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      Understanding the role of COVID‐19–related workplace stress and institutional betrayal on mental health in nurses: Some heroes wear scrubs

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          Abstract

          This study examined the association of three specific COVID‐19–related workplace stressors (percentage of nursing work with COVID‐positive [COVID+] patients, number of COVID‐19–related patient deaths witnessed, and living separately from family for safety) and their associations with posttraumatic stress symptoms (PTSS) and symptoms of major depressive disorder (MDD) and generalized anxiety disorder (GAD) among 391 nurses (93.6% White, 93.4% utilize she/her pronouns). Cross‐sectional data were collected via an online survey. Institutional betrayal (i.e., the perception that an institution failed to protect a member who depends on and trusts it) was examined as a moderator of these associations. Although institutional betrayal was not a significant moderator in the three individual models, it held small‐to‐medium–sized positive main effects with PTSS and symptoms of GAD and MDD in both the individual and combined models. In the individual models, the percentage of nursing work with COVID+ patients was significantly positively associated with all three mental health conditions, f 2 = .019–.195, whereas it only showed a significant effect with PTSS in the combined model, f 2 = .138. Living separately from family was significantly positively associated with PTSS and MDD symptoms in both the individual, f 2 = .037 and .015, respectively, and combined models, f 2 = .025 and .013, respectively. Number of patient deaths held a significant positive association with PTSS alone, f 2 = .022, in the individual model only. The findings are discussed in light of ways in which health care settings can better support and prioritize mental health among nursing staff.

          抽象

          Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies

          (AsianSTSS)

          簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯

          Traditional Chinese

          了解與新冠肺炎相關的工作壓力和製度

          對護士心理健康的影響:身穿手術服

          摘要

          本研究調查了391名護士(93.6%白人, 93.4%使用她/她的代詞)中三種特定的與新冠肺炎相關的工作場所壓力源(與新冠肺炎陽性[COVID+]臨床治療者的護理工作百分比, 目睹的新冠肺炎相關臨床治療者死亡人數, 以及為了安全而與家人分開居住)及其與創傷後壓力症(PTSS)、重度抑鬱症(MDD)和廣泛性焦慮症(GAD)症狀的關聯。橫斷面數據通過在線調查收集。制度背叛(即, 機構未能保護依賴和信任它的成員的看法)作為這些協會的調節因素進行了研究。雖然制度背叛在三個個體模型中不是顯著的調節因子, 但在個體模型和組合模型中, 它對創傷後壓力症和廣泛性焦慮症和重度抑鬱症症狀都有中小程度的正主效應。在個體模型中, 新冠肺炎陽性臨床治療者的護理工作百分比與所有三種心理健康狀況均顯著正相關, f2 = 0.019 ‐。 195, 而在聯合模型中, 僅與創傷後壓力症有顯著影響, f2 = .138。與家庭分離與創傷後壓力症和重度抑鬱症症狀均呈顯著正相關, 分別為f2 = 0.037和0.015, 與組合模型, 分別為f2 = 0.025和0.013。僅在個體模型中, 臨床治療者死亡人數與PTSS單獨存在顯著正相關, f2 = 0.022。根據衛生保健機構如何更好地支持和優先考慮護理人員的心理健康討論這些發現。

