The Association between Mental Health Symptoms and Quality and Safety of Patient Care before and during COVID-19 among Canadian Nurses
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Collection and Sample
2.2. Measures
2.2.1. Outcomes
2.2.2. Predictors
2.2.3. Control Variables
2.3. Statistical Analysis
3. Results
3.1. Descriptive Findings, Between-Group Differences
3.2. Results of Logistic Regression Analyses
4. Discussion
4.1. Implications
4.2. Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics (Categorical Variables) | Before COVID-19 | During COVID-19 | p-Value a |
---|---|---|---|
n (%) | n (%) | ||
Gender | n = 4729 | n = 3585 | <0.001 |
Female | 4331 (91.6) | 3356 (93.6) | |
Male | 398 (8.4) | 229 (6.4) | |
Professional designation | n = 4729 | n = 3585 | <0.001 |
LPNs | 757 (16) | 675 (18.8) | |
RNs, RPNs, and dually registered | 3972 (84) | 2910 (81.2) | |
Education | n = 4729 | n = 3585 | 0.001 |
Diploma/certificate | 1459 (30.9) | 1225 (34.2) | |
Undergraduate and graduate degree | 3270 (69.1) | 2360 (65.8) | |
Employment status | n = 4728 | n = 3585 | 0.231 |
Full-time | 2962 (62.6) | 2209 (61.6) | |
Part-time | 1277 (27) | 1026 (28.6) | |
Casual | 489 (10.3) | 350 (9.8) | |
Role | n = 4729 | n = 3585 | <0.001 |
Direct care provider | 4231 (89.5) | 3087 (86.1) | |
Nurse leader | 381 (8.1) | 378 (10.5) | |
Educator | 117 (2.5) | 120 (3.3) | |
Healthcare sector | n = 4723 | n = 3581 | <0.001 |
Acute care | 3480 (73.7) | 2264 (63.2) | |
Community care | 822 (17.4) | 856 (23.9) | |
Long-term care | 421 (8.9) | 461 (12.9) | |
Geographical region | n = 4709 | n = 3568 | <0.001 |
Urban | 2953 (62.7) | 2269 (63.6) | |
Suburban | 831 (17.6) | 716 (20.1) | |
Rural | 925 (19.6) | 583 (16.3) | |
Nursing experience | n = 4714 | n = 3570 | <0.001 |
5 years or less | 1416 (30.0) | 862 (24.1) | |
6 to 10 years | 1006 (21.3) | 711 (19.9) | |
11 to 15 years | 804 (17.1) | 631 (17.7) | |
16 to 20 years | 392 (8.3) | 359 (10.1) | |
21 years or more | 1096 (23.2) | 1007 (28.2) | |
Characteristics (Continuous Variables) | Before COVID-19 | During COVID-19 | p-Value b |
Mean (SD) | Mean (SD) | ||
Age | n = 470,040.50 (11.60) | n = 355,342.57 (11.68) | <0.001 |
Pre-COVID-19 Responses | COVID-19 Responses | ANCOVA | |||
---|---|---|---|---|---|
n | Mean (SD) | n | Mean (SD) | ||
Mental Health | |||||
Anxiety | 4241 | 6.94 (0.09) | 3257 | 8.66 (0.10) | F (1, 7487) = 173.50, p < 0.001 |
Depression | 4240 | 7.44 (0.09) | 3237 | 9.07 (0.11) | F (1, 7466) = 132.55, p < 0.001 |
PTSD | 4267 | 44.54 (0.29) | 3243 | 47.16 (0.33) | F (1, 7499) = 36.12, p < 0.001 |
