Mediating effect of coping strategies on the relation between social support and depressive symptoms among patients after cardiac transplantation. / Mediacyjny wplyw strategii radzenia sobie ze stresem na relacje miedzy wsparciem spolecznym a symptomami depresji u pacjentów po przeszczepieniu serca.

OBJECTIVES: This study aimed to evaluate the role of different types of coping strategies as a mediator in social support and depressive symptoms among patients after cardiac transplantation. METHODS: 123 participants after heart transplantation took part in the study. All the participants completed self-report questionnaires using the following instruments: Beck Depression Inventory Short Form (BDI SF), Berlin Social Support Scales (BSSS) and Coping Orientation to Problems Experienced (the brief COPE). RESULTS: Actually received social support and perceived available social support (both emotional and instrumental) proved to have a significant direct impact on the occurrence of depression. Coping strategies mediated the correlation between the actually received social support, the perceived available emotional social support and depressive symptoms. The individuals with low perceived available support and the actually received social support (both emotional and instrumental), as well as those resorting to the coping strategies of avoidance and denial, proved to be prone to experiencing depressive symptoms. A significant mediating effect on depressive symptoms was identified between active coping, planning, positive reframing, self-blame, and the actually received support. CONCLUSIONS: All social support types were found to be directly correlated with symptoms of depression. Coping strategies proved to mediate the correlation between the perceived social support and depression.

The mediational effect of coherence on the relationship between mental load and job burnout among oncology nurses.

AIMS: The purpose of this study was to determine the mediational effect of coherence on the relationship between mental load and job burnout among oncology nurses. BACKGROUND: Working stress and strain cause high mental load and can lead to job burnout among oncology nurses. Sense of coherence protects against the negative consequences of occupational mental load and may prevent professional burnout. MATERIALS AND METHODS: The study was carried out with 165 oncology nurses from chemotherapy departments. The data were collected from April to September 2013 using the Antonovsky Sense of Coherence Scale, Meister questionnaire, and Maslach Burnout Inventory. RESULTS: Manageability mediated the relations between Mental Load and both Emotional Exhaustion and Depersonalization. Meaningfulness exerted significant mediational effect on the relationship between Mental Load and Depersonalization. Manageability and Meaningfulness attenuate the unfavourable effect of Monotony and Unspecific load on motional Exhaustion and Depersonalization. CONCLUSIONS: Sense of coherence, especially Manageability and Meaningfulness, seems to be an important resource for oncology nurses, buffering the negative impact of mental load on well-being of nurses. Strengthening the sense of coherence can be helpful in preventing or dealing with professional burnout.

The effect of clinical variables on distress and depressive symptoms among heart transplant recipients.

BACKGROUND: Heart transplantation (HTx) is the standard treatment for end-stage cardiomyopathy and coronary artery disease. Although major improvements have been made in the prevention and treatment of acute graft rejection, comorbidities still limit the long-term survival of heart transplant recipients. The risk of poor outcome, such us major health status aggravation and death, can stimulate the occurrence of depression and stress in this population. The aim of this study was to determine the impact of comorbidities on depressive symptoms and distress among heart transplant recipients. MATERIAL/METHODS: The sample included 131 HTx recipients from one site. Data were collected during a follow-up in-hospital appointment, using the questionnaires assessing depression (Beck Depression Inventory Short Form) and stress (Perceived Stress Scale-10). Statistical analyses included descriptive statistics, Pearson correlations, t-tests, and generalized linear models. RESULTS: Study patients were 75.6% (n = 97) male, 100% (n = 131) Caucasian, 74% (n = 89) married, with the mean age of 54 years at time of heart transplantation. Nearly half of the participants (40.5%) presented depression symptoms at the time of evaluation. Severe stress was observed in 30% of individuals. Depression symptoms and severe distress were more commonly observed in patients with many comorbidities, requiring multiple drug therapy, and high NYHA score. Moreover, in a multivariate logistic regression, depression and high distress level occurrence were predicted by the following independent factors: cardiac allograft vasculopathy, cancer, diabetes, higher NYHA score, and comorbidities. CONCLUSIONS: The prevalence of depression and severe distress is common among heart transplant recipients. Patients with many comorbidities are at higher risk of psychological indisposition.

Sense of Coherence vs. Mental Load in Nurses Working at a Chemotherapy Ward.

