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Accessible summary: What is known on the subject?: Supervised Quarantine has been shown to impact the psychological well‐being of those in quarantine both during the COVID‐19 pandemic and in previous pandemics.There are few studies regarding the psychological impact of supervised quarantine for the purpose of COVID‐19 mitigation.There is little research regarding the psychological well‐being of professionals maintaining quarantine, despite the fact they risk potential psychological distress. What the paper adds to existing knowledge?: This paper addresses the paucity of knowledge regarding the psychological well‐being of those undergoing quarantine in a purpose‐built facility.The quarantined study population involved uniquely domestic arrivals and also professionals maintaining quarantine.Lack of control, isolation and miscommunication were perceived as challenging mental well‐being. What are the implications for practice?: Although psychological distress in Domestic arrivals appeared low, there are still identifiable stresses on mental well‐being.Mental health workers need to be cognizant that point entry to COVID‐19 quarantine (Domestic vs. International as well as specific regions) may influence risk of psychological distress.Mental Health nurses supporting those in quarantine should afford quarantined individuals a degree of choice, establish regular clear communication and consider how to establish peer support mechanisms within the quarantine environment. Introduction: Supervised quarantine may compromise psychological well‐being. There is equivocal evidence regarding psychological distress in compulsory supervised quarantine facilities. Aims: To evaluate the mental well‐being of people undergoing and working in a supervised COVID‐19 quarantine facility. Method: Mixed methodology was used, including a cross‐sectional analysis of psychological distress (DASS‐21) and individual semi‐structured interviews (10 professionals maintaining quarantine and 10 quarantined persons). Results: Overall levels of psychological distress were low. Those quarantining from Victoria had significantly lower depression scores compared to all other departure points. Qualitative analysis identified distress being linked to a lack of control, isolation and miscommunication. Discussion: Quarantine was associated with low levels of psychological distress. This was lower in people travelling from Victoria, a state where there were higher rates of infections and restrictions. Interviews showed that psychological distress was conceptualized as being associated with supervised quarantine, but participants recognized the overall importance of quarantine. Implications for Practice: Mental health professionals supporting quarantined people should consider original departure points may predict levels of psychological distress. Implementing ways of gaining control through affording choice, improving communication channels and establishing peer support networks within quarantine settings may help maintain mental well‐being. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the predictors of burnout in female nurses during the first wave of the COVID‐19 pandemic. It also sought to evaluate the relationship between each of the variables studied (anxiety, depression, sociodemographic and COVID‐19 variables) and the dimensions of the burnout. Background: One of the groups of health care workers worst affected by the COVID‐19 crisis has been women working as nursing staff, due to the high percentage they account for at a global level and their direct contact with infected patients. Design: This was a cross‐sectional, quantitative study. Methods: Four hundred forty‐four Spanish female nurses from hospital and primary health care centres took part in the study. The data were obtained in 2020 by means of an online survey. Results: Symptoms of depression are a common predictor variable to all the dimensions of burnout, whereas symptoms of anxiety predict emotional exhaustion and depersonalization. Age and years of experience in the job predict depersonalization, whereas the probability of contracting the infection is a predictor variable of emotional exhaustion and personal accomplishment. Conclusion: Predictor variables should be considered in the creation of prevention and intervention plans to reduce the levels of burnout in female nurses. Summary statement: What is already known about this topic? During the COVID‐19 pandemic, nurses have been exposed to high levels of burnout. Research has shown that nurses experience high levels of anxiety and depression in pandemics, in comparison with other job positions in the health care sector.Being a woman and having certain previous psychological conditions (symptoms of anxiety and depression) are predictors of emotional exhaustion and depersonalization. What this paper adds? This research focuses on