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Background: Endoscopy nurses in China face significant work-family conflicts, where the clash between high work demands and family responsibilities markedly increases the risk of occupational fatigue. This not only affects the nurses' physical and mental health and overall well-being, but also poses a threat to the quality of care and patient safety. This study, grounded in the Conservation of Resources theory, constructs a moderated mediation model to examine the mediating role of positive coping style in the relationship between work-family conflict and occupational fatigue among endoscopy nurses in China, as well as the moderating effect of perceived social support., Methods: A convenience sampling method was employed to select 315 endoscopy nurses from 25 tertiary hospitals across 14 provinces in China. A questionnaire survey was conducted using the Fatigue Assessment Instrument, the Work-Family Conflict Scale, the Simplified Coping Style Questionnaire, and the Perceived Social Support Scale. The moderated mediation model was validated using Stata16.0., Results: Our findings reveal that work-family conflict is a significant predictor of occupational fatigue, with a negative impact on positive coping style. Positive coping style, in turn, is negatively associated with occupational fatigue. Furthermore, positive coping style partially mediates the relationship between work-family conflict and occupational fatigue, accounting for 35.52% of the total effect. Additionally, perceived social support mitigates the negative effects of work-family conflict on positive coping style and occupational fatigue., Conclusion: There exists a moderated mediation effect between work-family conflict and occupational fatigue among endoscopy nurses in China, wherein positive coping style serve as a mediating variable. Perceived social support mitigates the negative impact of work-family conflict on positive coping style, while enhancing the alleviating effect of positive coping style on occupational fatigue. Therefore, improving endoscopy nurses' levels of perceived social support and coping strategies may help to prevent and alleviate the occurrence of occupational fatigue., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zeng, Zhou, Liu, Xie, He and Zhang.)

Aim: The aim of this study is to examine the relationship between the coping attitudes and compulsive online buying behaviors of nurses., Methods: This descriptive and correlational study was conducted with 253 nurses working in a research and training hospital in Istanbul between June and December 2022. Data were collected using a 'Participant Information Form', the 'Coping Attitudes Assessment Scale (R-COPE)', and the 'Compulsive Online Shopping Scale (COSS)'. Data were analyzed using descriptive statistics, Pearson's correlation coefficient, and multiple linear regression analysis. A p-value of <0.05 was considered statistically significant., Results: The mean R-COPE score of the participants was 87.79 ± 10.40, and their mean COSS score was 26.00 ± 25.03. There was a negative and statistically significant correlation between the total R-COPE scores and the total COSS scores of the participants (p < 0.01). The coping attitudes (β = -0.147) were a significant and negative predictor of compulsive online buying behaviors. Marital status (β = 0.152), frequency of access to the internet (β = 0.273), frequency of online shopping (β = 0.365), and monthly amount of money spent for online shopping (β = 0.123) were significant and positive predictors of compulsive online buying behaviors. These variables collectively explained 33 % (R 2  = 0.328, p = 0.000) of the total variance in the compulsive online buying behaviors of the participants., Conclusion: Nurses had moderate levels of coping attitudes and low levels of compulsive online buying behaviors. Having low levels of coping attitudes, being single, accessing the internet frequently, doing online shopping frequently and spending a high amount of money for online shopping every month predicted the compulsive online buying behaviors., Competing Interests: Declaration of competing interest The author(s) declare they have no potential conflict of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The study aimed to evaluate the ethical dilemmas faced by nurses who provide care to patients with hematologic cancer and determine their coping mechanisms using a phenomenological approach. This qualitative study was conducted with 35 nurses employed in clinics specializing in hematologic cancer patient care, living in diverse regions of Turkey, using semistructured, in-depth interviews through the WhatsApp mobile application. The snowball sampling technique was utilized to identify participants, and interviews continued until data saturation was achieved. All interviews were recorded and subsequently transcribed. Data analysis was conducted using Colaizzi's phenomenological analysis method, with the study adhering to the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist for reporting. In the analysis of the data, 2 categories (ethical dilemma situations and coping experiences) and 6 subthemes (treatment, care, professional values and beliefs, emotions, struggling with emotional burdens, and psychosocial approach) emerged. According to the results, nurses responsible for hematologic cancer patients struggle with ethical dilemmas in healthcare delivery and face challenges in effectively addressing them, which could potentially impact the quality of healthcare provided by nurses., Competing Interests: The author has no conflicts of interest to disclose., (Copyright © 2024 by The Hospice and Palliative Nurses Association. All rights reserved.)

Nurses are at the frontline, dealing with people's most immense healthcare needs in stressful and demanding work environments. Consequently, it is essential to thoroughly examine how various coping mechanisms might affect the relationship between stress and quality of life (QOL). This study aimed to examine the mediation effect of both problem-focused coping (PFC) and emotion-focused coping (EFC) mechanisms on mitigating the effect of stress on the QOL among Jordanian nurses. A multisite cross-sectional descriptive correlational design was used in this study. An online survey was completed by 203 nurses using a convenience sampling technique between October 2023 and January 2024. The study included nurses working in different Jordanian healthcare sectors including governmental, private, and university-affiliated hospitals. Several measures were used to collect data, including questionnaires on sociodemographics, QOL, coping, and stress. Two models were hypothesized for this study. The two models were analyzed using Andrew Hayes Process Macro Model 4 for testing the mediation effects. Additionally, descriptive and correlational analyses were run prior to the main analysis. The results showed that coping significantly mediated the relationship between stress and QOL with variations between PFC and EFC. In conclusion, psychological distress symptoms were common among Jordanian nurses; psychological distress, coping, and QOL are correlating variables. Nurses' stress levels and coping modalities can predict QOL with a superior effect of PFC compared with EFC. Strategies should be put in place to improve effective coping to improve nurses' QOL. The results of this study have important implications for nursing education, practice, future research, and policy., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wafa'a Ta'an et al.)

Purpose: Psychological violence and harassment have been reported to be associated with mental health problems and turnover intention among nurses. Cyberbullying, a hidden form of harassment using information and communication technology, is attracting attention as a factor that threatens the mental health of nurses. This study aimed to add coping characteristics, social support, and workplace social capital to psychological violence, harassment, and cyberbullying in female nurses and determine their association with depression and turnover intention., Participants and Methods: An anonymous, self-administered questionnaire survey was conducted, targeting 2,158 female nurses working in four domestic hospitals, excluding those in management positions. The analysis included 1,151 nurses who responded (valid response rate: 53.3%). Multiple regression analysis was performed with depression and turnover intention as dependent variables and psychological violence and harassment, cyberbullying, the brief scales for coping profile (BSCP) and social support scale scores, and social capital (SC) as independent variables., Results: Depression was positively correlated with psychological violence and harassment, cyberbullying, and the BSCP subscale "avoidance and suppression" and negatively correlated with the BSCP subscale "changing the point of view" and social support subscales "support from supervisors" and "support from co-workers." Turnover intention was positively correlated with psychological violence and harassment and the BSCP subscale "avoidance and suppression" and negatively correlated with the BSCP subscale "changing the point of view," social support subscale "support from supervisors," and vertical SC., Discussion and Conclusion: The results suggest that work environments should prevent psychological violence and harassment in nurses to promote a sense of security and eliminate mental health problems. Cyberbullying was inferred as a factor that could lead to mental health problems among nurses. Therefore, each nurse should raise their awareness of information literacy, besides attending more to their words and attitudes.