EE | 4116 | 28.18 (0.20) | 3151 | 30.41 (0.23) | F (1, 7256) = 53.44, p < 0.001 |
DP | 4119 | 8.92 (0.10) | 3153 | 8.82 (0.12 | F (1, 7261) = 0.44, p = 0.51 |
PA | 4073 | 13.64 (0.12) | 3097 | 13.75 (0.14) | F (1, 7159) = 0.31, p = 0.58 |
Quality and Safety | |||||
Safety grade | 4096 | 3.28 (0.02) | 3174 | 3.40 (0.02) | F (1, 7259) = 30.78, p < 0.001 |
General quality of nursing care | 4095 | 3.24 (0.01) | 3178 | 3.17 (0.01) | F (1, 7262) = 21.54, p < 0.001 |
Recommend to family and friends | 4089 | 3.02 (0.01) | 3169 | 3.07 (0.02) | F (1, 7247) = 6.40, p < 0.05 |
Pre-COVID-19 | During COVID-19 | |||||
---|---|---|---|---|---|---|
Safety Grade | General Quality | Recommend to Family and Friends | Safety Grade | General Quality | Recommend to Family and Friends | |
OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | |
Mild Anxiety a | 2.16 *** (1.86–2.51) | 2.37 *** (1.81–3.13) | 2.40 *** (1.97–2.94) | 1.86 *** (1.55–2.25) | 2.06 *** (1.47–2.94) | 1.73 *** (1.31–2.30) |
Moderate Anxiety a | 2.46 *** (2.03–2.98) | 3.32 *** (2.45–4.52) | 3.41 *** (2.71–4.31) | 3.08 *** (2.47–3.84) | 3.52 *** (2.47–5.09) | 2.68 *** (1.99–3.62) |
Severe Anxiety a | 4.30 *** (3.41–5.46) | 3.97 *** (2.88–5.48) | 6.36 *** (5.00–8.11) | 3.38 *** (2.69–4.26) | 5.41 *** (3.83–7.76) | 4.58 *** (3.44–6.16) |
Model= | 8.55, p = 0.38 | 8.26, p = 0.41 | 13.29, p = 0.10 | 7.82, p = 0.45 | 15.68, p = 0.05 | 1.95, p = 0.98 |
n | 4095 | 4094 | 4088 | 3126 | 3130 | 3122 |
Mild Depression b | 1.90 *** (1.63–2.21) | 1.85 *** (1.41–2.44) | 1.78 *** (1.45–2.18) | 1.69 *** (1.39–2.04) | 2.00 *** (1.44–2.82) | 1.54 ** (1.16–2.04) |
Moderate Depression b | 2.41 *** (2.00–2.92) | 2.86 *** (2.13–3.85) | 3.17 *** (2.54–3.96) | 2.43 *** (1.97–3.00) | 2.48 *** (1.75–3.53) | 2.44 *** (1.84–3.26) |
Moderately Severe Depression b | 3.06 *** (2.40–3.92) | 3.19 *** (2.27–4.46) | 3.84 *** (2.97–4.97) | 3.03 *** (2.36–3.89) | 4.31 *** (3.02–6.20) | 3.40 *** (2.50–4.64) |
Severe Depression b | 4.95 *** (3.46–7.24) | 4.12 *** (2.74–6.13) | 6.80 *** (4.95–9.38) | 4.24 *** (3.07–5.92) | 7.15 *** (4.84–10.64) | 7.19 *** (5.09–10.20) |
Model= | 14.85, p = 0.06 | 2.52, p = 0.96 | 9.88, p = 0.27 | 5.34, p = 0.72 | 10.37, p = 0.24 | 5.36, p = 0.72 |
n | 4095 | 4094 | 4088 | 3107 | 3111 | 3105 |
PTSD c | 2.65 *** (2.32–3.02) | 2.96 *** (2.39–3.69) | 3.61 *** (3.07–4.24) | 2.42 *** (2.09–2.80 | 2.69 *** (2.17–3.37) | 2.62 *** (2.17–3.17) |
Model = | 5.05, p = 0.75 | 10.51, p = 0.23 | 9.11, p = 0.33 | 7.48, p = 0.49 | 10.26, p = 0.25 | 8.20, p = 0.41 |
n | 4096 | 4095 | 4089 | 3174 | 3178 | 3169 |
