Search Results (2,063)

Background: Moral harassment (mobbing) in healthcare, particularly among nurses, remains a persistent issue with detrimental effects on mental health, resilience, and quality of life. Aim: We examine the relationship between the resilience of nurses working in Emergency Departments (EDs) and how these factors influence experiences of workplace mobbing. Methods: This cross-sectional study included 90 nurses from four public hospitals in Greece’s 5th Health District. Data were collected between October 2023 and March 2024 using the WHOQOL-BREF, Workplace Psychologically Violent Behaviors (WPVB) scale and the Connor–Davidson Resilience Scale (CD-RISC). The sample consisted primarily of full-time nurses (84.3% female; mean age = 43.1 years), with 21.1% reporting chronic conditions. Most participants were married (80.0%) and had children (74.4%), typically two (56.1%). Statistical analyses—conducted using SPSS version 27.0—included descriptive statistics, Pearson and Spearman correlations, multiple linear regression, and mediation analysis, with significance set at p < 0.05. Results: Resilience was moderate (mean = 66.38%; Cronbach’s α = 0.93) and positively correlated with all WHOQOL-BREF domains—physical, psychological, social, and environmental (r = 0.30–0.40)—but not with the overall WHOQOL-BREF. The mean overall WHOQOL-BREF score was 68.4%, with the lowest scores observed in the environmental domain (mean = 53.76%). Workplace mobbing levels were low to moderate (mean WPVB score = 17.87), with subscale reliabilities ranging from α = 0.78 to 0.95. Mobbing was negatively associated with social relationships and the environmental WHOQOL-BREF (ρ = –0.23 to –0.33). Regression analysis showed that cohabitation and higher resilience significantly predicted better WHOQOL-BREF outcomes, whereas mobbing was not a significant predictor. Mediation analysis (bootstrap N = 5000) indicated no significant indirect effect of resilience in the relationship between mobbing and WHOQOL-BREF. Conclusions: Resilience was identified as a key protective factor for nurses’ quality of life in emergency care settings. Although workplace mobbing was present at low-to-moderate levels, it was negatively associated with specific WHOQOL-BREF domains. Enhancing mental resilience among nurses may serve as a valuable strategy to mitigate the psychological effects of moral harassment in healthcare environments. Full article

Objectives: This study investigated levels of work engagement and the occurrence of compassion fatigue among nursing professionals during the COVID-19 pandemic. Methods: A cross-sectional, descriptive, and correlational study was conducted at a Brazilian university hospital between February and April 2022. The Brazilian versions of the Utrecht Work Engagement Scale (UWES-9) and the Professional Quality of Life Scale (ProQOL-BR) were administered. Results: High levels of compassion satisfaction (44.9 points), low levels of burnout (21.0 points), and low levels of secondary traumatic stress (22.8 points) were observed. No professional demonstrated a profile consistent with compassion fatigue. Engagement levels were high for dedication (5.3) and moderate for vigor (4.9), absorption (4.5), and overall engagement (4.9). Burnout showed moderate negative correlations with vigor (r = −0.611, p = 0.005) and dedication (r = −0.599, p = 0.019). Compassion satisfaction showed moderate positive correlations with vigor (r = 0.522, p < 0.001) and dedication (r = 0.572, p < 0.001). The overall engagement score was moderately and positively correlated with compassion satisfaction (r = 0.532, p < 0.001). Conclusions: This study identified high levels of work engagement, especially regarding dedication, and low levels of compassion fatigue among nursing professionals. The data suggest that even amid the emotional and physical demands imposed by the pandemic, participants preserved their emotional well-being and maintained a positive relationship with their work. Full article

