Patterns of work-related stress and their predictors among emergency department nurses and emergency medical services staff in a time of crisis: a latent profile analysis.

BACKGROUND: Previous studies have shown that a disease outbreak may cause high stress among healthcare workers. However, the vast majority of those studies applied a variable-centered approach, in which relationships between the variables are believed to be identical across the studied population. The main purpose of this study was to identify latent profiles of healthcare workers with similar combinations of levels of various work-related stressors during the coronavirus disease 2019 (COVID-19) pandemic and to examine their predictors. METHODS: A cross-sectional paper-and-pencil study was conducted among a convenience sample of 297 emergency department (ED) nurses and 219 emergency medical services (EMS) staff members working in 10 hospital EDs and 52 EMS centers in Ardabil province, Iran. Data were collected using the Health and Safety Executive Management Standards Indicator Tool (HSE-MS IT). RESULTS: Using the latent profile analysis (LPA), five work-related stress profiles were identified: "high stress with a good understanding of one's job role" (11.1%), "moderate stress" (41.9%), "relatively high stress with average demands and a very low understanding of one's job role" (23.8%), "low stress" (18.0%), and "generally low stress but with very high job demands and relational conflicts" (5.2%). Age, marital status, service location, workplace, and the number of overtime hours significantly predicted profile membership. CONCLUSION: The results of the study suggest the importance of incorporating various sources of stress and using the person-centered approach when investigating the work-related stress of healthcare workers during disease outbreaks. Identifying sociodemographic and work-related predictors of profile membership may be useful for preparing interventions that will be better suited to healthcare workers' needs.

Risk communication and risk perception along with its influencing factors in Covid-19 disease: Focusing on the Extended Parallel Process Model.

Introduction: Following the global spread of the Covid-19 infection, the Iranian government adopted measures to control the spread of the disease, but they were not applicable without the acceptance and interaction of the general population. This study used the Extended Parallel Process Model (EPPM) components to attempt to determine risk communication and risk perception along with its influencing factors in Covid-19 disease among the population of northwestern Iran. Method: This cross-sectional study was conducted among the general population of the province. Demographic characteristics and extended parallel process model questionnaires were used to collect data, which was then analyzed based on descriptive (frequency, mean, standard deviation) and inferential statistics (t-test, analysis of variance, regression, chi-square) in SPSS-25 software. Results: This study showed that 63.8% of the participants continually followed Covid-19 news, and 34% of participants used social media to get the news and warnings related to the Covid-19 pandemic. Among the domains of participants' risk perception for Covid-19 disease, the three domains of self-efficacy, response effectiveness and intention had the highest means compared with other domains. Significant correlations were found between risk perception and the dimensions of age, gender, marriage status, number of family members, place of residence, underlying disease, history of Covid-19, and family history of Covid-19 disease (p < 0.05). Multivariate linear regression analysis revealed that perceived sensitivity, perceived severity, self-efficacy, fear, defensive avoidance, intention, and behaviors were independent predictors of response efficacy (p < 0.001). Conclusion: More than two years after the onset of the spread of Covid-19 disease, the risk perception of the disease among the study population was still insufficient in many areas. Risk of communication refers to the point of interaction between the government and the people, and the need to improve public trust in this issue is strongly felt.

Predictors of patient safety competency among emergency nurses in Iran: a cross-sectional correlational study.

AIMS: This study aimed to assess predictors of patient safety competency among emergency nurses. BACKGROUND: The role of emergency nurses is to provide high-quality health care to patients and ensure their safety. The patient safety competency includes the absence of unnecessary or potential harm when providing health care to patients. In providing health care, effective teamwork can affect patient safety and outcomes. Psychological safety is essential to effective teamwork. Psychological safety allows health care workers to accept the interpersonal risks needed to perform effective teamwork and maintain patient safety. METHODS: This study was cross-sectional correlational research. Using convenience sampling methods, 254 emergency department nurses from five educational hospitals were enrolled in the study. Patient Safety in Nursing Education Questionnaire was used to measure the patient safety competency, the teamwork questionnaire to examine the teamwork, and Edmondson psychological safety questionnaire was used to measure psychological safety. Descriptive statistics, t-test, one-way analysis of variance (ANOVA), Pearson's r correlation coefficient, and multivariate stepwise linear regression analysis were applied using SPSS 14.0. RESULTS: Participants' mean patient safety competency score was 2.97 (1-4). Between 18 independent variables evaluated in the multiple regression analysis, seven had a significant effect on the patient safety competency of emergency nurses (R2: 0.39, p < .001). CONCLUSIONS: The patient safety competency of emergency department nurses was primarily related to the structure and leadership of the team and secondary to psychological safety and experience in patient safety activity. The results demonstrated that policymakers and hospital managers should improve and enhance team structure and leadership via supervision and cooperation with the nursing staff. The development of training programs in patient safety activities, improvement, and increase of psychological safety at the levels of the nursing units is essential to increase patient safety competencies in the emergency nursing program.

