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Background: Although the nursing staff is fundamental in assisting individuals with mental illnesses (MI) to stop tobacco use, they often have mixed feelings about providing tobacco treatment (TT) services to people with MI in inpatient psychiatric settings.
Objective: Therefore, this study aimed to understand factors associated with nursing staff’s intentions to provide TT interventions for individuals diagnosed with MI in a psychiatric facility using the constructs of the theory of planned behavior (TPB).
Method: Secondary data analysis was performed using cross-sectional data collected from 98 nursing staff who worked in a state inpatient psychiatric facility. A 15-item questionnaire was used to assess nursing staff intentions to provide TT services based on TPB constructs, including attitudes (four items), subjective norms (four items), perceived behavioral controls (four items), and intentions (three items) toward providing TT. The mean scores of each subscale ranged from 1 to 7. A logistic regression analysis was used to examine the relationship between TBP constructs and nursing staff intentions to provide TT for people with MI.
Results: Nursing staff had an acceptable mean score in the intentions subscale (4.34 ± 2.01). Only two constructs of TPB explained nursing staff intentions to provide TT: subjective norms (OR = 2.14, 95% CI [1.46, 3.13]) and perceived behavioral control (OR = 2.33, 95% CI [1.32, 4.12]).
Conclusions: The constructs of the TPB, the subjective norms, and the perceived behavior control were able to predict nurses’ intentions to provide TT for inpatients in a psychiatric setting. Accordingly, we suggest implementing policies that make TT a normative practice while supporting the confidence and competence of nurses to deliver TT in psychiatric facilities.
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People with psychiatric disorders (PDs) are disproportionately affected by tobacco use and its associated harms. Although several unique risk factors are known for this population, few studies have examined differences based on urban or rural residence.
Objectives:
We aim to examine factors associated with tobacco use and consumption among rural and urban patients with PDs.
Methods:
This is a retrospective correlational study using clinical data of 2,060 patients admitted to a government inpatient psychiatric facility between January 1, 2016 and December 31, 2016. Information was obtained on demographics, rurality status, smoke free policy status, substance use history, psychiatric diagnosis, and history of tobacco use. Logistic and multilinear regression analyses were performed to examine factors associated with tobacco use and consumption, stratified by urban and rural status.
Results:
Tobacco users were significantly more likely to reside in rural as compared to urban settings (67.2% vs. 58.8%; p<0.001). Factors significantly associated with tobacco use among the urban population were male sex, history of substance use and treatment, and externalizing disorder. Among the rural population, history of substance use and treatment, less than high school education, decreasing age, and shorter length of hospital stay increased the risk of tobacco use. White, less than high school education, and psychotic disorder were significantly correlated with greater tobacco consumption in the urban population. For the rural population, male and less than high school education were positively associated with increased tobacco consumption.
Conclusions:
Although rural patients with PDs are more likely to use tobacco, they face similar risk factors as compared to their urban counterparts. This suggests the need to increase access to treatment for rural individuals with PDs to reduce such disproportionate tobacco use prevalence and related disease risk.
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People with psychiatric disorders (PDs) have high risks for tobacco use and associated health effects; however, little is known about differences in tobacco use status and consumption by urban or rural residence. Among patients with PDs, we examined the association of smoke-free policy on tobacco use by rural/urban residence METHOD: A cross-sectional retrospective study (N = 2060) among patients in a psychiatric facility was conducted. Multi-logistic and multilinear regression analyses assessed differences in outcomes stratified by rural/urban status.
Results: Among rural residents, a substance use history (odds ratios [ORs[ = 2.82, 95% CI: 2.01-3.96), high school education (OR = 0.71, 95% CI: 0.51-0.98), older age (OR = 0.99, 95% CI: 0.98-1.00), and longer length of hospital stay (OR = 0.99, 95% CI: 0.98-1.00) were associated with tobacco use. Among urban residents, male sex (OR = 1.38, 95% CI: 1.02-1.86), a substance use history (OR = 2.61, 95% CI: 1.86-3.66), and externalizing disorder diagnosis (OR = 2.72, 95% CI: 1.35-5.48) correlated with tobacco use. Increased tobacco consumption among rural residents was associated with being male (β = 0.12, p = 0.007) and having less than a high school education (β = 0.14, P = 0.001). Whereas, White ethnicity (β = 0.14, p = 0.006), having less than a high school education (β = 0.11, p = 0.022), and a psychotic disorder diagnosis (β = 0.25, p = 0.038) were associated with greater tobacco consumption in urban residents. Smoke-free policy was not associated with tobacco use (OR = 1.08, 95% CI: 0.87-1.34) and consumption (β = 0.05, p = 0.134).