OBJECTIVE: The aim of this study was to analyze the relationship between the sense of coherence and the level of mental load among nurses working at a chemotherapy ward. METHODS: The study, conducted in 2013, included 164 nurses working at inpatient chemotherapy wards in Krakow, Poznan, Kielce, and Gliwice (Poland). The mean age of the study participants was 43.07±7.99 years. The study was based on a diagnostic survey with Antonovsky's Sense of Coherence Scale (SOC-29) and Meister questionnaire. RESULTS: The levels of Mental Load, Monotony and Unspecific Load, correlated inversely with the levels of Coherence, Manageability, Meaningfulness, and Comprehensibility. Longer work experience was associated with lower levels of Coherence, Manageability and Comprehensibility and higher levels of Mental Load, Overload and Monotony. Age of nurses correlated inversely with the Manageability level. Heavy mental and physical workload turned out to be the main factor causing dissatisfaction of the study participants. CONCLUSIONS: Longer work experience and lower levels of Coherence are associated with higher risk for mental overload.

Shift schedule, work-family relationships, marital communication, job satisfaction and health among transport service shift workers.

OBJECTIVES: Existing research has documented that shiftwork consequences may depend on the shift system parameters. Fast rotating systems (1-3 shifts of the same kind in a row) and day work have been found to be less disruptive biologically and socially than slower rotating systems and afternoon and night work. The aim of this study was to compare day workers and shift workers of different systems in terms of rotation speed and shifts worked with regard to work-family and family-work positive and negative spillover, marital communication style, job satisfaction and health. MATERIAL AND METHODS: Employees (N = 168) of the maintenance workshops of transportation service working different shift systems (day shift, weekly rotating 2 and 3­shift system, and fast rotating 3-shift system) participated in the study. They completed the Work- Family Spillover Questionnaire, Marital Communication Questionnaire, Minnesota Job Satisfaction Questionnaire and the Physical Health Questionnaire (a part of the Standard Shiftwork Index). RESULTS: The workers of quicker rotating 3-shift systems reported significantly higher scores of family-to-work facilitation (F(3, 165) = 4.175, p = 0.007) and a higher level of constructive style of marital communication (Engagement F(3, 165) = 2.761, p = 0.044) than the workers of slower rotating 2-shift systems. There were no differences between the groups of workers with regard to health and job satisfaction. CONCLUSIONS: A higher level of work-family facilitation and a more constructive style of marital communication were found among the workers of faster rotating 3-shift system when compared to the workers of a slower rotating 2-shift system (afternoon, night). This may indicate that the fast rotating shift system in contrary to the slower rotating one is more friendly for the work and family domains and for the relationship between them. Int J Occup Med Environ Health 2017;30(1):121-131.

The influence of sense of coherence on emotional response in heart transplant recipients - a preliminary report.

INTRODUCTION: The success of heart transplantation in prolonging life and well-being must be considered in reference to its psycho-social outcomes, which intrinsically affect the long-term post-transplant morbidity. Sense of coherence and emotional response to organ reception are important factors in this group of patients. THE AIM OF THIS STUDY: The aim of this study was to assess the contribution of sense of coherence to emotional response to transplantation in heart transplant recipients. MATERIAL AND METHODS: The study was conducted on a group of 46 heart transplant recipients. The following research tools were applied in the assessment of personal resources (sense of coherence) and emotional response to heart transplant surgery: the Sense of Coherence Questionnaire developed by Antonovsky (SOC-29) and the Transplant Effects Questionnaire (TxEQ). The data were analyzed statistically. RESULTS: Heart transplant recipients do not experience guilt toward the donors and have no difficulties in disclosing their identities as heart transplant recipients. The study reports good adherence to immunosuppressive treatment recommendations and both a moderate concern about and a sense of responsibility for the transplanted organs among the patients. Global SOC was associated with guilt toward the donor, concern about the transplanted heart, and disclosure of the recipient's identity. CONCLUSIONS: The strength of the patients' global sense of coherence is related to the level of their emotional response to the heart transplant surgery.

[Psychometric properties assessment of the Meister questionnaire (Polish version) used in evaluating mental load among nurses]. / Ocena wlasnosci psychometrycznych polskiej adaptacji kwestionariusza meistera do oceny obciazenia psychicznego w pracy pielegniarki.

