Aggression and burnout in nurses during COVID-19: A cross-sectional study.

Workplace violence against nurses, an ever-present problem in the healthcare workplace, has been increasing with COVID-19 and affects occupational health. This study analyzed the consequences of COVID-19 on violence against nurses, identifying its association with burnout, emphasizing the importance of work-related variables. A total of 1013 actively employed nurses in Spain with a mean age of 34.71 years filled out a computer-assisted web interviewing survey. Aggression as a consequence of their work was reported by 73.44% of the nurses. Those most affected were in primary care, and verbal aggression by patients and their families was the most frequent. Nurses who were attacked scored significantly higher in emotional exhaustion and depersonalization. Furthermore, 83.22% said that COVID-19 was an important factor in the increase in violence toward healthcare workers. Analysis showed that a perceived secure environment was a mediator between the belief that COVID-19 was an influential factor in the increase of violence and the depersonalization dimension of burnout. Increasing perceived security in the work environment among nurses can be effective in promoting well-being, work performance, and commitment to the profession.

Repercussions of perceived threat to health in the Spanish population.

Studies have shown that COVID-19 has had a worldwide psychological impact. Confinement due to COVID-19 has had important repercussions on the mental health of the general population, with high levels of stress, anxiety, depressive symptoms, post-traumatic stress disorder, and so forth. Similarly, important labor, economic and social changes taking place are affecting people's well-being. The objective of this study was to analyze the repercussions of perceived threat from COVID-19 on the mental health of the population, and to evaluate the mediating role of perceived economic impact. The participants were 1160 adult residents of Spain aged 18 to 82, 69.9% of whom were women. A sociodemographic questionnaire, the Questionnaire on Perception of Threat from COVID-19 and the General Health Questionnaire were administered. Perceived threat had a positive direct effect on all four health dimensions analyzed. Among the indirect effects, the perceived economic impact of COVID-19 mediated in the relationship between perceived threat and each of the health dimensions. The results of this study have demonstrated the need to promote joint action promoting public mental health to minimize the psychological repercussions of new outbreaks.

Job strain and burnout in Spanish nurses during the COVID-19: resilience as a protective factor in a cross-sectional study.

BACKGROUND: Nurses are frequently exposed to chronic stress in the workplace generating harmful effects such as job strain and burnout. On the contrary, resilience has been shown to be a beneficial variable. The objective of this study was to analyze the relationship between dimensions of the Job Demand Control-Support model, resilience and burnout in nurses, and examine the mediating role of resilience between job strain and burnout. METHODS: A descriptive, cross-sectional study reported in line with the STROBE guidelines. Active nurses were invited to complete an online questionnaire in September, 2020. With snowball sampling, 1013 nurses, with a mean age of 34.71, filled out the Job Content Questionnaire, the Maslach Burnout Inventory and the Resilience Scale. RESULTS: The results showed the existence of four groups of professionals based on job strain. The nurses in the "High Strain" group (high demands and low control) showed higher scores in emotional exhaustion and cynicism, while those in the "Active Job" group scored higher in personal realization and resilience. The findings showed that job strain affects burnout in nurses, and this effect is mediated by resilience. CONCLUSIONS: The findings of this study showed that a high level of resilience could exert a fundamental role in ensuring well-being and proper job performance by nurses. Nursing managers should see to the personable variables or competencies that provide and favor an opportunity for nurses to widen and improve their practice, in pursuance of satisfying and responding better to people's needs and the systems they work for.

The "Mask Effect" of the Emotional Factor in Nurses' Adaptability to Change: Mental Health in a COVID-19 Setting.

During healthcare catastrophes, such as the current COVID-19 pandemic, nurses are exposed to highly stressful situations derived from their work and personal activity. Development of coping strategies for such situations can improve nurses' physical and mental health. This study analyzed nurses' adaptability to change, with attention to socio-demographic variables in a COVID-19 setting, and identified the repercussions on their health. This quantitative, observational and cross-sectional study had a sample of 351 nurses aged 22 to 64 with a mean age of 40.91 (SD = 10.98). The instruments used for the study were the ADAPTA-10 questionnaire and the General Health Questionnaire (GHQ-28). It was observed that age, sex, and having a stable partner significantly influenced scores on the emotional, cognitive-behavioral, and adaptation to change factors. Finally, the emotional factor mediated between positive COVID-19 in someone close and the presence of health problems. Understanding the elements that help adapt better to change and adversity enable effective interventions to be developed for improving emotional health of nurses, especially for those in whom there are positive cases of COVID-19 in their personal or work environment.

