-
International Journal of Nursing Studies May 2019Nursing shortages have profoundly impacted hospitals and consequently increased financial expenditure, resulting in work overload, thus augmenting nurses' stress and...
BACKGROUND
Nursing shortages have profoundly impacted hospitals and consequently increased financial expenditure, resulting in work overload, thus augmenting nurses' stress and burnout levels. Studies have found that resilience helps nurses reduce the effects of stress and burnout. However, the factors associated with nurse resilience are yet to be determined.
OBJECTIVES
This systematic review aims to identify the associated personal and work-related factors of nurse resilience.
DESIGN
This systematic review has been registered in the international prospective register of systematic reviews (Registered Number: CRD 42018094080). Results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol.
DATA SOURCES
The systematic search was undertaken between March and April 2018 in five databases: CINAHL Plus, MEDLINE (Ovid), PsycINFO, EMBASE, and Scopus. The searched terms combined in each database were: resilience, hardiness, work, employ, occupation, job, and nursing.
REVIEW METHODS
Full-text English articles published between 2000 and 2018 were included. Studies were also included if they involved: (1) nurses who provided direct patient care, (2) resilience and its associated factors, (3) an empirical quantitative study, and (4) a quality assessment grade of 'good' or 'fair'. Two authors carried out the study eligibility and quality assessment independently. A narrative synthesis was utilised following the Job Demands-Resources model to identify the factors of job demands and resources, which were associated with nurse resilience.
RESULTS
A total of 38 articles met the criteria and were systematically reviewed and narratively synthesised. Various resilience scales utilised in these studies made it unfeasible to synthesise the evidence using a meta-analysis. Inconsistencies exist when examining personal and work-related factors. Job demands (stress, burnout, posttraumatic stress disorder, and workplace bullying) were negatively associated with resilience, while job resources (coping skills, self-efficacy, social support, job satisfaction, job retention, and general wellbeing) were positively related to resilience. Using a quality assessment tool, 23 studies were rated as 'Good', 15 were assessed as 'Fair', and 20 were found to have a risk of bias.
CONCLUSIONS
Understanding nurse resilience can proactively help nurses identify or prevent potential problems, thus fostering job resources and ultimately achieving personal and professional growth. Increased nurse resilience can help nurses reduce emotional exhaustion, increase work engagement, and enhance function when facing workplace challenges. This can assist nurses to establish strategies to deal with adversity and attenuate the effects of job demands. Further research is needed to explore nurse resilience and develop a consistent instrument for measuring resilience.
Topics: Adaptation, Psychological; Attitude of Health Personnel; Burnout, Professional; Humans; Job Satisfaction; Nursing Staff, Hospital; Resilience, Psychological; Workload
PubMed: 30925279
DOI: 10.1016/j.ijnurstu.2019.02.014 -
CA: a Cancer Journal For Clinicians May 2016Answer questions and earn CME/CNE The American Cancer Society Head and Neck Cancer Survivorship Care Guideline was developed to assist primary care clinicians and other... (Review)
Review
Answer questions and earn CME/CNE The American Cancer Society Head and Neck Cancer Survivorship Care Guideline was developed to assist primary care clinicians and other health practitioners with the care of head and neck cancer survivors, including monitoring for recurrence, screening for second primary cancers, assessment and management of long-term and late effects, health promotion, and care coordination. A systematic review of the literature was conducted using PubMed through April 2015, and a multidisciplinary expert workgroup with expertise in primary care, dentistry, surgical oncology, medical oncology, radiation oncology, clinical psychology, speech-language pathology, physical medicine and rehabilitation, the patient perspective, and nursing was assembled. While the guideline is based on a systematic review of the current literature, most evidence is not sufficient to warrant a strong recommendation. Therefore, recommendations should be viewed as consensus-based management strategies for assisting patients with physical and psychosocial effects of head and neck cancer and its treatment. CA Cancer J Clin 2016;66:203-239. © 2016 American Cancer Society.
