Aims and objectives This study aimed to portray the prevalence and associated factors of psychological distress among frontline nurses during COVID-19 outbreak. Background The COVID-19 outbreak has posed great threat to public health worldwide. Nurses fighting against the epidemic on the frontline might be under great physical and psychological distress. This psychological distress was predominantly described as sleep disturbance, symptoms of anxiety and depression, post-traumatic stress, inability to make decisions and even somatic symptoms. Design Cross-sectional study. Methods Frontline nurses from designated hospitals for COVID-19 patients were invited to complete an online survey by convenience sampling, and the survey included six main sections: the General Health Questionnaire, the Perceived Social Support Scale, the Simplified Coping Style Scale, the Impact of Event Scale-Revised, socio-demographic, occupation and work history. Multiple logistic analysis was used to identify the potential risk factors of psychological distress. The study methods were compliant with the STROBE checklist. Results Of the 263 frontline nurses, 66 (25.1%) were identified as psychological distress. Multiple logistic analysis revealed that working in emergency department, concern for family, being treated differently, negative coping style and COVID-19-related stress symptom were positive related to psychological distress. Perceived more social support and effective precautionary measures were negatively associated with psychological distress. Conclusions The study demonstrated that COVID-19 had a significant psychological impact on frontline nurses. Early detection of psychological distress and supportive intervention should be taken according to the associated factors to prevent more serious psychological impact on frontline nurses. Relevance to clinical practice This study highlighted that the frontline nurses were suffering from varying degrees of psychological distress, which needed early screening and supportive intervention for preventing more serious psychological impact on frontline nurses. Beside, more specific measurement should be combined with the GHQ-12 to assess the varying degrees of psychological distress in frontline nurses.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jocn.15454

Psychological impact of COVID-19 outbreak on frontline nurses: A cross-sectional survey study.

Objectives Our aims were to assess the relationship between workplace violence, job satisfaction, burnout, organisational support and turnover intention, and to explore factors associated with turnover intention among nurses in Chinese tertiary hospitals. Methods The purposive sampling method was used to collect data from August 2016 through January 2017. A total of 1761 nurses from 9 public tertiary hospitals in 4 provinces (municipalities) located in eastern (Beijing), central (Heilongjiang, Anhui) and western (Shaanxi) regions of China completed the questionnaires (effective response rate=85.20%). A cross-sectional study was conducted using the Workplace Violence Scale, Chinese Maslach Burnout Inventory General Survey, Minnesota Job Satisfaction Questionnaire Revised Short Version, Perceived Organizational Support-Simplified Version Scale and Turnover Intention Scale. Results A total of 1216 of 1706 (69.1%) participants had high turnover intention. During the previous 12 months, the prevalence of physical violence and psychological violence towards nurses was 9.60% and 59.64%, respectively. As expected, the level of turnover intention was negatively correlated with participants’ scores on job satisfaction (r=−0.367, p Conclusions Perceived organisational support served as a mediator between workplace violence, job satisfaction, burnout and turnover intention, and it had a significantly negative impact on turnover intention. Therefore, nursing managers should understand the importance of the organisation’s support and establish a reasonable incentive system to decrease turnover intention.

https://bmjopen.bmj.com/content/bmjopen/8/6/e019525.full.pdf

Workplace violence, job satisfaction, burnout, perceived organisational support and their effects on turnover intention among Chinese nurses in tertiary hospitals: a cross-sectional study.

Background
Violence at work is one of the major concerns in health care activities. The aim of this study was to identify the prevalence of physical and non-physical violence in a general health care facility in Italy and to assess the relationship between violence and psychosocial factors, thereby providing a basis for appropriate intervention.