female nurses, and makes an important contribution given the lack of studies that assess these variables from a gender perspective.Symptoms of depression have been identified as a common predictor variable of the three dimensions of burnout in female nurses during the pandemic, but anxiety only predicts emotional exhaustion and depersonalization, not personal accomplishment.Age and years of experience in the job predict depersonalization, whereas the probability of contracting the infection is a predictor of emotional exhaustion and personal accomplishment. The implications of this paper for practice: The probability of contracting the infection, years of experience as a nurse and age are variables related to higher levels of burnout in female nurses.Absence of depression symptoms is associated with low levels of the three dimensions of burnout, whereas anxiety only predicts depersonalization and personal accomplishment: the implications of this should be considered in developing preventive programmes for burnout. [ABSTRACT FROM AUTHOR]

Background: The first wave of the COVID‐19 pandemic caused a shortage of health care staff, forcing the hiring of senior nursing students. Aims: To describe the psychosocial impact and coping strategies used by nursing students during the first outbreak of the COVID‐19 pandemic and to understand the coping strategies they employed. Method: A qualitative exploratory study was conducted, based on Sandelowski's proposal. Purposive sampling was carried out to recruit 18 students hired during the pandemic. The students were interviewed between 18 March and 15 June 2020. Semi‐structured interviews were conducted using a digital platform. An inductive thematic analysis was performed. Findings The students lived alone and isolated during their contract to protect their cohabitants from possible contagion. The impact of working during the pandemic leads to experiences of stress, insomnia, nightmares and anxiety. Nursing students coped with the emotional burden through mental disconnection and the support of co‐workers and family members. Conclusion: Psychological support and tutoring should be provided by health centres. In addition, in these special circumstances, universities should adapt the training provided. Summary statement: What is already known about this topic? In Spain, as in many other countries, a state of alarm was declared during the first wave of COVID 19. The Ministry of Health established measures to manage the health crisis and contain infections, including the hiring of senior nursing students to work.Working conditions had a high physical and psycho‐emotional impact on health professionals.The lack of prior experience of students in the context of a pandemic and how they enter the workforce could make it difficult to develop adequate coping strategies, enhancing the presence of mental and emotional disorders.What this paper adds? During their work, and in order to avoid contagion, the students lived apart from their families, limited their contacts and were isolated in refuge in rooms or homes. Upon entering the home, they showered, changed clothes and disinfected any surfaces they touched.The students described feeling stressed due to the lack of protective equipment and staff, heavy workloads and lack of knowledge regarding the unit and work protocols. They worried about making mistakes, doing their jobs poorly or being unable to help patients. When they got home, they had episodes of insomnia and anxiety.Faced with this situation, students used mental disconnection or distraction as coping strategies. Others shared their fears and uncertainties with other health care professionals and family members, seeking support and understanding. Other times, they tried to be strong and hide their suffering.The implications of this paper: The incorporation of students as relief for professionals in a situation of extreme need is not exempt from significant psychosocial risks and should include monitoring programs and psychological evaluation.The hospitals should monitor and mentor students to facilitate their adaptation to similar situations in the future.The students required greater support from the administration, including offering them housing where they could live away from family and relatives. [ABSTRACT FROM AUTHOR]