Topics: Accessory Nerve Diseases; Aftercare; American Cancer Society; Anxiety; Bursitis; Deglutition Disorders; Dental Care; Dental Caries; Depression; Disease Management; Dystonia; Fatigue; Gastroesophageal Reflux; Head and Neck Neoplasms; Health Promotion; Humans; Hypothyroidism; Lymphedema; Neck Muscles; Osteonecrosis; Periodontitis; Peripheral Nervous System Diseases; Respiratory Aspiration; Sleep Apnea Syndromes; Sleep Wake Disorders; Stress, Psychological; Survivors; Taste Disorders; Trismus; Vestibular Neuronitis; Voice Disorders; Xerostomia
PubMed: 27002678
DOI: 10.3322/caac.21343 -
Diseases of the Colon and Rectum Jun 2017Physician burnout in the United States has reached epidemic proportions and is rising rapidly, although burnout in other occupations is stable. Its negative impact is... (Review)
Review
BACKGROUND
Physician burnout in the United States has reached epidemic proportions and is rising rapidly, although burnout in other occupations is stable. Its negative impact is far reaching and includes harm to the burned-out physician, as well as patients, coworkers, family members, close friends, and healthcare organizations.
OBJECTIVE
The purpose of this review is to provide an accurate, current summary of what is known about physician burnout and to develop a framework to reverse its current negative impact, decrease its prevalence, and implement effective organizational and personal interventions.
DATA SOURCES
I completed a comprehensive MEDLINE search of the medical literature from January 1, 2000, through December 28, 2016, related to medical student and physician burnout, stress, depression, suicide ideation, suicide, resiliency, wellness, and well-being. In addition, I selectively reviewed secondary articles, books addressing the relevant issues, and oral presentations at national professional meetings since 2013.
STUDY SELECTION
Healthcare organizations within the United States were studied.
RESULTS
The literature review is presented in 5 sections covering the basics of defining and measuring burnout; its impact, incidence, and causes; and interventions and remediation strategies.
CONCLUSIONS
All US medical students, physicians in training, and practicing physicians are at significant risk of burnout. Its prevalence now exceeds 50%. Burnout is the unintended net result of multiple, highly disruptive changes in society at large, the medical profession, and the healthcare system. Both individual and organizational strategies have been only partially successful in mitigating burnout and in developing resiliency and well-being among physicians. Two highly effective strategies are aligning personal and organizational values and enabling physicians to devote 20% of their work activities to the part of their medical practice that is especially meaningful to them. More research is needed.
Topics: Burnout, Professional; Delivery of Health Care; Humans; Incidence; Medical Errors; Near Miss, Healthcare; Personnel Turnover; Physicians; Professional Autonomy; Stress, Psychological; Suicide; United States; Workload; Workplace
PubMed: 28481850
DOI: 10.1097/DCR.0000000000000844 -
Journal of Youth and Adolescence Sep 2019Given the recent rise in adolescent mental health issues, many researchers have turned to school-based mental health programs as a way to reduce stress, anxiety, and... (Meta-Analysis)
Meta-Analysis
Given the recent rise in adolescent mental health issues, many researchers have turned to school-based mental health programs as a way to reduce stress, anxiety, and depressive symptoms among large groups of adolescents. The purpose of the current systematic review and meta-analysis is to identify and evaluate the efficacy of school-based programming aimed at reducing internalizing mental health problems of adolescents. A total of 42 articles, including a total of 7310 adolescents, ages 11-18, met inclusion for the meta-analyses. Meta-analyses were completed for each of the three mental health outcomes (stress, depression, and anxiety) and meta-regression was used to determine the influence of type of program, program dose, sex, race, and age on program effectiveness. Overall, stress interventions did not reduce stress symptoms, although targeted interventions showed greater reductions in stress than universal programs. Overall, anxiety interventions significantly reduced anxiety symptoms, however higher doses may be necessary for universal programs. Lastly, depression interventions significantly reduced depressive symptoms, but this reduction was moderated by a combination of program type, dose, race, and age group. Although, school-based programs aimed at decreasing anxiety and depression were effective, these effects are not long-lasting. Interventions aimed at reducing stress were not effective, however very few programs targeted or included stress as an outcome variable. Implications for practice, policy and research are discussed.
Topics: Adolescent; Anxiety; Child; Depression; Female; Humans; Male; Primary Prevention; Program Evaluation; School Health Services; Stress, Psychological; Students
PubMed: 31346924
DOI: 10.1007/s10964-019-01085-0 -
BMC Health Services Research Dec 2017Nurses leaving their jobs and the profession are an issue of international concern, with supply-demand gaps for nurses reported to be widening. There is a large body of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Nurses leaving their jobs and the profession are an issue of international concern, with supply-demand gaps for nurses reported to be widening. There is a large body of existing literature, much of which is already in review form. In order to advance the usefulness of the literature for nurse and human resource managers, we undertook an overview (review of systematic reviews). The aim of the overview was to identify high quality evidence of the determinants and consequences of turnover in adult nursing.