Moderate EE d | 2.34 *** (1.92–2.84) | 3.15 *** (1.94–5.32) | 2.54 *** (1.82–3.59) | 1.79 *** (1.40–2.29) | 1.91 * (1.15–3.29) | 1.23 (0.81–1.89) |
High EE d | 5.56 *** (4.67–6.63) | 7.67 *** (5.01–12.41) | 7.76 *** (5.82–10.56) | 4.78 *** (3.87–5.94) | 6.02 *** (3.94–9.68) | 4.95 *** (3.56–7.06) |
Model= | 10.33, p = 0.24 | 6.11, p = 0.64 | 12.03, p = 0.15 | 6.05, p = 0.64 | 3.39, p = 0.91 | 8.30, p = 0.40 |
n | 4055 | 4053 | 4048 | 3092 | 3096 | 3088 |
Moderate DP e | 1.98 *** (1.69–2.32) | 3.52 *** (2.53–4.93) | 2.46 *** (1.99–3.04) | 2.04 *** (1.70–2.44) | 1.52 ** (1.12–2.05) | 1.91 *** (1.49–2.45) |
High DP e | 4.24 *** (3.58–5.03) | 9.33 *** (6.91–12.78) | 5.14 *** (4.23–6.28) | 4.32 *** (3.56–5.25) | 5.19 *** (4.02–6.73) | 4.83 *** (3.84–6.09) |
Model= | 10.26, p = 0.25 | 7.72, p = 0.46 | 10.77, p = 0.22 | 10.41, p = 0.24 | 6.07, p = 0.64 | 3.67, p = 0.89 |
n | 4058 | 4057 | 4051 | 3093 | 3098 | 3091 |
Moderate PA f | 1.59 *** (1.36–1.85) | 1.75 *** (1.29–2.39) | 1.64 *** (1.34–2.00) | 1.46 *** (1.22–1.74) | 2.03 *** (1.47–2.84) | 1.45 ** (1.13–1.87) |
Low PA f | 2.99 *** (2.54–3.53) | 4.40 *** (3.34–5.87) | 2.59 *** (2.14–3.15) | 2.92 *** (2.43–3.52) | 5.53 *** (4.12–7.53) | 3.07 *** (2.43–3.89) |
Model= | 5.83, p = 0.67 | 5.84, p = 0.66 | 6.49, p = 0.59 | 7.50, p = 0.48 | 8.76, p = 0.36 | 9.80, p = 0.28 |
n | 4014 | 4014 | 4007 | 3038 | 3042 | 3035 |
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Havaei, F.; Tang, X.; Smith, P.; Boamah, S.A.; Frankfurter, C. The Association between Mental Health Symptoms and Quality and Safety of Patient Care before and during COVID-19 among Canadian Nurses. Healthcare 2022, 10, 314. https://doi.org/10.3390/healthcare10020314
Havaei F, Tang X, Smith P, Boamah SA, Frankfurter C. The Association between Mental Health Symptoms and Quality and Safety of Patient Care before and during COVID-19 among Canadian Nurses. Healthcare. 2022; 10(2):314. https://doi.org/10.3390/healthcare10020314
Chicago/Turabian StyleHavaei, Farinaz, Xuyan Tang, Peter Smith, Sheila A. Boamah, and Caroline Frankfurter. 2022. "The Association between Mental Health Symptoms and Quality and Safety of Patient Care before and during COVID-19 among Canadian Nurses" Healthcare 10, no. 2: 314. https://doi.org/10.3390/healthcare10020314
APA StyleHavaei, F., Tang, X., Smith, P., Boamah, S. A., & Frankfurter, C. (2022). The Association between Mental Health Symptoms and Quality and Safety of Patient Care before and during COVID-19 among Canadian Nurses. Healthcare, 10(2), 314. https://doi.org/10.3390/healthcare10020314