Mental Health in Settings with COVID-19 Positive Cases in the Spanish Population: The Protective Role of the Capacity to Adapt to Change.

BACKGROUND: The capacity to adapt to change in complex, highly demanding situations, such as those derived from the COVID-19 pandemic, is essential in maintaining one's mental health. This study analyzed the mental health of the Spanish population in settings with COVID-19 positive cases and the protective role of adaptation to change. METHODS: The sample consisted of 1160 adult Spaniards aged 18 to 82 with a mean age of 38.29 (SD = 13.71). Data were collected by a CAWI (Computer Aided Web Interviewing) survey which included the General Health Questionnaire (GHQ-28), Adaptation to Change Questionnaire (ADAPTA-10), and an ad hoc questionnaire related to COVID-19 (perceived economic impact, COVID-19 positive diagnosis or not, and whether there was a positive case close to them). RESULTS: The data revealed that the perceived economic impact showed a negative association between the emotional factor and the total score in adaptation to change. Lastly, the emotional factor in adaptation to change operated as a protector from the effect that a setting with COVID-19 positive cases exerts on mental health. CONCLUSIONS: Coping with COVID-19 requires strengthening the capacity for adaptation to changes generated in the setting, especially emotional, as it could contribute to improving the mental health of individuals, especially in those settings where they find and know a COVID-19 positive case.

Adaptation to Change Questionnaire for Nurses: Validation and New Needs in the Context of COVID-19.

BACKGROUND: The worldwide pandemic caused by the SARS-CoV-2 coronavirus has challenged healthcare systems and the professionals who work in them. This challenge involves strong changes to which nurses have had to quickly adapt. Emotional and cognitive-behavioral factors influence the capacity for adaptation to change. Based on this model, the objective of this study was to validate the Adaptation to Change Questionnaire (ADAPTA-10) for identifying professionals in a population of nurses who have problems adapting to adverse situations such as those caused by COVID-19. METHODS: This study was performed with a sample of 351 nurses. (3) Results: The ADAPTA-10 questionnaire was found to have good psychometric properties, and to be an effective, useful tool for nurses in research and clinical practice. The two-dimensional structure proposed in the original model was confirmed. Scales are also provided by sex for evaluation of adaptation to change; the highest scores on the emotional component were among nurses who had not personally encountered the virus. CONCLUSIONS: This instrument will be able to detect of the needs for adaptation to the new reality associated with COVID-19, as well as other situations in which nurses are immersed that demand adaptation strategies.

Coping Strategies as a Mental Health Protection Factor of Spanish Nurses during COVID-19.

BACKGROUND: Due to the healthcare crisis caused by COVID-19, nurses have been exposed to stressful, uncertain situations. In such situations, emotional coping strategies are especially important due to their repercussion on health. The purpose of this study is analyze the relationships between nurses' coping strategies and health, with attention to factors related to perceived threat and/or someone close to them is COVID-19 positive. METHODS: This descriptive cross-sectional study was done with a sample of 351 nurses in Spain. In addition to the questionnaire on perception of threat from COVID-19, the Cognitive Emotion Regulation Questionnaire and the General Health Questionnaire, an ad hoc question asked them whether someone close to them was COVID-19 positive. RESULTS: Perceived threat and use of negative coping strategies were related, and these strategies were related to a greater presence of somatic symptoms, anxiety, social dysfunction, and depression. CONCLUSIONS: Given the work and personal influence of coping on nurses, interventions must be designed to promote adaptive strategies.

Questionnaire on Perception of Threat from COVID-19.