METHODS
Reviews were identified which were published between 1990 and January 2015 in English using electronic databases (the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS) and forward searching. All stages of the review were conducted in parallel by two reviewers. Reviews were quality appraised using the Assessment of Multiple Systematic Reviews and their findings narratively synthesised.
RESULTS
Nine reviews were included. We found that the current evidence is incomplete and has a number of important limitations. However, a body of moderate quality review evidence does exist giving a picture of multiple determinants of turnover in adult nursing, with - at the individual level - nurse stress and dissatisfaction being important factors and -at the organisational level - managerial style and supervisory support factors holding most weight. The consequences of turnover are only described in economic terms, but are considered significant.
CONCLUSIONS
In making a quality assessment of the review as well as considering the quality of the included primary studies and specificity in the outcomes they measure, the overview found that the evidence is not as definitive as previously presented from individual reviews. Further research is required, of rigorous research design, whether quantitative or qualitative, particularly against the outcome of actual turnover as opposed to intention to leave.
TRIAL REGISTRATION
PROSPERO Registration 17 March 2015: CRD42015017613 .
Topics: Adult; Female; Humans; Intention; Interpersonal Relations; Job Satisfaction; Leadership; Male; Motivation; Nursing Staff; Organizational Culture; Personnel Turnover; Power, Psychological; Review Literature as Topic; Salaries and Fringe Benefits; Workload
PubMed: 29246221
DOI: 10.1186/s12913-017-2707-0 -
Journal of Medical Internet Research Jul 2017Stress, depression, and anxiety among working populations can result in reduced work performance and increased absenteeism. Although there is evidence that these common... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Stress, depression, and anxiety among working populations can result in reduced work performance and increased absenteeism. Although there is evidence that these common mental health problems are preventable and treatable in the workplace, uptake of psychological treatments among the working population is low. One way to address this may be the delivery of occupational digital mental health interventions. While there is convincing evidence for delivering digital psychological interventions within a health and community context, there is no systematic review or meta-analysis of these interventions in an occupational setting.
OBJECTIVE
The aim of this study was to identify the effectiveness of occupational digital mental health interventions in enhancing employee psychological well-being and increasing work effectiveness and to identify intervention features associated with the highest rates of engagement and adherence.
METHODS
A systematic review of the literature was conducted using Cochrane guidelines. Papers published from January 2000 to May 2016 were searched in the PsychINFO, MEDLINE, PubMed, Science Direct, and the Cochrane databases, as well as the databases of the researchers and relevant websites. Unpublished data was sought using the Conference Proceedings Citation Index and the Clinical Trials and International Standard Randomized Controlled Trial Number (ISRCTN) research registers. A meta-analysis was conducted by applying a random-effects model to assess the pooled effect size for psychological well-being and the work effectiveness outcomes. A positive deviance approach was used to identify those intervention features associated with the highest rates of engagement and adherence.
RESULTS
In total, 21 randomized controlled trials (RCTs) met the search criteria. Occupational digital mental health interventions had a statistically significant effect post intervention on both psychological well-being (g=0.37, 95% CI 0.23-0.50) and work effectiveness (g=0.25, 95% CI 0.09-0.41) compared with the control condition. No statistically significant differences were found on either outcome between studies using cognitive behavioral therapy (CBT) approaches (as defined by the authors) compared with other psychological approaches, offering guidance compared with self-guidance, or recruiting from a targeted workplace population compared with a universal workplace population. In-depth analysis of the interventions identified by the positive deviance approach suggests that interventions that offer guidance are delivered over a shorter time frame (6 to 7 weeks), utilize secondary modalities for delivering the interventions and engaging users (ie, emails and text messages [short message service, SMS]), and use elements of persuasive technology (ie, self-monitoring and tailoring), which may achieve greater engagement and adherence.
CONCLUSIONS
This review provides evidence that occupational digital mental health interventions can improve workers' psychological well-being and increase work effectiveness. It identifies intervention characteristics that may increase engagement. Recommendations are made for future research, practice, and intervention development.