Aim and Objectives: The aim of this study was to evaluate the psychosocial difficulties and life experiences of nurses working in the disaster area following the earthquake on February 6, Kahramanmaraş centered earthquake with a phenomenological approach., Background: After natural disasters such as earthquakes, nurses play a significant role in providing both physical and psychosocial support. Therefore, the experiences of nurses in this field are necessary both to support them and to assist disaster survivors., Materials and Methods: In this study, in which the phenomenological research method was used, semi-structured in-depth interviews with 18 nurses who provided health care services during the February 6 Kahramanmaraş earthquake were conducted between January and February 2024 via Whatsapp mobile application. Snowball sampling method was used to reach the sample group. Interviews continued until data saturation was achieved. All interviews were audio recorded and then transcribed. The data were analyzed using thematic analysis. The study was conducted and reported according to the COREQ checklist., Results: Data analysis revealed two themes (psychological and social difficulties caused by the earthquake, traumatic stress and coping experiences as a nurse) and five sub-themes (social difficulties, psychological difficulties, traumatic events, reactions and coping)., Conclusion: As a result of the study, it was determined that nurses providing health care services were negatively affected psychosocially by the traumatic stress situations they experienced in the earthquake centered in Kahramanmaraş on February 6. It was determined that nurses had great difficulty in coping with the traumatic stress situations they experienced. It was concluded that the February 6 earthquake caused secondary traumatization in nurses., (© 2024 The Author(s). Public Health Nursing published by Wiley Periodicals LLC.)

Objective: Healthcare professionals are highly susceptible to adverse psychological outcomes amid the COVID-19 pandemic due to their job duties. As the largest part of the healthcare workforce, growing attention has been paid to nurses' adjustments to the pandemic. Despite the distress, recent studies found that nurses could still experience positive changes (i.e., adversarial growth, AG) during the pandemic. Research on the general populations has indicated that individuals' stress responses, coping resources, and coping strategies are associated with their AG during the pandemic. This study examined how sociodemographic characteristics, secondary traumatic and posttraumatic stress, coping resources, and coping strategies were associated with AG among nurses in Hong Kong amid the fifth wave (i.e., the most disastrous wave) of the COVID-19 pandemic., Method: Recruited through local nursing associations between May 24 and June 13, 2022, 209 nurses in Hong Kong completed an online questionnaire measuring the abovementioned variables., Results: Hierarchical regression results found that those affiliating with a religion, having participated in mental health-related workshops, higher levels of secondary traumatic stress (STS), social support, job satisfaction, plus more frequent emotional processing were associated with higher AG (βs ranging from 0.15 to 0.31, p s < .01)., Conclusions: Nurses did report AG during the fifth wave of the COVID-19 pandemic in Hong Kong. To promote AG among those nurses, future interventions should enhance nurses' understanding about the potential impact of STS on their well-being, solicit their interpersonal and work-related coping resources, plus facilitate their use of effective coping strategies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Moral distress has negative effects on physical and mental health. However, there is little information about nurses' coping strategies reducing moral distress., Aim: The purpose of this study was to investigate the coping strategies of intensive care unit nurses reducing moral distress in Iran., Study Design: This is a qualitative study with a content analysis approach., Participants and Research Context: The research sample consisted of nurses working in intensive care units of teaching hospitals affiliated to Tehran University of Medical Sciences. Samples were selected among eligible nurses by purposive sampling. Data were obtained through 17 in-depth, individual, and semi-structured interviews with 17 nurses. Graneheim and Lundman's (2004) 6-step content analysis method was used to analyze the data. Data management was also performed by MAXQDA software version 20. The COREQ checklist was used to report the study., Ethical Considerations: This project was approved by the Ethics Committee of Tehran University of Medical Sciences. All ethical guidelines in research were followed., Finding: The data analysis resulted in the formation of two main categories of desirable coping strategies (with two subcategories of compensation and rejuvenation) and less desirable coping strategies (with three subclasses of indifference over time, escape and concealment)., Discussion: The intensive care unit nurses in dealing with ethical problems first try to solve the problem through discussion, but when they fail to resolve it peacefully, they resort to several coping strategies. Factors, such as increasing experience, lack of support from hospital managers and officials, poor communication between colleagues, the need to maintain hierarchy, fear of reprimand, and a sense of powerlessness, changed the nurses' preferred strategies. It is important for managers to provide a blame/punishment-free atmosphere for expression of ethical experiences; a supportive atmosphere in which staff can engage in ethical discussions without fear of punishment. They should also provide opportunities for rest, rejuvenation, and adequate training for their employees., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: The death of a patient negatively affects the professional dimension of nurses' functioning and also their private lives, where professional experiences and emotions are often transmitted., Aim of the Study: The main aim of the study was to discover how the nursing staff assessed their self-efficacy in dealing with the death of a patient., Materials and Methods: The researchers used a diagnostic survey method and a self-authored survey, Life Satisfaction Scale (SWLS), Coping Inventory for Stressful Situations (CISS), Generalized Self-Efficacy Scale (GSES), Courtauld Emotional Control Scale (CECS), The Death Anxiety and Fascination Scale with the Death Anxiety Subscale. The study group consisted of 287 individuals., Results: Working in a hospital is stressful in the opinion of 79.44% of the respondents. 39.37% of the respondents feared death. In the course of work, the death of a patient in the department was sometimes experienced by 34.84% of the respondents, always experienced by 29.97%. The respondents usually did not make their compassion for a dying patient based on the patient's position in society (57.84%). In the case of the majority (84.67%) of the respondents, the employer did not provide mental support for the staff in difficult situations. The majority of the respondents did not feel the need to broaden their knowledge of death and dying (64.11%)., Conclusion: The surveyed nurses most often presented low or average life satisfaction, high self-efficacy, average levels of stress and coping in all three styles (with a preference for avoidance-oriented), and a high level of death fascination and an average level of death anxiety. The majority of the nurses in difficult situations and when a stressful situation occurred did not receive support from their employer or from physicians, but could count on the assistance of fellow nurses and a divisional nurse. The majority of the respondents felt that psychological support in their work was important and would gladly benefit from it. Although most nurses did not feel the need to broaden their knowledge of death/dying, they would take part in such a course if it were possible., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Kowalenko, Krajewska-Kułak, Kowalewska, Kułak-Bejda, Kulik, Gaworska-Krzemińska and Van Damme-Ostapowicz.)

Background: Nursing occupational fatigue has emerged as a critical issue affecting the safety and health of nurses. This phenomenon not only impairs nurses' performance and mental well-being but also poses risks to patient safety and the quality of care provided. This study focuses on endoscopic nurses to explore the mediating role of positive coping styles between sleep quality and occupational fatigue, aiming to identify effective strategies to alleviate fatigue, thereby improving the work environment and enhancing healthcare quality., Methods: From July to August 2023, a cross-sectional design was used to select 258 endoscopy nurses from 25 top-three hospitals in 14 cities across 5 provinces in China. Data was collected through general information questionnaires, Fatigue assessment instrument, Pittsburgh sleep quality index, and Simple Coping Style Questionnaire. A structural equation model of sleep quality - positive coping style - occupational fatigue was constructed using Amos 26.0, and Bootstrap was employed to test the mediating effect., Results: The results showed that the mean scores of sleep quality, occupational fatigue, and positive coping style for endoscopy nurses were 8.89 ± 4.13, 17.73 ± 5.64, and 18.32 ± 10.46, respectively. Positive coping style were negatively correlated with sleep quality and occupational fatigue ( p < 0.001). Positive coping style partially mediated the relationship between sleep quality and occupational fatigue, with a mediating effect value of 0.253, accounting for 42.10% of the total effect., Conclusion: Sleep quality can indirectly affect the level of occupational fatigue through positive coping style. Nursing managers should enhance nurses' positive coping skills, improve nurses' sleep quality, and reduce occupational fatigue among nurses., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zeng, Zhou, Xie, He and Ling.)

