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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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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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Purpose: Continued cigarette smoking after a major cardiac event predicts worse health outcomes and leads to reduced participation in cardiac rehabilitation (CR). Understanding which characteristics of current smokers are associated with CR attendance and smoking cessation will help improve care for these high-risk patients. We examined whether smoking among social connections was associated with CR participation and continued smoking in cardiac patients.
Methods: Participants included 149 patients hospitalized with an acute cardiac event who self-reported smoking prior to the hospitalization and were eligible for outpatient CR. Participants completed a survey on their smoking habits prior to hospitalization and 3 mo later. Participants were dichotomized into two groups by the proportion of friends or family currently smoking ("None-Few" vs "Some-Most"). Sociodemographic, health, secondhand smoke exposure, and smoking measures were compared using t tests and χ2 tests (P < .05). ORs were calculated to compare self-reported rates of CR attendance and smoking cessation at 3-mo follow-up.
Results: Compared with the "None-Few" group, participants in the "Some-Most" group experienced more secondhand smoke exposure (P < .01) and were less likely to attend CR at follow-up (OR = 0.40; 95% CI, 0.17-0.93). Participants in the "Some-Most" group tended to be less likely to quit smoking, but this difference was not statistically significant.
Conclusion: Social environments with more smokers predicted worse outpatient CR attendance. Clinicians should consider smoking within the social network of the patient as an important potential barrier to pro-health behavior change.
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Purpose: To summarize existing evidence of parents’ barriers to seeking mental healthcare for children at risk of ADHD.
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The Role of Architectural Design in the Wellbeing of Patients Living with Rheumatic Diseases.
Hunter McKenzie
Architecture plays an important role within the health sector. Architects are given the unique task of meeting traditional architectural standards for general construction while adhering to the distinctive needs of those who will live or work there. The nuances of this task are often heightened when meeting the needs of people with physical disabilities such as Rheumatic Diseases (RD).
RD’s often involves painful joints, swelling, and inflammation. This creates challenges regarding an individual’s ability to work, manage their activities of daily living, and subsequently, maintain their overall independence. Patients living with RD can struggle with the likes of getting dressed and getting out of bed, and other tasks such as turning on a tap and opening a bottle cap. In fact, in a bulletin on musculoskeletal diseases, the World Health Organization (WHO) concluded that,
“Although fatal diseases attract much more public attention, RDs or musculoskeletal disorders are the most frequent in the world population, with undoubted repercussions on health and quality of life, causing huge load costs for health care services.”
Given that people living with RD almost always experience challenges with activities of daily living at some point, having a proper environment is critical to maintaining independence. A discordant environment can greatly impact their health and functionality. For contemporary architecture, a continued focus on the modern world without much attention to health implications can overshadow considerations for mobility and ease of living for individuals living with RD. Small environmental changes such as secure carpet edges, secure bathroom surfaces, well-placed handrails, and optimal lighting can go a long way to improve safety of the home environment. Cutting back on clutter can be useful as well; so, incorporating built-in storage would be useful. Carefully designed environments can improve the quality of life of people living with RD. Such environments can only be created if architects have the proper knowledge.
An interdisciplinary approach is required that promotes a healthy balance of environmental awareness, health, and well-being. For example, studies on the value of physical activity and home exercises emphasize the need for adequate physical space. These spaces promote a conducive environment for those with physical disabilities to perform exercises that are necessary to maintain functional independence. This design element must be taught in the architectural education system. Although architectural students are taught to consider unique needs as given by American Disability Association requirements, the needs of people living with RD are not frequently addressed in architecture schools. If such lessons are added to the curriculum, the new generation of architects may have increased awareness of the importance of providing environments in which individuals living with RD can thrive. With such training, we can ensure the creation of a supportive architectural environment that encourages safety and independence for people living with RD.
Punzi, L., Chia, M., Cipolletta, S., Dolcetti, C., Galozzi, P., Giovinazzi, O., Tonolo, S., Zava, R., & Pazzaglia, F. (2020). The role of architectural design for rheumatic patients’ wellbeing: the point of view of Environmental Psychology. Reumatismo, 72(1), 60-66. https://doi.org/10.4081/reumatismo.2020.1251
Briggs, A., Woolf, A., Dreinhöfer, K., Homb, N., Hoy, D., Kopansky-Giles, D., Akesson, K., March, L. (2018). Reducing the global burden of musculoskeletal conditions. Bulletin of the World Health Organization, 2018;96:366-368. doi: http://dx.doi.org/10.2471/BLT.17.204891
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Examining posttraumatic growth (PTG) can yield insight to constructively understand and approach trauma among nurses. Data was analyzed from 299 nursing staff on traumatic experiences and resulting PTG. Work-place trauma resulted in the lowest PTG scores among nurses should be explored.
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Mental Health & Our Environment: How the Architecture Around Us Affects Our Mental Health
Hunter McKenzie
Managing mental health problems should incorporate factors beyond medicinal approaches. Our environment plays a major role in either assisting or hindering positive mental health. As such, architects can use design and construction to build environments that convey a feeling of comfort and security. The importance of architectural design on mental health can be seen in the designs of modern mental health facilities, particularly within the psychiatric hospital system in North America.
