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Special Issue "Nursing and COVID-19"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Nursing".

Deadline for manuscript submissions: closed (31 July 2022) | Viewed by 29295

Special Issue Editors

Prof. Dr. Richard Gray
E-Mail Website
Guest Editor
School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3004, Australia
Interests: mental health services; psychosocial interventions; co-morbidity; workforce
Special Issues, Collections and Topics in MDPI journals
Dr. Sonia Udod
E-Mail Website
Guest Editor
College of Nursing, University of Manitoba Winnipeg, Winnipeg, MB R3T 2N2, Canada
Interests: nurse manager development; nurse leader role in transitions of care; nurses' work environments; health care quality; qualitative research approaches; healthcare leadership
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Nurses have been a frontline workforce in managing the COVID-19 pandemic, and there are many important reflections and observations that need to be discussed and shared by clinicians and researchers. This Nursing Reports Special Issue on “Nursing and COVID-19” will provide a platform to highlight the issues and challenges faced by nurses practicing in hospital and community settings during the pandemic by bringing together experts to present evidence-based discussions on the impact, experience, and reality of providing evidence-based nursing care during the crisis. We are particularly interested in papers that examine the psychosocial impact of COVID-19 on nurses, showcase novel and innovative ways of delivering patient care (e.g., telehealth), and consider the organizational and management challenges of providing a safe and effective nursing service. This timely dialogue is highly relevant, as the COVID-19 pandemic continues to profoundly impact the way in which we live and work.

You may choose our Joint Special Issue in Nursing Reports.

Prof. Dr. Richard Gray
Dr. Sonia Udod
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • COVID-19
  • nursing
  • pandemic
  • public health
  • workforce

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Published Papers (25 papers)

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Article
Protective Factors against Morally Injurious Memories from the COVID-19 Pandemic on Nurses’ Occupational Wellbeing: A Cross-Sectional Experimental Study
Int. J. Environ. Res. Public Health 2022, 19(18), 11817; https://doi.org/10.3390/ijerph191811817 - 19 Sep 2022
Viewed by 403
Abstract
The COVID-19 pandemic was a fertile ground for nurses’ exposure to self- and other-Potentially Morally Injurious Events (PMIEs). Our study explored the effects of nurses’ memories of self- and other-PMIEs on occupational wellbeing and turnover intentions. Using an experimental design on a convenience [...] Read more.
The COVID-19 pandemic was a fertile ground for nurses’ exposure to self- and other-Potentially Morally Injurious Events (PMIEs). Our study explored the effects of nurses’ memories of self- and other-PMIEs on occupational wellbeing and turnover intentions. Using an experimental design on a convenience sample of 634 Romanian nurses, we tested a conceptual model with PLS-SEM, finding adequate explanatory and predictive power. Memories of self- and other-PMIEs were uniquely associated with work engagement, burnout, and turnover intentions, compared to a control group. These relationships were mediated by the three basic psychological needs. Relatedness was more thwarted for memories of other-PMIEs, while competence and autonomy were more thwarted for memories of self-PMIEs. Perceived supervisor support weakened the indirect effect between type of PMIE and turnover intentions, through autonomy satisfaction, but not through burnout. Self-disclosure weakened the indirect effect between type of PMIE and turnover intentions, through autonomy satisfaction, and both burnout and work engagement. Our findings emphasize the need for different strategies in addressing the negative long-term effects of nurses’ exposure to self- and other-PMIEs, according to the basic psychological need satisfaction and type of wellbeing indicator. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
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Article
Competencies of Nurse Managers as Predictors of Staff Nurses’ Job Satisfaction and Turnover Intention
Int. J. Environ. Res. Public Health 2022, 19(18), 11461; https://doi.org/10.3390/ijerph191811461 - 12 Sep 2022
Viewed by 383
Abstract
Nurse managers have played an integral role in stabilizing the nursing work environment and workforce in the face of the COVID-19 pandemic, yet the competencies required for such a feat are largely unknown. This study was conducted during the pandemic to identify the [...] Read more.
Nurse managers have played an integral role in stabilizing the nursing work environment and workforce in the face of the COVID-19 pandemic, yet the competencies required for such a feat are largely unknown. This study was conducted during the pandemic to identify the specific domains of nurse manager competencies that associate with nurse outcomes. A cross-sectional survey was conducted on a convenience sample of 698 staff nurses to measure the perceived competence of their nurse managers and their job satisfaction and turnover intention levels. The overall perceived nurse manager competency level in our sample was 3.15 out of 5 (SD = 0.859). The findings indicated that 34.3% of nurses were dissatisfied with their current jobs, and 36.3% of nurses were considering leaving their current workplace. Regression analyses identified “Team Communication and Collaboration” (β = 0.289; p = 0.002), “Staff Advocacy and Development” (β = 0.229; p = 0.019), and “Quality Monitoring and Pursuance” (β = 0.213; p = 0.031) as significant predictors of staff nurses’ job satisfaction and “Staff Advocacy and Development” (β = −0.347; p < 0.000) and “Team Communication and Collaboration” (β = −0.243; p = 0.012) as significant predictors of nurses’ turnover intention. The findings of the study have implications for the future recruitment, training, and performance evaluation of nurse managers. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
Article
Working Conditions and Wellbeing among Prison Nurses during the COVID-19 Pandemic in Comparison to Community Nurses
Int. J. Environ. Res. Public Health 2022, 19(17), 10955; https://doi.org/10.3390/ijerph191710955 - 02 Sep 2022
Viewed by 434
Abstract
The psychological health and work challenges of nurses working in prisons during the COVID-19 pandemic are understudied. We evaluated the work and wellbeing characteristics of a California prison nurse group, with a comparison to those of a community nurse group. From May to [...] Read more.