Background: Although efforts to reduce aggression and violence in emergency departments are important, it is also critical to minimise harm and support staff where this occurs. This research describes support mechanisms emergency nurses value when they experience occupational aggression and violence., Methods: A mixed-methods design including thematic analysis of six interviews and descriptive analysis of fifty-one surveys, with experienced emergency nurse participants and respondents from a single large urban emergency department., Results: Four key themes summarised coping with aggression and violence: Minimising exacerbating factors (mental health, lack of understanding of zero tolerance in practice, and wait times); Support before violence (use of huddles and having experienced nurses on each shift); Support during violence (education including restraint, self-defence, de-escalation and legalities); and Support after violence (debriefing, incident reporting and a sense of 'toughness') CONCLUSION: Emergency nurses need preparation and support to competently manage complex mental health presentations, understand legal rights, communicate effectively with patients, families and colleagues and access event debriefing. Security staff are valued team members but also need adequate resourcing and preparation., Competing Interests: Declaration of Competing Interest All authors were involved in the design, conduct, drafting, editing and checking of final manuscript. We have no conflicts of interest to declare., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Stress is inevitable in the nursing profession, and ways of coping are one of the solutions to reduce stress. Social support is one of the influencing factors on coping strategies, but there is probably a difference between the effects of received or perceived social support on coping strategies., Objective: The aim was to investigate the relationship between received and perceived social support with ways of coping in nurses., Methods: This is a cross-sectional descriptive-correlational study. The sample consisted of 292 nurses by simple random sampling. The data collection tool included Zimmet's multidimensional perceived social support scale, McCain and Marklin's perceived social support questionnaire, and Lazarus' ways of coping questionnaire. Data were analyzed using Pearson correlation and multiple regression tests in SPSS v.22., Results: The results showed that received social support (β= 0.20, p < 0.001) and perceived social support (β= 0.35, p < 0.001) are able to explain changes in the dimension of seeking social support. Received social support (β= 0.16, p = 0.005) and perceived social support (β= 0.22, p < 0.001) are able to explain changes after positive reappraisal, but only received social support could explain changes in accepting responsibility (β= 0.15, p = 0.01)., Conclusion: This study showed that received and perceived social support have a significant correlation with ways of coping, but only able to explain the changes in social support seeking dimensions, positive reappraisal, accepting responsibility. Both types of social support are necessary, but that received social support covered more adaptive coping strategies.

Background: It is critical to minimize nurse turnover to improve the quality of care and patient safety. In-depth investigation is required to better understand the factors related to nurses' turnover intentions., Aim: This study aimed to determine the relationships between burnout, general wellbeing, and psychological detachment with turnover intention among nurses in China., Methods: A cross-sectional survey using convenience sampling was conducted in one hospital in China between January 2023 and March 2023. A total of 536 nurses were surveyed using the General Wellbeing Schedule (GWB), the Maslach Burnout Inventory scale (MBI), the Psychological Detachment scale, and the Turnover Intention scale. The collected data were analyzed using SPSS 26.0 statistical software. The chi-square test and binary logistic regression analysis were used to explore the factors related to turnover intention., Results: Our data demonstrated that the turnover intention scores were 13 (10, 15.75), with 56% of nurses exhibiting a high level of turnover intention. Binary logistic regression analysis results indicated that being on a contract (OR = 4.385, 95% CI = 2.196-8.754), working in the pediatrics (OR = 2.392, 95% CI = 1.267-4.514) or obstetrics (OR = 2.423, 95% CI = 1.145-5.126) department, and experiencing burnout (OR = 1.024, 95% CI = 1.008-1.041) were associated with a heightened level of turnover intention. Conversely, organizational satisfaction (OR = 0.162, 95% CI = 0.033-0.787) and general wellbeing (OR = 0.967, 95% CI = 0.946-0.989) were identified as factors that hindered the intention to leave., Conclusions: Findings from this study suggest that nurses were employed on a contract basis, working in pediatric or obstetric departments, expressing dissatisfaction with the organization, reporting low general wellbeing, and experiencing high levels of burnout that require special attention. The identification of these risk factors can inform targeted interventions and support programs aimed at improving the wellbeing and retention of nurses in these settings., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Zhang, Lin, Li, Li, Jia, Guo and Bai.)

Nurses are at risk for work-related fatigue, which can impact their health, well-being, and job readiness. The purpose of this study was to examine the levels, types, and factors associated with fatigue in registered nurses (RNs) in direct patient care (DCRNs) and in non-direct patient care (non-DCRNs) roles. A cross-sectional survey was administered to 313 RNs. Measures included: Multidimensional Fatigue Symptom Inventory, Occupational Fatigue Exhaustion Recovery, Brief COPE, PROMIS® Global Sleep Disturbance, and Job Content Questionnaire. Acute fatigue levels in RNs were similar to those in diseased populations, and nearly 50% reported moderate/high levels of chronic fatigue. DCRNs reported higher levels of acute and chronic fatigue than non-DCRNs, but the differences were small and disappeared when accounting for other factors associated with fatigue including sleep disturbance, job strain, workplace support, maladaptive coping, and especially intershift recovery, which accounted for 20%-41% of fatigue variability. This study suggests that it may not be only nurses providing direct patient care who are at risk for acute and chronic fatigue. Intershift recovery may be particularly important in alleviating acute and chronic fatigue in nurses., (© 2021 John Wiley & Sons Australia, Ltd. This article has been contributed to by US Government employees and their work is in the public domain in the USA.)

Purpose: This study was investigated the mediating effect of coping behaviors in the relationship between the second victim experiences after patient safety incidents and the nursing practice changes., Methods: A cross-sectional survey was performed using structured questionnaires. Participants were 218 clinical nurses in general tertiary hospitals in South Korea. Data were collected through an online survey and snowball sampling from August 11 to September 6 2020. Data were analyzed using SPSS 23.0 program. A mediation analysis was performed using multiple regression and a simple mediation model applying the PROCESS macro with 95% bias-corrected bootstrap confidence interval., Results: The mean scores of second victim experiences was 3.41/5. Approach coping (β = .55, p < .001) and the avoidant coping (β = - .23, p = .001) showed mediation effects in the relationship between second victim experiences and constructive change in nursing practice. Avoidant coping (β = .29, p < .001) showed a mediation effect in the relationship between second victim experiences and defensive change in nursing practice., Conclusion: Coping behaviors has a mediating effect on the relationship between second victim experiences and nursing practice changes. To ensure that nurses do not experience second victim, medical institutions should have a culture of patient safety that employs a systematic approach rather than blame individuals. They also need to develop strategies that enhance approach coping and reducing avoidant coping to induce nurses' constructive practice changes in clinical nurses in experiencing second victims due to patient safety incidents., Competing Interests: The authors declared no conflict of interest., (© 2021 Korean Society of Nursing Science.)

