Relationships between nurses’ empathy,self-compassion and dimensions of professional quality of life: A cross-sectional study

BackgroundJob stress and burnout are common among healthcare professionals, and nurses in particular. In addition to the heavy workload and lack of recourses, nurses are also confronted with emotionally intense situations associated with illness and suffering, which require empathic abilities. Although empathy is one of the core values in nursing, if not properly balanced it can also have detrimental consequences, such as compassion fatigue. Self-compassion, on the other hand, has been shown to be a protective factor for a wide range of well-being indicators and has been associated with compassion for others.ObjectivesThe main goal of this study was to explore how empathy and self-compassion related to professional quality of life (compassion satisfaction, compassion fatigue and burnout). In addition, we wanted to test whether self-compassion may be a protective factor for the impact of empathy on compassion fatigue.Methods and participantsUsing a cross-sectional design, 280 registered nurses from public hospitals in Portugal's north and center region were surveyed. Professional quality of life (Professional Quality of Life), empathy (Interpersonal Reactivity Index) and self-compassion (Self-compassion Scale) were measured using validated self-report measures.ResultsCorrelations and regression analyses showed that empathy and self-compassion predicted the three aspects of professional quality of life. Empathic concern was positively associated with compassion satisfaction as well as with compassion fatigue. Mediation models suggested that the negative components of self-compassion explain some of these effects, and self-kindness and common humanity were significant moderators. The same results were found for the association between personal distress and compassion fatigue.ConclusionsHigh levels of affective empathy may be a risk factor for compassion fatigue, whereas self-compassion might be protective. Teaching self-compassion and self-care skills may be an important feature in interventions that aim to reduce burnout and compassion fatigue.     

A cross-sectional study of clinical emergency department nurses’ occupational stress,job involvement and team resilience

IntroductionThe occupational stress of clinical nurses has drawn increasing attention. It has been proven that occupational stress is related to job involvement, and job involvement affects team resilience. However, research on the relationship between emergency nurses’ occupational stress, job involvement and team resilience is lacking.AimTo explore relationships between occupational stress, job involvement, and team resilience among a sample of emergency nurses and determined significant influencing factors of occupational stress in emergency departments.MethodsIn four hospitals in Shandong, China, 187 emergency room nurses participated in a study. The Utrecht Work Engagement Scale, the Chinese version of the Stressors Scale for Emergency Nurses, and a scale for evaluating the team resilience of medical professionals were used to collect data.ResultsThe overall occupational stress score of nurses working in the emergency departments in Shandong province was 81.07 ± 25.80. The results of Single-factor analysis demonstrated that the scores indicating the occupational stress for emergency nurses differed significantly with respect to age, education level, marital status, children, professional title, work experience and work shift (P < 0.05). Additionally, there is a negative correlation between job involvement and team resilience and occupational stress. Multiple linear regression results showed that the job involvement, team resilience and work shift were statistically significant influencing factors of the level of occupational stress (change R² = 17.5 %, F = 5.386, P < 0.001).ConclusionsStronger team resilience and more active job involvement resulted in lower occupational stress levels experienced by emergency nurses.     

Shift nurses’ social jetlag,anxiety, and premenstrual symptoms: A cross-sectional study

BackgroundAlthough rotating shifts are essential for nurses to ensure optimal patient care, rotating shifts expose them to an imbalanced circadian rhythm. Shift work leads to nurses experiencing diminished sleep quality, which affects their wakefulness and judgment, curtails work performance, and affects care quality.AimTo investigate the relationship among social jetlag, anxiety, and premenstrual symptoms in nurses working in 8-hour rotating shiftsMethodsParticipants were 194 shift-working nurses in three South Korean university hospitals from March 21 to April 2 in 2021. Chronotype and social jetlag were assessed using the Munich Chronotype Questionnaire for Shift Workers. Anxiety was measured with the State-Trait Anxiety Inventory X-1. Premenstrual symptoms were measured using the Shortened Premenstrual Assessment Form. This cross-sectional study adheres to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.FindingsAmong participants, the mean overall social jetlag was 3 hours 45 minutes. Hierarchical regression analysis revealed that social jetlag (on evening shift) and anxiety significantly influenced nurses’ premenstrual symptoms. Moreover, individuals’ chronotype and preference to work the night shift were identified as predictors of premenstrual symptoms.DiscussionNurses working on shifts are bound to experience greater social jetlag compared with the general population and are at an elevated risk of deteriorated quality of life. Nursing managers should consider individuals’ chronotypes and social jetlag when establishing shift schedules and identify strategies that relieve anxiety in nurses working in rotating shifts.ConclusionSocial jetlag and anxiety adversely affect premenstrual symptoms in female nurses working in 8-hour rotating shifts.     

