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      Influence of caring for COVID‐19 patients on nurse's turnover, work satisfaction and quality of care

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          Abstract

          Aim

          This study aims to examine, through the lens of the Job Demands‐Resources model, the influence of caring for COVID‐19 patients on nurse's perception of chronic fatigue, quality of care, satisfaction at work and intention to leave their organisation and the profession.

          Background

          Studies have examined how fear of COVID‐19 contributes to the mental, physical and work adjustment among nurses. To date, few studies have been conducted examining how caring for patients with COVID‐19 contributes to work outcomes among nurses.

          Methods

          This is a cross‐sectional survey involving 1705 frontline nurses and licensed practical nurses in Quebec, Canada. From these, 782 reported caring for COVID‐19 patients.

          Results

          High chronic fatigue, poor quality of care, lower work satisfaction and higher intention to leave their organisation were found for nurses caring for COVID‐19 patients. Poorly prepared and overwhelmed nurses showed higher turnover intention than those well prepared and in control.

          Conclusions

          There is an urgent need to provide support to nurses during the pandemic, with a long‐term strategy to increase their retention.

          Implications for Nursing Management

          Nurse administrators play an important role in supporting their nurses during a pandemic in the form of education, training and policy development to positively impact quality of care and retention.

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          Most cited references51

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          Statistical notes for clinical researchers: assessing normal distribution (2) using skewness and kurtosis

          As discussed in the previous statistical notes, although many statistical methods have been proposed to test normality of data in various ways, there is no current gold standard method. The eyeball test may be useful for medium to large sized (e.g., n > 50) samples, however may not useful for small samples. The formal normality tests including Shapiro-Wilk test and Kolmogorov-Smirnov test may be used from small to medium sized samples (e.g., n 2.1 Kurtosis is a measure of the peakedness of a distribution. The original kurtosis value is sometimes called kurtosis (proper) and West et al. (1996) proposed a reference of substantial departure from normality as an absolute kurtosis (proper) value > 7.1 For some practical reasons, most statistical packages such as SPSS provide 'excess' kurtosis obtained by subtracting 3 from the kurtosis (proper). The excess kurtosis should be zero for a perfectly normal distribution. Distributions with positive excess kurtosis are called leptokurtic distribution meaning high peak, and distributions with negative excess kurtosis are called platykurtic distribution meaning flat-topped curve. 2) Normality test using skewness and kurtosis A z-test is applied for normality test using skewness and kurtosis. A z-score could be obtained by dividing the skew values or excess kurtosis by their standard errors. As the standard errors get smaller when the sample size increases, z-tests under null hypothesis of normal distribution tend to be easily rejected in large samples with distribution which may not substantially differ from normality, while in small samples null hypothesis of normality tends to be more easily accepted than necessary. Therefore, critical values for rejecting the null hypothesis need to be different according to the sample size as follows: For small samples (n < 50), if absolute z-scores for either skewness or kurtosis are larger than 1.96, which corresponds with a alpha level 0.05, then reject the null hypothesis and conclude the distribution of the sample is non-normal. For medium-sized samples (50 < n < 300), reject the null hypothesis at absolute z-value over 3.29, which corresponds with a alpha level 0.05, and conclude the distribution of the sample is non-normal. For sample sizes greater than 300, depend on the histograms and the absolute values of skewness and kurtosis without considering z-values. Either an absolute skew value larger than 2 or an absolute kurtosis (proper) larger than 7 may be used as reference values for determining substantial non-normality. Referring to Table 1 and Figure 1, we could conclude all the data seem to satisfy the assumption of normality despite that the histogram of the smallest-sized sample doesn't appear as a symmetrical bell shape and the formal normality tests for the largest-sized sample were rejected against the normality null hypothesis. 3) How strict is the assumption of normality? Though the humble t test (assuming equal variances) and analysis of variance (ANOVA) with balanced sample sizes are said to be 'robust' to moderate departure from normality, generally it is not preferable to rely on the feature and to omit data evaluation procedure. A combination of visual inspection, assessment using skewness and kurtosis, and formal normality tests can be used to assess whether assumption of normality is acceptable or not. When we consider the data show substantial departure from normality, we may either transform the data, e.g., transformation by taking logarithms, or select a nonparametric method such that normality assumption is not required.
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            Mental health problems faced by healthcare workers due to the COVID-19 pandemic- a review