The psychological health and work challenges of nurses working in prisons during the COVID-19 pandemic are understudied. We evaluated the work and wellbeing characteristics of a California prison nurse group, with a comparison to those of a community nurse group. From May to November 2020, an online survey measured psychosocial and organizational work factors, sleep habits, psychological characteristics, COVID-19 impacts, and pre-pandemic recall among 62 prison nurses and 47 community nurses. Prison nurses had significantly longer work hours (54.73 ± 14.52, p < 0.0001), higher pandemic-related work demands, and less sleep hours (5.36 ± 1.30, p < 0.0001) than community nurses. Community nurses had significantly higher pandemic-related fear levels (work infection: p = 0.0115, general: p = 0.0025) and lower perceived personal protective equipment (PPE) supply (p = 0.0103). Between pre-pandemic and pandemic periods, both groups had significantly increased night shift assignments and decreased sleep hours, but the prison group had increased work hours. Although not statistically significant, both groups had high occupational stress and prevalence of post-traumatic stress symptoms. Our results indicate that prison nurses experienced work and wellbeing challenges during the pandemic. Future research and practice ought to address nurses’ workload, PPE, and psychological resources in correctional facilities and healthcare organizations. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
Article
Psychometric Properties of the WHO-5 Well-Being Index among Nurses during the COVID-19 Pandemic: A Cross-Sectional Study in Three Countries
Int. J. Environ. Res. Public Health 2022, 19(16), 10106; https://doi.org/10.3390/ijerph191610106 - 16 Aug 2022
Viewed by 464
Abstract
Nurses’ well-being has been increasingly recognised due to the ongoing pandemic. However, no validation scales measuring nurses’ well-being currently exist. Thus, we aimed to validate the WHO-5 Well-Being Index (WHO-5) in a sample of nurses. A cross-sectional multinational study was conducted, and a [...] Read more.
Nurses’ well-being has been increasingly recognised due to the ongoing pandemic. However, no validation scales measuring nurses’ well-being currently exist. Thus, we aimed to validate the WHO-5 Well-Being Index (WHO-5) in a sample of nurses. A cross-sectional multinational study was conducted, and a total of 678 nurses who worked during the COVID-19 pandemic in Spain (36.9%), Chile (40.0%) and Norway (23.1%) participated in this study. The nurses completed the WHO-5, the Patient Health Questionnaire-2 (PHQ-2), the Generalized Anxiety Disorder-2 (GAD-2) and three questions about the quality of life (QoL). The WHO-5 demonstrated good reliability and validity in the three countries. Cronbach’s alphas ranged from 0.81 to 0.90. High correlations were found between the WHO-5 and the psychological well-being dimension of QoL, and negative correlations between the WHO-5 and PHQ-2. The unidimensional scale structure was confirmed in all the countries, explaining more than 68% of the variance. The item response theory likelihood ratio model did not show discernible differences in the WHO-5 across the countries. To conclude, the WHO-5 is a psychometrically sound scale for measuring nurses’ well-being during a pandemic. The scale showed strong construct validity for cross-cultural comparisons; however, more research is required with larger sample sizes. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
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Article
Ultra-Orthodox Nursing Students’ Cultural Challenges Inside and Outside Their Community during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2022, 19(15), 9215; https://doi.org/10.3390/ijerph19159215 - 28 Jul 2022
Viewed by 397
Abstract
In line with findings that nurses from minority groups have an important role in making health services accessible to their community, our study aimed to identify the challenges ultra-Orthodox Jewish nurses faced during COVID-19 in their encounters with patients and health staff from [...] Read more.
In line with findings that nurses from minority groups have an important role in making health services accessible to their community, our study aimed to identify the challenges ultra-Orthodox Jewish nurses faced during COVID-19 in their encounters with patients and health staff from other communities, as well as their own community. The ultra-Orthodox community is a highly religious group that maintains isolation from general society, a phenomenon that affected its member experiences during COVID-19. Our research followed sequential explanatory mixed methods. The quantitative phase included a questionnaire completed by 235 female students (111 ultra-Orthodox and 124 non-ultra-Orthodox), followed by a qualitative phase, which included six focus-groups (n = 15). The quantitative analysis showed that the ultra-Orthodox students felt a higher sense of responsibility toward their community. They used their authority and knowledge to guide their community during the pandemic. The qualitative analysis identified two themes expressed as challenges ultra-Orthodox nursing students encountered within their community and with other sections of Israeli society. Our research shows the important role that transcultural nurses play in mediating updated health information otherwise inaccessible to their community, especially in times of crises. It is important to address dilemmas this group faces inside and outside their respective communities. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
Article
A Topic Modeling Analysis of the Crisis Response Stage during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2022, 19(14), 8331; https://doi.org/10.3390/ijerph19148331 - 07 Jul 2022
Viewed by 392
Abstract
The core of disaster management is the ability to respond spontaneously and rapidly to unexpected situations and also to apply planned and adaptable responses that follow manuals and guidelines. This study aimed to observe the changes in information during the COVID-19 pandemic period [...] Read more.