Student registered nurse anesthetists (SRNAs) experience high levels of stress related to the level of difficulty and time commitment associated with an integrated Doctor of Nursing Practice anesthesia program. Although some degree of stress is necessary for motivation, unmanaged stress can contribute to illness, dissatisfaction, and substance use. A search of the literature showed that mindfulness meditation training reduces stress and improves academic performance in graduate student populations. An evidence-based practice project was developed and implemented to provide SRNAs with a novel stress management mechanism. A guided mindfulness meditation application for smart phones (Headspace, Headspace) was chosen as the intervention modality. Research shows that this application is an effective and convenient delivery system for mindfulness meditation training, decreasing stress during a 10-day trial. SRNAs attended a mindfulness presentation and completed an introductory guided mindfulness meditation module using the Headspace application on their personal smart phone. Preintervention and postintervention surveys (N=33) using the Depression Anxiety Stress Scales 21-item questionnaire were analyzed using the Wilcoxon signed rank test. Results showed significant reductions (P<.01) in depression (Z=-3.36), anxiety (Z=-3.07), and stress (Z=-3.46) scores, representing reductions of 32%, 32%, and 47%., Competing Interests: Name: Taylor Foley, DNP, CRNA; Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None. Name: Jennifer Lanzillotta-Rangeley, PhD, CRNA; Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None. The authors did not discuss off-label use within the article. Disclosure statements are available for viewing upon request., (Copyright © by the American Association of Nurse Anesthetists.)

Background: Specific personality traits may affect the ability of nurses to deal with patient death. The relationship between personality and death coping self-efficacy (DCS) has rarely been investigated in the palliative care setting. In this study, we explored the associations between different personality profiles and DCS in clinical nurses from general wards and ICU., Methods: A cross-sectional survey of 572 Chinese nurses was conducted between August and September 2020, by way of a self-administered questionnaire., Results: Among the Big Five Personality Traits, in nurses the score was highest for conscientiousness and lowest for neuroticism. With regard to DCS, nurses scored highly on the intention of hospice care. The Big Five Personality Traits were found to explain 20.2% of the overall variation in DCS. Openness, agreeableness and conscientiousness were significantly associated with DCS in nurses., Conclusions: Nursing managers should pay attention to differences in personality characteristics and provide personalized and targeted nursing education. This should improve nurses' DCS, enrich their professional development and promote high quality palliative care for patients and their families., Competing Interests: The authors have declared that no competing interests exist.

Negative workplace behavior affecting nurses is an internationally recognized problem. This study examines the types and extent of negative workplace behavior experienced by nurses in non-metropolitan, regional acute care settings and their ways of coping when subject to that behavior. A cross-sectional study was conducted involving 74 nurse participants in four regional hospitals in Australia. The structured questionnaire consisted of four parts: demographic questions, the Negative Acts Questionnaire - Revised, questions on exposure to bullying and/or incivility and policy awareness and use of pathways, and the Ways of Coping Questionnaire. Overall, 34% of participants were exposed to bullying and 49% to incivility over the previous month. The most common type of negative workplace behavior reported was "work-related bullying," which included exposure to excessive workloads, unrealistic deadlines, and information being withheld. Nurses reported the use of a variety of coping mechanisms, including problem-focused coping strategies and seeking social support. The findings imply that negative workplace behaviors occur not only at individual nurses' level but also derive from the broader contexts of organizational management and systemic factors., (© 2020 John Wiley & Sons Australia, Ltd.)

Objective: To explore the level and influencing factors of frontline nurses' post-traumatic growth (PTG) during COVID-19 epidemic., Methods: A cross-sectional survey was conducted in February 2020 in three hospitals in China. The Post-traumatic Growth Inventory (PTGI) was used to investigate the PTG of frontline nurses. Data on related factors, including demographic characteristics and subjective variables, were collected. The Event-Related Rumination Inventory was used to assess rumination. Pearson's or Spearman's correlation was calculated for bivariate analysis. Independent sample t-tests or one-way analysis of variance and multiple linear regression analysis were used to examine the related factors., Results: A total of 179 frontline nurses were recruited, and 167 were included in the analyses. The mean PTG score was 70.53±17.26. The bivariate analyses showed that deliberate rumination was modestly positively correlated with PTG (r=0.557, p<0.01), while intrusive rumination had a modest negative correlation with PTG (r=-0.413, p<0.01). Multiple linear regression demonstrated that working years, self-confidence in frontline work, awareness of risk, psychological intervention or training during the epidemic and deliberate rumination were the main influencing factors of PTG among frontline nurses and accounted for 42.5% of the variance (F=31.626, p<0.001)., Conclusions: The PTG of frontline nurses was at a medium to high level and was influenced by working years, self-confidence in frontline work, awareness of risk, psychological intervention or training and deliberate rumination. It is necessary to strengthen psychological guidance and training for frontline nurses and promote their deliberate rumination on epidemic events to improve their PTG., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Abstract: Nurses and other healthcare professionals across the US have experienced and are still experiencing different types of moral anguish during the COVID-19 pandemic. This article discusses moral distress and the other forms of moral anguish that nurses experience, how the COVID-19 pandemic has exacerbated moral distress among nurses, and coping strategies., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Nurses in nephrology are susceptible to nurse burnout. This article discusses the causes, signs, and symptoms associated with burnout. Prevention strategies, as well as patient and nurse safety, are reviewed., Competing Interests: The authors reported no actual or potential conflict of interest in relation to this continuing nursing education activity., (Copyright© by the American Nephrology Nurses Association.)

High attrition rates of novice nurses partly reflect how well nursing education programs are preparing students for the physical, mental, and emotional demands of nursing practice. Resilience is a positive adaptation to stress that improves the ability of nurses to effectively navigate complex challenges, and adversity without losing personal balance and the desire to stay in the profession. Resiliency is both a process and an outcome that is modifiable through education and practice. Clinical conferences, or group debriefings, are an underdeveloped component of nursing education that provide timely opportunities to focus on building aspects of resiliency and prepare students for a sustainable transition into practice., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Purpose: Health care professionals, particularly nurses, are considered a vulnerable group to experience acute stress disorder (ASD) and subsequent psychological distress amid COVID-19 pandemic. This study aims to establish the prevalence of acute stress disorder and predictors of psychological distress among Jordanian nurses., Methods: A quantitative, cross-sectional, descriptive and comparative design was used. Data were collected using a Web-based survey. A total of 448 Jordanian nurses (73% females) completed and returned the study questionnaire., Results: The majority of nurses (64%) are experiencing ASD due to the COVID-19 pandemic and thus are at risk for PTSD predisposition. More than one-third of nurses (41%) are also suffering significant psychological distress. Among our sample, age, ASD and coping self-efficacy significantly predicted psychological distress. More specifically, younger nurses are more prone to experience psychological distress than older ones. While higher scores on ASD showed more resultant psychological distress, coping self-efficacy was a protective factor., Conclusion: Given that individuals who suffer from ASD are predisposed to PTSD, follow-up with nurses to screen for PTSD and referral to appropriate psychological services is pivotal. Coping self-efficacy is found to ameliorate the effect of psychological distress on nurses' traumatic experience. Such findings warrant intensive efforts from health care institutions to provide psychosocial support services for nurses and ongoing efforts to screen them for traumatic and psychological distress symptoms., Implications for Nursing Management: Nursing leaders and managers are in the forefront of responding to the unique needs of their workforces during the COVID-19 crisis. They need to implement stress-reduction strategies for nurses through providing consecutive rest days, rotating allocations of complex patients, arranging support services and being accessible to staff. They also need to ensure nurses' personal safety through securing and providing personal safety measures and undertake briefings to ensure their staff's physical and mental well-being, as well as providing referrals to appropriate psychological services., (© 2020 John Wiley & Sons Ltd.)

