnically diverse population and continues to host immigrants from different countries. The present study aimed to examine the factors associated with ED use among new Asian immigrants in New Zealand.MethodsA secondary analysis of 2016-2017 New Zealand Health Survey database. Univariate and multivariate logistic regression models were employed. A total of 414 new Asian immigrants were identified.ResultsAsthma, diabetes, chronic pain, anxiety, hypertension, body mass index, waist measurement, perceived health status, and distress were associated with a significantly increased likelihood to ED visits. The multivariate logistic regression analysis revealed that asthma (adjusted odds ratio = 5.29, 95% confidence interval, 1.26-22.24) and perceived health status (adjusted odds ratio = 0.81, 95% confidence interval, 0.66-0.99) were factors associated with ED use among new Asian immigrants.ConclusionAsthma and perceived health status were the 2 key factors associated with ED use among new Asian immigrants in New Zealand. ED use among new Asian immigrants encompassed both chronic health conditions and mental health indicators.     

香港脑卒中患者抑郁状态及其影响因素的纵向调查

目的脑卒中后抑郁状态是常见的精神卫生问题,应引起临床医护人员的关注。本文旨在探讨影响首次卒中患者出现卒中后抑郁的相关因素。方法采用6个月纵向研究设计,共选定两个观察时间点:T1,入住康复病房后的48h内;T2,相距T1后的第6个月。数据收集均于受试者当时的居住地进行。纳入居住在香港特别行政区首次患脑中卒的患者(除外伴有意识障碍或失语症)。结果T1和T2时卒中后抑郁的发生率分别为69%和48%。向后线性回归分析发现,共有5个变量可解释T2时卒中后抑郁55%的差异。其相关因素包括:在T1时抑郁症状的水平(P<0.001)、患者社会角色在病前为居家主妇(P=0.039)、在T2时的功能残疾水平(P<0.001)、获得的信息支持(P=0.025)及朋辈间的交谊支持(P=0.001)。结论本研究的结果表明,卒中后抑郁可以是因卒中致残及家庭角色改变而出现的一种精神卫生问题。心理及社会支持是照顾护理脑卒中患者时不可或缺的一部份。     

The Acute Incident Response Program: A Framework Guiding Multidisciplinary Responses to Acutely Traumatic or Stress-Inducing Incidents in the ED Setting

BackgroundClinicians working in the ED setting are exposed to traumatic and stress-inducing incidents, which may increase the incidence of psychological sequelae, including burnout and acute stress disorders. The purpose of this project was to develop and implement a novel debriefing program as an early intervention for acutely stress-inducing events in the emergency department.MethodsThe 2-stage Acute Incident Response program was developed and implemented in the emergency department of the John Hunter Hospital to guide an interprofessional response to acutely stress-inducing incidents. This psychological support framework draws on existing concepts of critical incident stress management along with elements of contemporary “hot debriefing” models to create a concise, clinician-led response program incorporating elements of both work group peer support and clinical team performance improvement. The Acute Incident Response program is novel in its concurrent focus on both salient clinical factors and emotional responses of affected clinicians.ResultsThe developed Acute Incident Response program framework predominantly focuses on the wide dissemination of a peer-driven debriefing model. When additional support is deemed necessary by trained clinical champions after the Hot Acute Incident Response process, escalation to a central response coordinator ensures targeted secondary support follow-up for all affected team members.This program has been introduced at 1 site and warrants further targeted investigation to determine its efficacy and utility in a broad range of clinical contexts.ConclusionThe Acute Incident Response program is an accessible and meaningful model to guide a functional, clinician-led response to acute incidents in the ED setting. The model could feasibly be applied in a wide variety of clinical contexts.     

Traumatic Events Among Cancer Patients That Lead to Compassion Fatigue in Nurses: A Qualitative Study

ContextCancer care nurses are frequently exposed to patients' traumatic experiences and are at high risk of compassion fatigue.ObjectivesTo describe the components and frequencies of traumatic events experienced by patients with cancer, which give rise to nurse compassion fatigue.MethodsThis study is a supplementary analysis of data from a previous qualitative study. Semistructured interviews were conducted with 30 Japanese nurses, with at least two years of experience in cancer care and a history of compassion fatigue. Content analysis and constant comparison was used to identify relevant subcategories and categories. The frequencies of these subcategories and categories were then evaluated.ResultsEleven subcategories and four categories were identified. The kappa coefficient of these subcategories, determined by two independent raters, was 0.89. Subcategories with the highest frequencies among participants were as follows: having symptoms of cancer progression (n = 20; 67%), suffering because of insufficient pain control (n = 11; 37%), and being informed about getting cancer (n = 10; 33%). The four categories were as follows: worsening of physical condition (n = 20; 67%), bad news from doctors (n = 19; 63%), difficulty in treatment (n = 18; 60%), and emotional conflict with family (n = 6; 20%).ConclusionThis study identified the components and frequencies of traumatic events among patients with cancer that lead to the onset of nurse compassion fatigue. Such information will aid in understanding the triggers of compassion fatigue, allowing for possible preparation to reduce the risk of this occupational hazard.     

A Prospective Cohort Study of Factors Associated With Place of Death Among Patients With Late-Stage Cancer in Southern Africa

Context

Identifying factors that affect terminally ill patients' preferences for and actual place of death may assist patients to die wherever they wish.