The core of disaster management is the ability to respond spontaneously and rapidly to unexpected situations and also to apply planned and adaptable responses that follow manuals and guidelines. This study aimed to observe the changes in information during the COVID-19 pandemic period by collecting and analyzing information announced on a hospital intranet by an infection control team. This study performed text mining of large amounts of data to investigate notices about in-hospital strategies towards COVID-19 to identify changes in the coping strategies during the pandemic. Notices announced within the infection control rooms of 12 university hospitals in South Korea from 1 January to 31 August 2020 were searched. Four representative topics were identified based on the stepwise keywords shown in the topic modeling analysis: (1) “Understanding the new infectious disease”, (2) “Preparation of a patient care and management system”, (3) “Prevention of spread and securing employee safety” and (4) “Improvement of the management system according to the revision of guidelines”. Countries where an infectious disease emerges should provide accurate information on the disease and guidelines to determine how to respond. Medical institutions must revise and complement them while considering their specific circumstances. To efficiently respond to an infectious disease crisis, governments and medical institutions must cooperate closely, and implementing a systematic response is crucial. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
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Article
Factors Predicting Post-Traumatic Positive and Negative Psychological Changes Experienced by Nurses during a Pandemic COVID-19: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2022, 19(12), 7073; https://doi.org/10.3390/ijerph19127073 - 09 Jun 2022
Viewed by 639
Abstract
It is common knowledge that COVID-19 affects physiopathological changes in all systems of the human body. On the other hand, events related to the COVID-19 pandemic also have a significant impact on the social and mental sphere of human functioning. The aim of [...] Read more.
It is common knowledge that COVID-19 affects physiopathological changes in all systems of the human body. On the other hand, events related to the COVID-19 pandemic also have a significant impact on the social and mental sphere of human functioning. The aim of this study is to determine the relationship between selected sociodemographic variables and selected subjective cognitive resources, and the positive and negative perception of the consequences of the COVID-19 pandemic in a group of nurses working in Poland. The computer-assisted web interviewing method was conducted between 1 and 15 May 2020. Participants were requested to complete the following questionnaires: The Changes in Outlook Questionnaire (CIOQ), The Impact Event Scale-Revised (IES-R), The Multidimensional Scale of Perceived Social Support (MSPSS), The Safety Experience Questionnaire (SEQ), and The Meaning in Life Questionnaire (MLQ). Three-hundred and twenty fivenurses working all over Poland participated in the study. Their mean age was 39.18 ± 11.16 years. A higher average level was noted among the surveyed nurses in the Positive Change subscale (18.56 ± 4.04). In a multivariate model, taking into account both sociodemographic and cognitive variables, the level of perceived traumatic stress, the level of social support, a sense of security, reflection on safety and a sense of meaning and meaning in life were independent predictors of a positive perception of the consequences of the COVID-19 pandemic. Those variables explained as much as 37% of the dependent variable, and the nature of the relationship was positive. While we are still a long way from understanding the full range of the long-term impact of the COVID-19 pandemic on mental health and psychosocial well-being, it is possible that in this challenging context there are many individual resources available to perceive the effects of the current pandemic positively. Therefore, they should be strengthened through the development and implementation of intervention programs to improve the mental state of nurses. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
Article
Effect of Job Stress on Burnout among Nurses Responding to COVID-19: The Mediating Effect of Resilience
Int. J. Environ. Res. Public Health 2022, 19(9), 5409; https://doi.org/10.3390/ijerph19095409 - 29 Apr 2022
Cited by 1 | Viewed by 777
Abstract
Background: This study was conducted to evaluate the relationship of job stress, burnout, and resilience of 271 nurses who worked alternately at a university hospital in South Korea Province and a state-designated inpatient ward for COVID-19 in Korea. Methods: The study sample included [...] Read more.
Background: This study was conducted to evaluate the relationship of job stress, burnout, and resilience of 271 nurses who worked alternately at a university hospital in South Korea Province and a state-designated inpatient ward for COVID-19 in Korea. Methods: The study sample included nurses who worked at a university hospital in South Korea, during the period between February 2020 and May 2021. The participants (n = 271) responded to an online survey between April 2021 and 12 May 2021. The questionnaire included information related to job stress, burn out, and resilience. Results: In phase 1 of regression, job stress had a significant negative effect on resilience of recovery (β = −0.397, p < 0.001). In phase 2, job stress had a significant positive effect on burnout (β = 0.513, p < 0.001). In phase 3, resilience had a significant negative effect on burnout (β = −0.459, p < 0.001). Seventy-five percent of burnout was directly associated with job stress, while 25% of burnout was indirectly associated through mediated effects, through resilience. Conclusions: The promotion of resilience would not only serve as the basis for active coping in situations where burnout and stress are severe, but also serve as a basic driving force for actively overcoming them. Further study to cope with stress and reduce burnout at the organizational level should be conducted. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
Article
Early Nurse Management Experiences from Finnish COVID-19 Hubs: An In-Action Review
Int. J. Environ. Res. Public Health 2022, 19(8), 4885; https://doi.org/10.3390/ijerph19084885 - 17 Apr 2022
Viewed by 994
Abstract
Primary healthcare (PHC) clinics are the point of access for many COVID-19 patients; however, the focus of crisis response work has been in securing hospital capacities. The purpose of this study was to describe the early nurse management experiences from PHC clinics within [...] Read more.
Primary healthcare (PHC) clinics are the point of access for many COVID-19 patients; however, the focus of crisis response work has been in securing hospital capacities. The purpose of this study was to describe the early nurse management experiences from PHC clinics within Greater Helsinki dedicated to caring for all ambulatory patients with possible COVID-19 symptoms. The study objectives were to make PHC crisis response contributions known and to provide an in-action review (IAR) of crisis response efforts. Nurse managers from the four COVID-19 hubs in Greater Helsinki were interviewed using thematic pair interviews. The data were analyzed inductively using thematic analysis, by which four main themes emerged: (1) capacity development led to a state of flux, (2) infection prevention control (IPC) was critical, (3) management of staff was essential in facilitating crisis response, and (4) respondents’ personal experiences. The state of flux stressed the provision of PHC services, but quick developments in telemedicine eased that burden. Conversation surrounding IPC was extensive, though discrepancies suggest that global efforts to standardize IPC practices must begin locally. Leadership was adjusted to accommodate for the crisis, especially regarding the motivation of staff. A vision to aspire toward in crisis recovery is needed. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
Article
Impact of SARS-CoV-2 Pandemic on Psychosocial Burden and Job Satisfaction of Long-Term Care Nurses in Poland
Int. J. Environ. Res. Public Health 2022, 19(6), 3555; https://doi.org/10.3390/ijerph19063555 - 17 Mar 2022
Viewed by 667
Abstract
Psychosocial consequences of the coronavirus pandemic are severe for health care workers due to their higher levels of exposure. Nurses often experience tremendous psychological pressure as a result of their workload in a high-risk environment. The purpose of this study was to determine [...] Read more.