Conclusions: Despite higher rates of tobacco use among rural patients with PDs, they have similar risk factors as their urban counterparts. However, residing in a location with a smoke-free policy may not contribute to tobacco use behaviors among those with PDs.
Keywords: psychiatric disorder; rurality; smoke-free policy; tobacco consumption; tobacco use.
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Compassion fatigue is a consequence of chronic work-related stress exposure among healthcare providers. Nursing is a high-risk, stressful profession which increases nurses’ vulnerability to compassion fatigue symptoms compared to other healthcare workers. Compassion fatigue has serious consequences for nursing staff, patients and healthcare organizations. Though several studies on the prevalence of compassion fatigue among nurses have been published, the reported data vary considerably across studies; and few meta-analysis have examined the prevalence of compassion satisfaction and compassion fatigue among nurses with large sample sizes.
Objectives: To systematically assess the prevalence of compassion satisfaction and compassion fatigue among nurses, and to evaluate the effect of different geographical regions, years and departments on the prevalence of compassion fatigue.
Design: Systematic review and meta-analysis DATA SOURCES: The Cochrane Library, PubMed, EMbase, Web of Science, CINAHL, PsyclNFO, China Knowledge Resource Integrated Database (CNKI), Wanfang Database, Weipu Database (VIP), and Chinese Biomedical Database (CBM) were searched in the systematic review. The time frame for the searches included all literature before January 31st, 2020.
Review methods: The reviewers independently completed study selection, quality assessments, data extraction and analysis of all included literature. The mean scores and standard deviations of the three subscales of the Professional Quality of Life (ProQOL) scale were pooled using random effects meta-analysis in Stata 16.0 software package. Finally, subgroup analyses were conducted to explore the sources of between-study heterogeneity.
Results: A total of 79 studies were included in the systematic review and meta-analysis, consisting of 28,509 nurses worldwide from 11 countries. In our studies, the pooled mean scores of compassion satisfaction, burnout and secondary traumatic stress were 33.12 (95% CI: 32.22-34.03), 26.64 (95% CI: 26.01-27.27) and 25.24 (95% CI: 24.69-25.79), respectively. In addition, the Asian region had the lowest levels of compassion satisfaction but the highest levels of compassion fatigue symptoms, while the Americas and Europe had the lowest levels of compassion fatigue but highest compassion satisfaction. Levels of compassionate fatigue in nurses increased gradually from 2010 to 2019, reaching the highest level in 2019; and nurses from ICU had the highest levels of compassion fatigue symptoms among all nurses.
Conclusion: The levels of compassion satisfaction and compassion fatigue among nurses are moderate. Nurses from the Asian region and in ICUs suffer from severe compassion fatigue symptoms, and the prevalence of compassion fatigue has increased over time. These findings may provide hospital administrators with the theoretical basis for the management and treatment of compassion fatigue.
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Compassion fatigue has emerged as a detrimental consequence of experiencing work-related stress among psychiatric nurses, and affected the job performance, emotional and physical health of psychiatric nurses. However, researches on Chinese psychiatric nurses' compassion fatigue are dearth. This cross-sectional study aimed to investigate the prevalence and factors of compassion fatigue among Chinese psychiatric nurses.All participants completed the demographic questionnaire and the Chinese version of Professional Quality of Life Scale (ProQOL-CN). One-way ANOVA, t-tests, Levene test and multiple linear regression analysis were conducted to evaluate factors associated with compassion fatigue.A total of 352 psychiatric nurses in 9 psychiatric hospitals from the Chengdu, Wuhan, and Hefei were surveyed. The mean scores of compassion satisfaction, burnout and secondary traumatic stress were 32.59 ± 7.124, 26.92 ± 6.003 and 25.97 ± 5.365, respectively. Four variables of job satisfaction, exercise, had children, and age range from 36 to 50 years explained 30.7% of the variance in compassion satisfaction. Job satisfaction, sleeping quality, and marital status accounted for 40.4% variables in burnout. Furthermore, job satisfaction, average sleeping quality, and years of nursing experience remained significantly associated with secondary trauma stress, explaining 10.9% of the variance.Compassion satisfaction, burnout and secondary traumatic stress among Chinese psychiatric nurses were at the level of moderate. The higher job satisfaction, healthy lifestyle (high sleep quality and regular exercise), and family support (children, stable and harmonious marital status) positively influenced compassion satisfaction and negatively associated with burnout or secondary traumatic stress.