            Highlights • The current review was done to conduct systematic appraisal of studies conducted on Mental health problems faced by healthcare workers due to the COVID-19 pandemic. • Out of 23 articles selected by initial screening 6 original articles were included in the final review. • Review of all the 6 articles showed that several socio-demographic variables like gender, profession, age, place of work, department of work and certain psychological variables like poor social support, self-efficacy were found to be associated with increased reporting of stress, anxiety, depressive symptoms, insomnia in HCW. • There is increasing evidence which suggests that COVID-19 can be an independent risk factor for stress in HCW.
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              COVID‐19 anxiety among frontline nurses: predictive role of organisational support, personal resilience and social support

              Abstract Aim This study examines the relative influence of personal resilience, social support and organisational support in reducing COVID‐19 anxiety in frontline nurses. Background Anxiety related to the COVID‐19 pandemic is prevalent in the nursing workforce, potentially affecting nurses’ well‐being and work performance. Identifying factors that could help maintain mental health and reduce coronavirus‐related anxiety among frontline nurses is imperative. Currently, no studies have been conducted examining the influence of personal resilience, social support and organisational support in reducing COVID‐19 anxiety among nurses. Methods This cross‐sectional study involved 325 registered nurses from the Philippines using four standardised scales. Results Of the 325 nurses in the study, 123 (37.8%) were found to have dysfunctional levels of anxiety. Using multiple linear regression analyses, social support (β = ‐0.142, p = 0.011), personal resilience (β = ‐0.151, p = 0.008) and organisational support (β = ‐0.127, p = 0.023) predicted COVID‐19 anxiety. Nurse characteristics were not associated with COVID‐19 anxiety. Conclusions Resilient nurses and those who perceived higher organisational and social support were more likely to report lower anxiety related to COVID‐19. Implication for Nursing Management COVID‐19 anxiety may be addressed through organisational interventions, including increasing social support, assuring adequate organisational support, providing psychological and mental support services and providing resilience‐promoting and stress management interventions.
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                Author and article information

                Contributors
                Role: Associate Professormelanie.lavoie-tremblay@mcgill.ca
                Role: Full Professor
                Role: Research Assistant
                Role: Associate Professor
                Role: Full Professor
                Role: Full Professor
                Role: Full Professor
                Journal
                J Nurs Manag
                J Nurs Manag
                10.1111/(ISSN)1365-2834
                JONM
                Journal of Nursing Management
                John Wiley and Sons Inc. (Hoboken )
                0966-0429
                1365-2834
                16 September 2021
                16 September 2021
                : 10.1111/jonm.13462
                Affiliations
                [ 1 ] Ingram School of Nursing McGill University Montréal Quebec Canada
                [ 2 ] Nursing Department University of Quebec in Outaouais Gatineau Quebec Canada
                [ 3 ] Nursing School University of Sherbrooke Sherbrooke Quebec Canada
                [ 4 ] Faculty of Nursing Laval University Quebec Quebec Canada
                [ 5 ] Faculty of Nursing Montreal University Montréal Quebec Canada
                Author notes
                [*] [* ] Correspondence

                Mélanie Lavoie‐Tremblay, RN, PhD, Associate Professor, Ingram School of Nursing, McGill University, 680 Sherbrooke West, Suite 1813, Montréal, Quebec H3A 2M7, Canada.

                Email: melanie.lavoie-tremblay@ 123456mcgill.ca

                Author information
                https://orcid.org/0000-0001-8707-9855
                https://orcid.org/0000-0001-7948-5570
                https://orcid.org/0000-0002-4309-0478
                https://orcid.org/0000-0002-1798-5681
                https://orcid.org/0000-0002-0782-5457
                https://orcid.org/0000-0002-0617-2861
                Article
                JONM13462
                10.1111/jonm.13462
                8646604
                34448520
                cdf73066-b50e-4d89-af08-254c3d6227d0
                © 2021 John Wiley & Sons Ltd

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                : 01 August 2021
                : 03 May 2021
                : 23 August 2021
                Page count
                Figures: 0, Tables: 4, Pages: 11, Words: 9144
                Funding
                Funded by: Le Réseau de recherche en interventions en sciences infirmières du Québec (RRISIQ)
                Funded by: Ordre des infirmières et infirmiers auxiliaires du Québec (OIIAQ)
                Funded by: Ordre des infirmières et infirmiers du Québec (OIIQ)
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.9 mode:remove_FC converted:06.12.2021

                covid‐19,nurse,quality of care,turnover,work satisfaction
                covid‐19, nurse, quality of care, turnover, work satisfaction

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