Mediating Effect of Perceived Organizational Support on the Resilience and Mental Health of ICU Nurses

Objective:To investigate the mediating effect of organizational support on the relationship between resilience and anxiety-depression-stress by researching ICU nurses.Methods:A total of 675 ICU nurses in Shaanxi Province were surveyed using the organizational support scale,the resilience evaluation scale for medical staff,and the Depression-Anxiety-Stress Scale(DASS-21).Results:The resilience of ICU nurses had significant correlation with the level of organizational support(r=0.448,P<0.01),but was negatively correlated with depression(r=-0.238,P<0.001),anxiety(r=-0.287,P<0.01),and stress(r=-0.213,P<0.01);the level of organizational support of ICU nurses was also negatively correlated with depression(r=-0.452,P<0.01),anxiety(r=-0.410,P<0.01),and stress(r=-0.490,P<0.01).The sense of organizational support played a mediating role between the resilience of ICU nurses and their depression-anxiety-stress,the mediating effect accounted for 78%of the total effect.Conclusion:The perceived organizational support and resilience is an important external protective factor for the mental health and ability of ICU nurses.The management departments should continue to pay attention to the mental health of ICU nurses,take effective measures to improve the sense of organizational support and resilience of nurses,and ensure the good mental health of ICU nurses.

Examining perception of job satisfaction and intention to leave among ICU nurses in China

Objectives:Previous studies in China's Mainland found ICU nurses to be less satisfied with their jobs and more inclined to leave them than are nurses in other hospital units.We aimed to determine ICU nurses'perspectives on the factors that influence job satisfaction and whether or not to continue working in the ICU.Methods:Nine ICU nurses were asked five open-ended questions to elicit the nurses'perspectives on job satisfaction and intentions to leave.Data were analyzed according to the process described by Knafl and Webster(1988).Core concepts were identified using the constant comparative method.Results:Two themes emerged as major influences on job dissatisfaction:1)stress experienced from excessive workload demands and the ICU work environment,and 2)a lack of respect and recognition for the nurses'work.Two themes emerged as major influences on job satisfaction:1)recognition of work,and 2)professional opportunities and relationships with coworkers.The effects of job satisfaction or dissatisfaction on the nurses'intentions to leave their jobs varied,although three categories were identified.Conclusions:For ICU nurses in China,sources of job dissatisfaction are potentially remedied with simple interventions.Adequate staffing is necessary but not sufficient for a positive work environment.Administrators should address the factors that directly affect their nurses'levels of job satisfaction,as it will ultimately result in less staff turnover and greater patient care.

The Relationship between Social Support and Burnout among ICU Nurses in Shanghai:A Cross-Sectional Study

Objective： The associations between social support and burnout were explored in ICU nurses of Shanghai. Methods： We performed a cross-sectional study of 356 ICU nurses by applying random cluster sampling. Data were collected using self-reported questionnaires under the instruction of trained investigators. Data on emotional exhaustion, depersonalisation and feelings of low personal accomplishment etc. were collected, calculated and analyzed. Results： The participants had a mean age of 26.96 years （SD 4.07）. The mean value （M） and stand- ard deviation （SD） of emotional exhaustion was M=31.85, SD=8.38, those of depersonalisation was M= 11.69, SD= 5.54 and those of feelings of low personal accomplishment was M= 19. 79, SD = 7.02. The high degree of emotional exhaustion （EE）, depersonalisation （DP）, and lack of personal accomplishment （PA） were revealed to be 76.4%, 39.6%, and 94.9%, respectively. The major influencing factors of emotional exhaustion included support from co-workers（b=0. 343, t = 1.98, P=0. 049）, taking leave（b=-1. 182, t=-3. 747, P=0. 001）, requisition of work（b=-l. 41, t=-2. 369, P=0. 018）, and supervisor support（b=-0. 524, t=-3. 926, P=0. 001）. The major influencing factors of depersonalisation were support from the supervisor（b=-0. 333, t=-4. 146, P=0.001）, age（b=-0. 89, t=-2. 272, P= 0. 024） and requisition of work（b=-0. 148, t=-2. 124, P=0. 034）. There was a positive co-relationship between personal accomplishment and supervisor support. Conclusions： Supervisor support, age, and requisition of work were the major influencing factors of depersonalisation. In addition, supervisor support plays an important role in low personal accomplishment. Further research should focus on supervisor support, co-worker support, time on leave, and requisition of work associated with emotional exhaustion.

Influential factors and correlation analysis of hospital ethical climate and psychological empowerment of ICU nurses

Background and aims:Objective To investigate the current situation of ICU nurses'hospital ethical climate in China and analyze the correlation and influencing factors of hospital ethical climate.In order to provide a new direction and idea for creating the good hospital ethical climate,relieving the nurses'job burnout and stabilizing the nursing team.Methods:A total of 226 ICU nurses from 6 tertiary Tianjin hospitals were selected as subjects,and the Chinese version hospital ethical climate scale and psychological empowerment scale were used for investigation.Results:The gender and labor relationship of ICU nurses affected the perception of nurses'hospital ethical climate;hospital ethical climate and psychological empowerment were positively correlated;stepwise regression analysis showed that labor relationship and psychological empowerment can explain 58.5%variation rate of hospital ethical climate.Conclusion:We should pay attention to the current situation of the hospital ethical climate of ICU nurses.Managers should create a comfortable working environment not only to provide good material conditions for nurses and transfer of right,but also to pay attention to the nurses'mental state and negative impact of ethical issues.Hospital managers should reasonably allocate human resources,establish effective incentive and assessment standards,reasonable reward and punishment system and promotion mechanism.To provide comprehensive learning resources and channels.To improve nurses'awareness of their own professional value.Creating a harmonious and positive hospital ethical climate,reduce the impact of ethical issues on nurses,improve nurses'enthusiasm and satisfaction.