Aim and objective: We explored the experiences of nurses who cared for coronavirus disease 2019 patients in Iraqi Kurdistan. Background: Nurses play a major role in response to pandemics and epidemics in delivering patient care. The experiences of nurses who provided care have significant short and long‐term consequences for individuals, communities, and the nursing profession. Methods: Descriptive qualitative research approach was adopted in this study. We interviewed 12 nurses (22–50 years) who cared for the coronavirus disease 2019 patients in one of the clinical units of two coronavirus disease 2019 hospitals in Iraqi Kurdistan in 2020. Interviews were conducted via phone calls and were analysed using the thematic analysis method. The Consolidated criteria for reporting qualitative research checklist was applied when constructing this paper. Results: The nurses had to care for a number of situations during the outbreak of coronavirus disease 2019 in Kurdistan. As people in the public did not believe that there was such a virus, nurses often had to deal with this lack of knowledge and aggression from some patients and their family members. Most nurses changed their preventive behaviours since the coronavirus disease 2019 outbreak at hospital or in public. This was mainly to protect not only themselves but their patients, colleagues, family members and friends. They were cautious about the use of a mask at the hospital and in public. Most nurses experienced fear, stress, anxiety and isolation during this period. Conclusions: The patients had some concerns about their health and staying at hospitals, and some of them had aggressive behaviours towards nurses at corona hospitals. The public, close friends and relatives of the nurses had a fear of getting the infection by the virus through the nurses. However, the nurses attempted to protect themselves, colleagues and family members, and provide the best care to coronavirus disease 2019 patients. The nurses had a high obligation towards care giving at hospitals. Relevance to clinical practice: The negative experiences of the nurses regarding the care of coronavirus disease 2019 patients must be considered in clinical settings. Sensitive policy programs must be established to protect nurses from the ostracization and stigmatization of the coronavirus disease 2019 pandemic and to allow them to be able to achieve their professional practices safely. [ABSTRACT FROM AUTHOR]

Aims/Objectives: Examine the affective state (anxiety, depression), life satisfaction, stress and worry, media consumption and perceptions of pursuing a career in nursing amidst the COVID‐19 pandemic. Background: Nursing students worldwide have reported increased stress, fear and anxiety amidst challenges and risks associated with COVID‐19. It remains unclear what impact COVID‐19 will have on nursing students in the United States (US) as they prepare to enter the workforce. Design: Cross‐sectional study of undergraduate nursing students at one university in the Northeastern United States. Methods: Students (N = 161) completed an online survey (July 2020) about health and life satisfaction, affective state (depression, anxiety), stress and interest in pursuing nursing. Descriptive statistical analysis described sample and quantitative data. Linear regression was used to examine whether media consumption, stress, affective states predicted interest in pursuing a nursing career. Qualitative thematic analysis was applied to the open‐ended question, 'How has COVID‐19 influenced your interest in pursuing a nursing career?'. The Standards for Reporting Qualitative Research (SRQR) checklist was used to evaluate methodological quality. Results: Mean stress score was 56.6 (range 0–100), 55.6% of respondents felt unsettled about the future, and 68.2% reported feeling overwhelmed. 18.7% of students reported moderate to severe anxiety, 19.8% reported moderate to severe depression and 54.4% reported that COVID‐19 influenced their interest in nursing. Six themes emerged from qualitative analysis: no change, reaffirming/confirmatory, importance of nursing, reality check, positive influence and negative influence. Conclusions: Universities/colleges and nursing faculty should prioritise universal mental health assessment for nursing students and enhance mental health services to support and monitor this population. Relevance to clinical practice: Mental health services to support nursing students are warranted in the wake of the COVID‐19 pandemic. Reduction in nursing workforce may have significant impacts on staffing ratios, patient outcomes, nurse burn‐out and other aspects of clinical care. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to explore nurses' experiences and perceptions at selected United States (U.S.) healthcare sites during the COVID‐19 pandemic. Background: The COVID‐19 pandemic brought rapid changes to the healthcare community. While a few studies have examined the early pandemic experiences of nurses in China and Europe, nurses' experiences across the United States have remained relatively underexplored. Design: A qualitative study design was used. Methods: Using a constructivist grounded theory methodology and methods, we conducted eight focus groups across four hospital sites in the eastern, midwestern and western United States. Registered nurses with a minimum of six months' experience working in all clinical specialties were eligible. Forty‐three nurses participated. Data were analysed iteratively using the constant comparative