Workplace bullying is a serious problem that hinders the provision of quality care services by seriously affecting their physical, psychological, and social health status. Workplace bullying experiences refer to verbal and nonverbal harassment, work-related harassment, and external threats. Workplace bullying responses are negative reactions that occur in individuals who have experienced workplace bullying, while coping is the process by which an individual copes with stress. This study aims to analyze the relationship between nurses' workplace bullying experiences, responses, and ways of coping. We studied 113 nurses working in hospitals, analyzed the data using SPSS 25.0. We found that the more positive use of the positive viewpoint, the lower the bullying reaction in the workplace (r = -0.268, p = 0.004). Workplace bullying responses were lower as more positive ways of coping were used (r = -0. 268, p = 0.004). In conclusion, nurses who experience bullying in the workplace should be supported by the hospital organization and within the nursing organization, and a receptive nursing culture should be established. There is also a need for an intervention plan that allows nurses to use positive ways of coping with workplace bullying experiences.

The coronavirus disease (COVID-19) outbreak in December has seen more than 76,000 cases in China, causing more than 3,000 medical staff infections. As the disease is highly contagious, can be fatal in severe cases, and there are no specific medicines, it poses a huge threat to the life and health of nurses, leading to a severe impact on their emotional responses and coping strategies. Therefore, this study will investigate nurses' emotional responses and coping styles, and conduct a comparative study with nursing college students. This study was conducted through the online survey 'questionnaire star' from February 1st to February 20th, 2020 in Anhui Province, using the snowball sampling method to invite subjects. The results found that women showed more severe anxiety and fear than men. Participants from cities exhibited these symptoms more than participants from rural areas, however rural participants experienced more sadness than urban participants. The nearer a COVID-19 zone is to the participants, the stronger the anxiety and anger. The COVID-19 outbreak has placed immense pressure on hospitals and those nurses at the frontline are more seriously affected. Hospitals should focus on providing psychological support to nurses and training in coping strategies., Competing Interests: The authors have declared that no competing interests exist.

Background: The nurse, when performing emotional labor at work, tunes her own emotions to the patient's expectations. The self-regulation strategies which are then used weaken her mental strength and contribute to various symptoms of occupational burnout syndrome (OBS). In addition, certain positive relationships have been found between selected emotional labor strategies and increased work engagement. The skills of empathizing with the patient are the nurse's protective resource. Empathy allows to share emotions with the patient while maintaining the attitude of a neutral observer. It also helps to take actions to reduce pain and suffering, and to build a relationship of mutual trust and cooperation. The purpose of the present study, conducted in a group of surgical nurses in January‒March 2019, was to analyze a theoretical model which assumed the mediating role of emotional labor strategies in the relationship between empathy and OBS., Material and Methods: The sample consisted of 84 surgical nurses employed at the University Hospital in Kraków. A cross-sectional design was used with the application of a questionnaire method. In the study, the Polish version of the Link Burnout Questionnaire by Jaworowska was used, together with the Empathy Quotient - short by Jankowiak-Siuda and the Deep Acting and Surface Acting Scale by Finogenow. For the statistical analysis, the IMB SPSS Statistics 24 with Hayes PROCESS version 3.4 was employed., Results: A negative correlation between the level of empathy and the severity of OBS symptoms was confirmed in the study. The use of the surface regulation strategies of emotional labor weakened the protective effect of empathy on burnout. The use of deep action processing strategies of emotional labor supported this relationship., Conclusions: The flexible use of emotional self-regulation strategies by the medical staff deepens their personal contact with the patient, and mediates in the level of empathy and the severity of OBS symptoms. Med Pr. 2020;71(4):461-71., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Background: The results of numerous studies indicate that the nurse profession is burdened with an increased risk of feeling stressed and experiencing professional burnout. Effective coping with stress can protect against professional burnout as well as impact on patient care. These effects may be influenced, e.g., by personality traits. By the study, the authors decided to check whether personality traits such as empathy, impulsiveness and venturesomeness would play a predictive role for flexibility in coping with stress., Material and Methods: By the study, the authors analyzed the results obtained from 137 nurses. The following research tools were used: the Impulsiveness-Venturesomeness-Empathy Questionnaire by Eysenck and Eysenck, in the Polish adaptation by Aleksandra Jaworowska, and the Flexibility in Coping with Stress Questionnaire (FCSQ-14) by Małgorzata Basińska et al. Both tools were characterized by satisfactory statistical properties. By addition, the respondents completed a personal survey which allowed collecting basic personal data., Results: Venturesomeness positively correlated with flexibility in coping with stress and all its dimensions (strategy repertoire, strategy variability and reflexivity) at the low level. Similar dependencies for empathy and impulsiveness were not shown. Similarly, in assessing the predictive role of selected personality traits for flexibility in coping with stress, only venturesomeness turned out to be an important predictor. Although the model turned out to be statistically significant, it allowed explaining the variability of flexibility only in 7%., Conclusions: There was a low statistically significant relationship between the nurses' venturesomeness and their flexibility in coping with stress. Empathy and impulsiveness did not play a predictive role for flexibility in coping with stress. Med Pr. 2020;71(4):451-9., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Aim: The study aimed to assess the effectiveness of an assertiveness training program on psychological wellbeing and work engagement among novice psychiatric nurses., Design: A quasi-experimental design was utilized (one group pre/post assessment)., Setting: The study was conducted at The Abbasia hospital for mental health in Cairo, Egypt., Subjects: The subjects of the study were 36 novice nurses who were starting their careers the hospital during 2017/2018., Tools: The current study used four tools for collecting the data: socio-demographic data sheet, Rathus Assertiveness Schedule, Riff's Psychological Well-Being Scale, and Utrecht Work Engagement Scale., Results: The study results revealed a statistically significant difference between measure one and measure two intervention program regarding assertiveness skills, psychological well-being, and work engagement. Also, there was a significant positive correlation between the total mean scores of assertiveness skills and total mean scores of psychological well-being., Conclusions: This single-group feasibility study demonstrated that assertiveness training for novice nurses seems feasible. It may achieve a favorable outcome in developing assertiveness skills and improving psychological wellbeing., Recommendations: Further randomized controlled trials with more extended follow-up periods are required., (© 2020 Wiley Periodicals, Inc.)

Objectives: The nursing profession entails many stressful situations and challenges, such as heavy workload, shift work, emotional demands and professional conflicts. In the light of the results of the research conducted so far, flexible coping has occurred to be highly adaptive, as its association with adaptive struggle with the disease, fewer depressive symptoms and both greater mental well-being and better health have been proven. In connection with the above, the aim of this study was to determine the nature of the relationship between cognitive flexibility and flexibility in coping in nurses, taking into account the moderating role of age of the respondents, seniority and the sense of stress., Material and Methods: The study sample consisted of 280 persons working as nurses (age range: 21-66). The number of women and men reflected their percentage distribution in this profession, as it is highly feminized. The following methods were used in the study: the Cognitive Flexibility Inventory (CFI) by Dennis and Vander Wal, the Perceived Stress Scale (PSS-10) by Cohen et al., the Flexibility in Coping with Stress Questionnaire (FCSQ-14) by Basińska et al., and a self-developed survey., Results: As the obtained research results show, cognitive flexibility in both the Control and Alternatives subscales was a predictor of flexible coping and their subscales. The analysis revealed that the model of the relationship between cognitive flexibility and flexibility in coping was moderated by age, seniority and the sense of stress., Conclusions: Coping skills and flexibility are positively correlated with the psychological adjustment of nurses. Int J Occup Med Environ Health. 2020;33(4):507-21., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Background: Since the declaration of the coronavirus 2019 (COVID-19) outbreak as pandemic, health workers have shown an incredible commitment to their patients, sometimes in apocalyptic conditions. We explored ways to deal with the coronavirus stressor and psychological outcomes among physicians and nurses., Subjects and Methods: 124 healthcare workers in General Hospital Nasice (Croatia) were invited to participate in a study by performing within the period of March 26 to April 6 2020 questionnaire collected information on socio-demographic characteristics and living conditions that may be risk factors for covid-19 concern, Short form health survey-36, Depression Anxiety Stress Scales (DASS-21) and Ways of Coping Questionnaire (WOC; consisting of 8 subscales: Confrontive Coping, Distancing, Self-Controlling, Seeking Social Support, Accepting Responsibility, Escape-Avoidance, Planful Problem Solving, Positive Reappraisal)., Results: 11% healthworkers reports moderate to very-severe depression, 17% moderate to extremely-severe anxiety and 10% for moderate to extremely-severe stress. 67% of medical staff are worried. No statistically significant differences in the scales of depression, anxiety, and stress were found between nurses and physicians, but differences were found on Escape-Avoidance and Positive Reappraisal subscales. Nurses use significantly more avoiding coping style and positive reappraisal than doctors. Seeking social support is more pronounced in those over 40 years old, while those under 40 use more avoidable stress management techniques., Conclusions: Monitoring and ensuring the mental health of coronavirus care staff is crucial for global health. The education of medical staff in the field of stress management is a conditio sine qua non of the issue of an adequate relationship with the COVID-19 pandemic.