The mediating roles of moral courage and moral resilience between nurses’ moral distress and moral injury: An online cross-sectional study

AimsTo investigate the mediating role of moral resilience and moral courage in the association between moral distress and moral injury.BackgroundThere is a preponderance of nursing literature about moral distress, moral resilience, moral courage and moral injury. However, examining moral resilience and moral courage as mediators remain underreported during the COVID-19 pandemic and in the context of a developing nation.DesignCorrelational, cross-sectional design compliant with the STROBE guidelines.MethodsA convenience sample of nurses (n = 412) from the Philippines were recruited using social media platforms (e.g., Facebook, Messenger, Twitter). Four self-report and validated scales (8-item Moral-Distress Appraisal Scale, 21-item Nurses’ Moral Courage Scale, 17-item Rushton Moral Resilience Scale and 10-item Moral Injury Symptom Scale: Healthcare Professionals Version) were used to collect data from January to July 2022. Pearson’s r, bivariate analysis and multistage regression analyses were used for data analysis.ResultsThis study afforded a model that depicted the interrelationships of moral distress, moral resilience, moral courage and moral injury. Moral distress has a negative impact on moral resilience and moral courage while positively affecting moral injury. Moral resilience positively influences moral courage while having a negative impact on moral injury. Moral courage has an indirect impact on moral injury. Finally, moral resilience and moral courage demonstrated a mediating effect between moral distress and moral injury.ConclusionsHealthcare organizations, policymakers and nurse managers should include policies and programs that include improving approaches to modifying workplace conditions and evaluating nurses' moral resilience and courage. Nurse managers need to advocate ethics education and professionalism. Nurses must practice self-care strategies to strengthen morally resilient and courageous therapeutic practices.     

Relationships between nurses and family caregivers: partners in care?

Increasing reliance on family care of elderly people at home calls for a critical analysis of the relationship between formal and informal caregivers. Although much has been written about how health professionals and family caregivers should relate to one another, we know very little about the relationships that develop between them. Using data from a qualitative study, this article illustrates that relationships between community nurses and family members caring for frail elders are complex, dynamic, and multifaceted. Shifting boundaries in caring work leads to changes in nurse-family caregiver relationships, which can be categorized as four distinct, yet interconnected, types: (1) nurse-helper, (2) worker-worker, (3) manager-worker, and (4) nurse-patient. Each type is described, and implications for nursing practice and research are discussed.     

Thyroid cancer survivors’ perceptions of survivorship care follow-up options: a cross-sectional,mixed-methods survey

Purpose

This study investigated thyroid cancer (TC) survivors’ perceived satisfaction with and perceptions of survivorship care follow-up options.

Methods

Well-differentiated TC (WDTC) patients receiving follow-up care at an academic cancer centre completed a questionnaire assessing perceived satisfaction with follow-up care involving different clinicians and mediated by the Internet (email or videoconference) and their perceptions of these follow-up options. We examined associations between patient characteristics and perceived satisfaction with follow-up care options. Qualitative responses were analysed using conventional content analysis.

Results

Two hundred and two respondents completed the questionnaire (80 % response rate). The majority strongly agreed or agreed that they would be satisfied with specialist (surgeon, oncologist, or endocrinologist) follow-up (90.6 %) or a shared-care model that integrates specialists with primary care (67.5 %). One third (32 %) would be satisfied with video-based and 26 % with email-based specialist follow-up, 15 % with primary care alone. Longer time since diagnosis and health-related Internet use were associated with higher perceived satisfaction with Internet-based follow-up. Younger age was associated with higher perceived satisfaction with primary care follow-up. Qualitative responses (n?=?145) revealed that survivors need reassurance they are receiving adequate care, regardless of the model or medium. Enablers to primary care and Internet-based follow-up are discussed.