          Simplified Chinese

          了解与新冠肺炎相关的工作压力和制度

          对护士心理健康的影响:身穿手术服

          摘要

          本研究调查了391名护士(93.6%白人, 93.4%使用她/她的代词)中三种特定的与新冠肺炎相关的工作场所压力源(与新冠肺炎阳性[COVID+]临床治疗者的护理工作百分比, 目睹的新冠肺炎相关临床治疗者死亡人数, 以及为了安全而与家人分开居住)及其与创伤后压力症(PTSS)、重度抑郁症(MDD)和广泛性焦虑症(GAD)症状的关联。横断面数据通过在线调查收集。制度背叛(即, 机构未能保护依赖和信任它的成员的看法)作为这些协会的调节因素进行了研究。虽然制度背叛在三个个体模型中不是显著的调节因子, 但在个体模型和组合模型中, 它对创伤后压力症和广泛性焦虑症和重度抑郁症症状都有中小程度的正主效应。在个体模型中, 新冠肺炎阳性临床治疗者的护理工作百分比与所有三种心理健康状况均显著正相关, f2 = 0.019 ‐。 195, 而在联合模型中, 仅与创伤后压力症有显著影响, f2 = .138。与家庭分离与创伤后压力症和重度抑郁症症状均呈显著正相关, 分别为f2 = 0.037和0.015, 与组合模型, 分别为f2 = 0.025和0.013。仅在个体模型中, 临床治疗者死亡人数与PTSS单独存在显著正相关, f2 = 0.022。根据卫生保健机构如何更好地支持和优先考虑护理人员的心理健康讨论这些发现。

          Resumen

          JOTS‐22‐0325.R4 sp/abs

          Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET)

          Entendiendo el papel del estrés relacionado con COVID‐19 en el lugar de trabajo y la traición institucional en la salud mental de los enfermeros: Algunos héroes usan uniformes médicos

          SALUD MENTAL EN ENFERMEROS DURANTE COVID‐19

          Este estudio examinó la asociación de tres factores estresantes específicos relacionados con COVID‐19 en el lugar de trabajo (porcentaje de trabajo de enfermería con pacientes con COVID positivo [COVID+], número de muertes de pacientes relacionadas con COVID‐19 presenciadas, y vivir separado de la familia por seguridad) y sus asociaciones con los síntomas de estrés postraumático (SEPT) y los síntomas de trastorno depresivo mayor (MDD en su sigla en inglés) y trastorno de ansiedad generalizada (GAD en su sigla en inglés) en 391 enfermeros (93,6% caucásicos, 93,4% utiliza pronombre ella). Los datos transversales se recopilaron mediante una encuesta en línea. La traición institucional (es decir, la percepción de que una institución no protegió a un miembro que depende y confía en ésta) fue examinada como moderadora de estas asociaciones. Aunque la traición institucional no fue moderador significativo en los tres modelos individuales, tuvo efectos principales positivos de tamaño pequeño a mediano con los SEPT y los síntomas de GAD y MDD tanto en el modelo individual como en el combinado. En los modelos individuales, el porcentaje de trabajo de enfermería con pacientes COVID+ se asoció significativamente de manera positiva con las tres condiciones de salud mental, f 2 = .019–.195, mientras que solo mostró un efecto significativo con SEPT en el modelo combinado, f 2 = .138. Vivir separado de la familia se asoció significativamente de forma positiva con los síntomas de SEPT y MDD tanto en el modelo individual, f 2 = .037 y .015, respectivamente, como en el modelo combinado, f 2 = .025 y .013, respectivamente. El número de muertes de pacientes mantuvo una asociación positiva significativa con SEPT solo, f 2 = .022, únicamente en el modelo individual. Los hallazgos se discuten a la luz de las formas en que los entornos de atención médica pueden apoyar y priorizar mejor la salud mental entre el personal de enfermería.

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          Most cited references34

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          Diagnostic and Statistical Manual of Mental Disorders

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            A brief measure for assessing generalized anxiety disorder: the GAD-7.

            Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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              The PHQ-9

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                Author and article information

                Contributors
                (View ORCID Profile)
                Journal
                Journal of Traumatic Stress
                Journal of Traumatic Stress
                Wiley
                0894-9867
                1573-6598
                April 2023
                March 14 2023
                April 2023
                : 36
                : 2
                : 421-432
                Affiliations
                [1 ] Department of Psychology The University of Memphis Memphis Tennessee USA
                [2 ] Center for Anxiety & Related Disorders Department of Psychological and Brain Sciences Boston University Boston Massachusetts USA
                Article
                10.1002/jts.22920
                36917155
                346e370a-7677-45c9-9c5e-6600b980bb7e
                © 2023

                http://onlinelibrary.wiley.com/termsAndConditions#vor

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