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People with mental illness (MI) have a disproportionate tobacco-related disease burden and mortality. Tobacco-use rates in people with MI are nearly twice that of the general population. Reasons for tobacco-use in this population may be a result of diminished tobacco-related disease risk perceptions. The purpose of this study was to examine the reasons for tobacco-use and perceived tobacco-related health risks among psychiatric inpatients. A correlational design was employed to survey a convenient sample of 137 patients from a psychiatric facility in central Kentucky. Information obtained from participants included demographics, psychiatric diagnoses, tobacco-use and exposure history, medical illness history, reasons for tobacco-use, and tobacco-related illness risk perceptions. The primary reasons participants endorsed for tobacco-use were for stress reduction, followed by addiction, then boredom, psychiatric symptom control, social, and negative mood. In addition, about 72% of participants used tobacco to cope with MI symptoms and 52% to manage the side effects of their medications. Participants were most likely to endorse that tobacco-use caused lung disease (83.2%), heart disease (79.6%), cancer (77.4%), and premature mortality (79.6%) but were less likely to admit that it may cause addiction to other drugs (39.4%) or MI (23.4%). Given the high endorsement of tobacco-use for stress reduction and psychiatric symptom control, it is important for mental health nurses to properly educate consumers on tobacco addiction and evidence of its effects on mental health. Strategies to incorporate our study findings into routine mental health services may address the tobacco-use disparities experienced by people with MI.
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Background: Compassion fatigue is a work-related professional hazard acquired when providing healthcare for patients. This hazard can lead to physical and mental health problems for nurses and may also affect the nursing care quality for patients. However, studies on Chinese nurses’ compassion fatigue are scarce, especially large sampled, multi-center empirical research.
Objectives: The goal of this study was to assess the prevalence of compassion fatigue among Chinese nurses, and to explore the factors associated with compassion satisfaction, burnout and second traumatic stress.
Design: A cross-sectional design with a convenience sample.
Settings: Participants were recruited from 11 tertiary hospitals in western (Chengdu, Chongqing), eastern (Hefei), southern (Shenzhen) and central China (Wuhan, Huangshi).
Participants: A total of 1044 registered nurses from different nursing departments were surveyed.
Methods: Demographic, work-related information, lifestyle questionnaire and the Professional Quality of Life Scale were used in this study. Descriptive statistics, t-tests, one-way analysis of variance, and Pearson or Spearman's correlation analyses were used to compare the differences and examine the relationships between participants’ demographic and work-related variables and compassion satisfaction, burnout and secondary traumatic stress. Multiple linear regression models were performed to identify salient variables associated with compassion satisfaction, burnout and secondary traumatic stress from among demographic and work-related factors.
Results: The mean scores for the dimensions of compassion satisfaction, burnout and secondary traumatic stress were 32.63±6.46, 27.36±5.29, and 26.88±5.13, respectively. The age of 36 or higher, being married, higher job satisfaction, good sleep quality and regular exercise were positively associated with compassion satisfaction, while smoking was a negative factor; these five factors explained 25.7% of the total variance. The average number of hours worked per day was a positive factor for burnout, while being married/member of an unmarried couple, job satisfaction, sleep hours per day and sleep quality were negative factors of burnout, explaining 38.8% of the total variance. In addition, we also found that four factors, poor sleep quality, low job satisfaction, more work hours, and second-hand smoke exposure were related to secondary traumatic stress, explaining 9% of the variance.
Conclusions: Our findings reveal a serious phenomenon of the poor professional quality of life among Chinese nurses. The results may provide clues to help nursing managers identify nurses’ vulnerability to compassion fatigue and implement targeted strategies to reduce nurses’ burnout and secondary traumatic stress, while supporting compassion satisfaction.