Background/Objectives: This retrospective multicenter study, conducted within the ORCHESTRA Project, investigated SARS-CoV-2 reinfections among 5777 healthcare workers (HCWs) from four University Hospitals (Modena, Verona, Padova and Trieste) in northern Italy, aiming to assess the risk of reinfection and its determinants, comparing the clinical characteristics of reinfections with those of first infections, and examining the impact of preventive measures and vaccination strategies. Methods: HCWs completed an online questionnaire between June and August 2022. The survey collected demographic, occupational, and clinical data, including information on first infections and reinfections. Statistical analyses were performed using SPSS 28.0, through bivariate and multivariate approaches. Results: Response rates were 41.8% for Modena, 39.5% for Verona, 17.9% for Padova, and 17.4% for Trieste. Among the respondents, 4.8% (n = 276) experienced 2 infections and 0.5% (n = 27) reported 3 infections, out of a total of 330 reinfection cases. Additionally, 43.0% (n = 2787) reported only one infection, while 51.5% were never infected. Reinfection rates increased across five study phases (based on the epidemiological context), likely due to the emergence of new SARS-CoV-2 variants. A booster vaccine dose significantly reduced reinfection risk. Higher reinfection risk was found among HCWs aged ≤30 years, those with chronic respiratory diseases, and those working in COVID-19 wards, particularly nurses and allied health professionals. Reinfections were associated with a lower frequency of symptoms both during the period of swab positivity and after a negative swab, as well as with a shorter duration of swab positivity. No significant differences in symptom duration were found between first infections and reinfections. Conclusions: Despite its limitations, the online questionnaire proved a useful tool. Natural infection and vaccination reduced both reinfection risk and symptom severity. Prior infections should be considered in planning vaccination schedules and prioritizing HCWs. Full article

Background/Objectives: Emotional intelligence has emerged as a key factor in shaping nursing performance and care quality, yet its specific mechanisms and impact within the Greek public healthcare context remain underexplored. This study aimed to investigate the role of emotional intelligence in ethical behavior, crisis management, and the perceived quality of care among nurses working in Greek public hospitals. Methods: A cross-sectional survey was conducted among practicing nurses using validated instruments to assess emotional intelligence, ethical compliance, crisis management skills, and care quality. Data were analyzed using covariance-based structural equation modeling (CB SEM) to examine both direct and indirect relationships among variables. Results: The results indicated that emotional intelligence training had a strong and significant effect on nurses’ ethical behavior and their ability to manage critical situations. However, the direct effect of emotional intelligence on the perceived quality of care was not significant; instead, its influence was mediated through improvements in ethics and crisis management. Conclusions: These findings suggest that the benefits of emotional intelligence in nursing are most evident when integrated with supportive organizational practices and ongoing professional development. Overall, this study highlights the need for comprehensive emotional intelligence training and a supportive workplace culture to enhance ethical standards, resilience, and patient care quality in Greek healthcare settings. Full article

This paper aims to discuss the transition of new graduate nurses into the workforce, the preparation provided to equip them through the novice–beginner stage, and the theory–practice conundrum. Background: In Australia, new graduate transition programs have been in existence since the 1990s. While there is widespread acknowledgment that this period is pivotal for new graduate nurses entering the profession, there is a lack of consensus on the definition of best practice to achieve optimal preparation for new graduate nurses transitioning into the workforce. Methods: This discussion paper integrates the nursing literature on this topic with the extensive professional experiences of the authors, who are currently working as clinicians in metropolitan hospitals and hold academic positions at universities. Their insights are informed by the literature sourced from peer-reviewed English language journals, including reviews, empirical studies, and national and international reports. Discussion: Recruiting and retaining nurses presents a multifaceted challenge that requires the development of effective tools and strategies to build a sustainable workforce. Both the literature and the authors’ experiences highlight several key factors influencing the preparedness of new graduates. These factors include workplace culture, the demands placed on new graduates, and the support, education, and training they receive. The perspectives shared in this article offer valuable discussion points that can deepen our understanding of the current issues and contribute to the development of more effective solutions. Full article

Background: Overtime adversely affects physical and mental health, contributing to irritability, anxiety, reduced sleep, and even cardiovascular issues, ultimately lowering care quality and increasing turnover intentions. This study aimed to investigate whether prolonged overtime increases the risk of occupational burnout over time among healthcare workers. Methods: We conducted a four-year longitudinal observational study using secondary data from annual surveys (2021–2024) of healthcare workers at a medical university hospital in Taichung, Taiwan. Burnout was assessed using the personal burnout (PB) scale from the Copenhagen Burnout Inventory (CBI), with high PB levels (HPBL) defined as scores in the upper quartile of the 2021 baseline. Survival analysis utilizing the Kaplan–Meier method and Cox regression investigated burnout progression and the effects of overtime. Results: HPBL was defined as PB scores ≥45.83 (upper quartile in 2021). The proportions of HPBL were 30.28% (2021), 33.29% (2022), 36.75% (2023), and 32.51% (2024). Survival analysis confirmed that the risk of burnout increased over time, with the survival time estimated at 2.50 ± 0.03 years and lower survival probabilities observed among participants working overtime (Log-rank test, p < 0.0001). Multivariate logistics revealed overtime work, female gender, being a physician/nurse, and reduced sleep as independent risk factors for HPBL (OR = 3.14 for overtime, p < 0.001). These findings support the hypotheses on burnout progression and the impact of overtime. Conclusions: Overtime significantly heightens the risk of burnout, which worsens over time. Female sex, healthcare roles, obesity, and insufficient sleep are additional risk factors. Limiting overtime and proactive interventions are crucial to preventing burnout in healthcare workers. Full article