The psychiatric hospital effectively contributed to the development of a new field of environmental psychology that focuses on the function and design of spaces to prevent mental illness and promote mental health within man-made environments. Mental health professionals began partnering with architects to address the unique challenges and needs of psychiatric hospitals that were being negatively impacted by poor patient outcomes. As a result of this partnership, psychiatric hospital architectural design began to look a bit less like a hospital and a bit more like home. This home-like environment not only promotes a patient-positive psyche and development but also humanizes the hospital environment. While maintaining safety is a top priority, the hospital design incorporates key elements of a recovery focus. This includes day rooms that look and feel like living rooms, hospital bedrooms that are styled after dormitories, and courtyards that provide an easily accessible outdoor space.
The rapidly developing world of modern medicine has concurrently made great strides. By coupling advanced therapies with required medications, more patients than ever are able to return to their homes and community to live fulfilled lives. Both patients and health professionals benefit from the new and more informed design approach for our current-day psychiatric hospitals.
Ramsden E. Designing for Mental Health: Psychiatry, Psychology and the Architectural Study Project. 2018 Oct 17. In: Kritsotaki D, Long V, Smith M, editors. Preventing Mental Illness: Past, Present, and Future [Internet]. Cham (CH): Palgrave Macmillan; 2019. Chapter 10. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538043/ DOI: 10.1007/978-3-319-98699-9_10
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Gardening as a Stress Reliever
Madelyn Strong
Today on the vlog we have Mady Strong, a nurse and gardener. She discusses how gardening provides exercise, vitamin D from the sun (which helps to absorb calcium, and aids in mental health by relieving stress), and allows for mindful time alone, which is a source of self care for many. Gardening decreases cortisol levels and boosts serotonin and dopamine which relieves stress and boosts mood. Like caring for patients as a nurse, Mady enjoys nurturing her plants from seeds to full grown. Sensory gardens are great for all people but especially helpful for those with sensory processing disorders. Mady is passionate about promoting gardening among her patients and the general public.
Chloe: Welcome to the BH WELL video blog. I'm Chloe Robertson, your host. BH WELL stands for Behavioral Health Wellness Environments for Living and Learning. Today on the blog we have with us Madelyn Strong, a recent UK College of Nursing graduate. She specializes in psychiatric nursing and has an interest in using gardening to aid patient recovery. Hi Mady.
Mady: Hi Chloe.
Mady: Yeah, as a new grad I don't have much space, so it mainly consists of potted plants. So right now, I have a garden shelf outdoors and then I have a garden shelf indoors. and I have a variety of succulents. I have indoor plants that are just tropical plants, and then I have all kinds of herbs. My next project is going to be growing pumpkins.
Mady: Yeah, so actually I'm going to talk about three different things with this.
- It might be new for this to be considered, but gardening is actually a form of exercise. It's good to get your three typical days of exercise per week, whether that be a walk outside, or on the treadmill, or any form of exercise, but gardening outdoors gives you a little boost. You can do that as your 4th and 5th day outside of exercise, something like that.
- And then it also it gives you some vitamin D. So if you're outside in a garden, you’re getting exposed to vitamin D. It helps me in particular as a nurse because I'm oftentimes lifting patients or helping them with their activities of daily living and maybe bearing some of their physical weight and so the vitamin D from the sun helps absorb calcium and helps keep my bones strong.
- And then thirdly, gardening benefits your mental health. So gardening reduces some of my stress and it allows me to just spend some mindful peaceful time with myself.
Mady: Gardening first of all decreases your cortisol (that’s your stress response) and there have been many studies, one done by NYU in their rehabilitation program, which looked at a number of people and their cortisol levels and when they had them outside gardening, it lowered those levels and helped them manage their stress. Gardening also boosts your serotonin and your dopamine, so that positive response that your body has, and helps to make you feel better.
Mady: Okay so I like to talk about this a lot just because to me it is what fuels my passion for gardening. So a lot of times I picture my seeds as my patients. Giving them all the nutrients that they need, giving them the water, and the food, and just the love and the empathy. I know that sounds funny but it is true, you know, you have to talk to your seeds and tell them that they're beautiful and growing. I do that with my patients too and I think that's probably the closest thing to magic that I'm ever going to experience in my life. So it gives me a sense of compassion and it allows me to continue my learning. So like I learn something new that I should be doing for my plants and I get to take that and watch how my plants flourish, it's like the coolest thing in the world.
Mady: So I'm not sure if you've ever heard of sensory gardens, but sensory gardens are a lot of times used for people that might be suffering from autism or people that have like traumatic brain injuries, which is an area that I love to study. So gardening can help that just by seeing new sights and sounds. People with autism, a lot of times, will have extreme reactions to new sensations and being in a sensory garden and getting to taste fresh hibiscus, or getting to smell a new smell that they've never smelled, or hearing the birds outside. All of those are really good for anyone, but especially those with sensory processing disorders.
Mady: I'm really passionate about starting this. Gardening has really just been something that I've done for myself, I've kind of tried to spread it in my inner circle and my family. But as far as my patients go, I would love to bring that to our hospitals in the area. I know Eastern State Hospital, which is a psychiatric hospital here in Lexington, has gardens and they allow patients to go out and terraces and participate in that. But I think it should be a year-round thing and I think that if I can bring some of the research that's being done all across the United States to UK that would be awesome. And hopefully spread that in our whole state of Kentucky.
Donnelly, Gloria F. PhD, RN, FAAN (2006). Therapeutic Gardening. Holistic Nursing Practice, 20.(6), 261.
Hussein, H., Abidin, N., & Omar, Z. (2016). Sensory Gardens: A multidisciplinary effort. 10.21834/AJBES.V1I1.18
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Serious complications of stroke, one of the leading causes of morbidity and mortality in the United States can be mitigated if treated in a timely manner…
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