BACKGROUND: The objective of this study was to assess psychometric properties of the Polish version of the Meister questionnaire for subjective assessment of work-related mental load among nurses. MATERIAL AND METHODS: A group of 211 nurses (mean age, 43.1 +/- 7.26) participated in our study. In the process of adaptation stability (test-retest) reliability and factorial validity were assessed. The Maslach Burnout Inventory (MBI) was used as a tool for assessing construct validity). RESULTS: Factor analysis of the questionnaire confirmed a very good fit between input data and factor model (Kaiser-Mayer-Olkin measure of 0.83). Selected variables, including overload, monotony, and non-specific load, explained 57%, 41%, and 66% of the variance, respectively. The analysis proved high validity of the tool, Cronbach alpha was 0.83 for the total score. The correlation factor for questions and scores in subscales was high. Repeated measurements resulted in similar outcomes, which proved the stability of this measure. The analysis of construct validity showed that overload, monotony, and non-specific load presented positive correlation with emotional exhaustion and depersonalisation. Correlation between variables was moderate (rHO = 0.39-0.58; p < 0.001). 'he total score indicated the following correlations: strong positive with emotional exhaustion (rHO = 0.6, p < 0.001), negative with personal achievements, and positive and moderate with depersonalisation (rHO = -0.14; p < 0.05, rHO = 0.48; p < 0.001). CONCLUSION: The Polish version of the Meister questionnaire meets all psychometric criteria and may be used for evaluating mental load among nurses.

The role of rewards and demands in burnout among surgical nurses.

OBJECTIVE: Job rewards have both, an intrinsic and an extrinsic motivational potential, and lead to employees' development as well as help them to achieve work goals. Rewards can balance job demands and protect from burnout. Due to changes on the labour market, new studies are needed. The aim of our study was to examine the role of demands and individual rewards (and their absence) in burnout among surgical nurses. MATERIALS AND METHODS: The study was conducted in 2009 and 2010 with 263 nurses who worked in surgical wards and clinics in hospitals in Southern Poland. The hypotheses were tested by the use of measures of demands and rewards (Effort-Reward Imbalance Questionnaire by Siegrist) and burnout syndrome (Maslach Burnout Inventory). A cross-sectional, correlational study design was applied. RESULTS: Nurses experienced the largest deficiencies in salary and prestige. Exhaustion was explained by stronger demands and lack of respect (large effect). Depersonalization was explained by stronger demands, lack of respect and greater job security (medium effect). Reduced personal achievement was explained by more demands and greater job security (small effect). CONCLUSIONS: Excessive demands and lack of esteem are key reasons for burnout among surgical nurses. Job security can increase burnout when too many resources are invested and career opportunities do not appear. These results may help to improve human resource management in the healthcare sector.

Empathy and burnout among physicians of different specialities.

AIM: The aim of this study was to assess the level of empathy and burnout among physicians of different specialization, as well as to determine whether a correlation existed between the level of empathy and burnout. MATERIALS AND METHOD: Seventy-one physicians took part in the study - 25 women (35.2%) and 46 men (age between 25 to 68 years). The physicians were either employed in hospitals, outpatient clinics or university departments in Krakow. The participants were asked to fill out a personal questionnaire, the Maslach Burnout Inventory (MBI) and the Emotional Empathy Scale (EES) as well as describe four chosen tables from the Thematic Apperception Test (TAT). RESULTS: The average empathy score for the whole group was 14.3 (SD ± 6.4). The average levels of each of the burnout (according to MBI) elements for the whole group were 21.72 for emotional exhaustion, 9.62 for depersonalization and 29.07 for loss of personal accomplishment. For the whole group a negative correlation was noted between loss of personal accomplishment (according to MBI) and the level of empathy (according to EES) (r = -0.23, p <0.05). For the whole group negative correlations were noted between the level of emotional exhaustion, depersonalization and the total level of burnout (according to MBI) and the level of empathy (according to TAT) (r = -0.30, p <0.05; r = -0.39, p <0.01; p = -0.32, p <0.01 respectively). CONCLUSIONS: Concluding, medical specialists have a significantly higher level of empathy than surgeons and family physicians. It is imperative to remember that increasing depersonalization and emotional exhaustion can have a negative impact on empathy.