Purpose: To assess the association of back pain and treatment-seeking behavior for such pain with work-related emotional burden (regret about care), regret coping strategies, and physical burden among newly practicing nurses., Methods: We used data from the Impact of Care-related Regret Upon Sleep (ICARUS) cohort collected between 05.2017 and 07.2018 using web-based surveys (weekly for measures of emotional burden, physical burden and coping strategies, and monthly for back pain and seeking care). We investigated immediate associations and temporal influences between burdens and back pain with linear mixed models and cross-lagged Bayesian models, respectively. Coefficients were standardized to allow comparison between burdens. Logistic regression was used to examine the association of burdens with seeking care., Results: Among 105 nurses with an average follow-up of 3 months, 80 reported at least one episode of back pain. Neither physical nor emotional burdens had an immediate association with back pain. However, number of days with back pain in a given month was associated with an increase in both burdens during the previous month, with similar degrees of association (emotional: b = 0.24, physical: b = 0.21). Decision to seek treatment was associated with an increase in back pain frequency (OR 1.12, p = 0.04) and intensity (OR 1.80, p = 0.002) and a decrease in emotional burden (OR 0.95, p = 0.03). Coping strategies were associated neither with the occurrence of back pain nor with care-seeking., Conclusion: While both emotional and physical burdens were associated with increased frequency of back pain the following month, emotional burden additionally showed a negative association with the decision to seek care.

Aims: The article examines nurses' experiences to institutionally enforced choices they must make regarding what patient care will be left undone. Cognitive dissonance theory is used to discuss how missed care is reconciled with the nurses' sense of professionalism and feelings of compassion., Background: Research into missed nursing care and care rationing is increasing, with an awareness that it impacts on nurses' coping ability., Methods: In-depth video and telephone interviews were conducted with four experienced nurses who were asked to describe how they made choices regarding required patient care and how they managed care under workload pressures., Results: Thematic analysis of interview narratives revealed four key themes describing the experiences of nurses managing their work: compromising care; incongruity between professional standards and organisational resources; emotional exhaustion; and depersonalization., Conclusions: Nurses expressed concerns that their professional values regarding patient care are being lost in a quest to achieve financial targets. It raises questions regarding ethical and psychological dilemmas created for workers by work intensification., Implications for Nursing Management: Financial effectiveness negatively impacts on nurses' emotional and clinical well-being cannot be easily dismissed, given that cognitive dissonance arises from attempting to provide quality care of patients whilst meeting organisational financial targets., (© 2020 John Wiley & Sons Ltd.)

Psychiatric ward (PW) nurses are at a higher risk to encounter workplace violence than are other healthcare providers, and many interventions have been developed to improve their mental health. We compared the effectiveness of biofeedback training (BT) and smartphone-delivered BT (SDBT) interventions on occupational stress, depressive symptoms, resilience, heart rate variability, and respiration rate in a sample of abused PW nurses. This was a quasi-experimental study. Structured questionnaires were administered before and six weeks after the intervention. Data were collected from April 2017 to October 2017. A total of 159 abused PW nurses were randomly assigned to BT, SDBT, and control groups, and 135 of them completed all processes of our protocol, with the study consisting of 119 females (88.1%) and 16 males (11.9%) and their age range being from 22 to 59 with the mean age of 35.61 and a standard deviation of 8.16. Compared to the controls, both the BT and the SDBT intervention groups experienced significant improvements in depressive symptoms, resilience, and respiration rate; and the SDBT group experienced significant reductions in occupational stress. Considering the cost, accessibility, restrictions time and space, SDBT be used as an effective intervention in people with resilience or occupational stress., Competing Interests: The authors declare no conflict of interest.

In recent years, nursing has come to be considered a high-risk and high-pressure profession, given the fast-paced working environment and constant need to handle emergencies, especially for nurses working in hemodialysis centers. Nearly every day, nurses are confronted with life and death situations and are required to provide skilled, high quality care for their patients, in fast-paced and demanding environments. Thus, nurses are susceptible to both psychological stress and other mental health problems, making them more vulnerable to burnout when compared against other healthcare professions.An anonymous online questionnaire was completed by a group of participating nurses, using the web-based survey platform WeChat. Registered nurses working in hemodialysis centers were randomly selected from 5 comprehensive tertiary level hospitals in Sichuan Province, China. The data collection instrument comprised two parts: demographic data and a nurse burnout questionnaire-the Maslach Burnout Inventory. Overall, 70 nurses were invited to participate, with 65 returning completed questionnaires, giving a response rate of 92.9%. In this survey, the burnout level was set at28.15 ± 12.39 for emotional exhaustion (EE), 10.23 ± 5.47 for depersonalization (DP), and 37.19 ± 8.31 for personal accomplishment (PA)-EE and DP levels are found to be high at the level of burnout.Job burnout was found to exist widely among the nurses of hemodialysis centers, which may then result in adverse effects on their physical and mental health. Active interventions can significantly reduce job burnout and also help maintain the stability of nursing workforce levels.

The increasing number of cancer patients and prolonged periods of illness have led to an increase in nurses' stress and various other problems. This research aimed to identify the stress resulting from caring for cancer patients and the methods for coping with stress among cancer care nurses. The research subjects were 180 clinical nurses caring for cancer patients in a hospital in Korea. Stress caused by excessive workloads, inappropriate compensation, and interpersonal conflicts with physicians was high. There was a difference in stress according to age. Coping strategies differed according to religion, education, occupation, hospice education, job satisfaction, and leisure activities. The higher the stress, the greater the number of coping strategies used. Problem-related coping was associated with more diverse stressors. Stress characteristics differed according to various factors, whereas stress coping strategies depended on the stress characteristics of clinical nurses caring for cancer patients. Future research following a critical approach will be needed to elucidate the compassion fatigue related to the stress strategies of clinical nurses. These findings could contribute to the development of interventions to reduce stress in clinical nurses by providing evidence on the stress and coping methods of nurses who provide palliative care for cancer patients.