Psychosocial consequences of the coronavirus pandemic are severe for health care workers due to their higher levels of exposure. Nurses often experience tremendous psychological pressure as a result of their workload in a high-risk environment. The purpose of this study was to determine the impact of the SARS-CoV-2 pandemic on the psychosocial burden and job satisfaction of nurses employed in long-term care. One hundred thirty-eight nurses employed in long-term care participated in the study. The respondents were 96.4% female and 3.6% male. The mean age of the respondents was 53.99 (standard deviation—4.01). The study was conducted between February and June 2021. The research tool was a standardized psychosocial risk scale questionnaire, which is a scientifically validated diagnostic tool with high reliability and accuracy coefficients. The primary tests used during the statistical analyses were non-parametric Mann–Whitney U (for two samples) and Kruskal–Wallis (for more than two samples) tests for assessing differences. During these analyses, in addition to standard statistical significance, appropriate p-values were calculated using the Monte Carlo method. Correlations between ordinal or quantitative variables were made using Spearman’s rho coefficient. The results obtained allow us to conclude that the respondents rated the characteristics present in the workplace that constitute psychosocial risks at an average level. Emotional commitment and continuance-type commitment to the respondents’ job position were also at a medium level. Respondents’ self-rated ability to work for nurses employed in long-term care during the SARS-CoV-2 pandemic and commitment to patient care was high at 4.0 and 4.18, with a maximum of 5 points. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
Article
A Phenomenological Study of Nurses’ Experience in Caring for COVID-19 Patients
Int. J. Environ. Res. Public Health 2022, 19(5), 2924; https://doi.org/10.3390/ijerph19052924 - 02 Mar 2022
Viewed by 1452
Abstract
This study aimed to understand and describe the experiences of nurses who cared for patients with COVID-19. A descriptive phenomenological approach was used to collect data from individual in-depth interviews with 14 nurses, from 20 October 2020 to 15 January 2021. Data were [...] Read more.
This study aimed to understand and describe the experiences of nurses who cared for patients with COVID-19. A descriptive phenomenological approach was used to collect data from individual in-depth interviews with 14 nurses, from 20 October 2020 to 15 January 2021. Data were analyzed using the phenomenological method of Colaizzi. Five theme clusters emerged from the analysis: (1) nurses struggling under the weight of dealing with infectious disease, (2) challenges added to difficult caring, (3) double suffering from patient care, (4) support for caring, and (5) expectations for post-COVID-19 life. The findings of this study are useful primary data for developing appropriate measures for health professionals’ wellbeing during outbreaks of infectious diseases. Specifically, as nurses in this study struggled with mental as well as physical difficulties, it is suggested that future studies develop and apply mental health recovery programs for them. To be prepared for future infectious diseases and contribute to patient care, policymakers should improve the work environment, through various means, such as nurses’ practice environment management and incentives. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
Article
Good Care during COVID-19: A Narrative Approach to Care Home Staff’s Experiences of the Pandemic
Int. J. Environ. Res. Public Health 2022, 19(4), 2106; https://doi.org/10.3390/ijerph19042106 - 13 Feb 2022
Viewed by 1217
Abstract
Due to its major impact on Dutch care homes for older people, the COVID-19 pandemic has presented care staff with unprecedented challenges. Studies investigating the experiences of care staff during the COVID-19 pandemic have shown its negative impact on their wellbeing. We aimed [...] Read more.
Due to its major impact on Dutch care homes for older people, the COVID-19 pandemic has presented care staff with unprecedented challenges. Studies investigating the experiences of care staff during the COVID-19 pandemic have shown its negative impact on their wellbeing. We aimed to supplement this knowledge by taking a narrative approach. We drew upon 424 personal narratives written by care staff during their work in a Dutch care home during the COVID-19 pandemic. Firstly, our results show that care staff have a relational-moral approach to good care. Residents’ wellbeing is their main focus, which they try to achieve through personal relationships within the triad of care staff–resident–significant others (SOs). Secondly, our results indicate that caregivers experience the COVID-19 mitigation measures as obstructions to relational-moral good care, as they limit residents’ wellbeing, damage the triadic care staff–residents–SOs relationship and leave no room for dialogue about good care. Thirdly, the results show that care staff experiences internal conflict when enforcing the mitigation measures, as the measures contrast with their relational-moral approach to care. We conclude that decisions about mitigation measures should be the result of a dialogic process on multiple levels so that a desired balance between practical good care and relational-moral good care can be determined. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
Article
Assessment of Psychosocial Functioning of Polish Nurses during COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2022, 19(3), 1435; https://doi.org/10.3390/ijerph19031435 - 27 Jan 2022
Cited by 2 | Viewed by 872
Abstract
(1) The COVID-19 pandemic has significantly affected the psychological well-being of people around the world. The aim of this study was to assess the levels of psychological distress of nurses (anxiety, depression, stress, insomnia) in relation to sociodemographic variables and psychosocial variables: self-assessment [...] Read more.