Conclusions

WDTC survivors want specialists involved in their follow-up. A specialist/primary care shared-care approach appears to be a suitable alternative to specialist-led follow-up for TC survivors. Internet-based visits could address some aspects of follow-up care for some WDTC survivors. Future work should examine patient and provider requirements for shared, multi-modal survivorship care.

     

General practitioners’ attitudes toward follow-up after cancer treatment: A cross-sectional questionnaire study

Objective An increasing number of cancer patients place a significant workload on hospital outpatient clinics, and health authorities are considering alternative follow-up regimens. It has been suggested that follow-up of cancer patients could be provided by GPs. This study aimed to explore GPs’ experiences with the provision of follow-up care for cancer patients, and their views on assuming greater responsibility in the future.

Design Electronic questionnaire study.

Subjects GPs in seven regions in Norway.

Results A total of 317 GPs responded. Many GPs reported experience in providing follow-up care to cancer patients, during the years following initial diagnosis primarily in collaboration with hospital specialists. More than half of the GPs were satisfied with their collaboration. Most GPs preferred to be involved at an early stage in follow-up care and, generally, GPs felt confident in their skills to provide this type of service. Fewer than 10% were willing to assume responsibility for additional cancer patients, citing potentially increased workload as the main reason.

Conclusions GPs acknowledged the importance of providing follow-up care to cancer patients, and the majority felt confident in their own ability to provide such care. However, they were hesitant to assume greater responsibility primarily due to fears of increased workload.

• Key Points

• It has been suggested that follow-up of cancer patients can be provided by general practitioners (GPs). The viewpoints and attitudes of GPs regarding such follow-up were investigated.

  • GPs reported broad experience in providing follow-up care to patients after active cancer treatment.

  • GPs acknowledged the importance of follow-up care, and they felt confident in their own ability to provide such care.

  • Fewer than 10% of GPs were willing to assume responsibility for additional cancer patients, citing potentially increased workload as the main reason.

     

Nurses’ personal and ward accountability and missed nursing care: A cross-sectional study

BackgroundMissed nursing care is considered an act of omission with potentially detrimental consequences for patients, nurses, and organizations. Although the theoretical conceptualization of missed nursing care specifies nurses’ values, attitudes, and perceptions of their work environment as its core antecedents, empirical studies have mainly focused on nurses’ socio-demographic and professional attributes. Furthermore, assessment of missed nursing care has been mainly based on same-source methods.ObjectivesThis study aimed to test the joint effects of personal and ward accountability on missed nursing care, by using both focal (the nurse whose missed nursing care is examined) and incoming (the nurse responsible for the same patients at the subsequent shift) nurses’ assessments of missed nursing care.DesignA cross-sectional design, where nurses were nested in wards.ParticipantsA total of 172 focal and 123 incoming nurses from 32 nursing wards in eight hospitals.MethodsMissed nursing care was assessed with the 22-item MISSCARE survey using two sources: focal and incoming nurses. Personal and ward accountability were assessed by the focal nurse with two 19-item scales. Nurses' socio-demographics and ward and shift characteristics were also collected. Mixed linear models were used as the analysis strategy.ResultsFocal and incoming nurses reported occasional missed nursing care of the focal nurse (Mean = 1.87, SD = 0.71 and Mean = 2.09, SD = 0.84, respectively; r = 0.55, p < 0.01). Regarding the focal nurse's assessment of his/her own missed nursing care, findings showed that, above and beyond nurses’ overload and personal socio-demographic characteristics, higher personal accountability was significantly associated with decreased missed care (β = −0.29, p < 0.01), whereas ward accountability was not (β = −0.23, p > 0.05). The interaction effect was significant (β = −0.31, p < 0.05); the higher the ward accountability, the stronger the negative relationship between nurses' personal accountability and missed nursing care. Similar patterns were obtained for the incoming nurses' assessment of focal nurse's missed care.ConclusionsUse of focal and incoming nurses' missed nursing care assessments limited the common source bias and strengthened our findings. Personal and ward accountability are significant values, which are associated with lower missed nursing care, beyond scarce resources. Implementation of local and national education programs for nurses and managers, accompanied with empirical research, might increase personal and ward accountability, thereby decreasing missed nursing care. This might help to create a safety culture and reduce negative outcomes for patients, nurses, and organizations.     