Aim: To find out how resilience level is related to work performance of nurses., Background: Resilience is a developable and teachable skill which helps to recover from adversities and continue functioning above the norm. Though combating negative effects at work such as burnout is widely researched, harnessing positive organisational effects such as work performance through resilience is yet to be well-established., Methods: Cross-sectional study enrolled 230 nurses from Sri Lanka. The level of resilience at work and performance were assessed using culturally adapted and validated tools. How each resilience subscale predicted the nursing performance was assessed using bivariate correlation and linear regression analysis using ordinary least squares method., Results: The total resilience scale score demonstrated significant and strong positive correlations with all subdomains of nursing performance, as well as with overall performance (p < .05). In linear regression model, six out of seven subscales in resilience scale predicted 70.5% of variance of work performance., Conclusion: Higher resilience level at work is associated with better working performance among nurses., Implications for Nursing Management: Nursing profession is well-known to be of highly stressful and fostering resilience would be extremely useful as an investment to combat such negative effects, while yielding positive organisational benefits such as better work performance., (© 2019 John Wiley & Sons Ltd.)

Compassion fatigue is known to impact the well-being of nurses and patient safety outcomes. Currently, there is limited academic understanding of the role of demographic factors in contributing to compassion fatigue in critical care nurses. The aim of this study was to examine the relationship between nurse demographic characteristics and the development of compassion fatigue, as indicated by level of burnout and compassion satisfaction in critical care nurses in Saudi Arabia. The cross-sectional study design included administering three surveys to critical care nurses (n = 321) in four Saudi public hospitals to examine the nurse demographic variables in relation to compassion fatigue, the compassion fatigue coping strategies of nurses, and nurse resilience. The results show both demographic and workplace structural elements, such as length of work shift, education level, and nationality, were all significant factors in resilience to compassion fatigue among Saudi critical care nurses, whereas factors of age and sex were not significant. This study concludes that the demographic characteristics of critical care nurses enable the identification of levels of compassion fatigue and compassion satisfaction, and their resilience to the effects of compassion fatigue., (© 2019 John Wiley & Sons Australia, Ltd.)

Objectives: To compare the relation of quality of life to occupational coping and verify the association of these indicators with sociodemographic variables of tenured and outsourced nurses., Methods: Cross-sectional study, carried out from June to November 2014, with 145 outsourced nurses and 45 tenured nurses. We applied an identification instrument (WHOQOL-bref) and Occupational Coping Scale. Student's t-tests and Pearson's correlation coefficient were used., Results: Tenured nurses had better quality of life (p=0.011) and a mean in the Avoidance factor with a strong correlation (p=0.001). Female public servants (p=0.006; p<0.0001), between 40 and 66 years old (p=0.005; p=0.031), specialists (p=0.028; p=0.005), with a family income from 2.5 to 6.8 minimum wages (p=0.021; p=0.006) and working in the morning or afternoon (p=0.043; p=0.020) and morning and afternoon (p=0.038; p=0.007) showed a difference in quality of life and in Avoidance factor, respectively., Conclusion: Tenured nurses demonstrated better quality of life, and some variables trigger differences in the groups, demonstrating the need to promote occupational health.

BACKGROUND: Estimates of substance use (SU) in nurses is on par with that of the general population: between 6% and 8%. However, collecting sensitive information such as SU is difficult based on social desirability and fears of disclosure. AIMS: Part of a larger study surrounding nurses' self-reports of SU ( n = 1,478), the purpose was to explore open-ended responses of nurses ( n = 373) who were invited to "Please add any additional comments related to substance or alcohol use that you have experienced or witnessed in registered nurses." METHOD: This qualitative study employed a content analysis of 373 nurses' open-ended responses collected via an online survey. RESULTS: The majority of nurses ( n = 250) forwarded comments that described SU in other nurses, while 24 comments reflected the nurse's past or current SU. Content analysis revealed the following four themes: (1) differing social network proximity to SU; (2) individual process: vulnerability to adaptive/maladaptive coping resulting in positive and negative outcomes; (3) bedside, system, and organizational spaces and effects; and (4) there are no SU issues in nursing. CONCLUSIONS: Although direct reports of SU constitute approximately one quarter of the comments forwarded, nurses reported peers' struggles with SU, including observing nurses working in patient care while impaired and the use of substances to cope with work and personal stressors. Individual factors and system-related failures appear to be contributors to SU in nurses.

Background: A psychological resource, positive orientation, may moderate stress and protect nurses from burnout. The purpose of this study was to determine the role of positive orientation and stress-coping strategies in predicting professional burnout among Polish nurses. Methods: A total of 1806 nurses employed in 23 hospitals in northeastern Poland participated in the study. The study used a standardized Positive Orientation Scale, Mini-COPE, and the Copenhagen Burnout Inventory. Results: On the stenographic scale, 21.8% of nurses had high levels of positive orientation, 46.8% were average, and 31.9% had low positive orientation. A total of 21.1% of respondents reported personal burnout. Most nurses reported work-related burnout (27%) and burnout in contacts with patients (28.4%) With increasing levels of positive orientation, nurses more often used adaptive strategies that focus on a problem and emotions. Personal burnout accounted for 16% of the variance of the dependent variable (β = -0.32; R 2 = 0.16), which was slightly lower than work-related burnout (10% (β = -0.23; R 2 = 0.10)), and burnout in contacts with patients (9% (β = -0.22; R 2 = 0.09)). Conclusion: The reduced level of positive orientation proved to be the main determinant of the professional burnout of Polish nurses. Burnout-prophylactic programs should be geared towards developing individual psychological resources, including positive orientation and the acquisition of effective stress-coping skills.

Objectives: This study examines the mediating role of stress coping styles-problem-focused coping and emotion-focused coping-on the relationship between work stress and psychological well-being in clinical nurses according to career experience., Methods: A cross-sectional survey design was used. Data were collected from February to March 2016. The study population was composed of 399 nurses working at two university hospitals with over 500 beds located in Seoul and Gyeonggi-do in South Korea. Self-report questionnaires were administered to measure work stress (Work Stress Scale), stress coping styles (Korean version of The Ways of Coping Checklist Scale), and psychological well-being (Ryff's Psychological Well-being Scale). A multiple-group path analysis was performed using SPSS version 21.0., Results: In the path model analysis (N = 399), work stress directly influenced psychological well-being. Both problem-focused coping and emotion-focused coping were indirectly influenced in the relationship between work stress and psychological well-being. In the group of nurses with 3 years or less of career experience (n = 202), work stress was significantly related to psychological well-being. Only emotion-focused coping exerted a partial mediating effect on the relationship between work stress and psychological well-being. On the other hand, in the group of nurses with over 3 years of career experience (n = 197), work stress was not significantly related to psychological well-being. Both problem-focused coping and emotion-focused coping exerted a full mediating effect on the relationship between work stress and psychological well-being., Conclusions and Clinical Relevance: This study's path analysis displayed a distinct pathway in the relationships among work stress, stress coping styles, and psychological well-being between nurses with 3 years or less and nurses with over 3 years of experience. The intervention with decreasing work stress and emotion-focused coping could be effective for nurses with less career experience, whereas the intervention with focusing on improving emotion- and problem-focused coping could be effective for nurses with more career experience. The practical implications of the results suggest that nurses need different stress management programs according to their career experience, as the appropriate use of stress coping styles would improve the psychological well-being of nurses as influenced by their work stress., (© 2019 Sigma Theta Tau International.)

Nurses are frequently required to engage in shift work given the 24/7 nature of modern healthcare provision. Despite the health and wellbeing costs associated with shift work, little is known about the types of coping strategies employed by nurses. It may be important for nurses to adopt strategies to cope with shift work in order to prevent burnout, maintain wellbeing, and ensure high quality care to patients. This paper explores common strategies employed by nurses to cope with shift work. A workforce survey was completed by 449 shift working nurses that were recruited from a major metropolitan health service in Melbourne, Australia. Responses to open-ended questions about coping strategies were analysed using the framework approach to thematic analysis. Four interconnected main themes emerged from the data: (i) health practices, (ii) social and leisure, (iii) cognitive coping strategies, and (iv) work-related coping strategies. Although a range of coping strategies were identified, sleep difficulties often hindered the effective use of coping strategies, potentially exacerbating poor health outcomes. Findings suggest that in addition to improving nurses' abilities to employ effective coping strategies on an individual level, workplaces also play an important role in facilitating nurses' wellbeing.