Background/Objectives: Effective teamwork is crucial for minimizing human error in healthcare settings. Medical teams, typically composed of physicians and nurses, supported by auxiliary professionals, achieve better outcomes when they possess strong collaborative competencies. High-quality teamwork is associated with fewer adverse events and complications and lower mortality rates. Based on this background, the objective of this study is to analyze the perception of non-technical skills and immediate learning outcomes in interprofessional simulation settings based on E-CRM items. Methods: A cross-sectional observational study was conducted involving participants from the official postgraduate Medicine and Nursing programs at the Catholic University of Murcia (UCAM) during the 2024–2025 academic year. Four interprofessional E-CRM simulation sessions were planned, involving randomly assigned groups with proportional representation of medical and nursing students. Teams worked consistently throughout the training and participated in clinical scenarios observed via video transmission by their peers. Post-scenario debriefings followed INACSL guidelines and employed the PEARLS method. Results: Findings indicate that 48.3% of participants had no difficulty identifying the team leader, while 51.7% reported minor difficulty. Role assignment posed moderate-to-high difficulty for 24.1% of respondents. Communication, situation awareness, and early help-seeking were generally managed with ease, though mobilizing resources remained a challenge for 27.5% of participants. Conclusions: This study supports the value of interprofessional education in developing essential competencies for handling urgent, emergency, and high-complexity clinical situations. Strengthening interdisciplinary collaboration contributes to safer, more effective patient care. Full article

Introduction: Nurses are the largest group of healthcare workers, and healthcare managers should pay attention to the quality of work life and the health and working capacity of nurses in order to ensure a sufficient number of nurses and a stable workforce. Aim: The present study aimed to determine nurses’ quality of work life, work ability index and intention to leave the nursing profession and to examine the associations between nurses’ quality of work life, work ability index and intention to leave the nursing profession. Methods: An online cross-sectional study was conducted. A total of 498 nurses completed the instrument, consisting of demographic data, Brooks’ Quality of Nursing Work Life Survey (BQNWL), Work Ability Index Questionnaire (WAIQ) and questions on their intention to leave their current job or the nursing profession. Results: Most nurses had a moderate quality of work life (QWL) (73.7%) and a good work ability index (WAI) (43.78%). Men (p = 0.047), nurses who study (p = 0.021), nurses who do not have children (p = 0.000) and nurses who do not take care of their parents (p = 0.000) have a statistically significantly higher total WAIQ score. Most nurses (61.1%) had considered changing jobs in the last 12 months, and 36.9% had considered leaving the nursing profession. A statistically significant positive correlation was found between the total BQNWL and the total WAI. The study found no correlation between QWL, WAI and intention to change jobs or leave the profession, which was unexpected. Conclusions: To ensure the provision of necessary nursing care and a healthy working environment for nurses, it is necessary to regularly monitor QWL and WAI and take measures to ensure the highest quality of working life. Further longitudinal and mixed-methods research is needed to understand the relationship between QWL, WAI and intention to leave. Full article

Aim: To explore the experiences, beliefs, and values of patients who participated in a two-arm randomized clinical trial assessing a nurse-led intervention program for chronic pain self-management, which demonstrated positive effects on pain reduction, depression, and anxiety, and on health-related quality of life 24 months after completion of the program. Design: Descriptive phenomenological qualitative study. Methods: Patients were recruited via telephone, informed about the study, and invited to participate in an individual interview at a place of their choice (hospital or home). All interviews were audiotaped, and an inductive thematic analysis was performed. Results: Seven interviews were carried out between both groups. Six emerging categories were found: effective relationship with the healthcare system, learning to live with pain, family and social support, behaviors regarding pain, resources for self-management, and concomitant determinants. Conclusions: Patients report key aspects that help us to understand the impact of this type of nurse-led group intervention: the intrinsic therapeutic effect of participating in the program itself, the ability to learn to live with pain, the importance of family and social support, the modification of pain-related behaviors, and the identification of resources for self-care. The findings highlight the need for gender-sensitive, individualized care approaches to chronic pain, addressing stigma and social context. Expanding community-based programs and supporting caregivers is essential, as is further research into gender roles, family dynamics, and work-related factors. Full article