Violence towards health care workers in a Public Health Care Facility in Italy: a repeated cross-sectional study

Workplace violence (WPV) is a global public health problem and has caused a serious threat to the physical and mental health of healthcare workers. Moreover, WPV also has an adverse effect on the workplace behavior of healthcare workers. This study has three purposes: (1) to identify the prevalence of workplace violence against physicians; (2) to examine the association between exposure to WPV, job satisfaction, job burnout and turnover intention of Chinese physicians and (3) to verify the mediating role of social support. A cross-sectional study adopted a purposive sampling method to collect data from March 2017 through May 2017. A total of nine tertiary hospitals in four provinces, which provide healthcare from specialists in a large hospital after referral from primary and secondary care, were selected as research sites based on their geographical locations in the eastern, central and western regions of China. Descriptive analyses, a univariate analysis, a Pearson correlation, and a mediation regression analysis were used to estimate the prevalence of WPV and impact of WPV on job satisfaction, job burnout, and turnover intention. WPV was positively correlated with turnover intention (r = 0.238, P < 0.01) and job burnout (r = 0.150, P < 0.01), and was negatively associated with job satisfaction (r = − 0.228, P < 0.01) and social support (r = − 0.077, P < 0.01). Social support was a partial mediator between WPV and job satisfaction, as well as burnout and turnover intention. The results show a high prevalence of workplace violence in Chinese tertiary hospitals, which should not be ignored. The effects of social support on workplace behaviors suggest that it has practical implications for interventions to promote the stability of physicians’ teams. (Project Identification Code: HMUIRB2014005), Registered March 1, 2014.

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The impact of workplace violence on job satisfaction, job burnout, and turnover intention: the mediating role of social support

Workplace violence against healthcare professionals: A systematic review

Community health workers are the main providers of community health services in China and have been important in the process of health system reform that has been in place since 2009. Therefore, it is critical that healthcare managers and policy decision makers motivate current staff and improve their job satisfaction. This study examined workplace characteristics and their contribution to job satisfaction in community health workers in Heilongjiang Province, China. A cross-sectional survey of 448 community health workers, from three cities in Heilongjiang province, was conducted between October 1, 2012 and December 31, 2012. Multistage sampling procedures were used to measure socioeconomic and demographic status, job satisfaction, and both actual and desired workplace characteristics. Factor analysis was conducted to determine the main factors contributing to workplace characteristics, and multiple linear regression analysis was performed to assess the key determinants of job satisfaction. Eight groups of factors were identified as the most important workplace characteristics. These comprised system and policy; fringe benefits; work itself; work relationships; professional development; recognition; work environment; and remuneration. In all cases, all desired workplace characteristics were higher than the associated actual workplace characteristics. The main determinants of job satisfaction were occupation, years worked in health service institution, and five subscales representing the gap between desired and actual workplace characteristics, which were system and policy; fringe benefits; working relationship; professional development; and remuneration. These findings suggested that managers wishing to enhance job satisfaction should assess workplace characteristics comprehensively and design mechanisms that reduce the gap between actual and desired workplace characteristics.

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Relationships between actual and desired workplace characteristics and job satisfaction for community health workers in China: a cross-sectional study.

Objective Hospital workplace violence is one of the most frequently reported types of workplace violence in the world, and it harms the mental and physical health of medical staff. Existing research on workplace violence focused more on cross-sectional studies, than longitudinal studies. Therefore, this study examined the dynamic impact of hospital workplace violence on the mental health of medical staff, with the aim of providing appropriate countermeasures and suggestions for hospitals to develop targeted psychological intervention measures in time for medical staff who experience workplace violence. Design A prospective cohort study. Participants A total of 112 medical staff who had experienced workplace violence in the hospital for the first time were chosen. Setting An unconditional latent variable growth curve model was established based on the average value of the general health scale scores of medical staff, and gender and violence types (intimidation threats, physical violence) as control variables. Each medical staff was assessed for depression and anxiety at 4 different time points and the changes in the trajectories was observed. Results There were significant differences in the incidence of mental health and anxiety among medical staff at different observation times. There were significant individual differences in the initial mental health status, growth rate of anxiety and depression of medical staff. Conclusions Hospitals should undertake various psychological intervention strategies based on the staff's mental health to safeguard those who have experienced workplace violence.