(1) The COVID-19 pandemic has significantly affected the psychological well-being of people around the world. The aim of this study was to assess the levels of psychological distress of nurses (anxiety, depression, stress, insomnia) in relation to sociodemographic variables and psychosocial variables: self-assessment of health, quarantine, psychological support, presence of chronic diseases and the Impact of Events Scale (IES-R). (2) A total of 207 nurses working with COVID-19 patients at the Independent Public Clinical Hospital No. 1 of the Pomeranian Medical University in Szczecin participated in the study. The study was conducted with the diagnostic survey method, using the Athens Insomnia Scale, the Generalized Anxiety Disorder questionnaire, the Impact of Event Scale—Revised, the Patient Health Questionnaire-9, The Perceived Stress Scale and a questionnaire of our authorship. (3) Among the respondents, 40.58% suffered sleep disturbance, 36.71% had mild anxiety, 71.95% had high stress according to the PSS-10 and 31.88% had depression according to the PHQ-9. The study observed that the chances of insomnia decreased with the age of the respondents. Moreover, the form of employment of nurses significantly affected the levels of depression, anxiety and stress. (4) Education, gender and age were variables that significantly affected the severity of anxiety, depression and insomnia in the surveyed nurses working with patients with COVID-19. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
Article
Spirituality in Patients at the End of Life—Is It Necessary? A Qualitative Approach to the Protagonists
Int. J. Environ. Res. Public Health 2022, 19(1), 227; https://doi.org/10.3390/ijerph19010227 - 26 Dec 2021
Cited by 2 | Viewed by 1224
Abstract
Spirituality is the most unknown aspect of palliative care despite being the need that is most altered in the last moments of life. Objective. To identify on the one hand the spiritual needs of patients who are at the end of life and [...] Read more.
Spirituality is the most unknown aspect of palliative care despite being the need that is most altered in the last moments of life. Objective. To identify on the one hand the spiritual needs of patients who are at the end of life and on the other hand, the way in which nursing professionals can work to provide effective accompaniment in this process. Method. A qualitative study was conducted which applied different data collection techniques. This was done to describe the phenomenon from a holistic perspective in relation to experts’ perceptions of the competencies required by health professionals and palliative patients’ spiritual needs. Semi-structured interviews were conducted within both populations. In order to analyze the qualitative data collected through interviews, discourse was analyzed according to the Taylor–Bodgan model and processed using Atlas.ti software. Results. Three well-differentiated lines of argument are extracted from the discourse in each of the groups, on the one hand in the group of patients they define the concept of spirituality, system of values and beliefs, and the Factors that influence the spirituality of patients at the end of life (differentiating palliative care areas/other areas) and on the other, the professionals agree with the patients in the line of argument of concept of spirituality although they define more metaphysical categories and the other two lines of argument that result are the spiritual attention in this process and the need for formation in spirituality. Conclusions. The provision of spiritual care gives meaning to the actions of nursing professionals when it comes to providing end-of-life care, achieving holistic care, humanizing death, and promoting a dignified end. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
Article
Nursing Home’s Measures during the COVID-19 Pandemic: A Critical Reflection
Int. J. Environ. Res. Public Health 2022, 19(1), 75; https://doi.org/10.3390/ijerph19010075 - 22 Dec 2021
Viewed by 1325
Abstract
This study examined the pandemic measures taken by nursing leaders to cope with COVID-19 at a nursing home in Singapore. The pandemic has affected over 215 countries, sparking a series of containment and pandemic measures by governments and healthcare organizations worldwide. Long-term care [...] Read more.
This study examined the pandemic measures taken by nursing leaders to cope with COVID-19 at a nursing home in Singapore. The pandemic has affected over 215 countries, sparking a series of containment and pandemic measures by governments and healthcare organizations worldwide. Long-term care facilities are especially vulnerable to the pandemic, but little has been reported about the nursing homes’ measures in handling the pandemic. The present study used Morley’s (2014) three-stage critical reflection method to review meeting minutes, organizational emails, and government advisories on the COVID-19 pandemic measures undertaken by nursing leaders at a nursing home in Singapore between January and June 2020. The pandemic measures were broadly classified into four groups: (1) infection surveillance and containment measures; (2) ensuring continuity in clinical care and operational support; (3) resource and administrative coordination; and (4) staff training and development. Nurses have played a vital role in the fight against COVID-19 by ensuring continuity in patient care and demonstrating clinical leadership in pandemic efforts. This study proposes a useful nursing pandemic structure that outlines a set of functions and measures required for handling a pandemic and that can be applied to various medical emergencies and contingencies. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
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Article
The Impact of COVID-19 on Levels of Adherence to the Completion of Nursing Records for Inpatients in Isolation
Int. J. Environ. Res. Public Health 2021, 18(21), 11262; https://doi.org/10.3390/ijerph182111262 - 27 Oct 2021
Viewed by 820
Abstract
The COVID-19 pandemic has led to an increased workload for nurses and organisational and structural changes, which have been necessary to meet the needs of inpatients in isolation. Aim: To describe the impact of the COVID-19 pandemic on levels of adherence to the [...] Read more.