Background: This study examined risk factors for syndrome novel coronavirus 2 virus (SARS-CoV-2) infection and self-reported adherence to infection prevention and control (IPC) measures among healthcare workers (HCWs) at a hospital in Thailand near the Myanmar border. Methods: From March to July 2022, HCWs aged ≥ 18 with COVID-19 exposure at Mae Sot General Hospital completed a questionnaire on IPC adherence, training, and COVID-19 knowledge. Nasopharyngeal samples were collected bi-weekly for SARS-CoV-2 testing. A mobile application was used for real-time monitoring of daily symptoms and exposure risks. Chi-square, Fisher’s exact tests, and log-binomial regression were performed to investigate association. Results: Out of 289 (96.3%) participants, 27 (9.9%) tested positive for SARS-CoV-2, with cough reported by 85.2% of cases. Nurse assistants (NAs) had a higher risk of infection (adjusted relative risk [aRR] 3.87; 95% CI: 0.96–15.6). Working in inpatient departments (aRR 2.37; 95% CI: 1.09–5.15) and COVID-19 wards (aRR 5.97; 95% CI: 1.32–26.9) was also associated with increased risk. While 81.7% reported consistent hand hygiene, 37% indicated inadequate IPC knowledge. Conclusions: HCWs, especially NAs and those in high-risk departments, should receive enhanced IPC training. Real-time digital monitoring tools can enhance data collection and HCW safety and are likely to be useful tools for supporting surveillance and data collection efforts. Full article

Background/Objectives: This quantitative cross-sectional study examined the relationships between self-efficacy, compassion fatigue, and the quality of nursing work life (QNWL) in primary care nurses from the Dammam and Riyadh regions of Saudi Arabia. This study examined how these factors varied according to gender, education, income, and years of experience. Methods: A total of 158 primary care nurses completed validated survey instruments, including the General Self-Efficacy Scale, Professional Quality of Life Scale—Version 5, and Work-Related Quality of Life Scale-2. Descriptive statistics were used for data analysis. Results: The results indicated that participants experienced elevated self-efficacy (M = 29.53, SD = 0.52), moderate compassion fatigue (M = 54.62, SD = 10.16), and moderate overall quality of work life (QWL) (M = 3.26, SD = 0.52). Positive correlations were identified between self-efficacy and QWL (r = 0.250, p < 0.05) and compassion satisfaction (r = 0.533, p < 0.05). By contrast, compassion fatigue was negatively correlated with QWL (r = −0.259, p < 0.05). Notable disparities in QWL were identified according to education level and years of experience, with nurses possessing advanced degrees and those with less experience having elevated QNWL scores. Conclusions: This study highlights the significance of promoting self-efficacy and mitigating compassion fatigue to improve the quality of nursing. Administrators and nurse leaders should consider strategies such as continuous professional development, psychological support, and effective workload management to enhance the well-being and retention of primary care nurses. Full article

Background: The longitudinal RisCoin study investigated risk factors for COVID-19 vaccination failure among healthcare workers (HCWs) and patients with inflammatory bowel disease (IBD) at a University Hospital in Germany. Since the hospital served as the study sponsor and employer of the HCW, we implemented a custom mobile application. We aimed to evaluate the implementation, adherence, benefits, and limitations of this study’s app. Methods: The app allowed secure data collection through questionnaires, disseminated serological results, and managed bidirectional communication. Access was double-pseudonymized and irreversibly anonymized six months after enrollment. Download frequency, login events, and questionnaire submissions between October 2021 and December 2022 were analyzed. Multivariable logistic regression identified factors associated with app adherence. Results: Of the 3979 participants with app access, 3622 (91%) used the app; out of these, 1016 (28%) were “adherent users” (≥12 submitted questionnaires). App adherence significantly increased with age. Among HCW, adherent users were more likely to be non-smokers (p < 0.001), working as administrators or nursing staff vs. physicians (p < 0.001), vaccinated against influenza (p < 0.001), and had not travelled abroad in the past year (p < 0.001). IBD patients exposed to SARS-CoV-2 (p = 0.0133) and those with adverse events following the second COVID-19 vaccination (p = 0.0171) were more likely adherent app users. Despite technical issues causing dropout or non-adherence, the app served as a secure solution for cohort management and longitudinal data collection. Discussion: App-based cohort management enabled continuous data acquisition and individualized care while providing flexibility and anonymity for the study team and participants. App usability, technical issues, and cohort characteristics need to be thoroughly considered prior to implementation to optimize usage and adherence in clinical research. Full article