method. The COREQ guidelines supported the work and reporting of this study. Results: The nurses experiencing a pandemic (NEXPIC) grounded theory emerged positing associations between four interrelated themes: Challenges, Feelings, Coping and Ethics. Nurses reported Challenges associated with changes in the work environment, community and themselves. They expressed more negative than positive feelings. Nurses coped using self‐care techniques, and teamwork within the healthcare organisation. Moral dilemmas, moral uncertainty, moral distress, moral injury and moral outrage were ethical issues associated with nurses' Challenges during the pandemic. Moral courage was associated with positive Coping. Conclusions: Awareness of frontline nurses' complex and interrelated needs may help healthcare organisations protect their human resources. This new theory provides preliminary theoretical support for future research and interventions to address the needs of frontline nurses. Relevance to clinical practice: Nurses face added distress as frontline at‐risk caregivers. Interventions to promote nurses' ability to cope with personal and professional challenges from the pandemic and address ethical issues are needed to protect the nursing workforce. This study offers a new substantive theory that may be used to underpin future interventions. [ABSTRACT FROM AUTHOR]

Aims: This review aims to explore the prevalence and incidence rates of mental health conditions in healthcare workers during and after a pandemic outbreak and which factors influence rates. Background: Pandemics place considerable burden on care services, impacting on workers' health and their ability to deliver services. We systematically reviewed the prevalence and incidence of mental health conditions in care workers during pandemics. Design Systematic review and meta‐analysis. Data sources Searches of MEDLINE, Embase, Cochrane Library and PsychINFO for cohort, cross‐sectional and case–control studies were undertaken on the 31 March 2020 (from inception to 31 March 2020). Review methods: Only prevalence or incidence rates for mental health conditions from validated tools were included. Study selection, data extraction and quality assessment were carried out by two reviewers. Meta‐analyses and subgroup analyses were produced for pandemic period (pre‐ and post), age, country income, country, clinical setting for major depression disorder (MDD), anxiety disorder and post‐traumatic stress disorder (PTSD). Results: No studies of incidence were found. Prevalence estimates showed that the most common mental health condition was PTSD (21.7%) followed by anxiety disorder (16.1%), MDD (13.4%) and acute stress disorder (7.4%) (low risk of bias). For symptoms of these conditions there was substantial variation in the prevalence estimates for depression (95% confidence interval [CI]:31.8%; 60.5%), anxiety (95% CI:34.2%; 57.7%) and PTSD symptoms (95% CI,21.4%; 65.4%) (moderate risk of bias). Age, level of exposure and type of care professional were identified as important moderating factors. Conclusion: Mental disorders affect healthcare workers during and after infectious disease pandemics, with higher proportions experiencing symptoms. Impact This review provides prevalence estimates of mental health conditions during and after a pandemic which could be used to inform service staffing impact and formulation of preventative strategies, by identifying clinical populations who may be at high risk of developing mental health symptoms and conditions. [ABSTRACT FROM AUTHOR]

Background: Faced with this critical situation and directly involved in the treatment and care of COVID‐19 patients, front‐line healthcare workers are at high risk in terms of mental health symptoms. Aims and Objectives: To determine the stress, anxiety, depression, and insomnia levels of intensive care nurses during the pandemic with a structural equation model. Design: A multi‐site survey study. Methods: The study was performed with 194 nurses working in the intensive care units of five hospitals in Istanbul in July 2020. Data were collected using the Depression Anxiety Stress‐21 Scale and Insomnia Severity Index electronically. The data were evaluated with descriptive statistics in SPSS package program. In order to test the structural model and hypotheses of the research, path analysis was performed with LISREL statistical software program. A validation study for the suitability of these scales to the study sample was done by the researchers using the confirmatory factor analysis method. The study conforms to the TREND checklist. Results: In this study, the majority of the intensive care nurses had moderate to extremely severe depression (65.5%), anxiety (58.3%) and stress (72.3%) scores; in addition, 39.7% of the nurses experienced moderate or severe insomnia. Within the framework of a structural model; the effects of stress, anxiety and insomnia on