Topics: Humans; Internet; Mental Health; Occupational Health; Workplace
PubMed: 28747293
DOI: 10.2196/jmir.7583 -
Emergency Medicine Journal : EMJ Jul 2017Occupational stress is a major modern health and safety challenges. While the ED is known to be a high-pressure environment, the specific organisational stressors which... (Review)
Review
INTRODUCTION
Occupational stress is a major modern health and safety challenges. While the ED is known to be a high-pressure environment, the specific organisational stressors which affect ED staff have not been established.
METHODS
We conducted a systematic review of literature examining the sources of organisational stress in the ED, their link to adverse health outcomes and interventions designed to address them. A narrative review of contextual factors that may contribute to occupational stress was also performed. All articles written in English, French or Spanish were eligible for conclusion. Study quality was graded using a modified version of the Newcastle-Ottawa Scale.
RESULTS
Twenty-five full-text articles were eligible for inclusion in our systematic review. Most were of moderate quality, with two low-quality and two high-quality studies, respectively. While high demand and low job control were commonly featured, other studies demonstrated the role of insufficient support at work, effort-reward imbalance and organisational injustice in the development of adverse health and occupational outcomes. We found only one intervention in a peer-reviewed journal evaluating a stress reduction programme in ED staff.
CONCLUSIONS
Our review provides a guide to developing interventions that target the origins of stress in the ED. It suggests that those which reduce demand and increase workers' control over their job, improve managerial support, establish better working relationships and make workers' feel more valued for their efforts could be beneficial. We have detailed examples of successful interventions from other fields which may be applicable to this setting.
Topics: Burnout, Professional; Emergency Service, Hospital; Humans; Occupational Stress; Professional Autonomy; Workload
PubMed: 27729392
DOI: 10.1136/emermed-2016-205827 -
Journal of Pediatric Nursing 2021Psychological and symptom disturbances seriously affect hospitalized children's subjective experiences of hospitalization and their prognosis. We systematically reviewed... (Meta-Analysis)
Meta-Analysis Review
PROBLEM
Psychological and symptom disturbances seriously affect hospitalized children's subjective experiences of hospitalization and their prognosis. We systematically reviewed the effects of animal-assisted therapy (AAT) on pain, anxiety, depression, stress, blood pressure (BP), and heart rate (HR) in hospitalized children and teenagers.
ELIGIBILITY CRITERIA
A systematic review and meta-analysis were conducted using the English-language electronic databases PubMed, EMBASE, Web of Science, the Cochrane Library, Clinical Trials, Science Direct, EBSCOhost, Open Grey and Google Scholar, and the Chinese databases CNKI, Sinomed, Vip, and WanFang. These databases were searched through July 15, 2020.
SAMPLE
Eight studies, including four randomized controlled trials (RCTs) and four quasi-experimental studies were included, with a total of 348 participants.
RESULTS
Hospitalized children and teenagers with AAT had less pain (standardized mean difference = -0.49; 95% confidence interval [CI], -0.77 to -0.22; P < 0.001), lower systolic blood pressure (mean difference [MD] = -4.85; 95% CI, -9.50 to -0.21; P 0.04), higher diastolic blood pressure (MD = 4.95; 95% CI, 1.90 to 8.00; P = 0.001) than controls, while there was no significant difference in depression, anxiety, stress, or HR.
CONCLUSION
As an adjuvant to traditional treatment, AAT was beneficial for controlling pain and BP in hospitalized children and teenagers.
IMPLICATION
AAT may be an effective strategy for relieving pain and controlling BP in hospitalized children and teenagers, especially those with cancer. High-quality RCTs conducted or supported by nurses on the effects of AAT are needed.
Topics: Adolescent; Animal Assisted Therapy; Animals; Anxiety; Child; Child, Hospitalized; Humans; Neoplasms; Pain Management
PubMed: 33582447
DOI: 10.1016/j.pedn.2021.01.020 -
Journal of Advanced Nursing Jun 2018The aim of this study was to describe and summarize workplace characteristics of three nursing generations: Baby Boomers, Generations X and Y. (Comparative Study)
Comparative Study Review
AIMS
The aim of this study was to describe and summarize workplace characteristics of three nursing generations: Baby Boomers, Generations X and Y.
BACKGROUND
Generational differences affect occupational well-being, nurses' performance, patient outcomes and safety; therefore, nurse managers, administrators and educators are interested increasingly in making evidence-based decisions about the multigenerational nursing workforce.