Background: The migration of healthcare professionals poses a serious threat to health systems worldwide. This study examines attitudes toward brain drain and the factors influencing migration tendencies among medical and nursing students in Albania, with particular attention to nursing workforce implications. Methods: A cross-sectional study was conducted with 610 students in the 2024–2025 academic year using the 16-item Brain Drain Attitude Scale (BDAS). Socio-demographic and academic data were also collected. Results: The mean BDAS score was 53.43 ± 16.88. Pull factors (mean: 40.25 ± 12.76) were stronger motivators than push factors (mean: 13.19 ± 4.13). A total of 487 nursing, 73 midwifery-nursing, and 50 medical students participated (95% response rate). Nearly 40% expressed a desire to work abroad, citing financial prospects (48.2%), better living standards (46%), and personal freedom (42.1%) as reasons. Higher migration tendencies were seen in females (β = 0.50, p = 0.049), medical students (β = 1.01, p = 0.001), and third-year students (β = 0.46, p = 0.011). Conclusions: Migration tendencies are high among future Albanian healthcare professionals, with significant implications for the nursing workforce. Targeted policies are urgently needed to address brain drain through workforce investment and retention strategies. Full article

The number of people requiring palliative care is increasing. This can result in moral and ethical conflicts that may lead to psychological distress and moral injury. (MI). Solutions are needed to counteract career abandonment—supervision (SV) could be one solution. This study examines the extent to which palliative care nurses link MI to their everyday experiences and whether SV can contribute to the identification and prevention of moral distress and MI. In addition, factors that influence the implementation of, participation in, and perception of SV are analyzed. A qualitative study design was chosen for the investigation, consisting of guided interviews, narrative-generating questions with seven participants working in palliative care, and participant observation with audio recording during two supervisions of two palliative care teams with 16 participants in total. The data was analyzed using qualitative content analysis according to Mayring. The results show differences in workload between acute and palliative care wards. Time pressure and hierarchical structures promote distress and MI and are particularly evident on acute wards. The interviewees described specific experiences of MI. In addition, factors were identified that influence participation in SV. The analysis of SV showed that workload is a key cause of moral distress and can have an impact on health. SV can be used for sensitization and exchange. Implementation and acceptance of SV depend on individual and structural factors. In palliative care, signs of moral distress are present and are specifically addressed in SV, which means that SV can be a tool for dealing with stressful situations. Full article

Background/Objective: Frontline healthcare staff who contend diseases and mitigate their transmission were repeatedly exposed to high-risk conditions during the COVID-19 pandemic. They were at risk of mental health issues, in particular, psychological stress, depression, anxiety, financial stress, and/or burnout. This study aimed to investigate and evaluate the occupational stress of medical doctors, nurses, pharmacists, physiotherapists, and other hospital support crew during the COVID-19 pandemic in Saudi Arabia. Methods: We collected both qualitative and quantitative data from a survey given to public and private hospitals using methods like correspondence analysis, cluster analysis, and structural equation models to investigate the work-related stress (WRS) and anxiety of the staff. Since health-related factors are unclear and uncertain, a fuzzy association rule mining (FARM) method was created to address these problems and find out the levels of work-related stress (WRS) and anxiety. The statistical results and K-means clustering method were used to find the best number of fuzzy rules and the level of fuzziness in clusters to create the FARM approach and to predict the work-related stress and anxiety of healthcare staff. This innovative approach allows for a more nuanced appraisal of the factors contributing to work-related stress and anxiety, ultimately enabling healthcare organizations to implement targeted interventions. By leveraging these insights, management can foster a healthier work environment that supports staff well-being and enhances overall productivity. This study also aimed to identify the relevant health factors that are the root causes of work-related stress and anxiety to facilitate better preparation and motivation of the staff for reorganizing resources and equipment. Results: The results and findings show that when the financial burden (FIN) of healthcare staff increased, WRS and anxiety increased. Similarly, a rise in psychological stress caused an increase in WRS and anxiety. The psychological impact (PCG) ratio and financial impact (FIN) were the most influential factors for the staff’s anxiety. The FARM results and findings revealed that improving the financial situation of healthcare staff alone was not sufficient during the COVID-19 pandemic. Conclusions: This study found that while the impact of PCG was significant, its combined effect with FIN was more influential on staff’s work-related stress and anxiety. This difference was due to the mutual effects of PCG and FIN on the staff’s motivation. The findings will help healthcare managers make decisions to reduce or eliminate the WRS and anxiety experienced by healthcare staff in the future. Full article