The COVID-19 pandemic has led to an increased workload for nurses and organisational and structural changes, which have been necessary to meet the needs of inpatients in isolation. Aim: To describe the impact of the COVID-19 pandemic on levels of adherence to the completion of nursing records that document the risk of developing pressure ulcers, falling, and social vulnerability among hospitalised patients in isolation. Methods: Observational pre-post comparison study. Comparison between nursing records (the Braden, Downton, and Gijón scales) belonging to 1205 inpatients took place in two phases. Phase 1: 568 patients admitted in February 2020, prior to the COVID-19 pandemic, vs. phase 2: 637 patients hospitalised with COVID-19 in March–April 2020, during the peak of the first wave of the pandemic. This research adheres to the STROBE guidelines for the reporting of observational studies. Results: The degree of completion of the Braden, Downton, and Gijón scales decreased significantly in phase 2 vs. phase 1 (p < 0.001). The mean Downton and Gijón scale scores for patients admitted in phase 1 were higher compared to those of patients admitted in phase 2 (p < 0.001). The mean Braden scale score in phase 2 was higher than in phase 1 (p < 0.05). Conclusion: During the COVID-19 pandemic, there was a decrease in the completion of nursing records in the clinical records of patients in isolation. The levels of risk of developing PUs, falling, and social vulnerability of patients admitted to hospital were lower during the first wave of the pandemic. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
Article
Gender Bias and the Lack of Equity in Pandemic Nursing in China: A Qualitative Study
Int. J. Environ. Res. Public Health 2021, 18(19), 10273; https://doi.org/10.3390/ijerph181910273 - 29 Sep 2021
Viewed by 1105
Abstract
There has long been a gender bias in medicine. This qualitative study aims to identify the experience of sexism among frontline female nurses and further explore their expectations and possible strategies to get rid of gender bias. This is a descriptive phenomenological study [...] Read more.
There has long been a gender bias in medicine. This qualitative study aims to identify the experience of sexism among frontline female nurses and further explore their expectations and possible strategies to get rid of gender bias. This is a descriptive phenomenological study of 23 female nurses with 11 ± 3.98 years of experience who spent 36 ± 6.50 days at the frontline during the initial COVID-19 outbreak. We employed Colaizzi’s phenomenological analysis method to understand the subjective experiences, revealing the following themes: (a) materialization of gender identity; (b) incoordinate relationships; (c) future voice of female nurses. The gender bias experienced by female frontline nurses further challenges their emotional identity and self-identity. Therefore, it is important to require extensive consciousness-raising and policy support to defend female nurses’ rights. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
Article
Analyzing the Impact of COVID-19 Trauma on Developing Post-Traumatic Stress Disorder among Emergency Medical Workers in Spain
Int. J. Environ. Res. Public Health 2021, 18(17), 9132; https://doi.org/10.3390/ijerph18179132 - 30 Aug 2021
Cited by 4 | Viewed by 1995
Abstract
The early stages of the COVID-19 pandemic presented the characteristics of a traumatic event that could trigger post-traumatic stress disorder. Emergency Medical Services workers are already a high-risk group due to their professional development. The research project aimed to analyse the impact of [...] Read more.
The early stages of the COVID-19 pandemic presented the characteristics of a traumatic event that could trigger post-traumatic stress disorder. Emergency Medical Services workers are already a high-risk group due to their professional development. The research project aimed to analyse the impact of the COVID-19 pandemic on EMS professionals in terms of their mental health. For this purpose, we present a descriptive crosssectional study with survey methodology. A total of 317 EMS workers (doctors, nurses, and emergency medical technicians) were recruited voluntarily. Psychological distress, post-traumatic stress disorder, and insomnia were assessed. The instruments were the General Health Questionnaire-12 (GHQ-12), the Davidson Trauma Scale (DTS-8), and the Athens Insomnia Scale (AIS-8). We found that 36% of respondents had psychological distress, 30.9% potentially had PTSD, and 60.9% experienced insomnia. Years of work experience were found to be positively correlated, albeit with low effect, with the PTSD score (r = 0.133). Finally, it can be stated that the COVID-19 pandemic has been a traumatic event for EMS workers. The number of professionals presenting psychological distress, possible PTSD, or insomnia increased dramatically during the early phases of the pandemic. This study highlights the need for mental health disorder prevention programmes for EMS workers in the face of a pandemic. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
Article
Investigating the Effective Factors of Using Personal Protective Equipment from the Perspective of Nurses Caring for COVID-19 Patients: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2021, 18(15), 7882; https://doi.org/10.3390/ijerph18157882 - 26 Jul 2021
Cited by 2 | Viewed by 1388
Abstract
Considering the importance of appropriate personal protective equipment (PPE) for preventing COVID-19 transmission, the aim of this study was to investigate the factors affecting the use of PPE from the perspective of the nurses caring for COVID-19 patients. This descriptive cross-sectional study surveyed [...] Read more.
Considering the importance of appropriate personal protective equipment (PPE) for preventing COVID-19 transmission, the aim of this study was to investigate the factors affecting the use of PPE from the perspective of the nurses caring for COVID-19 patients. This descriptive cross-sectional study surveyed 240 nurses working in the central COVID-19 hospitals of Arak, Iran. Nurses were enrolled in the study by a convenience sampling method. The data collection tool was a validated questionnaire. Data were analyzed by SPSS 16 software using descriptive statistics, analysis of variance (ANOVA), and independent sample t-test. Environmental (4.24 ± 0.45), personal (4.16 ± 0.42), and organizational (4.04 ± 0.50) factors all contribute significantly to nursing attitudes about PPE use (p < 0.05). The average score, combining all identified factors, was 4.15 ± 0.31. The most influential factor contributing to appropriate use of PPE was environmental, while the least impactful parameters were related to rules and regulations. Environmental factors have the greatest impact on the use of PPE from the perspective of the nurses caring for patients with COVID-19. Managers and healthcare organizations should provide appropriate and adequate PPE to nurses, educate them on proper use, and monitor the process to resolve barriers. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
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Article
The Transformational Experience of Junior Nurses Resulting from Providing Care to COVID-19 Patients: From Facing Hurdles to Achieving Psychological Growth
Int. J. Environ. Res. Public Health 2021, 18(14), 7383; https://doi.org/10.3390/ijerph18147383 - 10 Jul 2021
Cited by 4 | Viewed by 1476
Abstract
The rapid spread of coronavirus disease 2019 (COVID-19) has put significant pressure on junior nursing staff. The objective of this study was to examine the in-depth experiences of junior nurses in providing care for COVID-19 patients within an acute care setting. This study [...] Read more.