Aim: To examine the effects of progressive muscle relaxation combined with music on stress, fatigue and coping styles amongst intensive care unit (ICU) nurses., Design: A randomised controlled trial of 56 nurses aged 18  years and older, with at least three months experience. The intervention group (n = 28) received a 20 minute session comprising progressive muscle relaxation combined with music for a total of eight weeks in the form of group sessions, while the control group (n = 28) received only a single-time face-to-face attention-matched education (20  minutes). The data collection tools were administered at baseline, at week four, eight and twelve., Setting: Internal Medicine, Anaesthesia, and Coronary Intensive care Unit of a training and research hospital., Main Outcome Measures: Primary outcome: Stress level. Secondary outcome: Fatigue severity and coping styles., Results: Stress scores in the intervention group decreased significantly at week 8 and week 12 (p < 0.05). Similarly, the fatigue scores were observed to be significantly lower in the intervention group at week 8 and week 12 in comparison to those in the control group (p < 0.05). The scores of coping styles, obtained for the acceptance sub-dimension were significantly higher in the intervention group compared to the control group at week 4, 8, and 12 (p < 0.05). The use of instrumental support, venting and the emotional support scores were observed to be significantly higher in the intervention group compared to the control group at week 12 (p < 0.05)., Conclusion: The results indicated that progressive muscle relaxation combined with music appears to be effective in decreasing stress and fatigue, and in improving the coping styles amongst intensive care nurses. Future studies should be conducted on a larger scale to make conclusions with higher probability., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Like most women, female nurses in the workforce experience life events such as marriage, childbirth, and child-rearing, and carry out numerous personal roles. This may result in an increase in various demands for nurses, and coping with these roles may promote work engagement. However, few studies have focused on work engagement or spillover effects, including those in the family domain, in female nurses with multiple roles. In the present study, we aimed to examine work engagement in female nurses and investigate its relationship with factors such as the presence or absence of multiple personal roles., Methods: The subjects of this study were 1225 female nurses working at three general hospitals, each with at least 200 hospital beds in Fukuoka Prefecture, Japan. The cross-sectional design of the study used anonymous self-administered questionnaires. Responses were received from 650 nurses (response rate 53.1%), of which 612 were valid (valid response rate 50.0%). Multiple regression analysis was performed on the 612 responses regarding associations between work engagement and the presence or absence of multiple roles (role as a wife or mother), spillover effects, coping characteristics, job demands, and job resources., Results: In general, the work engagement of female nurses was low, as is the case with other female workers in Japan, but work engagement was higher among female nurses with multiple roles than among those without. The regression analysis showed that factors associated with better work engagement in female nurses were family-to-work positive spillover, job resources, coping strategies including "changing a point of view," "active solution for problems," "avoidance and suppression," and the presence of multiple roles., Conclusions: The results indicate that in addition to resources in the work domain, a family-to-work positive spillover effect, which is a variable in the non-work domain, may also promote energetic work among female nurses. Therefore, it is necessary for nurses to receive support at work and use effective coping strategies.

Background: Emergency departments (EDs) are stressful workplaces. Limited research explores components ED staff find stressful and how they cope. The aim of this study is to describe ED staff perceptions of their working environment., Methods: A cross-sectional study was undertaken in 2017 in a public, teaching hospital ED situated in an outer-metropolitan low socio-economic area. ED doctors and nurses completed surveys exploring workplace stressors (the ED stressors tool), coping strategies (Jalowiec Coping Scale), and perceptions of the working environment (Working Environment Scale-10). Descriptive and comparative analyses were undertaken., Results: A 40% response rate (161/400) was achieved. Staff reported high workload, moderate self-realisation, and low levels of conflict and nervousness. Heavy workload, poor skill-mix and overcrowding were ranked as high-stress, high-exposure (daily) events. The death or sexual abuse of a child and inability to provide optimal care were ranked highly stressful but infrequent. Coping strategies most often used included: trying to keep life as normal as possible (90%) and considering different ways to handle the situation (89%)., Conclusions: Impacts of varying degrees of exposure of this young cohort of staff, with limited experience, to modifiable and non-modifiable stressors highlight site-specific opportunities to enhance staff perceptions of their working environment., (Copyright © 2018. Published by Elsevier Ltd.)

Objective: To analyze Nursing Occupational Risk, the relationship between resilience and job performance, and investigate the mediating effects of resilience on Nursing Occupational Risk and job performance. Methods: 406 nurses from33 clinical departments of Chengdu first-class hospital were recruited by randomsampling method. Thier Nursing Occupational Risk, resilience and job performance were interviewed by nursing occupational risk assessment questionnaire, the Scale of medical staff resilience and the job performance questionnaire, and analyze the relationship between variables. Results: The clinical nurses＇ resilience is 82.98±10.05, the clinical nurses' job performance is 145.79±23.55; here was a positive correlation between clinical nurses' resilience and job performance ( P <0.05) ; three variable of resilience can explain 33.2% of the variation of clinical nurses job performance; in the highest the Nursing Occupational risk, resilience served to mediate the relationship between Nursing Occupational Risk and job performance, which was 56.77% of the total effect respective. Conclusion: resilience are closely related to job performance. Resilience plays mediating role in the relationships between Nursing Occupational Risk and job performance, three dimensions of resilience can predict nurses' job performance. Improving the resilience of nurses can effectively improve their job performance.

Objective: To investigate the situation and influential factors of the job burnout among the nurses in Guangzhou, China. Methods: In April 2017, 166 nurses from 8 hospitals in Guangzhou were surveyed by applying the Maslach Burnout Inventory (MBI) to investigate their Emotion Exhaustion (EE) , Depersonalization (DP) and Personal Accomplishment (PA) , and applying Simplified Coping Style Questionnaire (SCSQ) to examine negative coping style and positive coping style based on group random sampling. Results: The nurses exhibited moderate burnout on both EE and DP, as well as severe burnout on PA. Compared with the nurses in the general hospitals, the nurses in the occupational disease hospital had lower scores on both EE and DP ( t =-7.305, -3.442, P <0.01) , and they had higher scores on PA ( t =2.597, P <0.05) . The married nurses had higher scores on EE ( t =2.988, P <0.01) . The nurses in the disinfection supply department had higher scores on EE and lower scores on PA than the nurses in other departments ( t =3.788, -3.990, P <0.01) . There was a significant difference on EE between different working age groups ( F =3.225, P <0.01) . 6-10 years and 21-25 years of working age had higher scores on EE. Positive coping was negatively correlated with DP ( r =-0.190) , and it positively correlated with PA ( r =0.323) . Negative coping was positively correlated with both EE and DP ( r =0.389, 0.293) .Hospitals types, negative coping style and positive coping style both entered the regression equation for EE ( R (2)=0.368, P <0.01) and the regression equation for DP ( R (2)=0.199, P <0.01) . Positive coping style and department types entered the regression equation for PA ( R (2)=0.201, P <0.01) . Conclusion: Nurses in Guangzhou got moderate level on both EE and DP, lower level on PA. Hospitals types, department types, marital status, working ages and coping style are all the influential factors of job burnout.