DESIGN
Mixed-method systematic review.
DATA SOURCES
Medline, CINAHL, PsycINFO and Scopus (January 1991-January 2017).
REVIEW METHODS
(1) The Joanna Briggs Institute's method for conducting mixed-method systematic reviews; (2) the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and (3) the Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines. The studies' methodological quality was assessed with the Mixed-Methods Appraisal Tool. Quantitative and mixed-method studies were transformed into qualitative methods using a convergent qualitative synthesis and qualitative findings were combined with a narrative synthesis.
RESULTS
Thirty-three studies were included with three main themes and 11 subthemes: (1) Job attitudes (work engagement; turnover intentions, reasons for leaving; reasons, incentives/disincentives to continue nursing); (2) Emotion-related job aspects (stress/resilience; well-being/job satisfaction; affective commitment; unit climate; work ethic) and (3) Practice and leadership-related aspects (autonomy; perceived competence; leadership relationships and perceptions). Baby Boomers reported lower levels of stress and burnout than did Generations X and Y, different work engagement, factors affecting workplace well-being and retention and greater intention to leave compared with Generation Y, which was less resilient, but more cohesive.
CONCLUSION
Although several studies reported methodological limitations and conflicting findings, generational differences in nurses' job attitudes, emotional, practice and leadership factors should be considered to enhance workplace quality.
Topics: Adult; Age Factors; Aged; Attitude of Health Personnel; Burnout, Professional; Cohort Effect; Female; Humans; Job Satisfaction; Male; Middle Aged; Nursing Staff, Hospital; Personnel Turnover; Workplace
PubMed: 29424038
DOI: 10.1111/jan.13538 -
International Journal of Nursing Studies Sep 2021The contribution of work to positive mental health is increasingly apparent. Transition into the workplace causes a range of stressors for new graduate nurses who... (Review)
Review
BACKGROUND
The contribution of work to positive mental health is increasingly apparent. Transition into the workplace causes a range of stressors for new graduate nurses who experience both psychological wellbeing and illbeing in their first year of practice.
OBJECTIVE
To determine published prevalence, predictors, barriers and enablers of new graduate registered nurse wellbeing, work wellbeing and mental health.
DESIGN
Systematic review of quantitative research.
DATA SOURCES
Databases included Cumulative Index of Nursing and Allied Health Literature, Excerpta Medica database, Medical Literature Analysis and Retrieval System Online and Psychological Information. Quantitative and mixed-methods studies were considered for inclusion if published in English from 2009 to 2019 reporting primary data analysis including new graduate nurses' wellbeing, work wellbeing and mental health.
REVIEW METHODS
Quantitative studies were systematically identified then screened and appraised against pre-determined inclusion criteria. Analysis was conducted by grouping according to analytical methods and results reported as a narrative synthesis.
RESULTS
Thirty-four studies were included. The quality of the evidence was variable with just a quarter of the studies being assessed as meeting the quality criteria on all nine measures. For the new graduate nurses prevalence of wellbeing, levels of resilience, optimism, and hope were found to be high. For work wellbeing, most reported higher job satisfaction by 12-months. For work illbeing, levels of burnout were moderately high, predominantly in terms of emotional exhaustion, and stress was initially high, particularly in terms of workload, but decreased over time. For the predictors, job satisfaction was positively predicted by structural empowerment and career satisfaction, and negatively predicted by co-worker incivility, supervisor incivility and emotional exhaustion. For work illbeing, stress was a positive predictor for intent to leave. Stress reductions were associated with momentary levels of high task mastery, social acceptance and role clarity.
CONCLUSIONS
For new graduate nurses, levels of emotional exhaustion, workload and stress were moderately high to high initially, decreasing over time as the graduate nurses' job satisfaction increased. Most studies focused on the nurses' intent to resign or stay and both psychological capital and work engagement positively predicted intent to stay whereas work stress positively predicted intent to resign. Resilience and group cohesion moderated the negative effects of some variables, thus may be potential enablers of work wellbeing. The standards of research reporting or design were generally sub-optimal according to quality indicators. Systematic review registration number: (CRD42020148812).
Topics: Burnout, Professional; Education, Nursing, Graduate; Humans; Job Satisfaction; Mental Health; Workplace
PubMed: 34218048
DOI: 10.1016/j.ijnurstu.2021.103997