Determining the Predictors of Self-Management Behaviors in Patients With Type 2 Diabetes: An Application of Socio-Ecological Approach.

Background: Type 2 diabetes complications are responsible for 2% of hospital emergency visits. Self-management practices are one of the most essential approaches to control type 2 diabetes. The goal of this study was to use an ecological approach to investigate the predictors of self-management behaviors in diabetes patients referred to the emergency department in Ardabil in 2020. Methods: In this cross-sectional study, 273 individuals with type 2 diabetes who were sent to the emergency department of Imam Khomeini Educational and Medical Center in Ardabil were included using the available sample method. Demographic information questionnaires, including the Diabetes Distress Screening Tool (DDS2), General Diabetes Knowledge (DKT2), Diabetes Empowerment Questionnaire (DES-SF), Patient Health Questionnaire 9 (PHQ 9), Beliefs to Treatment Effectiveness Scale (BTES), Diabetes Self-Efficacy Scale (DSES), Chronic Illness Resources Survey (CIRS), Situational Effects Questionnaire, and Diabetes self-management support (DSMS), were all used to collect data. The independent t-test, one-way ANOVA, Pearson correlation coefficient, and multiple regression were used to analyze the data. Results: The results of the study showed that in the framework of ecological approach, predictors of self-management behaviors at the four levels are as follows: at the individual level-gender (p = 0.025), education (p = 0.002), duration of diabetes (p = 0.38), having a glucometer at home (p < 0.001), diabetes empowerment (p < 0.001), personal support (p = 0.002), and self-efficacy (p = 0.047); at the interpersonal level-the main health support (p < 0.001), membership in social networks (p < 0.005), family/friends support (p < 0.001), and neighborhoods support (p < 0.001); at the group and organizational level-organizational support (p = 0.013); at the community and policy level-the impact of mass media in health (p < 0.001) and situational influence (p < 0.001). Conclusion: The impact of non-individual levels, such as the environment, on a person's decision to manage diabetes is crucial. Diabetes management necessitates a significant amount of effort, which involves maintaining the health of diabetes patients and the community while also minimizing emergency department workload.

Occupational stress and its relationship with spiritual coping among emergency department nurses and emergency medical services staff.

INTRODUCTION: Emergency Department (ED) nurses and Emergency Medical Services (EMS) Staff are faced with several stressors daily, such as the COVID 19 pandemic situation, which affects the health and the quality of services to patients. Spiritual coping with stress is an attempt to overcome the stress on the basis of what is transcendent. The use of spiritual coping strategies helps a person to overcome tensions caused by the work environment. OBJECTIVE: The current study aimed to investigate occupational stress and its relationship with spiritual coping among ED nurses and EMS staff. MATERIALS AND METHODS: This study was descriptive-correlational research. Using convenience sampling methods, 516 ED nurses and EMS staff were enrolled in the study. The study instruments included demographic information, HSE Occupational Stress, and spiritual coping questionnaires. Data were analyzed using SPSSv.22 software and the descriptive statistics, Pearson correlation test, t-test, ANOVA, and multiple linear regression. RESULTS: The highest and lowest levels of occupational stress were the dimensions of "demand" (2.96 ± 0.65) and "role" (3.89 ± 0.81) respectively. Multiple linear regression analysis showed that positive spiritual coping, negative spiritual coping, workplace, service location, type of employment, and work position were important factors affecting the occupational stress of ED nurses and EMS staff, which accounted for 0.34% of the variance. CONCLUSION: The findings showed the need to improve the work environment for ED nurses and EMS staff, including changes in physical working conditions, salaries, and better employment conditions. Training programs are recommended to reduce stress through the use of positive spiritual coping strategies.

Post-Traumatic Stress Disorder and Its Related Factors in Nurses Caring for COVID-19 Patients.