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Compassion satisfaction (CS) among healthcare professionals is a sense of gratification derived from caring for their suffering patients. In contrast, compassion fatigue, often a consequence of burnout (BO) and secondary traumatic stress (STS), is detrimental to healthcare professionals’ productivity and patient care. While several studies have examined CS, BO, and STS among healthcare professionals, the majority have assessed samples in specific disciplines. However, the comparative differences in these factors by discipline or work setting are not well known. The aims of this study were to examine the differences in CS, BO, and STS by discipline and work setting, and to assess demographic, work-related, and behavioural factors associated with these outcomes. An electronic survey was administered (N = 764) at a large academic medical centre in the southeast United States. Questions elicited demographic variables, work-related factors, behavioural/lifestyle factors, experience with workplace violence, and the Professional Quality of Life Scale. Findings of the study determined that the rates of CS, BO, and STS vary across healthcare disciplines and work settings. Demographic, work-related, behavioural, and work setting (i.e., experience of workplace violence) factors were differentially associated with experiences of CS, BO, and STS. The results of the study suggest two potential areas for research, specifically workplace violence and sleep quality as a means of further understanding reduced CS and increased BO and STS among healthcare workers. These findings have important implications for future research and policy interventions to enhance healthcare workers’ health and safety.
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Background and Objectives: Approximately 65% of psychiatric inpatients experience moderate-to-severe nicotine withdrawal (NW), a set of symptoms appearing within 24 hr after an abrupt cessation or reduction of use of tobacco-containing products in those using nicotine daily for at least a couple of weeks. The Minnesota Tobacco Withdrawal Scale (MTWS) is a widely used instrument for detecting NW. However, the psychometric properties of the MTWS have not previously been examined among patients with serious mental illness (SMI) undergoing tobacco-free hospitalization. The objective of this study was to examine the validity and reliability of the MTWS among patients with SMI during tobacco-free psychiatric hospitalization.
Methods: Reliability was tested by examining Cronbach’s α and item analysis. Validity was examined through hypothesis testing and exploratory factor analysis (N = 255).
Results: The reliability analysis yielded a Cronbach’s α coefficient of .763, an inter-item correlations coefficient of .393, and item-total correlations between .291 and .691. Hypothesis testing confirmed the construct validity of the MTWS, and an exploratory factor analysis yielded a unidimensional scale.
Conclusion: The MTWS demonstrated adequate reliable and valid psychometric properties for measuring NW among patients with SMI. Nurses and other healthcare professionals may use this instrument in clinical practice to identify patients with SMI experiencing NW. The MTWS is psychometrically sound for capturing NW during tobacco-free psychiatric hospitalization. Future research should examine the efficacy of the MTWS in measuring NW in this population over an extended period of hospitalization.
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Background: The nurse workforce shortage, partially caused by high work turnover, is an essential factor influencing the quality of patient care. Because previous studies concerning Chinese nurse work turnover were predominantly quantitative, they lacked insight into the challenges nurses face as they transition from university to their careers. A successful transition can result in new nurses’ commitment to their careers. As such, this study sought to understand how new nurses commit to the career and focused on identifying facilitators and barriers to such commitment.
Methods: This was a qualitative study using a grounded theory design. Through purposive sampling, clinical nurses were recruited from hospitals in Western China to participate in semi-structured interviews. The data was analyzed through coding to develop categories and themes.
Results: Theoretical saturation was achieved after interviewing 25 participants. The data revealed the ‘zigzag journey’ of committing to the nursing career. The emerging core theme was “getting settled”, indicating that new nurses needed to acclimate to the work reality in the nursing career. By analyzing the data provided by the participants, the researchers concluded that the journey to getting settled in nursing compassed four stages:1) “sailing out with mixed feelings”, 2) “contemplating to leave”, 3) “struggling to stay”, and 4) “accepting the role”. For most participants, nursing was described as a way to earn a living for their family, not as a career they felt passionate about.
Conclusions: Committing to a nursing career is a complicated long-term process. There seems to be a lack of passion for nursing among the Chinese clinical nurses participating in this study. Thus, the nurses may need continued support at different career stages to enhance their ability to remain a nurse for more than economic reasons.
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