Development and Evaluation of The Implementation of a Preceptorship Program for The Novice ICU Nurse Intensive Care Unit -A Secondary Publication

This study focused on the development and evaluation of the implementation of a preceptorship program adapted to ICU practice in the Ab.-T.region to provide preceptors with tools to support novice nurses.This action research was made possible with the involvement of the centers,preceptors,and novice nurses throughout the development and implementation of the program.This approach enabled participants to take ownership of the training content and fully utilize various tools.The program was implemented throughout the CISSS,where this study was subsequently carried out.Several novices mentioned that the program reinforced their sense of security and made them feel more equipped to handle complex care situations.The preceptors said they were better equipped to offer clinical support and novices were better prepared to work in the ICU.It is important to evaluate the development of the novice nurses’skills following their participation in this program and the long-term impact of this preceptorship.

Impacts of fighting against COVID-19 on critical care nurses'psychological and physical health:a literature review

Objective:To provide insight into the effects of the coronavirus disease(COVID-19)pandemic on the physical and psychological health of critical care nurses in adult units.Methods:A systematic search through the CINAHL,MEDLINE,and EMbase databases were performed.Studies that addressed“critical care nurses,”“COVID-19,”“physical effect,”and“psychological effect”from different perspectives were reviewed.Results:A total of 42 ar ticles were reviewed based on 2 aspects:critical care nurses'psychological and physical health.Negative emotions were the most common conditions:fear,anxiety,depression,and post-traumatic stress disorder(PTSD).Burnout,falling ill and having thoughts of self-harm,fatigue,physical burden,sleeping disorders,and chronic work overload also adversely affected the nurses'health.The nurses'health deteriorated because of the changes in the unfamiliar working environment and processes,colossal workload and chronic exhaustion,worries about themselves and their families,social response,and witnessing the death toll.Conclusions:Critical care nurses experienced adverse effects of the institutional reaction,social response,and individuals'reply to the COVID-19 pandemic upon their psychological and physical health.Suppor ting services and preparation for other unprecedented situations should be sustainably available.

A qualitative study on experience of nurses caring for patients with delirium in ICUs in China:Barriers,burdens and decision making dilemmas

Purpose:The purpose was to explore the experiences of nurses caring for patients with delirium in ICU in China.Methods:Semi-structured qualitative interviews were conducted with 14 ICU nurses in Beijing,China.Audio recordings of the transcripts were coded and analysed thematically.Results:The emergent themes reflected clearly similar experiences and were titled as follows:Internal and external barriers to care;Care burden:workload,psychological pressure and injury;Dilemmas in decision-making:balancing risks and benefits.Conclusions:The results of this qualitative study have provided a rich description of the perceptions of a sample of nurses caring for patients with dementia in Beijing.Clearly,the nurses suffered from their work experiences in several aspects:they lacked the knowledge and skills required assessing and managing the patients as early as possible;they were physically and psychologically stressed while looking after the patients and faced with dilemmas and compromises in their decision-making.

THE ACUPUNCTURE AND MOXIBUSTIONEXPERT SYSTEM

ABSTRACTIn order to meet the demands of the diagnosis and treatment in hospital,the research on thechannel and point time rules,the teaching request of acupuncture and moxibustion,we have designed the Acupuncture and Moxibustion Expert System. The system includes two fie:ds ofknowledge: acupuncture and moxibustion theory and its application(channel, point), the theoryand applies of the vigor and wane of QIXUE in the five internal organs (liver,heart,spleen,lungand kidney).The system consists of three subsystems:treatment system,inquiry system and teaching system.system functions:treatment system: register (provide data for medical record base), treat (provide help andsuggestion),give prescriptions (points, needle method).inquiry system:complete the require to acupuncture knowledge,apply theory,system operation, system maintenance, the timepoint, time - organ's QIXUE, time -']' GanZhi mutual relation,optimum time for acupuncture.teaching systems:complete the teaching work,it is applied to different levels,self--teaching,individual coach, imitative examination, self -- practice, self -- evaluation,teaching evaluation(step by step or series),give teaching advice,fulfil edition work.base:acupuncture knowledge base, inference rules base, data base, practice and examinationbase,procedure base,function base.user contact: base on production form,straight, contrary, straight --contrary inference way,base on frame inference way,inference tables,inacurate inference way.explanation form:context explanation,trace inference explanation.screen show form: words,image,statistics curve,table.knjwleage receiver:gain knowleage through compiling procedure learning method. The system procedure is compiled by C and Assemble language.conclusion:The system is designed for non--computer speciality people,it has the advantage of convenience for operation,powerful functionand ability of correcting mistakes.The system includes the Chinese moden experts knowkedge and experiences of dozens ofacupuncture and moxibustion experts, it has the features of rich knowledge,various kinds,it illustrates and explains thoroughly to clinic and neekle methods. It infers the best time for clinic touse needles.' The system can count up the data of medical record base,the point--time--treatment effectrelation,teaching dffect,and applying ability,it provides data for further research.The systen uses QIXUE theory and the mathematical model to providesn 8vZ~ SWIm KI+3 Z Kii-l i-u+1an assistant way to research the relationship or time rules of five organs QIXUE vigor or wane.The system has transparent,intelligence flexible character,it can be expanded.