Background: Post-Traumatic Stress Disorder (PTSD) is a mental disorder that can result from direct or indirect contact with traumatic events. The current study aimed to evaluate PTSD and its related factors in nurses caring for COVID-19 patients. Materials and Methods: This study was a descriptive correlational study. Using convenience sampling methods, 395 nurses were enrolled in the study. The study instruments included demographic information, Impact of Event Scale-Revised (IES-R), and General Health and Job Content Questionnaire (JCQ). Data were analyzed using the Pearson correlation test, t-test, ANOVA, and multiple regression analysis. Results: The mean (SD) age and work experience of the participants were 33.79 (6.74) years and 9.47 (6.47) years, respectively. Most nurses (86.60%) experienced PTSD. Multiple linear regression results showed general health (R 2 = 0.51, p = 0.001), job insecurity (R 2 = 0.51, p = 0.042), decision latitude (R 2 = 0.51, p = 0.037), and high age (R 2 = 0.51, p = 0.049) to be associated with an increase in PTSD, and having high social support (R 2 = 0.51, p = 0.043) was associated with a decrease in PTSD in nurses. Conclusions: Nurses have experienced high levels of PTSD after the fatal outbreak of COVID-19 disease. Stressful conditions associated with an increased likelihood of this disorder should be identified, and coping skills such as decision latitude (control) and social support should be strengthened to prevent the symptoms of this disorder in nurses.

Spiritual Coping of Emergency Department Nurses and Emergency Medical Services Staff During the COVID-19 Pandemic in Iran: An Exploratory Study.

Emergency department (ED) nurses and emergency medical services (EMS) staff have been recently exposed to high levels of stress due to the new Coronavirus (COVID-19) pandemic. This increased stress level may influence the physical and mental health of ED nurses and EMS staff and the quality of caregiving to the patients. A spiritual coping approach is one of the most commonly used strategies to help healthcare workers manage stressful events or situations. This study explores the spiritual coping (positive or negative) among ED nurses and EMS staff during the COVID-19 pandemic. A descriptive cross-sectional study was performed on 494 ED/EMS nurses in Ardabil Province in the northwest of Iran, using a convenience sampling method. The spiritual coping questionnaire (SCQ) was used to assess spiritual coping in the subjects. The results of this study showed that ED nurses and EMS staff generally used positive spiritual coping methods to reduce stress during the COVID-19 pandemic. Multiple linear regression indicated that workplace (ß = 0.22, p < 0.001), service location (ß = 0.16, p < 0.001), and type of employment (ß = - 0.13, p = 0.012) were significant predictors of positive spiritual coping, and older age (ß = 0.13, p = 0.045), overtime work (ß = 0.12, p = 0.01), and marital status (ß = - 0.12, p = 0.021) were predictors of negative spiritual coping. Our findings indicated that positive religious behavior was the main spiritual coping strategy used by healthcare workers. The findings could help emergency nurse managers to propose future strategies to minimize stress based on the use of spiritual coping strategies and provide time and facilities to pray.

Identifying the predictors of turnover intention based on psychosocial factors of nurses during the COVID-19 outbreak.

AIMS: Because of the direct contact nurses have with patients, they are exposed to more stressful events during the outbreak of infectious diseases, which increases their turnover intention, highly impacting not only nurses, but also patients and organizations. The present study aimed to identify the predictors of turnover intention based on psychosocial factors in nurses of Ardabil pre-hospital emergency and educational and medical centres during the COVID-19 outbreak. DESIGN: The present descriptive-analytical study was conducted in June, 2020. METHODS: A total of 479 nurses working in Ardabil pre-hospital emergency and educational and medical centres to fight COVID-19 were recruited for this study using the census method. Data were collected using the Demographic Information Questionnaire, Turnover Intention Questionnaire, Weiss & Marmar Impact of Event Scale-Revised (IES-R), General Health Questionnaire (12 C-GHQ) and Job Content Questionnaire (JCQ). Data were analysed with SPSSv.22 software using correlation, t test, analysis of variance, multiple regression and descriptive tests. RESULTS: The mean turnover intention score of nurses was 41.73 with a standard deviation of 12.11. The results of correlation coefficient revealed a positive relationship between PTSD, general health, job demand and job strain with turnover intention (p ≤ .01) and a positive and significant relationship between social support and turnover intention (p ≤ .01). Multiple regression analysis showed that the variables of gender, marital status, work position, decision latitude, social support, job strain, general health and post-traumatic stress disorder (PTSD) were predictors of turnover intention. CONCLUSION: Job stressors during the COVID-19 outbreak have led to an increase in nurses' turnover intention. Identifying and managing the factors related to job stressors will make it possible to prevent nurses' turnover intention in such critical situations.