The rapid spread of coronavirus disease 2019 (COVID-19) has put significant pressure on junior nursing staff. The objective of this study was to examine the in-depth experiences of junior nurses in providing care for COVID-19 patients within an acute care setting. This study employed a phenomenological method to understand the situation from a first-person perspective. Purposive sampling was used. Interviews were performed with 40 junior nurses (<4 years of clinical experience) who provided direct care to COVID-19 patients in isolation wards in acute care settings in Hong Kong. The interviews were conducted from 1 January 2021 to 24 May 2021 via virtual conferencing software (Zoom) to maintain social distancing, and the responses were analysed using Colaizzi’s seven-step method. Junior nurses’ psychological experiences of providing direct care to COVID-19 patients were categorised into four main themes. First, there were hurdles in the early stages, in which participants experienced negative emotions, such as fear, anxiety, helplessness, and fatigue. Somatic symptoms, such as headaches and sleep disturbance, were reported. Second, the adoption of self-care coping strategies enabled nurses to confront the hurdles, signifying the start of self-transformation. Third, junior nurses maintained positivity under pressure by appreciating their sources of support (including their families and other important relationships in their lives). Professionalism was also found to reinforce positivity. Fourth, self-transformation resulted in psychological growth, which prepared junior nurses to be resilient and confident in their clinical practice to take up future challenges in the ongoing battle against the pandemic. The hurdles experienced by junior nurses at the early stage of their work in isolation wards provided the foundation upon which self-transformation took place. Being able to employ self-care coping strategies and further sustain positivity characterised the self-transformation process. Eventually, junior nurses became resilient and more capable of understanding both the negativity and positivity of their experiences. The self-transformation process also enabled junior nurses to recognise and appreciate the wider support system from various parties in society. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
Article
Relational Capital and Post-Traumatic Growth: The Role of Work Meaning
Int. J. Environ. Res. Public Health 2021, 18(14), 7362; https://doi.org/10.3390/ijerph18147362 - 09 Jul 2021
Cited by 1 | Viewed by 1088
Abstract
Through a statistical survey of 760 front-line medical staff during the COVID-19 epidemic, this study attempts to explore the relationships between relational capital, psychological security, post-traumatic growth and the meaning of work. Data analysis verifies that trust, reciprocity, and identification can promote post-traumatic [...] Read more.
Through a statistical survey of 760 front-line medical staff during the COVID-19 epidemic, this study attempts to explore the relationships between relational capital, psychological security, post-traumatic growth and the meaning of work. Data analysis verifies that trust, reciprocity, and identification can promote post-traumatic growth by enhancing the individual’s psychological security. A high level of work meaning can enhance the role of trust, reciprocity and identification in promoting psychological security. Work meaning has a moderated mediating effect when trust and reciprocity affect post-traumatic growth through psychological security, but no moderated mediating effect is found when identification affects post-traumatic growth through psychological security. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
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Article
Nurses Who Are More Willing to Participate in the Fight against COVID-19: Evidence from China
Int. J. Environ. Res. Public Health 2021, 18(14), 7357; https://doi.org/10.3390/ijerph18147357 - 09 Jul 2021
Cited by 3 | Viewed by 1338
Abstract
When facing an infectious disease disaster, nurses’ willingness to work is critical. Nurses’ lack of willingness to work during a pandemic may worsen the shortage of health care personnel. The purpose of this study is to assess the willingness of nurses to participate [...] Read more.
When facing an infectious disease disaster, nurses’ willingness to work is critical. Nurses’ lack of willingness to work during a pandemic may worsen the shortage of health care personnel. The purpose of this study is to assess the willingness of nurses to participate in the fight against COVID-19 in China and to identify factors associated therewith. This cross-sectional study examines nurses working in 11 Chinese cities including Macau, Hong Kong, Shenzhen, Dongguan, Huizhou, Guangzhou, Zhaoqing, Foshan, Jiangmen, Zhongshan, and Zhuhai. Questionnaires were collected from 19 May to 7 August 2020. A total of 8065 questionnaires were received, of which 8030 valid questionnaires were included for analysis. A total of 53.4% of participants reported that they had signed up to support the COVID-19 pandemic response. Multivariate logistic regression analysis revealed that being single (OR = 0.72, 95% CI: 0.60–0.87), having no children (OR = 0.81, 95% CI: 0.68–0.97), possessing higher professional qualifications (OR = 1.25, 95% CI: 1.14–1.37), having a more prestigious professional title (OR = 1.68, 95%CI: 1.50–1.90), being an administrative supervisor (OR = 0.53, 95% CI: 0.45–0.63), having a higher caring dimensions inventory score (OR = 1.01, 95% CI: 1.01–1.01), working in a hospital (OR = 0.53, 95% CI: 0.39–0.72), and receiving employer-provided care training (OR = 0.77, 95% CI: 0.68–0.87) were predictive of nurses’ willingness to participate in the fight against COVID-19. We suggest that unmarried nurses should be given priority when recruiting to fight an epidemic and, for married nurses with children who are recruited to fight an epidemic, supporting measures should be provided for childcare. We suggest strengthening workplace training of caring for nurses in order to better retain and recruit qualified support for an epidemic outbreak of infectious diseases. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
Article
To Volunteer or Not? Perspectives towards Pre-Registered Nursing Students Volunteering Frontline during COVID-19 Pandemic to Ease Healthcare Workforce: A Qualitative Study
Int. J. Environ. Res. Public Health 2021, 18(12), 6668; https://doi.org/10.3390/ijerph18126668 - 21 Jun 2021
Cited by 10 | Viewed by 2253
Abstract
COVID-19 has caused a shortage of healthcare workers and has strained healthcare systems globally. Pre-registered healthcare students with training have a duty of care and can support the healthcare workforce. This study explored factors influencing the willingness of final-year nursing students to volunteer [...] Read more.