The ravages caused by the disease known as COVID-19 has led to a worldwide healthcare and social emergency requiring an effective combined effort from everyone to reduce contagion. Under these circumstances, the perception of the disease is going to have a relevant role in the individual's psychological adjustment. However, at the present time there is no validated instrument for evaluating adult perception of threat from COVID-19. Considering the importance of perception or representation of the disease in a state of social alert, our study intended to validate an instrument measuring the psychological process of the disease caused by the coronavirus (COVID-19). In view of the above, this study evaluated the factor structure and reliability of the version of the Illness Perception Questionnaire (IPQ) for COVID-19 in a sample of adults. The sample consisted of 1014 Spanish adults (67.2% women and 32.8% men). The exploratory and confirmatory factor analyses supported a unidimensional model of the scale, which was the one that showed the best fit and explained 43.87% of the variance. This brief version has adequate psychometric properties and may be used to evaluate the perception of threat from COVID-19 in an adult Spanish population. The validation of this instrument contributes to progress in representation of COVID-19 in our culture.

Mood and Affective Balance of Spaniards Confined by COVID-19: A Cross-Sectional Study.

The aim of this study was to analyze the mood and affective balance of Spaniards in quarantine and determine the predictive role of sociodemographic variables and mood on the negative affective balance. This cross-sectional study was carried out with a sample of 1014 Spanish adults, 67.2% were women and 32.8% men. The age ranged from 17 to 76. The instruments used were the Mood Assessment Scale and the Affective Balance Scale, which were implemented as a CAWI survey (Computer Aided Web Interviewing). Results showed that age correlated negatively with Sadness-Depression, Anxiety, and Happiness. Women had more Sadness-Depression, Anxiety, and negative affect, while men showed more Happiness and higher positive affect. Thus, the risk of a negative affective balance during confinement was greater for women and those who showed an emotional state marked by sadness-depression and anxiety, while older age and higher scores in happiness were associated with lower risk. In conclusion, knowing which groups are at risk of emotional and affective alteration can facilitate the detection and prevention of later disorders, such as severe stress and posttraumatic stress disorder, avoiding their generalized presence, and becoming a new public health problem derived from COVID-19.

El objetivo de este trabajo fue analizar el estado de ánimo y el balance afectivo de los españoles en cuarentena y determinar el papel predictivo de las variables sociodemográficas y de los estados anímicos, sobre el balance afectivo negativo. Se trata de un estudio transversal, con una muestra de 1014 adultos españoles, siendo el 67.2% mujeres y el 32.8% restante, hombres. El rango de edad estuvo entre 18 y 76 años. Los instrumentos empleados fueron la Escala de Evaluación del Estado de Ánimo y la Escala de Equilibrio Afectivo, empleando para su implementación una encuesta CAWI (Computer Aided Web Interviewing). Los resultados mostraron que la edad correlaciona negativamente con la Tristeza-Depresión, la Ansiedad y Alegría. Las mujeres presentan mayor nivel de Tristeza-Depresión, Ansiedad y afecto negativo, mientras que los hombres presentan más Alegría y mayor nivel de afecto positivo. Por lo tanto, el riesgo de presentar un balance afectivo negativo durante el confinamiento es mayor entre mujeres y entre quienes manifiestan un estado emocional marcado por la tristeza-depresión y la ansiedad, mientras que tener mayor edad y mostrar puntuaciones elevadas en alegría se asocia con menor riesgo. En conclusión, conocer los grupos de riesgo en alteraciones emocionales y afectivas puede facilitar la detección y prevención de trastornos posteriores, como estrés agudo y trastorno de estrés postraumático, evitando la presencia generalizada, y que esto se convierta en un nuevo problema de Salud Pública derivado del COVID-19.

Coping Strategies in the Spanish Population: The Role in Consequences of COVID-19 on Mental Health.

The worldwide health emergency caused by COVID-19 is a new challenge for humanity which individuals respond to in a diversity of ways. The type of coping people use in such a situation could lead to positive or negative consequences to their health. Our objective was to analyze the use of coping strategies in the general population with attention to sociodemographic variables, and to test the capacity of these strategies for mediating in repercussions on mental health. The 1,160 adults who participated in this study answered the Cognitive Emotion Regulation Questionnaire (CERQ-S) and General Health Questionnaire (GHQ-28). The data were collected in a CAWI (Computer Aided Web Interviewing). The results suggest that the coping strategies they used the most differed depending on sociodemographic characteristics, such as age, sex and education. Furthermore, two mediation models were estimated for positive and negative coping strategies in the relationship between the presence of COVID-19 near them and mental health. The "negative" coping strategies were found to exert an indirect effect as mediators in the impact that COVID-19 positive cases near them had on their health. The consequences to mental health of the impact of coping with adverse situations should not be underestimated and it is important to design programs to educate the population in coping strategies that promote their health.