Nursing students’ attitudes and experiences with mental illness: A cross-sectional study

Almost half (46%) of people will experience a mental health issue in their lifetime and all nurses need mental health knowledge and skills regardless of their area of specialization. Little is known, however, about student attitudes toward people with mental illness on entry to pre-registration nursing programs. The aims were to investigate Australian pre-registration nursing students’ attitudes toward, and prior experience with, people with mental illness on program commencement. This cross-sectional study used the Community Attitudes Toward Mental Illness (CAMI) scale with pre-registration nursing students, and questions on students’ prior experience with mental illness (self, family, friends). There were n = 311 (271 female/40 male) first year, first semester Bachelor of Nursing students at a national Australian university. Students reported prior experience with mental illness with family (49.5%/n = 154) and friends (61.4%/n = 191). Self-reported (36.3% /n = 113) mental illness, particularly anxiety and depression, significantly exceeded national averages. Most students held accepting attitudes toward people with mental illness, except for perceptions of dangerousness. This study provides new findings on nursing student attitudes and experience with people with mental illness on program entry. The high self-reported prevalence of anxiety and depression at program entry indicates a pressing need for early intervention and mental wellbeing strategies for students from commencement of their tertiary education. Fear-reducing education which challenges perceptions of dangerousness in relation to people with mental illness, and supportive mental health clinical placements during their program, may help improve students’ attitudes and reduce fear and mental health stigma.     

Complementary therapists’ training and cancer care: A multi-site study

PurposeTo explore professional experience and training of complementary therapists working within cancer care.MethodA Questionnaire survey of complementary therapists practising in three cancer care settings in North West England.ResultsRespondents (n = 51; n = 47 female; mean age 50 years, range 23–78 years) had varied career backgrounds; 24 were healthcare professionals who also practised as complementary therapists (nurse n = 19; physiotherapist n = 3; doctor n = 2) whilst 27 were complementary therapists with no prior healthcare background. Twenty-eight respondents reported working as therapists within a supportive and palliative care setting for over 6 years. Forty-seven respondents had undertaken healthcare-related continuing professional development in complementary therapies, although only just over half of the sample (n = 27) had received cancer-specific training. Cancer-related complementary therapy training related to the adaptation of therapies and comprised predominantly short courses. There was a lack of standardisation in the training received, nor was it clear how many courses were accredited.ConclusionFindings highlight the need for standardisation of training for complementary therapy provision in cancer care and statutory review of continuing professional development within this emerging field.     

Pre-registration nursing students’ perceptions and experience of intentional rounding: A cross-sectional study

This paper examines pre-registration nursing students’ perceptions of the practice of intentional rounding and perceived benefits for nurses and patients.Intentional rounding was developed to ensure nursing staff regularly check on patients to ensure that all care needs are met. It has been linked to a reduction in falls and call bell use, and an increase in patient safety. No previous studies have examined pre-registration nursing students’ role in the practice of intentional rounding during clinical placements nor the perceptions of rounding practices, important from a future workforce perspective.A cross-sectional multisite study was undertaken, and pre-registration nursing students completed the Nurses’ Perceptions of Patient Rounding Scale between August 2017– June 2018, distributed using online education platforms and email. Strobe reporting guidelines were used to report findings.Participants perceived positive benefits in intentional rounding for nurses and patients. Mixed opinions surrounded the sufficiency of education received around the intervention. Previous nursing experience was linked to opposing opinions of intentional rounding, depending on education levels.Participants had a positive perception of intentional rounding practices overall. Education surrounding intentional rounding needs to be consistent, and introduced before students are expected to actively participate in the practice of rounding on clinical placement.     