depression, which is the dependent variable, were found to be statistically significant (p <.001). Conclusions: It was found that the majority of the intensive care nurses fighting COVID‐19 on the front‐line experienced stress, anxiety, depression and insomnia at levels ranging from moderate to extremely severe; in addition, it was determined that there is a positive relationship between stress, anxiety, insomnia and depression. Relevance to clinical practice: This study, in which we have determined the mental health symptoms and insomnia levels of intensive care nurses, who are in the front‐line during the COVID‐19 pandemic, constitutes the scientific basis for the effective coping strategies that the authorities will take in this subject. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To investigate the present status of anxiety among nurses fighting the spread of COVID‐19 and its association with perceived stress and insomnia. Background: With the outbreak of COVID‐19, nurses have been caring for infected patients for a considerable length of time in Wuhan, China. Previous COVID‐19 studies generally focused on patients' medical treatment, but few considered healthcare workers' psychological needs while working with a pandemic involving an unfamiliar infectious disease. Numerous nurses have experienced mental health problems, such as anxiety. Design: The STROBE guidelines for a cross‐sectional questionnaire were implemented. Methods: An online survey of 643 frontline nurses working with COVID‐19‐infected patients was conducted from 3–10 March 2020. Sociodemographic data were collected, and the Generalized Anxiety Disorder Scale, the Chinese Perceived Stress Scale and the Athens Insomnia Scale were administered. Results: One‐third (33.4%) of participants reported anxiety, which was associated with perceived stress and insomnia among Chinese frontline nurses in Wuhan during the COVID‐19 pandemic. Significant associations were found between anxiety, perceived stress, insomnia, working four‐night shifts per week, experience working during more than two epidemics and fear of COVID‐19. Conclusions: This study found that a substantial proportion of frontline nurses caring for COVID‐19‐infected patients experienced anxiety. We recommend that nurse managers focus on working conditions and cultivate safe and satisfactory work environments. Meanwhile, frontline nurses should foster awareness of mental health and rely on online resources for psychological training to alleviate anxiety. Relevance to clinical practice: The findings of this study could facilitate better understanding of anxiety among frontline nurses; more importantly, healthcare authorities and nursing managers need to pay more attention to ensuring intervention training to reduce anxiety for frontline nurses worldwide. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To compare knowledge, anxiety, academic concerns and preventative behaviours between undergraduate nursing students in Australia and India during the COVID‐19 pandemic. Background: Based on the World Health Organization's direction for containment of the novel coronavirus (COVID‐19), countries implemented varying levels of restrictions including closure of university campuses and providing on line undergraduate education. Methods: Students in NSW, Australia and Kerala, India completed an online survey assessing their (a) knowledge and source of information about COVID‐19; (b) anxiety; and coping strategies; (c) academic concerns; and (d) preventative behaviours. Descriptive and inferential statistics were used to summarise the data. Results: Data from 99 Australian and 113 Indian undergraduate nurses were analysed. Greater number of Indian students indicated having sufficient knowledge of COVID‐19 (OR 0.22; 95% CI 0.08, 0.63), getting information about COVID‐19 from social media (OR 0.03; 95% CI 0.01, 0.07) and being concerned about 'attending clinical placement' (MD‐1.08; 95% CI −1.94, −0.23). Australian students reported significantly higher levels of anxiety (MD 1.99 95% CI 1.21, 2.78), difficulty sleeping (OR 18.00; 95% CI 6.76, 47.96), concentrating (OR 33.22; 95% CI 13.85, 79.67) and eating (OR 14.05; 95% CI 3.19, 61.84). Greater number of Australian students indicated that they would go to the University if they needed to meet with other students (OR 9.21; 95% CI 3.08, 27.55), had to access the library (OR 7.20; 95% CI 3.26, 15.90) or had a group assignment (OR 2.93; 95% CI 1.26, 6.77). Conclusions: Wide variations were present in knowledge, anxiety, academic concerns and preventative behaviours among undergraduate nursing students in two countries. Relevance to clinical practice: Undergraduate students may benefit from additional support from the University and staff in the clinical setting with online learning and resources in order to adjust to the 'new normal' and enable them to achieve academic success. [ABSTRACT FROM AUTHOR]