Predictors of Threat from COVID-19: A Cross-Sectional Study in the Spanish Population.

One of the first measures for fighting the worldwide spread of the COVID-19 pandemic is social isolation or quarantine. The perceived threat from COVID-19 in this situation, maintained over time, generates uncertainty and fears, etc., which could lead to mental disorders in the population. This study evaluated the perceived threat from COVID-19 in the Spanish population. The study design was cross-sectional and observational. The sample of 1014 participants recruited in Spain had a mean age of 40.87 (SD = 12.42). The gender distribution was 67.2% (n = 681) women and 32.8% (n = 333) men. Data were collected with an online survey. The instrument used was the Perception of Threat from COVID-19 Questionnaire, validated for the Spanish population. Our data showed a clear correlation between perceived threat with female gender, having children in one's care and level of education. However, no association was observed with age or marital status. Finally, we concluded that there is a greater perception of threat from COVID-19 by women with a lower education who have children in their care, and that they are also more sensitive to minor mental disorders, such as anxiety or stress, appearing.

The repercussions of perceived threat from COVID-19 on the mental health of actively employed nurses.

In the confrontation with the COVID-19 pandemic, threat perceived by the nursing population, and its association with sociodemographic and contextual characteristics, must be measured and evaluated as well as their repercussions on their mental health. Therefore, the purpose of this study was to analyse the repercussion of perceived threat from COVID-19 on the mental health of actively employed nurses, considering a COVID-19 diagnosis, whether their own or of someone close to them. The sample was comprised of 351 nurses. Sociodemographic data were collected, and the Questionnaire on Perception of Threat from COVID-19 and the General Health Questionnaire were administered. The three demographic and contextual variables mentioned were related to mental health, mediated in some symptoms by perceived threat. These results provide important information for implementing measures or psychoeducational programs for nurses, essential in the present pandemic for improving psychological adaptation and reducing the effects on their mental health.

Design and Validation of the Adaptation to Change Questionnaire: New Realities in Times of COVID-19.

Emotional and cognitive-behavioral factors influence people's adaptability to change. Based on this premise, the objective of this study was to develop, evaluate and validate the Adaptation to Change Questionnaire (ADAPTA-10) for identifying those who show poor adaptability to adverse situations, such as those caused by COVID-19. This study was carried out in a sample of 1160 adults and produced a 10-item instrument with good reliability and validity indices. It is an effective tool useful in research and in clinical practice. Calculation tables are provided for the general Spanish population and by sex to evaluate adaptability to change. The two-dimensional structure proposed in the original model was confirmed. This instrument will enable the needs for adaptation to the new reality associated with COVID-19 to be detected and also other situations in which the subject becomes immersed which demand adaptation strategies in the new situation lived in.

Threat of COVID-19 and emotional state during quarantine: Positive and negative affect as mediators in a cross-sectional study of the Spanish population.

AIMS: The objective of this study was therefore to analyze the effect of exceptionally stressful situations, such as the current health risk, on the cognitive and emotive state of the individual, that is, perceived threat and emotional state on affect and mood. METHOD: This was a cross-sectional study with snowball sampling. The sample came to 1014 Spanish adults (67.2% women and 32.8% men). The Perception of Threat from COVID-19 questionnaire, the Affective Balance Scale and the Mood Evaluation Scale were used. RESULTS: The results showed that the perception of threat from COVID-19 was related positively to negative affect and emotional signs, that is, sadness-depression, anxiety and anger-hostility. There was a direct positive effect of perceived threat from COVID-19 on sadness-depression, anxiety and anger-hostility moods, while anxiety and anger-hostility had a direct positive effect on perception of threat from the virus. Thus, there was a circular relationship, in which perceived threat influenced the presence of negative mood, and negative mood, in turn, linked to emotions of irritation and agitation from a present situation, promoted the feeling of threat. CONCLUSIONS: A negative affective balance increases both one's perception of threat from COVID-19 and negative mood. Thus, knowing the emotional and cognitive effects on the population would enable measures to be put into service to facilitate their effective coping.