Mental Health Status of Medical Staff Exposed to Hospital Workplace Violence: A Prospective Cohort Study

Objective Recently, Chinese ministries and commissions have issued a series of policies and systems in response to violent injuries to doctors, physical violence have been managed to a certain extent. However, verbal violence has not been deterred and is still prevalent, it has not received appropriate attention. This study thus aimed to assess the impact of verbal violence on the organisational level and identify its risk factors among healthcare workers, so as to provide practical methods for verbal violence reduction and treatment of the complete period. Methods Six tertiary public hospitals were selected in three provinces (cities) in China. After excluding physical and sexual violence, a total of 1567 remaining samples were included in this study. Descriptive, univariate, Pearson correlation and mediated regression analyses were employed to assess the difference between the variables, emotional responses of healthcare workers to verbal violence and the relationship between verbal violence and emotional exhaustion, job satisfaction, and work engagement. Results Nearly half of the healthcare workers in China’s tertiary public hospitals experienced verbal violence last year. Healthcare workers who experienced verbal violence had strong emotional response. The exposure of healthcare workers to verbal violence significantly positively predicted the emotional exhaustion (r=0.20, p<0.01), significantly negatively predicted job satisfaction (r=−0.17, p<0.01) and work engagement (r=−0.18, p<0.01), but was not associated with turnover intention. Emotional exhaustion partially mediated the effects of verbal violence on job satisfaction and work engagement. Conclusions The results indicate that the incidence of workplace verbal violence in tertiary public hospitals in China is high and cannot be ignored. This study is to demonstrate the organisational-level impact of verbal violence experienced by healthcare workers and to propose training solutions to help healthcare workers reduce the frequency and mitigate the impact of verbal violence.

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Effects of verbal violence on job satisfaction, work engagement and the mediating role of emotional exhaustion among healthcare workers: a cross-sectional survey conducted in Chinese tertiary public hospitals

There is well-established evidence to understand the characteristics of falls among the older patients with hip fracture in many countries, but very little knowledge existed in China. This study described the characteristics of falls in older patients with hip fractures from six Chinese hospitals.This cross-sectional study is a post-hoc descriptive analysis of a recently completed trial. Eligible patients were aged 65 years and older, with confirmed hip fractures due to falls, and were admitted to the hospital within 21 days of the fracture. All patients were consecutively enrolled and screened within one year (November 15, 2018, to November 14, 2019). The collected data included patient demographics and fall-related information.A total of 1,892 patients' fall-related information were described. Most patients with hip fractures caused by falls were in the oldest old age group (60.4% in age group ≥ 80), with an overall average age of 80.7 (7.6) years. There were more females (n = 1,325, 70.0%) than males (n = 567, 30.0%). The majority lived in urban (n = 1,409, 74.5%). Most falls (n = 1,237, 67.3%) occurred during the daytime (6:01-18:00). There were 1,451 patients had their falls occurring at home (76.7%). Lost balance (n = 1,031, 54.5%) was reported as the primary reason to cause falls. The most common activity during a fall was walking (n = 1,079, 57.0%).Although the incidence of fall-related hip fractures in China is unclear, preventing falls and fall-related hip fractures in older people remains an urgent health concern as the ageing society increases. Studies with larger sample size and diverse population are needed to robustly understand this growing epidemic. 

/pdf/characteristics-of-falls-among-older-hip-fracture-patients-26l5qlyv.pdf

Xinyan Liu

Papers

Relationships between actual and desired workplace characteristics and job satisfaction for community health workers in China: a cross-sectional study.

Mental Health Status of Medical Staff Exposed to Hospital Workplace Violence: A Prospective Cohort Study

Effects of verbal violence on job satisfaction, work engagement and the mediating role of emotional exhaustion among healthcare workers: a cross-sectional survey conducted in Chinese tertiary public hospitals

Characteristics of falls among older hip fracture patients from six Chinese hospitals: a post-hoc descriptive analysis