COVID-19 has caused a shortage of healthcare workers and has strained healthcare systems globally. Pre-registered healthcare students with training have a duty of care and can support the healthcare workforce. This study explored factors influencing the willingness of final-year nursing students to volunteer during the COVID-19 pandemic, the role of professional identity in volunteering as healthcare workers, and strategies to improve future volunteering uptakes and processes. A qualitative study using focus-group discussions was conducted. Final-year nursing students who volunteered, students who did not volunteer, and lecturers who supervised student volunteers were recruited. Interviews were conducted online, video-recorded, and transcribed verbatim. A thematic analysis was used. The themes were “wavering thoughts on volunteering”, “bringing out ‘the nurse’ in students through volunteering” and “gearing up to volunteer”. Findings suggested the need to look beyond the simplicity of altruism to the role of professional identity, operational, and motivational factors to explain nursing students’ decision to volunteer and their volunteer behavior. Providing accommodation, monetary and academic-related incentives, supporting the transitionary phase from students to “professional volunteers”, promoting cohesive and positive staff–student volunteer relationships, and establishing a volunteer management team are strategies identified to improve volunteering uptake and operational processes. Our findings advocate strategic partnerships between hospitals/communities and academic institutions in providing various healthcare services during pandemics. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
Article
Evaluation of the Risk of Anxiety and/or Depression during Confinement Due to COVID-19 in Central Spain
Int. J. Environ. Res. Public Health 2021, 18(11), 5732; https://doi.org/10.3390/ijerph18115732 - 27 May 2021
Cited by 4 | Viewed by 1844
Abstract
(1) Background: The confinement of the population in response to the COVID-19 pandemic was related to an increased risk of suffering from anxiety and/or depression in previous studies with other populations. (2) Methods: descriptive study using surveys (Goldberg Anxiety and Depression Scale) with [...] Read more.
(1) Background: The confinement of the population in response to the COVID-19 pandemic was related to an increased risk of suffering from anxiety and/or depression in previous studies with other populations. (2) Methods: descriptive study using surveys (Goldberg Anxiety and Depression Scale) with 808 participants over 18 years of age between 14 and 20 of May 2020 during the confinement due to the SARS-CoV-2 virus in Spain. (3) Results: 63% of the participants were at risk of suffering from anxiety and 64.9% were at risk of depression. Variables reaching statistical significance were: age (t anxiety = −0.139 and t depression = −0.153), gender (t anxiety = −4.152 and t depression = −4.178), marital status (anxiety F = 2.893 and depression F = 3.011), symptoms compatible with COVID-19 (t anxiety = −4.177 and t depression = −3.791), previous need for psychological help (t anxiety = −5.385 and t depression = −7.136) and need for such help at the time of the study (t anxiety = −9.144 and depression = −10.995). In addition, we generated two regression models that estimate the risk of anxiety and depression. (4) Conclusions: more than half of the participants were at risk of suffering from anxiety and/or depression, confirming the negative effect of confinement on the population. Full article
(This article belongs to the Special Issue Nursing and COVID-19)

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Systematic Review
Prevalence of Depression and Anxiety in Nurses during the First Eleven Months of the COVID-19 Pandemic: A Systematic Review and Meta-Analysis
Int. J. Environ. Res. Public Health 2022, 19(3), 1154; https://doi.org/10.3390/ijerph19031154 - 20 Jan 2022
Cited by 3 | Viewed by 1556
Abstract
The high risk of coronavirus (COVID-19) infection can increase the physical and psychological strain on nurses in professional practice, which can lead to mental health problems. The purpose of this systematic review and meta-analysis is to establish and estimate the combined incidence of [...] Read more.
The high risk of coronavirus (COVID-19) infection can increase the physical and psychological strain on nurses in professional practice, which can lead to mental health problems. The purpose of this systematic review and meta-analysis is to establish and estimate the combined incidence of depression and anxiety among nurses during the COVID-19 pandemic using standard measurement tools. A systematic search of the electronic databases PubMed, Web of Science, and SCOPUS was carried out to identify cross-sectional studies in the period from 3 March 2020 to 18 February 2021. Two reviewers independently and critically evaluated the studies which have been included, using the Agency for Healthcare Research and Quality checklist. We have identified twenty-three studies (n = 44,165) from nine countries. The combined incidence of depression among nurses was 22% (95% CI 0.15–0.30, I2 = 99.71%), and anxiety symptoms 29% (95%CI 0.18–0.40, I2 = 99.92%). No significant difference was observed in the percentage of depression and anxiety between the study subjects working on the frontlines vs. those in a mixed group (those working on the frontlines and behind the lines). This meta-analysis shows that over one-fifth of nurses in professional practice during the COVID-19 epidemic suffer from depression disorders, and almost one-third experience anxiety symptoms. This underscores the importance of providing comprehensive psychological support strategies for nurses working in pandemic conditions. Further longitudinal research is necessary to assess the severity of mental health symptoms related to the COVID-19 epidemic factor. Full article
(This article belongs to the Special Issue Nursing and COVID-19)
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