Association between Type-D Personality and Affective (Anxiety,Depression, Post-traumatic Stress) Symptoms and Maladaptive Coping in Breast Cancer Patients: A Longitudinal Study

Background:Type-D (distressed) personality has not been prospectively explored for its association with psychosocial distress symptoms in breast cancer patients.Objective:The objective of the study was to test the hypothesis that Type-D personality can be associated with psychosocial distress variables in cancer over a 2-point period (6 month-follow-up).Aims:The aim of the study was to analyze the role of Type-D personality in relation to anxiety, depression, post-traumatic stress symptoms, general distress, and maladaptive coping among cancer patients.Methods:145 breast cancer patients were assessed within 6 months from diagnosis (T0) and again 6 months later (T1). The Type-D personality Scale, the Hospital Anxiety and Depression Scale, Depression subscale (HAD-D), the Brief Symptom Inventory (BSI-18) Anxiety subscale, the Distress Thermometer (DT), the Post-traumatic Symptoms (PTS) Impact of Event Scale (IES), and the Mini Mental Adjustment to Cancer (Mini-MAC) Anxious Preoccupation and Hopelessness scales were individually administered at T0 and T1.Results:One-quarter of cancer patients met the criteria for Type-D personality, which was stable over the follow-up time. The two main constructs of Type-D personality, namely social inhibition (SI) and negative affectivity (NA), were related to anxiety, depression, PTS, BSI-general distress and maladaptive coping (Mini-MAC anxious preoccupation and hopelessness). In regression analysis, Type-D SI was the most significant factor associated with the above-mentioned psychosocial variables, both at T0 and T1.Conclusion:Likewise other medical disorders (especially cardiology), Type-D personality has been confirmed to be a construct significantly related to psychosocial distress conditions and maladaptive coping that are usually part of assessment and intervention in cancer care. More attention to personality issues is important in oncology.     

Gait- and Posture-Related Factors Associated With Changes in Hip Pain and Physical Function in Patients With Secondary Hip Osteoarthritis: A Prospective Cohort Study

ObjectiveTo identify gait- and posture-related factors associated with changes in hip pain and physical function in patients with hip osteoarthritis (OA).DesignProspective cohort study.SettingClinical biomechanics laboratory of a university.ParticipantsConsecutive sampling of female patients with mild-to-moderate secondary hip OA (N=30).Main Outcome MeasuresHip pain (visual analog scale) and physical function (physical component summary of the Medical Outcomes Study 36-Item Short-Form Health Survey) were measured at baseline and 12 months later. With changes in hip pain and physical function as dependent variables, linear regression analyses were performed with gait- and posture-related factors as independent variables with and without adjustment for age, joint space width, and hip pain or physical function at baseline. Posture-related factors included angles of thoracic kyphosis, lumbar lordosis, sacral inclination, spinal inclination, and spinal mobility. Gait-related factors were walking speed, steps per day, joint angles, external hip joint moment impulses, and daily cumulative hip moments.ResultsMultiple linear regression analyses showed that limited hip extension (adjusted standardized B coefficient [95% confidence interval]: −0.52 [−0.88 to −0.17]) and limited external rotation angles (−0.51 [−0.85 to −0.18]) during walking were associated with the worsening of hip pain. An increased thoracic kyphosis (−0.54 [−0.99 to −0.09]), less sacral anterior tilt (0.40 [0.01-0.79]), reduced thoracic spine mobility (0.59 [0.23-0.94]), less steps per day (0.53 [0.13-0.92]), and a slower walking speed (0.45 [0.04-0.86]) were associated with deterioration in physical function.ConclusionsGait- and posture-related factors should be considered when assessing risk and designing preventive interventions for the clinical progression of secondary hip OA.     

Prevalence and Associated Factors of Burnout Risk Among Intensive Care and Emergency Nurses Before and During the Coronavirus Disease 2019 Pandemic: A Cross-Sectional Study in Belgium

IntroductionThis study aimed to assess (1) the prevalence of burnout risk among nurses working in intensive care units and emergency department before and during the coronavirus disease 2019 pandemic and (2) the individual and work-related associated factors.MethodsData were collected as part of a cross-sectional study on intensive care unit and emergency nurses in Belgium using 2 self-administered online questionnaires distributed just before the pandemic (January 2020, N = 422) and during the first peak of the pandemic (April 2020, N = 1616). Burnout was assessed with the Maslach Burnout Inventory scale.ResultsThe overall prevalence of burnout risk was higher among emergency nurses than intensive care unit nurses but was not significantly different after the coronavirus disease 2019 pandemic (from 69.8% to 70.7%, χ^² = 0.15, P = .68), whereas it increased significantly among intensive care unit nurses (from 51.2% to 66.7%, χ^² = 23.64, P < .003). During the pandemic, changes in workload and the lack of personal protective equipment were significantly associated with a higher likelihood of burnout risk, whereas social support from colleagues and from superiors and management were associated with a lower likelihood of burnout risk. Several determinants of burnout risk were different between intensive care unit and emergency nurses.ConclusionOur findings indicate that nurses in intensive care unit and emergency department were at risk of burnout but their experience during the coronavirus disease 2019 pandemic was quite different. Therefore, it is important to implement specific measures for these 2 groups of nurses to prevent and manage their risk of burnout.     

Factors Associated With Symptom Relief in End-of-Life Care in Residential Care Homes: A National Register-Based Study

Context

Residential care homes (RCHs) are a common place of death. Previous studies have reported a high prevalence of symptoms such as pain and shortness of breath among residents in the last week of life.