Clinicians’ attitudes towards escalation and management of deteriorating patients: A cross-sectional study

BackgroundInternationally, rapid response systems have been implemented to recognise and categorise hospital patients at risk of deterioration. Whilst rapid response systems have been implemented with a varying amount of success, there remains ongoing concern about the lack of improvement in the escalation, and management of the deteriorating patient. It also remains unclear why some clinicians fail to escalate concerns for the deteriorating patient.ObjectiveThe objective of this study was to explore clinicians’ attitudes towards the escalation, and management of the deteriorating patient.MethodsA cross-sectional online survey of conveniently sampled clinicians from the acute care sector in a regional health district in Australia was conducted. The Clinicians’ Attitudes towards Responding and Escalating care of Deteriorating patients scale, was used to explore attitudes towards the escalation and management of the deteriorating patient.ResultsSurvey responses were received from medical officers (n = 43), nurses (n = 677), allied health clinicians (n = 60), and students (n = 57). Years of experience was significantly associated with more confidence responding to deteriorating patients (p < .001) and significantly less fears about escalating care (p < .001). Nurses (M = 4.16, SD = .57) and students (M = 4.11, SD = .55) in general had significantly greater positive beliefs that the rapid response system would support them to respond to the deteriorating patient than allied health (M = 3.67, SD = .64) and medical (M = 3.87, SD = .54) clinicians, whilst nurses and medical clinicians had significantly less fear about escalating care and greater confidence in responding to deteriorating patients than allied health clinicians and healthcare students (p < .001).ConclusionNurses and medical officers have less fear to escalate care and greater confidence responding to the deteriorating patient than allied health clinicians and students. Whilst the majority of participants had positive perceptions towards the rapid response system, those with less experience lacked the confidence to escalate care and respond to the deteriorating patient.     

Examining nursing students’ wellness and resilience: An exploratory study

Undergraduate nursing students report high levels of stress which can negatively impact their overall wellness, and their academic and clinical performance. Despite this knowledge, there are few studies that have examined the well-being of nursing students and their ability to demonstrate resilience. Therefore, the purpose of this exploratory study was to examine resilience and wellness, together with the key factors that promote a well-being in nursing students from mid-western Canadian university. The sample of 196 undergraduate nursing students completed an online Nursing Well-being and Resilience Survey. Findings indicated that most nursing students had good health; however, many presented with anxiety and/or depression and a decreased sense of wellness in the physical, spiritual, and emotional domain. Other significant findings included participants >26 years old having lower burnout scores, higher ego-resilience and well-being scores compared to students ages 20 to 25; and, 2) there were differences between campus locations in terms of Professional Quality of life (compassion satisfaction, burnout, and traumatic stress) and sense of well-being. Understanding how resilience and wellness are influenced throughout the nursing program is a first step in developing targeted wellness initiatives for different nursing student populations.     

A literature review on the mutual impact of the spousal caregiver–cancer patients dyads: ‘Communication’, ‘reciprocal influence’, and ‘caregiver–patient congruence’

PurposeA diagnosis of cancer is the start of a journey of distress and adjustment for both the patient and his/her spouse. However, the dyadic phenomena are less conceptualised and related research is in the early stages. This review explores concepts of mutuality among spousal caregiver–cancer patient dyads and identifies directions for future research.MethodA systematic search, including trawling through six electronic databases, a manual search, and an author search, was conducted to identity articles that had been published in English and Chinese from January 2000 to March 2013, using key terms related to caregiver–patients dyads in cancer care. An inductive content analysis approach was adopted to analyse and synthesise the concepts of spousal caregiver–cancer patient dyads.ResultsThirty-one articles were identified. The findings are described according to Fletcher et al.'s proposals for conceptualising spousal caregiver–patient dyads. The proposed concepts of ‘communication’, ‘reciprocal influence’, and ‘caregiver–patient congruence’ have been found to be interrelated, and to contribute to the spousal caregiver–patient dyads' mutual appraisal of caregiving and role adjustment through the cancer trajectory.ConclusionsThe findings highlight the importance of a perspective that focuses on the nature of the relationship between couples coping with cancer and the quality of their communication with each other. It is recognised that communication may act as a fundamental element of the abovementioned three concepts. Better communication between couples would probably facilitate reciprocal influence and caregiver–patient congruence, which in turn would have a positive effect on intimacy between the couple and improve the caregiving outcomes.